Tuesday, March 06, 2007

From a doctor in Hawaii

This post is an email (posted with permission) from a doctor on the big island of Hawaii.

hello tina,
i just finished listening to your interview with terri gross on "fresh air" and had a comment. first, the interview was great and you bring up some great points about the history of birthing and the current (abysmal) state of birth management.
my issue is the neglect of mentioning of the role of a family doctor in the birth process. as a practicing family physician, i have delivered well over 500 babies and helped to raise them. family docs deliver and manage labors mush more like midwives than other md-obstetricians. we are trained in an approach that is patient centered. not surgically oriented, so the options that you discussed a midwife might suggest are well within the practice of most family physicians practing ob as part of their training. but, family docs have more physician trained decision making capabilities than many midwives and broader surgical training that sometimes is of benefit. also, family doctors often have more insight into how the birth of this individual child into the family unit may be affecting labor, through the deeper and more extensive interaction with the rest of the nuclear and often with the extended family.
i urge you to consider mentioning, or learning more about the role of the family physician in the american and international birthing process. a good start is the american acedemy of family physician website at www.aafp.org.
i currently practice on the big island of hawaii. my current practice scope is limited, and does not include ob, partly because of "political" infighting among the ob-gyns in this town and their desire to limit access of family doctors to obstetrical patients. and also, because i have adopted 2 little girls from china in the past 2 years and am busy being a mom.
but, i loved my obstetrical practice and very strongly feel, and the data at aafp will back me up, that family docs are an underutilized resource in the field of obstetrics. we have really excellent track records for safe, non- operatively intervened and happy outcomes.
i'm happy to do whatever i can to educate the folks about our role.


Baby Keeper said...

I am new to your site and have only read these first two posts. I'll read more about your book, but have to say I totally agree with both of these posts.

This is for the family practice doctor. I totally agree with her and was just five minutes ago having the same conversation with a colleague, a family practice physician. Part of our conversation was my belief - through my experience in pre and perinatal psychology (www.birthpsychology.com) and birth trauma healing work -- is that the obstetrician has so little history, connection, and knowledge of the woman and all that she brings to the birth. I am an advocate for the baby. www.Itsthebaby's birth.com is my website. As the FP here says, OB/GYNs are not woman-centered, but surgery centered. I find that often not even the midwives are as baby-focused as I would like to see. Birth is often focused on the mother's needs and "choices" without a real consideration for the baby. I write extensively about this on my blog, www.hospitalbirthdebate.blogspot.com where I "let loose" a lot. For the most part, on my website I really do try to present a balanced perspective about the process of birth in the midst of all the parties of interest. I do believe tort reform should involve addressing the lack of a standard of care around for maternity care in the US. Birth and the drug, protocols, and policies varies from state-to-state, hospital-to-hospital, doctor-to-doctor, and nurse-to-nurse. The evidenced-based science gives us a good standard but it is not followed in obstetrics. I support midwifery care and homebirth AND I am concerned that unless we as a society address the vagaries of the maternal health care system, the winning of states to allow midwives is just the opening of the door for midwives to be held accountable and liable in malpractice suits. Until there is a political will for woman and men to be responsible from pre-conception through infancy and beyond, with appropriate use of drugs and technology, I think we are just getting deeper and deeper into trouble no matter who attends the birth.

Lastly, I want to let you and the physician from Hawaii know about the SAFE BABY RESOLUTION being introduced in Hawaii this legislative session. You can read about it at www.safebabyresolution.blogspot.com.

Thank you so much. I look forward to checking out the rest of your blog and book.

L. Janel Martin-Miranda

Jessica A Bruno said...

ITA with what the last commenter said about this. Personally, I feel they need to stop asking for money in order to run to not for profit organizations for midwifery or traditional birth or breastfeeding or etc because I feel it is creating even a bigger mess.

Well, I'm college educated or so on. So, I don't have exactly research to back up my opinions on this. Always, been passionate about women and children so on. Currently, I'm an clerical volunteer in the Maternity Department at the local community hospital by me. What I see, hear, read, so on there is very eye opening to me. Its hard for me to continue to volunteer there since what I learnt online about this subject is really better then what they do there. The people whom I work for and with really don't understand where I'm coming from on this subject.

Think thats it.

Thank you for writing the book Birth and this blog.

Gratefully yours,

Jessica A Bruno