No news is not necessarily good news

Well, locally, there is no news to report. The BAC held it's third in the ongoing monthly protests against the indefensible banning of midwives from Pleasant Valley Hospital. No official word from the administration concerning a reversal of their blunder. Continued delays from apologizing to the midwives and those of us who support them are unacceptable. The local press has dropped the ball and there is the appearance of apathy. However, behind the scenes we are doing what we can to keep this travesty on the radar screen. Off the record sources have indicated that some in corporate CHW are not too happy with the St. John's administration. CEO Mike Murray is leaving for unknown reasons. Because they never tell the truth about such things we can only speculate as to why.

There has been no movement from the OB committee on its unwritten ban on Breech deliveries. In light of the NIH VBAC concensus concluding that the banning of VBACs at many hospitals around the country is not evidenced based one would hope that reasonable minds would rethink the banning of other evidenced supported procedures like Breech delivery. But then, fairness, logic, science and collegiality are not values of the current hospital committee. And, since, these defacto bans do not hinder their practices there is no need for them to be reconsidered. Every week that passes continues to hurt their reputation, their bottom line and the patients of our community as many are becoming informed and looking elsewhere for birth options.

My hope is to see a renaissance of common sense and return of birth choices which will include an eventual disbanding or reorganization of the committee structure in the OB department. I will continue to write, speak and try to work with those in the administration who still remember their mission statement. Please continue to make your opinions known to CHW through e-mails and letters and protests, when necessary. The BAC website has the contact information. I would also urge you to join and become active with the Birth Action Coalition at www.birthactioncoalition.org . Thanks, Dr. F

Micro vs. Macro:

Some of my dear friends are excited about the events on Capitol Hill yesterday. There are parts of the massive health reform bill that suit their agendas. Such is the case with the Mama Campaign people who have done really good work in improving access and payment to CPMs. Or, the portion of the bill that improves access to health coverage for those in need. Worthy objectives, yes. While this sort of "Micro" thinking may be personally satisfying for a worthy agenda I would like to caution my friends from too much euphoria. For, in my opinon, the "Macro" of this bill, the corrupted process by which it came to pass and the inevitable intrusion by tax, mandate or yet to be determined legal quandries into our lives, will make America worse off. Those of you who know me, know I cherish personal autonomy and responsibility over the collective. Soon to follow will come the poison in this pill. Restrictions on choices and mandates on behavior with unforseeable costs and debt from a class of elites whose leftist philosophy believes, truly, that they know best. Watch for ads on TV frightening you or seducing you. Soon to come will be the tax incentives or punishment for behavior that they think is good or bad. One size fits all is not an American value. For me, this assault on our individuality transcends political bickering. I don't trust big government. But you guys know that. Their track record at ruining things they touch is pretty good. American education is a good example. My point here is not to suggest how you should think. Only that it is important to think. As we fight for the causes we believe in don't forget to look up and outside at the bigger picture of where this confusing, massive mandate is taking us. Thanks, Dr F.

New Facebook Page

Hi All, One of you was energetic and thoughtful enough to create a Facebook page for me at:

http://www.facebook.com/home.php?ref=logo#!/pages/Stuart-Fischbein-OBGYN/364977701696?ref=ts

So now fans (and foes) have another place to check and see what I am up to or supportive of. Most of the news has been very positive towards what we believed all along. Nothing new to report at my local hospitals and it is doubtful that the NIH VBAC conclusions will cause even a ripple of remorse or guilt on the part of administrators and doctors who continue to uphold several policies without supportive medical evidence. I will continue to try to work respectfully for a return to common sense and patient autonomy out here.

Danielle from Momotics has posted a survey of 861 post c/section moms which looks at the feelings of the actual patient. What a novel idea! Asking the actual patients affected by the interventions modern medicine performs how it affects them. you can find it at:

http://momotics.com

Lastly, I believe the BAC is planning another rally at the corner of Rose and Gonzalez this Friday at 11 AM. Please check out the BAC website for details. Dr. F

Final NIH VBAC Consensus Report

This is really welcome news. A government appointed panel has looked at the evidence objectively and concluded that VBAC should be a viable option for women. They also stated that in most instances it is as safe or safer than elective c/section, the opinions against VBAC were not evidence based and hospital policies that obstruct this option should be revisited. As always, they state more studies are warranted in several areas. Please read for yourself and forward to patients, colleagues and your institutions. Thanks, Dr. F

http://consensus.nih.gov/2010/vbacstatement.htm

Trust Birth Dinner & Upcoming VBAC class

Julie and I had a wonderful time tonight at the Trust Birth Dinner in Redondo Beach. Thank you Carla, Heather and all the dedicated birth goddesses who honored me along with so many other deserving people. I am grateful for the energy you share that rejuvenates my drive for our common goals. So nice to meet Sara Buckley and see Paul Fleiss among the honorees, too.

Sunday from 1:30 to 5:30PM at my Century City Office is the VBAC education class led by Jen Kamel of VBACfacts. There is still room if anyone is interested. I will be attending and offering my 2 cents worth. Below is the information. If interested contact Jen through facebook or leave a comment here and I will get back to you. Dr F


There are still tickets available for the class this Sunday which will be the only class offered in Los Angeles for 2010. The class is close to being sold out, so if you are interested, don't delay!

Another reason to RSVP as soon as possible: I am printing up bounded books of the presentation and want to make sure I have enough for everyone.

Dr. Stuart Fischbein OB/GYN will be present to answer questions.

The latest couple who registered are driving 170 miles one way. Don't let distance hold you back from attending!

Warmly,

Jen

You are invited to the following event:
The Truth About VBAC - Los Angeles

Date:
Sunday, March 14, 2010 from 1:30 PM - 5:30 PM (PT)

Location:
Offices of Stuart Fischbein, MD
10309 Santa Monica Blvd, Suite 300
Los Angeles, CA 90025

Action Alert

Please view the following message from Docs4patientcare and send to to everyone you know. For I believe a government takeover of healthcare is the purpose and inevitability of the current bill and would be detrimental to our patients and the individual right to autonomous decision making that we cherish. Rationing and limits on birth options and choice would certainly follow.

http://www.youtube.com/watch?v=8D_e1osuomg

We at docs4patientcare appreciate your attention at the vital time in history. Dr. F

Draft summary of NIH VBAC position

Very good news and reassuring that at least at the academic level evidenced based reasoning and common sense have prevailed. Please read the initial statement from the National Institute of Health on VBAC:

http://www.nih.gov/news/health/mar2010/od-10.htm

The conference was a worthwhile experience and I believe the panel members have the most honest of intentions. I am so glad I went. I hope some of you followed the webcast and if not, it will be up soon through the NIH website. My take on the conference was that it is clear from the presentations and the panelist conclusions that there is no convincing evidence that VBAC is inherantly unsafe nor is it ethically a choice that should be denied to any informed woman. While I do not think there is a snowball's chance in hell it will cause any immediate effect on hospital policy, I do believe if disseminated to patients they can make a convincing argument to their local hospitals that they cannot be forced into surgery and have the right of informed refusal.

One of the most compelling points of the conference to me was the following. ACOG's 1999 statement No.5 changing the word readily to immediately available was not based on any evidence. It was likely done to give ACOG members legal cover in cases where compliance was maintained and still a bad outcome ensued. The result was no real protection against the fear or reality of a disastrous law suit and only fed the fear which led to VBAC bans at more than 30% of American hospitals. Amazingly, neither before ACOG came out with the "immediate" guideline or in the ten years since has there been any studies undertaken that have ever shown that having emergency help immediately available has done anything to lower the incidence of cerebral palsy, neonatal death or maternal morbidity over the "readily" available (30 minutes decision to incision) standard! It is horrifying for me to actually learn that so many of these repeat c/sections were inflicted on women based on nothing but fear and economics. My profession should be ashamed of our cowardice.

I will post a link to the final NIH consensus statement when it appears. The BAC website and VBACfacts are also a great resource to follow the story. Spread the word!