In response to the epidural questions and the $$$ issue, Kathleen Bruce
responded with the hospital brings in cold hard cash. Not so in a managed
care environment. It is to the hospital's benefit, financially, to have a
laboring woman use a little of any resource as possible. I think the
issue is not standard of care or financial...The issue has to do with the
culture of women giving birth. Some women do not trust their body's
ability to birth a baby without our technology. I feel a sense of sadness
for them as birth can be such a powerful experience. Just so you know. I
am a hospital based, R.N., IBCLC, manager of a Breastfeeding program.
On Tue, 16 Apr 1996, Automatic digest processor wrote:
> There are 9 messages totalling 268 lines in this issue.
>
> Topics of the day:
>
> 1. Conference information
> 2. Persistant Posterior Position
> 3. Would you believe--Epidural comment -Reply
> 4. Epidurals mean $$$
> 5. Urine drinking (non-breastfeeding)
> 6. recalcitrant pediatrician / frenotomy issue
> 7. urine trivia
> 8. community standard???
> 9. LACTNET Digest - 15 Apr 1996 - Special issue
>
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>
>
>
>
> ----------------------------------------------------------------------
>
> Date: Mon, 15 Apr 1996 15:10:22 -0500
> From: Keith and Charlotte Esau <[log in to unmask]>
> Subject: Re: Conference information
>
> >Subject: Conference information
> >Sent: 4/15/96 2:11 PM
> >Received: 4/15/96 2:21 PM
> >From: Sharon Coe IBCLC, [log in to unmask]
> >Reply-To: LACTNET List, [log in to unmask]
> >To: LACTNET List, [log in to unmask]
> >
> >Hi all,
> >
> >I've tried to access the web page on conferences and haven't been able to. I
> >can't decide if this is due to my inexperience with the web or some other
> >problem. I tried http://www.prairienet.org/lli/AreaConf.html that was posted
> >on Lactnet 4/14 but no luc.
> >
> >I'm very interested in getting information about these conferences. I
> >unfortunately couldn't get to one I really wanted to go to last week because
> >I didn't know in time to get my schedule straightened out so that I could.
> >
> >I would appreciate any help I can get.
> >
> >TIA
> >Sharon Coe LVN IBCLC
>
> Sharon,
>
> Try <http://www.prairienet.org/llli/AreaConf.html> instead. :) That will
> take you to a page listing Area La Leche League Conferences. I tried it
> to make sure the address was correct. The address you gave was missing an
> 'l'.
>
> Charlotte Esau, LLLLeader, Olathe, KS USA
>
> ------------------------------
>
> Date: Mon, 15 Apr 1996 17:12:44 -0400
> From: "- Patricia E. Predmore" <[log in to unmask]>
> Subject: Persistant Posterior Position
>
> A few weeks back I posted a queston regarding difficult labors with babe in
> persistant posterior position and poor early nursing. Two of you were kind
> enough to repsond with references (I need them to deal with a pediatrician).
> However, my computer was unkind nd the pots, although once saved on a file,
> are now gone. Please e-mail me privatelyif you were one of the wonderful
> people who responded . I believe Marie was the name of one of you.
>
> I've seen many of these babes nurse poorly in the early hours/days but
> gradually catch on. Anecdotally, we try patience, frequent offerings and
> mroe patience and things usually work out fine. But I need the references
> for the med staff. One of you mentioned mucles that would be involved.
>
> My apologies,
>
> Pat Predmore, RN, BSN, ICCE
>
> ------------------------------
>
> Date: Mon, 15 Apr 1996 18:47:19 -0400
> From: "Mickey Gillmor-Kahn, CNM" <[log in to unmask]>
> Subject: Re: Would you believe--Epidural comment -Reply
>
> The reason anesthesiologists care if women are choosing not to have
> epidurals has to do with the fee for service nature of medical practice. If
> women don't want them, they can't collect their fees. OB anesthesia is a
> BIG money maker.
>
> In teaching hospitals, they want to teach, so even if they're not paid fee
> for service they want more to do. And even in teaching hospitals, the MDs
> are usually supported by the fees they generate by doing procedures.
>
> And if some people believe that epidurals aren't the greatest thing since
> sliced bread, then the anesthesiologists might have to recognize that this
> procedure isn't all it's cracked up to be.
>
> It's a sad world.
>
> Mickey Gillmor, CNM
> Atlanta, GA
> [log in to unmask]
>
> ------------------------------
>
> Date: Mon, 15 Apr 1996 19:25:01 -0400
> From: Kathleen Bruce <[log in to unmask]>
> Subject: Epidurals mean $$$
>
> Margery, dear Margery, for every epidural, there is COLD HARD CASH coming
> into the hospital. They CHARGE for this, and for the accompanying IV, and
> medications..and, etc etc etc. Not to mention that anesthesiologists make
> money when they work, ie when they give anesthesia. When you think about
> it, anesthesia for laboring women is a big cash producer, is it not?
>
> THAT is one reason they get upset when people like you discourage moms from
> taking the "standard" treatment of anesthesia during labor. They lose out.
> Standard of care my eye.
>
> I heard a story from a CNM friend of mine, who worked in a hospital where a
> large portion of the clients were Hispanic and poor. The women would be
> wheeled down the hall, with the head of the baby crowning, and they would
> have an anesthesiologist slip in an epidural...an extra $600 on the
> bill..and frequently the women didn't need it or want it.
>
> This is not the norm, I am sure.There are many honest and wonderful
> anesthesiologists. But, we need to know that things like thiscan and do
> happen. Call me cynical but realistic. My apologies if I have offended... I
> am not against anesthesiologists in general. All specialties have their
> place. However, at times, one could question the motive.
>
> Sad. Kathleen
>
> Kathleen B. Bruce, BSN, IBCLC, LLLeader, co-owner Lactnet, LLLOL, Corgi-L
> LACTNET WWW site: http://www.mcs.com/~auerbach/lactation.html
>
> ------------------------------
>
> Date: Mon, 15 Apr 1996 19:19:42 -0700
> From: Arly Helm <[log in to unmask]>
> Subject: Re: Urine drinking (non-breastfeeding)
>
> urine is also supposed to be
> >good on the feet to cure blisters!
>
> That makes a lot more sense than drinking it.
>
> He explains that there is a large amount
> >of melatonin, from the pineal gland, in urine... - and he says that
> >scientists are attempting to use it to
> >develop a drug to help with jet-lag.
>
> I suspect the melatonin being used in research and sold in food stores did
> not originate from anyone's urine, although I admit I don't know what the
> source(s) is(are).
>
>
> Arly Helm [log in to unmask]
>
> ------------------------------
>
> Date: Mon, 15 Apr 1996 19:33:06 -0700
> From: Arly Helm <[log in to unmask]>
> Subject: Re: recalcitrant pediatrician / frenotomy issue
>
> > I can't
> >figure it out, we have circumcisions being performed at abounding rates in
> >hospitals and yet practically no one will do a frenotomy!
>
> Just tie the baby in the restraints on the circumcision table upside-down,
> maybe he'll get a frenotomy instead!
>
>
> (Don't mean to make fun at baby's expense, but one has to have a sense of
> humor here.)
>
> Arly Helm [log in to unmask]
>
> ------------------------------
>
> Date: Mon, 15 Apr 1996 22:20:00 -0400
> From: Margery Wilson <[log in to unmask]>
> Subject: urine trivia
>
> And medical trivia: barbiturates got their name because the
> researcher obtained the urine to make the initial batch from a
> woman named Barbara.
>
> No kidding.
>
> Margery Wilson, IBCLC
> Massachusetts Institute of Technology
> I work in same building with Dr. Wurtman, who I noticed was
> referenced for his work with pineal gland. He is currently
> marketing melatonin...I'll have to ask where he gets the
> ingredients...
>
> ------------------------------
>
> Date: Mon, 15 Apr 1996 23:11:40 -0400
> From: "Linda J. Smith, BSE, FACCE, IBCLC" <[log in to unmask]>
> Subject: Re: community standard???
>
> Marie Davis, now I've heard everything!
> And Margery: the anesthesiologists are coming from... THE BANK. Why else
> would they be so eager to sell their wares?
>
> Epidurals, the "community standard?" HA! If they were standard, all women
> would have little holes in their back ready for the tube delivering the drug.
> Maybe that wouldn't be bad for when we sit on hard seats for hours in
> classrooms, offices, etc. Wonder how we'd keep the water out when swimming?
>
> If epidurals are "standard" now, we could likewise say that "twilight sleep"
> (morphine plus scopalomine -a hallucinogen) was standard,
> saddleblocks-with-forceps was standard, and "knock em out" was standard too.
> The actual "standard" around the world is an unmedicated home birth with a
> traditional birth attendant.
>
> Hiding the risks happens here, too - at the military base hospital the
> anesthesiology residents ply their trade in the maternity clinic waiting
> room. Only this time, they're trying to line up teaching materials - er, I
> mean "patients" - so they can meet their monthly quota of pregnant women to
> anesthetize, and move on to something more exciting. I know they need to
> learn, blah blah blah. Surely there's another way.
>
> I better stop before I get carried away but not without one final word:
> BALDERDASH! (Hmm, maybe dads should have the epidural as "standard" to
> prevent the intense sensations experienced during the activities surrounding
> conception?)
>
> Linda Smith, BSE, FACCE, IBCLC with dictionary in hand to define "standard."
> Dayton OH where the daffodils are FINALLY blooming!
>
> ------------------------------
>
> Date: Mon, 15 Apr 1996 23:45:55 -0400
> From: "Ellen Kadden, M.A., IBCLC" <[log in to unmask]>
> Subject: Re: LACTNET Digest - 15 Apr 1996 - Special issue
>
> I have been lurking for quite a while now, with a brief break when our
> first(brand new) computer was stolen. Now we are up and on-line again, and I
> am at least computer literate enough to type out a message.
> My name is Ellen Kadden and I have a small private practice and large
> rental depot in Fairfield CT.. I have just begun working with Medela in a
> corporate setting, also, a job that I share with another LC. I have been a
> LLL leader for 12 years, a rental depot for almost 10 years, and IBCLC for 6.
> My major claim to fame is that my now 10-year-old Peter was a 720-gram
> premie, totally breastfed and wonderfully healthy and bright. You can see
> his pix on the front cover of Marsha Walkers' pamphlet and the LC series on
> premies.
> A few comments I must make:
> 1. My 16-year-old daughter wants to sign up for COLIC and specialize in
> answering machine messages-both recording and explaining to ones' friends.
> 2. I have a masters degree in special education and 8 years of
> experience in that field. I have taught kids with Down Syndrome to read. I
> certainly can teach mothers to breastfeed. In this part of the country I am
> not deemed qualified to work in a hospital or doctor's office without the RN.
> BUT I DON'T WANT TO BE A NURSE! (yes, I am shouting-sorry) Today I heard
> about a local doctor's office that is sending an LPN to a 40-hour course so
> she can beome their LC. (yes-they know me)
> Change does not happen quickly in New England, and I'm having to keep my
> options open as far as going back to the classroom when my kids get older.
> O-my kids-Sarah is 16, a junior in high school, wants to be a physical
> therapist, loves figure skating (watching) and is lucky enough to have a mom
> who also enjoys it so she gets to go to all kinds of neat places like
> Edmonton last month to see the World Figure Skating Championships (it is very
> cold there. but very friendly) My idea of a really great time would be if I
> got to go to a skating competition and then a Breastfeeding conference!
> You've heard about Peter who is now in the fourth grade and plays violin
> and piano and loves classical music. In between is David who is 13, plays
> oboe and getting more and more involved in karate. He is very shy, loves to
> sail and swim, and wants to be a writer, I think.
> My husband Jack commutes to NYC and works as a Metro Editor for the New
> York Times. Whenever you hear about something weird happening in Long
> Island, he is responsible for the coverage, and doesn't get home until really
> late. He has helped me breastfeed all three of the children for extended
> periods by trusting my parenting instincts-not always the easiest thing to
> do, especially in this culture.
> I am all caught up on Lactnet, and do enjoy the discussions and use many
> of them as references in my work. I especially enjoy the politics (the
> discussions, not the reality) and the cultural/anthropological stuff.
> Also just returned from a day at Baystate listening to Alan Lucas and
> Paula Meier speak on premies. It"s too late to get into that now
> Thanks for the great late-night reading
> Ellen in CT where we might be finished with snow-maybe
>
> ------------------------------
>
> End of LACTNET Digest - 15 Apr 1996
> ***********************************
>
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