Re: VBAC dying art>
From: Glen Elrod (dr99645@yahoo.com)
Tue Mar 31 18:12:34 2009
Can you share that consent form? i'm just curious what it says.
Glen
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From: vnellsch <vnellsch@eastex.net>
--
________________________________
To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.obgyn.net>
Sent: Tuesday, March 31, 2009 11:23:07 AM
Subject: Re: VBAC dying art>
joanne,
we have an anesthetist in house 24/7 anyway. the o.r. crew is notified, and come in when the patient goes from latent phase labor to active labor. practically speaking, the on call o.r. crew is usually here anyway. the big changes are in the consent form and the monitoring/permitted activity of the patient. i saw a vbac candidate monday, showed her the new consent form, and she and her partner both blanched. if the intent of the hospital is to stop or cut down on vbacs, i would have to say this will do it. verner nellsch, md
>----- Original Message ----- From: "Joanne Bulley, MD" <islesannie@gmail.com>
To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@mail.obgyn.net>
Sent: Monday, March 30, 2009 9:07 PM
Subject: Re: VBAC dying art>
> Verner,
>
> Do you have a full OR team in house with each VBAC once she is in active
> labor?
>
> If not ... what is your decision to incision time when you call "stat"
> OR team?
>
> Are you really "OK" flying so bare in the seat of the pants?
>
> Back in Residency (1981-1985) and when we started VBACs here in Keene in
> 1985: our protocol required in-house OR team present and waiting. In
> residency that was not so bad - because we had residents in anesthesia
> and one was always assigned to L&D. But in this small community town -
> it was a pain for the OR team. They would come in when she arrived in
> labor and set up an OR table for C/S - then go to their quarters and
> sleep / wait for the possible call. After some number of years (5?
> maybe 6?) we quit making them come in and set up the table and wait -
> but the OR was always notified. If they had to do another emergency
> case - they did call a back up team to be available for a Stat C/S.
>
> Joanne
>
> At Mon, 30 Mar 2009, vnellsch wrote:
>>
>> i am in a small community hospital about an hour north of houston, texas. i have been quietly doing vbacs here for the last ten years. no troubles from doing them, but here recently, the hospital, spurred on by some of the labor and delivery nurses, have promulgated a policy that may keep me from doing many. verner nellsch, md
>>
>
> --
> Joanne Bulley, MD
> solo gyn
> Keene, NH
