OB-GYN-L Messages for December, 1995: Re: fetal monitoring--response to Dr. Nagey

Re: fetal monitoring--response to Dr. Nagey

From: Geff Klein

gklein@bcm.tmc.edu

Fri Dec 22 23:40:50 1995

>Childbirth is not a disease. And rather than medicating it to the point where the only natural part of the birth is that it is not done through an incision, there ought to be serious thought given to all the "what-if's" and the consequences of preventing all those remote possibilities. Life is risk, after all, and risk can't be medicated out of existence....or should every woman giving birth expect the lawyers for the medical team and the facility to also dictate the process?

I feel sympathy for the ordeal that you went through.. However, every story has two sides. It is a shame that your caretaker is not present to voice his/her interpretation of the events that lead up to your premature delivery, instrumental delivery, and perineal laceration.

We in the practice of Ob-Gyn are forced to deal with the simple fact that every expectant parent comes with the ideal that they are ENTITLED to a perfectly healthy, normal, intelligent, defect free infant, no discomfort during labor, and no complications as a result of the process of being pregnant. Well guess what... that is an impossible task... Eventually, each practitioner will encounter a situation with a bad outcome regardless of the level of care given.

Unfortunately, even when everything was done by the book, if a damaged infant or mother is the result of a pregnancy, a lawyer's services are sought and the physician is forced to defend himself/herself in a climate of accusation..

In those circumstances, a jury of non-medically education people are charged with the responsibility of interpreting facts. However, they are generally swayed more by the emotion evoked by tragic circumstances and the fact that large insurance companies have the ability to compensate the plaintiffs.

This understandably puts the physician in a defensive stance. Your damned if you do and your damned if you don't is the general feeling of most docs. Most doctors, despite the conventional wisdom, just want to provide good medical care. We are constantly barraged with stories just like yours with a biased angle towards faulting the doctor with negligent care where none may exist.

I don't know you personally and would hesitate to guess on your inclination to litigation... But, I would generalize that if a woman in your exact circumstances suffered from complications at 35 weeks, was allowed to continue without intervention, and was left with a neurologically handicapped infant, she would seek out the services of an attorney questioning why nothing was done sooner. As well, she would relate to all of her friends (and perhaps, post on the internet) that her doctor ignored problems that if had been addressed in a more timely fashion would have improved her chances for a healthy child...

Geffrey H. Klein, MD Baylor College of Medicine Dept of Obstetrics and Gynecology Listowner: OB-GYN-L http://www.bcm.tmc.edu/obgyn/obgyn-ce/geff.html

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