How to retrain obstetrics and change incentives

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No animal in nature needs to be taught how to give birth. So why have we convinced human mothers they do?

In this episode, I sit down with Dr. Stu Fischbein, an obstetrician who spent more than two decades attending hospital births before stepping outside the system to examine it more closely. After years working in highly structured medical environments, he began asking a difficult question: why hasn’t more intervention led to better outcomes?

Modern approaches to birth and healthcare have drifted from basic human biology, and how fear, liability, and protocol often replace judgment and trust. This isn’t a debate about extremes—it’s a grounded look at how medical intervention, when applied by default, can create cycles that are hard to escape.

We also touch on trusting your body, the loss of autonomy in healthcare, and why outcomes haven’t meaningfully improved despite more technology, more testing, and more control. The patterns we unpack here don’t stop with medicine—they show up anywhere systems replace thinking.

You’ll Learn:



[00:00] Introduction

[01:43] How birth was medicalized through vilifying midwives and destroying natural practices

[12:25] The takeover of obstetrics training and the relegation of OB-GYNs to gatekeepers, while outcomes worsened

[18:29] Dr. Stu’s shift from classical training to questioning everything

[33:33] Why we need to educate 13-15 year old women about their bodies

[45:42] How and why the NICU admission rates have doubled

[01:03:37] Why for-profit hospitals can't financially survive if women who don't need medical intervention go elsewhere

[01:30:38] How doctors manipulate women using relative risk instead of actual risk

[01:52:25] How to retrain the obstetrical system starting with medical schools

[02:26:09] Why treating 99.9% of GBS-positive women with antibiotics destroys babies' microbiomes

[02:36:12] Why routine pap smears and mammograms are mostly unnecessary

[02:45:25] Why nature designed women to give birth alone in safe spaces

Resources Mentioned:

Midwife books by Sara Wickham | Website

Breech Without Borders | Website

Click here to get an exclusive discount to our Birthing Instincts Podcast Patreon membership. Use promo code ALECZECK50 for half off your first month, excluding our Medical Professionals Level. This Patreon is a great way to get additional content and support from Dr. Stu and the entire Birthing Instincts family.

Find more from Dr. Stu:

Birthing Instincts | Website

Birthing Instincts | Instagram

Birthing Instincts | Podcast

Find more from Alec:

Alec Zeck | Instagram

Alec Zeck | X

The Way Forward | Instagram

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