|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: UK Pap rules was Sexual abuse was Spanking babiesFrom: Cheri Van Hoover (cherivh@xdcr.com)Mon Feb 27 11:21:19 2006
GA12L@aol.com wrote: > I am a MIDWIFE not an > obstetrician. As a MIDWIFE I am expert in normal, low risk pregnancy > and childbirth. Please keep in mind that your definition of midwife is not the only one accepted internationally. In the United States, midwives also provide well-woman GYN care and some primary care. Our scope of practice includes the entire reproductive and post-reproductive life span of women. At the first prenatal visit a pelvic examination is standard in the United States. In addition to appropriate cultures and Pap testing, a general inspection by speculum and bimanual examination is performed. I have discovered many abnormal findings by doing this examination, despite my midwifery persepective of presumed normalcy. A few of the things uncovered by this exam have been cervical polyps, large fibroids, infibulation (the woman was unaware that this had been done), size-dates inconsistency, etc., etc., etc. I looked in the British standard text, Mayes' Midwifery, which I consider a first rate text on midwifery care (you can read my review of it for the Journal of Midwifery and Women's Health, May 2005, Vol. 50, Issue 3, Page 253). Mayes' Midwifery recommends that the first prenatal visit be a thorough history and the ordering of appropriate laboratory tests, but does not mention a physical exam of any kind. The editors then go on to state that the "woman usually has a medical examination generally carried out by the obstetrician once her pregnancy is confirmed, and this is focussed in content." This exam includes a "cervical smear if necessary," but it appears that this is not routinely done. The text says, "A vaginal examination is only made in pergnancy if there is a specific indication. If a routine cervical smear is due to be taken, it may be deferred until the postnatal examination." Fascinating difference. I, of course, prefer what I'm used to, and believe that it has proven valuable over the years. But apparently this is not considered to be necessary or valuable by midwives and/or obstetricians in other parts of the world. Cheri
-- Cheri Van Hoover, CNM, MS Faculty, Midwifery Institute at Philadelphia University
|
|
Return to
|
Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Thu Oct 2 04:52:05 2008 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.