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DrStusPodcast.comAnnouncing my new podcast on timely topics surrounding birth, life, entertainment, politics and Los Angeles Kings hockey. No subject will be off limits. Its Dr. Stu's Podcast (my friend and cohost, Brian Whitman, from talk radio came up with the name) because its my podcast, I guess. We will be posting about 2 a week and you can listen online at drstuspodcast.com or download them from iTunes. Hope you will join me and Brian and producer Randy for some lively, timely conversations. Future guests in August include breech mom Kimberly Van der Beek, Aleks Evangeleidi and Blyss Young from the Sanctuary (birthsanctuary.com) and doula Sara Avalos (fulloflifebirth.webs.com/)
An Amazing 24 HoursThe birthing world is certainly nothing, if not unpredictable. Yesterday I had the honor and exhaustion of attending 3 home births in less than 24 hours. Indelible memories of all three and so different. Birth 1 was in the middle of the night in a lovely home on a lonely road in the foggy hills of Malibu. Labor lasted less than 2 hours and culminated in a water birth delivered by mom and dad and future big sister. Then is was off to Burbank where after a long labor and a heroic effort to bring baby down I assisted the delivery of a beautiful baby girl with a forceps delivery. Yes, they still exist and are a great tool when needed that, sadly, has all but disappeared from the arsenal of the more recently trained obstetrician. Then it was home to rest or so I thought. 2 hours later the third client called with leaking clear fluid. A first time mom at 42 weeks, positive group B strep colonization and breech, too. Contractions started in quickly so off I went to give her a dose of antibiotics and hopefully rest on her couch instead of mine. Only 4 hours later and less than 24 hours since I arrived in Malibu she was pushing out her frank breech baby boy to an amazing display of strength and jubilation! Waterbirth, forceps and breech all in one day. To say I have an interesting job would be an understatement. Special thanks to a fog challenged Robyn, Heather and Sheila and intern Mary Beth and, of course, Beth and Kelly.
Print Media NewsA new and revealing book which I highly recommend by my friend Jennifer Margulis was just released on April 16th. "The Business of Baby" shares its insight into how parents should make decisions on this life changing subject. In the interest of full disclosure, I am biased as I am cited numerous times in the text. Check it out at amazon.com. I also had a letter to the editor of the American Journal of OB/Gyn (AJOG) accepted for publication. Despite being limited to 400 words I am glad to have the opportunity to respond to a recent opinion piece by an ACOG ethicist who is very anti-homebirth.
Simi Valley StorySimi Valley is just one of many communities hostile to the legimate, evidenced based option of VBAC. Worse, some OBs often skew their counseling in an unethical manner. In her first pregnancy, this mom was told they "suspected" her 1st baby was too big. (If I had a nickel for every time I have heard that one). Not knowing any better, mom had a schedule c/section without labor. Her too big baby was 7 pounds, 12 ounces! No shame and no apology from her physician. I guess his intentions were good, or were they? Fast forward 2 years to pregnancy #2. More informed, she sought out VBAC options but nothing suitable in local hospitals. She sought care with me for a home VBAC. Again, trusting in the normalcy of labor she endured 4 days of prodromal contractions and finally got active. About 8 hours later she was holding little Esteban in her arms with dad and grandma and doula Jaci right beside her. She has my respect for her persistence and conviction. We both know that the best way to avoid a VBAC is to avoid the first c/section. She would like others to know this from her experience and challenge the often unethical status quo.
Dr. Stu on WSLR radioWhat's up with the breech was the topic on live radio in Sarasota, Florida today. I was a guest along with 2 other practitioners experienced in breech delivery. Take a moment and listen in at: maternallyyoursradio.com Thanks
Twins in Santa BarbaraWe want to celebrate the trust and joy of a fantastic couple who gave birth to twins last weekend at their home in Santa Barbara. Mom was born at home herself and gave birth to her first baby at home back east. Dad was on board from day one. After moving to Santa Barbara they became pregnant with twins and their desire to have a natural birth was not welcomed by the practitioners at Cottage hospital. Well aware of their options and the risks and benefits of both hospital and home birth they decided that their home was the best choice for them. We met and discussed the need to meet certain milestones and remain healthy. We were highly motivated and excited when labor started Sunday afternoon. Baby A came pretty quickly head first but baby B remained transverse and was delivered breech. What an amazing couple, fantastic birth team and unforgettable evening. Once again when choice is restricted despite supportive medical evidence women will seek out reasonable options and Birthing Instincts is honored to assist them in doing so.
Raining babies and good fortune!Friday is here at the end of a very busy week. 3 beautiful and different out of hospital births and a wallet lost and then returned made for an exhausting yet rewarding experience. Honored to attend the water birth of a head down baby girl in Santa Monica on the same night as the arrival of baby Kenny frank breech at the Santa Clarita Birth Center. Then 2 days later another new client gave birth to her frank breech baby on all fours in Venice. One more breech out there in Burbank to go. I love that the word is getting around that for some families a vaginal breech birth is a safe and realistic option. I just hope there is enough of me to go around. Seems to be raining upside down babies lately. On a different but no less uplifting note was how my faith in mankind was renewed for the moment by a young man named Alberto. Leaving the Sanctuary on Wednesday to attend the birth in Venice I must have dropped my wallet while getting into my car on Inglewood Blvd. near Venice Blvd. I realized it was missing at 3:30AM on my way home. Searched high and low with no luck. While accepting the annoying fate ahead of me of replacing and notifying everything and everybody I was encouraged to say a prayer to St. Anthony by my dear friend Beth. Not 30 minutes later Alberto called my office to report he found my wallet. I met him near the Sanctuary Thursday afternoon where he returned it intact, cash and all, and refused a reward. I know he will be rewarded in so many other ways and his honesty inspires me to pay it forward. Thank you Alberto, Renee, Molly, Angela, Monica and Sheila for a most amazing week.
VBA2C Success at Santa Clarita Birth CenterCongratulations to the lovely couple who achieved their dream of a vaginal birth after 2 previous c/sections before dawn today at the Santa Clarita Birth Center. A familiar story of frustration when dealing with their local hospital's restriction on choice led them to seek out Birthing Instincts. Tears of joy and accomplishment on mom's face as she held a newborn on her chest for the first time. Thanks to Heather, Robyn, Teesa and especially to Renee and her beautiful Santa Clarita Birth Center.
Current EventsRecent and upcoming events involving Dr. Stu are worthy of mention. On the September 26th edition of the new Ricki Lake Show Ricki and director Abby Epstein hosted a Business of Being Born reunion show. Issues concerning home birth, VBAC and choice were discussed withmany of the players from the groundbreaking documentary. Dr. Moritz, midwife Cara, doula extraordinaire Ana Paula Markel, Ina May Gaskin and myself were among those who made an appearance. Taping a live show was quite an experience. Green room and makeup and even craft services! Hope you caught it and if not you may find it at The Ricki Lake Show archives. Next up I will be on 2 panel discussions at the "Heads Up" Breech Conference in Washington November 9-12. The list of experts is impressive including Dr. Martin Gimovsky and Dr. Frank Leuwen. A few years ago this conference was instrumental in changing the stance of the Canadian OB/Gyn Society's position on breech birth. They put out a statement supporting the choice of selected breech birth and took the noble position that Canadian resident physician training programs should once again be teaching breech vaginal delivery techniques. This year we are hoping to bring a bit of common sense to American medical training programs and very soon before the skill is lost. I am honored that one of my clients who had a successful home breech delivery will be on a panel speaking about her experience. Thank you, Kimberley. Would love to see any of you there. Oh, and by the way, Jodie Myers beautiful film of Aurora's Breech Home Birth has nearly 500,000 hits on youtube! Amazing!
The First 50Fitting that on Labor Day 2012 I would have assisted in my 50th out of hospital birth. In the 2 years that I have had the joy and privilege to be involved with these 50 beautiful families I have learned so much about the nature of normal birthing. Today, I was able to witness the successful Sanctuary Birth Suite birth of baby Luke to a mom with 3 previous c/sections. The look on mom and dad's face says it all. This is the 2nd VBA3C in the past couple weeks. Overall, I have had 94% of my clients deliver vaginally. 45 at home and 2 after transport. The c/section rate of 6% overall which includes only 1 primary and 2 unsuccessful VBACs is pretty remarkable considering my clientele included 15 VBACs, 7 singleton breeches and 5 sets of twins. In many obstetrical practices in our country all 27 of these mothers might have had a scheduled c/section. 29 mothers were having their first vaginal attempt while 21 were multiparas. As I have repeated many times, there is much evidenced based medicine supporting these choices as reasonable options. And while out of hospital birthing is not for everyone, at least the information and the choice ethically belongs to the pregnant woman. Dr. F
Dr. F Interview on Baby Booty and other news.A few months back I was interviewed on the internet about my philosophy of birthing. You can view the Skype interview at : http://yourbabybooty.com/interviews/how-to-be-fearless-in-pregnancy-childbirth-dr-stuart-fischbein-interview/ A word of caution about the transcript. There are a lot of obvious transcription errors and such but the content is worthy of your time. Also, want to announce another successful external version this week at the Sanctuary. This first time mom had exhausted all other remedies and using hypnosis by Luree the unmedicated procedure took less than a minute. It feels great to use the skills I learned years ago for the benefit of our clients and the honoring of informed choice.
Trusting Data and Each Other.Over the past 2 months I have assisted at 7 home deliveries. Of the 7, 2 were breeches and 3 were VBACs. Once again showing the with proper selection and respect of choice these 5 women were able to deliver the way nature intended. In far too many settings today all 5 of them would have had surgical births. Today I was fortunate to assist and witness the home vacuum assisted vaginal birth after 2 previous c/sections of baby Marcus. Mom was so happy to give birth at home and Dad was so supportive of her informed choice. Special thanks to Monica and Sheila of the Sanctuary team for their dedication to the profession they love.
Breech in People MagazineIts going to be a busy summer. The word is spreading that birthing options do exist and more and more families are doing their homework before just accepting the limited world of medicalized and operative birth. Such was the case yesterday morning when a lovely family in Torrance gave birth at home to a baby girl frank breech. Coming into care only 5 days earlier as they had been given no options and felt pressured by their OB to have a scheduled c/section. Coming from a medical family they took the time to educate themselves and found me and the Sanctuary midwives. After 2 long prenatal visits where informed consent and birth choices were discussed they chose a different path that culminated in such joy. ...... On a exciting note, please check out the current May 28th issue of People Magazine, page 42 for another story on home breech delivery and the wonderful, educated people who make that choice. all good things, Dr. F
Home VBACAnnouncing the birth of Hannah Rose in water to loving family on 4/15/2012. The Birthing Instincts team is delighted to support the evidenced based option of VBAC. Having had a surprise c/section with her first baby who presented in labor as an undiagnosed breech (No option for Vaginal Birth was offered to her), mom and dad were determined to have a natural birth should the fates allow. Fortune and common sense prevailed and 11 days early out came little sister Hannah. This is especially meaningful to me as she now shares the birthday of my own mother who would have been 86. Regards, Dr F
Blog UpdateJust a reminder that on occasion I get inspired to write down my thoughts at my blog site: Hit the blog button at www.supportdrfischbein.com Hope you find it interesting and comments are welcome. Dr. F
Breech Saga, a new chapter!Being pretty much alone in offering the option of selected breech delivery has great rewards and the rare drawback. March 13, 2012 was a day with both. Two lovely Birthing Instinct families, one 11 days late and the other 5 days early, were in labor with breech babies. Only dilemma was they were 65 miles apart in typical Los Angeles traffic from Ventura to the Hollywood Hills! Normally, when simultaneous labors occur in any home midwifery practice there is always a colleague available and willing to help out. In the case of breech, however, none of my supporting midwives purposely deliver them any more. Fortunately, some still have the skill and while I left Ventura in early morning rush hour traffic to drive to a rather precipitous sounding labor in Hollywood I was blessed to be working with one of those saintly practitioners in Ventura willing to stand in "just in case" and honor the process. At 7:43 AM in the hills near the Hollywood sign, was born a baby boy, complete breech, and beautiful to delighted mom, dad and big sister. Once all was stable it was back into the Mini Cooper for the return drive to Ventura. Over the next 6 hours labor stalled out at 8 cm. All our tricks at trying to bring back contractions were unsuccessful. In a perfect world a transport to a birth friendly hospital for some rest and pitocin might have made a vaginal birth possible. However, since we do not live in that world and no one would deliver any breech vaginally in the local hospital a non-urgent c/section was our only option. At 5:05PM a daughter and sweet baby sister entered the world to the welcoming arms of mom and dad. Two different stories and a whole lot of miles made for some interesting memories. Lets not do that again soon! Wouldn't it be nice to have more practitioners trained and willing to offer the evidenced based selected breech option to families in our community? Thats one of my long term goals in my quest for common sense and individual choice to return to the birthing world. Dr. F
Upcoming EventsSunday, March 4th at 4PM I will be sharing a conversation with the West LA ICAN group at : The SPOT CAFE & LOUNGE
4455 Overland Ave (south of Culver)
Culver City, CA 90230
Topics include: ?What are some true indications for cesareans according to ACOG?
?How much does hospital policy influence birth choices?
?Who is concerned about VBAC?
?How does insurance influence primary cesareans and VBACs?
?What does the medical evidence show? April 1st I will be in San Diego at the Natural Baby Fair at 9AM lecturing on options of VBAC, Breech and Twin deliveries. May 5th I will be in LA speaking on handling home emergencies for the California Association of Midwives (CAM) in a Video-conference. And on May 11th I am schedule to go to Miami for their 3rd annual VBAC summit.
The tale of two twins!Twin deliveries, different stories. 2 sets of twins delivered in my practice in the past 36 hours. Early this morning, on her bedroom floor, Monikka gave birth to her babies at 39 1/2 weeks. Twin girl A came head first and weighed in at 8 pounds, 5 ounces and her brother came 10 minutes later, footling breech weighing in at 7 pounds 4 ounces. Almost 16 pounds of babies! A beautiful tale of trust and persistence and a delighted extended family with a of of patience. Congratulations to Monikka and David. One day earlier, a woman who was transferred from my care 2 weeks ago gave birth to her twins by c/section at CMH. Although both these women had delivered over 9 pound babies in the past, Ellene's twins were breech/vertex which convention says should not be delivered vaginally. This is what I was taught and is the practice at almost all hospitals in the U.S. Because she had delivered so easily in the past I did a search of the literature and found, like much of conventional practice, that a c/section for term twins in this position was not evidence based. However, the world we live in and the world we are striving to create in childbirth are still far apart. After respectful discussion of the situation we all agreed that the good of the many outweigh the good of the one and the only best option was to transfer care. In an ideal world with an ideal facility and supportive environment I have little doubt that Ellene and Jason could have birthed their twins in a natural way. Reason number 237 why I am committed to creating a free standing facility where trusting birth and choice can be respected without fear. A place where evidenced based medicine and true informed consent allow women another birthing option.
Media Events this month.Some upcoming events. Last Saturday I recorded 24 short videos on topics relating to pregnancy for about.com. Now being edited they should be up in the coming weeks. Will post a link when they are. Also, I will be making my second appearance on Gena Kirby's Progressive Parenting Internet Talk Radio program this coming Monday evening at 7PM Pacific time.
Home External VersionWell, its a new Year! It began with a home visit this afternoon on a new client referred by Mary Lou O'Brien. Alison's second pregnancy was persistent frank breech at 38 1/2 weeks. Her 1st delivery was a home birth with Mary Lou. We discussed her option of external version after more natural methods had been unsuccessful. However, the cost of going to the hospital for this family was prohibitive so they accepted the very small risk and great benefit of trying to flip the baby at home in bed. Without medication but with portable ultrasound available and a very cooperative baby the version took less than 30 seconds. An easy forward roll put the baby's head down to the delight of mom, dad & little brother Ocean. Birthing Instincts is overjoyed for them and proud to be able to offer choice, informed consent and alternatives such as external version and breech delivery options. Thanks Mary Lou. Be sure to let us know what happens next. A peaceful 2012 to all. Addendum: On January 16th, 2012 little Orion was born at home, head first, to loving mom and dad. Storybook ending.
Dr. F on Blog Talk RadioOn Monday evening, December 19th, 2011 I had the privilege of being interviewed by Gena Kirby on her internet talk radio program. Our 90 minute conversation focused on the state of breech delivery in America but we also just chatted and took a few questions about a variety of topics relevant to home birthing and the current state of maternity care in the U.S. Worth a listen. Please cut and paste into your browser. Thanks and Merry Christmas. Dr. F http://www.blogtalkradio.com/progressive-parenting/2011/12/20/breech-birth-a-reality-a-conversation-with-dr-fischbein
Birthing Instincts in Orange County12/5/11 I had the honor of attending another sweet home breech birth this morning in Irvine, CA. Congratulations to Hallie and Michael on seeking out all their birth options, believing in me and the welcoming of their 8 pound son, bruised little bottom and all. Very sweet. A magnificent couple with the "right stuff" and so deserving. Special thanks to Beth, Jaclyn, Robin, Barb and for the trust and referral from South Coast Midwifery.
Not quite Siskel & EbertRicki Lake & Abby Epstein sequel documentary, "More Business of Being Born", was released last month. This 4 DVD set delves into areas of informed consent and birthing options and I highly recommend it for families and friends who want to know what choices exist out there. Obviously, I am a fan as the film supports my position but it gives an honest description of the current birthing world. You will find me talking in the film about some of these issues in the segments on Birthing Options and VBAC. It would make a great gift to those close to you who may be unaware that normal birth has options.
Best laid plans.....November 18, 2011: A busy week for me and the Birthing Instincts team. Trust in the birthing process can come in many forms. On Monday, after 26 successive vaginal births over the past year, including 7 VBACs, 2 sets of twins and 5 vaginal breech deliveries, I had to emergently transport my first client for a VBAC that began to have symptoms of a possible scar separation while pushing. Knowing the early signs and symptoms of this problem allowed a timely transfer of care to a supportive team at Kaiser Hospital in Los Angeles. On arrival, the baby was fine and there was even consideration of allowing her to try to resume pushing. However, because of mom's discomfort and knowing that a vaginal delivery was not imminent a repeat c/section was suggested, accepted and performed. Mom and Dad were initally disappointed but once they saw their beautiful 8 pound 2 ounce baby boy they felt comfortable with their informed decision. Thank you Beth and Sada for your invaluable help and support. Early this morning I had the honor of attending the twin home birth of baby Evelyn and baby Thomas on mom and dad's bedroom floor. Sometimes things just happen so fast that all the planning goes out the window. In a labor that lasted less than 3 hours the twins were born 7 minutes apart weighing in at 6 pounds 10 ounces and 5 pounds 14 ounces. Just before sunrise big brother William woke up, sleepy eyes and all, to greet his new siblings. Congratulations to Elizabeth and Nick and grandpa, too. Karni, Hayley, Helga and I were overjoyed and honored to bear witness. Happy Thanksgiving to all.
Congratulations11/2/2011 Congratulations to Emma & David and big sisters, Alyssa and Alecia on their home water birth this afternoon of new daughter/ baby sister, Ava?. Weighing in at 9 pounds 13 ounces and 11 days overdue we were all delighted to finally welcome her home. As always, a big hug to Karni!
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