Re: vbac on demand .the key point
From: Jamie (ajfields@pine-net.com)
Fri May 23 09:39:15 2008
So is the answer to that forced intervention? Intervention that also
carries a set of risks? I do get that OBs in this situation are very
exposed. The woman, however, is equally trapped. And while the OB's
profession and financial survival are at stake, the woman's bodily
integrity has to count for something. Again, it's the system, and while
litigious patients (along with lawyers and insurance companies) helped
create the system, this specific woman did not. You don't even know
that she isn't willing to accept the risks; you're assuming it's likely
because some other people have not. And, she still has a right to
decline surgery.
At Wed, 21 May 2008, emilio porro wrote:
>
>The Key point of this discussion is that some people want a result (good
>birth )without accepting the risks (uterine rupture,fetal death or
>suffering and great risk for mother) and are prompt to change idea if
>something has gone wrong as you can read (also for midwives)
>>From Ina May Gaskin web site
>http://www.thefarm.org/midwives/imgnazis.html
>t is hard to say why the mother who lodged a complaint against Amin,
>Walker and Thorpe with the Board of Consumer Affairs did so‹her baby was
>born sound and healthy at their birth center two years ago, despite the
>fact that the mother arrived there late in labor with a baby that turned
>out to be in breech position. Because the baby arrived so quickly after
>the discovery of his position, there was no time to call emergency
>services.
>
>Yours faithfully
>Emilio Porro M.D.
>
>At Wed, 21 May 2008, Jamie wrote:
>>
>>Why is she the enemy? I see that both of you are trapped by the system.
>>Document, document, and document some more. You can't do surgery
>>without consent.
>>
>>Oh, and since I haven't been here in a while, I'm a L&D nurse. Patient
>>advocacy is my soapbox.
>>
>>At Sun, 11 May 2008, verner nellsch wrote:
>>>
>>>thanks. witnesses and document. i still feel exposed, and subject to the
>>>whims of someone who just wants what they want, and to hell with other
>>>considerations. vnellsch
>>>
>>>>>>>----- Original Message -----
>>>From: "Dr Eberhard W Lisse" <el@lisse.na>
>>>To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@mail.obgyn.net>
>>>Sent: Sunday, May 11, 2008 8:38 AM
>>>Subject: Re: vbac on demand
>>>
>>>> Tape your discussion with the patient, get as many witnesses as you
>>>> can, call your lawyer, insurance, Chief of Staff, Chief of Nursing and
>>>> whoever else you can think of.
>>>>
>>>> And run as far away as you can.
>>>>
>>>> If you can't run away, get Peds, your assistant, OR and your anesthetist
>>>> to come in, deliver her and if it ruptures, take her to the OR and try
>>>> to save her life.
>>>>
>>>> We don't have EMTALA here, so in this particular situation I'd advise
>>>> her and if she didn't want to listen, I would unaccept her, and refer
>>>> her to the State Hospital.
>>>>
>>>> greetings, el
>>>>
>>>> On May 11, 2008, at 13:28, verner nellsch wrote:
>>>>
>>>>> question--you are an ob/gyn on call for a small community hospital (3
>>>>> delivery beds) with the or crew and anesthetist at home on call. a 26
>>>>> y/o g3p2 comes to the hospital, with a history of 2 previous cesareans,
>>>>> the first for cephalopelvic disproportion. she is unknown to you or the
>>>>> other ob/gyn practicing at the hospital. she is 1 cm, ruptured, at term.
>>>>> she demands a vbac, and refuses to have a repeat cesarean.
>>>>
>>--
>>JFields, RN, BSN
>>
>--
>Emilio Porro
>M.D. Ob.Gyn.
>Como
>Italy
>http://www.sanbonaventura.com
>who,whose, with,what,why,where,when,while,watch world wide web
>
--
JFields, RN, BSN
|
|
