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Re: The 'Infamous' Ina May Gaskin From: Kathi Wilson (wilsonk@gtn.on.ca) Fri Sep 29 08:10:53 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: art fougner, md: "Re: The 'Infamous' Ina May Gaskin" Previous message: DoctorJoe@aol.com: "Re: ACOG's Statement" Next in thread: Paul Prior MD: "Re: The 'Infamous' Ina May Gaskin" Reply: Paul Prior MD: "Re: The 'Infamous' Ina May Gaskin" "Anna Meenan, MD" wrote: > But does that mean we can't call it a shoulder dystocia unless somebody > gets a rotator cuff injury? That's a bit extreme. That was a bit tongue-in-cheek and I apologize for that. However, I think that the problem of definition remains. We've had this discussion, as my fellow midwifery listers will acknowledge, at length on the midwifery list -- that is, when is an SD an SD? People may be "resolving" a problem that wasn't really one in the first place, and labelling it shoulder dystocia -- I've seen it happen on more than one occasion. There's a real tendency to get panicky about shoulders if they don't appear right after the head, and an accompanying tendency to call that shoulder dystocia. Most often it's not. > I never said that the hands and knees position is the be-all and end-all > of shoulder dystocia management. It IS a very useful maneuver that is > underutilized and it definitely DOES make other maneuvers, such as Woods > screw and delivery of the posterior arm MUCH easier (for babies that are > really really stuck in there). I certainly do not disagree with this, as, of course, I use it myself. However, I am concerned that the message being conveyed is that this is *the* solution to resolving SD. Your comment re: the registry appeared to me to promote the concept that it was. I do wholeheartedly agree that it's another tactic to use and a good one. But anyone attending childbirth better have a whole *lot* of tactics up their sleeves when it comes to SD, and be prepared to move from one to another pretty quickly when the first (or second) doesn't work. As Betsy has noted (and I have also found), shoulders can get *stuck* in the hands and knees position, and the solution is to roll the mother over into McRoberts. When I first began practice, I used to call what I now label "sticky shoulders", shoulder dystocia. It's all a matter of comparison, I think. -- Kathi Wilson, RM Ilderton, Ontario, Canada mailto:wilsonk@gtn.on.ca ********************** Thames Valley Midwives 346 Platts Lane, London, Ontario, Canada http://tvm.on.ca mailto:info@tvm.on.ca Next message: art fougner, md: "Re: The 'Infamous' Ina May Gaskin" Previous message: DoctorJoe@aol.com: "Re: ACOG's Statement" Next in thread: Paul Prior MD: "Re: The 'Infamous' Ina May Gaskin" Reply: Paul Prior MD: "Re: The 'Infamous' Ina May Gaskin"

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