"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.

Friday, January 22, 2010

Another absurdity brewing at Pleasant Valley Hospital

Pleasant Valley......sounds like such a wonderful place. Wrong! The pediatric and obstetrical committees are at it again. I was forwarned but not yet officially notified that the ob committee has recommended and the Medical Executive Committee has approved a new policy that will forbid midwives from delivering babies at this facility. They will have to deliver in Oxnard at St. John's Regional Medical Center. Pleasant Valley, our home hospital, across the street from our office will now be off limits to midwives. The two midwives who are credentialed to work there were never consulted or informed of any problems or reasoning behind this new punitive policy. Neither were the physician groups who support and collaborate with the midwives. It was all done in secret and without explanation. I suspect the workers in the cafeteria knew before we did.

Midwives have had admitting privileges at the twin campuses since the mid 90's. In the entire history of the takeover of these two hospitals by Catholic Healthcare West the medical staffs have been comingled. Credentialed Practitioners can admit to either campus. This move to restrict access to one of the campuses is unprecedented according to those who have been in the community for years. This is yet another assault on the ability of certified nurse midwives to care for low risk pregnant women in any setting by doctors and an administration who treat birth as a disease.

While we attempt to get to the bottom of this and possibly appeal to the board of directors, your phone calls to the administration expressing your displeasure would be appreciated. 805 988-2500 and ask for Administration. Mike Murray is the current CEO but has tendered his resignation. This, too, is curious timing. Anyway, Anne Kelley, MD is the new Chief of Staff. taking over for Dr. Niesluchowski. Juan Torres, is still the OB Chairman. Contacting any of these people or going directly to the Board of Directors may be futile but make your voice heard, please. SJF


  1. Again, I'm dumbfounded. I just can't believe this. It's becoming a truly frightening time for women to bear children. We live in the information age... a time when we have the answers to SO many questions, and yet we move in a backward direction. Greed and power are sick aspirations and I can't help but think about the Salem Witch trials when I think about the future of midwifery and the future of birthing in this nation.

    Do your administrators have an address (either snail mail or email) that we could write to instead. I'm much better with the written word, especially when I can sit down and organize my thoughts. I'd be more than willing to compose a letter and send it to as many people as necessary.

    Please keep fighting the fight... the women in your practice and in your community need you. Thanks again for all you do to support birth and human rights.

  2. I know! Here are some addresses:
    Write to any or all of the people listed.

    St. John's Regional Medical Center
    1600 North Rose Ave
    Oxnard, CA 93030
    Phone: (805) 988-2500

    Corporate Headquarters:

    Lloyd H. Dean
    Catholic Healthcare West
    185 Berry Street, Suite 300
    San Francisco, CA 94107
    Phone: (415) 438-5500

    Please copy me on anything you write at angelfischs@yahoo.com
    And feel free to copy the Ventura County Star and the Camarillo City Council, too. I really believe the community has no idea what is being done to their local hospitals and to their choices.

    Thank you for your efforts and kind words, Stuart

  3. Hi,

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