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Re: Section on demandFrom: RModugno@aol.comMon Apr 24 19:02:34 2006
In a message dated 4/24/2006 7:57:42 P.M. Eastern Standard Time, heidi@nybble.net writes: I present it to them, help them sort through it (I took a few statistics courses back in the day... *yawn*) and then I would encourage her make a decision based on those facts. Answer any questions she has concerning vaginal birth- what is her real concern? Is it about the HSV, or is she just looking for a way out of "labor?" That's a legitimate concern, but she needs to face that rather than look for a reason for a c/s, IMO. If it really is about the risk of the HSV, she needs realistic risks of the baby contracting the disease, versus risks to the baby of RDS from the elective c/s (and perhaps a discussion about risks to her future pregnancies such as stillbirth, placental issues, etc. but I bet you already talked about those with her). What are the complications for the baby if there are no active lesions? How about offering to wait for labor and then allowing her to make a decision based on whether or not she has any lesions at the time of labor? Of course that's a pain in the ass for scheduling, but it's the most responsible medical course of action if she is not interested in prophylaxis with meds. Thanks for responding, Heidi! All covered. Robert Modugno MD MBA FACOG Marietta, GA
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