"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, May 25, 2010

Laying Low and letting the process work

I have not posted in nearly two weeks. But that does not mean things aren't happening out here in Ventura County. Some revealing events are taking shape but the details are protected by their veil of confidentiality. One important event happening next month is the arrival of an investigative panel sent by ACOG to review the policies, procedures and doings of the OB committee. Apparently, things have finally gotten so obviously bad with this committee that even the always complicit hospital administration had to do something. There was no hiding it anymore. So they have hired a group of ACOG physicians and nurses, at a price tag of more than $37,000.00, to come for 4 days and perform an "objective" investigation, chart, policy and meeting minute reviews and conduct personal interviews with all members of the department including midwives. At the OB department meeting I was specifically assured by one of the hospitals top administrators that anyone who wanted to be interviewed would have 30 minutes in private. Now, however, there are rumors that they may be backing away from this promise. There are many of us who would make a lot of noise if they even try something like that. I am hopeful that this will be the first step in returning honesty, common sense and reason back to our department. I would like to see those that have for so long abused their position of power be humbled to the point of apology and punishment and we can hope for a revamping of the committee model and a return to evidenced based medicine and national standards that benefit patients rather than a small totalitarian group of petty obstetricians forcing their will upon us.

Also, Joyce, Victoria and I have almost completed the final edits of "Fearless Pregnancy, 2nd edition" and hope to have a release date in early June. It will be available online in real soft-cover book form or as a download e-book format. Amy Tinney and I also have 2 meetings this week with persons possibly interested in helping with our maternity center idea. I see Laurel Phillips has some fundraising events going on up in Santa Barbara. Please check out the Santa Barbabra Birth Center web site for details. I may also soon be helping out with the Sanctuary birth team as a consultant in the Los Angeles office and I have heard exciting news that they will soon have a facility for midwife assisted out of hospital birthing on LA's west side. All the best, Dr. F

1 comment:

  1. Keep us posted on the release of your book. I will pre-order several copies if that's possible.