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August 14th, 2009
Dr. T

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DEBORAH POTTER, guest anchor: What role does faith play in a delivery room? If you ask one doctor in Atlanta, the answer is a big role. Dr. Joseph Tate delivers babies the old-fashioned way, using methods some obstetricians call risky. But his patients say God guides his hands. Mary Alice Williams has our report.

MARY ALICE WILLIAMS: Babies always surprise you, and most expectant mothers hoping for this joy, and chaos, fully expect to deliver a healthy baby — naturally.

UNIDENTIFIED WOMAN: Thank you Dr. Tate.

WILLIAMS: The birth of Sarah Miller’s two daughters surprised her and her husband Bill. She was unable to dilate enough to allow for natural birth. They were delivered by cesarean section.

SARAH MILLER: It makes it very hard to breast-feed. It makes it hard to do anything and bond with the baby, and I just want a vaginal birth.

UNIDENTIFED BIRTH HELPER (to patient): This baby is so good.

WILLIAMS: Vaginal birth after c-section — or VBAC — carries a rare but real risk of uterine rupture, life-threatening to both mother and child. Most obstetricians won’t risk it.

Dr. JOSEPH TATE (DeKalb-Gwinnett OB/GYN, Norcross, GA): She’s going to do it this time.

WILLIAMS: Dr. Joseph Tate risks VBACs all the time, even when the odds are against him.

Dr. TATE: I didn’t say to Sarah — I could say to her, “Look, you had two shots at it, and you didn’t perform. Tough. I’m going to do a cesarean.” I got to look at it positively. I will give her a fair shot at it, as long as she and the baby are doing well. That’s always the bottom line.

WILLIAMS: Dr. Tate, known as “Doc T,” is the sole practitioner of DeKalb-Gwinnett OB/GYN in Atlanta. It’s a family business. His wife Phyllis and daughter Elizabeth work in the office. He hasn’t had a vacation in 13 years because he works a super-human schedule.

Dr. TATE: We have, oh, another one, two, three, four that are within a week, another four that are two weeks within, another five that are three weeks.

WILLIAMS: Orthodox Jewish women make up about 20 percent of Dr. Tate’s practice. The rest are women of all faiths. How many babies has he delivered?

Dr. TATE: Somewhere over 5,000.

WILLIAMS: Sarah and Bill are hoping to make it five thousand and one.

Ms. MILLER: Well, I’m connected with a lot of mother groups online, and basically Dr. Tate’s name comes up over and over again, because there is nobody else.

WILLIAMS: That online mother’s forum is the International Cesarean Awareness Network — ICAN.

KATE SANDHAUS: Doc T is the only actual OB who participates. This is a one-in-a- million doctor. This is not just any doctor.

WILLIAMS: Kate Sandhaus, just three weeks before delivering her second child, arrived on Doctor Tate’s doorstep desperate for a VBAC after her first was born by a frightening emergency c-section. Doc T agreed to help her.

Ms. SANDHAUS: He’s available to all of us in a way that — I just — I don’t know any other doctors like that. I think that Doc T is committed to doing what’s right. He’s not swayed by what’s convenient, and the reason he practices medicine the way he does is because of his faith.

WILLIAMS: Doc T is an Orthodox Jew, a faith that requires of men many obligations, including praying three times a day.

(to Dr. Tate): What does prayer do for you?

Dr. TATE: It’s a communication with God. Judaism is establishing your own relationship with God. It’s a personal relationship. We don’t believe that God just kind of sets things out here and then you willy-nilly go your own way. We believe he does take a personal interest.

WILLIAMS: Dr. Tate is a pillar of the men’s study group at Beth Jacob synagogue in Atlanta. His rabbi, Ilan Feldman, calls him his go-to guy and a stickler when establishing the religious calendar.

Rabbi ILAN FELDMAN (Congregation Beth Jacob, Atlanta, GA): He’s got a clock which is connected to Pueblo, Colorado, an atomic clock because he’s that precise, and no matter what the synagogue clock says, when his clock says it’s time to begin, we begin.

WILLIAMS: On the Sabbath and high holidays Orthodox Jews may not carry things outside the home. So Doc T, a crack engineer long before he was called to obstetrics, constructed an eruv — a religious boundary that binds the entire community into one household.

Rabbi FELDMAN: So that for the purposes of Jewish law, an individual would be able to carry or transport items outdoors on the Sabbath on Shabbat.

WILLIAMS: As for Dr. Tate using his cell phone and delivering babies on the Sabbath, Jewish law makes exceptions.

Rabbi FELDMAN: Jewish law does have adjustments, so to speak, for people who are serving matters of life and death, and certainly a medical doctor like Dr. Tate would be governed by that exception.

(to Rabbi Feldman): Do you suspect that his Judaism makes him a better doctor?

Rabbi FELDMAN: There’s no question about it. In my opinion, the defining quality of a doctor beyond his training and his intelligence is his humility, and Dr. Tate is devoted and humbly in the service of his patients and of their Creator.

MICHELLE FRANK: People all around America, especially in the Orthodox Jewish community, really know about him — just a great asset to us.

WILLIAMS: Michelle Frank belongs to Dr. Tate’s synagogue. Three years ago in New York — with 26 people descending for Passover Seder — she went into premature labor. Rachel was born by cesarean.

Ms. FRANK: Physically it was really atrocious. I actually couldn’t even sit up for about 36 hours after she was born. It was just excruciatingly painful.

WILLIAMS: She’d been assured delivering naturally the next time would be no problem. She was in for a shock, as are many women in her circumstances.

Ms. FRANK: They’re absolutely not getting to do it. You have major hospitals in Atlanta who deliver, say, 16,000 babies a year, and they have c-section rates close to 40 percent.

WILLIAMS: Nationally, more than 9 out of 10 births following a c-section are surgical deliveries. Emory University Hospital Midtown, where Dr. Tate delivers, supports VBACs. But studies show more than a quarter of hospitals don’t or if they do can’t find doctors to perform them. Dr. T delivered Michelle’s new baby Danielle by VBAC.

Ms. FRANK: You’re on cloud nine. It’s so unbelievably amazing. It’s just the way that a woman was made to deliver a baby.

WILLIAMS: (to Ms. Frank): Do you think that his Orthodox Jewish faith makes him a better doctor?

Ms. FRANK: I think it makes him a better doctor, because I think that it helps to instill a lot of confidence in him. He does things that no other obstetrician will do. Whether they can or can’t they just won’t, and he’ll tell you that he really feels like God just sort of guides his hands in his deliveries, and some of the things that he does, and some of the stories that have been told, there’s just no way to do that on your own. I mean, you have to have help, and he attributes that help to God.

Dr. TATE: When you understand that there is another power in the world, and it is not just about you, then God gives you the ability sometimes to do things beyond what you particularly can do.

WILLIAMS: Natural births mean less blood loss and risk of infection for the mother and fewer respiratory problems for the newborn. But on this Sabbath day, there’s a problem with Sarah. Her tailbone is blocking her baby’s birth.

Dr. TATE: What I don’t tell people always is when I’m in tough situation I’ll close my eyes and I’ll say a silent prayer, and I want Him to let me know if this is something that can be done, let me do it, let me do it well. But if it’s something that can’t be done, well, let me know, and if I need to do a cesarean to—that’s the right thing, then we’ll do that. I need help, and I’m not ashamed to ask for it.

WILLIAMS: The result? A healthy seven-pound, two-ounce girl delivered naturally. This baby surprised everyone.

Ms. MILLER: Thank you so much.

WILLIAMS: And before you know it, this tiny newborn will join this crowd — every one of whom was delivered by Dr. Tate.

I’m Mary Alice Williams for RELIGION & ETHICS NEWSWEEKLY in Atlanta.

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29 comments

#1

What a great segment! Doc T delivered my son last year. I also found Dr. Tate at the end of pregnancy, desperately hoping for the chance to deliver without surgery. Our baby’s middle name is Joseph, in honor of the amazing Doctor who helped bring him into the world. We desperately need more doctors willing to put their patients above everything else. Definitely one in million!!

#2

Dr. Tate delivered my youngest daughter 20 and 1/2 years ago. She was a v-back baby. My 1st babygirl was a c-section baby in Houston and when we moved to Atlanta, I could not find a Dr. that would not do a 2nd c-section – till I found Dr. Tate, thank G-d! He was amazing and he is so dear to our hearts!

#3

fyi I didn’t know the rate of C-Sections in some Atlanta hospitals is approaching 40%.

#4

what a blessing to see a doctor who believes that the way the creator designed birth is still valuable!!!!!!!!!! I have 4 children and the last two were home births totally natural. My bond with my children has grown stronger and the experience for me of childbirth was much more treasured.

#5

What a wonderful segment on a long time friend.
The families in the Atlanta area are very fortunate to have such a special person. Boston’s loss is Atlanta’s gain.
Having known Joe since c. 1968, I can say ‘ I knew Dr. T when … ‘
Any information from me about Dr. T’s Early Years will require a substantial contribution to his favorite charity!!!
With warmest wishes to Joe, his family and his patients. /s/ ram

#6

Dr Tate delievered two of my sons, 24 and 21 years ago and he was great then too! Dr. Tate also handled a miscarriage I had after the 2nd son wonderfully and I never wondered if that baby girl as dead or not. It was a hard time, but a wonderful time at the same time!

#7

What a wonderful segment on a VBAC-supportive OB! Thank you.

I do take some issue with the comment that “Dr. Tate risks VBACs all the time,” however. The risk of uterine rupture, while real, is less than 1% for most moms attempting VBACs. In addition, since the segment itself mentions that “Natural births mean less blood loss and risk of infection for the mother and fewer respiratory problems for the newborn,” wouldn’t that also mean that the OBs who deny moms the right to VBAC *risk c-section* all of the time?

#8

Dr Tate delivered all 3 of my children, one of them at an unplanned location – my home! I’ve known him for 13 years, as our OB/GYN, as a good neighbor and as a friend. He’s the real deal.

#9

I take issue with the phrase “even when the odds are against him,” referring to Dr. T’s willingness to “risk” VBAC for the women he is working with. In fact, the odds of a successful VBAC are 70% or better. The odds of a uterine rupture are, as another reader noted, less than 1%. The odds are definitely in Dr. T’s (and his patients’) favor– as they would be in favor of any provider deciding to practice low-risk obstetrics. The ethics of these decisions are up to the providers (including hospitals), the insurers, and the lawmakers who could faciliate for families’ health.

#10

Dr. Tate is an example of why I’m so proud to be Jewish. He is a tzaddik!

#11

I am very thankful for Dr. Tate. I have four children, and could not go to Dr Tate until after my last baby (insurance reasons). I had a pregnancy after my 4th which ended up in a miscarriage….I went to Dr Tate when I found out I was pregnant. He spent 2 hours going over my history (which was complicated). When I went to subsequent visits, he remembered my history as if he had known me all my life. He is the smartest doctor I have ever known and he is a huge blessing to the women of Atlanta.

#12

I recently attended a planned vaginal breech birth with Dr. T. It was truely a blessing to see an OB that will practice based on the best interest of the mother and baby rather than malpractice and money. He was the only chance for this mother to avoid surgery. The birth was absolutely beautiful.

#13

I cried as I watched this video clip. I have had SIX unnecessary c-sections. I have contacted Dr. Tate and he has told me that he would support me with a TOL…I just about fell out of my chair as I was reading the email! I am trying to make plans to get to Atlanta now.

#14

Dr Tate delivered my baby and we will be forever grateful to him and his family /staff. I had a polymyomectomy due to several large fibroids. The practice I went “agreed” to my wish of attempting a VBAC Okayed by my surgeon. They also emphasized the fact that I was taking probably too many chances, that we might do a C-section. Listening to them C-section sounded like a high probability for a patient like me. Even one of the OB/GY told me that due to my history they will never attempt a VBAC in the US. Lawyers could be very aggressive and they would go the safest way. They weren’t receptive enough and tried to talk me into a C-section. I kept looking and found online Dr Tate’s name. I switched to his practice at 25 weeks. He went over my surgery report, my medical records and explained the risks even low inherent to any VBAC. That being said if I wanted to do it he was willing to hold my hand throughout this journey and do all he could to deliver my baby safely. If a C-section was inevitable, he’ll perform one. It reassures me so much to hear him say that he would hold my hand. It represents the idea that I have of the doctor/patient relationship. Needless to say that I was scared, worried to death for my baby and me. He took my worries seriously and explained all the security layers Crawford Long and him take for VBAC patients. I kept praying about it, asking God to help us make the right decisions and to preserve us. This article reflects so much what he does faithfully. I highly recommend Dr Tate. He never rushes you in a 5-10 minutes visit; he is knowledgeable, caring, compassionate and very funny. You are definitely in good hands with him. Whatever your situation is he’ll take you to the right direction. You can feel that he has his patients well-being at heart. I also met so many patients who only had praises for him. Trust your instinct and trust him.

Good luck to you ladies

#15

I currently live in New Jersey, the state with the most C-sections. I have a 3 year old little boy that I look at and at times cry, saying if I have a C-section for his little sister and something goes wrong he’d be without a mommy.
No one here will deliver a breech. Although, I would be considered a canadiate. Frank breech, no placenta previa, 1 vagina birth, don’t want any medication that can interfer with delivery, etc. Unfortunately, I heard the hospital I will birth at has a very high C-section rate and even got a court order for a woman to have one, and after DYFS got involved and took her baby. I wish someone would plz help, but it seems as no one cares enough to.
From NJ. Unique5truth@yahoo.com 37wks

#16

Dr Tate delivered my fourth child via c-sec. We had hoped for a VBAC but it wasn’t to be. However, because of my spinal disability, he planned very well for my c-sec and I was able to have it awake – something I had not even been able to consider with my previous two c-secs. Dr Tate is a wonder.

#17

Dr. Tate is awesome, He delivered all five of my moms children and the last two of my grandmas, and he will deliver my children also. He just has a way about himself, when my husband and I got married by husband thought I was crazy to travel almost an hour away to have him as my OBGYN, but I had my husand come once and he loved him and wants him to be his doctor also! When my mom was pregnant with her third we lived in New York and she went into labor and made her way all the back to atlanta just for him to deliver him, she didnt trust anyone else to deliver her children, and Im the same way! We love Dr. Tate and Family!!!

#18

I love my doctor and his family! What my daughter didn’t mention (comment #17), when in delivery with her sister (my 2nd Child), I wasn’t able to find a comfortable pushing position, and when the nurse’s at Northlake Regional were freaking out, Dr. Tate, allowed me to deliver on all fours, knowing that nature would take it’s course, and that the baby would be fine. I would travel the world to have him as my doctor. He is the absolute best. I love you, dad & mom!

#19

Dr Tate sounds like a wonderful doctor. What a gift he must be to his patients. Just a note to PBS, all births are “natural”, even c-sections. I think the term you’re looking for is “vaginal” birth. I think it’s important that we use supportive and anatomically correct terminology to describe the variety of birth experiences women have.

#20

It surprises me when I hear most doctors will not deliver a baby naturally after a C-section. Over 20 years ago, my daughter had two babies after a C-section. And, one of the was a 10lb baby. No problems at ll———–and she is a small boned woman.

#21

Every woman has the right to make their own choice, in consultation with their doctor, but there is something women should know. C-section is far safer for the baby, especially in cases of prematurity or when there may be other known or unknown medical issues.

Vaginal birth is traumatic and squeezes the head very hard. If there is anything that could cause a brain bleed, it is far more likely to occur in a vaginal birth than in a gentle (for the baby) c-section.

Both my kids were born by c-section. Just FYI, I realize I am very unusual, but while it took me five days to recover from my 1st c-section (which followed 12 hours of labor) my second c-section was scheduled. I was walking around the 2nd day and left the hospital on the 3rd day.

It turned out that my second child had an undetected problem with his placenta. The doctors didn’t realize until a week before he was born that he was going to be unusually small. He was born by scheduled c-section only two weeks before term, but he had a number of issues related to his small size, including reduced production of clotting platlets. He had to stay in the NICU for two weeks. Before he left they took a brain MRI “just to check” but the doctor said “I would be very surprised to see any problems, because of the fact that he was delivered by c-section.”

By contrast, my neighbor has a child that was born two months early (vaginally) and he suffered a very serious brain bleed and has multiple problems associated with cerebral palsy (cannot walk or talk at age 3.)

So don’t dismiss good reasons for having a c-section out of hand. I realize there can be problems in any situation, but doctors aren’t necessarily recommending c-sections just because they’re too lazy or untrained to carry out a successful VBAC.

#22

Virginia’s comment (#21 above) shows that she has bought into the erroneous notion that c-sections are automatically safer for the baby. If that were true, we should do 100% c-sections. In fact, over that last 40 years, the US c-section rate has gone from about 5% to about 30% with no real change in the cerebral palsy rate. Her assertion that vaginal birth is traumatic while c-section is gentle for the baby shows that she has done neither!

We are living in an unprecedented time, for now as the c-section rate keeps rising, for the first time, both maternal and neonatal complication rates are also rising.

Of course there are times when a c-section is necessary, but 1 out of 3 belies the fact that birth is by nature a normal, safe event for both mother and child. VBACs and other obstetrical procedures that reduce c-sections can continue to be preformed as I said in the segment, “as long as she [the mother] and the baby are doing well. That’s always the bottom line”.

#23

Quote from Virginia …
“By contrast, my neighbor has a child that was born two months early (vaginally) and he suffered a very serious brain bleed and has multiple problems associated with cerebral palsy (cannot walk or talk at age 3.)”

Perhaps that is because he was born 8 weeks early, not because he violently erupted from his mother’s vagina. Most preemies end up in the NICU because they are not fully developed, not because of the way they came out.

“He was born by scheduled c-section only two weeks before term….”

Two weeks is still premature.

#24

I just made my first appointment with Dr. T and I am so excited I can hardly stand it. He came highly recommended from a friend of mine. I had a terrible first birth and never thought I would find they type of Doctor I was looking for!!! Can’t wait!

#25

Dr. Tate is my OB and I am so grateful for him. I was nervous about switching OBs after I had known mine for several years, but after I was misled into an unneccesary C-section last year, I knew I had to go to an OB who cared more about the client than treating me as a patient. My husband and I are so pleased that we have a holy person helping in our childbirth preparation.

#26

My daughter Elizabeth is also another successful VBAC story done by Dr. Tate. I would not change anything about her birth. I traveled from Cleveland, TN near Chattanooga, TN. to see Dr. Tate and it was well worth the drive for every appointment. I had an unecessary C-section for the birth of my first child. My husband and I are so happy we found him, because every local doctor here beleive in repeat C-sections, No VBACs at all. Dr. Tate was my only hope for a vaginal birth. My husband and I did alot of research on repeat C-sections and the maternal death rate was actually higher than the uterine rupture risk. We would rather have taken the very low risk of uterine rupture than the risk that was higher of mine or the baby’s death. I am so happy we put our lives in the hands of Dr. Tate instead of someone wanting to automatically take her at 37 weeks. Anyone considering VBAC and can get to him, please do, you will not regret it. The results out ways all th other factors. We love you Dr. Tate, Thank you very much!!

#27

I cannot thank Dr. T enough. After 2 previous C sections, the last being a horrendous vertical incision in 2003, my wife was determined to have a VBAC. Luckily she found Dr. Tate. I hope some of his interns have the intestinal fortitude to adopt his philosophy.

Funny thing I learned from this interview is about him asking God for guidance. When my wife was laboring he sat at the foot of the bed during a difficult period of the labor. I saw him close his eyes for maybe 10-15 seconds. It was in the wee hours of the morning so I thought, “I don’t know if I want this dude delivering my baby, he looks like he needs some sleep.” Now I know the rest of the story.

#28

I was pregnant with my fourth baby at 46 years old, 14 years after my 3rd baby. I wanted a pro. I had good OB’s with my first three pregnancies and births, but Dr. T.was, by far, the BEST OB that I ever had. Personal and professional with a God-given “sixth sense,” especially in knowing how to help a woman during labor, Dr. Tate truly is one in a million. I do thank God for him and highly recommend him to friends.

#29

Hallo

I am 32 years old, after 6 month of marriage I got pregnant, and after almost 40 week
I had first baby via emergency C-section, But baby died (it was CORD PROLAPS case).

I miss dearly and think about my child constantly, But I am trying to know this matter about my future.

I kindly request you to please give me your expert opinion about my following question.

1. Can any affect my fertility after a c-section in this case..?

2. How long after a C-section can I start thinking about having another baby?

3. What precaution I have to take when I get pregnant again..?

4. How many chances to deliver normally after first c-section..?

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