Homebirth midwives and postpartum hemorrhage

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On 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…

This young woman did not have to die, leaving her infant daughter motherless. She died because she chose homebirth, because hemorrhage is and has always been one of the leading causes of maternal mortality, and because a hospital only “8 minutes away” isn’t close enough.

But almost certainly contributing to her death is the fact that homebirth midwives know virtually nothing about postpartum hemorrhage.

Actually, it’s worse than that. Homebirth midwives believe that they can control hemorrhage by doing what they know how to do best: nothing.

In the world of homebirth midwifery clowns, few are as inane as Jan Tritten, the editor of Midwifery Today. Consider her recent editorial on postpartum hemorrhage.

Tritten is appallingly ignorant about the causes of postpartum hemorrhage. She actually appears to believe that postpartum hemorrhage occurs when mother and midwife don’t have the proper thoughts.

The most important thing I can say about hemorrhage is, “Don’t cause one.” If the body is well fed and mom is low on stress and feels loved, motherbaby and their process of labor and birth work well. Our first and most important job is to facilitate what is already a beautiful process. God designed this process to work, but birth workers can come along and do interventions that may cause hemorrhage…

The real causes of postpartum hemorrhage include uterine atony (failure of the uterus to contract after birth), retained placenta (failure of the placenta to completely detach after birth) and injuries to the uterus itself (such as tears of the cervix, which can happen if a woman tries to push the baby through before the cervix is completely dilated). Obviously, none of these has anything to do with what the mother or the midwife “thinks.”

Where did Tritten get such an appallingly stupid idea about what causes postpartum hemorrhage?

Perhaps she got it from these midwifery clowns, Jenny A. Parratt, and Kathleen M. Fahy, the authors of Including the nonrational is sensible midwifery:

For example, when a woman and midwife have agreed to use expectant management of third stage, but bleeding begins unexpectedly, the expert midwife will respond with either or both rational and nonrational ways of thinking. Depending upon all the particularities of the situation the midwife may focus on supporting love between the woman and her baby; she may call the woman back to her body; and/or she may change to active management of third stage…

So not only do we have the editor of Midwifery Today indulging in massive stupidity, there are actually midwifery professors and journalists who encourage this idiocy.

And they’re not the only ones. According to Tritten:

I asked a question about hemorrhage and Margie Dacko had the most interesting response:

“I never used Pitocin in over 2400 homebirths. My hands are my favorite and best tool to stop bleeding (or getting placentas out). BTW, I don’t use eating placenta, herbs or homeopathic bleeding remedies either. They are unnecessary. The uterus wants to stop bleeding, just needs a “helping hand” on occasion…”

The uterus wants to stop bleeding??!!

And just how does a uterus with a tear in the cervix stop itself from bleeding? It can’t.

There is an old saying that to a hammer, everything looks like a nail. To a homebirth midwife, who knows nothing and can do nothing, everything looks like it needs no treatment.

For a homebirth midwife to acknowledge that childbirth, just like pregnancy, just like any natural process, is not perfectly designed, is to acknowledge her own worthlessness. It gives new meaning to the bizarre claim that homebirth midwives are “experts in normal birth.” They’re experts in doing nothing and pretending that nothing is what needs to be done.

God help you if you or your baby needs emergency treatment. These clowns certainly won’t.

  • Kira

    I read until I came across this statement – “But almost certainly contributing to her death is the fact that homebirth midwives know virtually nothing about postpartum hemorrhage.”

    So you’ve interviewed every midwife and determined that NONE of them know ANYTHING about postpartum hemorrhage? I highly doubt that is true. My midwife actually knew a lot about it and dealt with my postpartum hemorrhaging wonderfully.

    I understand that you are passionate about this subject, but spreading false claims (lies) is not helpful.

    Midwives are wonderful care providers and deserve much more credit than that.

  • Chelsie S

    Unfortunately my first birth ended in a postpartum hemmhorage- the midwife had completely mismanaged the third stage. She pulled out half of the placenta only- causing hemorrhage. I was lucky I was across the street from the hospital but horrified that that midwife completely justified the entire incident, as did the other midwives who owned the birth center. Even after I told the others what happened, they sided with the midwife who made the mistake!!! Only after posting a horrible review to yelp did they bother to contact me saying they “couldn’t believe I FELT this way,” ladies. Midwives, I didn’t FEEL a certain way I was fed a false fairy tale of peaceful natural birth and then tossed next door to the hospital! I had no pain relief as the midwife punched into the uterus to remove the rest of the placenta twice- then twice more at the hospital with an OB, I nearly had to have a hysterectomy, and I had a blood transfusion, the midwives treated this ordeal as “no biggie” when I limped and hobbled in barely walking to tell them what the midwife did. It was a big deal and I am traumatized.

  • Mary K

    I just came across this thread. With my first, I had an incredibly healthy and uneventful pregnancy. After the vacuum delivery, the nurse came back in, pressed on my abdomen and an absolute ocean of blood came out. Within a minute, I was in the OR next door getting a D & C for my retained placenta. They wanted to do a transfusion but I felt fine. Would I have died if I were at home? I don’t know, but it would have been at least 30 minutes until I could have arrived at a hospital. This is the 21st century, and women don’t have to give birth like it was 500 years ago.

  • E

    This is completely ridiculous. Most midwives are very well trained in managing postpartum hemorrhages. I had a homebirth and lost over 1,000 ml of blood (very long labour). My midwives were on the ball and handled it excellently — pitocin injection, IV drip, and removal of the clots. Everything was fine and there was no need to be in a hospital. This kind of thing can be handled VERY effectively at home, and it was!

  • Katy

    I had a homebirth with my first, and hemmoraged after he was born. My midwives chose to carry Pitocin even though they weren’t supposed to, because they understood the medical impact of not having it on hand, and felt it was the ethical thing to do. Not sure if it saved my life, but very happy they chose not to follow the rules!

  • Lola Black

    I had excellent prenatal care, I ate well and was well rested, happy and positive and still had postpartum hemorrhage due to uterine atony, thanks God! I was at a hospital in the caring hands of and awesome Medical Team that makes feel calm and confident even when my life was truly at risk.
    Now I am the proud mother of 13 month old and pretty healty twin girls.
    may be now the “birth-goddes” story but a happy one with no regrets.

    • meagain

      My wife and son would have both died if had we not been in a hospital.
      My diabetic wife was already high risk, and had developed a fever after
      many hours of labor when she still hadn’t fully dilated. She delivered
      via CS, and the tests came back positive for strep in the canal. Not
      only was our son being born early and stayed in NICU for a few days to
      stabilize, but he could have been born blind from the strep if he had
      been delivered without a CS. I’m sorry, but there is nothing natural
      about letting your child be exposed to life-long impairment or death,
      and no midwife would have been able to handle that emergency. Our son is
      a healthy elementary school student with very high grades (would have
      had straight-A honor roll if not for an 89 in one subject).

      My
      wife’s friend, who was pregnant before my wife was pregnant with our
      son, sadly relied on a doula because she didn’t have insurance. The
      doula (it was revealed afterward) KNEW the mother developed gestational
      diabetes during the pregnancy, but never told her, pretended everything
      was okay, and (which I think was illegal) never turned her over to a
      doctor’s care. Knowing this, she even allowed the baby to go several
      days too late and too large. The morning the doula scheduled they would
      try to deliver, the mother realized something was wrong when her son was
      not moving at all, and not in a good way. The mother kept calling the
      doula because she was worried and frightened. However, to show just how
      important this birth was to the doula, she kept running around town
      doing personal errands before she finally showed up late in the day. By
      then, the infant had already been deceased for some time.

      Well,
      the mother ended up having to go to the hospital to deliver anyway, but
      not for happy reasons. The doula showed up and tried to instruct family
      members on who was allowed to go in with the mother, as if the hours of
      stillbirth labor was her show to run (my wife traveled ten hours and was
      finally there by this time to support her friend). Someone FINALLY came
      to their senses and kicked out the doula, who should have been
      arrested, but the mother just let it drop and refused to ever speak to
      the doula again. To add insult to injury, no insurance and a hospital
      delivery anyway, and the doula (who, by the way, used to be the mother’s
      friend) has never once taken responsibility for her criminal
      negligence!

      • meagain

        Umm. Don’t know what happened, but the post I made looks all wonky. That’s not how I typed it in. Sorry everyone.

      • Karen in SC

        Was the tragic stillbirth a planned homebirth with just a doula? Did you mean that the doula was going to act as a midwife? Is this in the US? If not qualifying for medicaid, many hospitals have a charity program for births. Appalling and sad.

  • auntbea

    Gah! I go away for three days and there is a giant sh*tstorm with some person named after a town in New Mexico and apparently one of Alan’s friends and I can’t read it because STUPID DISQUS.

    • Susan

      well, if you DO get to read it let me know if you figure out his or her true identity which the poster says can be figured out …

      • Bombshellrisa

        Why in the world would we care about the identity of someone so monumentally unhinged?

        • Eddie

          That person’s identity is only interesting if she or he is somehow personally involved or knows the family (as s/he implied). Otherwise, yeah, why would we care?

          • Bombshellrisa

            Exactly. I feel if the person was involved in the incident or knows the family they really should be trying to be as clear and concise with posting a response as to what part they feel is inaccurate. Someone coming here and saying “these are the details that were left out” and posting calmly would certainly NEVER be treated in a disrespectful way. Instead we get the equivalent of Dr Doofensmertz from “Phineas and Ferb” (I know I spelled that wrong)

          • Eddie

            Of course, if someone actually knew the family, the most appropriate way to address inaccuracies in Dr Amy’s source — and thus in this blog post — would be to contact Dr Amy by Email. Her Email address is easily found at the top right of every page. But doing so wouldn’t generate nearly as much drama.

            P.S. I love Phineas and Ferb.

          • Bombshellrisa

            Me too!

          • Truth or consequences

            I am sure she checked with her source before she posted….Right!

    • Eddie

      You really didn’t miss that much. To all appearances, that person came here primarily to attempt to provoke a reaction and then gleefully chortle over having done so, after massive emotional projection onto the various commenters who responded to him or her. I believe there was an actual point buried beneath her or his tangled web of logic, but it was frankly difficult to discern. Whatever that discussion was about, it wasn’t very productive and little communication occurred.

      Aside: I’ve noticed that a large fraction of those who swoop in here because a single blog post caught their attention are people who cannot distinguish between respect (what I have for Dr Amy) and worship (something I don’t have for any human being on the planet). In the NCB community … and in the crunchy community in general … it seems that some leaders get and expect worship, not just respect. And some just melt down when they don’t get it.

      • Bombshellrisa

        I think that they EXPECT it. I liked my doctor, but I don’t get on Facebook, Yelp, ect and write multiple paragraph glowing reviews for her. She wouldn’t want me to!

      • auntbea

        Wow. Yeah. Just read it. Well, tried to read it. Then gave up on reading it. No idea what that was about.

      • Truth or consequences

        You are the most correct of all of the posts! I did want to get a reaction! The reaction I was looking for was a response from Amy! I can respect Amy for her vast knowledge. I have no problem with her position. I intentionally lit a fire under the the statement “She didn’t have to die”. I wanted to see if her followers would stand behind her even if she took some exaggerated liberties with the feelings of all involved in this situation. I guess I wanted to see if Amy could be empathetic and sensitive to those that are grieving. I am sure she grieved at the loss of life under her care.
        I am simply a bystander to this tragedy. I see the pain and self reflection by the survivors.

        I am not interested in being respected. Look at my posts!
        It was fake outrage designed to get a response. I wanted to see what kind of people are here? Are they able to see a person in pain and be tolerant? Are they people that will lash out with petty digs to a person that is apparently upset with the insensitive liberties taken with Amy’s post?

        That was my agenda.

        I have full respect for those that want to have their baby in a hospital. I have full respect for those that are fed up with the treatment they get from the medical system and they are searching for alternatives.

        I have my this group.

        I am sure Amy has read most of this or has had followers call her and tell her “That nutjob is back”!

        She will reflect on her decisions to post this article.

        (Or not)

        In all fairness to Amy, It would look bad if she took the post down.

        It would also look bad if she admitted that she took some liberties at the expense of those that are still grieving.

        I am leaving in good conscience!

        I am sad for the deceased and the grieving.
        I am sad for what happened here.

        • Eddie

          If your posts had come across as a person in pain, I and others would have reacted differently. Instead, you came across as someone with an axe to grind. I never got grief from your posts. Instead, I got a mixture of smug and outraged and trying to provoke a reaction. Still, many of us started out responding in a productive fashion, and only threw our hands in the air after you persisted in posting in that unproductive tone.

          Despite your stated goal, you were less seeing if people could be empathetic, and you were more probing human psychology. You got the exact style of responses I would have predicted if I were a lurker here, and the exact style of responses you would get almost anywhere on the internet with that tone.

          I honestly don’t get why you think Dr Amy would look bad if she took a post down. Any post. Nor do I get why you think she would look bad if she found out that the facts were different from what she first assumed and added a disclaimer or comment to that effect.

          As to your name … I don’t get it. I can see the truth part. You say that the facts Dr Amy’s quoted are wrong and you feel that she was irresponsible in referring to a recent tragedy someone posted about without actually knowing if that person’s facts were correct. I get that part. But “consequences”? (scratching head.) I don’t get it.

          I don’t get how this blog post could be taken as “taking advantage of the family.” And you refer to this as “Amy’s fictional tale,” as if Dr Amy made it up when you very well know she didn’t. You talk about people here “carrying water” for Dr Amy, when really, we were reacting to your tone more than anything else.

          Again, if you actually wanted a response from Dr Amy, specifically, Email would have been a more productive way to start that conversation, and a different tone here would have gone a long way as well. That is how I, personally, would have gone about it, FWIW.

          And as I said before, whatever the actual details, it is absolutely tragic that the mother died. Whether she could have been saved in a hospital or not, her death is tragic.

          Could her life have been saved in a hospital? Keep in mind that doctors who post here have regularly reported that they say the kind untruth to the family so that the family doesn’t feel even worse about the tragedy. So what is the actual truth? I have no idea, clearly, as I have no access to those with the facts. Does this matter? In the context of choices other people make in the future, yes, if more lives can be saved as a result. To the family? No, probably not. And either way, it’s tragic.

          • Bombshellrisa

            Eddie-you are brilliant. Have to post this for you http://youtu.be/KGp7zTu4fvM

          • Eddie

            “How can he be your nemesis? He doesn’t even have a hat!”

            Hmmm… so who is Dr Amy’s nemesis? Whoever it is, they’re not very good at it.

          • Truth or consequences

            Your response is reasonable. I know that Amy has had some tragedies. I wouldn’t wish that on anyone. I guess that is why I found her post to be odd coming from a person that has experienced tragedy. Would she like her tragedies misrepresented in a blog? Would the family of her patient want this kind of exposure if it isn’t correct?

        • Lizzie Dee

          Yours is such a weird reaction though – and as Eddie says, your point if you had one got lost in your chortling glee at insulting just about everyone.

          You seem to be claiming some moral high ground, some super-sensitivity. But, like many who come here with the intention of provoking, I think you are deceiving yourself. You hint at superior knowledge, personal involvement. But I think you are exploiting this poor woman’s death for your own purposes in the way you claim Amy is, and, unlike Amy, for no good purpose.

          If this woman were my daughter, I would be mad with grief and distress. Deaths in childbirth are sadly not unantural, but they are against Nature in essence. Such lasting grief when there should be joy, children left motherless, families bereft. It should make the Gods weep. “She didn’t have to die” is railing against the savagery of it, and intended to look at what went wrong, how it can be prevented going wrong for others. What she died of isn’t that much the point – she died away from help, or the help was ineffective. Would I, if personally involved, feel comforted if it turned out to be some rare occurrence that could not have been prevented? I doubt it. Would my grief be made worse by a discussion like this? Maybe, I don’t know. Given the magnitude of the tragedy it wouldn’t have a whole lot of relevance.

          What right have you to take such a stance? It is as well you are not interested in respect, because what you have done was not respectful of this woman or her family – just a game for your own amusement.

          • Truth or consequences

            “What she died of isn’t that much the point”
            Hilary used that one quite unsuccessfully!

            I simply asked Amy to show some integrity. She makes sweeping statements about this woman and her caregivers based on a post from by a grieving family member on the day of the event. There is much more to this story that isn’t public information. If you want to use the Hilary argument to try and distract from the simple question I asked, go for it!

            If you are the kind of person that doesn’t care about the the woman that Amy misportrayed, that is your choice too!

            Amy claims this women didn’t have to hemorrhage to death.

            I asked Amy a simple question: Did this women die the way you say she did?

            The room then erupts with venom towards me for asking the question.
            Look how far this conversation has strayed from that simple and relevant question.
            I have admitted that hemorrhage is a legitimate issue. It just seems unethical for Amy to drag this tragedy into her post when she has no idea of the facts of this case.

            I am certainly not amused by your lack of caring!

            That is just another dig at me for asking Amy an uncomfortable question?

            Amy….Are you out there?

    • Ainsley Nicholson

      It went roughly like this:
      Dr Amy: “The sky is blue most of the time”

      T&C: “How do you know the sky is blue? Sometimes it turns green before a tornado”

      BlogRegular1: “The sky is usually blue, sometimes cloudy, and very rarely green.”

      T&C: “But it could have been green! Amy just assumed it was blew!”

      BlogRegular2: “Amy was talking about the weather, and the specific color of the sky doesn’t change the fact that there was weather. PS. the color is spelled ‘blue’, not ‘blew'”

      T&C: “Now you are making fun of my speeling!! I JUST WANT AMY TO ANSWER THE QUESTION!! it is so much fun watching you all self-distruct!”
      and so on.

      • Truthinquiry

        Brilliant characterization! T or C is just a blathering idiot! You nailed it perfectly! I wish I could come up with lengthy dialog to put people, that ask uncomfortable questions, in their place!
        I guess I lost that ability as I matured to adulthood! They asked one question and you were able to convert that into a weather lesson about a plethora of storm conditions!

        • Box of Salt

          Truthorwhatever: Did Lizzie Dee have it right, and you are just going for getting banned from this site and crowing about it elsewhere?

          Please consider the comments I and others have made about your style. It’s not working for you.

          !

          On the other hand, apart from your new handle, you spell better than Truth or Consequences did.

  • koffeewitch

    If you want to see homebirths decline; the solution is very simple: do something about doctors and hospitals. Most advocates of homebirth choose that route because of numerous horrible experiences with all those self-righteous medical “professionals”. Do away with mandatory lithotomy positions and stirrups, offer comfort measures other than just an epidural, allow time for family bonding and do in-room triage, actually support moms who choose to breastfeed, actually communicate with a woman before you walk up and stick your hands in her crotch and – oh my god! tell those 20 something year old residents who have just graduated med school and have never had a baby to shut up about their personal lives when we’re having contractions and/or pushing the baby out. Actually ASK before you bring half a dozen med students in to stare at a woman’s bulging perineum. Most of us had nothing in the world against the idea of having babies in the hospital until our hospital experiences. Naturally, the things Ive brought up are the best case scenarios, not the horror stories of fetal distress from improper Pitocin dosages or babies exposed to antibiotic-resistant bacteria, etc. If OBs are so great, why are so many sued by their patients, especially in comparison with midwives? Improve your game a little bit and maybe hospitals will not get such a bad rap from natural birth advocates. (You all CAN deliver in a normal, un-medicated situation, right?)

    • suchende

      If you want to stop people driving with their kids out of car seats, give away car seats free. Why even bother campaigns discussing the safety issues?

      As for the issue of why OBs get sued, I can field that one, as a JD. I would never sue a CPM. She doesn’t carry malpractice insurance.

      • koffeewitch

        The car seat analogy doesn’t work for me so well. We are talking about clients/consumers refusing one form of care service in favor of an alternative because they are displeased with the care provider. Improve hospitals and care (especially in the United States) and women will not feel so desparate to avoid hospitals at all costs. The growth of homebirth reflects dissatisfaction with OBs and hospitals. Until doctors and hospitals fix this situation, homebirths will continue to grow in popularity (and in acceptance).

        • Amazed

          Women do not feel so desperate to avoid hospitals. It’s only a small, albeit vocal minority of self-proclaimed princesses who don’t want to be the next number in their doctor’s career who do. You know, the women who wouldn’t mind if they share the beautiful experience of giving birth to their first breech baby with the midwife to whom this is also her first breech baby.

          And then there are the women who are genuinely traumatized by their hospital experiences. Instead of helping them overcome their fear, avowed homebirthers crow about the beauty of homebirth and lure them into it. And when a baby or mother is lost, they croak, ‘so sorry, so tragic’, When questioned about the safety of homebirth in the light of the particular death they contributed to, they hide behind “it was her choice!” and go to hug their own living children. Why not – it isn’s as if the tragedy happened to them. Why should they care?

          Women are not desperate to avoid hospitals. You jut wish they were.

          • koffeewitch

            If women were not wanting to avoid hospitals the homebirth movement would not have grown 29% between 2004 and 2009. Insurance rarely covers the costs of homebirths; so the fact that people are shelling out thousands of dollars out of pocket or opting for unassisted births tells me otherwise. Granted this is definitely a minority of women. Most American women are happy to get an epidural. But you”ll notice that even Dr. Amy says in interviews that she left OB practice because she cannot defend the current medical system…http://www.thedailybeast.com/articles/2012/06/25/home-birth-increasingly-popular-but-dangerous.html
            You also talk like babies don”t die in the hospitals everyday from dumb decisions, understaffing, mismanagement, etc.

          • Amazed

            30 % of less than 1 % is still a miniscule number. Nowadays, women are so sheltered from reality that they are ready to shed thousands of dollars to risk their life and their baby’s life without even knowing it – but expecting that if something goes south, the hospital will save them. Poor ladies, they love them hospitals then, right?

            No one here ever said that babies don’t die in hospitals, sometimes due to malpractice or bad judgment. We have a mother here whose baby died in a hospital that tried to be ‘natural’ and limit c-sections. No one denied that she received bad care.

            That’s the difference between you and us. We don’t excuse hospital deaths with the fact that homebirth death exists. You – generic you and you in your post – are trying to do the opposite.

            Still, statistics show that for compatible women, giving birth at home is far more riskier than giving birth at hospital, so your argument is false. Look at Colorado numbers. Look at Oregon numbers. Look at the Birthplace study where midwives were real midwives.

          • The Bofa on the Sofa

            Remember the old South Park (about 9/11, I think) that said that “25% of the american people are stupid.” It’s based on the observation that if you look at polls, it’s always about 25% that believe really stupid things. At the time, it was 25% believed that 9/11 was a conspiracy. Similarly, it’s like 25% believe that Obama was born in Africa.

            HB doesn’t even come close to THESE lunacies. I suspect it’s more comparable to the belief that the moon landings were faked, although if I’m wrong, it’s because it’s even less common than that.

            To call HB a “fringe” movement is an understatement.

          • Amazed

            Yeah. Even here, in Eastern Europe, where you have to pay for your epidural and your elective C-section, women go to the hospital, with or without those – because they know that they and their babies will be safer there. They don’t just stay at home to labour in bliss, they go to the hospital, to the evil doctors, just in case they need to be mutilated and given those bad meds that could, you know, bring their child out alive.

          • Eddie

            Bad logic. Home birth is growing because people are convinced it is just as safe as a hospital birth. In general, those people are wrong. If the people choosing home birth understood the true level of risk, some of them would still choose it, as is their right. More, IMO, would not.

            Yes, babies die in the hospital. Don’t you understand that what is important is the relative level of risk, and not the fact that risk exists? Also, do you really believe that most babies that die in the hospital die not because there was little chance of survival, but because of dumb decisions, understaffing, etc?

          • BeatlesFan

            Oh dear FSM, not the “babies die in hospitals” line AGAIN.

            Quick (if slightly overused) analogy for you: people who drive drunk cause car accidents. People who drive sober also cause car accidents. The fact that sober people cause accidents does not mean driving drunk is as safe as driving sober. Drunk driving carries more risk, yet it doesn’t follow that sober driving is safe 100% of the time.

          • The Computer Ate My Nym

            If women are so happy with home birth, why are they opting for hospital births so often? Home birth rates are falling in much of the world and it’s not clear that they haven’t peaked and started to decline even in the US.

          • Captain Obvious

            Along with the increase in homebirths as you speak of, are a growing number of women blogging about if they had only known better about the dangers of Homebirth with midwives, often not licensed or insured. Also an increase in blogs and campaigns like sisters in chains, hurt by Homebirth, safer births in Michigan, midwives speaking out about the dangers of Homebirth like the one in Oregon who basically stated it is more dangerous.

        • suchende

          Then to my old analogy I default: getting a homebirth because you are dissatisfied with the experience is like trading a Mercedes with faulty AC for a Pinto with faulty brakes. Sure, you feel comfy until you come upon a red light.

          So again, why is it wrong to point out that we should drive cars with functional brakes instead of insisting that Mercedes make fail proof AC systems?

        • BeatlesFan

          I have a friend who had her first child via homebirth. I find it hard to believe she could be dissatisfied with OBs and hospital birth, having not had one before. Her second was born in hospital because he was premature and needed a few weeks in NICU- and that situation only “reinforced [her] belief that the hospital is NOT the place to give birth!”

          So, to recap: she rejected hospital birth the first time, not because of bad experiences, but because she read Ina May and bunch of related BS, which convinced her homebrith was safer. When her HB midwife refused to deliver her preemie at home and sent her to the hospital instead, she left STILL supporting HB over hospital birth even though her child would most likely have died if born at home.

          You can blame hospitals for HB rates all you like, and I’m sure there are some women out there who have chosen HB due to previous hospital experiences. That said, my own friend is an example of how some women just like having their heads in the sand.

        • Captain Obvious

          Most Homebirth stories on line are women trying to one up the other on how great their birth was. Usually doesn’t list previous bad experiences. In fact, a growing number of first time moms are seeking homebirths. Oops, there goes your theory. Yes, some women choose Homebirth because of bad experiences. I have read where some mommas change midwives midpregnancy too! Care to explain that? I wouldn’t let my neighbor build my house if I had an arguement with my contractor. I would find another contractor. Woman should find an OB, CNM, or pediatrician that they like.

      • The Bofa on the Sofa

        BTW, aren’t a good number of lawsuits brought against OBs coming from the fact that they DIDN’T do a c-section?

        • Poogles

          “BTW, aren’t a good number of lawsuits brought against OBs coming from the fact that they DIDN’T do a c-section?”

          Absolutely! In fact, I believe the majority of Obstetrics-related malpractice suits rest on the argument that a CS should’ve been done, or should’ve been done earlier. Sometimes even when the mother was offered one and refused it.

    • “Most advocates of homebirth choose that route because of numerous horrible experiences with all those self-righteous medical “professionals”.”

      Interesting. Most of the moms I know that chose homebirth did so b/c they believed it to be just as safe if not safer than a hospital so they wanted the more intimate experience of being at home – NOT b/c of a prior bad experience.

      My reason for wanting a home birth with our first was based on what I was being told and the books/literature I was reading and movies I was watching – all coming from those in the home birth community.

    • “If OBs are so great, why are so many sued by their patients, especially in comparison with midwives?”

      B/c patients CAN sue their doctors. Kinda hard to sue someone who doesn’t have insurance….. let me introduce you to some home birth loss moms that would have LOVED the option to sue their ridiculously negligent (yet still practicing!) midwife.

      • Amazed

        This. And because OBs are expected to perform miracles by the simple virtue of being doctors. Mom’s sweet midwife, though… she did anything possible. She was even ready to make mom placenta cookies! She cannot have possibly been wrong. Some babies were not meant to live.

        And some moms are just never able to add the second, missing part of the sentence, ‘especially when they were born at home’.

    • Lizzie Dee

      (You all CAN deliver in a normal, un-medicated situation, right?)

      Don’t you just love that one?

      Well, no, some of us couldn’t. And don’t regard that as much of a measure of our worth. And very many more really couldn’t care less about those who think it is an achievement.

      • BeatlesFan

        I suppose, technically, everyone CAN deliver in a normal, un-medicated situation. However, not everyone will live through it. I note Koffeewitch didn’t include the word “safely” in that sentence.

        • The Bofa on the Sofa

          Being me, of course, my first thought is not whether it is an issue of can or can’t, it is “how likely are you to succeed?” and “why does it matter if I don’t?”

          Even if the chance of successfully delivering in a normal, un-medicated situation is high, there is no reason that anyone should have to do if they don’t want to.

    • Karen in SC

      We CAN and many of us DID. And I’d trade a heck of a lot of inconveniences to be sure of a SAFE birth.

    • Eddie

      Hospitals and doctors are not perfect. Doctors are human beings and hospitals run run by human beings. You cannot expect perfection. The same is true of midwives. The medical system definitely has room for improvement, and there are plenty of people rightfully pushing for that improvement. I support that.

      However, I wouldn’t risk my wife or child’s life due to a bad experience. I would find another doctor and/or another hospital.

      If I go to an auto dealer and am treated horribly, I don’t give up on buying a car and instead get a horse. I go to a different auto dealer. I also do my best to ensure that the bad actors at the first dealer are punished appropriately and I let them know why they will not get my business again.

      And no, not all people CAN deliver in a normal unmedicated situation. That’s why less than 100 years ago, at each childbirth, there was about a 1% chance of the mother dying and a 7% chance of the child dying. That’s why early in the last century, 1/4 of all women who died in their childbearing years died in childbirth. Do you know what changed that? Modern obstetrics. Do you know what is missing in every part of the world with a huge death rate in childbirth? Modern obstetrics.

    • Ainsley Nicholson

      Mandatory lithotomy positions….just which decade are you referring to? At my last delivery, an un-medicated hospital birth, I was moving all over the place, standing up, squatting, whatever I wanted to do. No-one objected or even commented on it.

    • Bombshellrisa

      I am so very sorry that you had this happen to you. As a survivor of sexual assault, I can understand that people have triggers, people have limits and there needs to be a preamble before there is a procedure.

      What other “comfort measures” do you think are equal to or greater than an epidural for pain control? Penny Simkin, when speaking of comfort measures during labor, uses things like wrist massage and counterpressure.

      “Actually ASK before you bring half a dozen med students in to stare at a woman’s bulging perineum” The best way to make sure this doesn’t happen is to read your admission forms carefully. If you are at a teaching hospital, your admission form will clearly state that you will have students, interns and residents caring for you and following your plan of care. Make sure that you state you do NOT agree to this.

      “maybe hospitals will not get such a bad rap from natural birth advocates” But then again, with all the improvements to hospital birthing centers with things like fold out couches, squat bars, keeping the babies in the room for the entire stay, stereo systems and room service 24 hours, what else is there left to complain about? The difference between the midwife run birthing center that I learned at and the birthing center in the hospital where I work now is that there are teams of people ready to respond in minutes, an OR down the hall (or a door down if you are high risk), effective pain meds and real things to help when things go south (and 24 hour room service). Both places have jacuzzi tubs, Ipod players, dimmer switches for the lights and beautiful areas to walk in while you labor. And while those things might mean MORE to people who want a nice experience, in the end the nicest experience is one where you and your baby get to go home and both of you are well.

      “You all CAN deliver in a normal, un-medicated situation, right?”

      I have no desire to be talked to like my labor pain was trivial, like it was caving to take pain meds, like I had to cry harder to be heard. My nurse was the NCB nurse from HELL. She sounded like all the midwives that I had trained with, the ones I thought I would be. I didn’t get to have the privilege of effective pain relief because the nurse who was caring for me asked me the same question you posed here. It was condescending then and it’s nauseating now.

    • Dr Kitty

      Sorry, your last sentence is hard to understand, in fact the above wall of text wasn’t easy to read full stop,

      Do you mean “I assume that all of the OBs who post here are able to deliver women who are unmedicated” or “I assume all the women who post here are able to deliver normally and unmedicated, if only they chose to”.

      I’m sure the OBs are all perfectly happy to participate in a spontaneous, vertex, singleton, vaginal birth without analgesia.

      But no, not all of us CAN deliver safely vaginally, and there is no reason why we should have to.

      Suing is about damages.
      No insurance = no damages= very little point in launching a ruinously expensive lawsuit.

      • Captain Obvious

        And most women choose to deliver medicated. It is not forced upon them. In many countries epidurals are not an option and women are protesting that it is their right to have epidurals.

        • Eddie

          My wife’s first deliveries were in a part of Eastern Europe where medical practices are still profoundly paternalistic, as recently as the last five years when my youngest nephews and nieces were born. NOTHING for pain, period, patient not involved in any decision making, father not allowed in the delivery room so the mother is on her own against the staff … a far, far cry from what NCB advocates complain about in the US. My wife loved the fact that not only was nothing pushed on her against her will, but nothing was refused either. Having had totally unmedicated deliveries against her will, she loved the epidural on the last one.

    • BeatlesFan

      How is that a best case scenario? I had no mandatory positions, no stirrups, no residents, no episiotomy, no forceps or vacuum, no cervical checks without giving permission, no pain meds or pitocin pushed on me, no condencension; we had immediate skin-to-skin, bonding time, and rooming in.

      I’m sorry if your experience was really that horrible. Did you do anything about it- file any complaints, offer suggestions, anything?

      I don’t know how many OBs end up being sued by their patients, but I can tell you the reason midwives don’t get sued is because they don’t carry insurance. It’s hard to find a lawyer willing to file a lawsuit that isn’t going to bring in any money after it’s won.

    • The Computer Ate My Nym

      Do away with mandatory lithotomy positions and stirrups,

      Done. Even the public hospitals in this area have birthing suites with jacuzzis and birthing balls.

      offer comfort
      measures other than just an epidural,

      Also done. Comfort measures from sitting in a bathtub (prior to rupture of membranes) to IV meds to epidurals are widely available in most hospitals. In fact, the more common complaint is how long it takes to get an epidural.

      allow time for family bonding and
      do in-room triage,

      Done. I don’t know of any hospitals which don’t allow and encourage time for the parents (and other support people) and the baby to be together after birth unless there is an immediate emergency. Ok, so hospitals like to do silly things like make sure the baby’s breathing before tossing it back to the mother, but after the baby’s pink and warm, back to the parents it goes for as long as they desire.

      actually support moms who choose to breastfeed,

      Have you read this blog at all? Hospitals are all but forcing women to breastfeed at this point.

      actually communicate with a woman before you walk up and stick your
      hands in her crotch

      Good idea…unless the hand is in the crotch because the baby’s dying and needs to come out right away.

      You all CAN deliver in a normal, un-medicated situation, right?

      Nope. Uterine malformation, now with scar. Trying to deliver “normally” is a death sentence for me. Thank you for the implication that I should have died in labor.

    • Lisa Miller

      When was the last time you birthed in a hospital. My first birth was ten years ago and none of this was an issue. Let me guess, you learned about hospital birth from home birthers? Yeah, figures.

    • Captain Obvious

      So many outdated and wrong or selfish statements. I could write so much. The only aspect I will address is the medical student and resident statements. Yes, the woman should consent to students and residents. You can always refuse. You can always choose a doctor who work in a private hospital. How are students and residents going to learn if they don’t get training. Even if you had a midwife with a midwife student, you would get double exams. I have said more on this then I cared to give credence to.

      • Lisa from NY

        The NCB movement exaggerates the number of women and babies who get staph infections in hospitals and die from them, so anyone reading their literature is scared into a HB.

        Here are the actual statistics:
        http://www.statisticbrain.com/staph-infection-statistics/

        • Eddie

          Does that actually mean that 1.2 million people catch some infection in the hospital every year? Also, I assume the count of MRSA infections includes both hospital and community acquired versions. Hmm, and those stats don’t say what country or countries are included, so I don’t know what the baseline is.

    • Lizz

      How long has it been since you’ve given birth in a hospital? Have you tried more then one hospital?

      Generally your complaints are really painfully outdated. Heck I wish the staff would have left me alone about not breastfeeding and I never saw a medical student. With my son they made me walk the floor for two hours because I wasn’t progressing, hell half the reason I got the epidural was so they would let me lay down. I’ve had three friends have a natural birth in hospital with their doctor’s support. Also two out of three of the local hospitals ADVERTISE that they have natural comfort measures,rooming in, lactation consultants,high VBAC rates and a primary cesarean rate of around 12%. The hospital up the hill from me has a staff of 30% CNMs and the U of U hospital is running a trial on both VBA2C and waterbirth.

      So what the hell are people complaining about exactly?

      • Lizzie Dee

        I cannot for the life of me understand how women got fixated on an umedicated birth. An uncomplicated one – yes, we all would like that. But the history of childbirth has surely been the search to make it safer and less painful, and most women are pretty happy with the idea that they do not have to cope with mind-blowing, potentially psychologically scarring pain. Making a virtue out of suffering such pain doesn’t seem a lot like progress to me. Watching my daughter’s labours – which were not particularly long, nor particularly/unusually painful I don’t think, the contrast between her happy excitement and participation in what was going on the first time with an epi versus her miserable, out of it, begging for relief natural birth did not sell me on the virtues of unmedicated. Like banging your head on the wall, the relief when it is over may seem like bliss – but an achievement?

        Surely an easy birth is much like a bad one – arbitrary and not within your control.

  • Lost in Suburbia

    This is perhaps neither here nor there, but the coincidences seem to line up. The death mentioned could be this woman: http://pulaskinews.net/north-little-rock-times/obituaries/amanda-garbacz.html Her age, date of death, and college degree match up with what the baby center post indicated. The location matches with the poster. The information available on a matching facebook profile https://www.facebook.com/amanda.garbacz fit with a pregnant mother, due on the 15th, who was having a baby Lillian. Can’t find anything else regarding cause of death, but for those who were insistent on verifying info, this could be a start.

    • Susan

      If that’s the same person it’s terribly sad. What a beautiful young woman. Also it looks like her sister “likes” the Amniotic Fluid Embolism foundation so that could be the cause of death. I don’t see anything about homebirth but she seems to be interested in such causes. It’s possible. How very sad no matter what. If they are trying to keep it private though I think they have a right to that. T or C isn’t doing the family any favors by demanding the facts behind the post. I hope she doesn’t actually know the woman.

      • Amazed

        What? You mean you’ve met a homebirth advocate who was acually concerned about the family after the you know what hit the fan? Where?

        • Sick of picking names

          Reaching much! Amazed at amazed! (Formerly truth or consequences but now asked to change my name with every response) What a pathetic bunch you are!

          • Amy Tuteur, MD

            Stick to one name or your comments will be deleted.

          • Bombshellrisa

            Ever notice that the people who insist that their comments are being deleted OR have to pick a new name every time they want to comment are the ones that can’t spell or punctuate?

          • Truth or consequences

            Did you ever notice how infantile you look when you smear!

          • Bombshellrisa

            smear-noun-a usually unsubstantiated charge or accusation against a person or organization

          • Truth or consequences

            Pedantic and rude?

          • Truth or consequences

            She chimes in

          • Box of Salt

            Truth or consequences, she’s explaining the rules of the website to you. Changing your name is at best rude and confusing, and at worst called sock puppetting and is dishonest.

          • Truth or consequences

            I disclose who I am in every post …..so?

      • Guesteleh

        T&C is the midwife, isn’t she? And she’s freaking because someone in the family posted that it was a hemorrhage and she thinks she’s going to get blamed for the death. So she comes in here, hysterically insults everyone and reveals enough information so that commenters are able to ID the woman. Brilliant.

        • Susan

          Ok… maybe TorC is a ER doc who dabbles in midwifery?

          • Truth or consequences

            Well, thanks to whoever allowed me to continue to post under my screen name!
            Amy, do you plan to update your post to include a disclaimer? What exactly does the 24 year old have to do with your post? everyone else ….feel free to pick at my punctuation and spelling? LOL

          • Box of Salt

            Truth or consequences, please take this in the spirit intended, which is constructive criticism. You have complained that you have been criticized for your writing style, and I’m one of the persons who did so. And I will again.

            Please consider this: adopting the of style an angry child throwing a temper tantrum is not an effective means of communication.

            As I commented on the Twelve Things post: if you have a connection with case mentioned on Babycenter and quoted in Dr Amy’s post, I am sorry for your loss.

            But that does not mean you would not have been better served by communicating your concerns in a rational and reasonable manner.

            If you are posting here just to get attention or to irritate Dr Amy because you disagree with her viewpoint and dislike her style– by all means keep throwing your temper tantrum. Just don’t act so surprised at the types of responses you elicit.

          • Truth or consequences

            I am not a family member. I asked a reasonable question and you continue to smear me. I am not a child. I just asked a question. As for the response by Amazed, More of the same. Total disregard for all involved in this tragedy. Amy has had her share of tragedies. Would she like to have this kind of dialog about her? People discussing without any knowledge of the facts?

          • Lizzie Dee

            Oh get real. People do have a voracious appetite for other people’s tragedies. It isn’t unkind, it is normal.

            When bad things happen, people don’t know how to react, and often withdraw or don’t say anything. Tragedies/grief are isolating, but gossip/speculation still takes place out of earshot. Some of it inevitably filters back, and maybe can be hurtful, but an understanding that it is human ought to help. Most people would offer comfort if they knew how.

          • Eddie

            Truth or Consequences: FYI, Disqus is buggy. Many of us have run into different problems with it. It’s generally very nice and it has some good points, but it also has problems. Whatever happened with your screen name likely had very little to do with this site and more to do with Disqus. I don’t have any inside information. Just sharing my experience.

            I hope you understand that the entire reason people poke fun at your writing is due to your tone. If your tone were not so childish, if your comments were not so over-the-top, so full of chortling, “look at the reaction I got this time, boy you must really be riled now,” you would get very different responses.

            Aside: Commenters here are far less riled than you appear to believe. The strongest emotional reactions you’re generating are irritation and eye rolling.

            What is your goal, here? If your goal is to get a question answered, then you will best achieve that goal by dropping the attitude and more politely asking. For better or for worse, when you blaze into a site with a strong attitude and spend most of your energy provoking reactions, you are not likely to get productive responses — and you would be mistaken to expect them.

            If you have inside information about this unfortunate event, then I respectfully suggest you EMail Dr Amy. That’s what I would do if I were in that situation.

            For the record, it is absolutely tragic that this mother died, whether the cause was PPH or something else.

          • Truth or consequences

            Facts will come and Amy can explain herself.

          • Lizzie Dee

            For a moment with all the names, I thought your project might be to get yourself banned, and then do a Feminist Breeder style Ra Ra about your fearless triumph. Bit hard to figure out what else it might be. Demanding that Dr. A answers a question that is only obscure to you or assuming that you can demand a disclaimer is clearly doomed to failure. (My daughter on a bad day likes to ask questions where the answer is glaringly, blindingly obvious. It can get a bit tiresome, but it usually indicates that she is feeling insecure and needs attention.)

            When bad, unexpected, incomprehensible things happen people react in strange and unpredictable ways. But I think it is fairly common to feel: This shouldn’t happen. How can we prevent it happening to others? It was certainly one of my strong responses to a “bad outcome” So a post about hemorrhage and how not to deal with it seems appropriate to most of us – but not to you, because maybe that was not the cause. If you know differently, have facts we don’t have, state them.

          • Truth or consequences

            Hemorrhage is a legitimate topic. However, It has no place in this story.

          • Truth or consequences

            ER doc? ….really!
            Folks, it is really an easy question for [AMY] to answer!

        • Lost in Suburbia

          I was able to track her down exclusively based on what the baby center poster wrote, nothing that T&C wrote. I actually didn’t even bother to read most of what T&C wrote before, but maybe I’ll go back and take a look now.

          • Susan

            You’re hired if I ever need a PI.

          • Truth or con-munism

            Giggles! ,.. You are doing the same thing that Amy did! Slanderous assumptions with no facts to impart liability on yourself! 😉
            I really like how you make it so that I have to re-establish my screen name so I can reply! As for reading back! PLEASE DO!
            It is obvious that most of you just react and smear rather than read and use critical thinking!

          • Lost in Suburbia

            I’m curious – who do you think I’m making assumptions about? I was making statements regarding my original post about who I thought might be the dead mother. I’m not seeing how that could be considered slanderous.

            I suggest that you use your critical thinking skills, and be careful what assumptions you make about all posters here. Not all of us are anti-homebirth or midwife-hating people. You however, have done a fantastic job affirming some of the stereotypes many readers here have about homebirth/midwifery supporters.

        • Truth or consequences

          I am not the midwife! You lose credibility by smearing reasonable questions! Again, Amy,…do you know the facts of this case? Amy may be an excellent OB, but she completely misrepresented the case of the 24 year old woman. She found one paragraph from a family member that didn’t know the real circumstances of her death. She spoke out of grief and shock of the situation. Amy ran with it. I can assure you, I am fully aware of the circumstances of this case and Amy took full advantage of this family and she stumped at the expense of this family. She is right as rain about hemorrhage, it just has nothing to do with this story. She makes this 24 year old woman look foolish! The deceased woman cannot defend herself from Amy’s fictional tale. I am amazed how willing you all are to carry her water on such a huge misrepresentation.

      • Spiderpigmom

        “If that’s the same person it’s terribly sad. What a beautiful young woman”: you mean it wouldn’t be as sad if she had been a homely middle-aged woman? A life is a life is a life.

        • Susan

          Not what I meant. But she was a beautiful young woman. Not my way to value life by a person’s beauty or age. Though being so young does seem quite tragic.

        • Eddie

          I think it’s common to measure a loss, in part, by years of life lost. A younger person has lost more of their life than an older person, so it is more tragic. Saying, “A life is a life is a life” is true, but too simple. When my 90 year old grandma died, it was sad, but it was not tragic. She was ready to go. She”d had a long and happy life surrounded by people who love her. When a young child dies with their entire life ahead of them, it is especially tragic. I expect that Susan meant what she said in that light.

          • Squillo

            WHO (and other orgs) use “disability-adjusted life years” to measure the burden of disease. There’s a nice summary here.

      • Blindly follow Amy

        Amy has no idea of the facts of her post and she writes “She didn’t have to die” in her lead in. (formerly TRUTH OR CONSEQUENCES) All I asked is she qualify her statements?

        I know you want to carry water for her and trash anyone that calls her on her insensitive and false assertions concerning this case! I am sure she will make every attempt silence my simple questions. Amy does not want these questions asked and she will eventually keep me from asking! For the trolls that criticize me for changing my screen name, It is done to emphasize that I am forced to change it, due to a modifications to the guest interface. All I can say is: Keep on trashing!
        Others will read this and understand how you operate!
        If you see no other responses from me, it will be as a result of blocking me from asking questions.

        • Karen in SC

          So you would have been okay with the statement “She most likely didn’t have to die?”

          Anyone who read this and went back to the original source is intelligent enough to consider that there may have been other issues, a different diagnosis or maybe even some freak occurrence like the mother also got hit by lightning. HOWEVER that doesn’t invalidate the important facts about the risk of PPH and the danger of experiencing one during a homebirth.

  • Bombshellrisa

    Looks like He Who Shall Not Be Named has sent us a troll. You know the drill people.

  • Hannah

    A very stupid interview in the Guardian:

    http://www.guardian.co.uk/lifeandstyle/2013/jun/01/natural-birth-childbirth-midwife-ecstasy

    Beyond the usual there’s her belief that “we are in London, one of the richest cities in the world. And the women having babies are well nourished and are only having one, two or three babies. They are incredibly safe,” which betrays a very rarefied client base and her encouragement of well informed middle class women to game the system:

    “The counter-melody of the book is a call to women to take control and play the system to get the best one-on-one care for themselves. Book yourself a home birth, Flint is saying, which will immediately get you care from a more engaged midwife, free on the NHS – a midwife who is interested in you and who wants you to have a great experience. Then, by all means go to hospital down the line, but go with your midwife by your side.”

    By the way, here’s some reporting of her late nineties disaster from the time:

    http://news.bbc.co.uk/1/hi/health/340399.stm

    http://www.guardian.co.uk/uk/1999/may/16/nicoleveash.theobserver1

    http://www.independent.co.uk/life-style/is-this-the-end-for-home-birth-1093814.html

  • ratiomom

    Dr Amy, it seems that you`re definitely making an impact. At the very least, you manage to piss off the right people. Look at this:

    https://www.facebook.com/EvolutionaryParenting/posts/608147825864374

    You are one of only 3 blogs they want to see removed from the internet. The other two are the fearless formula feeder and navelgazing midwife, but they get mentioned only once. They should give you an award 😉

    • FormerPhysicist

      I have to check out some of those blogs. 🙂

    • Dr. A “ruins the lives of innocent women” someone says. NCBers don’t do irony, do they? I wonder which innocent women they have in mind? The midwives? The dreamers who do not want to deal with unpalatable realities?

      Such tender sensibilities in these warrior women!

      • Frequent Guest

        That juxtaposition has always killed me. They are fierce nature warrior birth mamas, but OMG don’t offer them scientific facts or, even worse, an EPIDURAL; you’ll offend their delicate sensibilities!

      • The Bofa on the Sofa

        Ignorance is bliss, baby!

      • Squillo

        Indeed. If a little criticism can ruin your life, maybe it’s time to rethink publishing your thoughts.

      • Amazed

        But Lizzie, she does. Can’t you see what a huge blow the very existence of this blog is to the poor innocent women who place all their value in their vagina? Dr Amy dares claim that they aren’t so spwecial snowflakies after all. That maybe they are not so much more special than, say, virtually every woman who has ever walked this earth.

        Imagine the horror! Their lives are ruined!

    • Amy Tuteur, MD

      Awesome!

      They finding me so threatening precisely because they know that what I write is the truth, and therefore I threaten their desperate desire to feel superior to someone.

      Cassels is angry because I’ve exposed her as the fool that she is, not once, but twice in the past few weeks.

      • Truth or consequences

        If truth and slander mean the same thing, Yes, you are an expert! If writing posts from the heart rather than from facts surrounding the incident you are writing, yes, you are brilliant!

        Have you answered the questions posed to you about your fact finding on the mother’s day article? Do you know for a fact that she died from blood loss? Did you opine on other potential causes of death? What about the possibility of amniotic embolism? What is the survival rate for this condition? Does that possibility detract from your agenda?

        • The Computer Ate My Nym

          Oh, good, you finally found your way to the right post.

          As far as I know, there is no further information released publicly on this poor woman’s death. But I’m not sure why you should doubt the eye witness’ account that she died of massive hemorrhage. Massive hemorrhage is an easy diagnosis–you see blood coming out of the vagina at a high rate and the person getting rapidly paler and weaker. Not subtle.

          I’m not sure how you decided that amniotic fluid embolus must be the diagnosis, but in answer to your question, the mortality is between 20% and 60%–when the event occurs in the hospital and treatment is immediate. If the woman in this case did have an AFE she would have had as much as an 80% chance of survival in the hospital-and none at all at home. So, no, that doesn’t detract at all from Dr. Tuteur’s agenda of informing women of the risk of home birth and, in fact, adds to it. Thank you for pointing out the additional risk.

          • Truth or consequences

            Lots of numbers….very good! How long did it take for this young lady to get to the hospital? did the hospital ask the right questions of her condition and treat accordingly? Is that the 20% of you concise stats you seem to be comfortable with? What were the findings of the medical examiner? I know, this is not the point and not important to the discussion of her post! Agenda agenda agenda! Don’t bore me with facts, allow people without a clue win the day! Between 20 & 60%… very concise! Those stats line up with the survivability of a plane crash!

          • Ann

            When someone is carried in to the ER with buckets of blood pouring from her vagina, there aren’t that many questions to ask.

          • Truth or consequences

            Ann, Were there buckets of blood pouring from her vagina? Please enlighten all of us on your first hand knowledge on this particular case?

          • Susan

            If someone who was actually paid to care for this woman, at home or in the hospital, commented it would be a violation of the patient’s right to privacy. It’s one of the more difficult things about the internet age that the patient has the right to say anything he or she wants about a doctor, or midwife, online but the provider has absolutely no right to defend herself. I am not a fan of homebirth midwifery myself but that’s just the truth. We only have the facts that are provided online.

          • Jo

            The only person with first hand knowledge is dead.

          • Bombshellrisa

            What is wrong with a cousin being the eyewitness?

          • Truth or consequences

            Was he/she an eyewitness? There is nothing in her post that puts he/she in the situation as an eyewitness emotional tragedy.

            My whole point is, can AMY answer my simple questions? Are her assertions facts? Is she using this tragedy to further her agenda? I still don’t know, she hasn’t answered any of those reasonable questions? I get responses like ” hemorrhage is easy to detect because they would be bleeding from the vagina”. Yes that would be one of the obvious ways to detect hemorrhaging. Does that response address the question? Was she bleeding from her vagina? Are we comfortable assuming she was?

            8 min. from the hospital? [Was] she 8 min. from the hospital? How long did it take to get her there? Was it 8 min? Did [AMY] fact check this or did she just use scorched earth tactics to further her agenda?
            I assume there was an autopsy. What were the results? Is AMY concerned that the results may not line up with her accusations and talking points? There are facts in her article. do those facts have anything to do with this particular story? Does she post a disclaimer in the post that she has no knowledge of the facts in this case other than the paragraph from a grieving family member?

          • Eddie

            Scorched Earth? Huh? Hyperbole much?

            Dr Amy very clearly noted the source, as she always does. Is an additional disclaimer really helpful or necessary? Are you suggesting that the readers of this blog are so illiterate or unthinking that they need BIG BOLD DISCLAIMERS everywhere, or else they shall be lead astray?

            If you think there is not enough information to reasonably report on, you are welcome to that opinion. However, the hyperbole of the rest of what you’re saying betrays your position that you’re just looking for anything to disagree with.

          • Truth or consequences

            So asking reasonable questions are hyperbole? She noted the source. Great!!! Does that source have any credibility (Under these circumstances)? They are rightfully riddled with grief. Is this a good source for the absolute truth regarding the situation? They know their relative died and unless they know all of the circumstances surrounding her death, It is premature to come to grandiose conclusions. Amy has certainly done that. Do you think Amy was balanced in her approach? Her quotes were longer than the short statement provided to seed her post. I guess they didn’t do an autopsy because you all have all determined the cause of death because Amy has spoken. I guess the seeking facts have no place here!

          • Eddie

            Asking reasonable questions is not hyperbole. “Scorched earth” is. Slander is. Saying she claims all midwives are quacks is. I very very clearly put my use of hyperbole in that context. Either you missed that context, which doesn’t bode well for your reading comprehension, or you deliberately overlooked it so you could misinterpret what I said, which doesn’t bode well for your credibility. This is why people are reacting the way they are to you. You are not merely asking questions … you’re asking leading questions where you presume an answer.

            Do I personally think Dr Amy was balanced in her approach? Dr Amy clearly used that post as a springboard into a related point. She gave the source, so that anyone can see that the facts are not perfectly known. Were I to write this post, I would write something different and more balanced, but then again, I don’t have a blog nor do I have the time or energy to run one. I am not an activist. Nor do I have the expertise it would take to run a blog in this area of knowledge.

            Given the details of the death, it sounds like the information is reasonably certain. That is, she gave information on a method of death that is trivial to diagnose. You are correct that there could be more to this story, and that it’s possible the information is inaccurate. That doesn’t mean it is irresponsible to use that unfortunate event as a springboard for a discussion of the issues.

            Seeking facts most certainly has a place here. Depending on how you go about it, you’ll either be well received or not. Welcome to the internet. People like to assume that people who follow this blog are mindless sheep. That’s really entertaining. The people who post regularly here do disagree with Dr Amy, with each other, on a regular basis. We are adult enough to be able to handle the conflict and to think for ourselves, and to trust other people to be able to evaluate the evidence on their own.

          • Truth or consequences

            She clearly has contempt for midwives and refers to them as clowns in this article. That is slander. Her post most definitely accuses the midwives as incompetent. I find it offencive for her to build a storyline out of thin air and make unqualified and potentially untrue allegations as to why this poor woman died. All she has to do is answer the simple and direct questions. She must be qualified to do so! She even has my permission to talk down to me for having the nerve to ask if she did any fact finding on this particular post?

          • Eddie

            Referring to someone as a clown is not slander. Good grief. Again, hyperbole. Criticism is not necessarily slander, and having contempt for a subset of a group does not qualify as having contempt for the whole group. This has been explained to you, but you ignore it. You clearly have an axe to grind, but are trying to act as if you do not. It’s not convincing.

            Dr Amy did not build a story line out of thin air. As I already said, she took a tragic event and used it as a springboard to discuss the issue.

          • Truth or consequences

            Yes she did use this tragedy as a springboard. The problem is, she used this poor woman for her own agenda and didn’t know the facts of the case. Why doesn’t she wait and use a real case to push her agenda. A woman died and she makes unqualified claims that she died from blood loss. She does not know this for a fact yet, she treats it like it is a fact. I have a problem with that and you should too.

          • Amazed

            A young, healthy woman died in childbirth – something that almost never happens today in first world countries – and the best you can do is argue whether it was a blood loss or another condition that she would have had a FIGHTINGT CHANCE against in a hospital killed her?

            Homebirth killed her, in either case. You and your moron sisters who preach how safe it is killed her. Now, go to the original post and do what good little homebirthers, especially those who encourage others to homebirth do – add your voice to the “so sorry, mama’ chorus and go on merrily with your life.

            Oh, I forgot – in this case, it is “so sorry, bubba. So sorry, family’ before going to another site to rant how unfair people are when homebirth is concerned.

          • BeatlesFan

            FFS, if you think the BBC post Dr. Amy used as a basis for this blog posting was fake, go onto BBC, look up the post, and bitch about it there.

            “Why doesn’t she wait and use a real case to push her agenda?”

            The only way you could know this case is fake is if you were the one who wrote it, and you were lying. And, as others have said, even if the BBC post was fake, that doesn’t change the fact that PPH happens, and that women have a much better chance of survival in the hospital. It doesn’t change the stupid BS she quoted the midwives as saying.

            If I tell a story about a friend of mine who drove drunk and ran over a group of schoolchildren to give an example as to why driving drunk can be dangerous, the fact that I made the story up doesn’t suddenly make drunk driving safe.

          • LukesCook

            Oh dear. Better look up “slander”. And “offensive” while you’re at it.

          • Captain obvious

            Pot meet kettle?

          • Sue

            Using three ”!!!” correlates highly with using hyperbole. QED.

          • Amy Tuteur, MD

            “My whole point is, can AMY answer my simple questions?”

            No, that’s not your point and it is disingenuous to pretend that it is. Your point is that you are desperately searching for reasons to discount and dismiss this death. You are hoping that you might pretend that it didn’t actually happen.

            Sorry to disappoint you.

          • Truth or consequences

            Very nice Amy! Please find a passage in anything I posted that I have dismissed the death of this poor women. Please…You must be brighter than that. Are you not able to answer the questions, or, are you so inclined to smear and divert because it exposes you? How arrogant you must be to tell me what my point is! Was there an autopsy? If there was, what were the findings?

          • LukesCook

            “Does she post a disclaimer in the post that she has no knowledge of the facts in this case other than the paragraph from a grieving family member?”

            Actually yes, she has made it abundantly clear what the source and extent of her information is. Or are you not able to get that from the text without a label in caps: “DISCLAIMER”?

          • Dr Kitty

            Say the hypothetical woman was 5 minutes from the hospital.
            And got there alive.
            And received the optimum care.

            And still died, because she arrived two minutes too late.

            The readers of this blog think that such a death would be both needless and preventable.

            How would you describe such an entirely hypothetical death?

          • Bombshellrisa

            Actually, it does shed light to look at these questions. While we don’t know the details, this is what I know from attending homebirths and births in a birth center which is three minutes from a hospital. ” How long did it take for this young lady to get to the hospital?” That is a biggie. Before a patient is transferred, the midwives usually call around to the nearest hospitals to see who can take a patient. Just because there is a hospital very close doesn’t mean that they will be staffed for a transfer. There could have been a lot of time calling around and that is time wasted. There are other people here who have delivered with the midwives I was a student with and they noted that while there is usually a hospital very close to their home, the midwives don’t like to transfer patients to certain hospitals because the staff there will not hesitate to report them for care that falls below the state standard. So that may mean laboring on all fours in the backseat of your car while the driver navigates three freeways and a toll bridge to get you to the hospital that has a bed. “did the hospital ask the right questions of her condition and treat accordingly” The question could also be posed: did the midwife stay with the patient during transfer and bring all records including copies of the chart with H&P and all notes pertaining to the pregnancy and labor? Someone bleeding a profuse amount may or may not be capable to speak. If there are no notes and no midwife to give report, it’s going to take longer to assess the patient’s condition and what course of treatment to take. If the patient hasn’t had any blood work done, before any blood can be given there has to be a type and screen along with a crossmatch.

          • The Computer Ate My Nym

            How long did it take for this young lady to get to the hospital? did the
            hospital ask the right questions of her condition and treat
            accordingly?

            No idea how long it took her to get to the hospital. The post states that it was “8 minutes away”. Assuming it really was and they got her there in 8 minutes, she was most likely dead by the time they got there. Even if it was an AFE, which, as others have pointed out, is extremely rare compared to the risk of PPH. Either one is deadly within minutes without treatment. And it’s hard to ask a dead person the right questions.

            How often do planes crash and how often does amniotic embolism occur?

            Extremely rarely and extremely rarely. Your questions are the equivalent of saying “Are you SURE a plane didn’t really run into her car?” in response to someone saying, “My cousin died in an auto accident.” Sure, there are examples of planes running into cars and when that does happen, it’s almost always because something was drastically wrong with the plane, but why bring it up when car crashes are common? And why bring it up when it helps your case not at all. PPH is almost completely survivable in the hospital with proper preparation (type and cross done, IV in place). AFE can be treated in the hospital, with greater difficulty, but survival is expected. Neither can be treated adequately in the home birth setting. A woman with AFE at home will die 100% of the time. One in the hospital will die 20-60% of the time. I’ll take even a 40% chance of living over a 0% chance.

        • Amazed

          “What about the possibility of amniotic embolism? What is the survival rate for this condition?”

          What did those who put that rubbish into your head tell you about this condition? Let me guess: it’s so dangerous that death is inevitable. It is… when it’s your glorious mentors who attend the woman in home setting.

          So, what do you think the survival rate is?

          • Truth or consequences

            SO,…not answering simple questions is the proper response? I asked Amy to answer a simple question and then you show up with a bag of smoke. You want me to answer the question? It was hypothetical. Do you know what hypothetical is? Amniotic embolism is rubbish! Excellent! The only thing about her post we know to be fact is that her name is Amy, she is opinionated and claims ALL midwifery quackery! Amy has spoken! I will assume you have no idea what the stats are on that condition. If you did, you attempt to debate the issue. Instead, amniotic embolism is rubbish.

          • Karen in SC

            Your question is answered below. Your other assertions are rebutted in several posts in this blog. You could learn more about what Dr. Amy claims if you read more posts. What about the recent post on the Oregon homebirth death rate? What about the post “Extreme Homebirth?” Have you read any of the stories of incompetent midwifes on the Hurt by Homebirth page? Dr. Amy even provides a short video!

            You have multiple opportunities to learn about this side of the debate. Then please use specific studies or facts if you’d like to disagree.

          • Truth or consequences

            I am not disagreeing, I am asking cogent questions. I am so glad Amy has made video’s. I am sure they are very one sided and agenda driven. You may follow her all you want and accept her opinions and carefully selective or invented facts so you can blindly follow them. She is very selective on what she presents and she leaves out whatever detracts from her agenda. She doesn’t care if she is patently incorrect on posts. I can’t expect that you would find it odd that she hasn’t jumped at the opportunity to smear me because I ask simple questions about her post. The bag

          • Eddie

            If you have alternate facts that are backed up by medical studies, by all means, present them. You’re not asking cogent questions. You’re asking leading questions.

            Almost all people who come here to challenge Dr Amy’s facts fail to quote actual or reliable medical studies. Which fails to lend credibility to the challenges. Quite a few of the people who come here to challenge her include ad hominem attacks on her or the commenters here — as you did — which again detracts from credibility.

          • Truth or consequences

            She made the claims and I called her on it. It goes to her credibility. If she knows all of the fact surrounding this case she should just come out and say she does!

          • Eddie

            (Rolling my eyes) You are fixated on this one point. Most of the blog post above relates loosely at best to the details of the story you are going after. She gave her source. You want her to have inside information. Dr Amy made the claims? She quoted another person. She then made reasonable conclusions, assuming the quoted person was accurate, and … as I said several times now … used that as a springboard to a bigger topic.

            If it turns out to be untrue … let’s say the original poster on Baby Center was lying or just misinformed, then most of the above blog post still stands. Only the first two paragraphs (not counting the quote) are invalidated. The rest is still a valid discussion.

          • Truth or consequences

            Ho hum yawn….I can assume she quit working because she is unqualified. I am basing this on loose details such as “those who can’t do,…teach” Is that a loose enough? we don’t need no stinking facts to make ludicris assertions! I guess hearsay is good enough!

          • Sue

            Those who can both do and teach are way ahead of those who can only complain and argue. T or c – you’re not contributing anything useless.
            What are your experience, treatment and results for post-partum hemorrhage?

          • Sue

            Oops – not contributing anything useFUL

          • Truth or consequences

            OK, Sue, you must have more information on how this woman died! I stand corrected! This woman could have been saved! She hemorrhaged to death. Be sure and let Amy know these facts! I am sure she will be relieved!

          • suchende

            Anyone can question a claim (see e.g. moon landing hoaxers). But if you want a seat at the table, you better bring more than a conspiracy theory. What is your evidence?

          • BeatlesFan

            For someone who repeatedly complains that others are putting words in her mouth, you seem to have no problem doing it yourself. Sue said absolutely nothing about the woman mentioned, nor how she died.

          • Eddie

            You’re off the rails with illogic at this point, and you’re entirely missing the point. Whether that’s deliberate or not I can’t tell. You’re treating a blog post as if it’s a medical journal article. Silliness. And you treat the readership as if they have no ability to judge for themselves, no education, and need every little detail spelled out. That may be true of some other blogs (although in general it shouldn’t be as long as there is transparency), but it is not true here. Much of the readership here is highly educated and has the ability to come to their own conclusions.

            P.S. I apologize, I cannot help myself. It’s “ludicrous”

          • Amy Tuteur, MD

            Cogent? You’re kidding, right?

            You are demonstrating exactly why I do what I do. You desperately want to pretend that these disasters don’t happen and my posts make is extremely difficult to keep practicing the denial that is integral to homebirth advocacy.

          • Truth or consequences

            I am completely aware these disasters happen and I would appreciate your not inventing falsehoods of things I never said. I asked you questions concerning your fact finding on this particular post and you can’t find a way of answering those questions without attempting to smear me. You have no idea what really happened in this case and you know it. you are making a grand fool of yourself by sidestepping the obvious and it doesn’t reflect well on your believability. I am glad you have a cause, and that is your right. Spreading misinformation on this tragic case is unethical at best! If you present information that backs the claims that this women hemorrhaged to death, I will apologize to you with hat in hand. Your continued smear tactics just makes you look small and desperate to save face.

          • Sue

            “T or c”’s posts are very telling indeed. When he or she says ”believe her selected or assumed facts”, this person assumes that, like in many blogs, the readers don’t know how to verify the information.
            Pro Tip: many people who regularly comment here also know the science. Many who don’t know how to look it up. Those who can’t access or evaluate the research ask intelligent (even ”cogent”) questions, which are answered by people who actually know stuff. Unlike many other blogs, where the author can say anything that suits the spin and the fans applaud.

          • Bombshellrisa

            I was thinking that they sound very much like He Who Shall Not Be Named.

          • Box of Salt

            Bombshell, Nah: “He Who” speaks better into his voice-to-text device than “T or C” writes. Plus, with his ego he’d want the credit for everything he said, no matter how ridiculous.

          • Eddie

            I agree. Also, “He Who” was less trolling and more into the love of the debate and showing how smart and crunchy he was.

          • Bombshellrisa

            Agreed Box of Salt and Eddie. I just think with the whole “every detail most be accounted for if this story is to be believed/but what if this wild, super rare something came up instead of the logical answer” approach was wildly familiar. He also changed his post name again, not his real name, into something more anonymous (it said I had 88 new comments, all from him from the old threads under his new name).

          • Truth or consequences

            I love it!!! I love watching kool aid drinkers melt down to slinging insults when they can’t answer a question. They protect their god from scrutiny! Gather around Amy now…She is not capable of defending her position! Gather tight now!

          • Karen in SC

            She did reply at least once. Your concerns and questions have been answered. You have also been insulting and using personal attacks. Guess you didn’t understand the point of using a post as an illustration for an issue that was then discussed in more detail (though in a general way), highlighting how untrained birth attendants view PPH. You just don’t want to understand, I think…. I dare you to put the terms PPH and hemorrhage into this site’s search engine and read all the posts.

          • Truth or consequences

            Yeah…she didn’t say anything other than she was sorry that I didn’t know what my own point was? good answer!

          • Box of Salt

            Truth or consequences,
            “slinging insults when they can’t answer a question”
            You never answered mine: based only on the publicly available information quoted from Babycenter, did this this woman die before medical attention was obtained?

          • Eddie

            You are getting increasingly ridiculous, and that’s saying something as your argument started out ridiculous. Note: Ad hominem attack: “You’re ridiculous.” Non-ad-hominem attack: “Your argument is ridiculous.” Just in case you couldn’t tell the difference.

            Dr Amy is our god now? Project much? Dr Amy can defend herself, or not, to your attack or anyone else’s. She’s an adult. She doesn’t need my defence. The responses you see are not a circle-the-wagons defence of Dr Amy, although you clearly see it that way.

            And seriously, melt down? I think you’re more emotionally involved in this discussion than anyone you’re arguing with. Your arguments are so extreme and off-the-wall and frankly just silly that you don’t have a lot of credibility.

          • Anj Fabian

            Occam’s razor, anyone?

          • Truth or consequences

            What was the illustration? The bag of blood? The misuse of the tragic death of a woman to bolster her topic? I have no problem with the topic. I have a problem with a doctor misusing props. She has no idea of the circumstances of that woman’s death! She made claims that could be entirely untrue. That is unethical and could be harmful to the feelings of the family members of that woman.

          • Dr Kitty

            T&C’s posts read like they are being written by the MW in the above case, or someone who knows her.

            That is, they read like the posts of someone who really, really wants the young woman’s death to have been unavoidable, and the care the MW provided (or didn’t provide) to be irrelevant.

            So, T&C, what is your agenda?

          • Truth or consequences

            My agenda is to expose Amy for using the death of this woman to further her agenda. Amy needs to check her facts before she defames the dead!

          • Susan

            Are you Bob Barker?

          • Box of Salt

            “My screen name should give you a better idea of who I am.”

            You’re a pre-teen playing a party game?

          • Susan

            Are you Dr. MR ER doc who does home births in TX? Is that behind this rant?

          • Truth or consequences

            That begs the question “What is your excuse’? I love it when Kool-Aid drinkers begin to melt down! Amy has no idea what the facts are in this case. Insulting me, in an infantile manner, doesn’t change that fact!

            Have fun! LOL

          • Susan

            “I love it when Kool-Aid drinkers begin to melt down! ”

            Nah, I find it annoying, maybe they need to add a little lithium to the NCB/AP Kool Aid. Are you a friend of Jennifer Margolis and upset about the book reviews on Amazon?

          • Susan

            yeah, I think this is someone different too. If this one had perfect SAT score I’d be suprised 🙂

          • Squillo

            Not me. I was thinking it was either someone for whom English is a second language or someone who is so angry they can’t write coherently (or both). Alan (that was his name, right?) managed to be comprehensible, whatever his faults.

          • Truth or consequences

            Excellent! Smear and insult when you can’t deal with the questions. Nice tactic! It is old and worn out though, It is nice to see the old debate tactic! Trashing the writing skills of other debaters is a good tool! Bravo!!!

          • Squillo

            I wasn’t aware of trying to debate you. When I do, you’ll know it because I’ll address you directly. I think other posters have dealt adequately with your questions.

          • Truth or consequences

            “Not me. I was thinking it was either someone for whom English is a second language or someone who is so angry they can’t write coherently (or both). Alan (that was his name, right?) managed to be comprehensible, whatever his faults”.

            I’m sorry if you were addressing someone else! It is so hard to tell what or whom you are addressing!

          • Susan

            She was discussing whether you were someone else who has posted here and tended to derail the discussion from the topic at hand to another issue. She wasn’t trying to debate you. I have been trying to get you to acknowledge that it’s a GIVEN that no one even knows if the baby center post represents a real person. It could be a fraud. It wouldn’t change anything about the points made. You are table pounding about something that is a non issue. This woman might not exist. Therefore her family and midwives you are so vehemently defending the honor and feelings of might not exist. But a discussion of postpartum hemmorhage and how it is treated by homebirth midwives is very valid, and illustrating it with a bag of blood is very appropriate especially because that’s something that can only be done in a hospital. I don’t get your outrage about this? You have made an awful lot of posts about it.

          • Lizzie Dee

            Is it outrage? T & C seems to me to be enjoying herself to much for that – more like the gleeful “Gotcha” of those with a bee in their bonnet who win arguments no-one else is having by completely missing or mangling the point.

          • Susan

            I have no idea. Right now, after seeing the link to some woman who did apparently die postpartum that was posted, I just hope s/he doesn’t know exactly who it is and is upset about the cousin’s babycenter post. It would kind of explain some of her posts and why it matters to her so much that it isn’t called a PPH?

          • Truth or consequences

            I can assure you, nothing about this blog is enjoyable! Will I be back to post facts about this case? We will have to see. I will take the family into consideration in that decision! I am really just trying to understand Amy’s motive for her misrepresentation of this woman.
            I will also consider the mindless and ridiculous responses I have received. I am quite sure that facts are not the cornerstone with this crowd!

          • Truth or consequences

            I can assure you that she exists! Why would I take issue with Amy’s assertions that she bled to death! She obviously has no concern for the family when she spouts off about things she has no clue about! Her first line is “She didn’t have to die” How do you think that looks to a family member! Amy says “She didn’t have to die”. Does she think that she has no impact? I don’t care what her agenda is. She go’s out and finds a one-liner on another site and then uses it to further her opinions on a subject unrelated to this case. That is what has me outraged! Regardless of what you might think of me, (I couldn’t care less of what you think of me), You should expect more professionalism from Amy. You obviously kiss the ground she walks on. That is your choice. Implying this 24 year old bled to death as if she had first hand knowledge, is really irresponsible and foolhardy!

          • Amazed

            “I can assure you that she exists! Why would I take issue with Amy’s assertions that she bled to death!

            Oh so you can give us information about the other way homebirth (a.k.a you, your moronic sisters in stupidity and/or moronic fake careproviders, most likely) killed her?

            How do you know she exists? You can’t know it without knowing the circumstances. So would you stop sobbing that Dr Amy doesn’t know them and enlighten us what they are, exactly?

          • Squillo

            The way Disqus nests comments can be confusing. The arrow next to a commenter’s name points to the name of the person to whom they are replying.

          • Truth or consequences

            Oh…since you being so critical of my writing, you might want to check your punctuation!

          • Squillo

            Q.E.D.

          • Truth or consequences

            Very good! smear the unknown person! I am just asking Amy to tell me if this woman really did hemorrhage I assume she can answer that? Oops…I used the assume word!

          • Susan

            My goodness T or C how do we even know that the woman actually exists? She might not… it really wouldn’t change the points that Dr. Amy made at all. I once followed an entire thread about a set of quads that was a hoax. If I had posted something about the care of multiples and the risks of multiples it would not have made my point less true. It’s a springboard for discussion that’s all. No one CAN verify these posts. Gosh for a long time the NCB/AP crowd liked to say that Dr. Amy didn’t really exists and was an ACOG front. Maybe it was her news interviews that now they just resort to putting dr in quotes. I’d just call her Amy too if people like you were not so intent upon denying the validitity of her education.

          • Truth or consequences

            I think I will just sit back and watch you all self destruct! This is hilarious! You are adding things I never said. You smear me because I ask questions that Amy should be able to answer. You attack my writing skills! This is really funny and tragic all at the same time! Now the question is: “does this woman even exist” ! I think I am done here! Maybe I have been sucked into your alternate universe! I want out! LOL

          • suchende

            This guy is a MUCH less talented writer. Probably ESL, though, so I don’t mean that as an insult.

          • Truth or consequences

            Please use your skills of research on this case to help vindicate Amy! I am sure she will appreciate it!

          • Susan

            T or C, read what Eddie wrote. Of course no one knows anything about the veracity of a post on Babycenter. It could be entirely the fictional work of a Munchausen’s by Internet. But the posts by the midwives? Those are real, and they are disturbing.

          • Box of Salt

            Truth or consequences: here’s a “cogent question” for you.

            Based on the quoted Babycenter comment linked above, did the woman who lost her life die before medical attention could be attained?

            Autopsy details are not going to change the fact she removed herself from potentially life saving medical resources.

          • Truth or consequences

            I never claimed to know the circumstances? If you read any of my posts, I am asking Amy if she did any fact finding to base her professional opinions? Amy is putting herself out there as an expert on [this] particular case. The newspaper indicated that she died at the hospital. No indication of the total circumstance were provided. BTW,..this is my whole problem with Amy’s post. You make the assumption that she died as a result of not having competent medical resources. Please let Amy know what you know. It will help her story!

          • Karen in SC

            I believe that time of death has to be called by an MD. So even if the death occurred at home or in the ambulance it would be called at the hospital.

          • Truth or consequences

            Brilliant!

          • You know…. if the home birth midwife was so capable of delivering a baby, why did they transfer to the hospital at all? Why didn’t the midwife take care of it herself? You are just hell bent to insist that your question won’t be answered but does it really matter exactly how the woman died?? Let’s focus on the real issue: why didn’t her hired professional caregiver know how to handle the situation? B/C SHE WAS NOT CAPABLE. SHE NEEDED DOCTORS AND NURSES AND LIFESAVING EQUIPMENT THAT CAN ONLY BE FOUND IN A HOSPITAL. If it WAS afe, she sure as hell didn’t stand a chance at home. If it was pph, it’s a damn shame a midwife couldn’t take care of it or at least keep in under control until the poor mother was in the right hands. If it was something else? Who knows. Name one thing a mother in labor can die from that ONLY a home birth midwife would know how to handle.

          • Truth or consequences

            WOW…So tell us what happened! we are all ears! Hey everyone!…she has the skinny on the tragic death of this girl! Go Dula..Go! No qualified help, huh! yes yes!

            Pathetic!!!

          • Where, oh where, in my comment does it say that I know how she died??????? I actually said the opposite, that who knows how she died. I’m starting to think you are either not “all there” or you are on drugs or something. You don’t make any sense and you sound a little crazy.

          • Box of Salt

            Actually, Truth or consequences, what’s pathetic here is your ranting and raving and excessive use of question marks and exclamation points. Any point that you had about a lack of fact checking prior to the blog host Dr Amy selecting this particular comment from Babycenter has long since been drowned out by your subsequent childish comments filled with accusations, innuendo, and insults, plus typos, spelling, and/or grammatical errors (disclaimer: yeah, I post those too), while ignoring questions you don’t want to answer.

            You shot yourself in the foot.

          • Eddie

            uhh,…. Dr Amy is not, in fact, putting herself out there as an expert on this particular case. Where do you get that from?

            I know, I know…. ask a silly person, get a silly answer.

          • “I am sure they are very one sided and agenda driven.”

            So what is Dr. Amy’s agenda? What does she have to gain by sharing the sad stories that are rarely shared in the home birth community?

          • Truth or consequences

            She puts a bag of blood at the top of her post and sites this tragedy. Starts her rant with “This woman didn’t have to die” I assume she means the 24 year old woman’s tragic death in the paragraph above. Sharing a sad story? Ok, share the sad story and say she will look into the cause rather than making ridiculous and misleading allegations to the family. Blaming the caregivers and insinuating that they are clowns! I have no problem with her doing what she does. I do have a problem with her misinformation at the expense of the 24 year old and her family. She has no idea of the circumstances of this case. NONE! She assuredly has an agenda and there is nothing wrong with that. It is her her “ends justifies the means” [SCORCHED EARTH] approach that I find grotesk! I would ask if mis Amy has ever lost a patient? Has she shared her sad story? Now lets use the same means she uses. Did her patient die later after she cured her of the illness she calls childbirth?

          • You have complained over and over that your question keeps being dodged and here you are doing the same thing…. Please answer my questions: What is Dr. Amy’s agenda? And what does she have to gain with that agenda?

          • Truth or consequences

            Her agenda is to badmouth midwifes and anyone that uses them! Sorry if you can’t see that for yourself!

          • I’m quite familiar with her blog and her thoughts about non-CNM midwives. What does she have to gain by voicing her opinions about home birth midwives?

          • You edited your comment. Wow, really? You honestly think this is about professional jealousy? Really?? Are you being serious?? You don’t think her blog is about her issues with our VERY flawed home birth midwifery system here in the US? It is all about jealousy?

          • Amazed

            Oh, she might very well think it. I’m starting to think that T o C is a homebirth midwife who is jealous of OBs and in her homebirth set mind thinks that the opposite must also be true.

          • Box of Salt

            Amazed, it’s human nature to project our own motivations to others.

          • Amazed

            Oh yes. When I was at the iniversity, I sometimes thought that at least 5 of my professors hated me. They never knew I existed, most likely.

            Let’s see the way NCB think: homebirth midwives’ livelihood depends on taking business away from OBs and hospital midwives, so they insist the opposite is true. They might even believe it, who knows.

          • Truth or consequences

            And the real agenda reveals itself!

          • Truth or consequences

            As I stated…Keep believing that I am a midwife! It just adds to the opportunity to drift further into the weeds on the topic!

          • Dr Kitty

            So you’re not?

            Just another “educated” NCB enthusiast?

            Can we now discount everything you say on the basis that your knowledge base about obstetrics, statistics and healthcare isn’t adequate, because everything you learned, you learned from Wikipaedia and Ina May?

          • Truth or consequences

            you asked a loaded question so answered the same way! Gave you lots of opportunity to squawk didn’t I ! Just so you have something else off topic to squawk
            about. I edited again! WOW!

          • My questions wasn’t loaded, actually. I wanted to know what you honestly thought was her agenda and what she stood to gain from it.

          • Truth or consequences

            SO you want me to think for Amy? If I were Amy….hmmmm? what would my agenda be?…..hmmm? Oh….It would be to make me look good and to have a blind following! yeah…that’s it!

            I don’t have an opinion on midwifery. I know you want to project that on me. Read my original post. I call on Amy to write a post that doesn’t drag a deceased women into her argument and claim she didn’t have to die because Amy say’s she didn’t . Her knowledge should stand on it’s own. She felt it was necessary to troll for a tragedy and then exploit it! AMY has no idea how that woman died! she fooled a good number of you into believing that 24 year old died that way. If you don’t care about facts, that is your right!

          • I see. My bad. By the aggressive nature of your comments and things you’ve written, it seemed that you believed that she had an agenda that you were fully aware of to make some sort of gain that you were aware of.

            I apologize.

          • Truth or consequences

            Hey… you’re the one that walked into that one! you asked me to tell you what her motives are? OK…I have no idea. ANYWAY…back to the post. Amy shouldn’t use a random post about a women that died and make misleading statements about how she died. THE END!

            You folks worship this woman and that is your problem! I don’t worship her…. My problem! yep…I am over it!

          • I don’t “worship” anyone. I agree with many things Dr.amy writes about home birth in our country. But I don’t agree with everything she writes. I am a fan of her blog and read every almost daily bc even when I don’t agree, I typically find it interesting.

          • Lizzie Dee

            T & C, what are your qualifications for TELLING people what they should and shouldn’t do? You are entitled to have an opinion on what people should/shouldn’t do, and the rest of us are entitled not to care much about your opinion.

          • Disgusted observer

            Sorry if I am infuriated by a doctor exploiting the tragic death of this woman! All I get from this thread, is people that defend this kind of misrepresentation and then they trash my writing skills?
            Infantile at best!
            (formerly Truth or Consequences, but now has to change my screen name in order to respond)
            BTW, Changing my screen name is another criticism as a response to one of my posts?
            As for your question… I am asking a question of Amy. Not teller her, or anyone for that matter, “what they should or shouldn’t do” It is all about the credibility and accuracy of her post and what she implies with her words.

          • “I edited again! WOW!” You are just pretty nasty, really. You wrote your comment. I responded. Then you edited your comment. So replied a second time, addressing your new edit. So I mentioned it, to (hopefully but clearly not effectively enough) explain why I replied twice.

            You are exhausting and rude and I need to go to bed.

          • Susan

            Doula Dani, you are one of the NICEST posters here and one of the most patient. If T or C has got you frustrated the rest of us don’t have a chance!

          • Bombshellrisa

            There are articles that talk about the difference in midwives (with a v when plural) in the United States. Dr Amy talks about certified nurse midwives and then the midwives who are homebirth, direct entry, lay midwives and certified professional midwives. She doesn’t speak against highly trained midwives. So no, she doesn’t have it in for every midwife, only the ones that haven’t attended formal training and whose practice is limited to out of hospital births (I had formal training, but I would not have been able to catch babies in any other setting but home) Have you been able to read any other posts or watch her video? Maybe try that and then come back and re-read the article in the context of understanding the HUGE difference in the two kinds of midwives and the way that they practice.

          • Guestll

            “She obviously couldn’t stay in the profession and raise kids at the same time?”
            So much for choice, huh? Again — how this movement ever got equated with feminism is beyond me.

          • Truth or consequences

            I agree completely! How did everyone get so far off topic. Bullying seems to be the mechanism at work here? Anyone want to touch the third rail?I linked Amy’s personal tragedies to unrelated facts? (like she did) By the way, All I asked amy to do was tell us how she linked the 24 year old’s death to her dissertation on Hemorrhaging? Her first line was “She didn’t have to die” Anyone…anyone?…

          • Eddie

            FYI: I have never heard anyone other than an NCB extremist refer to childbirth as an illness.

            Also, as an aside, I don’t believe scorched earth means what you think it

          • Bombshellrisa

            Come on now Eddie, you know you find the “scorched earth” approach *grotesk* too.

          • Eddie

            LOL, absolutely grotesk! Wait, I need some more hyperbole!!!! and SOME CAPS to let you know I’m SERIOUS!!!

          • Bombshellrisa

            Don’t get too serious, I have an agenda and you walked right into that one plus I wanna “drift into the weeds on topic”. ((that is the double shift sleep deprivation talking! I promise I won’t be so terrible in the morning))

          • Truth or consequences

            I loved high school! I take it you did too! You bring it to this discussion! I love to watch infantile bullying when they have nothing else to say! LOL…yes those were CAPS! 🙂

          • theNormalDistribution

            I’m not really sure what you expect anyone to say to that incoherent mess.

          • Eddie

            Bullying? You’re funny. Either you genuinely can’t distinguish humor (poking fun) from personal attacks, or you’re purposefully missing the distinction to give yourself another opportunity to try to get people to react. I’m long past caring which category you fall into, since at no point have you even attempted productive discussion. You’ve mostly postured and attacked. Armchair psychology coming, here’s your salt lick: You appear to be addicted to getting people to react, and to be predisposed to reading every response as if it has a strong emotional reaction behind it so you can prove how powerful you are in getting all of these people riled up. Hey, I said it was armchair psych. I never promised it was a reasonable diagnosis.

            With someone even attempting a productive discussion, I will go above and beyond to continue the same. You are so over the top, however, that yes, I poke fun. I know you gleefully take this as a sign that you have won the “argument.” I see it as a sign that you have argued so unproductively that I don’t see you as worth trying to engage in a rational argument. Change your style and I’ll change mine as well. I started out engaging you rationally, giving you benefit of the doubt. I gave up.

          • No answers from AMY

            Pedantic much!
            I asked Amy to assign facts to the tragic death of this 24 year old mother that she exploits in her post. How does it apply to her dissertation on hemmorage? Does she know anything about this case? The answer I get is: “TorC must be the midwife” (FALSE).

            Another good one was: Amy answered the question by telling me I don’t know what my point is? (NOT AN ANSWER)
            I could go on, but what would be the point.
            (formerly Truth or Consequences but am forced to change my screen name in order to respond)

          • Truth or consequences

            Thanks Eddie! I needed your expertise on how to parse my words?

          • Eddie

            (blink) Huh? Non-sequitur.

          • Guestll

            If you would bother to read here, you would indeed know that Amy writes about having lost a patient — a baby — there’s a whole post on a breech baby who wouldn’t turn. She has lost a patient — and she has shared a sad story.

          • Truth or consequences

            So what did she do wrong? Did that patient have to die? Can she say for sure that she could have stopped the hemorrhaging of that patient? (maybe you can see my point if I lay out the story the way she does) I have no idea of the circumstances of her losses. I can attach her tragedy in a loose and irresponsible way too. Hey I can use that misfortune and talk about facts surrounding hemorrhage! It’s all good ….right!

          • Truth or consequences

            I will leave that alone and let it sink in based on the conversation. After all, I don’t know the facts surrounding her tragedy.

          • suchende

            “She doesn’t care if she is patently incorrect on posts.”

            Dr. A is wrong with some frequency, as any topical commenter will be, and amends her posts when new information comes to her attention, which you would know if you actually read her blog regularly.

          • Amazed

            And she makes the amendment evident, like all honest bloggers do, instead of just correcting the information and then pretends the incorrect information was never given.

            But of course, Truth is a writer, not reader.

          • Truth or consequences

            Just not this one….Right?

          • suchende

            Where is the new information? Do you have any actual facts?

        • Captain obvious

          “Common things occur commonly”. 2-3 women die every day from maternal hemorrhage in the USA. I have yet to see an AFE in my 21 year career, thank god. But you are so tainted that you pose the everly so rare AFE. Maybe she was struck by lightning while giving birth? Maybe she had an aortic aneurysm that ruptured while pushing? Maybe a van full of kids going to a kegger party drove through her front part of her house running her over is what killed her? WTH

          • Truth or consequences

            Made my point beautifully

          • Dr Kitty

            Non sequitur

    • Frequent Guest

      Hmm, tried to go to the Evolutionary Parenting website (link from the FB page) and it’s been taken down. Verrryyyy interesting.

    • Susan

      They want to remove Navelgazing Midwife? Gosh, nothing more confronting to a cult than an apostate. Good for Navelgazing Midwife!

  • Bombshellrisa

    This is exactly why, for all their hand wringing about obstetrics being “male dominated” (really?) and their wailing about the “cascade of interventions”, these “midwives” are the REAL problem with womens’ healthcare. They don’t take complications seriously, they won’t admit that things can go terribly wrong and some affirmations or herbs will not cut it. They are the ones that insist that womens’ bodies are “designed” to be pregnant and give birth, that contractions aren’t painful rather should be viewed as rushes and pleasurable and that sitting in a lukewarm kitty pool in your living room is supposed be more comforting than real pain medicine. These same idiots who claim to be wise women and treat things with herbs contradict themselves. Remember the stuntbirth plan in another post? The women said that Angelica should be give to help deliver the placenta. Angelica is supposed to be a potent blood thinner, just what you don’t want right about then. Or the midwife who wanted to blow her cinnamon scented breath into someone’s face to stop a PPH? Yeah, cinnamon is ALSO a blood thinner (but really wouldn’t have an effect either way when it is administered that way!). An “expert in normal birth” will not use interventions because the ones they are able to use are ineffective. Smooth seas never made a skilled sailor and “experts in normal birth” are not experts at all.

    • Captain Obvious

      Experts in normal birth are observers, you really don’t need to do anything but watch. Many deliveries are normal, I love those. Homebirth midwives can be experts in normal birth, hell, my child could be an expert in normal birth. Let Homebirth midwives tout that they are experts in normal birth. I want an expert in safe birth. Someone trained with a 4 year college degree, 4 year medical school degree in normal and pathological anatomy and physiology, and a 4 year OB/GYN residency trained in any and all complications that may arise. I don’t want to start with an observer and have to be transferred to a hospital for someone who really knows how to handle my birth. My child can call 911, I want someone who will start and finish my pregnancy care with confidence and a good outcome. That is a great birth experience. My vacations are for fun, not my births.

      • Karen in SC

        “I want an expert in safe birth.”

        One of the best sentences I’ve read on this blog – it summarizes the entire issue!

      • ^^ This.
        Captain, I always love reading your comments. This was one of my faves.

        • Captain Obvious

          Thanks Dani, and what do the Homebirth midwives charge for observing them birth, er, I mean providing their expert in normal birth care…$3000-6000. Just wow. And the 911 phone call for help is free.

  • Tacy

    A co-worker of mine swears that with the birth of her first son, the pitocin administered by the doctor to get her labor going actually caused her PPH. In her words, the extra hard contractions caused by pitocin cause the PPH. Is this really a risk of using pitocin to induce labor, or is taht woo talk? She has started talking about how “The Business of Being Born” is a GREAT book.

    • Susan

      It’s not totally woo. It is a risk factor for PPH, but so are a lot of things pitocin is used for in the first place. A tired overdistended uterus is a risk factor.

      • In my simplistic and unscientific explanation to myself, I assume that there are several different causes of PPH – not to mention using the same term for a relatively small increase in blood loss and catastrophes. Daft remedies may well stop a not very serious occurrence, and all the resources of a hospital may occasionally fail. I sometimes wonder about things like shoulder dystocia as well – between a baby temporally stuck and those where nothing much works.

        Scientific and technological advances have made such a huge difference to mortality rates – but I am not entirely convinced that obstetrics doesn’t still have some way to go. It may not be possible to ever make it 100% effective, but the fact of remarkable success AND that birth is so often unpredictable and miraculous can add to the hazards when things go wrong. It isn’t just woo that leads to over-confident assumptions and failures of vigilance. Of course, as someone who had a “low risk” poor care disaster and “high risk” fantastic care, I am biased.

    • Captain Obvious

      Long labors fatigue the uterine muscle which makes it hard to contract up after birth. Ever do those marine gym class physical aptitude tests? Then try to lean on your arms after the push up tests? Same thing. If you have a long labor spontaneous or induced with pitocin you have a risk for atony and hemorrhage. If you have a short or normal length labor (not precipitous) spontaneous or induced with pitocin, you have less of a risk for atony or hemorrhage. I speculate this woman had a long labor that fatigued her uterus out or may have even have devolved fever and chorioamnionitis (which an infected uterus contracts worse than an uninfected uterus) which led to her bleed, not necessarily the pitocin.

  • amazonmom

    WOW. I had no idea just how bad the woo really was. My area has the unfortunate problem of Bastyr being in its backyard. LOTS of people believing this woo about PPH. I was even starting to believe the woo until I started digging into the data. These woo pitchers are dangerous killers, not “believers in women”.

    • Bomb

      The only Bastyr is good for is vandalizing their sign when you are in jr high school.

      • Bombshellrisa

        If you walk around the campus crying, you can get your aura read for free : )

  • Charlotte

    I’m not actually sure whether I hemorrhaged with my first. It was an emergency c-section, and all I remember is waking up 2 hours later. But afterwards, “blood transfusion” was on all my charts and I suddenly had antibodies against certain blood types that couldn’t have come from pregnancy since my husband doesn’t have the antigen, but my doctors and the hospital say they don’t have a record of me having a transfusion.

    • Anj Fabian

      My questions are:
      when did this happen? (year)
      Where did this happen? (country)

      • Charlotte

        It was 2011 in the US (NC). The nurses at my OB/GYN go over my medical history at certain visits, and suddenly they started mentioning a blood transfusion……and I’m thinking, wait, what? When did this happen? I called the hospital where I gave birth and they said I didn’t have one during my birth. Then I got told that pre-op blood work before my second c-section turned up with antibodies that could have only come from a blood transfusion with an incompatible blood product, since my husband doesn’t have the antigen so getting it from pregnancy via contact with my baby’s blood was not possible. I even asked my mom if I had had a blood transfusion at some point in my childhood that I was unaware of and she said no. The only scenario that makes sense is that I had one during my first c-section, but somehow my records for lost or it was written down in some places but not others. It wouldn’t be the first time. The doc who did my surgery didn’t write down hardly anything he should have, which made my visit to the maternal-fetal medicine doctor before my next pregnancy difficult because I couldn’t answer anybody his questions about delivery despite having all my surgery notes.

  • Bomb

    OT

    Can anyone help me out with info on SUA, induction, and stillbirth?

    We have SUA. I’m getting the impression from my OB that 39 weeks is when he’d deliver me, no later. (Previous babies came at 37 and 38 wks on their own).

    I am worried about stillbirth associated with the SUA. I go in for U/S and monitoring on Monday, but I’m getting the impression that unless baby is <10% for size or doing very poorly on monitor that nothing will happen until 39 weeks.

    I dont know why but it isnt sitting well with me for some reason. Is there any indication or compelling info on induction at 36 or 37 weeks for SUA babies? I am feeling like I'd rather have aggressive management, potential NICU stay/jaundice than run the risk of stillbirth.

    I'm worried that earlier delivery could be warranted simply because of the SUA, but the doctor isn't going to do it unless things are dire because of the 39 week rule. I guess I want reassurance that this is standard management for an SUA baby, and not 39 week rule bullshit that I need to argue with my OB about.

    Input appreciated!

    • Captain Obvious

      IIRC, 1% of pregnancies have SUA, with ranges of 0.5-6% depending upon population in question. 65% of these babies with SUA are normal. The other 35% are at risk for growth restriction, structural abnormalities or rarely aneuploidy. Isolated SUA (no other abnormalities seen by sono and no growth restriction) does not need to be induced. Non-isolated SUA may need induction depending on working diagnosis.

      • Bomb

        Thank you!

    • Elizabeth Abraham

      I am not a doctor, and I had to look up SUA to get single umbilical artery. Googling is not turning up a hell of a lot for me. (BTW, I would like to issue a particular warning about wikipedia and info on pregnancy complications. I don’t think their user base is as geeky and obsessive about getting things right in this area as they are on some other topics.)

      So: My concern about induction at 39 weeks, for you, is that you seem very likely to go into labor earlier then that on your own. Which might be fine, but that puts you at risk of delivering an infant who is comparatively high risk for congenital medical problems, when the specialists you might dearly want to have on hand are off shift.

      How fast were your prior labors? How far do you live from the hospital? Is precipitous labor a concern? How is the L&D unit staffed? Is there an anesthesiologist and a neonatalogy team on the unit at all times? (It is, IMO, acceptable to have to page neonatology in from the NICU. It is not acceptable for L&D to share an anesthesiologist with the ED, or for the ana to have to be paged in from home.) Does labor present any additional risks for a baby with SUA? How fast can they do a crash section? Are there any soft markers for congenital anomalies? Have you had an amniocentesis, and would it be appropriate? Is the doctor seeing any potential signs of early labor? How pregnant are you now, and how often is he planning to see you? Have you had a consult with maternal-fetal medicine or high risk OB?

      You say: “I am feeling like I’d rather have aggressive management, potential NICU stay/jaundice than run the risk of stillbirth.” I think you need to say that to your doctor.

      Fundamentally, I think you are very unlikely to convince anyone to do an induction prior to 37 weeks, unless there are signs of fetal distress or placental insufficiency. You might swing 38. You might not be pregnant that long. You might get them convinced that the correct route is hospital bed rest on the ante-natal unit, which is sort of horrible (especially with two kids at home). (I hated the ante-natal unit even though they were sweet as could be and brought me cake every day. I fantasized about breaking out. Two weeks after hospital discharge, I hemorrhaged at home. It would have been better to be at the hospital when that happened.)

      • Bomb

        Googling for me turned up lots of people getting inductions early without other indications, and lots of people going to 39 weeks just fine, and lots of talk about stillbirth.

        I am definitely going to tell my doctor my concerns, but if a bunch of people were like “holy shit baby needs to be born by 37 weeks!” I’d be a lot more aggressive.

    • Charlotte

      Sounds like most babies are okay waiting until 39 weeks, but truth be told, I would personally be a nervous wreck waiting that long.

  • Rachel

    I guess I handled a recent delivery all wrong… instead of manually extracting a retained placenta, administering Pitocin, methergine, and cytotec along w/ bimanual massage for the subsequent postpartum hemorrhage, and repairing the small but bleeding cervical abrasion I should have just focused on supporting love between mom and baby and “called mom back”. What was I thinking? By the way, mom was a multip with spontaneous labor, who pushed twice, intact perineum. The only intervention prior to delivery was the epidural she requested.

  • Liz

    One of the many terrifying aspects of these kinds of articles, is that women like Jan Tritten seem completely legitimate to lay people, consumers and the media. She is even a CNM (if I remember correctly)! The PR campaign behind MANA, the CPM credential, MEAC schools, etc. is astounding at how well it has done in making it seem safe and (again) legitimate. I think about how aspiring midwifery students and mothers alike hear things such as “Bastyr University” or “National College of Midwifery” and assume that they must be rigorous programs (as they tout themselves to be). Then once you are in the program or hire a midwife and see/hear their “CV” (I use this term loosely here), it’s easy to believe they are highly trained and experienced.

    This post should be absolutely shocking to me, but unfortunately l know for many of us it’s just another day over at Midwifery Today. Amy you put it oh-so-well when you called it a festival of stupid.

    • Squillo

      Jan Tritten’s not even a CPM. Check out her C.V.

      She is, however, a CM–Certified Moron.

  • Jocelyn

    Has anyone seen this? http://abcnews.go.com/blogs/health/2013/05/30/conn-woman-delivers-home-alone-birth/ Does it sound to anyone else like she did this on purpose, and is just pretending she didn’t mean to give birth at home?

    • guestK

      Wow.
      “Luckily for Bovino, a natural birth advocate, she had done her research during her pregnancy on delivering without the aid of medicine or, now, in her extreme case, without the aid of anyone else.”

      So all that ‘research’ and her strategy is?

      “I said, ‘Come on baby, come on baby,’”

      • Jocelyn

        And “What Bovino does know for sure is that she wants to use her accidental home birth as a message for other moms.

        ‘I want to be an inspiration to other women to empower them to trust themselves and their instincts,’ she said. ‘Hospitals are there, and they’re wonderful in emergencies, but a lot of times women don’t trust themselves and their bodies that they’re able to do it.’

        ‘I trusted my body and the process,” Bovino said. “I tried to stay as focused and looking inward as I could and not let any fear come over me.’”

        • Anj Fabian

          Money quote:
          “I want to be an inspiration to other women to empower them to trust themselves and their instincts,” she said.

          Put herself on a pedestal much?

    • LukesCook

      Well. She had ctx for 5 hours. Then her waters broke. The story doesn’t reveal how long after that the baby was born, but I assume it would be unusual if it were immediately. She found the time to phone her husband. But at no stage until it was all over did she bother to phone hospital, midwife or ambulance? As she says, she “trusted her body” and decided to go it alone.

  • Why don’t they try to think positively about bona fide healthcare providers and their abilities to handle these situations – that kind of positive thinking might actually be useful!

  • anne

    I have trouble thinking positive thoughts when I’m bleeding out. Just sayin’.

    That poor family. I can’t imagine the horror of knowing your loved one died that way.

  • Meredith Watson

    Positive thinking is nice–I don’t have anything against it, however saying it’s your “thoughts” that cause these complications is just a thinly veiled way of saying, “It’s your own fault.” It’s as insulting as it is idiotic. Perhaps my baby had a GBS infection because she wasn’t thinking about unicorns and rainbows during her trip down the birth canal?

  • Lisa Miller

    **Breaks into a round of “Don’t dream it….beeeeee it”

    • Lisa Miller

      On a side note I had a bit of bleeding after my first and with my second the placenta didn’t so much as budge for 45 minutes. It was Pitocin that stopped them both, not will power. the nurse forgetting to turn the pit off for 6 hours after the birth was shitty though. Terrible really.

  • moto_librarian

    All of you regular readers know my story. Every time I read about what passes for “knowledge” about PPH among these clowns, I feel my blood pressure go up. They don’t want anybody to devalue their birth experiences, but the second that you start talking about how disempowered and frighted you felt after experiencing dangerous complications, you’re told that it’s your fault and that you shouldn’t “fearmonger” other moms. They are dangerous idiots.

  • Laura

    All right: all you stats pros, like Dr. Amy, let’s look at the number and please comment:
    1) what is the risk in a low-risk term pregnancy of severe pph?
    2) If this midwife delivered 2400 babies, based on figures in question 1, is it possible she has never actually experienced a severe pph?
    3) If she did have a mother experience a severe pph, would she even know it soon enough to effectively stop it?
    4) I would not want any woman to be the 2401st delivery who suffered a severe pph at the hands of this midwife and didn’t make it.

    • mollyb

      She said she’s never personally used pitocin, not that she’s never transferred a woman to the hospital for treatment. I’m guessing that’s what’s happened more than a few times.

      • Squillo

        Ignore it, and it goes away. And if it doesn’t go away, make sure it’s someone else’s problem.

    • Captain Obvious

      Hemorrhage maternal mortality rates 1987-1996
      National 7.7/100,000
      Wash DC 22.8/100,000
      New York 12/100,000

      USA Maternal Mortality 2003: 2-3 women die every day in the USA due to pregnancy related complications. Obstetrical hemorrhage is one of the Mose preventive cause of maternal mortality.
      19.6% Embolism
      17.2% Hemorrhage
      15.7% HTN
      12.6% Infection
      19.7% Other

      Reasons for missing PPH:
      No/inadequate identification of risk factors
      Delayed diagnosis/wrong diagnosis
      Underestimation of blood loss
      Delayed/inadequate/wrong treatment
      Inadequate/inappropriate referral or transfer
      Inadequate documentation
      Chain of communication issues

      • Amy Tuteur, MD

        Oh, she’s undoubtedly had many women hemorrhage, but she couldn’t treat them because she didn’t carry pitocin. I’m sure she has never performed a C-section, either, even when it was necessary.

      • Laura

        Thank you Captain Obvious!

      • Lisa from NY

        HTN stands for Hypertension (sometimes caused by preeclampsia)

        • Eddie

          How does hypertension directly cause death? Or does “hypertension” as a cause of death mean that death occurred from an event caused directly by the high blood pressure, such as a stroke?

          I know that the rate of maternal death varies quite a bit by race in the United States. I also know the hypertension rate varies quite a bit with race, in the same way: http://www.cdc.gov/bloodpressure/facts.htm Do all of the causes of maternal pregnancy-related death vary in the same way, by race, or are there a few that are responsible for all of that variation?

          I’ve read multiple times and places that it is not understood why African American women have such a worse rate of death at childbirth, but isn’t that partially explained by the hypertension rate difference?

    • Captain Obvious

      Around the world 160 million women become pregnant every year. Of these, 15% develop serious complications which lead to the deaths of about 600,000 women due to complications related to pregnancy.

  • Eddie

    The stupid, it burns, it burns! Wow, that is appallingly, recklessly, negligently stupid. Any mother who dies as a result of this negligence should result in a charge of homicide.

    I won’t even quote from the midwifery today article. There is just too much stupid there to pull out a couple of the worst ones.

    I didn’t realize that so many midwifes were Christian Scientists, believing that God will either cure you or not, but that you should not interfere medically. (That is sarcasm. I don’t really believe they are Christian Scientists. They just have an overlapping set of beliefs.)

    Oh, and I find the term “motherbaby” just as irritating as the constant use of “mama” by those folks.

    • Jocelyn

      I dislike “motherbaby” even more than “mama.” It’s like some weird alien.

      • Dr Kitty

        …it makes me think that the motherbaby will be the kind of people who go to Motherboy conventions.

        • Squillo

          Or grow up to be a motherf#cker.

      • BeatlesFan

        I get a kick out of “motherbaby” because it sounds like something my son would say. When he was younger, he always combined the names of family members- my parents were NanaPapa, my nephews were TylerCaleb, etc. For the record, anyone who reminds me of my three-year-old is not going to be in charge of my healthcare.

        • auntbea

          My daughter is 14 months and can’t be bothered to remember who is who and so calls both my husband and me “MamaDada”

          • Eddie

            My youngest went through a phase where she used the word “mommydaddy” to mean “parent.” She knew “Mommy” and “Daddy” but also used “Mommydaddy” when from context it seemed she didn’t care which one of us answered. I thought it was pretty clever.

          • theNormalDistribution

            That is adorable.

    • Bombshellrisa

      That along with the whole magical thinking, which is sometimes substituted for “God” or “Lord” or “Jesus” when they are talking about who will step in.
      I prefer my term “motherbabyplacenta”.

      • Amazed

        Motherbabyplacentacord. Or motherbabyplacentacordmidwife. After all, what is most important is the beauty of the process. In the fifth part of the term’s eye, of course * snarl*.

    • Amy Tuteur, MD

      I thought we had established long ago that mother and baby are separate and that their interests can also be separate. It is inherently sexist to refuse to acknowledge that mother’s autonomy.

      • Eddie

        Did you respond to the wrong comment perhaps?

        Just in case you meant to reply to my post, I wasn’t talking about a homicide charge for the family. I was talking about a homicide charge for the negligent care givers. I believe we’re on the same page.

  • Lisa from NY

    I am willing to bet that the midwife waited 2 hours before calling paramedics.

  • desiree

    A few hours after DD2 was born (by c-section), a nurse checked my bleeding and didn’t like what she saw. She told me I wasn’t haemorrhaging, but bleeding more heavily than she’d like. She also told me that her shift was ending soon and to make sure the nurse following her knew and checked me often. Of course she put it in my chart, but I loved the way she kept me up to date and asked me as another backup to make sure the bleeding didn’t get overlooked. That, to me, was far more empowering than if she’d told me, in one way or another, that I was responsible for the bleeding and could stop it.

    Also, it makes me worry very much about the mothers who are left in this condition by midwives. If my bleeding could pick up, I’m sure it’s happened to other women too. Scary.

  • Jocelyn

    “If the body is well fed and mom is low on stress and feels loved, motherbaby and their process of labor and birth work well. Our first and most important job is to facilitate what is already a beautiful process. God designed this process to work, but birth workers can come along and do interventions that may cause hemorrhage…”

    Here they are, again, putting the blame for any kind of problem on the mother. According to their logic, if the “birth worker” doesn’t do any kind of intervention, then the only other explanation for hemorrhaging is if the mother is stressed out or doesn’t feel loved. Oh, you had a massive PPH? Sorry, I guess you weren’t trusting your body enough!

    • Something From Nothing

      They are super religious nuts! I don’t mean religion in the sense of a church. I mean dogmatic belief without evidence, and a strict adherence to fixed beliefs. Religion poisons minds.

  • twinmom

    This really pisses me off. I lost over 2000ml due to uterine atony. It was interventions (uterine artery ligation + blood transfusion) that saved my life. These people, their lies, their propaganda, and their delusions of grandeur have devastated and destroyed lives. I don’t know how they sleep at night.

    • Lisa from NY

      My friend gave birth at home with a hospital only ten minutes away. She went into shock before she reached the hospital and needed 4 units of blood as well as being intubated with oxygen. She is lucky to be alive.

  • attitude devant

    “motherbaby” —- gag me.

    “God designed this process to work” —- I understand why Ina May’s brand of woo embraces intelligent design–she is the wife of a fundamentalist preacher after all. But why do hippies like Jan Tritten unthinkingly spout this faux-religious bullshit? Oh, that’s right. They DON’T think.

    • Something From Nothing

      It’s a different kind of religion. It’s obvious. Oh, and people are monkeys.

      • The Bofa on the Sofa

        This made me think of the Ina May comment the other day about women “not being machines.” Given that is buried, I will just bring it up here instead. I thought of it the other day when my son was watching this

        http://www.youtube.com/watch?v=jh2-g3ftCaE

        Take THAT, Ina May! I’ll believe Schoolhouse Rock over Ina May any day.

        Three is absolutely a magic number, and a noun is a person, place or thing.

    • OBPI Mama

      Well, I met Ina May and her husband when I attended The Farm’s Midwife Assistant Workshop back in my “trust in your body and you’ll be fine” days. He is a NUT! Definitely not a Christian pastor. Very spacey, lots of time in between his sentences (drugs perhaps, he admitted it back in the day), very very very New Age-y. Ina May talked a lot about how women can’t push out their babies right when too many people are around them and too much is going on (a “pooping in front of people/syphinctor” analogy was used quite a few times).

  • AmyM

    These people make me angry. A good friend of mine just had a baby 10 days ago. (in the hospital, everyone was healthy, no woo) She had a textbook pregnancy, labor and delivery. She hemorrhaged anyway—luckily, a mild to moderate one, immediately after the birth which they got under control very quickly. With pitocin, uterine massage and manual removal of clots. She didn’t need a transfusion, she didn’t have significant tearing and she went home the usual 2 days after the birth…healthy, with a healthy baby.

    I don’t get why they need to assign blame..it is clear to all OBs, LnD personnel, and women and hospital personnel in developing countries that hemorrhages happen. They can happen to anyone, and there is no blame…just the hope that the woman is in the right place at the right time, so she can be saved.

    I’ve told my PPH story several times here….like others, I lost a whole lot of blood in very short amount of time. I was in the hospital, and even there, narrowly avoided transfusion. I know there are women here who got transfusions. 8 minutes is definitely long enough to bleed out….if I had been home when the PPH happened, I wouldn’t be here to be outraged by this.

    • Captain Obvious

      A 130# (60kg) pregnant woman has a blood volume of 6000ml at 30 weeks. A 1000 ml blood loss results in vasoconstriction of venous and arterial vessels to maintain essential perfusion. Increased systemic vascular resistance to maintain BP until blood loss exceeds 30%. After a 30% blood loss, then the BP and cardiac output fall in parallel. Because of the increase in circulatory volume and increased SVR, changes in Vital signs are delayed. Pulse is the first VS to change, then respirations, pallor mental status, urinary output, delay in capillary refill, then BP. So OBs feel safe waiting for them to recognize a hemorrhage before considering preventing one, said no OB ever.

    • Jocelyn

      I agree. My first thought when I read “the midwife may focus on supporting love between the mother and her baby; she may call the woman back to her body…” was just anger. These idiots know nothing, and they’re killing people.

    • The Bofa on the Sofa

      I don’t get why they need to assign blame..it is clear to all OBs, LnD personnel, and women and hospital personnel in developing countries that hemorrhages happen.

      As Dr Amy noted the other day, it is only the NCB loons that treat these problems as some sort of personal failure. As for why, it’s standard marketing. You first have to convince the customer that they have a problem that only you can solve.

      • Justaninformeddoc

        Man, it’s a good thing that “Dr” Amy decided to stay at home and raise her children because she obviously lacks what it takes to care for women and their babies: compassion, intuitiveness, judgement. God help this poor family who made the informed decision, as all adults in the US are allowed, to birth at home. You know nothing about what happened at this birth , yet are so willing to pass judgement, lacking all information needed even begin to do so. This is not a homebirth vs. hospital birth issue. A young woman did what she felt was best for her and her child, and paid the ultimate price. Shame on all of you who don’t know the facts. Get a life, people, and let this family grieve as the true facts of this birth unfold. Sign me, a doctor who knows better than to pre-judge circumstances while the jury is out (but not entirely unknown to me). This is the most hateful birth website anyone can reference, and I’ve perused many. Prayers to those who clearly have some thinking to do. God help you all.

        • Jocelyn

          Hateful? No. Critical of those who are putting others lives in danger with their ignorance? Yes.

          You think we don’t care about the women and children who are dying? Then you clearly don’t understand this site, or any of us who feel so passionately about this topic. We care FAR more about the real, long-term outcomes for these families than the people on the natural childbirth sites who are the very ones who put them in danger. We’re not judging this family; we grieve for them. We’re judging the community of uneducated, inexperienced, and unskilled midwives and “natural birth advocates” that lied to them at put them at risk.

          The family who made the “informed decision”? How informed do you think they were? Do you think they were told by their midwives the true maternal and perinatal death rates of home birth? Do you think they were told the true risks of PPH? Do you think they really had ANY idea what kind of risk they were taking on? Or do you think the mother was told her body was “made for this,” that this was “natural,” and that she just needed to “trust birth”?

        • Bombshellrisa

          Compassion and intuition-just what I would value over logic and years of medical school.

        • Eddie

          Pray tell, how is this site hateful? Critical, yes. Judgemental, yes. Hateful? No.

          And this is *precisely* a home birth vs hospital birth issue. There are no guarantees… but the odds of dying from PPH at home are much higher than if you are in a hospital, yeah?

          There are many things people are allowed to do that aren’t great life choices. You’re allowed to smoke. That doesn’t make it a wise choice. Just because something is legal doesn’t meant it is above reproach, nor above criticism.

          The idea is this: publicizing these kinds of failures helps prevent midwifes from sweeping the evidence under the rug. Thus, future mothers-to-be will have more information about the actual risks of home birth. How many times do we hear, “I only live ten minutes from the hospital” as a justification for why home birth is safe? Ten minutes isn’t close enough.

          Think of this web site as a form of “tough love.” A lot of people call it hate. They misunderstand. Their ideological blinders prevent them from seeing the point. The point is keeping more mothers and more babies alive.

        • Victoria

          Wait. You are a doctor who then puts Dr Amy’s title in quotations?

          • Susan

            I noticed there was a psychiatrist reviewing The Business of Baby positively and a MD/midwife. But the quotation marks and the “you stayed home” sound like Feminist Breeder. Doesn’t matter, we all know there are a few true woo believer MDs. I can’t imagine anyone who ever worked for a medical degree acting like the degree wasn’t valid because the holder of the degree wasn’t practicing anymore.

          • Dr Kitty

            Oh Psychiatrists…they are a breed of their own.
            I know one whose business cards state “international man of mystery” and “collector of erotic art” along with “psychiatrist”…I wouldn’t trust his opinion on childbirth much either.

          • Jocelyn

            Yeah, not buying it.

          • BeatlesFan

            I’m guessing chiropractor! All the NCB and anti-vaxx sites seem to think they are doctors, right?

        • The Bofa on the Sofa

          I’m kind of wondering why you posted this in response to my comment, but never actually addressed my comment.

  • Squillo

    I’m wondering, if the uterus “wants to stop bleeding,” why does it “need a helping hand sometimes?”

    Does it say, “I only bleed when I feel like it. But I can stop anytime I want”? Will a twelve-step program help?

    • Lisa from NY

      But they believe it, just like being positive.

    • desiree

      My uterus likes to bleed, that’s its hobby. Or maybe I need to switch my BC pill…

    • Frequent Guest

      “Will a twelve-step program help?” — thanks for causing me to snort coffee through my nose…

      • Squillo

        Think happy thoughts and inhale some cinnamon. Should clear that right up.

  • Mel

    A cousin of mine first son was huge. His head was delivered, then his shoulders got stuck. They couldn’t budge him and needed to his head back into the uterus so they could CS him. This caused a cervical tear which combined with DIC almost killed my cousin.

    How did it turn out? She’s alive and well and so is her adorable son. You see, my cousin delivered at a hospital. When her normal delivery took a sudden, dangerous turn, she was already in a place that could administer the needed medications and transfuse blood products.

    How did my cousin respond to this delivery? When she got pregnant with her second son, she scheduled a planned CS at the same hospital. Her second son is quite a cutie-pie.

    • Anj Fabian

      That’s one of the nightmare scenarios.

      ofc the NUCB fanatics would point out that the Zavanelli maneuver precipitated the crisis, while ignoring the life threatening shoulder dystocia. (which could have been easily resolved with the gaskin maneuver, naturally)

      • Mel

        And I would reply that they did try the Gaskin maneuver after trying the really bent knees with supra-public pressure. Then they tried rotating the posterior and anterior shoulders. The little guy was really and thoroughly stuck. (Although I wasn’t there, I can’t imagine that the attending OB shouted “Sweet! I get to try and shove a baby’s head back into the uterus! Another Zavanelli day! I’ve had to help push parts of calves back into cows and it’s hard enough on a much more streamlined animal. )

        No matter how much she trusted birth, she needed a CS.

  • Captain Obvious

    How many times have you read that routine pitocin use post partum is unnecessary? That if a post partum starts, then the home birth midwife can then start to try and stop it. How stupid. Much of the practice is anticipation of a particular problem occurring. I just delivered a woman’s fifth child after 36 hours of fatiguing uterine contractions using pitocin. She had borderline AF levels distending her uterus, chronic hypertension, and superimposed per eclampsia. I put cytotec 800 mcg per rectum prior to delivering the placenta and rapidly infused pitocin after the placenta delivered and performed a bimanual massage keeping that uturus tone. Then I put 20 units of pitocin in the next liter of IVF to help prevent delayed atony. Why wait until your hemorrhaging to try and prevent a disaster? Do we do that with any other facet of life? We preventably use seat belts, antacids before eating Mexican foods, baby aspirin daily for CV health, birth control pills to prevent pregnancy, etc. Yeah, there is a good one. Don’t use contraception routinely. But if you do get pregnant you can find a clinic to prevent a child by performing an abortion. I know, bad example. But that is how stupid I feel having a “wait and see” attitude about third stage is.

    • attitude devant

      Drives me absolutely nuts. And then MY patients come in with these birth plans that say “no routine pit” (because they read that on some stupid woo website) and I have to spend 30 minutes explaining why that’s a foolish request and why the birthsages they admire so much are total idiots.

      • AmyM

        birth sages. got it. I read it as “birthsages” like “massages”, like “uterine massage” to control bleeding, which felt way more like pummeling than massage and I couldn’t understand why they would admire that and give it a woo-ey name. Then it all made sense, when I added the space. 🙂

      • Elizabeth Abraham

        I’ve had two babies, and we’ve stopped now, but it seemed to me I didn’t have babies without bleeding a lot. I officially hemorrhaged both times. Don’t take a black light to my house, you’ll think someone died there. (Every time Bones looks at a teeny puddle of blood and declares it “a fatal quantity”, I laugh.)

        We treated that with medicine! Awesome, excellent, modern medicine, that has been shown to work.

        Every now and then, some birth advocate will bring up Semmelweis, and use him as an example of the medical profession being wrong because they ignored important data. It does not seem to occur to them that midwives are behaving like the medical establishment in that story, ignoring data and embracing crap when there are solutions that have been proved to work.

    • The Bofa on the Sofa

      Someone needs to quote me here….

      The goal of intervention is to PREVENT problems, not solve them.

      • BeatlesFan

        I’m really starting to think we need to have t-shirts printed with that saying on them.

        • auntbea

          Maybe we can just make a list of common responses, and refer parachuters to it. Oh, that? Please see #6. Oh, and also #11.

    • melindasue22

      I’ve jumped on threads to mention ever so gently that active management of the third stage is much more effective than expectant management. I will throw in a study showing this and people will acknowledge it but will say that it doesn’t differentiate between an undisturbed labor and a labor full of interventions. Ugh.

      • Charlotte

        It drives me nuts when people claim something isn’t true, then I’ll show a study that proves it is, then they start saying it may be true but the difference isn’t big enough, etc. Some people are just determined to believe what they want to believe no matter how much evidence stares them in the face,

    • Lisa from NY

      What if patient had a previous cesarean? Can you still give pitocin in the third stage of labor?

      • Captain Obvious

        Yes, risk of pitocin for TOLAC is to a baby really. After the baby is out, pitocin is fine. You can induce using pitocin in a woman with a stillborn and previous CS under that same logic.

        • Lisa from NY

          Thanks.

  • KarenJJ

    Hearing of a mother dying in childbirth takes my breath away. I had a brief moment scared and wondering what was happening and if it was going to be life-threatening (in hospital, post c-section, my blood pressure dropped suddenly and I felt very faint and nauseous). It’s heartbreaking to think this woman would have had those moments and not come through it.

    That someone thinks a good response to that is to keep talking, or to suck on cinnamon candy and breathe on someone. Well, I start feeling violent.

    • attitude devant

      I had a PPH. I had PIH and a long labor. It was managed aggressively and I didn’t need a transfusion. It was over two decades ago, but I have never forgotten how helpless and incapacitated I was…and how completely I trusted the obstetrical colleagues who were caring for me. God help me if one of these ignorant fools had been in charge.

  • LukesCook

    Every woman planning a homebirth should sign a piece of paper acknowledging that if she starts to haemorrhage, her midwife will respond by “calling her back to her body”.

    • Mel

      I prefer blood tranfusions, thanks. Yay for hospitals!

  • Aunti Po Dean

    “Call the woman back to her body” I ask you?? ( head desk head desk)