"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.

Tuesday, September 29, 2009

International Breech Conference Coming Up

Just to let you all know I have been asked and am honored to speak at a panel discussion on breech delivery at the International Breech Conference in Ottawa, Canada on October 15-16th.

I think Ina May is also schedule to appear there. The full schedule of events can be found at the website below. Hope you will spread the word and please let me know if you or any of your colleagues plan to attend. I hope to share ideas about bringing back the option of selected breech delivery to America as the Canadian Ob/Gyn Society has recently endorsed. Would be great to see youthere, Stuart


Breech Conference http://www.breechbirth.ca/Conference.html

International Breech Conference

The Bronson Centre

Ottawa, Canada - October 15-16, 2009

Programme
Conference Registration
Pre-Conference Workshop
Evening Event: Birth, a play by Karen Brody
Sponsorships, Exhibitors
Visiting Ottawa

The International Breech Conference is a forum where birth professionals and parents alike can share their knowledge and experience with breech birth, creating a community which can work together towards breech delivery practices and protocols which respect the individual needs of each family and each birth.

PROGRAMME
NEWS!
We are delighted to announce that Dr. Marek Glezerman will be joining us from Tel Aviv. Dr. Glezerman published important early criticism of the Term Breech Trial and will be speaking from the perspective of a centre that participated in the contraversial TBT.

The programme features prominent doctors, midwives, and researchers from around the world, including Germany, Australia, the UK, and the United States, as well as speakers from Ottawa and across Canada. Topics range from varying techniques and protocols of breech delivery, to education of mothers and informed choice issues, to methods of assisting breech babies to turn to vertex.
click here to view the programme

CONFERENCE REGISTRATION DETAILS
Registration fees are on a sliding scale. Registering as an Obstetrician or Professional (a category including family doctors, nurses, midwives, naturopaths, chiropractors, and doulas) may include CME or CEU credits.

Click here to register for the International Breech Conference!

PRE-CONFERENCE WORKSHOP (PROFESSIONALS)
Doctors, Midwives, and Nurses may register separately for "A Day at the Breech", a hands-on workshop featuring Jane Evans, UK Midwife and internationally acknowledged expert in breech birth, as well as Dr. Frank Louwen and Dr. Anke Reitter of Frankfurt, Germany, whose work in the last five years delivering breeches with the mother in the upright position has eliminated the need for forceps rescues.

Registration is limited. To register or to get on the waiting list for A Day at the Breech, please send an email to breechbirth@gmail.com.

Contact us: breechbirth@gmail.com

Monday, September 28, 2009

Dr. F on Health Care Debate Panel

I N V I T A T I O N

What: Forum on Health Care
When: Oct. 1, 7:00 p.m.
Where: Calvary Chapel, 2697 Lavery Court, Suite 10, Newbury Park, CA 91320
Who: Conejo Coalition for Responsible Government.
Contact: 805-262-2477, cguillot@roadrunner.com


This Forum on Health Care will consist of a panel of medical professionals and others on both sides of the Health Care reform debate. The purpose is to exchange real ideas for reasonable reform that preserves liberty and choice for the individual.

Seats on the panel may still be available for professionals favoring government-run health care; suggestions are welcome.

This forum is open to the public at no charge. It is a non-partisan event; no signs or clothing displaying a point of view will be admitted. Security will be provided.

It would be great to see you there! SF

Friday, September 25, 2009

The Coalition for Improving Maternity Services Responds to The Today Show’s Biased Reporting of Midwifery Care and Home Birth

Sept. 22, 2009

Dear Producers of The Today Show,

The Coalition for Improving Maternity Services (CIMS) and the undersigned organizations are disappointed with The Today Show’s misrepresentation of midwives and home birth that aired on Sept. 11, in a segment titled “The Perils of Midwifery,” later changed to “The Perils of Home Birth.” This biased and sensational segment inaccurately implied that hospitals are the safest place to give birth even for low-risk women and mischaracterized women who choose a home birth with a midwife as "hedonistic," going so far as to suggest that these women are putting their birth experiences above the safety of their babies. Neither could be further from the truth.

Unfortunately, The Today Show did not do its homework on the evidence regarding the safety of home birth and midwifery care. The segment featured an obstetrician who presented only the American College of Obstetricians and Gynecologists’ (ACOG) position in opposition to home birth, but it did not make any attempt to present the different viewpoints held by the many organizations that are committed to improving the quality of maternity care in the US. We are deeply saddened that the show did not take the opportunity to note that both CIMS and The National Perinatal Association respect the rights of women to choose home births and midwifery care, and that the respected Cochrane Collaboration recommends midwifery care because it results in excellent outcomes.

There is no evidence to support the ACOG position that hospital birth for low-risk women is safer than giving birth with midwives at home. What the research does show is that the routine use of medical interventions in childbirth without medical necessity can cause more harm than good, while also inflating the cost of childbirth. However, the current health system design offers little incentive for physicians and hospitals to improve access to maternity care practices that have been proven to maximize maternal and infant health.

“Birth is safest when midwives and doctors work together respectfully, communicate well, and when a transfer from home to hospital is needed, it is appropriately handled,” says Ruth Wilf, CNM, PhD, a member of the CIMS Leadership Team.

That is why the national health services of countries such as Britain, Ireland, Canada, and the Netherlands support home birth. In those countries, midwives are respected and integrated into the maternity care system. They work collaboratively with physicians in or out of the hospital, and they are not the target of modern day witch hunts. These countries have better outcomes for mothers and babies than the US.

Childbirth is the leading reason for admission to US hospitals, and hospitalization is the most costly health care component. Combined hospital charges for birthing women and newborns ($75,187,000,000 in 2004) far exceed charges for any other condition. In 2004, fully 27% of hospital charges to Medicaid and 16% of charges to private insurance were for birthing women and newborns, the most expensive conditions for both payers. The burden on public budgets, taxpayers and employers is considerable.

As US birth outcomes continue to worsen, it should come as no surprise to The Today Show that childbearing women are seeking alternatives to standard maternity care. After all, American women and babies are paying the highest price of all—their health—for these unnecessary interventions, which include increasing rates of elective inductions of labor and cesarean sections without medical indication.

To the detriment of childbearing families, the segment “The Perils of Midwifery” totally disregarded the evidence. Although the reporters acknowledged that research shows home birth for low-risk women is safe, that message was overshadowed by many negative messages, leaving viewers with a biased perception of midwifery care and home birth. CIMS makes these points not to promote the interests of any particular profession, but rather to raise a strong voice in support of maternity care practices that promote the health and well-being of mothers and babies.

One of the ten Institute of Medicine recommendations for improving health care is to provide consumers with evidence-based information in order to help them make informed decisions. The Institute recommends that decisions be made by consumers, not solely by health care providers. The Institute maintains that transparency and true choice are essential to improving health care. We remain hopeful that the medical community will soon recognize the rights of childbearing women when it comes to their choices in childbirth and will respect and support these choices in the interest of the best possible continuity and coordination of care for all.

We urge The Today Show to provide childbearing women with fair and accurate coverage of this important issue by giving equal time to midwives, public health professionals, researchers of evidence- based maternity care, and especially to parents who have made choices about different models of care and places of birth.

Sincerely,
Coalition for Improving Maternity Services
Academy of Certified Birth Educators
Alaska Birth Network
Alaska Family Health and Birth Center
American Association of Birth Centers
American College of Community Midwives
American College of Nurse-Midwives
Bay Area Birth Information
Birth Network of Santa Cruz County
Birth Works International
Birthing From Within, LLC
BirthNet
BirthNetwork National
BirthNetwork of Idaho Falls
BirthNetwork of NW Arkansas
Choices in Childbirth
Citizens for Midwifery
DONA International
Doulas Association of Southern California
Evansville BirthNetwork
Harmony Birth & Family
Idaho Midwifery Council
Idahoans for Midwives
InJoy Birth and Parenting Education
International Childbirth Education Association
International MotherBaby Childbirth Organization
Lamaze International
Madison Birth Center
Midwives Alliance of North America
Motherbaby International Film Festival
Nashville BirthNetwork
National Association of Certified Professional Midwives
North American Registry of Midwives
Oklahoma BirthNetwork
Perinatal Education Associates, Inc.
Reading Birth & Women's Center
Rochester Area Birth Network
Sage Femme
The Big Push for Midwives Campaign
The Tatia Oden French Memorial Foundation
Triangle Birth Network
Truckee Meadows BirthNetwork

About Us
The Coalition for Improving Maternity Services (CIMS) is a coalition of individuals and national organizations with concern for the care and wellbeing of mothers, babies, and families. Our mission is to promote a wellness model of maternity care that will improve birth outcomes and substantially reduce costs. The CIMS Mother-Friendly Childbirth Initiative is an evidence-based mother-, baby-, and family- friendly model of care which focuses on prevention and wellness as the alternatives to high-cost screening, diagnosis, and treatment programs.

Thursday, September 24, 2009

Cord Clamping and philosophy

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

Taken from the original "Common Sense" written around 1776. The wisdom of these amazing men is still inspiring today. We must remember to challenge things that do not make sense. Just because something has been done a certain way for a long time does not make it right. Often there are ulterior motives, sometimes faulty logic, but all the more reason to never stop thinking and speaking out. SJF

Remember to ask "Why?" when something does not seem sensical.

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

A quote from "Common Sense" written around 1776. The wisdom of these men is inspiring. To not question why we do some things routinely

Wednesday, September 23, 2009

Just an Update

Hi all, Very little news to report this week on my interactions with my hospital. Seems as long as I "behave" to their liking and, as such, ignore certain patients rights issues and give consent and admit patients per their recommendations all is well. Except that I have had to refer 5 patients this past month to other doctors or institutions so that they could have a chance at a vaginal birth. I have also had 2 patients reluctantly agree to a repeat c/section because they would prefer to remain with The Woman's Place and my care. I am waiting for my attorney to review some of their letters to see if we can at least challenge the taking of my credentialed privilege to do vaginal breech deliveries. I have long been approved to do them and there is no official policy against vaginal breech delivery at the hospital and yet they have told me if I allow another scheduled breech delivery they will suspend my obstetric privileges. Your support through all this has been uplifting but the process of trying to do what seems right to me is so tedious and slow. I have been invited to speak at a health care forum in Westlake Village on October 1st at the Calvary Church. Open to the public. I am hoping to attend the international breech conference in Ottawa next month. I have also offered to attend a Catholic Healthcare West seminar in Sacramento, October 9th, on obstetric policies in the CHW system to provide an alternative voice. I need approval from the chairman of the OB committee at St. John's in order to go so I am not holding my breath. Its been more than a week since I sent my written request. Will keep you posted.

Sunday, September 20, 2009

More Thoughts About Early Cord Clamping

Thanks to my Facebook Friends for this article:

Cord Clamping Danger to BabiesShare
Wednesday, July 1, 2009 at 5:11pm
By Lucy Johnston HEALTH EDITOR, Daily Express Weekend – Dec, 16, 2007

CLAMPING a newborn baby's umbilical cord too soon after birth can lead to oxygen deprivation and may explain the dramatic rise in autism, scientists have warned.

Groundbreaking research suggests the routine practice of cutting the cord quickly after delivery may reduce an infant's supplies of oxygen and nutrient rich blood in the crucial minutes before they start breathing.

Specialists now believe that in vulnerable infants this is leading to brain hemorrhaging, iron deficiencies and mental impairment, including autism, a mental condition characterized by extreme loneliness and a desire for sameness. Experts say this now affects up to one in 100 children … a sevenfold rise over the past decade.

Last night. David Hutchon, consultant obstetrician at Darlington Memorial Hospital who has studied the effects of cord clamping said: "Babies are being put at risk by clamping the cord too quickly.

"The blood and oxygen supplies in the baby are rapidly decreasing during the minutes after birth. Infants need an increased blood volume to till their lungs and the rest of their organs that are coming into use.

He added: "In susceptible infants, early cord clamping and the lack of blood to the baby increases the risk of brain hemorrhage and breathing problems. This could help explain the rise in autism. Why are we doing it?"

He added that he considered the modern practice of early cord c1amping to be "criminal" in particularly vulnerable and undernourished infants. And he said, "Obstetricians are more likely to clamp early than midwives. It is perhaps significant that autism seems to be more prevalent in babies who were delivered by an obstetrician.”

Umbilical cords are now clamped almost immediately ... before 30 seconds in many hospitals because over the last 20 years doctors have increasingly believed this could reduce the risk of mothers bleeding to death.

However: a growing number of experts, including Mr Hutchon, believe the risks to the baby outweigh the potential harm to the mother. They say at least three minutes should elapse before the cord is cut to allow the mother's blood from the placenta to continue to flow into the baby until its breathing is more established.

Their theory is borne out by recent research. In one major study, involving more than 1,900 newborns and published in the Journal of the American Medical Association, delaying cord clamping for two minutes reduced the risk of anemia by half and low iron levels in the blood by a third.

Eileen Hutton, assistant dean of midwifery at McMaster University in Hamilton, Canada, who carried out the research, said: "These benefits extend beyond the early neonatal period."

Another study carried out by Andrew Weeks, and published in the British Medical .Journal had similar findings: Dr Weeks, senior lecturer in Obstetrics at the University of Liverpool and practicing obstetrician at Liverpool Women's Hospital, told the Sunday Express: "I delay the cutting of the cord. This is especially important for premature babies who have fragile blood vessels. The lack of blood supply could theoretically lead to autism.

"There is evidence to show it [immediate clamping] can damage a baby but none to show it can benefit."

Patrick O'Brien, spokesman for the Royal College of Obstetricians and Gynecologists said: “The latest research does suggest parents should be given a choice and it should be discussed routinely in antenatal classes.”

Birth injuries caused by immediate clamping of the umbilical cord are explained and discussed fully at the following web sites:

www.autism-end-it-now.org
www.birth-brain-injury.org
www.cordclamp.com

G. M. Morley MD FACOG

Email obgmmorley@aol.com

I gave a PowerPoint presentation on cord clamping injuries at Darlington
Memorial Hospital on September 24, 2007.

GMM.

Wednesday, September 16, 2009

Dispelling a Myth About the Umbilical Cord

The umbilical cord around the fetus’ neck cannot strangle your baby! There, I said it. Now, let’s discuss the logic behind this truth. Nature has devised a system to nourish the developing baby inside the womb of all mammals. The placenta and umbilical cord are an amazing creation of both form and function. The placenta acts as a factory for hormones to support the pregnancy, a filter that among a myriad of tasks acts to bring in good things and remove waste and provides a reserve of blood and oxygen to support the baby through labor. The umbilical cord is the conduit by which nutrients such as sugar and oxygen help feed the baby via its two veins while through its one artery passes the waste by-products of growth.
Understanding how a baby gets its oxygen allows us to understand why a baby cannot strangle or “choke” on its cord. In order to choke, one must be using its trachea to breath air. Clearly, there is no air in the uterus, the baby does not breathe through its throat and, therefore, cannot choke. When an ultrasound reveals the cord around the neck it is a normal human response to anthropormorphasize the intrauterine baby to our extrauterine experience. But this is not the case and there is no reason to have fear. So, let’s dispel once and for all the rumor that a cord around the neck (nuchal cord) is more dangerous than any other situation. About 35-40% of normal term babies are born with the cord around the neck at least once. It can also be wrapped around the body or legs or even at times have a true knot. None of which are usually significant as the cord is designed to deal with this.
Cord compression can occur anytime during pregnancy. The cord is well equipped to handle temporary squeezing as the 3 vessels are cushioned by a matrix called Wharton’s jelly and the surrounding amniotic fluid. In labor, sometimes after the bag of waters breaks and fluid leaks out, the cord can be repeatedly compressed with contractions. This is not uncommon and is not, by itself, a sign of distress. Your practitioner or nurse can listen to or interpret the fetal heart rate pattern to know whether any intervention is necessary. And the compression of the cord almost never is an emergency or a cause for the tragic death of a baby inside the womb. When that tragedy occurs we all want to know why and often, mistakenly, we are told it was a “cord accident”. Compared to the number of times I have heard this mentioned by patients or news stories the real truth is that this is a very rare event.
Please be reassured that your baby will not strangle on its cord because it is not breathing through its neck like you and I. If you hear someone repeat this rumor you would be doing a great service to pregnant women everywhere by logically explaining to them the reasons why.

Sunday, September 13, 2009

Perspective on the Rights of a Fetus

ACOG has clearly come out against home birthing and last year made a formal statement that the safest place for giving birth is the hospital or a birthing center attached to a hospital. In a recent Today show interview, ACOG spokesperson, Dr. Erin Tracy, stated that in rare circumstances a home birth can go awry resulting in injury or death to the fetus and used this reasoning to argue against supporting a woman's right to informed consent and choice. So, my understanding from this is that ACOG has deep concern over the rights of the unborn baby and puts those rights above the mother's.

In July of 2007, ACOG reaffirmed their statement of policy regarding abortion. Paragraph #3 states: "Termination of pregnancy before viability is a medical matter between the patient and physician, subject to the physician's clinical judgement, the patient's informed consent and the availability of appropriate facilities."

Paragraph #5 states: "Informed consent is an expression of respect for the patient as a person. It particularly respects a patient's moral right to bodily integrity, to self-determination regarding sexuality and reproductive capacities, and to the support of the patient's freedom within caring relationships. A pregnant woman should be fully informed in a balanced manner about all options.....The professional should make every effort to avoid introducing personal bias."

"The College continues to affirm the legal right of a woman to obtain an abortion prior to fetal viability. ACOG is opposed to abortion of the healthy fetus that has attained viability in a healthy woman (Dilitation and Extraction or late term abortion). Viability is the capacity of the fetus to survive outside the mother's uterus." Although against this procedure, they do acknowledge that a late term abortion may be the most appropriate procedure in a particular circumstance to save the life or preserve the health of a woman and only the doctor, in consultation with the patient, can make this decision. ACOG also states that a select panel they convened could identify no circumstances under which this procedure would be the only option to save the life or preserve the health of the woman.

I was sort of confused by this last paragraph so don't feel bad if you have to reread it, too. Anyway, their statement of policy on abortion concludes in bold print: "The intervention of legislative bodies into medical decision making is inappropriate, ill advised, and dangerous."

So, realizing that I am editorializing here a bit let me see. Hmmmm, they are on a lobbying campaign to discourage or eliminate a woman's choice of home birth because it can very rarely cause damage to a fetus but they are against legislation to prevent a woman's choice of a late term abortion which kills viable fetuses. Am I missing something here? Am I comparing apples to apples? Is this an amazing bit of ACOG hypocrisy? Please comment as I would love clarity here. Thanks, Dr. F

Friday, September 11, 2009

9/12 Rally in Thousand Oaks

Here are the details:

What: "912 Protest Against Socialized Health Care and Government Spending."
Where: Hillcrest & Lynn Rd., NE corner, across from the Oaks Mall parking lot.
When: Speakers: 12:30 - 2:00 p.m. ----- Protest: 11:00 - 3:00 p.m.
M.C.: Trevor Woolley
Organizer: Carolyn Guillot -- 805-262-2477

Hope you can attend. We are all individuals with life experiences that make us unique and shape our decisions. We are not identical, our lives should not be relegated to an RVS code and one size fits all medical guidelines set by faceless panels. Having been a practicing physician for more than a quarter century I have seen the demise of personal liberty to the detriment of the individual. Whether it is big business or big government, we should not trust our lives to those motivated by economics. Surrendering personal choices and responsibility to the false god of "equality" will lead only to enslavement. Never a good thing.

You all know the issues that I stand for. Birth choices and personal responsibility. My belief is that this can best be achieved through changes in the current system and not a government run system. While dealing with insurance companies is all too often maddening beyond reason, it is so much worse trying to care for patients under the current government programs of MediAid and MediCare. Doctors cannot make a living, run a business and do what is right by their patients under this immense regulatory burden, poor reimbursement and the fear of a guilty until proven innocent audit and legal system. If an insurance company wrongs a patient or a practitioner there are avenues of recompense. And as burdensome as they might be one can sometimes prevail. You can appeal to their medical reviewers, the insurance commissioner or even sue. But who can you appeal to when the government run insurance company harms you?

So, this among many reasons is why I support the private sector with oversight. Oversight, not over regulation. Government is the problem! The reason there is no competition from out of state insurers is government regulation. The reason that the few remaining in state insurers offer one size fits all policies is government mandate. You have heard this before but here is what government can do, and within weeks, to show they mean what they say.
1) Remove blocks to interstate commerce. If you can buy your TV from Ohio why not your health insurance?
2) Remove employers as the purchasers of health insurance and thus make it portable. Would you let your employer dictate the one model of car you can have?
3) Stop insurers from cherry picking healthy patients and excluding ones with prexisting conditions. Here is where a government pool supported by charitable organizations supported by citizens freed from high tax burdens could contribute to those truly unfortunate.
4) Allow decisions to return to the patients and their practitioners who know them as individuals. I support use of outcomes data and evidenced based decision making. No panels or guidelines that dictate one size fits all policies.
And 5) The greatest restriction to meaningful reform in all areas of our lives, not just health care, is the American tort system. Fear of being sued drives up costs everywhere. you cannot have meaningful, cost saving health reform without tort reform. Liberals must capitulate on this or all other reforms, government or private, will not work. How can anyone support a system that holds a health care worker or institution responsible for an adverse outcome when the diagnosis or treatment is delayed because of bureaucratic inefficiencies?

Imagine you have a new headache. Your physician examines you and thinks an MRI is necessary. He orders one but there is a delay of 4 months before you are allowed to get it. In the meantime you have a stroke. Is the doctor at fault? In the currently proposed healthcare bill, without tort reform, he/she would be. A career destroyed. What doctor would want to practice under such a system. Even more worrisome is who is going to want to go into medical school knowing this is what awaits them. A life of living under the microscope of Monday morning quarterbacks holding a legal axe over your head. The President and Congress want to rush through a bill that few have read, almost no one understands and spend trillions of dollars faster than I could get you that MRI. Now I have a headache!! How much for a couple aspirin?

Thursday, September 10, 2009

Dr. F at Health Care Rally

I have been asked to appear and speak at a rally on 9/12 in Thousand Oaks. The main theme is against a government take over of health care and indiscriminate spending. So much has been said already pro and con that there is little I can add. My hope is that I can say a few words about cost savings in maternity care using the midwifery model. And back it up by giving a real face to the issue from one with expertise who is actually doing the work. I am hoping that on one subject left and right can agree. That being that the ultimate decisions in any health care proposal need to belong to the patient. On another note, my daughter and I will take a moment on the morning of 9/11 to pause and remember the tragedy of 8 years ago. God bless the memory of those lost on that day.

Saturday, September 5, 2009

Please check out my interview from Stand and Deliver. Soon to be posted on my web page as well. Thanks to Rixa for doing this.

http://rixarixa.blogspot.com/2009/08/interview-with-dr-stuart-j-fischbein.html

Stand and Deliver (formerly The True Face of Birth): Interview with Dr. Stuart J. Fischbein

Source: rixarixa.blogspot.com

Baby flips after visit to Berlin Wellness Group

On a nice positive note, I saw a patient today, September 4th, at 40 weeks gestation upon the kind referral from Elliot Berlin, DC. She thinks she might have been in breech position for several weeks but was only confirmed by her doctor in Pomona 2 days ago. This left little time for interventions that might help turn the baby. She was also concerned because there was no practitioner in her area she could find to take her on at this late date let alone offer a breech vaginal delivery.

She underwent chiropractic manipulations yesterday and last night reports a lot of fetal movement. Upon presenting to my Camarillo office today ( a very long drive from Pomona!) I am happy to report the baby had spontaneously flipped to vertex. Ultrasound confirmed the findings on Leopold's maneuver and the environment around this 8 pound baby looked great. She was sent home with a binder and hopes renewed for a natural birth back in Pomona. Kudos to the wonderful doctors at the Berlin Wellness Group and to the dedication of such marvelous parents who endured the drive through the infamous LA traffic to keep the dream of their desired birth experience alive. Dr. F

Wednesday, September 2, 2009

Comment on Huffington Post

As a newly trained physician just out of residency back in the 80s I remember inviting my parents to Las Vegas for my formal acceptance ceremony into the fellowship of ACOG. I was so proud to be a part of what I thought was the pinnacle of my profession. Fast forward 20 years and now I wonder what has happened. Did they change or did I? ACOG does many good things and their continuing education and promotion of some research and programs have been a benefit. But, all too often of late, they have done some really stupid things. ACOG has released several Committee Opinions that defy evidenced based research, common sense and even the the very foundation of their organization that purports to respect a woman's autonomy and choice. I have written them for an explanation as to who decided and on what evidence and received only anecdotal hogwash from their executive vice president. Whether they or their blind supporters and shills like Amy agree with out of hospital birth is not the real question. To make statements based on "consensus opinion" that are purposely designed to remove choice is unscientific, unprofessional and belittles their organization. Those that are behind these pronouncements know what they are doing will influence policy, insurers and hospital administrators. It is an abuse of power and wholly unhypocratic. Patient autonomy and choice as well as honesty are the issue here. Whether readers, shills or ACOG are supportive of home birth and midwifery or not we should all strive for respect of the patient's intelligence, dignity and liberty. ACOG comes out last year with a statement against out of hospital birthing and now puts out a call for stories to back up their opinion? Isn't that sort of backwards, insulting and poor research technique? Simply embarassing. Not the pinnacle anymore.

http://www.huffingtonpost.com/louise-marie-roth/acog-up-to-dirty-tricks_b_274372.html#postComment

Tuesday, September 1, 2009

Midwives Reinstated !!

Hi All, Well, a big thank you to Terry Cole, MD, a long time supporter of midwifery, who stepped up and agreed to be our backup. This should satisfy the ever changing rules of the MEC for now. I had to switch days to cover my Century City office from Mondays to Tuesdays because we could not find any physician willing to back me backing the midwives on Mondays. I spoke to 5 of the members of the OB committee and a total of 8 members of the attending staff and all refused. The reasons went from reasonable to absurd but not surprising. At least now our patients can get the care they desire while we continue to work for their rights to choose the manner by which they give birth.