"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.

Wednesday, February 2, 2011

Even on Vacation....

Darn those Goolgle alert search engines. While on vacation I was browsing my email and was alerted to a post by The Skeptical OB (Amy Tuteur)claiming MANA is trying to hide death statistics. Many of you know of this blogger from her vehement stance against VBAC, homebirth and midwives. I don't think she likes me much either. In her current blog at:


she says,"I have been hammering away at this issue in the past 4 years in every possible forum and with every professional homebirth advocate I could find ... and the silence has been deafening".

Well, I believe that most of us do not take her seriously so do not bother responding. However, since she has somewhat of a following and has the ability to confuse and upset many readers I decided to accept her challenge and offer to debate her in an open forum. I guess I just found relaxing in a tropical paradise too peaceful and so I responded to her as follows:

Dear Dr. Tuteur, You seem to be very passionate and knowledgeable in your blogs. I am happy to respond to you and break the silence you claim is deafening. Who are you really and what is your background and expertise in this subject? You have been pounding away at midwives, VBAC, homebirth and me from a place of anonymity for 4 years. Many professionals dismiss you simply as an agitator who likes to see herself in print. I am happy to give you the benefit of the doubt and accept your challenge. Lets have an open debate. I am inviting you to accept an opportunity to debate me on this subject at a public venue of your choice. Or, if you prefer, I will ask ACOG or MANA to set up a public forum in the next year where you and I can debate face to face and respond to questions from attendees. You can reach me via email at stuart@thewomansplace.com. Lets stop the hyperbole and name calling and debate our differences like professionals and like adults.
Sincerely, S. Fischbein, MD FACOG

I will let you know if I hear anything. For those on the east coast, please stay safe and warm. Dr. F


  1. This was Amy's response:

    "Do you know how many babies died?I'm confused, Dr. Fischbein. What is there to debate about the fact that MANA is hiding the number of babies who died at the hands of CPMs? If you know the number, please share it with the public, because American women have a right to know the truth.

    If you don't know the number, why don't you try to find out for the rest of us. You have extensive contacts in the world of homebirth advocacy. Surely MANA would tell you how many babies died. Or do you think that it is acceptable for MANA to hide the truth about the dangers of homebirth?

    * By the way, I think readers deserve to know that Dr. Fischbein and I have tangled publicly in the past when I wrote about his conviction for sexual exploitation of a patient."

    - The Skeptical OB February 2, 2011 11:45AM

  2. Excellent. I look forward to it, if it happens.

  3. And my response to Dr. Tuteur's nonresponsiveness:

    Public Debate request #2

    Dear Dr. Tuteur, Your response in nonresponsive. We are not surprised. Debates are designed for each participant to present their data and for the audience to learn and possibly decide which they choose to believe. Why would I need to find out any numbers for you? You must already have definitive evidence and numbers against MANA in order to make your statements against them. Or did you libel MANA just for fun? Again, here is your chance to bridge your gap of foolishness to attain some credibility. The debate offer still stands. I remind you it was your challenge which I have accepted. As for my past history, while irrelevant to the MANA topic, we can spend time at the opening of the debate discussing both our personal histories, credentials, training and experience in this field. With all due respect, Amy, ad hominum attacks are the weapons of those without an argument. You have my email.

    Sincerely, Dr. Fischbein
    February 3, 2011 9:26AM

  4. You are a brave man to take on the spin doctor!

  5. Very well stated. This woman obviously has no intention of publicly debating, but how I would love to see it!