There is a new kid on the block in some hospitals, and it's someone you likely haven't met yet - the laborist. A laborist is much like a hospitalist, someone who doesn't have a practice outside of the hospital, but merely sees patients who are in the hospital, in conjunction with their own midwife or physician. This is someone who can walk in an see you to discuss options without having to leave their patients waiting in the office. They can be there quickly, should your baby decide to make an appearance sooner than predicted. And, the work a set number of hours and go home, allowing for the next laborist on duty to show up. Sounds nice, right?
Certainly there are benefits to having a laborist for many reasons and not just for the practitioners that they back up. I prefer working with a laborist, someone who specializes in birth, as opposed to having the emergency room physician have to attend a really rapid birth. While skilled, they don't have the nuances of birth that they practice on a daily basis, and it's obvious in some of the things that happen more frequently. (In my own experience as a doula, I see more episiotomies when an ER doctor is called, where I feel, and have been told later by the physician, it might have been avoided.) The biggest problem for moms is that they frequently have had no contact with the laborist prior to labor, so no relationship. Most moms assume that their doctor or midwife will be the person catching their baby. The relationship that they've built was designed to help them trust the person with whom they've seen with important moments. That said, many women wind up with an on call doctor anyway, with whom that may or may not have had contact.
That said, a new study shows that using a full time laborist model might help hospitals reduce the number of cesareans births that are done. One place I really see this being beneficial is for hospitals that do vaginal births after cesarean (VBAC). Since many require the doctor or midwife to be in the facility for the entire labor, it can be a burden on them, causing them to restrict the numbers of VBAC clients that they see or being fast to say that they are ready to perform a repeat cesarean. Having a laborist can reduce the strain on these practitioners, allowing more moms to labor freely. The same is true for physicians who are worried that a mom may require intervention in the wee hours of the night, someone is there to take care of them, thus preventing the need for a preemptive intervention.
Your thoughts? Have you had a laborist in your birth? Does your hospital use this model?
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Source:
Am J Obstet Gynecol. 2013 Jul 25. piiS0002-9378(13)00656-X. doi: 10.1016/j.ajog.2013.06.040.
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Hospital Hire May Lower Cesarean Rates originally appeared on About.com Pregnancy & Childbirth on Monday, August 12th, 2013 at 07:08:43.
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