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Re: Birth PlansFrom: Bryan Jick (drbryan@earthlink.net)Sun Jun 22 22:53:01 1997
Birth Plans - excellent thread! But, since this thread occurred during the weekend, I ask everyone...why the heck we are spending so much time on the computer during the weekend? In Pasadena, I get a fair share of Birth Plans, and I have developed a philosophy. Most of the patients care much more how you respond to their Birth Plan, than what is actually on it! They want to know... are you flexible? Do you care about their desires and preferences? Can they talk to you? I usually tell them that I will always try to honor their birth plan as long as the labor is proceeding smoothly and safely. In the event of a problem, I tell them that I will likely have to intervene based on my medical judgement, and in some cases, this means throwing out the birth plan. Now, there are also unacceptable birth plans. I had one...No C/S, No Pitocin, No Fetal Monitoring, No IV, etc...This patient saw me for the first visit only, I then told her to find another doctor (I even gave her some names of my more "naturally oriented colleagues." Bradley patients tend to have the more detailed Birth Plans, bit I have noticed there are two types of Bradley patients. Those who go to Bradley because of an innate distrust and dislike of the medical profession, and those who like the fact that they get so many classes! The latter group has no clue about the anti-doctor agenda, but within a few classes they usually figure it out. By the way, is Bradley a national phenomenon or just a California (West Coast) thing? One more item: what about fetal monitoring? Intermittent external, vs. doptones. Comments? Regarding the specifics: clear liquids O.K., walking epidurals - people ask while pregnant, but seem not to ask once they are in labor cord pulsing - I put the baby on mom's abdomen, so I clamp quickly to try and avoid pumping fetal blood back into the placenta I.V. - I encourage routine IV or saline lock as an "insurance policy" but I allow no I.V. for the low risk patient, based on an informed consent type discussion. Regarding midwives on the list: I APPROVE, because I can learn from their postings and their views. Face it, we all think our own views are right, and so should they. Ultimately, I strive to learn, and hearing what they have to say is helpful to me, as is hearing what all the DOCS have to say as well. BYE
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Bryan S. Jick, M.D., F.A.C.O.G.
Obstetrics and Gynecology
Pasadena, CA.
voice: (626) 304-2626
fax: (626) 796-6495
e-mail: drbryan@earthlink.net
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