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Re: VBAC, immediate availabilty and change in hospital policy From: art fougner, md (evsono@pipeline.com) Tue Feb 13 07:29:10 2001 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: art fougner, md: "Re: Being in the wrong place..." Previous message: DoctorJoe@aol.com: "Re: VBAC, immediate availabilty and change in hospital policy" consent form is nice but the statement that trial of labor after section ( or "trial of scar" as Dr. Raymond so aptly put it ) is safer than elective repeat section is quite controversial, especially if an emergent section becomes necessary. art At Tue, 13 Feb 2001, Douglas Krell wrote: > >Dr. Raymond writes: > >> If any doctor sits with a patient whose uterus is scarred doing a "trial >of >> scar" for 18 hours from 2 cm then he deserves to get all the shit that's >> coming to him. Isn't the partogram in universal use in the US...? > >I practice in a smaller hospital in a tourist community where many family >practitioners >have independant privileges to attend VBAC. They routinely "induce" or >"augment" VBACs and >do so without regard for patient safety or ACOG guidelines. The OBGYN's are >obliged to cover >these patient and their doctors should disaster occur...the hospital, the >family docs, and even many of the OBGYN's have brushed the issue aside as no >lawsuits have come out of few bad outcomes that we've had. > >I love Ron Ainsworth's consent form and with his permission I'd like to >request that the hospital >require it for all VBACs. We would have to modify it for our patient's >level of education and translate it into Spanish. > >BTW...no one uses partograms here. That is considered much too contrived >and "medicalized" for such >a situation as natural childbirth...which is the idealized outcome for most >parturients. The active management of labor >is a practice style which most here would apply randomly. > >-- >Douglas Krell MD > -- art fougner, md A series of 1000 cases begins with but a single anecdote. Next message: art fougner, md: "Re: Being in the wrong place..." Previous message: DoctorJoe@aol.com: "Re: VBAC, immediate availabilty and change in hospital policy"

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