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Re: Birth Plans From: art fougner, md (evsono@pipeline.com) Thu Oct 25 14:01:20 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: doctorjoe@aol.com: "GYN More contraceptive suits" Previous message: art fougner, md: "Re: Ob: Molluscum Contagiosum" In reply to: Dr. Ainsworth: "Birth Plans" Next in thread: rmodugno@aol.com: "Re: Birth Plans" Reply: rmodugno@aol.com: "Re: Birth Plans" Why stop at Birth Plans? How about Life Plans - what pre-school to attend, grammar and high schools, college? What career? What hobbies, sports, etc? My admittedly anecdotal experience is that having kids involves running from one unplanned incident to the next. Even birth itself often is the net result of unplanned activities. Control? What Control? Just my opinion. I could be wrong. Art At Thu, 25 Oct 2007, Dr. Ainsworth wrote: > >I've always seen the downside of birth plans to be that anything a >patient expressly wished to avoid would be by a fluke of nature >absolutely necessary during her delivery. It's like the stars line up >against them and our attempt to meet their expressed needs. They have a >posterior labor with severe back pain and require an epidural; membranes >rupture with meconium and the FHT's cannot be monitored externally - >internal monitoring required; they have a dysfunctional labor and >require pitocin; and the list goes on and on and on. > >A study in the Journal of Reproductive medicine, Oct 2007, looks at >patients presenting with birth plans. They found that in their study >patients with birth plans did not have an increased incidence of >episiotomy (~25% in both groups) or cesarean section (17% in both >groups), but were less likely to receive epidural anesthesia (48% of >patients requesting no epidural did receive one, 78% of patients with no >birth plan received an epidural). Interestingly, the subset of >nulliparous patients requesting no epidural did not have a significant >difference in epidural rates from other patients (66% vs. 88%). The >one thing they didn't report on was the percent of patients expressly >requesting an epidural who received and epidural - I know it's not 100% >in our institution! -- art fougner, md "May The Wings of Liberty Never Lose a Feather." - Jack Burton Next message: doctorjoe@aol.com: "GYN More contraceptive suits" Previous message: art fougner, md: "Re: Ob: Molluscum Contagiosum" In reply to: Dr. Ainsworth: "Birth Plans" Next in thread: rmodugno@aol.com: "Re: Birth Plans" Reply: rmodugno@aol.com: "Re: Birth Plans"

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