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Re: Opinion on Labor inerventions?

From: j wang, M.D. (anonymous@obgyn.net)
Mon, 11 Dec 2000 20:29:35 -0600 (CST)


At Mon, 11 Dec 2000, chrissy wrote: >
>I know this is difficult to answer, however, I was wondering what your
>opinion is on the following: During Labor I want as little medical
>intervention as possible. I feel that OB's are TOO concerned for fetal
>outcome and tend to overlook maternal outcome. (personal opinion) I am
>using an OB and will discuss the following with him
>
>I want to avoid an episitomy. Does perineal massage, hot packs, oil to
>perineum work better to stretch the perineum?

They can. It is wirht trying. >
>Is it necessary to have IVF and not be able to eat?......this is not
>general surgery.

By IVF I presume IV fluids. In the correct patient, it can be avoided, but most docs still want an IV acess put in even if fluids are not given. It would be rare to be allowed to eat solid food while in labor, liquids are OK just about anywhere. (Solid food can increase the chance of vomitting in labor - not a pleasant experience).

>
>Isn't it better to wait until the baby is in the birth canal to push
>rather than at 10cm? (let the baby work it's way down)

It usually is in the vagina by that time. Pushing a t full dilation helps bring the baby down - it augments the uterine forces. The baby is passive in this stage.

>
>What is the best postion for laboring? I heard on your back fights
>against gravity, squatting puts too much pressure on your perineum?
>

The best position is the most comfortable one for the patient.

>Thanks for your professional opinion.

--
James Wang, M.D
Assitant Clinical Prof.
Tufts University School of Medicine

**Note: Opinions expressed here are for educational purposes only and, as such, do not constitute a physician-patient relationship. This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options and/or interventions.




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