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