Re: Arrest of dilatation;birth as result of
From: Jamie (ajfields@pine-net.com)
Thu Aug 3 08:18:16 2006
The problem is that in the state where this is occurring, homebirth is
not a legal option unless it is unassisted.
At Thu, 03 Aug 2006, emilio porro wrote:
>
>birth is the final result of a dinamic event with three
>variabilities:mother, fetus,uterus
>example:mother general conditions are good?preeclampsia?narrow pelvis?
>uterus:contractions are present?efficient?spastic?
>baby: is big,small,adequate for gestational age?fetal presentation?is
>suffering in labor?
>as only pretty supportive a doula is more than enough.
>a midwife must also know (because she has studied for years)obstetrical
>semeiotics.
>I agree that now is TRENDY tell to the patient what she wants to hear from
>You but this is not always professionaly correct.
>in obstetrics (that is preventive medicine) I follow the FIVE P RULE :PRIOR
>PREPARATION PREVENTS POOR PERFORMANCE.
>When a patient comes in hospital she accepts the medical rules of the
>hospital (after beeing well informed);as alternative she can have a birth at
>home alone or with a midwife who accepts also the medical-legal risks of a
>distocycal birth.
>Yours faithfully
>Emilio Porro M.D.
>Como-Italy
>http://www.sanbonaventura.com
>
>>From: garrys@mindspring.com (Garry E. Siegel, M.D.)
>>Reply-To: ob-gyn-l@obgyn.net
>>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>>Subject: Re: Ob: Arrest of dilatation
>>Date: Wed, 2 Aug 2006 22:56:45 -0500
>>
>>Sue:
>>
>>What's the solution?
>>
>>I think we would agree that induction with pre-eclampsia at term is
>>warranted, and if she's not progressing, she's not progressing.
>>
>>Her reticence to proceed to a section allowed a fever to develop, and
>>she didn't progress, got antibiotics, and still had a section.
>>
>>Dan, this patient did not have an assessment of her pelvis before
>>induction.
>>
>>Listers, would you expect a CNM or MD to have done so?
>>
>>Dan, had I personally assessed her pelvis in the office, and told her
>>that it was not good, and that the chance of success was poor, I think
>>she would have looked at me like I was crazy, and then asked why not
>>try. I have not been successful convincing/selling/arguing/cajoling
>>patients who are not accepting of honestly given advice and direction,
>>and, you know, they don't always do what you want/tell them to do.
>>
>>Garry
>>
>>At Wed, 2 Aug 2006, Stmidwife@aol.com wrote:
>> >
>> >Respectfully, that is why they are going to a midwife for midwifery as
>> >opposed to an Obstetrician to participate in the Obstetrics of 2006.
>> >
>> >Sue
>> >
>> >In a message dated 8/2/2006 4:19:37 P.M. Pacific Standard Time,
>> >ob-gyn-l@obgyn.net writes:
>> >
>> >You're on the mark, but I truly think that the CNMs are pretty
>> >supportive and frankly attract those patients who are dissatisfied
>> >elsewhere, and are unrealistic about hospital based Obstetrics in 2006.
>> >
>> >Garry
>>
>>--
>>Garry E. Siegel, M.D.
>>Private Practice
>>Roswell, GA
--
JFields, RN, BSN
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