Perspective on the Rights of a Fetus

ACOG has clearly come out against home birthing and last year made a formal statement that the safest place for giving birth is the hospital or a birthing center attached to a hospital. In a recent Today show interview, ACOG spokesperson, Dr. Erin Tracy, stated that in rare circumstances a home birth can go awry resulting in injury or death to the fetus and used this reasoning to argue against supporting a woman's right to informed consent and choice. So, my understanding from this is that ACOG has deep concern over the rights of the unborn baby and puts those rights above the mother's.

In July of 2007, ACOG reaffirmed their statement of policy regarding abortion. Paragraph #3 states: "Termination of pregnancy before viability is a medical matter between the patient and physician, subject to the physician's clinical judgement, the patient's informed consent and the availability of appropriate facilities."

Paragraph #5 states: "Informed consent is an expression of respect for the patient as a person. It particularly respects a patient's moral right to bodily integrity, to self-determination regarding sexuality and reproductive capacities, and to the support of the patient's freedom within caring relationships. A pregnant woman should be fully informed in a balanced manner about all options.....The professional should make every effort to avoid introducing personal bias."

"The College continues to affirm the legal right of a woman to obtain an abortion prior to fetal viability. ACOG is opposed to abortion of the healthy fetus that has attained viability in a healthy woman (Dilitation and Extraction or late term abortion). Viability is the capacity of the fetus to survive outside the mother's uterus." Although against this procedure, they do acknowledge that a late term abortion may be the most appropriate procedure in a particular circumstance to save the life or preserve the health of a woman and only the doctor, in consultation with the patient, can make this decision. ACOG also states that a select panel they convened could identify no circumstances under which this procedure would be the only option to save the life or preserve the health of the woman.

I was sort of confused by this last paragraph so don't feel bad if you have to reread it, too. Anyway, their statement of policy on abortion concludes in bold print: "The intervention of legislative bodies into medical decision making is inappropriate, ill advised, and dangerous."

So, realizing that I am editorializing here a bit let me see. Hmmmm, they are on a lobbying campaign to discourage or eliminate a woman's choice of home birth because it can very rarely cause damage to a fetus but they are against legislation to prevent a woman's choice of a late term abortion which kills viable fetuses. Am I missing something here? Am I comparing apples to apples? Is this an amazing bit of ACOG hypocrisy? Please comment as I would love clarity here. Thanks, Dr. F

9/12 Rally in Thousand Oaks

Here are the details:

What: "912 Protest Against Socialized Health Care and Government Spending."
Where: Hillcrest & Lynn Rd., NE corner, across from the Oaks Mall parking lot.
When: Speakers: 12:30 - 2:00 p.m. ----- Protest: 11:00 - 3:00 p.m.
M.C.: Trevor Woolley
Organizer: Carolyn Guillot -- 805-262-2477

Hope you can attend. We are all individuals with life experiences that make us unique and shape our decisions. We are not identical, our lives should not be relegated to an RVS code and one size fits all medical guidelines set by faceless panels. Having been a practicing physician for more than a quarter century I have seen the demise of personal liberty to the detriment of the individual. Whether it is big business or big government, we should not trust our lives to those motivated by economics. Surrendering personal choices and responsibility to the false god of "equality" will lead only to enslavement. Never a good thing.

You all know the issues that I stand for. Birth choices and personal responsibility. My belief is that this can best be achieved through changes in the current system and not a government run system. While dealing with insurance companies is all too often maddening beyond reason, it is so much worse trying to care for patients under the current government programs of MediAid and MediCare. Doctors cannot make a living, run a business and do what is right by their patients under this immense regulatory burden, poor reimbursement and the fear of a guilty until proven innocent audit and legal system. If an insurance company wrongs a patient or a practitioner there are avenues of recompense. And as burdensome as they might be one can sometimes prevail. You can appeal to their medical reviewers, the insurance commissioner or even sue. But who can you appeal to when the government run insurance company harms you?

So, this among many reasons is why I support the private sector with oversight. Oversight, not over regulation. Government is the problem! The reason there is no competition from out of state insurers is government regulation. The reason that the few remaining in state insurers offer one size fits all policies is government mandate. You have heard this before but here is what government can do, and within weeks, to show they mean what they say.
1) Remove blocks to interstate commerce. If you can buy your TV from Ohio why not your health insurance?
2) Remove employers as the purchasers of health insurance and thus make it portable. Would you let your employer dictate the one model of car you can have?
3) Stop insurers from cherry picking healthy patients and excluding ones with prexisting conditions. Here is where a government pool supported by charitable organizations supported by citizens freed from high tax burdens could contribute to those truly unfortunate.
4) Allow decisions to return to the patients and their practitioners who know them as individuals. I support use of outcomes data and evidenced based decision making. No panels or guidelines that dictate one size fits all policies.
And 5) The greatest restriction to meaningful reform in all areas of our lives, not just health care, is the American tort system. Fear of being sued drives up costs everywhere. you cannot have meaningful, cost saving health reform without tort reform. Liberals must capitulate on this or all other reforms, government or private, will not work. How can anyone support a system that holds a health care worker or institution responsible for an adverse outcome when the diagnosis or treatment is delayed because of bureaucratic inefficiencies?

Imagine you have a new headache. Your physician examines you and thinks an MRI is necessary. He orders one but there is a delay of 4 months before you are allowed to get it. In the meantime you have a stroke. Is the doctor at fault? In the currently proposed healthcare bill, without tort reform, he/she would be. A career destroyed. What doctor would want to practice under such a system. Even more worrisome is who is going to want to go into medical school knowing this is what awaits them. A life of living under the microscope of Monday morning quarterbacks holding a legal axe over your head. The President and Congress want to rush through a bill that few have read, almost no one understands and spend trillions of dollars faster than I could get you that MRI. Now I have a headache!! How much for a couple aspirin?

Dr. F at Health Care Rally

I have been asked to appear and speak at a rally on 9/12 in Thousand Oaks. The main theme is against a government take over of health care and indiscriminate spending. So much has been said already pro and con that there is little I can add. My hope is that I can say a few words about cost savings in maternity care using the midwifery model. And back it up by giving a real face to the issue from one with expertise who is actually doing the work. I am hoping that on one subject left and right can agree. That being that the ultimate decisions in any health care proposal need to belong to the patient. On another note, my daughter and I will take a moment on the morning of 9/11 to pause and remember the tragedy of 8 years ago. God bless the memory of those lost on that day.

Please check out my interview from Stand and Deliver. Soon to be posted on my web page as well. Thanks to Rixa for doing this.

http://rixarixa.blogspot.com/2009/08/interview-with-dr-stuart-j-fischbein.html

Stand and Deliver (formerly The True Face of Birth): Interview with Dr. Stuart J. Fischbein

Source: rixarixa.blogspot.com

Baby flips after visit to Berlin Wellness Group

On a nice positive note, I saw a patient today, September 4th, at 40 weeks gestation upon the kind referral from Elliot Berlin, DC. She thinks she might have been in breech position for several weeks but was only confirmed by her doctor in Pomona 2 days ago. This left little time for interventions that might help turn the baby. She was also concerned because there was no practitioner in her area she could find to take her on at this late date let alone offer a breech vaginal delivery.

She underwent chiropractic manipulations yesterday and last night reports a lot of fetal movement. Upon presenting to my Camarillo office today ( a very long drive from Pomona!) I am happy to report the baby had spontaneously flipped to vertex. Ultrasound confirmed the findings on Leopold's maneuver and the environment around this 8 pound baby looked great. She was sent home with a binder and hopes renewed for a natural birth back in Pomona. Kudos to the wonderful doctors at the Berlin Wellness Group and to the dedication of such marvelous parents who endured the drive through the infamous LA traffic to keep the dream of their desired birth experience alive. Dr. F

Comment on Huffington Post

As a newly trained physician just out of residency back in the 80s I remember inviting my parents to Las Vegas for my formal acceptance ceremony into the fellowship of ACOG. I was so proud to be a part of what I thought was the pinnacle of my profession. Fast forward 20 years and now I wonder what has happened. Did they change or did I? ACOG does many good things and their continuing education and promotion of some research and programs have been a benefit. But, all too often of late, they have done some really stupid things. ACOG has released several Committee Opinions that defy evidenced based research, common sense and even the the very foundation of their organization that purports to respect a woman's autonomy and choice. I have written them for an explanation as to who decided and on what evidence and received only anecdotal hogwash from their executive vice president. Whether they or their blind supporters and shills like Amy agree with out of hospital birth is not the real question. To make statements based on "consensus opinion" that are purposely designed to remove choice is unscientific, unprofessional and belittles their organization. Those that are behind these pronouncements know what they are doing will influence policy, insurers and hospital administrators. It is an abuse of power and wholly unhypocratic. Patient autonomy and choice as well as honesty are the issue here. Whether readers, shills or ACOG are supportive of home birth and midwifery or not we should all strive for respect of the patient's intelligence, dignity and liberty. ACOG comes out last year with a statement against out of hospital birthing and now puts out a call for stories to back up their opinion? Isn't that sort of backwards, insulting and poor research technique? Simply embarassing. Not the pinnacle anymore.

http://www.huffingtonpost.com/louise-marie-roth/acog-up-to-dirty-tricks_b_274372.html#postComment

Midwives Reinstated !!

Hi All, Well, a big thank you to Terry Cole, MD, a long time supporter of midwifery, who stepped up and agreed to be our backup. This should satisfy the ever changing rules of the MEC for now. I had to switch days to cover my Century City office from Mondays to Tuesdays because we could not find any physician willing to back me backing the midwives on Mondays. I spoke to 5 of the members of the OB committee and a total of 8 members of the attending staff and all refused. The reasons went from reasonable to absurd but not surprising. At least now our patients can get the care they desire while we continue to work for their rights to choose the manner by which they give birth.