"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

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


  1. Dr. F - Just wanted to say hello! I've been following your story for a short time - thanks for all you do! Looking forward to reading your blog.


  2. Hi Diana, I hope to have many positive things to blog about in the coming months. Thank you for your support as sometimes it is a bit lonely doing the right thing. Dr. F

  3. Greetings Dr. Fischbein,

    I am so inspired and excited to witness you following your heart as I have been called a "salmon swimming upstream" myself for the lifestyle choices I have made. Your support in being my OBGYN as well as backing up my midwives 6 years ago assisted with a the birth of my healthy son Bridge now 6-years-old. We have chosen a path that is less traditional; conscious pregnancy, home birth, attachment and conscious parenting, keeping him in-tact, shared sleep, Waldorf Education, alternative medicine and so on. Please let me know if you would like me to draft a letter based on my patient experience in support of your efforts, as I am honored to support you in gratitude for the support I and my family received.

    Love Nicole Nathanson

  4. Hey Nicole, Your words here are so appreciated. Having your support, whether in thought, word or deed is an honor. Quite simply, thank you for taking the late hour to share your story. Warmest Regards, Dr. F

  5. This is Dena Moes here, on my hubby's email acct. Just want to say congrads on experiencing homebirth! What a difference, eh? I am so grateful to you for your support. Thanks for all you do for homebirth midwifery! take care.