westward and explore the frontier of Texas. A descendant of the barber-surgeons of the middle Ages, I have no formal training in my field. I have acquired my education from watching and through personal experiences. My patients are just like me; they come from my neighborhood with similar ethnic and cultural backgrounds. I support minimal inter- vention when assisting in the natural course of pregnancy, labor and delivery. However, one must remember that not all outcomes are successful. My patients must be strong, healthy women. Most have an average of six to seven live births and multiple miscarriages in their lifetimes. Unfortunately, a vast percentage of their live born babies do not survive infancy. This may be because most deliveries occur at home, involve complications, and I have limited resources to aid in the process. I am unable to stimulate labor or relieve any of the intense pain they experience. As a result, when a baby is trapped in the birth canal, I have nothing safe to offer. Unfortunately, my patients experience numerous complica- tions, commonly resulting in the death of both mother and baby. clusively for women. My education involves 4 years of college, 4 years of medical school and 4 years of standardized training in an OB/GYN residency. Not part of the local neighbor- hood, I have lived and trained in several states outside of Texas. Although I support minimal intervention as I assist the natural course of labor, I am equipped to offer abundantly more assistance than my mid-wife predecessors. By following standard protocols that recommend best practices to safely care for my patients, my hospital-based care is available to women who are healthy and strong, older, or even possess medical concerns. The numerous techniques and technologies available allow me to stimulate a dysfunctional labor, minimize the pain experienced, use forceps, or perform a cesarean section. As a result, my training allows me to minimize complications for both mother and fetus. My patients have smaller families, and their offspring survival rates far exceed those from the Texas frontier days. |