<<"I do see everyone on the L/D floor when I am on call, even if they are
hoping for an unmedicated birth, are antepartum patients, etc., because I
want to at least know what their airway looks like in case of an emergency,
and I certainly talk about" epidurals then if they are interested.">>

Can you imagine if everyone who drove a car had to submit to this
examination? If there were a motor vehicle collision, (and there are far
more people driving and having MVCs than women giving birth, and it is far
more sudden, and disasterous) how on earth would an anesthesia department
manage?

We have a similar argument about VBAC deliveries. "We induce VBACs because
if you were to deliver when the surgical/anesthesia staff is not at the
facility, if there were an emergency, you would not be covered." I always
retort with the thought that if I were in an MVC, "after hours," (not
between 9am and 5pm) I would hope they would transport me to a facility that
could manage an emergency!

This thought sets people up for the panic environment, where they are forced
to make an unnecessary decision. It feels like the "if your baby doesn't
gain x ounces, you MUST give her formula!"

Oh, and here's a local story... There is a new "hyperbilirubin visit" at one
of our local hospitals. The mother/parents are required to bring the newborn
back to the hospital for a mandatory bilirubin exam. However, it is ONLY the
BREASTFEEDING mothers who are required to make this extra visit. While I
understand the need to make sure a baby is breastfeeding well, why is this
check not done BEFORE the baby leaves the hospital, and why are we not
checking the formula-feeding parents for lack of parenting resources
(leaving the child in the car seat all day, not changing diapers, bottle
propping...)

Nothing like a family holiday to make you cranky!

Best wishes,
Sam doak

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