"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, May 1, 2011

Only 2 state-licensed birthing centers in Central Indiana close

Citing problems with insurance coverage and insurers reluctance to pay for birthing center births despite the savings of about 50% from the cost of a hospital birth these 2 centers were forced to close. The midwife running the 2 centers, Barbara Bechtel, also stated that the insurers demanded an obstetrician be her backup rather than the family medicine doctor she had been relying on. She could not find cooperation from the local obstetric community and so this option for mothers is no longer available. There was no mention of problems with bad outcomes to justify the noncooperation. But is it hard to figure out why? See the full article at the link below. Dr. F


1 comment:

  1. Barbara Bechtel, the midwife operating the Expectations center closed after significant and protracted litigation following the intrapartum death of a baby in her care in 2003. Bechtel lost on appeal in 2010 on her argument that the bereaved parents could not sue over the death since the baby had died before she was born. She was also sanctioned in 2012 for abandoning thousands of patient records when she left the state in 2011.

    "There were attempts to resuscitate Skyleigh for twenty-five minutes, but it became evident that the infant died while Brown was in labor and that the fetal heart rate monitor, which had indicated a heart rate, was actually registering Brown's heart rate. An examination of the umbilical cord and placenta revealed “a large thrombus midway in the cord.” Id. at 270. An autopsy revealed no abnormalities in Skyleigh." - See more at: http://caselaw.findlaw.com/in-court-of-appeals/1533168.html#sthash.vtTvIXDM.dpuf


    Skyleigh's grave


    She should be eleven years old.

    Bechtel is alive and well and has opened up shop in Brooklyn.http://dahliamidwifery.wordpress.com/