What are the differences between the medical model of obstetrics and the midwifery model of care? How can you improve your birth experience and outcomes, when delivering at a hospital with an OB? Dr. Stuart Fischbein shares his insights, as well as why he does breech deliveries, VBACs, and home births.
To listen here, click the play button on the player above, or click the button below to listen in iTunes.
What we talked about:
- What are the differences between the medical model of obstetrics and the midwifery model of care?
- How Dr. Stu ended up practicing within the midwifery model
- How OB’s are overqualified in 85% of what they do, and not properly trained for the other 15%
- The true uniqueness of an obstetric practice, and how it’s becoming a lost art
- How our maternity system has inverted incentives, which have made these skills disappear
- Why leaving your house should count as an intervention
- How the current standard of care is anti-mammalian
- Benefits of having a caregiver that practices a midwifery model of care
- Is “high-risk” a self-fulfilling prophesy?
- Repeat after me: you are a client, not a patient
- To ask more of your OB, you need to ask more of yourself: be informed
- Don’t be afraid to ask questions
- The litmus-test question: “What would you recommend me to do if my water broke?”
- The importance of establishing a relationship with your care provider: both for your satisfaction and your outcomes
- How the laborist model has back-fired
- VBACs: an absence of procedure that requires no special skill
- Why are we not outraged about the approx. 800.000 unnecessary cesareans that are done each year?
- Hire a doula, take your time, and other ways to buffer against the traditional medical model
Resources, links, and other great info:
- Midwifery Model of Care, from Midwives Alliance of North America
- Midwife-led versus other models of care for childbearing women, review, from the WHO Reproductive Health Library
- Models of Maternity Care, from Our Bodies Our Selves
- Philosophical cornerstones of Mother-Friendly care, from the Coalition for Improving Maternity Services (CIMS)
- Birth by the Numbers: Myth and Reality Concerning US Cesareans
- Citizens For Midwifery – organization
- The laborist model
- “Home Birth” with an Obstetrician: A Series of 135 Out of Hospital Births, (PDF) study by Dr. Stuart Fischbein
Related Birthful episodes:
- Birth Models and How They Affect Your Birth, with Robbie Davis-Floyd
- Choosing Your Care Provider, with Robin Elise Weiss
- Your Baby the Mammal (Part 1), with Diane Wiessiger
- Why an OB Chose a Homebirth, with Amali Lokugamage
- Vaginal Birth After Cesarean, with Nancy Wainer
About Dr. Stuart James Fischbein
Stuart James Fischbein, MD was Board Certified in 1989 and became a Fellow of the American College of Obstetrics & Gynecology in 1990. He has been a practicing obstetrician in Southern California since completing his residency in 1986. While well trained at Cedars-Sinai Medical Center in the standard medical model of obstetrics he had the respect and vision to support the midwifery model of care and served as a backup consultant to many home and birthing center midwives for 25 years. In 1996 he founded The Woman’s Place for Health, Inc., a collaborative practice of Certified Nurse Midwives and Obstetricians in Camarillo, California.
In 2004, Dr. Fischbein co-authored, “Fearless Pregnancy, Wisdom & Reassurance from a Doctor, a Midwife and a Mom” www.fearlesspregnancy.net. For his efforts he has been awarded the Doulas Association of Southern California (DASC) Physician of the year award three times and was the very first recipient of DASC’s lifetime achievement award in support of pregnant women. He has spoken internationally on breech and vaginal birth after cesarean section and has appeared in many documentaries, including: “More Business of Being Born”, “Happy Healthy Child”, “Reducing Infant Mortality”, “Heads Up: The Disappearing Art of Vaginal Breech Delivery” and multiple YouTube videos discussing birth choices and respect for patient autonomy and decision making.
Dr. Fischbein now works directly with home birthing midwives www.birthinginstincts.com and offers hope for those women who prefer and respect a natural birthing environment and cannot find supportive practitioners for VBAC, twin and breech deliveries. He is an outspoken advocate of informed decision making, the midwifery model of care and human rights in childbirth. Hear more of his thoughts and advocacy for evidenced-based, reasonable choices on his podcast at www.drstuspodcast.com. His recently published paper, “Home Birth with an Obstetrician, A Series of 135 Births” critically analyzes his home birthing statistics. Dr. Fischbein has as a goal the re-teaching of the skills, such as breech and twin vaginal birth, that make the specialty of obstetrics unique.
Connect with Dr. Stu through his website, or on Facebook or Twitter.
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