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Re: Midwives as list-members (was c/sec in 14 y/o)From: John G. M. Robertson (jgmr@unixg.ubc.ca)Sun Nov 30 22:32:22 1997
As I have said in the past (don't ask when, I've been on the list for over three years, it was (relatively) a long time ago) I am for Midwives on the list. I have worked with may midwives in the past, and for the most part the experiences have been quite good. Like Dr. Cristalli some of the skills I learned in normal vaginal delivery were from Midwives (although I rarely see low risk OB these years). With respect to Trish Goudie's comments about surgical practice I respectfully submit that the decision making process that comes before surgery is part of the surgical practice (atleast I was taught that the decision making process was one of the most important parts of the surgical practice). While I am not sure I would have managed the case the same way, I was not there. As we have heard from other list members the "standard of care" in Brazil may not be the same as it is in any of the places we practice, and as in the US where medicolegal matters seem to colour some of the decision making process, there may be factors in brazil that change the way the patient is approached. Only people who do cesarian sections actually have to make the decision wether to do them or not, in the end they are the final authority. They have to live with their decisions. I appreciate input from others when I am making the decision, but in the end I make it. If you look back to my original post on this subject you will note that I said that I did not see an indication for C/S in this patient at the start, and that continuous support (ie 1 to 1 nursing, supportive family, etc) would be more appropriate. Certainly the tone of the initial post to me was that this physicians colleagues were pushing for C/S and he was trying an induction first. Some might even say that if his colleagues were in agreement that a C/S should be performed that the standard of care - in that community - would be C/S. Don't know that I would want to practice their if it were. Lastly Marjorie Dacko's post was concerning. No one should be forced to work without a net. Is there no way for a midwife to get malpractice insurance? I'm sure that is all as clear as mud! J.G.M.Robertson MD, 109-9181 Main St. Chilliwack, B.C. V2P 4M9 (604) 793-9988 e-mail jgmr@unixg.ubc.ca The best we can do for one another is to exchange our thoughts freely; and that, after all, is about all. James A. Froude (1818-1894) -----Original Message----- From: Joseph E. Shaeffer <JSCNM@concentric.net> To: Multiple recipients of list <ob-gyn-l@talk.obgyn.net> Date: Sunday, November 30, 1997 7:48 PM Subject: Re: Midwives as list-members (was c/sec in 14 y/o)
>Dr. Robertson,
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