Postpartum University® Podcast · Maranda Bower, Postpartum Nutrition Specialist

The Problem with Obstetrics and How it's Failing Mothers with Dr. Stuart Fischbein EP 245

December 9, 2025·1 hr 8 min·4 clips

Dr. Stu says the system is to make money and get babies in the bassinet, no matter how long they live.

1. Postpartum University® Podcast episode 245 centers on Dr. Stuart Fischbein's critique of obstetrics and postpartum care for mothers. 2. Miranda Bauer hosts the conversation, and Dr. Stuart Fischbein, called Dr. Stu, brings 28 years in hospital birth and more than 12 years in home-birth obstetrics. 3. The episode asks why the medical system still leaves mothers without real postpartum support and what a different care model would require. 4. Dr. Stu says he trained at Cedars-Sinai Medical Center in Los Angeles in the early 1980s, when obstetrics relied on protocols, algorithms, and the Friedman's curve. 5. He describes routine hospital practices from that era, including IVs, blood draws, consent forms, monitors, immediate cord clamping, and handing babies to the warmer. 6. He says every pregnant woman at the University of Minnesota got a mediolateral episiotomy during his medical training. 7. He explains that local home-birth midwives asked him to take transport cases in Los Angeles, and that work changed how he saw birth. 8. He says midwives asked concrete questions about immediate cord clamping and taking the baby to the warmer instead of to the mother. 9. He says the collaborative model that developed later let midwives handle normal births while he handled problems. 10. He argues that obstetricians are trained to expect problems, while midwives are experts in normal birth and are not a lesser profession. 11. He says the medical model treats pregnancy as illness, while the midwifery model treats pregnancy as wellness and accepts uncertainty. 12. He says the hospital system is built for efficiency, billing, and moving women through care rather than for human connection. 13. He says postpartum training is missing in modern medical education, and the usual system still sends women home on postpartum day 2 with a six-week check. 14. He says midwives often visit on day 1 or 2, day 5, and day 10 to 14, then remain available later as "your midwife for life." 15. He says mother and baby should be treated as a dyad, not as separate patients split between obstetrics and pediatrics. 16. He says breastfeeding support suffers when hospitals rely on shift-based lactation consultants who may give different advice on different days. 17. He says postpartum recovery improves when mothers rest, stay skin to skin with the baby, eat warm easy-to-digest food, and reduce visitors. 18. He says women should ask for better care, because women who do the work of finding the right practitioner have less emotional and physical trauma. 19. The conversation is direct, critical, and personal, with Miranda asking follow-up questions and Dr. Stu moving between clinical memory, policy, and culture. 20. Listeners interested in birth advocacy, midwifery, and postpartum care will get the most from it, while people wanting a neutral how-to birth guide may skip it.

As heard by us

A blunt critique of maternity care that ties trauma to system design.

Dr. Stu Fishbein's long run in hospital birth and home birth gives the conversation its spine, and Miranda Bauer uses that background to make a system-level case about maternal care.

Read the full review in PlayNext →

Why you'd press play

When you want a blunt read on postpartum care that keeps missing mothers.

Read the full recommendation in PlayNext →

Listen to the show on

Apple Podcasts Spotify

Play clips from this episode More from Postpartum University® Podcast