Just beware the documentation. It is not enough to say that you discussed the pro's and con's of the course of action, you have to write exactly what you said. Cheers Judy
--- wump fish <[EMAIL PROTECTED]> wrote: > People will try and sue for a poor outcome regardless of the > info given etc. > But, if you have provided them with adequate info, and they > have made their > choice and you exercise the 'expected' level of skill - their > case will be > unsuccessful. > > I've just finished a legal, risk management course and learned > a lot. People > will sue whatever (and unpredictably sometimes), but you can > protect > yourself against them being successful. Women and their > partners need to > take responsibility for their birth experiences, and we should > be > encouraging them to do so. > > Rachel > > > >From: "brendamanning" <[EMAIL PROTECTED]> > >Reply-To: ozmidwifery@acegraphics.com.au > >To: <ozmidwifery@acegraphics.com.au> > >Subject: Re: [ozmidwifery] Scottish dads push wives toward > C-sections? I > >don't think so > >Date: Sun, 16 Oct 2005 15:27:07 +1000 > > > >Whilst I agree totally in theory.......... > >"Bad workmen always blame their tools". > >I mean we are all talking about 35 years exp of 'seeing' > births or > >deliveries here are we not ? I too had a KRF del x 1 & was OK > afterwards so > >it isn't a personal bias (mind you, made sure I had the next > babies at home > >!!). Just observation & experience. > >Whatever the instrument, NB, Wrig, Keill .... it's > incidental, whatever the > >surgery it's incidental, damage happens. Some places don't > use Keill > >anymore because they cause maternal damage, in inexp hands, > if they kept > >using them knowing this, we'd consider them negligent > wouldn't we ? > >Some folks love the Ventouse, some hate it. > >Some folks love EL C/S, some condemn it. > >We've all seen horrific outcomes from what we thought (& to > all intents & > >purposes appeared) to be NVDs at the time haven't we ? > >I have actually been present on more than one occasion when > an OB has given > >what I considered (given the time, energy & urgency in the > situation) to be > >a very reasonable & balanced summary of events with choices, > options, > >rationales, possible sequalae etc & the woman & her support > team have made > >their choices & then.......... sued later. > > > >Go figure............ > >As I say, emotive, subjective stuff all the way isn't it ? > > > >With kind regards > >Brenda Manning > >www.themidwife.com.au > > > > > >----- Original Message ----- From: "Ken WArd" > <[EMAIL PROTECTED]> > >To: <ozmidwifery@acegraphics.com.au> > >Sent: Sunday, October 16, 2005 2:34 PM > >Subject: RE: [ozmidwifery] Scottish dads push wives toward > C-sections? I > >don't think so > > > > > >>Sorry, I too have seen some dreadful injuries, but not with > Kielland, and > >>my > >>own experience with the Kielland was okay, no episi and only > a very small > >>tear. Which I thought was pretty good considering the huge > epises I'd had > >>with the others. It was the Neville Barnes forceps that did > the damage, > >>not > >>to me but the baby, and I think it was the stuck shoulders > that caused the > >>neck. Some of the worse injuries I have seen have been > wriggleys lift > >>outs. > >>Dreadful placement of the blades, although my 2 wriggleys > births were > >>fine, > >>no probs with me or the babies. We do need to remember that > not all forcep > >>births result in injury, and are sometimes necessary > >> > >>-----Original Message----- > >>From: [EMAIL PROTECTED] > >>[mailto:[EMAIL PROTECTED] Behalf Of > brendamanning > >>Sent: Sunday, 16 October 2005 12:12 PM > >>To: ozmidwifery@acegraphics.com.au > >>Subject: Re: [ozmidwifery] Scottish dads push wives toward > C-sections? I > >>don't think so > >> > >> > >>Ken, > >> > >>Your story is a very common one. > >>I think we all saw a good many Keillands Rotations in our > day & often the > >>dreadful resulting lacerations & pain, injury & suffering > that went along > >>with them for mother & baby. > >>I agree with Rachel in that often this was caused by > operator error, the > >>Reg > >>'practising' (foot on the end of the bed stuff, makes me > shudder to think > >>about it). > >>Fourth degree tears were not uncommon & the long-lasting > damage to babies, > >>womens minds, pelvic floors & pelvic organs was horrendous. > >>BUT.............and I realise this could be construed as > inflammatory but > >>it's not intended to be, really !! > >>Perhaps in the age of 'new obstetrics' if women ceased > sueing OBs for > >>everything that went wrong then they (the OBs) wouldn't all > be resorting > >>to > >>C/S at absolutely any excuse. > >>Really it's a very emotive argument & the OBs are damned if > they do & > >>damned > >>if they don't. Sometimes we midwives are in the same boat !! > >>I'm not defending them overly here, just telling it like it > is. > >>The OB is the story below emerges as skilled but he could > just as easily > >>have had the arse sued off him for mishandling or something > if the outcome > >>had been less favourable couldn't he? > >> > >> > >>With kind regards > >>Brenda Manning > >>www.themidwife.com.au > >> > >> > >>----- Original Message ----- > >>From: "Ken WArd" <[EMAIL PROTECTED]> > >>To: <ozmidwifery@acegraphics.com.au> > >>Sent: Sunday, October 16, 2005 10:26 AM > >>Subject: RE: [ozmidwifery] Scottish dads push wives toward > C-sections? I > >>don't think so > >> > >> > >>>I have experienced 4 assisted vaginal birth myself. The > second was > >>>dreadful, > >>>and injured the baby, dislocated his neck. Number four was > posterior, 2 > >>>hrs > >>>of no descent in 2nd stage. I could feel she was stuck and > tried > >>>everything. > >>>In the end I demanded an epidural and forceps. Once the > doctor rotated > >>>her > >>>into oa she just about fell out. I saw his a lot in my mid. > An op rotated > >>>into a oa with forceps and then the mother birthing with no > further > >>>assistance. > >>> > >>>-----Original Message----- > >>>From: [EMAIL PROTECTED] > >>>[mailto:[EMAIL PROTECTED] Behalf Of > wump fish > >>>Sent: Sunday, 16 October 2005 9:24 AM > >>>To: ozmidwifery@acegraphics.com.au > >>>Subject: Re: [ozmidwifery] Scottish dads push wives toward > C-sections? I > >>>don't think so > >>> > >>> > >>>I wonder if he told her that it would be better for her > baby if she > >>>experienced some labour - even if she then had a c-section. > Although I > >>>doubt > >>>that option would fit with his schedule. > >>> > >>>I also think that it is a shame that women are missing out > on the option > >>>of > >>>an assisted vaginal birth due to the lack of obs skills. I > have observed > >>>some fantastically gentle and effective instrumental births > by > >>>experienced > >>>and skilled obs. Including brow presentations manouvered > and delivered > >>>with > >>>intact perineums. Far better than abdominal surgery. > Perhaps if the obs > >>>in > >>>Australia concentrated on their own area (abnormal birth) > instead of > >>>wasting > >>>time in ours (normal birth) they may develop the skills > women need them > >>>for. > >>> > >>>Rachel > >>> > >>> > >>>>From: "Susan Cudlipp" <[EMAIL PROTECTED]> > >>>>Reply-To: ozmidwifery@acegraphics.com.au > >>>>To: <ozmidwifery@acegraphics.com.au> > >>>>Subject: Re: [ozmidwifery] Scottish dads push wives toward > C-sections? I > >>>>don't think so > >>>>Date: Sat, 15 Oct 2005 22:52:48 +0800 > >>>> > >>>>Rachel, you raise an interesting point. > >>>>One of our obs was talking to a woman in clinic last week, > she is 4'9" > >>>>and > >>>>baby is posterior and not engaged at 39 weeks (primip) so > he was > >>>>advising > >>>>her to go straight for C/S - now I do not necessarily > agree that she > >>>>could > >>>>not deliver - given some time to allow her body to do it's > thing so > >>>>please > >>>>don't flame me, but his words were that he felt she would > have a > >>>>struggle > >>>>and that these days it was felt that it is better to have > a C/S than a > >>>>difficult vaginal birth, whereas in past times there was > no choice but > >>>>to > >>>>attempt vaginal birth. > >>>> > >>>>On the plus side, we have had several successful ECV's of > late and even > >>>>have had obs talking women into VBAC!!!! > >>>>Sue > >>>> > >>>>"The only thing necessary for the triumph of evil is for > good men to do > >>>>nothing" > >>>>Edmund Burke > >>>>----- Original Message ----- From: "wump fish" > <[EMAIL PROTECTED]> > >>>>To: <ozmidwifery@acegraphics.com.au> > >>>>Sent: Saturday, October 15, 2005 6:24 AM > >>>>Subject: Re: [ozmidwifery] Scottish dads push wives toward > C-sections? I > >>>>don't think so > >>>> > >>>> > >>>>>I wouldn't be too impressed by UK c-section rates. What > is more > >>>>>important > >>>>>is the 'normal' birth rate. I worked in a large regional > referral unit > >>>>>in > >>>>>the UK (5000 births per year). The Consultant was always > bragging to > >>>>>new > >>>>>drs that the c-section rate was around 20%. He used to > get rather > >>>>>p**sed > >>>>>off when I interrupted to point out that the normal birth > rate for a > >>>>>'low > >>>>>risk' primip was 49%. The instrumental birth rate was > very high. > >>>>> > >>>>>I have noticed here (Queensland public hospital) that the > c-section > >>>>>rate > >>>>>is around 30+%. But, women very rarely have instrumental > births. Often > >>>>>the > >>>>>c-sections are done at full dilatation and the baby's > head has to be > >>>>>dis-impacted from the pelvis. I asked about it (I ask far > too many > >>>>>questions), and was told it was because the drs don't > have the > >>>>>experience > >>>>>or skill of instrumental births, therefore prefer > c-section. Those > >>>>>women > >>>>>that do have instrumental births often end up with 3rd > degree tears. > >>>>> > >>>>>I can only speak for the hospitals I have worked in (both > public > >>>>>sector), > >>>>>but my observations are the 'normal birth' is higher than > the rate in > >>>>>the > >>>>>UK. > >>>>> > >>>>>Rachel > >>>>> > >>>>> > >>>>>>From: [EMAIL PROTECTED] > >>>>>>Reply-To: ozmidwifery@acegraphics.com.au > >>>>>>To: ozmidwifery@acegraphics.com.au > >>>>>>Subject: Re: [ozmidwifery] Scottish dads push wives > toward C-sections? > >>>>>>I > >>>>>>don't think so > >>>>>>Date: Fri, 14 Oct 2005 13:12:57 EDT > >>>>>> > >>>>>> I just wish we had their C/S rate!! Ours is about 5 > times that > >>>>>>lately. The > >>>>>>other week I counted 18 out of 30 women on one ward had > had the chop - > >>>>>>there > >>>>>>were also a few antenates, believe it or not! We're a > major tertiary > >>>>>>hospital, > >>>>>>I know, but they weren't all fulminating P.E.T's, or > grade 3&4 plac. > >>>>>>praevias! > >>>>>> But don't ya just love some of those threatening > stand over > >>>>>>tactics > >>>>>>by > >>>>>>"support" (now there's a loose term) people demanding > you give pain > >>>>>>relief? We've > >>>>>>had to call security a few times - it can be so > distressing for the > >>>>>>women > >>>>>>and > >>>>>>the birth process, eh! GW > >>>>> > >>>>>_________________________________________________________________ > >>>>>Be the first to hear what's new at MSN - sign up to our > free > >>>>>newsletters! > >>>>>http://www.msn.co.uk/newsletters > >>>>> > >>>>>-- > >>>>>This mailing list is sponsored by ACE Graphics. > >>>>>Visit <http://www.acegraphics.com.au> to subscribe or > unsubscribe. > >>>>> > >>>>> > >>>>>-- > >>>>>No virus found in this incoming message. > >>>>>Checked by AVG Anti-Virus. > >>>>>Version: 7.0.344 / Virus Database: 267.12.1/135 - Release > Date: > >>>>>15/10/2005 > >>>>> > >>>>> > >>>> > >>>>-- > >>>>This mailing list is sponsored by ACE Graphics. > >>>>Visit <http://www.acegraphics.com.au> to subscribe or > unsubscribe. > >>> > >>>_________________________________________________________________ > >>>Be the first to hear what's new at MSN - sign up to our > free newsletters! > >>>http://www.msn.co.uk/newsletters > >>> > >>>-- > >>>This mailing list is sponsored by ACE Graphics. > >>>Visit <http://www.acegraphics.com.au> to subscribe or > unsubscribe. > >>> > >>> > >>>-- > >>>This mailing list is sponsored by ACE Graphics. > >>>Visit <http://www.acegraphics.com.au> to subscribe or > unsubscribe. > >> > >>-- > >>This mailing list is sponsored by ACE Graphics. > >>Visit <http://www.acegraphics.com.au> to subscribe or > unsubscribe. > >> > >> > >>-- > >>This mailing list is sponsored by ACE Graphics. > >>Visit <http://www.acegraphics.com.au> to subscribe or > unsubscribe. > > > >-- > >This mailing list is sponsored by ACE Graphics. > >Visit <http://www.acegraphics.com.au> to subscribe or > unsubscribe. > > _________________________________________________________________ > MSN Messenger 7.5 is now out. 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