An Intimate interview with, Obstetrician, Dr Andrew Bisits.
(Dr Andrew Bisits currently works as Head of Obsterics at the Royal Womens’ Randwick and was Head of Obstetrics, John Hunter Hospital, 2007-2015).
Background info: During his time at JHH Dr Bisits was highly accomplished supporting low-risk breech to birth vaginally and working with midwives to establish the Belmont Birthing Centre! Thank you, Andrew!
Nat (Interviewer): “I see you as probably one of the best obstetricians in the world! How do you describe yourself?”
[Andrew has a big, long laugh]
Dr AB (Dr Andrew Bisits): “I certainly do not describe myself like that. I am purely an Obstetrician.”
I am moved by his humbleness
Nat: “Your time running the JHH has made you quite famous, what do you see as your proudest achievements?
Dr AB: “One of them, is that I actually came to understand birth…a little, better… I always reflect on when our first baby was born…I was useless at the time of that birth”
At that time DR AB had been working for four years, full time, as a trainee OB.
Nat: “You felt useless…”
Dr AB: “I learnt a lot from that birth, from just watching my wife…she just wanted everything to be quiet… She just wanted to curl up – and labour like that.
Nat: “And the birth went well?”
Dr AB: “Yes it did. That birth was a real learning in its own right. But it was only after the birth of our second, that the totally, indescribably unique, nature of birth hit me.”
Nat: “What happened in that birth?”
Dr AB: “It was just at the time of him being born…I saw someone leaving the world, as in dying, and I saw him birthing into the world, and this overwhelming experience has stayed with me every day since.”
As he shares this, strong emotion rises up in him as he continues.
Dr AB: “As you can see it was overwhelming then and still is now.”
I do my best to delve deeper, extremely curious about his personal revelations
Dr AB: “They’re the only words I can use to describe it. I keep on thinking about that and then I keep on seeing the total uniqueness of birth – in each birth.”
Nat: “There is a deep emotion then, that you bring to your work?”
DR AB: “ah, yes… and that allowed me a greater ability to relate to the situation of the birth, it has given me the ability to know, and feel at times, what might be right and what might not be right. And that often flies in the face of what is currently described as evidence.”
Nat: “How do you balance this ‘intuition’, with the level of responsibility on your shoulders”?
Dr AB: “The responsibility sometimes we perhaps overstate, because essentially this is a normal process that on most occasions looks after itself. Birth is very different to other medicine where you are dealing with something broken and you work to fix it.”
Nat: “We could call you an old, wise, obstetrician, couldn’t we”? [we both laugh at the use of the word “old”]. “How are you different to a newer, fresher, OB in the field?”
Dr AB: “Well I think, it would be a natural thing for someone younger to come in and want to control things and minimise risks, and they find it difficult to relate to the total uniqueness of every birth, it’s just seen as a ‘way of having the baby’, and that’s ‘not much different to a caesarean’. That’s not a criticism by the way, that’s probably close to how I started out.”
We discuss communication styles
Dr AB: “I talk with each woman, not in terms of ‘this is what you have to do’, or ‘allowed to do’, but instead I will say: ‘this is probably what’s advised for you and now you can consider this, in your situation”.
Nat: “How many trainee OBs have you passed this onto?”
Dr AB: “Quite a good few, I hope. But it’s met with active and passive resistance. Because of the social circumstances of birth there seems to be a need to discuss risk in a blunt and authoritative way. I don’t think anyone deliberately does it, but women often feel scared into decisions – the women say this themselves”.
Nat: “What’s the solution?”
Dr AB: “I’ve been having discussions with a professional negotiator, a mother, who we worked with for her birth, she is proposing a “negotiating paradigm’. You would tell the pregnant woman the risk, but also acknowledge other significant needs in the woman, that will modify how she understands that risk. The discussion would also acknowledge the needs of the OB. Not just one person has the ‘answer’. The problem is, stats are often mentioned as if we do have the certainty, but it’s anything but a certainty. In the cold light of day, statistics about risk, are only averages.”
This frankness reminds me of how Andrew spoke up about OBs “overtreating women” in “Birth Time, the Documentary”.
Nat: “If one of your children were birthing your grandchild what advice would you give them?”
Dr AB: “I did have this recently! My son’s partner was birthing and I will be direct here, I was concerned because she was planning to birth in our hospital. I was worried; is she going to be railroaded, with the best of Intentions, into this and that? I was worried that small, mild problems, could mushroom into huge ‘potential problems’ and her special birth experience be taken from her – inadvertently.”
Nat: “What did you say to her”?
Dr AB: “My advice to her was to get into one of the Midwifery groups. I also got my son and her doing a private birth course – which was great for them. This approach later helped to cushion her from the world of potential problems and even when small mild issues did arise (a bit of blood pressure), her birth was able to stay special.”
