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Re: episiotomy and shoulder dystocia wasits effects on perineal body/From: Garry E. Siegel, M.D. (garrys@mindspring.com)Sun Apr 27 21:48:15 1997
At Sat, 26 Apr 97, Robert J. Woolley wrote: > >In message <199704270109.UAA17267@talk.obgyn.net> writes: >> Garry the chickenhearted (right out of Monty Python) does not believe >> that an episiotomy makes a difference in a shoulder dystocia unless you >> need it to get your hand in the vaginal to maneuver. Usually, that >> would be in a primip, but not in a multip. >> >> However, I will always cut one (probably a small one), so the >> prosecuting attorney can't harass me as to why I didn't. >> >> I'm being honest on this one--who needs the aggrevation of not making an >> epis and then wondering! > >So you cause injury, pain, and risk--with zero benefit--to your patient for a >hypothetical benefit to yourself. The very definition of "unethical" in my book. > Dear Bob: Among the collection of internet friends, I felt comfortable being honest, just as you obviously do. Your remarks may well be correct (I don't think so), but they are stated in such a way that is inflammatory and insulting. I do not have the time or the energy to debate this with you, and felt that my reply would be best handled in this open forum as opposed to privately. I may be old fashioned, traditional, unwise, uneducated, and many other things, but I don't think unethical is one of them. I suspect that many of us do things that we might not do if we didn't have the background fear, however small and remote, of any imperfection leading to malpractice litigation. I do not plan to respond to your remarks on this topic, as you have crossed the line as far as I'm concerned. Garry
-- Garry E. Siegel, M.D., FACOG Private Practice Roswell, Ga.
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