-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

US neonatal mortality and morbidilty, was Homebirth, was VBAC, ect From: fran wilson (530rose@msn.com) Mon Apr 24 00:25:56 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dr Eberhard Lisse: "Re: Home Birth VBAC" Previous message: fran wilson: "US neonatal mortality and morbidilty, was Homebirth, was VBAC, ect" Next in thread: Laure: "Re: US neonatal mortality and morbidilty, was Homebirth, was VBAC, ect" Reply: Laure: "Re: US neonatal mortality and morbidilty, was Homebirth, was VBAC, ect" Maybe reply: Seele, Mona: "Re: US neonatal mortality and morbidilty, was Homebirth, was VBAC, ect" Maybe reply: Seele, Mona: "Re: US neonatal mortality and morbidilty, was Homebirth, was VBAC, ect" >From el@lisse.NA Mon Apr 24 00:25:53 2006 Received: from ac.lisse.NA (ac.lisse.na [196.44.151.137]) by dns.obgyn.net (8.11.6/8.11.6/dsb-1.1) with ESMTP id k3O5Pmt23778 for <ob-gyn-l@obgyn.net>; Mon, 24 Apr 2006 00:25:49 -0500 Received: from [192.168.0.3] (epi.lisse.NA [192.168.0.3]) by ac.lisse.NA (Postfix) with ESMTP id 4140D1A57C; Mon, 24 Apr 2006 06:25:45 +0100 (WAT) Message-ID: <444C532F.4000707@lisse.NA> Date: Mon, 24 Apr 2006 06:25:19 +0200 From: Dr Eberhard Lisse <el@lisse.NA> Reply-To: el@lisse.NA Organization: Dr Eberhard W Lisse User-Agent: Mozilla/5.0 (Macintosh; U; PPC Mac OS X Mach-O; en-US; rv:1.8) Gecko/20051201 Thunderbird/1.5 Mnenhy/0.7.3.0 MIME-Version: 1.0 To: ob-gyn-l@obgyn.net CC: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> Subject: Re: Home Birth VBAC References: <BAY110-DAV1102242B37683E30DB0169C6B90@phx.gbl> In-Reply-To: <BAY110-DAV1102242B37683E30DB0169C6B90@phx.gbl> X-Enigmail-Version: 0.94.0.0 Content-Type: text/plain; charset=windows-1252 Content-Transfer-Encoding: 8bit Lyndon, I would have my lawyer help me with writing something like this,because later it may later be scrutinized word for word.... It is premature, because the cause of death has not been established by Post Mortem or any other means. el on 4/23/06 10:09 PM Lyndon Taylor said the following: > > Please critique my RCA > > Root Cause analysis : > > What happened: > > Baby Fiona May was born stillborn I would unpersonalize this by not referring to the stilborn by name. > after a failed home birth attempted > VBAC after 3 previous cesarean sections by a lay midwife and her don't call her a lay midwive, refer to her by name or initial (Ms D) > parents. The lay midwife attended the patients home delivery. She ... patient's ... > examined the patient. Monitored the fetus heart rate. Diagnosed low > heart tones. Directed transport of the patient. These are allegations, not facts and you have to make this clear. > The lay midwife > attempted to deflect blame from herself by reporting to authorities > that the baby still had a heart beat on transfer , This particular allegation I would change to what she actually said in your and other witnesses' presence. > and continued by trying to interpret the bedside ultrasound to > show fetal breathing movements which is not only a sign of a live > baby but a healthy baby. Ultrasound verified IUFD. On arrival at ER Ultrasound examination performed by me, Dr X, Technician Y, with an experience of ## years, showed no fetal heart beat, no fetal movement, no fetal breathing, no Spalding's sign, no Halo sign. Ms D refused to leave the room and told the patients that she saw on the Ultrasound ... > The situation was aggravated by the fact that the fetal monitor was > picking up the mothers heart rate of 140-150. Leave auto the aggravation. > The lay midwife also put > on a glove with the intent of reexamining the patient in L+D at the The > Hospital. Leave out the intent, unless she informed you that she was going to examine. > This clearly showed that the lay midwife was attempting to > continue to practice midwifery without a license not only outside of the > hospital but in Labor and Delivery at The Hospital. She was informed > that she did not authority here and security had to be called to > convince her to leave. Since there was no record of Ms D having privileges at this hospital to admit or treat patients she was asked to leave, and since she refused Security had to be called... > Immediate cesarean section was done for maternal reasons. Specifiy the reasons. > When did the event occur: 2006. > > Areas impacted: The Hospital and the Department of Nursing. ER Transport. > > . > > Processes impacted: > > The lay midwife was practicing professional nursing and advanced > practice nursing without a license and without the collaborative > agreement and support of a supervising licensed physician. These are not your processes, ad unless you have evidence these are allegations and I would trat them as such. > Only CNMW may practice midwifery in Illinois. > The lay midwife also deflected the transport from the Nearest Hospital > to The Hospital losing precious minutes in an acute situation. Something like: There is Hospital A closer to the home of the patients where, in My opinion, this could have been handled earlier... > Human factors relevant to the incident: > > The midwife and parents wanted to believe the baby was still alive. How did you come to know about this? > The > OB on call had no opportunity to establish a relationship with the > patient OK > and had to deliver a message they did not want to hear. What did they say? > Equipment factors relevant to the incident. > > The fetal monitor picked up the maternal pulse of 150 making it appear > that the baby was alive. When, where, interpreted by whom, how. > Uncontrolled external factors relevant to the outcome: > > Lay midwifery is illegal in Illinois > > . Most CNMW’s work legally in a hospital in Illinois. > > CNMW’s who do Home Births usually screen for risk factors and only do > low risk home birth’s in Illinois. > > Outlaw lay midwives are uncontrolled. General statements that may not even be relevant to the outcome. > Other factors evaluated in regard to this incident: > > Fiona May died in connection to a home birth attempted VBAC by a > reckless lay midwife and her misguided parents. > > More VBAC home births are being offered by lay midwives on the internet. > > This is partially in response to patient discontent fueled by > misinformation given by lay midwives either intentionally or > unintentionally because of lack of education and experience . > > The cesarean section rate is approaching 30 % fueled by the fear of > litigation forcing Obstetricians to adopt a risk avoidance practice of > medicine. Tort reform could help. > > There is a decline in the VBAC rate. 30-50% of VBAC attempts fail. Some > are never attempted because of risk avoidance. > > More hospitals are discouraging or banning VBAC’s. > > There are more repeat cesarean sections > > More patients may attempt home birth VBAC’s with multiple previous C/S > > There may be more Fiona May’s. > > Fiona May is a poster child of what can happen with high risk home > birth. (VBAC after 3 previous C/S).. > > This tragedy must not be concealed if we want her life to help save > other innocent baby's lives. She can help patients understand the > various risks associated with home birth VBAC. > > CNMW’s who play by the rules should lend support to this endeavor. This whole section should go. Does not belong into the Analysis, some of it is opinion, and not backed up by evidence. Next message: Dr Eberhard Lisse: "Re: Home Birth VBAC" Previous message: fran wilson: "US neonatal mortality and morbidilty, was Homebirth, was VBAC, ect" Next in thread: Laure: "Re: US neonatal mortality and morbidilty, was Homebirth, was VBAC, ect" Reply: Laure: "Re: US neonatal mortality and morbidilty, was Homebirth, was VBAC, ect" Maybe reply: Seele, Mona: "Re: US neonatal mortality and morbidilty, was Homebirth, was VBAC, ect" Maybe reply: Seele, Mona: "Re: US neonatal mortality and morbidilty, was Homebirth, was VBAC, ect"

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 04:52:52 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.