Gah.
I've now been back at work for 6 weeks, and there are two arguments I NEVER want to have again as long as I live:
1. That all emerg docs are not inferior clinicians who just triage people and refer everything without doing any actual medical management
2. That having my baby delivered by a midwife was NOT a stupid, irresponsible decision
Seriously, people. Just let it go.
posted by Couz at 7:54 PM
4 Comments:
I would actually like to hear about the midwife controversy. I wasn't aware that there was one.
9:44 PM
My wife and I decided to use a midwife. We think it is a better decision than a doctor. In fact, we met both the doctor and the midwife and we trust the midwife more.
11:40 PM
I was doing some obstetrics reading and surprise. The ritgen maneuver, taught by most physicians, (extending the head as it's crowning) is actually more likely to cause tearing. Midwives flex the head, and this presents a smaller diameter, ergo less tearing.
Also traditionally taught by physicians: valsalva pushing, ie "hold your breath and push baby out" vs exhalational pushing, which midwives usually do. Again, slightly better outcomes with exhalational pushing (better apgars, slightly higher cord pHs for whatever that's worth).
I'm changing my practice because of that.
9:28 PM
Thanks a lot for sharing this post...great stuff.
2:02 AM
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