Homebirth kills mothers, too

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Not one, but two maternal deaths at homebirth have occurred in the past several months.

Yesterday, Mother’s Day, from Baby Center:

My husbands cousin passed away today while giving birth. She was 24, beautiful, had just graduated with her masters in engineering, and was getting married. She was due may 15th. She went into labor today. She had a home birth and midwife. She bled to death on the way to the hospital that was 8 minutes away. Her daughter is alive…

But wait! That’s not all.

A St. Louis area doula reports on the death last fall of both mother AND baby. The piece originally appeared in the Fall 2012 issue of the Missouri Friends of Midwives newsletter. Although the doula does not specifically mention that this was a homebirth transfer, she does say that it caused her to question her own decision to have a homebirth (which, having learned nothing, she ultimately did anyway).

Addendum 5-16-13: The doula added the following to her post, “this was a PLANNED HOSPITAL BIRTH. It was not a homebirth or a homebirth transfer. This mother was attended by an obstetrician, not a midwife. This update isn’t meant to invite further dialogue …” Surprising, considering that the doula is an aspiring homebirth midwife, treasurer of her local chapter of Missouri Friends of Midwives, and wrote about it in the Missouri Friends of Midwives. I apologize for the error.

Why do mothers die at homebirth? Because homebirth midwives and doulas replace knowledge of childbirth with “faith” in birth:

… I have been “brought up” in the midwifery and homebirth community. As a result, my heart and mind have been continually washed with faith in the birthing woman’s abilities and the newborn babe’s resilience. Trust birth. Birth works. I’ve heard it all many times over. I believed it like a religion…

Why do mothers die at homebirth? Because homebirth midwives don’t understand that low risk does not mean no risk.

I recently attended a birth as a doula in which the mother died. And making things even more horrific, the baby died as well. They had both been perfectly healthy the entire pregnancy and labor…until they weren’t…

Why do mothers die at homebirth? Because the hospital is never “close enough.”

… When my client and her baby died, I was in the room. I was tapping her arm and feeling for her pulse and calling out her name…and then I looked in her eyes and knew she was no longer inside looking back at me. I was a foot away when the doctor caught her baby girl, as purple as an eggplant in the face and white everywhere else. I was clutching the father’s arm when he was told the impossible news some 45 minutes later that neither mother nor baby could be saved.

Why do mothers die at homebirth? Because homebirth midwives obsesses about the process and take the outcome for granted:

I have not been able to talk to this beautiful mother – who I came to care about deeply –about the amazing job she did in labor and birth, and I will never be able to have that conversation with her…

Did the doula learned anything from this hideous tragedy? Of course not.

… Got mad at God. Felt helpless. Questioned whether or not I still wanted to have a homebirth. Wondered about everything over and over again – if my client had been sufficiently informed of the risks vs. benefits of various interventions, if the presumed cause of death was accurate, if I was a horrible doula/if I would be a horrible midwife, if I could regain trust in my baby and my body, and if that would be enough …

What is the matter with homebirth midwives are homebirth advocates. A mother and baby are dead. They are DEAD!! You can’t get a better, more brutal confirmation of the fact that trusting birth is NEVER enough, yet these fools prattle on about regaining her trust in a process that has just been shown to be entirely untrustworthy.

The doula titled the post, When Birth and Death Meet. A more appropriate titled might be When Ignorant Homebirth Midwives Meet Birth, Mothers and Babies Die. Trust that, not birth.

  • Jj

    this dude is a crackpot and a shill. total loser with nothing but lies to tell. embarrassed for him.

    • Empress of the Iguana People

      “Dude” typically refers to males, so I do not know who you are referring to. Certainly not Dr. Amy, mother of 4.

    • Charybdis

      So, dude, why are you creating a zombie apocalypse of old posts?

    • Who?

      save it for yourself, dude, your need is greater.

  • ducky

    This post should be substantially re-written. Not that I disagree with the main argument, but the above interpretations of snippets from that article are so out of context as to be misleading. The doula herself *is* ruminating on the difference between low risk and no risk – and processing the problem with home birth midwifery attitudes that she herself experienced firsthand: “Trust birth. Birth works. I’ve heard it all many times over. I believed it like a religion. And it’s not that I don’t believe in birth anymore…but it’s no longer so simple.” I suppose that re-writing this post in the context that it was a hospital birth weakens the impact, but the message that mothers and babies are at risk would still come through loud and clear… while more accurately representing the author of that article.

  • Lisa from NY

    Did the mother have a stroke?

  • yentavegan

    The death of this mother and child has me questioning my belief in the ability of modern medicine and ob/gyn’s ability to predict / prevent fatalities like this one.
    So please, all you highly trained professionals out there reading this blog, what went wrong for this mother? It is not a common event to lose a mother and infant to hemorrhages like the one described, is it?

    • What I don’t quite understand is where your belief comes from? The ability to predict/prevent fatalities in childbirth is much the same as the ability to predict/prevent road accidents, surely? With the added complication that people have forgotten that bad things can happen.

      Things have improved a lot, of course. Doctors can now prevent/predict many things but not remove all the risks. It is confusing that by pretending there aren’t any risks that is the problem.

      • yentavegan

        I come from a large fertile family and I live in a community where many woman have large families, So drawing from my own experiences I know of no healthy mothers under the care of an ob/gyn giving birth in a hospital dying of a hemorrhage.
        I am assuming the mother referred to in the above blog was healthy and had no underlying medical conditions, but perhaps that part of the story wasn’t shared by the blogging doula.
        I am asking if someone out there, with medical training can speculate reasonable what went wrong.
        My belief that pregnancy and birth under the care of an ob/gyn is no longer a dangerous life threatening event is based only on everything and everyone I know. Which scientifically speaking is still “bubbkis”.

        • suchende

          No human institution is perfect and perfectly able to prevent every tragedy. Your lack of experience with it just shows how rare in-hospital PPH death is: to find incidents, you need a big sample. But pregnancy and birth ARE still life-threatening events.

          With that in mind, my mom came very close to dying from PPH in hospital in the 80s because she refused blood transfer.

          • Amazed

            My mom was also one of the lucky ones. She didn’t get examined immediately after birth and she bled almost to death about an hour later alone in her room. Obviously, mistakes happen in every environment. A new mother can bleed to death in less than 10 minutes even nowadays.

        • Unfortunately, it is. I come from a smallish family who have not had large families. We are all healthy. One late intra-uterine death (avoidable) one dead twin, (and a haemorrhage for my mother) one brain damaged (avoidable) one cord accident averted, one serious infection for mum, seven healthy children. I could chalk up several more poor outcomes amongst more distant relatives and friends. It is very, very easy to assume these are things of the past, but it is false. Most women can stay blithely unaware and continue to regard a healthy child as a given, and I am glad of that. But it is just an assumption based on faulty information.

          The question of which haemmorhages can be controlled and which can’t is still interesting.

          • Jj

            “blithely unaware” is NOT what women are. how condescending and nasty. we are aware, and WE BRAVE IT ANYWAY. outcomes are not better in hospital. so stop the propaganda.

      • Jj

        YEAH, PREDICTING ROAD ACCIDENTS AND BUILDING TO AVOID THEM IS WHAT INDUSTRIAL ENGINEERS DO, what is your point?

        male medicine is sexually sadistic, and that is why “obstetrics” exists. their PLEASURE. yep. end of.

        • Empress of the Iguana People

          You must have had some truly unpleasant experiences with doctors. I have been much luckier. Besides, if it excites male doctors sexually, why do we never see their boners? Really really tight underpants? DOn’t be silly.

        • Charybdis

          I think your statement of “male medicine is sexually sadistic and that is why ‘obstetrics’ exists…” is where you have gone wrong.

          Males don’t see OB’s/GYN’s. These doctors, by definition, don’t see males and, as a result of that, they don’t practice “male medicine”.

          What is happening to the quality of the parachuters these days?

        • AnnaPDE

          No, road engineers see where the chance of accidents is high and try to create conditions that lower the chance and mitigate outcomes. Kind of like when people have medical care throughout the pregnancy to be aware of possible complications, and go to hospital for the birth in order to have competent medical staff and life saving equipment around.
          They can’t predict individual accidents and can’t prevent “freak” accidents.

  • Kevin

    Dr. Amy,

    I tried to reach you via email with a question. However, the email address DrAmy5@aol.com did not work. Can you confirm this address so that I can reach you?

    • Amy Tuteur, MD

      That’s correct. I’ve been getting emails all morning, so I’m not sure why yours didn’t come through.

  • anniew

    Are we reading the same “When Birth and Death Meet” story? I’m confused – no where does it say anything about this being a homebirth. In fact, everything indicates it was a hospital birth. I called a friend who is a doula and asked her about it; she said it was a planned hospital birth, not a homebirth.

    • anniew

      Never mind. I just went back to re-read the story. I guess I was not the only confused person. Now it says this was a planned hospital birth, with an obstetrician. So, I guess even modern obstetrics and being in a hospital can’t guarantee bad things won’t happen. very sad

  • R T

    Did you read this in the comments “springbaby13 · Pass a Note!
    Posted 05/12/2013 I am so very sorry. That could have been any of us. I hope her husband doesn’t blame the baby for it.” WTF?!

    • Squillo

      I suspect that’s a reference to a common trope in literature and films–bereaved husband hates child who “killed” his wife, leading to a lifetime of interesting and reader-friendly psychological problems in the child.

  • lucy logan

    From “When Birth and Death Meet” ;”As legendary midwife Ina May Gaskin has put it, maternal mortality is the last thing you expect when you are expecting. Virtually no mother goes into a pregnancy or birth thinking she might die – and no mother should have to think that. ” actually-i think its safe to say most mothers throughout most of human history have gone in to birth with the clear recognition that they might die, as have soldiers going into battle …

    • lucy logan

      this quote also really got me ‘And amidst everything, my baby, my sweet little baby who previously had been relatively still in my womb, sensing my fears and I believe desiring to take care of me, started wiggling around more often inside my belly.” what kind of mother thinks its their infants job to take care of them?! yet this seems to be a common belief in this crowd.

      • Dr Kitty

        REDUCED movement is a problem, not MORE movement.

        • lucy logan

          but that was her point. she was panicking becuase of reduced movment so the kiddo kicked aroudn more to mae her feel better. Not only is it wrong as an expectation it is obviously absurd. i am guessing about the youngest a kid can have enough Theory of Mind to empathize with thier mom and want to make her feel better is about 12-18 mos or so.

          • Amazed

            Hi, Lucy.

            Let me enlighten you. The kids who want to comfort their mom from before they are born are the kids of birth goddesses. 12-18 months is the period when sheeple, like, sat, you and me, must wait before receiving empathy from the other end.

            Are you sure you’re magical and trusting birth enough? I know for sure I am not, so when I start having kids, I’ll have to do the waiting.

        • I have known bereaved mothers whose babies movements increased before passing inutero.

          • The Bofa on the Sofa

            My sister says that her baby was exceptionally active on his last day (before he was stillborn). My awful take on it is that he was thrashing around because he was in distress. It’s a terrible thing to even think about.

            I have never heard an explanation for why he died, but I wonder if it wasn’t a detached placenta (I was pretty young at the time, and it’s not something that you bring up after 35 years). She was well past due I remember (probably 41 wks or so).

      • Eddie

        “sensing my fears and I believe desiring to take care of me”? Really, someone wrote that nonsense of a neonate? (Is “neonate” the correct term?) Wow, what romance, what drama, what absolute nonsense.

    • Exactly. I’m an art historian, and sometimes when trying to find an accurate date of birth for an artist or an art patron who lived many centuries ago, it is useful to find when his mother updated and registered her last will and testament. In many times and places, it was typical for a woman to get her affairs in order while she was pregnant, as she knew very well that she might die in labor.

    • Squillo

      Which argues for the fact that modern obstetrics has been tremendously successful in making motherhood safer–at least in places where obstetrics are generally available. And I’ll bet there are plenty of women in, say, Afghanistan or the Sudan who are acutely aware that they might die.

    • Poogles

      “actually-i think its safe to say most mothers throughout most of human history have gone in to birth with the clear recognition that they might die, as have soldiers going into battle …”

      This reminds me of the customs of ancient Sparta – the only citizens who had the right to have their names inscribed on their grave markers were men who died in battle and women who died in childbirth, as both were considered to have given their lives in service to Sparta.
      http://en.wikipedia.org/wiki/Women_in_ancient_Sparta

      • Comrade X

        I believe there was a similar thing in Viking culture – automatic admission to Valhalla’s feasting halls was granted to men who died in battle, and women who died in childbirth (who were considered to basically have died in battle).

    • MJ

      Actually, approaching the birth of my first child was the first time in my life I had ever felt that I was doing something that could possibly kill me. That, to me, was part of what made creating and delivering a baby so powerful. And yet so many of the women who prattle on about the transcendent power of birth completely downplay the risks. You can’t have it both ways.

      • The Bofa on the Sofa

        I agree, it is a concept that I can’t understand. There was nothing scarier than when my wife was pregnant. I constantly worried about her health and the health of the baby. I just can’t grasp the idea of “trust birth.” It is so completely and OBVIOUSLY wrong. All it takes is a moment of looking at history.

  • moto_librarian

    This is a senseless death. If she had been in a hospital, she would almost certainly be holding her child right now. Because of modern obstetrics, we have the luxury of being insulated from the realities of birth when left to the dictates of Mother Nature. No one wants to “fearmonger” pregnant women by discussing the very real dangers of childbirth to both mother and child. In the aftermath of my first birth, I spent a lot of time trying to process the experience. When I really think about it, it still scares the hell out of me, and it was nearly four years ago. I will always remember the raw panic that I felt when I started to feel woozy from blood loss, the distinctly wondering if I might be dying. If I hadn’t been in a hospital, I would have had the same outcome as this woman. That is both sobering and terrifying.

    • The Bofa on the Sofa

      No one wants to “fearmonger” pregnant women by discussing the very real dangers of childbirth to both mother and child.

      What do you mean by that? I thought that OBs were always playing the “Dead Baby Card”?

      No, it’s not that no one wants to discuss the real dangers of childbirth, is that there are those who do deny the reality of it and consequently don’t want to hear it.

    • theadequatemother

      fearmonger? Sheesh…which is it people, are pregnant woman empowered strong creatures or wilting delicate flowers that can’t bear to hear the truth. I wish the NCB crowd would at least be consistent.

      • moto_librarian

        I agree! I would much rather have an honest assessment of the risks of pregnancy and childbirth. A lot of people really hate “What to Expect When You’re Expecting,” but it offers a very realistic look at many of the things that can (and do) go wrong.

  • Jeevan Kuruvilla

    Very sad to hear that you’ve maternal deaths which sound pretty similar to maternal deaths at our place. Most of which occur due to late presentation in the hospital. To make matters worse, we’ve people around who advocate for childbirth at home and it’s on the increase in affluent communities.

    • Lizz

      I saw that from something my friend who lives in Kerala posted on Facebook. What’s even worse is you have American CPMs sometimes going over to India and practicing among the wealthy women of places like New Delhi. It’s kind of sickening that our under qualified midwives are going over there to sell women on painless childbirth and water birth centers.

      • AmyP

        About 12 years ago, I did Russian-English interpreting for a group of Russian-speaking midwives and other health care professionals who were visiting a US women’s hospital for professional development. They took a Lamaze class and met with US hospital midwives. That was where I first heard the term “cascade of interventions.” It’s only been in the last year, since coming here, that I’ve deprogrammed myself from the stuff I “learned” from that experience and from my hospital childbirth classes.

        Ever since I discovered this blog, I’ve been very squicked out about my role 12 years ago in spreading the NCB gospel. But I didn’t know any better at the time. And of course the traditional Russian way of birth does not involve medical pain relief…What an awful waste of resources to bring all those Russian medical people over to the US and teach them how not to care for patients.

        I think we need to be very aware of the global dimension, because the amount of harm that NCB does may be exponentially larger in a low-resource setting.

        • Lizz

          That reminds me of all the articles I’ve seen talking about women in Japan hardly ever getting epidurals. From what I’ve seen and heard from my friends from there is that it’s just shameful to express that your in pain. I had a friend who was in a severe car accident where parts of her face were literally stapled back on and she still insisted that it would be shameful to show that she was in pain.

    • attitude devant

      Dr. Kuruvilla, we are all big fans of your blog. Thank you for the work you do for women.

  • Sue

    OT: Nice takedown on Margolis’ book in NY Times by Annie Murphy Paul (disqus won’t let me post link – it’s May 10th.)

  • GreyOneSoon

    I will never understand the appeal of this whole home birth crap. My wife recently had a stillbirth at 38.5 weeks. It was the most horrifying experience of our lives. The baby was fine one day with normal fetal cardiotocography, two days later she didn’t feel him move the morning when she woke up and we went straight to L&D where they found no heartbeat.

    My wife had routine obstetric care throughout the pregnancy – more than most probably since we were receiving treatment for fertility issues as well. Baby was fine and mother was fine until suddenly they weren’t. It turned on a dime instantly.

    I thanked the L&D staff one thousand times for getting my wife through the delivery as safely as possible. It took three days from ripening to delivery, but my wife got the best care possible. He was a small baby (under 7lbs) and there was still shoulder dystocia which could have created a problem had it been a live birth.

    I can’t imagine how much more horrifying this experience could have been, but home birth or anything but the best care provided by an OB/Gyn would have made it so much more horrifying. If my wife hadn’t received care under her OB, we would have been questioning EVERYTHING about the pregnancy. If she wasn’t in the hospital and tried to deliver the baby at home the shoulder dystocia could have created problems for my wife. Thankfully the rest of the delivery was pretty routine, but I can only imagine how much worse it could have been had we chosen to receive lesser care.

    The doctors and nurses in L&D did whatever they could to provide the best outcome given the circumstances. In my mind, that is all that matters – the outcome.

    • HM

      ” Baby was fine and mother was fine until suddenly they weren’t. It turned on a dime instantly.”

      How true.

      I am so very sorry for your loss. That is just terrible.

    • thankfulmom

      I am so very sorry for the loss of your son. I lost a 14 month old son. When I read that people think they could handle the loss of a child I know they have absolutely NO idea what they are talking about.

      My condolences to you.

    • Amy Tuteur, MD

      I am so sorry for the loss of your son. Thank you for sharing your story.

    • anony

      So sorry for your loss.

    • Amazed

      I am so sorry for the loss of your baby. Thanks for sharing.

    • Awesomemom

      I am sorry for your loss.

    • So very sorry for your loss. If you guys need anything, just say the word. You have support here.

    • fiftyfifty1

      My condolences to you and your wife. I am so sorry you lost your precious son.

    • Sue

      So sorry to hear of that tragedy – thanks for giving us your insight.

    • Dr Kitty

      Condolences on the loss of your son. Thnk you for sharing your experience.

    • I am so sorry for your loss and thank you for sharing!

    • theadequatemother

      I am so sorry for your loss. I remember the face of every woman I have ever put an epidural into who experienced the same heartache and every woman and baby in the same situation who ended up coming to the OR for a c/s. When I think about or work in quality improvement in hospital based maternity care, these are the faces I see.

    • auntbea

      There is no baby whose loss is not devastating, but to lose a baby after struggling with fertility is just that much worse. My condolences.

    • The Computer Ate My Nym

      I’m very sorry for your loss!

    • Durango

      I’m so sorry about the loss of your son. I cannot even imagine. Thank you for sharing your story.

    • moto_librarian

      I am so very sorry that you and your wife lost your precious son. This is every parent’s worst nightmare. Thank you for sharing your story with us.

    • I don’t have a creative name

      How heartbreaking. Precious boy. I am so sorry for your devastating loss.

    • MJ

      I am very, very sorry for your loss.

    • Frequent Guest

      I’m so incredibly sorry for your loss.

    • Cellist

      Thanks you so much for sharing your story with us all. Words are inadequate – I am so sorry for you loss.

    • Jessica

      I am so very sorry for the loss of your beautiful son.

    • CanDoc

      My heart breaks for your loss. So sorry. Thank you for sharing.

  • Ethan’s mom

    The whole HB/woo thing sounds more and more like a cult to me. They brainwash their followers; they worship the process of birth; they are willing to sacrifice women and babies for their ideal, they have a tendency to be emotionally abusive, manipulative, sadistic and/or narcissistic. Logic, common sense, and the truth, have left the building and have been replaced by denial and unicorns. The only thing that matters is the birth.

    It angers me that more moms and babies, who were destined for life on this earth, will have their lives so cruelly taken away.

  • Pregnant Guest

    OT: I’m pregnant for the first time, planning to deliver at an in-hospital birth center with a CNM practice, if no complications arise before then. I know that the birth center has really strict risk-out criteria at triage (which I’m glad about) but I want to make sure that I’m really getting all the safety benefits of the in-hospital part of the plan. I would love suggestions of questions to ask my midwives, if anyone has any. I have the choice of delivering on L&D w/the same CNMs if I’d feel safer there. (For instance, I think intermittent auscultation is standard practice in the birth center rooms. I plan to ask for intermittent electronic monitoring instead. Other things I should be concerned about?)

    • theadequatemother

      can the birth center provide you with analgesia if it is desired? and if so, what (IM or IV narcotics, nitrous). If you end up wanting analgesia, especially an epidural, would you have to be transferred to L&D? How long would that take ie…what would be the delay?

    • Laural

      Not necessarily a safety issue, but, do they share nurses with the L&D in the hospital? If so, are the nurses familiar and comfortable with the different norms and expectations of the birth center? How is the rapport between the CNM’s and nurses? How your care team operates together can really impact your experience.

    • Gene

      What is the actual difference between a birth attended in the “birth center” and the hospital proper? Is it just a matter of decoration in the rooms or are there different procedures and protocols? Are you registered with the hospital as a patient? Are the physicians who provide the back up aware of you and your medical history? How far, physically, are you from the OR in case of stat c/s?

      And the pain control is a BIG deal. I’ve worked with CNMs at two hospitals. One hospital offered all manner of pain relief (including epidurals by anesthesia staff) to CNM patients. The other was “natura” relief only (no drugs of any kind). If you wanted any pharmacologic pain control, you would not be accepted as a midwife patient.

    • An Actual Attorney

      What’s their philosophy and are you comfortable with it? There’s a teaching hospital in my city with a CNM practice. If you look at their website and follow their links you find they are deep in the woo: anti vitamins, in love with Ina May, etc. Anyone who suggests I watch BoBB is useless in my opinion.

    • Rochester mama

      Ask what happens if at some point you require an OB back up, is there one on duty or just one “on call”. I had a great CNM drug free labor but my son’s heartbeat started noise diving when I started pushing. It when from my husband and the midwife to the whole OB and Peds team in seconds when she tried to change my position and it didn’t help. I ended up with a vacume assisted delivery but my son is completely fine and had great apgar scores because the hospital I was at had strict guidelines when to call in OB. They numbed me up as best they could with lidocaine before the epistomy and delivery. I had a crazy fast labor at just under 4 hours from my water breaking in my sleep to my son being born and I was only 37 weeks.

    • Susan

      If they use intermittant auscultation they may not ask for a saline lock either. We don’t use them routinely where I work either and I didn’t have one with any of my babies. But many people disagree so you should decide for yourself. It’s really not that big a deal and if you have one it’s one less worry in an emergency. All of the advice in this thread is great I would love to hear the answers you get. I might ask about who is usually there when the baby is born in case there is a need for resuscitation. It’s nice to have more than the midwife and a labor RN ( even if third just steps in for the birth and steps out when all is fine).

    • fiftyfifty1

      Yes, I personally would want electronic monitoring rather than auscultation. It is much much easier to detect subtle “lates” on a visual strip than by listening. It’s also better, in my opinion, if the strips also go electronically to a central monitoring area. Having somebody who is not directly involved with the case in a position to see the strips helps cut down on cognitive errors (subtle bias that the strip isn’t that bad because [insert excuse here]).

      • HIEmom

        We were victims of a cognitive error reading a EFM strip. My son lives with the consequences of late decels every single day. Guessing wrong between category 1 and category 2 can quickly lead to category 3. Go the safe route, please!

  • Anthropologist Underground

    It occurs to me that most of us laypeople are thankfully insulated from exposure to the moment of death. Which is good! But in the same way that it’s easy for some people to dismiss the danger of vaccine-preventable illnesses because vaccines are so effective that we rarely see them, the dangers of childbirth are easy for some people to dismiss because most births take place in the hospital and turn out fine. These folks have often never actually witnessed any death, let alone the types of death that result from childbirth so they assume that actual doctors overstate the risks.

    I was reminded of our collective distance from death recently when I watched a stranger die. (I presume…cardiac arrest, no pulse for a very long time, but IDK how it actually turned out because I left once the EMTs arrived and I was just in the way.)

    I’m astonished that witnessing and actively contributing to the death of a mother and infant didn’t trigger some self-reflection in the doula other than how sad it was that she couldn’t pester a dead mother and child for self-validation.

    • Sue

      Also very telling that hemorrhage – a leading cause of maternal death in the developing world – can also be a cause of death in middle class America – if you let “nature take its course”.

      • Wishful

        How did we get here? Why are all little girls not taught that birth can mean death at their mothers knee the same way we are taught so many other lessons? How do these people deal when their loved ones are dying? I have so many questions with no answers.

        • Awesomemom

          Because in the hospital it does not necessarily mean death. I plan on talking with my kids (especially my daughter) about how dangerous it can be out of the hospital and maybe that will help head things off and they won’t get it in their heads that birth is safe.

        • T.

          Because:
          1. OBs and hospitals make birth seems safe
          2. Because people are afraid that, if women would know the danger, they may choose not to have children.

    • Lost in Suburbia

      Why do you assume the doula actively contributed to the death of the mother/baby?

      • Anthropologist Underground

        You’re right. My bias is showing. The doula didn’t mention advocating for in-hospital care where they have the equipment and training to act quickly and potentially change the outcome. I assume that the doula was in favor of the homebirth, which was a significant factor contributing to the deaths. The doula was part of the cascade of misinformation, and therefore I view her as a contributor to the outcome.

  • E-m

    In the second one, do we have more information indicating it was a home birth transfer other than the doula questioning her own home birth plans? It seems like being that close to those deaths could have that effect even if it was a hospital labor, too.

    The part about her heart and mind being washed in the trust birth ideology is priceless. It seems like she comes so close to seeing that for what it is.

  • Karen in SC

    Someone somewhere said this about the risk of homebirth: Low probability/High consequence. So true! How easy is it for us to insist that it won’t happen to me.

    • Sue

      Medicine understands that low-prob/high consequence combination. That’s why we check people’s necks after injury, do an ECG for chest pain, exclude meningitis in children with high fever. Hardly anyone has the condition, but, when they do, it can be catastrophic. Doctors and nurses are held accountable for missing that stuff.

  • AL

    Ladies, off topic, but not really, I saw this piece on CBS Sunday Morning yesterday which infuriated me. I sent the piece to Dr. Tutuer as well via email. So misleading with a lot of misinformation.

    http://www.cbsnews.com/video/watch/?id=50146659n

    • The Computer Ate My Nym

      Even more off topic, but amusing, the ad I got before the video started was for…v!agra. Generating more business for the midwives?

  • Captain Obvious

    “I am glad I got my homebirth, as I cannot imagine going through that in a hospital setting.”

    http://community.babycenter.com/post/a41957626/i_did_it_but….

    This women states she didn’t get the amazing experience she was promised with Homebirth. She suffered during labor but is justifying it as a better experience than had she been in the hospital? Analgesia may have helped her experience. She doesn’t even appreciate how dangerous of a risk she took. Sounds like her bladder took a beating.

    • Bombshellrisa

      I have to shake my head at stories like these, how do they KNOW what it would have been like in the hospital?

    • Captain Obvious

      Marketing. Sounds good when midwives are described as highly educated and that they risk out higher risk moms. That medical doctors “manage” labor. Well midwives manage labor in their own way and many are not as educated as this video suggests and definitely doesn’t risk out as willingly as the video suggests. A “parody” (I say parody, but in reality, it would more factual about American Homebirth) video about their real education and their real attitudes about any mom can deliver any baby when the baby chooses to come should accompany this video.

      • Captain Obvious

        Should be under CBS video. :-/

    • araikwao

      It’s always “*get* my homebirth”, “I *got* my homebirth” – it just makes me uneasy. Maybe it’s the smugness and entitlement as they tick the first box in the Achievement Parenting Checklist (TM)?? Or their ignorance of the bullet they (and hopefully their baby) just dodged?? Either way, it sends a little shudder through me every time..

      • Sue

        I’m imagining the babies POV:

        “Sure, my Mom got her “experience” – but did she think about ME stuck in here? Of course not – unborn babies don’t have rights – we literally have no voice! I had the most massive screaming headache for hours and hours, all the time wishing I could scream out “I’m STUCK, get me OUT, call the DOCTOR”, but nobody could hear it. And now they’re all smug ‘cos they know I’ll probably forget all about it…”

    • auntbea

      Guess they don’t teach lay midwives how to insert catheters?

  • Mom of 2

    I’m about to reveal my inner nerd. I love Harry Potter, in a I totally wish I had been accepted to hogwarts kind of way. Harry loses both his parents as a baby in a senseless murder due to being betrayed by a friend. JK Rowling, excellent writer that she is, does a wonderful job of conveying Harry’s bitter regret and the hole left in his life, when he expresses how he wishes his mother was kissing him goodbye when he leaves for hogwarts or that she had been there to make his birthday cake or longs for the siblings he might have had.

    Home birth maternal deaths are every bit as senseless as Harry’s parents’ deaths. If that child knows that her mother died an agonizing, preventable death because of one stupid choice, her regret, like Harry’s, will know no bounds.

    Thanks to obstetrics, Harry is the only person I know who grew up without a mother. I hope that this horrible trend doesn’t change that.

    A mother of 6 died a couple weeks ago in Utah after c section number 6. Very tragic. But she was in a hospital and had a team of specialists doing everything possible. Her children, while devastated, will at the very least have the knowledge that she didn’t die at the hands of an uneducated idiot for an ideology

    • The Computer Ate My Nym

      Her children, while devastated, will at the very least have the
      knowledge that she didn’t die at the hands of an uneducated idiot for an
      ideology

      I’m not sure I’d say that. She died because her husband made her keep having children when it was clearly unsafe for her to do so because his religion told him that she should. I hope her daughter somehow gets out of that and only takes the risk of dying in childbirth when she wants to, that her sons find it in their hearts to support their future partners (if female) in that same decision.

      • Mom of 2

        I was referring to the home birth ideology. I only read the story on the local news, and I didn’t get the impression that her husband made her keep having children. Perhaps her religion led them both into that ideology, yes, but I’m not sure where you got that her husband made her do it. Do you have a source for that?

      • Awesomemom

        You are completely and utterly wrong about the LDS religion. We are encouraged to have children yes but how many ect. is left up to the couple in consultation with Heavenly Father. We are not told to keep pumping them out if it puts our health at risk. I know some people are rolling eyes about consulting with God but what ever. The official doctrine is not kids at all costs.

      • Jocelyn

        Also, I think you may have understood the LDS church’s position on marriage. “Her husband made her” makes it sound like the man is in a more powerful/authoritative role in the marriage, which isn’t true. We believe in completely equal partnership in marriage.

        Here’s a great quote (from the April 2013 “Ensign” magazine, the official magazine of the church) which explains it really well:

        “In considering the equal partnership, Elder L. Tom Perry of the Quorum of the Twelve Apostles eloquently said: “There is not a president or a vice president in a family. The couple works together eternally for the good of the family. … They are on equal footing. They plan and organize the affairs of the family jointly and unanimously as they move forward.” Both husband and wife have a sacred obligation to refrain from thoughts and actions that might undermine that equal partnership.”

        The Quorum of the Twelve Apostles is at the top of our church leadership; so, that’s straight from the top.

        • The Computer Ate My Nym

          The Quorum of the Twelve Apostles is at the top of our church leadership;

          How many of them are women?

          • Jocelyn

            How many were women in Jesus’ day?

          • DiomedesV

            Is that your standard for gender equality?

          • Jocelyn

            No, I’m just pointing out that some doctrines stay the same despite societal changes. Since we believe God is in charge of our church, we believe that there’s a reason for it.

          • DiomedesV

            In other words, there is no gender equality in the church since that is the way God wants it. Weren’t you just arguing that this was not the culture of the LDS church?

          • Jocelyn

            No, that’s not want I’m saying “in other words.” You’re twisting my words, so I’ll again turn to someone who can say it better than me.

            This is a quote from M. Russel Ballard, another member of the Quorum of the Twelve Apostles:

            “Our Father in Heaven loves all of His children equally, perfectly, and infinitely. His love is no different for His daughters than for His sons. Our Savior, the Lord Jesus Christ, also loves men and women equally. His atonement and His gospel are for all of God’s children. During His earthly ministry Jesus served men and women alike: He healed both men and women and He taught both men and women.

            The gospel of Jesus Christ can sanctify both men and women in the same way and by identical principles. For example, faith, repentance, baptism, and the gift of the Holy Ghost are requirements for all of God’s children, regardless of gender. The same is true of temple covenants and blessings. Our Father’s work and glory is to bring to pass the immortalityand eternal life of His children. He loves us all equally, and His greatest gift, the gift of eternal life, is available to all.

            Even though men and women are equal before God in their eternal opportunities, they have different, but equally significant, duties in His eternal plan. We must understand that God views all of His children with infinite wisdom and perfect fairness. Consequently, He can acknowledge and even encourage our differences while providing equal opportunity for growth and development.”

            And that’s what we believe. I don’t know how to explain it much better than that.

          • T.

            I know that this is going to unlash Hell, but, whatever.

            I come from a Fascist family. My great-grandfather was a mininster under Mussolni. This is a simple fact, since a lot has happened since then, and I do not believe what they did, I have no problem with it.

            However, I have a lot of propaganda material of the Fascio, which is obvious if you think of it.

            Now, reading those material, you read things like (very rough paraphrases here):

            “Fascism does believe in equality of men of all races. Yet, since we are not all the same, we will all have different, but equally important role in the Country.”

            This is just before invading Etiopia, mind you.

            My great-grandfather and my grandparents believed those things. They did not think themselves racist.

            I am NOT comparing Fascism to any religion. My argument is a tad bit subtler. What I mean is that I have yet to find one religion or ideology in the current century saying outright, in their “pamphlet”:

            “Why, yes! We DO think women are inferior and should be threated as such”<- religion

            "Why, yes! We DO think that other races are mindless vermin that should be eradicated!"<- political ideology

            Etc etc etc

            Even Islamic states under the Shari'a claims to do it to "respect" women.

            It is the outsider eyes that note that, maybe, just maybe, it is not exactly like that…

            I have no knowledge of Mormon, nor I particularly care about it to tell the truth. It is the general thought.

          • Right. Men get to lead, while women get to have babies. Men get power, while women get to, um, cook and clean. Men can be priests, while women can be wives.

            *Gag*
            When people get “separate but equal” duties, and somehow one gender gets all the good ones with power and one gender gets all the scut work, things are NOT equal.

          • Awesomemom

            No, men are assigned to lead while women are blessed to be able to bear children. We are not relegated to scut work. I choose to be a stay at home mother but that does not give my husband a free pass to sit on his ass when he gets home from work and order me around. He does a great deal of scut work too. Honestly I would not want the duties of a priesthood holder, it is a lot of work and I have enough of my own. I get access to all the blessings and that is enough for me. I have plenty of power and I don’t need to go seeking for more. Just because you tell me I should want this does not mean that I really would be better off with it.

          • Kerlyssa

            But what about the women who DO want it, and don’t want to be housewives? If your daughter wants this, what are you going to say to her? That she has enough, that it was enough for you, and she shouldn’t want to aspire to what her brothers are allowed to do?

          • Awesomemom

            She doesn’t have to be a housewife and I would encourage her in any career that she wanted to try (except maybe if she wanted to be a drug dealer, I would have issues with that). My mom worked all my childhood and still does. I just made a different choice than her and it is all good. If she wants to have the priesthood I would recommend that she joins a church that allows that. I would not love her any less if she did not choose to continue in the religion that she was brought up in. Hopefully I would teacher as i have been taught that just because we are not given the official priesthood that she is not cut off from it and can still enjoy all the blessings from it that the men have and do enjoy.

          • VeritasLiberat

            What was there in this post to downvote, unless one is an intolerant asshole like the NCB harpies?

          • theNormalDistribution

            Try replacing “the official priesthood” with “a seat in political office” and “religion” with “country” and see how you feel about it.

          • VeritasLiberat

            ..Why would I do that? Those things are not analogous

          • Eddie

            If our country had a single, state-sponsored religion, I would agree with you. But we do not. We have quite a plurality of religions, but one country.

          • theNormalDistribution

            Funny you should say that. Because there are actually more than one country on this planet, last time I checked. I’m sure someone who has grown up in a specific religion, practiced by their whole family, community, and everyone they are close to, would feel exactly the same way about leaving their religion as you would about leaving your country. It’s so not a choice that you forgot other countries existed.

            I think the analogy is an apt one to illustrate the callousness of suggesting that if you don’t like the doctrine, you should choose a different one – rather than questioning whether or not the the doctrine itself is wrong.

          • Eddie

            I think you’re deliberately missing my point. You said, “Try replacing “the official priesthood” with “a seat in political office” and “religion” with “country” and see how you feel about it.” I was pointing out in the context of your statement, that there is only one country, but many religions. Do you seriously believe for one second that I forgot that other countries existed? I am married to someone who was not born in my country. I was trying to respond to what I understood the context of your statement to be.

            One’s religion is simply not analogous to the country you live in. It’s a poor analogy. It overreaches. I get the point you are trying to make, but the analogy is too imperfect for me to accept it.

            I known a great many people that have left the religion of their birth. Yes, doing so was traumatic for some of them. I also know a lot of people who left the country of their birth. And this was traumatic for some of them. But the two are different in too many ways to be analogous.

            I respect people who work to change a religion from within, who question doctrine. I respect people who decide that a given religion — even if that of their birth — is a poor fit for them, so they find one that fits their beliefs. I also respect people who do their best to follow their religion, whether it is the one of their birth or one of their direct choice, whether it is one I personally agree with or not, as long as they don’t have to break their soul to do so, or anyone else’s. (I clearly mean “soul” metaphorically in this context.)

          • theNormalDistribution

            I have no idea how you concluded from what I said that there is only one country (and no, of course I don’t think you have forgotten that there are other countries; the comment was facetious. Because really. What?)

            This is what I was suggesting to DiomedesV:

            “If she wants to have a seat in political office, I would recommend that she move to a country that allows that. I would not love her any less if she did not choose to continue in the country that she was brought up in. Hopefully I would teacher as i have been taught that just because we are not given seats in political office that she is not cut off from it and can still enjoy all the blessings from it that the men have and do enjoy.”

            Leaving a country and leaving a religion are obviously not the same. The analogy is in the relationship between being a member of a social group and holding a position of power. I see no material difference in those relationships, but if they don’t resonate with you personally, then the comparison is useless. I could have just said to try the race substitution suggested up-thread but race and gender are directly analogous in terms of status inequalities, and if it wasn’t obvious what someone may find objectionable to the original post when the inequality was gender based, I doubted substituting race would help.

            I get the point you are trying to make, but the analogy is too imperfect for me to accept it.

            The only usefulness in making an analogy (in my opinion, anyway) is to demonstrate something subtle in a more obvious way. To aid in understanding. It can’t be used to prove anything, and I certainly wasn’t attempting to. So whether or not you “accept” (I don’t understand what that means) the analogy is not important. You say you understand the point I was attempting to illustrate, so it has succeeded in its purpose. If you disagree with it, we won’t make any progress in understanding where we differ if you insist on arguing against the analogy instead of my actual point.

            Let me remind you, DiomedesV was complaining that there was nothing to dislike in the previous post. I responded because I disagree. If you think the post was harmless, then great. Lovely. But now you understand, at least in vague terms, why I and at least one other disliked it.

          • Eddie

            If you disagree with it, we won’t make any progress in understanding where we differ if you insist on arguing against the analogy instead of my actual point.

            Very well put, and quite right. My position on religion when it comes to freedom vs sexism is too complicated for me to figure out how to summarize without leading into rabbit holes and tangents and misunderstandings. It depends too much on context. Maybe if religion were more central to my thinking — or if I were an atheist — I would see this differently. I don’t know. But I did understand from the beginning why you & others didn’t like the post you were criticizing.

          • You may have been taught it, but it is, frankly, a lie. Without the power, prestige, and recognition of official priesthood, women are clearly relegated to second-class status.

            Remember, gender to race conversion.

            Hopefully I would teacher[sic] as i have been taught that just because we (black people) are not given the official priesthood that she is not cut off from it and can still enjoy all the blessings from it that the men white people have and do enjoy.

            Still sound equal and innocuous?

          • theNormalDistribution

            No, men are assigned to lead while women are blessed to be able to bear children.

            What a disgusting thing to say.

          • Awesomemom

            If you say so.

          • Bombshellrisa

            And what if they are unable to have children? Where is the blessing for them?

          • Anonyme

            Please read my response downthread. Motherhood is not the female equivalent to the priesthood. Men are required to hold the priesthood and any man can qualify for it. The same is not true of motherhood. Women who can’t have children may adopt, of course, but they are certainly not required to. A woman’s maternal status has no bearing (so to speak) on her standing in the church.

            The church believes that women who were not able to have children in this life will have that opportunity in the next.

          • I’m happy you’re happy. I realize that sounds snarky, but I do mean it.

            What would you tell a woman who did want priesthood powers and responsibilities, who didn’t want children, and who very clearly was NOT happy with housework? Would you support her in her quest to change the LDS, or tell her to go sit in her box and like it?

          • Awesomemom

            I would never support a person that was campaigning to change how the church was run because that is not how it works. If she was not happy with how it is run she is free to leave but the church is not run from the bottom up.

            Also honestly I don’t get why you think that all LDS women are relegated to being stay at home mothers who are forced into servitude to their husbands. We are encouraged to stay at home and raise our kid as the situation allows. It does not always work out that one parent can stay at home or even wants to stay at home and solely raise the kids. A great many of my female friends in the church work, my own mother worked, one of my sisters works while her husband takes care of the kids and goes to school. I would like to eventually finish school and have a career when my living situation accommodates that but with my husband being in the military and moving around a lot it is just not in the cards right now. I don’t see those desires as against church doctrine.

          • Right. So a woman is taught from birth that the LDS is the One True Church ™, many of her friends are there, her family is there. If she leaves, she pays a huge cost- her social networks disintegrate, she loses friends, and she may well be cut off from family as well. She may lose her marriage. On top of that, there’s the psychic stress of ‘rebelling’ against people you have been taught are true authority, and rejecting the LDS version of God (which comes with serious after-life consequences in the LDS). Strong women can and do do this on a regular basis, but it’s not nearly so easy as “well if you don’t like it just leave”. You, of all people, should know that, being as you’re imbedded in it right now.

            I don’t see all LDS women as being relegated to husband-based servitude. I see them encouraged to do it, but by no means forced. I’d also like to point something out: if the language used for gender was used for race, NO ONE would put up with it or see it as anything other than racism.

            Even though men and women blacks and whites are equal before God in their eternal opportunities, they have different, but equally significant, duties in His eternal plan. We must understand that God views all of His children with infinite wisdom and perfect fairness. Consequently, He can acknowledge and even encourage our differences while providing equal opportunity for growth and development.

            When used to talk about gender, it’s just as clearly sexism. You can live under that system if you like, but you need to see it for what it is, and it’s very sad to me that you’re raising your daughters in it.

          • Eddie

            FYI: Anecdotal, maybe not at all representative, but I knew a man who was socially cut off after he left the LDS church, whose wife was counselled by local church elders to divorce him when he left the church. (And so she did.) LDS friends I’ve talked to about this said that their local elders would never counsel such a thing. I have no idea how widespread this is.

            Religion is a funny thing, because even when a church (any church, any religion) hierarchy says not to do extreme things, or not to interpret something in an absolutist way, some people will. That’s not necessarily the fault of the church. It’s a fault of those people But this depends on the degree to which the church in question explicitly or implicitly drives or supports or just allows those behaviors. It depends on context.

          • Anonyme

            I feel like I need to clear something up here. Parenthood is an eternal responsibility in the LDS Church (that just makes you tired thinking about it, doesn’t it) and is equally shared by men and women. The same comparison can’t be made with the priesthood and maternity. Men are expected to qualify for the priesthood and fulfill their duties therein. It is hoped that women will want to have children, but motherhood is not the complement to priesthood.

            As I’ve stated upthread, women do have leadership responsibilities in the church. The fact that they are not the same as men’s doesn’t bother most women because they don’t see it as a sign that God loves them less. Of course some women have left the church over this and some remain and try to change it. My answer to Feminerd below (although she didn’t ask me) would be neither. I would never tell someone to sit in her box, but I wouldn’t support the “ordain women” folks either. That’s because I believe that the idea that only men hold the priesthood comes from God. It’s doctrine, not policy, and not subject to any kind of grassroots movement.

          • Anonyme

            Women fill essential leadership roles in local units of
            the church (called wards and stakes). Women also lead on a worldwide level. Linda Burton is the general president of the Relief Society, an organization with over 6 million members. Sharon Eubank is the director of LDS Charities, which has projects in 179 countries. The CEO of Deseret Book (not a part of the church but a subsidiary of its
            holding company) is a woman and she has the nerve to not even have any babies.

            While the nurture of children is the primary
            responsibility of mothers, husbands and wives are
            obligated to help one another as equal partners
            (https://www.lds.org/topics/family-proclamation). In last month’s church magazine you can read this statement by one of the apostles: “There is no task, however menial, connected with the care of
            babies, the nurturing of children, or with the
            maintenance of the home that is not [the husband’s] equal obligation.” I know, I know . . . he’s a man.

          • VeritasLiberat

            So children are worthless scut work? Nice to know you feel that way.

          • LukesCook

            “Routine and often menial labour” – yes, that describes a fairly significant portion of child care, especially very young children, and extra especially if you’re doing all the cleaning, cooking and cloth diaper washing as an adjunct.

          • Housework is. Children are not, but some aspects of caring for them certainly are (I do not love changing diapers, for instance). Good job reading what I wrote and immediately missing the point.

            Scut work is also not worthless. It generally needs to be done. It’s just unfun, often physically taxing, gives no power, pays poorly, doesn’t engage the brain, and has no prestige associated with it. Janitorial work is scut work, as is dishwashing, busing tables, being a streetsweeper, picking crops, and a great many other necessary jobs.

          • theNormalDistribution

            I don’t understand… Your quote seems to support DiomedesV’s assertion that it’s simply because god wants it that way. Can you spell it out for me? Why do women and men not have the same opportunities?

          • Mom of 2

            one could certainly argue that there is gender inequality in the leadership of the lds church, but you can’t jump from that to the idea that husbands force their wives to have tons of kids. If you can’t show any evidence that this woman was pressured by her husband to have 6 kids, then don’t say it. End of discussion.

            Good grief. I was trying to point out how tragic it is when a mother dies in childbirth, which we all agree on, not start a religious argument.

          • suchende

            I don’t know what American institution you could point to and say, “THERE, no gender inequality.”

          • Mom of 2

            Hear, hear, suchende!

          • DiomedesV

            I never fucking said it. I just said that the understanding of what must be a fraction of the cultural diversity of the Mormon church does not preclude the possibility.

          • Anonyme

            If the women of the church support the teachings of the church’s top leaders, what difference does it make if those leaders are men? The issue is the LDS Church’s position on equal partnership in marriage, not how it decides its leadership.

          • The Computer Ate My Nym

            If the women of the church support the teachings of the church’s top
            leaders, what difference does it make if those leaders are men?

            I grew up more or less Catholic. Considering the answer to this question is one of the reasons I’m not any longer. If a certain group forbids a subset of its membership from being the leaders of the group-either by law or de facto-then those members are not equal. No matter how enlightened and genuinely interested in fairness the non-subset leaders are, there simply will never be equality. In the context of Catholicism, women can be involved, make some (mostly local) decisions, and can be “prominent individuals” within the Church (a famous example is Mother Theresa). But they can’t be the priests, bishops, or the Pope. They can never set policy. Therefore, it’s simply never going to be an egalitarian institution until that changes.

            I don’t know whether the LDS actually forbid women from leadership roles or simply don’t, in general, select women for these positions. But until there is a roughly 50% representation at the top and all levels, I’m going to have a hard time taking the claim that everything is completely equal seriously.

            And, in case you’re wondering, yes I have noticed that the same could be said for the US government. If women were equal in the US do you think we’d even be discussing this issue? There is no men’s movement for home vasectomies or home TURP. The NCB movement was formed by sexists and the thin coating of feminist rhetoric that has been laid on top of it doesn’t change that in the least.

          • Eddie

            If women were equal in the US do you think we’d even be discussing this issue?

            I absolutely believe we would be discussing this no matter what the gender mix was at the top. Sexism isn’t something that men created. If that were the case, it would be far easier to cure. I seriously do not believe that NCB was consciously created “to keep women down, to put them back in the kitchen where they belong.” It’s more subtle than that. Many of the strongest proponents of NCB are women.

            Just having women equal in positions of power to men does not solve the problem. It only solves one part of the problem.

          • theNormalDistribution

            I don’t think TCAMN was saying that men created sexism. Women are very often contributors to gender inequality.

          • Eddie

            My point is that sexism is a more complicated issue than who’s in charge. TCAMN asserted that having equal representation at top government levels would mean we wouldn’t be talking about these things, which suggests that getting women in charge would make them go away. True, this doesn’t mean that men *created* sexism, but it does say that getting women in charge will make sexism go away. And that’s just not true.

            Given a lack of tone in internet, let me just point out that I’m not angry or upset or irritated or hurt or anything like that. Just responding intellectually.

          • auntbea

            She is using the number of women in power as an indicator, not a causal variable.

          • Eddie

            Even with that analysis, I still strongly disagree with the idea that sexism or sexist-related illogical thinking would go away around the same time we have equal representation. I believe we’ll have equalish representation well before any time that sexism becomes a minor cultural influence.

            An example of why: The NCB crowd believe they are the true feminists, even as they fight to reduce women’s choices. I’m positive that just about all of those folks would be happy to vote for female representation though, as long as it was someone who agreed with their ideology.

          • auntbea

            Of course. Equal representation is neither absolutely necessary nor sufficient. But the two are correlated. Ergo, an indicator.

          • theNormalDistribution

            I don’t disagree with your point, but I don’t agree that she was asserting that equal representation at the top would imply we had equality. She said p^ -> q^, and you took it to mean that she thinks p -> q. She was saying that she finds the claim that women are equal in an organization dubious as long as all or most of the leaders are men. Obviously that’s not axiomatic, but considering the fact that our society (and the majority of societies) are patriarchal to some degree, it’s not an unreasonable n=1 test for equality.

            Regarding the lack of tone – don’t sweat it. I’m tone deaf anyway. 😛

          • Eddie

            The piece I was responding to was this, specifically:

            And, in case you’re wondering, yes I have noticed that the same could be said for the US government. If women were equal in the US do you think we’d even be discussing this issue?

            I completely agree with the rest of what she said. But that part … I completely believe that we’ll have equal representation some day, hopefully in my lifetime. I am not at all confident that the failure of critical thinking that leads to extreme lactivism, NCB, antivax, and whatnot will ever disappear.

        • Bombshellrisa

          ” “Her husband made her” makes it sound like the man is in a more powerful/authoritative role in the marriage, which isn’t true. We believe in completely equal partnership in marriage.”
          Ok, perhaps the official stand on marriage is the wrong way to measure it then. What is the church’s official stand on birth control?

          • Anonyme

            “Husband and wife
            are encouraged to pray and counsel together as they plan
            their families. Issues to consider include the physical and
            mental health of the mother and father and their capacity to
            provide the basic necessities of life for their children. Decisions about
            birth control and the consequences of those decisions rest
            solely with each married couple” (https://www.lds.org/topics/birth-control?lang=eng).

          • Bombshellrisa

            But another post here says that members of the church are encouraged to have children. So if there is encouragement to have children, that means there IS pressure to reproduce. And sure, the decision may be between a husband and wife, but it would be very hard to go against the grain of the dynamics of your church and community of faith.
            I live in a primarily LDS town in a neighborhood that is mostly members of the church. The bishop and his wife live next door to us. I have experienced my next door neighbors as wonderful, caring, supportive people. They understand the dynamics of our family and why we are reluctant to have more than one child. But we are not a part of their church or their community of faith. My husband’s business partner grew up in this same church knowing these same people and they do treat his choices (which have been the same as ours) differently.

          • Anonyme

            Tell your neighbor to read section 21.4.4 of Handbook 2 (I am not making this up; we are that organized):”It is the privilege of married couples who are able to bear children to provide mortal bodies for the spirit children of God, whom they are then responsible to nurture and rear. The decision as to how many children to have and when to have them is extremely intimate and private and should be left between the couple and the Lord. Church members should not judge one another in this matter.”

            I don’t know what else to say. We’re not perfect. Not everybody follows the manual, figuratively speaking.
            People criticize even though they’ve been taught not to. Mere coincidence that the Provo-based band Neon Trees wrote “Everybody Talks”?

          • Bombshellrisa

            I didn’t mean just about having children, I was merely illustrating how hard it is to still feel a tug from the community that you USED to be associated with to do a certain thing, especially if you were raised that way and are still to some point having to deal with the community. I can only imagine what it would be like for someone who made choices that were not the norm for their community how out of place they might feel. And how for those within the church, how it might influence them.

      • MtW

        I am LDS and I don’t know a single family that has a husband “forcing” wives to do anything, let alone have children. Perhaps he was an abusive rapist, but that is in no way anything the church condones. Keep your disgusting bigotry to yourself.

      • KumquatWriter

        Perhaps there is confusion about the LDS church vs the Mormon Fundamentalists, and perhaps a dash of Quiverfull?

        I’m an Atheist, but my college roommate and long-time friend is devout and practicing LDS. I find the religion fascinating.

        • Not My Name

          The vast majority of LDS I know have 2 kids (and our ward is made up of people from all over, from Utah to NY, our town is mostly transplants). A few have 4, and still fewer have 5+. I would like to have 5 or 6 but my husband is against more than 3. Many of the people I know come from families of 6+ kids (one friend has 11 siblings!) but in this economy most people now are choosing to have fewer children. All of my friends use birth control and are no kind of quiverfull.

          I’m an atheist married to a Mormon and I’m the one being told 3 kids will be enough. I never realized how PC it was to bash mormons and be otherwise totally intolerant and offensive until I married one.

          • Staceyjw

            Bashing both atheists and LDS is pretty acceptable in most places. It sucks!

      • The Computer Ate My Nym

        There are crazy fundie LDS, just like there are crazy fundie (other) Christians, Muslims, Jews, Hindi, atheists, etc. Heck, I’ve met some agnostics that I consider fanatics (yes, they are very strange). I had the impression that this couple was of the more fundamentalist sort, that they were having children to rack up quiverfull numbers rather than because they enjoyed raising lots of kids and that the leading force behind the impulse to have more was the father, but I can’t find the article I read that gave me that impression any more. If I’m wrong and they really just liked having loads of kids, well, I think a 6th c-section is a ridiculous risk to take but they didn’t ask me so I was out of line commenting the way I did.

        • Dr Kitty

          Not necessarily crazy to have more than 4 CS. Higher order multiple CS is pretty common in Saudi Arabia, for example.
          http://www.ncbi.nlm.nih.gov/pubmed/16868394

          • The Computer Ate My Nym

            I’d like to see someone besides the Saudis confirm that result. Nothing against medical care in SA, but they seem to be the only ones who find no increased risk. The related articles from other countries suggest increased morbidity with 3+ c-sections. (Though some are from the 20th century so could be obsolete.)

          • The Computer Ate My Nym

            Actually, the more I think about it, the more this result seems unlikely. Being a grand multipara is a risk in itself (though 4 isn’t GM, of course, so maybe the line is simply set too low to show a signal). Multiple surgeries of any sort complicate future surgeries. For example, it’s rare to go beyond 2 CABGs because it’s hard to crack the chest a third time and get anything other than scar tissue to stitch back together. I suppose an abdominal surgery is easier-no bone to go through and maybe you can go into the same incision somehow to limit the number of scars-but it’s still hard for me to believe that it’s not an additional risk. Plus I still haven’t seen anyone outside the one group report this finding.

        • Anonyme

          The family in question is LDS, or Mormon. According to mormonnewsroom.org, there is no such thing as a “fundamentalist” Mormon. Crazy Mormon, maybe; fundie Mormon, no. There is no “quiverfull” movement in the LDS Church. LDS parents have more children than average for several reasons, but racking up numbers is not one of them.

          • Not My Name

            There are fundie mormons that practice polygamy, live in compounds, etc, but they are not part of the LDS church. They’ve been kicked the hell out. This couple was part of the regular LDS church. Reading everything people in their community have to say about them, they sound like an active, loving family.

            Liz P and Bambi both have huge families, I don’t see people here raking them over the coals, saying Liz has a big family because Gabe is forcing her to have kids or because they are religious freaks. Or that Bambi, who had 7 children is brainwashed or subdued by her husband. Seeing that a couple is LDS and assuming one knows their motives, and that those motives are clearly just to rack up kids is pretty horrible.

          • Staceyjw

            I agree. Some people just like big families, and 6 isn’t even all that many. 6 Cs may sound like a lot, but it’s not unheard of to have even more than this.

          • Antigonos CNM

            Ethel Kennedy had more than 6. That is beside the point. I don’t know of any religion which REQUIRES a woman to die in order to fulfill her “childbearing potential” but there are women who CHOOSE to use a religious excuse to have more children even when strongly urged not to, for medical reasons. An increasing phenomenon we are seeing among haredi [ultra-Orthodox] women in Israel, where fertility treatment is government-subsidized is that post-menopausal women are demanding treatment, because they believe it is a “mitzvah” to have children as long as possible, even beyond medical common sense. This has nothing to do with rabbinical teaching; it is purely a personal desire.

            Changes in the technology, and methodology of C/S have made the possible safe number higher than before, but the decision isn’t iron-clad. It depends entirely on the woman’s individual situation. After all, some women still shouldn’t ever become pregnant at all, for purely medical reasons.

          • The Computer Ate My Nym

            I don’t know of any religion which REQUIRES a woman to die in order to fulfill her “childbearing potential”

            Really? Never heard of Catholicism? Savita Halappanavar died because she was in Catholic country that required her to continue the pregnancy no matter what the cost to her. Not to mention the Catholic saint who is a saint because she died attempting to carry a pregnancy that she knew would kill her. And the teaching that birth control is evil and using it will send you to hell. Sure sounds like a religion that requires a woman to die for her childbearing potential to me.

          • Antigonos CNM

            I stand by what I wrote. Some religions — mine, for example, allow birth control in certain circumstances and even termination within strictly restricted parameters; if a Jew says otherwise, he/she is ignorant of rabbinic literature on the subject. Most religions have some form of “opt out” clause, such as risk of maternal death if a woman becomes pregnant or if it is certain the infant will be born with a defect incompatible with life. Catholicism takes the view that one must practice abstinence — not very realistic, but even the Pope does not demand that every woman MUST do everything possible to conceive even if conception will undoubtedly kill her. [And family planning IS permissible, even if the means are highly flawed as in the “rhythm method”]. When I said that a woman is not required, I meant that no religion insists that an ostensibly fertile woman of childbearing years MUST do everything possible to conceive because of her potential to do so. If that were true, every nun in every convent would be obliged to give birth simply because she is physically capable of it. Granted, the alternative of deciding not to have a sex life is not a form of contraception most women would choose, but it exists.

            What happened in Ireland was a travesty, and even the Irish Catholic clergy were not happy about it. It was a layman — a doctor, not a priest — who made the decision not to assist the woman who was already miscarrying and the fetus was lost in any event. BTW, I do believe Eire does not actually have an established State religion, and so he was in error about that too.

          • The Computer Ate My Nym

            No religions that require women to die for their childbearing potential? http://thinkprogress.org/health/2013/05/13/2001191/beatriz-abortion-el-salvador/?mobile=nc

          • Eddie

            To be fair, that problem is from the country, not the religion. Catholicism from the very top says that “life of the mother” is a valid excuse. This doesn’t mean that all countries choose to allow it, but that is not because of the church hierarchy.

            This is not a simple black & white issue where the church itself is the problem. The problem is people and their interpretation and application of religious law. The Catholic religion absolutely does NOT require women to die in childbirth. Some countries, however, do, because of their Catholic beliefs.

            FWIW, I am not a Catholic, although I am 1/2 Catholic by birth.

            Where I live, a big issue is pharmacists refusing to give out birth control because it is against their beliefs. My wife needed birth control so she wouldn’t die from an ovarian cyst. (She wasn’t yet at the stage where she needed surgery, but she had a cyst rupture when she was young and came very close to dying. Within minutes, the doctor said.) No religion I am aware of would refuse treatment under that circumstance, but the problem is the pesky individuals who are absolutist in their thinking. You can blame the religion itself, but that is missing the real problem.

          • Honestly, I think the risks really jump when you go from 3 to 4 cesareans. Weird things happening with the placenta, IUGR, maternal death… not good.

          • Staceyjw

            Yes there are, the FLDS- Fundamentalist LDS!
            They do have many kid and are pro natalist, as well as practicing polygamy.

          • Anonyme

            I think the point is that while the “Fundamentalist” LDS may have co-opted part of the name of the LDS Church, the LDS Church rejects that use of its name. The Associated Press Stylebook notes: “The term Mormon is not properly applied to the other … churches that resulted from the split after (Joseph) Smith’s death.”

          • Kerlyssa

            Well, that’s like China getting aggressive when people call Taiwan Taiwan.

          • Anonyme

            Keep in mind that quote is from the Associated Press, not the church. Anyway, it’s more like Catholics objecting to Lutherans calling themselves Catholics.

          • LibrarianSarah

            Sorry Anonyme but you are approaching no true Scotsman here. The FLDS is classic fundamentalism. The LDS made a large doctrinal change and some people rebelled against it in the name of doctrinal or ideological purity. The Mormon church does not have a monopoly on the LDS label. Even in Joesph Smith’s lifetime they shared it with the Community of Christ.

          • VeritasLiberat

            No, the split with what is now called the Community of Christ (formerly the Reorganized Church of Jesus Christ of Latter Day Saints) did not happen during Joseph Smith’s lifetime. As for the FLDS, they have about the same relationship to the COJCOLDS that the Branch Davidians had with the Baptists.

          • Anonyme

            I think you’re approaching the inability to distinguish between a Scotsman and an Irishman. The FLDS may be fundamentalists, but they’re not Mormons. At least not according to that venerable institution, the Associated Press: “The term Mormon is not properly applied to the other … churches that resulted from the split after[Joseph] Smith’s death.”

            Now, those who don’t venerate the AP as I do may continue to improperly call these other churches Mormons, but I will continue to shout “Och aye, lassie! Those groups have no affiliation with The Church of Jesus Christ of Latter-day Saints.” Commenters here have been using anecdotes from those sects as if they had some connection to LDS Church doctrine, but they don’t. I’m not saying there aren’t some wacky Scotsmen out there but please, don’t call us Irish. (It’s just an analogy! I’m of Scots-Irish descent!)

          • Cait

            My parents were quiverfull LDS Mormons. And I’ve known many other mainstream Mormons who believed that women should have as many babies as physically possible — one of whom died in childbirth — though they didn’t necessarily use the quiverfull language to describe it.

            It’s only been a few decades since the church general authorities were routinely describing birth control as evil and a violation of temple covenants. You can try to whitewash this part of Mormon culture, but in my humble opinion, that definitely qualifies as dishonesty with your fellow man.

        • LibrarianSarah

          There can be no “fundamentalist atheists.” Fundamentalism is a reaction or backlash against religious change. For example, Mormon fundamentalism is a reaction against the Church of Later Day Saints disavowing polygamy. The idea is to get back to the “fundamentals” of a religion. Atheism is simply a lack of belief in god and hasn’t changed since it’s onset. I know it seems nit picky but it is important that we use these kind of terms correctly. Also, unless someone threatens to shoot you in the face, don’t call them militant either.

          • Poogles

            “There can be no “fundamentalist atheists.” ”

            Thank you! There can be atheist extremeists, certainly, as any position can be taken to an extreme, but that is not the same as being a “fundamentalist” or being “militant.”

          • theNormalDistribution

            I’m not sure I even agree with that. It’s awfully hard to take “I reject your -insert god claim-” to an extreme. I suppose you could feel really strongly about it, but that’s not extremism.

      • DiomedesV

        Religion is more than just theology, it’s culture as well. Every religion has cultural factions. Muslims, Catholics, Jews, and yes, Mormons. Utah Mormons are widely regarded as having a different culture than Mormons elsewhere, particularly on the East coast. Even within Utah, there are pockets “fundamentalist” types that many Mormons would not even recognize. It’s entirely possible that this couple continued to have children beyond when it was healthy for the mother for religious reasons, and no defense on the part of other LDS members can change that fact.

        If TCANM saw evidence that the woman was pressured into having more children for religious reasons, then that might very well be the case.

        • Anonymous

          Their inability to produce such evidence seems to imply they saw “Mormon” and that was their evidence.

          No one can claim to know the inner workings of the family, and indeed, the father may be a horrible person raping his wife and forcing her into pregnancy after pregnancy, or perhaps brainwashing her into them.

          Regardless, ‘His religion’ does not tell them to have children at all costs, and is a false statement.

          What the supposed culture tells them to do is harder to ascertain, but telling a bunch of LDS they don’t know the culture as well as an outsider looking in, that obviously has negative views of the religion, is silly. I grew up in Provo, which is spitting distance away. Let me guess…I was mysteriously sheltered from the culture somehow?

          • Kerlyssa

            The problem is that it is not THE culture. There are variations from community to community, with actual splinter groups diverging wildly. The LDS church is more recent, and none of the splinter groups has had much success in growing like splinter groups from other religions have(cough,cough, Protestant, cough cough), but they still exist, and still call themselves ‘LDS’ or ‘Mormon’..

          • Anonymous

            Her memorial was at a regular LDS church, not a splinter sect. Stop grasping at straws.

        • Awesomemom

          I have lived in Utah and elsewhere and in all the wards I have been in there has not been pockets of ultra conservative pump kids out at all costs people. That is one of the things I really like about the LDS Church. We are all taught the same things through out the world. The Church leaders go to great lengths to make sure we are literally all on the same page. If I were to attend a ward in England the expectation would be that they would be on the same lessons in the same books as my ward in California. Individuals might feel slightly differently but the local church leaders are not going to be out there telling people to take dangerous risks with childbearing when the top leaders in the church frequently tell us that it is not advisable to keep having kids in the mother’s life is in danger.

          • Kerlyssa

            There are some Mormon communities that practice any number of anti-woman practices. Have been since almost the beginning. Being part of mainstream, SLC centred LDS doesn’t necessarily mean that you’d know more about these offshoots than other people who have had more dealings with them. Not commenting on this particular case, just saying that being part of the LDS church doesn’t make a person an expert on the religious motivations of everyone who calls themselves LDS.

          • Awesomemom

            If they go as far as to go against the governing authority of the church which has clearly stated that a woman’s health is more important than pumping out more kids then they are no longer LDS plain and simple. If their leaders find out that they are preaching against what the general authorities are teaching they will be removed from what ever leadership position they may have held and if they don’t repent they can be removed from membership of the church. It may sound draconian, but there are no renegade congregations that get to pick and choose what doctrine they want to follow, that is just not how the church works.

          • theNormalDistribution
          • Anonymous

            You don’t cease being a Scotsman for liking cereal. The LDS church WILL kick your ass out if you participate in behaviors they have forbidden. A school district may hire a child molester, however they have strict rules regarding hiring and will fire the person if they are made aware of the situation. Claiming school districts support hiring child molesters and arguing against resistance to that stance with no true Scotsman would be just as ridiculous.

      • The Computer Ate My Nym

        Just so people know, I didn’t actually initially even remember that the specific sect this family practiced was LDS. When I said “religion” I meant Christianity. It’s not an egalitarian religion as far as I can tell in any branch. The leadership is largely male*, the source document is overtly sexist, the teaching is traditionally sexist. That doesn’t mean that every person who practices the religion is sexist, but it creates an environment in which sexism can flourish.

        *In fact, are there any Christian sects in which the leadership, the equivalent of the Pope or the 12, is equally male/female or mostly female? I don’t know of any, but my knowledge is not extensive.

        • auntbea

          The Salvation Army is known for having involved women in the leadership long before other denominations and they are still pretty egalitarian that way (though not in some other ways!)

        • Mom of 2

          It’s a pretty big leap from “Christianity is often sexist” to “she died because he made her have lots of babies.” many people who identify as Christian or lds are not actively practicing, who knows if they were active. We also don’t know if this pregnancy was planned or a failure of birth control. And we don’t know if they were even aware that 6 c sections is risky–not all docs explain and not all patients spend their time reading up on it. Whatever the case, posting without a source that he forced her to have 6 kids is illogical and cruel.

    • auntbea

      “I love Harry Potter, in a I totally wish I had been accepted to hogwarts kind of way”

      Wait. Did you *apply* to Hogwarts?

      • Hermione

        One does not apply. One is contacted by the Ministry of Magical Education with an offer

    • Sue

      I’m with you, Mom of 2 – I LOVE the insight and cleverness of HP. I was never shortlisted for Hogwarts, but read enough (alongside my child – I would get each volume to read after her) to feel like I was taking the correspondence course!

      How strong is that orphan/stepmother culture! Clear evidence that “natural” all too often doesn’t work – even without the interference of evil doctors and nurses.

  • Anon1

    I cannot tell you how grateful I am to have found this blog and scrapped my own homebirth plans years ago. My son would surely have died.

  • Squillo

    I was clutching the father’s arm when he was told the impossible news some 45 minutes later that neither mother nor baby could be saved,

    And who’s the lucky sod who gets to not only attempt to try to save the mother and baby but also gets to tell the family he/she was unsuccessful?

    The evil OB.

    And they wonder why there’s animosity.

  • Rebecca

    There are roughly 40,000 homebirths per year, based on the 1% statistic. With the US at a MMR of 21 per 100,000, you’d predict 8 maternal deaths per year associated with homebirths, if homebirth is really “as safe as life gets.” We already know about 2 within the past 12 months. Somehow this is the next statistic that needs to be revealed.

    • The Computer Ate My Nym

      21 per 100,000? The last number I heard was 14 per 100,000: way too high, but lower than 21/100,000. But maybe the rate has risen since I last looked. Either way, homebirths are supposed to be for low risk women so the total mortality doesn’t apply. The figure of merit (which I don’t know) is the mortality rate among low risk women.

    • Dr Kitty

      No Rebecca, you’d predict fewer than 8 deaths, as NONE of the women with pre-existing medical conditions (obesity, respiratory diseases, transplant recipients, congenital heart disease survivors, cancer patients, type 1 diabetics, sickle cell anaemia, clotting disorders, complex autoimmune syndromes etc) should be having babies at home.

      If there were 8 maternal deaths in 40/000 I’d be HORRIFIED.

    • The Computer Ate My Nym

      Whatever the background statistic, I agree that MANA should publish its overall maternal mortality statistics. We only know that two deaths made the news. We don’t know how many didn’t make the news or didn’t get picked up by Dr. Tuteur for whatever reason.

    • Staceyjw

      There were 4.5% OOH births in Oregon in 2012. While half of those were in the hospital owned (but free standing, CNM run) birth center, the rest were HB MWs. I think once the data is better, we will see the number is higher. The number was accurate because of a change in birth certificates, prior to the change, a good chance of these would have been recorded as hospital due to transfer.

  • Wren

    How soon do we get the “but mothers die in hospitals too” people? They will arrive and yet again will fail to grasp the difference in rates.

    • Amazed

      An hour, at most. Coming from NGMs Facebook page. The Australian case was discussed there and there were lots of “high infant mortality because of unnecesarry CS-s”, “when hospital have perfect stats, then we can start looking at homebirth stats” and “it was her doctor’s fault for scaremongering her with the informed consent!” There is a Kerri there – a full-fledged fanatic. Don’t recommend her for peope with high blood pressure.

      • Eddie

        “When hospitals have perfect stats” is a wonderfully mobile goal post that can never be reached. Perfect for use in defending an ideology. It’s frightening that people actually think that way.

        • Amazed

          Worst thing is, the woman who made this comment was just protecting her cash. She’s a homebirth midwife, unlicenced, I imagine. She’s been working for 32 years and she’s attended over 2400 births, can you imagine? About 40 births a year! I am… amazed.

          • Karen in SC

            sounds like potential IRS fraud to me….

          • Amazed

            Scratch that, someone here can’t count, obviously. 80 births a year. That’s about 6-7 babies a month. What a midwife would take 7 damn women who are due the same damn month? I thought we were chanting ‘Personalized care, special attitude, full attention, ra-ra-ra, here we go.’

            Bloody irresponsible. Downright criminal.

            The poor women who hired her have no idea that they just got lucky… well, those on the right side of ‘2 neonatal deaths are not outside the range of expected for 600-700 homebirths’.

          • Staceyjw

            She is a liar.

      • BeatlesFan

        What contributes to hospital stats not being perfect is all the messy HB transfers that show up too late to be helped. These people have no right to be bringing hospital stats into the conversation, considering they help contribute to the negative stats in the first place. Do they also not realize that the hospital stats include babies who wouldn’t live regardless of where they were born? What a foolish argument.

        • Amazed

          They are a bunch of fools over there. Kerri is one of the worst. And the lady who made the comment is… you got it! A lay midwife.

        • Lost in Suburbia

          If the national homebirth rate is around 1%, is it really reasonable to assume that homebirth transfers really make that much of a difference in hospital stats, since hospitals are totally responsible for the large majority of those stats?

          • Amazed

            Since hospital stats for low-risk births are usually pretty close to excellent, I’d say that yes, transfers do make quite a lot of a difference. Those shameless Colorado midwives downright said that death rate of 2 wasn’t outside the range of expected for homebirths with a trained DEM. When these deaths go under the hospital’s blame hat, midwives’ stats look great. Hospital stats… not so much. And don’t forget, this particular midwife has the nerve to require perfect hospital stats. Not good. Perfect. Well, maybe she and her sisters-in-crime should stop dump THEIR bad stats, I mean cases, in the hospital and run.

    • Bombshellrisa

      Well, have your bingo cards ready-and look for words like spew and vitriol. Extra points if someone mentions Dr Amy isn’t practicing medicine anymore.

      • Sue

        Don’t you mean “Dr” Amy? (extra bingo point)

        • Bombshellrisa

          Oh dear, forgot my air quotes! Thanks for the reminder!

  • Dr Kitty

    What should maternal mortality be for low risk pregnancy, about 1/ 10, 000, ballpark?

    If MANA has 39,000 HBs on the books, they should have some maternal mortality data too…

    Going out on a limb to say they’ll know of more than 4 deaths…

    • The Computer Ate My Nym

      Dr. Tuteur has documented 4 maternal deaths during attempted home births, so the number has to be higher than 4. (Admittedly, I’m not sure if all the deaths she documented were on the MANA books, so technically their data could say fewer than 4.)

      • Dr Kitty

        Of course, when a hospital genuinely IS more than “10 minutes away” and midwives don’t carry any effective drugs (homeopathy, cohosh and cinnamon sweets don’t count) HB could be expected to have maternal mortality rates due to PPH approaching those found in the developing world.

        Unfortunately, an excellent diet and good sanitation do little to help if your uterus isn’t contracting and you are gushing blood like a fountain.

        The only mitigating factor would be that American women wouldn’t have Hb of 5 or 6 g/dL to start with like their Asian or African sisters, but you can lose your entire circulating blood volume in under 10 minutes (i.e.while waiting for the paramedics to arrive) from a massive PPH, so I don’t think it would really matter that much.

        • LukesCook

          Would one expect paramedics to be carrying effective drugs? Do we know whether this woman was travelling to hospital in an ambulance or in the back of the midwife/s car?

          • Paramedics stabilize and transport. Their treatment options are limited. At best, they’ll be able to mitigate the blood loss with replacement fluids.

            And they are NOT trained in child birth or managing PPH.

          • Dr Kitty

            There was a MASSIVE PPH when i was an OB/Gyn trainee,

            The kind of PPH where the hospital blood bank is emptied for one patient.

            The kind where the OR floor is *literally* awash with blood as it runs off the operating table, and multiple packs of chux pads are being used to try and mop up.

            The kind where the surgeon was miraculously able to stop the bleeding with B Lynch sutures and avoid a hysterectomy.

            The kind where the entire OB team has a debrief meeting and a good cry afterwards.

            The kind where the patient spends days in ICU afterwards recovering.

            THE KIND THAT IF IT HAPPENED IN A DIFFERENT BUILDING FROM AN OR AND A BLOOD BANK, NO MATTER HOW CLOSE, WOULD HAVE RESULTED IN DEATH.

            if HB midwives have never seen a major PPH, no wonder they “trust birth”. Anyone who has seen one of those type of massive PPH knows much, much better than that.

          • Antigonos CNM

            I am sure homebirth midwives have never heard of DIC.
            In the simplest terms possible, when hemorrhage is massive enough, all the coagulant components of blood are used up, and you can’t stop the hemorrhage even with transfusion. It is the scariest situation possible. And of course, in truly massive hemorrhage, one has to consider what happens when the brain and other organs are starved of their normal blood/oxygen supply for any length of time.

          • auntbea

            So then is there any way to fix it? Or does DIC=death?

          • The Computer Ate My Nym

            DIC’s one of these strange conditions: It clears right up if you can treat the underlying problem, if you can’t it just gets worse and worse, no matter how much you try to palliate. In the case of massive bleeding, it’s relatively easy. You give plasma, platelets, and cryopercipiate to replace the factors that are lost and have the patient do ok. This sort of thing is very hard on the body and it’s by no means a sure thing that a massive transfusion protocol, including factor and platelet replacement, will save the patient, but a young, previously healthy woman should have a decent chance of coming through with minimal damage if she gets treated promptly. As in, now, not in 10 minutes when you get to the completely unprepared hospital.

          • theadequatemother

            Don’t forget replacing calcium and maintaining normothermia…

          • Dr Kitty

            I think you mean “telling the woman to stop bleeding” and “calling her back to her body”.

            Said by people who have never seen what 20 units of blood on an OR floor looks like (nb the human body holds 7-10 units of blood), in a massive PPH you can replace the entire blood volume 3 or 4 times.

          • The Computer Ate My Nym

            Check. In fact, consult the checklist, which most hospitals will have for a massive transfusion protocol. (Another advantage of hospitals: that “impersonal” medicine that has a protocol for many worst case scenarios rather than relying on the providers to wing it in an emergency.)

          • KarenJJ

            Have you got “woman sitting in the corner sucking on a cinnamon lolly and blowing her cinnamon breath on the patient” in that checklist? Because according to Midwifery Today it totally works.

          • attitude devant

            No, auntbea, DIC does not equal death. If you have an experienced team, a good blood bank, and good lines, you can replace the clotting factors and stabilize the situation. But you have to start before the patient is moribund. And when someone can exsanguinate in 10 minutes (and a pregnant woman can) there is no time for transport.

          • fiftyfifty1

            cinnamon breath!

          • auntbea

            I think maybe you are not telling the truth.

          • Eddie

            OK, this is totally stupid, and I’m a little bit sick and light-headed and tired. But I honestly read that as “cinnamon death” the first time, did a double-take, and saw I read it incorrectly. Then thought about it and realized I got it correct the first time. Funny what a minor cold does to cognition.

          • Antigonos CNM

            Not inevitably, but it can be very, very hairy. The treatment, partly, at least, is to give ANTI-coagulants, which takes a lot of guts, believe me. Google “disemminated intravascular coagulopathy” if you want more information — it is a very complex syndrome. I’ve been involved in several cases where a “normal” birth wound up with weeks in hospital, most in ICU, and calls for blood and components from blood banks in other cities.

          • theadequatemother

            Uterine blood flow at term 300-800 ml/min(http://www.ncbi.nlm.nih.gov/pmc/articles/PMC438743/pdf/jcinvest00629-0042.pdf).

            Human blood volume 70 ml/kg +50% in pregnant women = 100 ml/kg.

            If you had an 80 kg woman, 8000 ml of blood = no circulating blood volume in 10-20 minutes…LOC and major organ dysfunction prior to that..probably around 5 minutes.

            HOw close is that hospital/ ambulance again? Oh right, way too far away.

          • Dr Kitty

            80kg is a big woman… I’m a 45kg woman, I’d have less time.

          • theadequatemother

            you’d be a goner for sure. It seems that most of the preggo ladies I come into contact with are 170-200 pounds these days but maybe we have more strapping lasses up here in the true North Strong and Free…;)

          • suchende

            80 kg at full term doesn’t seem all that big to me…

          • Dr Kitty

            It’s 12 and a half stone… It seems big to me, but then 70kg is supposed to be the weight of an “average” man (it give a BMI of 20-25 for heights between about 5’6″-6’2″) and you’re supposed to gain about 12kg in pregnancy (less if you are heavier to start with, more if you are lighter).

            I weighed about 50kg at term (losing more than 10% of your body weight with hyperemesis is not a recommended path to avoid gaining weight in pregnancy), but I’m short.

            Since the average Irish woman is about 5’5″, 80kg feels big to me.

          • suchende

            68 kg comes out to a healthy, normal BMI at my height, so obviously ending up there at full term seems more than reasonable to me.

          • auntbea

            That’s about how much I weigh now and I am definitely within normal range (though I might prefer a little less muffin in my top).

            45 kg, on the other hand, seems just unbelievably small to me. Do they really make adult clothing in that size?

          • Amazed

            My mom weighed 48 kg when she left L&D with brand new me. She isn’t that short, she was just thin then. She most definitely bought her clothers from adult departments.

            On the other side, maybe she didn’t gain much because we were both headed inwards. Liked the company of her organs, obviously, and pushed a few of them a bit down. Still hadn’t come back, as far as I know.

            Now, that’s a thing hospitals might like to examine when they are over with the important task of making hospital homelike to each individual mom’s taste. And unsterile. Big bad sterilized hospital-y hospitals.

          • KarenJJ

            Not so much in Australia (I have a sister a similar size that has trouble buying small enough clothes) but in Asia they do. Trying to buy clothes in Singapore was a no go zone for me (at 55kg and 160cm I felt pretty average for an Aussie). A blonde-haired blue eyed Aussie friend was told she was too fat for the clothes in the shop she visited in China (the shop owner didn’t realise she understood Mandarin).

          • Dr Kitty

            Sure, I’m a UK size 6.
            US 2.
            Shoes are an issue though 🙂

          • Amy M

            Not much. I am about that size…they make petite short for some brands of jeans, but they aren’t always easy to find. I am barely 5ft tall (150cm?), so I shouldn’t weigh 80kg. Almost full term (36wk) with my twins, I was about 140lbs (about 64kg?), had a nasty, but luckily not clinically severe PPH. Had I not been in the hospital at the time—probably could have bled to death just like that poor woman did. As it was, they got everything under control in about 5min I would guess (the incident is a bit hazy), and I narrowly avoided a transfusion—another 5 min certainly would have been transfusion-worthy, if not worse.

          • Staceyjw

            HA! thats only 175, which is about how much I was pre pregnancy 😉

          • Staceyjw

            That is so scary. I wonder if they even realize the risk.

          • Aunti Po Dean

            I saw the aftermath of a massive PPH once too Dr Kitty. It was in a hospital where the OR was on a different floor from the labor ward. Not only was the labor ward floor awash with blood, the corridor and lift floors were too.
            They ran out of O neg , I think the hospital only had a few units and they had to send for more. The woman was retrieved to a hospital with an ICU and she survived with kidney damage but spent a looong time in ICU.
            Once seen never forgotten that’s for sure!

          • Dr Kitty

            I was in the ER when they brought in a guy who managed to commit suicide by severing his jugular. Less bloody than that PPH.

            See Anthropologist’s post above.
            I’m rather more familiar with death and blood and despair than the average man in the street, and the idea that birth is all sunshine and unicorns is…well it would be funny if no one was dying.

          • fiftyfifty1

            ” Not only was the labor ward floor awash with blood, the corridor and lift floors were too. ”

            Now imagine all that blood in your car on the way to the hospital…. Or, rather, don’t.

          • Staceyjw

            No, most ambulances do not carry pitocin. They should.

          • The Computer Ate My Nym

            They could at least start an IV, administer fluids, (sorry-gross) try to hold pressure on the wound to slow the bleeding, and call ahead with the emergency. But of course you have to wait for an ambulance (hoping that the undertrained and underpaid 911 operator coded the emergency high enough) and the paramedics have to be able to get up to your house or apartment with a stretcher, etc. So I can see why simply making a run for the hospital might feel like the better alternative. Which means no help at all during transport, no advance warning for the hospital, etc.

          • Dr Kitty

            Hard to keep the cold chain intact in an ambulance. PR
            Misoprostol is a more realistic medication for first responders I think.

        • The Computer Ate My Nym

          It’s not just the distance to the hospital, it’s the time to the blood and safety of the transfusion. A person who hits the door bleeding to death isn’t going to have crossmatched blood already available. If she came in a private car, she won’t have an IV and will be severely volume depleted, making getting one in extremely difficult. And the ER won’t be expecting her so they won’t have anything prepared.

          So, best case scenario for running into an ER with a woman bleeding out from childbirth is that they somehow get an IV in, probably a central line because that’s quick and relatively easy, start fluids immediately, send someone to the blood bank at a run for whatever they have available, and get lucky with no immediate transfusion reactions. At best, she’s going to end up with a big line in her neck or her groin, multiple blood products, and a high risk of development of at least minor antibodies, which may complicate future pregnancies.

          At worst, she might die before anyone can get a line in, might die of a transfusion reaction, might die of DIC from the trauma, might end up with whatever blood borne infection we get to replace HIV (and don’t kid yourself-it’ll happen and there’s nothing we can do to stop it), might bleed to death because no one remembered to replace factor as well as RBCs and she couldn’t clot…It’s just not good. And in a situation that probably simply wouldn’t happen if she’d been in the hospital in the first place.

      • KarenJJ

        Was one of those the Australian one? Unlikely to be on the MANA books.

        • The Computer Ate My Nym

          I think you’re right, in which case I overstated the case. Sorry!

  • The Computer Ate My Nym

    Bled to death. Yuck. That almost certainly didn’t have to happen. If she were in a hospital, she would have gotten pitocin, possibly a D &C, would have already been typed and crossed so blood could be given rapidly and safely, could have gotten extraordinary measures like a hysterectomy or massive transfusion protocol if needed. Instead she bled to death trying to get to the hospital. Poor woman. And her poor fiance.

    • I don’t have a creative name

      What a waste of life. And the jackasses who played a role in convincing her that this was safe will go on with their own lives like nothing happened, never questioning their own rightness.

    • Staceyjw

      If she would have lost her uterus in the hospital, she may have been mad, but alive to complain that she should’ve had a HB. You know, because problems happen due to the hospital.

      • EmbraceYourInnerCrone

        Yup, my mom DID lose her uterus, when she hemorrhaged due to placenta previa and then her uterus ruptured(long story). It was 1966. And all she has to show for it is my normal, annoying little brother and a big scar…those horrible interventions resulted in a pink, 8 pound screaming baby with good apgars. Imagine that.

        Scariest day of my life, as she started bleeding at home and my grandparents basically hauled her out to the car and floored it to the ER which was 2 miles away. It was a very close thing but it turned out OK. She was supposed to have a scheduled C-section but my brother decided to arrive a week early.

        • Amazed

          The horror, I cannot imagine…

          My heart aches for her. Your poor mum.

          My mum was also one of the lucky ones who hemorraghed and lived to tell the tale. Not sure why they didn’t examine her after the 10 pounds of a little one made it out. A doctor’s mistake, obviously. The thing is, she was in the hospital where a cleaning woman entered by chance and saw that she was bleeding. They fixed her… barely.

          Imagine what would have happened had this been a homebirth? The midwife goes to the kitchen to make herself some coffee and when she comes back, the new mother had already bled a minute or two. Then, the ambulance and rushing to the hospital. With the hemorrage that had her seeing the tunnel with light at the end, who would bet that she would have hardly made it to the hospital?

          These poor women. Their familiea are crushed, for sure. Is this what a peaceful birth means?

          Oh where is Rose Kacary, Ms ‘At least she had a really lovely spontaneous birth at home?”

          By the way, was she convicted?

    • Karen in SC

      So that’s why I was stabbed in the hospital when I arrived to labor. One of those “interventions” and I disliked being poked for a blood draw. I might not have pouted if I had known the information gathered was potentially life-saving. D’uh.