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Re: Breech dilemmaFrom: Paul Prior MD (pprior@fast.net)Tue Mar 3 08:33:19 1998
>She does not want a section. She is begging to not have a section. If >they are notified of her breech status, she gets sectioned. If not >notified she'll probalby precip a breech vaginally. If not notified and >trouble, someone will be in deep do-do. > >What would you do? Please no flames about illegal immigrants, CNMs, >breeches, etc, etc. And note that I haven't revealed who her AP provider >is anyway. 1) Resist at all costs the temptation to withhold information based on the perception that you will be doing the patient a service. To do so would violate the principles of collaborative practice and place you at significant risk. 2) She can refuse section if she wishes - nobody can force her to. They can counsel her STRONGLY if that is their medical opinion, but in the end it is of course her decision. If you feel she is adequately educated about the risks then let her go there breech and deliver vaginally that way 3) If I ever found out that a CNM transferred a patient with a known breech and purposefully withheld information in order to try and skirt around my management (note: we do vaginal breeches, so I'm not questioning that aspect) I would have some ass in the fire real fast. That is the kind of thing that can revoke privileges real fast....
-- Paul Prior MD pprior@fast.net Don't Blame Me... PGY-IV Ob/Gyn I Voted For Bob Dole TRHMC-Reading, PA
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