May 8, 2019
For women, a very scary and anxious time of their life is
pregnancy. With it comes excitement, fear, and all the physical and
hormonal changes that add to the stress. Often at the top of all
these concerns is how their day of labor and delivery will go and
whether their child and body emerge from the other side without any
complications. C/sections are a very common procedure in the US for
women constituting 33% of all live births.
That c/section rate is fairly consistent across the country
and is due to a number of factors. Some claim it is the litigious
nature of our country, others say it is obesity, and even others
think it is the a procedure of convenience for the obstetrician or
even patient. However, my guest Dr. John LaGrand, believes it is
because at their heart, all doctors are interventionists and due to
a variety of factors will default to an intervention much earlier
than is probably necessary. His private practice, in which he works
collaboratively with four certified nurse midwives (CNMs), he
believes is a different way to practice obstetrics and has led to a
c/section rate of only 5%.
By allowing his CNMs the freedom to practice midwifery as they
were trained he is able to focus his time on gynecological
surgeries and the occasional forceps delivery or c/section when the
labor takes a turn from routine. His practice has had 49 out of 50
successful vaginal deliveries after prior c/section and despite
being a small percentage of total births in the large metropolitan
hospital has still lowered their overall c/section rate by a few
Dr. LaGrand tells his pregnant patients that their pregnancy
and labor will be like climbing a mountain and the CNMs are the
guides. They will assist the patients in their journey up the
precipice and usually get them their safely. However, if something
happens and they can't go any further, his guides will call the
helicopter to rescue them off the side of the mountain - he is the
helicopter and will only come if absolutely necessary. By setting
up his practice to let the midwives practice their craft and him to
be a true backup without interference he believes leads to such
We also learn in this episode about how he grew up in Halifax,
Canada and went to school with Sarah
. She's kind of a big deal. Certainly a bigger deal
than either of us.
Dr. John LaGrand is an OB/GYN
physician who practices in Grand Rapids, MI at Advanced OB/GYN. He
has one partner and 4 nurse midwives.
Dr. LaGrand's Website: Are
you looking to find out more about Dr. LaGrand?
Advanced OB/GYN: Dr. LaGrand's
is a Certified Nurse Midwife: An introductory explanation can
be found here.
Episode 011: My
discussion with Dr. Accad on treating patients, not populations
Andy Larson: This is the donation link to honor Andy's death
with the Grand Rapids Choir of Men and Boys where he blossomed and
served as a head chorister.
YouTube for Paradocs:
Here you can watch the video of my late son singing his solo on the
Paradocs YouTube page.
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