Well said Brenda

On 1/24/06, brendamanning <[EMAIL PROTECTED]> wrote:
> I am not on anyones side &  I am not  intending to be inflammatory.
> But I am a realist & inform my homebirthing clients that should they make
> controversial choices ( & I am a big supporter of BAC & VBreech) they need
> to be:  "not  intending to allocate blame if the outcome is unfavourable".
>
> It means NOT SUING the OB/MW if the outcome is poor because the client has
> chosen to take responsibility for her own decision-making.
> This doesn't make the client a "victim". She made informed choices, her
> caregiver agreed to work with them & the outcome is then the clients
> responsibility (barring out & out negligence).
>
> When we make important decisions we are accepting the responsibility of
> educating ourselves about the benefits & risks of a procedure & then
> accepting the outcome as this is the consequence of our actions. It's
> unreasonable to blame-shift if you make a decision while fully informed &
> then don't like the outcome.
> I'm not absolving health professionals of their role which is to provide a
> safe practice arena within their sphere of expertise. We are all accountable
> for our own practice. But the ever increasing litigiousness of our society
> is a large part of why womens choices are so reduced.
>
> I believe that compromise is the solution globally. Unfortunately there are
> alot of professionals & consumers who won't/don't/can't discuss & 'give a
> little to get alot'. Collaborative practice is where everyone ( health prof
> & clients) work together for the benefit of the client. That's what we are
> aiming for.
>
> With kind regards
> Brenda Manning
> www.themidwife.com.au
>
> ----- Original Message -----
> From: "Mike & Lindsay Kennedy" <[EMAIL PROTECTED]>
> To: <[email protected]>
> Sent: Tuesday, January 24, 2006 10:49 AM
> Subject: Re: [ozmidwifery] VBAC afterdehsicence or UR?
>
>
> >I like the point you make. People should be able to do it their way.
> > And I see and hear midwives annoyance at manipulative behaviour by
> > doctors. But I can also see it from a medical point of view. If it
> > goes wrong the patients become "victims" and they and their lawyers
> > come running looking for someone to blame.
> >
> > rgds mike
> >
> > On 1/23/06, brendamanning <[EMAIL PROTECTED]> wrote:
> >> Jo,
> >>
> >> I would absolutely agree with your first statement, heard it many times,
> >> "got in & saved/rescued your baby, just in the nick of time" !
> >> I am such a hero!
> >>
> >> With the second part: whilst very supportive of BAC I think labouring
> >> with a
> >> uterus which has already dehisced & is subsequently heavily scarred is
> >> really pushing the boundaries of safety.
> >> However: as long as the mother is well informed ( & being well informed
> >> means knowing the down side as well as the up side) about the risks & not
> >> intending to allocate blame if the outcome is unfavourable ie a second UR
> >> (
> >> hysterectomy etc, plus or minus a fetal death) then she can do what ever
> >> she
> >> chooses.
> >>
> >> I have seen in OT the uterus of a woman booked for a repeat EL LUSCS, not
> >> in
> >> labour, 38/40 with a dehisced area easily 5 cms in the old scar & no
> >> apparent ill effects for mother or baby. Normal obs, normal CTG, normal
> >> fetal mvmts. Absolutely no sign before OT that there was anything amiss.
> >> Amazing.
> >> She had been offered BAC & chose
> >> LUSCS...............................what if ?
> >>
> >> With kind regards
> >> Brenda Manning
> >> www.themidwife.com.au
> >>
> >> ----- Original Message -----
> >> From: Dean & Jo
> >> To: [email protected]
> >> Sent: Monday, January 23, 2006 11:15 PM
> >> Subject: [ozmidwifery] VBAC afterdehsicence or UR?
> >>
> >> not trying to be controversial (honest!) just wanting to think outside
> >> norm...how many times have I heard the story of an ob saying to a woman
> >> when
> >> giving her the repeat cs (for a 'failed vbac attempt not linked to a
> >> rupture) "oh the scar was so thin it could have ripped open at any
> >> second...lucky I saved you from it".  (well I am TRYING not sound too
> >> facetious)
> >>
> >> I suppose like anything we must look at rationale for the first event.
> >> IF a
> >> rupture did occur you could conclude that the repair to the uterus would
> >> be
> >> quite extensive IF she managed to not lose the uterus- hence the risks
> >> for
> >> future rupture would increase.  But a dehiscence has not been proven to
> >> be a
> >> serious concern according to the investigation I have done in the last
> >> almost 9 years.  There is speculation that a scar  can slightly part with
> >> no
> >> harmful effects.
> >>
> >> Just asking questions....don't they just HATE informed consumers! ;o)
> >> love Jo
> >>
> >> -----Original Message-----
> >> From: [EMAIL PROTECTED]
> >> [mailto:[EMAIL PROTECTED] On Behalf Of
> >> Janet Fraser
> >> Sent: Monday, January 23, 2006 8:40 PM
> >> To: [email protected]
> >> Subject: *****SUSPECTED SPAM***** Re: [ozmidwifery] VBAC afterdehsicence
> >> or
> >> UR?
> >>
> >> You made all my points, Jo.
> >> : )
> >> J
> >> ----- Original Message -----
> >> From: Dean & Jo
> >> To: [email protected]
> >> Sent: Monday, January 23, 2006 8:46 PM
> >> Subject: RE: [ozmidwifery] VBAC after dehsicence or UR?
> >>
> >> I would have to look for the research (we all know how 'fair' research
> >> can
> >> be!) but the stated contra-indicators for vbac is previous rupture.  Now
> >> it
> >> doesn't actually state if the chances of another rupture are higher than
> >> a
> >> normal scar or whether it is a case of "dam! Not going to let that happen
> >> again!" attitude.  You could argue I suppose that even a dehiscence that
> >> required repair would be considered the same as a repeat cs....??
> >> Perhaps
> >> no vbac after one rupture/dehiscence would be based on fear and/or
> >> presumption.  Similar to the situation where a woman loses a baby during
> >> labour there is the assumption that she will want a cs next time.???
> >>
> >> jo
> >>
> >> -----Original Message-----
> >> From: [EMAIL PROTECTED]
> >> [mailto:[EMAIL PROTECTED] On Behalf Of
> >> Janet Fraser
> >> Sent: Monday, January 23, 2006 3:37 PM
> >> To: [email protected]
> >> Subject: [ozmidwifery] VBAC after dehsicence or UR?
> >>
> >> Hi all,
> >> does anyone know of research on VB after UR? I was asked this:
> >>
> >> So if you've had a scar come apart to the point where the baby was on its
> >> way out via the DIY sunroof, and the ob says he would have had to cut me
> >> open to stitch it up even if I had pushed the baby out, would that make
> >> VBA2C too risky?
> >>
> >> Thanks in advance,
> >> J
> >>
> >> Joyous Birth
> >> Home Birth Forum - a world first!
> >> http://www.joyousbirth.info/forums/
> >>
> >> Attending births is like growing roses. You have to marvel at the ones
> >> that
> >> just open up and bloom at the first kiss of the sun but you wouldn't
> >> dream
> >> of pulling open the petals of the tightly closed buds and forcing them to
> >> blossom to your time line.
> >>
> >> ~Gloria Lemay~
> >>
> >>
> >>
> >>
> >>
> >>
> >> --
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> >>
> >>
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> >
> >
> > --
> > My photos online @ http://community.webshots.com/user/mike1962nz
> > My Group online @ http://groups.yahoo.com/group/PSP_for_Photographers
> >
> > "Life is a sexually transmitted condition with 100% mortality and birth is
> > as safe as life gets." Unknown
> > --
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"Life is a sexually transmitted condition with 100% mortality and birth is
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