Raeanne’s stuntbirth plan

Fool Rubber Stamp

Ahh, stuntbirth, also known among aficionados as freebirth or unassisted childbirth (UC).

Stuntbirthers like to pretend to themselves and others that this is how birth happens in nature (no, across all times, places and culture, birth is assisted), that birth is so deeply personal and “sexual” that a couple must experience it alone (really, then why do stuntbirthers post videos of it on YouTube for all the world to see?) and that it is safe. The entire practice would be nothing more than a punch line were it not for the fact that it kills babies. Indeed, both the leading American and Australian advocates of UC, Laura Shanley and Janet Fraser, have ended up with dead babies as a result.

Unassisted childbirth has no benefit for the baby and poses very serious risks. It is a form of medical neglect based on appalling ignorance and extraordinary selfishness and self-absorption. Don’t believe me? Consider Raeanne’s stuntbirth plan, found (where else?) on Mothering. com. Unfortunately, I cannot share the whole inane document, and it will almost certainly be deleted by the folks at MDC when they find that it is being ridiculed, but I can share the high points, starting with the fact that Raeanne dodged a bullet with her first baby (my first was 19 days “late”) and cannot tell the difference between luck and wisdom.

Early labor:

  • Make sure everything is cleaned up and in order in the house (no clothes or toys laying around where Raeanne could trip or bleed on them)…
  • If laundry needs to be washed throw a load or two in.
  • Start dishwasher if needed.

Pretty clever getting her husband to clean the house using labor as an excuse.

Active labor:

  • Maybe recommend a shower too? Help her blow dry her hair if she wants…
  • Remember that sometimes a red/purple line will appear between a woman’s butt cheeks that can indicate how dilated she is. Check for that! If it is slightly below the tailbone she’s at 6 or 7 cm. if it’s at the top of butt crack she is probably around 10 cm! Take a picture so Raeanne can help you analyse…
  • For emergency childbirth procedures refer to Emergency Childbirth by Gregory White!

Yup! In an emergency, just refer to the book. That’ll work.

The baby:

  • Make sure baby is breathing!
  • The most important thing is skin to skin contact (with a blanket draped over mother and baby), hearing familiar voices, a relaxed atmosphere, leaving the cord attached …

It’s hard to imagine that anyone is so ignorant that they actual believe that the “most important thing” is skin to skin contact, but stuntbirth aficionados are nothing if not gullible.

How about postpartum bleeding?

  • If placenta has not been delivered give Angelica: 1 dropper full under the tongue every minute as needed and up to 3 times.
  • If placenta has been delivered give Shepherd’s Purse 1 dropper full under the tongue every minute as needed (up to 3 doses) and a dime-sized slice of the maternal side (membrane side that was attached to the uterus) of the placenta to tuck into her cheek and get baby to nurse asap!
  • Ice cubes on the bottoms of her feet. This causes strong contraction through the sympathetic nervous system, and it also slows circulation and decreases bleeding.

Really? Really??!!

Hopefully Raeanne and her baby will survive her own stupidity, but, if so, that will only be luck … which Raeanne will never realize because she is an ignorant fool.

  • sdsures

    Wow, the original birth plan hasn’t been deleted yet (just follow the link in the post).

  • Libby

    Whew! I can sleep tonight!

  • PrimaryCareDoc
    • auntbea

      I’ve been checking and checking! Thank goodness!

      • PrimaryCareDoc

        Me, too. I felt kinda stalker-ish, but I was worried. By her dates, she was something like 44 weeks! Since she had a totally unassisted pregnancy, I would guess that her dates were off.

    • Aunti Po Dean

      Her birth story is now up, thank goodness all went well! Goodness knows what they would have done if they had needed help living an hour away from a hospital and with a doggy car!

  • PoopDoc

    Was poking around and so far no baby… Frightening how easy it is to figure out who a person is by just typing a few key words into Google. I must remember to be more obtuse with my internet personae…

  • KumquatWriter

    Any updates yet? I can’t believe I’m still concerned.

    • Karen in SC

      I poked around MDC this morning. Nothing. Though if the information on the profile is correct, she’s logged in within the last two days.

      There’s really nothing to stop people from making up a history and getting attention from a website. So who knows? Someone from her May Due Date club posted that one or two sentences that she had her 2HBA4C waterbirth. Really?

      There was another from that club that suspected twins. I thought she was UPing but tracking back her posts I saw she had an ultrasound that showed only one fetus. She just guessed there was a hidden twin since she was measuring so large and she could palpate two babies – she was 99% sure. At 41+3 she had a single baby boy at home, then gave birth to a two pound placenta.

  • I still wonder what happened to “Rachel Roggio” and her surprise UC twins http://www.mothering.com/community/t/1352351/4th-uc-unexpected-twins-warning-transfer

    • Ducky

      I dig a bit of digging… “Rachel” runs a general store in central NY and – fascinating fun fact- has a PhD in public administration. From snippits on the store’s blog and her other blogs I gather that both twins made it. She doesn’t explicitly mention, but it appears both are healthy now. It’s an interesting story…

  • I think about her a lot. Every time I log on, I check.

  • Box of Salt

    Any news on Raeanne? “19 Days Late” will be tomorrow.

    • Karen in SC

      If you can believe MDC’s profiles, she was just online today, but hasn’t posted since the 25th. I noted that her stated due date in her profile is June. So who knows with these people?

      • Box of Salt

        The due date she mentions in the post linked above is May 12.

  • Gracemarie Holub

    Thank you for all of you responses. I have continued to care for this patient with compassion and today life support was discontinued. I am hoping that in building a rapport with her, that I can convince her to deliver in a hospital if she decides to get pregnant again.

    • Eddie

      This is a really sad story. Good luck.

    • Box of Salt

      My condolences to the family.

  • Bombshellrisa

    Her latest update (9/25)

    “Nothing new for me…. I’m 41 +6 days… sure hoping this one comes before my dd did (42 +5)!!!!

    Praying the full moon works! COME ON BABY!”

    • Elizabeth Abraham

      Eh. Maybe she’s not really pregnant. UC/UP can lend itself just gorgeously to pseudocyesis.

      • Karen in SC

        Yikes! Someone else in the May due date group is 41 wks with twins. Or she thinks it’s twins. I didn’t track back too much, but could be she is UP’ing too. Just can’t understand UP’ing or UC’ing at all.

  • Gracemarie Holub

    As an OB on call for unassigned patients, I received a mother who had a Home vaginal birth after cesarean section for failure to progress. This was a water birth. A shoulder dystopia occurred. The lay midwife reported last fetal heart tones were 30 minutes prior to delivery.After a very difficult shoulder dystocia, the baby was born with an agar of 0. EMS was called and the mother and baby were transported to my tertiary hospital with an extremely experienced NICU team in waiting to attempt resuscitation.It has been 2 days and this baby has no primitive reflexes, no effort to breathe and no motion. The shape of the head and the lack of movement lead one to suspect both brain and spinal cord injuries. The EEG is flat and to be repeated.The discussion of brain death and discontinuing life supports has occurred. The family is undecided. I go into the NICU and see this beautiful little girl whose tragedy was so easily avoidable and tears fill my eyes.
    Yes, home midwifery is nice if everything goes well. But this is inexcusable. I will do everything in my powere to see that another family doesn’t lose a baby in these circumstances.

    • Amazed

      Gracemarie, I am so sorry for the tragedy you’re witnessing right now.
      If you are a regular reader, you’ll know that we often have discussions about how and whether doctors should inform parents about their part in the entire ordeal. It seems many parents with tragic outcomes say “It would have happened in the hospital, too, doctors said so!” because it’s so hard for the OBs to tell them the truth in no uncertain terms. I am a chicken myself and I suspect that if I were a doctor, I would try to spare them, too.

      Will you tell the little girl’s parents that it was all so easily avoidable, or will you vote for compassion?

    • KarenJJ

      These are such important stories to tell. It is a side of homebirth that midwives aren’t sharing. I swear some of the repeat offenders in the midwifery community would come close to being sociopaths.

    • I don’t understand any of this. I assume that the (to me) insane level of committment to a natural vaginal birth maybe sets up a conviction that a baby who cannot come through that unscathed “wasn’t meant to live” when the reality of that dawns in hospital, then most will have the CS, and moan afterwards that it was unnecessary. Homebirth tests the purity of one’s committment, removes temptation, and validates the ideology.

      Is this poor child actually still alive? Has the abstract “wasn’t meant to live” been replaced with life at any price – too late? Was she in trouble before the dystocia? Does a lay midwife with a fetascope serve any purpose? No-one can blame people grabbing at any crumb of comfort in these circumstances, but Lord it is hard to see this repeated when the means to at least attempt better is available.

      • fiftyfifty1

        “Does a lay midwife with a fetascope serve any purpose?”
        No.

      • The Computer Ate My Nym

        Is this poor child actually still alive?

        Almost certainly not. A flat EEG is almost certainly indicative of brain death unless something went very wrong with the procedure. She’s probably dead even if her heart is still beating on life support. I’m sorry for the family.

    • Squillo

      A tragic story, and one that should be told, but frankly, I’m concerned about your posting the details of a patient’s case publicly, even with no names. Unless you’ve significantly changed the details, I’d respectfully suggest removing the post.

      • suchende

        I think this level of detail is more than sufficient for my understanding of the legal and ethical confidentiality requirements.

    • Lisa from NY

      Maybe you could publish this story somehow, names and locations changed. These crazy women have to see the repercussions.

    • Lisa from NY

      Shoulder dystocia with brain and spinal cord injuries – sounds like the Gaskin Maneuver?

      • fiftyfifty1

        How so?

  • An Actual Attorney

    I just poked around MDC. Oh my — from the same poster:

    “This will be my third pregnancy and fourth (and fifth?) baby. …I suspect possible twins, and I’ll probably have a girl/girls, but it would be nice to have a boy. I have twin girls, ages 2.5 years, and my third daughter turned 1 a month ago. I have had all my babies unassisted, with no one else there except me and my husband. I’d like to birth solo this time. I’m also having an UP.”

    • Bombshellrisa

      She also “aspires to be a midwife”. She also mentions that she lives in an “isolated part” of West Virginia. That doesn’t bode well if there are complications.

      • An Actual Attorney

        Somewhere in there she also talked about only taking the earlier babies to the ped to get CPS off her back. It feels like watching a slow-mo car crash.

        • Bombshellrisa

          Off her back? So they are already aware of the situation in their home. Wonder who called CPS and for what?

  • Lena

    OT: Someone posted a link to a birth story earlier, where the mother–an hb transfer–claimed to have won a law suit because of her “birth rape” and c-section, etc. after transferring to the hospital. The whole thing smells like bullshit to me, but there’s one thing I’m really curious about. Is it likely or even possibe that an OB would call for a court order to get a laboring woman to accept intervention? This woman claims that the hospital called a judge several times, and that she even spoke to the judge, who told her that if he had to sign an order CPS would take her child from her.

    She HAS to be lying, right?

    • Elizabeth Abraham

      Some stories have hit the press of cases where the hospital went for a court order to perform a c-section on a patient who was trying to refuse it. If they think the patient is irrational or unable to consent, and the surgery is necessary to save her life or the baby’s, the doctors can call for a court order.

      It’s pretty damn rare, though. Judges aren’t just up at three in the morning, and they aren’t amused about this crap, and it’s practically guaranteed to get splashy publicity. It’s a time-consuming delay in an emergency situation. It’s far better and simpler to convince the patient to consent.

      Hospital staff have a lot of practice dealing with women in labor, not all of whom are going to be thinking clearly or acting wisely. They are really good at patient management.

    • Becky05

      I had attempted to post on this last night, but yes there have been court ordered cesareans. They aren’t common.

      See here:
      http://www.advocatesforpregnantwomen.org/articles/forced_c-section.htm
      They have an entire article supposedly on this and similar things, but really it conflates a lot of issues (all important, though): http://jhppl.dukejournals.org/content/38/2/299.full.pdf+html?sid=b0811f36-d4e4-4b51-a830-e175e6eee40c

      And I do hear about court ordered cesareans or CPS involvement being threatened to get women to follow medical advice:
      http://www.tampabay.com/news/health/usf-obstetrician-threatens-to-call-police-if-patient-doesnt-report-for/2107387

      • Lena

        Thanks Becky and Elizabeth.

        I’m against any coercion, no matter what the circumstances. I think in those cases there needs to be some kind of ironclad protection for the OB/hospital so they can’t be sued by those types of parents, but if they want to risk their unborn babies’ lives, that should be their decision. I’m not wasting any sympathy on them if the worst happens, but neither do I think it should be a criminal matter.

        • I’m against any coercion, no matter what the circumstances…

          But are you in favour of a baby that close to an independent life being allowed to die? Or even the mother? The thought of a woman being forced into surgery is pretty horrible, but the reason why she is refusing is quite relevant. I haven’t followed the links, but I should imagine this is very rare, and press reports quite unreliable. Don’t know the law, either, but I think in the UK they would be unlikely to GET a Court Order unless it could be proved that the woman was very irrational or “lacked capacity.” The law does defend the right to be foolish, I think, and doctors are not going to resort to that lightly.

          • Lena

            I agree that doctors wouldn’t do it lightly, which is why the story didn’t ring true to me.

            And while favour is way too strong a word, unless we’re talking major mental illness, dead babies and even mothers is the tragic price we’ll have to pay–I don’t want coercion, at all. Not just because of all the slippery slope implications, but from a purely practical standpoint, coercion makes these people martyrs and will just make more women fall into the woo. I honestly fear the NCB movement growing bigger if we allow hospitals and OB’s to force women to accept interventions, no matter how necessary.

          • I read one of the links – and that was talking about using the criminal law against women, which no question is barbaric.

            If a woman truly and clearly understands what she is doing, I too would be against coercion – but it is an impossibly difficult ethical question. The railing against the unnecessary CS implies that most women do see sense and complain afterwards. The law protects the right to say no, so no-one rational should need to fear it – though I suspect the climate may be different in the UK.

          • Amazed

            The law protects the right to say no, so no-one rational should need to fear it.

            But the moment something goes amiss, they start whining that no one told them, so their no wasn’t an informed choice.

            Look at Sarah Kerr. While I do have compassion for her loss, I was genuinely willing to slap her across her lying mouth. She was so informed, oh so informed. She made an informed choice but well, no one told her about the risks that were specific to twins, she wailed. No one means the doctor. But she was so informed! She supported Lisa Barrett through an inquest about a twin death. The implications, as I understood them, were that had the doctor told her about the specific risks, she might have considered a C-section.

            I am not against the right to say no. But it comes alonw with their share of responsibility for the outcome.

            By the way, the doctor claims that she did tell her. She was stunned, because Ms Kerr was willing to risk one of her twins to die in order to have homebirth. She’s a grieving mother. From what I’ve seen, she’s also a liar. And a hypocrite.

          • In my scheme of things, the right to say no is an absolute, but by “rational” I mean: understanding fully the consequences of saying no, and taking responsibility for the outcome.

            Doesn’t happen a lot in NCB, does it? Bad outcomes are always inevitable or somebody else’s fault. Why would a woman refuse a CS? The reason matters. If it is fear, panic, self-preservation, ignorance, then I can muster up some sympathy when they have to deal with the consequences. But if it is because a natural birth is a higher priority than the life of their child, if they are in effect, at some level, indifferent to the life of their child, sympathy is irrelevant isn’t it?

            How many of us would sacrifice ourselves for an unborn child? (A living child is something else altogether, of course.)

            The edifice of nonsense that is NCB is dedicated to selling women lies, lies that cloud judgement completely – particularly in regard to CS, and encourages women to be irrational.

            I don’t feel anger at the Sarah Kerrs. More a fascinated curiosity. How do you live with yourself? In part, I think I know the answer: being rational is hard and unnatural, rationalising is easy, and we are all very good at it. I am not sure if it lasts a lifetime – and if it does, I think one is diminished by it in a way that deserves pity and maybe contempt, not sympathy or anger.

          • Amazed

            But, Lizzie, it’s so hard to take responsibility for a bad outcome.

            I think my problem with these women is that in their heart of hearts they are not so different from me. I couldn’t take responsibility for a bad outcome, so I just listen to my fear which leads me to seek advice from people who are actually the experts in their areas. Maybe the NCB-ers are simply braver than me. But when the shit hits the fan, their reaction is just what I imagine mine would have been in similar circumstances.

            Why would a woman refuse a CS? The reason matters and I agree wholeheartedly. The thing is, the air of knowing it all is widely spread and when you realize you didn’t know it all, it’s usually too late. I can understand being unreasonable when facing a scary emergency. But knowingly making a choice weeks, months ago and then saying that you didn’t know it was dangerous?

            Today, I had a conversation with my mum. She thinks that there might be something to the opinion that CS are made for profit. Yet, C-sections have mostly replaced older procedures. When 32 years ago she was told that she needed a vacuum, she didn’t say no. That was the procedure she was offered and she accepted readily. What’s the difference? I think it’s the C-section myths.

            Today, my dad is making her a celebratory dinner for doing the hard job of pushing my amazing self out, (it’s my birthday today). Had she refused the vacuum, I might not be typing this right now. And no one ever suggested that it was unneeded. A boy I know had a huge bruise on his face where forceps came into play. Just an inch away, and today he might have been one-eyed. Still, no one says forceps are unneeded. Why this fear of C-section? Just because “abdominal surgery” sounds scarier? And is it ‘abdominal’ at all? Isn’t it pelvic?

            Thanks for commenting. Lizzie. Your input is always thought-provoking.

          • AmyP

            “Why would a woman refuse a CS?”

            Because she’s squicked out about the thought of being cut open?

            I wouldn’t refuse a CS, but I’ve been “educated” here. Nonetheless despite knowing that it’s safe (and the safest option for the baby), I still feel lingering anxiety about the idea of a CS.

          • Amazed

            “Why would a woman refuse a CS?”

            Because she’s squicked out about the thought of being cut open?

            Right. Being someone who’s freaked out by a simple gyn examination, I don’t have much of a leg to stand here.

            The thing is, everyone is entitled to a choice. No one is entitled to say that they weren’t informed or it was unavoidable when at the time they screamed “dead baby card!’ and ‘fetal monitoring is a joke these falling decels don’t mean a thing and you’re lying to me’.

          • Jessica

            That’s how I felt. I would have consented to one if it was medically necessary, but it was not and still is not something I would choose over a vaginal delivery.

          • rh1985

            I am currently trying to get pregnant, and personally my fear of c-section is not because of the the procedure itself but the way it is currently performed. I have an anxiety disorder and am TERRIFIED of being awake during surgery and fear I would have a severe panic attack on the operating table. If I do require a c-section, I really, really, REALLY want general anesthesia, but I’m not sure doctor will agree since it’s slightly higher risk – I think that risk is outweighed by the risk of me having a panic attack during surgery but again not sure doctor will agree.

          • Amazed

            But you are working on various options, aren’t you? It isn’t the same as saying ,No, no,no, I won’t’ and refuse even to entertain the notion months ago. That’s what a responsible adult does.

          • rh1985

            Yeah, it’s not that I won’t consent no matter what, I just would like to either have general or have it set up ahead of time so that they can knock me out or sedate me if it looks like I’m beginning a severe panic attack.

          • I had a general for the first, and an epi for the second. Given that it was a long time ago, choosing (pestering for) an epi was a bit unusual. I felt confident because I knew that a general takes effect VERY fast if there was a problem. There wasn’t, and I MUCH prefered the epi. I can sympathise with your fear though. It is a weird experience that boggles the imagination, where panic starts.It is the preliminaries that are spooky – and they are similar regardless of the anaesthetic. Don’t know if a sedative or some kind of familiarisation would help? Good luck anyway.

          • theadequatemother

            The ane will probably agree with you regarding GA…but when you get pregnant, get a referral to the anesthesia clinic to discuss this. You want to be sure that 1) your airway isn’t difficult and 2) why you will not be allowed to eat during labor and 3) whether or not you think you can try with some sedation and an epi or spinal and 4) whether psychotherapy/desensitization will be a useful preventative option (ie going to an empty OR with a therapist, lying on the table, having the monitors on etc etc), visualizing the operation occurring…

          • fiftyfifty1

            “Why this fear of C-section? Just because “abdominal surgery” sounds scarier? And is it ‘abdominal’ at all? Isn’t it pelvic?”

            No, it’s abdominal. And I don’t think it is fear so much as it is a rejection of abdominal because it is not the right hole. For assisted vaginal birth it is seen as just a little help. C-section is seen as failure altogether.

        • Elizabeth Abraham

          I agree it shouldn’t be a criminal matter.

          Here’s the problem: It’s easy to argue that a laboring woman was incapable of understanding material presented to her, or that she is otherwise incapable of making a properly informed consent or refusal. I don’t think that labor makes a patient automatically not competent, but there are certainly situations in labor where a patient’s competence may be questionable. When I was in labor with my son, I stalled, badly, during the pushing phase. When I’d been pushing for about four hours, they told me they wanted to bring out the vacuum extraction equipment and give it a try. It took them most of the next hour to run through the informed consent material, between contractions, while I had a major case of the labor shakes. I was running a fever of 102, and my husband was on the other side of the room with his head between his knees. If things had gone wrong, I am sure that my consent would not have held up in court, but what else were they going to do? At that point, the best alternative was to go for a c-section instead, and I was no more capable of understanding that set of consent forms then any other. I am quite sure that, had I refused a c-section for my daughter, they’d have had a judge on the phone ASAP, because we were in imminent mortal danger. They didn’t call a judge, they just sent a very reassuring doctor to be sincere and convincing at me. It worked – I’m sure that guy has a great track record. I believed his every word. Of course, I also thought he looked like Hawkeye Pierce, and I know from the post-partum follow up that I was wrong there.

          Honestly, I think if they’re on the phone to a judge, it
          means that they’ve screwed up the patient management side of things beyond recall. It’s an admission of failure. Some failures are beyond
          the staff’s ability to control – some patients are beyond reason. Some failures are real failures – it’s possible to be enough of a jerk that even patients in imminent mortal danger find you unconvincing.

          No matter what the patient says during labor, the doctor remains responsible for the outcome, and liable if the outcome is poor. As long as that’s true, doctors are going to feel the need to insist on imposing their professional judgment on patients.

      • Lisa from NY

        In cases of overweight mothers, why don’t the doctors force the women to go on diets so they would not need Cs?

        • fiftyfifty1

          Huh? Am I missing that you are joking?

          • suchende

            It’s a slippery slope argument. If you can force a woman to do X for the benefit of the fetus, why can’t you force her to do Y. Of course slippery slope arguments are considered to be a logical fallacy.

  • The Computer Ate My Nym

    No update on the thread today. She could still be pregnant or have delivered or have died of bleeding or have had a fit of sanity and gone to the hospital or have delivered following her birth plan to the letter and now be sitting around composing the perfect smug update. I hate not knowing how things end.

    • Karen in SC

      I hate the “not knowing”, too! Almost obsessively dedicated to getting closure.

    • Bombshellrisa

      She posted this on 5/21

      “I’m 41+2 today also! But I’m terribly impatient! 🙁
      My dd and I pray every time I put her down for a nap or bedtime that baby will come soon. In fact she preemptively chimes in with “Baby… soon”! She’s practically as anxious as I am, it seems!

      I’m a firm believer that babies come when they’re ready, but I’m also feeling very sorry for myself that apparently I’m one of those mothers that take a bit longer to grow their babies!

      I’m thinking full moon might work too, although it didn’t last pregnancy when I was exactly this far along!”

  • Lisa Miller

    Ick

  • Ducky

    I was sort of nodding along until she gets to the point of instructing her husband to reference the book if there’s an emergency… and that while estimating blood loss the usual guideline should be 2 cups, but hey, she lost 3 cups last time and it was fine… she also uses the term “shockiness” which I feel belies a sort of basic ignorance about the life-and-death difference between volume shock due to blood loss and the parasympathetic / sympathetic reactions of the nervous system under stress.

    • The things I learn here! (Starting from a point of fairly comical ignorance.) Could you explain a bit about the second kind of shock? Last week, my daughter suffered from what appeared to be a very painful back spasm. (For the first time.) I am not good in medical emergencies, tending to under-react. Reading that list, I was a bit dismayed that if that was shock, she had been in it. Is that a psychological or a physical thing? My daughter is extremely stoic about low/medium level pain, but cannot handle bad pain at all – because she doesn’t usually experience any.

      We did end up in the Emergency room – but the ambulance men administered nitrous oxide, so the worst was over by the time we got there, and I am still figuring out what happened.

      • fiftyfifty1

        I hate that medicine uses the term “shock” because it means something very different for lay people. Lay people use it to mean what Ducky said: the parasympathetic/sympathetic reactions to stress. Examples are the racing heart you feel when your body releases adrenalin (sympathetic system) or the lightheadedness/fainting/nausea/sweating you can get when the vagus nerve (parasympathetic system) kicks in. These stress response systems can be triggered by psychological stress (e.g. anger or the sight of blood) or by physical stimuli (e.g. applying pressure over the receptors in the neck or severe pain). This sort of “shock” is not dangerous. The only way it could be dangerous would be if it caused you to faint and bump your head, or if you had a very weak heart prone to abnormal rhythms.
        Now medical shock is a very different beast and very dangerous. It is when the body’s ability to get enough oxygen to the tissues is in danger of collapsing. Causes include massive blood loss or severe dehydration (hypovolemic shock) or severe blood infections (lay term: blood poisoning) also known as septic shock. It is NOT caused by psychological stress or pain. It always has a serious physical cause.

        • auntbea

          What is it when you get cold, weak, and disoriented? That’s what I (as a layperson) have always taken shock to be.

          • Dr Kitty

            A vasovagal pre-syncopal episode.

            Usually remedied easily by lying down and drinking something sweet.

          • KarenJJ

            Bit of a mouthful there..

            I might stick to ‘shock’ personally..

  • rh1985

    I personally can’t think of a LESS relaxing place to give birth than at home, except perhaps in a moving car? and for some reason I keep thinking of the mess after…..

    • If I hads a history of popping out babies whithout much pain or trouble, or was completely ignorant of the many things that can go wrong/chasing some crack brained form of proving myself/insanely phobic about hospitals/very fragile I might feel more relaxed at home. I might decide to chance it without being relaxed on the basis that the odds are reasonable even though what you are risking is crazy. Never, never, never on the basis of the hospital is ten minutes away. Next door isn’t near enough if you find yourself in real trouble. .

    • Mama to 2

      Huh-different strokes for different folks, I suppose. I was so much more comfortable giving birth at home than my birth at the hospital. It was a gorgeous, sunny day and I was able to walk around in my garden to get contractions going. It was so nice not having random hospital staff come into my room-some with no introduction of who they were or why they were there. It was just me, my husband, my mom, my daughter, and my birth team (my midwife, her student and her assistant). And it was so wonderful to take a shower in my shower, and eat my own food instead of hospital food (ick), and then crawl into my own bed with freshly washed sheets. As to clean up- husband jokes that they left the house cleaner than when they came-they did everything including our dishes. Also, they know how to prevent a mess from happening and strategically placed towels and chux pads.

      And since this is the site it is I will add that I was 27 and a second time mom with a previous uncomplicated vaginal delivery, with no signs of high blood pressure, GD, or any other “variation of normal” and a normal 20 week ultrasound and went into labor at 39 weeks. My baby was also head down and in an optimal position. My midwife was a CNM and ND. Her assistants are all L&D RNs and her student was an ND student (I doubt that counts for much among this crowd, but surely it’s a little better than a CPM or DEM). The entire birth team was trained yearly in advanced resuscitation at the hospital with the highest level NICU in our city (a level 3 I think…). We also live 10 minutes away from a hospital with a Level 2 NICU (and that’s 10 minutes on a Friday of a holiday weekend at 5:30 PM, the majority of the time it’s 3 minutes-we did many test runs). I felt very safe and do not feel my choice was irresponsible.

      • Sounds nice. Though I note you missed out most of the labour part. Second baby, assume it didn’t go on for too long, Were you irresponsible? Maybe not as irresponsible as some, as you seemed to have reasonable care, but yes, you were, in counting on nothing going wrong. It didn’t, so you can feel empowered.

        I was dead impressed at the start of my sister’s home birth, as she calmly followed her routine. I was a lot less impressed when she was screaming, the midwives (highly trained NHS) had gone home to get some sleep and things were starting to go very wrong. I got them back just about in time. My sister’s views are unprintable and still unforgiving.

        Do you actually believe that a disaster could have been averted without the resources of a hospital? No matter how close, how many test runs? No-one is actually arguing that a homebirth can’t turn out well, blissful, – just that counting on it isn’t that great an idea.

        • Mama to 2

          I’m not sure where in my post you’re getting that I was counting on nothing going wrong, I was counting on everything going wrong. That was why I did test runs to the hospital, I had a hospital bag packed and in the car, I had the hospital’s L&D department on speed dial in my cell phone which I kept charged at all times. I grilled my midwives on what they would do in every possible situation I could imagine.

          I was not “without the resources of the hospital” I was 10 minutes away from the resources of the hospital-it was a 3 minute drive from my driveway to the doors of the emergency room the entire month my son was born-I also live in a single story house and my husband could easily pick me up and put me in the car which as I said before was packed and ready to go. Thus 10 minutes (at most) away from a C-section (we had the number readily available to call ahead), from a neonatologist, from all the excellent equipment in that NICU. Also, like I said before my midwives are trained and have the equipment for advanced resuscitation should the baby had needed it (he didn’t-both my babies were breathing before they were all the way out). They also had advanced equipment to remove meconium from the lungs (forgive me, I don’t remember what it’s called). They have antibiotics, IVs, pitocins, other meds I don’t remember write now. Again, I feel like there were few situations they wouldn’t have been prepared for. I’m sure someone could come up with a possible scenario, but the likelihood of it happening would have to be weighed against the possibility of getting in a car crash on the way to or from the hospital, getting a hospital acquired infection, or being the victim of surgical error. So, yes, I do think most disasters could be averted.

          Also, do you have any studies showing that second time mothers under 30 with previous uncomplicated vaginal births, attended by CNMs 10 minutes away from a hospital with a NICU have any worse outcomes than their counterparts giving birth at hospitals-I would be very interested in seeing them if you do.

          As for how my labor actually went. I was 5 CM dilated and 100% effaced at 38 weeks, with sporadic, slightly uncomfortable contractions. At 39 weeks, they started getting more regular so I called my midwife and she came over and I was 7 CM, still having only slightly uncomfortable contractions that I could walk and talk through. After I got in the tub they got a lot weaker-at least they felt like they did, but I kept dilating so apparently something was happening and up through 10 CM I was kind of able to tell I was having contractions but I was walking and talking through them (I know I’m a freak of nature-I have really weird labors). Baby’s heartbeat was perfect the entire time. So at 10 CM they broke my water and he was right there and I spent 40 minutes being a baby and not wanting to push him out because I knew it was going to hurt but, finally I decided the contractions (which had finally gotten painful) were worse than pushing him out and he was born in 5 pushes (again, perfect heart rate the entire time). He was 9 lbs of fatty, healthy baby. Never during the entire thing did they leave so they could sleep (that sounds incredibly irresponsible to me-how do they make sure the babies heart rate stays strong and nothing goes wrong?)

          The only drama that happened was afterward when my placenta detached but wouldn’t come out. They had to remove it manually-which hurt like a motherfucker (I totally would’ve taken an epidural for that), but was over pretty quick. They then gave me a couple doses of pitocin and had an IV set up before I even realized what was happening. The nurse was super quick at doing an IV (a lot faster than the nurse who needed three tries to get the IV in at the hospital-she blamed it on me having “weird veins” which apparently weren’t a problem for this nurse). I had zero lasting effects from blood loss and felt fine the next day (well, other than feeling like I’d been hit in the crotch with a train, but that’s birth for you), and it wasn’t because I was lucky, it’s because my birth team was so good.

          I’m so sorry your sister had a bad experience. It would be so scary to be alone and unattended when things are going wrong. I’m horrified your sister’s midwives would leave her all alone to go sleep. That is seriously negligent care and I hope you notified their superiors about that. I hope everyone made it through alright.

          • I have read your reply with interest.As a low risk mother who, in the event, had a low risk birth with proper attendants yours is the kind of homebirth that most would not consider a problem. I still don’t get it. I literally do not understand what is the big plus about being at home. Or where that degree of trust and confidence comes from, to be honest. Yours is the prevalent attitude, and justified in most cases perhaps – but not one I am ever likely to share.

          • Mama to 2

            lol, I thought you said my homebirth sounded nice! (Totally kidding) I don’t need you to understand or share my attitude about birthing at home-I would certainly never try and convince someone else to do it. If you had the experiences I did with hospitals and the birth experience with my first you might understand and if I’d lived your life and had the experience you did with your sister I probably wouldn’t get it. If you are interested in understanding my (many and complicated) reasons for choosing it I’d be happy to explain them to you (they have nothing to do with “earth mother goddess” bullshit or feeling superior to anyone else). But maybe we should just say “different strokes for different folks” 🙂

          • Box of Salt

            Mama to 2 “I’m not sure where in my post you’re getting that I was counting on nothing going wrong, I was counting on everything going wrong.”

            It’s the fact that you chose to birth at home at all that shows you were counting on nothing going wrong.

            For all you protests that you were only 3 to 10 minutes away from being inside that ER, you are still without the resources of the hospital for those first 3 to 10 minutes. Minimum 3 to 10 minutes.

            From your story, it sounds as though you did reduce the risks of birth at home quite well (qualified providers, etc).

            But let’s not pretend that your choice did not increase your risk. You accepted the risk: Fine. If you truly believed that everything would go wrong, you would not have accepted the additional risk.

          • Mama to 2

            “let’s not pretend that your choice did not increase your risk”

            Do you have any studies to back that up? Any studies that say a second time mom with a proven pelvis, under 30 with no abnormal tests, 10 minutes away from a hospital birthing with a CNM at home is at increased risk? And remember the plural of anecdote is not data, as they say. I’ll wait right here while you go find them 🙂

            There are risks unique to going to a hospital as well, though we are doing our best to minimize them. The risk of driving to the hospital with a woman in labor-the risk of driving period (it’s the number cause of death for children in America, if I remember correctly). The risk of driving home from the hospital with a tiny newborn. The risk of hospital acquired infection, risk of hospital error. Fortunately hospitals are getting better and better about this, but the risks still exists. Of course in many cases all these risks are outweighed by the benefits of being at a hospital-I’ve just never seen any data that convinces me I would have been safer in a hospital considering these risks than at home-with the care providers that I was with.

            Most of the care my midwives couldn’t provide at home would have involved surgery which needs to be prepped for (an OR and a surgical team). Since we could call ahead, they could start doing this as we were driving there. I think the same would be said for a blood transfusion-we could call, tell them my blood type and have them have the blood ready and waiting when we got there. I can absolutely see pregnancies and labors where it’s safer to be in the hospital, again, I’m just not convinced that mine was one of them. I will certainly be willing to reconsider if you can find studies proving otherwise.

          • Box of Salt

            Mama to 2 ” I think the same would be said for a blood transfusion-we could call, tell them my blood type and have them have the blood ready and waiting
            when we got there”

            Sorry, honey, they’re still going to type and cross match it after you arrive. This is one thing you can’t call in.

          • Amazed

            To repeat myself in this thread, too: a woman can bleed to death in less than 10 minutes. Sure, they can have the blood ready when the woman arrives. If she arrives alive, that’s it.

          • Mama to 2

            Okay, number one, your mom didn’t have a proven pelvis if it was her first baby. I guess it had just been proven, maybe that’s what you meant? Or maybe I’m reading your wording wrong, was her first baby healthy and this was her second birth? I’m a little confused. Did she have a history of post postpartum hemorrhage? There were no problems with her first pregnancy? I guess I’d really need to understand more before I can comment on her specific situation. I’m very sorry that happened to her in any case.
            For what it’s worth I had no history of postpartum hemorrhage and my midwives examined me very carefully for excessive bleeding-especially since I had the placenta drama I described above.

            Also, like I said above the plural of anecdote is not data. If you were to show me a study that said that women birthing at home under the care of a CNM (with my specifics:under 30, no abnormal tests, second time mother, etc) were more likely to die of hemorrhage than women at a hospital than I would be interested in discussing that with you. This story (while I’m very sorry it happened and am very pleased your mother is alright) means about as much to me in the context of this conversation as a lactivist saying that she knew a mother who chose not to breastfeed and her baby died of SIDS does to a mother who chose to formula feed.

            My point above was that the compounded risks of birthing at a hospital low though they might be, were probably relatively equal to the risks of birthing at home-in my situation. That was the conclusion I drew from looking at all the studies on homebirth, studies on birthing with CNMs, and birthing with my relative risk factors. And I’m not going to link to all those studies or studies on hospital acquired infection, hospital error, or traffic collisions per capita, or in the context of stressful situations, though they are out there because I have no need to pull them up to defend a birth that resulted in a perfectly healthy baby and mother.

            Sorry for the novel, I tend to be verbose-I’m working on it.

          • Amy Tuteur, MD

            You are completely missing the point, which is a very simple point. You or your baby could easily before you ever reached the hospital, even if the hospital is only 5 minutes away.

            If you want to have a homebirth because you are willing to accept the increased risk of dying, that is your right. But you don’t seem to have even a basic understanding of human physiology in life and death emergencies, not to mention that you are totally clueless about emergency medicine, so you have made your decision based on ignorance.

          • Mama to 2

            Again, I think it might be you who is missing the point and completely ignoring mine.

            I will ask one more time, do you have any studies showing that low risk mothers birthing with CNMs as close as I was to the hospital are any more likely to have worse outcomes?

          • Amy Tuteur, MD

            I just showed you one and you just ignored it.

            The ONLY people who think homebirth is safe are homebirth advocates. Everyone else, who has actual knowledge of medicine, science and statistics, knows better.

          • Mama to 2

            I apologize, you did link to a study, I totally missed that, let me look it over.

            Again, not a homebirth advocate-just a mama who somehow ended up in a position defending her last birth. I really only wanted to say that I did feel more relaxed at home and that clean up wasn’t a problem to the OP saying she couldn’t understand how homebirth was relaxing.

          • Eddie

            Sorry for the novel, I tend to be verbose-I’m working on it.

            I understand. I have the same problem. 🙂

          • Amazed

            This was her second birth. Four years ago,I was born healthy, although vacuum-assisted. Just what homebirth advocates call ‘unnecesarry intervention” because, you know, no one was hurt and mom and baby were healthy, so it must not have really been this bad to justify the use of vacuum.

            At her second birth, when she was 29, she was healthy, fit. Not a dip of a high blood pressure. Not even a particularly big belly because it turned out, second baby preferred to place itself more inwards, as well as her first one. He was born 10 pounds but well, our Dad is towering over Mom. He wasn’t macrosomic. He just came out. The best birth you can imagine for a second time mom… until the bleeding came.

            Every study I’ve seen shows that midwife assisted births at home are riskier than midwife assisted births in hospital. I can’t show you the study you want because homebirth midwives take high risk women when they should have taken only the women you describe. In short, because they are liars. Did you realize this when you posted your impossible demand?

            OK, now how about you show me studies that a second time mom with a proven pelvis is immuned to hemorraging heavily? It really is this simple. Sometimes hemorrage happens and no one would lose money on studies to prove that there is a special group of women to which the few minutes interval does not apply. But if you know about studies showing this protected status, by any means post links,

          • Mama to 2

            You were born four years ago? You type amazingly well.

          • Amazed

            What can I say, I’m a child prodigy. So happy you noticed.

          • Mama to 2

            🙂

          • Mama to 2

            Really? Even if they have my medical records already? As that hospital did because I wanted to cover all my bases.

          • An Actual Attorney

            When you say they had your medical records, what does that mean? Were you pre-admitted? Or just that your records were on file?

          • Mama to 2

            If I’m remembering correctly, they allowed me to pre-admit, because my midwives are awesome and convinced them.

          • Bombshellrisa

            Not sure how it works in other hospitals, but the ones around here always have their L&D patients pre-register, usually at some point during their childbirth classes. So they have all the records, an H&P and the usual info about allergies and blood type. By pre-admit, did you mean they were holding a bed for you?

          • Elizabeth Abraham

            Yes, even if they have your medical records already.

            I was brought, by ambulance, to the hospital the night my DD was born. I told the EMTs my blood type when they picked me up (I’m Rh-, so it’s important to me that they know). The ambulance brought me to a hospital that had typed my blood themselves three weeks previously… and hospital procedures STILL required them to re-type me before getting blood from the blood bank.

          • Mama to 2

            Hmmm, I wonder why they told me it wouldn’t be a problem then…

          • Elizabeth Abraham

            In my case it wasn’t a problem because they ran the test through the on-site lab as a rush job and got the typing back pretty fast, but it did still add time.

            I came in hemorrhaging, and it took about 2 hours from when I came through the door to when they got me into the OR. I’m sure it could have been done faster in a pinch, but it really did not seem to me that they were dragging their feet or anything.

          • Mama to 2

            I’m really sorry that happened. How did things turn out for you? Do you feel the delay caused lasting problems for you?

          • Elizabeth Abraham

            Things turned out fine for us. It was a terrifying night, and then we had an initially scary, ultimately tedious NICU stay (DD was born at 32w4d), and now I have a perfectly healthy three and a half year-old who you’d never guess was premature.

            I really believe that the hospital in question did their best for me. There was no waiting around. There was always a doctor or nurse in the room, usually more then one, and they were always doing something that at least seemed vital.

            I’m sure they could have moved things along faster at need (if I’d started to pass out, or if there had been indications of fetal distress or placental abruption), but I’m also pretty sure that the 5 minute decision-to-incision time is only achievable for patients who are already checked in. It’s not arrival-to-incision time.

          • Bombshellrisa

            Maybe they didn’t think it would be, simply because it was not a situation that they had faced before.

          • Box of Salt

            Mama Honey,
            would you sue them if they gave you the wrong blood type based on a phone call?

            That’s why I called you “honey.”

            See Elizabeth Abraham’s post below.

          • theNormalDistribution

            That’s why I called you “honey.”

            I don’t get it.

          • Eddie

            I also don’t get it.

          • Mama to 2

            No, I would sue them if they checked my medical records which had the correct blood type and still gave me the wrong blood type. Still not clear on why you’re still calling me Honey…

          • Box of Salt

            I’m not surprised you responded with 4 paragraphs of mostly irrelevant justification. Drunk driving? Dennis Quaid’s tragedy? That’s not the point.

            This is my point. It’s simple logic: the underlying assumption for removing yourself from the resources that mitigate disaster is that you won’t need them.

          • auntbea

            And/or that when you need them those resources will even be available, given that your existence, your labor, and your complication are all a surprise to the people who manage those resources.

          • Mama to 2

            Well, I’m assuming hospitals and NICUs are supposed to be ready for emergencies no? Shouldn’t a hospital be able to prepare for a crash c-section quickly, even if there isn’t much warning, thus the crash? It’s gotta be a pretty shitty hospital that can’t handle an emergent situation.

          • KarenJJ

            I imagine that a lot depends if the hospital knows you, has your records and they have confidence that they are accurate and also knows that you are having a homebirth.

            Not sure how it works where you are, but I have a government paid for homebirth program based from my local maternity hospital. It’s as good as homebirth gets, with two fully trained midwives attending homebirths and is limited to low risk mums within 30 minutes of the hospital (which is quite a distance, but small compared to the state I live in).

          • Bombshellrisa

            I have a friend in Australia, her midwives deliver at the hospital AND at home-part of the healthcare system, not independent midwives. The midwives offer things like waterbirth too. Not sure how many homebirths they actually do, since the criteria they use to determine who would qualify is quite strict.

          • KarenJJ

            It’s not hugely popular where I live. Even for free. I think it was about 0.5% are homebirths..

          • Mama to 2

            Huh, sounds somewhat similar to my experience. Although it’s not a government run program. Did you birth with them?

          • KarenJJ

            No. I actually don’t know anyone that did, although my friend gave birth at that particular hospital. But I am also relatively new to this area.

          • theNormalDistribution

            There sure are a lot of assumptions in your homebirth plan, aren’t there?

          • Mama to 2

            Okay, like what?

          • Bombshellrisa

            One I can think of is with your blood work. They can know your type, but they also have to screen and do a cross match. Doing a blood transfusion isn’t without risks, people can have severe reactions to the blood they are being given on top of whatever else they are having go wrong. They also have to be able to start an IV, even if you had one that your CNM placed, it might not be the right size to run blood through.

          • Elizabeth Abraham

            Even if your midwife had a sufficiently large one placed to run blood through, it might not mesh with the connectors they happen to have on hand.

            I was, at one point, transferred from one hospital to another, and at the second hospital, they had to pull out the heplock the first hospital gave me and replace it with slightly different hardware, because the connectors wouldn’t hook up.

          • KarenJJ

            I ended up with three in one hand after my emergency c-section. Quite a mess of tape and it took a nurse a while to unravel the lot.

          • Bombshellrisa

            That is so true. Also the vein has to be able to take a larger cannula and a large amount of fluid. The placement of the heplock would make difference. A just in case one in the hand or the antecubital area wouldn’t hold up. A start by a midwife or a paramedic is usually placed in whatever vein is available, for immediate use. We pull those field starts and place new ones when a patient is in the ER or admitted to the floor.

          • theNormalDistribution

            I’m pretty sure the post I responded to started with “Well, I’m assuming…”, so you don’t need to look far for your answer. You assume the hospital will be perfectly prepared for whatever emergency you may have, for one. Other posters have pointed out other assumptions, like thinking you can phone in your blood type or order a c-section on your way to the hospital like you’re ordering a pizza. You basically assume that nothing will go wrong that can not be handled with the resources you have at your disposal.
            And most importantly, you assume that a homebirth (with all your specific risks factors or lack thereof and with attendants with the same qualifications as yours) is as safe as a hospital birth, simply because you can’t find any evidence suggesting it is less safe. That is a pretty big assumption, if you ask me.

          • Amy Tuteur, MD

            Your assumption is flat out wrong.

            http://www.skepticalob.com/2012/05/pediatric-er-doc-homebirth-5-minutes.html

            Could you hold your breath for the time it takes you to get from your home to the hospital? If you can’t do it, why on earth would you assume your baby could do it?

          • Mama to 2

            But a baby can hold it’s breath in the time it takes to prep an OR for a C-section? Dr. Amy, can you link to a study showing that women with my specifics birthing with a CNM have worse outcomes than women birthing at a hospital? Because people seem to be skipping over that part of what I’m saying.

          • Amy Tuteur, MD

            http://www.nature.com/jp/journal/v30/n9/abs/jp201012a.html

            In the hospital, I can have a baby out in 5 minutes. You wouldn’t even be in the ambulance in 5 minutes. This is just basic common sense.

            Haven’t you noticed that the only people who claim that homebirth is safe are homebirth advocates? Everyone else is aware that homebirth leads to preventable perinatal deaths.

          • Mama to 2

            I can’t hold my breath for five minutes.

            The 3 L&D nurses that I talked to told me that it takes about 20 minutes at their hospitals to prep an OR for emergent C-sections for low risk women-for high risk women it takes 10 because they try and have an OR prepped already. Perhaps they were all lying-who knows.

            And I’m not a homebirth advocate, I think people should do what they want.

            Again, do you have any studies showing that women with my specifics birthing at home with a CNM have worse outcomes than women birthing at hospitals?

          • Amy Tuteur, MD

            So if it takes 20 minutes to open the OR at that hospital, that’s all the MORE reason that you should be there. Otherwise, if you experience a lifethreatening emergency, it’s going to take at least 20 minutes to get to the hospital first, so that’s 40 minutes all together. This is just common sense 101; why do women who choose homebirth have so much trouble with basic common sense?

          • Mama to 2

            Do they not have telephones at hospitals with which you might be able to contact them?

          • Elizabeth Abraham

            They can’t prep for your c/s until their staff calls for it, and their staff can’t call for it until they evaluate you, and they can’t evaluate you until you get there, and it takes longer to get into your car then you think it does.

            Not all hospitals are equally capable of handling a crash situation (and not all hospitals are equally capable of handling a crash section on all shifts): you need a lot of resources to be able to reliably go decision to incision in the times you’re assuming. I have no idea what hospital you’re talking about – maybe you’re three minutes from Brigham & Women’s, in an alternate universe where there’s never traffic on the Jamaicaway – so there’s no way to evaluate your claim that they could absolutely take care of you as soon you’re through the door.

            My experience doesn’t really support the assumption that you can get from home to the hospital in an emergency as quickly as you think you can.

          • Mama to 2

            Well, like I said above we had the car completely packed the hospital number on speed dial and everything in the car we would need including seat protection to prevent blood and fluid stains. All my husband had to do would be pick me up and put me in the car (we live in a one story house) and go, my midwives have their records they need placed in a way they can just grab them and go. This was not their first rodeo, so to speak. Like I also said during the many test runs we did, it never took longer than 7 minutes and that was during peak rush hour traffic, it was usually more like 3 minutes (10 minutes was one time during a holiday weekend on a friday at 5:30) and that was door to ER entrance.

            The hospital I’m talking about has a Level 2 NICU and is where they send high risk women. They are capable of crash situations. The admitting people I spoke with were comfortable with my midwives calling in an emergency and starting to getting an OR prepped. I’m not sure if they meant they would then have to diagnose the problem and call in the C-section, but they did assure me that paperwork and red tape wouldn’t delay it.

          • Amy Tuteur, MD

            Why do you think you know how hospitals work in OB emergencies better than actual obstetricians who work in hospitals and handle emergencies?

          • Mama to 2

            Oh I don’t presume to know-I’m simply repeating what they told me at this particular hospital. Perhaps they misrepresented how things actually work.

          • Elizabeth Abraham

            Only level 2? I guess you work with what you have, but I bet they wind up life-flighting a lot of babies.

            It took about ten minutes for me to leave my house once the ambulance got there. They had a gurney, and I didn’t give a damn whether I had a bag or not. Conveniently, I was fully dressed at the time.

            Who watches your first baby while you rush to the hospital to have your second? How does your husband open the car door while carrying you? Is it as easy to pick you up while you labor as it usually is? Are you as cooperative and coherent about the proceeding in this emergency as usual? Is he as clear-headed as he would generally be? Has someone attached an oxygen mask or anything that also has to be carried? Were you wearing any clothes when this emergency was declared? How about shoes?

            Do you see how leaving in an emergency might be more difficult then leaving to go to the grocery store?

          • Mama to 2

            Okay to answer your questions:

            1. My mom was in charge of watching my first baby during the entire labor, no discussion needed.

            2. I made my husband practice carrying me to the car, he made it work. I was pretty light even at full term.

            3. I actually tend to be quite coherent during labor (read my birth story) and fairly compliant-perhaps a little whiny when I’m able to speak.

            4. My husband is ridiculously clear headed in an emergency. It’s actually kind of annoying.

            5. I wore a dress through my entire labor.

            6. Don’t need shoes had ’em in my hospital bag all packed up.

            7. Not sure about the oxygen mask, tell me are they transportable or do they need to be plugged in? I would hope that since my midwives were very adept at transfer procedure they would have a protocol for that.

            I take your point, but I also did everything humanly possible to minimize the possibility of delay.

          • Elizabeth Abraham

            Oxygen masks are transportable, but they’re attached to oxygen tanks, which are another thing to load up and carry.

            IMO, the first thing to stop running properly when things are going badly physically wrong is your brain. People who are badly injured or ill are frequently also not able to think clearly. It slows things down.

          • Mama to 2

            I know, that’s why we had the experienced and well trained birth attendants to help us with that…That’s why I wasn’t birthing alone like the woman in the post this blog entry is about (I’m sure that could’ve been worded better grammatically, I must be getting tired).

          • Elizabeth Abraham

            On this issue, I think you’re making the incorrect assumption that everything will run the same way in an emergency as it will when you’re practicing. In the event of fever, blood loss, dysfunctional labor, eclampsia, or other crisis, things are likely to be quite different then they are in calm daylight. The presence of a team of experts will not make it easier to get you the door after a seizure, with a bad case of labor shakes, while you bleed like crazy, or with a baby stuck partway delivered.

            That’s the bit that makes people protest. You think of everything you can think of, and then emergencies hit and the things you thought of aren’t the things that bite you.

          • Mama to 2

            Okay since apparently reading more than a few words is too hard for you. I will say it again: Please back up your claims with peer reviewed studies, only then will I take your claims the least bit seriously.

          • Box of Salt

            Apology accepted. Thank you.

          • AmyP

            “I think the same would be said for a blood transfusion-we could call, tell them my blood type and have them have the blood ready and waiting when we got there.”

            Did you discuss this plan with the hospital staff?

          • Mama to 2

            Actually yes, when I was bringing them my updated medical records 🙂

          • An Actual Attorney

            I genuinely don’t understand how that would work. I’m not trying to be annoying, I just don’t. Was it ER or L&D staff? Do they know your midwife? Who do you even meet with to drop off records if you aren’t being followed by a doctor there?

            I had to go in for possible pre-E about 5 days before my planned CS. At that point, they got me right up and on the monitors, but then came to take al the intake info (insurance, personal data, etc.) One of the nurses said maybe they could do the pre-admit work for my CS. After she checked, she said she couldn’t because some of the pre-op blood work could only be done less than 72 hours before. I’m not sure of all the details. But there was something they needed to know before operating. Wouldn’t you need similar tests?

            I am assuming you are in the US, but I guess if you are not, that would explain it.

          • Mama to 2

            It was with L&D they had my records from my previous birth, I simply updated them. My midwives also know several of the doctors and other CNMs on staff and they were fine with it. Also, with this system (Providence) when your medical records are in the system they are accessible by the entire hospital, at least that what they explained to me when I dropped them off-its possible that was misrepresented. So they would be available in the ER. I’m a little murky about the rest of your question, if you care to elaborate. They would also have the blood pressure readings that my midwives were continually doing at home….

          • An Actual Attorney

            I’m not a medical professional, and really not very medically minded. So I probably don’t know enough to be clear. But there were certain blood tests that had to be done within 72 hrs of operation (as I understood it). Not an issue with me, since there was a planned CS and I just went in later and had the blood drawn. But I would assume they would need these tests (maybe blood count, but that’s a guess) to come back before they could operate. I’m just wondering if they talked about what you would have to wait for if you did have to come in for an emergency CS?

      • Eddie

        Most of the sarcasm you hear here about homebirth is really about the anti-scientific thinking, magical thinking, rejection of reality, profound lack of training of birth attendants, and so on, and not directly about home birth itself. I personally have no objection to home birth with a fully-informed mother, with properly trained attendants (which in the US means OB or CNM or CM, IMO), with proper risking out, with proper contingency plans (attendants with admitting privs at the closest hospital is ideal), and so on.

        Home birth is not a choice I would make. The risks are definitely not worth the reward for me. It does bother me that so many mothers put the “experience” higher in priority than a healthy baby — but I understand that is not the only reason some choose home birth. As you say, different strokes. I may or may not agree with someone else taking those risks, not that it matters. But it should remain a legal choice, as long as the attendants are properly trained, etc.

        • Mama to 2

          And I want to be clear, I have the same concerns about homebirth and am horrified by some of the incompetence of home birth care providers and how they treat their patients and am shocked at the lack of proper risking out that goes on in the homebirth community. I just feel under the proper conditions it can be done relatively safely and it bothers me when all homebirths are painted with the same brush.

          When I was deciding where to birth I looked at the studies on homebirth, looked at studies that addressed low risk women, and looked at studies that compared outcomes of births attended by CNMs vs other providers, looked at factors that made it safer and decided it was not unreasonable for me to choose a homebirth and I still feel comfortable with the choice that I made. Had I lived farther from a hospital, been pregnant with twins, had a badly positioned baby, been older, had problematic blood pressure readings, or had a previous Cesarian I would probably have made a very different choice.

          I have since looked at many of the stories Dr. Amy tells about people who have been hurt by home birth and I’ve never read one that would have happened had the person been under the care of my midwives. Either because my midwives have advanced resuscitation equipment and training, only deliver extremely close to a hospital, always go to the nearest hospital no matter what (even if they are less homebirth friendly), they would give IV antibiotics during labor if a person were GBS+,they have protocols for who takes care of the mother and the baby and they carefully risk out situations (ie they wouldn’t do breech birth, take on mamas with multiple risk factors, etc.) Oh and they also recognize excessive amounts of vaginal bleeding during labor aren’t normal (yeesh, some of those stories make my blood boil).

          I truly think advocates of safer birth have more advocates in the homebirth community than they realize.

          • Lisa from NY

            My friend was not overweight; no high blood pressure; no diabetes; singleton; normal growth; normal labor, but placenta did not come out so she bled. Midwife waited an hour and a half before calling paramedics.

            (I found it this is the norm for midwives, whereas doctors only wait 30 minutes before taking action.)

            My friend lost so much blood that she went into shock. (Now she is fine.) HB is never really a safe birth.

          • Mama to 2

            Well, like I said above, when the same thing happened with my placenta, they manually removed it immediately and gave me pitocin and IV fluids. And like I keep saying, unless you have a peer reviewed study based in the US saying that low risk women birthing with a CNM 10 minutes away from a hospital are more likely to die of postpartum hemorrhage, your story (while sad, I’m very sorry it happened to your friend) does not mean a whole lot-in the context of this discussion.

          • Karen in SC

            I think what Lisa from NY is saying is that even in your situation of lowest possible risk, highest possible preparation, something could happen. And in that case, being in the hospital would have a much higher probability of keeping you and your baby safe and healthy. I don’t know the exact statistics, but you may be right that *your* risk was numerically the same as in the hospital. But you can’t know ahead of time if you are going to be that *one* with the catastrophe.

          • Mama to 2

            And you can’t know ahead of time that you won’t be the person who gets necrotizing faciitis and loses 65% of her body flesh before she dies (this is extremely rare but it did happened in a real case of a birthing mother). There are risks to every choice you make, in general we just get used to them. And avoid the ones that are excessively higher than the others.

          • Amy Tuteur, MD

            But the risk of necrotizing fasciitis is orders of magnitude less than the risk of a life threatening emergency during childbirth. Avoiding the hospital for fear of necrotizing fasciitis is like leaving a party and driving drunk in order to avoid a meteor falling on you if you stay at the party.

          • Elizabeth Abraham

            Okay, quick poke around the internet comes up with odds of 7% that a woman who didn’t hemorrhage the first time around will experience PPH with her second baby (http://www.reuters.com/article/2013/01/29/us-postpartum-bleeding-idUSBRE90S0PE20130129).

            I was able to dig up a news story about a woman treated for necrotizing fasciitis after giving birth in a hospital. I found a lot more info about people treated for that disease after trivial cuts and scraps, and zipline accidents. I also found a case of a woman who acquired the disease from her midwife (http://oregonmidwifeinfo.com/jennifer-buccilli/). There are about 9,000 cases of necrotizing fasciitis in the U.S. every year, among a population 313.9 million people. Most of those cases appear to be community acquired (no one’s having zipline accidents in the hospital). Your odds of getting necrotizing fasciitis are about .03%, and people don’t seem to be acquiring it from their medical care.

            So what you’re saying, basically, is that you’re willing to take a 7% risk of hemorrhaging away from help, in order to fail to reduce your already very low odds of getting a very rare disease. That you could as easily acquire while gardening.

            How does that make any sense?

          • Mama to 2

            I was using necrotizing faciitis as an example, it’s not high on my list of concerns. I simply meant that since you said “But you can’t know ahead of time if you are going to be that *one* with the catastrophe.” you weren’t referring to statistical likelihood you were saying that if you end up being the one it doesn’t matter how unlikely this thing was to happen. I was simply pointing out that it could go the other way. But that’s a lot of interesting info on necrotizing faciitis, I never knew all that. I’ll have to tell my brother about it, he loves ziplining.

          • Elizabeth Abraham

            I’m not the one who said that you can’t know ahead of time if you’re going to be that one (although you can’t).

            Fundamentally, I think you do have to consider relative likelihoods. If you were really worried about necrotizing fasciitis, you’d pave your yard and then never go out there anyway. Lots of things can go wrong in labor (shoulder dystocia in about 1% of all births, for example), that I think warrant arranging access to care.

            My issue with you at this point is that you appear to me to be insisting that YOU weren’t taking any risk! Which is ludicrous. All choices are trade-offs of risks vs. benefits. You made a choice that slightly increased risk – it was yours to make, and I have no argument with you making it. I object to your attempt to portray your choice as not having risks, because you’re young and healthy and this was your second baby and therefore nothing could possibly go wrong. Your case reminds me of the BIrthplace Study (from the UK, so you’ll probably argue it doesn’t apply to you), which Dr. Tuteur wrote about in Dec. 2011 (www.skepticalob.com/2011/12/birthplace-study-yields-additional.html) and Aug. 2012 (http://www.skepticalob.com/2012/04/no-birthplace-study-did-not-show-that.html). Despite rigorous exclusion criteria, that study failed to show that planned homebirth with professionals equivalent to CNMs is safer then hospital birth.

          • Eddie

            That was so well put. I think you have captured the heart of this discussion and what is motivating it.

          • Mama to 2
          • Elizabeth Abraham

            You applied the cut and paste function to Karen in SC. That’s her post that you’re quoting here. I’m Elizabeth Abraham.

          • Eddie

            FYI: Disqus is very, very buggy. Many times I’ve had Disqus put the wrong name next to a post, confusing me as that is not that person’s writing style. Then I reload the page and see the correct name there. The name shown when loading a page seems to be reliable, but the name shown on dynamic updates to a page seem to be significantly less reliable.

          • theNormalDistribution

            I have never seen the wrong name next to a post, but I have noticed that the comment updating can be totally bonkers sometimes. I suggest you find a good rss plugin for your browser and subscribe to the comments feed. It’s very convenient for following conversation and you can ignore all the crazy Disqus shenanigans.

          • Susan

            My name was next to all the posts once!

          • Eddie

            True, a good RSS plugin would make for easier reading.

            Not only have I seen the wrong name next to a post (fixed by reloading the page), but I’ve also seen old posts get reposted, according to Disqus.

          • An Actual Attorney

            Can one of you please post step-by-step instructions for what that means? I’m not as smart as I pretend to be.

          • CarolynTheRed

            This is the comments RSS link:

            http://skepticalob.disqus.com/latest.rss

            I am between readers myself (I am still using Google Reader, which is going away next month), but you can use various RSS readers, possibly pick one from here:

            http://www.theverge.com/2013/3/19/4119006/the-best-google-reader-alternatives

            You pick one, install, then “subscribe” to the RSS link above.

            This isn’t step by step, but I’m not sure what your setup is.

          • An Actual Attorney

            Sorry. Talk to me like I’m stupid. I got Feedly for Chrome. But when I click Subscribe to Comments over on the right, i get a screen of what looks to me like gibberish.

          • theNormalDistribution

            Right click on the subscribe link, and choose “copy link address”. There should be some button in Feedly to add a feed, find that and then paste the link.

          • An Actual Attorney

            Thanks a million! So much better. I am in your debt.

          • theNormalDistribution

            I’m using RSS Feed Reader for chrome.

            https://chrome.google.com/webstore/detail/rss-feed-reader/pnjaodmkngahhkoihejjehlcdlnohgmp?hl=en

            Just go there and install the plugin. It’s pretty straightforward and free. If you don’t see the icon on the right hand side of your toolbar when you’re done, restart chrome. If it’s still not there, type chrome://extensions/ in the address bar, and check ‘enable’ next to feed reader. Then all you have to do is find the link on the right side of SOB that says “SUBSCRIBE TO COMMENTS”, click it, and enjoy the commenty goodness.

            If you’re not using chrome, I can’t suggest a plugin or tell you how to use it, but googling “firefox rss plugin” should find you one (or whatever browser you’re using). It should be similarly simple to install.

          • Squillo

            I use Feedly (which was based on Google Reader) on both Chrome and Firefox, and I really like it. You just get the free plug in from the appropriate palce (Chrome Web store or Firefox Add-Ons). It used to automatically grab your Google Reader feeds, so you didn’t need to configure it; that may have changed now that they’re divorcing themselves from Reader in advance of the shut-down.

          • theNormalDistribution

            Yeah, I think that happens when the poster changes their profile in some significant way. A week or so ago, I got a handful of replies from he who must not be named and felt a moment of dread… But they were all old, and coincidentally, he had changed his profile name. Oh Disqus, you so crazy!

          • Mama to 2

            You’re right. I’m sorry, I just realized that.

            I’ll just keep posting what I posted above.

            Eddie just put this thread into perspective for me. I’ve been trying to defend the birth I had and the choices I’ve made-which I don’t need to do. My son is gorgeous and healthy as am I (well..I’m healthy). And
            the context of this thread is now more in the argument for what future mothers should do. I’m not comfortable playing that role. I think
            future mothers should look at the data and do what works for them.

            Anyway, my husbands home and I want to spend some time with him before bed. Laters!

          • Eddie

            The doctors who post here have shared stores of extreme post-partum hemorrhage where a woman can bleed out in 5 – 10 minutes without immediate medical response. And of some serious disasters for the baby that can cause death in less than ten minutes. I don’t know how common these situations are, but there are definitely situations that arise during previously-low-risk pregnancies where you need a surgical response in less than ten minutes to preserve life.

            This may be why a recent Netherlands study found a higher risk of death at home birth than in a hospital. http://www.skepticalob.com/2013/04/dutch-midwives-struggle-to-avoid-accountability-for-high-perinatal-death-rate.html and that’s with European-style well-trained midwives. Dr Amy has also reported on Australian home births having a higher mortality rate than hospital births. http://www.skepticalob.com/2013/04/australian-midwives-boast-about-terrible-homebirth-death-rate.html

          • Mama to 2

            Yes, but I wasn’t birthing in the Netherlands or in Australia with one of their midwives, I was birthing in America with a CNM. Also, unless you are able to look at the data exclusively for low-risk second time mothers with no history of complications under 30, that neither of those studies applies to my situation.

          • Eddie

            Realistically, there will never be a study as specific as what you are referring to. I am not trying to convince you of anything. Nor am I judging you. I am just responding with the data I am aware of, from countries whose home birth attendants are trained at the same level of a CNM, and were there are proper risking out procedures.

            It is not realistic to expect data to so specifically apply to your situation. Thus, your objection does not seem very realistic. That’s like someone saying, “Yes, there are a lot of studies saying smoking causes cancer, but can you find a study of white middle-class male smokers who started smoking when they were 25 and only smoke one cigarette per day, who exercise daily. If you can’t then the studies don’t apply.” (I don’t smoke and never did. It’s a made up example.)

            Again, I’m not judging you. You are the best-case candidate for home birth. I’m just sharing the evidence I am aware of, which suggests that home birth has a higher risk than a hospital birth, even for properly low-risk women with properly-trained birth attendants.

          • Elizabeth Abraham

            You’re such a special snowflake that we can’t possibly extrapolate from existing data, is that it?

          • Mama to 2

            lol, no, but if you’re going to try to apply a study to the safety of my situation I expect it to be at least in the country I was in with birthing professionals of the same accreditation as level as mine were.

          • Box of Salt

            “but if you’re going to try to apply a study to the safety of my situation I expect it to be at least in the country I was in with birthing professionals of the same accreditation as level as mine were.”

            Please cite yours.

          • Mama to 2

            Huh?

          • Box of Salt

            This is in response to Mama to 2’s query to Eilzabeth Abrams re whether Netherlands et all are applicable:

            Please cite the peer reviewed studies which demonstrate the safety of homebirth with the providers typically available in the area where you live.

          • Mama to 2

            Okay, that makes more sense. The type of study that would be most applicable to me would be one that looked at CNM attended hombirths, of mothers under 30, without pre-e signs, GD, or GBS+, and having a proven pelvis within 10 minutes of a hospital. That study is probably not likely to currently exist. Although, perhaps the data is available and could be looked at accordingly.

            Eddie just put this thread into perspective for me. I’ve been trying to defend the birth I had and the choices I’ve made-which I don’t need to do. My son is gorgeous and healthy as am I (well..I’m healthy). And the context of this thread is now more in the argument for what future mothers should do. I’m not comfortable playing that role. I think future mothers should look at the data and do what works for them.

            I’m sorry I essentially called you an asshole-that wasn’t cool. I’ll go delete that comment now.

            Peace.

          • Amy Tuteur, MD

            Where is the study that you believe is applicable to you. If it doesn’t exist, there is no evidence that homebirth is safer for you, yet you chose it anyway.

            You chose it, because you “assumed” that you would be safe. But as your responses have shown, just about every fact that you have assumed about life threatening emergencies and emergency obstetric care in hospitals is false. Your assumption about homebirth safety is false, too.

            You are simply practicing a more sophisticated version of “bad things won’t happen to me.” But you are no different than the women whose babies died at homebirth, or who died themselves. They thought it couldn’t happen to them, either. They were wrong.

            Both you and they suffered from a failure of imagination. You didn’t make an informed choice; you unwittingly took a risk. It’s like bragging that you drove home drunk from the party and didn’t get killed. It’s like claiming that you made the choice to drive home drunk because you had never seen any studies demonstrating that the risk of death from drunk driving is increased among 20 somethings leaving a brown house and driving to a green one.

          • Mama to 2

            Okay, I debated about responding to this, but apparently, for better or worse, I don’t have the type of personality that lets me ignore this type of comment.

            I acknowledge that the format of this comments and the frequency with which I was trying to respond to them meant I didn’t convey things terribly accurately. That’s my bad, as the young’uns say (if they lived in the 90s).

            Dr. Amy, you believe if a woman doesn’t want to breast, for whatever reason, that’s fine and she should be respected and not pressured into it. I believe the same thing-feed your baby however you want and do not apologize for it. Formula feeding increases risk of SIDS (below are two peer reviewed scholarly studies showing that)

            http://ije.oxfordjournals.org/content/22/5/885.short

            http://jhl.sagepub.com/content/16/1/13.short

            Are these women also drunk driving? Why are you okay with the risk they take but not with the risk I took? Is it because it is small? Where is the cut off for you?

            I chose to have a home birth after reading different studies about homebirth and about my risk factors and birth with a CNM. My friend was in a BSN Nursing program at the time and I talked with one of her professors about it-she told me that out of hospital birth was the way the trend was going and I sounded like a very safe candidate for homebirth as long as I made sure to do it with a CNM and she recommended the one I went with. I took what precautions I could to make it as safe as possible.

            The study you posted did not mention if the population only included low risk mothers. On your hurt by homebirth website you posted a story about a CNM who attended an out of hospital breech birth (so horrifying-I had tears in my eyes through that whole story), that carries higher risk than the vertex birth I had-if those type of births are included in there the conclusion would not be as applicable to my situation. Can you at least grant me that being 27 instead of over 40, having a vertex baby, having CNMs instead of CPMs, having advanced resuscitation equipment, etc. at least have more effect on the outcome of a birth than the color of the house you are driving to has effect on the outcome of driving drunk? Can you at least grant me that?

            And I don’t consider myself any different than a mom who lost her child in a homebirth, and I don’t consider myself any different than the woman you’re discussing in this blog entry if she (God forbid) ends up losing her child. I am no different from a mother who loses her child, she hurts exactly as I would hurt if I lost mine (exactly as you would feel if you had lost yours, for that matter): devastated. The circumstances of my son’s birth were different from many of the stories you post. Unlike one of the stories, I was not having a breech birth out of hospital (and would never feel comfortable with that). Unlike the story you posted a few weeks ago, I did have advanced resuscitation equipment and practitioners able to use it and was much closer to a hospital with a NICU than she was (the woman at the birth center). Unlike the baby who died of GBS, I was GBS negative and had I been positive I had access to IVs and antibiotics. Unlike so many woman I would not labor at home with no progress for days on end (I think my limit for hard labor would be about 4 hours actually, I am a complete wimp-after an hour of hard labor I’m like “Fuck this!”) I had midwives who recognize that excessive vaginal bleeding is not bloody show. However the women who did birth in these circumstances do deserve compassion even if they made a choice different than mine. They are not like this man (actually more like monster) who dropped a cinderblock on his newborn baby because “he couldn’t afford another one.”

            http://www.dailymail.co.uk/news/article-2003539/Man-killed-newborn-daughter-cinderblock-afford-second-child.html

            Too often on this blog people seem to forget that mothers who homebirth are not in the same category as this man. They loved and wanted their babies and maybe they lost them due to choices they made-that is not at all the same thing as people in the other category. They and their babies are both deserving of recognition and compassion.

            The crazy thing is, Dr. Amy, I agree with a lot of points you make. I think CPMs are woefully undertrained. I think many conditions are unsafe to birth with at home. I think all babies should be birthed with advanced resuscitation equipment available and qualified care providers. And people like me in the homebirth community could be useful to you-together we could make a lot of changes in both the homebirth and hospital community for the better. We are people you can point to and say-these people have had homebirths and think they should be legal and safely available and they still think CPMs are unqualified/birthing far away from the hospital is unsafe/etc. We can tell you why people choose to have homebirths (it’s usually not for the reasons you’ve listed on your blog) and if you understand it you can address and see how you can make hospital birth an easier option for them (ie look at ways the experience can be better for victims of sexual assault, etc). We can help you talk to people in the Natural Childbirth community in a way that they’re more likely to hear. If you really want to save babies lives and not just run a successful blog with a lot of traffic-I think reaching out to the reasonable people in the homebirth community who also support reform is essential.

            But you don’t seem to see me (or people like me) as a possible ally. You just see me as a “drunk driver” who only valued her birthing experience and didn’t give a shit whether her baby lived or died. And that’s where you show your lack imagination.

          • fiftyfifty1

            ” Formula feeding increases risk of SIDS”

            No, read your sources again. They do not say Formula feeding increases risk of SIDS. They say that Formula feeding is *associated with* increased risk of SIDS. Do you think carrying an umbrela increases the risk of rain? The formula/SIDS situation is very different than the homebirth/death situation. The former is correlation, the latter is causation.

          • Eddie

            Honestly, no-one is really objecting to the fact of your homebirth. What some are objecting to — and they are saying this specifically — is that you appear to believe you didn’t increase your risk by making that choice. This isn’t worth arguing over, as it’s past. Your risk of those past births is now a known quantity. I’m not going to argue about it. I’m just trying to clarify what, precisely, people are objecting to.

            Talking in general, the best evidence available tells us that home birth with fully-qualified attendants is associated with an increased risk of fetal death when compared to hospital birth. For properly-risked women with proper contingency plans … which sounds like your case … the increased risk is small. But again, according to the best evidence we have, the increase is not zero.

            But it does fall into the category of informed consent. The mere fact of increased risk does not mean something should be illegal. Adults get to make choices, within certain limits. Just as adults have the right to refuse medical treatment for themselves and for their children. Adults have the right to jump out of an airplane with a parachute, to bungee jump, and to do all manner of risky things. In those cases, we typically require informed consent where the risks of these activities are not hidden.

          • Mama to 2

            Saying I was like a drunk driver who got lucky feels a little like an objection to the birth I had. I object to people driving drunk…

          • Eddie

            IMHO, you are mishearing the analogy. I understand how you took it. I also understand how it is intended. Driving drunk increases the risk of an accident. However, most of the time, drunk drivers will not get into an accident. Also, drunk drivers do not appear to accept that they are at increased risk.

            Most homebirthing mothers — at least the ones who post here or on other blogs I have encountered — fall into that same category of taking on an increased risk of harming themselves and another, but rejecting that they took an increased risk. Even many home birth mothers where disaster struck insist that it was God’s will and that nothing could have saved the baby. (Probably a coping mechanism.)

            Again, the objection is not truly to the home birth itself, but to the act of taking on increased risk while rejecting that there was increased risk. Again, in your specific case, the increase is most likely small. MDs and nurses who post here have repeated posted (over a period of months/years) situations that occurred in low-risk mothers in a hospital that would have necessarily resulted in death or permanent injury for someone even five minutes from a hospital. Birth is just not perfectly predictable. A woman who never had PPH before can have one, and a PPH can be quickly fatal, for one example. There appear to be even more situations that can permanently injure or kill a fetus in five to ten minutes.

            Birth is unpredictable and inherently risky. Even in a hospital, some lives cannot be saved. Outside a hospital, a larger number cannot be saved.

            Again, the risk of your home birth, in hindsight, is a known quantity. There is nothing to speculate about. There is nothing to argue about.

          • Box of Salt

            Eddie: you have put this so well it bears repeating:

            “Again, the objection is not truly to the home birth itself, but to the act of taking on increased risk while rejecting that there was increased risk.”

            Mto2 ended up deleting her first response to me when I tried to point that out yesterday.

          • The analogy to drunk driving is the tendency to mistake luck for judgement. Have you never heard one justify their decision on the grounds that, in their case, the risks were reduced because of several special factors that do not apply to the irresponsible ones?

            Pointing out flaws in your argument is not the same as objecting to your birth.

          • Eddie

            Thinking about this analogy longer, there are two kinds of drunk drivers:

            1) I drove home drunk last night, but it was a really stupid thing to do. I got lucky because I didn’t get into an accident. I won’t do it again.

            2) I drove home drunk last night and nothing happened. See, I’m a good driver when I’m drunk. The risks are exaggerated. The fact that nothing bad happened proves that there was no risk.

            #1 recognizes the increased risk, #2 rejects it. When other people listen to these two drivers, they will be more likely to emulate the second one than the first one. For someone who drove drunk once but never will again, the risk is moot. Nothing happened that time and there will be no further increased risk. Unless they are type #2 and will unwittingly encourage others to emulate their example.

            Drunk driving and home birth are similar in several ways — for both, most of the time things will go OK. In fact, the risk of a death is higher for a home birth than for an instance of drunk driving, as Bofa on the Sofa has pointed out. This is not because of the uncommon risks of home birth, but because birth is inherenty risky. (As is driving.)

            The very best studies we have available, which don’t apply perfectly to your situation because you require so many caveats, tell us that home birth necessarily has a higher risk than hospital birth, simply because being even ten minutes from a hospital is enough to prevent some lives from being savable.

          • Susan

            Mama2, since this study with the data that applies best to your situation was so critical in proving that homebirth is safest in your situation can you share a link to it?

          • Mama to 2

            I’ll just repeat what I said above. The type of study that would be most applicable to me would be one that looked at CNM attended hombirths, of mothers under 30, without pre-e signs, GD, or GBS+, and having a proven pelvis within 10 minutes of a
            hospital. That study is probably not likely to currently exist. Although, perhaps the data is available and could be looked at accordingly.

            Eddie just put this thread into perspective for me. I’ve been trying to defend the birth I had and the choices I’ve made-which I don’t need to do. My son is gorgeous and healthy as am I (well..I’m healthy). And
            the context of this thread is now more in the argument for what future mothers should do. I’m not comfortable playing that role. I think future mothers should look at the data and do what works for them.

            Peace.

          • The Bofa on the Sofa

            The problem with the “I’m a low-risk pregnancy” argument is that the description of “low-risk” is only with respect to normal pregnancy. Given your circumstances, you might very well be relatively low-risk.

            HOWEVER, the absolute risk of a “low-risk” pregnancy is much, much higher than anything anyone would normally accept. Compare it to drunk driving. Is that risky? Yet, the risk of your baby dying in a “low-risk” pregnancy is, in fact, much higher than the chance of dying in a car accident if you drive drunk. Shoot, the risk of the baby dying is about 3 times greater than the risk of a drunk driver even getting in a car accident (death or no death). It’s about 1.5 times greater than a drunk driver even getting a friggin DUI!

            Think about that. Your “low risk” pregnancy is so risky that your baby is more likely to die than for a drunk driver to get a DUI.

            Your child, even in a “low risk childbirth” is more likely to die than is a driver in a NASCAR race. And it is not because driving stock cars is a safe activity. It;s just that childbirth is one of riskiest endeavors that people ever do in their lives. Even the “low-risk” version.

          • fiftyfifty1

            But what studies did you use, seeing that (of course) no study can be a perfect fit?

          • Mama to 2

            Like I said in the post you’re responding to, I’m not going to talk (well type) anymore about my son’s birth or reasoning I used to make my decision. I have no need to defend it and I’m not looking to convince anyone else to birth at home.

          • fiftyfifty1

            No, I understand. I’m not interested in your specific reasoning regarding your son’s birth. I’m just interested in the studies you referred to. Many of us here are familiar with the various studies (no one more so than Dr. Amy, of course). I would be interested in hearing which ones influenced you most etc.

          • Mama to 2

            I see, let me see what I can find.

          • Mama to 2

            So I was looking them up and I realized there’s not much point in posting them. I’m not going to defend them or defend how they show I was a good candidate for home birth. If you really want to see what they are I’d be happy to pm them to you (does this site have a pm function?)

          • Amy Tuteur, MD

            In other words, you can’t find any studies that support your claims. No surprise there.

          • Bombshellrisa

            But homebirth is built into the system in Australia and the Netherlands-so it could be argued that the criteria for risking out and hospital transfers as well as the emergency plan are all better and adhered to.

          • KarenJJ

            I don’t see why Australia wouldn’t be a reasonable comparison considering the lack of data on US CNM outcomes and homebirth. It’s not like we do completely outrageous things here – kangaroos not used in lieu of ambulances or anything.

            I thought part of someone taking responsibility of having a homebirth was acknowledging the increased risk and choosing to do it anyway (whatever floats your boat). Not denying the risk like you’re doing on here. There is an increased risk, but the overall risk is very low and (considering I’m not remotely involved in patient care) it is one for individuals to make.

          • Bombshellrisa

            Kangaroos! lol

          • Mama to 2

            lol, I did laugh at the kangaroos.

            I guess I’m just not familiar with the Australian accreditation process and it’s similarities and differences from the American CNM system. I’m not familiar with the equipment they carry or if they have a uniform criteria for risking patients out of a homebirth. I’m also having a hard time discerning what they defined as low-risk. I’m also not familiar with how far away from a hospital they are willing to attend a birth. But perhaps it is an apt comparison let me see what I can find and if you have the answers to those questions, please share.

            Perhaps I did increase my risk by birthing at home, I still have a hard time seeing that a second time mom, at my age, with no abnormal tests, that close to the hospital, with the attendants I had, really put me at much higher risk, but I’ll allow that it possibly did. In any case, the result of that birthing is (finally) sleep in a room just down the hall and I’m done having babies so as Joey Tribiani of Friends says: “The point is moo.” I think I may need to extract myself from this thread, my head is starting to hurt and I’m starting to get a little depressed that the best thing I have to do during the middle of a holiday weekend is post multiple comments on a blog.

          • Eddie

            Mama to 2: I cannot speak for anyone else, but my perception is that you are not being attacked, even as some are arguing very strongly. This kind of conversation might be easier in person, where you have more obvious clues as to tone. Seeing this number of messages in a short time, I thought to myself, “This blog almost needs a chat service for this kind of conversation.” 🙂

            Most of the regulars here are passionate about reducing risks in childbirth as much as possible, for a wide variety of reasons. In the hospital as well. (Dr Amy has posted before about some dumb practices some hospitals have had that increased risk in the name of supposedly lowering it.) It is in that context that this thread is going on.

            You made your choice. You don’t need to justify it to us. You don’t need to prove anything to us. The posters here want you to understand the risks as they see them, based on the studies that are available. This isn’t because you did something “wrong” or because you need to recant. (That would be silliness.) It’s because the posters here want future mothers-to-be to understand the risks so they can make an informed choice.

            My littlest is asleep on the couch 15 feet from me, with our dog curled up right next to her.

          • Mama to 2

            Oh, I don’t feel like I’m being attacked. I’m just getting tired of responding to so many questions and having a hard time keeping up.

            As someone who has talked to many people who’ve had homebirths, including in situations I would choose not to have them. I can tell you the very best way to reduce birth risk and keep women birthing in hospitals: tell all hospital staff who come in contact with patients to treat women with respect. In my experience the number one reason women choose to birth at home is because they had an awful birth experience at the hospital.

            Things like an anesthesiologist having a woman’s husband hold her down through contractions for 20 minutes while he placed the epidural-for extra kicks this is also a woman who was a victim of sexual assault. There is no need to place an epidural that way. My saint of an anesthesiologist at my first birth stopped during working during contractions and even held my hand during them-clearly it can be done differently.

            Another woman as told when her epidural wasn’t working and was making still yelling in pain “You need to be quiet there are women out there in real labor.” This after the nurse had pressured her into the epi in the first place. Her husband had to kick the nurse out and demand another one.

            There are a million more stories just like these. If every time you saw a story like that you said “That is horrible and it’s absolutely not okay. Here are the people you should talk to to report that kind of behavior.” You would get so many more women back into the realm of hospital birth. Truly most of the women I know just want their awful experiences to be acknowledged and assurances that these things will not happen again…

          • Elizabeth Abraham

            Those things are horrible and absolutely not okay. I hope those women were able to get in touch with patient advocates at the hospitals in question and file complaints.

            It is absolutely fine – sometimes vital – that patients be able to request changes in staffing on their cases. Ideally, no nurse would ever say anything as dumb as “there are women out there in real labor”, but when it happens, the patient has to be able to remove that nurse from their case. Unfortunately, no set of hiring and training procedures will ever be perfect (anyone can be sweet for an interview, and anyone can have a lousy day), so this kind of feedback is important in hospital staffing. It sucks to have to be the person who calls out the behavior problem, and I am very sorry that your friends were in that position.

            Unfortunately, it’s also true that some NCB advocates seem bent on poisoning the well, attempting to convince women that the behavior you’re calling out is the considered acceptable within the hospital system, and that the only recourse is to avoid the hospital entirely. Neither of these things is true!

            The vast majority of women are already in the realm of hospital birth, and the people who argue for hospital birth generally also argue for quality in patient care. This makes me uncertain that we could sway the remainder by saying what I’ve just said – We say that all the time. Less fearmongering and better risk assessment from NCB advocates might make a little more difference.

          • Mama to 2

            Thank you. It’s nice to hear someone say that.

            It’s absolutely true that no hiring procedure will ever be perfect, but we can absolutely expect the highest level of professionalism out of our birth attendants and have sanctions in place for when they mistreat a patient. So often women are told “that’s just the way hospitals are.” As happened with many of these women.

            I agree, natural childbirth advocates actually really annoy me. They do paint hospitals badly and I wish instead of doing that they would help hospitals find ways to be more “user friendly” so to speak-that do not compromise safety. And off topic, I wish they’d acknowledge the times when epidurals are not only safe but actually help the labor progress.

            I also think that just as we should call out midwives who mistreat their patients (and believe me I do) we should do the same with hospital attendants.

          • Eddie

            Years ago I had a girlfriend who spent a lot of time in the hospital. She once asked a nurse who was trying to put in an IV, “Are you drilling for oil?” Her veins were small and very scarred from a lifetime of IVs. Too high a fraction of nurses were offended when she tried to explain that she needed someone with extraordinary skill, and she experienced a lot of pain when nurses would not listen to her. Some of her doctors were just horrible people, no bedside manner, very insulting, and months later we found out they missed some things that should have been obvious. Like a diagnosis of lyme disease during the middle of the epidemic in a part of the country where it was common.

            You are absolutely right when you say the US hospital system is imperfect, although this depends on where you are in the country. The hospital where my youngest was born was extraordinary, and really seemed to want to do the right thing. Every person we came into contact with was great, and when interventions were offered, they were not forced. My wife and I have nothing but good things to say about her experience.

            I fully expect that every regular here will agree with your point that where hospitals have these poor practices, they need to fix them. I certainly believe so.

            My experience — second-hand since I’m male — is that hospitals and the people inside them all-too-often do not take women as seriously as they take men. A woman reporting pain may not be taken as seriously as a man reporting pain. Hopefully it’s a lot better today than when I was dating that girlfriend, but it was very clear to me at times that were she male, she would be better listened to and she would be taken more seriously. I found that totally unacceptable, but talking to other people, I found her experience was not unusual, at least in that part of the country.

            Long winded, but hospitals are not perfect. They’re made up of people, so they’ll never be perfect, but there is always room for improvement.

          • Mama to 2, you sound like a reasonable woman. My reaction to your first posts was to agree on “Different strokes” and not engage any further. Eddie, in his very reasonable comments, suggests that this kind of exchange of views is easier face to face, but I do not agree. Face to face, I absolutely would not engage at all, but politely agree to disagree at a very superficial level.

            The most reassuring thing I have read in your post is that you do not plan to have more children. Having had two relatively easy births, and delightful, relaxed homebirth, you would presumably have made the same choice again. I do respect the right of women to make that choice. I do accept that not all who choose it are idiots who privilege the experience over the outcome deliberately. I still think it is a very unwise choice.

            Yes, it is safe for low risk women. You are still gambling on low risk being a stable category – and it isn’t. The more homebirths, the more unnecessary deaths. Your post started with your walk in your sunny garden, and ended with all well. A very positive experience for you – and I do like to hear of those kind of positive experiences. But what effect would reading that have on someone who has read the hospital horror stories? Someone who, for reasons I simply do not understand, thinks the birth has some kind of long term significance? And that safety is a given if you are healthy and low risk?

            You imply that the reason women choose homebirth is because hospitals are horrible. That may be the reason they give, but certainly in first time moms I am not so convinced that is honest. Hospitals are or can be horrible. They are not invariably safe, either, because birth is not safe. They still function to reduce considerably the bad things that can happen in childbirth.

            Should women rail against bad treatment? Of course, loud long and often. But I think women should also accept the realities – that it is, sometimes, the birth that is horrible not the hospital, and chasing the rainbow of an idealised birth increases risk and disappointment.

            Our perspectives are different because low risk broke down for me good and early – unexpectedly, unpredictably. I spent weeks in hospital, and lost the fear. Was I treated badly? Some of the time, yes. Most of it was trivial, water of a duck’s back set against the real issue of survival. My first experience was ghastly, and the outcome was bad. The idea that I would run for home the second time makes no sense at all. NCB very patronisingly concedes that hospitals serve a purpose for those “other” mothers. But no-one can count on not being one of them.

          • Mama to 2

            I wouldn’t spend anytime worrying about or being reassured by what someone writes on a blog comment. For all you know I’m a 14 year old boy who jerks off (wanks if you’re a Brit) every time I read the word homebirth and am totally just messing with you and making it up as I go along.

            There are so many more important things to worry about in the world of obstetrics. Why not worry about low income minorities? Their outcomes are still very poor if I’m looking at the data correctly. Or how about women in developing countries who don’t have acccess to proper maternity care or birthing hospitals. Or women in India who are married off extremely young and start having babies at 12 or 13 and end up with multiple gynecological problems. Or girls in the Congo who are kidnapped and gang raped and conceive children extremely young and in awful conditions. I imagine all these women have poorer prognoses and outcomes than any I would be at risk for (with my puported circumstances)? Are these women less worthy of our concern? Are they less worthy of attention? Are they less in need of smart people such as yourself trying to come up with solutions?

            Or how about looking at termination services? I think the case of Dr. Kermit Gosnell highlights the need for safe qualified people to provide safe legal abortions. I’m surprised I haven’t read more about him on here-he was someone who purported to be qualified to offer obstetrical and/or gynecological services (which one does abortion fall under?) when he wasn’t board certified in either (someone please correct me if I’m wrong) and clearly wasn’t qualified to perform either. People say midwives kill babies, he stabbed live infants in the back of the neck because he didn’t understand the late term abortion procedure and in several cases just ended up inducing labor. He gave an 86 lb woman way to much anesthesia because apparently he didn’t understand how to use that either and ended up killing her. Women who choose homebirth usually have other options, this man preyed on people who were desperate and had no where else to turn. Surely his patients are worthy of attention and advocacy towards their cause (safe, legal, easily accessible termination services).

            If none of these causes interest you and you still feel your attention, worry and concern are still best placed on homebirth, then listen to what I’m
            saying-I’m giving you insight into why many women choose homebirth. I don’t have a bone to pick in this fight-I’m done having babies and I don’t care
            where women choose to birth-I choose to spend my time worrying and focusing on causes that I consider more pressing. But if you really want to keep a lot
            of women from home birthing demand that hospitals always treat women with dignity and respect-because when you don’t-more often than not you just
            convinced a woman to homebirth. Of course birth is horrible sometimes but that is not a cop out for not at all times treating women with dignity, compassion and respect. If this happened for most women (most not all) instead of being shamed or forced to do things against their will (ie being held down for an epidural during contractions while screaming for them to
            stop) then I truly think you would see less women choosing to homebirth.

            And of course midwives abuse and mistreat women-that’s partially what this blog is dedicated in part to talking about that isn’t it? Like I said it sounds like your sister’s midwives were incredilby negligent and I hope they were reported-that was not safe and it was not okay. And I will denounce any other midwife
            who mistreats and/or offers anything less than entirely professional care. I suggest you attempt to do the same in any hospital story you hear. Women are much more willing to listen to you when they feel
            heard.

          • LukesCook

            ” But if you really want to keep a lot
            of women from home birthing demand that hospitals always treat women with dignity and respect-because when you don’t-more often than not you just
            convinced a woman to homebirth.”

            You’re not doing the hospital any favours by having your babies there, you know. You go there because it’s the safest place for you and your baby, not because the hospital will be just gutted to be left out of your special, sparkly birth. The stats of course speak for themselves. Most women choose hospital birth because they’re not so juvenile to require hospitals to beg and grovel that women act in their own best interests and those of their children.

          • Mama to 2

            Again, I don’t have a bone to pick in this fight, I really don’t care-other women’s choices that don’t effect me aren’t really something that concerns me (though I do think they should be given accurate information and have access to qualified professionals). The people on this blog do seem to care where a woman births, isn’t that part of the point of this blog? If you want to increase the rate of women birthing at hospitals this is one of the ways to achieve that goal.

            “The stats of course speak for themselves. Most women choose hospital birth because they’re not so juvenile to require hospitals to beg and grovel that women act in their own best interests and those of their children.”

            Okay, so why the existence of this blog? Do you think you can belittle, shame, and ridicule women into a hospital birth? Do you think that’s more effective than listening to their concerns and having an honest and respectful conversation?

          • Mama to 2

            I’ve been thinking a lot about this. Do you think hospital staff shouldn’t treat women (or any patient) with respect at all times? Do you really think that story I told about my friend is okay? Do you think it’s not traumatic for a woman who has been the victim of sexual assault to be held down during very painful contractions while she screams at them to stop, while putting in her epidural? Especially when it doesn’t have to be done that way? Do you really think that’s an okay thing to happen to someone?

            Is it okay for a nurse to tell a woman whose epidural isn’t working “You need to be quiet, there are women in real labor out here.” Is that professional? Is that appropriate? Is that something you want happening in hospitals?

          • fiftyfifty1

            My mother had a number of good hospital experiences, according to her, before deciding to homebirth. I can vouch for at least one of them because I was there and old enough to remember it. She didn’t give up on the hospital because she was driven away. She changed to home because the woo enticed her away. And despite being as low risk as a woman can be, my mother very very nearly lost her youngest at homebirth. (But why should I care, because babies die in India too, right?)

          • Mama to 2

            I’m sorry that happened to your mother and glad the baby survived. Of course I don’t mean you shouldn’t care, she’s your mother. I’m saying Lizzie Dee shouldn’t be worried or reassured by with unverified comments made on a blog than real, concrete problems going on in the world.

          • fiftyfifty1

            I don’t get it. How are deciding which of these blog comments are worth caring about? After hearing my comment you say you are sorry about what happened to my mom, and glad the baby survived. But you think Lizzie Dee’s reaction to your story is misplaced because it happened in the developed world and that she should worry about the developing world instead. But my mom lives in the developed world too… so I am confused about why you care. Personally I do get caught up in stories of what happen to moms and babies. And not just here in the U.S.– “The Learner” is a great birth blog from India that I read too (the link is over on Dr. Amy’s blog roll on the right). It may sound silly with all the trouble that goes on in the world, but I do worry about individual moms and babies. For instance I am relieved that you won’t be having a homebirth again. Not only do you sound like you have decided your family is complete, but also you were really careful to make sure you were a low risk candidate. Now that you are no longer low risk (due to your retained placenta/PPH history), you are no longer a candidate for homebirth based on your own criteria.

          • Mama to 2

            I don’t think Lizzie Dee’s reaction to my story is misplaced I think it’s ridiculous to spend much time worrying about what someone writes in a blog comment. Like I said above, I could just be a 14 year old who jerks off every time I read the word home birth or a crazy old lady with a bunch of cats.

          • fiftyfifty1

            So you are a Poe?

          • Mama to 2

            Is that a fancy people speak for Troll? Or a person with a sexual fetish for the word homebirth?

          • Mama to 2

            Oh, God if I get pregnant again, I won’t have to worry about where I’m birthing because I’ll have shot myself in the head. No more babies-two is plenty!

          • Jeez. If you get to choose the place of birth, do I get to choose what I “worry” about? I don’t think I worry about homebirth, I argue against it. Not against the other things you suggest – because as far as I know, no-one is advocating for them or pushing them on the unsuspecting. Am I concerned and sometimes angry and horrified? Of course, who isn’t?

            You are here reading and contributing lengthy posts which clearly you do not feel distract you from wider concerns. Why do you think that doesn’t apply to others?

          • Mama to 2

            “You are here reading and contributing lengthy posts which clearly you do not feel distract you from wider concerns”

            Contributes to the crazy cat lady troll theory. What mom of two has time to write this stuff?

            If you want to worry/be reassured by the stuff I’m posting knock yourself out-your cardio-vascular system. I’m just saying it makes more sense to worry about people in real life you know are real, whose problems/situations you know are real.

          • My cardio vascular system is as well as can be expected, thank you.

            It wouldn’t really matter if you are a crazy cat lady – as far as I understand it, you are arguing a case FOR homebirth – so long as people take the precautions you took. You mentioned in one of your posts that you were assured that it would then be safe, and indeed that this was now the “trend” – a safer way than submitting yourself to the potential hazards and unpleasantnesses of hospitals. You are entitled to believe that, and on this occasion it was true for you. As you do not intend to test your thesis further, you will not suffer as a consequence. For all I knew, you might well have been a baby a year person. As you are not your faith in your method will not be tested further. Your other point I believe was that not all homebirthers are extremists. I accept that – but I think to some extent it is the moderate case that is problemmatic. ….safe for low risk women/in optimum conditions….is to me, a trap for the unwary, the caring and conscientious. Here in the UK, the conditions are much better – midwives ARE qualified, women ARE risked out. Things can still go badly and suddenly wrong.

            As for your sneering injunction to worry about real things, real people – I have daughters, granddaughters and I am in contact with several young women whose attitudes to birth are still somewhat unformed and uninformed. I do care that they are sold the pup of blissful, risk free birth so long as you do it right.

          • Eddie

            Good point on F2F comments. You’re right, it depends on the person. A great thing about the internet is that it’s easier for people to say controversial things to other people. A bad thing about the internet is the same. 🙂 The great equalizer. My point was along the lines of, in a F2F conversation there are more cues about whether someone is berating you or chiding or just curious. Sarcasm is more obvious in person (usually!). But yes, I neglected the fact that certain conversations just won’t take place in person, for a lot of people.

            I like the way you frame birth — that it’s not “hospital birth” that is unpleasant. It’s birth, period, for many women. It’s easy during an unpleasant and trying time to find legitimately bad things and pin all of the unpleasantness on those things. That’s a coping mechanism.

          • Mama to 2

            “Most of the regulars here are passionate about reducing risks in childbirth as much as possible, for a wide variety of reasons”

            I’m curious, if this is the case, why isn’t there more discussion of childbirth in the developing world? Places where they go through pregnancy and give birth without any proper maternity or obstetrics care. Places where they have no access to hospitals. Don’t women there probably have a higher risk of death, stillbirth, intrapartem loss, and neonatal loss than even women homebirthing her under the riskiest of circumstances? Why isn’t there more discussion on this blog of what can be done to help them? If there has been, please direct me to it-I would be happy to be corrected. Homebirthing women usually have a choice, those women don’t have a choice. Shouldn’t those of us passionate about making be birth safer be trying to look for ways for it to be safer for them? Giving them options?

            Off the top of my head, discussion topics could include effective NGOs, effective use of money, programs that have been effective in developing countries, cultural changes we can encourage, ways to encourage OBs to work overseas…

          • fiftyfifty1

            Should we stop monitoring bridges in the Unites States because bridges in the former Soviet Union are in even worse repair?

          • Mama to 2

            Of course not, I never said we should stop monitoring or being concerned about childbirth in the developed world. But if I were a passionate advocate of improving bridge safety for all, I think I might look at bridge safety around the world and what we could do to improve it instead of simply focusing solely on bridge safety in the developed world (uggh, I keep wanting to write 1st and 3rd world, but I know that’s offensive to some people).

          • Box of Salt

            Some more food for thought for you, Mama to 2: how much credibility do we have when trying to justify international interventions if we can’t clean up our own act first?

          • Mama to 2

            Are you going to call me honey again if I answer this?

            Should we not send food overseas to countries where hunger is a problem because we haven’t solved the obesity epidemic and malnutrition problems here? I think sending food overseas can be problematic for other reasons (ie it can fall into the hands of warlords and doesn’t get into the hands of people who need it-as happened in Somalia), but I don’t think that’s a good argument for not doing it.

            Don’t we have some of the best obstetrical (is that the right adjective?) care in the world in our hospitals? I certainly don’t think it would worsen problems to send money to build maternity hospitals in places where there are none and it wouldn’t hurt anything to have obstetricians go over to other countries and work in poor populations for a few years (maybe there could be programs for student loan forgiveness or something…)

          • Box of Salt

            Mama to 2, I do agree with you on some points. I think we could do a lot more to help others in greater need. But these issues (as you note in your first paragraph) are very complex. Does it help if you build a state-of-the-art hospital without trained staff? Or if you cannot guarantee power and clean water?

            However, the point I was trying to make followed fifty fifty’s bridge analogy. How do you export solutions to problems when you have not solved those problems for yourself yet? Why would anyone want to accept those solutions?

            As I said, it’s just food for thought.

          • Mama to 2

            Okay, let’s talk about here. I live in the US so that’s what I’ll talk about. Minorities in the US are still more likely to have poorer birth outcomes than their white counter parts, what can we do about that? I believe low income people are more likely to have poorer birth outcomes, how should we address that? Should we raise the medicaid eligibility age? What about access to maternity care in rural communities? Do we need more incentives for qualified doctors to convince them to work there? Is telemedicine an option for some prenatal care? What can we do to decrease drug use during pregnancy? Are there laws in place to make sure pregnancy is not considered a pre-existing condition? Is that a part of the affordable care act?

            My only point is that there is a lot of work to be done in obstetrics care and not all of it has to do with Natural childbirth and homebirth.

          • Box of Salt

            Mto2 (please forgive the abbreviation) “Are there laws in place to make sure pregnancy is not considered a pre-existing condition? Is that a part of the affordable care act?”
            If it isn’t, it should be. I’m digging through this website now: http://www.healthcare.gov/law/information-for-you/pregnant-women.html
            But all I’ve found so far is that GD screening is covered.

            My view is that the Affordable Care Act should be expanded to provide universal health care coverage for all Americans, and in addition we need laws at the federal level mandating paid parental leave, and in particular longer leave for new mothers.

            Since I have a day job in a non-medical field, my advocacy has been limited to my own voting, donations to campaigns and organizations which are (mostly) aligned with my views, and presenting my views in discussions, including on line such as this one.

            “there is a lot of work to be done in obstetrics care and not all of it has to do with Natural childbirth and homebirth.”
            I absolutely agree with you there. But keeping in the spirit of things – yes, we can work on both.

          • fiftyfifty1

            A number of these topics actually have been covered on this blog. And a number of the clinicians who post here work in our “real lives” addressing these problems. My own medical school loans were paid off by a state-funded underserved-area incentive plan. I have opinions about medicaid (and medicare) and belong to a group of docs lobbying for a single-payer plan for the U.S. My clinic won a large telemedicine pilot grant last year, and I have a lot of opinions about how it (mainly doesn’t) work. Income and racial disparities in outcomes are something I address daily. I’ve got a lot of opinions about supporting chemically dependent moms both during and (in my opinion more importantly) AFTER pregnancy.
            But the main focus of The Skeptical OB is debunking NCB myths and raising awareness about the increased risk of mortality at homebirth. It’s ok to have a focus.

          • Eddie

            Indeed, there are different kinds of work to do in the US about obstetrical care, and not all of it has to do with NCB or its related ideologies. Nor is NCB the only discussion point of this blog. In any case, just because people spend time here doesn’t tell you what they are doing with their other time and resources. The “starving kids in ___” argument doesn’t work for me. That is, “The problem you bring up isn’t the biggest problem, so you should focus on the bigger ones.” Everyone gets to pick the issues of interest to them, for whatever reasons that those issues are meaningful to them.

          • fiftyfifty1

            But you feel our obstetrical care is driving women to birth at home. How then could you justify sending our obstetrical care abroad?

          • Mama to 2

            I have no problem with obstetrical care in the US-it’s top notch-I have problems with the individual obstetrical providers who treat patients poorly. I don’t object to sending doctors and medical technology to those who need it…

          • Box of Salt

            Is it just Disqus or did Mama to 2 just delete her whole profile as well as certain posts? Now she seems to be showing up as “Guest.” Could someone using RSS feed clarify?

          • Me

            Sorry, it’s me, I was trying to unsubscribe to the e-mails because they were clogging my inbox and accidentally deleted my profile. Whoops. Oh, well, good excuse to go to bed-my hubby has been bugging me to get off the computer. G’night all.

          • Box of Salt

            Mto2, no biggie! It was just weird because you came up as Mama to 2 on the sidebar, but “Guest” when I clicked on it.

          • Eddie

            Hmm, Mama to 2 seems to have deleted her Disqus account. I didn’t see that coming.

          • Bombshellrisa

            Oh lord no! Look what happened on the I5 bridge in WA state this past week!

          • Eddie

            Typing on a tablet while BBBBQing so this will be short and with typos. I can think of several reasons but I can only speak for myself of course.

            There are already organizations focussed on developing world issues such as doctors without borders. They don’t focus exclusively on any particular issue, except helping people medically. I periodically donate to them.

            Also, the mothers-to-be in developing countries who could be most helped are unlikely to be reading an internet blog. In the US, home birth is predominantly an middle and upper class thing … These women are using the internet and can be swayed by reading birth stories and analysis.

            Also, as you say, different strokes. People get to pick causes that are meaningful to them.

            I could go on. There are many causes and many organizations dedicated to them. A blog on developing world need is one I am unlikely to be able to contribute to, except maybe for those few countries I’ve been to. I choose to contribute cash to some causes, my time to others. We each get to choose where our time or money or other resources are valuable and none of us have to justify our choices to another. Questions are not unreasonable tho.

          • auntbea

            Because there are already a lot of blogs about improving health care in the developing world but not very many (critically) addressing NCB in the US? And because Dr. Amy is not particularly qualified to address policy evaluations? And because Dr. Amy is allowed to be passionate about improving whatever aspects of childbirth she wants?

            You seem to have come here and demanded that we a) agree with you that your homebirth was different safe and b) that Dr. Amy write her blog about something else.

            So in other words, you started an argument and now seem to be surprised that people are arguing with you.

          • Mama to 2

            I don’t think anyone needs to accept or approve of my homebirth. I don’t think Dr. Amy needs to change the content of her blog. Actually I think a lot of what she writes is important and should be said. I demand nothing. I think it’s easier to convince people in the NCB community to come look at what she has to say if I can say that she advocates improved obstetrical care for all.

          • Squillo

            Should we assume you don’t care about other issues because you’ve chosen to spend time debating here?

          • fiftyfifty1

            ” kangaroos not used in lieu of ambulances or anything.”

            No, it’s not the kangaroos instead of ambulances that’s the problem. It’s the vegemite instead of erythromycin eye ointment that we worry about.

          • araikwao

            Hey, Vegemite is good stuff! (but no eye ointment is used routinely here, anyhow)

          • fiftyfifty1

            How do they decide which babies to give it to? I suppose risk factors for mom having an STD? That probaby would catch most of the cases. Although I have had 2 married women test positive for Chlamydia during pregnancy. One was not a shock to me (husband was professional athlete), but the other was. I even told her it might be a false positive. But then it wasn’t…..

      • Bombshellrisa

        An ND as in a naturopathic doctor? There are quite a few killer CPMs who also hold ND licenses, the ND license is what they use to skirt the fact that they are not allowed to practice midwifery anymore.

  • Guestmama

    Omg I made the mistake of browsing the MDC UC board, and came acoross this gem:

    “Both my placentas came out within a half hour or so, but with my UC the membranes stayed attached and the placenta hung between my legs for over 24 hours. I had to call Pamamidwife for advice because although I knew everything was fine, I felt I was missing some piece of information that would easily help me get it out.

    I wound up twirling the placenta so the membranes sort of “roped up” and then reaching up inside and wiggling it back and forth until it detached. It took about 30 second total.”

    I cannot even begin to fathom spending the first day of my newborn’s life with a placenta dangling between my legs. Wow. Holy freaking WOW.

    • Eddie

      When will this be posted on youtube? It’ll be the next dance craze.

    • Lizz

      I made that mistake too. I’m trying to figure out what the hell would make a parent turn down the PKU test and hearing screening?

      • Lena

        They turn down the PKU test because then the government will have their babies’ DNA and who knows what they’ll do with it.

        I’m not kidding. That is one of the reasons MDCers give for not doing the test.

        Also, heel pricks are traumatically painful, apparently.

        • The Computer Ate My Nym

          Um…PKU isn’t a gene based test. I’m not sure you could even extract a decent amount of DNA out of the nucleated cells you get from a heel stick, though I may be underestimating what someone with a PCR can do.

          I’m sure heel sticks make babies cry, but I’ve got to admit that I don’t even remember mine and can’t see that I was traumatized by it.

          • fiftyfifty1

            You are underestimating what a PCR can do.

          • The Computer Ate My Nym

            Now that I think about it, I have a vague memory of a study where researchers in Africa (Uganda?) collected spots of blood, dried them, and shipped them to the US for analysis of some gene or another. So you can extract DNA from a tiny sample of WBCs. That being said, I can’t imagine why the government would care what anyone’s DNA would show. Or that a government that was intending to do something evil with DNA results would have any particular trouble with forcing people to give up blood in some other way. In short, it’s a useless paranoia.

          • Eddie

            There are all kinds of useless paranoias out there. During the H1N1 scare, I actually heard a caller to a radio show say that her family wouldn’t be getting the H1N1 vaccine because who knew what eugenic (for that person, using the vaccine to kill off the less desirable) purpose the government was really using the vaccine for. The radio show host clearly had no idea how to respond to that, it was so far off the radar.

          • The Computer Ate My Nym

            Um…it is killing off the less desirable flu strains, so I suppose she kind of had a point. Or something. Actually, I can’t figure it out at all from the human-centric point of view. Was the vaccine supposed to contain something that would kill “less desirable” people who got it? How would that even work?

          • Poogles

            “Was the vaccine supposed to contain something that would kill “less desirable” people who got it?”

            I’m guessing the paranoia was more along the lines of the vaccine being created by the people who “control the world” to use against the general population, by causing death or maybe infertility in those who get it while the people “in power” avoid the vaccine. NWO-type crap.

          • Eddie

            Yeah, exactly that, NWO crap. The kinds of paranoia that the X-Files made fun of. There was dead air for maybe five to ten seconds before the radio host was able to respond with incredulity.

            I listen to talk radio to keep my blood pressure up, and boy does it work well. That was my trick for cross-country drives back in the day … find talk radio. I would be so angry at the idiocy I was hearing that there would be no risk of falling asleep.

          • auntbea

            Are you my long-lost twin?

          • Eddie

            Sis! Where have you been!?

          • The Bofa on the Sofa

            Yeah, but since when is the Center for Disease Control “trying to control the world”?

            I always get a kick out of people who talk about the CDC as “the Government.” Not in the least. Although the director is an appointed position, those that work at the CDC are not elected or anything, they are hired as scientists. Moreover, the committee that actually determines the vaccination schedule are not even employees of the CDC, they are best described as consultants. Their identities are available, they are anything but “the government,” they are folks like the Chair of Pediatrics at LSU or Distinguished Professor of Infectious Disease at Johns Hopkins and things like. IOW, they are very high profile researchers in the area of things like, vaccination.

            They are no more “the government” than I am (literally – I serve on (and have even chaired) panels for the NSF)

          • The Computer Ate My Nym

            – I serve on (and have even chaired) panels for the NSF

            Clearly, you’re part of the conspiracy to push crazy science like the big bang theory and evolution on us all. Some congresscritter or another said so.

          • auntbea

            You’re right that consultants to the CDC (or the NSF) are not part of the government, but regular employees of the CDC are. Government includes the bureaucracy, of which the CDC is part, and there is no reason you can’t be both a scientist and an agent of the government. Ditto with the scientists at the EPA, the FDA and the NIH. Whether these we trust the output of the CDC does in fact have something to do with whether we trust the government.

          • The Bofa on the Sofa

            But the employees at the CDC are not “governing” in any way. They are public employees, much like the postal workers and the city custodians that fill the potholes in the streets.

            I forgot to mention, I have been paid by the NSF to fulfill my duties for them. That they have a full time gig does not make them the government any more than my paid consultant position does.

          • auntbea

            They don’t make policy, no. But that doesn’t mean they aren’t “The Government.” Policy doesn’t just magically implement itself. The vast majority of “The Government” are the people who execute the policy (which is why the bureaucracy is considered part of the executive branch.). Employees of the CDC are hired to carry out government policy and are only as scientifically independent as the policy allows them to be.

            When people distrust the CDC, it is based on a belief that the government has *not* granted them leeway to protect public health and is instead using them as a propaganda machine. Doesn’t hold up to scrutiny in the American context, but is not on its face implausible. It is silly to assume that scientists at the CDC are enacting their own political agenda. But it is NOT ridiculous to view the CDC’s work as a representation of government’s interests. Because it is.

            And yes, the guys who fill the potholes are part of the government too. If they don’t do their job, it is considered a governance failure. (If they were private, it would be considered a market failure.)

          • The Computer Ate My Nym

            There does seem to be a movement within Congress to make the NSF into a government propaganda organ. I think it was Lamar Smith who was proposing that all grants funded by the NSF should be reviewed by Congress to make sure they were consistent with Congress’s goals. Or something like that. I admit that I’m not quite sure what they’re thinking, but the whole idea of a Congressional level approval AFTER peer review has declared a grant to be high quality and high impact makes my skin crawl. Specifically, it wants to crawl to another country that does not have a similar law.

            http://news.sciencemag.org/scienceinsider/2013/05/what-representative-lamar-smith-.html

          • Eddie

            I completely agree about how awful it is that Congress wants the right to approve/deny individual grants.

          • auntbea

            Yes. I am one of the people who got her funding cut.

          • The Computer Ate My Nym

            Crap. They’re already doing this? I thought it was still in the “stupid proposals” stage. Or did you get cut under the sequester? My sympathy either way. I’ve been calling my congressperson to try to prevent this sort of thing, but there’s only so much a congressperson from Philadelphia can do about idiots from Texas.

          • auntbea

            The amendment to cut political science funding passed a while ago, and that seems to have opened the door to attempts to cut other disciplines too. Well, actually, they didn’t cut existing projects, but will refuse to fund future projects that do not meet the criteria of improving national security and/or the economy. It is yet to be seen whether a) the policy stays in the next budget or b) what percent of political research can be justified according to those criteria. (Most political scientists would say almost all, but Congress may disagree.)

          • The Computer Ate My Nym

            So…where are all the dead and infertile people? I and practically everyone I know got the H1N1 vaccine. And get the yearly vaccines. We’re all still alive and some of us have even had kids since then. I certainly had had plenty of flu vaccines before becoming pregnant.

          • HM

            I was talking to a woman who was substitute teaching in my school the other day. She was telling me how unnamed higher powers are killing middle and lower class people so that rich people can take over the world. Because you know rich people never get vaccinated. It’s a rule. I also pointed out to her that she and I were both vaccinated and we are fine. She just said, “Well some people believe it.” I was pretty sure it was a lost cause so I didn’t bother continuing.

            She is also a member of this crazy religious cult so I’m guessing they brainwashed her. So glad she is helping educate young minds.

          • The Computer Ate My Nym

            She was telling me how unnamed higher powers are killing middle and
            lower class people so that rich people can take over the world.

            Point 1: She is insufficiently paranoid. The rich people have already taken over the world.

            Point 2: What would rich people gain by killing off their labor force and consumer market?
            Point 3: Yes, I am the sort of weirdo who tries to make people’s paranoia make sense.

          • R T

            DNA can be extracted from a drop of blood much smaller than the amount required for the PKU.

        • fiftyfifty1

          I’ve often pondered this excuse for refusing the newborn screen. Does it reflect Cluster A traits (odd beliefs and paranoia)? Or does it better fit with Cluster B traits (i.e. narcissism)? Because who else except a narcissist would believe that the government had nothing better to do than to try to test my DNA?
          ……..hmmm…..I think I lean toward Cluster A being the explanation.

      • R T

        This explains why some people opt out of it http://www.cchfreedom.org/pr/CCHCpkunbsReport092408.pdf

        I’d didn’t because of family history of CF and even though we did PGD testing on our embryos, I felt like we couldn’t be to safe. Many of my friends opted out of it for their babies though.

        • Eddie

          Is that document accurate in its recording of the history of the PKU test? I’ve never heard of the Citizens’ Council on Health Care so I don’t know if they are evidence-based or paranoia-based.

          • The Computer Ate My Nym

            As far as I can tell, sort of. The PKU screening test really does have about a 50% specificity. What the CCHC doesn’t say is that any infant with a positive screen has a second test which is 98% specific to confirm the diagnosis before being treated. The more extreme claims, including that the test increases the rate of MR, I couldn’t find any particular backing for.

          • Karen in SC

            how can a test of a drop of blood increase the rate of mental retardation? I thought the risk of undiagnosed PKU was mental retardation.

          • An Actual Attorney

            I think what it’s saying is that girls who live grow up to have retarded kids, when they should have died or at least not reproduced because they have PKU. It’s a pretty offensive statement.

          • Lizz

            Eugenic statements just always have this level of disgusting to them.

          • R T

            Yep, that’s the disgusting part. They’re pretty much saying the PKU test should never have become routine because it had allowed women who should have died to live and reproduce possibly handicapped children. This is all part of the hippie eugenics movement I grew up around. Letting nature take its course, in their minds, healthy and better for everyone on the planet.

            I forgot to add, recently a friend of mind called me from Colorado asking me to help her decide if she should allow the PKU test for her preemie. She was concerned about the government keeping the blood and also of false positive resulting in more testing. I suggested she speak with the doctors at the hospital. I told her CO doesn’t require parental consent to do the PKU so possibly it had already been done. She freaked out and asked the doctors and nurses in the NICU. They were really nice to her and said they would find out what happens to the blood. They called the lab for her and found out the sample is kept for 6 months and then destroyed. However, they said she could have the sample returned to her and destroy it herself. The doctors said she could opt-out of the test on religious grounds. I was surprised they were so laid back. When I had my son in CA they were very pushy about it! I misunderstood our pediatrician and thought he was going to do it in his office when we were discharged. When I told the nurses we were doing the PKU later they were really nervous and freaked out! They got the on duty Peditrician to come talk to me. I explained what was going on and he actually called my Peditrician. My Peditrician explained it was a misunderstanding. He wanted us to do the PKU in the hospital AND some additional tests for CF in his office. We did the PKU right away, but I got the impression they wouldn’t have just shrugged and let us leave with out it like my friend did in CO. I guess it depends on where you have your baby.

          • The Computer Ate My Nym

            Oh dear. It’s worse than I thought. Also indicates that they don’t understand genetics. PKU is recessive. Killing the affected cohort by neglect won’t make the gene disappear. Just subject the children and their families to unnecessary pain and suffering, given that the condition is highly treatable.

          • Eddie

            They basically claim that the diet is so restricted and unpalatable that kids are dying of malnutrition, and they also throw out there the claim that some kids with PKU don’t need a restricted diet at all.

          • Eddie

            The claim in the document was that 19 out of 20 positives were false and thus many healthy kids were subjected to the very restricted PKU diet which didn’t have enough protein for them. I don’t know whether that claim is true or not (whether the PKU-safe diet would in fact harm a kid who didn’t have PKU). That was just their claim. The document also claimed that many kids with PKU didn’t need the specialized diet.

          • The Computer Ate My Nym

            I couldn’t figure that out either. As far as I can tell, they seem to be claiming that kids put on the diet unnecessarily were at higher risk for mental retardation, but I’m not sure I understood the claim at all.

          • Eddie

            Yes, that was the claim. From page 3, they claim the test is “bad” because:

            * The PKU test was quite inaccurate, causing injury and death in normal children.
            * “Maternal PKU” has led to the birth of more mentally retarded children.

            The latter point is so disgusting I won’t comment on it. As evidence of the former point, on pp3-4 they present this quote from Dr Norman Fost:

            So many children—we don’t know how many—were made retarded by this program. Some were killed. In fact, kwashiorkor [malnutrition found typically in third world countries] developed in America in the PKU
            program in children who had profound protein malnutrition because of the restricted diet

            I find it odd that a doctor who says that steroids are not harmful would say the above. Dr Fost seems to be a medical ethicist who has espoused some views I find pretty questionable.

          • LibrarianSarah

            It’s a “health freedom” organization. Not a place I’d go for medical information.

          • Eddie

            That’s good to know. Thanks.

          • LibrarianSarah

            Always here to help!

        • Lizz

          Ok so that explains the paranoia about the PKU test, still wondering about the hearing screening unless it’s another ‘Oh my gosh they might keep government records on my child’ thing.

          But my Husband and I wouldn’t have missed that test for anything since we both have an adopted parent and Hubby’s Mom has Galactosemia in her family.

    • rh1985

      I think I feel a little sick after reading that….. do placentas smell bad?

      • fiftyfifty1

        That depends on if you like the smell of blood.

        • AmyP

          This reminds me of the Geico commercial where the punchline is, “…as happy as a vampire at a blood drive.”

  • BeatlesFan

    Can someone please explain to me why it makes a difference which side of the placenta the supposed life-saving piece comes from? I realize chewing placenta to stop PPH is totally idiotic so there is no real way to answer this question… but this is the first time I’ve ever heard that where on the placenta the piece comes from actually matters. Where did this originate?

    • Roze of the Valley

      I think it originated when people did not understand science and thought it the devils work and where also very hungry… nom nom nom

    • AmyP

      It’s like Alice in Wonderland and the mushroom–one side makes you bigger and the other side makes you smaller. Enjoy responsibly!

    • Antigonos CNM

      Well, one side [that was attached to the uterus] looks like raw meat; the other is covered with the membranes that faced the baby. As for smell, initially there isn’t much–basically it smells of blood and amniotic fluid, but, unrefrigerated, it gets high pretty quick [in Olden Times, OB units had huge commercial freezers and all placentas were kept for the drug companies who extracted hormones from them. It’s all done synthetically now.]

  • Lizz

    Do you guys ever wonder why the obsession with”alternative ways to check dilation”? I learned how to check my own cervix last time, it helped me know to go in to the hospital at 20 weeks when my only symptom was cervical pain. It just seems handy to know more then just an approximate number based on sounds,emotions or butt pictures, you know like whether your presenting part is something hard like a head or a butt as opposed to something complicated like a foot or a hand or a face. But I guess that would depend on them caring what the presenting part is?

    • Elaine

      I think it’s to avoid disturbing the laboring woman while she is in Laborland… which does sound terribly woo-ey, but to be entirely fair, who WANTS to be hassled in labor to have fingers stuck in their vagina, unless it’s necessary? And if an alternative method is actually reliable and less invasive, why not use it?

      Knowing a presenting part would be a good, though, but if the baby is well engaged presumably the presenting part will stay the same, so that information could be determined from one check.

    • areawomanpdx

      Because there is no need to check something if it’s not going to change how you’re going to act. If a woman’s been at 9 cm for 5 hours in the hospital (I doubt it would even go this long), there’s going to be some sort of intervention. But at home, these midwives wouldn’t even know where to start, so they just sit on their hands. And then there’s the legitimate fear of introducing infection. Even in the hospital, they’re wary of doing too many vaginal checks on someone who’s water has broken.

  • Are you nuts

    Her poor husband. He probably feels like he would be insensitive to suggest his wife is beyond crazy for wanting to do this, so he’s going along with her dangerous little game. I can’t even my imagine my sweet husband trying to deal with my labor pain, a delivery of a child who you can bet has had little or no pre-natal care so who knows what kind of issues they could face, and the aftermath of dealing with new baby and mama! Hoping for a safe outcome for all.

    • Allie P

      I’m curious why everyone seems to think the husband is the innocent bystander in all this? A lot of the crazy homebirthers I’ve seen are of the Quiverfll Christian variety who think women deserve to suffer and want to avoid not only c-sections but all prenatal care because it risks their baby-making machines — I’m sorry, wives ability to carry 20 children.

      I’ve also seen plenty off woo-ful husbands, even on this site, arguing for “natural” at all costs and other crapola.

      It’s entirely likely he’s not only a full participant in this horror show but also an instigator.

      • drsquid

        a guy at work was the only one to suggest i should do delivery drug free and the only one who seemed disappointed that i got the epidural id always intended on getting

        • Something From Nothing

          He possibly enjoys the idea of women in pain?

        • Did you suggest he go drug free if he ever passes a kidney stone?

      • Are you nuts

        Fair point. I know women don’t have a monopoly on crazy when it comes to birth or anything else. I guess I was in the mindset of wives castrating their husbands after reading two posts on TFB’s train wreck Facebook page where she asked followers to post about their husbands not being supportive enough of home birth or breast feeding.

        I still can’t in a hundred million years imagine my husband willfully navigating anything to do with a placenta!!

        • Just A Guest

          Every family is different and their emotional needs are different. Some people would think that my husband is unsupportive or insensitive or doesn’t care about me in some way for not wanting to remain with me in labor. But I am his wife and one of the people who know him best in the world. I know that wasn’t the case. I have no doubt that my husband loves me deeply. Most women are accompanied by a husband/partner when they have a baby but my husband was a combat veteran who saw and heard several people dying. I decided early on if the environment or the sounds I made or the pain I was in was too much for him that I would respect that. I love him enough to not ask for something he wasn’t readily capable of doing. I was accompanied by females that I was close to and I was fine with it. Besides, the truth is that men have only come into delivery rooms recently and having babies was historically a woman’s business anyway. If I’m wrong please correct me, but I think the truth is that it was like that for thousands of years that female midwives and other female family would help during a birth and the men (even the husband) would stay out of their way. I can’t imagine putting THAT kind of pressure on my husband to bring up the idea of an unassisted birth where he is expected to be the attendant and the emotional support and be totally responsible for the outcome. My husband would go off the deep end with PTSD. I’m sure some husbands wouldn’t mind being everything at a UC, but I sure wouldn’t dream of it. My husband needed someone else to take care of me and to have someone else reassure him that I was ok. Feminist Breeder can say whatever she wants. My husband is amazing, a bigger supporter of my goals and way more helpful with the home and the children than home birth dads I know. I’d take a man who was a supportive husband and dad during the part where you raise the children over a cheerleader at an unattended birth any day!

          • Dr Kitty

            Sounds like you and your (amazing BTW) husband make just the right choices for yourselves. Good for you.

          • Lena

            It makes me genuinely happy that you and your husband understand and support each others’ needs. I love reading stories like that.

          • Karen in SC

            Tell your husband that he’s got some fans on this site.

          • Elizabeth Abraham

            UC seems to me to put the laboring woman’s partner in a truly awful bind. If things go wrong, who is he supposed to work with? Is a woman who just pushed out a baby going to sit up, note that the baby’s blue and manage the key first step in ANY resus (CALL FOR HELP) herself?

      • areawomanpdx

        I’ve been hired as a doula for a fair number of births where I am a compromise between the woman and the man. He thinks homebirth is absolutely batty and she is afraid of the hospital because of all the idiotic rhetoric. Men don’t read “The Thinking Woman’s Guide” or watch BOBB of their own accord. I think it’s true that there are a few batshit assholes out there, but the vast majority of men can’t conceive of wanting a homebirth.

        • Anon

          In general it seems like the men ‘on board’ are also the kind that would have an opinion on which tampons (or diva cups?) the woman uses. Pretty outside the norm, and usually a level of exerted control that the woman isn’t online bleating about how he is going to be doing laundry and following her birth plan.

          • The attitudes of men can be just as varied and interesting, can’t they? I have my own ideas of how men SHOULD be – and they are probably not universal. Watching programmes Like One Born Every Minute, I am often gobsmacked. The popularity of “natural”, it seems to me, does a disservice there. When I see men treating it like it is no big deal and what is the fuss about, I want to smack them. My own was of the terrified and paranoid variety, which also has its downside. Controlling I could definitely do without.. I think some men also feel validated by a phoney definition of womanliness as well.

            I do like reading on here of husbands who seem to get it right, and support without overwhelming. Most of us really want to make a family as well as a baby – and it can be more difficult than popular culture portrays it. Well done to those who manage it on equal terms.

          • AmyP

            “When I see men treating it like it is no big deal and what is the fuss about, I want to smack them.”

            When I was having my older kids a decade or so ago, I mentioned to my dad that my husband and I were taking a childbirth class and a breastfeeding class. My dad wanted to know why I needed to take those classes–doesn’t it all come naturally and haven’t women managed perfectly well without all that? The funny thing is, he’s a cattle rancher and has attended many difficult bovine labors as well as working with cows who are refusing to allow calves to nurse.

            He somehow did not make the connection to his own experiences.

            http://beefmagazine.com/health/calving/using-calf-puller-0301

            I think the average husband will tend to follow his wife’s lead in matters of pregnancy, childbirth and early childhood development.

      • Who me?

        Absolutely! Case in point, the death of Misty Horner and her baby. They did not believe in western medicine, and she had a home birth. Her baby died at the birth, and she died after suffering a month with an infection she developed during/after labor. She wanted to get medical attention, but her husband wouldn’t let her. Her parents sued and won a lawsuit against Misty’s husband stating that the homebirth was at fault for her death. This is not uncommon at all. MDC has, of course, covered up these deaths, but quite a few were posted on MDC. I think Free Jinger still has a record of most of these.

      • The Computer Ate My Nym

        OTOH, I doubt a Quiverfull type would agree to a birth plan that involved his cleaning up the house. He’d insist that she do that and serve him a sandwich while she was in the second stage of labor if he were that sort. Which isn’t to say that he’s not into the woo in general, of course.

  • Lisa from NY

    Sung to the tune of “I’ve been working on the railroad” with sincerest apologies to the composer.

    I want to do a UC, Because I have a PhD.
    Birth is unassisted, No midwife for me.

    Got my birthing books ready, In English, real easy.
    Got my droppers of remedies, See friends, no worries.

    Come on can’t you push, (2x)
    Why won’t he come out?
    Come on can’t you push, (2x)
    Why won’t he come out?

    Something’s wrong with the baby, It’s halfway out, you see.
    Something’s wrong with the baby,
    Call the number for emergency!

  • Bomb

    These women make me ashamed of my gender, and I find them all over the damn place. Anything having to do with parenting there is some self educated moron detailing their vast lack of brainpower for all the world to see.

  • Staceyjw

    I hate Disques. There’s so much funny to CnP, but it won’t let me. Is there a trick I should know?
    (was thinking of the last comment from a mom that had her 3rd baby on the toilet…)

  • studentmidwife

    the very beginning of her birth plan is disturbing too.

    “Normal heart rate for baby is no less than 110BPM and no more than 170 between contractions.

    That being said, in the second
    stage of labour 75% of babies will have an ‘abnormal’ heart rate due to
    normal physiological processes such as head compression.”

    Which I am translating as “normal heart rate is this, but if you hear something outside this range that’s okay because it’s also normal.”

    Oh, the stupid. It burns. I’m worried about her poor little baby.

  • Staceyjw

    This isn’t UC, it’s Husband as MW. I guess he is better than a CPM, since at least he will be quick to dial 911 (ugh I have my doubts)

    Oh, don’t be so meen Dr A, she did say that after the ice cubes and woo, if the bleeding didn’t *slow* (not stop) she would transfer. Of course, that was followed up by what to give her for shock (Emergen-C? cayenne? really?), so I guess it’s just in their for reassurance?

    I think someone ought to give her a REAL list of things that she needs to look out for. she is woefully ignorant. Sure hope she is lucky.

  • Lisa from NY

    Maybe she wants do demonstrate Darwin’s theory – survival of the fittest, with her breed dying out.

    • The Computer Ate My Nym

      Alas, no. NCB is spread by meme and only mockery and evidence will kill it.

  • mollyb

    I find it curious that she’s fine with certain technological interventions–does she have any idea how much technology goes into creating her PPH ice cubes or her ass camera? But pitocin to stop bleeding? Baaaaad.

    • auntbea

      But my womanly body wasn’t designed to make ice cubes! Although, that would be really convenient.

    • Lisa from Ny

      Sometimes the placenta can’t be removed and the only way to stop the bleeding is with a hysterectomy.

  • Isilzha

    So, if you suspect a woman is in shock from blood loss after childbirth, just elevate her legs and give her a weird drink made with cayenne pepper, lemon juice and maple syrup.

    • Sounds like Master Cleanse

    • Antigonos CNM

      And ice cubes on her feet. Don’t forget the ice cubes!

  • The term “stuntbirth” is great because it gives a very accurate name to a certain NCB practice. Since language is so powerful and so important to the way people think, it might be helpful if people like Dr. Amy and her readers came up with even more good terms to describe other practices as well. For example, instead of the Natural Childbirth Community, Dr. Amy and readers could call themselves the Rational Childbirth Community, or the Evidence Based Childbirth Community, or the Better Safe Than Sorry Childbirth Community. Instead of healing VBAC or healing homebirth, what about life saving c-section – LSCS? Something about how feeling bad about feeding your baby formula would be like Buzz Aldrin feeling bad he was the second man to walk on the moon. (Not really sure where I’m going with that one) Perhaps lots of these terms already exist, and I’m just not aware of them, but if not, it wouldn’t hurt to meet the NCB community catchy term by catchy term.

    • Eddie

      i like it. Reframe the debate; don’t let the crazies determine the playing field.

    • ratiomom

      I like this! We should come up with a name that covers the whole natural/irrational/masochistic movement, from natural childbirth to breastfeeding-at-all-costs to extreme attachment parenting.
      Once the thing has a name, it can be pointed out easier.
      I have trouble framing a cathchy phrase that covers it all. Unfortunately `naturalism` is already taken. Guilt-led parenting? Irrationalism? Postmodern motherhood?

      Anyone?

      • auntbea

        Martyrdom?

  • The Computer Ate My Nym

    Two thoughts:
    1. Why does she put everything in the third person? Am I the only one that finds that strange?
    2. Where did the red/purple line thing come from? I don’t remember hearing anything like that before even within the woosphere.

    • auntbea

      I’ve definitely seen that before. People sometimes their beautiful purple line in their birth stories.

      • The Computer Ate My Nym

        Any idea where the claim comes from? Is there any physiologic basis for it at all? A number of NCB claims do have a twisted grain of truth in them.

        • auntbea
          • The Bofa on the Sofa

            Before I follow that link, please tell me it does not contain pictures of women’s buttcracks?

            (not that I have any problem with pictures of buttcracks, but there are better places to find them)

          • auntbea

            It is an article in a medical journal. It appears to be buttcrack-picture free.

          • The Bofa on the Sofa

            So there is a “moderate correlation” between line length (for those who have one) and dilation. However, that correlation has an r^2 value of all of 0.124, which is pretty meaningless.

            I am curious, though, how she plans to measure the line length by looking at a picture. The study shows that the line length, once it develops, is generally in the 5 – 10 cm range, and that each cm difference (that’s less than 1/2 inch) constitutes a 2 cm change in dilation, so the difference between 6 cm dilated and 10 cm dilated is less than an inch. Of course, considering that the standard deviation is about an inch, a line measuring 7 cm could be anywhere from 0 – 10.

          • auntbea

            Hey man, it’s not my butt or my journal article! Don’t ask me.

          • Laura

            Maybe there will be pictures posted on Dr. A’s site soon of “buttcrack cupcakes”!

          • Eddie

            The link posted by Captain obvious does indeed have a (mostly chaste) picture of a buttcrack.

          • SkepticalGuest

            Just say “No” to crack.

          • The Computer Ate My Nym

            Thanks! It’s an interesting article, but I’m not sure that measurement of the line on the butt is going to make it as an indicator of dilation in the long run…

          • Amy Tuteur, MD

            The article is a classic example of the crap that is published in some scientific jouranls. The idea that there are a lines on the outside of the body that indicate what is going on inside is beyond stupid. Are there lines on other animals that indicate internal function? No there aren’t.

            As for the theory that vasocongestion could lead to an ascending line, descent of the head could cause vasocongestion, but dilatation of the cervix could not.

          • The Computer Ate My Nym

            I was having trouble figuring out what the mechanism for the line could possibly be. I’ll take it as a given, for now, that they did see a line and that it did have a vague correlation with dilation (i.e. that this isn’t out and out fraud).

            But even making best case assumptions, the correlation is so low that I don’t see any use to the concept. And the standard error is so high that (as Bofa pointed out), the range of potential dilation indicated is so wide that the measurement is clinically useless. In short, I don’t see this as clinically useful even assuming that everything in the article is correct and without fraud or error.

            The idea that there are a lines on the outside of the body that indicate what is going on inside is beyond stupid.

            I have to say that I think you’re overclaiming a bit here, though. Physical signs on the surface of the body can indicate internal changes. Red streaks on the skin can indicate a cellulitis, for example. So I don’t see the idea as completely impossible in principle, just disproven by the article that claims to prove it.

    • It’s a buttrometer?

    • Captain obvious
    • Amy Tuteur, MD

      Tsk, tsk, tsk. If she really trusted birth, why would she need to assess dilatation by any measurement?

      • The Bofa on the Sofa

        Why does it matter how much she is dilated in the first place? The baby will be born when it is ready to be born. Her body will know when to push.

    • Wren

      I hadn’t heard about this before either. Learn new woo every day, huh?
      I did ask my husband if he noticed anything on me. His response? “Funnily enough, I wasn’t looking at your butt crack”. Good answer.

  • yentavegan

    Uc falls outside the range of normal, Should this mother/father be reported to CPS for wanting to bring forth their baby in this manner?

    • I know people who have grown up in foster care. As much as I disagree with this woman’s choices, you have no idea what danger you’re putting this kid in by calling CPS. Wouldn’t wish that on anybody. Except in the most extreme cases (this is not it) CPS takes a bad situation and makes it infinitely worse.

      • yentavegan

        thanks for your perspective. I just wondered if UC is an indicator for dangerous neglectful abusive parenting.

        • BeatlesFan

          In my experience working in “the system”, CPS is more concerned with immediate signs of neglect; IE, a child not being fed, a child not receiving medical attention for a current illness or injury, a child being abused, or a mother testing positive for drug use immediately following birth. A child being born at home, or not vaccinated, might be used as an argument if the child were taken for another reason, but I can’t imagine a child would ever be removed from parents for those reasons alone. UC is not a direct indicator for neglectful abusive parenting just like hospital birth isn’t a direct indicator of non-abusive parenting.

        • Bombshellrisa

          This is how the saga with the Henderson clan got started.

      • nohika

        Please don’t generalize like that. 🙂 CPS does what it can.

  • Antigonos CNM

    Remember that sometimes a red/purple line will appear between a woman’s butt cheeks that can indicate how dilated she is. Check for that! If it is slightly below the tailbone she’s at 6 or 7 cm. if it’s at the top of butt crack she is probably around 10 cm!

    Somehow my midwifery tutors in Cambridge forgot to teach me that…

    It’s easy to be snarky, but in fact, some of her points are indeed the sort of things we did in the UK at homebirths. But the intelligent things are so mixed with sheer weirdo woo, it leaves me shaking my head. I really hope she survives the experience, and so does her baby [and maybe her poor husband, as well].
    [Don’t know why this last paragraph is in italics…]

  • Allie P

    Pictures of my butt crack? REALLY? I can’t imagine anything I’d less like to do in labor than have my husband take a picture of my butt crack for the two of us to analyze.

    I’m beginning to think the NCB movement is on par with sexual kinks. this is bizarre.

    • The Bofa on the Sofa

      No, if you think about it, it is just like those wedding stories with Bridezilla having to control everything. That’s all this is, it’s just another event for her to control. It’s not about sex, it’s all about her. And her husband’s job is to service the queen.

      • suchende

        Everyone I know personally who homebirthed had major fertility issues. I get the sense that homebirth or med-free birth appeals to women who want to 1) prove they aren’t broken and 2) want to assert control over their reproduction in a way they couldn’t at conception.

        • I don’t have a creative name

          Exactly. I’ve noticed the link between infertility and this mindset as well and your points about why are right on.

          • The Bofa on the Sofa

            Which is really, really scary. Let’s see, you’ve gone to great lengths just to get pregnant to have a baby, and then you are going to take major risks just to prove your “womanliness”? I’m not all that impressed by guys who try to show off how “manly” they are by doing stupid things, either.

          • Ethan’s mom

            Even if you didn’t have fertility issues, you’ve still invested approximately 40 weeks to ensure the health and wellbeing of your child. To then go and put not only that, but also your child’s future on the line to prove you’re a “woman” seems idiotic.

        • How true!! My husband’s cousin spent tens of thousands of dollars on IVF and then planned a homebirth despite the fact that she had both advanced maternal age and had only one delivery before that was a c-section. Thank goodness she transferred to the hospital in time for another emergency c-section.

        • Wren

          That was one reason it appealed to me, but my husband was smart enough to insist on the hospital for the first. After that, it was definitely hospital for the second. Fertility issues also led me to a lot of other NCB crap but luckily I wasn’t brainwashed enough to risk my baby, either when he turned out to be footling breech or when he stopped nursing at 9 months.

      • mamaellie

        Funny thing is it sould be so much easier for her husband to cater to her if she were to give birth in a hospital. He could leave afterwards and show back up all showered and clean with flowers and chocolates and maybe something homecooked and yummy.

    • mamaellie

      Why do they need to analyze her butt craxk anyway? Isn’t that at odds with the idea that her body will tell when to push?
      I do love that one. throughout all my labors I’ve never had a single urge to push. I just waited to be told it was time and then pushed frantically and desperately. During one birth I was told they wouldn’t do a cervical check because my body would “know what to do”. I waited until a few conractions into transition and just hoped for the best.

      • Deb

        It’s a way for her to prove how educated she is, that she knows all about this simple, obvious sign, but doctors and medwives need to use nasty invasive exams. Just proves how ignorant and divorced from women’s natural bodies and the birthing process they are.

  • PoopDoc

    The one I pity is her husband. Worst case scenario he will be cleaning the house, cooking for everyone, minding the older child, playing photographer, and running full codes on his wife and baby. That’s gonna be a long day.

    • Antigonos CNM

      That actually happens in a lot of homebirths. When I did postpartum visiting, I often found Mom nearly fainting from exhaustion because, instead of resting after birth, she was doing all her usual housework — Dad [and sometimes Gran] having proved incapable of coping.

    • yentavegan

      actually that is best case scenario. worst case scenario is dad burying mom and baby in back yard to hide the crime.

    • Meredith Watson

      That is why I love hospital birth (Aside from the all important life saving care available). After giving birth, who doesn’t want someone else to do the clean up, bring food and do the laundry while you and your husband rest and dote on your baby?

  • Amy M

    Anyone notice the one on the 40wk roll call thread who doesn’t know if she’s having multiples? She says she thinks twins, because she is huge….she is also at least 41wk (according to her). It is certainly possible for twins to go overdue, but way more likely for them to be premature. Since it is clear this moron hasn’t had any prenatal care, I wonder at the odds of GD + giant baby. I know it is mean, but I like laughing at the ones who swear by their womanly intuition that they are having twins (or more!) and turn out to be wrong. I wonder also, is she planning a UC with her suspected twins?

    • Karen in SC

      Indeed, yes. BlessedJess on that site was measuring large, so large she thought she had triplets since she was also sure she double-ovulated. Ended up with a full term yet very small singleton. Had no prenatal care, she did it all herself with Google Scholar and a midwifery textbook.

      • suchende

        And she hinted that the baby might have developmental delays.

        • The Bofa on the Sofa

          I don’t think I’d take it seriously. She’s jumping to an autism diagnosis just like her triplet claim. It’s all just “look at me!”

          • Karen in SC

            but, but, how? there were no ultrasounds, no formula, mother and father ate special fertility parenting diets, and I would bet they don’t vax.

          • The Bofa on the Sofa

            But was she vaccinated? That’ s Kim’s Stagliano’s desperation plea…

          • PrimaryCareDoc

            She also might have mercury fillings.

          • Dr Kitty

            Hang on, BlessedJess’ kiddie isn’t even two years old, IIRC.
            If she’s thinking ASD at that early age, the diagnosis is MUCH more likely to be developmental delay or sensory disability.

            Of course IUGR and prematurity are both risk factors for ASD and learning disability.

          • The Bofa on the Sofa

            If she’s thinking ASD at that early age, the diagnosis is MUCH more likely to be developmental delay or sensory disability.

            A medical diagnosis, perhaps. However, that’s not what we are talking about. We are talking about the statement that “she hinted that the baby might have developmental delays.” I’m saying, I wouldn’t take that as a medical diagnosis, but more likely HER diagnosis, and, as such, it’s probably as accurate as her diagnosis of triplets. It’s not based on anything other than her need to be the center of attention. She didn’t have triplets, so now the kid’s going to have autism.

            As far as we know, the extent of “developmental delays” could be that the baby wasn’t sitting up alone by 9 mos or some other silly milestone.

            Of course IUGR and prematurity are both risk factors for ASD and learning disability.

            In real life, yes. But we aren’t talking reality, here, we are talking la-la land, and the views of a whackaloon who was convinced she was going to have triplets.

          • Antigonos CNM

            Autism is caused by malignant miasmas, or “it’s in the air”, doncha know? Or else she wasn’t chanting the right mantra.

          • The Computer Ate My Nym

            Hypoxia. (What, not the answer she wanted?)

      • BeatlesFan

        I wonder how many of these women who diagnose themselves with multiples actually go out and buy double strollers and enough supplies for multiple babies. I’m willing to bet all the money in my empty bank account that, while they are CONVINCED they are having twins or triplets, they still only prepare for one baby.

        • auntbea

          A stroller? Are you out of your mind? Strollers are EBIL! I am trying to imagine what other supplies a super-crunchy family would need multiples of, and I am drawing a blank.

      • Elaine

        I remember that! She said that even though nobody had ever UCed triplets before she could totally do it. I begged her to go get a scan and she got shirty with me for fear-mongering. It’s so terrifying to watch these women who are totally cool with the idea that their babies could quite likely die.

    • Antigonos CNM

      I’m sure she eats such an excellent diet that she doesn’t consider it possible to have gestational diabetes Hope she doesn’t have a shoulder dystocia. [Of course she could be large because of polyhydramnios, which can be indicative of all sorts of fetal conditions…not to mention that if she has spontaneous rupture of membranes, there could be a cord prolapse, but hey, that’s just the way the cookie might crumble…] Or the baby can just be big; generally each subsequent pregnancy results in a slightly bigger baby than the one before.

      • auntbea

        Really? Oh God. I guess I’ll stop at two then.

    • OBNurse

      And she says she has been leaking amniotic fluid for 4 weeks! No big deal!

      • Amy M

        I bet she is just peeing herself.

    • drsquid

      on a forum i used to read a lot which wasnt crazy crunchy, people parachuted in regularly absolutely SURE they were having twins. the vast vast majority of the time they were not.

  • grenouille

    From the plan:
    -About 1/3 of babies will have a nuchal cord (cord around their neck) at
    birth. If it is loosely wrapped and you are able to unwrap it, do so,
    but it is more than fine if you are unable to!

    Leaving a nuchal cord is more than fine? Doesn’t that imply that it’s better to leave it alone? So why tell him to unwrap the cord if he can? Just not sure how he is supposed to follow these directions. She is pushing so much of the responsibility for her crazy plan onto him. Not sure why he is accepting it.

    Between styling her hair and taking pictures of her butt crack, he is going to be a busy man. It would be hilarious if lives weren’t at risk.

    • The Bofa on the Sofa

      Between styling her hair and taking pictures of her butt crack.

      SNORT!!!

      Good thing I had swallowed my drink, because this made me lose it…

    • Karen in SC

      National Lampoon’s Homebirth Movie?

    • Antigonos CNM

      Hang on! If she wants her husband to unwrap a nuchal cord, then it’s no longer an UNASSISTED childbirth!!! [I’d like to see a mother unwrap a cord herself — maybe if she’s a Chinese acrobat?]

  • Dr Kitty

    Something for Raeanne to think about.
    I used to work in hospitals managing cardiac arrests, probably on a weekly basis.
    Now I work in GP, where my chance of dealing with a cardiac arrest is probably once or twice in the next 30 years.

    My annual CPR training has gone from the full ALS algorithm, to Basic Life Support and AED (which amounts to “turn the machine on, stick on the pads and do what it says”).

    No matter how good my resuscitation skills WERE, I don’t use them enough to make them good NOW.

    How Raeanne’e poor husband is meant to resuscitate either of them while reading from a book… No. Just no.

    How a CPM who has never actually had to resuscitate a real person is going to do trying to remember algorithms she learned a year ago…not good either.

    Crash teams and paramedics aren’t good at resuscitation because they are doctors and nurses and paramedics, they are good because they have lots of real life experience.

    • Dr Kitty

      Also, AEDs retail for £1500.
      No reason why a homebirth midwifery practice couldn’t buy one, if they wanted. It isn’t exactly exorbitant for a piece of equipment that could be life saving.

      I mean, surely they spend that much on rebozos and homeopathic remedies?

  • EllenD

    “Normal heart rate for baby is no less than 110BPM and no more than 170 between contractions.” Uh.. no… I’ve cared for plenty of moms with babies with “normal” heart rates by this definition who are showing signs of fetal distress. A fetus can have a baseline of 150 with minimal or absent variability and repetitive late decelerations to 120. By her definition, the baby is fine, but I would be intervening, because that baby is sick. It’s strange to me that people think intermittent doppler at home is a substitute for actual health care.

    And how exactly is someone taking a picture of your anus/butt crack less invasive than a SVE by a qualified, experienced provider? Blech.

    • Antigonos CNM

      I doubt this lady knows what “beat to beat variability” even is. [And this is why I oppose these home fetal dopplers, btw. Parents get a FHR within normal parameters, think everything’s fine as a result, when it may not be]

      • The Bofa on the Sofa

        When we were pregnant, fetal home dopplers were supposed to be available by prescription only. Don’t know if that is still the case. Of course, that didn’t stop people from getting them (then again, they weren’t using them to monitor labor, these were the other extreme – those so paranoid about something going wrong that they wanted to be able to check for a heartbeat multiple times a day)

        • Antigonos CNM

          In Israel they can be purchased without prescription, and, although I repeatedly removed the advertising in my clinic, I found the reps would put it right back. Along with ads for cord blood banks [hugely expensive and fairly worthless]. The aim was to make it look as if we endorsed this stuff.

        • Wren

          I bought one here in the UK when I was pregnant with my first. We were travelling to the US for a few weeks around 20 weeks and I didn’t want to freak out and go to a hospital just because I got worried about it. I could feel movement, but not regularly yet.
          At least I had learned how to use one while on a maternity placement as a student nurse and it did keep me from going to a hospital when the baby was quiet for a while.

      • EllenD

        Plus, there is always the possibility that the mom’s pulse is running 120, and they are counting maternal pulse rather than FHR.

        • Antigonos CNM

          That actually happened to me once. Good thing I was taught to check maternal pulse at the same time. Mother was tachycardic, baby was bradycardic. Both seriously.

        • Charlotte

          That seems to happen frequently at home birth. A good 1/3 of the stories I’ve read involve surprise at a stillbirth because they swore the heart rate was 120 moments before birth, and it turns out the midwife had been measuring mom’s heart rate for hours. Baby was long dead.

          • Lisa from NY

            If you see such a story, please post.

  • theadequatemother

    My favorite part is where hubs is instructed to get the baby a diaper and an outfit…oh and olive oil for its bum. I thought skin to skin was the holy grail here…what’s the rush to get everyone dressed?

  • Rabbit

    I think my favorite line was “Keep an eye out for signs of shockiness;” She uses the term “shock” appropriately earlier in the plan, why use “shockiness” here? I will admit that the image that sentence first conjured up was of a bleeding post-partum woman zapping everything she touched.

    • EllenD

      you know… shockiness. Like Steven Colbert’s truthiness.

    • Yammy

      That gave me a chuckle. Sounds like something a toddler would say to describe static electricity.

    • LovleAnjel

      My brother is an EMT/firefighter and uses “shocky” for a parasympathetic reaction, to differentiate it from true shock. But I doubt that’s how she found the term.

  • Allison

    Even if thought something like this was a good idea, my husband would never go for it! That’s a lot of pressure on the dad to make sure everyone is ok. And, I don’t know how the poor guy would be able to focus on reading the emergency childbirth book if there really was an emergency…

  • Hannah

    So all this crap about ways to stop hemorrhage (mmm, placenta in the check, classic)- and one tiny paragraph devoted to the actual baby? And her plan is basically blow on its face and tickle its feet?? Are these women completely delusional, or do they truly just not give a shit about their babies?

    What kind of man agrees to this crap? What would make him think that he is equipped to do this? What would make him want to do this, especially when he has to do a bunch of chores (notice that he’s supposed to do more laundry immediately after it’s over), preen his wife (blow dry her hair, for heavens sake?), AND he’s supposed to be able to gauge how much blood loss is too much and decide when to call 911? This stuff makes me too angry. I might have to stop reading this blog, because it makes me too upset.

    • Given that his wife is delivering his baby as part of their mutually agreed-upon crackpot scheme, the least he can do is tidy up before and after. It might be like rearranging the spilled Lego and deck chairs on the Titanic, but I appreciate the thought. It’s one of the few coherent thoughts in the entire document.

    • E-m

      I am guessing that part of the lack of emphasis on the baby is an assumption that she’ll be able to take care of any baby issues and the husband only needs to know about what to do if she is unable to make decisions. The idea that there could be mommy issues and baby issues at the same time is not worth thinking about, I guess.

    • studentmidwife

      I want to know who is supposed to make sure the baby is breathing as mom is bleeding to death and “showing signs of shockiness.” Because really, if you’re showing signs of shock then you are in really, really serious trouble. It’s not something ice cubes and cayenne are going to fix. If Mom is experiencing “shockiness” then exactly no one is going to watching that baby.

  • Box of Salt

    Has there been any followup to this? She posted the due date as May 12. Of course if we add in the next 19 days based on her first baby she’s expecting the new one May 31st (next week)

    I wonder how they’re all doing.

    • C T

      As of yesterday, she’s still pregnant and overdue (41+2). http://www.mothering.com/community/t/1383034/40-week-roll-call/80#post_17363425

    • Karen in SC

      Despite the idiocy, odds are with them. Even the previously-discussed BlessedJess from MDC managed to UC. Not the twins or triplets that she was expecting from her research on Google Scholar – a very small girl singleton. So small there was a risk of cord prolapse. But she beat the odds and was able to nurse and gain weight quickly.

  • Elle

    Whoa… I had no idea that women came equipped with handy dandy “dilation indicators” on their rear ends! Why don’t they teach this stuff in medical school? It sounds a lot like the “wetness indicator” strip that some disposable diapers come with these days. Well, you know what they say – we get our best ideas straight from nature!

    • The Bofa on the Sofa

      I wondered about that one, too. I’ve heard a lot of the lore around pregnancy, but that one is new to me. Thank goodness for summer reruns.

    • PrimaryCareDoc

      OMG. I missed this on the first reading. “Take a picture so Reanne can analyze it. ”

      Dead. I’m dead.

      • Bombshellrisa

        Cause that is exactly what i want to do as I agonize in unmedicated labor in my own house-analyze a pic of my butt crack to try and guess how dilated I am. Brilliant.

    • Karen in SC

      Anyone ever see any documentation on that? LOL Of course there’s a reliability somewhere right?

    • An Actual Attorney

      Sounds like those pop-out indicators that come in a turkey.

  • The Bofa on the Sofa

    Seems to me it would be a lot easier just to go to a hospital that is already prepared for all these contingencies.

    • I don’t have a creative name

      But then they’d just be “mainstream” and would lose the identity they’ve built a persona around.

  • Dr Kitty

    Ice cubes on the feet. Really?
    REALLY?

    Neither the cardiovascular system, nor the nervous system works the way she thinks it does.

    • I don’t have a creative name

      Ssshhh.. don’t be negative. Fear is the only thing that makes birth go wrong.

    • Yammy

      I can never get over stuff like drops under the tongue for serious complications, either. I would absolutely love to see in writing the biochemical explanation for how Angelica and Shepherd’s purse/placenta gumdrop does anything other than fuck all in their respective scenarios. Otherwise, why not have potions of tongue of dog, lizard leg, and and eye of newt on hand? Too out of vogue?

  • Jessica Atchison

    I just don’t even know what to say about this. I really don’t.

  • PrimaryCareDoc

    I love it. The whole idea of having a birth plan for a UC is so insane. I picture her bleeding out as her husband frantically flips through the multi-page plan. I hope she included a helpful index or table of contents.

    I also love all the chores. Do laundry! Start the dishwasher! Make food! Pick up toys! The poor husband has to be maid, midwife, doula, and neonatologist. A homebirth sounds so relaxing!

    What’s with her writing the whole thing in the third person? I mean, she’s really the only person who is going to read it.

    • Squillo

      The whole idea of having a birth plan for a UC is so insane.

      Especially because so many parts of it are about using an extremely poor substitute for effective intervention in case of emergency (which never happens, doncha know?)

      It drives home the point that this is really, truly about thumbing one’s nose at authority rather than benefiting mother or baby in any meaningful way.

      • Eddie

        It’s also about thumbing one’s nose at reality.

        • Squillo

          Too true.

  • suchende

    She tore last time, so her plan this time is to avoid squatting and to apply honey.

    Know what worked great for me avoiding tearing? And epidural.

    • slandy09

      The thought of honey being applied to my nether regions makes me shudder. Just…ew.

      • The Bofa on the Sofa

        Hey, don’t knock it…

        although it completely depends on the context…

        (see rule 34)

        • But sticky! And sugar!

          It could be fun, but the clean-up afterwards … *shudder*. At least honey is unlikely to induce things like yeast infections, as it’s naturally sterile and actually has some really cool antibacterial properties.

      • drsquid

        wtf is honey supposed to do in this context? glue it back together?

  • I don’t have a creative name

    This is horrifying. Raeann, if there is a catastrophic emergency, your baby is dead. Dead. No do-overs. D

    • The Computer Ate My Nym

      Not to mention that you could be dead with no do-overs.

  • Maybe life insurers should refuse benefits for deaths as a result of planned UC’s – surely it has to be analogolous to suicide.

    • Antigonos CNM

      No, it’s more analogous to murder, as far as the baby’s concerned. If the mother dies, it’s suicide.

  • I can’t imagine placing that kind of pressure on my husband. Whoah.

    • suchende

      If he still needs this list 2 days out, seems like he’s not feeling the pressure.

      • KarenJJ

        I imagine him sitting there with the phone in his hand and his finger hovering over the 0. That’s what my husband would have done.

        • KarenJJ

          Should add: that comment works better knowing that the phone number for emergency services where I am is 000.

  • Karen in SC

    She writes that the baby will still be getting oxygen if the placenta is still attached. Why do women still believe this?

    • Right, because where is the placenta supposed to get the oxygen?

      • auntbea

        Haven’t you noticed that it’s balloon-shaped? What do you think it’s full of?

        • Hot air? Maybe it also serves as backup transportation to the OR?

  • Susan

    Once again reading the link is worth the time it’s much worse in totality than Dr. Amy’s quotes! There is so much more emphasis on how to save Raenne than there is on how to save the baby. Call 911 if Raenne is in shock. If the baby isn’t breathing, don’t worry, 1 minute will seem like ten and all is ok if the cord isn’t cut….. ( poor husband even has to draw cord blood)

    • LynnetteHafkenIBCLC

      Just for fun, I decided to see how long I could hold my breath for. I lasted 20 seconds before I felt myself on the verge of losing consciousness. Of course, I didnt have any skin to skin contact, so I’m sure it would be totally fine for a baby. Um, I mean “likely” totally fine.

      Several minutes later I still feel shaky. I really hope she doesnt do this to her baby.

      • Antigonos CNM

        Well, babies are born with exceptionally high hemoglobin levels to help them cope with hypoxia, but after 4 minutes, brain cells do begin to die…

        • LynnetteHafkenIBCLC

          That is good to know. Of course some idiot will interpret that as babies don’t need to breathe until four minutes after birth…

          • Poogles

            “Of course some idiot will interpret that as babies don’t need to breathe until four minutes after birth…”

            No, no, no, the placenta provides oxygen as long as the cord is pulsing, so that means that babies don’t need to breathe until 4 minutes after the cord stops pulsing…ugh.

    • Squillo

      One minute seems like ten… maybe that’s because it’s one-tenth (or more) of the time you have before your baby’s brain starts to die. Maybe that innate panic is Mother Nature’s way of saying, “Get proper help, you bleeding eedjit!”

      • auntbea

        Mother Nature is Scottish?

        • Squillo

          Irish. In my head, she sounds a bit like the Lucky Charms leprechaun.

          • auntbea

            Magically delicious.

          • BeatlesFan

            Plasagna, anyone?

    • I don’t have a creative name

      Of course there is. This birth isn’t about the baby.

    • I don’t know why everyone feels so sorry for her husband. Of the three of them, he’s the most likely to survive this debacle. In the very likely event that he lives, he’ll have to do some chores. Cry me a river, man.

      • Jennifer2

        I feel sorry for the husband because he’s likely either clueless and in for a real shock when his wife and/or baby end up in the hospital or worse or he’s fully aware that this is a redonkulous “plan” and is going to be filled with self-loathing if anything happens to his wife and/or baby that he could have prevented by just telling her she’s batshit crazy and he’ll have no part in her homicide/suicide mission.

    • stenvenywrites

      This is just a tiny bit worse — and may even be slightly better — than a homebirth assisted by a Birth Junkie. A NCB looney would be too invested in The Plan to call 911, but at least the husband/father presumably loves the baby; maybe. just maybe, if the rubber hits the road and he loves the baby more than he’s henpecked by Reanne, he’ll do the right thing.

      • suchende

        Having birthed one baby and read a million nutty NCB claims, I feel as qualified to be a midwife as a CPM. So I see how women make the leap to UCing.

  • Eddie

    What she does for herself is one thing. My worry is that these kinds of things posted publicly will convince others that it’s a reasonable idea.

    • That’s why it must be countered publicly also.

  • For PPH and shock….

    “-Have Raeanne drink 1 teaspoon Cayenne powder, 1/4 cup warm water,1/4
    cup lemon juice with 1 tablespoon maple syrup. It strengthens
    contractions, regulates blood pressure and treats shock.”

    Okay. I doubt I can choke that done when I’m fit and healthy, but when I’m weak and in shock? I could well aspirate it if I fail to spit it out instead of swallowing it.

    • Dr Kitty

      Hang on, isn’t that the mixture beyonce used to lose weight for a movie?

      • Bomb

        It is a pretty well known “detox” drink. You’re supposed to go on a fast and eat nothing but that. I have no idea why this idiot thinks it does anything for shock or contractions.

        • auntbea

          Maybe because when you go on a fast and eat that stuff, your GI tract cramps in protest, and really all those abdominal organs are pretty much the same thing anyway?

    • Hey, the Master Cleanse!

    • suchende

      “Honey, you’re bleeding out, hang on, gotta mix up some master cleanse.”

      • PoopDoc

        Thought that recipe looked familiar. That stuff works for EVERYTHING!

        • suchende

          Have you tried cinnamon and honey yet? I mix mine with my raw milk and I’ve never had cancer, asthma or autism.

    • Bombshellrisa

      That is the recipe for the “Master Cleanse”. I drink something like that every morning because my great grandmother and grandmother did, it’s just a tradition for me while I wake up. I wouldn’t trust it to do anything important though.

    • Elaine

      Also, is he going to pre-mix that, or is she going to be bleeding on the floor while baby isn’t breathing and he’s trying to find the teaspoon measure and figure out which bottle is chili pepper and which is cayenne?

      • Squillo

        My guess is that nobody’s actually thought about it. My other guess is that neither of them has ever been a responder in an actually life-threatening emergency. If they had, they’d know that the little checklist and instructions are all but useless.

  • Just awful.

  • Marie

    She wants people to pray for her. I am praying for the baby. As a NICU nurse, so much is wrong with her “plan.” Babies don’t plan the way you do.

    • Antigonos CNM

      Well, I pray for her, too. She’s in a lot of danger, as well as the baby. But as has been written, the poor fool will probably luck out…will be fascinated to know what happens.

    • If prayer worked, women and babies would never die in childbirth. Seeing as how god(s) clearly don’t intervene in this sort of thing, it doesn’t seem very useful to ask people to do something that very obviously doesn’t work. Hospitals work. Pitocin works. Blood transfusions work. C-sections work. Prayer? Not so much. It’s just another aspect of her woo-crazy that she thinks prayer’s going to make a damn bit of difference to the outcome.