At first glance, obstetrician Robert Biter and unlicensed “midwife” Rowan Bailey appear to have a lot in common. Both presided over homebirth deaths and both face serious consequences as a result. It seems to me, though, that the differences between the two cases are far more instructive than the similarities. Moreover, those differences tells us a great deal about the professionalism of doctors, and the utter lack of professionalism of homebirth midwives.
Consider:
1. Rowan Bailey broke the law and Dr. Biter did not.
This is a critical distinction that seems to have escaped most homebirth advocates. The Medical Board of California found that Dr. Biter demonstrated gross negligence in his care of patients and was both dishonest and unprofessional. However, Dr. Biter was practicing under a valid medical license. At no point did he ever represent himself as something he was not. In contrast, Bailey was practicing midwifery illegally and was allegedly misrepresenting her credentials to parents.
Had Dr. Biter presided over the death of a baby while unlicensed, he almost certainly would have been arrested as well.
2. Dr. Biter carried malpractice insurance and Rowan Bailey did not.
In keeping with the legal requirements for practicing medicine in California, Dr. Biter carried malpractice insurance. The patients that he has injured may be able to collect compensation. In contrast, Bailey offered no such protection for her patients.
3. Dr. Biter was disciplined by his own profession.
The medical system did not close ranks to protect Dr. Biter. First he lost his hospital privileges, then he was placed on probation by the Medical Board of California, and currently he is facing revocation of his license. In contrast, no midwifery board or organization took any disciplinary action against Bailey. Indeed, they didn’t even bother to investigate.
4. No doctors rallied around Biter when he lost his hospital privileges.
They understood that the loss of privileges represented a very serious accusation against Biter and withheld judgment until more of the facts were known. Indeed, the only people who rallied on Dr. Biter’s behalf were homebirth advocates, including Ricki Lake, who made no effort to determine the facts of the situation and blithely accepted Biter’s claim that he was being “persecuted.”
5. No doctors or medical organizations raised money to support Dr. Biter.
Why? Because the medical profession does not feel threatened when bad doctors are disciplined. In contrast, homebirth midwives feel threatened when incompetent midwives are investigated, charged, tried and punished. They do not want to be held responsible for their actions or any carnage that follows in the wake of their actions. They want to be able to entertain themselves by attending births and getting paid for it. They apparently feel no responsibility to make sure that their actions are safe.
These differences make a mockery of the claims of homebirth advocates that there is a double standard for obstetricians and for midwives. Preside over a death while practicing without a license and you may go to jail regardless of whether you are a doctor or a midwife. Commit malpractice as a physician and you will not be protected by your medical colleagues; they will not support you; will not rally for you and will not raise money on your behalf. They will discipline you and even drum you out of the profession. There are very real and very serious consequences for physicians who fail to care for patients appropriately and no one is arguing that penalties for malpractice are unjustified.
You have to give homebirth advocates credit for one thing, though. They are ideologically consistent. Commit negligent acts, commit malpractice or preside over a perinatal death at homebirth, and homebirth advocates will insist you are being “persecuted” whether you are a doctor or a midwife. Homebirth advocates are consistent in their morally bankrupt behavior.
