Just Cut.

This is a response to a thread on an interesting forum. A forum of OB's from around the world who sit around and share "war stories" or ask for opinions from eachother.

So this is what riled my hair today...

This first part is from one OB asking about a case, and what her esteemed peers would do:

I have a good one for y'all to ponder. 23 y.o. primigravida, currently> >at 34 weeks gestational age with twins. Currently weighs 399. EFW at> >31 weeks on both twins was 5 pounds. Cephalic/cephalic presentation.> >During a visit to L&D for false labor, monitoring was essentially> >impossible.> >> >Route of delivery?

So here is one OB, telling the list that she has a 400lb woman with twins, what should she do... (ok, and here is my thing? She do? Do what? Why does she get to choose this person's route of birth? When birth is not even going to happen right now?)

And a response from another esteemed OB:

I would rec. C/S at 36 weeks. If not you will end up doing her at 3 in the morning after a 34 hour labor wit 28 hours of ruptured membranes and get out 2 sick kids. Again, IMHO. This old dog learned one new trick over the years, Vaginal Bypass before labor is the answer. I doesn't matter what the question is. (TIC, at least a little bit)

Alright. So lets look at this....

C/S at 36 weeks: Why? Does she have pre-e? The babies will not even be considered term then!

Doing her at 3 in the morning: Is this implied to prophylactic cut during 9-5 just in case it might be a late night?

After a..... get out 2 sick kids: Can you say ASSUMPTIONS? How does this one man know how this woman's labor will go? Do they hand out crystal balls in med school these days? He has not a single bit of data on this woman, her heath or anything besides her weight. And what grantees that the kids will be sick?

34 hour labor: NOT that uncommon in first time births!

28 hours of ruptured membranes: Why? Are you implying to artificially rupture the membranes? Or assuming that they will rupture on their own.. based on what?

Vaginal bypass: Great term is it not. Is the vagina broken? Does she need permission to use this part of her body?

It does not matter what the question is: ? Too short? cut Too tall? cut Fat? cut Old? cut Too many babies? cut.


Sigh.... This is not the only time I have seen such callous attitudes that if you ask me represent a decent proportion of our obstetrical community. This one person is using his "professional opinion" not based one bit on any hard data about this woman to decide her fate for her.

So when people ask me about my bandwagon. About my cause.... Read the above, you tell me, Why? What is wrong with this woman besides two things that are not even rare, obese and twins.

If you are so interested in such wonderful wisdom of how our bodies are incapable of birth, wonder on over to the board of Gods and Surgeons at OBGYN.net.