What do single women think of a male OB/GYN?

[jwk]

Sweet Tea, I was referring to childbirth in hospitals, not childbirth in general.
to say it in the words of a native English speaker (Claire T. Porter)who thinks the same about it as I do: "As with all types of abuse, competitions among individuals or groups to determine who has been abused the most and the worst derail the discussion and diminish more nuanced understandings about the nature of the abuse."

Ah, so only childbirth in hospitals is rape. Childbirth at home is a beautiful, wonderful experience - unless mom or baby die in the process.

Did you EVEN pay attention to the previous post about what rape REALLY is? That shouldn't be difficult to understand in any language. Rape is NOT childbirth, or a pelvic exam, or simply putting your legs in stirrups.

And as far as home childbirth - it's just like pap smears and pelvics. It's your body - do what you want. I've never understood why fairly intelligent people want to put themselves and their newborn at risk by birthing them at home, but I guess that's their/your right, dumb as it is in this day and time.

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[Global Disrobal]

So how about that residency program in New York? Have you registered for the Match yet?

Oooops. I thought this was the OB-GYN Residency Forum. My error! I guess I must have wondered into the Social Gynecology forum by mistake.

Good evening everyone!

This shiznit is classsssic...

 

[Janice]

Pain with a pelvic exam? I've had at least 10-12 in my lifetime and have NEVER experienced pain! Discomfort....maybe. But I understand that anytime an object is inserted into my vagina up to the cervix, it's not going to be an orgasmic experience! Virgins undergoing the exam? Make up your mind! Approximately 9 out of 10 times you respond on here, it's to emphatically claim that virgins shouldn't even be OFFERED the exam, much less have one! According to you, gynecologists shouldn't even be allowed within 500 yards of them! The 'mentality' of my PREFERRED MALE OB/GYN stinks so badly that I continue to go back to him year after year after year.... Geez, he forces me to make my appt. and if I don't show up by God, he finds me, and kicking and screaming I am forced into his stirrups so he can have his way with me! The 'male doctor' isn't doing women favors by performing an exam she doesn't want or need? I supposed only the 'female kind' are capable of that! For God's sake, lady, if you don't want annual exams then by all means sit at home and rot in peace by yourself! Self treat your UTI's, yeast infections, ovarian CA, endometriosis, etc.! Nobody here gives a damn what you do, as long as you don't do it in their office or hospital! You/Asherah, have thrown around the rape word more than I can bear. Have either of you ever been TRULY raped? Ever been thrown down, had a hand cover your mouth to muffle the screams, had your clothes ripped off of you? Have you ever had to endure lying beneath a 200lb man, sweating and groaning and clawing at your body like some wild animal? Ever had anybody hold your wrists together so tightly you thought they would break, and then have a penis shoved into you over and over again? If not then you need to shut the f**k up! You have no clue as to what it's like to be truly raped unless you have been the victim of what I have described above! I don't consider having a doctor put two fingers into my vagina during an examination that I initiated invasive, sexual, or brutal! Instead of spending your precious time at the local bowling alley or surfing the web to find a bunch of nutjobs to claim that giving birth was comparable with rape, perhaps it would be more meaningful to go to your local bookstore and buy a book about womens healthcare and obtain at least SOME smidgen of knowledge about this subject of which you so righteously proclaim to know so much about! Otherwise, let this thread die in peace, and spare the rest of us from your obscene, warped, and psychotic opinions! And do yourself a favor. Find a qualified therapist who is capable of prescribing you with some high doses of Haldol, Lithium, or Prozac! I assure you, you need it!!!!
May you rot in peace Janice!!!

You're talking loud and not saying too much. Doctors are NOTdoing women a favor giving an exam they don't want. Virgins with no problems DON'T need them exams, etc, and anything else I said. You don't have to believe jack that I've said. Just because you have not had any pain with the exam, doesn't mean somebody else hasn't. I hear women talk about the pain and discomfort with the exams all the time.

And not all cases of rape is based on strong arm violence. Ever heard of the date rape pill? That allows them to bypass the struggle stage. Another thing, rape is rape, whether it was violent where the victim was beat up, or whether she got the date rape pill slipped into her drink. It doesn't matter as she is just as upset. So don't be stupid and limit rape to being beat up and held down. That's the typical male sterotype of a rape victim. I don't need to be raped to state my opinions on this board. Glad that's not the case. If you have been brutally raped in life, I am not glad to hear that, although it does not change my argument about the gyn exam and abuses of it. You and others like you need to quit putting every woman in the cancer boat. Not every woman who doesn't do yearly paps, is going to have cancer of the cervix. Because not everybody is going to have the same thing in life. That's a fact that scientifics can't explain. Neither can the medical establishment. Since you've been so brutally raped, perhaps you would benefit from the Haldol, Lithium, or Prozac. I for one, don't need it.

One other thing, UTI's and yeast infections are at least self treatable.

 

[Global Disrobal]

Coincidentally Janice, how does one self-treat a UTI (short of crossing the border)?

Last I checked Cranberry juice can only go so far...

 

[Oats]

I'm not the one that looks stupid Janice. Look in the mirror. I'm well aware that there are date rape drugs. Somehow I knew you would come back and teach all of us about rape, so whatever. I've dealt with more of them than you ever will. We still have a better understanding of it's definition than you though. Along with everything else I might add. I never claimed to be a rape victim so don't you dare put words into my mouth. Stupid??? Me??? That's a joke considering who it's coming from. And I still urge you to seek therapy. You need it more and more with each post. Was that 'calm' enough for you Janice?

 

[Sweet Tea]

Virgins with no problems DON'T need them exams, etc, and anything else I said..

Funny, I never would have known I had a problem had I not had a Pap smear. As a virgin.

How on earth are you going to treat a UTI at home? Do you particularly enjoy kidney infections? Craberry juice and lots of water will only go so far, and Azo (or Uristat) only makes you feel better...it doesn't actually do anything to get rid of the infection.

 

[neilc]

You and others like you need to quit putting every woman in the cancer boat. Not every woman who doesn't do yearly paps, is going to have cancer of the cervix.

nope, not everyone that skips the pap will get cancer. but, that sure would suck to be one of the few that suffers from this terrible illness, that can be effectively treated if caught early, simply because you (an undereducated buffoon, by all accounts, no less) tell people that it is an unneccesary and useless exam.

if you don't want it, don't get it. but, the exam has dramatically reduced the incidence of a terrible, deadly disease. ignoring that fact is just ignorant.

again...try to get this through your thick, empty skull...nobody is forcing you or anyone else to get annual exams! however, this exam is proven to be beneficial to women's health! you are right in saying not everyone will get cancer of the cervix. but, SOMEBODY will...and, that somebody could be you (even if nobody will have sex with you) or somebody that you love, or anyone else.

i may not get prostate carcinoma. i sure don't like a finger in my butt. i may not get colon cancer. i also don't want some 3 foot long flexible tube in my rear end. but, if these tests will enable me to take control of my health, and perhaps catch a disease early, and enable me to be cured, i will suffer through them. and, i will not regret it for one minute, even if i turn out to be healthy and cancer free for ever...

so, please janice and freinds...wake up....stay far, far away from the ob/gyn if you want. but, to sit hear and state that these exams are worthless is a stupid thing. they may be worthless to you, but to the thousands of women that are alive today because the caught the cancer early and beat it they are not so worthless.

 

[IdiotBoxen]

Pure comedy platinum (yes, it's improved from the gold standard!).

Do you have any idea how serious a UTI can get if left untreated? That crap you get at the health store with some ingredient in it never subjected to scientific scrutiny ain't going to help you when you've destroyed your kidneys. And you're going to have such fun when the radiologist has to visualise your ureters and kidneys with a dye...

I've never forced anyone to have a pelvic. I can strongly advise them to have one, but if they don't want it. Fine. Sign the papers and don't let the door hit you ass on the way out.

There is no way of knowing which patient will get which disease. (I'm sure my attending is hiding that crystal ball somewhere in his office!). If you can predict this, please ring the Nobel committee, i'm sure they'd love to hear from you.

Lastly, i'm only a MSIV, but i've delivered a few babies. Describing this as rape is the oddest thing i've ever heard. We let those women have safe pregnancies, delivered healthy babies and looked after mother/baby after birth. Saying it is rape cheapens rape immensely as the horrible crime it is.

 

[GeddyLee]

I just have one question here for Janice.

Who are the women that are being forced to have the exam? I've never heard of this happening. I guess women are being dragged to the Ob/Gyn and then strapped to the examination table? Hell, most of the women that visit the GYN make their appointments voluntarily. I could see your "rape" argument if they were being forced into the exam, or drugged and then given the exam. But consent is always given for the pelvic exam, or any other exam for that matter.

You make the most idiotic argument I've ever heard. Doctors' offices are overflowing with patients who are there on their own free will, who are we forcing into exams rooms?

Virgins with no problems DON'T need them exams

hmmm. Them exams?

I's ain't gwine offer them virgins no exams heah in da private areas...no sir.

 

[Heliums]

I would like to point out if you look at some population pyramids of different countries where women are provided medical birthing care the survival rate is higher than countries which do not provided this type of care. Medical birthing care has increased the life expectancy of women. That is a fact period, not even debatable. Perhaps doctors became tried of their wives and infants dying during childbirth and wanted to do something to improve their survival rate. Yes, medicine was male dominated at the time certain protocols were instrumented but how can you say that these male doctors did not have a genuine interest in saving the lives of women. Please note that male doctors have wives and daughters which I am sure they want to survive during childbirth. They were not trying to control women they just wanted the women that they loved to live and not die during childbirth.

 

[Pekin74]

Doctors (for the most part, 99% of the time) don't do what they do because they want to dominate you. Your vagina isn't that interesting; especially when they *have* to see 35+ a day. They're actually pretty nasty.

I'm a 30 year old man.
I don't want to condemn male gynecologists in general because I know some women are actually more comfortable with them than with female doctors. But only an i d i o t can say that vagians are nasty. This shows clearly the "respect" you have for women and their privacy. I'm dreading the possibility of my girlfriend being examined by a doctor like you.
No, not all gynecoligists are perverts. But some of them are. A friend of mine could tell you. So stop keep on repeating that Janice is talking nonsense. Maybe she is exagerating in many ways. But young women often feel scared and embarrassed about this intimate procedure. They require understanding and very sensitive approach. You should know it best as a doctor. And you come here and say that nobody is interested in girls' vaginas because they are quite nasty!!! What a horror it must be for you to look at them!!!!

 

[Drakensoul]

Doctors (for the most part, 99% of the time) don't do what they do because they want to dominate you. Your vagina isn't that interesting; especially when they *have* to see 35+ a day. They're actually pretty nasty.

I'm a 30 year old man.
I don't want to condemn male gynecologists in general because I know some women are actually more comfortable with them than with female doctors. But only an i d i o t can say that vagians are nasty. This shows clearly the "respect" you have for women and their privacy. I'm dreading the possibility of my girlfriend being examined by a doctor like you.
No, not all gynecoligists are perverts. But some of them are. A friend of mine could tell you. So stop keep on repeating that Janice is talking nonsense. Maybe she is exagerating in many ways. But young women often feel scared and embarrassed about this intimate procedure. They require understanding and very sensitive approach. You should know it best as a doctor. And you come here and say that nobody is interested in girls' vaginas because they are quite nasty!!! What a horror it must be for you to look at them!!!!

Too bad you didn't read my other posts in which I've pointed out numerous times that the idea that people come to a forum and expect everyone to act as if they're in a clinical setting is ludicrous. I'm not your girlfriend's doctor. I'm not your doctor. No one on here knows who I am, and I can discuss any issue I wish in however a manner I choose, and it in no way reflects how I conduct myself in person. At all. In any way. Absolutely zero. So, please, the next time you feel the need to point out to someone what a horrible physician they must be because of an -anonymous post- they make on an online forum, save it. Shove it. Do whatever you want with it, but don't bother throwing it at the person.

I never once said that 'nobody is interested in girls' vaginas because they are quite nasty!!!.' That's the thing about forum posts: they're free to contain opinion. I'm a gay male; yes, I find the vagina quite nasty from a sexual mindset, which is what was being discussed throughout. Are doctors rapists: Are they 'getting off' on giving a pelvic. I don't need to view the vagina as a beautiful work of art to want to give healthcare to women, and I certainly haven't compromised anyone's 'privacy.' At all.

Thanks for taking the time to register and make a pointless post and call me an 'I D I O T,' though. That's much better and more mature. What's with all these 'new' *coughcough* people registering and heading straight to the OB/GYN forums to continue these ******ed topics? Give me a break.

You don't know anything about my "understanding" or "sensitivity," it's just easier to try and slam someone by saying they must make an awful <insert profession here> than to actually come up with something meaningful to say.

Thanks!

 

[Sweet Tea]

Pekin74--

It's not just that Janice/asherah is saying "some male gynos are perverts". I think everyone here is willing to accept that some male gynos are perverts, as are some teachers, priests, plumbers, politicians, and rock stars. She is making broad, sweeping statements saying that ALL male gynos are perverts, that NONE of them know how to treat women, and that NO women would want to be examined by a male gynecologist. She also states that the Pap smear is a worthless exam unless you're having sex. Clearly, it's not a worthless exam. While most cases of cervical cancer are associated with HPV which is a sexually transmitted virus, not all cases of cervical cancer are caused by HPV. There have been enough cases of cervical cancer in virgins to recommend Pap smears in every woman above the age of 18.

Janice/asherah, just like every other woman, has every right to refuse to have a Pap smear for whatever reason. No one is fighting her on that point. No one can force a woman to have a Pap smear; physicians can only strongly recommend it. She also has every right to request a female physician if she does decide that she needs a Pap. What angers people about Janice/asherah is that she insists that every woman feels the same as she does, and she refuses to believe that not all women will make the same choices for their bodies as she does.

Personally, I see my gynecologist every year. It's not fun. I don't enjoy it. But I also don't enjoy going to the dentist or paying my taxes. However, if I don't go to the dentist, I run the risk of having cavities that get so bad that I have to have my teeth removed, if I don't pay my taxes the IRS is going to be really unhappy with me, and if I don't go to the gynecologist then I run the risk of dying from undiagnosed cervical cancer. I can put up with a few minutes of discomfort a year in order to protect myself. If Janice/asherah doesn't want to do that, fine. It's her body.

No one here or anywhere else is going to examine Janice/asherah if she doesn't want to be examined. Period. She just needs to stop spouting "medical facts" on a residency board, and she needs to stop insulting male gynecologists who actually want to help women.

 

[ayndim]

I would like to point out if you look at some population pyramids of different countries where women are provided medical birthing care the survival rate is higher than countries which do not provided this type of care. Medical birthing care has increased the life expectancy of women. That is a fact period, not even debatable. Perhaps doctors became tried of their wives and infants dying during childbirth and wanted to do something to improve their survival rate. Yes, medicine was male dominated at the time certain protocols were instrumented but how can you say that these male doctors did not have a genuine interest in saving the lives of women. Please note that male doctors have wives and daughters which I am sure they want to survive during childbirth. They were not trying to control women they just wanted the women that they loved to live and not die during childbirth.

While I am not against the yearly exam and I have one every year with a female CNM, I am going to burst your bubble about the doctors and childbirth. In countries where midwives are used for most prenatal care, delivery and postpartum check up, the infant mortality rates are lower, as are the maternal mortality rates. Do a search if you don't believe me. The US ranks 39 or 40 in infant mortality for the year 2003. And in the US, when using only low risk pg stats, the cnm still outperforms MD/DO's in that area. Don't take this as I believe we don't need MD/DO's obs. They are very necessary for gyn onc and high risk pgs or when a section is truly needed. But I think they need some lessons on managing low risk moms. Of course, some of the interventions are driven by fear of malpractice suits. Hope that midwifery does not head in the same direction here.

As for the whole female/male debate, I think it is the individuals choice. I choose a female because of being a rape survivor. But it is not the same thing as a pelvic. However, having a male is tense (hence very uncomfortable exam) and brings back too much for me. Plus, even if I preferred a male I love the care a CNM provides. I think I have posted it before. A pelvic is not the same as rape. I had a pelvic one time with a male (er room) and while it was uncomfortable physically and emotionally it was no where near rape. And childbirth was certainly no where near that, even in a hospital. Then again I had my CNM, my nurse and my husband in there and no one else (except a female student nurse with #2). Of course, if you are uncomfortable having males, students or anyone else in there you should let your dr/cnm and/or nurse now. I have never heard of a mom's wishes not being respected. With my 1st I had to have peds in because of some meconium stained fluid. My nurse asked for them to send all female if possible and they did (this is one time I would not have refused a male in the room because my discomfort comes secondary to my child's well being.

Sorry for any typos but I am once again attached to a nursing baby.

 

[Heliums]

While I am not against the yearly exam and I have one every year with a female CNM, I am going to burst your bubble about the doctors and childbirth. In countries where midwives are used for most prenatal care, delivery and postpartum check up, the infant mortality rates are lower, as are the maternal mortality rates. Do a search if you don't believe me. The US ranks 39 or 40 in infant mortality for the year 2003. And in the US, when using only low risk pg stats, the cnm still outperforms MD/DO's in that area. Don't take this as I believe we don't need MD/DO's obs. They are very necessary for gyn onc and high risk pgs or when a section is truly needed. But I think they need some lessons on managing low risk moms. Of course, some of the interventions are driven by fear of malpractice suits. Hope that midwifery does not head in the same direction here.

Sorry for any typos but I am once again attached to a nursing baby.

Damn you for making me do research! Okay, The country of United Arab Emerits population pyramid has been shaped by decreased life expectancy due to death of women during childbirth. (in population pyramids women are on the right and men are on the left). The reason why I have noted this particular country is because women rely solely on midwives during childbirth. Due to cultural constraints (which I neither condone nor condemn it is their culture) women can not become doctors so they must use midwives. Men are not allowed to medically treat women during childbirth. Thus it has been documented that women without proper medical care during childbirth run a higher risk and do suffer a shorter life expectancy due to complications that arise during childbirth. Please note that this country is unique in relying solely upon midwives for childbirth. Midwives may be useful in some situation but when complications arise they do not have adequate medical training. This is truly a male dominated country in as far as they are letting women die during childbirth at alarming rates that actually affect their population demographics. When a country loves and appreciates its women they try to address their unique needs. As I have stated previously when medicine was dominated by males they did try to address the needs of women because they appreciated them. You may not agree with certain medical protocols but at least you have the choice to choose.

 

[ayndim]

Damn you for making me do research! Okay, The country of United Arab Emerits population pyramid has been shaped by decreased life expectancy due to death of women during childbirth. (in population pyramids women are on the right and men are on the left). The reason why I have noted this particular country is because women rely solely on midwives during childbirth. Due to cultural constraints (which I neither condone nor condemn it is their culture) women can not become doctors so they must use midwives. Men are not allowed to medically treat women during childbirth. Thus it has been documented that women without proper medical care during childbirth run a higher risk and do suffer a shorter life expectancy due to complications that arise during childbirth. Please note that this country is unique in relying solely upon midwives for childbirth. Midwives may be useful in some situation but when complications arise they do not have adequate medical training. This is truly a male dominated country in as far as they are letting women die during childbirth at alarming rates that actually affect their population demographics. When a country loves and appreciates its women they try to address their unique needs. As I have stated previously when medicine was dominated by they did try to address the needs to women because they appreciated them. You may not agree with certain medical protocols but at least you have the choice to choose.

I am talking about midwives with medical (nursing) training who are RN's with masters in midwifery not lay midwives. Look at the Scandinavian countries. Having a baby with only a mw (no matter the training) and no dr backup is insane. Sends shivers right down my spine.

Drs are absolutely necessary. A CNM is a good option for a low risk pg and delivery. But not everyone is low risk. And although the c-section rate in the US is too high sometimes it is necessary for a section. A CNM who thinks she doesn't need Dr backup is a tragedy waiting to happen. As a future CNM (ob/gyn dr is not for me) I absolutely want a dr backup when a situation is beyond my scope or knowledge. My CNM practices with 4 other cnms, 3 ob/gyn's and 1 gyn. The dr is just a call away. It is in the countries where midwifery is the normal for low risk and with Dr back up that have the low rates.

With the malpractice rates rising and ob's declining, I think that we will see more low risk pts seeing cnms and saving the drs for the more high risk pts. It is even better when there are practices with both. I think most nurses, whether AP or RN's know when they are in over there head and will call for a Dr. Certainly a cnm (I don't really like the idea of lay midwives myself) doesn't have the education of a Dr. and would never presume to know as much. But I do think they are completely competent to handle low risk situations. I guess in the end the seeing a CNM would be considered receiving proper prenatal care and medical attention.

Okay I am rambling and am totally burned out from studying so much. Hopefully you can understand my post (even nursing students have to study their a**es off. Never mind I pulled 16 credits in the summer and one class was half the normal length but all the material. All A's so far. ) But it sounds like we are agreeing here. Drs are necessary but CNM's are great for low risk pts, with proper backup.

 

[drbizzaro]

there are some girls (who have never been touched down there by another guy before), who have stated that they have been aroused by the touching of a male gyn...

 

[ayndim]

there are some girls (who have never been touched down there by another guy before), who have stated that they have been aroused by the touching of a male gyn...

BS, BS, BS

Are you going to be aroused if I am doing a vasectomy on you. Probably more like terrified since I am not a doc. I am assuming you are a man because a women would never believe that or repeat it.

Truly there is nothing less arousing than having duck bill put up your vagina, opened up and having your cervix scraped. Oh fun I can have a big O just thinking about it. Oh yeah and having a dr/cnm/pa put two fingers up there (especially a turn on if you are a virgin. What a lovely stretching feeling) and push down on you uterus. And even better if you are in a fertile period and your cervix is high. I think you have found a new form of foreplay (okay well some sicko probably is doing that already). Can't wait for my husband to get home from working out of town so we can try it out. Oh such fun.

Truthfully most women need their clitoris stimulated and I have yet to have a pelvic/pap do that. Now a man having a rectal with a female doc. I can see that one. And yes I have had half a bottle of a really good bordeaux.

 

[Drakensoul]

BS, BS, BS

Are you going to be aroused if I am doing a vasectomy on you. Probably more like terrified since I am not a doc. I am assuming you are a man because a women would never believe that or repeat it.

Truly there is nothing less arousing than having duck bill put up your vagina, opened up and having your cervix scraped. Oh fun I can have a big O just thinking about it. Oh yeah and having a dr/cnm/pa put two fingers up there (especially a turn on if you are a virgin. What a lovely stretching feeling) and push down on you uterus. And even better if you are in a fertile period and your cervix is high. I think you have found a new form of foreplay (okay well some sicko probably is doing that already). Can't wait for my husband to get home from working out of town so we can try it out. Oh such fun.

Truthfully most women need their clitoris stimulated and I have yet to have a pelvic/pap do that. Now a man having a rectal with a female doc. I can see that one. And yes I have had half a bottle of a really good bordeaux.

ROFL I can't wait for my rectal, now. Such hype you have created!

 

[concord]

I am a male third year med student and I love OB/GYN.
Why you ask? Am I a perv?
It is sad that this is even an issue, I could understand if it was coming from the general population of women.
To Start, most of medicine involves seeing naked people in compromising positions. A female in family practice, internal med, and Gastoenterology, will most likely stick something up a mans anus on a daily basis many times there fingers. What about a female family doc checking for hernias should no women ever get to do a complete physical because they might enjoy fondling testicles. Of course not I a just starting by making a point.
OB/GYN is MEDICINE and an incredibly interesting, exciting, and fulfilling specialty. There is no other specialty that one decision can effect 140 years of life the young mother and the fetus. Where a doctor can be part of the single most important part of being alive, to bring another human into this world. How about being able to get to know your patients and their family, especially if you have delivered several of their children and be a surgeon at the same time (and not just c-sec) hysterectomies, myommectomies, tubal ligations, tuoplasties, ect?
On my rotation I have only come across a few pts who requested a man and 95% were Muslim.
OB/GYN is a treacherous residency and a hard life style after, If we left the profession for women to do it would suffer greatly! Not because women could not do a great job, but because not only would the number of ob/docs dwindle but so would the number of maternal fetal medicine specialists, gyn oncology, gyn reconstructive surgery, reproductive endocrinologists?. Do you see where I am going with this?
IN CLOSING SORRY LADIES, BUT MEN FIND YOUR PHYSIOLOGY AND YOUR ABILITY TO REPRODUCE INTERESTING AND WE DON?T WANT YOU OR YOUR FETUS TO DIE DURING A ECLAMPTIC EPISODE OR FOR YOU TO BECOME STERIL DUE TO RECURENT PID! I AM SORRY WE FEEL THAT WAY US MEN ARE SUCH JERKS!

 

[on_the_fence]

I am all for males going into OB/GYN. I have had two males OB/GYNs (not b/c I have anything against females) -- one of them was a little too touchy feely, spending like 5-10 minutes per breast during annual exams. My current OB/GYN is awesome -- I have never felt uncomfortable during exams. There is no reason that being a male should keep you from becoming an OB/GYN -- do what you love b/c you'll do it better than something you don't.

 

[on_the_fence]

Doctors (for the most part, 99% of the time) don't do what they do because they want to dominate you. Your vagina isn't that interesting; especially when they *have* to see 35+ a day. They're actually pretty nasty.

I'm a 30 year old man.
I don't want to condemn male gynecologists in general because I know some women are actually more comfortable with them than with female doctors. But only an i d i o t can say that vagians are nasty. This shows clearly the "respect" you have for women and their privacy. I'm dreading the possibility of my girlfriend being examined by a doctor like you.

I am sure that there are days when a doc sees a "nasty" vagina -- it is the same idea as going to the dentist. Do you open up and go "Ahh..." after you just ate a bunch of garlic? No, you brush your teeth. So do you go to the gynecologist all smelly and unwashed? No, you freshen up. I am sure there are women out there who have rather unsightly vaginas, and I would guess that ob/gyns notice the difference between ppl who care about hygiene and those who don't...

So as long as your gf keeps herself tidy, you have nothing to dread. And it's not like the doc would say anything about it if she didn't -- so you'd never know.

 

[asherah]

Doctors (for the most part, 99% of the time) don't do what they do because they want to dominate you. Your vagina isn't that interesting; especially when they *have* to see 35+ a day. They're actually pretty nasty.

I'm a 30 year old man.
I don't want to condemn male gynecologists in general because I know some women are actually more comfortable with them than with female doctors. But only an i d i o t can say that vagians are nasty. This shows clearly the "respect" you have for women and their privacy. I'm dreading the possibility of my girlfriend being examined by a doctor like you.
No, not all gynecoligists are perverts. But some of them are. A friend of mine could tell you. So stop keep on repeating that Janice is talking nonsense. Maybe she is exagerating in many ways. But young women often feel scared and embarrassed about this intimate procedure. They require understanding and very sensitive approach. You should know it best as a doctor. And you come here and say that nobody is interested in girls' vaginas because they are quite nasty!!! What a horror it must be for you to look at them!!!!

You're right, Pekin. Most physicians would use the argument that they do their exams in a completely objective, scientifical way and therefore, patients shouldn't worry about that.
First of all, that's not an excuse for saying that patients need to go to some psychiatrist, if they still feel bad and even raped. Doctors seem to only allow patients having the feelings that they pre-describe them! If you feel worse, then you are abnormal. (very respectfull yes)
Then you have these docs or medstudents like dragensoul, for instance, who think vaginas look nasty! Proof that physicians not always view nudity in an objective way. If you want to become a gyn, while having these thoughts about vaginas, then it is clearly you are not being objective and certainly do not have any respect for women.
He says not everybody should demand to be treated as his patients on this board, but that's not what we are doing. As if his disrespectfull thoughts would suddenly change when he's doing a pelvic exam, no that's where he started to think about it like that.
He doesn't have to come up with the fact that he's gay either, he proved himself that gay gyns are not a garantee to treat patients with respect.

And again, the reason why I don't want male gyns in the gyn industry is to change the MENTALITY in this industry, because they have started this unhealthy view on women.

 

[asherah]

Pekin74--

It's not just that Janice/asherah is saying "some male gynos are perverts". I think everyone here is willing to accept that some male gynos are perverts, as are some teachers, priests, plumbers, politicians, and rock stars. She is making broad, sweeping statements saying that ALL male gynos are perverts, that NONE of them know how to treat women, and that NO women would want to be examined by a male gynecologist. She also states that the Pap smear is a worthless exam unless you're having sex. Clearly, it's not a worthless exam. While most cases of cervical cancer are associated with HPV which is a sexually transmitted virus, not all cases of cervical cancer are caused by HPV. There have been enough cases of cervical cancer in virgins to recommend Pap smears in every woman above the age of 18.

Janice/asherah, just like every other woman, has every right to refuse to have a Pap smear for whatever reason. No one is fighting her on that point. No one can force a woman to have a Pap smear; physicians can only strongly recommend it. She also has every right to request a female physician if she does decide that she needs a Pap. What angers people about Janice/asherah is that she insists that every woman feels the same as she does, and she refuses to believe that not all women will make the same choices for their bodies as she does.

Personally, I see my gynecologist every year. It's not fun. I don't enjoy it. But I also don't enjoy going to the dentist or paying my taxes. However, if I don't go to the dentist, I run the risk of having cavities that get so bad that I have to have my teeth removed, if I don't pay my taxes the IRS is going to be really unhappy with me, and if I don't go to the gynecologist then I run the risk of dying from undiagnosed cervical cancer. I can put up with a few minutes of discomfort a year in order to protect myself. If Janice/asherah doesn't want to do that, fine. It's her body.

No one here or anywhere else is going to examine Janice/asherah if she doesn't want to be examined. Period. She just needs to stop spouting "medical facts" on a residency board, and she needs to stop insulting male gynecologists who actually want to help women.

Sweet tea,

for your information, I am NOT the same person as Janice, thank you very much.
You see, there are many more women who think the same about the fact that there need to come a change in the MENTALITY of the gyn industry. Not because you never met them, or they never told you, that they don't exist.
So please, stop your prejudices about this.
You can read for instance books of Sheila Kitzinger, if you want to know more about this subject (she is a gynecologist herself by the way)

 

[Drakensoul]

Blah blah blah blah blahhhhhhhhhhhhhhhhhh

Just couldn't let your troll-thread die, could you? Even after insinuating in the other thread that you were gone and weren't going to continue this mindless stupidity. Yet burning stupidity continues to invade my brainnnnnnn!!

Yet you continue to do the exact same thing; pretend like you have any clue whatsoever how any of us on this board would practice medicine based on our postings.

He says not everybody should demand to be treated as his patients on this board, but that's not what we are doing.

...is contradicted by

he proved himself that gay gyns are not a garantee to treat patients with respect.

Since the only person I'm discussing issues with here is YOU, in order for me to prove that I don't treat PATIENTS with respect, YOU would have to be the PATIENT. Which means YOU are expecting me to act as a PHYSICIAN and treat you as a PATIENT on an online forum within which we share OPINION and PERSONAL THOUGHTS.

Sorry, but no. You have no idea what you're talking about, and your now obvious attempts to be inflamatory and "upset" or "anger" me don't really do anything beyond making me laugh and smile a bit.

Again, you have absolutely no clue whatsoever how anyone on this forum practices medicine. None. There is no point to even suggesting that you do other than to try and stir up a flame-fest.

You also seem to lack reading comprehension for the thread in general. The thread has degenerated into an arguement over whether or not physicians view women from a sexual mindset. From a sexual mindset, I find the female anatomy gross. Read that again carefully, because it has absolutely nothing to do with a medical or clinical mindset. Zero.


Your postings in their entirety now center desperately on trying to link peoples' personal statements on this board to their practices as physicians or medical students, and it won't work. Sorry. As much as you would love to say that people here must make horrible physicians and hate women because they're not sexually attracted to women (which is all I've said at this point), and as much as you would love to believe that you've somehow proved that I'd be a terrible, horrible doctor because you don't like the way I post on a forum, it doesn't work. They have absolutely nothing to do with one another.

I could curse you up one side and down the other and tell you that I thought you were the most vile thing to ever walk the planet, and it would have absolutely nothing to do with my sensitivity as a clinical practicioner. But I guarantee that you would try to link the two.

Anyway, yeah.. It's rather amusing to me to see you fall to this level.
Please, by all means, continue to sling personal insults toward me. Maybe you'll end up banned.

Much love!!!!!!

---------------------------------------------------------

he proved himself that gay gyns are not a garantee to treat patients with respect

HUMAN GYNs are not a guarantee to treat patients with respect. HUMANS are not guaranteed to do anything at all. The fact that you consider posts on these forums as "PROOF" about efficacy as a clinical practicioner is laughable. I haven't proved ****.

This will, however, be my final post on this topic (and I'll stick to that). I feel dumber for having been dragged into this, and you're not saying anything new anymore... just going around and around with the same flawed logic. I'm worried that you'll take my continued responses as me having a need to defend myself or prove something to you, and I have no such need. Feel free to continue flaming me unmercilessly now that you won't have me opposing it.

Hope you find what you're looking for in life, and that it go well for you.

 

[vanelo]

Janice:

Are you straight?

(If not that would explain a lot of things)

 

[neutropeniaboy]

Sweet tea,

for your information, I am NOT the same person as Janice, thank you very much.
You see, there are many more women who think the same about the fact that there need to come a change in the MENTALITY of the gyn industry. Not because you never met them, or they never told you, that they don't exist.
So please, stop your prejudices about this.
You can read for instance books of Sheila Kitzinger, if you want to know more about this subject (she is a gynecologist herself by the way)

Asherah,

If you're not the same person as Janice, then you must be a biological sister...or at the very least, from the same uneducated region of the south...or an immigrant from the same province of the same country (perhaps even rooming together in the distant past)...because your grammar and her grammar equally suck.

(And, there are an absurb number of suspiciously similar constructs and misspellings.)

 

[Skoundrel]

Asherah and Janice have to be the same person!

 

[Seaglass]

absurb

Absurd. If you are going to rag on someone's spelling you should probably make sure yours is correct. Now - back to the show!

 

[neutropeniaboy]

Absurd. If you are going to rag on someone's spelling you should probably make sure yours is correct. Now - back to the show!

You neglected to place a comma between "spelling" and "you." But, touche...

 

[Seaglass]

Ah - but my post wasn't about grammar. I did check the spelling on it twice though.

 

[jvarga]

Maybe it is time you invest in a grammar checker, Seaglass, since your last post again contained a "missed" coma (I'll let you decide where it should have been placed). I'm sorry to post such a childish thing, but I just could not resist myself at this time of night. Sorry!
But we digress...

 

[MoosePilot]

Asherah,

If you're not the same person as Janice, then you must be a biological sister...or at the very least, from the same uneducated region of the south...or an immigrant from the same province of the same country (perhaps even rooming together in the distant past)...because your grammar and her grammar equally suck.

(And, there are an absurb number of suspiciously similar constructs and misspellings.)

Why, because there aren't any uneducated regions in the North?

Oh, that's right, as you increase latitude, IQ goes up. Just like increasing distance from the Atlantic or Pacific correlates with decreasing intelligence. Geographic prejudice is one of the last acceptable forms to some folks.

Now I totally agree that they seem like the same person, but I just can't stand by while the Southern part of the country gets slammed

 

[Sweet Tea]

Now I totally agree that they seem like the same person, but I just can't stand by while the Southern part of the country gets slammed

Agreed. Just as gender has no bearings on whether or not a person is a sensitive and skilled physician, geographic location has nothing to do with intelligence.

 

[Oats]

Agreed. Just as gender has no bearings on whether or not a person is a sensitive and skilled physician, geographic location has nothing to do with intelligence.

Well said!!

While I don't think Neutro meant to offend anybody, he did. Neutro, not all of us from the south are ignorant. I know that statement was directed at Asherah, but please remember that there are others on this forum who may take offense to such a statement. Thank you for refraining to say such things in the future. Peace.

 

[Skoundrel]

Asherah,

If you're not the same person as Janice, then you must be a biological sister...or at the very least, from the same uneducated region of the south...or an immigrant from the same province of the same country (perhaps even rooming together in the distant past)...because your grammar and her grammar equally suck.

(And, there are an absurb number of suspiciously similar constructs and misspellings.)

OMG you made me laugh so hard coffe came out of my nose. Lesson do not drink and read posts!

 

[neurogeek]

In defense of neutropenia boy, I have to point out that he did say "uneducated region of the South." I am from Louisiana, and I will not hesitate to agree that there most definitely are uneducated regions in the South. Neutropenia boy would, I'm sure, include "uneducated regions of the North, East and West" if he were to make an exhaustive list of the possibilitities for the origins of janice and asherah.

 

[Oats]

You are correct, Neurogeek. I digress. Just goes to show one should not jump to conclusions about statements made from each other in here. Thank you for your CONSTRUCTIVE criticism! Again, peace.

 

[saiyagirl]

Well, I'm a 3rd year male medical student who's interested in OBGYN, and although I agree there is an increased demand for female OBGYNs, I wouldn't go so far to say that our future is bleak.

Again, there are women who prefer female OBGYNs. However there are some who prefer a male. The majority of women, however, just want a doctor who they feel comfortable with; someone they feel they can freely commuincate with; someone who listens to their concerns and shows compassion, sensitivity and empathy; someone they trust....irrespective of gender.

exactly. well said.

Janice, you really are doing a disservice to women and feminism in general by assuming we all think alike.

 

[GeddyLee]

And in the US, when using only low risk pg stats, the cnm still outperforms MD/DO's in that area. Don't take this as I believe we don't need MD/DO's obs. They are very necessary for gyn onc and high risk pgs or when a section is truly needed. But I think they need some lessons on managing low risk moms. Of course, some of the interventions are driven by fear of malpractice suits. Hope that midwifery does not head in the same direction here.

Hmm...I wish I knew where this statistic came from. Is the statistic based on number of malpractice suits filed?? Of course, I suppose you could include morbidity from epi-durals and IV drugs given, which CNM's don't use, but that doesn't indicate that MD's are inadequate in managing obstetric patients.

Optometrists like to claim a similar statistic and say they have never had a complication in this or that. I'm not buying it.

You seem to believe that with all equal....equally low risk patients, etc...that CNM's outperform MD's. This is just plain bias. Women who go to CNM's are probably interested in natural birth, and don't ask for epi's, drugs, or anything else. Also, some MD's may take the CNM's "low risk" patient to c-section, where the CNM lacked the education to see a potential complication by continuing with spontaneous delivery. Of course, I'm sure you understand that epidurals, IV drugs, and the occasional prudent c-section might all cause some morbidity that the CNM's just wouldn't be exposed to due to their scope of practice. Also, MD's are probably more likely to get sued than CNM's, since people see MD's as fat cash cows.

I suppose we should require all pregnant women to have deliveries through CNM's if they are "low risk", so that we can have a lower mortality/morbidity rate in childbirth.

Bottom line, there is no way that a CNM is better at delivering babies than a MD/DO. This is either a biased statistic, blatent lies, or pure ignorance. But please, please, please, point me to the source of your statistic. I'm curious.

 

[Janice]

exactly. well said.

Janice, you really are doing a disservice to women and feminism in general by assuming we all think alike.

How am I doing a disservice to women and feminism when a lot of women are afraid to question doctors and especially afraid to say no to a pelvic exam just because the doctor wants to do one. That's whether they want it or need it or not. Especially if the doctor is a man.

Women need to get out of the habit of putting doctors on a pedestal and making gods out of them.

And I'm doing women a disservice? I don't think so!

 

[Janice]

Hmm...I wish I knew where this statistic came from. Is the statistic based on number of malpractice suits filed?? Of course, I suppose you could include morbidity from epi-durals and IV drugs given, which CNM's don't use, but that doesn't indicate that MD's are inadequate in managing obstetric patients.

Optometrists like to claim a similar statistic and say they have never had a complication in this or that. I'm not buying it.

You seem to believe that with all equal....equally low risk patients, etc...that CNM's outperform MD's. This is just plain bias. Women who go to CNM's are probably interested in natural birth, and don't ask for epi's, drugs, or anything else. Also, some MD's may take the CNM's "low risk" patient to c-section, where the CNM lacked the education to see a potential complication by continuing with spontaneous delivery. Of course, I'm sure you understand that epidurals, IV drugs, and the occasional prudent c-section might all cause some morbidity that the CNM's just wouldn't be exposed to due to their scope of practice. Also, MD's are probably more likely to get sued than CNM's, since people see MD's as fat cash cows.

I suppose we should require all pregnant women to have deliveries through CNM's if they are "low risk", so that we can have a lower mortality/morbidity rate in childbirth.

Bottom line, there is no way that a CNM is better at delivering babies than a MD/DO. This is either a biased statistic, blatent lies, or pure ignorance. But please, please, please, point me to the source of your statistic. I'm curious.

CNMs not better at delivering babies than MD/DO? I thought you guys are suppose to be about saving lives and not about who's better?!? Maybe there's a race going on within the medical establishment? You keep forgetting one major point. It's all about the relationships formed between a doctor and his/her patients. And that is what makes some people "Better". The amount of trust, the level of comfort, the open line of communication, and a very big listening ear. Those are the attributes that makes someone better than another.

Maybe the CNMs are better.

 

[neilc]

CNMs not better at delivering babies than MD/DO? I thought you guys are suppose to be about saving lives and not about who's better?!? Maybe there's a race going on within the medical establishment? You keep forgetting one major point. It's all about the relationships formed between a doctor and his/her patients. And that is what makes some people "Better". The amount of trust, the level of comfort, the open line of communication, and a very big listening ear. Those are the attributes that makes someone better than another.

Maybe the CNMs are better.

sorry, but all the bedside manner in the world does not cover incompetence...the qualities that you mention are important, for sure. but, they are certainly not all that is out there...

i think the point is that every person has an equal chance of being a good listener, whether they be CNM or MD/DO. so, assume equal footing there, unless you have some sort of evidence to the contrary...(and, no janice, the idea that all male ob/gyns went through school and training solely to trick you into gettin a pap smear is not legitimate evidence)...in that case, i would think that it is logical to assume that MD/DO's have much more experience, broader qualifications and a larger scope of practice that enables them to do more for a pregnant woman, who all may have different levels of need. i agree that there is a place for CNM's, and that many of them do excellent work. however, i also think that MD's are essential to the picture, even if only to have in the background in case of problems...

all the factors that geddylee mentioned seem reasonable to me. it is not likely, at least in my limited experience, that CNMs would demonstrate better care if the factors he mentioned were accounted for. ayndim stated that ob's needed some "lessons" in the care for low risk moms, but i have not seen any evidence that supports that. in my experience, low risk births typically work out well no matter who delivers the baby. compare similar patients in each group and you will likely see similar outcomes. as risk goes up, care is directed solely at the MD, and complication rates increase. compare all patient populations in each group, and it seems very likely that MD's would have worse numbers...

so, to put it succinctly. is it better to have an MD around or a CNM? well, if i were pregnant, and had to pick only 1 of those providers, i would go with MD, just in case i presented breech, or failed to progress, or whatever other potential disaster arose that a CNM couldn't handle. perhaps that is what is meant by better....

 

[ayndim]

Hmm...I wish I knew where this statistic came from. Is the statistic based on number of malpractice suits filed?? Of course, I suppose you could include morbidity from epi-durals and IV drugs given, which CNM's don't use, but that doesn't indicate that MD's are inadequate in managing obstetric patients.

Optometrists like to claim a similar statistic and say they have never had a complication in this or that. I'm not buying it.

You seem to believe that with all equal....equally low risk patients, etc...that CNM's outperform MD's. This is just plain bias. Women who go to CNM's are probably interested in natural birth, and don't ask for epi's, drugs, or anything else. Also, some MD's may take the CNM's "low risk" patient to c-section, where the CNM lacked the education to see a potential complication by continuing with spontaneous delivery. Of course, I'm sure you understand that epidurals, IV drugs, and the occasional prudent c-section might all cause some morbidity that the CNM's just wouldn't be exposed to due to their scope of practice. Also, MD's are probably more likely to get sued than CNM's, since people see MD's as fat cash cows.

I suppose we should require all pregnant women to have deliveries through CNM's if they are "low risk", so that we can have a lower mortality/morbidity rate in childbirth.

Bottom line, there is no way that a CNM is better at delivering babies than a MD/DO. This is either a biased statistic, blatent lies, or pure ignorance. But please, please, please, point me to the source of your statistic. I'm curious.

I am finishing a chem class right now and have work but I will "re-find" my stats source and post them. I believe they were from the WHO but my brain is fried right now so don't hold me to it. I thought I posted the links but that pesky brain of mine must have had the day off. By the way, many women with CNM opt for epidurals or drugs. CNM's are supportive of the women and her choices, not natural birth nazis.

I don't think this was the original source but it does back up what I said.

http://www.withwomanweb.com/safety.asp

http://www.maternitycenter.com/facts1.html

When I have more time I will do a search for my original source, which was not a mw site.

Actually, if a pt went to a section, they would not any longer be low risk and if it was a mw patient, the mw would have called the dr for the section. The patient would have been excluded from the low-risk group (remember stats). And a CNM does have the education to see a potential complication. And we are not counting section morbidity here. Obviously, drs deliver many babies safely each year. So no they are inadequate but they could be better. Why is it that there is no way CNM's are better than MD's at delivering babies? More training does not always equal better outcomes. Although, CNM's have extensive training too. Perhaps the training of future OB's needs to be changed a bit. CNM's spend more time with their pts both in prenatal care and during labor and delivery. They are also less likely to push interventions on the mom. Maybe this does change the outcome but who is influencing the outcome if the dr wants to do an episiotomy or a section for failure to hurry up. And I will say it again, drs are great for higher risk deliveries (this is where their training really come through) but they either need to treat mom like low risk or stay in high risk.

 

[GeddyLee]

I am finishing a chem class right now and have work but I will "re-find" my stats source and post them. I believe they were from the WHO but my brain is fried right now so don't hold me to it. I thought I posted the links but that pesky brain of mine must have had the day off. By the way, many women with CNM opt for epidurals or drugs. CNM's are supportive of the women and her choices, not natural birth nazis.

I don't think this was the original source but it does back up what I said.

http://www.withwomanweb.com/safety.asp

http://www.maternitycenter.com/facts1.html

When I have more time I will do a search for my original source, which was not a mw site.

Actually, if a pt went to a section, they would not any longer be low risk and if it was a mw patient, the mw would have called the dr for the section. The patient would have been excluded from the low-risk group (remember stats). And a CNM does have the education to see a potential complication. And we are not counting section morbidity here. Obviously, drs deliver many babies safely each year. So no they are inadequate but they could be better. Why is it that there is no way CNM's are better than MD's at delivering babies? More training does not always equal better outcomes. Although, CNM's have extensive training too. Perhaps the training of future OB's needs to be changed a bit. CNM's spend more time with their pts both in prenatal care and during labor and delivery. They are also less likely to push interventions on the mom. Maybe this does change the outcome but who is influencing the outcome if the dr wants to do an episiotomy or a section for failure to hurry up. And I will say it again, drs are great for higher risk deliveries (this is where their training really come through) but they either need to treat mom like low risk or stay in high risk.

Well, I think we have ore answer then.

So the CNM goes to deliver a low-risk pregnancy. If everything works out, then it's a success. If a complication arises and the pregnancy goes to section, it's no longer low risk, and thus any complication that occurs doesn't affect the CNM's fantastically good statistics. However, if it's an OB, they do their own section, rack up complications and voila....it appears CNM's are better than OB's.

As for Janice....being a great listener won't help when the baby is breach with the cord wrapped around it's neck. Sorry. Fetuses are really obnoxious that way. I can't imagine why anyone would want anything other than a board certified obstetrician delivering their baby. If the CNM is doing it, and things crump quickly, you won't have time to page the OB on call, hence either mom or baby is going to suffer.

By the way...if an OB typically pays around $100,000+ in yearly malpractice insurance premiums....how much does a CNM pay?? It seems really fair that CNM's can deliver all the low risk babies, pay low malpractice, and not be sued because they pass all the complications off to the MD, who in turn, assumes a higher risk profile and pays higher malpractice. Maybe the MD's should take a similar approach and refuse to deliver high risk pregnancies. Maybe malpractice premiums are skyrocketing because midlevels are now known to provider low risk care, thus making all physicians high risk to insurance companies!

Of course, CNM's could go the route of Optometrists and CRNA's and lobby for legislation to get priveleges to expand their scope of practice and start doing their own sections...then we'll talk morbidity/mortality statistics.

It seems pretty obvious to me that yourstat is biased, just on the basis that pregnancies that transitioned from low risk to higher risk were no longer included in the stat. Of course, we also all know that any statistic can be manipulated to prove whatever point you seek to prove. It was my observation that most truly low risk pregnancies pretty much delievered themselves...I can't imagine how an MD could fudge it up, much less a CNM.

Personally, I find it a little disrespectful that midlevels come on MD/DO forums and talk about how they do the job better than MD/DO's. I've seen this now on CRNP, PA, CRNA's and optometry threads. It's a bit arrogant to think you do the job better than someone with about 4 times the length of training, and probably many years more experience. And not only longer training, but more intense, complete, and better training. I don't think midlevels would ever know the difference unless they later pursued training as an MD or DO, hence the cavalier attitude.

I think a quote on ER sums it up best...you're a midlevel, which means you can handle 90% of the patients that come through the door....unfortunately, that also means you will kill the other 10%.

 

[GeddyLee]

From http://www.maternitycenter.com/facts1.html:

I. Quality of Care: Certified nurse-midwives caring for low risk women improve the infant mortality rate while lowering the cesarean section rate, both in hospitals and birth centers, compared to physicians caring for equally low-risk women.

A. Birth Certificate data from 1991 was examined for all singleton vaginal deliveries between 35 and 43 weeks. After controlling for socio-demographic and medical risk factors, the outcomes for physicians and nurse-midwives were compared:

1. The risk for neonatal mortality was 33% lower for births attended by CNMs.
2. The risk of delivering a low birth weight infant was 31% lower for CNM attended births.
3. The mean birth weight was 37 grams higher for CNM attended births.
4. The infant mortality rate was 19% lower for CNM attended births.
[Source: MacDorman, Marioan, et.al. Midwifery care, social and medical risk factors, and birth outcomes in the US. J Epidemiology and Public Health, May 1998 Vol. 53:5;310-317]

Low birth weight is caused by the person doing the delivery?? Maybe they are including partial birth abortions in their statistic.

So you expect me to believe that for every 100 mothers that die at the hands of an OB, only 67 die at the hands of a CNM, even given completely equal circumstances??? This must be do to cherry-picking. CNM's won't take a patient if there is any slight hint of complication, while the OB's take anyone.


B. Examining differences in the practices of family physicians, obstetricians and certified nurse-midwives caring for low-risk women, the authors found the following:
1. The cesarean section rate was 8.8% for nurse-midwives.
2. The cesarean section rate was 13.6% for obstetricians.
3. The cesarean section rate was 15.1% for family physicians.
4. Nurse-midwives used 12.2% fewer resources than either group of physicians.
[Source: Rosenblatt, Roger A., MD MPH, et.al. Interspecialty Differences in the Obstetric Care of Low-Risk Women, American J of Public Health 387:3;344-351, 1997]

Maybe CNM's don't see potential complications that the OB sees, thus they are less likely to go to section.

C. ?The National Birth Center Study? reported on the outcomes of care for 11,814 women who were admitted in labor:

1. No maternal mortality.
2. Neonatal mortality of 1.3 births/1000; 0.7/1000 if lethal anomalies were excluded. These rates are comparable to studies of low risk in-hospital births.
3. Cesarean section rate of 4.4%, approximately one-half that is studies of low risk in-hospital births.
[Source: Rooks, J.P.,et.al. Outcomes of care in birth centers: The national birth center study. New England Journal of Medicine 312:1804-1811, 1989]

D. Patients of certified nurse-midwives were much less likely to:

1. Have a variety of technological tools used to monitor or modify the course of labor.
2. Be continuously electronically monitored during labor.
3. Receive oxytocin to induce or augment labor.
4. Be given epidural anesthesia.

As a consequence, these factors probably result in fewer CNM patients having an operative delivery. The lower rate of cesarean sections is associated with shorter hospital stays and smaller expenditures for operating room and anesthesia staff.
[Source: Rosenblatt, Roger A.,MD MPH, et.al. Interspeciality Differences in the Obstetric Care of Low-Risk Women, American J of Public Health 387:3;344-351, 1997]

Why does this site seem to say that epidural anesthesia is a negative outcome?

Similarly....monitoring the baby and mother during labor is bad??? how else will you know if the baby is in distress? AHAH!! this is why CNM's go to section less frequently. If you don't know the baby is in distress...you won't induce labor or take the mother to C-section.

Take my advice...don't buy every statistic at face value.

 

[ayndim]

Well, I think we have ore answer then.

So the CNM goes to deliver a low-risk pregnancy. If everything works out, then it's a success. If a complication arises and the pregnancy goes to section, it's no longer low risk, and thus any complication that occurs doesn't affect the CNM's fantastically good statistics. However, if it's an OB, they do their own section, rack up complications and voila....it appears CNM's are better than OB's.

As for Janice....being a great listener won't help when the baby is breach with the cord wrapped around it's neck. Sorry. Fetuses are really obnoxious that way. I can't imagine why anyone would want anything other than a board certified obstetrician delivering their baby. If the CNM is doing it, and things crump quickly, you won't have time to page the OB on call, hence either mom or baby is going to suffer.

By the way...if an OB typically pays around $100,000+ in yearly malpractice insurance premiums....how much does a CNM pay?? It seems really fair that CNM's can deliver all the low risk babies, pay low malpractice, and not be sued because they pass all the complications off to the MD, who in turn, assumes a higher risk profile and pays higher malpractice. Maybe the MD's should take a similar approach and refuse to deliver high risk pregnancies. Maybe malpractice premiums are skyrocketing because midlevels are now known to provider low risk care, thus making all physicians high risk to insurance companies!

Of course, CNM's could go the route of Optometrists and CRNA's and lobby for legislation to get priveleges to expand their scope of practice and start doing their own sections...then we'll talk morbidity/mortality statistics.

It seems pretty obvious to me that yourstat is biased, just on the basis that pregnancies that transitioned from low risk to higher risk were no longer included in the stat. Of course, we also all know that any statistic can be manipulated to prove whatever point you seek to prove. It was my observation that most truly low risk pregnancies pretty much delievered themselves...I can't imagine how an MD could fudge it up, much less a CNM.

Personally, I find it a little disrespectful that midlevels come on MD/DO forums and talk about how they do the job better than MD/DO's. I've seen this now on CRNP, PA, CRNA's and optometry threads. It's a bit arrogant to think you do the job better than someone with about 4 times the length of training, and probably many years more experience. And not only longer training, but more intense, complete, and better training. I don't think midlevels would ever know the difference unless they later pursued training as an MD or DO, hence the cavalier attitude.

I think a quote on ER sums it up best...you're a midlevel, which means you can handle 90% of the patients that come through the door....unfortunately, that also means you will kill the other 10%.

I cannot believe you are a med student or pre med student. Certainly I hope you aren't a dr. If a pt becomes high risk THEY ARE NOT INCLUDED IN ANYONE'S STATS. That means that a mw's low risk pt is not included in the drs stats. Have you actually taken Stats? High risk would be outliers and not included. And more training does not equal better trained people in all cases. Drs are great in high risk instances, however, if they are treated low risk pts the same as a high risk pt that is not good either. However, I imagine there are drs who are great with low risk pts. But the majority just don't seem to be that way. Hopefully, the tide is turning and the sky-high section rate and episiotimies will go down. And drs do not have 4x the training as CNM. 4 years med school, 4 years residency. CNM 2 years nursing school (1st 2 years of a BSN are pre-req, much like premed , training), minimum 1 year l&d experience, 2 to 3 years MSN. That is at a minimum of 5 years of training. Yes a dr has more extensive and intensive training. CNM's are not meant to. They service low risk pgs and routine exams. But they can take care of minor complication, including cords around the neck if a vag delivery. I don't know of many cnms who want to take away the drs right to do a section. The goal is to avoid them not learn how to do them. The fact is that the lowest risk of infant mortality is in developed countries with most babies delivered with CNMs. Why can't you admit to the possibility that drs might not have the best outcome with low risk pts? At least do the research yourself before you blow it off. Just because you don't want to examine the possibility doesn't mean it isn't true.

As for CRNA's. They are highly trained professionals. But if you look into the procedures they are doing they don't handle the highly complicated ones (like liver transplants). They just don't have the training a MDA does. If you don't believe me search some CRNA jobs and see what they are actually being hired to do.

So if I as a future midlevel can admit somethings are beyond my training and experience, why can't you as a future dr admit that there are somethings drs are overtrained for?

 

[ayndim]

Low birth weight is caused by the person doing the delivery?? Maybe they are including partial birth abortions in their statistic.

So you expect me to believe that for every 100 mothers that die at the hands of an OB, only 67 die at the hands of a CNM, even given completely equal circumstances??? This must be do to cherry-picking. CNM's won't take a patient if there is any slight hint of complication, while the OB's take anyone.



Maybe CNM's don't see potential complications that the OB sees, thus they are less likely to go to section.


Why does this site seem to say that epidural anesthesia is a negative outcome?

Similarly....monitoring the baby and mother during labor is bad??? how else will you know if the baby is in distress? AHAH!! this is why CNM's go to section less frequently. If you don't know the baby is in distress...you won't induce labor or take the mother to C-section.

Take my advice...don't buy every statistic at face value.

Okay if they are missing complications that must be handled by sections why aren't we seeing higher mortality rates with CNM's. I had a CNM 3 times and an epidural 2 times. Didn't see it as a negative outcome. I had a horrible pelvic pain in the last pg and it was the 1st time I was pain free. In fact, I would like to have one now so I can lay in bed for a while.

The birthweight issue is thought to stem from the fact that a CNM will generally spend more time with a patient on prenatal visits and is more likely to give more nutritional advice (I did my stats term paper on birthweight, weight gain and provider so I have done tons of research on this).

What is such a bad thing about drs looking to CNM's to see what they are doing right? It is not the person but the care that is the issue. And just to say again cnms like having a person with more training backing them up. There are going to be instances where a complication is beyond a CNM's training. CNM's aren't looking to take drs jobs away. With the projected shortage of ob providers it would be kind of hard to do anyway.

 

[Katee80]

I stumbled across this thread about 3 months ago. I went to Mexico..came back after 3 weeks....I'm just tickled that this thread refuses to die!

 

[JattMed]

Hell hath no fury like a woman scorned!
Yikes..............
Someone has been 'wronged' and it is being overly promulgated for some effect of sympathy, fearmongering or hate inspiring.
Someone's whole experience has transmogrified one's definition of men in general.......scary...so what's next?
The (insert 'ethnicity, race, height, creed, sexual orientation etc., etc.')doctor 'wronged' a female patient therefore all of 'them' are bad, evil rapists?