It must be awesome to have followers so gullible that you can make up whatever you want, no matter how idiotic, and your supporters will believe you. Ina May Gaskin, the ultimate fraud, should know. She makes it up as she goes along and homebirth advocates, among the least knowledgeable people alive on the subject of childbirth, promptly accept it.
Gaskin has made up “facts” about post dates pregnancy, maternal mortality, and animal reproduction.
Gaskin’s biggest lie? It’s hard to choose since there are so many and they are so stupid, but any top ten list of Ina May Gaskin’s biggest lies would have to include her “Sphincter Law.” Let’s let her explain it:
… I will start with the observation that the vagina and the cervix—not just the anus and the urethra—are sphincters, that is, the circular muscles surrounding the opening of organs which are called upon to empty themselves at appropriate times.
There’s just one teensy, weensy problem. Neither the vagina, nor the cervix are sphincters.
What is a sphincter? A sphincter is circular muscle that surrounds the opening of an organ, as the illustration below demonstrates.
The vagina does have some muscular fibers, but most its muscular strength is longitudinal and the cervix is not made of muscle or encircled by muscle at all. But Ina May is not worried about that since her followers don’t know any anatomy or physiology and are unlikely to check.
What is the anatomy of the vagina?
The vagina consists of an internal mucous lining and a muscular coat …
The muscular coat (tunica muscularis) consists of two layers: an external longitudinal, which is by far the stronger, and an internal circular layer…
So there is muscle in the vagina but the strongest fibers run longitudinally. In other words, it is not a sphincter.
How about the the cervix? According to Hassan et al.:
The uterine cervix is essentially a connective tissue organ. Smooth muscle accounts for less than 8% of the distal part of the cervix. Cervical competency, defined as the ability of the cervix to retain the conceptus during pregnancy, is unlikely to depend upon a traditional muscular sphincteric mechanism… It is now well-established that the normal function of the cervix during pregnancy depends upon extracellular matrix.
No, the cervix is not a sphincter, either.
The human body does have quite a few sphincter muscles including the anal sphincter and two urethral sphincters (internal and external). There are others: the upper esophageal sphincter, which opens as food passes into the stomach, the sphincter of Oddi, which controls the release of bile and pancreatic enzymes into the duodenum, and the iris, which controls the size of the pupil to regulate the amount of light entering the eye.
According to Ina May:
For anyone dealing with or organizing maternity care, probably the most important feature of sphincters to understand is that they function according to several factors:
- Sphincters open best in conditions of privacy and intimacy
- Sphincters open best without time limits
- Sphincters are not under the voluntary control of their owner. They do not obey orders, such as ‘urinate now!’, ‘push!’, or ‘poop!’
- Sphincters, however, do respond well to praise if there happens to be another person in the proximity of the sphincter’s owner. This other person might be the mother of toddler or a midwife assisting a woman giving birth
- The opening of sphincters can be facilitated by laughter (the owner’s)
- When a person’s sphincter is in the process of opening, it may suddenly close if that person becomes frightened, upset, embarrassed, or self-conscious. This is because high levels of adrenaline in the bloodstream do not favor (sometimes they actually prevent) the opening of the sphincters
- The state of relaxation of the mouth and jaw is directly correlated to the ability of the cervix, the vagina, and the anus to open to full capacity. A relaxed and open mouth favours a more open vagina and cervix.
Really? Let’s test these claims.
The iris opens best in conditions of privacy and intimacy? No. The iris opens and closes in response to the amount of ambient light and privacy and intimacy have no effect.
Sphincters are not under the voluntary control of their owners? Wrong. Whether or not a sphincter is under voluntary control depends of whether it is made of smooth muscle or skeletal muscle. Both the external urethral sphincter and the anal sphincter are under voluntary control. Indeed the entire point of toilet training is to teach children to control these sphincters?
High levels of adrenaline do not favor (sometimes they actually prevent) the opening of sphincters? That’s why when people are very frightened they do not pee in their pants or defecate. Oops! That’s obviously a lie.
In fact, every one of these “rules” is nothing more than a complete fabrication, as even the most cursory knowledge of human anatomy demonstrates.
Gaskin professes surprise that no one has mentioned the Sphincter Law before.
I would argue that Sphincter Law may apply in both the first and second stages of labour. In the first stage, most of us who have been midwives for several years have noticed that, once in labour, a woman’s cervix will occasionally close. I described the first such case (Gaskin, 1978), but I have found no other documentation in the 20th and 21st century medical literature of this rather common phenomenon…
That’s hardly surprising, Ina May, since you made the whole thing up.
There is a saying in science that extraordinary claims require extraordinary proof. In the world of homebirth, extraordinary claims require no proof at all, just a self-proclaimed “midwife” willing to lie and a bunch of ignorant followers willing to believe.
I wouldn’t be too quick to rule out an element of sphincter function for the cervix. https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.15043
Your article was really hard to read.
Hard because it was quite horrible towards a person.
Just because she calls a cervix a sphincter, it doesnt mean she is wrong about childbirth.
I think she is probably ‘liking’ a cervix to a sphincter.
its like someone trying to give skeletal advice about the 10 fingers and then branding them an idiot because people have 2 thumbs and 8 fingers and not 10 fingers, etc.
Technically you are 100% correct., but I felt your attack was a bit too harsh.
If she can’t get the basic facts about female anatomy correct, why would you think she could be right about childbirth? What part of what you have just read provides any confidence in anything Ina May says about … well, anything?
She expounds upon this claim. She has a bunch of “sphincter laws” based on this claim. She didn’t misspeak, and she doesn’t explain why two extremely different sets of muscles would behave similarly. If someone wanted to talk about hand anatomy and common problems of the hand, and said that people have 10 fingers, I would indeed be wary of anything they said. If they said hands had 10 toes, I would immediately disregard what they had to say about hands. Ina May said that hands had ten bones in them, that’s how wrong she is.
I was booted off the Facebook group “Friends of The Farm” for disputing the answer to a question of whether The Farm was anti-abortion. Of course they were! It’s clearly stated in their own literature, and that was the whole purpose of offering free midwifery service to outsiders. Many women have benefited from this, but it would have been a different story for a Farm woman with an unwanted pregnancy.
The Farm founders were also transphobic. I heard Ina Mae open a NYC talk in the 1970s by quoting a newspaper article about someone who had had a “sex change.” She lamented such squandering of medical resources, and challenged the audience: “Doesn’t that seem weird?” She saw it as a sign of societal decadence. No compassion at all for people with gender dysphoria, who still often attempt suicide.
The manager of the “Friends of The Farm” FB group indignantly retorted that she’s known Ina Mae for over 20 years, and the sainted midwife would never have said such a thing! But she did – much longer ago than 20 years. I had no trans friends at the time, but even so I was shocked that she’d open a speech by trashing some stranger.
Therefore, I sought out Stephen in the back of the room to ask how The Farm would deal with a gay couple. He hedged by saying, “If the relationship looked sound enough, we probably wouldn’t blow their cover.” IOW, they’d need to stay in the closet!
The Farm has done a good job of concealing the cause of Stephen’s death, but I suspect some form of dementia. He seemed less than lucid even as a Green Party candidate in 2000, when he posted a tasteless political joke involving Tipper Gore.
The last photo of the pair together shows Stephen with a vacant stare and Ina Mae with a brave smile: “Nothing to see here, folks!”
If they had led quiet private lives, that would be none of our business. However, the Gaskins were public figures presenting themselves as spiritual teachers and role models. Stephen was even briefly offering The Farm as a potential retreat for elders (though “Rocinante” obviously never happened). What can be gained by keeping his last years a secret?
Just food for thought: A reliable source confided that one of her female relatives had learned to control release of menstrual blood, as one might urine, eliminating the need for pads or tampons. I don’t know how she did it. There may be ways to open and close the cervix that don’t involve a sphincter muscle. Yogic techniques enable some practitioners to gain voluntary control of normally autonomic body functions.
Two things
Just because Ina May is unprofessional doesn’t mean all home births are inherently wrong. Not all advocates of home birth, nor all midwives are followers of her and not all of them care about or believe the things she has said.
Also, I really wanted to know the actual facts about the cervix. How does it open and close? I’m not a medical professional and so ‘extracellular matrix’ is not enough information to explain to me how it functions.
Anyway, I will look elsewhere and ask some medical folks I know, but I just thought I’d say – if the author is aiming to help people who are convinced by pseudo-science, it would be really useful for the anatomical science to be more accessible / explained.
Ancient Greek physicians believed in order for women to release an egg required an organism. We have learned more since then. We have also learned more since the strict belief that only certain orifices are sphincters. Many midwives have verified the Gaskin Sphincter Law. It has been peer-reviewed (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2776526/). We now know more than the information above.
Ina May Gaskin is a charlatan and has blood on her hands from all the babies who died as a result of her homebirth advocacy (including one of her own).
“Ancient Greek physicians believed in order for women to release an egg required an organism. ”
What the hell does that even mean?
Just the tone and aggressiveness of this article is enough for me to turn away from this doctor whose arrogance and obvious lack of humility is so common in a profession which doesn’t have that much to be proud of… Gullible may be, but I’d trust Ina May hundred times more than this so called doctor busy protecting her little business. Deplorable…
#that’snicedear
“I’d trust Ina May hundred times more”
Ina only seems to get off on sexually assaulting women, so you’re probably safe on that front.
And since you don’t have a cervix, she gets your anatomy a lot less wrong than she gets mine.
All in all, not as bad an idea as a pregnant woman trusting Ina. I mean, still not a _good_ idea.
Ah, a tone troll, so lovely. Her tone isn’t always my favorite either, but this is Dr. Amy’s internet persona, not her professional one, or for that matter her social one.
You can go to Ina May for your own pregnancy, Francois. I’d far rather see someone with an education like Dr. Amy, not a wanna be with bizarre ideas about rubbing women’s “buttons” because apparently orgasms are supposed to make labor happen better or something. Having been in labor, I think she’s f’ing nuts.
Ina May sexually abuses her patients. I’d take Dr Tuteur over her any day. I would pay to NOT have ina May as a health care provider.
Hell, I’d go without any help over having this disgusting woman anywhere near me.
http://www.skepticalob.com/2013/06/would-you-hire-this-midwife.html
Seriously, even if you think tone trolling is legit, the Ina quotes from this post are just… super creepy.
Agreed! Any “professional” should know how to write in a more diplomatic way to provide FACTS and not be so angry. We want facts not opinions.
the cervix is not a sphincter. that’s a fact. Glad we could help.
I know! My goodness, how dare someone be upset that Ina May is a complete idiot with no biological knowledge and yet people listen to her! It’s not natural to be frustrated by idiocy, oh no, and everyone knows that if you get angry about it then you automatically lose, right?
Or, howzabout no, that’s not how it works. If an angry tone is enough to make you ignore facts, then you don’t give a damn about facts. That says unpleasant things about you, but not really anything about the person who gave you the facts.
Thanks Lindsey. I’ve had other exchanges with Dr Tuteur and I concluded never to trust a word from a person whose only interest is to protect the system which feeds her so well by calling charlatan anyone who doesn’t belong to her multi-billion medico-pharmaceutical commercial business…
No, you’re busy protecting the quackery system that allows you to make money by scamming the unwary. You must be so proud of yourself.
Hey, she’s back, always with the same friendly objective style. I read somewhere that you’d given up your practice, I’m so glad… So long “Doctor”…
Hmmm, you likely read it at the top of her blog, where she posts it quite clearly. It’s interesting that you phrase it as HER being “back,” since it’s actually her blog. I think that means YOU’RE back. And whether you like it or not, she is a doctor, no scare quotes needed.
Yes dear Momofone, I only came back on this ugly blog to congratulate Lindsey for showing some common sense our dear doctor seems to have so little. I do respect medical professionals who show some humility in their approach to medical care. The arrogance shown by this blog’s owner justifies the quotes in my post. I feel sorry for your profession for being defended in such a nasty way by someone who thinks so highly of herself and considers her immature statements as medical truth. Have a great day.
Thank God, I was in the mood for a clown show. Please. Do go on.
Nope, thank you!
You can’t resist.
Ol’ Francois proves yet again that dumb as dog shit and unintentionally funny go together like inebriated hillbillies and explosives.
Then how do you explain your smug condescension?
You also apparently think highly of yourself and consider your incorrect statements as medical truth. Please, please, please exhibit more of YOUR arrogance by mansplaining about women’s bodies and experiences.
(Who is this Kenny Rogers impersonator, anyway?)
This quack has no knowledge of cervices or irises.
Actually….
http://www.ncbi.nlm.nih.gov/m/pubmed/27166013/
Ina May is very aware that the cervix is not considered a sphincter. She’s saying it acts like one. And she’s aware current medical doctors are taught that it is impossible for the cervix to close. What she’s saying is that it does happen. To say that this is an impossibility and that all of the anecdotal evidence is wrong without even investigating this seems silly. To say that every time a previous measurement is larger than the current measurement then the ONLY reason for that is that the previous measurement was wrong because it is IMPOSSIBLE for a cervix to undilate seems just silly to me.
https://www.youtube.com/watch?v=YJV3wDqry_Y
Well Dawn we know you’re not in communications if it took you a couple of days to come up with that.
Ina May and her appalling late husband are bad news. If I have the choice between someone who let her baby die for want of medical care, and an actual doctor, I’ll listen to the doctor. Why would anyone have confidence in someone who advocates the sexual assault of women during labour in the guise of pain relief?
Smart people who know way more about physiology, pregnancy, labour, birth and babies that Ina May ever will find her positions on these matters farfetched, if not completely wrong.
Honestly, I’d have an unassisted birth in the middle of the woods over having Ina May Gaskin anywhere near me during birth.
Also a very fair choice. I’d just add ‘(during birth) or any time.’
Is that the best you could do? I’m disappointed. All I’ve heard from you is a lot of “Oh yes it IS!!!” and now “That is NOT what she said [apparently to divert attention away from what YOU said], and if you don’t believe anecdotes then you’re dumb, because this is what I think, and someone said it happened, so it must be true!”
I don’t have the time for responding to these things. It really feels like I’m talking to a wall. I have a three year old who pays more attention to what I’m saying than you do. I won’t be engaging again in this utterly pointless effort to communicate with vicious children.
We pay plenty of attention to what you say; the difference is that your three-year-old accepts it as fact, and we don’t.
Nope the difference is you clearly still don’t know what my argument is. And after this much time invested it’s clear you don’t even care you just want to argue. When did you hear me say “oh yes it is!!!”
“Nope the difference is you clearly still don’t know what my argument is”
Your argument is that the cervix, after having had its extracellular matrix broken down until it’s thin and weak and can be forced open by the uterus pressing a baby down into it, can somehow violate the basic tenets of biology, chemistry, and physics to instantly re-generate that tough ECM while simultaneously pulling itself together against the pressure of the uterus shoving a baby down on it, despite the lack of muscle in any sort of a position to pull it in that direction.
I’ve quoted you already where you were saying, in various ways, “oh yes it is!”
I don’t believe you yourself know what your argument is.
We know what your argument is. You started by: The cervix is a sphincter. We showed proof that it doesn’t.
So you change your argument to: Fine it’s not, but it doesn’t matter, it still closes during labour. And we are once again showing you various proofs that it doesn’t and even cant close and various explanation as to why someone as uneducated as Ina May might think it does.
You are just sour because you have no valid argument and we are not as gullible as your 3 years old.
My very first post:
Such anger! And none of what you’re saying matters. If your cervix is or isn’t a sphincter- nothing changes. Yes people give birth all the time in unsafe environments. Ina May is simply observing that women’s labors seem to stall when they’re not feeling safe. Why would this be such a shock to you? it seems perfectly scientific and reasonable. If a cervix is not exactly a sphincter but acts like one during birth I just don’t see the point in being so furious about semantics. Have you ever been a part of an unmanaged birth? Have you witnessed a cervix close up several centimeters suddenly?? These midwives you clearly despise know some things you probably never get the chance to observe.
And the refutations are still:
Everything changes.
Just because people have given birth in unsafe situations doesn’t mean we should encourage it. (And birth the Ina May way is definitely an unsafe situation.)
Her observation is wrong.
Seeming “scientific and reasonable” is not the same thing as actually being such, and that is why a lot of dangerous bullshit still clings to life despite being thoroughly discredited.
It does not act like a sphincter during birth, that’s not semantics.
“Unmanaged” is a horribly dangerous state for something that can go so catastrophically wrong so quickly.
What would midwives observe in there handful of births that an OB would not see in their thousands?
and many people have already pointed out post where you have said that the cervix is a sphincter.
And actually, the cervix being or not being a sphincter ABSOLUTELY changes everything. You are just too uneducated about basic physiology to see how important it is.
The cervix does not have a significant amount of muscles. How then does is closes? Muscles are the only thing in the body capable of actual movement. Everything you have that moves is moving because of muscles. How do you propose that a cervix, that does not contain a significant amount of muscles, is moving?
If your argument was limited to ‘stress can sometime affect labour’ than yea, I’d be of a mind to answer with: Probably, but I don’t think it’s a major factor in birth complications (considering virtually 100% of birthing women are stressed and in pain).
But your argument is: Stress can block labour because it causes the cervix to contract.
This is absolutely false. The cervix is not a sphincter and it absolutely does not ‘act’ like one during birth. It cannot act like one because it doesn’t have the basic cell structure to do so.
“Ina May is simply observing that women’s labors seem to stall when they’re not feeling safe. Why would this be such a shock to you? it seems perfectly scientific and reasonable. ”
It’s the opposite of reasonable. It makes no sense. Imagine two women in labor in the prehistoric times. They feel unsafe – because bad weather is coming, because the lions are roaring, because a tribe of Neanderthals is on the march. Say one woman has a labor that stalls due to the stress, and she’s lying in the ground in agony with a baby still inside of her when the floods come, when the lion comes, when the Neanderthals invade. The second woman has a labor that hurries due to the stress, that shoves the kid out right away so the woman can grab it and run (or chose to ditch it and run, and live to have another baby, because nature doesn’t care about individuals). Which one will survive to pass her genes on? Which bodily behavior will be selected for?
And in fact, that’s exactly what you see. Stress is one factor associated with pre-term labor and birth:
http://www.ncbi.nlm.nih.gov/pubmed/26855101
http://www.ncbi.nlm.nih.gov/pubmed/19741043
http://www.ncbi.nlm.nih.gov/pubmed/24216160
And studies (you love those, yes?) are looking into the biochemical mechanisms of same:
http://www.ncbi.nlm.nih.gov/pubmed/26504199
http://www.ncbi.nlm.nih.gov/pubmed/26070700
Etc, etc
I’m pretty sure that ‘semantics’ doesn’t mean what you think it means….
When?
https://disqus.com/home/discussion/skepticalob/no_ina_may_the_cervix_is_not_a_sphincter/#comment-2778268419
https://disqus.com/home/discussion/skepticalob/no_ina_may_the_cervix_is_not_a_sphincter/#comment-2777774702
https://disqus.com/home/discussion/skepticalob/no_ina_may_the_cervix_is_not_a_sphincter/#comment-2777765962
https://disqus.com/home/discussion/skepticalob/no_ina_may_the_cervix_is_not_a_sphincter/#comment-2777604212
https://disqus.com/home/discussion/skepticalob/no_ina_may_the_cervix_is_not_a_sphincter/#comment-2777560109
https://disqus.com/home/discussion/skepticalob/no_ina_may_the_cervix_is_not_a_sphincter/#comment-2777476480
https://disqus.com/home/discussion/skepticalob/no_ina_may_the_cervix_is_not_a_sphincter/#comment-2777447654
Your argument is “Ina May is right even when she’s wrong!” At the end, that’s what it boils down to.
Your three year old pays attention, because you can just say “this is what it is” and demand they agree, or else they get in trouble. Here, you have to actually meet adult standards of proof, but you continue to use the same tactic of demanding we believe you without question. You’re not getting anywhere not because we’re childish, but because we aren’t.
So wait. You spent how many days trying to defend Ina May Gaskin, insisting that it is to a sphincter!!!! You even quoted a dubious MD page and 100 year old veterinarian stuff to prove it.
Now, having been completely demolished in those attempts, you turn it around and now insist that hey, Ina May knew it wasn’t a sphincter all along! Ha! Showed us, you did!
Showed us that you don’t have an ounce of intellectual credibility, of course.
Are you KIDDING?! How many times do I have to say a thing before you people pay attention to what my argument is??? It is and has been that regardless of whether or not it is the full definition of a sphincter, if it closes during labor as I believe if it were studied we would see that it sometimes does, then Ina May’s theory is right.
is and has been that regardless of whether or not it is the full
definition of a sphincter, if it closes during labor as I believe if it
were studied we would see that it sometimes does, then Ina May’s theory
is right.
Right, but it doesn’t close during labor, although it can appear to because the stress of labor can make it swell, causing the opening to become smaller–which is not at all the same as the cervix pulling itself shut.
And whether it’s a sphincter (i.e., a ring of muscle) matters because if it isn’t one, then it has no mechanism by which it can slam itself shut. It doesn’t close itself during labor; it can’t reverse the biochemical processes that made it ripe, and the contracting uterus puts pressure on it, making it open–that same pressure can’t close it up again any more than pushing on the side of a door that’s marked “push to open” can make that door close.
Ina May’s theory is wrong.
The cervix will continue to open as long as the presenting part is applying pressure to it. If the cervix closes, it means that the pressure being applied to it has lessened. For example, in a uterine rupture the path of least resistance for the baby becomes the abdominal cavity instead of the cervix and vagina. For the baby to stop applying pressure to the cervix to this extent is a huge red flag. OBs know very well that the cervix can close during labor, but it’s due to mechanical factors, not psychological ones.
Here is a reply from a MIDWIFE further downthread. I’m cutting and pasting it here so that you don’t have to tax yourself looking for it. Thank you Ms. Deborah for spelling this out.
I’m going to add my two cents worth into this debate for what it’s worth.
I think you are confusing the cervix and its function with a kind of metaphorical gate complete with its own unique gatekeepers, who, depending on the situation and environment of the labouring woman, allow the cervix to open or close back up again.
Regardless of the correct terminology of whether the cervix is a sphincter or not, your fundamental understanding of what the cervix is and does and how it may be affected during labor is incorrect.
As a midwife I have seen many labors stall. The most common reason is due to an obstruction of some kind. When this happens the cervix often becomes oedematous and gives the impression that it is less dilated than it was previously. The cervix hasn’t “closed” in response to stress or any other kind of emotional discomfort. It has simply become swollen in the same way other tissue becomes swollen when it is injured or when unrelenting pressure is put upon it. Sometimes the cervix itself may have its own particular form of pathology. It may be scarred or damaged in some way or diseased. This will affect its ability to dilate normally and may give the impression of “opening and closing”.
I know it must be hard for you to digest the thought that Ina May is not the expert she purports to be and that she is actually quite detestable in her sexist attitudes and questionable practices.
There has been a lot written about The Farm and its leader Stephen and it’s not all sunshine and rainbows.
You could think of it like putting on a shirt. The opening for the head
is usually smaller than the head itself. While I push my head through it, the opening is stretched and become bigger. if I stop pushing, the opening will unstretch. It’s now smaller than it was a few seconds earlier. But the opening of my shirt didn’t contract itself or closed itself. It just stopped being stretched. Anything that reduces the amount of pressure a baby’s head is putting on the cervix can make it look like it contracted, but it’s not what happened.
And many people also brought the point of swelling.
Maybe a turtleneck would be a better analogy?
I told my boss that my morning preparation was arrested due to the head-hole of my turtleneck closing due to stress and not allowing my head through. He asked if I had any proof that a head-hole could spontaneously slam shut in the absence of a drawstring to close it, and I told him to talk to Dawn.
Haven’t you been taught that it’s very important to reassure your shirt and cuddles them a little before you put them on to prevent stress induced turtleneck closing?
No, no, no. You have to relax your jaw, mouth and throat and moan, using low toned “OOOOOOOHHHHHHHHHMMMMMMMM’s” to relax the turtleneck to prevent the stress induced closing.
While masturbating of course 🙂
(or having your madwife do it for you)
More extreme example, but absolutely.
Get off my brain wave! {giggle}
It’s not a theory, it’s a hypothesis, and an absolutely crappy one.
Or, you know, the cervix is swollen and feels less dilated but isn’t.
You think it hasn’t been investigated.
But the anatomy, histology and physiology of the cervix is well known. It does not have any amount of muscle capable of causing a contraction or closing itself.
We have already provided many example of things that could make it look like it’s closing, but it isn’t. You are just ignoring them all.
I haven’t seen any studies done about the cervix and how it operates during birth so please.
Would you need a study to tell you that the lungs don’t beat? They don’t beat, and can never beat, because unlike the heart the lungs are not a muscle.
However, the lungs DO make a rhythmic sound when you listen to them through a stethoscope, just like the heart. We normally call that sound “breathing,” but Ina May’s logic would say it means the lungs are a muscle and are beating.
They’ve been cited in several posts below. Dr Amy even posted pictures of the histology of the cervix vs skeletal and smooth muscle, so that you can see the difference (actually ‘see,’ rather than your metaphorical ‘see’). Just because you don’t understand them doesn’t mean they don’t exist.
Again, have there or haven’t there been studies about how the cervix dilates in labor?????????
They’ve been cited in several posts below, as I just said.
this is not a study about how the cervix dilates during labor. This is not something we can draw a conclusion from about whether or not the cervix undilates.
That’s exactly what it is. The cervix dilates because of, in this order, a specific set of biochemical changes, and then pressure on it from the presenting part of the baby due to uterine contractions.
How the bloody hell do you figure that? It specifically talks about effacement and dilation.
Here you go. Here’s one, that a kind soul posted earlier and further downthread for you to peruse. It even cites the medical book it is taken from.
not sure why I’m wasting my time, but this is from the textbook “Histology for Pathologists, Third Edition,” Ed: Stacey E. Mills, MD:
“In contrast to the wall of the uterine corpus, which
is predominantly muscular, the stroma of the exocervix is mainly fibrous tissue admixed with elastin through which run infrequent strands of smooth muscle.”
Note the word “infrequent.” Infrequent strands of muscle do not a sphincter make.
Then from the section on the cervix during pregnancy:
“The stroma of the cervix undergoes a complex series of biochemical and biomechanical changes during pregnancy and parturition that taken together are known as cervical “ripening.” The initial change seems to be extensive destruction of collagen fibers by various collagenases accompanied by the
accumulation of gel-like acid mucopolysaccharides. This process causes the cervix to soften, a
process that reaches its zenith immediately before parturition. As a result, the cervix is easily effaced by
the presenting part of the emerging infant. ”
Nowhere does it mention anything about a sphincter or sphincter-like behavior.
I thought you had read the textbook in its entirety? You said you had read it all. I would have thought you’d check the references that are cited to really delve into the topic.
*crickets* from Dawn whenever someone with real knowledge shows up…
Sweetheart, there has been enough studies about the mechanics of labour, cervix included. The problem is that someone like you have no way to understand them because they don’t write “the cervix is or isn’t a sphincter”. You see, they’re written for people who already have a pretty good idea how human body works. That disqualifies you. Automatically. That damned education is needed to understand them.
My pleasure: (here’s the result of a 5 minutes google search, since you like google so much)
– http://emedicine.medscape.com/article/263311-overview#a3
– http://www.ncbi.nlm.nih.gov/pubmed/2225599
– http://www.ncbi.nlm.nih.gov/pubmed/7554594
– https://en.wikivet.net/Cervical_Softening_-_Anatomy_%26_Physiology (this last one is not a study, but it’s a veterinary reference website, showing you that unlike what you pretended earlier, even veterinarians don’t believe the cervix is a sphincter.
Do we know everything about the cervix, no. But we certainly know that it is absolutely not a sphincter and that it is unable to contract during birth.
I want to pull those two papers you cited! Interesting to note that the few scattered smooth muscle cells apoptose during the ripening process, so there is zero muscle of any kind present once the cervix is competent to dilate.
Don’t tell Dawn. She’ll be crushed.
We know that some women have what has been called a “dynamic” cervix that opens and closes during pregnancy and leads often to preterm birth…
Citation needed.
And also proof that this opening and closing of the cervix is an active contraction that can happen during labour.
http://emedicine.medscape.com/article/402598-overview#a1
Yeah, I would love to have access to that proof myself. What needs to happen is a research study in which someone accurately keeps track of the dilation of the cervix of women in labor, and I don’t believe that has happened. All I have for you is anecdotal evidence of nurses checking dilation and then finding the cervix several centimeters smaller than it was, which I’ve personally witnessed, and reports of “dynamic dilation” during labor.
I think there is reason to believe we need more information than we have.
Part of the challenge in what you suggest is that you don’t think accurate records are kept at the moment. OBs and other doctors here, and midwives here, all agree that the cervix doesn’t get smaller during labour. You and Ina May disagree.
For you, that’s compelling. For others, not so much.
Oh I absolutely don’t think accurate records are kept- Amy herself admitted she has to “correct” the measurements of less experienced nurses who she assumes measured wrongly. This is one of the main reasons I feel so strongly about this- the assumption that someone very experienced measured several centimeters off seems to happen too often.
It’s a measurement made blindly with fingers. Or course it’s very prone to errors.
And that’s what I think is interesting. Someone measures, someone with more knowledge/experience measures and reviews, and that’s accepted as good practice.
Do you think Ina May accepts that someone in her circle (or anyone else, come to that) could ever measure more accurately than she does? Or is Ina May’s word the final say?
I think human error is a part of the equation for sure. But there have been reports of a woman being several cm dilated and then completely closed. Anecdotal, yes.
Dr Amy Tuteur/ the OBs I’ve worked under arent standing over the shoulder of a nurse who is measuring wrongly and then immediately re-measuring. She’s waiting an hour, two hours and then finding the cervix smaller.
And she’s assuming the first measurement is wrong because she’s been taught the cervix absolutely can’t get get smaller during labor.
And why has she been taught this, pray tell? Just because YOU can’t understand the conditions that would let an organ dilate and that are not there for a cervix, it doesn’t mean that people who spent 8 years studying it – at least 8 – can’t. All you have is internet ramblings by loons who have no idea what they’re talking about.
There is anecdotal evidence that a vaccine turned someone into the Incredible Hulk. I guess you believe this one as well? Or are only sexual predators the one you believe?
Except that the OBs are also checking the cervix multiple time in the same labour. They would also notice the difference between their own measurement.
You have any actually written proof of this sudden closure of the cervix? Or did you read it on the internet from someone who hear it from someone who heard it from her cousin who heard it from the hairdresser?
Basically, your stance on the matter is: Even though right now we have absolutely no real evidence of this ever happening, it has never been recorded, there is no anatomical, physiological or histological evidence that it can happen, and we have a ton of evidence that point that cervical contraction is not happening and not even possible, I’m going to keep thinking that it’s real until it has been proven impossible in every single imaginable situation possible.
And then, even if we did manage to prove in every single possible way that it’s not possible, you’d claim we can’t be sure because we didn’t do it on the moon.
You’ve said it, all you have is anecdotal evidence. That isn’t worth anything. There is no credibility behind that claim. Nothing supports that claim. Those who made it where just wrong in their evaluation of the dilatation or in their reasoning to explain the changes in dilatation.
Never been recorded? Ina May Gaskin must have recorded it, among other people who do all their own checks and don’t just assume a measurement is wrong bc it doesn’t fit their expectation.
I get that anecdotal evidence isn’t science, I really do. But I don’t believe it’s not worth anything. I think it warrants studies. How do you explain all of the nurses who report witnessing it? All of the women who claim it happened to them? Every one of them is wrong? Because te cervix can only open and close in preterm labor, eh? Is that it?
Ina May Gaskin has also recorded that masturbating pregnant women is an acceptable medical treatment. So excuse me for not putting much worth into her works.
All those who pretend they saw it are usually DEM. Why are OBs not seeing it? You are basically saying that there is a worldwide conspiracy of OBs to lie on medical chart about cervix contraction. For what purpose?
Perhaps they are in cahoots with vaccine manufacturers et al?
Oh FFS. This is a link to a discussion of cervical insufficiency – that is, the cervix doesn’t stay firm enough through pregnancy to keep everything inside. It’s not a discussion of the cervix ‘slamming shut’ during labor, it’s a discussion of the cervix unable to stay properly closed up to term. The cited papers are all about trying to identify women with the greatest risk of delivering pre-term.
You keep trying to prove to us that the cervix can slam shut during labor if the woman is uncomfortable or stressed, and all you can show us is links to discussions of when the cervix is _too_ ready to let things out.
Not even Ina May says the cervix “slams shut” you guys made that up yourselves
You said that the cervix can close during labor enough to prevent the baby from coming out, with enough strength to work against the uterus pushing the baby. How else to describe it?
I love when you guys tell me the things I supposedly said! It’s fascinating, really.
So now you are not saying that the cervix can close itself during labour? What the hell have you been saying then?
*crickets*
I think what she’s been saying all along is “Ina Mae is right and obstetricians are wrong.” Really, the details don’t matter, which is why she keeps moving the goalposts and grasping at straws. All she cares about is that her income depends on her being privy to ‘secret knowledge’ that OBs dismiss/don’t have, so she’ll just find something, anything, that fits that description.
Which I find hilarious, given that voiding oneself is a well known response to being frightened.
This is proof the cervix opens and closes without mechanical force sometimes.
We also already know that the cervix opens and closes during menstruation as well. Are you going to pretend this is proof it can contract itself during birth?
And according to Ina Mae, that would be caused by being too relaxed during pregnancy, and we need to stress the crap out of those women?
A dynamically changing cervix is a dramatic finding that can be seen during ultrasonography. The cervix shows varying degrees of funneling of the internal os over time in association with vigorous closing and opening of the cervix. These cervical changes occur in the absence of uterine contractions.
I like how, every time you are proven wrong, you move the goal post.
Whatever the cervix does during a pregnancy is no indication of what it’s capable to do during labour.
So far, I’ve found no indication that a dynamic cervix is secondary to muscles contractions inside of the cervix. So it does not in any way proves that a cervix could contract during labour.
The goal post all along has been exactly this: that I don’t think we have solid evidence that the cervix doesn’t close during labor and that more studies should happen. I believe the cervix can undilate. I believe this used to be common knowledge and now because it isn’t taught in medical school and a bunch of lay midwives report it then it’s treated like blasphemy because what could an idiot midwife without an education ever know about birth that someone who went to medical school doesn’t know.
Evidence that it can contract: A midwife without any real medical training told me so.
Evidence that it cant:
-Multiple anatomic and histologic evaluation of the cervix that show an absence of muscles fibers or any other kind of cell to cause a contraction in the cervix
-Not seen by any medical provider with actual medical training, either during labour, pregnancy, after labour or in not pregnant women.
-Multiple studies on the process of cervix ripening during labour and it’s changes back to normal state afterwards, none of which ever showed any evidence of contraction of the cervix.
Like I said, you’ll never accept any kind of proof that it doesn’t.
It also used to be common knowledge that bloodletting was a cure for anything. But I guess they just stopped teaching it to doctor so they all forgot about it.
Mmmm lack of muscle fibers…. No doctor has witnessed a dynamic cervix?? Wrong. I already proved that earlier
And as I’ve said, I have found no proof that dynamic cervix is caused by muscles contraction in the cervix. Do you have any?
Nope. Just that it’s not from the baby’s head and not from contractions.
So….It proves nothing about what a cervix can or can’t do during labour. Like I said, it does open during menstruation, which also doesn’t prove anything about what it can or can’t do during labour.
Oh ok. And that’s solid enough to base an opinion because…you said so?
You can have whatever opinion you want. I don’t see Ins May proven wrong here at all, and I’d like to see more studies done on cervical contractions or the lack thereof during labor
You are busting your ass trying to make the evidence and your arguments fit what Ina May says. It must be very difficult to consider that she could be wrong.
And as I’ve said: Dynamic cervix does not equal the cervix being able to contract during labour.
So the cervix can contract without mechanical force but DEFINITELY NOT during labor right?
Considering we are comparing a change of opening in mm with a dynamic cervix (of which, I can’t find the cause, so it doesn’t prove that it’s something that could happen during labour) a change of opening in cm during labour, I’d say that no, one does not prove the other is possible
The cervix does not contract. It opens by being forced open by something else. Typically, the head of a baby being pushed by the uterus. Remove that pressure – by delivering the baby, ideally – and the cervix no longer stays as fully open – but it doesn’t contract, as the placenta and/or someone’s arm can easily go through it.
The cervix, once ripe, is a bystander.
Ahhhh I see. It doesn’t contract except during cervical insufficiency at which time it does everything we say it can’t do and we don’t know how or why but that it CANT do those things during labor. I get it now. Case closed then. Glad that’s over. Phew.
……cervical insufficiency is not a contraction or closing of the cervix. It’s actually the cervix OPENING before it’s supposed to.
Yes, but a dynamic cervix “vigorously opens and closes” aka contracts and dilates.
You are really grasping at straws here and making very huge extrapolation here. Again, the fact that this small changes in the cervix can happen during pregnancy does not mean that any significant contraction, even less one of many cm of dilatation, can happen during labour.
Also, you moved the goal post again.
This whole discussion started because Ina May stated that the cervix is a sphincter and can close itself during labour because of stress. Dr. Tuteur explain it wasn’t the case.
You jumped in, claiming it is a sphincter.
We showed you it wasn’t
You came back with: Ok, but it still contracts during labour.
We showed you it doesn’t
Then you went with: I’m just saying that nobody knows how a cervix works, so we can’t be sure it’s not true.
We showed you how a cervix works.
And now you are at: But look, the cervix ‘might’ have some very minimal muscular activity during pregnancy.
Nope. The cervix doesn’t contract. It doesn’t contract when it’s in good nick and holds the pregnancy to term, and it really doesn’t contract when it’s insufficient and you get preterm delivery. It’s odd that you think that the existence of cervical insufficiency is proof that the cervix can contract and arrest labor.
As far as I can tell, the mechanism of dynamic cervix is unknown. But it doesn’t appear to be muscular contractions, so it doesn’t prove that contraction is possible during labour.
It could be anything really, but there is no proof that whatever this mecanism is, it could close a cervix multiple centimeter very rapidly, during a labour (which only a muscular contraction would be able to acheive).
You have no mechanism. We have described to you in excruciating detail how the cervix opens due to biochemical changes that break down and thin the matrix that composes the cervix (including causing the death of the few muscle cells scattered in it to start with), leaving the cervix free to be pushed open.
You have no mechanism, part 2: the cervix simply can’t close itself, any more than a double amputee can climb a ladder. The cervix has no muscle. Once it’s ripe, it’s at the mercy of what the uterus and baby are doing to it. You’re clinging to the complaint that we don’t have nanometer-level resolution of the double amputee not climbing the ladder.
You have no correlation. You say that stress stops labor; there is a lot of good evidence that stress causes preterm labor, and that is more in line with evolutionary pressures. There’s no evidence that stress stops labor; the correlation goes the other way (difficulties in childbirth due to size/positioning of the baby vs mom’s pelvis are often painful and stressful).
You think what you think because it’s a nice narrative that helps you make a case that doulas are a medical necessity rather than a nice-to-have. But that’s not how science works.
http://emedicine.medscape.com/article/402598-overview#a1
Again, this does not prove the cervix ability do contract during labour.
Some people’s cervix can apparently figure it out despite not having a mechanism: ”
A dynamically changing cervix is a dramatic finding that can be seen during ultrasonography. The cervix shows varying degrees of funneling of the internal os over time in association with vigorous closing and opening of the cervix. These cervical changes occur in the absence of uterine contractions.”
I explained down below what this article refers to. Pro tip – it doesn’t talk about the cervix contracting.
It has NOT been studied. The way the cervix dilates in labor has not been studied and clearly needs to be.
Are you really claiming that we don’t know why and how a cervix dilates in labour? You really are an idiot.
http://emedicine.medscape.com/article/402598-overview#a1
“
That piece is about incompetent cervix and has nothing to do with labor.
Yes, this piece is not about labor. But it is about the cervix contracting without the use of force. And if the cervix can do that during preterm labor then it seems like we need more evidence in order to conclusively rule out the idea that it could possibly sometimes do that during labor.
If what you assert could be proved, how would that change the way that pregnancy, labour and delivery are managed?
No, it is not about the cervix contracting. Words have meaning, and you don’t get to play Humpty Dumpty and say that ‘sphincter’ and ‘contract’ mean just whatever you want them to mean at the time. Contract refers to the action of muscle, to the shrinking in size as the muscle fibers slide across each other and closer together. A contraction is a flexion of a bicep, or an action of the uterus, and it’s easy to see and measure. A small variance in a diameter that’s caused by greater susceptibility to outside forces due to cervical incompetence is not a contraction, and that is not a technicality – that has everything to do with the point you are making, which is that during normal, non-pathological labor, a cervix can close of its own accord and stop the baby from coming out despite effective uterine contractions. Cervical incompetency has nothing to say about that.
It’s almost like she didn’t read the same article she posted.
I think part of the problem – and oh lord, you have so many problems – is lack of clarity in language.
“And she’s aware current medical doctors are taught that it is impossible for the cervix to close.”
That’s obviously not true, because the cervix slowly comes back to close to its post-partum state after birth, and doctors know this well. What has been shown to be true is that the cervix does not suddenly reverse the biochemical changes that make it ‘ripe’ (soft and thin) and allow the uterus to force it open by jamming a baby through it – during the process of the birth of the baby. These biochemical changes take time to reverse, which is why midwives and doctors can get their arms through a cervix post-partum to retrieve placenta (and if stress and fear caused cervixes to slam shut, they’d never get their arms out again) and why it’s a lot easier to put an IUD in a woman in the weeks after vaginal birth.
Ina Mae does not know biology or chemistry, she only knows sexual abuse of laboring women. So she made this shite up out of whole cloth.
I think part of your problem, and oh lord you have so many, is that you want this argument to continue because it’s all you have. I, on the other hand, have a three year demanding my attention and crawling al over me, so I forget that unless I spell out the specifics of the thing we’ve been discussing for days in every post (“current medical docs are taught it is impossible for the cervix to close DURING LABOR”) then you will all act like you don’t know what I’m saying even though it is absurdly obviously. I don’t have time for this.
“I don’t have time for this”
You have time to comment endlessly without addressing the substance of any posts. It took you two days to finally admit that you really didn’t know what a sphincter was and to stop insisting that the cervix was one, and then to start insisting it didn’t matter what the cervix was. I suppose that’s progress?
If you have time to lie to pregnant women and try to convince them that your mistaken, antiquated, misogynistic views are the truth, we will make the time to counter them with science. Because the only reason we’re here is because the lives and health of women and babies are very important to us, for a variety of reasons. This forum is full of doctors, midwives, scientists, mothers, and friends of mothers, loss mothers and mothers of mothers, and many of these are overlapping.
Upvote this one.
It can’t be said too often that Dawn puts her trust in someone who is not worthy of anyone’s trust.
You are the one who came back here after a few days of absence. So apparently you want this argument to continue.
I’m still waiting on proof for your claim that a cervix can snap shut around a baby that’s partway out.
Piranha cervix mental image…
I’m still waiting on your acknowledgement that Ina May proudly molests laboring women. Or did you already acknowledge that somewhere, but it’s cool with you?
A lot of people here have active toddlers, and haven’t used her as an excuse for making shitty arguments.
Why on earth would I acknowledge your tangents that have literally NOTHING to do with anything I’m saying???
Also please outline my “shitty” argument.
It has EVERYTHING to do with what you’re saying. You’re singing the praises of a sexual predator targeting women in labour and think her this great and revered.
I guess you’re licking Fischbein’s butt as well? After all, he would be a great OB in your opinion. A sexual offender, just like your patron saint Ina May Boobskin,
You cite Ina May as a valid source of information on the behavior and composition of the cervix.
It IS relevant that Ina May thinks that sexual abuse during labor is appropriate, because it calls EVERYTHING SHE THINKS ABOUT CHILDBIRTH into question.
It is relevant because, I, personally, want to see you admit you’re allying yourself with a person who sexually assaults women and admits it.
Everyone else has thoroughly outlined why your arguments are shitty. I don’t have to rehash it. You’re just trying to get my to waste my time on what’s already been done.
Note to self – Dawn considers sexual molestation by self-professed health care providers to be a ‘tangent.’ Is that a service you provide as a doula – to not care terribly much whether or not your client is having her breasts played with and her clitoris rubbed by her HCP?
What do you have to say about the links I posted below, showing that maternal stress is a risk factor for pre-term labor rather than post-dates, in contrast to what Ina Mae’s hypothesis would predict?
Funny, her language uses no such hedging:
Yeah, that’s not a metaphor. She’s saying, very clearly, that the cervix, JUST LIKE the anus and urethra, is a sphincter, and specifically called out that it’s made of muscle. IOW, she doesn’t know WTH she’s talking about. Also nothing that the sky is fairly blue outside.
You clearly only watched the beginning
I didn’t watch any of it. I have no interest in listening to a woman who purports to be knowledgable about birth and female anatomy yet refers to the vagina as “the puss” while giving medical advice.
Don’t worry, Nick, Dawn will watch you for you, her tongue lolling out of her mouth with excitement as she listens to her goddess once again.
Ickity ick.
I hesitate to quantify what comes out of Ina May’s mouth as “medical advice”.
Perhaps it should say “while framing what she says as medical advice”?
Ina May is very aware of how to rub a woman’s clitoris during labor and get a handful of boobs while she’s at it.
Uggggh!
If the cervix (sphincter or not) can close in reaction to psychological stressors, it seems to me the best prevention would be effective pain relief. Given that, I’d assume Ms. Gaskin advises women to give birth where it’s widely available.
Nah, she just fondle them and pretend it’s a form of analgesia.
Shorter Dawn Baston:
“Manatees are cows.”
Us: “Um, no, they might have some generic features in common, but they’re different animals…”
Dawn Baston: “Prove they’re not cows! Look, here’s a link to a webpage that calls it “The cow of the sea!””
Us: “That’s just a thing a page is saying, if you look up in any textbook…”
Dawn Baston: “I looked in a textbook, and it didn’t say that a manatee isn’t a cow!”
Us: “Urm, it’s not going to say everything a manatee isn’t, you just need to look at what a cow is vs what a manatee is…”
Dawn Baston: “You can’t believe what someone says about a cow just because they went to Harvard!”
Actually from my perspective:
You: open any anatomy book if you want proof that the cervix isn’t a sphincter!
Me: show me where in an anatomy book you find this proof!
You: you’re stupid! Why would it say that in an anatomy book?!
The entire discussion has gone that way. It’s amazing.
http://www.hopkinsmedicine.org/mcp/education/300.713%20lectures/2014/byung_kang_pelvis_09.15.2014.pdf
The cervix forms the inferior part of the uterus and is shaped like a short, broad cylinder with a narrow central channel. The
body of the uterus normally arches forward (anteflexed on the cervix) over the superior surface of the emptied bladder ( Fig.
5.54A ). In addition, the cervix is angled forward (anteverted) on the vagina so that the inferior end of the cervix projects into the
upper anterior aspect of the vagina. Because the end of the cervix is dome shaped, it bulges into the vagina, and a gutter, or
fornix, is formed around the margin of the cervix where it joins the vaginal wall ( Fig. 5.54B). The tubular central canal of the
cervix opens, below, as the external os, into the vaginal cavity and, above, as the internal os, into the uterine cavity.
The vagina is the copulatory organ in women. It is a distensible fibromuscular tube that extends from the perineum through the
pelvic floor and into the pelvic cavity ( Fig. 5.56A ). The internal end of the canal is enlarged to form a region called the vaginal vault.
Amy will you please tell your cult following that a cervix can close during birth.
Dawn, will you please point us at the temple where you pray at the revered Ina May, a labouring women fondler, her own baby’s killer and other babies’ killer?
I haven’t been, but it’s probably right next to the temple where you believe everything this woman says just because she went to Harvard.
Oh, I don’t believe her because she went to Harvard.
I believe her because what she writes about here matches the best practices of the ACOG and SOGC.
And the fact that she didn’t let her own child die without any attempts at getting him medical attention. That’s a big one for me.
And because she supports it with citations from actual respectable sources, and because she has the training that you so despise, and because she isn’t a sexual predator of labouring women, and because she didn’t sit by and watch her own baby die… We’re so strange, I know. We could just “rever” her like you do rever Ina May but we choose not to. She even labours (pun intended) to give us sources because she knows she’s not going to be taken to her word just because she says the sky is green.
It’s interesting, though, how you equate believing something that is well-supported with your blind devotion to Ina May’s inane dronings.
Her citation doesn’t even say that. It says it’s unlikely that it acts like a traditional sphincter.
There’s no such thing as a “traditional” sphincter, something either meets the definition or it doesn’t.
I don’t care for traditional sphincters anyway. We’re more the progressive sphincter types in this household.
You’re ruining this nation!
That’s my plan!
I’m quoting the exact wording so take issue with her source not me
Try again.
It says that “Cervical competency, defined as the ability of the cervix to retain the conceptus during pregnancy, is unlikely to depend upon a traditional muscular sphincteric mechanism.” In other words, that the womb is probably not held in place by the bodies normal method of holding things inside, which is sphincters.
http://mfmfellowship.com/downloads/ch3_cervical_insufficiency.pdf
It doesn’t close. That’s just one of the many wacky things made up by Ina May. Here’s some ugly stuff about your hero:
http://www.skepticalob.com/2013/06/would-you-hire-this-midwife.html
Also the proof you’re basing this entire article about the cervix not being a sphincter apparently rests on:
“Cervical competency, defined as the ability of the cervix to retain the conceptus during pregnancy, is unlikely to depend upon a traditional muscular sphincteric mechanism.”
Yeah man, science. So much of this science is thrown around angrily at us “psuedoscientists.” So hypocritical.
Actually, the proof that the cervix is not a sphincter rests on opening any basic anatomy and physiology textbook and looking at what a real sphincter is versus the cervix. Or, heck, taking an anatomy course and dissecting a body yourself to see, so you don’t have to rely on experts.
I’m glad, at least, that you’re passing on insisting that the vagina is a sphincter too, as was claimed. That one is just too ridiculous to think about.
Do the medical doctors who wrote this know how it’s supposed to be common knowledge that the cervix isn’t a sphincter? Maybe tell them? http://m.med-health.net/Function-Of-The-Cervix.html
Where do they write that it is a sphincter? Where do they equal menstruating with giving birth?
Wait, seriously???
It clearly says: One of the most important functions of the cervix is as the sphincter for the uterus.
‘m done with this discussion. If you want to prove that Ina May is wrong about sphincter law then you’ll have to work harder.
Oh yes. Does your fluency in English include fluency in texts? Clearly not. They’re only talking about such a function in relations to monthly cycles. And they don’t say it’s a sphincter.
I haven’t looked at their sources anyway. Other posters have. Since they obviously have no names and organizations listed, it’s just a random internet page anyway.
I also found a number of vets who describe the cervix of animals as being a sphincter in addition to a medical journal from 1908 stating that the cervix is a sphincter. I’m not attempting to prove anything other than that it’s debatable, not black and white like this blog makes it appear. For me the question is settled- the cervix opens and closes during birth, I know this to be true, I think most OBs probably know this to be true, so just because the cervix isn’t a typical sphincter doesn’t negate anything.
There’s not a lot of information available but if you want to disprove Ina May then you haven’t done so.
Yes, the cervix opens (dilates) during labor and delivery and closes after delivery (with possibly some tiny changes during labor if the baby’s head is no longer applying the same pressure as before) – but not in any way related to the ways and reasons that Ina May gives. Not due to fear, intimacy, laughter, praise, adrenaline or the tension (or lack of) in the mouth and jaw.
You are SO positive about this, but we haven’t even studied it scientifically yet. That’s unscientific. Test your hypothesis!
“(W)e”? What hypotheses exactly have you studied? I would be very interested in reading your research.
Exactly. Once again, for the tenth time- everything I have said on here is just to support one argument only: that this blog sets out to prove Ina May Gaskin’s Sphincter Law wrong and it fails to do so. I’m not here to prove it right, I’m not a scientist. But to act as if the science is there on either side is frustrating and useless. You’re speaking definitively in a way I am not.
I’m responding to a direct quote from you: “You are SO positive about this, but we haven’t even studied it scientifically yet.”
Until Ina May or someone else first provides meaningful evidence for her claimed Law of Sphincters, there is nothing we need do. The Burden of Proof is on the claimant.
“You are SO positive about this, but we haven’t even studied it scientifically yet. That’s unscientific. Test your hypothesis! ”
No…Ina May is the one who would need to test her “sphincter law” hypothesis, which she has not done. There is no reason to believe any of what she says about her “sphincter law” is actually true because there is no evidence of it.
not sure why I’m wasting my time, but this is from the textbook “Histology for Pathologists, Third Edition,” Ed: Stacey E. Mills, MD:
“In contrast to the wall of the uterine corpus, which
is predominantly muscular, the stroma of the exocervix is mainly fibrous tissue admixed with elastin through which run infrequent strands of smooth muscle.”
Note the word “infrequent.” Infrequent strands of muscle do not a sphincter make.
Then from the section on the cervix during pregnancy:
“The stroma of the cervix undergoes a complex series of biochemical and biomechanical changes during pregnancy and parturition that taken together are known as cervical “ripening.” The initial change seems to be extensive destruction of collagen fibers by various collagenases accompanied by the
accumulation of gel-like acid mucopolysaccharides. This process causes the cervix to soften, a
process that reaches its zenith immediately before parturition. As a result, the cervix is easily effaced by
the presenting part of the emerging infant. ”
Nowhere does it mention anything about a sphincter or sphincter-like behavior.
Hey, I learned something! I didn’t know collagen destruction was a key part of cervical ripening. I work with MMPs in other (very different) contexts – I wonder if they’re involved here?
Yep I’ve already read that entire thing myself.
So you just plain don’t know what a sphincter is? Tell us, in your own words.
I’ve given the definition of a sphincter several times in this thread. The cervix is a circle. It opens and closes to let out menstrual fluid and babies. Dilation can increase or decrease during labor and if you’re not open to this fact because you haven’t seen it documented by people who go to Harvard then I’m afraid the people who go to Harvard are failing us and need to investigate further.
The mouth is a circle, it opens and closes, it lets things in and out, but it’s not a sphincter either.
http://medical-dictionary.thefreedictionary.com/sphincter
https://en.wikipedia.org/wiki/Sphincter
So that’s the definition of a sphincter for you – a circle that opens and closes to let things out? That’s necessary and sufficient to characterize something as a sphincter?
Check out this stylish sphincter bag: https://s-media-cache-ak0.pinimg.com/736x/c8/8a/b5/c88ab5cc25692de2f58308a2a4453e09.jpg
A case could be made that the bag is more like a sphincter than the cervix is! You can open and close it just with the drawstring, after all.
Right? But it seems to me that mechanical force is what opens and closes the bag, not the fibers of the bag contracting.
Good point.
This is a sphere, not a circle, but it has an opening that lets things in and out: http://www.disneyfanatic.com/wp-content/uploads/2014/09/spaceshipEarth-620×330.jpg
Sphincter?
https://www.youtube.com/watch?v=vfWk_babujs
No muscle…..:P
There’s muscle in my finger operating the shutter release, though.
Would you like a treat? The ‘entire’ thing? The whole book, or the 100 or so words quoted?
I would love a treat.
Then why are you still insisting that the cervix is a sphincter?
The very basic definition of a sphincter is a circular ring of muscle. The cervix is NOT a circular ring of muscle.
which one of those things is it not? It’s circular. It’s a ring. It has muscle.
It must be a circular ring OF muscle, not a circle that has muscle fibers in it.
A sphincter is like a drawstring with the drawstring being the muscle. The cervix does NOT contain a circular ring of muscle. All you have to do is look at it under the microscope to see that.
I’ve done tens of thousands of cervical checks, possibly even hundreds of thousands and I never found one that showed a cervix had closed. Yes there were cervical checks where the opening had been narrowed by pronounced swelling of the cervix itself, and there were exams where I was forced to correct the incorrect previous assessment by someone less experienced, but the cervix does not close.
That’s not surprising because the cervix dilates by mechanical pressure forcing it open. Once it is opened, it doesn’t close.
It would be impossible to know for sure that you were correcting a mistake rather than finding a cervix had un-dilated. it happens all the time- a nurse swears a patient was at 8 and the OB says 5. There are two possible reasons for this.
We do know the cervix doesn’t always open only by mechanical force. For example, during menstruation or early miscarriage.
Of course it opens because of mechanical force. Why do you think there are menstrual cramps and severe cramps associated with miscarriages?
Well then those same cramps that open a cervix should be capable of closing it
Yes, because if you can push on a door to open it, you should be able to close it by continuing to push on it in the same direction.
Well then those same cramps that open a cervix should be capable of closing it
Wait, what? That makes no sense at all. A contracting uterus puts pressure on the cervix, pushing it open. Why on earth would you think that a contracting uterus, by putting pressure on the cervix, could somehow CLOSE it too?!
The phrase ‘inter-operator variability’ has never entered your mind-space, has it?
By saying “there are two possible reasons for this”, I think you’ve accidentally summed up your entire way of thinking.
There are undoubtedly multiple reasons why a nurse and an ob might disagree about the amount of dilation, but you think there are only two. And in your mind, that the correct reason is that obs suck and midwives are great. It’s a simplistic way of thinking.
Here’s are microscopic views of different circular structures within the body. The description notes that the cervix has relatively little smooth muscle and that it propels nothing.
http://www.bu.edu/histology/m/append04.htm
Thanks. Until I read your article, I always thought the cervix WAS a sphincter, because I’m not a doctor and haven’t studied anatomy or physiology. (It’s round. It opens. It closes. Sounds like a sphincter to me!) However, your descriptions and definitions are very clear and coherent, and I am very glad to know something that I did not know before.
By the way, this is why I engage people who know what they’re talking about–my excellent obgyn/CNM practice–to care for me during my pregnancies and labors. Goodness knows doctors and modern medicine have plenty of faults, but one thing that makes my “sphincters” feel nice and relaxed is the knowledge that the baby or I is HIGHLY UNLIKELY to die from something preventable like hemorrhage, puerperal fever, or Group B strep.
Edited to change “are” to “is” in the last sentence.
The. Cervix. Is. NOT. A. Muscle.
Never has been, never will be.
You are being stupid on purpose here.
Yes it’s round, yes is has some muscles in it.
But its muscles are not organized into a ring that are able to contract themselves in an organized fashion to close the cervix. So it is not a sphincter.
So, you were knowingly giving false information when you said it had not been scientifically studied? That’s known as lying.
They’ve studies whether or not the cervix closes during labor? Great! That’s the one thing that will put this to rest for me
Have you tested your hypothesis about cervix contracting during birth?
Vets? An article more than 100 years old? Holy cats, you’re reaching.
When new research cancels out old beliefs, to the past they go and belong.
The reason I found this site was that a vet in my country thought herself equal to her patients and she’d never had a dog or cat go to her office to give birth, so she chose to homebirth her human baby. The baby didn’t make it but mom made the news. That was the first time I heard that homebirth was even a thing somewhere. Colour me unconvinced that animals and humans are this much alike. Last time I checked, I only had hair on my head, not all over.
were not even debating the safety of home birth here. We’re simply discussing the cervix.
And you give vets’ knowledge as something to go by. I do not agree and I told you my reasons why.
I didn’t quote the vets because I’m not an idiot, it was said in passing but I do think it’s worth mentioning.
So you won’t quote them, but what they said is worth mentioning? You’re citing them either way.
So, Dawn. If the cervix is a sphincter that contracts when you’re stressed, is relaxation during pregnancy the cause of miscarriage? Do we need to stress the crap out of pregnant women until they reach term? Do you suggest sleep deprivation instead of cerclage?
I looked in a veterinary anatomy book and saw that mammals have tails, and although I can’t see mine, I assume it’s there, somewhere. Because mammals lactate, or something.
When Amazing Niece is hungry, she sounds remarkably like a Bengali tiger. A baby-sized one, of course. Never occurred to me to look for the reason for this very amazing coincidence.
In my defense, that occasion a few days ago was the first time she got truly hungry in her five months of life. Mom’s visually nonexisting but finctioning like a prize heifer’s breasts spectacularly failed her that time. A glitch. As we know, happens even to mama tigers.
Ever heard of someone breaking their coccyx? Also known as the “tailbone”?
You bring us something from 1908? Wow.
For your information. I’ve just opened my veterinary anatomy textbook and there is absolutely no mention anywhere of the cervix being a sphincter.
Tsk, tsk. Don’t you bring up that new-fangled veterinary expertise around here. Just because you are a vet doesn’t mean your opinion means jack, compared to that 100 year old reference she has.
Come on, Bofa! Didn’t Mrs Bofa tell you that the cervix is a sphincter and this bit of knowledge hadn’t changed in the last 110 years of vet knowledge?
If you go back enough in time, you will also find that doctors used to think that a woman’s uterus was bifid, just like those of rabbits. That’s because the Church forbade the dissection of human bodies, so the study of internal anatomy was done on animals instead.
But medieval medicine books do not give an accurate picture of medicine in the 21st veg century!
1908!!!!! You are using a source from 1908 for medical information? Get thee to a library and talk to the reference librarian!
I’m going to add my two cents worth into this debate for what it’s worth.
I think you are confusing the cervix and its function with a kind of metaphorical gate complete with its own unique gatekeepers, who, depending on the situation and environment of the labouring woman, allow the cervix to open or close back up again.
Regardless of the correct terminology of whether the cervix is a sphincter or not, your fundamental understanding of what the cervix is and does and how it may be affected during labor is incorrect.
As a midwife I have seen many labors stall. The most common reason is due to an obstruction of some kind. When this happens the cervix often becomes oedematous and gives the impression that it is less dilated than it was previously. The cervix hasn’t “closed” in response to stress or any other kind of emotional discomfort. It has simply become swollen in the same way other tissue becomes swollen when it is injured or when unrelenting pressure is put upon it. Sometimes the cervix itself may have its own particular form of pathology. It may be scarred or damaged in some way or diseased. This will affect its ability to dilate normally and may give the impression of “opening and closing”.
I know it must be hard for you to digest the thought that Ina May is not the expert she purports to be and that she is actually quite detestable in her sexist attitudes and questionable practices.
There has been a lot written about The Farm and its leader Stephen and it’s not all sunshine and rainbows.
I’m going to add my two cents worth into this debate for what it’s worth.
Your two cents are gold! That post is probably the best explanation of what is going on in this whole thread. Dawn, if you read nothing else, read Deborah’s post.
Your mouth opens and closes while eating. It’s not a sphincter.
Hey, no fair! That was my argument! Give it back, I wasn’t done playing with it yet!
https://disqus.com/home/discussion/skepticalob/no_ina_may_the_cervix_is_not_a_sphincter/#comment-2778171619
They do call it a sphincter. They specifically call it a sphincter.
That’s the problem though; who exactly are “they”?
Maybe someone should tell them. Unfortunately, no author is listed, so we don’t know whom to tell.
Let’s set up a mass mailing list to all wikis!
No citations on that page, I notice.
Oh, hey, look at the great info available on that site!
http://m.med-health.net/Chai-Tea-Benefits.html
I don’t know, Dawn Batson. The site claims to be written by MDs, but the “about us” section names no names and solicits contributions from the readers, without any reference to their qualifications. Plus, looking around a bit further reveals a page recommending home treatments for food poisoning and another recommending aloe vera for weight loss. Something tells me this isn’t a very authoritative site.
I will give you that. I’m aware the website I referenced seems very un-MD upon further inspection.
Good you recognize that. Perhaps in the future, instead of forming your opinion and just running to any source you can to try to support it, you might actually look into reliable sources FIRST and then form your opinion?
Pffft! Silly Bofa! *Everyone* knows you start with a preconceived idea and then try to find evidence to support it. Or, if you can’t find anything to support your preconceived notion, you then claim that if *all* the literature does not SPECIFICALLY state otherwise, then your idea is valid, because the literature (and I use that term loosely) did not specifically say it was or wasn’t true, depending on what you are trying to prove.
And this is why you do not use the first googled result that shows what you want it to.
https://media.giphy.com/media/83QtfwKWdmSEo/giphy.gif
Oh so you type things in the internet and then rush to the first site saying what you want to see without checking who maintains it first? Why am I not surprised?
Such anger! And none of what you’re saying matters. If your cervix is or isn’t a sphincter- nothing changes. Yes people give birth all the time in unsafe environments. Ina May is simply observing that women’s labors seem to stall when they’re not feeling safe. Why would this be such a shock to you? it seems perfectly scientific and reasonable. If a cervix is not exactly a sphincter but acts like one during birth I just don’t see the point in being so furious about semantics. Have you ever been a part of an unmanaged birth? Have you witnessed a cervix close up several centimeters suddenly?? These midwives you clearly despise know some things you probably never get the chance to observe.
Actually, a lot changes, did you not even read how differently the cervix operates from a sphincter?
Just because something is done, doesn’t mean it should be encouraged.
Because it is blatantly and flagrantly false.
So do a lot of falsehoods touted by woomeisters, it’s part of what makes them so dangerous.
It doesn’t act like one at all! Read, damn you, read!
Define “unmanaged”, because I’m pretty sure having an OB in attendance automatically rules it out.
I’m curious what she never observed in the thousands of babies she delivered, and if there might be good reasons she never saw whatever it was.
I read the article, I think the problem is you don’t understand what I’m saying. I’m not saying women should give birth in unsafe environments. I’m responding to what keeps being thrown around as some kind of “proof” that Ina May is wrong- that because women give birth in unsafe environments all the time then clearly labors don’t stall when women feel violated. This is such bad reasoning. Women do give birth when they feel violated or unsafe but that doesn’t mean their bodies don’t make it harder for them- that the cervix doesn’t close back up a few centimeters.
And again, sphincter or no sphincter, a cervix doesn’t just dilate but it also closes up. Its actually unscientific to tell someone who has been a midwife for thousands of births that because science hasn’t proven it then she’s a liar. Is it harder to put in a tampon when you’re tense? Yes. Is it harder to poop when someone else is in the room? For a lot of people it is. Do people sometimes defecate themselves when they’re stressed? Yes. But that doesn’t negate that there is an emotional component to our bodies that makes certain biological processes more difficult under certain situations which is the actual point Ina May is making.
Unmanaged birth means a birth that is allowed to progress without interference. Most OBs haven’t witnessed what “normal” birth looks like because they’re so eager to change it. But so much of what a typical OB does is unscientific. Putting a woman on her back and telling her she’s not “allowed” to move around. Inducing half the births they attend because the baby is “post date.” Calculating due dates not by the length of a woman’s cycle and ovulation date but in a dangerous one size fits all manner. This is why our c section rate has sky rocketed and our infant mortality And maternal death rates are some of the worst in the developed world.
There is such a strong angry backlash against “woomeisters.” It’s everywhere. It’s no wonder we can’t figure out how to stop having wars- because people can’t even talk about birth without attacking people who have different views than we do. But a lot of my choices you find so infuriatingly “woo” are the result of the complete disregard for science in the field of medicine. So often I see this blind faith to the established norm and anything that challenges that incites fury. But western medicine ignores science in real and dangerous ways all the time.
Compared to an OB who has also attended thousands, and actually studied human anatomy and physiology?
Your second paragraph is a bunch of meaningless comparisons between unrelated processes and structures, while your entire third paragraph is nothing but bullshit that has been refuted on this blog over and over again.
Oh, that’s extremely clear.
Give some examples. And keep in mind, there’s no such thing as “Western” medicine. There’s modern medicine, which is used around the world, and there are various “alternative” medicines, some of which are regional, many of which aren’t.
If you think the cervixes of women giving birth in dangerous situations close back up a few centimetres, the onus is on you to prove that not someone else to disprove it.
Actually the burden of proof lies with the person who decided to publish an article ridiculing a revered midwife’s observations. but since you asked- I’ve seen a nurse enter a room and tell a woman she’s six centimeters dilated. A few hours later an ob will check and he’ll say she’s four. Aside from my own observations I fall back on what countless midwives who have attended countless births have observed. If you want to publish something that refutes these observations then post something that actually refutes them please.
“Revered” means nothing. Jim Jones was “revered”. So were David Koresh, Cyrus Teed, and L. Ron Hubbard. Doesn’t make anything they said worth a damn though. So no, I will not be taking medical advice from someone who refers to genitals as if she were still in middleschool.
Hum no, the burden of proof is on Ina May, who has to give some scientific evidence to the ridiculous stuff she’s saying. No matter how many of you ‘observed’ something, it doesn’t make it true, it’s the midwives job to actually prove that it’s true.
And everyone knows that checking dilatation is not actually an exact science. It uses fingers ffs. Maybe the first nurse has really tiny finger and the OB has huge ones?
So, about your totally real nurse/OB story, which definitely happened, and which you’re certainly not making up or exaggerating for impact. Do you think it’s more likely that the cervix closed, or that there was a measuring discrepancy between two providers?
Oh that’s cute. I think they assume it’s a difference in finger size. And I think assumptions are bad science.
So, why are you taking the assumptions of women on the internet as face value? Why are you refusing to show any kind of proof to your rambling? Why are we the only ones who should bother showing proofs?
This whole page is about proving Ina May wrong and it doesn’t do that at all. I don’t have to prove Ina May right, I just have to say you didn’t prove her wrong either.
Before anything else, Ina May needed to prove herself right. She didn’t do that, but many people have still listened to her anyway and have risked severe injury to themselves and their children because of it, so Dr. Tuteur attempted to undo some of the damage.
As discussed previously, the burden of proof falls on you when you make a claim, which you did. You either evidence it or look like you have no idea what you’re talking about.
And your anecdote is not evidence. Even assuming both that you’re telling the truth and the nurse and doctor each measured accurately, this still wouldn’t tell us why it actually happened. I mean really, even your unverified anecdote doesn’t say what you want it to say. You could at least pretend she told you afterwards it was because she was frightened. Make the effort!
Honestly I didn’t even know this was debated- and am still not sure it is. It’s happened a couple different times at least in my limited experience, it’s all over the internet. No anecdotal evidence isn’t science but it certainly suggests in the lack of science that there is something happening here worth looking into.
There’s no ‘certainly’ about it.
I never said WHY it happened. We haven’t been talking about the WHY.
I’m afraid that won’t do. You’re claiming that women’s cervixes close up during labour when they feel violated and unsafe. If you didn’t think their feeling violated and unsafe was relevant, you wouldn’t have mentioned it.
This isn’t an article – it’s a blog post. If this were published in a peer-reviewed journal, it would be referred to as a review paper or possibly an editorial.
It sounds nitpicky, but it’s a critical distinction between the level of oversight into the claims made. Blog posts have no peer oversight. Editorials have a small amount of peer oversight. Review papers have somewhat more peer oversight (at least in the fact that someone could argue that an important topic was missed or that a paper was misconstrued). Articles have the highest level of peer-review behind them.
Which leads to why many of us are getting exasperated. We ask for actual, peer-reviewed information on the “emotional regulation of cervix dilation” ….and we get sent to websites that are essentially blogs without named authors. A few years ago, you might have been able to argue that you didn’t have access to those papers, but between PubMed, Google Scholar and ResearchGate, you should be able to support your views with actual, peer-reviewed papers.
It’s like being handed a copy of “Goodnight, Moon” when you ask for a description of lunar landforms or a copy of “Pat the Bunny” when asked for the dietary needs of lactating rabbits.
But if stress makes cervixes closes, and if all midwives see it, but OBs dont. Doesn’t that mean that giving birth with a midwife is way more stressful than giving birth with an OB?
how do we know no OBs see it? Is that just an assumption? Aren’t assumptions unscientific?
See, why should I bother proving my arguments when you don’t have to? It goes both way honey.
OH! You gave me an opening! Thank you! *quivers with nerd glee*
Actually, all science is based on a series of assumptions. These assumptions are studies within the field known as “nature of science”. These assumptions can be based on the culture in which the scientist is embedded, the discipline in which the scientist is trained, and the personal history of the scientist themselves.
So, for example, the USA gov’t has decided that studying how children are affected by handguns should not be funded. That has affected the questions that researchers can ask about the effects of handguns in households with children.
Likewise, a country in which intercourse is expected to be unpleasant for women is not going to have scientists researching cures for vaginal pain during intercourse.
I’m pretty sure I don’t have to prove anything to anyone. I’m not publishing articles trying to prove that someone is an idiot with a flimsy sentence that doesn’t prove anything.
Minus the publishing articles part, I think you just described yourself quite well.
But, er, why are you having this discussion if you’re not trying to prove the correctness of your position? Look, I’m a layman. Go ahead and prove that cervixes close up during labor to me. I do ask that your sources be reliable, though–ie, article from journal indexed on Pubmed, or an information sheet from, say, ACOG or the NIH. Simply saying “midwives see it all the time” is not sufficient, because CPMs don’t have the formal training in anatomy and physiology to make that determination.
For that matter, even ‘doctors see it all the time’ would not be an acceptable answer either. The would be asked to prove it.
Doctors don’t have to prove things!!! Midwives don’t have to prove things. Scientists prove things and scientists haven’t proven anything about the cervix being or not being a sphincter. All of this prove it business is exhausting because there isn’t proof either way. It’s a discussion! And it’s a discussion because an article was posted as if it were proof against something someone posited, and it isnt. Ina May wrote a book about her philosophy on birth. She backs it with decades of her own experience. She doesn’t market herself as a scientist therefore there is no burden of proof. A scientist is welcome to come along and prove or disprove any part of it while Ina May continues doing her work which is midwifery.
If we were talking about pizza toppings, Ina May could claim that mozzarella cheese is made from unicorns and I wouldn’t care. The problem is that, in childbirth, lives and brain function are at stake. Anyone taking on such a responsibility had darned well better know what she is talking about; the application of incorrect theories can literally kill. So if Ina May advances any new theories, she needs to prove them.
Interesting fact, Dawn: Doctors are a form of medical scientist. While many do not publish papers, all are quite capable of running a decent, publishable study.
I would hope that midwives would hold themselves to the same standards of well-designed studies, peer-reviewed journals and practice guidelines. (I am a bit of a dreamer, I know.)
Snap! I missed the most obvious bit: Scientists don’t prove things. We can occasionally disprove the null hypothesis (on a good day), but we don’t and can’t prove things.
“She doesn’t market herself as a scientist therefore there is no burden of proof”
I don’t market myself as a scientist. Buy my herbal tea, it will guarantee an easy birth and make you rich. I don’t have to prove it!
“Scientists prove things and scientists haven’t proven anything about the cervix being or not being a sphincter.”
Care to revisit this one, in light of your backpedaling above?
yeah, why would you guarantee something? Ina May doesn’t guarantee anything. This is a bad analogy.
Nice ignoring of the question.
This is the dumbest thing I have read in weeks. I’ve been trying not to flame you, but I can’t hold this in any longer. Medicine is a science, you witless tool. Learn something, anything, I don’t care what, hell, learn origami for all I care, but then at least there will be something in your head besides this moronic anti-intellectual contrarianism, and you’ll have done something that wasn’t a complete waste of everyone’s time and ludicrously dangerous to anyone stupid enough to listen to you.
I’m not even being that contrary. I’m not even saying the cervix IS a sphincter. Saying the quote doesn’t even say definitively that it isn’t a sphincter isn’t that contrary. Saying even if it isn’t a sphincter it still opens and closes during labor also isnt that contrary. NOthing I’ve said is really that contrary or moronic. There are a lot of birth professionals who have been doing this for years who believe that sometimes cervixes un-dilate partially, and I don’t think the evidence for that being just human error is totally believable. Now please explain to me what I’ve ever said that was “ludicrously dangerous.”
The bullshit lies you stated about OBs, for one.
Given that the evidence is overwhelmingly strong that 39-week induction reduces perinatal mortality and lowers the rate of unwanted C-sections when compared to your favorite method, sitting on your hands and waiting (aka expectant management), your crap about ‘pushing pitocin’ is indeed both ludicrous and dangerous. No OB ‘pushes’ pitocin. They advise it when indicated because their job is to get healthy moms and babies out of the other end of a pregnancy. Midwives and doulas, in contrast, are all about selling birth as an ‘experience,’ like it’s a trip to Disneyland.
Ina May’s work is keeping her hands “busy” during childbirth, massaging baby oil onto womens’s “buttons” while taking time out to tell the woman’s husband how nice the woman’s tits are.
One of the reasons I left the WTE boards is because they were so moderated and delicate, that they were the equivalent of talking about your favorite pizza toppings.
“I like pepperoni”
“I prefer sausage”
“Oh, my favorite is ham and pineapple.”
“I don’t like cooked pineapple. Just ham for me.”
“Hey, that’s not nice jumping on her like that. She was just expressing her opinion.”
That’s what happens when you have a “discussion without trying to prove the correctness of your position.” It’s content free. And boring as all hell.
Now, at least with pizza topics, it’s all opinion. But she is treating this like Zeke on the Big Bang Theory. “That’s what you gotta love about science – there’s no one right answer”
https://www.youtube.com/watch?v=fvOWE5S4x9U
I don’t know why I’m continuing this discussion. I started it because I felt the article didn’t disprove what it claimed to disprove. But it’s clearly been a massive waste of my time because all anyone wants to do is call names and say asinine things that are beside every point, so I’m going to stop now. I’m fairly sure Amy knows the cervix can dilate and undilate. It’s highly unlikely she’s seen that many more births than I have and not noticed it.
You shouldn’t have started it as it was an old thread. Now you drag us all back into this again. You can’t even read for comprehension. Just quit since nothing we say will change your mind.
Why? Because she’s a doula and she makes her money peddling this nonsense.
Amy, are you going to sit there and act like you haven’t seen a cervix close back up a few centimeters? Really?
I don’t peddle anything. As a doula I support every safe decision a woman makes. If she wants an epidural I am all for it. If she wants an unassisted home birth I strongly discourage her and do not participate. I am aware that epidurals can solve everything and have seen them help a woman progress. Educating is beyond my scope. I strictly support.
You’re pretty wrong, then. If you say something, the burden of proof is on you, you evidence it. Or look like you’ve no idea what you’re talking about, obviously. Your choice.
That’s so funny you should say that, as that was my original beef with this article.
Don’t think nobody’s noticed you’ve still proved nothing.
So, where is Ina May’s proof then?
In all fairness, I see no evidence that you are publishing any kind of article in a peer-reviewed process.
Because – honestly – this should be a super easy, low-hanging fruit study to run and get published if women’s cervixes respond to stress as rapidly and invariably as you believe they do.
It’s really not that hard.
1) You need to find a HRRC (Human Research Recruitment Committee) to verify that your proposal is safe to be studied on humans. Since the humans are pregnant women, there is a higher level of oversight required, but that just means you need to be very clear about the benefits and risks of your study to the patients going in. Best spot to start is the nearest biomedical science research university.
2) You’ll need a primary investigator or PI. That friendly OB is probably a good starting spot plus a faculty member at the university with the HRRC.
3) You need to write up a proposal for your work. What I’d recommend is combining hourly cervical checks by the OB PI with an hourly survey of Likert-type (or actual Likert) items. That would be items like “In the last hour, I have felt scared a)never, b) a short time, c) half the time d) most of the time, e) all the time. You’ll need to find a verified, reliable survey (or make one yourself…which takes ~3 years) and need to run down some studies to support the ideas behind the cervical dilation and emotion connection.
4) Collect your data.
5) Analyze your data.
6)Write and publish.
Nah, she just needs to write about it on her blog page. Just as good!
“Unmanaged birth means a birth that is allowed to progress without interference. Most OBs haven’t witnessed what “normal” birth looks like because they’re so eager to change it”
So, by your statement quoted above, “normal birth” is considered “unmanaged birth” because OB’s don’t see, understand or promote “normal birth”. If midwives are self-identified experts in “normal birth” and eschew interventions because “normal birth” does not need interventions/interference, then why do midwives do things like monitor fetal heart rate, check the cervix for dilation and effacement, sweep membranes, promote using castor oil as a labor inducer, suggest position changes, birth balls, tubs, etc?
All of those things I just listed are interferences and could *gasp* be construed as “natural interventions” because a woman’s labor is not being allowed to happen “naturally” for her. And if unmanaged birth equates to normal birth, then midwives and all their “natural interventions/interferences that aren’t REALLY interventions/interferences” aren’t necessary either.
Because midwives DO interfere/intervene when a woman is in labor and delivering their child. They interfere/intervene in a decidedly “non-mainstream medical” sort of way, but interfere/intervene they do.
What does this have to do with anything again?
So you talk shit and when said shit is proven irrational, you exclaim, “What does this have to do with anything again?” What is has to do with anything is that it’s another one of your irrational, unsupported, illogical claims.
It doesn’t seem like you’re following along. http://m.med-health.net/Function-Of-The-Cervix.html
Which comment caused this retort?
My statement was a comment on how OBs maybe aren’t noticing certain traits of normal birth that midwives are because they’re intervening and changing it?
It makes sense that a midwife would see different patterns than an OB pushing pitocin and epidurals who pops in every few hours if that.
Pushing pitocin and epidurals?
Listen now, you dangerous asshole! Just close your fucking mouth and use the time you spend worshipping Ina May’s butt to pray that the OBs you rush your clients too with complications that could have been managed at the hospital but weren’t because you were saving women from having pitocin and epidurals pushed on them are capable to save them or their babies without lifelong damages! You freaking nut! You’re a fucking doula. When you graduate from whatever riduculous program you’re attending, you’ll still know about 10000 times less than OBs – and you won’t know nearly enough to fathom why pitocin and epidurals aren’t pushed but needed and life and bran saving. Oh, and while you’re at it, please don’t let your own preterm baby die following your revered Ina May’s lead.
Pushing epidurals and pitocin? Ina May plays with women’s tits during birth, you fool, and if you don’t know it, google the citations of her book before the last edition. Since you love googling so.
Hi darling. Yes OBs push pitocin and epidurals- is that shocking for you? Pitocin and epidurals have their place but not in most births. What are your thoughts about our c section rate out of curiosity?
I’m not rushing my clients anywhere, I’m not sure where you get your info but 99 % of my clients choose hospital births with awesome OBs who understand birth.
Hi, sweetheart. It is indeed shocking for me since women want epidurals on big scale and pitocin is applied when needed and doesn’t lead to nearly the same death and brain damage toll your beloved non-interventional, unmanaged births do. When you have made your clients think that you know what you’re talking about and pitocin is only pushed on and almost never needed, of course they’ll feel it was pushed on them. You took care to make them think so.
I thought you were going to be a midwife? I admit I am not seeing much sense of getting any official capacity if you don’t plan on having midwifery clients. And if you do, I pray you had the knowledge to recognize complications and good sense to rush the women to the hospital in time. By what I saw here, I doubt it.
What about the USA c-section rate? I prefer to look at the low-risk peri rate since that’s the only way to know that something different should have been done. And it’s reached dramatic low since the c-section rate plummeted. Of course, there are many c-sections that are unneeded. Has Ina May invented the machine that can tell us which ones they are in advance?
Oh pit is given only as needed? It’s cute you think so. And pitocin causes less damage than births without it? You’re hilarious.
Yes, sweetpie. Low-risk OB attended births, with and without pitocin – lower peri mortality. Midwife-attended homebirths which are by default low-risk since the women you so respect holler from the rooftops that they’re only taking low-risk clients – zero pitocin and mortality that’s several TIMES higher. Clearly, pitocin isn’t the devil and “pushing” pitocin isn’t nearly as dangerous as sitting on your hands at a labouring woman’s home, basking in the respect of someone like you and not pushing for a hospital.
Please tell me that you can at least gather this much? No advanced education is needed!
Dear entire skeptical OB community! Listen up! Doulas do not tell their clients what to do! I encourage my clients to get informed about their options and then I back those options as long as it doesn’t pose danger to them or the baby. I don’t know where you get your information about my role but it clearly needs clarifying despite being completely OFF Topic
My midwife “pushed” (recommended) pitocin and an epidural. It was good advice, though in hindsight I think she could have pushed for the c-section sooner as well.
I haven’t yet responded to any of the amazing assumptions made about my aspirations, my philosophy, my supposed lack of respect for OBs or necessary interventions or my ego and that’s because they’re off topic. But I would like to take this opportunity to again point out that you sound like a psychopath.
I guess it would be so. Since you rever people who harass women in labour and let their own babies die without seeking medical help for them but are sweet on talking, someone like me, caring about lives and brains, comes across as so very strange.
Are you under the impression that your posts on this very page are a secret or something?
Ive already said almost all of the births I’ve attended have been alongside great OBs. If you’re insinuating as everyone else has that I don’t respect the knowledge and skill of those OBs then that’s yet another assumption.
I insinuate nothing, I stated clearly that all up and down this page you have made insulting comments about OBs as doctors and people.
For example???
Not following how this is an example. I wasn’t even attempting to be insulting. It’s a very different style- the midwifery model vs the typical ob model. It makes sense that if you have multiple people checking a laboring woman, if you’re rushing the birth, if you’re augmenting with pitocin then you might miss the cervix closing a bit or you might have an easy time assuming the less experienced nurse was just wrong.
The reason this is so difficult for me to drop is because I’ve seen it happen more than once and I’ve only attended 30 some odd births. I’ve also seen labor seem to stall over emotional factors and then resume when those factors are resolved. I’m aware this isn’t science but it’s something that’s very hard to shake. I’m clearly in no position to prove anything to anyone, I didn’t come into this discussion confused on that front. But Amy’s response about discrepancies in cervix dilation being because other people were wrong doesn’t have me convinced.
Ok, so let’s get this straight. You’ve been to 30 or so births, and during those events have formed a view about those births, which you then extrapolate to all births.
And this is your basis for disagreeing with doctors and highly trained and qualified nurse/midwives. They have years of education and training, and have attended thousands of births, all of which you dismiss in favour of, effectively, ‘the vibe’.
I think with this assertion you have made your point eloquently. Perhaps more eloquently than you realise.
What have I extrapolated to ALL births?? Not a damn thing. Have I ever said ALL births do anything??? Also, that was a self admitted “only” thirty births. I’m not sitting here assuming I’m some expert on anything. I do know that some women I respect believe very strongly that your cervix can close up a few centimeters, I do know that I’ve seen it happen more than once, I do know that there is a lot of anecdotal evidence that it happens, I do believe that a lot of the time a doctor assumes some idiot doesn’t know how to measure dilation and is off by several finger widths that it’s more likely the cervix changing. Now someone please tell me why Ina May Gaskin would make up a lie like that? What purpose does that serve??
Thanks for sharing what you know and believe.
I have no idea whether Ina May believes what she says, or not. It actually doesn’t matter. A weight of science and medical opinion says she is in error, and that what she believes is wrong. Would I put my life and safety in her hands, based on this article and your passionate advocacy of her views? I would not. Your advocacy has done her no favours.
Thankfully I’m not privy to the workings of a mind that let her own baby die for want of medical attention. Or to the workings of a mind that advocates sexually abusing women in labour.
WHAT VIBE? Not all doulas are the same doula. Not all doulas have the same thoughts, motives, personality, style, mindset. I don’t talk about VIBES, I don’t even like the word. You don’t know the first thing about what I think about any of it.
The bigger issue is that you have no idea what you think about it either. As you have displayed here, you just ‘know’ stuff, without reflecting on it.
I quite see you wouldn’t talk about the vibe. I wouldn’t either if I was an ignorant hobbyist making a living flogging that ignorance to the gullible and ill-informed.
If you attend enough pregnant women, with that attitude, someone will be seriously injured or will die. But then, and this all doulas and other birth hobbyists, whatever they style themselves, do have in common: it won’t be your fault, because it was her choice, and you were only relying on your feelings.
How will someone be injured or die based on my attitude? Please elaborate. How does my belief that the cervix is capable of closing during labor change the course of anybody’s history??
It doesn’t seem you even know what a doula does.
You must be very different when dealing with your clients than in your interactions here. You show no respect here, not even for yourself with your ducking and weaving.
I don’t care what a doula does, or more accurately, claims to do or to be able to do. ‘Get paid’ seems to be the only thing they all have in common. Certainly nothing a kind partner, friend, sister or mother couldn’t do, more cheaply and more respectfully.
it’s hard to tell the order things were posted in on this thread, but it’s not hard to see that I’m not ducking and weaving anything. I’ve summed up my position more times than I can count, but I’ll do it once again. I believe it is possible for a cervix to close up during labor, and I don’t believe this blog post refutes what it claims to refute. From the beginning and consistently all along I’ve said “whether the cervix is a sphincter or not….” which means I’m not arguing that it is, I’m arguing that it acts like one.
I also began respectfully and then after having my character and my intelligence repeatedly insulted, I peppered in some sarcasm here and there. But definitely nothing in comparison to the furious insults I received myself. No, I definitely don’t respect people who call me names. I think thats repulsive and childish behavior.
As far as your not knowing or caring what a doula does? That’s fine with me, I just wish you would stop making assumptions about what I do and what will supposedly happen if you don’t even know that much.
For the record, my job is not to inform or educate. I support women’s choices as long as they are safe. I’ve supported women through voluntary inductions, I’ve supported women through c-sections. I’ve gotten nothing but great feedback from these women and they claim I was a great comfort.
Seeing as how more than half of my clients were single mothers, teen mothers, or immigrants whom I didn’t charge a penny from I don’t know that it gets much cheaper than that.
‘Yes OBs push pitocin and epidurals- is that shocking for you? Pitocin and epidurals have their place but not in most births.’
So is that an opinion you keep to yourself, or do you share it? If you share it, do you claim that isn’t ‘education’? I’d suggest that your communication might come across as education, even if that is not your intention.
Words have power. I understand you don’t recognise that-you’ve accused some people here of playing with words or indulging in semantics, when all we have done is responded to the words you provided. ‘Seeing the cervix’, for example. You were patronising to the person who picked you up on it, because they didn’t realise you were speaking figuratively. It wasn’t obvious to this lay person that you were.
If you set yourself up as knowing something, among people who believe they know less than you do, then they may just take you seriously. That’s a profound responsibility, whether or not you understand or accept it.
Take care with your words if you are a serious person trying to do some good in the world.
And what is it I “just know” “without reflecting on?” The fact that this blog has done a poor job of refuting Ina May’s claim?
God help us when you do try to be insulting! You were as offensive as hell to obstetricians while praising midwives to high heaven and now you’re backpedaling like crazy.
You don’t have the knowledge needed to correctly use a textbook. (What do they teach you in middle school anyway?) You don’t have any medical education. You have 30 births under your belts compared to Dr Amy’s thousands. And you think your “not being convinced” should be impressive when you can’t make the difference between IS a muscle and CONTAINS muscle? Dear God.
What about midwives who sneak shots of pitocin to laboring mothers without their consent?
Wait, is that seriously a thing that happens? Because that’s horrifying.
Yes. Someone, I can’t remember who right now (The Honest Midwife, I think) wrote about how the CPM’s are trained/taught to use pitocin on the sly, as well as vacuum extractors (they called it “the fruit”, because Kiwi is a brand of vacuum extractors, I think).
Hair-raising stuff.
http://www.honestmidwife.com/cytotec-tea/
“It wasn’t something that the midwives openly discussed, the clients were never informed, and it certainly was never written down in anyone’s chart. But sometimes, with a little wink, they might indicate that they had given her “just a little Vitamin C,” and let the students figure out the rest. It was drilled into us in class that we should never give Cytotec to anyone who had had a previous Caesarean section because it dramatically increases the chance of the uterus rupturing, a deadly emergency. But giving just a little bit to a woman with no history of uterine surgery? It might just be enough to help a lazy labor pick back up! Cytotec was also administered vaginally to induce labor; the midwife would tell the client she was inserting evening primrose oil.”
That’s repulsive.
Especially when you read between the lines of that quote and see that it’s common and accepted for the CPMs to oversee HBACs.
What about them
Pitocin is evil when an OB decides to use it (and TELLS the mother about it) to help augment contractions, help induce labor, or deal with a PPH because…..well, REASONS.
Midwives who surreptitiously slip a laboring mother a shot of pitocin to help with contractions due to an extended labor, ineffective and/or disorganized contractions, or other intuited reasons are well within their rights to do so?!!?!
How is that any different than an OB using pitocin, other than the fact that the OB TELLS the mother about the pitocin and a lot of midwives don’t mention it at all?
I know several people who gave birth to very early preemies–24 weeks–they definitely didn’t feel safe during labor. Wonder why their labors didn’t stall? They sure as hell wanted them to.
The 2 hours ambulance ride to the hospital with an NICU apparently wasn’t stressful enough for my coworker to prevent her from giving birth to her 26 week preemie.
I already said this, but once again, nobody is saying it’s impossible to give birth if you’re stressed. For the love of god you all sound like my mom who refused to quit smoking on the grounds that her mother smoked all her life and never got cancer. You’re smarter than this reasoning, I’m sure.
So it’s stress causing delayed labour when you say it is, and the rest of the time it isn’t delayed it’s just Nature doing its thing.
And so what if Nature doing its thing kills a few babies or mothers, or leaves them permanently injured?
Or does that overstate your position?
No, what I say has nothing to do with anything. Sometimes cigarettes cause lung cancer and sometimes they don’t. Sometimes stress causes a cervix to close and sometimes it doesn’t.
The rest of your questioning is out of left field and has literally nothing to do with anything that were talking about here. Do try to stay on topic.
Your first sentence shows remarkable self awareness.
If you meditate on that sentence for a while, rationality may be within your grasp.
That’s ironic- I’m literally the only one here trying to stay on topic.
It’s sarcastic, not ironic.
Literally.
We are staying on topic. The issue, Dawn, is that you struggle to articulate how the cervix works under stress.
You said “I already said this, but once again, nobody is saying it’s impossible to give birth if you’re stressed.”
followed by the sarcastic use of ” Sometimes stress causes a cervix to close and sometimes it doesn’t.”
So which do you believe in – stress will not cause the cervix to close enough to impede birth (statement one) or stress will cause the cervix to close enough to impede birth (statement two)?
This.
There are also women who fully “trusted” birth and had relaxing water labors at home who never progressed. Maybe cervixes have their own brain and their own emotions?
They’re sentient little gatekeepers–who knew?
I’ve got an idea for the next horror film monster now.
Sequel to Teeth maybe?
*Shudder*
I’m thinking that due to radiation in the atmosphere or whatever, all the cervixes decide it’s time to detach and live independent lives, but first they must rid the planet of human life.
That might run into legal trouble for the concept being too similar to The Day My Butt Went Psycho.
Ah-ha! TDMBWP almost certainly involves a sphincter and you just said it was too similar to the cervix movie. Clearly that means the cervix is a sphincter. Check mate!
😉
{shiver}
Thank God I had a hysterectomy when I did!
Hahahahahaha
You really think that any one of those midwives has managed to see something that an OB didn’t? Get over yourself.
Get over MYSELF? I’m not sure what I have to get over, but one thing this OB hasn’t observed that all the midwives I know have observed is that the cervix opens and closes.
So, for some reason, midwives are the only one who see a cervix closing. But OBs don’t?
So then there are 2 possibilities: Either the midwives are mistaken in what they are seeing. Or midwive are causing the cervix to close.
The cervix is dilated by the contractions pushing the baby’s head against it, so anything that affect the uterine contractions could make the head stop pushing against the cervix or even move the baby a little back up, giving the impression that the cervix is now less open. But it’s not because a magical sphincter muscle that only midwives know about has contracted.
This is a bad argument, and I’m getting exhausted responding to all the unsound reasoning but ok I’ll bite. Again.
A. You’re assuming only midwives know the cervix can close during birth.
B. There’s also the very obvious possibility that the OBs are far less attuned, that multiple people checking a cervix can make it too easy to assume a change in dilation is really just a difference of finger size, and anyway most OBs have very little contact with the woman before the pushing stage.
I’m actually a little confused about why this is such a hard thing to grasp. We know the cervix closes after the birth, so why would it be so far fetched for it to close during??
Besides the presence of a baby trying to pass through, you mean?
And that baby can also reverse station and go back up into the pelvis! Gasp!
In that case, thank heavens for c-sections, right?
Thank heavens for c sections anyway, but the baby comes back down again lol
Prove it.
Ask any OB. This isn’t debated.
Any OB, including the one whose blog you’re posting on?
I would be so surprised if this OB debated this fact, yes.
https://en.wikipedia.org/wiki/Philosophic_burden_of_proof#Holder_of_the_burden
Many people have already bothered with giving you real argument such as: Open any anatomy textbook and you’ll see that the cervix isn’t a sphincter.
But we both no you don’t care about actually science and actual fact. And my own argument is just as valid as your ‘I googled it’ argument. Or basically any argument you’ve provided. None of them are based on any kind of science.
I’ve also already given you 2 plausible explanation as to why a cervix might appear to be contracting.
Show me an anatomy book that says a cervix isn’t a sphincter, please
Granted it’s been a few years since I read one, but I’m pretty sure anatomy books don’t list things that aren’t sphincters, just things that are sphincters.
So, what would the analogous sphincter be in men?
Men don’t have a cervix sweetie. I’m sorry.
Of course not, honey, that’s why I asked about analogs. Men have the Braille version of the alphabet while women have the print. They both have the letter A but the A’s don’t look anything alike.
Some men do.
Show me an anatomy book that says my left knee is not a sphincter, please.
If you can’t, does that mean it is?
Oh lord this is exhausting. It was stated that if you open any anatomy book you’ll have proof that the cervix is not a sphincter. Then when I say show me that proof you respond with this bs. Which is it??
And you take offense at my calling you ignoramus.
My education has nothing to do with medicine, biology and so on. But I know enough to gather that you don’t have an idea of a main principle in any science: you can’t prove a negative. Not possible. Never. So please prove your positive… and be convincing. A hint: Google University isn’t legit around this corner of the internet.
You are trying to tell me you can’t prove a cervix isn’t a sphincter? Good grief
Are you continuing to tell us you can prove a cervix is a sphincter? Because you aren’t offering any citable proof.
Why would an anatomy book say that? It might as well say the cervix isn’t an elephant for all the meaning it would add. i
Thanks for proving my point, which was a response to repeated claims that if you open any anatomy book you’ll find proof that the cervix is not a sphincter
So anything not specifically excluded by an anatomy book is truth?
You’re about to set the world of anatomy by storm! You heard it first here, people: according to Dawn, the cervix is an elephant, as proved by the fact that no anatomy book says it is not.
Not sure where that leaves Ina May’s sphincter hypothesis?
Do midwives terrify elephants into closing?
You’d need to check the book. If it doesn’t say so, I’d suggest that is a very likely outcome.
Of course, I’m no expert on elephants, cervixes or sphincters. But it seems like that shouldn’t stop me blowviating (sp) about them.
I thought this one would be boring, but she turns out to be super fun!!!
Oh my god read! Please! AGAIN: what I said was a response to someone repeatedly saying I only need open an anatomy book to find proof that Ina May is wrong.
Yes, because if you open an anatomy book, you will find that the cervix does not actually have the necessary characteristics that define a sphincter. You will not find the specific statement “The cervix is not a sphincter,” because textbooks are heavy and expensive already, and reprinting all of the things that everything in there isn’t will not help. You have to engage your brain to the teeeeeniest extent.
I will if you will pal. I actually think this is all semantics. As I’ve said all along, whether the cervix fits the definition of a sphincter perfectly or not, if it opens and closes during labor then it’s a moot point. And there are people on both sides saying both things, but in this instance I trust the person who does her own checks throughout the birth.
It’s hard for me to make the assumption that the cervix doesn’t close up and that human error accounts for all of the instances in which it has appeared to do so. It’s hard for me to assume that the midwives who are the only one to check their clients’ cervix during their births aren’t crystal clear about when it has closed up and when it hasn’t. It’s hard for me to think of a reason why so many nurses and midwives are certain this happens. I have the highest respect for an OB who is open to the idea that a midwife who has delivered as many babies as she has might know something despite not going to Harvard. The attacks I’ve received on this thread about my lack of education have been vicious and are telling. It’s as if you can’t even presume to point out a bad argument if you haven’t graduated college. It’s obvious nobody here has any interest in discussion unless the discussion supports what they already think. It’s just been a lot of very childish name calling except by Amy herself who added to the discussion like an adult.
The issue is whether or not the cervix is a sphincter. Ina May says it is, but she just made that up since it’s absolutely untrue.
Gaskin’s claim is that anxiety can cause the cervix to close BECAUSE it is a sphincter.
That’s wrong on two points:
First, as we’ve demonstrated to you repeatedly, the cervix is NOT a sphincter.
The second issue, which we haven’t yet discussed, is that anxiety causes sphincters to OPEN not close. That’s why people urinate and defecate in situations of extreme stress.
Ina May is an uneducated fool and the only people who believe her are other uneducated fools.
It doesn’t even work according to Dawn’s logic. If anxiety and fear make sphincters close and if the cervix were a sphincter, most births would end in disaster. How many primagravidas are not anxious at some point during labor? Hardly any, because labor is painful and unpredictable, and both of those things naturally cause anxiety and fear. So logically, then, this sphincter-cervix would be snapping shut in nearly every first birth, and then due to that experience likely repeating the same performance in every birth after that.
“As I’ve said all along, whether the cervix fits the definition of a sphincter perfectly or not,”
Actually, you’ve been arguing pretty damn hard that it is indeed a sphincter, and opens and closes based on the action of smooth muscle. Despite what the biologists, obstetricians, pathologists, midwives, and veterinarians have told you. You’ve been sticking on that point and re-posting multiple times a link to a lay website that you think supports your misconception.
If you want to change your point to ‘stress stops labor,’ we have plenty of evidence throughout history that this isn’t the case, and would need more than just your say-so to convince us. Like, say, a published study of some decent quality, and one that takes into account the actual workings of the actual cervix that have been actually very well studied. That’s what research studies are for – to test a hypothesis in a controlled fashion, and to open up that test to fair comment and replication. Minds change all of the time in modern medicine based on quality data, not on anecdote.
“I have the highest respect for an OB who is open to the idea that a midwife who has delivered as many babies as she has”
How many babies do you think the author of this blog post has delivered? I’m interested to know, as the homebirth midwives that have paracheuted in have generally delivered a fraction of a percentage of yer average OB.
“It’s just been a lot of very childish name calling except by Amy herself who added to the discussion like an adult.”
She’s been more than patient with you, that’s for sure. And you haven’t had much pertinent to say to her educational posts.
I’m not referring to any midwives except the ones who have been doing it for forty years and might know what they’re talking about.
And I haven’t been arguing pretty hard that the cervix is a sphincter. I’ve been arguing that it hasn’t been proven not to be. I’ve been saying from the very beginning that even if it isn’t it still closes sometimes during labor.
Your words:
“which one of those things is it not? It’s circular. It’s a ring. It has muscle.”
“They do call it a sphincter. They specifically call it a sphincter.”
“Do the medical doctors who wrote this know how it’s supposed to be common knowledge that the cervix isn’t a sphincter? Maybe tell them?”
This is not arguing that the cervix is a sphincter?
Maybe she’s arguing that it’s in some unresolved quantum superposition? It would make as much sense as anything else she’s said.
Until it’s observed, the cervix is simultaneously open and closed.
And may or may not contain a very confused cat.
I love this thread.
There’s a pussy joke in there, but I’m too tasteful to make it.
Schrodinger’s Cervix?
Ah, I get it. You don’t know the difference between a category and a hypothesis.
“Sphincter” is a category. We say that things that have certain characteristics fall into certain categories. Eg, things of a certain size with four wheels that have tires on them and propel humans and cargo using an internal motive force are in the category of ‘car.’ You can look at a thing and see if it meets the pre-defined criteria of that category. You don’t have to ‘prove’ if something is a car or not, you just need to look at the thing and see if it meets those criteria.
“The cervix opens and closes in response to stress” is a hypothesis. The person making that claim has to design an experiment to ‘prove’ (the old use of the word, meaning ‘test’) that hypothesis, and then show the design and the results to the broader community for comment, critique, and replication. With enough replication, hypotheses become accepted as generally true.
Biologists and pathologists have looked extensively at human cervixes. They’ve done the work for Part 1, the classification. It’s not a sphincter by virtue of being a circular-ish thing that other things go through, any more than a horse is a car because it carries people and cargo.
We have substantial evidence that Part 2 is not the case, as we have scads of terrified, stressed women throughout history giving birth, including prematurely, precipitously, and other super terrifying and stressful situations. We have zero evidence that it doesn’t, as noted above, because anecdotes based on highly variable measurements where the variability hasn’t even been characterized aren’t evidence (see Part 1, above, as ‘evidence’ is one of those pre-defined things).
Actually it’s not. Because what kind of structure it has determines how it opens and closes. If it’s a sphincter, it should be able to close with decent force, and at any time. Were it a sphincter, it should be seen closing, not just before and after labor, but sometimes during it, because no bodily process or the parts involved are perfect. So if the cervix is a sphincter, there should be the occasional mother who has a baby partway out when suddenly the cervix clamps down. Does this happen?
Yes!!! Which has been my point all along.
Then prove it happens. Please, because that only allows the possibility of it being a sphincter, not guarantees it.
Also, your point all along has been “it starts opening, woman gets stressed, baby goes back up, and cervix closes”. Which is not the scenario I just described.
You’re the one who asserted it’s a sphincter (or so close to being a sphincter that it’s semantics to debate the point). You cough up the relevant anatomy book excerpts.
http://m.med-health.net/Function-Of-The-Cervix.html
That citation is maybe one step up from a Wikipedia article. No author is given, no professional body has approved it.
Actually, it’s several steps down. Take a look at the rest of the website.
oh it has muscles, hurray. Sorry honey, still doesn’t make it a sphincter.
Do you know what a sphincter is? It’s a circular bunch of muscle that keep an orifice closed by contracting. When a sphincter is closed, it’s because it’s muscles are actively contracting.
If the cervix was a sphincter, then it would be kept closed because of muscle contraction. It isn’t.
If it was a sphincter, then, as with all other sphincter, it would be possible to manually open it close to it’s relaxed opened size at any time without much pain or any trauma. (probably 10cm at any time, since that’s how much it opens during birth). It isn’t.
If it was a sphincter, whenever anyone does a manual exam to check for dilatation, they would feel the cervix contract on their finger (as you would putting your finger through any other sphincter). They don’t, because it’s not a sphincter.
General anaesthesia causes a general relaxation of practically all muscles, including sphincters. Pupils dilatation is actually a way to monitor anaesthesia. Fasting is recommended because the esophageal sphincters will relax and make vomiting more likely. People under general anaesthesia will also have relaxation of the anal and urethral sphincter, which makes ‘accidents’ happen quite frequently.
If the cervix was a sphincter, general anaesthesia of any women (pregnant or not) would cause it to relax and open. Causing a risk of uterine infection in basically all women and having an extremely high risk of causing labour/abortion in pregnant ones. It doesn’t, because it’s not a sphincter.
If the cervix was a sphincter, it would be controlled by nerves. (I sure as hell don’t remember any nerve responsible for cervix sphincter contraction and relaxation in any of my anatomy books.)
People with spinal cord lesion usually end up with fecal and urinary incontinence. Those people would most likely also end up with cervix sphincter incontinence. Depending on how those imaginary nerves works, the cervix would either be constantly completely dilated or constantly constricted. It isn’t the case.
Administration of muscle relaxant would also cause your cervix to open.
There are also a lot of problems that can affect sphincters when they don’t work correctly. That’s the case for urinary incontinence, people with gastric reflux etc. Ever heard of anyone with cervix sphincter dysfunction?
Any basic logic would tell any woman that it’s a good thing that the cervix isn’t a sphincter. It would be horrible if it was. Most sphincter will contract due to stress or pain. Virtually 100% of women giving birth are stressed and in pain. It would be extremely counterproductive. (and no, it wouldn’t happen only a few times, cervix contractions would be a constant problem is basically all births)
For a moment, I’ll stick with your “OB’s are less competent in cervical checks” hypothesis.
If that is true, why aren’t L&D nurses who do the cervical checks lining up to support you? After all, someone is doing those checks and for over 99% of women in the USA, it’s not an untrained midwife.
There is a problem with your assumption of OB incompetence, though. OBs may have less to do with a woman’s cervical checks than a L&D nurse – but they do a whole hell of a lot more of them over all time periods than untrained midwives. And certainly way more than a doula would.
Oh I totally think a lot of L&D nurses would agree with me. There’s anecdotal evidence all over the Internet.
EVIDENCE ALL OVER THE INTERNET
OH MY GOD IT’S SO FUNNY I CAN’T DEAL
“We know the cervix closes after the birth, so why would it be so far fetched for it to close during??”
We know that the beaded curtain closes after I pass through it, so why would it be so far-fetched for it to close as I pass through it?
The cervix closes after birth because those strong uterine muscles are no longer jamming a baby through it, and it slowly regains its pre-birth biochemical structure (unripens, if you like). It doesn’t ‘slam shut,’ or else the lovely stories of CNMs and docs getting their arms through the cervix after delivery to pull out retained placenta wouldn’t exist.
What do you think ‘effaced by the presenting part’ means, in the description of the cervix above? Seriously, in your own words.
and apparently it takes weeks for the cervix to close up again. I had a very educational visit with my OB this week.
This is why it was easier and less painful to have my IUD inserted at 6 weeks postpartum than it was to have it replaced 5 years later.
http://babyandbump.momtastic.com/pregnancy-third-trimester/1179387-2cm-dilated-now-week-later-my-cervix-closed.html
Just a two second Google because it’s time for a glass of wine and tv. Why don’t you take a minute to do some googling yourself and with an open mind read about all the women who report their cervix closing back up. Have fun! Night everyone!
Just a two second google search revealed that if you are who your name suggests you are, you’re a doula who’s full of herself and gorging on natcherel childbirth, studying midwifery but having no real education, or at least none deserving to be listed in your bio. I am constantly baffled at how people like you think they can fly in and school a bunch of doctors, midwives (real, not like the pretended midwifery I assume you’re “studying” – but it really isn’t your fault, it isn’t as if you ever had any real education to compare it to) on medicine and human body without feeling how they’re embarrassing themselves. I guess lapping at Ina May’s bullshit, aka revering her, must feel really good.
Look! You aren’t the only one who can google. The only difference is, my googling won’t potentially kill or maim anyone. Yours… not so sure. Nature is a cruel deity and your patron saint has sacrificed babies’ lives to her.
Well I am just STUNNED that you put that together! I’m clearly trying to keep it quiet that I have seen babies be born and been present during other women’s cervical exams. I guess I shouldn’t have signed my FIRST and LAST name on these comments.
Now why don’t you attempt to stay on topic and Google the actual point of this discussion, k? Then when you have something that actually adds to the discussion we can continue. Won’t that be fun?
Why don’t you put your first and last name so we can judge the person behind your comments?
I didn’t think I was trying to school anyone. Im very humble in my work. How was I to know it was so revolutionary an idea that a cervix can close and open??!
Well, since you’re so big on googling, I thought you’d love to know that you aren’t the only one who can google. Of course, it’s a little embarrassing that you think googling is a legit way of getting information but for someone with your level of education, I guess it must be big.
You were trying to school an OB. And humble is the last thing you showed here. It isn’t as if we know your work, right? We have to go by your words. They aren’t this impressive.
I see you clearly couldn’t grasp the idea that a cervix is NOT a sphincter either. My only consolation is that you’ll be unleashed on women far away from me. Not that it’s great but it is something.
I always shudder when I see someone who’ll be able to put a “midwife” after their name running in to defend babykiller Ina May and deriding obstetricians. It speaks delayed transfers and lives or brain cells lost to me. You’re headed there, methinks.
This is giving me a headache. I literally ASKED you to google something and you respond by telling me I’m not the only one who can google.
By trying to school an OB do you mean me questioning her supposed “proof” that a cervix isn’t a sphincter? Are OBs gods who should never be questioned?
Except that, anecdotes is not science and is totally unreliable. The fact that you think that asking people for their experience on the internet shows how much you know nothing about how science work. Do you also believe all those people who say their child are vaccine injured because they said so on the internet?
No matter what those women think happened, it still doesn’t make the cervix a sphincter. It isn’t. That’s an established anatomy fact.
You know what else isn’t science? Saying you’ve disproven Ina may gaskins sphincter law by quoting something that says a cervix is “unlikely” to be a sphincter!!!!!!
And if you really wanna get into the topic of vaccine injuries we can do that. We can talk about the millions of dollars awarded to families who have been able to prove beyond a reasonable doubt that their vaccines caused their autism.
Typical. A birth junkie and an anti-vax junkie. Let me help you around here: Microbirth is the next step for you.
“We can talk about the millions of dollars awarded to families who have been able to prove beyond a reasonable doubt that their vaccines caused their autism.”
Oh please do post links to these cases. Please note that compensation for encephalopathy, “autism-like symptoms” or mitochondrial disorders do not count.
And isn’t it ‘balance of probabilities’ in the vax court?
I thought it was just ‘table injury post-vax, you win,’ no causality needed.
Oh, wait, for non-table, it’s 50% and a feather? And the autism omnibus case still didn’t win.
Are you saying that because you know it in a special way, or because it isn’t published anywhere???
I’m just having fun with this now.
I have a “vag” and uterus, so by Kate’s standards, I can opine on these things.
(I own a Ducati, which, thanks to the complexities of global ownership, was financed through Volkswagen Automotive Group. I call it my VAG-mobile.)
You make a very fair point.
Nice bike, great name!
But is is a crotch rocket?
You’re on fire today Nick! The ‘ruining our country’ response above made me laugh out loud. Then this!
Yes, it is.
If it’s a table injury you really don’t have to “prove” anything except that the injury occurred within a defined timeframe after the vaccine was administered. If it’s not a table injury, you still only have to prove it was more probable than not – otherwise known as “50% and a feather”.
Yes, @dawnbatson:disqus … please do post links. Please also note that autistic + vaccine-injured =/= autism is the vaccine injury.
The whole whopping zero of them?
We can talk about the millions of dollars awarded to families who have been able to prove beyond a reasonable doubt that their vaccines caused their autism.
Actually no, we can’t. No families have ever proven that. The “beyond a reasonable doubt” standard (let’s call it “BRD” for short) only applies to criminal cases. You can’t put someone in jail for murder/rape/etc. unless you can prove their guilt beyond a reasonable doubt.
That is ALL the BRD standard applies to. If you sue someone, you only have to prove that it’s “more likely than not” that they did X and that X caused your injury or financial harm. If it’s a hair more likely than 50-50, you win. That’s what Poogles was referring to as “50% and a feather” (picture a scale with 50% on one side, 50% on the other, and a feather on one side of the scale: the side with the feather wins).
And most vaccine injury cases don’t even have to do that. If your/your kid’s injury appears on the official table (http://www.hrsa.gov/vaccinecompensation/vaccineinjurytable.pdf), all you have to do is show that you/your kid experienced that injury within a certain time period after getting the vaccine. You don’t have to show causation AT ALL; that is, you don’t have to even present any evidence that the vaccine is what caused the injury. You just have to show that X injury happened within Y time after getting the shot.
And if the injury isn’t on the official table, then you just have to prove that it’s “more likely than not” (50% and a feather) that the injury was caused at least in part by the vaccine. It doesn’t even have to be caused solely by the vaccine–just partly, and just by 50% and a feather.
Do you know what the burden of proof is, Dawn?
Holy shit, you really do believe that googling is the same as research. You’re a self-parody.
To actually “see” the cervix you have to insert a speculum.
Lol I’m using the word see as one would use the word observe. Try to follow along
Oh when you say ‘see’, you don’t mean ‘see’.
Silly us, paying attention to what you write!!
She reminds me of Gma Gardner. Do you remember her? The Midwife of great knowledge and mechonium.
Seriously, it all makes sense when you realize no one actually visually inspected the cervix…..
Yes, I thought I was speaking to very educated people here. See can mean to perceive with the eyes and it can ALSO mean to discern or deduce mentally or to understand. does that help?
Oh…it makes so much more sense when you realize that the midwives “deduced mentally” that the cervix has closed rather than actually seeing that the cervix has closed.
Now, I’ve seen a bovine cervix reduce in diameter during a labor – but that was caused by change in the dam’s position moving the calf off the cervix. When the pressure of the calf was off the cervix, the cervix stopped dilating and regressed slightly.
After a few more contractions, the calf was repositioned at the cervix, the cervix completed dilation and the calf was born.
Here’s the problem, though, Dawn. The cow was more comfortable and relaxed when her cervix closed. She had been laying down, found that position uncomfortable, and stood up. That movement set about moving the calf and closing the cervix.
IOW, you take what midwives tell you they have deduced as God’s holy truth. Glad to have that one cleared.
Even if we take that as true, I am having trouble with the “deduce mentally” part of your claim. Are you claiming that the cervix closing is an issue of a logical proof or rational argument?
Because “deduced mentally” otherwise sounds to me a lot like “asserted to be so”
Get over YOURSELF, you self-professed ignoramus. Go lick Ina May’s feet some more and leave adult conversations to adults.
Name calling isn’t nice darling. And also when did I profess to be an ignoramus lol
When you put “No education listed” in your page, sweetheart. It’s a little sad that your fluent English doesn’t encompass the idea that “ignoramus” isn’t name calling. It’s stating a fact (one that you chose to disclose).
I refuse to justify this with a response as it doesn’t actually make any sense. You also sound like a child and have resorted to the same thing this whole blog resorts to- name calling and bad reasoning instead of calmly and respectably talking facts.
(You do realize you did respond, right?)
Yes, the words I’m not going to justify that with a response are always a response of a sort. But what it means usually is that what was said doesn’t deserve a rebuttal. I’m not going to defend the fact that I’m not an “ignoramus” for many reasons.
one thing this OB hasn’t observed that all the midwives I know have observed is that the cervix opens and closes.
So if the cervix only opens and closes when midwives are around not when OBs are, that must mean that midwives are really scary and that women can’t relax and have a baby when they’re around. Best drop that model of care then.
If your cervix is or isn’t a sphincter – oh yes, that changes all. That proves your venerated patron has no idea what she’s talking about. Then, the likes of you who doesn’t have ANY education, as mentioned on your page, aren’t likely to grasp why that matters.
Does it open and close? Is it a ring of muscle serving to guard or close an opening or tube?
Look, you’re clearly so educated. I’m sure you’re just resorting to being a nasty human being because you’re so angry at the idea that your education has apparently blinded you to some very basic things about childbirth. I can’t really take anything you say seriously though because you literally sound like a bully. If I knew who you were I still wouldn’t retaliate because I think that kind of behavior is repulsive. Best of luck to you and your fury.
It doesn’t help your argument to insult people for being educated or knowing some facts. Reasonable people may have differing opinions, but they must start from true facts. It simply isn’t up for debate that the cervix isn’t a sphincter, and so any arguments based upon that premise are invalid.
The text this article uses as proof that the cervix is not a sphincter actually says its “unlikely.” Our understanding of how the body works is evolving- surely you don’t think we have reached the point of full understanding of our bodies? Aside from that, it really doesn’t matter at all as I’ve already stated. Whether it is or isn’t defined as a sphincter, if it opens and closes around the opening to the vagina it’s acting like a sphincter.
Yes and no.
We are still learning lots about the cellular level actions of the human body. We are occasionally having breakthroughs in some areas of tissue study – but that tends to be how tissues change during disease states. We are getting better at figuring out what a few understudied organs (e.g., the appendix) do.
What we aren’t doing is suddenly realizing that organs that lack circular structures of voluntary or involuntary muscles are actually sphincters.
I suspect you know that already. That’s why you keep ignoring the line that states ” It is now well-established that the normal function of the cervix during pregnancy depends upon extracellular matrix”.
“if it opens and closes around the opening to the vagina it’s acting like a sphincter.”
Actually it’s opening and closing around the opening to the *uterus*, not the vagina. If it was the vagina, sex would be incredibly uncomfortable for women…
Yes, the point where the uterus opens to the vagina. Sex is very uncomfortable sometimes because of this, that’s true.
I’ve been repeatedly insulting for what an “ignormaus” my lack of education apparently makes me. But show me where I’ve insulted someone for being educated, please. And then show me where it isn’t up for debate. It used to not be up for debate that the world was round.
“Yeah man, science. So much of this science is thrown around angrily at us “psuedoscientists.””
“Look, you’re clearly so educated.”
I don’t think it’s unreasonable to construe these statements as insults toward people more educated than you are in obstetrics.
Are you kidding? My sarcasm began way after everyone else began attacking me about my education level and name calling. Pretty sure my response is deserved.
Everyone else? As far as I can see, that was only me.
Don’t forget the claims we only believe Dr. Tuteur because she went to Harvard, and the following inferences that going to Harvard was somehow a bad thing.
Tommy Lee Jones went to Harvard, and although I admire the dude’s acting chops, I’m not going to ask him about the workings of the female reproductive system.
I’m confused Heidi, can you clarify? You seemed POSITIVE this wasn’t up for debate? http://m.med-health.net/Function-Of-The-Cervix.html
Yep. I looked for descriptions of the cervix from ACOG, the NIH, the Mayo Clinic, and didn’t see anything talking about cervixes as sphincters. Citing some anonymous web page doesn’t really make your case.
It’s crazy how hard you’re doubling down on this nonsense. You’re outing yourself as willfully ignorant, over and over, and you can’t even see that.
My office door opens and closes. Prove it’s not a sphincter.
Hell, my friend has a play-house with a door that’s round, and when I’m walking through, there’s smooth muscle in it. I guess it’s a sphincter.
Hell, then all the Hobbits must pass through sphincters whenever they enter or leave their little Hobbit homes. ‘Cause their doors are round, right?
Oh, that gave me a smile.
It checks out.
Best response ever.
The old “keep sweet” card. Women are allowed to get angry, frustrated, annoyed and express those emotions. Refusing to listen to a woman just because she is expressing her anger, frustration, and annoyance is sexist as hell. Not to mention immature.
Oh dear http://m.med-health.net/Function-Of-The-Cervix.html
It’s gross and misogynist to try to dismiss a woman’s argument as being too “angry”. It’s irrelevant. It’s condescending. It’s bratty. It’s a cheap rhetorical technique.
It’s classic trolling but with an intellectual facade. Say something awful, and when someone (understandably) gets upset smile and say “you mad bro?” Or in this case “you are wrong cause you got mad bro.”
Why are you so angry? It seems obvious that labor won’t progress if a woman feels unsafe. I imagine with you in the room I would jump out the window before giving birth.
Why are you so angry?
Oh, I don’t know. Maybe the unnecessary suffering and loss of life that home birth causes?
It seems obvious that labor won’t progress if a woman feels unsafe.
Really? Then why does premature labor happen. Don’t women who are going into labor at 20 weeks feel unsafe? Why doesn’t that automatically stop the labor? How do women in war zones ever deliver? Heck, how did any woman before the late 20th century ever give birth? Or perhaps they weren’t scared and just made their wills for fun?
You’re making false comparisons. Birth attended by midwives works for a lot of women. If it’s not for you, fine. It doesn’t disprove Ina’s theory. You also sound as if you’ve never given birth or given birth with really unpleasant folk. It worked for me when I gave birth in a birthing center. It worked 5 out of 6 times for my mom (she hated her doc so much with my oldest brother she only used midwives for last 5 kids). This article is bizzare as is your reaction.
She hated her doc that much yet your oldest brother was born? How’d that happen?
But that’s not what you claimed. You didn’t claim “birth with midwives is possible.” You asserted that feeling unsafe will prevent labor from progressing. You don’t support that by showing that labor progresses with midwives.
It’s not about what “works,” it’s about what you claim “Doesn’t work.”
Birth works more often than not. Wether it’s attended by a doctor, a midwife, a taxi driver or your dog. No one is claiming that you cannot give birth to a healthy baby outside of a hospital. Humanity has survived without those for a long time. Lots of babies and mother died, but birth still ‘worked’ for a lot of people.
Actually, you’re wrong on all accounts. I have given birth attended by a very pleasant midwife and the very pleasant OB that she brought in to deal with the obstructed labor. So I’d have to say that giving birth attended by a real midwife, a CNM with credentials at any Ivy hospital, worked out very well for me.
Being attended by undereducated CPM/DEM and giving birth at home has worked out poorly for a number of women. About 3x more often than giving birth with an MD or CNM in a hospital, in fact. Where “worked out poorly” means “had a baby not survive.
If you don’t think that women being lied to and convinced that being attended by someone without adequate training or experience in a setting that is unsafe is something to get angry about, well, that’s your decision. But you asked why so angry and, well, that’s why.
Also, you haven’t answered the question: If labor won’t progress when a woman is scared, how do premature births occur?
Not to me. Therefore, you are going to have to actually explain it. I’d start with actually providing evidence that it is true.
It’s not something that can be explained. Seems like tacit knowledge for women. Do you! Have fun giving birth your way.
Labour won’t progress if a woman feels unsafe? That’s why no woman ever gave birth in an unsafe environment.
Kate’s discovered the cure for preterm delivery, just put an OB you don’t like in the room. Give her the Nobel prize
OK, so forget about explaining it, show that it is actually true in the first place.
As others have pointed out, women have given birth in very unsafe circumstances. Warzones, for example. Premature. Do you not think that women going into very premature labor feel unsafe? They are largely scared out of their minds!
3000 years ago, childbirth was recognized as being so bad that it was considered a punishment from God. Did they think it was safe? I doubt it. They feared it. Yet it happened.
Doesn’t seem obvious at all to me that feeling unsafe will prevent labor from progressing.
My tacit knowledge says that you are being paid $100 a post by Big Naturopathy to troll blogs and write nonsensical anti-OB comments. Does that prove that you’re a paid naturopathy troll?
It only seems obvious if you don’t know that women have given birth in concentration camps, on slave ships and plantations, during sieges, shackled to beds in prisons. Or if you think the women in those situations felt safe, I suppose.
Let’s not forget women giving birth during hurricanes!
Interesting ro read your opinion and facts… I’m a registered midwife in canada and I have seen women at 6-7-8 cm come back to 4-5 because the contractions had stops and the baby went back up even sometimes! Have’nt you see that before? My belief is that we don’t see it in hospital because most women who don’t dilate fast enought end up with pitocin. It’s impossible to go back if you have all the ocitocin needed. But still don’t you thik its physio’logical’ that if contractions stops cervix close back a little sometimes? I’m curious to read your answer! 🙂 Thanks.
It seems that Ina isn’t the only one who believes in a vaginal sphincter. There was even a patented device for such a sphincter. I guess sarcasm instead of neutral fact reporting is less valuable than this article would have us believe. http://patft.uspto.gov/netacgi/nph-Parser?Sect2=PTO1&Sect2=HITOFF&p=1&u=/netahtml/PTO/search-bool.html&r=1&f=G&l=50&d=PALL&RefSrch=yes&Query=PN/5931775
A patent being awarded is not proof of medical accuracy.
Ina May Gaskin fellow woman and sister and world renowned, you criticisms of her and her works simply define you and being resentful and spiteful. Make me waste 10 minutes of my time reading your self-inflating diatribe.
Sorry that facts don’t align with your fantasies.
Dudes need not comment. Call me when you got a vag and uterus.