Word: bwh
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Dates: during 1980-1989
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Ryan says that the majority of the complainants during her term as patient-advocate were women, many of them with gynecologic concerns. But she notes that "there has definitely been a rise in debate" on such issue in recent years, simply because of increasing national concern with obstetric issues. BWH and UHS doctors say that the broad movement among women's for "natural" childbirth and for more patient participation in the delivery process, has sparked a large proportion of the complaints against UHS. Because the University service has only two gynecologists available to women on the Harvard health plan...
Since the Joint Committee's April grievance was filed, Wacker says he has arranged with Dr. Kenneth J Ryan, chief of obstetrics and gynecology at BWH, to give women on the UHS plan the option of being treated by a BWH nurse midwife instead of by an obstetrician. The midwife option had been in the works for several years, but the grievance probably spend up implementation, says a UHS consumer council member who requested anonymity...
Doctors at BWH call the Caesarean section rate issue quite separate from other gynecologic complaints. Any discussion of delivery techniques inevitably becomes tied to the national debate on the subject. BWH's Dr. Ryan, for instance, has worked on a National Institute of Health task force on the topic and sent a memo to his staff in July 1981 expressing concern that BWH's section rate was too high. He recommended a long-term review independent of specific complaints Last spring, while the review was still pending and shortly after the Joint Committee filed its grievance. Ryan took what...
...John Davies, Ryan's temporary replacement, notes that "no one knows what a proper rate of Caesarean sections would be. "He adds. "There isn't any date to support the statement" that the BWH rate is too high...
Other doctors argue that BWH's Caesarean rate is high because, as a teaching hospital, it serves as a referral center for high-risk and complicated cases. And they add that concern for the safety for both mother and baby sometimes conflicts with patient preference for "natural" childbirth and maximum choice for the mother, who may not want to be operated on or drugged...