New Facebook Page

Hi All, One of you was energetic and thoughtful enough to create a Facebook page for me at:

http://www.facebook.com/home.php?ref=logo#!/pages/Stuart-Fischbein-OBGYN/364977701696?ref=ts

So now fans (and foes) have another place to check and see what I am up to or supportive of. Most of the news has been very positive towards what we believed all along. Nothing new to report at my local hospitals and it is doubtful that the NIH VBAC conclusions will cause even a ripple of remorse or guilt on the part of administrators and doctors who continue to uphold several policies without supportive medical evidence. I will continue to try to work respectfully for a return to common sense and patient autonomy out here.

Danielle from Momotics has posted a survey of 861 post c/section moms which looks at the feelings of the actual patient. What a novel idea! Asking the actual patients affected by the interventions modern medicine performs how it affects them. you can find it at:

http://momotics.com

Lastly, I believe the BAC is planning another rally at the corner of Rose and Gonzalez this Friday at 11 AM. Please check out the BAC website for details. Dr. F

Final NIH VBAC Consensus Report

This is really welcome news. A government appointed panel has looked at the evidence objectively and concluded that VBAC should be a viable option for women. They also stated that in most instances it is as safe or safer than elective c/section, the opinions against VBAC were not evidence based and hospital policies that obstruct this option should be revisited. As always, they state more studies are warranted in several areas. Please read for yourself and forward to patients, colleagues and your institutions. Thanks, Dr. F

http://consensus.nih.gov/2010/vbacstatement.htm

Trust Birth Dinner & Upcoming VBAC class

Julie and I had a wonderful time tonight at the Trust Birth Dinner in Redondo Beach. Thank you Carla, Heather and all the dedicated birth goddesses who honored me along with so many other deserving people. I am grateful for the energy you share that rejuvenates my drive for our common goals. So nice to meet Sara Buckley and see Paul Fleiss among the honorees, too.

Sunday from 1:30 to 5:30PM at my Century City Office is the VBAC education class led by Jen Kamel of VBACfacts. There is still room if anyone is interested. I will be attending and offering my 2 cents worth. Below is the information. If interested contact Jen through facebook or leave a comment here and I will get back to you. Dr F


There are still tickets available for the class this Sunday which will be the only class offered in Los Angeles for 2010. The class is close to being sold out, so if you are interested, don't delay!

Another reason to RSVP as soon as possible: I am printing up bounded books of the presentation and want to make sure I have enough for everyone.

Dr. Stuart Fischbein OB/GYN will be present to answer questions.

The latest couple who registered are driving 170 miles one way. Don't let distance hold you back from attending!

Warmly,

Jen

You are invited to the following event:
The Truth About VBAC - Los Angeles

Date:
Sunday, March 14, 2010 from 1:30 PM - 5:30 PM (PT)

Location:
Offices of Stuart Fischbein, MD
10309 Santa Monica Blvd, Suite 300
Los Angeles, CA 90025

Action Alert

Please view the following message from Docs4patientcare and send to to everyone you know. For I believe a government takeover of healthcare is the purpose and inevitability of the current bill and would be detrimental to our patients and the individual right to autonomous decision making that we cherish. Rationing and limits on birth options and choice would certainly follow.

http://www.youtube.com/watch?v=8D_e1osuomg

We at docs4patientcare appreciate your attention at the vital time in history. Dr. F

Draft summary of NIH VBAC position

Very good news and reassuring that at least at the academic level evidenced based reasoning and common sense have prevailed. Please read the initial statement from the National Institute of Health on VBAC:

http://www.nih.gov/news/health/mar2010/od-10.htm

The conference was a worthwhile experience and I believe the panel members have the most honest of intentions. I am so glad I went. I hope some of you followed the webcast and if not, it will be up soon through the NIH website. My take on the conference was that it is clear from the presentations and the panelist conclusions that there is no convincing evidence that VBAC is inherantly unsafe nor is it ethically a choice that should be denied to any informed woman. While I do not think there is a snowball's chance in hell it will cause any immediate effect on hospital policy, I do believe if disseminated to patients they can make a convincing argument to their local hospitals that they cannot be forced into surgery and have the right of informed refusal.

One of the most compelling points of the conference to me was the following. ACOG's 1999 statement No.5 changing the word readily to immediately available was not based on any evidence. It was likely done to give ACOG members legal cover in cases where compliance was maintained and still a bad outcome ensued. The result was no real protection against the fear or reality of a disastrous law suit and only fed the fear which led to VBAC bans at more than 30% of American hospitals. Amazingly, neither before ACOG came out with the "immediate" guideline or in the ten years since has there been any studies undertaken that have ever shown that having emergency help immediately available has done anything to lower the incidence of cerebral palsy, neonatal death or maternal morbidity over the "readily" available (30 minutes decision to incision) standard! It is horrifying for me to actually learn that so many of these repeat c/sections were inflicted on women based on nothing but fear and economics. My profession should be ashamed of our cowardice.

I will post a link to the final NIH consensus statement when it appears. The BAC website and VBACfacts are also a great resource to follow the story. Spread the word!

NIH VBAC Conference

Hi All, Just home from Bethesda, MD and the NIH VBAC consensus conference. So much to tell but too late tonight. The evidenced based data presented was very supportive of VBAC and patient autonomy in decision making. Whether that will be the consensus and whether it will make any difference with the forces against it remains to be seen. I suggest for the greatest details and insights you look to Jen Kemel's site at www.Jen@vbacfacts.com

In the coming days I will do my best to summarize my thoughts and observations and report on the consensus statement due out tomorrow afternoon. The statement will be published online at www.consensus.nih.gov

Archived videocasts of the entire conference will be available in approximately 1 week at www.videocast.nih.gov

Dr. F

VBAC support hits mainstream media

Very nice to see the NY Times publish this article on the eve of the NIH VBAC consensus conference. Kudos to Kim Gregory, MD for her honesty. So obvious what the burden of medical malpractice and money does to trump evidence based medicine. For when you remove them from the equation the safety and benefit from selected VBACs is clear. Hospitals and practitioners must recognize that the real battle on behalf of our patients should not be between them. United they should work toward insurance and tort reform. Although, I am not for a government takeover of medicine it is clear that it works for the women on this Reservation. Dr. F

http://www.nytimes.com/2010/03/07/health/07birth.html