"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, April 3, 2011

Questioning Veracity

After some prodding by me and others, finally, last week the Ventura County Star and writer Tom Kisken finally reported on the status of the longstanding midwife ban at Pleasant Valley Hospital in Camarillo, CA. I found the headline to be misleading, the article to be very milk toast and Mr Kisken's investigative effort into the veracity of the hospital administration to be lax at best. Those that have followed me for the past year and a half know of the issues to which I am referring. Please read and add your comment to the story at:

Midwives ban to be lifted at Camarillo hospital; question is when


I have sent Mr. Kisken the following e-mail after returning home from a fun filled weekend with my daughter and her Westlake High School choir class at the Heritage Music Festival in Anaheim. Hoarse and exhausted from chaperoning 160 kids through the event and long, good days at Disneyland and California Adventure.

Dear Tom, I just read your article is last weeks Star. I found it very disappointing. Once again you failed to get anyone to explain anything. You allowed administration to avoid answering the obvious question. "Why Certified midwives banned and not doctors?" Laurie Eberst was not even here when this happened. What could she possibly know about the truth other than what she had been fed? Where are the quotes from Ann Kelley or Eugene Fussell? If no one is talking doesn't that bother you? You quoted anonymous sources but did not say why anyone would need to remain anonymous here. How about explaining that your sources were reprimanded last time for talking to you? How about some investigative journalism into why anesthesia is and has been obstructing the midwives return? Did you speak with Dr. Kalcic? How can it possibly take more than a year to implement any policy change if they really want to change? Good investigative reporting would have asked those questions and not allowed a non-answer. Also, since I was a major part of their reasoning for the ban, why not approach me for information? Was not I the one who gave you the "push" in the first place? And what is that headline supposed to mean? It seemed almost tongue in cheek and very inappropriate. Was that story really your best work?

Sincerely, Stuart Fischbein, MD

I will patiently await his reponse and happily report any error in my facts should he wish to clarify. My colleague, Kim Rivers, has written a letter to the editor in reponse to the article. With her permission, I will post it if the Star refuses to.


  1. It's veracity. Love your articles and contribution to society, Dr. Fischbein. Thank you for being a champion in the cause.

  2. Darn, I keep doing that. Thanks, will fix.