Re: Arrest of dilatation;next question
From: emilio porro (sanbonav@hotmail.com)
Thu Aug 3 11:11:29 2006
I think that the next step is to ask yourself ,your collegues midwifes
,your politicians which are the reasons that have brought to this law:to
avoid medicolegal litigation?unlawful midwifery?safer birth in
hospital?more money for doctors?insufficient midwife clinical
preparation(see
http://freeonlinesurveys.com/rendersurvey.asp?sid=yrbk7l4inlimvqz189647)?(here
in Italy distance education for midwives doesnt exist.;You must be
present to theorical and pratical lessons in University (midwifery here
is a parauniversitary course)
I would like to know the answer or the answers
Yours faithfully
Emilio porro
At Thu, 3 Aug 2006, Jamie wrote:
>
>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
>
--
Emilio Porro
M.D. Ob.Gyn.
Como
Italy
http://www.sanbonaventura.com
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