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Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA

ARE MEDICAL SERVICES SAFE? By Donna Young

A Globe and Mail article, by Anne McIlroy and Paul Taylor, March 23, 2001, informed us that 60 percent of the medical students watched a doctor training them to act unethically; 47 per cent of 103 students interviews reported they feel pressure to act unethically very frequently, frequently or occasionally. Perhaps we should be concerned of the 53 percent who did not complain? Did they not know what was ethical or unethical practice?

McIlroy and Taylor reported this survey, started three years ago at the University of Toronto, indicated 60 percent of the graduating students were required and/or expected to: perform pelvic examinations on women under general anesthesia who had not given their consent; perform unnecessary procedures on unwary patients, including those who were comatose or unconscious; close wounds when they didn't know how; give psychotherapy sessions without supervision; to complete post delivery visits with patients who hadn't seen a doctor since giving birth; and to ask patients to return for follow-up visits that were purely for teaching purposes. Students complained they had little help from the doctors in assessing patients. Students felt they were providing substandard care, which included being instructed by a doctor to repair a child's scalp with inappropriate supplies and being part of a team that secretly administered intravenous drugs to a woman who had requested a narcotic-free vaginal delivery of her baby.

Dr. Richard Frecker, the U of T's associate dean of undergraduate medical education, said the data was compiled to let students know they do not have to comply with requests to act in a way they feel is unethical. Dr. Frecker implied that if unethical practices were happening at the U of T, it is happening across Canada and the US. He was sure of that. No truer words were spoken . . . The New York Times, March 27, 2001: Doctors punished are still prized by hospitals. It reported 44,000 deaths of 98, 000 persons hospitalized. Dr. Novello in her efforts to discipline doctors, last year in New York, took action against 411 doctors, a 21 percent increase over 1996. What are the BC and local statistics? No Oath, today, is required?

Infant Care by today's Practices: The report from the U of T, caused concern when I enquired as to one of their graduates practice, in Kamloops, BC. He was trained to do immediate cord clamping on an infants pulsating cord. That practice, is said to be now routine by our BC Ministry of Health. Locally, I did confirm that there is one doctor who does do delayed management of the pulsating cord. The local hospital permits both delayed and immediate clamping of the infants umbilical cord. Infants born in c-sections are most vulnerable to immediate cord clamping. Mothers are more risk to having a c-section, they represent 22 percent of the deliveries. One doctor that raised concern of higher unnecessary medical costs, is Dr. M. Wagner, New Zealand. His various reports, on the internet, indicate that the mother is said to be failing to progress within 12 hours of the deadline, she will be convinced she needs a c-section. In the 1950's 36 hours labour was normal, and 24 hours during the 1960's. Drugs are used to quicken the contractions, to have a woman comply to birth within 12 hours. The drugs can risk the mother to uncontrollable pain; the placenta may prematurely pull away from the mothers womb, resulting for a C-section, and a birth of a distressed child. Immediate cord clamping of the pulsating cord adds to the risk of a compromised child. C-section children have a higher statistics of being assaulted children. They run a higher risk of mental retardation of subtle degrees but have normal appearances. Their damage is associated with the need of a C-section, not the drugs/cord clamping. Parents should be requesting full copies of a C-section babies birth report, by all in attendance of the delivery, including the 3 Apgar Scores.

Immediate cord clamping when done is without the knowledge and/or informed consent of the mother. The practice may accommodate cord blood banks operating in Toronto, Edmonton, and Vancouver. Doctors going with this third stage labour management of the cord have no regard that immediate cord clamping can deprive the infant up to 80 percent of the total blood volume that should have been inside the infants body. That information is fact as to reports given out on the Internet by the cord blood banks. Their take of the cord blood from an infant can be 80 to 200 ccs. Infants victimized by immediate clamping are: limp/listless, have no grips in their fingers, slow in reflexes, pale in colour, may have heart murmurs, suffer iron deficiencies, had jaundice, are nervous children, easily frightened, may be prone to leukemia, more likely to experience learning and behavior problems, not evident in some cases, until the child begins school. Some teachers are asking for classes of 7. Toronto had over 60 percent grade 10 students fail an exam. A Moratorium on immediate clamping is needed. C-sections increase should be questioned. Future Births . . . 4 Million.