porno resim,sex resim,türbanlı porno resimleri,sex videoları izle,sikiş resimleri,
ataşehir escort,pendik escort,şişli escort,kurtköy escort,ankara escort,ankara escort,avcılar escort,istanbul travesti,maltepe escort,escort ankara,avcılar escort,ankara escort,antalya escort,ankara escort,türk porno,
Nice servis,nice bariyer,mantar bariyer,epoksi zemin kaplama,köşe koltuk,yükleme rampası,bft ,bahçe kapısı motoru,nice türkiye,nice türkiye,efsa web,nice türkiye,kepenk servisi,Dış cephe mantolama,pergola,
Kadınhanı Web Tasarımı,
esenyurt escort,beylikdüzü escort,beşiktaş escort,atakoy escort,escort istanbul,istanbul escort,
Trying to have a baby in flyover country
Armed Polite Society
August 18, 2017, 02:13:13 PM *
Welcome, Guest. Please login or register.

Login with username, password and session length
News:
 
   Home   Help Search Login Register  
Pages: [1] 2
  Print  
Author Topic: Trying to have a baby in flyover country  (Read 1110 times)
MillCreek
friend
Senior Member
***
Posts: 11,872


APS Risk Manager


« on: February 15, 2017, 05:59:33 AM »

https://www.scientificamerican.com/article/maternal-health-care-is-disappearing-in-rural-america/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+ScientificAmerican-News+%28Content%3A+News%29

It is getting more and more difficult to find a provider to deliver your baby and a hospital to do it in.  Lots of reasons for this: OB is a money-loser for hospitals, lack of reimbursement and the typical provider does not want to live out in the sticks.
Logged

_____________
Regards,
MillCreek
Snohomish County, WA  USA

I bear a passing resemblance to Squidward
Kingcreek
friend
Senior Member
***
Posts: 968


« Reply #1 on: February 15, 2017, 06:34:10 AM »

yup.
Not planning on any babies but if we were it's a 50 mile drive to a hospital that does OB. I don't know how many are "emergency" births at the local one or the one 20 miles away.
This has been the situation for a few years now.
Logged

What we have here is failure to communicate.
fistful
Green Bar of Nothing
friend
Senior Member
***
Posts: 47,783


A ranting, raving little man with a monkey head.


« Reply #2 on: February 15, 2017, 06:59:51 AM »

I guess it's their fault for being deplorable people that no one wants to live around. If they just hang a few rainbow black lives matter flags, that'll solve things.
Logged

When MLK used the techniques he learned from Gandhi - was that cultural appropriation?
BobR
friend
Senior Member
***
Posts: 3,626



« Reply #3 on: February 15, 2017, 07:29:57 AM »

There is also malpractice claims. According to an article I saw there is better than a one in ten chance of an OB having a claim filed against them (11% or so). That comes in around #7 of the top 10. The biggest problem is not where they fall in the top 10 but where they fall in amount paid per claim which is probably in the top 3 (SWAG).  My wife's GYN gave up the baby catching part of her practice because of the soaring cost of malpractice insurance.

bob
Logged
fistful
Green Bar of Nothing
friend
Senior Member
***
Posts: 47,783


A ranting, raving little man with a monkey head.


« Reply #4 on: February 15, 2017, 09:14:04 AM »

Quote
...student loan forgiveness for ob-gyn work therea benefit that is currently offered for dentists and primary care physicians in some underserved communities.

Isn't that the premise of Northern Exposure?


yup.
Not planning on any babies but if we were it's a 50 mile drive to a hospital that does OB. I don't know how many are "emergency" births at the local one or the one 20 miles away.
This has been the situation for a few years now.

It's interesting that the media seems more concerned with the "shortage" of baby-killing facilities in the fly-over states.
Logged

When MLK used the techniques he learned from Gandhi - was that cultural appropriation?
MillCreek
friend
Senior Member
***
Posts: 11,872


APS Risk Manager


« Reply #5 on: February 15, 2017, 09:44:17 AM »

Isn't that the premise of Northern Exposure?

It was, and the program continues to this day.  The major problem with the loan forgiveness programs is that as soon as the provider has worked off the debt, which typically takes 3-5 years, most of them head out to the big city.  We just started a new medical school in Washington state, as part of Washington State University.  The students will be rotated through various rural settings, and it is hoped that some of them will subsequently set up practice there.  One of the major barriers for these rural programs is a lack of jobs for the spouse/significant other.  If the spouse/significant other cannot find a job in their field in the given rural area, that is a strike against the provider moving there.
Logged

_____________
Regards,
MillCreek
Snohomish County, WA  USA

I bear a passing resemblance to Squidward
KD5NRH
friends
Senior Member
***
Posts: 9,827


I'm too sexy for you people.


« Reply #6 on: February 15, 2017, 11:19:19 AM »

The biggest problem is not where they fall in the top 10 but where they fall in amount paid per claim which is probably in the top 3 (SWAG).

Sounds like yet another negative effect of insurance companies playing the short game.  (Paying out a claim they could beat because it's cheaper than going to court right now, ignoring the fact that it encourages more shaky suits in the future.)
Logged
makattak
Dark Lord of the Cis
friend
Senior Member
***
Posts: 9,898



« Reply #7 on: February 15, 2017, 11:27:35 AM »

Sounds like yet another negative effect of insurance companies playing the short game.  (Paying out a claim they could beat because it's cheaper than going to court right now, ignoring the fact that it encourages more shaky suits in the future.)

There's also risk aversion. Show a jury a picture of a child with a birth defect (or the actual child) and claim it's the doctor's fault.

It's a roll of the dice as to whether the sympathy card gets the plaintiff far more than a settlement would have paid.

This is one issue where I don't think the current jury system is well situated to dispense justice.
Logged

"Political correctness is communist propaganda writ small... the purpose of communist propaganda was not to persuade or convince, nor to inform, but to humiliate; the less it corresponded to reality the better...To assent to obvious lies is to co-operate with evil, and in some small way to become evil oneself. One's standing to resist anything is thus eroded, and even destroyed. A society of emasculated liars is easy to control."
MillCreek
friend
Senior Member
***
Posts: 11,872


APS Risk Manager


« Reply #8 on: February 15, 2017, 11:30:38 AM »

Sounds like yet another negative effect of insurance companies playing the short game.  (Paying out a claim they could beat because it's cheaper than going to court right now, ignoring the fact that it encourages more shaky suits in the future.)

Speaking as the person here who actually does this for a living, I can tell you that when it comes to healthcare malpractice cases, they are vigorously defended.  I routinely spend tens or hundreds of thousands to defend a case that could have been settled for $50,000.  It is not in the best interests of the provider or the insurance company to get a reputation for paying nuisance settlements.  Having said that, healthcare staff make errors all the time, and when those errors reach the level of provable malpractice that cannot be successfully defended, you should look to settle the case.
Logged

_____________
Regards,
MillCreek
Snohomish County, WA  USA

I bear a passing resemblance to Squidward
zahc
friend
Senior Member
***
Posts: 4,618



« Reply #9 on: February 15, 2017, 11:38:16 AM »

I heard also that rural areas have growing numbers of drug abuse complications, and that's one of the reasons as well,

Hospitals are actually not needed to birth babies, and the concept of births as a 'medical' issue requiring treatment per se (rather than possibly being needed for complications) is a relatively recent one, even in the US. I have 3 babies so far, and have yet to step foot in a hospital. If hospitals get more expensive and distant, I expect some market elasticity to kick in, and some people will just go back to having babies for free.
Logged

Maybe a rare occurence, but then you only have to get murdered once to ruin your whole day.
--Tallpine
makattak
Dark Lord of the Cis
friend
Senior Member
***
Posts: 9,898



« Reply #10 on: February 15, 2017, 12:39:04 PM »

I heard also that rural areas have growing numbers of drug abuse complications, and that's one of the reasons as well,

Hospitals are actually not needed to birth babies, and the concept of births as a 'medical' issue requiring treatment per se (rather than possibly being needed for complications) is a relatively recent one, even in the US. I have 3 babies so far, and have yet to step foot in a hospital. If hospitals get more expensive and distant, I expect some market elasticity to kick in, and some people will just go back to having babies for free.

Part of THAT is also risk aversion. Yes, the birth is probably not going to have complications, but IF there are, you're already in a hospital.

From personal experience, pregnant women tend to be more than a little risk averse.

(To note, our last child's birth DID require hospitalization for my wife- she was preeclamptic. Thankfully, she and the baby came through with no problems, but I was mighty glad we were already set for the hospital.)
Logged

"Political correctness is communist propaganda writ small... the purpose of communist propaganda was not to persuade or convince, nor to inform, but to humiliate; the less it corresponded to reality the better...To assent to obvious lies is to co-operate with evil, and in some small way to become evil oneself. One's standing to resist anything is thus eroded, and even destroyed. A society of emasculated liars is easy to control."
fistful
Green Bar of Nothing
friend
Senior Member
***
Posts: 47,783


A ranting, raving little man with a monkey head.


« Reply #11 on: February 15, 2017, 01:19:29 PM »

I heard also that rural areas have growing numbers of drug abuse complications, and that's one of the reasons as well,

Hospitals are actually not needed to birth babies, and the concept of births as a 'medical' issue requiring treatment per se (rather than possibly being needed for complications) is a relatively recent one, even in the US. I have 3 babies so far, and have yet to step foot in a hospital. If hospitals get more expensive and distant, I expect some market elasticity to kick in, and some people will just go back to having babies for free.

I'm not saying don't have your kids at home, but that seems like a time when you really, really want to have a hospital close by.
Logged

When MLK used the techniques he learned from Gandhi - was that cultural appropriation?
lee n. field
friend
Senior Member
***
Posts: 9,995


tinpot megalomaniac, Paulbot, hardware goon


« Reply #12 on: February 15, 2017, 01:33:47 PM »

I heard also that rural areas have growing numbers of drug abuse complications, and that's one of the reasons as well,

Hospitals are actually not needed to birth babies, and the concept of births as a 'medical' issue requiring treatment per se (rather than possibly being needed for complications) is a relatively recent one, even in the US. I have 3 babies so far, and have yet to step foot in a hospital. If hospitals get more expensive and distant, I expect some market elasticity to kick in, and some people will just go back to having babies for free.

My daughter has had 3 at home, with the aid of a midwife.  Which is illegal in Illinois.
Logged

In thy presence is fulness of joy.
At thy right hand pleasures for evermore.
makattak
Dark Lord of the Cis
friend
Senior Member
***
Posts: 9,898



« Reply #13 on: February 15, 2017, 01:35:44 PM »

I'm not saying don't have your kids at home, but that seems like a time when you really, really want to have a hospital close by.

I should also note that our situation was one that would be dangerous and frightening in the situation from the article (no birthing hospitals nearby). She didn't feel right one night and called the on-call doctor. She said, effectively, "You're probably a little dehydrated. Drink some water and check in tomorrow." (She wasn't totally off-base, my wife had been into the office literally the day before and her numbers had all appeared fine, though there was a little question about the competence of the nurse who took her BP.)

She went into the office first thing in the morning and after checking her vitals, they told her to go straight to the hospital, which was 5 minutes away.

In a circumstance where the hospital (or the obstetrician) is 50 miles away, she'd have been in a much worse position.
Logged

"Political correctness is communist propaganda writ small... the purpose of communist propaganda was not to persuade or convince, nor to inform, but to humiliate; the less it corresponded to reality the better...To assent to obvious lies is to co-operate with evil, and in some small way to become evil oneself. One's standing to resist anything is thus eroded, and even destroyed. A society of emasculated liars is easy to control."
sumpnz
friend
Senior Member
***
Posts: 4,826


« Reply #14 on: February 16, 2017, 06:57:41 PM »

4 kids.  Not a one born in the hospital.  2 were born in the bath tub at free-standing birth centers, 1 in the car on the way to a free-standing birth center (with the bath tub filling), and one at home in our own bath tub.
Logged
Jocassee
Former Mod
friend
Senior Member
***
Posts: 4,263


Respek mah authoritay


« Reply #15 on: February 17, 2017, 07:41:31 AM »

4 kids.  Not a one born in the hospital.  2 were born in the bath tub at free-standing birth centers, 1 in the car on the way to a free-standing birth center (with the bath tub filling), and one at home in our own bath tub.


Mine is a mostly-unresearched opinion, but I do wonder if midwifery is what is needed here. Decentralized, home based care. Obviously some mothers are still going to need hospital care if they have risk factors. But midwives can identify those as well and help moms know when to head to the hospital.
Logged

They all wanna be Hank Williams, but they don't wanna have to die.
Chris
friend
Senior Member
***
Posts: 4,746



« Reply #16 on: February 17, 2017, 08:23:49 AM »

Wife needed an emergency c-section for the oldest.  It was a mess... almost 16 hours trying to induce labor, water broke after the first four, cervix messed up, went to OR, and the cord wrapped around his waist, wife started hemorrhaging, doc got it under control damned quick, and they were both fine.  Second son was a c-section by our choice.  Didn't want a repeat mess.

Our house is 15 minutes from the hospital.
Logged

No, I'm not mtnbkr.  Wink

a.k.a. "our resident Legal Smeagol."...thanks BryanP
"Anybody can give legal advice - but only licensed attorneys can sell it."...vaskidmark
sumpnz
friend
Senior Member
***
Posts: 4,826


« Reply #17 on: February 17, 2017, 09:24:40 AM »

Something like 70% of births do not need an MD, hospital, etc.  The reason midwifery isn't more commonplace is that most women want those services, and providing them has become the accepted norm.  That is neither inherently good nor bad. 

There are a lot of upsides to "natural" childbirth vs the medicated version that is so popular today.  But, as Chris pointed out, there are some (~30% - which is a huge number) that still require that medical intervention.  But for those that don't need that, midwifery can save substantial money, and result in a faster/easier recovery for mom.
Logged
sumpnz
friend
Senior Member
***
Posts: 4,826


« Reply #18 on: February 17, 2017, 09:29:47 AM »

My understanding is that in New Zealand pregnant women by default go to a midwife for their care.  Only those that meet certain higher risk profiles are referred to Ob's. 

However, that is because with their socialized medical system they are needing to ration care on some level to constrain costs.  Midwives are far cheaper than Ob's.  I'm not in favor of forcing that setup on all women, but the fact that midwives are banned entirely in some states, and massively restricted in others should change.  Making it more available as an option would be the best way to go.
Logged
Tuco
Fastest non-sequitor in the West.
friends
Senior Member
***
Posts: 2,445


If you miss you had better miss very well


« Reply #19 on: February 17, 2017, 12:15:51 PM »

https://www.scientificamerican.com/article/maternal-health-care-is-disappearing-in-rural-america/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+ScientificAmerican-News+%28Content%3A+News%29

It is getting more and more difficult to find a provider to deliver your baby and a hospital to do it in.  Lots of reasons for this: OB is a money-loser for hospitals, lack of reimbursement and the typical provider does not want to live out in the sticks.

It cost about 5000 to get my first daughter whelped.  She and my wife remained inpatient for observation for three or four days, due to my wife testing positive for a strep thing.  There were no complications.
I had a HSA at the time, and the bills came to me.
This was in 2002.

I expected it to be much higher.
Logged

7-11 was a part time job.
MillCreek
friend
Senior Member
***
Posts: 11,872


APS Risk Manager


« Reply #20 on: February 17, 2017, 12:31:53 PM »

I am the first to admit that because of what I do for a living (dealing with healthcare disasters), when we had our two children, it was in a tertiary medical facility with an OBG in attendance and me reading each panel of the fetal heart monitor as the printout came out of the machine as a backup.  I have seen way too many cases during L&D in which the feces hit the fan, even with an ostensibly low-risk birth. 

This, however, is my own paranoia.  I think that midwives are just peachy, and they are extensively used here in Washington state.  My enthusiasm for midwives is limited to an actual nurse midwife in a birthing center or hospital.  Washington state also allows for lay midwives with a considerably lesser degree of training and they usually do home births.  I personally would not use a lay midwife nor a home birth, again because of my background.
Logged

_____________
Regards,
MillCreek
Snohomish County, WA  USA

I bear a passing resemblance to Squidward
makattak
Dark Lord of the Cis
friend
Senior Member
***
Posts: 9,898



« Reply #21 on: February 17, 2017, 12:37:48 PM »

I am the first to admit that because of what I do for a living (dealing with healthcare disasters), when we had our two children, it was in a tertiary medical facility with an OBG in attendance and me reading each panel of the fetal heart monitor as the printout came out of the machine as a backup.  I have seen way too many cases during L&D in which the feces hit the fan, even with an ostensibly low-risk birth. 

This, however, is my own paranoia.  I think that midwives are just peachy, and they are extensively used here in Washington state.  My enthusiasm for midwives is limited to an actual nurse midwife in a birthing center or hospital.  Washington state also allows for lay midwives with a considerably lesser degree of training and they usually do home births.  I personally would not use a lay midwife nor a home birth, again because of my background.

Even without the experience you've had, I was doing the same with the heart monitor.

I also noticed that EVERY time we've had a child, the staff was rushing about dealing with several other births. Our 3rd child went so quickly, they had to pull the doctor out of a C-section to deliver her first. (and they got there just in time)

Our second child they induced because my wife was trending towards preeclamptic. They put her on the pitocin and then left for some time. When my wife told me she felt like she had to push, we had to get the nurse in there who quickly turned off the drip and ran to get a doctor.

In neither case did I feel they were incompetent, but I could tell maternity wards are (at least in my experience) very busy. A good father needs to be alert and watching out for the mother and the child, in all circumstances.
Logged

"Political correctness is communist propaganda writ small... the purpose of communist propaganda was not to persuade or convince, nor to inform, but to humiliate; the less it corresponded to reality the better...To assent to obvious lies is to co-operate with evil, and in some small way to become evil oneself. One's standing to resist anything is thus eroded, and even destroyed. A society of emasculated liars is easy to control."
cordex
friend
Senior Member
***
Posts: 3,568


« Reply #22 on: February 17, 2017, 01:29:12 PM »

My wife had an outstanding obstetrician.  She was the head of OB at her hospital, had a huge amount of experience, was completely supportive of my wife's preference for lack of any unnecessary intervention, and had an amazing bedside manner.  She was absolutely determined to be on hand to deliver our children (even though she had several other competent docs in her practice).  She didn't have to do much more than catch the baby both times, but I'm very glad the best, most capable OB in the county (and maybe the state) was on hand if something had gone wrong.

Both of my sisters (and lots of folks in our circle of acquaintances) are militant about home births.  This despite the fact that my younger sister's midwife let her go a couple of days after her water broke before delivering her first child.  Her daughter got a severe infection and ended up having to spend several days in the hospital on antibiotics.  On one of her girls the midwife nearly missed the birth entirely because she was out smoking.  Several of the midwives I've met have also really pushed crystals and herbal remedies. 

While I know there are good midwives and bad doctors, I wouldn't consider changing the choices we made even to save a few bucks.
Logged
Ben
Administrator
Senior Member
*****
Posts: 21,217



« Reply #23 on: February 17, 2017, 02:01:23 PM »

All I know about Norwegian medical practices I learned from Lilyhammer, but aren't midwives part of the standard medical process there for pregnancies? As in, they are a part of hospital medical staff and the woman gets one assigned to her?
Logged

"I'm a foolish old man that has been drawn into a wild goose chase by a harpy in trousers and a nincompoop."
MillCreek
friend
Senior Member
***
Posts: 11,872


APS Risk Manager


« Reply #24 on: February 17, 2017, 02:46:09 PM »

All I know about Norwegian medical practices I learned from Lilyhammer, but aren't midwives part of the standard medical process there for pregnancies? As in, they are a part of hospital medical staff and the woman gets one assigned to her?

This is a common approach in many European countries.  The midwives have hospital privileges, do the prenatal care, delivery and post-partum care, and have physician backup when necessary.  OB and FP handle the high-risk cases.
Logged

_____________
Regards,
MillCreek
Snohomish County, WA  USA

I bear a passing resemblance to Squidward
Pages: [1] 2
  Print  
 
Jump to:  

Powered by MySQL Powered by PHP Powered by SMF 1.1.21 | SMF © 2015, Simple Machines Valid XHTML 1.0! Valid CSS!