If trusting birth won’t prevent miscarriage, why would it prevent other life-threatening complications?

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I often write about the fact that homebirth advocates, despite their claims of being “educated” about childbirth, are generally quite ignorant. They lack the basic knowledge of science, statistics and obstetrics that would allow them to evaluate what they read on the Web (or more importantly, to recognize that you cannot become educated by reading on the Web).

Ignorance is not the only deficiency. Homebirth advocates seem to suffer from a serious problem with magical thinking.

What is magical thinking? It’s the belief that your own thoughts have power to “magically” control events. It’s difficult to imagine anything more emblematic of magical thinking than the inane mantra, “trust birth.”

Does trusting hearts prevent heart attacks? Does trusting pancreases prevent type I diabetes? Does trusting breast prevent breast cancer? Obviously not, so how can any grown woman counsel another with a straight face to “trust birth” as a method of preventing life threatening pregnancy complications? And how can any grown woman actually believe that “trusting birth” is going to have any impact on anything?

The idea that women could actually believe that “trusting birth” will have any impact is especially remarkable considering that most women already recognize that trust has absolutely no impact on miscarriage, the most common life threatening (to the embryo) complication of pregnancy. Indeed, miscarriage demonstrates that the philosophy of “trusting birth” is completely farcical.

Your body is perfectly designed to give birth?

Really? Then why do 1 out of every 5 confirmed pregnancies end in miscarriage?

Miscarriages are commonly caused by devastating genetic defects, such as the absence of a chromosome or an extra chromosome. A some point in the reproductive process, during the formation of the the ovum (or the sperm) or during fertilization, a massive genetic error occurs and that error is incompatible with life. No amount of “trust” can prevent these genetic errors and no amount of “trust” can prevent the miscarriages that result.

Let’s think about what that really means: the same body that is supposedly perfectly designed to give birth will create embryos with the wrong number of chromosomes approximately 20% of the time.

How trusting would you be of an airline if 20% of their flights crashed on takeoff and burned killing all aboard? How trusting would you be of an automobile manufacturer if 20% of their cars blew up the first time you turned the key in the ignition? How trusting would you be of a soup maker if 20% of people who consumed it got botulism and died? I suspect that you wouldn’t be very trusting at all. So how on earth can any woman trust any aspect of pregnancy when it ends in the death of the embryo fully 20% of the time?

How does trusting birth prevent a placenta that can’t transfer oxygen fast enough to a baby during labor? How does trusting birth prevent a breech baby’s head from getting stuck, killing the baby? How does trusting birth prevent the mother from having a stroke because of pre-eclampsia, killing her? Obviously it can’t prevent any of those things because “trusting birth” is nothing more than immature wishful thinking.

Why on earth would you think that a process that can’t even manage to assemble the correct number of chromosomes more than 20% of the time is going to result in a baby who fits perfectly, has a perfect placenta, and develops no life-threatening complications?

Simply put, how could any grown woman, with a modicum of intelligence “trust birth”? And how could any grown woman, with a modicum of intelligence, trust any provider who counseled her to “trust birth”?

Please, enlighten me as to why “trusting birth” isn’t among the stupidest possible prescriptions for a healthy baby and a healthy mother.

  • misterworms

    Imagine if genetic defects incompatible with life *didn’t* end in a spontaneous abortion early in pregnancy. Now THAT would be a process to have doubts about.

  • OBPI Mama

    I was told by some NCB that my son was a severe shoulder dystocia because I didn’t trust birth enough! Then my second son was breech and I was told I made him breech by being nervous while pregnant and trying to figure out if we should have a c-section or have a trial of labor after my first’s birth.

    So be careful pregnant women: not trusting birth causes shoulder dystocia. And a baby’s breech position is caused by a woman being nervous.

  • Captain Obvious

    For the sake of arguement, the cascade of interventions exist. Then for multiparous women being induced with an unfavorable cervix, the cascade of interventions works (avioding a failed induction of labor, CS may occur for other reasons) 92% of the time. And for multiparous women with a favorable cervix, the cascade of interventions works 99% of the time. Even for FTM with a favorable cervix, the cascade of interventions works 97% of the time. And for the dreaded FTM with an unfavorable cervix the cascade of interventions works 55% of the time.
    Now for the same of arguement the total CS rate is about 33%, then the cascade of interventions works about 67% of the time. And if the primary CS rate is about 15-20%, then the cascade of interventions works about 80-85% of the time.
    These are not bad odds, for these horrible cascade of interventions, especially given that the transfer rate of well practicing midwives risking out appropriate patients approaches 45%.

    • Captain Obvious

      Trust cascade of interventions

      • suchende

        That was pretty much exactly my birthplan. Or, as we phrased it in L&D, “ALL the interventions.”

      • theadequatemother

        can we burn sage grass and chant this together?

        • KarenJJ

          A Dr Amy NCB party. I’ll bring the cinnamon candy.

  • ShipOFools

    And in the face of every shred of evidence, we still get fools gleefully posting this crap:

    http://birthwithoutfearblog.com/2013/03/18/breech-twin-birth-without-fear/

    And one of my daughters, was told by a teacher in her college level human sexuality class that she had probably had an unnecessary c-section because the doctor pushed pitocin on her for his convenience to speed things up. Never mind that she was past her due date and over a course of weeks had been in and out of the hospital several times with intermittent labor…

    I thought college was supposed to further train us as critical thinkers, not feed us woo.

    • I have to admire the whole Photo Montage meme. It’s cherry picking at its finest. Anyone who has been through labor knows it’s not pretty or pleasant most of the time. If you leave all of that on the cutting room floor, you can pretend that a dozen or so images represent the sum total of the experience.

      Add in the monochrome photography to minimize things like pallor and blood and you have a wonderfully airbrushed fantasy.

      • Captain Obvious

        The “Now I lay me done to sleep” program enlists professional photographers to take momento photographs pro bono of full term stillbirths for families have such an event. They primarily use black and white photography for that exact reason.

      • Sue

        Where is the shot of the poop scooper?

    • auntbea

      Not to mention wildly unprofessional.

  • R T

    Actually, many/most of the same people who are devoted NCBers do believe if you get cancer you didn’t try hard enough to be good. At the very least you had too many negative thoughts which manifested in your body as illness. My aunt is super new agey to the point she actually said people’s cancer was a manifestation of their thoughts. Imagine her shock when she got aggressive colon cancer. She couldn’t believe it! After all those spiritual retreats and organic food and positive thoughts and she got cancer. I see you often post these “you wouldn’t do blank so why do you do blank” posts and half the time I think maybe you do not know who you’re dealing with to some degree. The magical thinking is much more all encompassing than birth philosophies for many.

    • Yes – the illusion of control encompasses everything else in life too, and when the thinking is that you have control and the good things that happen are because you manifested it, the converse of that is that if something bad happens to someone, it is also under their control, therefore their fault. Shame on them for buying into the toxins of big pharma or big agriculture or negative thinking or not having crystals and candles about. Because of my enlightenment I can control these things and it won’t happen to me.

      That’s why they become SUPER judgey and sanctimonious. The logical conclusions sort of demand it.

      There is always a reason someone’s birth didn’t go as planned. It was the interventions or pent-up arguments with a spouse (one of Ina May’s favorites) or even a bad midwife (meaning one who transfers too soon, usually)

      Until it happens to them and they were doing everything “right”

      • The Bofa on the Sofa

        And then there’s me, who’s motto, if I had to have one, is “Sometimes, shit happens for no reason at all.”

        I’m guessing that is an important fundamental distinction between me and them.

    • Sue

      Agree, RT. Over the weekend, I was at a conference that included a session on end-of-life care, as well as discussion about the place of preventative medicine. My conclusion is that death has come to be seen in some quarters as a personal moral failure – whether you die from cancer or advanced age, you clearly weren’t positive enough, didn’t fight hard enough, didn’t eat the right things, didn’t exercise enough.

      Prevention is good, but, at the end, we die.

  • I have a theory from personal experience… Its the illusion of control. We often puzzle at how well-educated women get taken in by NCB when they are rational about everything else. It’s because (in my case) we rational types like control. And there is nothing so wildly out of control as childbirth. I didn’t want to accept that. I accept responsibility with so much else in life, it sort of makes me a control freak. The idea of handing my life over to scary masked people at the scary sterile uncaring hospital really panicked me psychologically. Then there are these people saying I don’t have to do that. I can remain in control, in my own environment, and its ACTUALLY SAFER this way. All I have to do is “educate myself” (I can do that! I can read lots of books and websites) and “trust birth” Oh. Is that all there is? What a relief that birth doesn’t have to be what I always thought it was. All that can be avoided in a warm pool of water at home and “horse-lips” as taught by Ina May. And a few other things.

    Trusting birth is about regaining control over an intimidating life-or-death situation.

    But the thing is, as scary as doctors and hospitals are, as bewildering as a hospital can be, its the safest place to be, and for some women who are truly that scared of giving control over to scary strangers it is your first opportunity to demonstrate that as a mother you will walk through hell and back for the sake of your child.

    • Ob in OZ

      “scary masked people at the scary sterile uncaring hospital”
      I don’t think this happens anywhere but in old movies. Almost every Obstetrician loves what we are doing for a living, feels privileged to be involved in the birth of a new baby, and thus we are well known as the field with the nicest doctors who almost always have a smile on our faces. Even when I wear a mask, you can tell from my wrinkles that I’m smiling underneath.
      Otherwise what you wrote is completely understandable.

      • KarenJJ

        Sterile is a good thing, really. I do like me some hospital sterility when I am in hospital.

        That said, I was terrified of hospitals and didn’t trust doctors (long history there – finally concluded with a rare disease diagnosis in my mid 30s). I’d had very little experience with them and didn’t understand how the system worked or trust that the ‘system’ would meet my needs and my child’s needs. I was used to being able to order what I needed or wanted, so the hospital being more ‘prescriptive’ sounded like a loss of control and somewhat scary to me. Additionally I had methods of coping with a few oddities in my life that are counter to standard doctor advice but work for me (and interestingly these techniques were referred to by my doctors once diagnosed as ‘coping techniques’ – eg warming up when I had a fever).

        It was fine and I got over that. I’m now a big fan of hospitals, doctors and what they can achieve, but I do remember that anxiety very well. I understand it can feel overwhelming. I think it is a good reason to make emotional support and education a part of patient support (and it does seem to be these days). I don’t think it is a good reason to avoid hospitals and doctors altogether.

      • Well, I know that NOW.

    • Lisa from NY

      Brilliant post.

    • Dr Kitty

      Totally, I get that.
      I mean, for me NCB never appealed (I’m just not that into ANY of the things it offers as benefits).

      My sense of agency and control and comfort were very well catered to by my planned CS, which went perfectly to plan without any surprises, but I can get how the illusion of control that NCB offers can be appealing to some people.

      NCB is, however, an illusion of control.

    • Antigonos CNM

      The identification of a hospital with the myth that Hospitals are Where You Go to Die is still very potent. The very word “hospital” implies pathology, and that scares a lot of people.

      • Eddie

        Thus, the repeated statement we hear that, “Pregnancy is not a disease.” As if a disease is the only reason you visit a hospital.

        • BeatlesFan

          If there really are people who think hospitals are only for diseases, I’d love to see what they do when they break a bone or give themselves a really good slice with a steak knife.

          • Eddie

            I believe what these people think is that you only go to the hospital when something is clearly wrong, including getting cut. When they say, “Pregnancy is not a disease” they oversimplify their own beliefs in the interest of a “cute catchphrase.” Thus, by their thinking, at the beginning of most births, all looks A-OK, so therefore you shouldn’t go to the hospital.

            If problems in delivery appeared slowly, were clearly identifiable, and became life-threatening with a lead time of hours, I’d be willing to agree with them. As we all know, that is just not the case.

          • BeatlesFan

            Oh, I would certainly agree that pregnancy is not a disease; however, the catchphrase rubs me the wrong way because it implies that the person saying it believes that disease is the only reason to go to the hospital. I guess I’m just being bitchy about it and splitting hairs because most of the people who say that sentence are people I want to smack upside the head.

          • Eddie

            ROFL, no argument from me. That catchphrase is totally stupid, and I have the same reaction.

          • Sue

            I like to say that pregnancy is a physiological condition, but one that you can die from.

        • araikwao

          Not a disease, but absolutely a “condition” to be excluded in a zillion situations in healthcare, at least. And makes you more susceptible to a bunch of diseases. But i guess that doesn’t fly in NCB land. I wonder how the magical midwives treat venous thromboembolism or pregnancy-induced hypertension or pre-eclampsia?? Are they variations of normal, too? (no really, i wonder, as i haven’t yet seen any NCB stories where these occur. Does the magical thinking protect against these too?)

      • Ashley Wilson

        I think this is where I have the biggest problem with the NCB group. My mother had a myriad of health problems so I spent much of my childhood at the hospital with her. For me the hospital was Where You Go To Get Better. In fact, every person I know to have died, has died outside of a hospital, either because they couldn’t get there in time or (in one case) because they checked their self out against doctor’s orders (plus the occasional elderly “they just died nothing to do” that has popped up). If I didn’t have a completely debilitating fear of needles, I probably would have gone into medicine because of the view. It just boggles my mind when people act as if the hospital = the cemetery.

    • theadequatemother

      I wonder if this could be redirected. My need for a feeling of control manifests in contingency plans. For example, I have a plan for premature labour including where to go, who to call and in what order. I have a plan for precipitous OOH birth that includes the building manager on speed dial who will be called right after 911 so he can let the paramedics in and open my front door if it is locked and I’m unconscious from PPH. It also includes having a list of the phone numbers of the other physicians in my condo building (there is a pediatrician, an emerg doc and a rheumatologist…although I don’t think the rheum will be very useful, no offense). I have even go so far as to imagine preoxygenating myself prior to an emergency GA c/s.

      When I was away at university at the age of 18, I had a contingency plan for the steps I would have to follow if I got a phone call telling me both my parents have died in a car accident.

      Maybe this is pathological? It comes in handy for anesthesia tho – I might be anesthetizing a healthy 30 year old for day surgery but you bet have have a plan A, B, C, D for the airway if I run into trouble and have a plan for all the other relatively common complications.

      • It’s a bit obsessive, but in a functional way.

      • auntbea

        My doctor has pointed out that for most people with anxiety disorders (like me), we don’t actually want the anxiety totally eliminated, or even brought down to the “typical” level. Because, up until it becomes paralyzing, it’s useful to motivate and prepare for the worst.

        There is a reason people with anxiety are over-represented in academia and the professions.

        • theadequatemother

          I wouldn’t classify myself as anxious. I don’t feel anxious. I feel quite relaxed…if A then do B. There…taken care of, dismissed, no rumination.

          • auntbea

            Right, sorry. I wasn’t diagnosing you. I was just pointing out that that sort of contingency planning is often beneficial.

          • theadequatemother

            No worries, it’s a good point you make. And if you want to play armchair psychologist that is way less damaging than armchair midwifery!

          • Isn’t there quite a big difference between the forms of control exercised by people who like to be organised, and the much more neurotic form of people who cannot distinguish between what can and maybe should be controlled and what can’t? The kind that relies on logical thinking, and the kind that requires magical thinking?

          • theadequatemother

            I guess my question is that with a little help and direction, could magical thinking neuroses be channeled into something more adaptive?

      • Captain Obvious

        Like playing chess, you have plan several moves ahead in order to be successful

      • Ceridwen

        I do the same (and also don’t feel I’m an anxious person). I had early bleeding issues with my pregnancy and was at increased risk for preterm labor. I had a plan for that. I was nervous about being pressured to breastfeed even if it wasn’t going well for me/my baby, so my husband and I came up with a plan for when it would be OK to stop before the baby was even born.

        Oddly enough what I didn’t have was a birth plan in the sense that NCBers talk about them.

      • If they’re sound plans for things that might actually happen, and you get peace of mind from having a plan in place, that sounds very healthy.

    • auntbea

      WTF are “horse-lips”?

      • I’m almost embarrassed to say. Its her theory that if your lips are loose your cervix will follow and to ensure your lips are loose, you blow “horse lips”. It really impressed my doula that I had dug that deep into the magical thinking. But needless to say it didn’t work. lol

        • auntbea

          Is the cervix supposed to flap too?

          • theadequatemother

            Yes, right after it takes a bite of a crunchy apple out of your hand and tickles you with it’s whiskers!

          • Sue

            Mine likes carrots

    • Sue

      Rachel – I can relate to what you say. The difference for me is that my education and training is in health care, so I wasn’t susceptible to fear of hospitals or interventions, and I had negotiating power.

      Outside our areas of expertise, though, we can feel very vulnerable when we are accustomed to being competent.

  • auntbea

    Is there some thinking that more than 20% of pregnancies end in miscarriage. Of the numerous friends of mine who were trying to get pregnant at the same time I was, about 75% had at least one miscarriage, and several had more than one? Were we just on the unlucky end of draw? Is is because we were all within a year or two of 30?

    • WhatPaleBlueDot

      There are estimates that place total miscarriages at 50-75%. But 20% is the standard number for CONFIRMED pregnancies.

      • Antigonos CNM

        It is hypothesized that a great many pregnancies end so early that a woman thinks she’s just got her period a few days late. At that stage, the embryo is still so small that it isn’t going to be any bigger than an average menstrual clot, if that. So the woman never even suspects she was pregnant.

        • LisaJH

          I wonder if there were more miscarriages we didn’t know about in the past when we didn’t have all the super-early pregnancy tests we have now?

  • fiftyfifty1

    I see now that I should have thought more positive thoughts about my jaw. Like a total sheeple, I had just assumed that I would need my wisdom teeth removed by the dentist like so many people do. If only I had known the truth and faithfully repeated the mantra “Your body will not grow teeth too big to fit on your jaw”!
    Instead I was uneducated and when my dentist told me I didn’t have room, I believed him. To think that I could have avoided having my teeth extracted (a.k.a. Major Jaw Surgery)! I should have trusted Jaw.

    • rh1985

      lol! my wisdom teeth were so bad that they had to be cut into multiple pieces to be removed.

      • LibrarianSarah

        Mine were removed surgically. MOUTH RAPE! MOUTH RAPE!

        • Eddie

          *snort*! Good thing I hadn’t just been drinking milk, or right now I’d be screaming “nose rape!”

          • ShipOFools

            Sadly, the same fools who are pushing natural childbirth are also in a state of hysteria about dentistry. If we just trusted nature we’d all have perfect teeth…

        • Amazed

          I am now in breathless waiting whether the she-wolf, I mean, she-dentist, will decide to mouth rape me if said wisdom teeth finally decide to show up. Still, I imagine that if they have to make an appearance, it’ll better happen now. My mother had the tough luck of having those coming out just when she had to recover from not trusting birth.

          I suppose not trusting jaw is why I have 26 teeth only.

  • The Computer Ate My Nym

    How can anyone look at big, beautiful, full term babies like the ones on “Hurt by Homebirth” and think that they’re “not meant to live”? They’re absolutely meant to live, it’s just that, like anyone else, they die when deprived of oxygen. Humans aren’t anaerobes, not even before birth and the placenta does not contain chlorophyll.

    • T.

      They don’t mean it in a scientific sense, they mean “God/Nature doesn’t want those babies to live”.
      Which is nothing sort of human sacrifice.

      • The whole project of reproduction, far from being “natural” in the benign sense is actually preposterous. The potential for things to go badly makes far more sense – and the miracle is that it doesn’t – and assumptions that all problems can be avoided seems odd to me. Having things go wrong in the early stages in a way that is incompatible with life is rather a long way from a baby not being meant to live when it very clearly was. One is a kind of built in difficulty with the process, the other is attributing “meaning” to something that doesn’t have any. That is what religion is for, I suppose.

        • T.

          I perfectly agree, Lizzie. No baby is “meant” to die. Some embrios simply aren’t compatible and can’t develop. There is no meaning whatsoever.
          Healthy, big, full term infacts could live. Granted, the process can still sadly go wrong even when people do their best (“babies die in hospitals too!” *eyerolls*) but it is not a matter of “meaning”. Sometime, it is just bad luck. If you don’t do all you could, then it is not bad luck, it is you being an idiot.

  • Bomb

    OT: Woman dies, gives birth, brought back. Just another variation of normal…that would end in tragedy if not for those evil doctors.

    http://www.fox5vegas.com/story/22399862/woman-dies-gives-birth-comes-back-to-life

    • Lisa from NY

      Absolute miracle, but evil doctors didn’t allow midwives to do their magic with Chinese herbs first.

  • Look at what is told to women during prenatal classes and the widespread fear that telling women the truth might “scare” them. Women need to be told what can happen and what their legitimate choices are – including the legitimate choice to have an elective cesarean and the risks and benefits to it compared to planned vaginal delivery.

  • Lisa Miller

    See, the issue is that they will just say this backs up their “Some babies aren’t meant to live” BS they use for full term fetuses. I mean, I get it, and you guys get it….but they don’t get it.

  • yentavegan

    The most assertive and seemingly friendly women I met while attending birth/baby care classes were all under the spell of the NCB propaganda. “trust birth” was an oft repeated mantra.
    May be it was a combination of guilt for living privileged middle class lives that drove us to desire to experience life in it’s rawer ,most cruel form. And believing in the unspoken racists idea that we are the pinnacle of human existence and therefore we are built to birth.
    Looking back I shudder to realise just how many things could have gone terribly wrong.

  • Squillo

    How trusting would you be of an airline if 20% of their flights crashed on takeoff and burned killing all aboard?

    More like, exploded during manufacturing. Yeah, I’d trust that company’s aircraft.

  • Courtney84

    I make incredibly low amounts of progesterone following ovulation. Conception and implantation are unable to stimulate the production of an amount of progesterone that can maintain a pregnancy. However, when I sought medical treatment after my early miscarriages and corrected the problem by taking progesterone – Viola! Healthy (so far) pregnancy!

    Sometimes our body doesn’t work the way we need it to. This is why the practice of medicine exists. I will never understand why it is some people think reproductive organs are somehow impervious to biological failure when every other part of the body is known be vulnerable to malfunction.

  • Eddie

    Sometimes I wonder if the very religious are more prone to magical thinking. I respect faith and those who have it… But most people I know of faith haven’t rejected scientific thought. I notice of the blog posts about home birth and by midwives, I see a higher number of references to God than I would expect based on the rest of the internet. There is definitely a set of people for whom their faith is so strong that it strangles all rational thought. Still, this explains only a part of “trust birth.”. The rest appears to be a mystiicism specific to pregnancy/birth that seems highly enriched in so-called feminists. I wonder if this is studied.

    If someone had told my wife, “some children weren’t meant to live” after her miscarriage, she would have been devestated. Fortunately, it was early enough that we had not told many people yet.

    • I think you have a point there. Religion/faith is basically the idea that you can believe things even with absolutely no evidence or contrary to the available evidence and still be right. Or as the inimitable Tim Minchin put it, “Science adjusts its views based on what’s observed. Faith is the denial of observation so that belief can be preserved.”

      If you already think this way about one thing (God), why wouldn’t you think this way about other things (NCB, anti-vax, etc)? Some people manage to contain those mental pathways to just religion, but it’s not surprising a lot of people let the sloppy thinking spread.

      • Something From Nothing

        Yes, this. Tim Minchin is bloody brilliant. His song ” if you open your mind too wide, your brain will fall out.” Or “take my wife” made me laugh until I cried…

        • KarenJJ

          I did that to his ‘Lullaby’ song. I first watched it on TV after a rough evening on my own with the kids. I laughed so hard until I cried.

        • Dr Kitty

          We saw him live in 2008. He’s great.

          Unfortunately, we sat in the front row of a very small venue, and I had a great view of his bare feet from less than 6 feet away- I do not like feet.

          TMI- but the week we saw him is probably the week we conceived our daughter.

        • Squillo

          My very favorite is “The Good Book.”

      • ShipOFools

        Ironically, in the history of western civilization at least, this tension has gone on for centuries within religion. On the one hand, it can be argued (and I think with fair success) that it is the religious, i.e., faith-based, idea that the world can be known because it is not just random but operates according to rules and principles that can be learned, that has given rise to this thing called science. On the other hand, whenever knowledge threatens the status quo of the vested interests, the institutions panic and the old “appeal to authority” reflex kicks in.

    • Momster

      I have also noticed this, and it makes me nervous. A little too close to that old biblical business about a woman bringing forth children in pain and misery in order to repent for Eve’s alleged sin. It makes a certain brand of sense, though: someone who isn’t rational in one area of their thinking seems less likely to be rational in other areas.

      On a personal note, a woman with this belief system told me I miscarried because god needed another angel. She’s lucky I was too gobsmacked to give her a proper slap, like I should have done.

      • Eddie

        I’ve heard that one before “God needed another angel” — although fortunately not first hand. I understand that people who say this generally mean well and are trying to be sweet and cute, but I find it just as offensive as you do.

    • Lisa from NY

      My neighbor who was the “think positive” type, had absolutely no idea of the risks associate with childbirth. When it was time to transfer her to a hospital, her husband brought their two-year-old son to us with nothing other than his clothes and his stroller. We had no idea she even gave birth and we had no advanced notice.

      • Karen in SC

        What a great neighbor you are! Of course in a bleeding out situation no one is going to consider any needs of the two-year old. He’s probably lucky he wasn’t left at home.

        I hope you can get more details when the new mom is feeling better. What happened with the birth of the son? (also incredible at age 48) Glad it worked out but jeez talk about asking for trouble and getting it. I predict a near-miss that turns into “I almost bleed to death but the midwife was awesome!” story.

        • Lisa from NY

          I just found out she also had a second-degree tear this time. Her older son was born via C in a hospital, which she avoided. She had been 41.5 weeks and was induced, then given C.

          She hated being in the hospital with a tube down her throat with oxygen and gloves on her hands.

          P.S.: My friend is not into blogging. She is much nicer to me now that she sees she had no control over the 2nd degree tear and the placenta not coming out.

        • Lisa from NY

          She actually is a very private person. I feel guilty for having posted her story, but I hope that someone will see that homebirth is dangerous for the mother, too.

    • Charlotte

      I don’t necessarily think so. In my own experience, the most militantly atheist among my friends are also the most woo-infested when it comes to health. The Pacific Northwest is also the least religious area of the US, but also the most woo-ish. I think everyone is susceptible to the idea that we can just bury our heads in the sand and everything will be alright. It isn’t an issue of having faith in God = having faith in everything. It’s an issue of human nature thinking that ignoring a problem means it’s not really happening.

      • Eddie

        Good points, and you’re of course right that it’s a human problem to want to put your head in the sand. I do think there are some groups that are enriched in this kind of thinking relative to the population at large, but there is clearly no one group that owns the woo. It’s spread out across the population in interesting ways.

    • Something From Nothing

      I like you, Eddie. Your posts are always interesting.

      • Eddie

        Thank you!

    • Pam

      I think that this is mainly true (for fundamentally religious people). Especially if it is something taught by religious leaders. But blindly saying that because I believe in God that nothing bad will (ever) happen to me is totally inconsistent with faith.

      I work in a risk related scientific field, and find that my atheist boss (male) is the one person who has repeatedly told me throughout my pregnancy that women’s bodies are designed to know how to give birth and I just need trust that my body will do what it needs to do (and I assume that he thinks this will automatically result in a safe and healthy baby…but I’m not sure). Then again he is also the one that keeps telling people that marriage is 100% likely to end in divorce and therefore no one should marry. Meanwhile, I have faith in God (which has been also been strengthened by science and study) and I am definitely going to give birth in the hospital. We have loved and cherished this baby for nearly 9 months already, why would I risk his (or my) life at all?

  • auntbea

    I don’t like that picture. I still have nightmares about bleeding, since that was the signal I was miscarrying…three times in a row. 🙁

    • Nadvorna

      I was just about to say that. The first sign of my first miscarriage was waking up in the middle of the night soaked in blood, nightwear, sheet, the lot. Being reminded of it is not pretty.

    • Charlotte

      My blood work was abnormal, so I knew I was very likely to miscarry several days before I did. But that first bush of blood was still devastating, because that was the point where I knew all hope was gone.

    • BeatlesFan

      Today actually marks exactly one year since I woke up and went into the bathroom to find myself bleeding from an early miscarriage. While the sight of blood a mere 10 days after testing positive will always stay in my memory, I will also never forget being in a path lab, having blood drawn to check my HCG levels while a song played on the radio- I don’t know the name of the song or the artist since Top 40 isn’t really my thing, but the chorus of the song was “You tear me open and I keep bleeding, keep keep bleeding…”

      Had I been there under other circumstances, I suppose I would have appreciated the irony of that song being played in a path lab. As it was, it felt like a kick in the teeth.

  • ol

    While I was reading about “trust birth” I remembered a wonderful citation:
    “If I am ignorant about a phenomenon, that is a fact about my state of
    mind, not a fact about the phenomenon; to worship a phenomenon because
    it seems so wonderfully mysterious, is to worship your own ignorance; a
    blank map does not correspond to a blank territory, it is just somewhere
    we haven’t visited yet”
    – Eliezer S. Yudkowsky, rationality expert and AI researcher

    • Amy Tuteur, MD

      That’s a fantastic quote!

    • Squillo

      He’s also the author of Harry Potter and the Methods of Rationality, which takes the Potter series and retrofits it using the principles of science. Which is the version my children will be reading 😉

      • auntbea

        You tell your kids they can come over to Aunt Bea’s for the real version anytime.

  • Suzanne

    I am not positive, as I have not had my morning coffee yet, but is this line correct?
    “Why on earth would you think that a process that can’t even manage to assemble the correct number of chromosomes more than 20% of the time is going to….etc”
    Based on information given earlier in the post, it appears that this should then read as 80 %, or am I completely off my rocker? 🙂

    • Elizabeth Abraham

      Have some coffee, read again. I get why it takes coffee.

      The incorrect number of chromosomes are assembled slightly more then 20% of the time.

      • FormerPhysicist

        I can read it both ways. The point is excellent. The sentence could use editing.

    • GiddyUpGo123

      No, I had the same thought. The words “more than” confuse the sentence and make it possible to interpret it both ways. To me it reads “the process can’t get it right more than 20 percent of the time,” even though I know it means “the process can’t get it right 20 percent or more of the time.” It would be clearer if it said, “Why on earth would you think that a process that, more than 20% of the time, can’t even manage to
      assemble the correct number of chromosomes.” But now I feel like I’m nit-picking, so I’ll stop talking.

  • Guestll

    20% is confirmed pregnancies. If you count the number of conceptions that go wrong, some studies have found (by determining the presence of a protein associated with mammalian embryos) that the rate of early loss is almost half.

    Half. Half of all human conceptions don’t make a baby.

    My body was not designed to give birth. Nor was it designed to carry a living child very well, since 75% of my pregnancies ended in miscarriage due to aneuploidy. My eggs got old, and despite the fact that I am resolutely healthy on the outside, the damage caused by simply living my life (eg., getting older) had already been done. The number of eggs good enough to do the job (a healthy baby) had deterioriated. That’s a totally natural biological process I like to call ageing. 😉

    • Knowing all this I am amazed that we even manage to get pregnant, carry pregnancies to term and give birth to healthy babies. I am indeed a lucky person- it happened to me three times- all these times, I got pregnant without even trying. I never had a misscarriage. My babies were born healthy. I wish everybody was that lucky.

      • Guestll

        Humans are comparatively bad at reproduction. The fact that people who don’t want to get pregnant can seemingly do so with ease, especially when you’re going through that special hell…well, it sure doesn’t seem that way.

      • In some respects, I consider I was lucky too. Took risks when young and foolish, never had to deal with an unwanted pregnancy. Got pregnant easily when I wanted to, no miscarriages. (Though I did suspect perhaps the odd very early one.) Then my luck ran out – though I was lucky to survive, a mixture of good and bad with the doctors – my daughter’s problems could be much worse. Lucky in no ill effects from epi or CS. And, in my opinion, very very fortunate that I was never subjected to the woo and didn’t end up blaming myself.

        I have a lot of sympathy for those who suffer the misery and disappointments of infertility – but it shouldn’t mean feeling you have something to prove. Who to? None of us are designed to be guaranteed an easy birth, and we are absolutely not defective if we don’t. How AWFUL to feel you are “broken” with such an unreliable process. Maybe those who have painless easy births have something wrong with them? Not that one would blame. And I would have thought that at least an attempt to think rationally was a plus when it comes to mothering.

    • Phascogale

      I think I may have had a miscarriage. We were trying and I was late with my period (I’m never late and certainly not 3/4 days late). I was about to do a pregnancy test but I started bleeding. So this would be one of those that’s not included in the 20% statistics. And 50% sounds quite probable.

      And even if I had’ve had a positive test, when I started bleeding it may have been counted as a false positive as it was an early bleed.

      Just out of interest I spiked a high temp round about the time I would’ve ovulated so there likely would’ve been something wrong with the fertilized egg, hence the miscarriage.

  • EmbraceYourInnerCrone

    Well, as some people told me after my miscarriages, “some babies just weren’t meant to live” ” God has a plan” etc (really “God” planned for me to get pregnant with a wanted baby only to end up almost dying miscarrying?!! yeah your bloodpressure is not supposed to be 60/30 who knew) and while I know intellectually that a lot of miscarriages are caused by serious abnormalities incompatible with life, its still a blindingly insensitive thing to say to someone.

    • Elizabeth Abraham

      I *hate* that “some babies aren’t meant to live” bullshit. If God planned my miscarriage, I want to know why God’s such an asshole.

      Mostly, I want to know why “I’m so sorry” isn’t the first, automatic thing that people say. It’s not hard! It doesn’t require imagination or poetry!

      • suchende

        My theory, not all women react to miscarriage the same way. Some don’t find the experience particularly traumatic and will themselves say “some babies aren’t meant to be born.” Which signals to other people that it’s okay to say that.

        • The Bofa on the Sofa

          Of course, in a sense it is correct to say that “some babies weren’t meant to be born” in that, as Dr Amy describes, a large fraction of miscarriages are severe chromosomal issues. Biologically, those are not meant to be born, that is for sure.

          However, the problem is that word “meant,” especially when you start viewing it from an anthropomorphic perspective. If you view “wasn’t meant to live” as meaning “was meant to not live” or, worse, “was meant to die” that’s when it gets ugly.

          Unfortunately, it’s hard to know how the other person will hear that comment. Some may hear “some babies weren’t meant to live” as “sometimes biology screws up, and in that case, the miscarriage is the body’s way of saying, no, this isn’t going to work we need to start over”, but then there are those that will hear “God wanted your baby dead for some reason”

          That’s why it’s obvious that the best way is to avoid that situation altogether. As Elizabeth says, “I’m so sorry” is the response.

          • Dr Kitty

            When I do my “Dr, I’m pregnant” consultation, after checking that they want to proceed with he pregnancy, and offering congratulations and all the other things you do, I make sure I say something about miscarriage.

            I tell them that if they experience pain or bleeding they need to call me. That miscarriages are common, that they usually can’t be prevented, but that not all bleeding inevitably ends in miscarriage and we will do our best to take care of her whatever happens.

            Because I know the next time I see 15-20% of them I will be offering tissues and sympathy.

        • Sgaile-beairt

          what about when its nuns saying it….??

          • Dr Kitty

            Nuns say a lot of stuff that I feel completely comfortable ignoring.

            I find “Respectfully, Sister, I have to disagree with you and end the conversation here” works most of the time.

            YMMV.

          • suchende

            I am not trying to justify it, but people were questioning why people say things like that, and I think my post above is one of the reasons why.

      • Box of Salt

        I’d prefer a simple “I’m sorry.”

        In this case, “sorry” needs no qualification.

      • Amy M

        yep. I felt the same way about infertility…”maybe God didn’t mean for you to have children” or “it is all in God’s plan.” Really? What kind of dickish God would decide to make me infertile? If there is some plan for my life, why is it a secret? That’s about when I went athiest, and my scientific self decided that who gets afflicted with various diseases and conditions is totally arbitrary.

        • Squillo

          The proper answer to anyone who says a miscarriage or other loss is “God’s plan” is to take out a .45, shoot them in the face, and ask what God’s plan for maxilofacial reconstruction is.

          • BeatlesFan

            Marry me, Squillo.

      • Something From Nothing

        “If god planned my miscarriage, I want to know why god is such an asshole”
        – because god isn’t real. And bad shit happens.

      • Lisa from NY

        I am so sorry for your loss. I hope you have a healthy baby soon.

    • LynnetteHafkenIBCLC

      I like your username 🙂

      • EmbraceYourInnerCrone

        Thanks, I hijacked it from a “Maxine” character Hallmark card, she’s the snarky little old lady. She’s who I want to be when I grow up.

    • GiddyUpGo123

      I love that whole “God has a plan” crap. It’s so insulting to tell someone who just lost a child or a pregnancy that “God has a plan.” Somehow, we’re supposed to think that God has all these benevolent reasons behind the effed up crap that he does to people. That’s like murdering someone and then saying to his family, “Oh don’t worry, I had really good reasons for doing it.”

    • AmyP

      “…while I know intellectually that a lot of miscarriages are caused by serious abnormalities incompatible with life, its still a blindingly insensitive thing to say to someone.”

      I had a close relative tell me, “There was probably something wrong,” after I had my miscarriage at 13 weeks. On the one hand, duh, you think–of course there was something wrong. On the other hand, I really held it against her, because it didn’t comfort me to think that I had a baby that was so defective that he or she died. I wanted that baby.

      My husband and I had lunch with our old pastor and I told him the story. Our pastor said, “What she wanted to say was, it’s not your fault.” I told him, “You know what’s an even better way to say, It’s not your fault?’ An even better way to say it is, ‘It’s not your fault.'”

      This is a hard one to get right, and different people are comforted by different things. It took me over a year (and a new, healthy baby) to fix my relationship with that relative. If I hadn’t been able to have a healthy baby after that, who knows how long it would have taken.