Relay-Version: version B 2.10 5/3/83; site utzoo.UUCP Posting-Version: version B 2.10.2 9/18/84; site cadre.ARPA Path: utzoo!decvax!genrad!panda!talcott!harvard!seismo!rochester!cmu-cs-pt!cadre!geb From: geb@cadre.ARPA (Gordon E. Banks) Newsgroups: net.med Subject: Re: Psychological Factors Affecting Physical Condition Message-ID: <445@cadre.ARPA> Date: Wed, 5-Jun-85 11:29:58 EDT Article-I.D.: cadre.445 Posted: Wed Jun 5 11:29:58 1985 Date-Received: Thu, 6-Jun-85 23:00:29 EDT References: <1687@aecom.UUCP> <980@cbdkc1.UUCP> <357@unc.UUCP> Reply-To: geb@cadre.ARPA (Gordon E. Banks) Distribution: na Organization: Decision Systems Lab., University of Pittsburgh Lines: 25 > >Delete obstetrics and put it back in the hands of midwives! Or do you think >that a 20-40% c-section rate is "normal"? The c-section rate has little to do with training and much to do with economics and the threat of malpractice if a baby delivered through the canal is damaged. I am all in favor of more midwives. I have worked with them, and with GPs who do home deliveries, and think that both have a place. However, the drastic decrease in maternal mortality during the last 150 years is due to medical obstetrics, not midwives. Maternal deaths were COMMONPLACE in the old days. A properly trained midwife or GP makes an assessment of the likelihood of a complicated delivery and refers such cases to an obstetrician. Even when things look like they will go well, home delivery can be a bad choice. I recall seeing a child with a klumpke's paralysis (paralyzed hand) which occurred during a home delivery. Although the same thing may well have occurred in a hospital delivery, the mother was psychologically devastated and guilt-ridden for having had a home delivery. Maternal psychology is thus a factor to be considered, and is often hard to forsee. G. Banks, M.D.