Re: homebirth conversation
From: Andrew Folley (agfolley@hotmail.com)
Sun Nov 27 20:20:16 2005
I have been practicing 22 years in OB-Gyn. My philosophy has been that
nurses, midwives, dads and taxi cab drivers can deliver 95% of the babies
with no problems at home or in the back of the car.
My role and that of the hospital is to be there for the 1-5% of deliveries
that rapidly progress into a dire situation jeopardizing the health of the
mother and the baby. Often iit is difficult to predict who will be the
disaster. Minutes in the hands of a skilled practiioner (OBGyn) makes a
difference between life and death for the mom and brain damage or not for
the baby. andrew
>From: <igold@cox.net>
>Reply-To: ob-gyn-l@obgyn.net
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>Subject: homebirth conversation
>Date: Sat, 26 Nov 2005 21:50:15 -0600
>
> I have mostly read and not contributed to this discussion. Many of you
>know that I am a CNM practicing in the hospital only, but I did do
>homebirths from 1978-1998. >1200 of them. So, I have more than the 20 or so
>mentioned by some as a
>requirement................................................
> As a practitioner, today I would not attend homebirths. The reasons are
>many, but include the current legal climate in the US and lack of liability
>insurance and backup. I have (honestly) not seen many of the horrors that
>can occur at home that have been mentioned on this list. In my practice I
>only worked with women who were low risk, otherwise they had to go to the
>hospital. So, I have never done a breech at home, VBAC,twins, <37 weeks,>42
>weeks, Hgb <10, failure to progress, including a second stage >2 hours,
>etc.
> Honestly, I have seen many complications in the hospital which could
>have been prevented if at home (or with true midwifery care, harder and
>harder to provide today. In part because women don't want it!). These range
>from cord prolapse (2 weeks ago I assisted on a c/sec for an iatrogenic
>prolapse, the OB said he was pushing up the head to put the IUPC in to
>dilute the meconium!) to bradycardia secondary to low BP after epidural, to
>hypertonic contractions from pitocin, etc. I even practiced in a hospital
>where the OB pulled off the baby's scalp with a vacuum.
> We are fortunate to live in an era where we have the knowledge and
>tools to help women give birth more safetly than ever. This knowledge can
>be used safetly at home or in the hospital.
> For those of you who grew up in the hospital environment, I believe it
>is impossible for you to understand homebirth. I had a patient once, who
>was an OB/GYN, and so was her husband. Their patients and collegues asked
>them why they were having a homebirth, when they could have anything they
>wanted in the hospital. They replied "we don't want to have to ask". I know
>that "you guys" can't understand it.
> While I would no longer attend homebirths, if I were to have any more
>children, they would be born at home, as my 1st three were.
>
>Ingrid Gold, CNM, Phoenix
>
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