Yes, it is your fault that your baby died at homebirth

There are so many homebirth deaths occurring that I am having a hard time keeping up. I originally planned to blog today about the recent homebirth death in New Jersey attended by a CPM who had already had her license revoked. I’ll need to save that one for another day.

I came across the story of this homebirth death because of a post entitled, The MOTHER of all posts: IT’S NOT OUR FAULT.

Her heart rate was monitored closely with consistent reassuring heart tones the entire time. At the point when she was crowning … we were still getting a steady, consistent heartbeat. I pushed for a reasonably short amount of time and delivered her without the need of an episiotomy … and I only tore minimally not requiring stitches. She was born and had already passed, the cause of which we can only conclude was having suffered a cord accident in the last moments of birth. She received immediate emergency care but was unable to be revived.

The stories are sickeningly familiar. The blog detailing the mother’s commitment to unmedicated childbirth as “healthier”; the death that supposedly took place in the moments before birth; the clueless midwives who had no idea that the baby was dead; and the link to site where donations can be made to cover the cost of the funeral.

The mother is livid that someone chose to mention that it was her decision to have a homebirth that led to her daughter’s preventable death.

I received a comment on my blog yesterday. Completely, off the topic of the post it was attached to. Unrelated. Here is what it said:

Knowing that this was a “home birth” and that you have NOT once mentioned home birth in all the blog entries that you have written…I would like to just say one thing, that “women who give birth at home trade the “birth experience” for “safety”. There are “risks” with both home birth and hospital birth, but I can’t understand why anyone would want to sacrifice safety for experience…just saying!

… We are devastated by the tragic loss of our baby girl and this judgmental, hateful “anonymous” has the audacity to tell us it’s our fault…

If this person believes we are responsible that’s one thing, but to point their finger at grieving parents in the midst of our immeasurable pain, something this individual could NEVER understand, and try to shame us and blame us by telling us our child’s death is our own fault is disgusting. What type of human being could sink so low? How revolting can someone really be?

What type of human being? The type that cares that babies are dying unnecessarily.

One of the delicious little lies of the homebirth movement is that women who choose homebirth take responsibility for the outcome. The hell they do.

They blather on about being “educated,” about doing their “research,” about ignoring the advice of obstetricians, family members and friends. They insist they understand the risk that the baby might die … right up until the moment the baby dies.

Then they blame God, the universe, fate, anything else but themselves, the people actually responsible for making the choices that led directly to the death of their babies.

Hey life, universe, god or whomever it concerns,

I’ve got some questions for you.

I’m suppose to be celebrating the birth of my baby girl right now. Snuggling her, holding her and kissing her. Why am I planning a funeral?

She was healthy, strong and perfect, why couldn’t she survive the last moments of childbirth?? Why wasn’t my body perfect for her exit? I TRUSTED it. I trusted you.

No, you didn’t trust life, the universe or god. You trusted YOURSELF to know better than medical experts.

Who made the choice to deliver at home, far from emergency equipment and personnel? The homebirth mother. Who made the choice to hire a substandard practitioner? The homebirth mother. Who chose to ignore the medical advice of obstetricians? The homebirth mother. Therefore, who is responsible for the death of a baby that could have been prevented by obstetrical interventions provided by legitimate obstetrical providers in a hospital? Who else but the homebirth mother?

Saying that the homebirth mother bears responsibility for the death of her baby at homebirth is not incompatible with feeling sorry for her loss. It’s no different than grieving for a child who went through the windshield and died because her mother didn’t buckle her into a carseat. That mother is no doubt devastated, and no feeling person can failed to be moved by that devastation, but that doesn’t change the fact that the mother, through her action or inaction, is ultimately responsible for the death.

It is all so damned repetitive:

• The claim of being “educated”:

We researched for months, we read all the information we could find, we learned from every source out there. Our midwives educated us but never pressured us or even encouraged us to give birth at home.

• The claim that the midwives were not at fault.

Our midwives closely monitored the entire pregnancy… The attention, genuine concern and high quality care we received from these three amazing women (and EVERYONE who worked at the midwifery practice) was incredible…

Incredible? That’s not how I would characterize midwives who didn’t know that the baby was in distress until it dropped into their hands already dead.

• The pathetic assertion that the baby received the same resuscitative measures that would have been available in the hospital.

Could she have been revived if she were in a hospital? The same procedure that would have been made to attempt to resuscitate her in a hospital WAS MADE for Aisley.

No, the same resuscitative measures were not used. There was no expert resuscitation with intubation.

• The insistence that it is no one’s fault.

It was an accident that she died. Accidents occur in hospitals as well. The risk of infant death in a home birth is less than 1%. It was an unforeseeable tragic event. Would anyone blame a mother in a hospital for being responsible for her baby’s death? How dare anyone blame us!

How dare they blame you?

YOU are the one who chose to give birth far from emergency equipment and personnel. YOU are the one who insisted that you were “educated” about the risks of homebirth. YOU are the one who chose midwives who were so clueless that they didn’t even know that the baby died during your labor.

When a baby dies at homebirth, those who warned you are entitled to say “I told you so.” What happened to your daughter is precisely what those who warned you were afraid of. They did tell you so; you chose to ignore them. YOU were the one who made the decisions and therefore, YOU are the one who is responsible.

  • Fallow

    I like how this is sheer, nonstop, wall-to-wall babbling.

  • Rosalind Dalefield

    I work as a risk assessor, and I do not and never have worked for the insurance industry. I work for a government regulatory agency.

  • Rosalind Dalefield

    Good answer.
    I’m still reeling at the ignorance and stupidity of the first sentence ‘Birth is as safe as life gets’. Holymoly. How can anyone be that ignorant?
    I did a lambing beat when I was 15. It was then that I learnt that natural childbirth often means natural childdeath…and sheep don’t have anything like the dystocia/stillbirth rate of women.
    Maybe some of these idiots should do a lambing beat.

  • audacia

    Had to find out who this lady was.

    “Of course, there is nothing wrong with a site for parents who have lost their babies or had traumatic homebirth experiences. And there is nothing wrong with a one-sided advocacy blog. The problem is when a dogged journalist like Goldberg elevates Tuteur to expert. Tuteur is not a researcher, she’s not currently affiliated with any medical institution, and more importantly, she’s never published any of her kitchen-table calculations on the risks of home birth in any peer-reviewed journal. Yet she presents herself with the authority of a CDC epidemiologist when she writes, “Homebirth increases the risk of neonatal death. All the existing scientific evidence says so.”

    http://www.slate.com/articles/double_x/doublex/2012/07/daily_beast_and_home_birth_fear_trumps_data_in_a_new_story_on_having_babies_at_home_.html

    • Daleth

      You just failed the internet. Dr. Tuteur doesn’t do “kitchen-table calculations,” she cites to peer-reviewed studies. For instance:

      http://www.skepticalob.com/2014/02/new-cornell-study-shows-homebirth-has-4x-higher-death-rate-than-comparable-risk-hospital-birth.html

    • The Bofa on the Sofa

      Yet she presents herself with the authority of a CDC epidemiologist when she writes, “Homebirth increases the risk of neonatal death. All the existing scientific evidence says so.”

      OK, if you don’t believe her, look up the work of Dr Amos Grunebaum. He is

      1) a researcher,
      2) affiliated with a medical institution (Cornell), and
      3) has published his results in plenty of peer-reviewed journals.

      And you know what he says? The same thing that Dr Tuteur says. (Actually, Dr Tuteur is saying the same thing that Dr Grunebaum is)

      Is that good enough for you?

      Got anything real to complain about?

      • Young CC Prof

        And let’s not forget that pretty much all recent studies, including studies by homebirth midwives themselves, find death rates similar to Gruenbaum’s.

        • The Bofa on the Sofa

          Actually, I don’t even know why we have to mention such things. audacia has done “lots of research” “on both sides” so I’m she is obviously very familiar with all this.

    • Amy Tuteur, MD
  • Rosalind Dalefield

    I hate and loathe hospitals with a passion, and after being bullied and lied to during my first delivery, I wished passionately that I never had to deliver in a hospital again. However, I also knew that it would be the height of irresponsibility to attempt a homebirth. So I decided to make the hospital system work for me by finding an OBGYN I would trust and making my expectations, which included being kept fully informed and having my baby treated as precious, very clear to him. It worked.

    • Roadstergal

      This is an important point, IMO. Bad hospital experiences absolutely happen. Picking up and walking away from the safety of the hospital doesn’t help things, though. It doesn’t help your own future babies’ safety, and it doesn’t help all of the other woman who want to deliver in the safest place to do so. There are so many things that can be done to help hospital births be happier and more comfortable – some of which are being done, some of which could be implemented more broadly… and fearmongering about hospitals doesn’t help at all. Dr T has talked about how the NCB crowd automatically sets up the woman/OB relationship as adversarial, when it should be cooperative.

      • Rosalind Dalefield

        Exactly! Going off and having a homebirth is extremely selfish in two ways: it risks the baby’s life for the mother’s comfort, and it doesn’t prevent other women from having miserable hospital experiences. Requiring better care from hospitals is the answer. Women need to say that ‘It is my right to be treated with respect and kept fully informed during labor and delivery, but it is also my right to give birth in the place that is safest for both me and my baby, with a surgical theatre and NICU close at hand in case we need them’

        • Amazed

          That’s it! Why should it be one or the other? A few days ago, I got really cross at the pharmacy where they simply forgot to pass my order for some things my grandmother needed. They were completely unapologetic about it. Assholes. I didn’t leave it at that. But I also didn’t turn on my heel to leave in a huff and swear all pharmacies off. My grandmother needed those things. She is an anus praeter patient and they’re vital to her quality of life. Why would I claim, “We need nothing from you because we’re assholes” and instead turn to natural ways to make her everyday life better when the best results were to be achieved through a pharmacy?

          Same with homebirth. It is as if they don’t understand: if you go homebirth and something goes awry, it’ll be you and/or your baby paying the price, not the hospital staff who probably won’t even remember your face. It’s in your best interest to give birth in a hospital, not run away from it. By all means, try to change it. But don’t cut off your nose to spitr your face.

        • Megan

          This! I am planning on discussing with my OB the “family-centered cesarean” in the likely scenario that I end up with a scheduled RCS. (Then only scenario in which it appears to be safe for me to VBAC is if I have a complication-free pregnancy and go into labor on my own without the need for augmentation. Apparently I have a very large scar on my uterus as DD was very hard to get out). Do you think the NCB crowd would support my family-centered RCS? I somehow doubt it. But really I think improving the hospital experience is what we all should be striving for.

  • Homebirth mother

    Every other first world country has no problem with homebirths. Maybe instead of acting like a bitter lady who’s upset she’s losing business, help the medical community improve midwifery care. A women’s choice to have the pleasant birthing experience she wants sbould not offend you so much. I’m glad when I brought up my decision to have a homebirth with my doctor, who I had originally planned to have a hospital birth with, she didn’t act like an unprofessional twat like you. I’m sorry that the idea a woman would rather give birth at home than into your cold hands upsets you so much that you would tell a mother its her fault her baby died. That statement alone makes it very clear you do not care about any mother, you just see them as another paying customer.

    • Homebirth mother

      Disregard this comment, I looked at some of your other things and it seems to be ver clear that you are a a pseudo intellectual. You are basically a tumblr dr. I only wonder what you gain out of being so misleading and hateful.

      • Who?

        You’re not a pseudo-intellectual you are no sort of intellectual at all.

        And yes, while you are right the homebirth industry is misleading and hateful (‘not all babies are meant to live’ ‘doctors are only needed in real emergencies, which won’t be our fault and we won’t be able to recognise, but don’t go near any doctors they are evil’) you should learn to love yourself so you can then turn some of it outwards.

        Now I wonder whether you will use ‘twat’ to describe me, or one of the other choice vulgarities so beloved of the homebirth hangers on. It confuses me how ‘pure’ you want everything except the words you use.

        • Homebirth Mother

          I wonder why youre so hung up on the fact I used the word twat once when the lady who wrote this article tell mothers it’s their fault their baby died. I never used any words to describe myself being a pure person.You are quick to sling insults as well, so I don’t see why you’re sitting here acting like you’re taking a high road. Again, we could work on improving the medical training our midwives get instead of shitting on a woman for making her own choices, and try and make hospital births her only option. I find it very anti-woman to try and control a very important experience in our lives in such a heartless manner. Sitting here hating women for wanting to give birth at home helps literally nobody.

          • Fallow

            Don’t you get it? Homebirth midwives do not WANT medical training. They LOVE being incompetent murderers. If they wanted training, and thought they could actually pass the classes, they would GO TO NURSING OR MEDICAL SCHOOL.

          • Homebirth Mother

            Are you being serious or sarcastic?

          • Cobalt

            It’s true. The training is available to anyone who qualifies and is willing to do it what it takes to get it.

            And calling someone an immature narcissist because they care more about laboring on their couch than making medical care available for their baby isn’t an insult. It’s calling a spade a spade.

            You seem to have a real problem with holding people responsible for the outcomes of their choices.

          • homebirth mom

            It’s an insult, just because you agree with the insult doesn’t make it less of one. You would never hear a /real/ doctor say that to someone. I have a problem with shaaming mothers instead of helping improve the homebirth community.

          • Cobalt

            Immature and narcissistic are descriptions. They’re only insults if they’re falsely and/or gratuitously.

            Valuing your ability to sit on your couch more than your baby’s ability to get oxygen is immature and narcissistic. That’s a fact.

            The first step in improving the homebirth community is making the facts of homebirth known.

          • Daleth

            If it’s an insult that is TRUE, is there really a problem in saying it? If I call a man who has been convicted of rape a rapist, that’s an insult, but it’s also true. Should I NOT call a rapist a rapist? Why?

            There is no way to “improve the home birth community” without compromising the safety of babies, because being born at home in America these days is at least 4x more likely to kill them and 16.9x (call it 17 times) more likely to leave them permanently brain damaged than being born in a hospital is. In other words you can’t have a “homebirth community” without also having an unacceptably high number of dead babies and brain damaged children.

            The Netherlands is often touted as an example of safe home birth, and they do indeed have safer home birth than we do–that’s because they don’t allow fake midwives to practice (only the equivalent of nurse-midwives, ones with at least a bachelor’s degree in midwifery), and their midwives are overseen by hospital OB’s, and their midwives are not permitted to deliver women with any risk factors at home. But they STILL have one of the highest rates of perinatal mortality (that’s Latin for “babies who die during or just after birth”) in Europe.

          • Somewhereinthemiddle

            The homebirth community doesn’t *want* to be improved. The friends that I have that have chosen homebirth have repeatedly chosen CPMs or direct entry midwives over CNMs who attend home and hospital births. We are fortunate in our area to be able to choose from *several* hospitals that have CNM practices. Hospitals and providers that will let you decline pretty much anything you want (within reason), will do intermittent monitoring, have birth tubs, keep the lights low, uninterupted skin to skin, will release patients in 12-24 hours, etc, etc. And people are *still* chosing to have their babies at home with unqualified birth attendants who call themselves “midwives” with next to no actual medical training. There are entire groups of people who don’t *want* midwives to be regulated because that means that they will be subject to limitations like no primary VBAC, no multiples, no GD, and no other high risk situations. It boggles the mind but that is how it is.

          • madcapfeline

            My grandfathers cardiologist called him a selfish prick because he refused to quit smoking. So is she not a /real/ Doctor? And the only way to improve the homebirth community is to completely dismantle it and convince pregnant women that the lives of their children are more important than giving into their toddleresque “me, me, me, mine, mine, mine, now, now, now” desires.

          • Roadstergal

            Exactly. Calling someone gullible because they believe things based on lousy evidence isn’t ad hominem. Calling someone narcissistic because their comfort trumps their child’s safety isn’t ad hominem. You might disagree with those and argue against them, but each one represents a reasonable conclusion from a premise.

            Calling someone a twat because you disagree with her is not only ad hominem, it’s misogynist.

          • Who?

            Fallow is telling the truth. Yes, the subject is serious. And Fallow is also being sarcastic.

          • LibrarianSarah

            But school is HAAAAAAAAAAAAAARRRRRRRRRRRDDDDDDDDDD

          • Daleth

            If a woman chooses to give birth at home and chooses to ignore both research and sheer common sense showing that giving birth at home is dramatically more likely to hurt or kill her baby than giving birth in a hospital is, then yes, it actually is her fault.

            In practice, though, it tends to be more the fault of the fake midwives (CPMs, DEMs etc.) who lie to expectant mothers about safety.

            Here’s something about that from a former midwife:

            http://www.honestmidwife.com/wp-content/uploads/2015/04/High-Risk-FINAL1.pdf

          • Empliau

            Our midwives, you say. I have no part in untrained women who call themselves midwives. The only midwife I think worthy of the name in the United States is the CNM. Those incompetent birth junkies may be YOUR midwives, but I’m pretty sure most of the regulars here want nothing to do with them – and wish your midwives had less to do with women who believe their fantasies and lies about homebirth safety.

          • Who?

            I’m just interested in how ready the homebirth community is to use vulgarities when they claim, in all other aspects of their life, to aspire to purity and cleanliness. No drugs, no formula, just revolting language.

            The readiness to pollute minds and emotions, while being so determined to keep the body pure, intrigues me.

        • Homebirth Mother

          I’m also sitting here reading Amy leave comments to other people calling them names, so if she can throw it she can take it. That also leads me to believe that she is no real professional, and cannot be taken seriously. No real doctor would behave in the way she had in this article.

        • Homebirth Mother

          Here are some quotes of words amy used in the comments section, “you are startlingly narcissistic and immature.”, “The paper is a piece of junk designed to fool the gullible, and apparently that means you.”, “What makes you think I would want an ignorant fool like you as a patient?”, are the first ones I saw. This is unprofessional as hell, I called her a twat, but I’m not claiming to be a dr. She is just another bitter feminist and everything she says should be taken with a grain of salt.

          • Amazed

            She might be whatnot but she and the likes of her are the ones to whom you and your fellow “I care more about being comfortable than I care about my baby’s life” breeders run to and bleat “Save us, doc!” with your babies hanging blue and limp, stuck between your legs when the shit hits the fan as a result of your empowered choices.

            Yes, it is your fault, breeders, when your babies die at homebirth. The studies are out there and they all show the danger. You are in your right to think about your own comfort before everything else but when things go south, it’s your fault.

          • Daleth

            If by “bitter feminist” you mean “woman who is outraged that much loved and much wanted babies die or are permanently brain damaged because narcissistic unqualified people create fake ‘midwife’ credentials for themselves and lie to expectant mothers about safety,” then I guess you’re right.

    • SporkParade

      Which first-world countries do you have in mind? The Netherlands, with the highest perinatal mortality rate in Western Europe? The UK, which has seen scandal after scandal involving midwives prioritizing vaginal delivery over the life and brain function of the baby? Israel, where the national insurance WILL NOT pay for homebirth, and any midwife attending a homebirth must have at least 4 years of hospital experience?
      It’s kind of impressive how quick homebirth advocates who parachute in here are to use gendered insults to attack Dr. Amy. Calling someone a twat or a cunt or insulting their appearance for not being birth goddess-y is deeply mysogynistic.

      • Who?

        They are so vulgar, aren’t they? All that pure food and no drugs for the babies while they utter the most foul language all around them.

      • Roadstergal

        “Calling someone a twat or a cunt or insulting their appearance for not being birth goddess-y is deeply misogynistic.”

        But she IS a Birth Goddess!
        http://www.skepticalob.com/2014/07/dr-amy-birth-goddess.html

    • Sarah

      I’m fairly sure the UK is a first world country. Can you tell me what our perinatal mortality rate and transfer rates are for primagravidas, please? Because I personally would define them as a ‘problem’.

    • Rosalind Dalefield

      Really? Visit the AIM website in New Zealand. You will see that 90% of their members were among the 10% of women who had homebirths.

    • Cobalt

      So, a pleasant birthing experience is more important than lifesaving medical care? At least you’re honest about your priorities. Your inability to accept responsibility for the results of your own choices nicely demonstrates Dr. A’s point, too.

      MANA’s own data shows homebirth has a death rate 3 to 4 times that of hospital birth. Breech babies are 300x more likely to die at home. HBAC babies are 6 times more likely to die at home.

      Personally, I find babies being allowed to die for the sake of avoiding a doctor’s cold hands to be very offensive.

      I’d rather be the paying customer of an OB and hospital than of a CPM and a funeral home.

      • The Bofa on the Sofa

        So, a pleasant birthing experience is more important than lifesaving medical care?

        And even that just begs the question.

        I’ve not had any children, but I would think that the pain commonly felt in childbirth is sufficient to make it so unpleasant that no amount of Enya or scented candles is going to make up for it.

        • Sarah

          Enya might make it worse…

        • demodocus

          I had my husband sing; I think it mostly helped give him something to do. I liked the Handel.
          Then he started singing kumbaya to our newborn. I debated getting off the bed and strangling him but it was too much effort.

        • sdsures

          An OB who loves to singing in theatre to the new babies he greets! <3 https://www.youtube.com/watch?v=NBrhF77Hqag

          • KeeperOfTheBooks

            Awwwwww!
            The first time I met my OB, he was tossing an obstreperous toddler around while singing the “Spiderman” theme song so that the toddler’s mom could finish some paperwork without having it stolen/shredded by said toddler. I decided then and there that I liked that guy. 😀

    • Azuran

      As they say, truth hurts.
      Sugar coating it doesn’t help anyone.
      You put your baby in a car without a car seat, had an accident and the baby died? Well, it’s your fault that it died. (and claiming that it could have died as well if it had been in a car seat does not make it less stupid to not use one)
      Same goes for homebirth. You had a home birth and your perfectly normal, to term baby died? Well, IT IS your fault. Chances are, your baby would still be alive if it had been born in a hospital. Home birth has a higher death rate and brain injury rate. It is known and if you decide to still go for it, then it’s your fault if something happens to the baby.
      That’s the truth, whether you like it or not. And it needs to be told.

      If you don’t say the truth, people will not learn and will keep on making the same mistake and convince more people to follow their lead.

      • Roadstergal

        “and claiming that it could have died as well if it had been in a car seat does not make it less stupid to not use one”

        Exactly. Pointing out a story in the news where a baby died despite being in a car seat does not change the actual numeric risk to driving with your baby unrestrained vs in a proper car seat. And it doesn’t change the fact that foregoing a car seat for your baby because it’s a more pleasant driving experience for you is quite short-sighted.

    • Young CC Prof

      I had to let strangers carry away my newborn baby, because he needed help. It was the hardest thing I’ve ever done, and I would do it again in a second. They saved his life, cared for him tenderly, and gave him back to me, healthy.

      Cold hands? Better than empty arms.

  • jaydeezy

    These kind of people ALWAYS know more than anybody else does. And when it’s proven that they don’t, they always blame everybody but themselves. The comments on this article are proof enough of that. That’s why I can’t stand the “alternative medicine” crowd. Always insufferable know-it-alls, and then when the baby gets hurt, it’s cry time, as if their choices didn’t directly lead to it. I’m glad that many of them get hysterical when they read this article. Maybe next time they won’t do the maternal equivalent of throwing their baby into a box of broken glass and wondering why it got cut.

    • audacia

      Yes, and this woman knows it all right? Even though there is information out there that contradicts this. Do you truly believe that science cannot be bias? I like science but I have to understand that it is not always right. Sometimes hospital births are necessary but not always. Your comment is just silly and it compliments this blog well.

      • Wren

        I could easily have given birth to my daughter at home. Heck, I was 10 cm dilated when I got to the hospital. I completely agree that hospital births are not always necessary. What you are leaving out is that there is no way to know in advance which ones will be necessary.

      • Daleth

        “This woman” is a Harvard-educated obstetrician (and mother of four children), and her information comes from peer-reviewed scientific studies. Personally, between her and some “trust birth” blogger who works as a doula or has a degree in marketing (Ms. “VBAC facts,” I’m talking to you), I’m going to go with Dr. Tuteur.

      • Roadstergal

        “I like science but I have to understand that it is not always right”

        Stupid ‘science’ with its self-correcting mechanisms that continue to let us haltingly, slowly ease our way towards greater and greater accuracy. I’d much prefer a midwife who never admits to being wrong, who is always certain, who has ‘other ways of knowing’ that are much more legitimate than ‘studies’ and ‘numbers’ and ‘quantified risk.’ Statistics are a tool of the patriarchy.

      • Roadstergal

        Also:

        “Do you truly believe that science cannot be bias”

        Science is a process. It is what it is. _People_ can be biased and can misapply science, yes. You can then apply science to understand and account for bias. It’s a really great tool.

      • The Bofa on the Sofa

        I like science but I have to understand that it is not always right.

        I don’t understand. In the post above, you criticized Dr Amy for doing “kitchen calculations” and not being a researcher or publishing in peer reviewed journals.

        However, this comment seems to be a concession that the calculations are right, but sometimes science is wrong.

        Can you tell me how you figure out when science is right and when it is wrong? Aside from when you do or don’t agree with it, I mean….

        • audacia

          I was trying to point out a contradiction, you see. She claimed that the science backs up everything she says and clams that people try to understand studies that they are not qualified to. Yet, she is not a scientist herself. That was from an article a couple years ago. But yes, sometimes science is bias…do you not agree?

          • The Bofa on the Sofa

            But yes, sometimes science is bias…do you not agree?

            Yes, but so what? Is there any reason to think that applies here?

            Why is what Dr Amy suspect because of potential bias in science, but your objections are not? It’s just as likely that your objections are wrong because of bias (actually, more likely since you don’t have any basis for objecting in the first place).

          • audacia

            Because she is blaming women for the death of babies. I am not a Dr. telling women that hospital births are wrong and if your baby dies…it’s your fault. Wtf..There is evidence that supports the contrary and we can go back and forth arguing the strengths and weakness of either one or claiming that one is using a better method.
            These are pretty outrageous claims this woman is making and it can be pretty devastating if you read this after the death of a child.

          • The Bofa on the Sofa

            Because she is blaming women for the death of babies.

            When people make choices that lead to bad outcomes, who should be blamed instead?

            If I choose to drink and drive and kill someone, is it not my fault? Sober drivers kill others in car accidents, too.

            And how does blaming mothers for the deaths of their babies change the facts that homebirth is more dangerous than hospital birth?

          • audacia

            You are really comparing drunk driving to women who are trying to do what’s best for their children?

            And I am a piece of work?

            “how does blaming mothers for the deaths of their babies change the facts that homebirth is more dangerous than hospital birth?”

            Again there is evidence that supports the contrary . So we are at a stalemate.

          • Roadstergal

            “You are really comparing drunk driving to women who are trying to do what’s best for their children?”

            You’re the statistics major. Do relative risk of killing your baby by driving drunk with her in the car vs. killing your baby by delivering at home in Oregon vs the hospital. Show your work. I gave you a head-start upthread.

          • The Bofa on the Sofa

            You are really comparing drunk driving to women who are trying to do what’s best for their children?

            And drunk drivers are doing what they think is best for themselves, too. But their intentions don’t matter. I can mean all the best, but if I make a choice, and that choice is responsible for a bad outcome, then that means it comes back to me, and the choice I made.

            Again there is evidence that supports the contrary .

            The commentors here generally like to learn new stuff, so if you knew of some good evidence regarding the safety of homebirth in the US, we are always willing to hear it. Clearly, we are unaware of it, and since your search skills are so much better than ours, why don’t you help us out. Educate us.

          • The Bofa on the Sofa

            To add, audacia, if you really want to discredit Dr Amy, the best thing to do would be to actually present that evidence that supports the safety of homebirth. And then when she tries to discredit it, show how the evidence is correct and her interpretation is wrong.

            If you can do that, you will a) be the first, and b) effectively discredit her.

            And don’t you dare say that you aren’t interested, because you have already tried to discredit her, using an ad hominem approach.

          • Amazed

            Evidence that’s convincing only for those dumb enough to believe it shows the truth. But never mind. You aren’t going to bother with facts, eh?

          • Daleth

            If there is such evidence, post it. The fact that you haven’t posted it despite several requests from folks here tells me that you have no such evidence; you just assume that X is true and therefore also assume that there must be evidence to support that… But there isn’t, as you’ll find when you go looking for it.

            And yes. We are comparing drunk driving to other bad decisions that can end in permanent injury or death to yourself or other people (such as your own baby). Believing that X is safe when it isn’t, or that it’s unsafe for some people but the bad outcomes magically won’t happen to you because you have “the right attitude” or whatever, is a bad idea regardless of whether X is driving drunk or giving birth in a kiddie pool in your living room. The topic of your incorrect belief doesn’t make the incorrect belief somehow more valid.

          • Rosalind Dalefield

            Drunk driving is totally comparable to choosing homebirth because both significantly increase the risk of harm to oneself or others. Both are grossly irresponsible. If a drunk driver kills themselves or other people, they are responsible. If choosing homebirth costs a woman her life or that of her baby, she is responsible.

          • Who?

            It’s more an analogy, than a comparison.

            There’s one great way to shut everyone up.

            Post your evidence.

          • The Bofa on the Sofa

            Actually, ignore what I wrote below.

            Because she is blaming women for the death of babies.

            How does that even follow? How does blaming women for deaths of babies mean she is biased? Do you think she blames them first, and then is looking up data to support it?

            Your response doesn’t make any sense. We can argue about the ethical issues of responsibility, but that has no bearing on the scientific questions about the safety of homebirth.

          • Amazed

            “There is evidence that supports the contrary”.

            There is? Really bitch? Really?

            Shut your fucking mouth until you know what you’re talking about. There were people like you who thought it was all a great way to show how smart they were and how they knew better than ’em doctors. And they advised a friend of mine to wait till the very last moment before she went to the hospital to give birth to avoid them dangerous interventions.

            Luckily she’s too down to earth to listen to crap like yours. Thank god. Because the placenta started detaching and she was where she needed to be for the emergency C-section that saved her baby’s life. Healthy baby, healthy mom, soon to be discharged. It happened yesterday.

            It’s all an intellectual game to bitches like you. But to real moms and babies it’s life and death so shut your complacent trap and fuck off. Go clutching your shit of “evidence” and stay under your rock, safely away from vulnerable people.

          • audacia

            Lmao. Wow forget your bi-polar meds today did ya? I don’t try to argue with internet tough guys.

          • Amazed

            Actually, I forgot the pole I use to the hides of internet scum like you. Go away, vermin. You never know who you’re going to kill just so you can play your games pretending to be smart.

          • The Bofa on the Sofa

            Do have anything to contribute besides ad hominem attacks? First Dr Amy, not Amazed.

            Why don’t you go respond to my comment about Dr Gruenbaum. What ad hominem can you find to discredit him?

          • Roadstergal

            You’re arguing completely unsuccessfully with everyone.

            *statement and data*

            “That’s not right! She’s meen and not all sciencey, like I am!”

            *more data*

            “That can’t be right! Science can be biased!”
            Etc etc.

          • Sarah

            So’s your face.

          • LibrarianSarah

            Because a life altering mental illness is so funny! Ewww you don’t want to be one of those icky “crazy” people do you! LOLZ people need medication to function!

            /mockery

            I suggest you take Amazed advice and fuck off.

          • audacia

            Your right -people with mental illness have much more of my respect than Amazed and people who write LOLZ…

          • LibrarianSarah

            So you decide to double down on being a bigot then? Okey dokey.

          • audacia

            You guys are fun. I am a bigot. Ok then…I will list that on my twitter account next to feminist. Audacia the feminist bigot 🙂

          • LibrarianSarah

            Radfem?
            Don’t forget to add #Solidarityisforneurotypicalwomen

          • audacia

            Please you know nothing of me. So don’t try to sum me up by an internet comment after I was responding to someone who called me a bitch. What no response to that? Although, I will apologize to any one with an actual mental illness. My mother is actually a paranoid schizophrenic.. I think you should consider your own hypocrisies.

            It seems that you only extend your advocacy to those who you agree with. I would like to agree with you but you are too inconsistent for me to take seriously. You called someone stupid in your previous post so maybe you should save that # for yourself…

          • Who?

            Just post the stats in evidence of your position.

          • Roadstergal

            The data you claim exists that shows that homebirth is safer than hospital birth – show it to us.

            The data posted in this thread showing increased perinatal mortality and hypoxic injury to babies at homebirth – give us the specifics on why it’s wrong.

            I don’t know how we can be any clearer.

          • LibrarianSarah

            Yup I am okay with the word “stupid.” I am not against insulting people. I am against using the disabled and the mentally ill as ready made insults. I’m against punching down. Just so you know “stupid” comes from the word ” stupidus” which means “amazed, confounded, dull or foolish.” It is related to the word “stupor” and has nothing to do with the conversation.
            Not that any of this has anything to do with the fact that you used the mental ill as a weapon and now you are using your own mother’s mental illness as a shield.
            The fact that you can’t even take responsibility for your own words and just keep making excuses and lashing out shows that you have a lot of growing up to do.

          • audacia

            According to Merriam-Webster, the words “stupid” and “stupidity” enter the English language in 1541. Since then, stupidity has taken place along with “fool,” “idiot,” “dumb,” and related concepts as a pejorative appellation for human misdeeds, whether purposeful or accidental, due to absence of mental capacity.Oh but what about those poor individuals that hadn’t been raised with the privilege of a proper social context as you? I mean why stop extending your empathy? I am not hiding behind my mother..my family and I have always joked about such things because it’s a way to release tension and to deal with issues. But as long as your on your high horse and ok with it..I will also add I think context is important too. I’m not one of those people that get upset about people that joke about rape either (in the right context) either.I can tell already from your posts that you would disagree…to say the least. But that’s the way I feel. I don’t think making everything political or censoring peoples language is going to help. I think that the person calling me a bitch was acting irrational so I think I defended myself in a way that was certainly not the high road because I am an individual that is not perfect and apparently a heartless bitch. I suppose its insensitive but…I could really care less for someone that called me a bitch/vermin and for others that went along with it….So maybe I need to grow up but you need to get over yourself.

          • audacia

            Anyway- beyond all these endless jabs,useless snark and “lashing out” -I’d like to add that I don’t think home births are necessarily better or that we should go back to the dark ages. Modern medicine is great and should be used. There should be better standards/training for those involved in home births but I am completely against, unapologetically against this Dr. Amy and her claim that women are at fault if their baby dies of a home birth.

          • Who?

            People involved in homebirth should tell the truth about their training, experience and expertise compared to trained medical professionals, and should be honest about what they can do in the event of something going wrong, aside from calling-usually very late-for help from the medical professionals they otherwise dismiss and ignore.

            It is the attendants themselves who blame the mother, by reiterating
            that everything that happened was her choice, despite their earlier
            assertions that they are there to provide help.

            If women knew all this they would have a real choice about where to give birth, based on accurate information not the self serving spin of the homebirth industry.

            No one takes responsibility when a baby dies at home birth-the attendants head for the hills, parents are devastated, and the medical professionals called on at the last moment are traumatised, and often on top of that stigmatised by the attendants who have let their clients down. Sometimes they even get sued.

            When a baby dies in hospital the entire process is reviewed, lessons are learnt and training and standards are updated if required.

            Nice that you had time to consult the dictionary but not time to put together that list of sources that made your (now apparently somewhat amended) point about home birth.

          • Rosalind Dalefield

            You can add ‘troll’ too.

          • Nick Sanders

            So much respect that you use them as a casual put down.

          • audacia

            I know of everything written on this page….it is my comment that is truly tragic.

          • Rosalind Dalefield

            This post intentionally derides mental illness. Only a very nasty person would intentionally deride mental illness.

          • audacia

            No-you just don’t like my opinions and now you are suddenly an advocate for the feelings of the mentally ill? I don’t think so….

          • LibrarianSarah

            I know you are replying to Rosalind Dalefield but a AM an advocate for the mentally ill (and the intellectually disabled, and the developmentally disabled all nonNT’s really). Just because we comment on this website doesn’t mean that we don’t have any outside interests.

            I hope you take a good hard look in the mirror because bigotry against some of the most vulnerable people in our society is pretty disgusting behavior.

          • Megan

            At least you’re finally admitting that all you’re spouting here is opinions.

          • audacia

            Yes, and make no mistake. Everyone on here is spouting opinions.

          • Roadstergal

            In all of the time you’ve spent typing out all of these content-free comments, you could have shut us all up immediately by showing us the data.

            The data you claim exists that shows that homebirth is safer than hospital birth – show it to us.

            The data posted in this thread showing increased perinatal mortality and hypoxic injury to babies at homebirth – give us the specifics on why it’s wrong.

            I don’t know how we can be any clearer.

          • Megan

            Actually, I’ve seen at least two people list data for you and ask you to give your expert statistical analysis on it and yet, you have yet to respond to that.

          • Rosalind Dalefield

            My father had bipolar disorder and eventually committed suicide as a result, you heartless bitch.

          • Amazed

            I’m so sorry, Rosalind. I do have a mentally ill relative and I do have some idea of how hard it is. Nothing compared to what you’ve been through. It’s disgusting when people like audacia use the label as an insult.

          • LibrarianSarah

            I’m sorry Rosalind. My mom has struggled with BPD in the past as well and I can’t imagine what I would do if it took her.

          • audacia

            And I am suffering because from my bitchiness now. I have to read through all of these comments. What no compassion?

          • Rosalind Dalefield

            No you don’t have to read through all these comments. You could just go away and stop trolling this page.

          • The Bofa on the Sofa

            OK, here you say that you read through all these comments. Yet, you failed to respond to repeated requests to provide us with the evidence that you claim is out there showing the safety of homebirth. If you have read all the comments, I can only figure that is deliberate.

            Why is is that whenever we have these blowhards come in thinking they know everything, they spend their whole time responding to comments about insults or other such stuff and always conveniently ignore the substantive comments? It’s like they’d prefer to talk about everything but substance.

            And it happens all the time.

          • Who?

            You’re very touchy on the receiving end of bad language, I notice.

          • Nick Sanders

            Classy.

          • Cobalt

            And that is an example of using a description falsely and gratuitously as an insult. This is to be contrasted with describing actual narcissistic behavior as narcissistic.

            So, when someone uses these labels accurately, you call them mean. But you allow yourself to use them in a way that is deliberately offensive (to those with mental illness) and inaccurate, and that’s ok.

            Wonderful display of integrity. Fits nicely with “it’s wrong to blame people that allow their babies to die from lack of medical care because they are more comfortable on the couch for the baby’s death” and “telling the truth about homebirth isn’t the way to improve the homebirth community”.

          • audacia

            You people are truly insane. And my mom has schizophrenia…

          • Roadstergal

            You are, officially, boring. You’ve had all the time in the world to show us why we’re wrong, and to show us this quality data that stands in opposition to all of the data we have on hand.

            The only conclusion I can come to is that you have no data, and are just pissy at all of the data that shows the opposite of what you know, W-Bush like, deep in the truthy part of your gut.

            Yawn.

          • audacia

            Really, I am just starting to entertain myself.

          • Megan

            So you admit you’re a troll then? Makes sense. Trolls can’t provide citations to back anything up.

          • Cobalt

            Blaming someone for a baby’s death is the right thing to do when they chose to deny the baby medical and death is a result. If sit around and knowingly let your baby die, yes it is your fault.

            And if you’ve actually “done your research”, you’ll know everything that causes completely preventable deaths at home. You’ll know that in an emergency the baby may well be dead before an ambulance can even be dispatched. You’ll know that CPMs cannot provide any real medical care.

          • Daleth

            If there is evidence that supports the contrary, please post a link.

            That being said, I can’t even tell what you mean because your writing is too unclear. “The contrary” to what? The contrary to “hospital birth is safer than home birth”? Or to “home birth is unsafe”? Or to “when babies die in the hospital it is [or is not] the mother’s fault”?

            I once heard a saying that may be of interest to you: “Writing is nature’s way of showing us how unclear our thinking is.” In other words if your writing is unclear, it’s because your thinking is unclear.

          • audacia

            No I was referring to the previous post..try to keep up.

          • Roadstergal

            The data you claim exists that shows that homebirth is safer than hospital birth – show it to us.

            The data posted in this thread showing increased perinatal mortality and hypoxic injury to babies at homebirth – give us the specifics on why it’s wrong.

            I don’t know how we can be any clearer.

          • Who?

            How does the homebirth community react to the deaths of babies in homebirth? Loss mothers who post here say they are shunned, attendants ‘lose’ or refuse to hand over records to assist at post mortem, and tell them their baby wasn’t meant to live.

            Has that been your experience?

          • Cobalt

            I’m sure it would be additionally devastating. Better to get this information to mothers BEFORE they choose to take pointless and unexamined risks with their baby’s life. You know, the opposite of what CPMs do.

          • Cobalt

            So how do you explain the MANA study, conducted by homebirth CPMs, that agrees with all the mainstream research that homebirth results in at least three times more deaths? Were the CPMs biased against themselves?

            What about the data released by CPMs on the death rate at homebirth in Oregon? There was an eight times higher risk of death at home according to the homebirth midwives.

          • Daleth

            She is a medical doctor. Doctors are qualified to read medical studies–in fact it’s part of their job.

            Can you give any examples of science being biased? Can you explain why you think, in those examples, that it was biased?

          • audacia

            Really? We live in the internet age. If you are truly interested type those letters and hit enter or read a book-there is plenty of information out there. Geez..

          • audacia

            And btw, I know plenty of doctors that cannot figure out basic statistics. I saw this first hand.

          • The Bofa on the Sofa

            Are you google educated in statistics, too?

          • audacia

            Ouch. Nah, I have taken at least 3 courses in statistics. But I’m not claiming I know everything now so settle down. I like your claim that I am google educated though because I told you to look something up via a book or google scholar…Try it though.. it may do you some good love.

          • Roadstergal

            Wow, 3 whole classes in statistics. I’m sure nobody commenting here can match that.

            Why not show us exactly what your 3 classes in statistics allows you to do? Show us how the data cited in the papers referenced above was incorrectly gathered and/or analyzed.

            I’m particularly curious about what you think of the Oregon data on planned birthplace. It was collected and analyzed by a homebirth midwife, so it should be ‘bias’ in the direction you think is right, if at all.

            https://olis.leg.state.or.us/liz/2013R1/Downloads/CommitteeMeetingDocument/8585

          • audacia

            Yea I knew some patronizing a-hole would have something to say. I may have only 3 classes of stats under my belt but many of you folks just have reading comprehension problems. I would work on that before you go point fingers.

          • The Bofa on the Sofa

            So bring on your extensive statistics knowledge and explain how Dr Amy is wrong in her statistical analysis.

            Or consider this analysis by a statistics professor

            http://www.skepticalob.com/2014/02/a-statistics-professor-analyzes-the-new-paper-from-the-midwives-alliance-of-north-america-mana.html

            We have people who know statistics around,** so please provide your great insight.

            **Actually, I’ve never taken a course in statistics. However, I have presented original statistics research at the Joint Meeting of the American Statistical Association, to an audience full of statisticians.

          • Roadstergal

            You’re the one who is trying to convince us that we’re wrong by saying you’ve taken statistics classes. We don’t care how many you have or haven’t taken, we care how clear your arguments are. Show us clear arguments. Show us data and analysis. That’s what changes our minds. “Science can be wrong” and “you’re being an asshole” are not in the least bit convincing.

          • Megan

            And yet you still bring no real data or statistics t the table to support your claims. Put up or shut up. We’ll assume you either don’t know what you’re talking about and/or completely made up your claims until you do. We like facts here and are unimpressed by ad hominem attacks meant to distract from the real issue.

          • Rosalind Dalefield

            Dr Amy is not one of them.

          • Who?

            Are you sure? Or did your interpretation differ from their interpretation. Just because you disagree with them doesn’t make them wrong.

          • The Bofa on the Sofa

            Wow, I’ve never actually met anyone who admitted that their Google Education matched real expertise.

            I’ve encountered them, but none have actually tried to defend it. You are a piece of work.

          • Roadstergal

            Oh, well, I’m convinced. I had initially thought that many studies with quality data converged on the same conclusion, but you telling me to use Google turned me right around.

          • Daleth

            The letters I type when looking for medical info are “pubmed.” Do you know what that is?

          • Nick Sanders

            It’s called the Burden of Proof.

      • Roadstergal

        Okay, I spent the last few hours overlooking your terrible writing (compliments instead of complements, your instead of you’re (below), other basic errors that make it clear how poor your communication skills are) in order to see if you have a point. Good scientists can be bad at writing, lawd knows – I have worked with plenty.

        You have no data, just baseless opinions. You have weak-ass insults to sprinkle amongst your baseless opinions.

        My mind is open to being changed. I changed my mind on breastfeeding, eg, after being shown good data and discussion on the subject. But without good data and discussion grounded in reality, you have convinced me of absolutely nothing. I still agree with Dr T that mothers who choose homebirth are taking a morally dubious risk with their baby’s life. A risk they are free to take.

    • Rosalind Dalefield

      ‘when the baby gets hurt, it’s cry time’
      If you look closely, I think you’ll find that when the baby gets hurt, it becomes ‘make excuses’ time or ‘protest that it would have happened in hospital’ time or ‘say some babies aren’t meant to live’ time.

  • audacia

    So…if I have a baby in a hospital and the baby dies as a result…is it my fault as well? Hmm…there’s much evidence out there that conflicts with your information.

    I feel sorry for any woman that has read your article after losing a baby after a home birth because of your pompous opinion. I guess your attitude was invoked by that elitist education you received at Harvard. And yes, science can be bias.

    Regarding this-“Moreover, Ken Johnson failed to disclose a major conflict of interest. He is the former Director of Research for MANA.

    The paper is a piece of junk designed to fool the gullible, and apparently that means you.”

    What makes you think that your data cannot be skewed? Is it not possible? Or perhaps, you are not as smart as you think you are.

    • Daleth

      if I have a baby in a hospital and the baby dies as a result…is it my fault as well?

      It depends. Did you only have the baby in the hospital because you had a home birth catastrophe and got rushed to the hospital just before the baby was born? Then yeah, it is your fault, although you may be in a sense blameless because most likely your home birth midwife flat-out lied to you about the safety of home birth.

      Did you have a baby in the hospital because you went to the hospital in labor, instead of first trying to give birth at home? Then no, it’s not your fault.

      • audacia

        I find it rich that you cannot find the contradictions in your own responses. I do not have children but I have done research on both sides. I found that hospital births in many cases can be more dangerous with risks on both sides. That is my point. That after reading that information and I still go to a hospital and my hypothetical child is hurt or dead as a result….is this my fault? That is the fault in your argument. And it’s detrimental to any woman reading this after losing a child. If I were such a person I could write a blog on the dangerous of hospital births and then claim that it’s your fault if the child is brain damaged or dead as a result. It’s a pretty low stance to take. And btw. Nobody is attacking her on this comment section. I’m sure she’s home in her robe…she’ll be fine.

        • Daleth

          It’s actually not a fault in my argument. I think what your research missed is the fact that although things do sometimes go wrong in hospital births, the chances of a baby dying or being brain damaged in a hospital birth are much lower. If you just count how many babies die or are brain damaged after hospital births, it looks like a bigger number, but that’s because in this country about 98% of births happen in hospitals and only about 1% happen at home.

          What actually matters isn’t the raw numbers (i.e. how many babies died in hospitals or at home), but the amount per number of pregnancies. If 10,000 low-risk women do home births and another 10,000 low-risk women do hospital births, the home birth group will have about 13-14 dead babies while the hospital birth group will only have about 4, and the home birth group will also have about 17 times as many brain damaged babies.

          That is what we mean when we say home birth is more dangerous than hospital birth: it is more likely to kill or brain damage your baby.

          I don’t even understand why you think you could legitimately write a blog post that said it’s a woman’s fault if her baby dies in a hospital birth. Unless the mother did something like freebase cocaine shortly before going into labor, or refuse to consent to a c-section that was necessary to save the baby’s life, then the death of the child could not be her fault.

          • Cobalt

            Going to the hospital means you tried to prevent the death. You did everything you could to get a good outcome.

            Staying home means you couldn’t be bothered to help your baby survive.

        • Cobalt

          Please, show me your research that concluded hospital birth is more dangerous. Cite a study, I’m begging you.

          • audacia

            Even if I did-it doesn’t negate the fact that Dr. Amy’s findings from the study she cites is flawed….She says it herself in an interview. She also claims that women should have the choice….but yet, she writes this blog….ok

          • Roadstergal

            The data you claim exists that shows that homebirth is safer than hospital birth – show it to us.

            The data posted in this thread showing increased perinatal mortality and hypoxic injury to babies at homebirth – give us the specifics on why it’s wrong.

            I don’t know how we can be any clearer.

          • LibrarianSarah

            Just because you believe that people should have a choice doesn’t mean that you think that a particular choice is safe, or smart or without risks. I believe everyone should have a choice of what they eat but that doesn’t mean I think it is smart to eat nothing but chocolate ice cream.

          • Amazed

            How are they flawed? Why do you think so? Show us facts, not the “there’s evidence to the contrary!” rubbish you keep sprouting.

          • Cobalt

            So, you actually have no evidence to cite, nor can you describe how her findings are flawed. Maybe you just have “other ways of knowing”.

            And where in Dr. Amy’s post does she say women shouldn’t have the choice? She describes it as dangerous, immature, narcissistic, etc, but she never says it should be banned. The only regulation of homebirth she is calling for is better standards and accountability for homebirth “midwives”.

            There is a huge difference between calling something a bad option and actually trying to restrict access to it.

          • Who?

            Quite so. Choose what you like, then take responsibility for the outcomes.

          • audacia

            Of course there needs to be better standards. I agree with you. Better training is important.That’s why the US has higher rates of home birth deaths compared to other developed nations. Shouldn’t we be worried about this and advocating better standards instead of blaming women when things go wrong? And she is saying it’s a choice but…that title on for this blog. Do you really not see anything wrong with that?

            “She describes it as dangerous, immature, narcissistic, etc, but she never says it should be banned.”

            I think this is delusional thinking though. I mean do you really think she believes it’s a woman’s choice when she describes it this way?

            Say it’s an abortion debate..and a man claims that it’s a woman’s choice but it is “dangerous, immature, narcissistic.” I mean how would you feel if someone said something like? Would you truly believe he was on the woman’s side with confidence…sorry I cant get on board with this Dr. Amy train.

          • The Bofa on the Sofa

            .That’s why the US has higher rates of home birth deaths compared to other developed nations.

            Wait a minute.

            You claimed that there was evidence for both sides. Now you acknowledge that homebirth is more dangerous than hospital birth?

            “She describes it as dangerous, immature, narcissistic, etc, but she never says it should be banned.”

            I think this is delusional thinking though. I mean do you really think she believes it’s a woman’s choice when she describes it this way?

            Stupid choices are still choices.

            You make a common mistake. Just because a choice is allowed does not make it a good choice to make. There are a lot of things that we are allowed to do that are just plain dumb. And dangerous.

            “Riding a sled off a snowy roof into a wading pool” is not illegal. It’s stupid, idiotic and dangerous. It’s not banned, but it’s still a frat boy’s choice to do it.

          • audacia

            In the US. We are behind other developed nations. And I don’t believe that it is a dumb choice when we have individuals with good training, low risk and the right circumstances. Could something go wrong? Yes, but there is plenty of cases of unnecessary interventions, medical malpractice,ect. So, in these cases, I believe it should be a woman’s choice and no, I don’t think it is stupid.

          • The Bofa on the Sofa

            In the US. We are behind other developed nations.

            That’s for sure

            And I don’t believe that it is a dumb choice when we have individuals with good training, low risk and the right circumstances

            IF you can restrict it to “the right circumstances” you can minimize the risk, yes. And you might be willing to decide that the marginal increased risk is sufficient.

            BUT

            Even with properly trained providers, homebirth is riskier than hospital birth. Data from outside the US demonstrates that.

            Granted, it could be because those “properly trained” providers aren’t so properly trained as you think. For example, despite medical training, they are driven by ideology instead of by best medical practices.

            This is clearly demonstrated in the US. The bulk of homebirths are done by CPMs, which is a completely inadequate level of medical training. There are SOME CNMs that do homebirths (maybe 1% of homebirths are CNM attended?), but even for them, they are CNMs that are ideology driven whackaloons.

            Far and away, the legitimate US midwives, CNMs, won’t do homebirths, because they know damn well how dangerous they are. Consequently, the CNMs who will do them are the reckless ones.

            Other countries have more educated midwives that do midwives, but also have far more precautions in place. You can qualify all you want how “Homebirth is an acceptable choice under the right conditions”, and there is an argument for that. But what does that have to do with homebirth in the US? Nothing. Because those who do homebirths in the US don’t worry about those “right conditions,” they will take anyone who comes to their door (see Dr Amy’s post today as to why). Breech? Variation of normal, do it. HBACS? No problem. Pre-Eclampsia? Not a problem. Previous PPH? Won’t happen again. Midwife only has a high school diploma and no medical training? Peachy. No hospital backup? Lie about it. No malpractice insurance? Just sign a waiver.

            The day that the US homebirth community deals with these issues and their reckless behavior is the day we can start having the discussion about having homebirths in the US “under the right conditions.” Until that shit gets cleaned up, it’s not worth a start.

            Could something go wrong? Yes, but there is plenty of cases of unnecessary interventions, medical malpractice,ect

            Yes, if something goes wrong in a hospital, there are malpractice cases. But how is that a negative? In contrast, when a midwife fucks up and kills a baby, there’s NO recourse. I realize that money won’t bring back a dead baby, but it a) helps deal with the outcome, and b) it provides a mechanism for improving outcomes.

            No one likes bad outcomes, but at least with a hospital, you have recourse to cover your losses.

            So, in these cases, I believe it should be a woman’s choice and no, I don’t think it is stupid.

            Here’s a place where you and I are going to differ. Undergoing a medical procedure with a provider that does not carry liability insurance is the HEIGHT OF STUPIDITY!!!!!

            I don’t use a plumber who isn’t “bonded and insured.” Why would anyone put their life, or, more importantly, their baby’s life, in the hands of someone who can’t be held liable for any mistakes they make? That’s really fucking dumb.

            But that is what happens with homebirth in the US.

          • sdsures

            Low risk can and often does remain low risk…until something happens and it becomes an emergency, where the baby’s, and/or the mother’s lives are on the line. The adjectives “low-risk” and “unnecessary” (in regards to childbirth) can only be viewed with 20/20 hindsight.

            “Good training”? CPMs have BAD training.

          • sdsures

            I just wrote a reply to this post, and the reply disappeared. Is anyone else having this problem?

          • audacia

            That comparison is so outrageous btw. Again, comparing a procedure that woman believe is the best for them and their child to silly roof sledding. I can’t buy it. And I really don’t believe that you or Dr. Amy truly believe it should be a choice. If that is your opinion, I can’t make you believe otherwise but stop trying claim you think it should be a choice. ..

          • The Bofa on the Sofa

            comparing a procedure that woman believe is the best for them and their child to silly roof sledding. I can’t buy it.

            Why not? What’s wrong with it? Sledding is a roof is a choice that a) is not banned, but b) is still a bad one. And no one is talking about banning it. Therefore, the example demonstrates that it is possible to have choices available but that they are bad choices.

            BTW, whether you “buy it” or not, you might want to think more about it, and really, which is riskier – roof sledding or home birth? The difference is probably not near as big as you think.

            nd I really don’t believe that you or Dr. Amy truly believe it should be a choice.

            How can it NOT be choice? How can you force anyone to go to the hospital if if they don’t want to? It’s not possible to prevent anyone from having a homebirth. You can do what you can to prevent incompetent providers from assisting and facilitating homebirths, but even then you can’t because they do dishonest things like claim they are just there as friends providing support.

            So homebirth HAS TO be an available choice. The only alternative is that you forcibly remove someone from their home, and that only can apply if you know they are in labor.

          • Megan

            Why are you still here? You have conveniently ignored all the requests that you back up your claims with evidence, because that evidence does not exist. So what is the point of your presence exactly?

          • Who?

            Oh right-you have nothing, but Dr T is using flawed studies, therefore your position is superior to hers.

            Got it.

            And yes, that was sarcasm.

    • Who?

      Remember, your homebirth attendant will tell you it is all your choice, your responsibility. What she won’t tell you is what she can’t do, what conditions she can’t recognise, and what the relative likelihood is of those arising, and what might happen if they do.

      So who else is responsible for what happens in a homebirth-that it is all up to the mother is the homebirth midwife’s standard position. I don’t understand why you don’t see that.

  • Amy should be quiet

    I’m going to set aside my enormously over educated linguistic style for a moment, because I can think of no better way to say this, “Yo Amy, you a bitch!”

  • more educated then you

    This is the nastiest blind article I have ever read. It is a cheep and tired trick to blame the masses when the problems remain in the medical care system. Ms if you’re worried homebirths are going to make your job redundant your right. If your aim is to change peoples opinion of the medical care industry then maybe you should point your skeptical eye in that direction and perhaps read some articles you have apparently avoided when this post was listed. Let me do the work for you and tell you why people are turning away from overpriced OBGYNs.
    Many see the modern doctor as a misogynist keeper of medical knowledge using stress to influence the mother into scheduling her birth ( or
    c-section) so it can fit their busy schedule of ego centrism.
    After one looks at the birth death rate in America, which has dropped below 3rd world levels, it is obvious that a change in how modern hospitals treat
    and view pregnant woman isn’t just necessary, it’s the only humane
    option. Hospitals seem to be looking at the mother
    as a customer more then a human.
    It is these reasons and more that people are willing to take the risk and ignore your fear mongering and have home-births, instead of having their child killed with unnecessary techniques the medical care industry employs as standards.

    • Daleth

      Home births represent maybe 1% of births in the US. Given that number, it’s laughable to suggest that any OB in America is “worried homebirths will make their jobs redundant.” The reason virtually all OB’s oppose home birth is because home birth is 4 times more likely to kill your baby and 17 times more likely to leave it permanently brain damaged than hospital birth. (Oh, and those numbers are for all mothers–for first-time moms attempting a home birth, the numbers are much higher).

      • Squillo

        Exactly.

        How many patients (OB and gyn) does the average OB have in a year? A 2012 Medscape survey suggests between 2500 and 3750 (if we assume a yearly two-week vacation.) A 2003 ACOG-sponsored survey (the most recent I could find) says OB/gyns averaged 186 deliveries per year. So, using the most conservative estimates of OB patient load, each patient lost to homebirth would represent 0.53 percent of the doc’s DELIVERY income. It would not, of course, affect gyn income, so in reality, the total percentage of income lost is orders of magnitude smaller.

        So, no, I don’t think most OBs are feeling financially threatened by homebirth.

  • Amy Tuteur, MD
  • Annie

    I am very saddened by the tone of this post. My sister lost her son during her home birth 8 months ago. She sent me this article. After reading it I called her to see how she was as I was very upset by the brutality of your words. She was hyperventilating through her sobs. I couldn’t do a home birth after the lost of my nephew, but I respect the reasons for home birth.

    I am not here to argue home birth vs. hospital birth. I am here to say that your approach for education on home birth is insensitive and it disgusts me. You have no idea how much you are twisting the knife for those who have experienced such a horrific loss. You don’t need to place blame. They already struggle with a guilt that consumes them at times. Please do kick people while they are down. I would ask you to remove or rewrite your post and think about who your audience might be and if you are doing more harm than good. I know your words are going to replay in my sisters mind for a long time.

    • Daleth

      I’m really sorry for your sister’s son, who never got a chance to live.

      I’m also really sorry for your sister. The loss of a baby is a horrific thing to live with. And knowing that it almost certainly wouldn’t have happened if she had chosen to give birth in the hospital must make it infinitely, inexpressibly worse.

      Something that I hope will help your sister feel less guilty is the knowledge that she was lied to. Home birth midwives routinely lie to their patients, reassuring them that home birth is as safe as hospital birth–which is a flat-out lie. Here’s a link to an article on that written by a former home birth/birthing center midwife: http://www.honestmidwife.com/wp-content/uploads/2015/04/High-Risk-FINAL1.pdf

      And there are countless websites on which women lie to each other about home birth, and also about modern hospital birth–they portray hospitals as places where you are forced to lie on your back throughout labor, given episiotomies routinely, etc.–things that haven’t been done in hospitals since the 1980s. They lie about “interventions,” claiming that epidurals affect babies (they don’t–the meds never enter the mom’s blood stream and thus cannot reach the baby), claiming that doctors do c-sections just to get out of the hospital in time for their golf game (they don’t–most OBs work in shifts so if the baby doesn’t come by the end of their shift and the baby is still ok, they just leave and have the next OB come in for the rest of your labor).

      The natural childbirth movement, community, whatever you want to call it, is built on lies. And your sister got sucked into that, brainwashed basically with beautiful lies about how wonderful home birth is, and her baby son paid for those lies with his life.

      It is not herself your sister should be angry at. She should be outraged at her midwife, her doula (if she had one), every bullshit website she read that lied to her. I for one wish she had found Dr. Amy’s site before her son was born. That might have saved him–and that’s why Dr. Amy’s site exists.

  • Rach

    The attitude of this OB and her cruel words are exactly the type of thing that make people want to avoid hospitals like the plague. Here are the reasons I despise hospital births: The cold uninviting atmosphere of the room. Shifty uncomfortable hospital gowns. The position you have to assume because it’s most convenient for the physician (although it is not conducive to assisting with birth for the baby or mother). The IV in your arm and poles with fluids. The fact that you cannot have water even though youre doing hard work for hours (they offer ICE CHIPS). The fact that all the staff members there are paid and on the clock, therefore you must birth by their schedule and their direction because they have places to go and other things to do. (For my second child, I was told to stop pushing because the doctor wasn’t there yet. WHAT THE HECK!!!!) After your baby is born you get to hold them for a only a few moments before they are wisked of weighed, poked, and prodded by a total stranger. When they feel you’ve had enough time with the baby and the need to clear the room for the next mom in labor, they take your baby and draw labs, give vaccines and put them in the baby warmers until THEY feel you are ready to have your baby back. All of this is done by a staff who like the author of this article have a major condescending tone and superiority complex. You wonder why a mother chooses home birth???

    A friend of mine who is a labor and delivery nurse said that I can refuse anything I didn’t want, but that’s not true. After 6 tries to get an IV and failing, I told the nurse that I didn’t want an IV. She got an attitude and huffed and puffed and left the room. After that another nurse came into the room and in no uncertain terms told me I WAS getting an IV and then stuck me two more times.

    It was a horrible experience from start to finish and the only pay off was when I looked into my babys face and kissed him. I am trying to conceive again and as long as the pregnancy has no complications, I WILL be delivering at home. All of who want to judge those of us who would like to be in control and have a beautiful birthing experience without the bullying can tell your snide comments to someone else!

    • Amy Tuteur, MD

      You seems to have missed the entire point. This woman believed as you do and her baby is dead as a result. Is your experience really more important than whether your baby lives or dies? If so, you are startlingly narcissistic and immature.

    • Jessica Nohara

      When your baby dies, I hope you feel intense guilt.

    • Daleth

      Do you really care more about spending a day or two in a hospital gown in a “cold uninviting atmosphere” than you do about your baby’s life and brain?

      FYI, the IV port (“heplock”) is there in case you hemorrhage–it’s very hard, sometimes impossible, to get an IV into the veins of a person who is hemorrhaging, because the veins deflate when they lose blood. And the problem with that is that unless they can get IV fluids and possibly blood transfusions into you very fast, you will die (look up “hypovolemic shock” and “hemorrhagic shock”). My IV port saved my life–I went into hypovolemic shock.

  • Nova

    Amy,

    You are so harsh and cold, no woman in her right mind would want you in the room while giving birth – be it a hospital room or a room at home.

    • Nova

      Furthermore, your sensational language undermines any validity you may have had.

    • Rosalind Dalefield

      What I read from Dr. Amy’s posts is a passionate desire to see babies born alive and healthy. That’s hardly ‘harsh and cold’.

  • Captain Obvious

    CEFM was originally hoped to decrease CP. it hasn’t. It has led to more interventions and cesareans. BUT, it has significantly decreased intrapartum stillborn and neonatal seizures. Wouldn’t you agree that is important. I would allow a vacuum delivery or cesarean instead of having an intrapartum stillborn or a baby on phenobarbital. But you go ahead and be gullible and believe the woo hype.

  • Nicky Pemberton

    Thank god that people would never dare speak their minds, in public, with so much venom, cruelty and lack of compassion as they have done here on this blog. Safely hidden behind their computers, people let loose the nastiness that they secretly harbour against one another and their intolerance for points of view that differ from their own. The internet has definitely created a platform for people to express themselves freely. Let’s remember though that we are human beings and its cowardly to hide behind usernames and slag eachother anonymously. We need to evolve past primitive emotional reactions and find some integrity in our expression. After reading this entire blog, it’s so obvious that some of these bloggers take a sick pleasure in writing their cruel comments. Crude slags at a woman who just lost her baby disguised as concern for innocent infants? Who are you fooling here? A pretty sad state of affairs is an understatement.

  • Nicky Pemberton

    The risk of AROM (artificially rupturing membranes) isn’t in causing a vasa previa but I understand what you mean. If the AROM is performed before the baby’s head is low in the pelvis, the umbilical cord may become trapped in front of the head, cutting off the oxygen supply to the baby. Impatient OB’s that perform premature AROM’s are negligent and this problem does contribute significantly to hospital morbidity as a STAT C-Section will be required and that carries it’s associated risks, not to mention the potential risk to the baby of asphyxiation due to the cord compression.

    • Captain Obvious

      Nicky, again your ignorance is showing. If a vasa previa is present, performing an AROM may rupture a vessel coursing over the area of membranes in front of the fetal head. Of course AROM doesn’t cause a vasa previa. Read and understand before you comment. And for OB eating mama, if a vasa previa is present, when SROM occurs, what do you think is going to happen? The membranes are going to rupture, en caul is vary rare. Hemorrhage from vasa previa from AROM or SROM is almost a certainty. You picked a bad example. Some vasa previas can be detected by ultrasound visualizing Doppler vessels near the cervix, or by pelvic exam feeling a pulse in the membranes in front of the head. The woo genenerally discourage ultrasounds and pelvic exams so a doctor is more like to find and prevent a catastrophe from a vasa previa than a Homebirth midwife.

      • Nicky Pemberton

        Captain Obvious, “your ignorance is showing again”?
        Can people not have a decent discussion here? Again,
        slagging somebody under an anonymous username is cowardly.

        • Wren

          Perhaps if you hadn’t come in with insults and false assumptions you would have received a warmer welcome?

          • Nicky Pemberton

            Perhaps, but I don’t see a lot of warmth or welcome towards anyone here which why I’m signing off this forum.
            .

          • Susan

            Gosh, someone who posts here often just had a baby and the lines of congratulations warmed MY heart and I have never met her. Once in a while someone with a different opinion on the issue at hand comes in and is intellectually honest and polite; I don’t think those people would say they felt unwelcome or that the regulars lack warmth. It’s a smart group overall and what I most enjoy is if anyone, including myself, says something foolish they are called on it, and I have been from time to time. There are lots of people who post here that disagree with Dr. Amy on some point or another. What’s nice is she’s a grown up and so are we and we can deal with being confronted on issues. It’s healthy.

  • Nicky Pemberton

    It’s quite possible as well that Dr. Amy Tuteur is not who she says she is. I’ve never heard an OB speak so misguidedly or vehemently.

    • Wren

      Many attempts have been made to discredit her, but claiming she isn’t who she says she is, after years of running this blog, speaking in public and being involved in other skeptical blogs is a new one to me. It is quite possible that you made a completely ridiculous suggestion without the tiniest bit of evidence or research behind it.

      • Nicky Pemberton

        Yes, I realize that. After I posted that comment, I did do a short search and from that, she seems to check out. I was just so shocked by her commentary, I thought “how can this be?” but you’re right it wasn’t based on any evidence or research and I admit that fully.

        • Karen in SC

          Because of very vocal midwives and the lies they spout about how homebirth is safer than the hospital. In many cases, they even psychologically groom the parents so any tragedy, those grieving also take on the guilt, or ignore the incompetent care. (see above post)

        • Captain Obvious

          You sure do post a lot of comments, then do your research to find out you were wrong. Why don’t you try it the other way, read a little more then post.

          • Nicky Pemberton

            Thanks Captain OBVIOUS!! Lol!

  • QB

    Excuse me, Miss Amy, without the slightest intent of disrespect, I ask are you aware of the recent study of home-births? According to a new study, babies born from low risk mothers are no more or less likely to die in a home birth than low risk mothers in hospital births. With that being said the grieving mother whom you are condemning was no more inclined to have a living baby in her arms if she had delivered at a hospital. I hope you realize how vile and cruel you are being blogging hate to a mom who lost her baby.

    “Conclusions Planned home birth for low risk women in North America using certified professional midwives was associated with lower rates of medical intervention but similar intrapartum and neonatal mortality to that of low risk hospital births in the United States.”

    http://www.bmj.com/content/330/7505/1416

    In addition, I would also like to point out how TINY the absolute risks are for babies of low-risk mothers dying at all, in your outdated study that has been replaced. The risks in that particular study were ~0.7% for hospital births and ~2.1% (that’s 0.021 or 21/1000, ma’am) for home births. That means in every 979 (nearly a thousand) healthy happy babies only 21 (less than 30) passed away (In that study however). The authors of the study explained that because the risks are so small, it fluctuates between values of 1 to 3%, therefore, direct comparisons between the values are not appropriate.

    Can you please explain what is your bitterness about women teaching their newborns to use the potty so they won’t have to sit in their own stool, having them at home in the intimacy and privacy of family into a warm quiet familiar environment they were aware of as preborns, being healed with the herbs from the earth, or being breastfed extensively and/or with a younger sibling? Why does this disturb you when it does no harm, makes little ones happy, and welcomes a child into the world in love and deep consideration (as you implied, BFing is indeed hard). Why does nature disgust you, so much? It just doesn’t make any sense… Please explain.

    • Amy Tuteur, MD

      It’s not a recent study and it ACTUALLY showed that homebirth with a CPM in 2000 had a death rate 3X higher than comparable risk hospital birth in the same year. The authors have publicly acknowledged that they did not compare homebirth to hospital birth in 2000, but instead to a bunch of out of date papers extending back to 1969.

      Moreover, Ken Johnson failed to disclose a major conflict of interest. He is the former Director of Research for MANA.

      The paper is a piece of junk designed to fool the gullible, and apparently that means you.

    • The Computer Ate My Nym

      That means in every 979 (nearly a thousand) healthy happy babies only 21 (less than 30) passed away

      No, it means that for every 21 babies who died, 979 survived. Not necessarily happily or healthily. A baby with anoxic brain damage due to prolonged second stage which is severe enough to cause learning defects or cerebral palsy or even persistent vegetative state will not be among those 21 who died, but they will certainly be damaged by mismanaged delivery. Mortality is only the tip of the iceberg.

  • QB

    Is it my sister’s fault her baby died in a c-section?

    • Daleth

      Nope. And I’m really sorry that happened. The only way something like that would be the mom’s fault is if she did something like freebase cocaine during labor, or she attempted an unassisted or fake-midwife assisted homebirth that went badly wrong and was then unable to get to the hospital in time to save the baby.

      And in the latter case, it would only sort-of be her fault, because so many “midwives” and doulas and so-called “supportive” women online tell infinite lies about home birth, and some women get brainwashed into believing that home birth is as safe as hospital birth.

  • Sad Dad

    This just happened to my son Isaac, I was scared but my wife and the midwife reassured me constantly it was safe, got to the hospital too late, RIP Isaac July 2, 2013

    • The Bofa on the Sofa

      Oh how awful 🙁

    • S

      I am so very sorry.

    • yentavegan

      I am so sorry for your loss.

    • Bombshellrisa

      I am so sorry

    • Jocelyn

      I am so, so sorry.

    • Susan

      I am so sorry about the loss of your son.

    • fiftyfifty1

      Oh Sad Dad, I am so so sorry for the loss of your son.

    • Squillo

      I’m very sorry for your loss.

    • Box of Salt

      I am sorry for your loss.

    • Amy M

      I am so sorry to hear of your loss.

    • I don’t have a creative name

      This just breaks my heart. Yet another casualty of the NCB lie that tells women that birth is “safe”. It isn’t, and how heart rending that so many families have to find out the hard way that they’ve been lied to.

      I am truly sorry for your devastating loss.

    • I’m so sorry. So sorry….

    • That’s terrible. I’m sorry for your loss.

    • Daleth

      I’m so so so so so so sorry.

  • Megan E Powers Cma

    And what about MATERNAL mortality rate?
    Face it doc: the ONLY reason you down natural and homebirths is because YOU don’t as much MONEY. (NONE at all, since it requires a midwife) and you can’t STAND that! I can’t stand money hungry OBs like YOU, which is why I will ALWAYS use a midwife. What’s your c-section rate doc?? 30%? Higher? You disgust me, ESPECIALLY when you go against current ACOG guidelines

    • Amy Tuteur, MD

      What makes you think I would want an ignorant fool like you as a patient?

      Conspiracy theories are the “explanation” for everything among the those who don’t understand what they are talking about and who feel powerless. Thanks for dropping in and illustrating that point.

      • QB

        “What makes you think I would want an ignorant fool like you as a patient?”

        It doesn’t matter, you were fired decades ago. Jeez, why do you act so vicious and coldhearted , Amy?

        • Amy Tuteur, MD

          Do you always make things up to suit yourself or do you just make things up about me?

          • Nicky Pemberton

            This is a debate about home vs hospital birth. The real debate, however, is about competent birthing practices. Without more details it’s hard to know exactly what happened at this delivery however it sounds like perhaps the midwives were not monitoring the baby appropriately because they were “surprised” when the baby was stillborn. If this was in fact the case, these midwives were negligent. Negligence occurs both at home and in the hospital. People (including the very misinformed Dr. Amy Tuteur) seem to think that all home births involve hippie midwives singing to babies to revive them. This is pretty far from the truth. Here in Canada, home birth with a midwife is legal and covered by MSP. The midwives take the same NRP course as the GP’s, OB’s and paediatricians and they arrive for delivery with all the necessary equipment to fully resuscitate the baby if need be, the same as at the hospital, and are skilled and certified to intubate the baby. You should not be risking “ending up the river without a paddle” as commented here. If this is the case in the US, that’s appalling. Here, midwives are obligated to follow protocol. Transfer to the hospital, if needed, is streamlined in advance. As a perinatal nurse, I would not give birth at the hospital where I work, not because of the high mortality rate, but due to the very high morbidity rate for both mothers and infants. Definitely, OB’s need to address their skyrocketing C-Section rates, overuse of oxytocin and AROM before things will improve. Even though our midwifery program is very safe, the same hospital vs home birth debate goes on here too. It is mostly due to the public’s misguided perception that homebirths are provided by incompetent hippie midwives which is not at all the case. Many perinatal nurses on my unit choose midwifery care for their own births because it’s more thorough. Only very low risk births are attempted at home and some of these end up as hospital transfers, wherein upon admission to the hospital, an OB is waiting. The midwife remains part of the team and still follows the mother postpartum for 3 weeks. If no midwife is involved, the mother is discharged home at 24- 48 hours with only one follow up visit to the GP a week later. As for postpartum follow up by Public Health..what public health? Our Healthy Beginnings program was stripped of almost all it’s funding. The funding went directly to vaccination programs.
            In closing, Dr. Amy Tuteur is the kind of person that is not cut out for a caring profession such as medicine. Also, her ability to reason (or lack thereof) and arrogance are an example of how even medical specialists can fall short. Her argument is tantamount to a doctor blaming a mother for the death of her baby from a hospital acquired infection because she chose to deliver at a hospital with a poor record of infection control.

          • Wren

            Do you understand that a CPM, the type of “midwife” used in this case, does not compare in any way to midwives in the rest of the Western world? They do not have anything close to adequate training and are not working within the rest of the healthcare system at all. Transfers are generally no more than dropping the patient and running off, as they have absolutely no hospital privileges and generally do not hand over their patients at all. They have neither the equipment nor the training to perform their job adequately. Perhaps some understanding of that prior to your criticism would have been good?

          • Nicky Pemberton

            Yes, we used to have the same kind of problem here in British Columbia before midwifery was legalized. Why are these CPM’s still allowed to practice? Why don’t you have a legitimate midwifery care model available there? Where in the U.S. did this happen?

          • rh1985

            Well, there are certified nurse midwives, but I believe most of them deliver in hospitals.

          • Nicky Pemberton

            In Canada, we have Registered Midwives. They have admitting privileges and do practice mainly in the hospital. The still do a significant number of home births though. They have a higher level of education than American Certified Nurse Midwives. Some labours start out at home, however, if things don’t progress smoothly, the patient is transferred to the hospital and the MRP becomes the OB. A perinatal nurse is also assigned. Only low risk pregnancies where the patient lives in close proximity to a hospital are permitted. If a patient is transferred to the hospital, the midwife remains a part of the team and will still care for her patient postpartum. Our midwifery care is modelled after the Norwegian and Swedish ones as they have the best track record and lowest rates of mother/infant mortality and morbidity.

          • Bombshellrisa

            The midwife in question is a Seattle based CPM. She attended a friend’s homebirth and decided she wanted to be a midwife. If she had any proper training, this story would never have happened.
            Dr Amy has said time and again there IS a qualified credential for midwifery-in the US it is the CNM. The reason she speaks out against CPMs is they are the ones who are the most vocal, the most reckless and are by and large the provider women turn to for home births in the US. Most are more like Gloria Lemay and Moreka Jokular than a real healthcare professional. But they have a tremendous amount of support even from Certified Nurse Midwives and they know how to manipulate the political system enough to benefit from it.

          • Nicky Pemberton

            Thanks Bombshellrisa for your reply.

          • rh1985

            While I can’t explain why they are legally allowed to practice, I can explain the “demand” for them – I personally wanted OBGYN care so I don’t have personal experience, but from what I’ve heard from mothers I know online who used CNMs, the ones they saw were affiliated with OBs, delivered at hospitals, risked out patients, sent for detailed high risk ultrasound if needed, wouldn’t deliver vaginally if a c-section was indicated, etc. One mom I know of saw a CNM for the entire pregnancy, but her very flexible baby managed to go breech at full term so the affiliated OB gave her a c-section (she had no problem with this, some crazy people would). And unfortunately there is a radical part of the natural birth community for whom avoiding those things is their hill to die on, basically.

          • DaisyGrrl

            I’m also in Canada (Ontario). On the Ontario midwives association website, there’s a newsletter bragging about a midwife attending a homebirth over an hour’s drive from hospital (so had there been a complication, she could well have been screwed, even with air ambulance). Our midwives also attend VBACs.

          • Nicky Pemberton

            That doesn’t sound very responsible.

          • DaisyGrrl

            I agree it’s not very responsible, but it’s happening amongst educated midwives (similar to BC midwives) and this irresponsible behaviour is encouraged by the governing body. While the midwifery model of care is very attractive, I don’t think that can make up for some downright dangerous practices.

          • Nicky Pemberton

            Sounds like some new protocols are needed. I don’t agree with attempting a home birth unless the mother lives within close proximity to the hospital and the midwife needs to transfer as per protocol without delay.

          • Karen in SC

            New protocols, or just adhering to existing protocols, is what Dr. Amy is fighting for with this blog. Currently there are no penalties or censure or anything for midwives who don’t risk out properly.

          • Captain Obvious

            You do realize this blog is primarily about the undereducated, under licensed, underinsured CPM credential in the USA. You sound so ignorant and foolish when you come on here comparing apples to oranges. Read a little about the blog before you burst into criticism, you probably would agree with a lot of what is posted here.

          • Nicky Pemberton

            Captain OBVIOUS, Wren already explained that to me. I got it and responded. Why are you re-explaining that to me and continuing to call me ignorant (3rd time here)?

          • Karen in SC

            That was an earlier reply (5 hrs ago). The way Disqus nests posts and replies does make it difficult to follow comments in a time organized way. Also noting that many posted must remain anonymous due to work requirements etc.

          • Nicky Pemberton

            Thanks Karen, I appreciate that. What I don’t appreciate is people that sling mud on forums just because they can get away with it. I’m a perinatal nurse and have posted my name because I am not ashamed of anything that I have posted here and am willing to stand behind it with my name. I admitted when I had made a mistake (something that I don’t see anyone else doing here) and am not ashamed of that either. I believe it’s part of a healthy discussion and part of listening and learning from eachother.

    • Squillo

      Actually, natural homebirth doesn’t require a midwife.

      It’s kind of fun when someone parachutes in to tell us how money-grubbing ob/gyns are so afraid of homebirth cutting into their profits. Let’s look at some actual data, shall we?

      A midwife makes close to 100% of her income from her birthing clients. How many clients does your midwife have? Let’s be generous and say four. That comes to 48 births a year. Each patient she loses to hospital birth is a fraction more than 2% of her annual income. If she averages fewer births, that percentage rises quickly.

      How many patients (OB and gyn) does the average OB have in a year? A 2012 Medscape survey suggests between 2500 and 3750 (if we assume a yearly two-week vacation.) A 2003 ACOG-sponsored survey (the most recent I could find) says OB/gyns averaged 186 deliveries per year. So, using the most conservative estimates of OB patient load, each patient lost to homebirth would represent 0.53 percent of the doc’s DELIVERY income. It would not, of course, affect gyn income, so in reality, the total percentage of income lost is orders of magnitude smaller.

      So tell us again which practitioner has the greater incentive to ignore a patient’s/client’s welfare in order to squeeze every penny out of her?

    • Captain Obvious

      Here is One of Dr Amy’s comments about maternal mortality.

      http://www.skepticalob.com/2010/03/hold-handwringing-is-maternal-mortality.html

    • Daleth

      Does your midwife attend your births for free? No, she charges you several grand, correct? And she’ll charge you that even if your home birth ends in a hospital transfer and the baby is born there, with her not even in the building. I wonder why you don’t see her as money hungry.

  • letting your baby die should be child abuse not an accident.

  • Sara, God bless you, Im so sorry for your loss, one of the Midwives who was at your center did my prenatal care in XXXXX, I had a breech and I had had a previous C/S. She kept telling me all was fine you wont need an epidural blah blah blah… I have a family member who is a M.D., who educated me about this stuff. I immediately transferred care to an OB and had and really really wonderful C-section and a healthy living baby. Thank you Jesus!! Please keep on speaking up, what they did to you was beyond wrong!!

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