Strollerderby : ob gyn

What's a 'Laborist' and Why is She At Your Birth?

Madeline Holler — Mon, 09 Mar 2009 19:56:00 GMT

Go home and go to bed, OBs! Stay in the margins, skilled midwives! There's a new birth attendent in town and she's coming to a hospital near you.

Or, perhaps, she's already there.

In an effort to fill the void of obstetrician-gynecologists who have stopped delivering babies, hospitals are increasingly staffing "laborists" or "OB specialists" to attend the births up in Labor and Delivery. Maybe one attended your recent birth?

These laborists are, indeed, doctors themselves. They just don't have their own OB practices, don't pay astronomical malpractice insurance and typically work only part time -- maybe a weekend shift or a few nights a week.

Some hospitals think having laborists fill in during birth will make giving birth in the hospital safer since they can be with the laboring mother from the time she arrives at the hospital. Laborists also won't suffer sleep deprivation, since their shifts are defined. The fact that laborists will attend the births also means OBs won't have to cancel the morning's appointments to rush to the hospital. So it's win-win ... for doctors and hospitals!

But let's focus on the mom for a sec. Is it fair that after doing all her research and getting to know her OB over nine-ish months that she should show up on the big day and be greeted by a perfect stranger? After discussing her birth plan, hopes and dreams, should she have to go over it all again, presumably between contractions? What about philosophical clashes between the pre-natal OB and the laborist? Is this the final step in the McDonald's-ization of L&D?

The woman featured in this Boston Globe article on laborists was pleasantly surprised by her laborist and all the attention she got while in labor. She says she had never spent so much time with a doctor. And this was BEFORE she even began pushing out the baby. What's interesting to me is that this woman wasn't even told a laborist might be there attending her birth. That would bother me greatly.

I'm all about midwives and homebirth, but I've had a hospital birth and I do kind of like the idea of (1) someone attending the birth who's pulling a shift and not anxious to get home and (2) a doc who is well-rested and not burned out on birth.

Is a laborist for you? Is this any different than getting care from a large practice of OBs who share responsibility anyway? Or does this make you want to hug your midwife a little closer?

Baby-Faced Boy Becomes a Father

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Photo: Boston Globe

Today Show Says: Doulas Get in the Way

Miriam Axel-Lute — Mon, 24 Nov 2008 18:30:00 GMT

Despite having been exceedingly happy with my own home birth, I know birth location is a very personal choice. When I have friends who are planning to give birth in a hospital, I don't go home-birth evangelical on them. I just have three words: "Get a doula."

A doula, or labor assistant, is a trained birth attendant, but not a medical professional. Their role is to provide support for the laboring woman—reassurance, massage, etc.—and her partner, and also to be a patient advocate when needed, not inserting their own opinions, but understanding what the parents want to happen under certain circumstances and sticking up for it. How many OBs read birth plans these days? Breastfeeding, circumcision, pain relief . . . In these days of understaffed hospitals, it's good have someone keeping track of you, your needs, and your decisions.

The extra, consistent support makes a difference. In fact as far back as the 1970s, all sorts of clinical studies show that the presence of a doula reduces complications and c-section rates and improves mothers' feelings about the birth outcomes. Sounds perfect, doesn't it? A nice middle ground in the birth-location fight, a win-win situation? DONA International, a group that trains doulas, was hopeful that that was the message that a recent Today Show segment on doulas would spread.

They, and many others who have used doulas, were dismayed to find that instead a huge amount of the segment was devoted to a doctor who wanted to emphasize how doulas get in the way, inserting their own (non-doctorly!) opinions, and arguing with doctors. Her hospital has actually banned them. I have to wonder if they had any hard numbers on birth outcomes that contradicted the larger clinical studies, or whether they just don't like being challenged.

If it had just been her inclusion that was the problem with the segment, I would have disappointed but understood that it was coming from the twisted meaning of "balance" that operates in journalism these days (i.e., "We must find one extreme opposing viewpoint, even if it's a lie or represents only 2 people out of the whole world"). But the host and resident expert were also astoundingly snotty and condescending throughout, full of smug phrases like "buyer beware" (You know, unlike choosing an OB) and "this is a luxury for most women" (You know, unlike an increased risk of major abdominal surgery, which is just fine) and "Make sure they know they're not there to get in the way."

Yes, doulas are not medical professionals and shouldn't be trying to act as such. But as this stunning article points out, unfortunately, laboring women often need someone adovcating for them, and it shouldn't always fall on the partner.

Interestingly, the text article on the Today Show's site is very different in tone and content, and much more positive.

DONA hasn't issued an official response yet, but it's planning one. Its supporters are, not surprisingly, already asking people to write in and complain.

More by this author:

Rich guy pretends to be gynecologist to see women naked

Brett Singer — Tue, 17 Jun 2008 16:00:00 GMT

I always thought that if you were rich, you could get dates. I mean, money can't buy you love, but it can buy you sex, right?

Well, maybe not. Zalman Silber, a "wealthy businessman" from Monsey, NY, has been accused of playing doctor, literally. Two women have charged that Silber rented a Park Avenue office and pretended to be a gynecologist. Then he gave the women, um, a full exam. This article at LoHud.com goes into a little bit more detail; let's just say that Silber did a very thorough examination.

He may have worked a similar scheme with a police officer in Rockland County. According to today's Daily News, Silber would tell women that they needed a gynecological exam in order to obtain a certain insurance policy, and that the exam had to be given by this doctor. At his house. Except that the doctor wasn't really a doctor, he was a cop. Then Silber would watch from another room. The officer has been suspended from the force without pay pending a full investigation.

It gets better (well, creepier). Silber's lawyer is Kenneth Gribetz, a former Rockland County District Attorney who resigned in a scandal that included such juicy details as an extra-marital affair and photos of him in women's clothing. So far his defense of Silber is that, "the statute of limitations [has] run out on two of the incidents cited by investigators," and "only two of four victims were able to pick Silber out of a lineup." Oh! Then he must be innocent.

This should be some trial.

Silber, a Hasidic Jew, is married with five children and another on the way. His wife Gila, "declined to comment." Wouldn't you?

Let be the first to say that Silber is not good for the Jews.

If you want to know how he got rich, you can read this article over at Inc.com. Silber created the Skyride, a simulated helicopter ride at the Empire State Building. He then sold the business for almost $10 million. A sample of his business advice: "Take advantage of other people's toil. That's really what everything is about." What a guy. He is described a "well-known philanthropist" who is "known within the Jewish community for helping people pay for medical care and other services." Or offering them a discount if he treats them himself! (Ba-dum-bum.) His ex-wife's brother, Alexander Halpert of Borough Park, Brooklyn, said, "He's a good man. When someone needed a doctor, he would arrange it." Yeah, maybe that's not the best thing to say right now.

It should be pointed out that all of these charges are unproven and are merely allegations. Even R. Kelly was found innocent. So who knows. But what a creepy story. It's like I've always said: men are pigs. (And I can say that, because I am one.)

image: New York Daily News

Strollerderby : ob gyn

What's a 'Laborist' and Why is She At Your Birth?

Placentas Washing Up in Illinois Sewer

Baby-Faced Boy Becomes a Father

The Trouble With Wanting a VBAC

Today Show Says: Doulas Get in the Way

Rich guy pretends to be gynecologist to see women naked

Political Nanny: Women, Dear Sweet Angry Women!

Dustin Hoffman's wife wants him out of the house

In Happier News, Police Shoot Man ...

Not So Hot - Male Strip Tease Teach Suspended

Britney Spears - Dang Y'all I Forgot My Pants AGAIN! (this isn't really related but I really like the headline)

Strollerderby : ob gyn

What's a 'Laborist' and Why is She At Your Birth?

Placentas Washing Up in Illinois Sewer

Baby-Faced Boy Becomes a Father

The Trouble With Wanting a VBAC

Today Show Says: Doulas Get in the Way

Rich guy pretends to be gynecologist to see women naked

Political Nanny: Women, Dear Sweet *Angry* Women!

Dustin Hoffman's wife wants him out of the house

In Happier News, Police Shoot Man ...

Not So Hot - Male Strip Tease Teach Suspended

Britney Spears - Dang Y'all I Forgot My Pants AGAIN! (this isn't really related but I really like the headline)

Political Nanny: Women, Dear Sweet Angry Women!