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Re: Informed consent From: Larry Glazerman (l.glazerman@rcn.com) Wed Jun 7 10:15:00 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Shell Walker: "bash the USA" Previous message: Heidi Streufert: "Re: Informed consent" In reply to: Heidi Streufert: "Re: Informed consent" Next in thread: Joanne Bulley, MD: "Episiotomy, was Informed consent" I think the issue here, as it is in my hospital, is that providers are required to have patients sign a document, purportedly an "informed consent" document, giving permission for vaginal delivery. The fact is, one cannot consent to something that one does not have the power to refuse. I've recommended (to deaf ears) a document that reads something like.......... I understand that I am pregnant, and my baby is expected to be born around this date. I understand that during the course of the labor, my provider might recommend certain steps be taken, including ................ I consent (don't consent) to each of these procedures. Etc. The issue, again, is "consenting" to vaginal delivery (birth). -- Larry R. Glazerman, MD Ob-Gyn at Trexlertown, PC larry.glazerman@lvh.com -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Heidi Streufert Sent: Wednesday, June 07, 2006 11:10 AM To: Multiple recipients of list OB-GYN-L Subject: Re: Informed consent On Jun 7, 2006, at 10:48 AM, Joe Cutchin wrote: > Its a shame women aren't having 4 to 8 vaginal deliveries so you > youngster could see what the perineum looks like afterwards. It > goes without saying that episiotomy is used only when necessary. I > would be surprised if all here don't have that discussion with > their patients during the gestation. Enough. Joe C The fact is that in my area many of the OB/GYNs find it "necessary" in nearly all primips. Dr. Cutchin, aren't you from the DC metro area as well? I'd love to know what some of the US docs here think a "low" epis rate is? The doctors who I have worked with (as a doula) who claim to have "low" rates are still doing them about half the time in primips, and almost never for fetal distress. I'm glad to hear that after 20+ years of research some of your are changing your practice, but our definitions of "necessary" are far different, I think. By the by, my preceptor does work with a population of women who indeed have 4-8 (and more) babies (Plain folk), and I'm not sure what you are implying we youngsters would see, but they tend to rarely tear and they certainly don't look as bad as some of the mothers I see as a doula (rather than as a student, still observing) the second time around after having had epis with a first birth and a poor repair or an extension of an epis. Heidi S in Maryland CPM Student Next message: Shell Walker: "bash the USA" Previous message: Heidi Streufert: "Re: Informed consent" In reply to: Heidi Streufert: "Re: Informed consent" Next in thread: Joanne Bulley, MD: "Episiotomy, was Informed consent"

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