Recently, my two kids and I stood alongside dozens of pregnant women, actress/activist Ricki Lake and hundreds of others to protest Scripps Encinitas Hospital. Some of the women holding up "Bring Back Dr. Biter" signs were so far along, they looked like they might give birth right there on the sidewalk.
What doctor could bring a woman forty-weeks pregnant to stand on a street corner, holding up a sign for hours in the baking Southern California sun? There's only one I know of who could inspire such loyalty. His name is Robert Biter, but around here, he has been dubbed Dr. Wonderful.
Even before Dr. Biter, an OB-GYN here in San Diego, had his privileges to practice medicine at Scripps suspended, people were talking about him. Talking about how he truly cares about his patients as if they were family, and about the trust he has in a woman's body to do what it was made to do. Dr. Biter's cesarean section rate is rumored to be a low five to seven percent, compared to the nationally rising rate of 31.8 percent in 2007, though California doesn't publicly report cesarean rates for individual doctors. And when his patients do need surgical intervention, he has been known to say, "We're not just having a cesarean, we're going to have a birth." His Facebook fan page has over a thousand members, and the blogosphere is filled with stories and warmly lit pictures of Dr. Biter lovingly guiding babies into the world.
The reasons for Dr. Biter's suspension from Scripps have never been made public, but we know it wasn't prompted by a patient complaint, and the California Medical Board reports that there are no disciplinary actions against him. Of course, a hospital can suspend a doctor for something as insignificant as not filling out the right paperwork. But Dr. Biter's insistence on protecting a woman's right to labor in whatever way she chooses is in direct contradiction to the way most hospitals do business in this country. Those of us committed to this vision are suspicious and distressed that our biggest advocate has now, with no warning, been told he has nowhere to deliver.
My own story with Dr. Biter began shortly after the birth of my first child almost four years ago. I'd planned to give birth to her at The University of California-San Diego (UCSD)'s Birth Center with a midwife. But due to complications, we ended up in the labor and delivery wing of their hospital, a teaching institution, attended by a midwife and several residents. During the birth a resident was called in to perform an emergency episiotomy on me. Her cut was way off the mark and never healed properly.
That's when I found Dr. Biter. He was recommended to me by one of the UCSD midwives as a "midwife's doctor." I was soon to find out why.
I had to endure three procedures to bring my body back to "normal." Each time I would spend eight hours a day sitting on a surgical site while trying to get the hang of nursing, tears of frustration mingling with those of exhaustion and pain. But through it all, this man was at our disposal -- always compassionate and caring. He even gave us his cell phone number, and I didn't hesitate to use it.
I called him late one Friday afternoon, nervous that the latest wound had not healed, and he told me to come on by. Held up by a hungry infant and traffic, when I finally got there, I found him sitting in a darkened office, his staff long since gone. My gratitude almost turned to tears when he assured me that this time things were looking great.
When the hospital's lawyer sent me a letter saying they weren't responsible for my injury because my body was somehow abnormal (which it is not), Dr. Biter was furious.
He scooted his examination stool close and locked eyes with me. "There is nothing abnormal about your body. It was and is perfectly normal ... you are perfectly normal ... you are perfectly and completely normal."
I let his healing words wash over me. This time, I didn't even bother to hold onto the tears that heated up behind my eyes.
Our experience with Dr. Biter during my second pregnancy and birth was equally empowering. At prenatal visits, he always kept me completely informed, answering questions and discussing everything I could think of, sometimes for an hour at a time.
During the birth, I remember reaching transition and feeling like nothing would be able to lessen the intensity. Dr. Biter put his finger on my third eye and got me to look at him. "Come back to me," he said. "You just have to get through this next one, that's it." He let me take my time in labor, never pressuring me to change or do anything other than what felt right. Thus, I was able to tune into my own body's wisdom which shot me, like an arrow aflame, towards my goal. When I was finally ready to push, he took an authoritative tone that was so different from the past, I took note. "Listen very carefully," he said. "I'm going to use some oil to make sure your body is ready for the baby to come out. Go ahead and push when you feel ready, but when I say to stop, you stop. You're not going to want to, but it's what you have to do."
We'd come that far together and I was ready to listen to his instructions, even through my haze of pain. Soon after, I began to push on my hands and knees. His hands were in such a place that I know he could only feel and not see what he was doing, but he was still able to guide my baby out without one single tear to my body.
After the birth, Dr. Biter congratulated me for "climbing your Everest," and told me, "You had the birth you truly deserved." I know he hoped this labor would undo the trauma of the last, and I'm finding that it really did.
On Friday, May 21st, Dr. Biter was finally reinstated at Scripps Encinitas and promptly resigned. Neither the hospital nor Dr. Biter has made a public statement since then. But every day that he is shut out of the medical establishment, another woman has to abandon her birth plan. I believe that this man will one day be known for helping to change the face of birth in this country, to help the medical community see birth for what it is: a normal, healthy process.
But in the short run, there will be scores of women who will lose out if they can't labor with Dr. Biter. These women may enter a hospital only to have their powerful inner voice taken away when they are told to question what they know about their own bodies. They may be forced to lie down when they know they can labor better on their knees. They may be advised to take pain medication even if they are doing fine without it because "it's gonna get a lot worse." They may be scared into opting for interventions they don't need because these routine interventions can make labor easier on everyone present. Everyone, that is, except a mother and her baby.
For their sakes, I'll do my best to support Dr. Biter in whatever his next step might be. I'll do this for Dr. Biter's patients, for a woman's rights to choose the type of birth and birth attendant that's best for her and because I know, without a doubt, that he would do the same for me.
To find out more about Abi visit AbiCotlerORoarty.com. Images courtesy of Dawn Tacker, Eos Photography
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Jessica Zucker, Ph.D.: PBS's 'This Emotional Life:' Connecting With Baby Before Birth
I know that many of us have heard stories about what happened to Dr.Biter at Scripps and the kind of bullying these tales depict seem very plausible to us, given what a threat such a Natural-birth advocate is to those who need to protect status-quo and to those who profit so much money from our healthcare.
I strongly suspect that many more facts about what happened at Scripps will come out when the lawyers clear out. I also agree with mybabysmommy when she suggests we all find the OB we are happy with (or midwife, of course) and respect each others decisions.
I continue to want to focus on why Dr. Biter means so much to his supporters because I think it calls attention to some serious deficiencies in the way we birth babies in our hospitals today (see my earlier comments). To that end I am outlining a new piece on some of those issues. Forgive me, though, if I write it slowly. I really am often writing with little voices interrupting...especially when they should already be asleep!
ps- I do know that Dr. Biter is in the process of mailing out letters to his patients
Second rate OB's- you can keep the uninformed patients who blindly follow your recommendations. But those mothers who get pregnant with their 2nd baby will probably search more diligently for another Dr after they reflect on the way their 1st birth didn't go the way it should have.
Duh. Attacking Dr Biter only goes so far, what they are actually doing is insulting the intelligence of us Mothers who truly KNOW without a shadow of doubt, that Dr Robert Biter and like-minded others truly care for us and the future of women and babies. Thank you for lighting our fire.
I say all power to you for supporting and choosing another OB. Why can't you say that about me? I get what I get in Dr Biter, you get what you get in another OB...
If you truly think we are choosing to support an inferior doctor why don't you just shrug your shoulders and say "Who cares?" If you really are just another mother out there who chose another OB, why are you trying to change the minds of intelligent, well-informed, happy & satisfied Dr B patients? I don't understand your strong negative reaction to this. Who you say you are and what you write just doesn't add up.
And why do you care who raises money for Dr Biter? I believe Dr Biter - that he is not asking for funding. You know how I know? I am a patient and he has never solicited funds from me in any way. And honestly, I wouldn't care if he DID. In fact, I think he SHOULD.
Oh and your comment that the old school boys at Scripps "let him resign", what are they supposed to do - not let him resign? How would that be possible?
No reply needed because " You don't make no sense".
So, from san diego, I disagree with you--a group like theirs deserves Dr. Biter.
i wish the best for everyone involved.
I did alot of research on labor and delivery and wrote out a 1 page Birth Plan. I had to actually FIGHT (during my unmedicated labor) my first OBGYN to deliver my first child the way I wanted to. He tried to give me pitocin, was super frustrated with me pushing for 2 hours, and in the end of a 7 hour painful labor he gave an episiotomy (even though it was written in my Birth Plan that I didn't want one) after pressuring and threatening me if I didn't deliver immediately he was going to use forceps.
For my second pregnancy I did more research and God led me to Dr Biter. Dr Biter didn't pressure me to do one thing against my Birth Plan. I have recommended him to many women, and after talking to numerous women at the rallies I understood that the exceptional care that I and my friends were given is the rule with Dr Biter. He's intelligent & compassionate. A doctor "made" in heaven.
That is why I logically & intelligently (and not blindly) support Dr Biter.
Why do we wait for long periods at a good restaurant? Cause the food is awesome and we don't want to eat anywhere else. Why do we wait for hours to see Dr Biter? Because he is the best. If you choose to go with someone else, fine. You deserve
i think that many of his supporters are unfairly attacking the women's health pavillion at scripps encinitas. the staff that work in the women's health pavillion at scripps encinitas have nothing to do with this drama and are put in a very tough spot. many of them are proud dr biter supporters in fact. i am still planning on delivering at scripps encinitas because with or without dr. biter, scripps is still a baby/mother friendly hospital! they emphasise a mother's choice to birth how she wants, they promote breastfeeding, they utilize rooming in with your baby, etc. i think that everyone needs to take a step back and realize that this has become a circus and we all need to settle down a bit. dr biter's supporters have every right to support him and his critics have every right to critique him. no one's perfect. eventually this whole mess will be sorted out and hopefully some light will shine upon the real matters at hand.
(to cont.)
i chose to leave his practice at 33 weeks pregnant because two appointments were canceled on me. the first appt was canceled on me the day before my appointment and rescheduled for a week and a half later. this rescheduled appt was canceled on me a few hours before the appt. i am a first time nervous mother and would have appreciated a little compassion and explanation from the office, not just telling me that "many other women have also waited two weeks" and they were doing what they could. i appreciate the situation that they and dr biter were in, however some disclosure as to what was going on would have been nice. i had to read only speculation from the facebook site as the office would not say anything. it would have seemed appropriate for the office to send a letter or e-mail, or even call letting us know that we were still priority rather than sounding hassled when trying to reschedule a canceled appointment. i did feel quite "left in the lurch" as one person put it.
(to cont.)
Luck or fate, who knows which, brought me to Dr. Biter’s door during the pregnancy of my second child. I was looking for a doctor that would not treat me like just another pregnant woman, or number, and I got just that and more.
And to be totally honest with you, I could really care less how he spends my money as long as it helps him in some way or form. He WILL open his Birthing Center and be extremely successful and I am very happy to protest, fundraise, and think of many other ways I can help out in any way I can.
I will continue to support him even after my third child is born because of the way he has touched my life. My only wish is for other woman to be able to have the same experience of having him for their OBGYN and delivery of their children.
Dear Amy:
No confidentiality agreement.
I would welcome a more extensive investigation.
The truth will be known when the case reaches the judicial system which will be public.
While you haven't been practicing medicine for some time you may recall that it takes months to obtain privileges at another hospital.
I am not soliciting funds at all.
It is a shame that a more dedicated individual didn't get a chance to enter medical school and actually practice medicine the year that you were accepted. Shame on you.
Robert M. Biter, MD
Dr. Biter no doubt stands up for woman’s rights while they are birthing their children and he does not let such politics get in the way, such as a hospital mandating exactly how long it should take for me to push my kid out before the hospital intervenes, because that is what is good for them.
I commend Dr. Biter for standing up for our rights. I only wish more doctors would. Maybe our countries C-section rate would not be so high.
Dr. Biter has never asked, insinuated or provoke us in any way to do this for him. He is aware of what we are doing and is very grateful for our actions, he has written a statement thanking us for what we are doing but that is the extent to his involvement of our fundraising activities.
Dr. Biter has never asked, or even suggested that we do these things for him.
With that said, and you now knowing that WE, the fundraisers, are acting on our own behalf’s out of the goodness of our hearts, without anybody dictating our actions let me ask you this one thing…how exactly is Dr. Biter soliciting funds?
Dr. Biter IS NOT soliciting donations. I, along with many other supporters have rallied together to create fundraising events on our own without Dr. Biter's knowledge or participation. We all want to see him succeed with his career. All these negative comments sadden me. Obviously you have never been touch so emotionally by a Dr. that hundreds and thousands of people would rally behind. I wish that one day all of you had the chance to experience just that. Dr. Biter has given us so much, and all we want is to do something in return for him. All we are doing is showing our appreciation for him. Take your jealousy elsewhere, is does not belong here.
Amy Gold Donation Information
“I cannot express adequately what your support and donation mean to me. I can only promise in return that I will always support women, their rights to be involved in their healthcare choices and the sanctity of birth.” -Robert M. Biter, M.D.
Help us keep the dream of Babies by the Sea Birthing Cent......er and its mission alive and well.
Here is how you can help:
1. There is a PayPal link on www.bringbiterback.com to make donations to the Birthing Center Fund. At the present time this fund is not tax deductible. Dr. Biter is not managing this account. Any monies spent must be approved by an independent Board of Directors. A 2.9% charge will be taken out of the donation if credit cards or debit cards are used on PayPal.
2. If you prefer to send checks please make payable to Robert Biter, MD and send to Laura Fairchild, PO Box 561, Cardiff, CA 92007.
3. Deposits can also be made at any Chase Bank location. The account number is 844081893.See More
May 23 at 2:32pm · Comment · Like · Flag
Friday, May 14, 2010
Your Donations Help
ATTENTION ALL DR. BITER FANS:
A bank account was so that everyone can make donations to help Dr. Biter anyway we can. It is the Dr. Biter Birth Center Fund featuring Laura Fairchild as the Trustee. You can deposit cash or checks into this account in any amount. Please make all checks payable to Robert Biter. Lets show our support and all contribute to bring this wonderful Birthing Center to our Community.
The Account is held at Chase Bank
The account number is 844081893
Deposits can be made at any Chase Bank location.
If we all contribute what we can, we can sure make a difference with all of us pooling together.
Posted by birthsupport at 9:26 PM
I must have been sleeping or completely incoherent when I typed and posted that piece multiple times.
Let me start by saying that, I do not work for Dr. Biter, I am not affiliated with Babies by the Sea Boutique, or Birthing Center in any way, nor am I even a personal friend of his. I am simply a patient and supporter of his, just like the other fundraisers. Together, I and a group of thoughtful and creative woman have come up with some very generous ways to raise money for Dr. Biter all on our own.
Dr. Biter has never asked, insinuated or provoke us in any way to do this for him. He is aware of what we are doing and is very grateful for our actions, he has written a statement thanking us for what we are doing but that is the extent to his involvement of our fundraising activities.
Dr. Biter has never asked, or even suggested that we do these things for him.
With that said, and you now knowing that WE, the fundraisers, are acting on our own behalf’s out of the goodness of our hearts, without anybody dictating our actions let me ask you this one thing…how exactly is Dr. Biter soliciting funds?
During this entire chain of events, I have never considered once looking for a new doctor to see me through the rest of my pregnancy. Dr. Biter has not left me in the lurch. He is committed to being at the birth of this child and I will drive anywhere I have to see that he is.
In a report by the American Medical Association ("The case for medical liability reform"), more than 60% of liability claims against doctors are dropped, withdrawn, or dismissed without payment. Physicians are found not negligent in over 90% of cases that go to trial - yet more than $110,000 (2008 estimate, $100,000 in 2007) per case is spent defending those claims.
And the cost associated with defending even a case that is ultimately dropped or settled without payment is precisely why Scripps may have instigated the peer-review process in the first place. Scripps was named in four of the six suits, including the one scheduled to go to jury trial this Fall. How much do you suppose defending these suits is costing them?
Also, it’s really important for us all to look at the reasons he may have been such a threat the establishment and ask, don’t we all we deserve better out of our healthcare dollars?
But, DAustin (and FromSanDiego for that matter), I just have to ask:
1. Why is it so important to you to continually insinuate lawsuits, OB or Gyn, against Dr. Biter?
2. What do you do in your actual life (vs. virtual) that has you so interested in maligning Dr. Biter and exonerating Scripps? After reading your posts for 6 days now, I just have to ask: Ever work for a local hospital? Of course, if you do not want to reply, I completely understand and respect that. But my curiosity is beyond piqued.
As for Dr. Amy, many of you have probably figured out that she is on a larger crusade against homebirth and anything that remotely resembles the choices for women therein. And, no, she no longer practices medicine. If you visit this site, be prepared for pictured of babies hooked up to tubes and headstones of young moms (really, I wasn’t!) http://skepticalob.blogspot.com/
When I moved to SD, many of my natural style mom friends told me about Dr Biter, I am closer to La Jolla, so used IGO. I think a "natural" birth is the way to go, and I think there are way to many C secs in the US. A lot like you believe.
My concern and others' concerns with him is the lawsuits and the way they are ignored by his supporters. It seems to his supporters that everyone that is somehow questioning him is somehow part of this great conspiracy to malign him and not let women have a choice in their births, and that is not so. He seems to be using this to make money for himself. He could have stayed at Scripps, but chose not to, why? There are so many questions, but no answers from him.
I hope that helps clear up my interest in this case, I just hope the truth about the lawsuits comes out soon, we will see....now you can have your laugh at this stay at home mom.
I'm happy to satisfy your curiosity about my personal motivations:
I am a freelance writer in "real life," and have a personal interest in health care policy. I am particularly interested in issues that affect quality of care, especially as it is impacted by the difficulty in identifying and disciplining bad providers. This interest was fostered by experiences I had working in a hospital (not in Southern California) 20-plus years ago.
I am also interested in women's health, so this story piqued my interest on two fronts. As I've said, I don't know whether Dr. Biter is a good, bad or indifferent physician, but as a person who cares about these issues I was taken aback by the behavior of Dr. Biter's supporters for reasons I've stated in my other comments, and subsequently by Dr. Biter's own actions and statements.
I doubt this will do much to stem the free-flowing accusations about my putative hidden agenda, but you asked...
There is growing light being shed on the issue of "sham peer reviews" whereby doctors at hospitals make physician suspension decisions for purely vindictive or anti-competitive reasons -- with no fear of legal repercussions and with no due process of the law. Sham peer review is a strictly local process and is not supervised in any fashion by any state agency. If you do not believe this, do a Google search under "sham peer reviews" and read the stories at the following links:
http://www.medscape.com/viewarticle/515862
http://www.post-gazette.com/pg/03299/234499.stm.
http://hollandhart.typepad.com/healthcare/2006/05/twelve_signs_of.html
http://www.louisianamedicalnews.com/news.php?viewStory=934
In Dr. Biter's case, when it finally came down to an actual "Peer" review of the initial Scripps committee's decision to suspend his privileges, Dr. Biter's peers voted to reinstate him.
In addition to the issue of natural birthing options in a hospital setting, it would seem that some further investigative reporting needs to be done on the issue of sham peer reviews in this country.
A 2008 report (mandated by a 2006 change in state law) on physician peer review notes the problem created by the loophole in HCQIA, 42 U.S.C. 11112(b)(3). However, it notes as a more significant overall problem the inability of the peer review process to protect patients from bad doctors because, among other issues, 805s don’t get filed as often as they should, and because the state medical board often doesn’t make disciplinary actions against physicians public in a timely fashion. The report also notes that physicians may be advised by attorneys to use legal action to delay reporting. The authors suggest that reporting entities (i.e. hospitals) prefer to avoid making 805 reports, due to the time, cost and potential for legal wrangling involved.
Interestingly, the very practices involved in the Biter/Scripps case--reinstating a physician just before the 805 reporting deadline, or forced resignation--were cited in the report as being protective of bad doctors.
We don’t know whether sham peer review or avoidance of mandatory 805 reporting were at issue here. Dr. Biter has implied in his comments that there will be legal proceedings, so it is reasonable to assume that it will be some time before any light is shed on the topic, if ever.
As for lawsuits, there are several doctors at Scripps Memorial Hospital Encinitas who have had malpractice lawsuits filed against them, and they still have full hospital privileges. Among them is the Chief of Staff and other physicians on the small committee (none of them OB/Gyn physicians) that originally decided to suspend Dr. Biter's privileges.
If you are in the medical profession, you must know that malpractice lawsuits are increasingly common in medicine and that many doctors have given up their obstetrics practice for this very reason. Perhaps you would like to go to Scripps website, and then search each practicing physician's civil suit history with San Diego County to compare, before you start throwing out numbers that mean nothing in light of the number of births and surgeries performed by a physician. As you know, anybody can file a lawsuit for any reason - all you need is an attorney looking for a monetary settlement.
The only decision of any value is that of the Medical Board. No actions have been brought against Dr. Biter by the Medical Board of California - http://publicdocs.mbc.ca.gov/pdl/mbc.aspx. The decision to reinstate Dr. Biter's privileges was made by a large group of Dr. Biter's peers, who would not have reinstated him, with or without conditions, if they had found any evidence of wrongdoing.
You are entirely wrong. A medical board's decision is the ultimate sanction, not the only decision of value. The fact that Dr. Biter retains his license and hasn't yet been disciplined doesn't mean that he has been cleared of wrong doing.
I find it very interesting that Dr. Biter refuses to answer any questions, even though he himself acknowledged in this comment thread that he is not bound by any confidentiality agreements.
How many lawsuits are currently pending against him? At least 6 filed in the last 5 years according to public records, but he refuses to say if there are additional lawsuits pending or already settled.
Why did he resign his privileges upon getting them back, thereby leaving his patients in a very difficult situation? He refuses to say.
Why is Babies By The Sea Birth Center soliciting funds by asking for checks written to his personal account and specifying that the use of these funds is "unrestricted"? He won't provide an answer.
Does he currently carry OB malpractice insurance or has the insurance company dropped him? He won't tell anyone, including his patients.
His self-described "fans" don't seem to care about the answers, but the rest of us do and his patients are entitled to know the truth. There is not a single legitimate reason for hiding this information.
Please look for and read my comments regarding the fundraising activities. I hope they shed some light on that topic for you.
Anyone can file a malpractice/prof. negligence suit, provided they have had a bad outcome. Outcomes bad enough to result in a lawsuit are bad enough to warrant review. The lawsuits against Dr. Biter do not necessarily mean he was responsible for the outcomes, but they—both because of the number and the fact that several were filed over the past year--are relevant in that they may have been a trigger for the peer review that resulted in the initial suspension.
Thank you for sharing your story. I too am one of Dr.Biter's mommas in waiting, with 2 months to go. While this experience is a little unnerving for me, I have faith that this will work out as it is supposed to. This is because I believe in Dr. Biter. Having worked with him for 4 years now, it is more than clear to me that his heart is in the right place. It is also clear that he chooses to operate within but not buy into the medical system of fear surrounding women's choices in birth. This, I believe, makes him more vulnerable to being sued. His choices are not based on billable procedures or solely protecting himself from possible lawsuits, rather on supporting the wishes of the mothers in labor. As per previous posts, all doctors have lawsuits, some frivolous, some not. While it is possible Dr.Biter has made a mistake and is now being sued for that mistake, I choose to stand with him knowing the truth will be revealed and at his core he is doing the right thing for the right reasons. Dr. Biter owes no explanation to those naysayers wasting his time spreading fear around. I make this judgement from my experience with him, not because I am fearful of what could be.
As for any real mistakes of Biter's, I have not heard of them and I've talked to a lot of women both in person and online. I do know that the husband from the last couple he delivered before being suspended was out there picketing right along with us. I do not know of any OB suits against him and no one commenting here has had anything but amazing care from him.
With respect to the situation that led to his leaving Scripps, I have much faith that truth will out-- probably when legalities allow (although that is purely my own speculation). It is clear, though, that a doctor concerned with a woman listening to her body and taking her time in labor more than money or defensive, preemptive medicine would be threatening some in the big business known as healthcare .