Are Today's Obstetricians Giving Women What They Really Want?

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It seems patients of Dr. Robert Biter's are everywhere here in North County San Diego. For a long time now, I've enjoyed playing the game of mentioning him when I meet one and just buttoning my lips to listen to the glowing stories that come back to me. Such tales were echoed over and over in comments on my recent post, "Why I'm Protesting for my Natural-birth Friendly OB."

The post chronicled the buzz over the recent suspension, reinstatement and resignation of popular OB, Dr. Robert Biter, from San Diego's Scripps Encinitas hospital last month, and the hundreds of people who showed up at local rallies in his support. Even though this piece portrays individual stories -- mine with Dr. Biter and his with a contentious hospital -- I'm glad to see the attention Huffington Post readers are giving it for the larger issues at play.

Dr. Biter was cleared of any wrong doing under a peer review panel and the California Medical Board declined any sanctions against him ... Given the continued silence of both parties, it's not clear what legal proceedings may still be underway. Regardless, his enormous, continued support in my community says a lot about what many women want as health care consumers today.

A central aspect of Dr. Biter's popularity seems to be his unique ability to incorporate much of the midwife's model of care ... where birth is seen as a normal process ... he puts in endless hours to stay very present in a labor, however lengthy, and tailors the care to maximize a woman's innate ability to birth her baby without interventions ...

... Over the years I've met more than one patient in Dr. Biter's crowded waiting room who has driven hours just to see him. They make one thing clear, Dr. Biter does things differently than most. In addition to being more sincere and caring than some of our past doctors, he has extremely low rates for interventions like labor induction/acceleration drugs or c-sections. He also encourages women to move around during labor, as desired, to help the baby move down and out of her pelvis.

... Perhaps you are asking if Dr. Biter's way is less safe than the norm ... Even though we birth with OBs over 90 percent of the time in the U.S. ... we still have the second worst newborn mortality rate of any developing nation and our maternal mortality rate has doubled in the last 25 years.

Of course, there are plenty of women who aren't interested in a more natural birthing experience and options are abundant for them. But a real number of others are clearly starved for an OB who allows her to take her time in labor and resists the urge to intervene unless there is a genuine complication.

Like me, these women may want the option of having an epidural, or other medical tools available at their birth. But many of them don't feel their freedom of choice is respected once they walk through a hospital's doors.

... I do wonder why more doctors don't offer a way of birthing with fewer medical interventions, when a doctor who does, like Dr. Biter, has such a groundswell of support?

The situation is very similar in Australia, with very few obstetricians providing natural birth services. Obstetric care frequently involves interventions such as induction, epidural, vacuum extraction and so on. Yet it's very clear that natural birth is important to women. What will it take for obstetricians to feel mroe comfortable to provide natural birth services such as waterbirth, vaginal breech birth, VBAC, physiological birth positions, physiological third stage and so on? I expect it would take a change in our legal system and duty of care legislation to be in place.

a href="http://www.essentialbirthconsulting.com.au/about-melissa-maimann.html">Melissa Maimann, Essential Birth Consulting 0400 418 448