Counter-transference problems in hospital practice

Extra meetings: a tool for decisions and therapy

An Adolescent Unit uses the tool of any member of staff or patient group having the right to call a meeting. The development of this idea, anxieties about it, its usefulness and examples are presented. The meetings are used for communication, support or decisions and are often in themselves the vehicles for change.

Emergency caesarian section: a research study of the mother/child relationship of a group of women admitted expecting a normal vaginal delivery

This study follows a group of women who had their first babies by emergency caesarian section under a general anaesthetic and compares them with a control group who had a normal vaginal delivery. The emergency caesarian sections were not done for a clear cut medical emergency but for reasons such as foetal distress, prolonged labour, suspected cephalopelvic disproportion--all criteria open to different clinical judgment. The mothers and babies were seen one month, one year and three years after delivery. Significant differences were found between the attitude and behaviour of the caesarian group of mothers and that of the control group of mothers. There must be serious doubts about the need for an emergency caesarian delivery in this sample. They were a problem group of women as difficult to follow up as to deliver. In their histories there was a trend toward more difficulties in their past and present relationships. Did they need more sensitive handling during delivery to avoid an emergency caesarian section? Professionals frequently find anxiety hard to bear and need to act rather than attempt to understand the origin of the pain. It is easy to overlook the subtle long term effects of the action when it appears to solve the immediate problem.