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Re: VBAC Hospital Protocol From: Betsy Hyde (elishyde@connix.com) Fri Oct 1 20:44:43 1999 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Jim: "CPT Coding" Previous message: Joseph Shaeffer: "VBAC Hospital Protocol" Maybe in reply to: Joseph Shaeffer: "VBAC Hospital Protocol" Next in thread: Braun, R. Daniel: "Re: VBAC Hospital Protocol" At 8:12 PM 10/1/99, Joseph Shaeffer wrote: > >Do you find this protocol makes sense in addressing the ACOG bulletin? Does >it bother you as much as I that a family physician that may do 10 births a >year and cannot begin a c/section is allowed to manage the VBAC patient and >the CNM who does 100 deliveries a year cannot? Of course it doesn't make sense, Joseph. But lots of what comes down from the top makes no sense. The ACOG Practice Bulletin of 7/99 which addresses VBAC does not address which type of provider may attend VBACs; rather, it addresses the institutuional/professional requirements as follows: << physician immediately available throughout active labor capable of monitoring labor and performing an emergency cesarean delivery>> <<availability of anesthesia and personel for emergency cesearean delivery>> If one wants to strictly adhere to these guidelines, a CNM who practices in a setting with in-house anesthesia, and a physician in house, should be able to attend VBACs in labor. Our collaborative practice guidelines allow this. Without wanting to start a battle which has been fought time and time again on this list, a CNM in such a setting is more compliant with the 7/99 ACOB guidelines than a board certified OB-GYN who practicies in a setting with no 24 hour, in house anesthesia. At any rate, it makes no sense that you should not attend VBACs, while a FP with limited ob experience and no privileges to do c/s can attend them. These comments in no way imply that obs in community hospitals should/shouldn't attend VBACs, of that FPs should/should not attend VBACs. That is not the point of this post. My point is merely to address Joseph's question.... -- Betsy Hyde CNM Branford, CT Next message: Jim: "CPT Coding" Previous message: Joseph Shaeffer: "VBAC Hospital Protocol" Maybe in reply to: Joseph Shaeffer: "VBAC Hospital Protocol" Next in thread: Braun, R. Daniel: "Re: VBAC Hospital Protocol"

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