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Re: Informed consentFrom: claire (clairec1979@hotmail.com)Wed Jun 7 02:17:25 2006
>I've been doing this for 30 years and I still can't tell whether the patient >will start to tear during delivery when I see her during the prenatal period But you could say that 'IF your perineum starts to tear, I may want/require to do an episiotomy, would that be OK with you?' If she says no, I'd rather tear or only do one if baby is in distress/don't do one under any circumstances. Then surely you have to respect that (or at the very least trya nd change her mind) I was surprised that someone (in the US) said that as she had discussed episiotomy with her OB beforehand and made it clear that she didn't want one under any circumstances he did a forceps delivery without an episiotomy (I believe she said she ended up with a 1st degree tear) but obviously it must show in some circumstances the womans wishes are bein respected (even if that goes against what the OB/Midwife would generally do. I've seen people do episiotmies without consent (never mind informed), here it is meant to be discussed the circumstances in which you would perform one, and a verbal consent given before. The midwife who delivered my first did an episiotomy and I read about it in my notes - I thought I tore when she had to suture afterwards. I also saw one woman after having a vontouse OB went to suture her and she asked if she had torn badly 'Oh,no, it's from where I cut you' - what sort of consent is that?
-- Claire BSC Midwifery student
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