"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.

Sunday, January 30, 2011

Support for Delayed Cord Clamping

Watch Dr. Nicholas Fogelson's talk on evidence based support for delayed cord clamping from Grand Rounds at the University of South Carolina this month. Its a good resource should any institution or professional challenge the idea and argue that clamping of the cord immediately is "just what we do". Thank you Dr. Fogelson.

I love when science finally catches up to common sense. The burden of proof should be on those that support the intervention and not on proponents of what evolution has provided. Dr. F




  1. What's crazy is that most of the data I presented is not modern at all - it was published in the 1950s and 60s. The sad thing is that papers this old are not available online, and thus are nonexistent in the eyes of modern physicians. If it isn't available in downloadable PDF, it was never published!

  2. I know. Sad, isn't it. We have to go to college and medical school so we can learn how not to believe in common sense. If there is no study then it can't be true. You know, I never saw a study that said it was safer to cross the street when the light is green then when it is red. How did I know what to do? Again, thank you.