-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

Re: Dr. Sanchez-Ramos & CNM's From: Ari Gold (arig@getnet.com) Fri Feb 20 16:01:34 1998 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Gail Waldby, MD: "Re: Dr. Sanchez-Ramos & CNM's" Previous message: Ari Gold: "Zovirax for herpes suppression in pregnancy" In reply to: Luis Sanchez-Ramos: "Re: Dr. Sanchez-Ramos & CNM's" Next in thread: Calvin J. Siegers, MD FACOG: "Re: Dr. Sanchez-Ramos & CNM's" Reply: Calvin J. Siegers, MD FACOG: "Re: Dr. Sanchez-Ramos & CNM's" At 02:14 PM 2/18/98 -0600, you wrote: >At Wed, 18 Feb 1998, Ari Gold wrote: > >>In fact, many nurse midwives spend more time with their clients both >prenatally and in labor than OB's typcally do<< > >Because they see less patients and have no surgical responsibilities. > >>Many practices still choose to hire CNM's > >You can hire 4 midwives for the price of 1 OB/GYN > >>> they have > lower ceserean rates with matched >populations<< > >If you read the studies carefully you will see that this statement is >not true. Most of the studies were not truly randomized and in fact the >patients were either selected or were self-selected (I'll let you select >the study and I'll discuss its weaknesses with you) I do agree that >OB/GYNs in private practice perform many unneccessary cesarean >deliveries. Of course midwives can't perform cesareans, if they did, >their rates would probably be just as high > >>> higher rates for VBAC's, decreased rates of other >interventions<< > Please look at the following: Davis, LG, et al. Ceserean section rates in low-risk private patients managed by certified nurse midwives and obstetricians. Journal of Nurse-Midwifery 1994; 39;91-7. Baldwin, L.M. Do providers adhere to ACOG standards? The case of prenatal care. Obstetrics and Gynecology 1994;84:549-555. (This article demonstrates that nurse-midwives are more likely to adhere to ACOG standards than FP's or OB-GYN's) Rosenblatt, R.A. Interspecialty differences i the obstetric care of low risk women. American Journal of Public Health 1997;87:344-51. Rooks, JP, et al. Outcomes of care in birth centers. New England Journal of Medicine 1989; 321:1804-11. Oakley, D, et al. Comparisions of outcomes of maternity care by obstetricians and certified nurse midwives. Obstetrics and Gynecology 1996;88:823-9. (This article found that patients were satisfied to a greater extent with nurse-midwives that obstetricians). Bell, KE, and Mills, JI. Certified nurse-midwifeeffectiveness in the HMO obstetrics team. Obstetrics and Gynecology 1989;74:112-116. Jenkins, SM. The myth of vicarious liability. Journal of Nurse-Midwifery 1994;39:98-106. >Same response as above, especially for forceps deliveries > >>> lower rates of suit for malpractice<< > >That is because the physicians are the "deep pocket" > >>>I am glad you have clarified that this is your personal opinion, because it >>is clearly unsupported by clinical data, which demonstrate excellent >>outcomes with nurse-midwifery care, even among high risk populations, where >patients are managed collaboratively<< > >That depends on your definition of "high risk" and how much involvement >there is by OB/GYNs as collaborators. I'd be happy to discuss these articles after you have read them. I think they will illustrate my points well. Ingrid Gold, CNM arig@getnet.com Next message: Gail Waldby, MD: "Re: Dr. Sanchez-Ramos & CNM's" Previous message: Ari Gold: "Zovirax for herpes suppression in pregnancy" In reply to: Luis Sanchez-Ramos: "Re: Dr. Sanchez-Ramos & CNM's" Next in thread: Calvin J. Siegers, MD FACOG: "Re: Dr. Sanchez-Ramos & CNM's" Reply: Calvin J. Siegers, MD FACOG: "Re: Dr. Sanchez-Ramos & CNM's"

Return to

Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Mon Nov 2 05:27:05 2009

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.