OBGYNDoc
Minneapolis, MN
Female, 36
I am a practicing Obstetrician and Gynecologist, providing care for women in all stages of life. Approximately half of my practice consists of pregnancy-related care, including routine prenatal care, high risk obstetrics, and delivering babies at all hours of the day. The other half consists of gynecologic care, which ranges from routine annual check-ups to contraception and menopause. I perform many surgeries, including laparoscopies and hysterectomies.
Without becoming too political with this question, I'll simply say no. My responsibility to my patients is to provide them with counseling and the resources available to them when faced with a difficult decision about continuing or terminating a pregnancy. I always support my patients in their decisions. For every pregnant patient, I present the options for genetic screening available. Some people choose to be tested because they are looking for peace of mind, others choose to be tested because they would prefer to be prepared in the event that they are having a child with special needs. Others choose to be tested because they would terminate the pregnancy if there was an abnormality. All are valid options, and I want my patients to feel empowered to make their own decisions based on the education I provide and based on their own personal beliefs.
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I can't imagine how one could do a pap smear on oneself. That being said, I think it is difficult for all physicians to choose the provider for themselves and their family. But, doctors are patients too, and we look for exactly the same traits that everyone else does- intelligence, a good beside manner, and empathy.
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Trained midwives are skilled clinicians who are fully capable of providing care throughout an uncomplicated pregnancy and delivery. I have worked with some outstanding midwives, and I do think they can offer a different approach to pregnancies for patients who desire a more non-interventional approach. When choosing a midwife, be sure that he or she is a Certified Nurse Midwife (in some cultures, the term 'midwife' is applied to a lay person who participates in deliveries but who may not have official training and certification). I would always be sure that your midwife has an affiliation with a physician who will provide emergency coverage in the event that things do not go as expected. For a healthy woman without any major complications during the pregnancy, labor and delivery, a midwife is absolutely capable of providing prenatal care, performing deliveries, and caring for you in your postpartum period. If there are concerns for preterm labor, gestational diabetes, hypertension, multiple gestation or other complicating factors, I would recommend consulting with, and perhaps transferring care to, a physician. Finally, I would always recommend delivering your baby in a hospital or birthing center affiliated with a hospital. I do not support the concept of home births with a midwife.
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I have never had to break the news to someone that she is HIV positive. I have told someone that she has hepatitis C, which in many ways, is a very similar chronic disease. Fortunately, the treatments for HIV and hepatitis C have advanced to the point where people have the potential to live healthy, normal lives despite having the virus. I have taken care of patients with HIV and hepatitis C in pregnancy. If the viral loads are suppressed enough, and if they take their medications as instructed, these patients can go on to have healthy pregnancies without transmitting the infection to their babies.
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Nurse Practitioner
As gender roles continue to evolve, are you seeing a rise in the % of male nurses?
Police Officer
Can I become a cop if I have misdemeanors on my record?
Sommelier
Do you occasionally get a little turned off by wine snobbery?
Approximately half of c-sections are scheduled, mainly for indictions such as a previous cesarean section or breech presentation. The other half consist of unscheduled cesarean sections, for protracted labor, fetal intolerance to labor (fetal distress) or other unpredictable circumstances. So much about labor and delivery is unpredictable, and therefore the mode of delivery is often decided upon after a trial of labor that can last for minutes to hours to days. Because there is often an emergent nature to cesarean sections, I am very thankful for the advances in modern medicine that allow us to perform these lifesaving procedures immediately and safely.
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Most of the time, when a baby is coming out so rapidly that you don't have time to make it to the hospital (or are on an elevator), the delivery will happen on its own without any need for assistance. Maternal instinct takes over, and the mother will begin pushing when the right time comes. Once the head is crowning, just try to support the head and body as it delivers. Look around you for something relatively clean to dry off the baby and to keep the baby warm. Newborn babies are not able to maintain their body temperatures initially and can develop hypothermia very quickly. The best way to keep them warm is to put them directly skin-to-skin on the mother's chest and cover both up with something dry. If you have a shoelace, you could tie off the umbilical cord. Hopefully by then, help will have arrived!
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Yes. In very rare circumstances, a "perimortem" cesarean section can be performed. The decision to proceed with the surgery needs to be made immediately, before the loss of maternal blood flow has caused a lack of oxygen to the fetus. In skilled hands, a baby can be delivered by cesarean section within minutes, which may just allow at least one life to be saved.
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