"All that is necessary for the triumph of evil is for good men to do nothing" Edmund Burke, 18th century Philospher.

"A long habit of not thinking a thing wrong gives it a superficial appearance of it being right." Thomas Paine

"The welfare of humanity is always the alibi of tyrants." Albert Camus

"Choice is the essence of ethics: if there were no choice there would be no ethics, no good, no evil; good and evil have meaning only insofar as man is free to choose." Margaret Thatcher, March 14, 1977

“It is difficult to get a man to understand something, when his salary depends on his not understanding it.” ― Upton Sinclair

Explaining the Cause

I am a practicing obstetrician who is a strong supporter of patients rights to informed consent and refusal. I believe a patient has the right to choose her own path given true and not skewed informed consent. Following that tenet, just as a woman should be able to choose to have an elective c/section she should be able to choose not to have one, as well. The American system of hospital based obstetric practice has been eroding those choices for women for quite some time. Due to concerns of economics, expediency and fears of litigation women are being coerced to make choices that may not be in their best interest.

I have had a long relationship collaborating with midwives and find the midwifery model of care to be evidenced based and successful. I was well trained at Cedars-Sinai Medical Center in the mid 80's to perform breech deliveries, twin deliveries, operative vaginal deliveries and VBACs, and despite evidence supporting their continued value, hospitals are "banning" these options. Organized medicine is also doing its best to restrict the availability of access to midwives.

Home birthing is not for everyone but informed choice is. Medical ethics dictates that doctors have a responsibility and a fiduciary duty to their patients to provide true, not skewed, informed consent and to respect patient autonomy in decision making. Countries with the best outcomes in birthing have collaboration between doctors and midwives. This is not what has been happening in the hospitals of America. Its time for a change and the return of common sense.

The midwifery model of care supports pregnancy as a normal function of the female body and gives a legitimate and reasonable alternative to the over-medicalized model of birth that dominates our culture. Through this blog I hope to do my part to illuminate what is wrong with our maternity care system and what is right with it. I do not expect all to agree and that is OK. We must all understand that given honest data it is not always reasonable to expect two people to come to the same conclusion. Our differences should be respected.

Sunday, August 23, 2009

Thanks from Breech birth parents

June 4th 2009

Dear St. John's Pleasant Valley Hospital Administrator,

I wanted to relay our birth and patient care experience at your hospital.

My wife and I had planned on a natural home birth. Unfortunately, our baby was frank breech, and despite trying all the baby turning methods, she remained breech.
We tried everything, Acupuncture, chiropractic techniques, even an External Cephalic Version (at St. Johns Pleasant Valley with Dr. Fischbein, incidentally) but nothing worked. And even though none of these methods seemed to work, and we were draining our pocket books trying everything under the sun, we were still determined to have a natural drug free vaginal birth.

We were lucky enough to find Dr. Fischbein, who after many tests and evaluations determined that, with his expertise, my wife was a good candidate for a vaginal breech birth.

As it so happens Dr. Fischbein is one of very few doctors that have the experience and skill to perform a breech birth. Even though our home birth could not happen, we were thrilled to have the option of a natural birth. Dr. Fischbein, along with the help of his midwives, was able to deliver our beautiful daughter. We knew we were in very skilled and capable hands. Our birth experience was wonderful thanks to the nurses, midwives and Dr. Stuart Fischbein, at St. Johns Pleasant Valley.

As I understand, many hospitals will not allow breech births. We are so glad that St. John's Pleasant Valley Hospital is progressive enough and values patient choice to have allowed Dr. Fischbein to perform a breech delivery. After the successful birth of our beautiful daughter, the nursing staff took terrific care of us. We are so incredibly grateful to Dr. Fischbein and the staff at your hospital. We were so impressed with the care we received.

With much gratitude,

Jeff and Martinique Lin (and daughter Lexington Lin)

1 comment:

  1. That was in June. What a difference 2 months can make! If the OB committee has its way, the Lin's experience will not ever be replicated at Pleasant Valley Hospital or St. John's Regional Medical Center. IS this right?