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Re: homebirth conversationFrom: igold@cox.netMon Nov 28 10:05:10 2005
Just wondering..........what percent of deliveries in the US to you think fall under this criteria? Not the majority in the Phoenix area for sure. Enter the laborist.Ingrid > > From: Joe Cutchin <forcep@intercom.net> > Date: 2005/11/28 Mon AM 11:45:17 EST > To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> > Subject: Re: homebirth conversation > > 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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