Re: homebirth conversation
From: Joe Cutchin (forcep@intercom.net)
Mon Nov 28 09:42:28 2005
Ingrid, I regret to say this but due to our current legal system the
answer to your question is "yes". Joe C
igold@cox.net wrote:
> If one uses this "arguement", one would then be required to be at the bedside throughout the labor, as something could turn at anytime requiring the OB. Correct?
>
> Does it follow that birth should only occur where there is a physician to deal with it 24/7 in house?
>
> Ingrid Gold, CNM, Phoenix
>
>>From: "Andrew Folley" <agfolley@hotmail.com>
>>Date: 2005/11/27 Sun PM 10:24:31 EST
>>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>>Subject: RE: homebirth conversation
>>
>>I have been practicing 22 years in OB-Gyn. My philosophy has been that
>>nurses, midwives, dads and taxi cab drivers can deliver 95% of the babies
>>with no problems at home or in the back of the car.
>>My role and that of the hospital is to be there for the 1-5% of deliveries
>>that rapidly progress into a dire situation jeopardizing the health of the
>>mother and the baby. Often iit is difficult to predict who will be the
>>disaster. Minutes in the hands of a skilled practiioner (OBGyn) makes a
>>difference between life and death for the mom and brain damage or not for
>>the baby. andrew
>>
>>>From: <igold@cox.net>
>>>Reply-To: ob-gyn-l@obgyn.net
>>>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>>>Subject: homebirth conversation
>>>Date: Sat, 26 Nov 2005 21:50:15 -0600
>>>
>>> I have mostly read and not contributed to this discussion. Many of you
>>>know that I am a CNM practicing in the hospital only, but I did do
>>>homebirths from 1978-1998. >1200 of them. So, I have more than the 20 or so
>>>mentioned by some as a
>>>requirement................................................
>>> As a practitioner, today I would not attend homebirths. The reasons are
>>>many, but include the current legal climate in the US and lack of liability
>>>insurance and backup. I have (honestly) not seen many of the horrors that
>>>can occur at home that have been mentioned on this list. In my practice I
>>>only worked with women who were low risk, otherwise they had to go to the
>>>hospital. So, I have never done a breech at home, VBAC,twins, <37 weeks,>42
>>>weeks, Hgb <10, failure to progress, including a second stage >2 hours,
>>>etc.
>>> Honestly, I have seen many complications in the hospital which could
>>>have been prevented if at home (or with true midwifery care, harder and
>>>harder to provide today. In part because women don't want it!). These range
>>
>>>from cord prolapse (2 weeks ago I assisted on a c/sec for an iatrogenic
>>
>>>prolapse, the OB said he was pushing up the head to put the IUPC in to
>>>dilute the meconium!) to bradycardia secondary to low BP after epidural, to
>>>hypertonic contractions from pitocin, etc. I even practiced in a hospital
>>>where the OB pulled off the baby's scalp with a vacuum.
>>> We are fortunate to live in an era where we have the knowledge and
>>>tools to help women give birth more safetly than ever. This knowledge can
>>>be used safetly at home or in the hospital.
>>> For those of you who grew up in the hospital environment, I believe it
>>>is impossible for you to understand homebirth. I had a patient once, who
>>>was an OB/GYN, and so was her husband. Their patients and collegues asked
>>>them why they were having a homebirth, when they could have anything they
>>>wanted in the hospital. They replied "we don't want to have to ask". I know
>>>that "you guys" can't understand it.
>>> While I would no longer attend homebirths, if I were to have any more
>>>children, they would be born at home, as my 1st three were.
>>>
>>>Ingrid Gold, CNM, Phoenix
>>>
>>
>
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