|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Is C/S the safest method of delivery?From: C. Gentile, M.D., FACOG (charon@cajun.net)Sat Oct 9 12:05:45 1999
Some colleagues that I know are proclaiming that a primary C/S is the preferred and safest method of birth for the baby and probably the mother; i.e. "I have (would have) my wife deliver by C/S." The L&D nurses buy into this too......'Less time spent with laboring women.' Now I know the risk of both vaginal and cesarean delivery; but I find it hard to fight this trend. Patients seem to be convinced that a planned C/S is both more convenient and causes less pain and trauma; "A good doctor would not make you endure labor." I feel that this leaves me in a vulnerable position. Despite the best of care, I can not guarantee an outcome. I recently had a patient that delivered and 8 lb 2 oz infant after an uncomplicated labor and normal second and third stage. No obvious shoulder dystocia. The infant had an erb's palsy and has 95% of normal range of motion at one year of age. Needless to say the patient feels that I should have sectioned her to prevent this and the concurrent second degree laceration; and she has been supported in this position by colleagues. She just delivered her second child by elective primary section with another physician. Infant weight 7 lb 1 oz. Course complicated by spinal headache and superficial wound dehiscence and seroma. But of course, she feels that the other physician did everything possible for her and her baby. My goal is to have a healthy mother and infant, and to deliver by the method that is safest for both. I feel like a dinosaur for not adopting the 'C/S is the safest way' philosophy. Since a number of my colleagues in this area prefer C/S, I fell that legally I am unprotected (i.e. an abduncance of experts witness to testify against me if outcome is less than perfect). VBAC candiates are very rare despite education and reassurence that I will be with them throughout the entire in-hospital labor course. "Why attempt a VBAC when someone will do my repeat C/S as early as 36 weeks?") I know this is probably not the type of questions/problems you intended on addressing (and in fact, might sound like a moaning session), but I would appreciate your feedback. Please do not just dismiss my concerns. While I do not post to this site often, I almost daily review the site. I have read numerous post that seem to indicate that some practice trends are based on 'our litiganious society.' Additionally, I have heard that the only c/s you regret is the one you didn't do. While I personally have regreted C/S's in the past (i.e. was I too quick to move to section, did I over interpt the FHM pattern, was I just to tired to stick with a difficult labor), I can so the logic of that state of mind. I wish I had a little humor to inject here; but this is something that is weighing heavily on my mind. Thanks.
|
|
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: Wed Dec 2 05:29:22 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.