(with Dr. Stuart Fischbein, Ob/Gyn, dad of 4) It’s not often you chat with an Ob/Gyn who is passionate about ensuring women fully hear (and have the right to hear) the risks & benefits of ALL their options available & who believes the midwifery model of care has many strengths. Dr. Fischbein cares deeply about moms, babies and wants you to have THE best birth experience. Whatever that looks like for you.
He dives right into ‘fear of birth’ – why so many of us deal with birth fears, why it’s so pervasive around us & what you can do about it.
Dr. Fischbein encourages mamas to have solid relationships with their practitioners- feeling the freedom to ask any & all questions. He talks how communication is so key for openness & to build trust.
He also urges women to trust their body’s ability to give birth- birth “is not an illness, it’s not to be feared” he said. Dr. Fischbein gives examples of powerful birth experiences that are fearless, and shares what his favorite moments are, as an OB/GYN, during birth. I was pretty surprised to hear what he said.
You’ll Also Learn:
- Why all the media hype around birth can cause you to fear birth.
- How you can have an amazing & powerful birth experience in a hospital.
- How being educated about all your options eliminates fear & replaces it with empowerment.
Who is Dr. Fischbein?
Dr. Stuart Fischbein, MD has been an OB/GYN for over 25 years. He’s the co-founder of The Woman’s Place, Inc., an innovative model of collaboration between midwives & obstetricians. He’s also the co-author of “Fearless Pregnancy, Wisdom and Reassurance from a Doctor, a Midwife and a Mom.” He currently practices at The Sanctuary Birth & Wellness Center and attends homebirths. Dr. Fischbein, who collaborates with midwives, is passionate about the ‘right of women’ to true informed consent and refusal in the birth process. Dr. Fischbein is the dad of 4 kids.
Check out Dr. Fischbein’s book: “Fearless Pregnancy, Wisdom & Reassurance from a Doctor, a Midwife, and a Mom” & his site www.birthinginstincts.com. [private Premium Membership|Gift-Premium Membership|Coaching|Vault]
[/private]What do you think? Share below…
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Dr. Stuart Fischbein- How to be FEARLESS in Pregnancy & Birth
Sarah: Hi, this is Sarah Blight with Your Baby Booty interviews where we cut through the fluff of all the information you’re bombarded with about pregnancy and childbirth and get to the heart of the matter, what you really need to know, and want to know to make the best decisions for you and your baby.
Well today, we’re talking about fear and how to be fearless in pregnancy and childbirth and even after. Here to talk to us about that topic tonight, we have Dr. Fischbein. He’s an OB. He’s been OB/Gyn for 25 years. He is the cofounder of the Woman’s Place, which is a really cool innovative model of collaborative care with midwives and doctors, and he’s the co-author of Fearless Pregnancy: Wisdom and Reassurance from a Doctor, a Midwife, and a Mom.
He’s also a dad of 4 kids himself, and he has a lot to say about this topic, and he is really passionate about the midwifery model of care, which we’re going to find out why an OB is so passionate about midwives, and that women really have the right to be informed and to know what their options are in pregnancy and childbirth.
So thanks so much Dr. Fischbein for being here tonight.
Dr. Fischbein: It’s a pleasure. Thanks.
Sarah: So from all your experience as a dad and an OB, you’ve done a lot in your career, what are you the most inspired to share with expectant moms?
Dr. Fischbein: That pregnancy is not an illness; that we’ve had three generations of American women who have been sort of confused or – now I hate to use the word brainwashed, but I’ll use the word brainwashed to believe that if it weren’t for medical technology and hospital settings that our species would have probably been extinct long ago; that women need to give birth in a hospital; that giving birth outside of the hospital is either ridiculed, archaic, stupid, those sorts of myths that are played over and over again, and if you repeat these things enough times, and you develop a culture that actually believes that this is evidence based.
What is really true is that for women who have no problems with their pregnancy, the evidence doesn’t suggest that at all. As a matter of fact, the evidence suggest that it’s not safe necessarily or safer necessarily to give birth in a hospital. So the idea that pregnancy is an illness is something that my midwives that I work with and I and then several other physicians in the community and nationwide are trying to repackage the message.
Dr. Fischbein: We’re trying to brand the issues in such a way that people start to ask the proper questions to find out why have we been told that if it wasn’t for these interventions that my baby might die or that I’m going to have a terrible outcome or some problem. All these fear-based issues have become an art in the forefront. So I think that would be the number one thing.
Sarah: So that totally leads into our topic tonight which is fear, and if we’re brought up believing that the system is what’s really going to get us through this time in our lives, you know, just really endure it rather than thrive, it seems like it would be a no-brainer. Of course, people would feel fear. So what can you tell women to really try to diminish that fear?
Dr. Fischbein: Well, it’s really a great question. I’m going to start with sort of an example that we often use. Every week, at the Sanctuary, we meet couples that are looking at options. The Sanctuary Birth and Family Wellness Center is a collaborative practice between licensed midwives and doctors, mainly myself, and then doctors who back us at hospitals to where we offer people birthing center or home birthing.
And one of the founders of the sanctuary – her name is Bliss – often says this, “First of all, birth is a very special time in a woman’s life. She may do it two, three times, maybe once. It is extremely memorable. That baby is only going to be born once. It is a monumental experience for any woman that’s gone through it whether it’s at home or in a hospital. It’s life changing, and we treat it as if it’s having your appendix out. And it really needs to be thought of in a different way.”
And one of the things that she suggests is, you know, that some people will talk about their weddings. The other would be major events in a woman’s life. You have weddings and birth. Probably the two most memorable moments in a woman’s life. For weddings, we have no trouble spending $20,000; $50,000; $100,000 on our wedding.
Dr. Fischbein: But when we’re pregnant, we look at our insurance card. We take out our book. We say I’ve got to deliver at this hospital and use this group of doctors, and I’ve got to do what they tell me, and I’m going to go here, and I’m going to have this blood test, and I’m going to have this, and I know I’ve got to have an IV, and I’m going to come in, and I can’t eat anything, and that’s just the way it’s done.
And we accept that.
Dr. Fischbein: And we have to step back and say maybe we need to change how we look at birth, and look at it as an event rather than as a medical problem.
Dr. Fischbein: Imagine for an instant that they had such a thing as wedding insurance, and from the time you were 18 years old, you paid $100 a month to an insurance company, and when the big day finally came and you’re 30 years old, and the big day finally came, your wedding was covered except for a small co-payment. Wouldn’t that be great?
Dr. Fischbein: However, what if they’ve decided that you could only eat this kind of food, and you could only have it at this facility, and you couldn’t pick out the dress you wanted, and invited people that you didn’t like? Would any of us accept that? The answer is no, of course, we wouldn’t accept that, but that’s exactly what we accept when it comes to the birth of our baby.
Dr. Fischbein: So maybe we need to rethink it. So the first thing you have to understand if you want to get past this is that normal birth is not an illness and it doesn’t need to be feared. There are things that can go wrong in pregnancy, and I’m sure we’ll get to those questions, and I don’t want to elaborate too long…
Dr. Fischbein: …but hospitals and newborn intensive care units certainly have a place in modern medical obstetrics, but not for everybody. People need to be given a choice. Some people given a choice will choose that anyway…
Dr. Fischbein: …but other people given a choice will choose not to go to the hospital, and if everybody knew what the evidence states and what the statistics are then they can make a choice that suits them as an individual.
Dr. Fischbein: We end up sort of putting everybody into a package. Everybody is the same. It’s one size fits all policies and protocols and procedures in hospitals. That’s not the way you make birth memorable.
Sarah: Is it just our culture Dr. Fischbein that kind of thrives on this culture of worry and fear based, is it all the messages that we’re kind of bombarded with? Is it just unique to our American culture? Is there anywhere else in the world that has this fear?
Dr. Fischbein: Well, it’s different in other countries. In the European countries, it’s different. They have a different model of obstetrical care, but anywhere that you have media, anywhere that you have right now the competition for internet advertising, and your TV news advertising, and 600 channels on your direct TV, you know, they’re going to want to draw your attention. And how do you draw someone’s attention to something? You market something that’s interesting.
Dr. Fischbein: Normal birth is less interesting than problems. You don’t ever see a headline in the New York Times that says “All Planes Land Safely Today”.
Dr. Fischbein: Yet, most planes land safely. That is the norm, but when we have plane crashes, especially if you have video, then it’s spectacular. Then you see it over and over and over again. And so, people that see this over and over and over again start to fear that. It starts to build up a fear. It is something that is particularly pervasive in our culture also because – And I know that my friends in the American Legal System are not going to always like what I have to say, but we do have a litigious culture.
Dr. Fischbein: And we have people that are encouraged to sue, so there are economic reasons, there are medical legal reasons, there are expediency reasons why we’re all stuck in this rut, and maybe we’ll go through those as the interview goes along, and I can elaborate more on each one of those. But yes, it is more pervasive in the United States culture than it is in most of the Western, European countries.
Sarah: Is it possible as a woman who is pregnant to over prepare for pregnancy and therefore kind of induce stress or fear by just being too prepared or know too much about everything that could happen?
Dr. Fischbein: Well, that question is a yes, but it’s also, you know, if you’re a well- educated patient, it’s better off than somebody who’s ignorant. You’re far more likely to have irrational fear if you are not educated. But yes, if you read too much. And there are many sources of both in the internet and the books that are fear-based. The most pervasive or the most well read book in pregnancy, which I won’t mention, which everyone gets at least one copy of when they get pregnant, is a fear-based book.
Dr. Fischbein: It makes you worry. It makes you more concerned. But I would never say that educating yourself is a bad thing.
Sarah: So using a filter as your taking in information is probably a good idea.
Dr. Fischbein: How to find the filter is a more difficult thing.
Sarah: Well, correct.
Dr. Fischbein: But developing a relationship with your practitioner, a trust in your body are probably the two most important things that a woman can do when she’s pregnant. Trust that your body knows what to do. It’s been biologically developing over a million years. It knows how to reproduce. It knows how to deliver a baby, and if you let it do that then it will do its thing right most of the time. And if you have a practitioner that you trust whether it be a doctor, a midwife, family practitioner, your grandmother, it doesn’t really matter. If you have that trust and you have that confidence, then fear has a tougher time getting in.
One of the ways to determine whether you have a good relationship with your practitioner is to be able to feel like you can ask questions and not feel like you get the eye rolling or the short answer or the don’t-worry-about-that or the patronizing comment. There’s no question that’s stupid in pregnancy, and if you’re made to feel as if your questions are stupid, it’s maybe time to look elsewhere for another practitioner because if you feel uncomfortable in that setting, you’re going to feel less empowered by the time you’re in labor.
Dr. Fischbein: And it really is about the empowerment of the woman in her own body, in her own sort of primitive limbic brain to trust that the system will work. If you start to think too much, your higher brain functions take over, and the inner fear with the reflexive processes. This is sort of a weak analogy, but stress causes upset stomach, right?
Dr. Fischbein: When you stress about things you could get hyper. You’d get upset stomach. It’s not that you ate anything different or any different. It’s just that your body puts out hormonal factors that do that.
Dr. Fischbein: So your body’s interfering with the normal process of digestion, which is something that you don’t have to think about.
Dr. Fischbein: Labor is also something you shouldn’t have to think about. The minute you start thinking you interfere with labor.
Sarah: That’s really good. So that leads to my next question which is can you give us examples in your experience of how fear has really held women back or affected women I guess I should say as they’re in labor?
Dr. Fischbein: Sure. I mean I would liken it with the example of other mammals. I mean obviously, a lot of us think of us as higher mammals, but we’re mammals nonetheless. We give birth to our children live born from the uterus through the vagina into the world.
If you look at other mammals and how they give birth, they go off to some quiet place. They don’t go to the center of the freeway. They certainly don’t go to the emergency room. They go off to some quiet place, and who do they go with? Nobody. They go off alone.
As a matter of fact, the other members of the herd tend to leave them alone. They tend to not want to be interrupted, and if they want to walk around, they walk around. They’re not confined in any one space. As a matter of fact, it’s really rare for a laboring mammal to just sit down until they’re ready to give birth. If they’re hungry, they eat.
And if the predator comes nearby, if they’re disturbed, then their higher brain takes over. They put out adrenaline. Adrenaline sort of stops the secretion of oxytocin, which is your own natural hormone causing your uterus to contract.
Contraction space out, the animal gets up, does its fight or flight response or runs away. And when things calm down, and the thing that’s caused them to be stressed or fearful is gone, they would then settle back down, find their place, and they’ll give birth.
We, as a species, do it all wrong. Everything we do in the hospital birthing world is sort of counterintuitive to what nature designed. We leave our nest to get in our car and drive through an emergency room or put in a wheelchair or taken upstairs to labor and delivery where we’re asked to sign a bunch of consent forms. Not very primitive brain stuff. We’re asked to pee in a cup before changing into a hospital gown. We’re not wearing our own jammies or we’re not walking around naked like we might do in our own home.
Dr. Fischbein: We’re put into bed. We’re strapped in bed with these monitors on our belly so they can watch the baby. Often, we’ll put an IV in your arm then put the blood pressure cuff on your arm. You’re not allowed to eat. If you have to go to the bathroom you ask permission. You’re being interrupted constantly for vital signs and asked questions. You have people sitting around the room. Your husband, your mother-in-law, your grandmother are sitting in chairs staring at you. Actually, they’re not really staring at you, they’re staring at the machine next to you. You’re all looking at it. This is so counter…
Dr. Fischbein: …with what nature designed. It’s a setup that puts out the stress and fear-based hormones that will cause your labor to be interrupted so it’s no doubt – Excuse me – it’s no wonder that we have such a high rate of Pitocin usage (drug that induces labor) and then epidural usage, but Pitocin is painful. It causes the contractions to be a little stronger, a little more close together.
You can’t take it. Part of the reason you can’t take it is because you’re not allowed to get up. You’re not allowed to walk around. You’re not allowed to get in the shower or use other methods of pain control, so you end up asking for an epidural, and now you can’t move at all.
Dr. Fischbein: You can’t feel your legs. Your blood pressure drops. Your baby doesn’t like that. They have to turn off the Pitocin. Then they turn the Pitocin back on. The baby’s heart rate goes down again and they rush you down the hall for a c-section, and thank God, we have the operating room present at this neck rate. And it was all sort of iatrogenically (caused by physicians) caused by the whole process of interrupting that primitive deer or horse or cat often they’re own little space doing their own little thing. So I think your question had something to do with deer… (smiling big)
Sarah: (laughing really hard) Now, I love your tangent.
Dr. Fischbein: But if the fear – If you can avoid the fear then the whole – fear interrupts that whole labor process and then leads to all these interventions, these cascade of interventions, which then leads to this high rates of medicalized birth, forceps, vacuums, c-sections, and a sort of a lack of satisfaction in the process.
Dr. Fischbein: When you sit back weeks later and you start to analyze what happened, there’s a lot of questions there. They’re unanswered. Like…did I really need that? Did I really – Was this really the way it was supposed to be?
Sarah: Is it…?
Dr. Fischbein: And when we have a c-section rate approaching 35% in this country, to believe that one-third of women are not capable of doing what nature designed is astonishing, and there should be more people challenging it, and I think that with programs like this and other avenues of getting the word out then people are beginning to start to wake up. I mean home birth in this country is still less than 1% of the birth, but it’s picking up.
Dr. Fischbein: And high-profile people like Ricky Lake and other people doing their thing gives people the idea to stop and think for a second and ask the questions maybe there’s a better way…
Sarah: Dr. Fischbein, is it possible for a woman to have a hospital birth in a way that isn’t stress and adrenaline filled and to kind of have a soothing natural wonderful experience? Have you seen that?
Dr. Fischbein: Yes.
Sarah: And who are those women who have that?
Dr. Fischbein: Okay, it’s not easy because hospitals have policies to have timetables. They interfere with that primitive stuff that we were talking about. The women that do that are again the women that I said earlier are comfortable in their own skin. They’re confident in their body’s ability to do it. They have good support system. They have a trusting practitioner who’s onboard with them. They very likely have a doula. I can’t stress enough for people that give birth in a hospital, but you’re far less likely to have interventions or need a cesarean section when you hire a doula.
So anybody who chooses to give birth there whether it’s for medical reasons or just because you feel safer there hire a doula, but those are the things. And you can design – And you can come in with a birth plan, and you may get a nurse that’s great. And remember, your primary care giver at a hospital is not your doctor, all right.
Dr. Fischbein: Your doctor’s at home or in the office, and the nurse is your primary care giver, and the nurses do change shifts, but if you get lucky and you get a really good nurse, you can have a great experience.
Dr. Fischbein: Sometimes it’s a crapshoot because nurses come in all shapes and sizes. They have good days and they have bad days. They have good experience and bad experiences, and so you don’t know which you’re going to get. That’s why if you have a doula that you’ve met throughout your pregnancy, she can act as an intermediary to prevent you from being drawn out of your primitive space.
Dr. Fischbein: But yes, it can be done…
Dr. Fischbein: …and then you can ask for delayed chord clamping. You can ask for no separation of the baby because there’s no reason that after a baby’s born that in the first hour, it needs to be separated from its mom. Again, going back to our nature model, when a baby horse is born, do they come and take it away from the mother? Do they come with tooth clamps and cut the cord? No. I mean I’ve seen baby horses walking around while dragging their placenta along the ground.
Dr. Fischbein: They fall off eventually.
Dr. Fischbein: That’s not a problem. And the mother never leaves the – I mean the baby and the mother never separate. The mother licks the baby, smells the baby, bonds with the baby, and the same thing goes on with the baby. As soon as it can stand up, it goes for the nipple. That’s what should be done. There’s no reason that you have to weigh a baby, dry the baby off, or put a little hat on the baby, or you know, clamp the cord and cut the cord, and – Those things are done in the hospitals partly because they have time tables. They have to move on. They have to do their charting. There’s so much charting in the hospitals because of the legal stuff that goes on.
Dr. Fischbein: And part of it is done because of a saying by Thomas Paine from the American Revolution. He said the long habit of not thinking something is wrong gives the superficial appearance of it being right.
Dr. Fischbein: And if the habit was always to take the baby from the mother, and dry the baby off, and swaddle the baby, and then hand the baby back to the mother…that’s the way it’s done. No one thinks, why are we doing that? Why are we even taking the baby away from the mother in the first place?
Dr. Fischbein: Nature didn’t design the baby to have to be taken away from the mother except in those rare cases where babies aren’t doing well, and resuscitation or something by an ICU team is important. Fine. But on rare cases, even when babies are mildly suppressed, the best resuscitation that could happen for a baby is to stay connected to the placenta of the mother. While the baby’s outside and trying to learn how to breathe, and taking its first breath, and looking around, it’s still getting oxygen and nutrients in volume (meaning from the blood from the placenta) from the mother.
As a matter of fact, when babies are born, a certain percentage of their blood volume has actually been squeezed into the placenta, and if you cut the cord immediately after the birth, you’re actually depriving the baby of something that belongs to the baby.
Dr. Fischbein: So yes, it can happen, but it only happens to well educated people. Otherwise, the system kicks in and takes over.
Sarah: So let’s compare for a moment the patients you’ve had who were fearless, who were educated, who were prepared, who trusted their bodies, and who were active participants in their own birth process to the women you’ve seen who just kind of gave themselves over to the system. What differences do you see after the fact in these women as far as how they feel, how they perceive themselves just in general?
Dr. Fischbein: Well, I think it’s the question that sort of has a fairly obvious answer. I think that, you know, to some women, birth is just an event that goes on, and it’s not that important. You know, they deal with their lives differently, and again, every woman is an individual…
Dr. Fischbein: …but if I had to generalize, women that have an empowering birth where they feel great, they have a more loving relationship with their child. They have more connection with their baby. They have a more loving relationship with their spouse or their partner. They feel stronger. They feel there’s no question about their birth. They don’t look back and say, geez, I wonder if I could have done this differently. There’s no sort of regret. I can’t tell you how many times in interviews that we do or when I see a new client, and they come in, and they start to tell me about their birth story. First of all, halfway through their story, I could finish the story for them.
Dr. Fischbein: I’ve heard the same thing so many times. But there’s such a question in their mind and they don’t feel like some of the things that happened to them were necessary.
Dr. Fischbein: And they have a regret about that.
Dr. Fischbein: Sometimes they even have anger, anger at themselves for not moving forward, anger at their practitioner, even anger at their spouse, or sometimes their spouse has a feeling of helplessness watching his beloved wife sort of be forced into this tract, and today, at a meeting, one of the husbands said, “You know, if we’re in a labor room and the doctor says we need a c-section, who am I to argue with the doctor?”
Dr. Fischbein: Again, getting back to the trusting relationship thing.
Dr. Fischbein: So there’s a real helplessness and a real feeling of guilt sometimes and anger sometimes and frustration, but you see it in people who don’t go through the process of empowerment, and a perfect example is when a woman transfers from a home birth after everything we’ve tried at home doesn’t work is she goes to the hospital, and if she ends up at the hospital having a cesarean section after whatever they do at the hospital fails, the chance of her having a satisfying experience is so much greater because she knows that the cesarean section was necessary and that the baby’s half brought them to the cesarean section and that every option was taken, as opposed to the woman who’s 3 days overdue who’s brought in by her doctor for induction, for no reason other than being 3 days overdue or I-think-your-baby’s-getting-big-syndrome, which happens all the time, ends up with the Pitocin epidural cascade and a cesarean section and wonders what would have happened if I would have just waited 3 or 4 more days? And they always wonder.
Sarah: Yeah. So I’m going to ask the question now that I’m sure all the women are thinking and men too who are watching this interview. Why is an OB so passionate about the midwifery style of care? Why are you such a big proponent of this?
Dr. Fischbein: I have to tell you that when I finished my residency program in the early ’80s, I had to no concept of any other way to do it than the medical model by which I was trained. I was the gung-ho resident. I was the administrative chief resident at Cedar Sinai. I came into practice. I thought I knew everything. I tell you, my evolution was a slow process. If you would have asked me that 25 years ago, if I would have been sitting here on Skype today with you having this conversation, I would have thought you were out of your mind. I looked at people who wanted to have a home birth, who wanted to have bury their placenta or make their placenta into capsules, or do this sorts of things is loony tunes. I really thought these people were out of their mind.
But as fortune would have it, when I started my practice, I was approached by some midwives and asked to be their backup physician, and of course, I’m building a practice from ground up. I’m not going to turn away the potential, you know, seeing new patients and developing new relationships. I said, “Sure.” And over time, you know, over the next 10 years, I realized that everything that I learned – not everything – but most of the things that I learned for low-risk pregnancies or normal pregnancies, I had to unlearn because quite frankly, I had no training in normal pregnancy.
Dr. Fischbein: But the definition of an obstetrician is somebody who’s trained in surgical birth, in surgery. I never had a lecture in 8 years of medical student residency on nutrition.
Dr. Fischbein: And not one on breastfeeding. I wasn’t prepared to deal with preventative healthcare. I was trained in fixing problems.
Dr. Fischbein: Then I saw that, you know, normal birth doesn’t require a whole lot of interventions. I would be backing 3 or 4 women a month for a certain midwife, and it would go 6 months before I have a transport, so where are all these women? What happened to them? Did they go someplace else? No, they all delivered at home. They all did great. So after 10 years of doing this, this is when I founded the Woman’s Place because I saw the collaboration between midwives and physicians was the best way to go. Midwives are trained in low-risk birth. Doctors don’t even want to deal with that.
Dr. Fischbein: I mean we do with it because financially, we need the money, and some of us actually love OB.
I shouldn’t say that they don’t want to deal with it, but ultimately, we’re not – Our model isn’t like that. Our model allows about 6 to 10 minutes for prenatal visits.
Dr. Fischbein: Midwives allow an hour.
Dr. Fischbein: It’s a whole different model.
Dr. Fischbein: But I saw that collaboration with midwives taking care of low-risk people, and then if something went wrong or somebody needed genetic screening, or somebody needed an ultrasound, or somebody is having twins, or baby ended up being breach, that was outside their scope of practice and that’s exactly what I wanted to do, and I found that fantastic.
So it was an evolution. It wasn’t just an epiphany over one night. It was an evolution of the process of seeing it. And also, I battled for common sense and evidence-based things to go on in hospitals, and I was rebuked over and over again. And so I sort of developed a chip on my shoulder about why can’t we do VBACs. It’s evidence based. It’s supported by the American College of OB/Gyn. It’s supported by the National Institute of Health. Hospitals banned them.
Why can’t I do breech deliveries? I’m credentialed to do them. I know how to do them. Hospitals banned them. My midwives were banned for a year from the local hospital, the Camarillo, where I was working for a while. For safety reasons, the art of safety, you know, the welfare of humanity is always the alibi of tyrants, and they were saying that it was unsafe for midwives whose patients are all low risk to give birth while OB/Gyns could still give birth at this hospital.
It was ludicrous, and I realized to a point that I could bang my head against the wall and come up empty every time, because I’m never going to win, or I could go off and I could try to start my own paradigm, which is common sensical and give women an alternative. And there’s so much support for what we’re doing out there that I feel good about my life now.
Dr. Fischbein: I feel good about my job. I’m happy to go to work. I’m happy to go to a birth. I never felt that way when I was driving into the parking lot at the hospital I was working at.
Dr. Fischbein: So if we try to tell women who are pregnant to live a good life, to be stress free, to eat well, to sleep well, to have good relationships with their partners, we have to walk the talk.
Dr. Fischbein: And I wasn’t. And I think most obstetricians are not walking the talk. The burnout rate’s pretty high. People are – You know, when they get a phone call at 2 in the morning and someone’s in labor, it’s oh crap.
Dr. Fischbein: It’s not…“how wonderful”.
Dr. Fischbein: And that’s the difference, and that’s sort of how I ended up where I am right now, and I love speaking about it. You know what? It makes me feel good to have people come up to me and tell me that I’m doing something good.
Dr. Fischbein: You know, as an obstetrician, you get a little bit of accolades, but really, all you hear about are the cases that go wrong, the people angry, people don’t want to pay their bill, that sort of thing. That’s the stuff that you get e-mails about or you get certified letters about. I don’t want to get certified letters about those things.
Dr. Fischbein: Doctors hate certified letters. We have certified letter cold sweats.
Sarah: Well, I have one last question for you. You’ve been an OB for 25 years. I’m sure you have a lot of, you know, amazing birth stories, but can you share with us one or two birth stories that really taught you something about birth?
Dr. Fischbein: Yes, I can. As a matter of fact, I can think of somebody very unique. Her name is Becky, and she is sort of in the fringe of the birth community. And she’s had three previous births. The first birth was a cesarean section, and then her second and third birth were vaginal birth after cesarean section both at home. In her fourth pregnancy, it turned out that she had twins, right.
Dr. Fischbein: So she couldn’t find anyone to do her twins VBAC in a hospital. I was willing to do them in the home setting, and I’ve done several other twins in the home setting. She was unique because at the time that she got to her term, both her babies were in the breech presentation.
Sarah: Oh wow.
Dr. Fischbein: Okay, breech-breech twins. Nobody does breech-breech twins. Nobody does breech vertex twins. Very few people do vertex breech twins unless they’re head first-heard first, which you call vertex-vertex. A lot of people are just going straight to c-section for twins, but the evidence doesn’t support that.
Dr. Fischbein: And so we did a literature search, and we looked around, and we found that there is no evidence against doing breech-breech twins that as a matter of fact, there are some anecdotal reports before and stuff that say that in the woman who meets a certain criteria who’s well educated, who chooses that path, and a practitioner was willing to support her then it’s worth – you know, you can do that.
Dr. Fischbein: But no one would allow her to have that done in the hospital, so where was she going to do that? The only place she could do it if she’s going to do it is at home. She trusted her body and she trusted our team, and she had a beautiful birth.
Dr. Fischbein: Her baby was born on February 14th a little after 10 in the evening. The next baby was born – And that was in the water in the tub. The next baby was born shortly after midnight on February 15th…
Dr. Fischbein: …and landed in her bedroom, and everything went – It went beautifully. And could something have gone wrong? Sure. But generally, when you trust labor and you follow things, and you don’t push beyond limits, things don’t go wrong.
So that for me was a wonderful thing, and we were able to give her the option, and since that time, we’ve done lots of breeches, because breeches in the Southern California area don’t have any option other than this wonderful old doctor at Glendale who does hospital breeches, but otherwise, breeches are automatically c-section. But breeches is just a variation of normal.
Sarah: Uh-huh. I like that, yeah, yeah.
Dr. Fischbein: So there’s – That birth – And then you know, there’s countless births where, you know, you just see the woman grab her own baby, pull it up on her chest, hold it there. You see the look about her face, the tears in her eyes, the look on her partner’s face.
My favorite time in a birth when I use to give birth in the hospital was when everything was sort of done, I was sitting in the chair in the corner of the room at the chart, filling out the chart, and just quietly looking at the couple with their new baby and maybe their other children would come into the room by then, and just in seeing that this is a family bonding event, it is.
It doesn’t have to be saying as taking out your appendix, and when we do a c-section, and we separate the mother from the baby, and the baby goes to the nursery, and the father is separated from the family, and everyone else is in the waiting room. You’re looking at the baby through the glass. This is not what nature designed. This is not what they intended in. It should be avoided as much as possible. It should not be nurtured. It should be avoided.
As I said earlier, there’s always a chance. When this is necessary, it’s important, but it should not be the law.
Sarah: I love that. Well, we’re going to end on that note. I really appreciate Dr. Fischbein your time and your passion for women and babies and this whole experience of empowering them to know that they do have choices and to really get the whole scoop on what their choices and options are.
To all the women watching, if you have any questions or comments about this topic, please let us know in the comment section below. We’d love to hear from you. Thanks everybody for watching. Thanks again Dr. Fischbein.