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Re: Trial of Labor?From: Margie Dacko, CM (dacko@lvcm.com)Wed Mar 31 08:33:07 1999
>>>> My inclination is to perform clinical pelvimetry at > >term, offer a trial of labor if appropriate; if there is arrest of > >dilation or descent with good contractions then go to c/section. > > > >Any comments? > > > >-- > >Yvonne Fried, M.D., FACOG In 20 years I have NEVER told a woman her pelvis was too small, no matter how small it seemed.......and in twenty years my c/s rate has remained approx. 2% (out of over 1400 deliveries), and my VBAC success rate is 100%. In no uncertain terms I tell all my patients that they have huge, roomy, pelvises and that a baby of any size would fit easily. I tell them that women without underlying medical conditions such as diabetes, grow babies that are just the right size for their bodies to deliver. I reaffirm with them at every appointment that birth is a normal function of the human female body and that she is the finished product of thousands of years of women having babies successfully. I make comments all the time about how well the baby's head fits so comfortably in her pelvis. I remind them that the reason they are waddling around is because their pelvis is getting looser and wider and softer for that baby to come through. On the wall in my prenatal rooms I have a dilation chart and I point out the 10cm circle on occasion to remind them just how open they are going to get during labor. The mind/body connection is very strong, and I find women believe and take very seriously what they have been told about their bodies.......this is the basis of most eating disorders. Maybe all this seems silly to many of you, but it seems to work, and it costs nothing, damages no one and makes women feel good about themselves. What is there to lose?
-- Margie Dacko, CM Nevada
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