CatskillsRN

Hello to all!!!! The big issue is not only Docs and CNMS, but the facts that if a CNM wants to have her own practice w/o having to be w/ a OBGYN then she is fried.. IN NYS the rates are impossible .... Lobby day for Midwifes was April 27th and this issue was brough up as well as the question of Hospital Priviledges and the difference of reimbursment rates for Medicaid for CNM's and OB's guess who is winning the higher rate of reimbursment ....

Hello!!!! the Danburry Doula program is poart of the Danburry Hospital in CT. I know one of them if u r interested to know more.

Hello!! As a mom of a profundly Deaf man (21 yrold) :rolleyes:and as an healthcare provider (RN, DOula, SNM) I have seen a lot od these situations,and from both sides as well. We all sign at home but I have been surprised sometimes by the lack of understanding and awareness from the healthcare sytem of the needs and of the differences of the Deaf community. I am trying to get a better fluency in ASL in order to get closer to my pts and I have seen some MW doulas RN following the same trend. The ideal is of course being fluent in ASL in order to communicate concepts and not only translating verbatim. Sometimes Clients will not even understand what the procedure is, or what the purpose of the procedure will be. There is an association in Az who is trying to provide OB and MW care with professionals trained to work with the Deaf community, I know a CNM in NYS (she is also a certified ASL interpreter) who was giving Childbirth Education to Deaf women in NYC at Seton Birthing center before it closed. I am very proud to say that her and i will be giving a class awareness about Mw profession in a NY deaf school to HS students and she will tlak about her work. I think that whoever has the most remote connection with the deaf community (ASL or not) should really think about starting creating individual or associative connections with some additional training in order to serve the deaf and HOH population. We need you! :uhoh21:

Jee I wish I had kept the Utah newspaper link... it was very neutral and I had read it in a MW list... I think I remember the article saying that MD's were on her case b/c of her refusal of the C/s and this is what lead to the charges anyway.... Yes her drug screen was + and it was probably another factor in the case.. At any rate, the fact of being charged of murder, regardless of the above circumstances, makes me fear consequences on the relation between providers and patients, when the provider thinks that refusing a procedure would endanger the fetus... In this case, the EFM strip, was the argument in favor to advise the c/s, leading the Md to think that the Fetus was in danger. However inumerous studies declare that EFM has not improved fetal mortality and outcomes at birth... how many times have we encountered strips that say that BB is not doing well, when in fact BB is ok at birth? I am not saying that EFM has never predicted fetal distress, what I am saying is that we consider EFM as an Instrument which will dictate accuratly a decision, when in fact there are so any other factors which should help decide for a C/S if necessary

Agreed!!!! but who reported to the DA??

Yes big problems see Presbiterian Hospital in Manhattan, Seton BC in Manhattan etc.... the only way to get out of this misery is to have your own practice, and to fight for hospital priviledges... I know some HB CNM that are just going w/o malpractice insurance period... scary Huh? ============ Some practices have had to close because of the malpractice problems. The ACNM lobbies for better midwife compensation from medicare, etc.. but it is hard to fight other bigger entities. CNM's here provide well-woman care (PAP smears, exams, etc.) as well as pregnancy/birth care. Some become qualified to do more technical gynecological procedures (can't remember which ones they may do at the moment), some also perform as first assists in surgery with the physicians for c-sections. Hospitals vary widely in how much they support normal birth, I would say. It also varies widely from nurse to nurse within a unit. But you should have a good amount of freedom to be supportive with your own patient (anyone correct me if I'm wrong there). It is the goal and philosophy to support normal and non-interventionist births, however some CNM's here have become more interventionist under pressure from patients and/or their practice (i.e. patient demands to be induced, or you have 20 patients waiting back in the office/time constraints, etc...). Some are being called "medwives".

Hi Gals, Just catching the thread, there is no doubt that this woman has serious issues, but is there any way to know whether the fetus would have survived with a C/S? i dont know may be maybe not. The real issue there is, MD pressing charges against a woman obviously not able to understand choices anyway... The second issue is: when this woman is going on trial, if the judge finds her guilty, this is ensuring a new jurisprudence. MD will be able to inforce their decisions on pregnant patients such as VBACS, etc.... scary if you ask me... just my 2 cents

HI Kim, Just go to google and type sexual abuse and labor, you will find a lots of tips and sites as well as papers written on the subject giving you suggestions and why their labor differs sometimes. Doulas and CNM are generally more aware of labor dysfunctions resulting from abuse but as a Psych nurse (I have 2 hats) I can tell that this is the only area that needs to be cared for. Yes Nurses need to be trained and aware of this but its also to the manager to change things. Good luck! Ginny