Natural childbirth and the cult of the male obstetrician

Can you still be Dr. Wonderful if you are engaged in inappropriate physical contact with patients? Evidently you can. Dr. Stuart Fischbein is still receiving the support of natural childbirth advocates even after being convicted of sexual exploitation of a patient. Now another “Dr. Wonderful” is facing disciplinary action and natural childbirth advocates have rushed to his defense without knowing the accusations.

Dr. Robert Biter, the “Dr. Wonderful” who worked with Barb Herrera (Navelgazing Midwife) has had his obstetric privileges at Scripps Encinitas suspended. Natural childbirth advocates have held marches, begun a letter writing campaign, and have blogged in support of Dr. Biter, all without having any idea of the charges against him.

Now Barb Herrera comes to his aid, and with friends like that, you don’t need enemies. Barb, a personal friend of Dr. Biter’s, believes she knows what is going on. You can read her post So, What’s the Deal with Dr. Wonderful? for yourselves, but the message I took away from it is that Dr. Biter has been accused of:

1. Failing to be available when his patients need him.

2. Repeatedly violating hospital policies and placing the hospital and its staff at risk of malpractice claims. Barb has written elsewhere that Dr. Biter confided to her that he expected to lose his privileges. That suggests that he was warned and placed on probation, but ignored the warnings.

3. Most disturbing, Dr. Biter has been accused of inappropriate physical contact with patients.

Now you or I might consider inappropriate physical contact utterly incompatible with being “Dr. Wonderful.” Natural childbirth advocates don’t see things the same way. Their heroes can do no wrong. Barb actually goes so far as to justify Dr. Biter’s alleged behavior with classic sexist excuses:

A common [comment] was that he was too chummy, too huggy. His physical kindness is a hallmark in Dr. Biter’s care and is welcomed by those that adore him. I’d almost forgotten the snarky things people had to say about how he hugged them too much until a Biter Rally attendant ran into a couple of RNs that alluded to the reason behind his expulsion was because he was too “friendly” with his patients and their families. When she mentioned it on-line, the topic quickly blossomed into “I noticed his affection for his clients in the photos you took,” and “At first I was taken aback by how he touched the women in the pictures.” Upon examination, we were able to see the sexism in the equation, that if he were a female OB, it wouldn’t seem out-of-place at all. I countered that I don’t often see female OBs hugging their patients, either. But, I suggested we exchange his male OB-ness for a midwife and the “ah-ha!”s had the picture. It isn’t inappropriate for a care provider to hug a client, it’s just crazy bizarre to see an OB doing it!

In the photo spreads I’ve done, I noticed that I took the pictures because Dr. Biter was doing something so unusual, so beautifully different than every other obstetrician –and many of the midwives- I’ve worked with in my life. I went over the photos again and smiled at the love that man has for life. I look and remember every moment of the births with him. Dr. Biter is so present with his clients. No matter how tired he is, no matter how much he still has to get done, he is there with whomever is in front of him. And women/clients/families feel that kind of adoration. It is returned to him a million-fold.

That’s a fairly good compendium of sexist excuses for inappropriate physical contact: She misunderstood. No one would have minded if he were a woman (well, duh!). No one would have minded if he were a midwife. The second and third reasons are really just variations of the first: “Don’t worry your pretty little head about it, young lady. It’s your fault because you misunderstood.”

Why do natural childbirth advocates put certain male obstetricians on a pedestal? The heroes of the natural childbirth movement are all men, but that’s probably because there were very few female obstetricians until recently. How can we explain the current tendency of NCB advocates to idolize male obstetricians who share their philosophy? I don’t know the answer, but I do know that female obstetricians and midwives are not recipients of the gushing adoration and the willingness to forgive all that are directed toward certain male obstetricians.

I commented on Barb’s blog, and of course she refused to post it. [addendum: my commented was posted on 5/19.] I commented on Rixa’s blog about her support of Dr. Biter in the absence of any information on the specific allegations. She removed my comment despite the fact that another commenter (an NCB advocate) agrees. That tells me two things: They found my criticism personally embarrassing so they removed it. In addition, they feel compelled to protect Dr. Biter by keeping the truth, or even speculation about the truth, from women.

The problem, though, is much bigger than this episode. NCB advocates need to ask themselves why they have made a cult of the male obstetrician, why they can forgive him anything, and why they respond with sexist putdowns to women who have observed or experienced inappropriate physical contact from certain male obstetricians.

addendum: According to the San Diego Union-Tribune, Dr. Biter has been served with 4 malpractice lawsuits just in the last 13 months. A search of the San Diego County Court webiste shows that there are another 3 lawsuits suits that have been filed between 2005-2008. Scripps Encinitas was named as co-defendant in 4 of the 7 suits including 2 suits filed in the past 5 months.