"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.

Monday, September 27, 2010

Internet TV interview

Here is a link to my interview on the Dr. Cassie Show on local KADY TV here in Ventura, CA. Dr. Cassie does great work with children and for the community and it was an honor to be a guest on her show. Check out what's happening with her at The Children's Therapy Network. Having good prenatal care and a nurturing birth will get babies off to a good start. Dr. F


First Waterbirth

Well, I am happy to announce I had the privilege of assisting on my first home birth in water. After 27 years of the lithotomy position it was really enlightening to experience another way. I was honored to be present for the birth of Eva and want to thank her parents for their trust. I also want to thank Karni and all my midwife and birthing advocate colleagues for their support during this transition. It seems the demand for information and alternatives to hospital birthing is growing. I am getting quite a few inquiries from women looking into all options. It feels really good to give them an open and honest discussion about choices. I have been contacted by women with previous c/sections, twins, breeches and medical issues. All seeking just an honest discussion about risks and benefits of their individual situation. It is with great respect that I thank those of you who send potential clients my way. While out of hospital birthing is not for everyone, the choice of how and where to give birth belongs to the woman and her family. All good things, Dr. F

Sunday, September 12, 2010

C-section rates higher at for-profit hospitals

From todays San Francisco Chronicle. This link below was sent to me by Brian Gilmore of Rumi Baby.
Looking only at low risk birth, women were 17% more likely to have a c/section at a for profit hospital than at a non-profit one. Each of us can draw our own conclusions but knowing what we know about what motivates many hospitals and physicians these days it is not surprising. In 2008, our practice in Camarillo at The Woman's Place had a 6% primary c/section rate compared to a greater than 20% primary rate at our local hospital overall in low risk women. I believe the difference is using the midwifery model vs. the obstetrical model for labor management.
This information has to rely on reporting of birth rates and methods by each institution. This may raise some question about honesty in reporting. I suspect the data comes from birth records so there is likely to be some credibility here. Just another reason pregnant women need to be educated and informed of choices, benefits and risks so keep spreading the word to your clients, family and friends.

Thanks, Dr F