Re: Question for Dr. Sarah Vaughan

From: Sarah Vaughan (NannyOgg_at_samael.demon.co.uk)
Date: 10/24/04 

Date: Sun, 24 Oct 2004 19:34:50 +0100

In message <NNked.4787$%h1.1793@newsread3.news.pas.earthlink.net>, Todd
Gastaldo <tgastaldo@earthlink.net> writes
>QUESTION FOR DR. SARAH VAUGHAN...
>
>Assuming OBs and midwives are ignoring simple biomechanics and the
>medical literature and closing birth canals up to 30%...
>
>Assuming OBs are KEEPING birth canals closed (keeping women semisitting
>or dorsal) when they pull with forceps and vacuum extractors...
>
>Are you saying that such behavior is within the law?

No idea about US law. The law in this country is that clinical practice
is legal if you can show that 'a responsible body of medical opinion'
would support acting in this way. This, of course, is vague enough to
be open to all kinds of interpretation, but basically - if it's common
and widely accepted practice to do things a certain way (from the
clinical POV, I mean), then you can't *legally* fault a doctor for
continuing to do things that way.

And, yes, I know that this isn't a great system. Got a better one?
Basically - who decides what's malpractice and what isn't, clinically?
Evidence-based medicine, for all its advantages, can be a very woolly
area indeed. We all know that today's accepted practice can be
tomorrow's hopelessly outdated way of doing things. Even in only a
relatively few years in the medical profession, I've also seen that
today's brilliant new finding can be tomorrow's thalidomide equivalent.
Add in the fact that the medical literature is now far too vast for
anyone to keep up with it in detail, and you can see that someone,
somewhere, is always and inevitably going to be doing things in a way
that either will be or has been shown to be suboptimal or even harmful.
If you arrest all the medical practitioners who do that, you simply
won't have any medical practitioners left - a situation which I like to
believe would do more harm than good, though I may be flattering myself
excessively.

Anyway, having depressed you with that one, here's a snippet to cheer
you up:

We've just had an old schoolfriend of mine & her husband visiting us for
the weekend. She was very solicitous of me and my 'delicate condition'
all weekend and, on seeing me squat down to put some plates in the
cupboard, said "Oh, I ought to be doing that for you!"

"Oh, no," I assured her, "squatting is good for pregnant women - good
practice for the second stage of labour."

Later on in the evening, she brought the subject up again. They have no
children yet, but want to try hopefully in a year or so, so she was very
keen on finding out as much as she could from me about the whole
business. So she asked me to tell her more about squatting in labour.
I explained that the trick was to get off your tailbone and that
squatting, all fours, or possibly side-lying might work. She thought
this made a lot more sense than lying down. And she's agreed to tell
any of her friends that are pregnant. ;-)

All the best,

Sarah 

-- 
"I once requested an urgent admission for a homeopath who had become depressed
and taken a massive underdose" - Phil Peverley

Relevant Pages