I am 4 God too, but I don't think He minds pictures of the naked bodies He made. He minds pictures, or anything, which inflames our lust, but I really don't think these fall into that category, do you? This is just meant to be humorous.

And in case you didn't get what Sarcasm 101 wrote, these guys have their penises and testicles tucked between their legs so you can't see them.

God doesn't require us to be prudes. If these pictures arouse you and are an occasion of sin for you, of course do not look at them. But they don't have that effect on most people, nor could it be expected that they would. Please reconsider your comment.
Susan Peterson

sigh

Big bottoms
Big bottoms
Talking bout mudflaps, my girl's got 'em.

I wonder if Marvin and Mary Sue had a shingle out front reading "Pappy's Pappies."

I am not sure why you refer to my work as a “perinatal cesarean risk prediction calculator” when that is not what my software does. My Cesarean Rate History® software tool provides the outcome of the last 100 similar women who have labored. This provides information not a prediction. I agree with you that 22 years of practice and ten thousand deliveries provides a wealth of experience. I am not sure why adding a few hundred thousand deliveries to your experience would not be a good thing. Imagine having the experience of all those deliveries as a first year resident. It is for this reason that my software is provided at no cost for resident training.

My Cesarean Rate Tracker® software tool providers a central location where an obstetrical care provider can store the results of their deliveries and compare the outcome of their deliveries to other providers in a confidential manner. This would help you with your postpartum cesarean rate calculation.

Your letter states; “So how do you select the person or group that will give you the best-standard-of-care shot at a normal delivery? Beats the hell out out me.” I believe that the answer to this question is that we need to look at a cesarean birth “measure” and not a “rate”. A cesarean birth measure takes into account the risk factors of an obstetrical care provider’s patient population therefore; it can be used to measure the results of an obstetrical care provider’s labor management strategies.

The Green Journal has reviewed my work and chose not to publish it “on the basis of priority”. The reviewers had many positive comments and commended me on my work. I would be happy to provide you with a copy of that research paper.

My data represents over half a million births that were attended by 2,915 different obstetrical care providers working out of 109 different hospitals. However, you are correct that nothing in my comment ascertains the true cesarean rate of your practice. My work is a quantum leap ahead of using the cesarean “rate” as a meaningful measure. ACOG recognized this same problem over 12 years ago and the Joint Commission is using the cesarean birth “measure” created by Dr. Main and his group in California as a result of this.

It seems to me that your attack on my comment offering you a solution to your problem would indicate that you really don’t want a solution. Other than your insults, you have not provided any meaningful evaluation of my work. There is a 38 minute PowerPoint presentation on my website that explains my work in detail. Please take the time to view that presentation before you refer to my work as “crap”.

This is pretty frightening, though I suppose that since your rate is so low (1/2 the average) that it just bumps their odds up to "average" if you're not on call that particular weekend :(

The most important piece of information to keep in mind when discussing cesarean birth rates is that the risk that labor will result in a cesarean birth is affected by BOTH a woman’s physical characteristics AND the labor management strategies used by the obstetrical care provider. Give me a population of twenty year olds having their second vaginal birth and my total cesarean birth rate will be well below 5%, however if my patients are all in their upper thirties and having their first birth, a 30% cesarean birth rate may be exceptional.

My Birthrisk Cesarean Birth Measure is the only measure available that takes into account the physical characteristics of both mother and baby so that we can finally measure the effects of how different obstetrical care providers manage labor. Once all obstetrical care providers obtain their Birthrisk Cesarean Birth Measure then women will finally be able to compare apples to apples. Any obstetrical care provider that wants to obtain their measure can do so for free. Any woman who is having a baby and wants to know how women with similar physical characteristics fared during labor can obtain a free Cesarean Rate History® at www.Birthrisk.com.

1. Regarding how it was no problem in the late 90's to get disclosure of personal/group data... he says they probably just made it up.

2. "It isn't practical for the individual clinicians to do this, though, it should be supported on an institutional level." - That was something we talked about, too. It's unrealistic to think that someone is going to sit down and do all of this, honestly (without someone double dog-daring you to do it).