... Andrew Bisits is a hushed presence as he facilitates the daily miracle of natural birth.
... the adored director of obstetrics in the Hunter region, is moving to Sydney's flagship Royal Hospital for Women, where he will help run its 4500-delivery-a-year birthing unit.
"I wanted to get closer to the action regarding birth policy in NSW,'' he said this week, describing the situation in NSW as a ''runaway birth machine that sees the need for intervention and risk management at every twist and turn of pregnancy and childbirth''.
When he starts on October 5 he will bring a trio of potent philosophies: that birth is a process usually best left to women assisted by midwives; that many complicated births can progress naturally if allowed to; and that fear, fanned by the medical profession, leads many women to choose unnecessary caesarean deliveries.
NSW Health has already accepted the surgical birth rate - about 30 per cent - is too high, pledging to reduce it to 20 per cent over five years.
But the appointment of Dr Bisits ... fires a symbolic shot across the bows of his own profession. Obstetricians are engaged in a long-running turf war with midwives, as the federal government finalises terms under which the latter will be allowed to practise independently.
Dr Bisits will use his new prominence to discourage, ''excessive participation of obstetricians in low-risk births … The first birth is going to last longer. It shouldn't last forever but people are too ready to jump in … it imprints a whole pattern for the rest of the woman's childbearing career.''
Vaginal birth after a previous caesarean is achieved by only about 13 per cent of women, and a state target of 50 per cent has been set for 2015. He also offers vaginal delivery of twins, and - most famously - of the 3 to 4 per cent of babies, like 22-month-old Lucinda Thurlow, who remain in the breech position at full term.
Lucinda's mother, Rebecca, travelled from Sydney to Newcastle because Dr Bisits was the only doctor she could find to help her deliver naturally.
''I was out of hospital the same day and both of us were so well,'' Ms Thurlow said yesterday. ''I felt the birth helped with bonding and breastfeeding. Also I wanted to experience a natural birth. It's an important part of life.''
The president of the Australian College of Midwives, Hannah Dahlen, applauded Dr Bisits' appointment, saying he had ''chosen to go against obstetricians' main line. That makes him a very brave man. We desperately need wise, reasoned and evidence-based voices … to overcome the politics and the division'' around birth ...
Fantastic news for the women of Sydney. It is becoming increasingly difficult for women to achieve a natural breech, twin or VBAC birth in hospital. Many hospitals have a concept of "natural birth" that is at odds with a woman's concept of "natural birth". Waterbirth, no continuous monitoring, no cannula "just in case" and upright, physiological birth positions are a real fight for some women in some hospitals. I have helped women who have come away from hospital appointments in tears, advocated for a natural birth on their terms, provided numerous second opinions and allayed fears. It's a shame this even happens. Hopefully now the women of Sydney will have a doctor they can turn to who can assist them to birth the way they feel is best for them and their babies.