Marion’s Message: When Do You Push the Panic Button?

At the March 2005 Midwifery Today Conference in Eugene, we sat in a circle discussing third and fourth stage problems. A young midwife with a hospital background raised a question. “When do you push the panic button?” People looked at her with interest and she continued, “What I mean is, in the hospital, they always stress that over twenty minutes from the time the baby is born to placental delivery is high risk. But people here are talking about much longer times. How do you know when you are in trouble?”

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About Author: Marion Toepke McLean

Marion Toepke McLean, CNM, attended her first birth as primary midwife in August 1971. She received her nursing degree from Pacific Lutheran University in 1966 and her midwifery and family nurse practitioner degree from Frontier Nursing Service in 1974. From 1976 through 2001 she did home, clinic and hospital births, while also working as a family nurse practitioner. In 1980 she taught a year-long program for local midwives, returning to Frontier Nursing Service to teach during the summer. She had a homebirth practice until 1985, when she went to work at the Nurse-Midwifery Birthing Service, a freestanding birth center. In June 2000 she completed a BA in International Studies at the University of Oregon, with concentrated studies on Mexico. Since 2002 she has worked in a reproductive health clinic and attended an occasional homebirth. She lives in Eugene, Oregon, and is a contributing editor to Midwifery Today.

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