Re: No Guts Not Glory, was Re: Open Mind, Brains Fell Out (was Re:
From: art fougner, md (evsono@pipeline.com)
Sat Apr 21 14:39:22 2001
Kathi -
as i opined, we all have to be true to ourselves.
as far as safety of trial of labor after section, some settings just
seem too risky. not fact, just opinion.
funny, when i pointed this out to the then President of ACOG when the
guidelines were looser, she rolled her eyes.
wonder what changed?
art
At Sat, 21 Apr 2001, Kathi Wilson wrote:
>
>"art fougner, md" wrote:
>
>> Ultimately, it's not about language but safety. can one truly justify a
>> trial of scar ( those europeans have a knack for hitting the nail on the
>> head) in a community hospital in wyoming in the middle of a blizzard?
>
>But, Art, how does she get out of the community to have her baby in the middle of the
>blizzard? Are you suggesting that she be evac'd a month prior to her due date to the
>regional centre? Who's going to pay for that -- she and her family?
>
>In Canada, we have had a disastrous experiment w/ flying Innu women out of the far
>north to large centres in the south a month prior to their due dates to deliver.
>Nobody considered the financial and social impact of separating women from their
>families and children for that extended period of time. The results included
>increases in family breakdown and abuse. Women took to concealing their pregnancies
>and lying about their LMP's in order to avoid being evacuated out to the little
>preggo concentration camps they got sent to, and then walking into the nursing
>stations in active labour to give birth.
>
>There consequences to geography which have to be considered. Last year, apparently,
>the only maternal childbearing related death in Manitoba was in a woman who died in a
>car accident in a snow-storm trying to get to the nearest hospital (over an hour
>away) in labour.
>
>I'm not arguing that you shouldn't plan carefully ahead because, of course, you
>should. But if you're going to have a high primary section rate (which many on this
>list seem to argue for) and then say that they have to VBAC in a tertiary care
>centre, there are going to be enormous social and financial costs involved -- and you
>could very possibly lose people en route.
>
>--
>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
>
--
art fougner, md
A series of 1000 cases begins with but a single anecdote.
