Re: Breech birth
From: art fougner, md (evsono@pipeline.com)
Sat Nov 26 18:00:10 2005
Steve
or as Insp. Harry Callahan put it, "Ya gotta be askin yourself a
question - do I feel lucky?"
Art
At Sat, 26 Nov 2005, Raymond Stephen wrote:
>
>It's not the place of delivery, but the people in attendance that need
>to be "homey". We are all in varying measure anti-interventionist, but
>there are differing opinions about what interventions are safe and what
>are not. The whole argument about home versus hospital is distilled
>into the question "how much risk are you prepared to take?"
>
>Steve Raymond
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Jamie
>Sent: Sunday, 27 November 2005 3:13 AM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Breech birth
>
>At Sat, 26 Nov 2005, DoctorJoe@aol.com wrote:
>>And I think this is a rough guide to how US Obstetricians try to do it.
>
>>Only the governing factor is AVAILABILITY OF THE BACK-UP FACILITIES.
>>"Going for" a c-section or other intervention across town, or into
>>town, or by taxi or ambulance is clearly less beneficial than if the
>help is immediately on hand (e.g.
>>within 30 minutes, as per ACOG protocol).
>>
>>So her you have the bone of contention here. Midwives (apparently)
>>don't think it's necessary to be within 30 minutes of a skin incision
>>(or feel that they've screened their clients well enough to guarantee
>>they won't need it) while OBs (at least in the US) feel that they don't
>
>>want ONE BABY to fall through the cracks, so they'll set up a "homey"
>birthing center IN the hospital.
>>
>>So I think everyone needs to concentrate on what we're really debating.
>
>>The few babies who NEED some sort of intervention and how and how fast
>>will it be provided. Selection can do wonders, but you can't fool
>Mother Nature forever.
>>
>>Joe P.
>
>The "homey" atmosphere in the hospital is just a facade, though.
>Hombirth isn't just about being comfortable-though a hospital labor bed
>is pretty far down on my list of comfortable places to give birth. It's
>about avoiding the interventions that increase risk. It is just next to
>impossible to have a hospital birth without unnecessary intervention.
>Many of them are done reflexively. A lot of homebirthers are willing to
>trade immediate availability of a c/s for the limitation of
>interventions because they believe it lowers overall risk. If
>intervention was only done when needed, then hospital birth might have a
>very small margin of safety over homebirth. Can you do that, though?
>
>--
>JFields, RN, BSN
>
>Tasmania Together 5 Year Review: Have your say http://www.tasmaniatogether.tas.gov.au/
>
--
art fougner, md
"I knew I was going to take the wrong train, so I left early."
Lawrence Peter Berra
