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Re: Vacuum extraction privileges for CNMsFrom: Tom and Elizabeth Johnston (yesallours@nc.rr.com)Fri Jun 15 20:16:01 2007
Is it the standard of care for CNMs to have vacuum extraction privileges? : As Susan said, it is an extra skill the senior CNM can learn based on practice needs. What is the policy at your institution/practice?: At our facility we can learn VAVD if we desire. About ½ of our CNMs do them and the others do not. What are your thoughts? I have very little use for VAVD. Of the last 250 deliveries in my facility that I’ve attended, I’ve needed operative vaginal delivery only 5 times ( 2 forceps, 3 VAVD). The few times I’ve “needed” help getting a baby out there was always been a resident readily available that needed the experience more than I do. I have been tempted to use vacuum more often but since I didn’t have it readily available I didn’t bother. My philosophy has always been “judicious use of technology.” If I don’t absolutely have to intervene I won’t. Do I think CNM’s Can or should use vacuum? In an isolated environment it can be a very useful skill in a pinch. In a big busy practice (mine is 12 CNM, 12 OB/GYN and we deliver 240-300 / month) where there is 24/7 OB access there is very little need for a CNM to learn the skill. Tom Johnston CNM, IBCLC Fort Bragg, NC
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