Following In Dr. Biter’s footsteps

A North Carolina physician is being investigated after having presided over 3 home birth fatalities.

In a statement issued through his attorney Friday, Dr. John David Hayes also said families of the babies have continued to support him.

Of course they do, most people choose birth providers specifically because they trust them. It is terrifying to think that someone you trusted hurt you unnecessarily. The article actually notes that the information came from an unnamed source and that details of the deaths will never be released. Someone saw a pattern and spoke up out of concern for other people, and I commend them for doing so. The fear of repercussion or being ignored is very daunting when deciding to report other people for misconduct.

Dr Hayes expects to be cleared of wrongdoing. I do not expect that for him. Most obstetricians lose one full term baby that was otherwise expected to live in their entire careers, and he has lost 3 in 10 years. At least that is if you believe that he was only taking low-risk patients, which seems to be the only possible way for him to excuse taking a patient for home birth to begin with. His arguments are nonsensical in some portions of the article:

“I expect that after a thorough and impartial investigation, all of my home birth practices will be found to be within the standard of care for an obstetrician in North Carolina,” he said.

Home birth is not the standard of care for any obstetrician. The standard of care for obstetrics involves having ready access to blood transfusions and an operating room, something no home birth can offer without an unacceptably long transfer period. That is why ACOG and virtually every obstetrician discourages out of hospital birth for patients. Most pediatricians discourage home birth as well, on the basis of having treated so many brain damaged patients who were hurt by their parent’s decision to home birth.

However, as Dr Hayes and a few notable exceptions prove (Dr. Biter, and non-OBGYNs Aviva Romm, Dr Sears, and the late Marsden Wagner) an adequate education is not always enough to protect doctors from believing in quackery.

For those who are unaware, Dr Biter is another male OB who was dead set on home birth and insisted on its safety. Unlike dr Hayes, Dr Biters patients did complain in the form of a lawsuit. Dr Biter ultimately surrendered his medical license in light of the fact that he botched a home birth and killed someone’s child. He later decided to open a birth center as a non-physician, until social media pressure caused it to close. Dr Biter has also been the subject of sexual complaints, having taken advantage of the dr-patient relationship in order to obtain sexual favors from his patients. He is very scummy.

Many people who are aware of the debate about malpractice reform know that a minority of doctors are usually responsible for the majority of malpractice claims. When your doctor swims against the current in their speciality it is very difficult to know if it is because they are ahead of their time or because they are quacks. This I know for sure- there are far more doctors who succumbed to quackery than those who were ahead of their time. Be careful.

No, OBs are not accountable

I was reading this post from the skeptical OB today

as you may or may not know, I was banned from the skeptical OB for calling Dr Amy out on being a fence sitter on the issue of date rape. Remember that any time she complains about being “silenced” by home birth bloggers for asking uncomfortable questions. She does the same thing to people who think there isn’t a neutral zone when it comes to rape.

IN this specific post Dr Amy says a survivor of sexual abuse who had several cuts to her perineum done to her body against her will during labor, by an OBGYN isn’t experiencing violence. She doesn’t even condemn the behavior of the OB at any point. She laments a series of home birth deaths in australia, one of the summaries she quotes points out that the mom chose home birth because she had been treated so poorly in the hospital. The only violence in birth is when the baby is injured? Here is as close as she gets to saying anything condemning that horrible physician:

Don’t get me wrong. I’m not claiming that hospital care is perfect. Although there is rarely any violence, there is a great deal of poor and disrespectful treatment.

Beforehand she literally says that the baby being inside the woman fundamentally changes the interaction. She talks as though women are simply vessels for children, and that being such a vessel fundamentally changes the way that a woman would experience having her gentials repeatedly cut against her will. The lack of empathy is very telling. The woman who was cut against her will, over and over, well before crowning, should be comfortable going back to the hospital because Dr Amy is apparently the ultimate authority on what constitutes violence or not. Its laughable, especially from a woman who insists that one must be an expert on a topic in order to have an opinion. Dr Amy goes on and on about the inability of midwives to call out their fellow midwives for negligence and damage done to patients, but here Dr Amy does the same thing and ignores deplorable conduct on the part of a gynecologist.  She goes on to say:

However, the chief victims aren’t Western, white, well off women; the chief victims are the elderly, people of color and those of lower socio-economic status.

For a skeptic she sure has an aversion to actually linking to evidence. Being white and college educated are one axis of privilege, but it doesn’t erase being female. It doesn’t erase the fact that women, regardless of any of their other characteristics, are targets for sexual abuse and violence by virtue of being female. Why anyone would believe that this problem vanishes in the hospital is beyond me. One kind of oppression does not erase the other. Dr Amy’s total ignorance of contemporary feminism and social justice movements is showing once again.

ANYWAY, I wish i could comment so I could let everyone know that NO, you don’t have many avenues for redress if your OBGYN decides to do all kinds of shit to you without your consent. You need a ton of money (enough to pay a lawyer for a lengthy and probably fruitless lawsuit). Medical boards don’t give a damn about this, and the doctor and hospitals have better lawyers than 99% of the population.

Women have many legit reasons for choosing home birth, and this is one of them. A lot of the people in the comments section of the Skeptical OB, who claim there are Very Serious Consequences for physicians who do things against your will, are living in a dream world. In the real world, your word doesn’t matter at all. I know from first hand experience. The issue at hand here is that midwives and home birth do not solve the problem. Horrible attitudes from other people about abuses of women during hospital childbirth (including disbelieving the women, rebranding their experiences as “disrespect” instead of abuse or violence, insisting that they will be compensated despite all evidence, etc) makes a vulnerable population easy pickings for midwives. I know that seeing unauthorized procedures done to patients during my time working in hospitals was instrumental in my decision to have an out of hospital birth. I knew that these doctors were not accountable because they did it all the time. There isn’t anything that holds them accountable for these issues. A suit for battery is unlikely to succeed and is hard to pull off. Ignoring the problems won’t make them go away, and will in fact drive more women to seek care from midwives, who at least pay lip service to how damaging abuse during childbirth can be to patients.