Re: Ob:  IVF candidate

From: JD Stewart,MD (jdstewartmfmob@sbcglobal.net)
Tue Sep 30 13:43:11 2008


St Elsewhere here- but then again the decision that one Shouldn't be a parent is not risk free, either. ( A risk involved with birth control, surgical sterilization, even abstinence...) That's apparent. (sorry...)

Life on earth is a risky business..no one here gets out alive.

Risky business vs. Frisky business...would anyone's opinion change if she had not had a tubal, but the conversation was centered on hormonal contraceptives in a 35 year old vs the same risk of another pregnancy for this same patient?

At Tue, 30 Sep 2008, Richard Chudacoff wrote: >
>Being the obstetrical coward that I am, I would definitely send her
>elsewhere, probably to an MFM (that I don’t often use :-) )
>
>--
>Richard Chudacoff, MD, FACOG
>
> _____
>
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Gordon
>Goldman
>Sent: Tuesday, September 30, 2008 7:11 AM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Ob: IVF candidate
>
>All of that is acceptable, but also acceptable is my option of sending her
>elsewhere for that to be done. I am entitled to my medically verifiable
>opinions and entitled to decide whom I will or will not accept as a patient
>and the attendant liability. At no point did I infer or opine that she
>should not have the options if she so desired, only that I would not do it.
>
>Yes, the decision is always ultimately the patient's regarding any treatment
>for any condition, but my decision as to accept that responsibility is
>ultimately my own.
>
>Gordon
>
>On Sep 30, 2008, at 8:50 AM, Ronald Ainsworth MD wrote:
>
>I agree with Joe. She should only be given the option of a singleton
>pregnancy and needs to understand that she could end up with a ruptured
>uterus, placenta acreta, etc. She needs to know that she could end up with
>no baby and a hysterectomy and that her living children could end up with no
>mother. Saying all that as non-biased as possible, the decision is
>ultimately hers.
>
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
>DoctorJoe@aol.com
>Sent: Monday, September 29, 2008 9:30 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Ob: IVF candidate
>
>In a message dated 9/29/08 10:36:44 PM, islesannie@gmail.com writes:
>
>I am interested in seeing what those doing OB say - and that may include
>telling me I am off base here!
>
>Well, I don't do OB now. But I think you're HALF way off base.
>
>There are two questions here:
>
>1) wanting another baby -- who is to say how many is too many? If you want
>to argue ZPG, go right ahead. But I don't think OBs (or witches) are
>supposed to strong-arm patients into having "only" 2 kids, or 3 kids, or 1
>kid. Does RED CHINA mean anything to you?
>
>2) purposefully trying for twins, especially with a scarred uterus -- now
>THAT is something a responsible OB can go balistic on. Primum non nocere is
>something that should be partially operative here. Don't go making things
>more difficult (twins!!!) that you have to. Don't go asking for trouble.
>
>There you go. You asked.
>
>Joe P.
>

>out WalletPop for the latest news and information, tips and calculators.
>(http://www.walletpop.com/?NCID=emlcntuswall00000001)
>

--
JD. Stewart, MD
MFM up too late all night, every night...still 10 years later




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