"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, May 9, 2011

What is.....Breech delivery at home?

If I were playing Jeopardy and the answer was: "The only option left in SoCal to a woman whose baby is butt first", the question would be.......(see title).

Proud to announce the delivery of little Andrew this morning, bruised bottom and all, to excited first time parents, Eva & Jared. When faced with no other option but forced, not elective, cesarean section they chose, instead, the unlikely option of a home breech delivery. Informed of options, risks and benefits and knowing they would like to have many children they felt that c/section was a bad choice for them. Hospital vaginal birth with the one doctor who still accepts primip breeches was financially nonviable due the limitations of their HMO policy. The Sanctuary Birth and Family Wellness Center midwives and I were delighted to help this couple achieve their goal in the comfort and privacy of their own bedroom. Using the skills I learned in training and adhering to specific guidelines for the safety of breech vaginal birth made this choice possible. Respecting the right of true informed consent and all birth options made it a wonderful day for all involved. Thanks Molly and Heather Anne. Dr. F


  1. Bravo! Lovely for baby, What a loving act, birth, catching, supporting, sharing a birth, sharing an-others labor, sharing the planet starts this way I am sure.

  2. What a heart of gold! It's a shame that our choices are being made for us, but luckily, we still have the option of home birth. All we need is the right support.