The Fallacies and Falsehoods of Dr. Lisa Masterson
In her recent article, Birth Wars, Jennifer Block quoted obstetrician Lisa Masterson urging women to turn over responsibility for their birth to a doctor. Said Masterson, “You don’t want to be responsible for the death of your baby or the death of your wife!”
The quote is taken from a May 11, 2009 episode of the television show, The Doctors, which features a regular panel of doctors and covers anything from childbirth to makeovers, even in the same episode. The tagline on the show’s Web site offers potential viewers a glimpse of what they can expect from the show: America’s medical dream team. Delivering answers daily.
But what if the answers about birth delivered on the show are consistently inaccurate?
Masterson introduces herself on the Web site with her story of a senior resident asking if she wanted to perform a cesarean, telling her confidently, “Anything that happens, I can get you out of it.” The experience sparked Masterson’s passion for obstetrics, which she sums up with “I can do anything and what I can do is help a woman have a baby and I can do it safely—I can learn how to do it safely.”
So confident of her ability as a doctor to make birth safe for women is Dr. Masterson that she tells women not to take on responsibility for their births. “We as obstetricians take on that responsibility [of getting a baby out]. You don’t want to take on the responsibility for your child. You absolutely do not,” said Masterson.
This quote is from the January 1, 2009 episode on childbirth (and plastic surgery makeovers), called the Alternative Birthing Debate, which was anything but a debate. There was no midwife present and the majority of the show focused on Masterson passionately over-inflating the dangers of childbirth and indulging in traditional obstetric rhetoric, such as attributing the health of co-host Jim Sears’ four siblings born at home to luck and vehemently denying that births are ever rushed along unnecessarily in a hospital.
The one-sided format was repeated in the aforementioned May 11, 2009 episode in which Ricki Lake and Abby Epstein went on the show to promote their book, Your Best Birth. Lake was later questioned about the episode by an audience member after a Southern California showing of The Business of Being Born and said she and Epstein had no idea that the show was being billed as a home birth debate. In fact, their promotion of Your Best Birth was sandwiched in an episode called Three Medical Procedures You Shouldn’t Fear. Two of the three “procedures” discussed—natural birth and vaginal birth after cesarean—are not medical procedures.
The Doctors’ Web site does not offer any retraction, clarification or substantiation of any of Dr. Lisa Masterson’s many erroneous claims about birth. As a complete and total knock-off of Lauredhel’s much more timely Hoyden About Town post in which she asked readers to critique the episode, I would like to ask readers of The Unnecesarean to do the same.
The official transcript of the January 1, 2009 show is pasted below. Please read the transcript and list specific, evidence-based corrections (and reactions) to the many inaccurate and disingenuous claims made by Lisa Masterson on The Doctors about childbirth.
Announcer: Next on THE DOCTORS, should you have your baby at home or in the hospital?
(Excerpts from upcoming segment)
STEPHANIE: It was amazing to be that in touch with my baby.
JANNA: And the ambulance arrived, took my baby from my arms, and he was dying.
(End of excerpts)
Announcer: THE DOCTORS have all your childbirth options so you can decide for yourself.
Dr. LISA MASTERSON (OB-GYN): (From upcoming segment) Labor can go wrong really fast and really bad. What can happen is the baby can get stuck.
Dr. ANDREW ORDON (Plastic Surgeon): (From upcoming segment) It’ll eliminate your wrinkles, brown spots and scars.
Announcer: …look 10 years younger without the surgery.
[NOTE: I am cutting out the entire makeover/ plastic surgery segment]
STORK: All of you know about home births, where moms at home with their husbands and sometimes with a midwife are delivering babies in…
MASTERSON: A bathtub.
STORK: A bathtub. Well, a lot of doctors, especially doctors you work with, obstetricians, want this practice banned. I want to know your opinion…
ORDON: You know, and the spin is that…
STORK: …is this a good thing or a bad thing?
ORDON: You know, the spin is, `Oh, the doctors want to control this, the doctors want to do this, it’s a perfectly safe thing.’ No, the bottom line, we as doctors, we want safety first for our patients, and there’s no question you’re safer pre-, intra-, and post-pregnancy care…
MASTERSON: At the hospital.
SEARS: Here’s the thing—here’s the thing…
ORDON: …in the hospital.
SEARS: I don’t know about that, Drew. There’s a lot of people that argue the other way. Actually, a lot of people don’t know this. Four of my siblings were born at home.
MASTERSON: They were very lucky, then.
SEARS: Yeah, they were lucky. The vast majority of—no.
ORDON: See, you’re admitting they were lucky.
SEARS: No, the vast majority of home births don’t go bad. It was a really safe experience if done the right way, with a doctor present—well, my dad being a pediatrician, and a certified…
ORDON: That helps.
STORK: Just a little help.
MASTERSON: OK, yeah, you’re in a different category. You have…
SEARS: You know, most of those horror stories—most of those horror stories you hear about are uncertified midwives that are too afraid to seek the medical care when they—when things do go bad.
MASTERSON: Absolutely not, because there can be certified, wonderful…
MASTERSON: …midwives who run into emergencies, and the problem is—and remember I’ve seen thousands…
SEARS: Mm-hmm. Oh yeah.
MASTERSON: …and thousands of deliveries. The problem is, anything goes in obstetrics.
MASTERSON: Anything can happen.
STORK: And the beauty of this debate is we’re going to continue it for the rest of this show…
SEARS: Oh, yeah.
STORK: …because this is a heated issue.
Up next, we’ll meet a couple who is struggling with this very decision. Do they have a home birth or a traditional hospital birth? Find out what every parent-to-be needs to know before making this choice.
JANNA: (From upcoming segment) My mother came in the room and called 911, and the ambulance arrived, took my baby from my arms, and he was dying.
STORK: … right now we’re going to go ahead and get back to the debate about home birthing. Having a baby can be completely overwhelming. There are so many decisions to make. Everyone has an opinion. Our first guests are expecting a child, and they’re riding the fence between a traditional hospital birth or something much more alternative.
(Excerpts from videotape)
JENNY (Considering a Home Birth): I am six months pregnant with our first child. We are still considering all of our different options for our birth plan. We do have to make a choice here pretty quick. I’m about to go into my third trimester. So this is really when you’re supposed to have your birth plan down. I think in a perfect world, the birth of our child would be very natural, a home birth, and working with a doula, and working with a midwife. And we’ve heard such great experiences. We are not planning on using an epidural. I’m very passionate about wanting to be fully present for the birth of our child, and not wanting to dull down that moment with anything. Some of the options that we’ve been considering include hypnotism births. We’ve looked at water birthing at home. The most appealing factor to me in a water birth is the ability to naturally alleviate pain through the process of being in the water. Hospitals are definitely for sick people, and I don’t feel like birth is a sickness.
BILLY (Considering a Home Birth): The reason why I’m turned off by hospitals is because it is cold.
JENNY: I think the main issue for us with home vs. hospital is that we were both raised in a very conservative background where babies are born in hospitals, so that’s what our family expects, but that is definitely not fitting with what we would do on our own.
BILLY: Doctors, we would like to make the best decision for ourselves and our baby.
JENNY: We would like to know if giving birth at home would be safe or if we’d be taking an unnecessary risk.
(End of videotape)
MASTERSON: Congratulations to you, and you look fabulous.
JENNY: Thank you.
MASTERSON: You’re about 24 weeks?
MASTERSON: So your baby’s about 11 inches, and about a pound and a quarter or something like that?
JENNY: Feels like a foot long, doing karate in there, something like that.
MASTERSON: Right, but this is a good time.
MASTERSON: You’re feeling good, you’re feeling happy about things.
JENNY: Yeah, feeling really good. A lot better than the first trimester,
just energywise and everything like that.
MASTERSON: Now, what made you think of a home birth?
JENNY: A home birth—well, we live a very holistic lifestyle already. We are vegetarians, we do a lot of natural, holistics, health things, so for us, going even to a doctor, to see an OB for the fact that we were pregnant was new. It was, you know, not my kinesthiologist, not my yoga, not my this or that.
JENNY: So it was a whole new realm to explore, and a lot to learn about.
MASTERSON: Yeah. Pregnancy the first time is new—is new to everybody, because it is a different world.
BILLY: Yeah, we’ve heard so many different rumors, and with that, it can really confuse you, so we started doing more research to find out what’s best for us.
MASTERSON: Did your OB help you, guide you a little bit as to home birth vs. hospital? Did they have any opinions, your own OB?
JENNY: Our OB is open, but, you know, every time I ask him, I say, you know,
`Can you help me as far as what I should do to prepare for this?’ He says,
`Well, it’s going to all be up to you,’ and I’m going, `Well, what does that mean?’
MASTERSON: Don’t you just hate that when we do that? `Oh, it’s your choice.’
JENNY: But, you know, it’s hard, I think, for an OB sometimes to advocate other forms of—I would think, if it—if that were my field, to advocate other forms of birthing if you’re looking to keep a patient there in your office.
But I don’t know, you know. This is so new, so when you ask and that’s the answer you get, it’s kind of a blanket answer to everything, you’re still left with a lot of questions.
MASTERSON: Well, what you should know about OBs, me being one, especially, is that we’re really interested in your safety and the safety of the baby, but we also are interested in you as an individual and making your own choices. And the idea is to just, while you’re here today, to help you make an informed choice.
STORK: Now, do you have friends who have had a delivery at home?
BILLY: No, not yet.
STORK: So no one’s gone through this that you know of?
BILLY: No, no one that close to us.
STORK: Since Jenny and Billy have never met someone who has gone through the home birthing process, we’re going to have them meet a couple who has, so we invited Stephanie and her husband, Marcel, here. Stephanie gave birth to a healthy baby girl just three weeks ago in a birthing pool in her own home.
Here’s what happened.
STEPHANIE: (From videotape) I was in pain, but it was really manageable, and
I was basically using some breathing exercises and trying to keep my breath and my tone in my voice very low. That low voice really helps when the contractions come, and help with the pain. And a lot of it is the mind-body connection. It was really amazing to be that in touch with my body and my baby.
STORK: How long were you in labor for?
STEPHANIE: Two hours.
STORK: Two hours?
Jenny, we brought Stephanie here for you, because you have to have a question.
JENNY: What was the main method you studied to learn about that?
STEPHANIE: Well, one of them is I went to pre-natal yoga classes. I’m also a pre-natal Pilates instructor, and post-partum. I did a lot of research. I read Ina May’s “Guide to Childbirth.” Talking to the—to the midwife was a big one.
MASTERSON: And OBs really want it to be a beautiful birth experience. That’s really important, actually, and you can have that process in the hospital, too. I’ll tell my patients, you know, `If you want to squat, if you want to swing from the chandeliers, as long as I can catch that baby.’
STORK: Swing from the chandeliers?
MASTERSON: You know, you can do whatever you want, you know, water, whatever, as long as I can get under and catch that baby and see how that baby’s doing in labor, it’s OK. But the big thing is, it’s just like when you have a party and something goes wrong, it can go wrong really fast and really bad.
STORK: And we’re going to—we’re going to let you get there in just a minute.
We can tell how Dr. Masterson feels. But first of all, congratulations to Stephanie and Marcel.
MASTERSON: Yes, absolutely.
STORK: Thanks for being here.
You at home may have some questions and some reservations of your own, so up next, a mother who says she not only regrets choosing an alternative birth technique for her son, but it almost cost him his life.
Unidentified Woman #1: (From upcoming segment) We wanted a hospital birth, we wanted safety, but we also wanted a nonmedicated birth. It was awesome.
JENNY: (From videotape) It’s really overwhelming picking a child birthing
method today. You have water birthing, home birthing, HypnoBaby birthing, a
traditional, old fashioned hospital birth. There are so many different ways
to look at giving birth now that it’s really time consuming.
STORK: Jenny and Billy are getting ready to welcome their new baby in just a few months. All is going great, except they still haven’t made that most important decision, do you have the baby at home or at the hospital.
We’ve talked about the home birth option, Jenny. There’s an alternative, which is called a birthing center. Have you thought about other options such as that?
JENNY: We visited a birthing center near to our home.
JENNY: When we got there, we were a little bit wary of the environment itself. It looked like a birthing center, you know. It was kind of half home, half a weird doctor’s office kind of place, so…
STORK: Which is the point, right?
JENNY: Yeah, yeah.
STORK: A little half and half.
JENNY: It just—it was very uncomfortable, I think.
JENNY: You know?
BILLY: It was a little uncomfortable. It was very homely, but it needed some upgrading, maybe.
MASTERSON: For those people who don’t know the difference between a birthing center and a—and a hospital, basically a birthing center does just look like a home. It’s trying to simulate that. Usually, they’re close to hospitals, but they’re not set up for emergency situations.
STORK: We’re trying to give you a potpourri of experiences here. So our next guest, Janna, had her son Devin at a birthing center like we just talked about. Tragic consequences.
Janna, thank you for being here…
JANNA: Thank you for having me.
STORK: …and sharing your story, because we really want to help Jenny and
STORK: …figure out what’s best for them. What happened with your son
JANNA: Well, I want to congratulate you guys for having your baby.
JANNA: It’s such a beautiful experience. I have four children. If there’s anything I can tell you, is this. Something devastating went wrong with the birth of my son. I had complete gynecological care in the—in the beginning, ob-gyn, was cleared there. I had four ultrasounds. Everything was cleared there. I was in the jacuzzi during his birth, had a great birth experience, everything went great. And then my son came out, and he had a very rare kidney disease that was missed. And his kidneys were the size of adult-sized kidneys, as you can see in the picture. And coming down the birth canal, the kidneys being so large, ruptured the lungs.
My mother came in the room—I haven’t seen these videos in so long—my mother came in the room and she knew, and after 45 minutes called 911. And the ambulance arrived, took my baby from my arms, wrapped him in a silver blanket, and he was dying. As soon as the doctors got Devin at the hospital, the local hospital there, they didn’t even have time to scrub before they were inserting chest tubes and calling for another hospital to get them. Devin was placed on ECMO, where the jugulars in the neck are cut, and he was placed on life support. He had no lung tissue whatsoever. They were blown out coming down the birth canal. Since then, we’ve had multiple, multiple surgeries, behavior problems. He’s 14 now.
MASTERSON: You’ve been through a lot. That was a difficult delivery, and afterwards, and now you’re still caring for Devin, and, you know, thank you so much for sharing that story with us, both stories. I think it’s very, very important to hear the things that can happen. Your first priority should be your health and the baby’s health. Like, as an
OB, we’re trained for all these emergency things that can happen during delivery, and I’m sure you’re wondering why this little baby’s sitting here like this, and this is to demonstrate what’s called a shoulder dystocia.
STORK: And we have a graphic of that, I do believe.
MASTERSON: You see the baby coming down, into the pelvic outlet…
STORK: So right now everything’s fine.
MASTERSON: Yeah. You would—seems like everything’s going well. You’re even to the point where the head’s starting to come out. Baby does make a turn, usually the head rotates as the—as the head comes out of the pelvis, and what happens is the shoulder, you can see, it gets caught up under the pubic bone, and so what happens is we try and make the pelvis wider by pulling the legs back, we try and push the shoulder down to get it underneath. There’s another thing called a—which I didn’t mention, a Woods corkscrew to try and get the baby out—sometimes we even break the shoulder. What can happen is the baby can get stuck, OK, because the shoulders keep the head from coming out.
What you do is you pull the woman’s leg back, you have somebody actually pushing down on her uterus to try to get this baby out, then you actually cut through the rectum to still try and get the baby out. Sometimes they’ve done what’s called a symphysiotomy, which is cutting through the pubic—right in between the pubic bones, and then the last thing you do is a trick we call a Zavanelli, and you push that—you try, and sometimes it doesn’t work—to push that baby back up in there, and then you rush them to do a Caesarian.
STORK: And that’s a big word. The moral of the story is you don’t want to do the Zavanelli at home.
MASTERSON: And we do everything we can to get this baby out. When you’re the other person down there and you have this life in your hands, and your life in your hands, you’re doing everything you absolutely can. We as obstetricians take on that responsibility. You don’t want to take on the responsibility for your child. You absolutely do not.
JENNY: What percentage of the births that you see in the hospital have an issue like this or some of the other ones?
MASTERSON: It can be like 10 to 15 percent, depends on the population, though, if you have bigger babies and things like that, but not always. The other thing that can happen is fetal distress. Some midwives will bring monitors with them to the—you know, to the home, but that is our only way to tell what’s going on with a baby, you know, during labor. Because sometimes baby can get in distress right at the very end, and we call that a crash, because that is just what it is. The baby all of a sudden can’t get any oxygen.
And this is how we figure these things out. We read these monitors, and a healthy baby will have a nice baseline and some variability. The other one, you see, that’s the baby’s heart rate. It’s dipping down and it’s having a hard time getting back up. And what happens is, all of a sudden it dips down, and this doesn’t go back up, and we call that a crash. And we run somebody back to a C-section to get that baby out, and you need to get that baby out in five minutes.
STORK: Things can happen to mom, too. Post-partum hemorrhage, where literally the mom is bleeding to death…
STORK: …from her uterus, so we’re just trying to cover all the bases…
STORK: …here to give the arguments for and against home birthing. The question, is there a compromise between home and hospital birthing? Our next guest just may have the answer.
(Excerpts from videotape)
Woman #1: It was the most joyful experience. I was so relaxed. I could enjoy the birth without having to worry about all the details. I would never regret it.
SCOTT: And we literally turned the delivery room into probably the best spot in all of Orange County.
(End of excerpts)
STORK: I have to admit, I’ve never before heard anyone confuse labor with being in a spa, but—that’s a first.
Jenny and Billy, they’re six months pregnant, they’re still trying to decide between a home birth or a hospital birth, and there are two major complications that you have to worry about, right?
MASTERSON: Well, we’ve been through a few, but really, the umbilical cord and the fetal distress and post-partum hemorrhage, which you touched on, but the other thing, the umbilical cord is something—you know, sometimes, you can just loop that umbilical cord around the neck, but other times, that’s when it makes the baby crash, because it just—it acts as a noose.
JENNY: Cuts off, right.
MASTERSON: Exactly. It cuts off the oxygen, and you’re not going to tell that until right at the very end sometimes, and you got to move quickly.
So—but, you know, there are compromises to this, and I think OBs, you know, are recognizing that you do want the celebration, you do want the happy experience, and that’s why most of the hospitals now have what’s called LDRs, or labor and delivery rooms. They are to mimic homes, and they’re really trying very hard to have that nice, home-y experience but with all the emergency situations, you know, taken care of.
STORK: Your story is so intriguing to me, because you’re talking about a spa, what a wonderful experience it was. What exactly was your birthing process like?
Woman #1: It was awesome. It was awesome. We wanted a hospital birth, we wanted safety, but we also wanted a nonmedicated birth, and so we chose HypnoBabies, which was awesome. And it’s not like the hypnotist thing that you think of with someone holding this little, you know, clock in front of your eyes. It’s actually scripts that you use, so every night Scott and I studied, and he would read me the scripts, and it’s basically the mind, you know, the mind is so powerful, and it really can control the body. And they actually don’t use the C word, which is contraction. They use the word birth wave. So if you think of a contraction, all your muscles start to contract.
If you say birth wave, you relax. So my OB was totally familiar with our doula and with HypnoBabies. She allowed us to stay home…
STORK: Explain to everyone what a doula is.
Woman #1: A doula is actually—it’s a Greek word, and it means to mother the mother. So she was there to assist us, to help us, and it was amazing. It was so amazing.
STORK: This HypnoBabies concept is so intriguing to me. Why don’t we do more of that?
MASTERSON: We’re getting around to it. We’re getting around to it. And like
I said, most of the hospitals now are changing everything to these really nice LDRs. They look better than my bedroom at home, and, you know, everything’s hidden away, and they’re really into, you know, letting you bring that in. So
I think if you find—if you talk more with them, that they’ll be more amenable to some of these things. Do you think that’s sort of helped you today, to make up your minds?
JENNY: Yeah. As an OB, what kind of things would you want to hear from your patient if you were trying to create a scenario like that in a hospital?
MASTERSON: Well, I would—I mean, a lot of times sometimes my patients will come in with a plan. But the only thing about thing, usually that plan goes out the window. Because the thing is, you have to just experience the process and—but going in with a plan, what it does is give me where you’re at. If I have someone saying, `I don’t want an epidural, I would like to stay away from medications if possible,’ then that’s how we approach it. Because the epidural or the pain medication has no bearing on the labor. So you can scream as much as you want, or focus, or do hypno or acupuncture or whatever you want to do. But then there’s other stuff available if you realize, `This isn’t for me.’ You know, I’ve seen a whole lot of things, you know, and…
JENNY: Well, working with—in a hospital with other OBs and seeing a lot of what goes on, I think—and a lot of the documentaries and things that are out there now—there’s this kind of feeling of fear around giving birth in a hospital that a doctor will rush you into something that’s not necessarily necessary, but kind is more to their advantage of getting out of there faster, getting back home to their families.
JENNY: How much does that actually go on inside a hospital?
MASTERSON: Zippo, OK? Because—and really, people will think that, and I will just tell you, you do not go into the field of obstetrics for a nice schedule, because you get up at 2 AM and 3 AM, and you can never tell when this has happened. To sit—to pick out one patient and say, `I’m going to scoot you along so that I can get to this thing,’ that’s just not why we go into the field.
BILLY: That’s great to hear.
STORK: And I think one of the take-aways from today is that home birth—home birthing can be a wonderful experience.
(To Masterson) I know you. You’re concern is the risks. That’s your job.
MASTERSON: Right. Right.
STORK: And I’m going to explain to everyone here why Lisa is so concerned about the well being of a newborn baby and the mother—I’m going to embarrass you a little bit—in addition to being a top notch ob-gyn here in America, Dr. Masterson has indeed dedicated—throughout her career, basically her life to increasing the number of live healthy births around the world, particularly in Africa. It’s a cause that she has so much passion for, she started telling me about it the very first day I met her. Let’s watch her in action right now.
(Excerpts from videotape)
MASTERSON: My mission is to decrease maternal mortality in underdeveloped countries, because people don’t realize, the biggest risk for women used to be childbirth until we switched it into hospitals. The C-section that we’re doing now, the woman hasn’t had any live births, and this is her third pregnancy. She’s had two other deliveries where one baby died pre-term, and the other baby went all the way to full term that was born dead. We’re trying to ensure that after this third pregnancy, she’ll finally have one live baby.
(End of excerpts)
STORK: I can’t tell everyone how proud we are of you and the work that you do. We’ll be getting ready for a show sometimes, and Lisa will say, `Well, I just got back last night from India, or Africa.’ The work you do is phenomenal. Tell us more about this charity.
MASTERSON: The biggest risk for women used to be childbirth, until we switched it into moving them into hospitals, and it—every minute, every minute a woman does die in labor, and it’s from post-partum hemorrhage or from hypertension, or her baby dies. And, you know, there’s so much of this going on, and it’s so easy to solve just how we’ve solved it here, so basically I go to these countries and try and provide equipment and training and skills, and we set up clinics in Kenya, and so it’s—it is—it is very close to my heart, as you can see, because it’s not necessary, and it—and it’s fixable, and it can be a great experience, but there can be things that, you know, can go wrong. But if you’re prepared for them, then you’re all set.
STORK: And I appreciate everyone for giving their side of the debate, and I think that this is going to continue to be something that’s debated, that you’re still going to probably go home and process.
BILLY: Oh, yeah.
STORK: If you want more information on the Maternal Fetal Care International Organization or any of the birthing methods that we talked about today, log on to our Web site, thedoctorstv.com.