Looking for something? Start here.
Custom Search

 



 

 

« Quick Hit: Study on Conflict Between Doctors and Midwives | ICAN of San Diego: Live Podcast with Ricki Lake and Abby Epstein »
Wednesday
May132009

Transcript of Ricki Lake and Abby Epstein on The Doctors

The Doctors aired the show “Three Medical Procedures You Shouldn’t Fear” on Monday, May 11, 2009 which featured Ricki Lake and Abby Epstein discussing birth options and promoting their new book, Your Best Birth.

The episode offers a lot of fodder for discussion.

 

Here are the transcripts of the videos (Part 1 and Part 2) posted on YouTube:

Dr. Stork: [to Dr. Masterson] You are in agreement 100 percent always with empowering women.

Dr. Masterson: Oh, we always want to empower women and I think hospitals have really gone to an extent to give that to women, to make the labor and delivery units, to make—I mean, there’s a lot of birthing centers, you know, in the hospitals that I’ve been to where the bedrooms look better than my bedroom. You know and there’s nurses there that’ll do all the hands off. You don’t have to have the epidurals. We know that and we’ve learned a lot from other countries that if you don’t follow labor properly you’ll have fistulas, so there’s reasons why we do interventions and you also don’t want to have a baby that’s born at home where the head’s stuck. Even if you do everything right, you can have a dead baby and a dead mommy and that’s the worst possible thing.

Dr. Stork: As a non-obstetrician, I really respect that if a woman wants to make that choice and if they know the risks and have educated themselves—

Dr. Masterson: [Hands in the air] You have a choice—

Dr. Stork: — I absolutely feel like that’s appropriate. I have friends who have delivered babies at home and right [to Dr. Masterson], I completely agree with you—

Dr. Masterson: [Holds out palm of hand] Take a risk with your baby if you want and there’s doctors that will go there with you.

Ricki: But there are some people out there who feel that having a baby in a hospital is taking a risk. You know, because if you look at a half a percent of women who choose to give birth at home, the infant mortality rates skyrocketing or getting up is not because people are choosing home birth.

Dr. Ordon: Why is it going up? That’s what I don’t understand.

Ricki: Why are our numbers so bad if we have all this technology?

Dr. Stork: That’s a great question.

Ricki: …you know, why? I want to mention malpractice and the climate that we are in, in this litigious climate that everyone wants to blame everyone else and the obstetricians are being sued left and right up until that child is eighteen—

Dr. Masterson: That just means that OBs are going to be ever cautious. You want your OB to be ever cautious. I will personally go on record and say OB/GYNs don’t go in the business of thinking about their c-section numbers. We would rather not even keep track of the rate because the answer to your best c-section rate is what is needed and that’s what is medically required because you want to save a life, you want to save a baby, so that is what we do. We stay up, we give our LIVES and we feel responsible for every mother and baby that we take care of.

Ricki: And midwives, I want to say, also are highly trained—

Dr. Masterson: [abruptly interrupts Ricki] Midwives are fantastic and I think they’re fantastic and they should be in hospitals. In Germany, that’s how they do it. That’s the best way they do it. There midwives take care of the baby.

Dr. Stork: Your emotion right now is tied into the work that you do in third world countries and your passion for maternal and fetal wellbeing.

Dr. Masterson: Well, it’s not even third world countries. I treat in county. I have seen thousands and thousand and thousands of deliveries. I know what can happen. And you don’t want to see that happen at home and you don’t want to be responsible for the death of your baby or the death of your wife.

Abby: I had first thought that Ricki was crazy and reckless to have a home birth but when I really studied and looked at studies that were done and also understood that, you know, a midwife who comes to your home to deliver a baby is prepared for hemorrhage, they do bring Pitocin, they do bring oxygen, they do bring an IV—

Dr. Masterson: [abruptly interrupts Abby] What if you can’t get to the place, if that doesn’t work—No! You [wags finger] cannot necessarily get there because even in a hospital sometimes you can’t transfer quickly.

Abby: But you can’t always—like you said, even in the hospital you can’t. Exactly.

Dr. Masterson: So why would you put yourself at an increased distance?

Dr. Stork: I’m going to play mediator here. Things are about to get very passionate. Don’t go away.

[Commercial]

Dr. Stork: I think the passion—you have to understand that the passion coming from Dr. Masterson—

Ricki: And we are laypeople and we don’t claim to be doctors or experts.

Dr. Stork: And I think it’s important and I want Ricki to make a comment here. As the moderator of this discussion, as someone whose cousin had two wonderful home births who I think is a very intelligent woman and made that choice after researching options, I respect a woman’s choice and [to Dr. Masterson] I know you do, too. What you don’t want is a misinformed choice and you’re passionate because you do run the risk with the home birth of having a complication where you can’t get to help in time. So, okay. Having said that… Ricki.

[laughter]

Ricki: I think, you know, our—our movie was a great tool for women and for me, personally, I had this incredible birth experience that’s in the film but also, see—women seeing images of women giving birth in ways they can’t even imagine. A woman at home standing up, pulling her baby out. A woman in a tub in birth center. You know, those are images that I think are really important especially with the media painting these horror story pictures. You watch, you know, A Baby Story and all of these scary shows that are the emergency c-section where we save the baby! And I think it’s really great to see a woman give birth the way she chooses to and have this experience, that people have that picture in their head of what it could be if only they were comfortable.

Dr. Masterson: It could be beautiful in the hospital.

Ricki: I’m not saying that. I know, I mean, I had a beautiful hospital birth with my first son. I’m not saying hospital or home birth is best. I am pro-choice in this area and I want women to have access to the information.

Dr. Stork: Give us a few words on the book.

Ricki: Yeah, it kind of takes it to the next level. It talks about VBACs, it talks about epidurals, it talks about all the interventions—

Dr. Stork: VBAC, which is…

Ricki: A vaginal birth after cesarean, which is really controversial because a lot of hospitals are no longer doing it. I think it’s 200 hospitals around the country won’t offer VBAC. [Cut to Dr. Masterson, nodding head] which is really unfortunate when you think a lot of women are given unnecessary c-sections with their first child, thus leads them to another c-section.

Dr. Stork: The book itself, it deals with obviously specifics?

Abby: It’s very down to earth, you know. It’s sort of like girlfriend language. It goes through everything from sort of how to… you know, how to envision what is your dream birth. What do you see? You know, building your birth team. How to pick your doctor, do you want a doula there? How to research, you know, your hospital and it goes all the way through post-partum and bonding. You know, if you have to have a c-section, it talks about, you know, what are ways to have a really great c-section? How can you prepare for that and what can you talk to your doctor about doing in the OR, you know, dimming the lights or—

Ricki: It also talks about one thing that I don’t think has ever been talked about in, I think, a book like this is, you know, sexual abuse and how your birth can really be a healing process for someone who’s been the victim of sexual abuse and I experienced that personally. So, umm, it just covers a lot of ground in a very accessible way and I’m really proud of it.I am thrilled to offer this as a tool for women to make the best choice when it comes to their birth.

 

 

 

Bookmark and Share       

PrintView Printer Friendly Version

EmailEmail Article to Friend

Reader Comments (11)

I didn't see the show, but thanks for posting a snippet. I managed to have an unmedicated birth in a hospital but it definitely wasn't a beautiful experience. They tried to scare me into a C-section. I had an episiotomy, which I think was totally unnecessary. My baby was away from me for HOURS after I gave birth ( I did nurse him for about 30 minutes before they took him to the nursery). Formula supplementation was forced on me. There were just a lot of things about the experience that weren't beautiful. I wish I'd had the sense to give birth with a midwife the way I always wanted to. My mom begged me to at least have the first in the hospital, "just in case" and I listened. Next time, no way. I had a healthy, normal pregnancy and there was no need for a hospital.

May 13, 2009 | Unregistered CommenterElita

Elita,

Totally. I think when people heard that I didn't have an epidural, they assumed that a beautiful, natural event took place. There was fentanyl blindness. There was coercion and open discussiion of how vaginal birth will increase my chances of infant mortality-- in front of me. There was prophylactic Pitocin administered during the third stage without consent. There was separation and lavaging of my baby for being "gaggy and spitty." There was the stupid nurse that said, "Child, you don't have enough milk for that big baby!" who gave her a sip of formula from a little cup.

I realized after my second child was born in a birth center and dealing with some institutional weirdness there that my only context of birth is how to have a positive experience in spite of the institution.

May 13, 2009 | Registered CommenterJill

Dr. Masterson seems to have the standard opinion that birth is a disaster waiting to happen. She seems to freak out at every turn and exclaim "Bad things happen! Be afraid! Don't trust anyone but doctors!" I had a pretty straightforward homebirth eleven days ago but when I took the birth records to the backup OB, the nurse freaked out. In this state 12 hours is considerd prolonged rupture of membranes (mine were ruptured for 13 hours) I was stalled at 7 cm for five hours. Thats failure to progress! If I had been in the hospital they would have tried to hurry me up with pitocin. When the LO was born it was discovered that she had a velamentous cord insertion that no one knew about (even though we had four sonograms and at least two were dedicated to trying to find a reason to risk me out of a home birth). In her situation, pitocin augmentation could have killed her. By the grace of God she's here because we had her at home.

May 13, 2009 | Unregistered CommenterShotgun_Mary

Mary! I think about you and wonder how you're doing over yonder.

I agree Dr. Masterson has a traditional "birth as accident waiting to happen" mentality. She's defending her profession pretty heavily and speaking on behalf of all OBs. I wonder how other OBs feel about her statements.

I'm so glad your birth wasn't unncessarily or aggressively managed. What a miracle. =)

May 13, 2009 | Registered CommenterJill

Those transcripts don't include the statements by Masterson that I found to be the most spurious. When the 7-months-pregnant woman came on because she wanted a natural birth after having a bad reaction to the epidural with her first child, Masterson told her that she may not have a reaction a second time. She also said that pain medication has "no impact on labor and birth" so women should feel free to choose whatever pain relief options are available to them. I couldn't believe that she would say that when clearly ALL forms of medical pain relief have an impact on the mother and child. ALL of them. I think it was such an irresponsible statement.

Masterson clearly has never seen a home birth, talked to a home birth midwife, or read any studies on the safety of home birth. I'm not sure why she was qualified to even have this discussion. I wished that they had an expert rather than Ricki Lake on to give that woman a smackdown with some hard facts.

May 13, 2009 | Unregistered CommenterHillary

Here's the part that stood out for me:

"I will personally go on record and say OB/GYNs don’t go in the business of thinking about their c-section numbers. We would rather not even keep track of the rate because the answer to your best c-section rate is what is needed and that’s what is medically required..." (Masterson)

Clearly, this is nowhere near an acceptable answer, for anyone who knows anything about statistics. It is an emotional answer, designed to state that OB/GYNs are practicing fear-based medicine, not evidence-based medicine. Seriously...you'd rather NOT keep track?? Have you no idea that any educated person would need a definition of what "needed" or "required" means? You really expect consumers to buy that? It really is the classic, trite argument that c-section is the gold standard in maternity care...according to what data, Masterson??

To respond to the comment on pain meds, I would argue that Dr. Masterson is not representing OB/GYNs, per se, but hospitals. OBs have no incentive to pump pain-relief drugs into women--hospitals do. Even individual anesthesiologists can be skeptical. To that, I say, I have a good story for you...An kismet encounter with a doc from our local "baby factory" who is a real skeptic:

http://chicagohypnobirthing.blogspot.com/2009/05/kismet.html

May 13, 2009 | Unregistered CommenterCindy Unger

Hillary:

Wow. I can't believe anyone who espouses themselves as educated would say something like that. Incredible.

Generally:

I think Masterson's comments bothered me mainly for the general idea: pregnancy and childbirth are illnesses. They're not! They are not they are not they are NOT! Yes, some women can have issues during pregnancy and labor and those should be dealt with appropriately. I don't think that there is a natural birth advocate in the world that doesn't recognize a place for the medico-technical side at all. But I think that pregnancy/childbirth should be looked at a little like the criminal justice system (I swear it makes sense): healthy until proven otherwise (see, like innocent until proven guilty? too much law school?). *I* am not in danger, and neither is my child, in pregnancy or during my baby's birth. If I have problems? Rock on, I'm there in the office: need me to sharpen the scalpel? I don't want to risk my life or the life of my child. HOWEVER, until there's a risk shown (other than the tiny risk that follows us around in our daily lives) gtfo of my vagina, mmkay? ;)

May 13, 2009 | Unregistered CommenterTara

I can't believe a doctor would say those kinds of things! Scaring a patient into thinking that if she has her baby at home, either she or her baby would die is absolutely ridiculous!

My best friend had her baby at home, and I am so jealous!

I had to have an "emergency" cesarean with my daughter because her heart rate kept dropping and they got worried. And now, come to find out, I may not be able to have a VBAC where I live because they might not do them anymore. I have already told my husband, if I can't have one here, I will move to another country to have one.

Doctors like this are what worry me about the medical profession. Pregnancy is not a disease that needs to be cured. Labor is not a traumatic event unless doctors make it that way. Why do they always want to make women terrified of what our bodies were made to do naturally since the dawn of time?!

May 13, 2009 | Unregistered CommenterKayce

It troubles me that medical professionals get so wrapped up in 'following procedures' and in their training that they forget that woman have been giving birth forever and know what to do. I understand that there are complications that need to be handled appropriately, but it seems many complications happen due to standard medical practices, or maybe because it's 'easier.' How ridiculous of Dr. Masterson to make such comments... and in public! She's a reason why women are afraid to be women!

I gave birth to my son in a hospital and was lucky to have my closest friend available as my spokesperson. She made sure that nothing unnecessary happened to me. She also made sure that if I needed to move, I did. If I needed a sip of water, I got one. I opted for natural child birth and that is mostly what I got. And while everything went well and without incident and relatively quickly, the IV was a terror, the fetal heart monitor hurt me during contractions, and I didn't see my baby for HOURS after they took him to the nursery. Luckily they didn't force a bottle on him and were very helpful with breastfeeding.

I am currently pregnant with another boy and am due within 5 weeks or so. (They come when they are ready, in my opinion!) I would love a home birth, but for insurance/financial reasons I will not. I do have a fabulous midwife this time around and have every confidence in her support. I look forward to another hospital birth this time with even less interference.

May 14, 2009 | Unregistered CommenterJessica M

Jessica... have a wonderful birth. Midwives rule.

"She's a reason why women are afraid to be women!" That's really interesting. There's something there-- pound women over the head with fear about their bodies and many will live in terror of their own physiology. Pretty deep.

May 15, 2009 | Registered CommenterJill
Comments for this entry have been disabled. Additional comments may not be added to this entry at this time.