One of the things I absolutely adore about homebirth advocates is that no sooner do I write a blistering take-down of their behavior than I turn around and find yet another spectacular example of said behavior.
On Friday, I wrote about the evil at the heart of homebirth advocacy. Homebirth advocates promote pure, unadulterated evil by aiding, abetting, and praising killer practitioners. Apparently homebirth advocates have never met an incident of babyslaughter that they can’t justify (to themselves).
Now Jennifer Margulis goes a step further. She lauds a doctor criminally convicted of sexually exploiting a patient.
Because home birth is gentler than hospital birth. Just ask this M.D. who used to fight with his colleagues to allow women to have VBACs and vaginal breech births in the hospital but now attends home births in southern California, including twins and breech babies.
Apparently his conviction for sexual exploitation perfectly okay as long as he supports homebirth.
Margulis’ piece is Why Doctors, Nurses, and Other Medical Professionals Are Choosing to Birth at Home. It is a classic example of the ignorant leading the gullible. Margulis’ found two (just count ’em, 1, 2) physicians who support homebirth. And that is supposed to prove what, precisely? That some doctors are venal enough to promote a deadly practice in an effort to make money through books, workshops and attracting new patients?
There are nearly 900,000 active physicians in the US and Margulis found 2. That means that 0.00022% of physicians support homebirth. The climate deniers are supported by a higher proportion of climate scientists, and the creationists are supported by a higher proportion of biologists. What a resounding endorsement … NOT!
So the post is pretty stupid on its face and would only convince those profoundly challenged by basic arithmetic and that isn’t even the biggest problem. The biggest problem is that Jennifer Margulis features a doctor convicted of sexually exploiting a patient, Dr. Stuart Fischbein. I first wrote about Fischbein in 2009 (Can you still be “Dr. Wonderful” after conviction for sexual exploitation of a patient?). What did he do?
According to the Ventura County Star:
His patient, identified in Medical Board records as S.K., was 14 years younger than he and earning her doctorate degree in psychology. She came to Fischbein’s office in Century City with her fiancee. They wanted to have a baby.
… He performed surgery … to remove a mass in her uterus and called her “sweet pea” in the recovery room. He sat at her bedside for long intimate talks, testifying in a hearing he viewed her as not just a patient, but as a woman…
S.K. said Fischbein told her he would be a better father than her fiancee. He persuaded her to leave him.
They talked about the ethics of doctor-patient relationships. She said he told her he dated “bushels” of patients. Fischbein denied the comment or any other relationship with a patient.
She said he advised her not to have sex for four to six weeks after surgery. Fischbein said in court he didn’t remember the discussion.
Five days after she was released from the hospital and eight days after surgery, he called and asked to visit her at her home in Los Angeles. They had sex then and again two days later at Fischbein’s home.
Fischbein was convicted of sexual exploitation in LA County Superior Court. The Medical Board of California placed him on probation for 7 years. The sordid story doesn’t end there.
In 2011, Fischbein petitioned the Board for early termination of his probation.
[gview file=”http://www.skepticalob.com/wp-content/uploads/2014/09/Fischbein-probation.pdf”]
The board was unimpressed with Fischbein’s request for a variety of reasons. However, most compelling to them was the fact that Dr. Fischbein has attempted to make a movie promoting “his side” of events, and portraying himself as a victim.
12. In the Fall of 2007, after Petitioner was placed on probation by the Board, he began working with a screenwriter friend on a … a script entitled “Bedside Man.” By this time. Petitioner had already completed the PACE Professional Boundaries program. The cover of the script states it is “based on a true story,” and credits “Story by Stuart Fischbein.” A promotional trailer was later made, in which Petitioner was also involved and credited… Although fictional names are used in the story, the script and trailer are obviously based on Petitioner’s version of events. [They] tend to minimize Petitioner’s culpability, make him look more like a victim and his victim less of one, and depict Petitioner as being persecuted for his views on some aspects of medicine.
13. In an effort to promote “Bedside Man” for financial investment to make a full length movie, the trailer was made accessible over the internet. One hospital where Petitioner was affiliated found out about it and contacted Petitioner’s psychotherapist… From her letter detailing the events, it appears that [she] was readily able to see the impropriety of the project while Petitioner had not. She told him that the project “did not represent him as a man who had made a terrible error in judgment.” [The psychotherapist] persuaded Petitioner that the project was an error and for the trailer to be removed from the internet. Petitioner has done so.
The Board did not terminate the probation, writing:
[He] views probation as punishment and an inconvenience… Although he no doubt has encountered difficulties practicing while on probation, he still tends to overstate those difficulties. He has openly chaffed at the requirement that he have a third party chaperone during interactions with female patients. It is clear that once off probation, the chaperone requirement would quickly disappear from his practice as the lessons learned from these events fade and the inconvenience grows…
The report concludes:
More alarming was Petitioner’s participation in the movie script and trailer. This activity shows that Petitioner still harbors bad feelings about what happened to him, suggesting that he does not fully believe he engaged in misconduct… Such a state of mind does not bode well for the proposition of removing Petitioner completely from the Board’s probationary oversight. In all, these events demonstrate sufficient concern over the course of Petitioner’s rehabilitation as to indicate that continuing probation with all terms should continue in order to protect the public…
Yes, it is alarming and disturbing that Fischbein does not understand the seriousness of the crime. It is equally disturbing that Margulis and other homebirth advocates do not understand the seriousness of the crime and are prepared to overlook it. Sexual assault and sexual exploitation are very serious problems in this country. It is appalling that Margulis would dismiss such egregious behavior in her desperation to find someone, anyone, to support homebirth.
I hope that she will remove any reference to Fischbein in her post and stop lauding a doctor convicted of sexually exploiting a patient. To portray such a doctor favorably, and to fail to warn other women of his conviction, is, in my view, nothing short of evil.
The fact that you are so vehemently opposed to home birth indicates extreme ignorance of safe, scientifically-supported practices. Scary.
Specifically which safe, scientifically-supported practices?
The UK birthplace study supports homebirth by properly trained midwives of well screened, low risk women, within a well integrated health system where no-one lives more than 45minutes from an operating theatre AND STILL the deaths and disabilities were higher in the HB group. Absolute numbers were low, but rates were statisticallly significantly higher.
When you move that to the US, with poorly trained midwives, a disconnected health system, no risking out and long distances to travel for healthcare, you get the MANA statistics- which proves HB is much, mich riskier for babies than delivering at home.
So, which population, in which setting, do you propose home birth is “safe” for?
http://www.ajog.org/article/S0002-9378%2813%2901604-9/abstract
This case control series suggests homebirth babies are 18 times more likely to need cooling therapy to treat hypoxic ischaemic brain injury than babies born in hospital.
But sure, “safe” is in the eye of the beholder.
Donald, you’re back!
Melissa Cheyney and MANA have publicly acknowledged their hideous death rates http://www.skepticalob.com/2017/03/melissa-cheyney-and-the-midwives-alliance-of-north-america-finally-acknowledge-their-hideous-death-rates.html
I don’t get the connection. Not all sexual abusers are home birth practitioners. The two women I know who were abused by their OBGYN doctors both had their babies born in hospitals. I know of many abusive healthcare workers. The fact that they potentially can take control over a person in a vulnerable or weak position (pregnancy, in particular later stages) is perhaps inviting to those who have trouble with control and power. They can also take control over children, the elderly, those who are physically handicapped, those who are under anesthesia, those who are on medication, or weakened by medical condition. I’m sure it happens plenty with conventional OBGYN doctors too. You can’t say it’s the home birthing that causes abuse. I don’t think condoning abuse is ever okay, though, nor is smoothing it over nor turning one’s back nor sliding it under the rug. So I agree but do not agree totally.
You do not know the details of the event. Anything is possible. Look at the Michael Brown case. some say there was racism and others deny it. People lie for myriad of reasons. the only safe means is to have a camera on the cieling and record every patient encounter. patients would have to consent to this and security measures would havef to be in place similar to the EMR, but God forbid some hateful patient should come after you if you were a man. There was a doctor in the residency program where I was that got through medical school and other times by alleging rape and demanding promotion. She tried the same thing, but the staff at the hospital got rid of her quickly.
That he supports home birth hurts his credibility. Yet there are women that lie about rape to get their demands met, there was one at the residency program a few years before I started their. The Internal medicine doctor, now program director was discussing it on rounds.
before I started there.
I think you misunderstand.
Fischbein has been CONVICTED.
He had his day in court to present his side of the story, and was found guilty. He doesn’t get the benefit of the doubt. He is a convicted criminal who brought the profession into disrepute. The definition of a “bad apple” if you will.
Fischbein has been investigated by the medical board and his conduct has been found to suggest he has no remorse for his actions, nor insight into why they are problematic, therefore his probation was not terminated.
If you know him, you may choose to believe his side of the story- however, the people charged with investigating the events objectively do not, and no-one has suggested his victim is lying about what happened to her.
Do you REALLY want to go down as an apologist for a convicted sex offender?
This is very OT, so I’m sorry, but I feel I can trust the commenters here to be rational people, and I am venturing into woo-woo territory. I also live in a woo-woo geographic area, so online is really my only source of support.
Any parents of children with autism or developmentally delayed children here? Where do you hang out electronically?
Thanks for any response. This is a new development in my life. I can’t handle the anti vaxers or wacko treatment fans. When they’re patients I can deal, but on a personal level, nope.
The Autism Science Foundation is a good place to start:
http://www.autismsciencefoundation.org/
I don’t have direct experience, but I found them in my ”discussions” with the anti-vaxers and they have both a rational voice and lots of up-to-date information.
Also try The Thinking Person’s Guide to Autism. If you do Facebook, they have an active page with lots of discussion with families, advocates and autistics.
The Autism Hub and Left Brain/Right Brain
Slightly O.T.
Does anyone have any evidence of a midwife (registered or not), stating (to a patient while in an advisory role) that the general scientific consensus is that home birth seems to carry more risk than a hospital birth? I haven’t seen any policy statement from any of these NCB organizations defining ANY risk.
This is really the core of the issue isn’t it? Patients have a right to informed consent, health care advisers have a duty to inform properly. What’s next, open up the med-cart & let people take what they want as long as they have access to the internet?
So to tie this comment with some down below, see Jocelyn’s blog post and the comments to it. Someone pulled the old, “I was reading until I saw you referenced Amy Tuteur blah blah blah.” A response was, she didn’t write the papers, she only referenced them.
And it got me wondering about the response, “Where ELSE are you going to find those papers?” They certainly aren’t showing up in homebirther blogs, that’s for damn sure. And you aren’t going to get them from midwives.
Are you asking for evidence of a midwife stating this? Or a professional midwifery organization stating this?
Two different things.
There are individual midwives who understand the limitations of homebirth – particularly in certain high-risk situations (breech, twins, VBACs, etc) and who will and do advise their clients to deliver in a hospital with a physician.
Those midwives are few and far between. To my knowledge no non-nurse midwifery organization (NARM, MANA, NACPM) has deemed any of these deliveries too high risk for home birth. These should be absolute contraindications for home birth – yet the CPM powers-that-be seem quite invested in attending these high risk births at home.
“There are individual midwives who understand the limitations of home birth” I agree. But, do they explain the risks to the patient. ALL THINGS BEING EQUAL (sorry, had to clarify my point), the scientific consensus is that home birth carries more risk than hospital birth. Informing patients of this simple fact would help to facilitate a truly informed decision & give more legitimacy to the process at least from an ethical perspective.
I agree. So who bears the responsibility and is to be held accountable: individual midwives, or their professional (“professional”) organizations?
[eh, BOTH, is really the correct response.]
Sometimes I think NARM/MANA/NACPM is invested in keeping midwives untrained so they can continue to bamboozle them into believing their assertions about the safety of home birth.
I live in a state where licensed midwives are not prohibited from attending breech, twins, VBACs at home, so every 22-year-old with a NARM certificate runs out and starts advertising that she can offer these services.
It’s all stupid on many levels. If midwives wanted to protect their profession, they would never allow this. And the unfortunate thing is very real [death] consequences are the results of these policies.
This is from 2011 – written by a lay midwife in the state of Oregon.
“Though I believe deeply in parents’ rights of choice regarding both careprovider and setting for the births of their children, I also believe that midwives have a core responsibility for self-identifying our own limitations in training, experience and skill as care providers for higher risk pregnancies.”
“…it is a midwife’s responsibility not only to assist prospective
homebirth clients in making fully informed, knowledge-based choices but also, just as importantly, to acknowledge the limitations of the care she can provide.”
“I wish to voice my support for placing breech delivery in the category of absolute risk.”
http://academicobgyn.com/2011/07/22/notes-from-a-reasonable-direct-entry-midwife/
Nice letter. I liked that. If they are were that sane this would be a boring blog!
This lay midwife is a distinct outlier, I’m afraid.
I could, but HIPAA 🙂
I respond as a licensed midwife, a CNM. I advise my patients of this and document it. However ACNM has not to my knowledge made a statement of the risks of homebirth, even to “low risk” women, in the United States. Very very unfortunate.
Should call this evidence based birth unless I don’t like the evidence!
http://archive.aweber.com/birthevidence/OcJiD/h/Update_on_the_ACOG_waterbirth.htm
I’m so grossed out by this. So, so, so grossed out. It is not hard to find the reasons why Dr Stu is attending births OOH. And yet, the homebirth advocates blindly flock to him and celebrate him. It’s just gross.
It’s easy to see what he’s doing here…all of the websites that have reviews on this reprobate are now being overwhelmed by birth nutters proclaiming how wonderful he is so that his actual patients and reviews are drowned out.
Narcissist.
I just threw up in my mouth,
I feel like I need a long, hot shower after reading about this douchebag (Fischbein). I’m also a survivor of sexual assault.
OT: This popped up when I was reading the news and wondered if anyone else had seen it? http://www.kidspot.com.au/home-birth-goes-badly-wrong-one-mums-story/
I cannot imagine watching my adult child and unborn grandchild get that kind of negligent “care”, leading to that kind of near miss. Good for the grandmother for stepping in! I m so happy for this mother that her misled choices didn’t lead to a dead/ injured baby or permanent health issues for her.
And fuck that horrible midwife for refusing to transfer when the mother wanted to go to the hosiptal.
Yeah, great way to respect the woman’s choices, refusing to allow her to transfer to the hospital when she wants to.Makes her feel like a real “mommy warrior”. Specifically, a warrior being tortured by the enemy.
Wow. That’s awful. The woman and the baby could both easily have died and there may still be permanent damage to the baby.
The frame story is just ridiculous as well. “Unfortunately” stories like this make women more reluctant to choose home birth? Sorry, but this is the norm of home birth, not the exception. Ok, most births don’t go this badly wrong, simply because most births don’t require intervention, but when something does go wrong, it’s always a disaster. And then the author of the column cites the old Janssen article and claims that it demonstrates that it demonstrates that home birth results in BETTER health for the mother and baby. Even Janssen never claimed that, but only claimed (falsely) that it resulted in outcomes no worse than hospital birth.
This is utterly terrible. I had to stop just a few paragraphs in. Four days of labor and 12 hours of pushing? UNREAL.
Effective 10/10/2007:
“SEVEN YEARS PROBATION WITH VARIOUS TERMS & CONDITIONS. RESTRICTIONS:DURING PROBATION, DR. FISCHBEIN SHALL HAVE A THIRD PARTY CHAPERONE PRESENT WHILE CONSULTING, EXAMINING OR TREATING FEMALE PATIENTS & HE IS PROHIBITED FROM SUPERVISING PHYSICIAN ASSISTANTS.”
It really is too bad that it does not specify “mid-level providers, including PAs, NPs, and midwives” I guess that Fischbein found a way around 3rd party chaperone part–he simply demands that all homebirths have a doula present. I question whether he had a 3rd party chaperone present at all visits, though….
It’s quite ironic actually. At first those supporting homebirth are all “Just because you got you MD doesn’t mean you are not an idiot” or “Real education doesn’t come from schooling but from experience.” or “You can’t trust doctors to look out for your interests (trust me instead)” or “Don’t let those doctors get near you WITH THEIR KNIVES!”
But the second, a doctor supports homebirth. It’s all “See homebirth is totally safe and wonderful this doctor says so.” Just like all denialists, they want the prestige of science without the scrutiny.
Two physicians who support home birth. One is non-OB Aviva Romm (who won’t attend home births herself), the other Fischbein. I suppose one could add Dr. Biter, so that’s a whole three!
Actually, I know of one more OB who chose a home birth. It’s a story my step-mother, a former obstetric nurse tells: One of the doctors she worked and his wife with decided, for whatever reason, to have their baby at home. There’s no tragedy in this story–in fact, the birth went fine. But then came the little matter of the fact that they’d used basically every towel in the house. The OB called my step-mother and asked her how one cleans linens after they’ve been dirtied in a birth. Her answer was “You don’t. That’s why we have all this disposable stuff.” Rumor has it that my evil step mother then laughed and hung up, but I have only her word for it that that’s what happened next.
His next two were born in the hospital, also without incident and with someone else to worry about the laundry.
http://www.akbirth.com
Remember the Wasilla OB/GYN who is married to a midwife? They had a home birth.
The husband is the back up OB for the midwife, Rebecca Wayman also works with them, remember her? She was an OB resident who had a home waterbirth.
Actually I think Romm attended the births of 2 of her grandchildren.
I’m pretty sure the way Margulis and others justify their support is that the patient consented to sex with Dr. Stu so it’s all good. What they’re refusing to understand is that patients can’t consent to sex with their healthcare providers–the power dynamic is so skewed that all sexual relationships between providers and patients are inherently coercive and exploitative. But this is in line with the terribly poor boundaries between homebirth midwives and their clients. Emotional entanglement makes it so easy to manipulate grieving parents into not suing you. It’s even in the book From Calling to Courtroom.
Isn’t it wonderful how he loves his patients so much?
Actually, Stuart Fischbein is the inspiration for Eric “Otter” Stratton, in Animal House. Note that, at the end of the movie where it tells what happened to all the members, we find out that Otter ends up being a gynecologist (in Hollywood).
OK, not really, but the similarities are not good.
“The question is not whether [I] broke a few rules or took a few liberties with [my] female guests. [I] did.”
I was thinking yesterday about an intro that Dr. Biter shared somewhere: “First thing you need to know about me, I’m a hugger.” I don’t want my doctor to hug me. I think it’s weird and inappropriate in a professional context. I don’t hug my lawyer or cleaning lady or freelance clients or colleagues. And most people understand that boundary and don’t feel the need to hug professional acquaintances or strangers upon their first meeting. However, sociopaths and other emotionally manipulative/exploitive types understand that breaking that boudnary is a good way to disarm someone, build a false familiarity, and unsettle them so that a little bit of power is in the abuser’s hands. That little bit of power grows as the abuser continues to transgress personal boundaries and insist on an overly familiar relationship.
Urggh. Thanks for explaining why my involuntary response to that ‘I’m a hugger’ statement was to shudder.
I freely admit that I’m a little weird about getting touchy-feely, but I don’t think it’s necessarily a bad thing to not want to hug someone I just met five minutes ago. I like to reserve hugging for instances when I want to express sincere affection for someone I’ve gotten to know and appreciate.
I am NOT a hugger. While I am perfectly happy to hug family, I don’t really hug my friends, and definitely do not initiate hugs with patients.
I have been hugged by patients, which is ok, but I don’t start it.
The most my patients get is a handshake and possibly a pat on the arm and a tissue if they are very upset.
I’m not sure if this is cultural, or personal or what, but any Dr who describes themself as a hugger sets my alarm bells ringing.
Drs, like lawyers, accounts and bank managers should not be all about the hugs.
It is just…creepy.
Is it an American thing? I’ve had some lovely, kind doctors but I’ve never had a hug from any of them and would find it rather weird.
I recently sat with a man whose elderly mother was dying. He was alone with her, and I felt he needed some support. After she died, I gave him a hug, which he gratefully returned.
I also recently hugged a very strong wife whose (too young) husband was being taken home to die of cancer.
I have a lingering memory of looking after a very well man in his nineties who had taken a fall. He still lived alone and told me how he had lost the love of his life, and cried as he told me how he felt sad every morning when he woke up alone in bed. I held his hand, but still regret that I didn’t give him a hug.
I only do this in exceptional circumstances but in both these cases, I felt the people appreciated the gesture.
I don’t think we always have to be ”hands off” – it;s the context that matters.
Yes, context. Sometimes a situation brings two people together in such a way that a hug is totally appropriate. It’s when a doctor (someone in a position of power) initiates a hug with a patient that he/she JUST MET that I get the alarm bells. Totally different.
Hi, Smooch – in the cases I describe, both were people in an emergency dept that I had “just met”, but the shared intense experience created some sort of bond. Not many people would have offered hugs in this context, but I (still) feel that they were an appropriate gesture – and an expression of my personality. Being a “mature” woman with grey hair possibly also helped.
I get the message above about a counsellor having to be meticulous – though there is nothing wrong with a handshake. I don;t like the fact that the sleezy ones like Fish characterise the exchange of humanity between patients and health care professionals. I also love picking up little babies (when they;re not too sick) – showing that I love babies and feel confident with them helps reassure worried parents. Yep, context.
IF a doctor I’d just met tried to hug me I’d run away. The obstetrician who delivered both my children did hug me once. I had antenatal and post natal depression with both pregnancies and was sobbing in his office at about 30 weeks with the second pregnancy and asking about being sterilised afterwards. He gave me a brief hug and pat on the arm and said it would all be over soon. It made me feel a bit brighter. He’d been my doctor for nearly 15 years though and it wasn’t creepy.
It might be. Americans are weird. And I can say that because (you guessed it) I’m an American 😉
No it’s not. After a particularly ugly incident at my hospital i was seeing one of the councilors for awhile. At the end of our sessions I offered a hug for him helping me get through so much, and he backed away from me and actually said “don’t ever do that with a therapist ever. That violates the barrier between patient and doctor.” He’s extremely professional and explains that he will completely ignore patients when he sees them out. If they approach him he’ll acknowledge them but quickly makes an exit.
To completely ignore patients when you see them out is rude, shows a complete lack of manners. That is not professional. Also, an “I prefer not to hug patients…” Would be preferable, that doctor just sounds unpleasant not professional.
It can be very tricky. I live in a small town and bump into patients all the time. I have to be careful when someone just looks familiar- can’t play the “where do I know you from?” game. (“Oh right! I’ve been treating you for repeated yeast infections!”) If we seem to recognize each other I give a smile and nod but don’t go out of my way to interact. If they approach me, I will totally, but carefully, chat. However, if I had to do one or the other, be too friendly or be considered rude, I’d go with rude. Hell, I will absolutely not befriend patients on FB, maybe some people find that uppity. But there’s got to be boundaries.
Memorably, I ran into a patient in Marks &Spencers once.
It just so happened that we were on a shopping trip to get “big girl panties” prior to potty training my kiddo.
So I’ve got a two year old in my shopping trolley singing “I want panties, big girl panties, mama’s going to get me panties, big girl panties, pink panties!” Over and over again at the top of her voice. Which I’m OK with, because, hey, if she’s excited, I think it’ll go easily (which it did), and I’m on the other side of town, and no-one knows me…
And at that point the patient decides to come over and say hello.
Mortifying.
No, what you’re saying makes sense, but to purposefully ignore patients if they greet you (which is the impression I get from this) is rude – very rude, I would change doctors if mine did that.
My first son died while I was pregnant with my daughter, so every time I saw a doctor from my OB practice (and I saw about half a dozen of them in the second half of my pregnancy) they each expressed their condolences and asked how I was doing, but none of them tried to touch me, something for which (in retrospect) I am very grateful. The circumstances of my son’s death were ugly and I had very little trust to go around and I didn’t have a whole lot of patience for people who suddenly wanted to act like they were my BFFs.
I’m so sorry for your loss.
Thank you.
I know people have claimed they don’t like strangers looking at their private parts, but I have to tell you, personally, I don’t let my FRIENDS check out my private parts, except in a sexual manner. If someone is going to have to do it for a medical exam and not sex, I would so much rather it was someone who saw it as just another stranger’s private part, as opposed to someone checking out their friend’s junk.
http://img4.wikia.nocookie.net/__cb20101221151754/pixar/images/4/4f/Lotso0005.png
Wait! Maybe that wasn’t a quote directly from Biter, it was your Toy Story 3 comment I was thinking of! Still, the Babies by the Sea post about “haters gonna hate, huggers gonna hug” and his reputation for hugging shows that the man has an issue with doctor/patient boundaries. Much like Fischbein. BARF BARF BARF.
And I agree with you. When I am at the lady bits doctor, it is a professional experience and I like maintaining that not-friends relationship, thankyouverymuch. I want someone to give me a strictly professional evaluation on the state of my babymaker and I don’t want to have them over for dinner later that week. Sometimes keeping people in boxes (friend, OB, never the twain shall meet) just makes life easier and less squicky for everyone.
In our small city, it’s entirely possible that you will meet your gynecologist at a social event. Or that student I gave a failing grade. We still smile and say hello.
That’s one of the things I like about being in kind of a big town. Although I will say that I happen to be friends (though not super close, mostly we just interact on Facebook and I text her occasionally with questions about birth) with one of the nurses that assisted at my daughter’s birth. She’s assisted at several of her friends’ births, and caught her nephew when her sister-in-law gave birth. I just think that a doctor pushing to be buddy-buddy with his/her patients is kind of weird and rather inappropriate. But he/she can’t help running into folks at the gas station in town if it’s, you know, the only gas station in town.
I have that same issue. I see the lady bits doctor in another town to avoid the situation entirely.
Totally spot on! I was on an antidepressant for a while and had just moved to a different state. I needed a new prescription, so I went to one of the two psychiatrists in the area accepting new patients. It was disturbing to say the least. He hugged me and I wanted to vomit. I knew it was a clear boundary violation, so I got my prescription and ran, never to return. Then I did some digging and found out there were complaints against him with the State Medical Board for inappropriate behavior with patients. I am so thankful I recognized him for the creep he was right away, but for someone who is vulnerable I could see how they could easily be manipulated. This guy was an atrocious excuse for a physician!
Yeah, that’s really kinda weird and I do feel sorry for the patients that DON’T recognize the boundary violation as you did. I have hugged my therapist (not psych) before, but that was after many months of weekly therapy. I had gotten to know and trust her.
For sure. What’s even more strange and what made my radar go up was when this doctor started talking about patients he had skyped with on a “personal” basis… all I could think of was get me out of here! Ugh!
they have such weird ideas about consent. Having sex with your patient is all fine and good, because consent. But if you so much as offer an epidural to a laboring woman, “OMG you’re pressuring and forcing interventions on her you monster!”
Not mention they call cervical exams “birth rape”
Thank you (I think…) for this post. Every time I hear the story of Bedside Man I just shake my head. Hello, Bozo! Yeah I’m talking to you! ANYONE with ANY sense would have taken the probation and slunk off to find another career that didn’t involve patient contact. But you seem bent on demonstrating that you really, really, really don’t get it, don’t you? Making a MOVIE about yourself and your bad behavior? You think that’s cute, or are you just some SoCal cliche: it’s all good if the script gets optioned? So much for sexual predators being rehabilitatable!
Let’s not forget that this doctor with boundary problems posted a picture of a patient’s vulva. http://www.birthinginstincts.com/blog/2014/3/28/from-a-fathers-perspective
I assume it’s not safe to click on this link with other ppl around, eh?
I guess it depends on who is around. It’s certainly not pornographic, just graphic.
And panic-inducing if you’re an OB, because it’s a footling breech.
Panic-inducing if you’re an OB patient as well. YIKES!
I’m in clinic today. I should be good. If you work at a bank, maybe NSFW 🙂
Oh, yuck! I’m sorry, but that was my first reaction to the picture. The baby lived, I guess, but what a risk to take!
Random thing I noticed: NCBers who have a breech pregnancy often talk about how the baby “decided” to be breech. Maybe that’s just a way of speaking, but it’s a little creepy in context. It sounds like they’re blaming the baby for being in the wrong position.
Well, there was this very old line of research, now somewhat doubted, that breech babies as a group were more likely to be neurologically atypical, irrespective of mode of delivery.
Higher incidence of lefthandedness, slower to walk, that type of thing?
I think I was taught that.
Yes. Exactly that.
Interesting that my left-handed, late-walking, mildly ASD (but very brilliant) 5-year-old was breech. (Breeches and lefties run in the family.)
Interesting that my leftie is not the one that was breech. Both were late walkers but that’s my fault, genetically. Lefties run in my family, too.
How late a walker? I’m curious because my son was 22 months when he finally walked and my 19-month-old daughter is still not cruising. Apparently it runs in the family because my dad didn’t walk until he was 2 or 3 years old, so I guess that’s my “fault” genetically 😉
FWIW, my kiddo didn’t walk comfortably until she was nearly 2. She had an odd path to full mobility: first she rolled over (that bit’s normal), then she could sit, but only if someone sat her up, then she could sit up by herself, then she could walk, but only if someone put her on her feet, then she could stand and walk and only then did she learn to crawl. She’s neurotypical, BTW. As long as there are no major neurologic or physical issues, kids learn to walk, in their own time and own way.
#1 walked the day before 15 months, #2 at 15.5 months (I think I was around 14months, and my older sibling a little later, don’t remember for the younger one!). I had really conflicting thoughts, thanks to some paeds physio experience and medical training thus far -knowing that 99% of kids were walking before mine, and that 18 months is the “official” cutoff for onset of walking, and after that we would typically be a bit concerned, but also knowing that they had that family history and that in every aspect of development they were doing just fine and had no neurological abnormalities. Obviously I’m not going to give you online advice about your children, but that’s my experience both personally and professionally, and the things we take into account in these situations.
My husband was born very early (low 30ish weeks) back in 1960. He was over 2 before he walked.
Our son was getting around the floor before he was six months, and was a notorious climber. He walked at 13 months, while we were on holidays with friends with a baby the same age: I think he put 2 and 2 together when he saw her.
Our daughter crawled at 4 months-ridiculous really, she used to crawl into walls and cry with frustration as she couldn’t work out how to fix it-and walked at 8 months, all the better to keep up with her brother.
Both kids have very flexible joints and high muscle tone, as does husband.
Husband’s a leftie, they are both righties. Son has had some proprioception issues, resolved by an OT. Both husband and son are a bit aspie in character, but function very well in ‘normal’ society.
Not seeing ANY of that in my breech 8 month old who is crawling around the house fast, climbing furniture, and taking apart anything he can get his hands on.
HOWEVER, here’s the interesting part. Once my OB got a look at the inside of my uterus, she was pretty sure he hadn’t just “decided” to be breech on his own. He’d gotten stuck between my fibroids, probably during the second trimester.
Neurologically atypical as in autism spectrum? IIRC, babies with ASD have differences in head to body ratio, so that might make them more likely to flip to breech, I suppose.
I’ve heard that, too, but my understanding is that the correlations observed are very slight.
I think the research around this is reasonably robust… but more because children who are mildly hypotonic are less likely to flip to cephalic.
You know, my mother-in-law was a footling breech. Born completely healthy by unmedicated vaginal delivery. Yet my husband and I are in complete agreement that, if any of our future hypothetical kids are breech presentation, we’re going straight for a C-section.
I have a BEAUTIFUL photo of a woman giving birth face presentation, and it is one of the great achievements of my career that it has never made it onto the internet.
http://www.birthcenter.com/testimonials-midwives/2014/4/10/leaning-in-for-support-from-heike
This picture really upsets me. The midwife embracing a naked, laboring patient. It’s inappropriate and it’s featured on the website for Puget Sound Birth Center.
Why did I click… WHY DID I CLICK???
All I could think about was how that chair can’t possibly be disinfected enough to be clean for the next patient to use it. I mean that seriously. It has too many nooks and crannies. All I can think about is how filthy that chair is.
OT: I finally posted the blog post I’ve been working on for a while, “10 Reasons I’d never ever ever have a home birth.” So, I know by posting this my anonymity is gone, but here goes: http://jocelynandjason.blogspot.com/2014/09/10-reasons-id-never-ever-ever-have-home.html
I’ve already been getting pro-homebirth backlash in the comments. I knew I would, but it’s stressing me out! But it’s worth it. I want people to know how dangerous home birth is.
That’s a great post, Jocelyn! I tried to comment but it wouldn’t let me do so without profiles I don’t have and I am not inclined on making.
Anyway, that’s what I wrote. Everyone is welcome to repost it without giving credit because, obviously, it isn’t a great revelation of mine and we’ve all said it here once in a while.
Amazing, isn’t it, that people who deny being homebirth advocates post a comment and at not seeing it immediately, start howling, “You’re censoring comments!”, instead of thinking that there might be a technical problem of some kind. Makes one wonder what kind of NCB echo chambers they typically dwell in.
Projecting much, Janelle?
And by the way, most of those studies actually RAISE hospital death rate artificially because when a midwife transfers and a baby dies, that death goes into hospital stats, Even so, homebirth midwives manage to score death rate at least 3 times higher than comparable risk hospital birth.
Darkly impressive.
Thanks Amazed! I just changed the setting so anyone can comment (even without registering); I added your comment under Janelle’s.
You’re so kind, mama! Huuuugs and thaaaaanks.
Do I sound dumb enough to pass for a MDC homebirth board member?
Now, on a serious note: thanks.
Great job!
The same endless droning – interventions, interventions, evil interventions. Nobody actually addresses the data showing that, in the absence of interventions, kids die more and have a greater incidence of sub-lethal but substantial issues, which really puts the claim of ‘unnecessary interventions’ into stark contrast. Isn’t “An ounce of prevention is worth a pound of cure” the sort of down-homey advice that everyone can agree on?
Terrific. Thank you!
Great post! I wish I had the guts to share it on FB, as I have a sister and a SIL who have both had out of hospital births (one at home and the other in a birth center that is like having a home birth in someone else’s home).
I am particularly enjoying reading the comments – my goodness, do these people have any brain cells whatsoever?
The comments, seriously! I have one commenter who keeps posting everything pro-homebirth under the sun, and just posted a TOTAL homebirth bingo comment. I think every phrase on the homebirth bingo card was in this comment.
I adore her! She’s hilarious!
The baby, who “did need some minimal resuscitation.”
Yeah. Pity that some other babies weren’t so lucky. In fact, I’m scared for each and every baby coming earthside into the incompetent hands of any of the midwives commenting on Gavin Michael’s case.
Carolyn Gall actually showed up in the comments.
She’s a Bingo all by herself.
Yeah! Just saw her!… aaaand here goes the anticipation. Did she really stop at such a moredate input? I am disappointed.
I’m going to pull the same stunt as Amazed since I’m don’t have the right kind of account to comment on your blog.
Please feel free to repost my comment directed at Wildflower12.
“The Journal of Perinatal Education” is “The Official Journal of Lamaze® International,” published by Springer Publishing.
While the journal is listed on PubMed (an index of peer reviewed journal articles hosted by the NIH), it is NOT published by the NIH. The NIH is primarily a research organization, which employs scientists and issues grants, not a publisher.
I just changed the settings so anyone can comment (even without registering); I did just add your comment under Wildflower’s! Thank you!
I took the “published by the NIH” to mean “the NIH funded the project”
To say it was “published by the NIH” shows how little the person actually knows about the way research works, of course.
Wow. The commentators who use the “fingers in ears; lalalala, can’t hear you” NCB dreck are quite impressive. And, y’know, kinda scary.
I have bookmarked to share with friends/relatives.
Great post, but I was surprised to find myself (and some other frequent posters here) quoted, verbatim, with neither attribution nor any indication that the words weren’t original to you. I understand not wanting to link here (I’ve seen the effect that has in NCB-related conversations), but it would be polite to acknowledge that a variety of people contributed to parts of the article.
Yes, I’m sorry about that. I didn’t know how to properly link to comments in a comment section. If you would like me to remove anything you said (I’m guessing in the section about what a hospital has that home birth doesn’t), please let me know. I was going to mention that when I posted the link here today, but I forgot to. I am sorry, and again, let me know if you would like anything removed.
A footnote acknowledging that other people contributed to the article would work for me.
Will do.
I’ve put it at the top of the “Lack of Equipment at Home” section.
Hey, a good thing has already come from your post: Dhanya, Shridam’s mom, posted there mentioning about her new little one. Since she isn’t a commenter here, I had no idea that she had a new precious bundle and I wouldn’t have known. So happy for her.
I just want to say, thanks for all the help from everyone continuing to comment. I can’t believe how many home birth crazies I’m getting! I had no idea I’d get such a response or so many comments, and it’s a bit overwhelming. So thank you!
Loved your post!
I am sorry getting this to you late, but you can always start taking apart the home birth nuts usual answers one at a time if you want to and go into detail with this, I noticed they always mention their midwife carried oxygen and can do infant CPR. Here is a link to the Neonatal resuscitation protocol http://emedicine.medscape.com/article/2172079-overview
That way they can see how stupid it is to think a tank of oxygen and one extra person is all they need until they either decide to call an ambulance while imagining the cord pulsing is doing something or get to that hospital that is (NEVER) 10 minutes away.
Do you always get so much commentor traffic at your blog, Jocelyn?
Hahaha, not in the slightest. I usually get like 1 comment per post, if that. On some of my craft posts I get more (like 30). But not even close to the amount of traffic/comments I’m getting on this post. It’s been viewed 9,500 times since yesterday. My normal traffic is about 40,000 for a whole month.
Those people probably lurk here and decided to attack you rather than face She Who Must Not Be Named.
Fantastic job!
Regarding the Canadian Study:
Under-reporting has a huge affect on data like that. There are almost no limits to the efforts that a hard core NCB’er will make to avoid a big, bad medical intervention (especially in BC, think Fraser Valley, where even Public Health Program Directors can be perpetual woo geysers). There is nothing formal, only anecdotal experiences to prove it. I could write a book.
The transfusion rate for home births in that study is amazing, must be the lowest on the planet….. The time frame used in the study is also very suspicious.
Actually. I’ve seen two required transfusions come into the ER myself over the last few years (one, of them the midwife hadn’t charted properly & didn’t even know the patients blood type). This is a small hospital. If I remember correctly (in that study), they omitted data from hospitals that didn’t use midwives. That would also affect the data.
I finally got a chance to read the post (which I can tell you’ve been working on for a LOOOOONG time – it’s huge!) and I’m working through the comments. You’re doing a great job of responding to each of them.
I have had it with this ridiculous brand of faux-feminism constantly being promoted by people like Jennifer Margulis and TFB. At best, Fischbein is a creep with no understanding of ethics; at worst, he is a serial predator. This type of behavior is utterly indefensible. Women deserve respectful care, not come-ons, from their doctors. Yet because Fischbein is willing to attend and encourage stunt birth, NCBers fawn all over him when they should be condemning his outrageous behavior.
This is not pro-woman.
Yeah, I just don’t understand how Fischbein is exactly the OB NCBers say they hate…except that he promotes homebirth, so nevermind, he’s great!
Just disgusting. More of the “only listening to women who say what we want to hear.”
Idolizing male cult leaders who engage in questionable or outright illegal sexual practices? Wow, could you possibly be less feminist?
http://www.birthinginstincts.com
Oh my.
Fishbein says, “I believe in women’s rights and the importance of consent.”
As long as their choices include having sex with you, right?
Ha! Yes, that was my response as well! Hey, if a woman WANTS to have sex with her doctor who sweet-talked her while coming out of anesthesia, who are we to tell that doctor that he should disrespect her choice?
I see that he’ll do vacuum and forceps at home too. He don’t need no stinkin’ NICU.
Holy sh.t. He’s still involved in healthcare? Is he still on probation–if so, is he violating the terms of his probation?
His probation ends 10/10/14.
“Dr. Stu.” More NCB name-changing to avoid accountability.