Re: ACOG Statment
From: D. Ashley Hill (dahmd@cfl.rr.com)
Sun Nov 26 22:03:46 2006
As the recepient of several surprise train wrecks from planned home
deliveries or lay birth deliveries gone bad, I agree that very often
"the hospital" and "those doctors" end up being the bad guys. Most
patients are not pleasant after 6 hours of hard pushing followed by an
eclamptic seizure and postpartum atony with hemorrhage. Typically they
don't like hospitals or physicians to start with and are on the lookout
for anything else to go badly.
What many of our non-US colleagues may not know is that in our legal
system the lawyers preferentially attack the party with the best
insurance, regardless of the level of fault, therefore there is little
impetus for lawyers to go after the person who attended the home
delivery. Instead, they go after the doctor and the hospital where the
patient ended up when things went awry at home.
Ashley
At Sun, 26 Nov 2006, Larry Glazerman wrote:
>
>At the risk of being flamed by my physician colleagues, while the
>statement below is clearly true (serious things CAN occur in low risk
>pregnancies), is it our position to coerce women who would rather
>take that real but small risk, rather than deliver in a hospital?
>
>Unfortunately, IMHO, the hooker here is the legal system. When a
>patient who chooses OOH birth does have a problem, and is brought to
>the hospital (as RESPONSIBLE midwives will do), it's often the
>physician and the hospital who bear the brunt of the family's anger
>and frustration, and often find themselves in a lawsuit, brought on
>by a patient with whom they have not had the opportunity to develop
>rapport, etc. That's why many obs are unwilling to support this
>situation. Is this fair? probably not. It is, however, sometimes a
>matter of self-preservation
>
>--
>Larry Glazerman MD
>St. luke's Center for Advanced Gynecologic Care
>(VERY HAPPY to no longer be doing ob!!!!!)
>
>On Nov 26, 2006, at 9:42 PM, Efrain Ramirez wrote:
>
>> Louana.. are you saying that "serious intrapartum complications may
>> arise with little or no warning, even in low risk pregnancies." is a
>> false statement? If you work long enough you will find out how true it
>> is, unfortunately...
>>
>> Ef
>>
>>> At Sun, 26 Nov 2006, Louana George, RN, LM, CPM, MA wrote:
>>>
>>> No one on this discussion has yet addressed the unsubstantiated and
>>> inflammatory statement that has not been sceintifically proven, to
>>> wit:
>>> "serious intrapartum complications may arise with little or no
>>> warning,
>>> even in low risk pregnancies." Is the ACOG board talking about the
>>> complications created by the regular and by now compulsory
>>> interventions
>>> at hospital births? I would think so, but where are the studies that
>>> prove this statement?
>>>
>>> Louana
>>>
>>> At Wed, 22 Nov 2006, Stmidwife@aol.com wrote:
>>>>
>>>> And that is exactly why I choose to work with a midwifery
>>>> partner!! We are
>>>> both at each and every birth, one for the mom and one for the
>>>> baby. We rotate
>>>> who is first call and that is the person to care for mom and the
>>>> other for
>>>> baby(comes around 8 cms). We actually have double of
>>>> everything plus some.
>>>> The nice thing is that I live 3 minutes from the birth center
>>>> and my
>>>> midwifery partner live several blocks from the center. I am
>>>> very blessed.
>>>>
>>>> Sue
>>>>
>>>> In a message dated 11/21/2006 9:56:47 P.M. Pacific Standard Time,
>>>> ob-gyn-l@obgyn.net writes:
>>>>
>>>> so sue,
>>>> not to be argumentative, but if mom and baby are both coding ,
>>>> who do you
>>>> save
>>
>> --
>> “ The greatest obstacle to knowledge is not ignorance,
>> it is the illusion of knowledge.” Daniel J. Boorstin - Historian
>
--
D. Ashley Hill, MD
Associate Director
Department of Obstetrics and Gynecology
Florida Hospital Family Practice Residency
Medical Director, Loch Haven Ob/Gyn Group
Division Director, Dept. of Ob/Gyn, Florida Hospital Orlando
Orlando, Florida
