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Re: Birth PlansFrom: Seagull665@aol.comWed Jul 23 20:14:17 2003
At Sat, 21 Jun 1997, jay kulkin wrote: > >We have several years experience with all of your issues. We have rarely >used "walking epidurals" only because we've had 1 or 2 requests and those >have been by patients currently pregnant. I'm still not comfortable with >eating during labor, though one of our midwives (who is lurking and reading >this-Hi there) used to tell patients to eat before coming to the hospital. >In fairness, we've not had any problems other than fits from our Anesthesia >colleagues. Most of the requests make sense, save money and create a less >invasive experience. birth plans give patients a sense of control- which >they need to have. Creates a team of which the doctor is a player. Hope >that helps. > >Jay > >At 02:33 PM 6/21/97 -0500, you wrote: >>I hope that this topic does not start a riot. >> >>I have been reading birth plans recently in an attempt to familiarize >>myself with the requests of patients who prepare them. Throughout my >>residency and first year of practice, I have not encountered anyone who has >>requested or prepared a birth plan. >> >>I am open to most of the concepts in the plans. There are a number of >>things routinely done in L&D that are very paternalistic and done for the >>convenience of the providers. I can understand the impetus for the mother >>to avoid enemas, narcotics, shaving, routine episiotomy, and the rapid >>removal of the infant to the nursery. >> >>I feel it is my responsibility to adhere to the patient's requests, however >>I am concerned with medico-legal liability concerning certain issues. >> >>I have listed a few of the items that I have no experience with. I am >>wondering whether other list members have encountered these requests, >>whether there is a reasonable explanation for the request, and what the >>potential adverse consequences are, medically and medico-legally, of >>complying with these requests. >> >>1) Eating during labor >>2) Ambulation with epidural >>3) Cord clamping after the pulsations cease >>4) No IV access >> >>thanks.. >> >>Geffrey H. Klein, MD >>listowner: OB-GYN-L >>Advisory Board Chairman, OBGYN.net < http://www.obgyn.net > >>Co-moderator: sci.med.obgyn >>gklein@bcm.tmc.edu gklein@icsi.net >>http://members.aol.com/gklein01/geff.html >>6800 W. Loop South #520 >>Bellaire, Texas 77401 >>(713) 664 8900 >> > Dear Geffrey,
Being a midwife of 24 years and an OB nurse for 8, I read your comments
with great interest. It is so refreshing to hear that it is important
to a young doctor to know what their clients want. This denotes great
respect. Thank you for honoring birth plans, they are very important.
Creating them, allows the parents to become clear on what they really
want, which in itself is empowering. Creating a new human being is a
life altering experience, a rite of passage. Shown clearly in recent
studies, empowered, educated people do better in labor in general.
I would also like to address the issue of food in labor. This seems to
be a stubborn holdout from the era of general anesthesia. Do your own
research, its not hard to find. The chances of aspirating in the O.R.
today is the same as being struck by lightening, twice, in the same day.
Labor is hard work. It is like climbing a steep mountain, very much
about endurance. Endurance is not possible without nutrition. More
credit might be given to the educated laboring woman. She is going to
know what to eat, which will be only light, easy to digest foods. The
educated woman trusts her body, and she will know what and when to eat.
In my experience, this is usually only a few bites of food periodically.
Of those educated, very few will have major problems. Ask woman if they
are attending a prenatal series. Know who is educated, and who is not.
Encourage them to do so. They will be taught how to eat, and how to
make birth plans. Do you know where the classes near you are? Do you
know what they teach? Have you ever attended one? Interesting, eh? LOL
Sharon Tolagson, LM,RN
>
-- Sharon Tolagson, LM,RN
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