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Re: First AssistFrom: CheriCNM@aol.comMon Aug 5 15:02:11 1996
At the HMO where I work the CNM is the usual first assist on C-sections. This works particularly well during the daytime hours, when the physicians are in the clinic upstairs and one of them can run down to assist if things get complicated. There is always a pediatrician and a nursery nurse present to receive the baby. At night, when there is one OB/GYN physician and one CNM in house, the second call OB is sometimes called in to assist on C-sections. It all depends on how busy the board is and whether any other problems are anticipated. If the CNM may be required at another delivery or needs to keep an eye on incipient problems, the second call assists. Having the CNMs trained to assist on C-sections expedites emergency cases. I really appreciate being able to do something constructive to help get the baby delivered when it's a crash situation. It was hard to stand by watching helplessly in my private practice, where we did not assist. On the other hand, I do not particularly enjoy participating in surgery and do not view it as "midwifery care." The primary reason I pursued a career in midwifery instead of OB/GYN medicine was because I did not want to be a surgeon. This was a conscious and deliberate choice that I made. I do the best job I can, and perform satisfactorily as an assistant in most situations, but I am very conscious that the surgery is easier for the primary surgeon when he or she has an assistant whose level of surgical skill is more nearly equal to his or her own. Cheri Van Hoover, CNM Kaiser Hospital Redwood City, CA
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