Option of Midwives for Deliveries 
Author Message
 Option of Midwives for Deliveries

Quote:
> DH>I'd sure hate to be in the delivery room when a teratoma or cystic

 > DH>hygroma decides to show up with a mid-wife around.  Hope she's fast at
 > DH>neonatal intubation...
 >
 > First of all, let's define your terms.  A teratoma is a
 > tumor.  It does not have an airway.  However, I surmise

Suggest you get together with the Ultrasound Department at your college or
university...this is a mass that can effect either the fetal neck or sacral
region (teratoma is an entire family of masses, including ovarian, etc.). When
it occurs in the neck area, it has a nice way of causing the trachea to shift
away from midline...even a good intubator would have trouble with this one.

 > We have fetal monitoring techniques and safe prenatal
 > imaging techniques that allow us to somewhat predict what
 > level of care a mother and a fetus will need at delivery.

As Ultrasound Program Director here at El Paso Community College I find your
last statement particularly alarming, and hope that the "us" that you refer to
in the last statement is a very knowledgeable Radiologist or Obstetrician.  I
am aware that midwifes have the ability to order sonograms, but do hope they
have enough common sense to have an expert interpret it.  Also, many of the
people (unregistered) performing sonograms are barely capable of performing a
Level I fetal evaluation (biometry only).

 > If we utilize and continue to develop these, I am
 > comfortable with our skill at predicting which Moms need
 > only nursing care for their delivery.  We are have limited
 > health care resources.  The most efficient use of them is
 > in everyone's interest.  Thanks for your interest in midwifery.

This is even more alarming than the previous statement...I was hoping that you
left the actual scanning up to the registered sonographers.   Many Ultrasound
schools often have RN's that enter for further education...it never ceases to
amaze me how many of them say " Gee, I didn't know you had to know all of
*this*".  Our field requires knowledge of not only lab values, and sonographic
pathology appearance tendencies, but also a grasp of Nuc. Med., CAT Scan,
X-Ray, MRI and what their results indicate (e.g. a Nuc. Med Tc99 that appears
"cold" indicates cyst or mass to us).  A knowledge of all systems and exact
location (i.e. not just aorta, but ALL tributaries-celiac sup/inf mesenterics,
each vessels location in comparison to one another and this doesn't even
scrape the ice berg!).  I have no doubt that anyone from an established
program would have trouble with transposition of the greater vessels, and
expect non-qualified personnel to miss any major anomalies in most cases. The
boards for Ultrasound average a 36-50% fail rate annually for first time
takers due to all of this material.  Many programs are changing from the 12-13
month format to the 24 month format, and this is *strictly* Ultrasound...I
don't see how anyone can even try to suggest that they feel "comfortable with
their skill of predicting which Moms need further follow-up".

The next time you hear of someone "predicting for Mom" run the following
abbreviated list of terms by them and see if they know all of the Dx criteria

by ULTRASOUND, not what just their *definition*:

Placenta Previa         Gastroschisis           Thanatophoric Dysplasia
Abruptio Placenta       Esophageal Atresia      Osteogenesis Imperfecta
Incompetent Cervix      Duodenal Atresia        Meningiocele
Low Lying Placenta      Cystic Hygroma          {*filter*}Atresia
Hydrocephalus           Sacral Teratoma         Multicystic Kidney
Hydrancephaly           Potter's Syndrome       Polycystic Kidney
Holoprosencephaly       Prune Belly Syndrome    Polyhydraminos
Encephalocele           Hydrocele               Oligohydraminos
Omphalocele             Fetal Hydrops           IUGR

_____________________  List shortened for brevity ____________________

Daniel Hagan
Ultrasound Program
El Paso Community College

--  
Uucp: ...{gatech,ames,rutgers}!ncar!asuvax!stjhmc!381!61!Daniel.Hagan



Wed, 28 Apr 1993 10:46:48 GMT
 Option of Midwives for Deliveries
This brings up an interesting question here.....

Lets just say (hypothetically), that there is a woman that has had a removal
of her uterus.... Now, her ovaries, and fallopian tubes are still intact, and
she still produces monthly eggs for fertilization....

What would happen, if this woman would want to conceive? Now, we know that
this is NOT possible, since she no longer has the uterus to carry the child
throughout birth..... BUT, is there such a way, that this woman could?

IS there any operation, or some other method, that is being done, to allow
these women to still be able to give birth? OTHER than the test tube baby
method.... and if Not, what are your chances of getting a midwife to do it for
you...and if so, where does a couple go to make arrangements LEGALLY to do it?
IS there a firm out there that does things like this.. or is it something that
you have to initiate yourself through legal aid?

Thanks for answering anyone!

                            -=*>> SysOp*Rosie <<*=-

--  
Uucp: ...{gatech,ames,rutgers}!ncar!asuvax!stjhmc!273!605.0!Rosie.Strohl



Fri, 30 Apr 1993 21:17:33 GMT
 Option of Midwives for Deliveries
Quote:
> Lets just say (hypothetically), that there is a woman that

 > has had a removal of her uterus.... Now, her ovaries, and
 > fallopian tubes are still intact, and she still produces
 > monthly eggs for fertilization....
 > What would happen, if this woman would want to conceive?

There's a new technique that involves donor eggs...this could be used, but the
women missing the uterus wouldn't carry the fetus, someone else would.  The
technique was talked about on the news last week, and allows post-menopausal
women to become pregnant.  The eggs are usually from a younger donor...and
reduces the risk of Down's Syndrome.  This technique could allow someone to
have a baby that is genetically theirs completely (i.e. the hysterectomy
patient's eggs + her husband's {*filter*}atazoa...carried by a third party).  I
don't know how the courts would rule on that one if the "carrier" decided she
wanted to keep the baby...you see the carrier no longer has a genetic
involvement.

The rest of your message aske dabout where to go, the legality and other
questions that I feel others here would answer better than myself.

Daniel

--  
Uucp: ...{gatech,ames,rutgers}!ncar!asuvax!stjhmc!381!61!Daniel.Hagan



Sat, 01 May 1993 23:36:02 GMT
 Option of Midwives for Deliveries

Quote:
> Gee, did you not get in the nursing school or something?

Not sure exactly what you're trying to say, but no I never even considered
nursing school...if I wanted to change careers it'd be Physical Therapy or
Occupational Therapy.

 > I resent the inference that I would suggest that I am
 > anti-medicine.  I am not at all anti-medicine.  If I was
 > faced with a difficult intubation I would be the first to
 > seek immediate medical intervention.  I am training to be
 > a nurse, not a doctor.  If I wanted to be a doctor, I
 > would have trained to be one.

I never suggested you were anti-medicine...if you were, why would you be
flashing the BSN at the bottom of all your messages.

 > Of course I would want a radiologist interpreting a
 > sonogram.  I thought that went without saying.  The "we"
 > refers to all health care professionals.

It "appeared" as if "we" meant all midwifes, which is a trend that has really
been taking off lately.

 > I can read and interpret the english language that is used
 > on the sonogram reports.  You really have got a chip on
 > your shoulder.  I am not suggesting that there be any
 > emnity or competition between medicine and nursing.
 > Radiologists have their thing to do, Sono Techs have
 > theirs, nurses have our thing to do.  Give it a rest.
 >
 > Richard DeWald, BSN Student
 > Univ. of TX - Austin.

No chip Richard, just tired of seeing all the mistakes made by unregistered
scanners, and then being lumped into the same category with them after they
blow a call.  Fortunately, your field has no similar comparison...if it did,
you may have a secretary with no medical background experience whatsoever
performing skills best left to a BSN nurse...this has occurred in our area.
As far as "competition" and "give it a rest" from your previous paragraph, I
was surprised by your response.  No competition from this end...perhaps you
could conclude a little more socialably next time?

Daniel

--  
Uucp: ...{gatech,ames,rutgers}!ncar!asuvax!stjhmc!381!61!Daniel.Hagan



Sat, 01 May 1993 23:36:20 GMT
 
 [ 4 post ] 

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