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Re: fetal monitoring--response to Dr. Nagey From: dahmd@gate.net Sat Dec 23 09:30:32 1995 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: MS GAIL M HART: "set ob-gyn-l address" Previous message: Gordon M. Goldman: "Re: fetal monitoring--response to Dr. Nagey" >From Geff Klein, with some stuff snipped: >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. I agree: I have had a number of incidents during the past year illustrate how little most US patients know about the possibility of pregnancy-related complications. After the infamous "ER" shoulder dystocia episode, I had patients commenting right and left how "it's impossible, of course, for a baby to get stuck coming out", or "what a dumb show; everybody knows they should have c/sectioned that lady". I always hear patients say that they want an ultrasound to be "100% sure" that there baby will be perfect. People on the internet post angry comments because their child has a birth defect, when the ultrasound and fetal monitoring were both normal. They ask "what did the doctor do wrong". People don't seem to care that many, many women, and their children, died as a result of labor and delivery even as recently as 100-200 years ago, and that we have made huge advances in obstetric care in the last century. I consider myself to be a "low-intervention" obstetrician, have a 9% c/s rate despite taking care of a number of high-risk patients, and have never believed that pregnancy is a disease. However, American women are getting pregnant later in life, which increases the potential for complications, and are getting pregnant with concomitant serious health problems (kidney transplants, hypertension, diabetes, heart disease, etc). Now, when I see a fetal heart rate monitor that looks even a little suspicious, I have to really think about doing a c/s, not because I really believe that the baby is sick, but because I would like to have malpractice insurance, a reputation, hospital privileges, and a job in the future. I fear we are not doing an adequate job of educating our citizens about the possibility, however remote, of something going wrong with their pregnancy. Maybe this would decrease some of the anger people feel when "something is wrong with my baby". Ashley Hill D. Ashley Hill, M.D. Assistant Director Department of Obstetrics and Gynecology Florida Hospital Family Practice Residency Orlando, FL dahmd@gate.net Next message: MS GAIL M HART: "set ob-gyn-l address" Previous message: Gordon M. Goldman: "Re: fetal monitoring--response to Dr. Nagey"

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