Unnatural childbirth: 5 goofy things that natural parenting advocates do that never occur in nature

LOL

Natural childbirth has nothing to do with childbirth in nature. Not only does it fail to replicate birth in nature, it adds on practices that have never been seen in nature and then pretends they are “natural.”

Here are 5 of the goofiest unnatural things that Western, white, well off advocates do while cluelessly preening to each other that they are imitating primitive people.

1. Waterbirth

No primates, let alone humans, give birth in water. Zip, zero, nada. It’s pretty obvious why: childbirth in water is UNNATURAL and puts offspring at risk for drowning. To the extent that infants are “designed”, they are “designed” to be born into air and take their first breathe of air in relatively short order. Animals and pre-industrialized humans make great effort to ensure that their offspring survive. They don’t include stunts as part of birth, because they find no benefit in impressing their peers.

2. Eating the placenta

You have to be the most gullible rube on the planet to be or use the services of a “placenta encapsulation specialist.” Human beings in nature do not eat the placenta, and they certainly don’t freeze-dry it first.

Indeed, the anthropological literature dates the first sighting to an indigenous group of California homebirth advocates (I kid you not). In Consuming the inedible: neglected dimensions of food choice, MacClancy and colleagues report:

In association with the natural childbirh movement from the 1960’s placentophagia was taken up in some ‘Western’ societies, especially in California, on the basis that it was ‘natural’, as ‘all’ mammalian species eat the placenta. The problem with this is that not all mammals are regularly placentophagous and our closest primate relatives also are not placentophagous… [M]odern placentophagia is based on an inaccurate idea of making the human birthing process more ‘natural’.

3. Lotus birth

I can’t decide who are the bigger fools. Those who eat their placenta or those who leave it attached to the baby to rot off.

To my knowledge, there is not a single higher order animal that leaves the placenta attached to the baby for more than minutes. Lotus birth has nothing to do with childbirth in nature. It was made up by a wacky woman trying to outdo her wacky peers. Amazingly, gullible natural childbirth advocates have adopted it, too.

4. Unassisted childbirth

Unassisted childbirth rarely if ever occurs among human societies. There is a good reason for that. Assistance in childbirth raises the chances that both mother and baby will survive what is universally accepted to be an inherently dangerous situation. Unassisted childbirth is yet another fabrication from whole cloth that childbirth advocates try to pass off as “natural” when it is nothing more than a stunt practiced by the clueless in order to impress their clueless peers.

5. Tandem nursing

Although widely beloved by lactivists, to my knowledge there are no higher order animals that practice tandem nursing. Breastmilk is reserved for the youngest child and the older child is invariably weaned. It is not clear whether that’s because allowing an older child to continue to nurse robs the baby of valuable food and nutrients, but it simply doesn’t happen in nature.

If none of the above 5 are natural, how did they come to be included in natural childbirth?

Easy. Natural childbirth has nothing to do with childbirth in nature. From its “father,” Grantly Dick-Read, to its current exponents, natural childbirth was made up to serve the interests and aims of its fabricators. Once you start lying about the inherent dangerousness of childbirth and lying that women are “designed” to give birth perfectly, it is a short step to making up never before seen practices and advertising them as natural.

The current fetish for unmedicated childbirth while refusing life saving interventions, complete with birth photographer, live tweeting and a video on YouTube, is about as natural as hunting rabbits with a bazooka while wearing camo. It is not only unnatural, it doesn’t even mimic what really happens in nature.

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  • Carrie C

    I am SO glad you mentioned tandem nursing! I have been trying to wean my almost-17-month-old in preparation for the birth of my newest little one at the end of March, and it is NOT going well. The thought of tandem nursing makes my skin crawl, though, and it’s hard to go against some naturally-minded friends who say, “She’s not ready! You should just tandem nurse!” When I think of my future little newborn, I remember how difficult it can be to establish that breastfeeding relationship (not only that, but just HOW MUCH you nurse in the beginning!), and throwing an older child into the mix just doesn’t seem “natural.” Thanks for the encouragement!

  • Peaceful mama

    Wow this is silly. lol. All of these occurrences happen in nature, and in human history. Water births have been around since Egyptian days, and tandem nursing happens all over the world. I’ve heard about you Amy, I don’t fancy your condescending jeering tone towards natural parents. We’re healthier, stronger and kinder beings. Why don’t you learn from us? Peace.

    • KarenJJ

      Healthier, stronger and kinder then who? Dr Amy? The babies that didn’t make it “earthside” during a failed attempt at an unassisted homebirth?

      And who is doing this and where are these practices occurring? Have you got some good references to share?

      • K&R’s peaceful mother

        We’re just so much more peaceful than the mainstream world in general. We love animals, planet earth, each other, and our children. Lol, no my sons went into the warm hands of their father in their ‘unassisted birth’ as you label it. I call it a transition–there is nothing magical or unnatural or scary about it. It’s just humans making their move from outside their mother’s body. They were safe and sound, and they didn’t shed a tear.

        I live in a ‘eco-village’ in Oregon. I posted to a comment above. Feel free to reply if you’re full of questions. Peace.

        • Eileen

          Funny, you all “love everyone” so much that you constantly criticize, belittle, and ostracize people who don’t think the same way you do. That’s just SO loving of you!

          • K&R’s peaceful mother

            Dr. Amy, just called me stupid, crazy, and naive, but you’re insulted because I stuck up for myself and said I brought my children into the world naturally? If you feel belittled and criticized, that is solely your own problems with yourself. I didn’t say it. Don’t put words in my mouth and don’t whine and complain about things you made out of the thin air. Get your stuff together young lady >:[

          • LibrarianSarah

            Yeah I am sure it is not your own smug, belittling language that has anything to do with it.

          • K&R’s peaceful mother

            And can you give me an example of smug belittling language, dear? Or are you simply mistaken ‘my language’ for your own insecurity?

    • LibrarianSarah

      “We’re healthier, stronger and kinder beings”

      Do you have any proof of this? Or is this like an affirmation thing. Repeat the lie enough times and it becomes the truth right?

      • K&R’s peaceful mother

        Of course I do! :D

        “Well planned vegetarian and vegan diets are appropriate for individuals during all stages of the life cycle, including pregnancy, lactation, infancy, childhood and adolescence, and for athletes. A vegetarian diet is associated with a lower risk of death from ischemic heart disease. Vegetarians also appear to have lower low-density lipo-protein cholesterol levels, lower blood pressure, and lower rates of hypertension and type 2 diabetes than nonvegetarians. Furthermore, vegetarians tend to have a lower body mass index and lower overall cancer rates.”
        — American Diet Association

        “a new study in Nutrition Journal finds vegetarians have lower incidence of depression, anxiety, and other mood problems than their meat-eating neighbors.”
        —http://recipes.howstuffworks.com/vegetarians-happier-than-meat-eaters.htm

        so there you go! remember: cows are friends, not food. lololol.

        • Anj Fabian

          Misquoted Pixar.

          There are a LOT of great food quotes from Pixar’s Ratatouille.

        • LibrarianSarah

          Did you get hit in the head and forget what this post was about? We were talking about parenting not nutrition. And it ironic you mention vegetarianism because that is exactly the kind of thing that Dr. Amy was talking about in this post. The only reason you have the luxery of being vegetarian is due to modern farming practices. If you lived in a hunter-gatherer society you would have to eat whatever is available including meat. So vegetarianism is just as “unnatural” as eating meat daily.

          • K&R’s peaceful mother

            “Did you get hit in the head and forget what this post was about?”

            It almost is beyond me the amount of rude crude and bitter women are on this page, apart from the infamous Amy.

            PS: Dr Amy hasn’t worked in her profession since the 90s. She is hardly qualified to talk about modern advances in childbirth and pregnancy. Nevertheless, she isn’t a registered dietician, nor is she a nutritionist, nor is she an anthropologist who actually studies the diet of our human ancestors. Most of our ancestors were vegan/vegetarians ( http://blogs.scientificamerican.com/guest-blog/2012/07/23/human-ancestors-were-nearly-all-vegetarians/) this was a Scientific America post. And furthermore as said by the actual proffesionals (The American Diet association; the largest organization of food and nutrition professionals, with close to 72,000 members made of researchers, educators, students, nurses, physicians, pharmacists,
            clinical and community dietetics professionals, consultants and food
            service managers) Vegan diets are healthier for people, because it’s natural for us. Furthermore furthermore (lol), there are strictly vegan tribes that have been around for thousands of years (http://www.thehindubusinessline.com/todays-paper/tp-life/article2204749.ece)

            Peace!

    • Box of Salt

      “natural parents”
      What does that even mean?

      What would be an *un*natural parent?

      • LibrarianSarah

        Ghost parents. Though I’d give it to her that she is probably heathier than a ghost seeing that she is not dead. Unless she is dead and is typing this on a zombie computer. Zoinks!

        • K&R’s peaceful mother

          You’re right I’m healthier than ghost parents and non-ghost parents. ;)

          • I don’t have a creative name

            But not healthy enough to stick to one name, huh Ellie?

          • K&R’s peaceful mother

            I don’t get your point, unfortunately. It seems as if you think overall health and fitness is determined by your comment name. Which is very very very silly. lol.

          • I don’t have a creative name

            I’m referring to mental health, Ellie. You keep pretending to be all these different people who are all supporting each other in their points, when it’s just you. You need some help.

          • Clarissa Darling

            Just logged in and happen to see your comment on the sidebar. How did you find out this person is Ellie? Just curious b/c this thread is so long, I tried to follow but, can’t keep up with all the nonsense. If all these people (Ellie, K&R’s mother, Vegan mom etc….) are the same then you are darn right this person needs some help!

          • Clarissa Darling

            BTW I wrote this Guest comment. I had to delete it because somehow discuss grabbed a photo from my real facebook page under my real name and assigned it as my avatar! I have no idea how that happened. These social media privacy filters are getting worse and worse!

          • I don’t have a creative name

            This was one of the names established as her when that whole mess broke. Even if it hadn’t been then, I’d be suspicious, because she’s not very good at disguising her writing style.

            And if it helps, I got your reply in my inbox, but it showed up as your regular username, no photo attached.

          • Clarissa Darling

            Oh must be out the loop. The last thing I heard on Ellie was she was on the Lamaze/C sections page when everyone was being meeeen to her and calling out her lies and as far as I know she had just gone away. Did something happen since then or is that the whole mess you’re referring to? IDK what happened with the photo. I went back in and changed my Disqus settings to the default photo so, glad to hear the other one is no longer showing up. I just hate that the system did that in the first place. It probably thought it was doing me some a huge favor linking my account with other social media or something. I’m super paranoid about privacy though so thanks but, no thanks Disqus!

          • K&R’s peaceful mother

            IDk who Ellie is… Honestly, I was googling placentograpgy and stumbled on this page bashing people. At least I know why you keep calling me Ellie, i was beginning to question your mental sanity.

      • K&R’s Peaceful Mother

        It means I do a whole lot of neo-hippie natural things; I am a raw vegan (50%), but I don’t make my kids do it. So far they’re ova-cooked-vegan. I live in a minimalist house made almost completely out of cob, with my two beautiful children and my common-law husband. We live in Oregon in a ‘eco-village’ (see here: http://eartheasy.com/blog/2012/02/modern-pioneers-what-its-like-living-in-an-ecovillage/) . It means I grow my own food, get my water from a well, get my energy from sunpanels and found a nifty way to compost my household waste: sell it or use it for gardening. It means I ate my placenta, and I birthed my child under a tree on my bed-pillow hands free with my husband and a older woman at my side, and labored in a tub. My children tandem nursed, and it was a beautiful bonding experience for the three of us :). My husband has pictures of the three of us sitting on my yoga mat leaned against a tree, watching the stream flow by, with both of my children in my arms–all of us smiling. Ah.

        • Dr Kitty

          Interesting photo.
          Are they both her children?
          A lot of “tandem nursing” is a woman feeding an older baby of her own who took in an infant when the infant’s mother died or couldn’t produce enough milk to feed it, rather than a woman feeding her own infant and older child.

          • K&R’s peaceful mother

            – A lot of “tandem nursing” is a woman feeding an older baby of her own
            who took in an infant when the infant’s mother died or couldn’t produce
            enough milk to feed it, rather than a woman feeding her own infant and
            older child—

            So women do tandem nurse in other countries, thank you :)

            Whether it’s yours, or you adopted a orphaned baby and raised it as your own, feeding two babies is feeding two babies. Point Blank. Amy is wrong.

  • GuestB

    Vegan Mom:
    “Have a wonderful day. (And no, I’ve wasted my time enough with stupid biddies, so I will not reply to your nonsense) GET A LIFE PEOPLE!”
    And yet she keeps coming back.
    ps – was that properly quoted?
    *sitting back in my chair waiting for a string of nonsense riddled with profanity and insults to come my way*
    This is WAY more entertaining than work!

  • Guesteleh

    You know, Eyeballs got permabanned for less than this. I realize there’s some entertainment value, but seems unfair, no?

    • Box of Salt

      For the record should “permabanning” become an issue, or
      even if it doesn’t: I really don’t care how Vegan mom wishes to address me.

      Her words speak for themselves, as do my own.

      • Amy Tuteur, MD

        I banned her. No doubt it will make her day.

        • fiftyfifty1

          Can we ask for a “switch” instead and have you invite Eyeballs back at the same time?

          • Amy Tuteur, MD

            Does anyone know how to contact her?

          • fiftyfifty1

            Not me.

        • GuestB

          Aw man! Just when things were getting interesting!

        • GuestB

          If someone is banned, can they still read the comments, but just not post?

  • Vegan mom returns

    Some observations about your retarded leader

    “Tuteur let her medical license lapse in 2003 and created the blog Home Birth Debate in 2006, which she used to advocate for her position, ”

    “In 2009 Tuteur moved over to her new blog, The Skeptical OB, the name of which is, on the one hand, misleading because she hasn’t been in practice for more than a decade”

    “when a dogged journalist like Goldberg elevates Tuteur to expert. Tuteur is not a researcher, she’s not currently affiliated with any medical institution, and more importantly, she’s never published any of her kitchen-table calculations on the risks of home birth in any peer-reviewed journal. Yet she presents herself with the authority of a CDC epidemiologist”

    “But “Dr. Amy” is real. I sat with her, face to face, for nearly three hours at a Starbucks off Route 1 south of Boston a couple years ago. She is not a researcher, not an epidemiologist, and probably not on anyone’s payroll; she is an obstetrician-gynecologist who left private practice more than a decade ago because, she told me, she’d had it with HMOs and wanted to spend more time with her four kids (she let her license lapse in 2003, according to the Massachusetts Board of Medicine). And for some reason, which I never quite got to the bottom of, she believes in every cell that Home Birth Kills Babies (that’s in fact the title of her most recent post on her new site, The Skeptical OB), and no amount of research evidence will convince her otherwise.”

    Wow and I’m the gullible idiot? LoL. You stupid bitching hags and mothers are more impressionably stupid and mindless than you give yourself credit, if you honestly think this woman has any credibility at all. She’s a blog writer who projects a medical title of a career that she hasn’t practiced in years. She is a Internet troll who arrogantly harasses women and puts them down for choosing to deliver at home via commenting, and you all are idiots. She had no education about the history and prevalence of lotus births, placenta eating and waterbirths. Furthermore, she contradicted herself several times when confused “happening in nature” with “happening with wild apes” and “happening in human history”. Yet! And yet, you stupid stubborn biddies refuse to acknowledge this when I bring attention to it, because that would only reveal the inevitable (that your leader is a dumb twat). Instead you all make like kindergartners and choose point your finger at the vegan mama because she said a ‘bad word’, then you proceed your debates with me with the “I know you are but what am I” argument. You have absolutely no counterarguments or alternative evidence to negate my comment, yet you arrogantly gloat and jeer as if you won the argument?

    What fucking grade are we in, ladies?

    You’ve only proven the gullibility and ignorance of anti-naturals, and the prideful attitude taken by the anti-home-births idiots, who spend more time fussing at women for their choices than on their kids.

    Have a nice day, you stupid hags. Get a life, and for the love of god wise up!

    http://slate.com/articles/double_x/doublex/2012/07/daily_beast_and_home_birth_fear_trumps_data_in_a_new_story_on_having_babies_at_home_.html?original_referrer=https%3A%2F%2Fwww.google.com%2F

    http://www.sciencebasedmedicine.org/dr-tuteur-has-decided-to-leave-science-based-medicine/

    http://www.universalhub.com/2013/blog-flamewar-winds-federal-court

    http://www.babble.com/pregnancy/winning-homebirth-debate/

    • PJ

      Probably no one addressed your nature in the human/animal kingdom quibble because it makes no sense and it’s a bit pointless to argue with people who don’t understand basic logic (as you don’t seem to). Plus your post was so rude and abusive that you really don’t deserve to be taken seriously.

      Maybe if you would try being a little civil you would get a more satisfying response.

      • Vegan Mom returns

        —”Probably no one addressed your nature in the human/animal kingdom quibble because it makes no sense and it’s a bit pointless to argue with people who don’t understand basic logic (as you don’t seem to).”—

        What subjective bullshit. “It makes no sense” to YOU because your author contradicted herself by defining ‘natural’ by what past civilizations practiced. Therefor, your counterargument is not winnable. So you do with all the unnatural birth advocates do, you reject straightforward evidence and call it illogical because it doesn’t fit your agenda, just like how you do with the NEW data that clearly shows how home-births are just as safe (if not better) than hospital births.

        You cannot argue ‘scientific logic’ when discussing *cultural norms*, moron.

        —”Plus your post was so rude and abusive that you really don’t deserve to be taken seriously.”—

        Awe, do you want me to kiss your booboo? :(

        More subjective BS. The truth is the truth, if we sat around trying to sugar code it just to pat the backs of a few crybabies we’re never going to get ahead. Your author has done her fair share of abuse with her anti-breastfeeding, anti-natural-child-birth, anti-elimination communication (calling people who train their babies to use to restroom early “increment obsessed”) BS blog posts, her arrogant and pessimistic “I-hate-life” comments on every natural parenting blog, and her self righteous jackassesry. She’s so much of a Internet troll, she has a reward as a famously recognized internet troll (as seen in the URL at the bottom of the page)

        Some famous quotes by yours truly; Play Pretend Doctor I-Have-No-Life:

        “I can’t decide who are the bigger fools. Those who eat their placenta or those who leave it attached to the baby to rot off.”

        “You have to be the most gullible rube on the planet to be or use the services of a “placenta encapsulation specialist.””

        “You don’t need a medical degree to appreciate the idiocy of birth in water.”

        Should I go on?

        And Im the bad guy for calling out the beldame point blank? This was just pitiful

        —”Maybe if you would try being a little civil you would get a more satisfying response.”—

        And maybe if license-less retired hag Amy would stop bullying people who do natural childbirths, or ANYTHING natural, call them out their names, and make arrogant condescending comments towards them, I wouldn’t have to give the little bitch a piece of my mind. I love your reasoning, call natural childbirth advocates idiots, gullible and stupid, make up false unaccredited lies about natural childbirth, and even make post after post mocking them and bullying for no conforming to her unnatural parenting styles, but when people lash back they are abusive and a big fat meanie head?

        PS: some benefits of leaving the baby attached to its placenta:

        “NHS rules say do it immediately, but cutting the umbilical cord too early may be putting babies at risk”

        The umbilical cord connects the developing baby to the mother’s placenta, supplying it with oxygenated, nutrient-rich blood. The practice of immediately clamping the cord after birth is currently widespread in NHS hospitals.
        But, as Ms Burleigh points out in her petition, a growing weight of respected scientific research is linking early clamping with a host of serious developmental problems.
        Independently published clinical studies and reports say that these may include anaemia, learning difficulties, ADHD, autism and even sudden death.”

        http://www.dailymail.co.uk/health/article-2302544/NHS-rules-say-immediately-cutting-umbilical-cord-early-putting-babies-risk.html

        I bet Troll Bitch Amy isn’t going to post that SCIENTIFIC ACCREDITED ACCURATE INFO on her blog when she mocks the parents who do lotus births

        “THE MASTER LIST OF TROLLS (URL)”
        http://veillifted.wordpress.com/the-master-list-of-trolls/

        • PJ

          Well, who am I to argue with someone who uses the SCIENTIFIC ACCREDITED ACCURATE Daily Mail as a source of scientific evidence?

          • Vegan Mom returns

            Are you serious? I can’t use a news articles, now?

            Ok, you can read the fucking study itself. Enjoy

            http://jama.jamanetwork.com/Mobile/article.aspx?articleid=206143

          • Box of Salt

            Vegan Mom, please note hereafter I will not reply to your profanity- or insult-included comments. If you are polite, I will respond in kind.

            Your study linked study is from 2007. Dr Amy wrote the following post in January 2013 about a Cochrane Review of the same subject; I guarantee you will disagree with her take on it.
            http://www.skepticalob.com/2013/07/delayed-cord-clamping-much-ado-about-nothing.html

            The post includes further links to the study and other analyses.

            I am posting this to show you that Dr Amy does indeed discuss studies, and also to show you that her post inspired a lot of discussion, including contributions from many who disagree with her. Read it for yourself, and the 325 (so far) comments.

          • Vegan Mom reruns

            “when a dogged journalist like Goldberg elevates Tuteur to expert. Tuteur is not a researcher, she’s not currently affiliated with any medical institution, and more importantly, she’s never published any of her kitchen-table calculations on the risks of home birth in any peer-reviewed journal. Yet she presents herself with the authority of a CDC epidemiologist”

            The comment that has the URL of this quote is the at the top. Is her opinion credible? Nope doubt it!

          • Box of Salt

            Vegan Mom, ” Is her opinion credible? Nope doubt it!”

            If your point in posting here is to argue that the blog author (Dr Amy)does not have credibility, you should not have started out by eliminating your own credibility through the liberal use of insults and profanity.

            Again, to reiterate my reply to your previous comment, if you wish to engage in discussion – engage in * discussion. * Skip tossing out insults.

            Engage in discussion.

          • Vegan Mom returns

            Here is some CITED AND REFFERENCE DATA FROM AN ACTUAL PRACTITIONER IN PEDIATRICS AND NEONATAL CARE FOR OVER 25 YEARS AND WHOM IS A MEMBER OF THE AMERICAN ACADEMY OF PEDIATRICS.

            “Summary:

            Delayed cord clamping promotes a healthy neonatal cardiopulmonary transition, prevents iron deficiency at a critical time in brain development, provides the newborn with a rich supply of stem cells, and helps sick neonates achieve better outcomes—all with little apparent risk to mother or baby. The evidence of benefit from DCC is so compelling that the burden of proof must now lie with those who wish to continue the practice of immediate clamping, rather than with those who prefer—as nature intended—to wait.

            What do you tell your patients, students and clients about delayed cord clamping? Do you have a favorite resource or two that you like to share? What are the community standards around delayed cord clamping in your community? Are health care providers discussing this with their patients? Do they have recommendations one way or another that you are hearing? Please join in the discussion.- SM

            References

            1) Mercer JS, Erickson-Owens DA. Rethinking placental transfusion and cord clamping issues. Journal of Perinatal & Neonatal Nursing. July/September 2012 26:3; 202–217 doi: 10.1097/JPN.0b013e31825d2d9a

            2) Andersson O, Hellstrom-Westas L, Andersson D, et al. Effects of delayed compared with early umbilical cord clamping on maternal postpartum hemorrhage and cord blood gas sampling: a randomized trial. Acta Obstetricia et Gynecologica Scandinavica. Article first published online: 17 Oct, 2012. DOI: 10.1111/j.1600-0412.2012.01530.x

            3) Chaparro, CM. Timing of umbilical cord clamping: effect on iron endowment of the newborn and later iron status. Nutrition Reviews. Volume 69, Issue Supplement s1, pages S30–S36, November 2011.

            4) Ceriani Cernadas JM, Carroli G, Pellegrini L, et.al. The Effect of Timing of Cord Clamping on Neonatal Venous Hematocrit Values and Clinical Outcome at Term: A Randomized, Controlled Trial. Pediatrics. Vol. 117 No. 4 April 1, 2006 pp. e779 -e786 (2,3 8,9(doi: 10.1542/peds.2005-1156). Published online March 27, 2006.

            5) WHO. Department of Making Pregnancy Safer. WHO recommendations for the prevention of postpartum haemorrhage. Geneva: World Health Organization, 2007.

            6) McDonald SJ, Middleton P. Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD004074. DOI:10.1002/14651858.CD004074.pub2.

            7) Andersson O, Hellstrom-Westas L, Andersson D, Domellof M. Effect of delayed versus early umbilical cord clamping on neonatal outcomes and iron status at 4 months: a randomised controlled trial. British Medical Journal. 2011; 343: d7157. Published online 2011 November 15. doi: 10.1136/bmj.d7157

            8) Ceriani Cernadas JM, Carroli G, Pellegrini L, et.al. The effect of early and delayed umbilical cord clamping on ferritin levels in term infants at six months of life: a randomized, control trial. Arch Argent Pediatr. 2010; 108:201-208.

            9) Hutton EK, Hassan ES. Late vs early clamping of the umbilical cord in full-term neonates: systematic review and meta-analysis of controlled trials. JAMA. 2007 Mar 21;297(11):1241-52.

            10) McDonald SJ, Middleton P. Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD004074. DOI:10.1002/14651858.CD004074.pub2.

            11) Carter RC, Jacobson JL, Burden MJ, et al. Iron deficiency anemia and cognitive function in infancy. Pediatrics. 2010; 126:2 pp e427-e434 (doi: 10.1542/peds.2009-2097).

            12) Mercer JS, Skovgaard R. Neonatal Transitional Physiology: A New Paradigm. J Perinat Neonat Nursing 2002; 15(4) 56-75

            13) Yao AC, Lind J. Effect of gravity on placental transfusion. Lancet. 1969; 2:505-508.

            14) Mercer JS, Vohr BR, Erickson-Owens DA, et al. Seven-month developmental outcomes of very low-birth-weight infants enrolled in a randomized controlled trial of delayed versus immediate cord clamping. J Perinatol. 2010; 30:11-16.

            15) Kinmond S, Aitchison TC, Holland BM, et al. Umbilical cord clamping and preterm infants: a randomized trial. British Medical Journal. 1993; 306:172-175.

            16) Rabe H, Wacker, A, Hulskamp G, et al. A randomized controlled trial of delayed cord-clamping in very low-birth-weight preterm infants. Eur J Pediatr. 2000; 159:775-777.

            http://www.scienceandsensibility.org/?tag=risks-of-early-clamping-and-cutting-umbilical-cord

          • Box of Salt

            Hmmm, Shouting, followed by reposting someone else’s Gish Gallop.

            It is an improvement over insults and profanity.

            I’ll leave the commentary to those who have more interest and expertise in this issue than I – my point is merely that discussion is welcomed here – if you are willing to engage in it.

          • Vegan Mom returns

            Cunt, you honestly need to step the hell down. I can do without the patronizing, especially coming from a retarded twat who uses references from a unaccredited blogger’s kitchen table calculations. The reason so many people hate this woman and the idiotic cunts like you who follow her, is because: not only are you all sciolistic idiots with not a single fiber of remote credibility, but because you act arrogant and prideful about your ignorance . If you think I wrote without the profanity to appease you, you honestly need to get you head out of your horse’s ass.

          • Box of Salt

            Bye bye.

          • Vegan Mom

            And good riddance! Peace!

            PS: love the valediction. My four year olds say it to mommy all the time when they go to school. The maturity of it really matches your juvenile intelligence level. Lol

          • PJ

            Aaand it’s posts like that that explain why people are laughing at you.

            (How can anyone reason with someone so ignorant that she doesn’t even realise why newspaper articles (let alone the Daily Mail (!)) are not legitimate sources of scientific evidence?)

            That notwithstanding, I too would be happy to engage with you if you could behave like a civilised and rational human being, but will no longer be responding to abusive tirades.

          • Vegan Mom returns

            “Aaand it’s posts like that that explain why people are laughing at you”

            You honesty think I give two shits from a group of ignorant bitches who think the comment “burn in hell” is wishing death on someone? Oh please, twaty, DON’T make me laugh.

            You’re passing on the same stupid arrogant attitude because of the reason you twats are always doing that, YOU HAVE NOTHING TO SAY. Get over it, bitch, calm the ego and admit your ignorance or hey, here’s a thought, stop replying on my comments, if you have nothing intelligent to come back with!

            “I too would be happy to engage with you if you could behave like a civilised and rational human being, but will no longer be responding to abusive tirades.”

            Oh, excuse me, I’m sorry, am I begging for your approval? Ha! Oh LOL. If i recall correctly i came to call this bitch out for all of her retarded nonsense. Stay in your place, please. Oh and also, it’s not a tirade, its answering to your notorious BS, that you’ve YET to answer to, because the fact of the matter is you can’t. So instead of confronting my arguments, you make like a craven cunt and knock at my manners. Great way to avoid the fact you’re full of shit! Bravo!

          • Eddie

            The popular press routinely misreports medical research and overhypes research that is interesting but not conclusive. News articles are interesting, but are not sources of scientific information.

    • Box of Salt

      Vegan mom, first: frankly, I don’t see much point in arguing with someone extolling the virtues of being all natural yet self-identifies as a vegan. In case the irony goes over your head again: Vitamin B12
      http://ods.od.nih.gov/factsheets/VitaminB12-QuickFacts/

      That’s obviously not the only issue here.

      I’m sorry you are having difficulty accepting that some of those things you value highly other people find pointless at best. I’m also sorry that you thought an appropriate response includes anger and insults. But what I really don’t understand is why you have come back to complain that no one here wants to have a discussion with you. Re-read your own posts, then ask yourself: would I want to interact with the person who wrote that?

      To quote another commenter: I hope you get the help you need.

      • Vegan Mom returns

        HOW many times have I gotten into the b12 debate? Oh, laugh out loud!

        Sweetie, you can get b12 from seaweed, algae, edible clay and edible soil. Most people around the world get their b12 from soil and clay. It’s becoming so popular now, 5 star chiefs are putting soil and clay into their thousand dollar dishes:

        *5 star Tokyo restaurant charges 10,000¥ for meals with dirt in them*

        http://www.odditycentral.com/pics/japanese-restaurant-uses-dirt-as-the-main-ingredient-for-its-expensive-dishes.html

        *B12 plant sources*
        http://www.veganhealth.org/b12/plant

        *CITED Scientific recognition to the Benefits of edible clay (it has minerals, supplements, detoxification capabilities + aids digestion)*

        http://www.magneticclay.com/eating-clay.php

        (FROM ABOVE URL)”These levels of mineral nutrient supplementation points clearly to the practical value of clay eating” — Dr. John Hunter, the
        Geographical Review

        “I’m sorry you are having difficulty accepting that some of those things you value highly other people find pointless at best.”

        I’m sorry you’re a pointless idiot who likes to pity yourself and lick your ulcers. I’m sorry you’re terrible at debating, staying on topic or answering to arguments. I’ve sorry I’ve wasted my time with someone who points out that I’m vegan to avoid their flaws in their argument. No one wants a discussion because no one can come up with a counterargument. They’re stupid and cannot disprove my claims. So they act as if a Internet comment actual hurt their feelings. I’ve kisses plenty of booboos, but I never thought Id have to do it to a adult!

        I’ve looked at my comments and then I laughed. I was very pleased with each and every one of them, and the pitiful sorry replies that followed. It was a hell of a good time telling you morons off and finally putting you in your place for once in your miserable lives.

        ” I hope you get the help you need”

        Eh, try harder next time, sport. This one made me lol with my friends and I’m quite sure that was the opposite effect. :)

        • Box of Salt

          Bye bye. You started an earlier reply to me by addressing me as “Cunt.”

          I was willing to cut you some slack. No longer!

          Bye bye!

        • Lizzie Dee

          I’ve looked at my comments and then I laughed. I was very pleased with each and every one of them,

          I think most of us could figure that out for ourselves. Though I think you may be over-estimating just a teensy bit the effect you are having.

          • KarenJJ

            Really? You aren’t convinced by her detailed analysis of the papers she’s read and the informative points she’s made? Well blow me down…

          • Vegan Mom

            Glad you enjoyed them, hag, they were a hell of a lot smarter than half of the sorry ass replies, you ugly twats were answering . All you did was make like grade schoolers and pick on the nerd. Get a life, old woman. Go play some bingo and leave this medical debates to the new school people, not the ones who grew up in a time where smoking cigarettes was ok even while being gravid.

            PS: did school in the olden days teach you how to properly quote? It seems that along with your inability to answer arguments, you aren’t capable of that either.

          • Lizzie Dee

            did school in the olden days teach you how to properly quote?

            Probably. But you didn’t seem worth the effort.

            I

        • PJ

          For the benefit of Dr Amy’s other readers, it’s a common myth that you can get B12 from seaweed and algae (what “edible clay” and “edible soil” are I have no idea–perhaps someone can enlighten me?). They contain an analogue to B12 that is completely useless to the body.

          Interestingly, strict vegetarians in countries like India have historically got at least some of their B12 from insects found on other food. Modern thorough washing and food processing techniques make remove this source of B12 (and bugs aren’t vegan anyway). Also interestingly, people from cultures with long histories of vegetarianism tend to be a lot better at absorbing nutrients like iron from plant sources–a nice example of evolution at work. (It’s also a myth that vegetarian foods like spinach are good sources of iron–in fact non-meat sources are much harder to absorb.)

          • Eddie

            The word of the day is “geophagy” :-)

            http://en.wikipedia.org/wiki/Geophagy

            Some macaws, in the wild, eat clay. That’s where I heard about this. How this relates to people, if at all, is not something I have any clue about. My random guess would be that in humans it’s a pica.

            In that context, I imagine that edible clay and soil are just clays and soils that don’t have anything poisonous or dangerous in them.

          • PJ

            I tried a google search and all I came up with were a lot of vegan websites with people who don’t understand basic science.

    • Kalacirya

      This person is definitely an angry teenage boy, their persistence in using the word “retarded” despite being told off the first time is what makes it apparent to me.

  • Vegan Mom

    And to all the angry old bitching hags, you can all kiss my big fat ass, until you can find a argument to contridict mine. As far as I see, your lashes are quite laughably stupid pointless and do not negate anything I had to say. As far as I see you stupid pathetic twats are mad your idiotic leader was proven wrong and called out in her own game. She’s a bitch, you’re all bitches, and you all need hobbies instead of obsessing over what women do with their placentas and their children. (Wow that felt so good to say) As usual, burn in hell, and fuck off.

    Have a wonderful day. (And no, I’ve wasted my time enough with stupid biddies, so I will not reply to your nonsense) GET A LIFE PEOPLE!

    PS: This comment was very entertaining to do :)

    • PJ

      You react exactly the same way all NCB advocates seem to when challenged to back up their claims with actual evidence–evade, abuse and flounce!

    • GuestB

      Burn in hell. Nice.

      While this has been entertaining, that was over the line. Does wishing death on people makes you feel good about yourself? I sincerely hope you get the help you need.

    • Eddie

      Ah, mistaking not being taken seriously by us as us being angry. Funny. Your posts were theater, not something taken seriously or responded to with intellect. if you actually intended something other than theater (which I personally doubt, but one never knows) then you chose the wrong tone.

      If someone went to a science forum and posted that the earth is flat — in the same tone you used — you’d get a similar response. The response you got has nothing to do with your facts (or lack thereof) and everything to do with your tone.

      But I’m sure you kind of know that already…

  • Burgundy

    Out of curiosity, I asked my mom who was a pharmacist and
    studied Chinese herb during her school years (I grow up in Taiwan where Chinese
    herbs was part of our daily life). She
    told me that no moms would eat their own baby’s placenta. In the old days (like before hospital), the mid wife would
    express the placenta to the herbiest for a fee.
    The herbiest would process the placenta into medication which was primarily
    used to cure “impotence”.

  • http://shameonbetterbirth.wordpress.com/ Shameon Betterbirth

    can anyone view this article in full?

    http://www.ncbi.nlm.nih.gov/pubmed/21888574

    I could not find the article that I found on pubmed when I was pregnant, but it was about people eating placentas somewhere in southeast asia. I’d say placentophagy is rare in human society but not completely absent. If people are very hungry they will eat just about anything.

  • Vegan mom

    This stupid bitch is halarious:

    “Unassisted childbirth rarely if ever occurs among human societies.”

    “No primates, let alone humans, give birth in water.”

    Wait, are we determining what’s natural by ANIMAL behavior or HUMAN CIVILIZATION behavior?

    If animal behavior, your stupid ass contradicted yourself. Animals don’t have medicated *childbirths so it IS natural.

    If in human civilization behavior, you’ve contradicted yourself several times.

    -Humans have been giving birth in pools, tubs, lakes and rivers since ANCIENT EGYPTIAN days, learn your shit. The practice was brought back into the mainstream world when a Russian doctor wanted to deliver a woman’s baby without UNNATURAL LAB DRUGS, and with something natural and cheap.

    -If you mean human civilization behavior, you’ve contradicted yourself, humans have had lotus births since ancient times too. The practice started in ancient china over 2000 years ago, the same goes for eating placentas its a primitive practice that aboriginal tribes in Africa, STILL DO.

    -and if you mean human civilization again, you contradicted yourself. Humans have been giving birth without midwives and assistance since we evolved from apes, do you think there was a doctor at the side of these tribal ladies?

    And if you mean civilization, you’re wrong. Tandem nursing has existed in civilization since FOREVER as well!!! If you don’t believe me you can haul your stupid old crusty bitter idiotic ass to Africa and watch a mother nurse her two year old and her cousin’s newborn. As a matter of fact, no, just watch the video “Babies” and just STFU

    You’re SOOO stupid, pathetic and desperate its just sad! You give doctors and professionals such a horrible name, please pick up a damn history book before I knock your head with it and PLEASE shut up, if you are unfamiliar with something!

    • KarenJJ

      You sound like you seriously know your stuff.

      Which aboriginal tribes ate the placenta? I know some places where they ate the baby (especially first born females) but not the placenta. This wasn’t in Africa though.

      And you’re right. Giving birth in water in Russia sounds very logical to me, especially in winter.

      • ol

        You are right :-) Waterbirth was invented in Russia only in 1970-s by Charkovsky, it’s not your west-style waterbirth, but with dolphins in the Black Sea. It was not available for many Soviet women.

        But in the past in countryside there was one strange for a modern person place where peasants used to give birth sometimes – it was a stove. It was big enough and warm and disinfected by heat before.

      • Vegan Mom

        “You sound like you seriously know your stuff.”

        Yeah, I do. What of it?

        “Which aboriginal tribes ate the placenta?”

        Ok I’ll humble myself with this one. I typed this on my iPhone and put in Africa, when I meant *Asia (damn you autocorrect)

        “In some cultures such as Vietnam and China the placenta is viewed as a life-giving force. Therefore, it is dried and added to certain placenta recipes in order to increase a person’s energy and vitality.”

        http://www.birthtoearth.com/FAQs/Placenta+Traditions.html

        “And you’re right. Giving birth in water in Russia sounds very logical to me, especially in winter.”

        Obviously you missed the part in my rant when I said “POOLS AND TUBS”. Learn how to read before saying something stupid. K, Babycakes?

        —We tend to think of labouring in water as relatively new. However, a writer on water births, Janet Balaskas, says that’s not so. She describes legends of South Pacific Islanders giving birth in shallow seawater and of Egyptian pharaohs born in water. In some parts of the world today, such as Guyana, in South America, women go to a special place at the local river to give birth.

        Giving birth in water (rather than labouring in it) is a relatively recent development in the Western world. The first water birth that we know about in Europe was in 1803 in France. A mother whose labour had been extremely long and difficult was finally helped to give birth in a tub of warm water.

        In the 1970s, some midwives and doctors in Russia and France became interested in ways of helping babies make the transition from life in the uterus (womb) to life outside as smooth as possible. They were worried about the way women in labour were cared for in developed countries.—

        http://www.babycentre.co.uk/a542003/the-history-of-water-birth

        (LOVE THE REFERENCES AT THE BOTTOM OF THE ARTICLE)

        “I know some places where they ate the baby (especially first born females) but not the placenta. This wasn’t in Africa though”

        And I know a man name Bill, what’s your point, sweetie? If you think it’s cannibalism LOL, you’re out of your mind. Its a much as cannibalism as it is ingesting your husband’s sperm cells. You’re not eating the body of a once living human being or the growing developing child you slaughtered, you’re eating ‘reproductive waste’ that is no longer needed for the newly born baby, and would rot and decompose into the earth anyway if you hadn’t consume it.

        —ARTICLE TITLE: Scientist Suggest Eating Placentas Are Good For You

        The entire animal kingdom does it, but most humans become squeamish and pull their faces at the very notion. But now, scientists are suggesting that mothers—and perhaps even fathers—would benefit from eating parts of the placenta following child birth. Yum.

        A team of researchers from the University at Buffalo has been studying afterbirth ingestion in other species to work out why they do it—and why it might be beneficial for humans. They point out that eating the placenta provokes an increase in mother-child interaction, promotes hormone release that stimulates caring instincts, attenuates pain—in both sexes— and even increases the possibilities for future fertilization.

        Mark Kristal, one of researchers, intends to conduct a full-blown trial to investigate the positive effects of eating afterbirth. Don’t worry, though—the results might mean we can get around the need to eat the stuff. “The outcome of such a quest need not be an exhortation for women to eat afterbirth, but for scientists to isolate and identify the molecule or molecules that produce the beneficial effect and use it to design pharmacological tools,” Kristal explained to EurekAlert!.—

        http://gizmodo.com/5897021/scientists-suggest-that-eating-placenta-is-good-for-you#replies

    • Jocelyn

      Excuse me? I don’t…Just…I know Dr. Amy doesn’t delete comments, but I wouldn’t blame her in the least for deleting this. How rude and disrespectful.

      • Vegan mom

        And she wasn’t rude and disrespectful when making this post?

        • Jocelyn

          She certainly didn’t cuss at anybody.

          • Vegan Mom

            Lol, did it hurt her feelings? She’s made it quite frank that she doesn’t give a fuck. Look at her sciolistic arrogant condescending tone? Is profanity needed?
            She’s done more than her fair share, without the ‘bad words’.

          • Amazed

            Tiny little you obviously does give a fuck, though. Hereby, your expressive language.

            Oh the good old days when women were striving to be ladies. Now, some of them express their hurt by being more vulgar than one time soldiers.

          • Poogles

            “Oh the good old days when women were striving to be ladies.”

            Eh, I have never wanted to be a “lady” or “ladylike” – used to piss my grandma right off when she would scold me with “Well, that’s not very ladylike!” and I responded with “I never claimed to be a lady”.

            Too often, IME, “being a lady” seems to overlap with being passive and uptight, and loaded down with a bunch of societal rules that apply only to women.

            I have no problem with women cursing and being vulgar (though not in all environments/situations, of course). I have no problems with women being physically agressive if the situation calls for it. I have no problems with women belching and breaking gas, if it is an environment where men could do the same and no one would blink an eye. I have no issues with women wearing whatever the hell they want (as long as they’re not breaking any dress codes or laws). There are many etiquette rules that I think are a waste of time, and so I don’t bother with them, and don’t expect others to (Thank You notes, for instance – I will tell the person “Thank You”, I just don’t see the need for it to be in a physically written form on pretty stationary for it to “count”).

            So, in general, I just strive to be a compassionate, kind, decent human being. I figure that covers all the important bases ;-)

          • Jocelyn

            This reminds me of two things. First of all, Graham’s Hierarchy of Disagreement: http://commons.wikimedia.org/wiki/File:Graham's_Hierarchy_of_Disagreement.svg. And secondly, that unattributed quote that goes something like, “When a man uses profanity to support an argument, it indicates that either the man or the argument is weak – probably both.”

          • Bombshellrisa

            I guess we are seeing another example of pounding the table.

    • realityycheque

      “This stupid bitch is halarious”

      Oh, the irony.

      • Vegan mom

        Very cheesy way to get out of an arguement you’re very sure you can’t win. Lol

        • Amazed

          … said Vegan mom in front of the mirror.

          Keep writing. Please.

          • Vegan Mom

            To every mumbling idiot who like the “I know you are but what am I” style argument in order to argue how silly I am for pointing this retarded twat’s laughable post:

            Until you can contradict my arguments with a cited or referenced claim, you need to shut your gormless traps up, and stop these 8th grade juvenile remarks. You sound like a fatuous, benighted, nescient dolt—much like your sciolistic infinitesimal-brained leader who wrote this laughable blog.

          • Amazed

            Thanks for being so considerate * smile*

        • PJ

          Which University of Google source did you get your facts from? Unless you can substantiate your claims with actual evidence, no one is going to take you seriously.

        • realityycheque

          Well, what was I supposed to say? “Nice collection of arguments from antiquity and appeals to nature”? Just because something has been done “for centuries” doesn’t mean it’s of any value, and just because something is “natural” doesn’t mean that it’s good for you. Arsenic is natural.

          I don’t agree with everything Dr. Amy says in her blog and I’m always open to alternative opinions, but you don’t make any compelling points, or provide any real evidence as to why these practices are beneficial for women or their babies. You parachute in here acting like a hysterical lunatic who is apparently incapable of engaging in a debate with other adults without resorting to swearing and abuse.

          “Wait, are we determining what’s natural by ANIMAL behavior or HUMAN CIVILIZATION behavior?”

          No, promoters of natural childbirth are:

          http://motherscircle.net/birth-like-an-elephant/

          “http://www.squidoo.com/eat-human-placenta”-

          “http://pregnancy.about.com/cs/placentas/a/placenta.htm”

          “http://www.naturalparentingadvice.com/natural-childbirth-tips.html” – “Every female animal instinctively knows to go somewhere dark and safe to give birth. Cats hide in closets, dogs go under a stairwell. Where do human females go – to a hospital with neon lights and strangers?”

          “http://www.unassistedchildbirth.com/unassisted-childbirth/truth-about-birth/” -
          “Animals intuitively understand this concept. [...] This is as true for domesticated
          animals as it is for animals in the wild. Purina’s Handbook of Cat Care advises owners to pet the laboring cat [...] Unfortunately, this book is not on the required reading list in most medical schools!”

    • GuestB

      The phrase “Give a person enough rope and eventually they’ll hang themselves” comes to mind here. I hope you come back to finish the job.

      • KarenJJ

        She’s doing a great job. Anyone with some more questions? I’d like to know how many Chinese and Vietnamese women she knows who actually ate their placenta?

        • Amazed

          “Anyone with some more questions? I’d like to know how many Chinese and
          Vietnamese women she knows who actually ate their placenta?”

          I am here and I do have a question. How cruel is it to eat your child’s spiritual twin? Cannibalism much?

          • Vegan Mom

            FOWARDED (originally sent to another idiot):

            —”I know some places where they ate the baby (especially first born females) but not the placenta. This wasn’t in Africa though”

            And I know a man name Bill, what’s your point, sweetie? If you think it’s cannibalism LOL, you’re out of your mind. Its a much as cannibalism as it is ingesting your husband’s sperm cells. You’re not eating the body of a once living human being or the growing developing child you slaughtered, you’re eating ‘reproductive waste’ that is no longer needed for the newly born baby, and would rot and decompose into the earth anyway if you hadn’t consume it.”—

          • burgundy

            Out of curiosity, I asked my mom who was a pharmacist and
            studied Chinese herb during her school years (I grow up in Taiwan where Chinese
            herbs was part of our daily life). She
            told me that no moms would eat their own baby’s placenta. In the old days (like before hospital), the mid wife would
            express the placenta to the herbiest for a fee.
            The herbiest would process the placenta into medication which was primarily
            used to cure “impotence”.

          • Amazed

            I often use a hair mask with placenta. Many uses, just not edible.

    • Amy Tuteur, MD

      Thanks for proving my point with an outstanding example of both stupidity and gullibility!

      • Vegan Mom

        Gullible this, you stupid stuck up bitch:

        —We tend to think of labouring in water as relatively new. However, a writer on water births, Janet Balaskas, says that’s not so. She describes legends of South Pacific Islanders giving birth in shallow seawater and of Egyptian pharaohs born in water. In some parts of the world today, such as Guyana, in South America, women go to a special place at the local river to give birth.

        Giving birth in water (rather than labouring in it) is a relatively recent development in the Western world. The first water birth that we know about in Europe was in 1803 in France. A mother whose labour had been extremely long and difficult was finally helped to give birth in a tub of warm water.

        In the 1970s, some midwives and doctors in Russia and France became interested in ways of helping babies make the transition from life in the uterus (womb) to life outside as smooth as possible. They were worried about the way women in labour were cared for in developed countries.—

        http://www.babycentre.co.uk/a5

        (LOVE THE REFERENCES AT THE BOTTOM OF THE ARTICLE)

        —ARTICLE TITLE: Scientist Suggest Eating Placentas Are Good For You

        The entire animal kingdom does it, but most humans become squeamish and pull their faces at the very notion. But now, scientists are suggesting that mothers—and perhaps even fathers—would benefit from eating parts of the placenta following child birth. Yum.

        A team of researchers from the University at Buffalo has been studying afterbirth ingestion in other species to work out why they do it—and why it might be beneficial for humans. They point out that eating the placenta provokes an increase in mother-child interaction, promotes hormone release that stimulates caring instincts, attenuates pain—in both sexes— and even increases the possibilities for future fertilization.

        Mark Kristal, one of researchers, intends to conduct a full-blown trial to investigate the positive effects of eating afterbirth. Don’t worry, though—the results might mean we can get around the need to eat the stuff. “The outcome of such a quest need not be an exhortation for women to eat afterbirth, but for scientists to isolate and identify the molecule or molecules that produce the beneficial effect and use it to design pharmacological tools,” Kristal explained to EurekAlert!.—

        http://gizmodo.com/5897021/sci

        Ok I’ll humble myself with this one. I typed this on my iPhone and put in Africa, when I meant *Asia (damn you autocorrect)

        —In some cultures such as Vietnam and China the placenta is viewed as a life-giving force. Therefore, it is dried and added to certain placenta recipes in order to increase a person’s energy and vitality.—

        http://www.birthtoearth.com/FA

        • Amy Tuteur, MD

          Just keep it up. I bet I’ll get enough maternial for an entire post on the stupidity and gullibility of homebirth advocates.

          • Amazed

            She can’t delete it, right? Not when she’s not logged in? I wouldn’t want us to lose these pearls of wisdom.

          • KarenJJ

            Drat, she’s started logging in and might delete some of these.

          • Amazed

            I noticed and I started taking precations. Too bad I can’t spare more than a few minutes at a time.

            A helping hand here?

          • KarenJJ

            Maybe she’s not logging in. I’m so tired I can’t see straight any more. You’re on your own I’m afraid Amazed. It’s bedtime on my side of the world. Good luck.

          • Amazed

            Disqus and its tricks again. I could have sworn that she was logged in 10 minutes ago.

          • GuestB

            Oh, lol. Thanks for admitting your comfort level of being crusty and angry. If you say this is the bitter old angry hags club, you guys rank highest. ;)
            If you don’t like that reference here is another. I love PDFs
            http://www.birthjourney.com/pd

          • GuestB

            That was VM, not me. I am not that good.

          • GuestB

            More vegan mom:
            So as long as you don’t use ‘naughty words’ you’re not a troll? But a woman who can’t mind her own fucking buisness and get A LIFE outside of judging other moms, ISN’T a bitchy cranky troll who needs to shut the hell up?
            Some Highlights:
            “when it is nothing more than a stunt practiced by the clueless in order to impress their clueless peers.”
            “You have to be the most gullible rube on the planet to be or use the services of a “placenta encapsulation specialist.”
            “I can’t decide who are the bigger fools. Those who eat their placenta or those who leave it attached to the baby to rot off.”
            Yet I’m the bad guy, (looking for info for my GF who wants to give birth in water and have a lotus birth), who stumbled on this unfortunate article, got insulted by the terrible and condescending ignorance and indeed finally called this hag for what she is? An angry old bitch?
            I’ve seen this beldame many times on the interwebs all she does is judge, hate and rant with little to no evidence to back up her claims. She posts her comments on plenty of blogs, and has a habit of pissing everyone off, running away and shutting up when proven wrong. Like about now. If she can SHUT UP, no one would need to lash back and hurt her feelings

          • Vegan Mom

            Translation: “I DID contradict myself, I’m outdated, old crusty, bitter and angry and I have nothing left to say. Oh, geez, I better make it seem like I won this!” LoL

            If you hate homebirths and people who don’t buy your hospital beds, and stuff their bloodstream a with your artficial drugs, and rather take advantage of nature, fine. But don’t shove your shit down my throat. If you’re arguing that WATER in comparison to LAB MADE DRUGS, is unnatural, i rest my case. You are as old, angry and cursty as you seem:

            “Most people find great comfort and repose with water. Perhaps because we begin our lives surrounded in liquid in the womb, this basic familiarity stays with us throughout our lives.

            Human beings are comprised primarily of water, and many special characteristics we have link us to aquatic mammals, perhaps carrying the memory of a time when the human species had an “aquatic interlude.” A three-day old fetus is 97 percent water, and at eight months the fetus is 81 percent water. By the time a human has grown to adulthood, the adult body is still 50 to 70 percent water, depending on the amount of fatty tissue.

            Human beings’ natural alliance with water is best witnessed in human babies who can swim naturally and easily long before they learn to sit up or crawl. During their first year of life, babies will calmly and happily paddle underwater, gazing around with eyes wide open. When they need to breathe, they naturally paddle toward the surface of the water before taking a breath. Babies instinctively know not to breathe while their heads are still submerged underwater. They wait until they reach the surface of the water before breathing. It seems to be only later that humans lose these instincts and become more prone to drowning.

            For thousands of years women have been using water to ease labour and facilitate birth. Wherever there has been even slightly warm water, there have been women bathing in it, using it ritually, and finding great comfort in it, especially in labour.

            Soaking in a tub of water to ease labour sounds inviting to most women. If the water is where a woman wants to be and there are no complications, then in the water is where she will feel the most comfortable. When it is time to birth the baby, there is no reason to ask the mother to get out of the water.

            When a woman in labour relaxes in a warm tub, free from gravity’s pull on her body, with sensory stimulation reduced, her body is less likely to secrete stress-related hormones. This allows her body to produce the pain inhibitors ‘endorphins’ that complement labour. Noradrenaline and catecholamines, the hormones that are released during stress, actually raise the blood pressure and can inhibit or slow labour.

            What is waterbirth?
            The act of giving birth in water is so incredibly simple. A mother submerges herself in warm, body temperature water during her labour. If she feels like giving birth in that warm buoyant state, there is no need to ask her to leave the water.

            The baby has grown in a fluid environment for the past 9 months. Babies adjust very well to being born in a birth pool. Waterbirth is miraculous.”

            http://www.bellybelly.com.au/birth/waterbirth-birth-in-water#.UfZ_rmS9Kc0

          • KarenJJ

            “old crusty, bitter and angry ”
            You say that like it’s a bad thing?

            And the bellybelly reference. Love it. Have they been giving more airtime to Meryl Dorey lately or have they finally pulled that “vaccination information” page for good?

          • Vegan Mom

            Oh, lol. Thanks for admitting your comfort level of being crusty and angry. If you say this is the bitter old angry hags club, you guys rank highest. ;)

            If you don’t like that reference here is another. I love PDFs

            http://www.birthjourney.com/pdfs/waterbirth_realities.pdf

          • GuestB

            Oh snap! I think she shut you up with her new “birthjourney” reference. She found a REAL source.
            (I can’t even type that with a straight face)

          • Amazed

            Experience is a great teacher. We’ve lost some priceless comments, so I am saving this one.

            Vegan Mom quote:

            Translation: “I DID contradict myself, I’m outdated, old crusty,
            bitter and angry and I have nothing left to say. Oh, geez, I better make
            it seem like I won this!” LoL

            If you hate homebirths and people who don’t buy your hospital beds,
            and stuff their bloodstream a with your artficial drugs, and rather take
            advantage of nature, fine. But don’t shove your shit down my throat. If
            you’re arguing that WATER in comparison to LAB MADE DRUGS, is
            unnatural, i rest my case. You are as old, angry and cursty as you seem:

            “Most people find great comfort and repose with water. Perhaps
            because we begin our lives surrounded in liquid in the womb, this basic
            familiarity stays with us throughout our lives.

            Human beings are comprised primarily of water, and many special
            characteristics we have link us to aquatic mammals, perhaps carrying the
            memory of a time when the human species had an “aquatic interlude.” A
            three-day old fetus is 97 percent water, and at eight months the fetus
            is 81 percent water. By the time a human has grown to adulthood, the
            adult body is still 50 to 70 percent water, depending on the amount of
            fatty tissue.

            Human beings’ natural alliance with water is best witnessed in human
            babies who can swim naturally and easily long before they learn to sit
            up or crawl. During their first year of life, babies will calmly and
            happily paddle underwater, gazing around with eyes wide open. When they
            need to breathe, they naturally paddle toward the surface of the water
            before taking a breath. Babies instinctively know not to breathe while
            their heads are still submerged underwater. They wait until they reach
            the surface of the water before breathing. It seems to be only later
            that humans lose these instincts and become more prone to drowning.

            For thousands of years women have been using water to ease labour and
            facilitate birth. Wherever there has been even slightly warm water,
            there have been women bathing in it, using it ritually, and finding
            great comfort in it, especially in labour.

            Soaking in a tub of water to ease labour sounds inviting to most
            women. If the water is where a woman wants to be and there are no
            complications, then in the water is where she will feel the most
            comfortable. When it is time to birth the baby, there is no reason to
            ask the mother to get out of the water.

            When a woman in labour relaxes in a warm tub, free from gravity’s
            pull on her body, with sensory stimulation reduced, her body is less
            likely to secrete stress-related hormones. This allows her body to
            produce the pain inhibitors ‘endorphins’ that complement labour.
            Noradrenaline and catecholamines, the hormones that are released during
            stress, actually raise the blood pressure and can inhibit or slow
            labour.

            What is waterbirth?
            The act of giving birth in water is so
            incredibly simple. A mother submerges herself in warm, body temperature
            water during her labour. If she feels like giving birth in that warm
            buoyant state, there is no need to ask her to leave the water.

            The baby has grown in a fluid environment for the past 9 months.
            Babies adjust very well to being born in a birth pool. Waterbirth is
            miraculous.”

            http://www.bellybelly.com.au/b

          • Vegan Mom

            To every scuffling and mumbling idiot who like the “I know you are but what am I” style argument in order to argue how silly I am for pointing this retarded twat’s laughable post:

            Until you can contradict my arguments with a cited or referenced claim, you need to shut your gormless traps up, and stop these 8th grade juvenile remarks. You sound like a fatuous, benighted, nescient dolt—much like your sciolistic infinitesimal-brained leader who wrote this laughable blog.

          • http://shameonbetterbirth.wordpress.com/ Shameon Betterbirth

            I find it very odd that you are deriding people for being mean or intolerant and yet use terms like ‘bitch’ and ‘retarded’. Makes me think you are a troll perhaps.

          • Vegan Mom

            So as long as you don’t use ‘naughty words’ you’re not a troll? But a woman who can’t mind her own fucking buisness and get A LIFE outside of judging other moms, ISN’T a bitchy cranky troll who needs to shut the hell up?

            Some Highlights:

            “when it is nothing more than a stunt practiced by the clueless in order to impress their clueless peers.”

            “You have to be the most gullible rube on the planet to be or use the services of a “placenta encapsulation specialist.”

            “I can’t decide who are the bigger fools. Those who eat their placenta or those who leave it attached to the baby to rot off.”

            Yet I’m the bad guy, (looking for info for my GF who wants to give birth in water and have a lotus birth), who stumbled on this unfortunate article, got insulted by the terrible and condescending ignorance and indeed finally called this hag for what she is? An angry old bitch?

            I’ve seen this beldame many times on the interwebs all she does is judge, hate and rant with little to no evidence to back up her claims. She posts her comments on plenty of blogs, and has a habit of pissing everyone off, running away and shutting up when proven wrong. Like about now. If she can SHUT UP, no one would need to lash back and hurt her feelings.

          • http://shameonbetterbirth.wordpress.com/ Shameon Betterbirth

            I curse like a sailor in my personal life, but I never use words that demean entire classes of people, like you have. the word bitch demeans all women. The word retarded demeans people with mental disabilities. Its repugnant. You keep arguing for respect. THAT is why I think you are a troll.

          • LibrarianSarah

            There is using “naughty words” and then there is using bigoted slurs that dehumanize an entire group of people for things they have no control over. I for one have no qualms calling you a bigoted piece of shit because you got up this morning and decided to be a bigot. You decided to you mysginistic and ablist language in attempt to hurt a woman whose only crime was disagreeing with you. I’d go on but I am almost at my stop and work calls. MassCHIP isn’t going to swear at itself.

          • PJ

            Your girlfriend, in addition to being gullible, is probably a bit too sensitive to be ever going on the internet if she is personally insulted by an article like this one

          • Kalacirya

            Oooh, we got a badass over here. Vegan mother whipped out some high level vocabulary. Clearly she’s qualified and educated enough to speak on this topic.

          • Bombshellrisa

            Probably Bastyr educated.

          • Lizzie Dee

            But clearly she has a well worn list of synonyms for ignorant.

            Just love that vocabulary! “nescient” and “gormless” in the same post! If it is her intention (and it clearly is) to insult, slightly less obscure terms might be more effective.

          • LibrarianSarah

            Seriously? Did you just use the word “retarded?” And you wonder why people aren’t taking you seriously? Here’s a hint, people don’t have high regards for bigots. So maybe you should think before you type and stop throwing around slurs.

          • PJ

            Actually, the way science goes is that you have to provide some actual, real evidence for your own arguments first.

            Thanks for the laugh though! :)

          • Box of Salt

            vegan mom, “stop these 8th grade juvenile remarks”
            stupid bitch
            stupid ass
            your shit
            stupid old crusty bitter idiotic ass
            STFU
            SOOO stupid, pathetic and desperate
            a damn history book
            PLEASE shut up

            Those words can all be found in your initial post. I guess it’s too late for me to suggest you follow your own advice.

          • GuestB

            And you think you are making yourself look BETTER?

          • KarenJJ

            “Human beings are comprised primarily of water,”

            And human beings also send millions of life-giving electrical messages around their bodies every day. I propose electrical birthing. Just grab this bare wire please while I throw this switch.

          • Bombshellrisa

            OMG, I needed that laugh this morning!!!

          • PJ

            Actually, human beings are composed mostly of empty space. So we should clearly be giving birth in a vacuum.

          • Eddie

            This is my favorite of all the responses to Vegan Mom!

            Yes, humans are primarily water. That has nothing to do with whether or not waterbirth makes any sense. You perfectly captured that. Without electricity, there is no heartbeat, no thought. But that doesn’t mean external electricity is a good thing.

            And I enjoy the idea that she can quote Dr Internet at us while if we disagree, we have to use cited and referenced claims. Oh, and the reference to “8th grade juvenile remarks” from the person that is making the most of them. Irony!

          • moto_librarian

            So I guess I just should have let my 1 year old stay face-down in the kiddie pool since he would have started paddling and breathing, right? You are such an idiot.

          • GuestB

            The drivel coming out of your mouth (or should I say keyboard) is just…hilarious.

        • PJ

          You seem to be so far removed from actual, scholarly research that you don’t even know what it is. You even seem to think that mythology counts as evidence (?!).

          • Bombshellrisa

            I do have to say that my “formal” education in midwifery included anecdotes just like the ones that she is quoting. No specifics, but stories about how closed flowers are floated in water next to a laboring woman and when the flower has opened, it’s “time” for the woman to push (cervical exams not needed!) and how affirmations and talking to your unborn baby about how you want to have an easy, short labor will “help” the baby understand what they need to do to make that happen. The students feel enlightened, like OBs must be so stupid to not understand such beautiful concepts and instead insist on exams, medicine and monitors.

    • Kalacirya

      Genius vegan mother, while you encourage us to read up on our history, we encourage you to pick up a primer on statistics and a science textbook or two. But likely that would be too difficult for someone like yourself.

  • yentavegan

    I wanted to have the best birth experience possible with baby #3 so I sought out information from a pro-natural anti-c/section support group. Here is what I was encouraged to do to avoid a repeat c/sec with my third pregnancy.
    1. Labor at home for as long as possible.
    2. refuse an IV.
    3. eat during labor at home. Make sure everyone in the hospital knows you just had a big meal.
    4. Refuse continuous Fetal Heart Monitor. If the ob wants to hear the baby’s heart beat ask him to use a stethoscope not a doppler machine.
    5. Do not let anyone make you lie down. Stay on your feet for as long as possible, walk the halls.
    6. Refuse all pain meds
    7. Do not let the ob break your membranes.
    I did all this. I antagonised my doctor and treated him as the enemy. I thought I knew more about birth than he did.
    My son was born with a knot in the umbilical chord and I lost more blood than the doctor was comfortable with.
    He REFUSED my business for baby number 4. Me and my attitude weren’t worth the aggravation.
    I was stupid and I put my life and my baby’s life in jeopardy for no reason.
    The natural birth know it alls did not celebrate my birth because after all I did use a hospital so I wasn’t edgy enough for them.

    • The Bofa on the Sofa

      That’s pretty offensive…

    • Captain Obvious

      I hate when the crunchy state they are paying the doctor for a service and he/she must follow their desires, because they are paying them for that service. I have had few patients, some pregnant, some gynecologic, that have tried to force me to do what they want. After the acute nature of their problem is over, they will receive a 30 day letter to give them enough time to find another doctor. Paying me to do what they want?
      When these women find a new doctor and their old records get forwarded to the new doctor, what do you think is written throughout the chart…? Have you ever seen the Seinfeld episode when Elaine couldn’t get a new doctor to take her as a new patient?

      • Eddie

        Some people mistakenly think that for any professional, “I’m paying your salary, you have to do what I want.” Which is misguided, at best. I, personally, expect a professional to tell me if I am wrong. After all, I’m paying them because they have the expertise and I don’t! I’m free to seek a second opinion with any professional if I don’t like what they say, but I am not morally right to belligerently demand that a professional do things my way.

  • lastrid

    “The current fetish for unmedicated childbirth while refusing life saving
    interventions, complete with birth photographer, live tweeting and a
    video on YouTube, is about as natural as hunting rabbits with a bazooka
    while wearing camo. It is not only unnatural, it doesn’t even mimic what
    really happens in nature.” Unmedicated, non-interventive childbirth is, indeed, natural. You might not agree with the practice, but you can’t pretend that women have always had pharmaceutical pain relief and doctors ready to slice and dice at any indication. Also, in rebuttal of your tandem nursing statement above (and for the record, I have never tandem nursed nor do I intend to make it happen), juvenile cats will nurse right alongside kittens.

    • Amy Tuteur, MD

      The philosophy of natural childbirth is a racist, sexist lie believed by gullible women who lack basic education in science, statistics and childbirth. There’s nothing “natural” about giving birth in a plastic kiddie pool filled with fecally contaminated water and bragging that you “accomplished” something by risking your baby’s life because you didn’t have pain relief.

      • Emily

        Is declining medical pain relief risky for the baby?

        • Amy Tuteur, MD

          No, neither is accepting it.

          What is risky is declining obstetric interventions, almost all of which are preventive medicine and designed to save the life of the baby and/or the mother or both.

          • Emily

            Ok. That makes sense. I was worried. I’m not getting an epidural because 3 out of 4 other women in my family who have had babies in the last few years have gotten extreme headaches for a few months after getting theirs. Blood patches helped somewhat. I know the headache’s not common, but it seems to be a thing in my gene pool. Still going to the hospital and doing what my doc says, though.

      • lastrid

        So many logical fallacies in this reply. It would seem that your favorite is the strawman. Just in case you’ve forgotten: http://en.wikipedia.org/wiki/Straw_man

        • Amy Tuteur, MD

          Maybe you should read it, since you don’t seem to know the definition of “strawman.”

          • lastrid

            Nowhere in my original comment did I say anything about waterbirth being natural. I’ve never heard anyone say that the photographer was natural. These may be things that women who desire to have an unmedicated childbirth also prefer, but no one in their right mind has ever argued them to be “natural”. The fact that you keep including these things and others in your arguments against natural childbirth when no one is arguing for them is indeed a strawman. As I stated before, and as you most certainly know, pain relief in the form of epidural anesthesia or other available forms is not natural and does indeed carry a risk to both the mother and baby. You may find that risk acceptable but that does not mean it’s not there.

          • Victoria

            Dr Amy is referring to the movement not the fact that some women give birth without drugs (which she herself has done but won’t shout from the rooftops so I will let you know). The “natural childbirth movement” includes things that are goofy and not found in nature – and they are argued for! Women want water birth available in hospital and like you mention about epidurals – it carries risk and “you might find that risk acceptable but that does not mean it’s not there.”

          • Eddie

            What does it mean that analgesia is not natural? So what? Clothes are also not natural. Nor is cooking food. Nor is driving or taking photographs or water birth. Do you wear shoes? Glasses? Contacts? Have you had dental work? Do you have indoor heating or air conditioning? Do you have a refrigerator? None of these things are natural.

            The “it’s not natural” argument is a non-starter. It’s bogus. Again, 100% perfectly natural childbirth has about a 7% chance of the child dying and a 1% chance for the mother. Anything you do that decreases that risk is not, by the same definition you are using, natural.

            So why does natural matter at all?

            Also, yes, an epidural has risk. That risk is vanishingly small for the mother and near unmeasurable for the baby. But you’re correct that it’s not zero. I bet that going without fetal monitoring has a far, far higher risk than an epidural. Given that, the whole argument that an epidural is “risky” is bogus, considering that the people who most strongly advocate for no pain relief also often advocate against active fetal monitoring.

      • Irene

        Amy, your bitter condescending tone towards all women who opt for natural homebirths is pathetic, millins of women have healthy unmedicated births, i was one of those looneys who chose to birth my daughter in our home, and guess what my daughter is healthy, we had no complications and i had manageable pain during it all. Why are you so aggressive towards all women who choose not to give birth in bright lights among strangers? Observation among any mammal shows intervention and stress to the mother can complicate the birthing process. Birth is a primitive process, best left to itself unless mom or baby is in distress, the reason many healthy women need intervention in a hosptal is because they are not in their nest where it is familiar and safe. Im not saying hospital births are bad, but To imply all homebirthers are selfish and deluded gives you little more credibility than a rabid goat, its a false assumption, and myself and thousands of other women are proof of that

        • yentavegan

          BINGO

        • Amy Tuteur, MD

          Actually, you are proof of the opposite, but are so clueless you don’t even realize it. Thanks for dropping by to prove my point.

          • Irene

            Wow, what a well reasoned reply, oh wait, your comment did notrovide any factual info, on what grounds can you claim im clueless, ad hominem attacks should be reserved for laymen, not people claming to be doctors despite not having practised in several years, Try again

          • Amy Tuteur, MD

            No, you kindly provided the proof that you are clueless.

          • Irene

            Ah i see how you handle confrontation that you cant answer intellectually.
            Please explain, what is so horrible of birthing the way we have for millenia, what so wrong with exclusive breastfeeding or cosleeping? Sure its not for everyone, but you heckle any woman who chooses to embrace her body and natural parenting.
            I welcome evidence to the contrary, but by experience and research i know there is nothing wong with a managed homebirth, in my country you are nearly 50% guaranteed to have a csection when you are admitted for borth. That is not natural and its not best for mom or baby. Your infantile replies are laughable but concerning coming from a supposed medical expert

          • Karen in SC

            Where do you get your 50% c-section statistic? What country did you say you were from? Dr. Amy has consistently provided analyses of peer-reviewed studies all over this blog (and non peer reviewed articles as well). You just have to look around.

            This blog supports informed consent, well trained health providers and the end of misinformation. Most interventions are used to help a woman have a vaginal birth, by the way.

          • Irenesane

            Yet she resorts to insult instead of evidence. I am merely stating homebirth when managed and prapared for xan be safe and much more fulffilling experience. I had two back up doctors/ gynaes and live within proximity of a good hospital, i know any women who choose thos option because intervention is not always necessary and often for the convenience and time management of the prfessionals, i know i have a close relative who performs many csections herself.

            Im from South Africa, i am well versed on the subject but youre welcome to school me if you believe you know more.

          • Eddie

            Yes, properly managed and risked out, home birth can be pretty safe. There’s quite a lot of evidence that in many countries, midwives don’t properly manage their patients, for example by taking on high risk patients, but never mind that for the moment. The point is that properly managed, hospital births are safer yet.

            There are individual exceptions to the rule. For example, the old canard, “My (friend/relative/acquaintance) survived the car crash because s/he was thrown from the car, which then caught fire. If s/he had been wearing a seat belt, s/he’d be dead.” That may or may not be true. But on average, wearing your seat belt vastly increases your odds of surviving a serious car crash.

            The same thing is true with hospital births. There are indeed individual bad or overly aggressive doctors or hospitals. Some countries are perhaps more interventionalist than necessary or even appropriate. And that absolutely should be addressed. But even with that truth, hospital birth is safer than home birth.

            I cannot speak for South Africa specifically. I have not seen any statistics about that country. But in general what I say is true.

          • auntbea

            “Please explain, what is so horrible of birthing the way we have for millenia”

            Uh, because lots of babies die that way?

          • Irene

            Did i say ALL women should birth at home? No, i said low risk pregnancies are fine to birth at home, ebus you Americans are so survivalist uou forget how much sanitation and better nutrition contributes to lower mortality rates. Just because some people are allergic to peanuts doesnt mean we ban them, some women have at risk pregnancies and should be closely monitored preferably in hospitals, low risk mothers have freedom to choose where they birth and rightfully sp. life has risks, none of us get out alive, im all for hospitals in emeregency but my experience with labour shows that natural bir without intervention is possible, normal and common. Irene

          • Amy Tuteur, MD
          • Box of Salt

            Irene: ” my experience with labour shows that natural bir without intervention is possible, normal and common”

            But my experience with labor shows that natural without intervention would likely have led to both my own death and my baby’s: please review CPD.

            Why, Irene, do you think *your* experience is more important and relevant than mine?

          • The Bofa on the Sofa

            I am happy to say that my niece just had a baby. She is the oldest living cousin on either side of her family (her older brother was stillborn at 41+ weeks), and this is her first. We are all very happy for her.

            And she had a c-section. She had a c-section because the baby turned sideways during labor (she had been sideways at one point, they straightened her out, but she turned again). They way they noticed that she had turned was because there was a drop in the baby’s heartbeat during labor, and they did an ultrasound to determine why. Those nasty interventions!

            Because she had those interventions, they prevented what could have been an absolute disaster. Instead, she has a beautiful baby girl.

            This nicely illustrates what I always say: interventions PREVENT problems.

            Oh, and I have to add:

            Irene: ” my experience with labour shows that natural bir without intervention is possible, normal and common”

            While your experience can indeed show that it is POSSIBLE, please explain how it shows that it is either a) normal, or b) common?

            Actually, don’t bother. A single person’s experience, pretty much by definition, CANNOT show that something is either normal or common.

          • Wren

            It may well be common, but that doesn’t make it a good thing for everyone or something that is somehow virtuous. Of my direct ancestors and siblings, I had the first C-section we know of. That seems to show that the more common and normal birth in my family is a vaginal birth. I’m sure glad my son was delivered via C-section rather than risk his life or brain on the more normal or common birth.

          • The Bofa on the Sofa

            Of my direct ancestors and siblings, I had the first C-section we know
            of. That seems to show that the more common and normal birth in my
            family is a vaginal birth

            But that’s the whole point, Wren. In order to determine that it is “common” you have to survey a lot of people. YOUR individual outcome cannot show that anything is common, which is what Irene claimed (that HER experience showed it was possible, natural, and common).

            The result for any individual cannot show something to be common (or natural).

          • Eddie

            It really is funny how so many people jump to that conclusion. “My experience was pleasant and empowering. Therefore, it will be so to every person who is in the right frame of mind.” That thinking is just wrong, but sadly, so common. Not just in the context of this blog.

          • Irene

            No, I did not say because that was my experience all women should have similar experiences. I know many women who’ve been extremely traumatised by birth, not by their own or doctors fautls btw- birth is a scary thing, but more focus should be put on education and support, and less on fearmongering.

            I come from a family where except for one, all babies were born vaginally(and i have a BIG family) I have also several twins in the family all of whom were born naturally (one set were premature). Maybe we were just extremely lucky, but it is NOT SO UNUSUAL to have a simple straight forward birth- ofcourse if you’re an obstetrician then you see all of the complications and few normal pregnancies (Im not a solopcist and assume my experience speaks for everyone) but also do mention one baby that went into distress does not disprove the millions of babies that descend w/o complication. Many of these commentors make it seem like ALL women and babies would die if it wernt for modern obstetrics and thats just not true. I also know of many women who’ve had prolonged births because they were prodded and poked when they just needed time and privacy. The human is not so different from other mammals (take the chimp) they always birth in complete privacy an has only been observed once in nature (why do you think women start nesting?) theresnothing wrong with birthing in your ‘nest’ if you have a low risk pregnancy.

            I’m an anthropologist with degree in zoology aswell, so I have done thorough research on mammalian births.

          • Lizzie Dee

            How can you KNOW that the births were prolonged because the women didn’t like being prodded and poked?

            And personally I would not be very happy with the idea that I should emulate a chimp.

            I was the first person in my family to need a CS. But not the first to be high risk, including premature twins. Most were, as you say, unmedicated, natural but did include a couple of dead babies, a couple of hairy near misses and probably some of the kind of complications that are inconvenient and often ignored.

          • Irene

            Hi Lizzie

            Sorry to hear about the complications in your family, sadly they are very often hereditary. But I am glad you had help on hand.

            Whether you like it or not- we are closely related to chimps, as I say Iam an anthropologist and degree in Zoology (so im not merely throwing this around) one of my thesises were specifically about birth in primates (and whether you like it or not, when it comes to a lot of things- we have a whole lot in common :/ ) I respect other womens choice to birth at hospital.
            Labour can and most probably will be prolonged when women are distressed and scared during birth. I can send you a long list of articles on the subject, just dont have them on hand

          • Lizzie Dee

            Ah, poor breeding stock. Should I go and hang my head in shame?

            The complications were quite varied. Some fairly “normal” you might say, a couple a bit more esoteric.

            Now, it makes sense to me that our opinions and views are heavily influenced by our personal experiences. You have studied chimps, and are very familiar with the similarities (which I do not dispute) but I am a bit more inclined to focus on the differences. Mainly that we are not chimps, and do not have to rely on natural. I don’t much mind what you believe, would not particularly challenge or argue. So long as you do not want to impose your template on me.

          • KarenJJ

            I liked a previous comment someone made on here a long time ago – are we breeding for vaginas or head size? One part of me, not so good for breeding purposes. The other part of me I hope is in relatively fine working order…

          • Lilly de Lure

            “Iam an anthropologist and degree in Zoology (so im not merely throwing
            this around) one of my thesises were specifically about birth in
            primates (and whether you like it or not, when it comes to a lot of
            things- we have a whole lot in common :/ )”

            As a fellow possessor of a zoology degree I feel I should point out that whilst we do indeed have many traits in common with chimpanzees and other primates we differ markedly from our closest cousins in both pelvis size (humans are narrower to allow bipedal locomotion) and neonatal head size (humans are MUCH bigger). Given the impact both of these factors have in the ease or otherwise of giving birth I must take issue with exactly how relevant your thesis on (comparatively much easier) primate birth is to that of humans.

          • Jocelyn

            If you welcome evidence to the contrary, please read the blog posts on this site which discuss the studies which show the rates of perinatal death at hospital birth vs. home birth.

          • irene

            I prefer to get my stats from less partial sources, ‘dr’ amy clearly hasmunresolved issues, and since. She has not had her license renewed she is not the best source of literature.
            But i actually havenread many of her articles, never commented, but its clear she has biases and anger issues which impede her ability to converse in a civil way

          • Karen in SC

            You most likely will come to the same conclusions then, at least in studying the data from the same sources as Dr. Amy. I don’t believe she has commented on any data from South Africa. Perhaps your country does have the most perfect conditions for homebirths, though I hope women who want to go to the hospital are allowed to do so.

            Dr. Amy gets angry because mothers and babies are being harmed or die preventable deaths with the way homebirth is experienced in the USA, and other countries she has written about. Wouldn’t you be angry if untrained women lied to women and took unnecessary risks that led to the deaths of South African babies?

            PS. Not renewing a license does not negate knowledge and training. You are the one being insulting.

          • Karen in SC

            According to this WHO report published in 2010, the c-section rate in South Africa is 20%, close to the 15% that was the report’s recommendation *at that time.*

            Since then, WHO has refuted their own recommendation. Here in the US, primary c-section rates vary but are usually around 10-15%. Higher number result from repeat c-sections and other issues particular to maternal health here in this country.

          • Karen in SC
          • Amy Tuteur, MD

            That makes as much sense as saying that you don’t believe that drunk driving is unsafe because the person who told you let his driving license expire.

            Do you believe Henci Goer? She never had a license. Do you believe Ina May Gasin? She has no license.

            Please explain why you wil believe any crap from a natural childbirth advocate who has no license, but cheerfully pretend that you can ignore what I say because I let my license expire.

            There isn’t any reason. It’s a stupid excuse, formulated by professional homebirth advocates who KNOW that I am correct, but figure that the average homebirth advocate is so ignorant and gullible that she can’t see through a supremely stupid excuse.

          • Irene

            No I dont know Henci Goer or Ina May Gaskin, I do however know the literature of SJ Buckley and several others in the field.

          • Lizzie Dee

            Nothing is wrong with any of those things but the reasons people sometimes give for doing them are illogical and the ideology that makes them seem like imperatives IS horrible because it peddles lies.

            Nobody minds if you want to embrace your body, but if you want to argue that it is The One True Way, and intellectually superior then you will be heckled by those who don’t believe that

          • irene

            You decided to ASSUME that I said homebirth is the ‘one true way’ never said so. I am calling out dr Amy for being so condescending towards all women who choose so. Please see above, my sister happens to be a physician who assists with a whole lot of csections- I do not condemn her or women who have elective csections, but homebirth should not ust bepainted black without giving some of the upsides- otherwise you are unreasonable

          • Wren

            I believe plenty of commenters here have had unmedicated vaginal births without interventions and no one has a problem with that. It’s the claim that it is somehow better and safer that people have a problem with. Natural (as thought that were a particular meaningful word for a species noted for its technological prowess) birth and parenting are just fine, as long as risks are understood.

            Somehow Dr Amy has failed to heckle me for my natural birth and failed to heckle herself too. Perhaps you need to look again at exactly what she takes issue with.

          • KarenJJ

            “ad hominem attacks should be reserved for laymen, not people claming to be doctors”

            I particularly liked the rapid goat insult. Do we give points for imagery?

          • Eddie

            I give points for creativity and imagery. But wow, what a “bingo,” Irene hit just about every major meme we see. And she is blissfully ignorant of how empty her arguments are, despite however much meaning they may carry for her.

        • Eddie

          Birth is a primitive process, best left to itself unless mom or baby is in distress, the reason many healthy women need intervention in a hosptal is because they are not in their nest where it is familiar and safe.

          A primitive process? Is that the excuse for eschewing modern interventions, that birth is inherently primitive? What does that even mean? So if that’s true, then why is it that hundreds of years ago when all births were at home, the death rate of mothers and babies was so much higher than it is today?

          Please keep in mind that first we got improvements in midwifery (a few hundred years ago), and that helped. Then we got improvements in sanitation (perhaps 150 years ago), and that helped more. And then, shortly before WW-II, we got modern obstetrics and antibiotics — and the death rate of mothers and babies plummeted to the point where many people have never met anyone who died or had a stillbirth.

          I, personally, would say that most homebirthers are naive, not selfish or deluded. Over-valuing “natural” but then being highly selective about what counts as “natural.” Largely ignorant about the past and the true risks inherent in birth.

          • Irene

            Please see my reply above. I do not judge women who choose hospital births, just like you should be able to accept that other women do differently, with the support of medical professionals.

            Over-valuing “natural” but then being highly selective about what counts as “natural.”

            Dont speak for all of us, I actually had a NATURAL birth (sans the waterpool/lotus birth or shaman chanting), and wouldnt have it any other way. I am convinced part of the reason I healed incredibly fast and my daughter barely even lost weight is because we were in a stress free sanitary surrounding with good support- and yes I will dare say this (but take it with a pinch of salt)- as nature intended …

          • Eddie

            When you jokingly say, “as nature intended,” can I assume that what you really mean by that is not an over-valuation or worship of “natural” but instead a desire to align medical practices with how the mind and body can scientifically be shown to work?

            Keep in mind, overwhelmingly, most of the mocking of home birth that occurs were is aimed at the, if I dare say it, lunatic majority of them that we encounter that make the reasonable minority look bad. Dr Amy and many commenters have repeatedly said (over the context of months of blog entries) that home birth should remain legal. The desire is not to outlaw home birth, but to ensure that those who provide health care services for those who home birth give honest and accurate information, properly risk out mothers who should not home birth, are properly trained, have medi-mal insurance, be held to a code of ethics, have failures investigated seriously, and in all other ways act like medical professionals.

          • irene

            Thank you Eddie,
            Yes your assumption is spot on. English is not my first language and at times i could convey my points differntly, but if you think in a diffent language it happens. I am all for responsible midwivery, and they should be held accountable what happens to their patients while under their care, i couldnt agree more, but ive read dr Amys articles on and off over nearly two years, since i conceived, and ive always undeerestood she is against homebirth all together, so if i misunderstood im sorry, i appreciate your well reasoned reply. Go well

          • Eddie

            Off Topic: One of my co-workers loves to wear this shirt:

            http://www.thinkgeek.com/product/9899/

            I think you get a pretty clear picture of what Dr Amy believes and what her goals are in this video: http://www.skepticalob.com/2013/04/homebirth-deaths-discussed-on-huffington-post-live.html Don’t click on the picture at the top. Click on the video right below it. It’s about 30 minutes long.

            Dr Amy argues quite forcefully. That leads many to misunderstand her goals, I think, and to take her as arguing for an extreme stance she isn’t really taking.

          • http://gamesgirlsgods.blogspot.com/ Feminerd

            From what I understand, Dr. Amy presents the evidence that homebirth is always more dangerous than hospital birth, but that women should be able to choose where they want to give birth anyways. She wants to make sure that people know that it is more dangerous and to understand that American midwives are often not well trained or well regulated so that people can make informed decisions about where to give birth.

          • moto_librarian

            “I am convinced part of the reason I healed incredibly fast and my daughter barely even lost weight is because we were in a stress free sanitary surrounding with good support- and yes I will dare say this (but take it with a pinch of salt)- as nature intended ..”

            Well, I’m glad that you healed quickly and your daughter didn’t lose much weight. I take it that you didn’t have any major tearing or blood loss, and that you had ample milk and your child was a good nurser right off the bat. I really am happy to hear when things go well.

            Here’s the rub though. I had a “natural” birth in the hospital with my first with absolutely no interventions (not even a heplock). The pain was mind-blowing, and I then had a massive pph caused by a cervical laceration. It was 6 weeks before I began to feel truly recovered. With my second, who was born with the aid of an epidural, pitocin, and AROM, I was up and walking as soon as my epidural wore off. I felt fantastic immediately after the birth. By your reasoning, I should blame natural birth for my bad recovery and credit the epidural for my easy one. In reality, the complications that I had the first time would have caused problems in recovery regardless of whether or not I had an epidural, and second births are generally easier than first births. When birth goes well, it really doesn’t matter where it takes place, but when it goes badly, you had better hope that you have access to the medical interventions that can save you and your baby’s lives.

        • Box of Salt

          Irene: “Birth is a primitive process”

          No. Mitosis is a primitive process. That’s cell division:
          the way unicellular organisms (algae, bacteria) reproduce.

          Humans reproduce sexually, using an entirely different process.

          The process of birth for humans is complicated. We humans, alone, on this world walk upright on two legs, yet biology requires our offspring to emerge between
          those two legs. There’s nothing “primitive” about it, unless you don’t understand the basics of biology.

          • Eddie

            A much better response than mine. I particularly like the reference to mitosis!

        • rh1985

          I would not feel comfortable and safe at home though, I would feel really anxious. I also don’t think unassisted childbirth is typical of human history – women were typically at least assisted by either a midwife or a female relative who had given birth before.

          • Irene

            I would never encourage an unassisted birth, and was also not saying ALL women should birth at home. My commentary was wrt dr Amy’s aggression and condescension towards seemingly all women who choose homebirth. For what it’s worth I did not do any of the above mentioned during my birth. But I was in my own room for the entire labour (5 hours from wake up to birth, no complications ,apgar of 10), and birthed my daughter in squatting position (which is a whole lot easier and more natural than pushing while sitting on a hospital bench)with support experienced midwife with more than 25years experience. I was allowed to do as my body told me, not what was for the convenience of rushed nurses or doctors.

            I also had not one but TWO gynaes backing me up incase. There are many women like me today who choose homebirth (becase WE feel comfortable, I would never assume all women WANT to birth at home- just because I did…) I had a healthy pregnancy, I’m a young fit woman, what I asked of dr Amy is why she feels the need to group all home/natural birthers together, thus spreading misinformation and paranoia among women researching hospital vs home births.

            Remember, many women who experience complications at home births may not have received/refuse prenatal care, also a big portion of amaerican homebirthers do so for religious convictions, and some of these ladies might be rejecting a doctors advise based on their religious views instead of best interest of their cihld- I dont think either is wise. But educate yourselves before you just CONDEMN those who choose differently from you.

    • Jocelyn

      A few of the regular commenters already brought up the juvenile cats nursing example – pointing out that the mother looked malnourished while trying to feed so many offspring. Tandem nursing is possible, but it requires the mother to consume many extra calories, a portion of which are burned off in the process of making breast milk, therefore making it an energetically unfavorable process to continue with offspring that can eat solid foods.

    • Eddie

      Unmedicated, non-interventive childbirth is, indeed, natural. You might not agree with the practice, but you can’t pretend that women have always had pharmaceutical pain relief and doctors ready to slice and dice at any indication.

      *blink* Huh? You really missed the point. Unmedicated non-interventive childbirth is natural, as you suggest. So is an approximately 7% fetal death rate and 1% maternal death rate per pregnancy, but who’s counting? Anyway, the part that is not natural is the “complete with birth photographer, live tweeting and a video on YouTube” part. It’s called irony: the natural right next to the not natural.

      Doctors ready to slice and dice? Good grief. That’s just silliness.

      • lastrid

        I didn’t miss the point. The title of this article is “5 goofy things that natural parenting advocates do that never occur in nature,” and then this is the first sentence “Natural childbirth has nothing to do with childbirth in nature. Not only
        does it fail to replicate birth in nature, it adds on practices that
        have never been seen in nature and then pretends they are “natural.”” No one ever claimed these things were natural. Water is a very potent pain relief, so it is popular. People like to have pictures of important events in their lives. Pointing out that there are not photographers “in nature” is ridiculous. There is no point being made there. It’s just snark, pure and simple. It’s also certainly not irony.

        I’m also interested in where you got your statistic of natural childbirth having a 7% fetal death rate and a 1% maternal death rate. Perhaps that is true in a third world country, but that is not where we are and there are many more confounding factors that just the fact that the mother doesn’t want her third stage to be managed. It’s faulty logic and does not do your stance any favors.

        • attitude devant

          Wow, You’re in deep, aren’t you? You really don’t grasp that the difference in fetal and maternal deaths between third world countries and your own is the availability of intervention.

          • lastrid

            Intervention is not the only reason. Quality prenatal care and proper nutrition and sanitation and clean water are all just as important differences. There are certainly times when obstetric intervention is necessary and I and the majority of the vilified natural childbirthers are very glad of its availability. Most women do not need obstetrical intervention though. Just because a few do does not mean we should not all be subject to it. That’s the point.

          • Amy Tuteur, MD

            Wrong.

            First of all, prenatal care IS an intervention.

            Second, sanitation and clean water were in place more than a hundred years ago. The massive drop in neonatal and maternal mortality has occurred since then.

            Obstetrics is preventive medicine. The interventions of obstetrics are preventive medicine. Saying that “most women do not need” interventions is like saying that “most women do not need to drive sober” since most drunk drivers make it home safely and never kill anyone. It’s like saying that there is no point to having a mammogram because “most women” don’t get breast cancer. In other words, it makes no sense except to those who have no idea what they are talking about.

          • Squillo

            Indeed.

            I had a totally unnecessary mammogram and surgical biopsy–exposing me to the risks of radiation and general anesthesia, among other things. My lump was benign, and I have a mildly disfigured breast.

            And yet, I haven’t met a single person trying to tell me that I should be furious that the surgeon recommended those things and only wanted my money or was just “fear-mongering” about the possibility of cancer.

          • Eddie

            Nor has anyone told you that you should have trusted your knowledge of your body, I bet.

          • Squillo

            No. Apparently women’s “other ways of knowing” apply only to childbirth, not breast cancer.

          • Dr Kitty

            I’m pretty sure that a lot of the time “other ways of knowing” refers to a combination of pattern recognition and experience.

            Sometimes I just “know” someone is really sick by looking at them. If I consciously break it down to clammy/cachectic/ureamic/ in pain/ tachypnoeic or whatever I’ll work out WHY they’re sick. It isn’t intuition that tells me they are sick, it is subconsciously processing the signs of sickness I have been very carefully trained to look for.

            Sometimes it can look like intuition or a “spidery sense”, but it isn’t, it is very careful training.

            It is why sometimes I’ll walk through a waiting room and call someone out of turn- if they look sick I’ll see them first and I know the difference between miserable and sick. It annoys me that people see the “intuition” as being of merit, but din’t understand that it doesn’t a gift or a psychic power. You earn it by hard work.

          • Eddie

            Decades ago, the car I had then started to shake on acceleration, but only at the top of each gear. I took it to a dealer and described it and the lady at the desk wrote, “shakes on acceleration.” I didn’t want to argue with her, so I waited until I saw my car go up and asked if I could talk to the mechanic.

            The mechanic (probably 40s?) was working with a young man, I assumed apprentice, maybe 18-20. I described the behavior. The mechanic went under my car to the U-Joint, showed how it wiggled an inch in either direction, said I needed a new one.

            The apprentice was quite literally in awe that from my description of behavior the mechanic could instantly identify the one piece that needed to be replaced.

            This was no “special way of knowing.” It was training and experience, leading to a finely honed intuition. “Pattern recognition and experience” is a good way of putting it. I’ve described it before as a well-trained neural net. Some people are more aware of small pieces of information, and are able to feed this information into their neural net. The more detail feeding into a neural net, the better its predictions can become.

            But what I find dismaying is those people who trust their intuition so highly that they stop verifying, stop investigating, and in some cases dismiss those who carefully investigate.

          • Dr Kitty

            Advances in the last 100 years that actually made a difference to maternal and perinatal mortality?
            Blood banks, antibiotics, safer anaesthetics, oxytocin, misoprostol, oxygen cylinders and mains electricity.

            Good sanitation in childbirth essentially boils down to hand washing, boiling water and soap. “Better nutrition” means a diet most of the world now has access to.

            Not much more than 100 years ago you had to make your own IV fluids from scratch, using a formula, and congenital syphilis was a major cause of miscarriage and neonatal death.

            Waving everything away as “unnecessary intervention” is arrogant, even hubristic.

          • Eddie

            All of those things you mention, however, are not natural. Proper nutrition and sanitation and clean water have only been available in recent times. Sanitation involves chemicals to kill bacteria and parasites, for example.

            Thus, the word “natural” that you’ve used several times is really quite meaningless, because you only care about some natural things and not others.

            Quality prenatal care and the other things you mention are indeed important. But by themselves, are not enough to bring fetal or maternal death close to today’s observed levels in industrialized nations.

          • Captain Obvious

            “Most” women do want epidurals. Epidurals are not forced upon them. A few, less than 1%, of women deliver at home. A small amount of women want natural unmedicated birth. When you argue, or debate, you sound foolish when you overemphasize and underemphasize the actual national average of such groups to meet your biased choices.
            Like for those of us who work in Healthcare, majority of women deliver in hospitals and want epidurals. And you cannot call all these women “uneducated”.

          • The Bofa on the Sofa

            And you cannot call all these women “uneducated”.

            Well, you CAN, it’s just pretty dumb.

            I remember in our baby class, I commented that the instructor should spend more time teaching about breathing techniques and stuff like that. That was my vision of baby class, I guess, with pillows on the floor, and dad helping mom breath. We didn’t do any of that. She told me, she doesn’t bother because most women just end up getting an epidural anyway.

            It was fortunate that I was in a reality based class. Taught by a lactation consultant, even. However, it really was about preparing us for what to expect in the hospital.

            So, to my point, this was my first recognition that, in fact, an epidural is pretty common.

        • Eddie

          First of all, I appreciate your thoughtful reply where you actually spelled out your disagreements enough that I understand exactly what you mean. This means we can have a productive conversation rather than just rant at each other. I’ll take a strong argument with criticism over ranting any way. It means we have a chance at actually communicating. Ranting just isn’t that interesting.

          We’re using different definitions of “natural.” Many people who use that word are referring to “before modern medicine” (~1930, picking a number out of the air) or “before the industrial revolution” (~1750) or even “palaeolithic” (pre-agriculture, > 8000 or 10000 year ago). When the word “natural” is used without qualification in the context of childbirth, I take it to mean one of those, typically the first.

          From your response, that is clearly not what you mean. Thus, we see irony and you don’t. It’s a difference in perspective. You don’t mean any of my three definitions of “natural” as we commonly encounter it here.

          Just 100 years ago in America, the stats are much as I quoted. During the 20th century, the reason for the dramatic increase in female life expectancy, relative to male, was due to decreases of death during childbirth. Less than 100 years ago in America, as I mention fairly often, 1/4 of women who died during childbearing years died during childbirth. Today it is a tiny, tiny, tiny fraction of that.

          Without access to modern obstetrics and modern medicine (antibiotics, C-Section, diagnostics, induction, and so on), the numbers I quoted (+/- a few percent for fetal mortality depending on practices) are what you get. If you got rid of absolutely all practices of modern medicine but kept the rest of our civilization, the maternal and fetal death rates would skyrocket.

          However, if you’re instead talking about delaying access to modern obstetrics and modern medicine as long as possible, while still having high quality prenatal care, but definitely and non-grudgingly taking advantage of modern medicine when there is no other choice, the death rate increases are not nearly so dramatic as they are in the absence of availability. Actually, if you have your natural birth (unmedicated and with no interventions unless required) in a hospital, your outcome is probably no better and no worse than the best possible stats.

          I would assert that this choice doesn’t meet the definition of “natural” as we often encounter it. But that’s fine. Each person gets to make their own choices about what is valuable to them.

          • PJ

            The term “natural” is completely meaningless, anyway. It’s natural for humans to use technology and alter their environment. There’s no magical cut off point where technology suddenly becomes so sophisticated that it goes from natural to unnatural.

          • Eddie

            I completely agree.

  • violinwidow

    We’ve often said on the facebook group that someone needs to spread around to NCBers that eating the meconium or smearing it on the baby’s head is beneficial and natural and see if it takes.

    • Elaine

      I saw a thread about smearing vaginal fluids on a baby born by c/s, so that they’ll get colonized with mom’s vaginal flora. Nobody in this thread said what I was thinking, which roughly amounted to “ick”. I mean, I know the baby comes through there in a vaginal birth, but actively seeking to get the fluids on the baby is a little much for me.

      • Squillo

        The idea doesn’t make me go “ick”–it makes me want to ask what they hope to achieve? Seems you’d have to smear them in the mouth, nose, or maybe eyes to achieve any putative systemic benefit. And I’d want to see evidence that those benefits a: exist, and b: outweigh known risks (HSV, GBS, other bacterial infections.)

      • yentavegan

        Thankful am I that this practice of smearing vaginal fluids on the c/sec newborn wasn’t promoted 25 years ago. The point of having a c/sec was to prevent transmission of herpes. so yeah, yuck and ick.

  • Dr Kitty

    I’m going to stick this here, because I don’t want it to get lost.
    Re: pregnancy dating.
    Luteal phase is constant for each woman without variation from cycle to cycle and lasts 10-16 days for the vast majority.
    Follicular phase can vary greatly between women and from cycle to cycle, lasting anywhere from 7-30 days.

    For most women it doesn’t actually matter. You know when their last period was, you know when they expected a period that didn’t arrive, you know when they first got a positive pregnancy test and they’ll have a first trimester ultrasound scan- worst case you should be a week out.

    The only times it becomes very important to pinpoint ovulation is when trying to conceive might be an issue- long distance lorry drivers, oil rig workers, Orthodox Jews (who can run into difficulties if they ovulate much before day 10 of a cycle) etc.

    • Wren

      In my case, both times the dates from the earliest sonogram we’re used but that’s due to PCOS and screwy cycles. My son was conceived at least 2 months after my LMP with ovarian drilling done in between the LMP and conception. My daughter was conceived about 2 months after a miscarriage with no period in between. In both cases I had scans by 6 weeks and dates were given from those.

      • Eddie

        Our youngest was conceived a few weeks, at most, after a miscarriage. The OB was very surprised, did a triple take when looking at the lab results. Did a literal triple take!

        We were sent to a lab for a sonogram to determine age. They separated my wife and I and asked her a bunch of questions such as LMP. Her English was not great; she misunderstood many of the questions and told them the date of the miscarriage as the LMP. If she didn’t understand a question, her bias was to give some answer that seemed maybe in the ballpark. She didn’t feel comfortable asking for clarification out of fear of being mocked for her “poor” English.

        I tried to explain to them that I needed to be in the room with her as her English wasn’t adequate for medical questions, but they absolutely refused. I was surprised and very frustrated. As a result of this, we were given a bogus due date. So I just did the correct math and came up with my own due date. The OB was fine with that. We didn’t return to that lab for the 20 week US and I made sure to tell them why.

        • Elizabeth A

          This is why medical translators. There are signs up all over the hospital lobbies here mentioning their existence and telling you how to request one. Unfortunately, the signs are in English. (And that’s the hospital, not individual doctor’s non-hospital offices or freestanding imaging facilities.) I don’t know why they insisted on separating you – most people want their partner in on the sonogram! I wouldn’t ever go back there either.

          When I got pregnant shortly after a miscarriage, I explained the situation to the midwives, and they wound up telling me they’d use the miscarriage date as LMP. The whole point of the first trimester ultrasound was to figure out my correct due date, since LMP was obviously not going to cut it.

          • Eddie

            Most places we went to clearly advertised medical translating services, but this one didn’t. Also, I so expected to be allowed to witness the entire ultrasound that I was shocked when they abruptly separated us and took her back. I wasn’t prepared for that and didn’t speak out until it was too late. I think they didn’t want to disturb the tech once she had started. It was very strange.

            When I complained, they gave a non-apology apology. When I explained we wouldn’t be returning, they basically said, “We’re sorry to hear that,” and didn’t seem to care. This strange policy was ironclad. Hopefully they lost a lot of business as a result and changed their mind. This was a small private imaging clinic. I wonder if one person’s ideologies drove their business practices?

            Ironically, all the places we visited that did have medical translation services available also never had a single problem letting me accompany her. Not a one, with only one exception of her mammogram appointments, where men were absolutely not allowed, period, no reason, never. :-) I have no idea what they do on the rare occasion where a man needs one! But for a mammogram, my wife was comfortable, she knew the drill, and wasn’t upset to be without me.

    • yentavegan

      Sensitive ob/gyn’s help women tweak their cycle with help from hormones so even Observant Jews with short windows of opportunity to conceive , conceive,

  • Antigonos CNM

    I agree with everything except that tandem nursing WITH TWINS is not that unusual [although I think it would be awkward as hell -- how would you scratch your nose?]
    Since a majority of women have their milk dry up fairly early in pregnancy, a nursing mother is one of the categories of women permitted by the Talmud to use a form of contraception until she wants to wean the baby she is nursing. Back in the first and second Christian centuries there wasn’t any Similac, or other milk substitute, and the Sages realized that nursing was only marginally contraceptive itself, and babies needed good nutrition until they were ready to eat “adult” foods.

    • AmyM

      I tried tandem nursing my twins for the 3 days we were in the hospital. Since my milk hadn’t come in yet, we were using formula through an SNS, which meant I needed someone on each side to hold and plunge the syringe, since I was using both arms to hold the babies. I think maybe the [nurses] holding the syringes may also have been holding my boobs. It was wicked awkward. As soon as we walked in the house with the babies, (and they needed feeding right away of course), I realized we didn’t have any nurses hanging around, and I only have one husband, so the whole nursing thing was abandoned in favor of tandem bottle feeding.

    • Ainsley Nicholson

      Awkward, yes, but doable. When I was nursing my twins, I would do a double-cradle hold. If I needed to scratch my nose, I would lean forward while lifting my hand at the same time- the babies would be joggled and not to happy about it, but they would stay latched. This was after they had got the whole nursing thing figured out, of course.

  • Lizz

    I don’t get this whole placenta thing. I see people save it for years in their freezer, or cook it and eat it, or make art with it, or leave it attached to the baby in a bag of herbs. I saw my placenta and it was gross and the second time my husband said it was worse because it had a large blood clot and was calcifying.
    I love things about the human body, heck I kept my wisdom teeth because I found them fascinating.
    I swear this placenta worship has to be some kind of weird paganism. Not that I have a problem with it but maybe people just have to admit this NCB thing has crossed into being a fundamentalist religion.

    • KarenJJ

      I don’t mind the tradition of planting it under a tree. We used blood and bone on our fruit trees and it was great. Seems like a practical use for it. On a spiritual level you could think of it as giving back to mother earth, if you’re into that and don’t have a dog that might dig it up.

      • Robin Byrne

        “….and don’t have a dog that might dig it up.” This totally made me laugh. I can just imagine having to wrestle a dog to the ground to remove a dirt-covered placenta from its jaws.

        • KarenJJ

          Yes, running around the back yard trying to get the placenta out of the dog’s jaw while yelling ‘drop it Spotty, DROP THE PLACENTA!’ appeals to my sense of humour too.

          But it also occurs to me that over history, far more placentas would have been eaten by wild dogs then by humans, so it is by far the more traditional way for the placenta to be disposed of then by enscapsulating it or eating it somehow.

          It also occurs to me that on the islands in the Pacific that practised cannibalism, they did things like eat the firstborn if it was a girl over eating the placenta (as far as I’m aware the placenta wasn’t eaten). It’s pretty bad when your community is short on protein and you’d rather eat the baby then the placenta.

      • SkepticalGuest

        I was trying to like this comment, but weird things started to happen. Instead of accepting my “like”, it was registering it as a “dislike” and the more I clicked the “up” arrow, the more “dislikes” it registered. (Yes, I should’ve stopped much earlier, but I was curious. This went from around 10 likes to – 16 dislikes. Bizarre.)

      • Lizz

        Planting a tree sounds fine but keeping it in your freezer for years is messed up.

    • Eddie

      I kept my wisdom teeth because I found them fascinating.

      I’m not the only one! :-) It helped that they all came out whole, even the impacted one.

      • Michellejo

        I kept my gallstones.

      • rh1985

        I still have mine, but they had to be cut up into pieces to be removed, they were so severely impacted. No wonder I couldn’t eat for nearly a week after….

      • fiftyfifty1

        I have all my baby teeth and my 4 wisdom teeth in a little box. I refused to give any to the tooth fairy. They seemed too cool to me.

        • Box of Salt

          I’m pretty sure my mom still has my baby teeth (I last looked at the box in the late 80s). The tooth fairy has collected my daughter’s in plastic baggies with dated tags and stored them in my lingerie drawer.

          I wanted to keep my wisdom teeth, but in confusion after the GA they got left behind at the surgeon’s.

      • Lizz

        Mine were so impacted two became one and it has a piece of my jaw bone that they had to break off because of the way the roots wrapped around it.
        They were waaay too cool to throw away.

  • Momma M

    I was still nursing my older toddler (18 months) when I became pregnant with my second child. Let me tell you something– I was glad when she lost interest about 12 weeks into the pregnancy because that’s when I started to feel like I would puke and/or throw my daughter across the room when she nursed. I certainly would have forcibly weaned her at that point if she had not have weaned herself. It felt terrible. I have a hypothesis that our bodies have evolved to discourage us from breastfeeding during pregnancy for some reason.
    On my breastfeeding boards there are mothers talking about their misery in breastfeeding during pregnancy. I want to yell “the kid is over a year! If you hate it, stop!” I assume it’s part of their martyr complex and the stunt parenting factor Dr. T talks about.

    • Dr Kitty

      Sure, Breastfeeding requires 500 calories a day and increased calcium and vitamin D intake. A pregnant woman requires 500 extra calories in the third trimester and extra calcium and vitamin D.

      Tandem nursing requires 1000 calories extra a day and large amounts of calcium and vitamin D.

      I’m not sure if NCB advocates realise that in most societies the kind of diet needed to sustain this is not feasible.

      • Lizz

        Yeah considering that large portions of Africa and Asia have problems with just getting Mom enough calories to run on let alone the needs of nursing.
        Also correct me if I’m wrong but isn’t the goal in breastfeeding in many of these places partially contraception? You know so they don’t wind up using up all their energy being pregnant and breastfeeding one let alone two kids.

      • The Computer Ate My Nym

        Not to mention that a woman with any degree of pregnancy induced nausea is going to have a great deal of difficulty sustaining that much calorie intake no matter how much food is available to her. I ate everything I could find while nursing my daughter (not pregnant, not tandem breastfeeding) and still lost weight. Which was fine with me–I had the weight to lose–but for a woman who started out thin could be difficult. There’s a reason that anorexic women become infertile.

        • Lizzie Dee

          One of the things that puzzles me is the insistence on “doing research” and being informed. There was an implication in a recent post that women who do NOT “do their research” are somehow completely ignorant about anything to do with childbirth and just turn up wide eyed at hospitals.

          But how do you know WHAT to research? Until I read these comments, I had never given much thought to tandem nursing, or the effects of feeding one child while growing another, milk drying up when pregnant. It sounds to me like this is one of the areas where wanting to be an Earth Mother or Goddess could get to be quite complicated and possibly detrimental all round.

          And that’s not to mention how you research. The internet is a nightmare of useless or conflicting information. Are their pregnant women who spend all their time in academic libraries? And do they really think they end up knowing more than experienced doctors? When even they can not always count on knowing which CS is absolutely necessary.

      • lucy logan

        yes that was my point. tandem nursing means the minimum dailly caloric intake for a woman is somewhere around 3,500/day. this is not feasible in most of the societies were were living in for most of human history–in most of those the more you need to eat, teh more you need to walk and then there is a point where the extra walking cancels out the extra food.

    • slandy09

      My mom weaned child #1 at 21 months because it was making her morning sickness worse than it already was. You may be onto something…

      My SIL forcibly weaned her third child because her pregnant self just couldn’t take it. She still feels guilty that she didn’t make it to two years with him *rolls eyes*.

      • KarenJJ

        I had a friend that fell pregnant very soon (kids are ten months apart – second one also came a little early). Her eldest got really fussy breastfeeding suddenly, even before she realised she was pregnant.

        • me

          My oldest’s nursing strike was one of the first signs that I was pregnant with #2 – I even took a home test that turned out negative, but a week later (when the nausea hit) I took another and, sure enough, it was positive. My oldest was about two at the time, so I used it as an opportunity to wean. I didn’t see the point in coaxing her back to the breast, pregnant or no, at that age.

      • Mel

        My mom’s first sign she was pregnant with a close spaced pregnancy was my brother’s refusal to nurse at 8 months.

    • http://www.europeanmama.eu/ Olga Mecking

      I was in a similar situation as you, I breastfed my girl till she was 14 months and then we stopped, by mutual consent- I didn’t feel good doing this anymore.So I encouraged her to stop and she did. Uff.

  • CS

    Okay, I have done three of the four above and consider them pretty benign.

    I had a water birth at a hospital with a CNM. It could have been that it was my second vaginal birth, but the recovery was a breeze. My baby was brought to the surface immediately and took her first breaths easily and without incident. I didn’t do this because I think it would impress anyone. I did it for the pain relief, even though it was far from painless.

    I did have my placenta encapsulated. I have a history of PPD and was willing to try anything to avoid it if I could. My family has a decent income and the fee to do this was affordable for us. Couldn’t hurt to give it a shot right? It did seem to help with some of the more severe mood swings although I didn’t completely avoid PPD this time. I mean, if someone wants to try this, there really doesn’t seem to be much harm.

    I have also nursed while pregnant and also tandem nursed with a newborn and toddler. I think it is key to make sure the littlest is gaining adequate weight and to make sure the maternal diet/ calorie is suffient. Again, I really don’t see the harm. I will readily admit that I didn’t find it all that pleasant and it didn’t last long, but it just doesn’t seem like that big of a deal.

    I don’t get Lotus birth at all. While it is kinda gross and seems a bit pointless, it seems pretty benign. And unassisted birth… Well it’s obviously not a wise or safe decision, so that seems like the only one really to get bent out of shape about.

    • CS

      Ahhh, three of the five.

      • suchende

        Do and try what you like, but don’t defend it by calling it “natural.” That’s really the point.

        • CS

          Eh, there is a whole boatload of stuff that people refer to as ‘natural’ that really isn’t. Guess I just don’t see why it would matter all that much as long as it isn’t harmful or dangerous.

          • Jessica

            Well, I suppose placenta encapsulation is harmless, apart from costing money, and if it doesn’t work, what’s the point? I suspect that most of the benefit mothers who’ve tried it claim to have experienced is the result of a much better known phenomena: the placebo effect.

          • CS

            Maybe… I haven’t seen research convincing enough to say with absolute certainty either way. For me, it was worth the possibility of throwing away $200 for something that may just be a placebo if it mean even a small measure of relief from PPD. Or it may have just been the inside laugh I got from grossing out my family. ;)

          • The Bofa on the Sofa

            Feel free to throw $200 my way. I’ll do a rain dance and chant some 80s lyrics for you. It might work, you never know.

            I could certainly use the money.

          • CS

            The only thing I would throw at you are tomatoes. I hate 80′s music, lol!

          • The Bofa on the Sofa

            Some people have reported that it helps.

            You have indicated that is good enough for you to try it, so what have you got to lose?

          • Ainsley Nicholson

            I would speculate that it only works for people like CS, who hate 80′s music. For these people, the sound of the 80′s music is unpleasant, but their feeling of relief when the music stops will help conteract postpartum depression. People like me, who actually like 80′s music, are SOL.

          • Amazed

            I’d try with the 60′s music. I adore it… mainly because I can actually understand the lyrics. I swear that nowadays, singers’ articulation is a dying art.

            ‘Say Wonderful Things to Me” – I think it’s very proper for the occasion.

          • FormerPhysicist

            Nah, Fleetwood Mac “Tell me lies, tell me sweet little lies”

          • The Bofa on the Sofa

            Nah, I’ve been thinking more of the Police. Something like Don’t Stand So Close to Me or King of Pain.

            (I don’t know why I have King of Pain running through my head lately, but at least it’s better than A Little More Love by Olivia Newton John that was last week)

          • realityycheque

            Is it harmless though? Just as people say that things like homeopathy are ‘harmless’, by relying on their placentas to evade PPH and PPD, they’re either avoiding or prolonging access to proper medical care, which could be harmful in and of itself.

            I may be wrong on this one, but isn’t placenta supposedly eaten because of the beliefs surrounding its oxytocin content? I was under the impression that oxytocin was a peptide hormone and therefore wouldn’t be effective when eaten anyway, as the hormone would be predominately destroyed by stomach acid before making it to the bloodstream.

          • CS

            Well, I think that depends on how someone approaches something like this. My attitude was to ‘try’ it and see if I felt like it made a difference. If I felt that I needed or wanted further treatment, I was also enrolled in a program that treats PPMD as a backup plan. Their usual recommendations are pharmaceutical treatments and counseling, so a more mainstream medical approach.

            What you are talking about is ‘relying’ on something, which could lead to issues with under treating PPMD.

          • realityycheque

            As someone who has suffered from depression for much of my life and experienced PPD after my son’s birth, I can fully empathise with the desire to try anything to avoid it/make it better. Whilst I don’t personally believe in the benefits of consuming placenta, I think having backup options and being open to the idea that eating it might not work is a healthy, realistic approach to any form of psychiatric treatment and much safer than many I’ve seen.

            People don’t seem to understand how rapidly a person who is predisposed to PPD or PPP can go downhill; literally, within a matter of days someone can go from being relatively ‘normal’ to acutely unwell, and within this time period any delay in accessing expert psychiatric care can be extremely problematic. I’ve heard of women killing themselves and their babies within 3 days of giving birth… there really needs to be better assessment and support out there for PPD and PPP.

            I feel angry about the outrageous ‘cure all’ claims some of these placenta consumption proponents come up with. The claims regarding PPH are particularly dangerous… put a bit of placenta under your tongue to cure/prevent PPH? Really? That is exactly the kind of misleading advice people die from.

          • CS

            Agree with you 100%. PPMDs can be fast and lethal. I’ve never even considered that placenta consumption can prevent PPH.

          • amazonmom

            Yes when I got severe PPD with all of my pregnancies (one live birth, two miscarriages) the woo pitchers came out of the woodwork with telling me to just eat placenta (Even someone else’s!) and I wouldn’t need that nasty medication. Yeah……. sure. They also told me I shouldn’t have given up breastfeeding to take medication, that what I needed to do was hold my baby more. I have since stopped hanging out with people who pitch woo.

          • realityycheque

            Wow, what a disgusting combination of ignorance and stupidity. It’s completely irresponsible to dispense advice like that… I’m guessing their experience with sufferers of mental illness is limited at best.

          • amazonmom

            You would be right. To tell you the truth I was scared out of my mind when I realized I was pregnant again. I’m taking medication throughout this pregnancy and will consider only partial or no breastfeeding at all after the birth. Every time I lactate, I get depressed and it doesn’t stop until I stop lactating.

          • auntbea

            Um, depressed mother does not sound like a good trade-off for the benefits of breastmilk. I think if anyone gives you crap for that decision, you should punch them in the nose. And then blame your hormones.

          • CS

            Would that be related to D-MER?

          • realityycheque

            Fingers crossed for you that you manage to avoid PPD this time around. Do whatever you need to do to care for your health, if breastfeeding negatively impacts on your mental health and you feel the need to stop, then stop. If anyone chooses to judge you for that, it says more about them than it does about you.

            Like my doctor said, “It’s better to have a healthy, loving, attentive mother and be given formula than to have a mum who is too depressed to function or bond with her child and breastmilk.”

          • Ainsley Nicholson

            Yes, oxytocin is a peptide.

          • auntbea

            Ahaha! I read this as :”oxytocin is people”!

            Don’t eat it! Don’t eat it!

          • FormerPhysicist

            Or just a different experience after a different pregnancy – for those who can compare two different experiences, with and without encapsulation.

          • CS

            Could be. PPMD seem to be rather understudied and even the specialists I saw couldn’t explain why PPMD would be an issue in some instances and not others. Obviously, some of it is situational, but not always.

          • Isilzha

            Harmless, I suppose, if you do it yourself, but I wouldn’t trust someone to not add something potentially harmful and not disclose the fact.

    • Claire

      “I did have my placenta encapsulated. I have a history of PPD and was willing to try anything to avoid it if I could. My family has a decent income and the fee to do this was affordable for us. Couldn’t hurt to give it a shot right? It did seem to help with some of the more severe mood swings although I didn’t completely avoid PPD this time. I mean, if someone wants to try this, there really doesn’t seem to be much harm.”

      What about a family that doesn’t have a decent income. What would they do when they think that this is their only way to be healthy (get nutrients, stave off PPD) and spend a chunk of money on doing this and it doesn’t work?

      • CS

        People are free to throw away money on whatever they want. Pyramid schemes, gambling, crappy investments, etc. If they haven’t taken the possibility that it may not work into account when choosing to spend their limited funds, that is their responsibility. No money back guarantees being issued that I am aware of.

        • Elizabeth A

          People ARE free to throw their money away on whatever the hell they want.

          What people aren’t free to do, what we have laws to prevent them from doing, is to lie to people about what they sell.

          There is no evidence whatsoever that eating placenta, raw or cooked, fresh or freeze-dried, does anything all to ameliorate or prevent PPD. Therefore, no one should be allowed to take someone else’s money by telling them that eating the placenta will do a darn thing about PPD.

          You don’t have to issue a money back guarantee to be a predatory liar.

          • CS

            I guess I view the world from much more of a ‘buyer beware’ viewpoint. If people don’t look into research themselves, they are setting themselves up to be lied to.

          • Elizabeth A

            I can believe in the value of reseatch without giving liarsa pass.

            By your standard, bBernie Madoff was a-okay.

          • CS

            I am not a legal expert in fraud, so maybe someone else can weigh in? In any case, the lady that I hired to do my encapsulation do not promise that it would prevent PPD. I am paraphrasing, but her wording on her website was something along the lines of “Women have reported that consuming encapsulated placenta has provided relief from symptoms from postpartum depression. There is insufficient research to substantiate this scientifically, but women have reported benefits.” Which is true, so I wouldn’t think that constitutes fraud.

            I am not an expert on all placenta encapsulation folks everywhere, so it could be some folks are making false claims about guaranteed results. Not sure about that one.

          • Squillo

            Sounds perfectly legal to me. She did exactly what supplement makers do and had the equivalent of the quack Miranda warning there.

          • KarenJJ

            That’s great. I like the three levels of reasoning when looking at this requirement:

            “the truthful way, the sinister way, and the bat-shit insane”
            (I had to delete a couple of extra ‘a’ characters at the end of the link.

          • Squillo

            Thanks. Cut-n-paste fail. I edited the link.

          • Isilzha

            BTW, whenever you read something like that you should realize it’s code for scam. The product has no proven benefits. If it did, then it would just be called medicine.

          • KarenJJ

            People need to be less gullible about this stuff.

            Millions of dollars are collectively spent on this sCam every year. It would be great if we could somehow redirect funds to something more beneficial for society. No idea how to do that. I’ve also bought into acupuncture and “integrated medicine” in the past. Wish I could work out how to get that money back and spend it on vaccinations in a developing country or something more useful.

            Reading “Trick or Treatment” was an eye opener for me. That and actually getting a diagnosis and effective treatment for an underlying condition instead of a well-meaning but ultimately useless ‘therapist’.

          • Box of Salt

            BTW, Trick or Treatment is by Ernst and Singh. Another worthwhile read is R. Barker Bausell’s Snake Oil Science. He has an excellent explanantion of regression to the mean.

          • Eddie

            Just like supplement manufacturers, they know how to skirt the legal requirements and make enough of a claim to convince people without making enough of a claim to make it all the way to “fraud.”

          • Amy Tuteur, MD

            You were lied to. Anyone you read that claimed that placenta has any value in treating PPD was lying.

          • Charlotte

            The fact that people were being scammed, hurt, and even killed by fake and tainted products is the whole reason we have laws against false advertising and harmful products to begin with. All the “research” in the world isn’t going to help if everyone else is similarly duped and saying that this or that helps or is safe. Some of their reasoning even sounds plausible.

          • The Bofa on the Sofa

            I guess I view the world from much more of a ‘buyer beware’ viewpoint.

            And I view the world from much more of a “sucker born every minute” viewpoint.

            I have often said (in many venues) that I sometimes think it is a shame that I have an ethical side, because if I didn’t, it would be so easy to scam people. Unfortunately, not everyone shares my ethics, and have no qualms taking your money selling you nothing. All it takes is suckers who are willing to hand it over.

        • Eddie

          Most people believe that punishing fraud is a legitimate government activity. Claiming an unproven health benefit so that you can make money as a business may cause no real harm in some cases other then money wasted.

          In other cases, it may cause people to eschew actual proven methods to help because the unproven one is marketed better, is marketed more positively (“always helps”), or because the method that actually helps has side effects and the one that does nothing at all also has no side effects (see most homeopathy).

          In some cases, the flim-flam also causes direct harm, in addition to convincing people to avoid actual proven ways that help. Every few years, some herbal remedy is taken off the market after killing people.

      • Antigonos CNM

        I have two objections. One is that there’s no real benefit, and possible harm from ingesting a substance that contains a smidgen of an important medication — take aspirin as an example. Willow bark tea, or an infusion of spirea, has been known as a febrifuge for centuries before the Bayer Company isolated the active ingredient, acetosalicylic acid, in 1904 and patented it as Aspirin [with the capital "A"; Bayer still holds the patent]. As a plant infusion you had to drink GALLONS of extremely strong brew to get the effect of one pill. Ditto placenta. Get a shot of some oxytoxic, or methergine in pill form. Much preferable from the point of view of action, and rather less messy. [and it spares Dad from long-term nipple stimulation which is just about as effective as eating the placenta]

        If you want nutrients, have a nice piece of grilled liver. The placenta is a kind of sieve; but unlike the liver, which deals with the byproducts of metabolism, placentas just store the dreck, more or less, as it filters the blood which passes through it. The placenta is a temporary organ, while one’s liver is meant to last a lifetime.

        • Lizzie Dee

          My objection to rather a lot of NCB nonsenses is that rationalising takes the place of reason.

          It is largely a matter of temperament, isn’t it? My general view is that humans are illogical creatures but that the world, or society or whatever works better, progress gets made if we struggle against our natural, primitive instinct to prefer magic to science, subjective explanations to objective, opinions to facts. If people want to eat placentas, strive for natural births, avoid epidurals while acknowledging that these things don’t make a lot of sense, I have no problem with that. If it makes you feel better and does no harm, no need to argue. But when people offer up crap scientific theories as to why what they do is the only, the right thing to do, I get itchy. I have no idea why I feel so strongly about it, really, as I know that it is natural to want to believe what is convenient and soothing but somehow or other I cannot buy into the idea that natural is best. Much too chaotic and random for me. Surely civilisation is a battle against nature?

          My mother, brought up before free health care here, was a great one for herbal remedies – some of them quite sensible, some of them very bizarre indeed. Maybe I am just reacting against that. (It is a sad fact of life that no matter how hard we strive for perfection as parents, our children will be critical)

    • PrecipMom

      How much are you willing to stake on the sanitary procedures of whatever person is encapsulating it? How do you prove that there is no contamination?

      • Squillo

        How do you know it was even placenta? There are no GMP regs or inspections.

        If I were the sort of person who sold placenta encapsulation, I might decide to skip keeping bleeding bits of ladies’ placentas in my ‘fridge or wherever and just use scraps from my dinner plate to fill the 99-cent gelatin capsules.

        • The Bofa on the Sofa

          But she doesn’t care, Squillo!

          She has out and out admitted it. She doesn’t care if it isn’t actually placenta, as long as she believes it is, the placebo effect is good enough for her.

          Below she states that she views it as “buyer beware.” In reality, it is a case of “a sucker is born every minute.” Because that’s what she is.

          You are absolutely right, that she has no friggin clue what is in these tablets. Scraps from the dinner plate is being generous, because that is actually meat. I was thinking more of maybe brown sugar, or flour, or sawdust.

          As you say, how would she know?

    • Isilzha

      “It can’t hurt”–Well, if there’s no proof that it helps even marginally (especially against other, more proven actions), then it certainly can hurt.

      Do you also want to trust people handling bodily fluids in their kitchen? It’s completely unregulated and who knows how sanitary the entire process is. Also, since the placenta isn’t going to do anything, most people adulterate it with stuff that will have an effect that can be felt. You may as well go buy some patent medicine from the 1800s.

  • Captain Obvious

    Maybe this is a topic for a different thread, but along those lines, What about all the natural childbirthers who don’t feel that a pregnancy has an expiration date like a library book. Many will refuse induction of labor at all costs and allow the baby to pick his/her own birth date. At least those mommas are non hypocritical. But so many out there boast how their doctor or midwife wants to induce them and they are refusing, yet then go about finding ways to induce themselves “naturally”. For the love of god.

    • BeatlesFan

      They can be hypocritical- as you just mentioned, the women who act like pitocin is made of anthrax and AROM is akin to boiling live kittens are the same ones who praise RRL tea, Evening Primrose Oil, and Castor Oil to the skies as ways to bring on labor.

      Also, I have a friend who touts the “babies to know when to be born” line, and in the same breath will tell you about her baby who, without noticable cause, was born at 34+6 and spent weeks in the NICU, being fed through a syringe.

    • AmyM

      Yes, I read the blog post just now, that Dinah’s mom wrote in response to us discussing her in last week’s post here. She talked about dangers to post-dates babies during labor, but didn’t once mention increasing risks of fetal demise with post-dates. She did mention that placentas could fail, but didn’t seem to connect that with anything.

      I don’t know, I’ve only seen it from the other end…my babies picked their birthday too early. Luckily, not so early as to damage them, so far as we can tell. I’m glad they showed up at 36wk instead of waiting until 42 and dying in-utero. I realize that stillbirth is still pretty rare, but who wants to take that risk, if there is access to medical care to get around it?

      • Ainsley Nicholson

        I also read Dinah’s mom’s blog post, and was bemused by her description of her induction at 43 weeks (or possibly 41 weeks) as “premature”.

      • amazonmom

        I know my OB will induce her patients at 41 weeks because of the increased risk of stillbirth when you wait longer. My grandmother lost her first child due to stillbirth at term. She would have given everything to have had her children in the modern day and possibly have had the chance to save her child when his movements greatly slowed a day before he was stillborn. She never would have understood why people are willing to take risks with their children’s lives just to be “natural”.

        • me

          Just wanted to note: decreased fetal movement is a failed test of fetal well-being, even when it is an informal “kick count” done at home by the mother. I’m sorry for your grandmother’s loss, and especially sorry that the technology wasn’t available to avert disaster :( That being said, daily kick counts (or at least paying close attention to fetal movement) is absolutely essential after the due date (really, starting as soon as fetal movement is regular). Had any of my kids’ movement slowed down in the last weeks of pregnancy I certainly would have reported this ASAP and gone in for induction.

          • amazonmom

            Poor Grandma believed for the rest of her life that if her doctor had listened to her that something felt wrong she could have saved her son. A nurse risked her job by telling her the gender of the baby, they never got to see him. She never went to the doctor again (except to have her four other children) until she had a heart attack and a quadruple bypass 54 years later. She was about ready to disown me when I got a job in NICU. I explained that we might not have been able to save him but she wouldn’t have been literally patted on the head and told not to worry either.

          • me

            That’s so awful :( The sad thing is, your grandmother was probably right – had they listened to her, they might have been able to save him (not sure what the availability or effectiveness of induction was back then, but they certainly could have done a c-section). Again, I’m so sorry for her loss.

      • The Bofa on the Sofa

        Our OB’s attitude is, “Nothing good happens after 40 weeks”

        If you actually have a solid due date, then there is really no benefit in waiting.

        • Ainsley Nicholson

          My OB will be inducing me at 39 weeks if I have not spontaneously gone into labor yet- which is standard protocol for their AMA patients. I’m actually nervous about waiting that long, and plan on asking if 37 or 38 weeks might be better. Do any of the experts here have some insights about this?

          • Karen in SC

            AMA? I only know that as “against medical advice” or the American Medical Association.

          • KarenJJ

            Advanecd maternal age? I’ve seen that one on here a few times.

          • Ainsley Nicholson

            Advanced Maternal Age (I’m 42).

          • Karen in SC

            Congratulations!! And I agree. Now that I know much more about the risks of childbirth, I think I would have lobbied for induction at the earliest date allowed then. My birth at age 40 went to 41 weeks. Mec, blue baby, low Apgar, retained placenta. All handled well by the hospital team.

          • Guestll

            Congratulations, Ainsley. :)_

          • Becky05

            Neonatal mortality and morbidity are higher prior to 39 weeks. The studies I’ve seen all show 39 weeks as the tipping point for the benefit/risk balance to favor induction, and many hospitals now have a strong policy against inductions before 39 weeks without a clear medical indication. I think it is unlikely that your doctor would agree to an earlier induction.

          • Ainsley Nicholson

            Well, that makes sense. Thank you! They’ll be monitoring me closely, so if a medical indication arises, we’ll know it.

          • Laural

            Good luck with that. I recently had a provider refuse to take me on as a patient after the first visit when I told her that I was uncomfortable that she would not admit me until I was 6 cm. Oh the rejection- I left the office holding back tears. (I am AMA, expecting #5, history of precipitous birth and have never gone past 38 weeks.. my tendency is to ‘silently’ dilate without actually being in labor and once labor hits I am essentially giving birth)

        • me

          Lol. I switched to a different provider after my OBGYN (who’d I’d only used for the GYN portion of the program up to that point) told me that very thing. I’d already had two 42 weeks pregnancies (one was induced at 42+1, the other came spontaneously at 42 exactly). Yes, I was sure of my dates. Yes, I underwent tests of fetal well being after 41 weeks (all were perfect). Yes I was still very comfortable – I planted a garden the week before #3 was born; washed my car the day before… nesting much? lol.

          I guess I didn’t mind waiting with #1 because my cervix was still unfavorable (0cm 0%) and my doc (head of OB at a major hospital) was okay with it. With #2 I really wanted to avoid being induced again as it was a pretty rough experience. I found CNMs willing to wait and fortunately she came of her own volition just a few days before the “deadline” those midwives were willing to give me until. With my third I asked my gyn at my first prenatal what her thoughts were and she gave me that gem (nothing good happens after 40 weeks) and went on to act all magnanimous about “giving” me 41 weeks IF nothing goes wrong (duh) and IF I still am comfortable (derp -who gets to decide that one?). At any rate, I wasn’t enthralled with her answer – she didn’t take into account my previous pregnancies or my family history of post dates pregnancy (grandma had 8 kids, none of them were “on time”), not to mention my preferences (obviously preferences are contingent on health status – I wouldn’t have refused induction had one been indicated).

          Needless to say I went on to have a spontaneous unmed delivery with a group of CNMs at a major teaching facility with zero complications. Now I’m not saying it’s for everyone, but a blind ‘induce ‘em all’ attitude would have left me with at least two unnecessary inductions, and possibly three c-sections… The “benefit” for me in waiting was avoiding needless intervention. Not everyone sees that as a benefit, but I certainly did.

          Okay… pounce ;)

          • desiree

            I tend to look at it from the OBs perspective. Sure, the chances that you’ll be the one to lose a baby are really slim, maybe 1 in 500. But over the course of a career, an OB is pretty much guaranteed to eventually lose a baby with a 42 week induction policy vs. a 40 or 41 week policy.
            When you think about it that way, it makes sense that parents sometimes feel at odds with the OB.

          • Squillo

            True.

            Most OBs will have seen unexplained stillbirths by the time they’ve practiced a few years. Inducing labor prior to 41 weeks reduces the risk of stillbirth. It may increase the risk of late prematurity in a subset of women with very uncertain due dates, but as a parent, I’d rather run the risk of having a 38- or 39-weeker with treatable problems than a 42-weeker with untreatable death.

          • me

            Well, all I’ll say is that I didn’t feel at odds in the least (I just collected my records on the way out the door, lol). The OB with the blanket policy delivered at the local community hospital (okay – it would have been convenient, only 5 minutes down the road as opposed to where I ended up delivering – 40 minutes away). The CNMs are affiliated with a nationally recognized teaching facility (this will reveal where, but their children’s hospital, literally next door to the women’s hospital, is currently ranked #2 in the nation for their neonatal care). Personally, policy or no, I think I made the right choice and stepped up in the world of medical care with that move ;) I also wonder if the smaller hospital isn’t more restrictive simply because they are smaller. Where I delivered would have been prepared for literally anything. The community hospital? Not so much. Then again, I don’t know if it was hospital policy, or just that OB.

            At any rate, I’m not saying she shouldn’t have been allowed to have that policy. I’m just grateful that I live in an area with options and have the means to make use of those options.

          • Captain Obvious

            At 41 weeks, a live baby in the nursery is better than two still in the womb. At least from the OB’s stress level perspective.

          • The Bofa on the Sofa

            You haven’t explained all the good things that happened with your pregnancy after 40 weeks.

            Nobody said “something bad will happen after 40 weeks.” The statement is that nothing GOOD happens after it.

            And none of your anecdote contradicts that;.

          • me

            The “good” thing that happened between 41 and 42 weeks with my first is that my cervix ripened a bit. Maybe spared my a section and if that is the case, it ultimately spared me three sections (even if you find a doc that will do a VBAC, none will do a VBAC after 41, sometimes 40, weeks, and induction is contraindicated for VBACs). So, yeah, that’s good. Don’t get me wrong, c-sections aren’t the end of the world, and even three of them isn’t the end of the world. But I much preferred being able to go home within 24 hours and not having my activity so restricted (especially when I had one or two toddlers at home to take care of).

            I know it’s just an anecdote, and I know the risk I took in sharing my decisions in the echo chamber. But seeing all the doom and gloom and women fearful to even go to 39 weeks… IDK, seems like you all think the baby, your uterus, and the UPS guy spontaneously combust three nanoseconds after your EDD.

            No, fear birth isn’t as dangerous a philosophy as trust birth is, but it still seems unhealthy. How about respect birth? And that’s just what I did. Excellent prenatal care, taking the advice of those (properly!) trained to help, making decisions WITH my providers, and having limits as far as just how far to go. All three times I delivered in the hospital with trained providers, made use of interventions as needed, and by the grace of god, or luck, or whatever, things went well.

          • The Bofa on the Sofa

            So the “good thing” that results from waiting after 40 weeks is that you are more likely to have a vaginal birth.

            Beg the question much?

          • fiftyfifty1

            So you poo-poo the advice of experts when you go overdue because long gestations run in your family. Do you recommend that I use the same logic to ignore the advice of my cardiologist because long QT intervals run in mine?

          • me

            The experts were the ones who let me go that far in the first place. Not sure who I was poo-pooing. Other than the OB with the blanket policy that didn’t take into account my personal or family history… But I suppose she was right and all the other providers were wrong. Oh, wait, my kids are alive and well and fighting in the living room as I type…

          • fiftyfifty1

            Based on the studies that were available to your first OB at the time (that gave too much weight to Bishop’s score in predicting success), I can’t fault your first OB. But after that, you doctor shopped to get the birth experiences you wanted and risked your kids to do it. You could have protected your kids from that needless 1/500 risk without (as a multip with a prior successful birth) even increasing your risk of C-section. But you didn’t wanna cause you didn’t liiiiiiiiiiiiiiiike your first birth experience! But hey, your kids dodged that bullet, so all is cool and your daring style has really impressed everyone!

          • me

            Yeah, call CPS. I also let my kids play on the dirty dirty ground and don’t use antibacterial wipes to exorcize the demons off the shopping cart before I plop my toddler in it. What a horrible parent I must be.

            My god. Is it any wonder so many kids have so many damn anxiety issues these days? If you all are representative of how hysterical (and I hate that word, it’s so misogynistic, but it fits here) many parents are these days, well no wonder….

            Look, I didn’t “doctor shop”. It didn’t take me long to find CNMs who were willing to “allow” me my right to patient autonomy (like, the first ones I called…. derp… guess your theory got blown up right there). But, no, I wasn’t willing to stay under the care of an OB who completely blew off my history, my family history, what I know about my menstrual cycles AND her own u/s data in favor of following some blanket policy. I wanted a provider who would look at the big picture and use, you know, critical thinking skills, as well as respect me as a human being (with rights) enough to make a reasonable decision wrt managing pregnancy past the due date. Despite the OB’s induction policy, the fact that she just didn’t give a rat’s ass about my medical data didn’t bode well overall.

            As for “risking my kids”? You say I’m trying to feel superior or impress people? And here you are trying to make yourself feel superior and impress people by being a bully. It’s sad that you have to tear others down to build yourself up. I also have to lol at your “needless 1/500 risk”. There is a “needless 1/1000 risk” associated with delivering at 40 weeks. Are you saying that women who don’t demand 39 week inductions are also risking their kids for their own experience and trying to impress everyone with their “cool and daring” style? If not, you are not only an asshole, you are a hypocrite.

            No one is arguing that there isn’t a slightly elevated risk at 42 w vs 40 w. The risks really go up quite dramatically after 43 w and I would never consider waiting that long. While you are willing to work yourself into a tizzy over a 1/500 risk, it certainly doesn’t seem like an unreasonable risk to me. But I suppose if you want to be a total sanctimommy and pretend that making your kids live in some hermetically sealed bubble makes you a
            Better Mommy, well, go ahead.

          • Jocelyn

            “Exorcize the demons off the shopping cart.” Bahaha. I even use those wipes, and I laughed out loud at that one. Thanks for making me smile. :)

          • me

            Wanted to add: the risk of stillbirth (independent of any other factors) is double for women over 40 vs women under 35. Is it irresponsible, “daring and cool”, for women to wait until they are over 40 and risk their kid attempting to have a baby? Why is a woman who waits to start a family until she is past 40 immune from your criticism? She is doubling her child’s risk of death by the same rate I did…. Hmmm. Should women be barred from having babies past age 40? Would it be okay with you if large numbers of OB had a policy that they only provide prenatal care and attend deliveries if the mother is under 35? Or do you think women have a right to decide to delay starting or adding to a family until the timing is right for them, even if the risks are somewhat elevated after a certain age? What’s funny – my risk of stillbirth at 41-42 weeks (being in my late 20s at the time) was THE SAME as the stillbirth risk of a woman in her 40s at 39 weeks gestation (which would be her lowest risk level). But I’m irresponsible and taking needless risks, while the older mothers are… what, exactly? Yes, I chose to go to 42 weeks. Just as they chose to wait until their 40s to get pregnant…. why is my choice so unreasonable to you, but their choice is peachy keen, when the end result is the same?

          • fiftyfifty1

            Yes, the increased risks of AMA are something I do discuss with young women as part of the rountine anticipatory guidance that I provide at yearly exams. But trying to shift attention off the risks you took and onto older mothers is as transparent as saying “Don’t blame me for refusing to strap my kids into their carseats–look over there at that kid on the back of a motorcycle!”. Nobody is fooled.

            You see yourself as a special snowflake. You came up with your own pet theory that the risks of going overdue somehow didn’t apply to you because going overdue runs in your family. You thought the OB you fired was stupid to treat you like a “regular” woman past her due date. But actually familial factors are not a special reason, they are the “regular”, most common risk factor for going postdates.
            You have genes that make you relatively insensitive to the “get me out of here” signals that a term baby and placenta put off. It’s a problem that runs in your family. Refusing medical treatment for it is foolish and selfish.

          • me

            “You came up with your own pet theory that the risks of going overdue
            somehow didn’t apply to you because going overdue runs in your family.”

            Um. Not quite. First, that wasn’t my sole reason for wanting to wait. There was other data available that suggested that I might not have even been a full 42 weeks along in the first place, but she was unwilling to consider that. Second, I never thought the risks didn’t apply; if I did, why would I have agreed to tests of fetal well being, or set tentative induction rates to occur fairly soon after going postterm?

            And how did I “refuse medical treatment” exactly? Is getting a second opinion the same as refusing treatment now? Because that is basically what I did. Do you actively discourage your patients from seeking second opinions in non-emergency situations? Because that seems a tad unethical.

          • me

            that should be “induction dates” not induction rates”.

          • me

            Oh, and I wasn’t trying to shift focus so much as provide an example of a similarly risky choice (and yes, it is a choice) that women make, that no one here seems to have a problem with. You say it’s a “different” kind of choice. Well, perhaps, but in either case the bottom line is that the child is at an increased risk of death so that the mother can do what she wants to do. You say I risked my children’s lives to have the experience I wanted; obviously that is the fallacy of oversimplification. But we can apply your oversimplification to the over 40 crowd, to see just how absurd it is: I guess you are entitled to the opinion that career aspirations are more valuable than a child’s life, and so that’s a “good enough” reason to double a kid’s risk of death. Personally I don’t look at it that way. There is more to a woman waiting until her 40s to start/add to a family than that. Just as there was more to my choices than what you are representing here.

          • fiftyfifty1

            You seem intent on comparing the outcomes of women who delay childbirth to those who delay inductions. Fine. Let’s break it down and compare risks and benefits:

            Going overdue increases the risk of perinatal death. So does giving birth past 40. So more or less equal there on the risk side of the equation.

            Now for the benefits: Children born to AMA mothers have on average higher IQs,are more likely to have good school performance, more likely to have an intact family, less likely to experience abuse or poverty, less likely to have obesity or asthma or develop chem dep. So lots of benefits there, and all accrue to the child. The benefits of refusing induction? Bragging rights for Mom, natch!
            TL;DR version: Something good happens after 40 years, nothing good happens after 40 weeks.

          • Guestll

            You said what I was trying to say, only better. Thanks.

          • me

            Well, you are entitled to the opinion that the only benefit to delaying induction until you are officially postterm is “bragging rights” (tho I’ve never bragged about it… it never really comes up…). That is your opinion. Super. If/when you have more children, if you happen to find yourself “still” pregnant after 40 w, go ahead and induce. That’s your choice. I chose something different. But if you go all santicmommy and make it out like you are A Superior Mother because you made a different choice, well, that just makes you a bitch, honey.

          • Wren

            So exactly what benefit to the baby do you believe exists at 41+ weeks to offset the risks?

          • Expat in Germany

            As far as I can tell, me uses crazy person logic and uses cherry picked articles to back it up. Weird analogies, false equivalencies mixed with numbers that she takes out of context. Have you ever read Foucault’s Pendulum?

          • me

            Care to point out the crazy person logic? And why are ACOG practice bulletins and statements by the AAFP “cherry picked” (I’m not quoting IMG here, lol)? Are those not reputable enough sources for you? Please, feel free to lead me to the policy of more reputable sources that contradict what those two organization have to say. TIA!

          • Expat in Germany

            easy: “post dates run in my family, so it is okay for mee to go past 42 weeks” is crazy person logic. You cherry picked statements out of context from the acog and aafp recommendations.

          • Expat in Germany

            “it is just as risky to have a baby after 40 years as what I chose to do, so what I did is okay” is also loony

          • me

            I was merely pointing out that there are choices that carry similar risk level to the child, that no one here seems to take issue with, which strikes me as hypocritical. I was not commenting on whether any given choice is “okay”. Personally I don’t believe either choice is immoral. But morality tends to be somewhat subjective. You are free to believe that either, or both, or neither, choice is immoral.

          • me

            @ Expat: I wonder why you keep paraphrasing, putting your own spin on my comments, but than wrapping them in quotations as tho I really ever said what you are claiming I said? Care to answer?

          • Expat in Germany

            brackets would’ve been better, but I don’t think I missed the mark in summarizing what you wrote.

          • me

            Actually you did. You left out other, more pertinent, reasons why I felt comfortable waiting – early u/s dating and what I know about my cycles. Not to mention, you brought morality into it, which I never did.

          • Expat in Germany

            I don’t think anyone wants to argue about you personally, just your implication that 42 weeks needn’t be a big deal if you think you are smarter than your doctor.

          • me

            I didn’t imply. You inferred. I never claimed to be “smarter” than anyone. I didn’t like that my former OB refused to listen to, much less consider, pertinent information about my history, not to mention the data she got from the early u/s. She basically interrupted me (very unprofessional, IMO) and said ‘we don’t change dates unless they are more than a week off’. Her abject refusal to consider all the facts struck me as a red flag – if she won’t consider all the facts in a non-emergency situation, what happens if/when the shit really hits the fan?

            I never said 42 weeks wasn’t a “big deal”, or that the risks shouldn’t be taken seriously, only that it is not, statistically, as dire a situation as many here are making it out to be.

          • auntbea

            How do you know she ignored information about your history, rather than considering it, and deciding it was not pertinent to her decision?

          • me

            Because she cut me off before I could even finish. Very unprofessional, but, yeah I would say she ignored it – she wouldn’t even hear me out.

          • me

            I wanted to add: I was really gobsmacked by her actions. Up to that point I had really liked her. As a GYN she listened to me, answered any questions I had, always took the time to explain things and give me options. I was so taken aback when she cut me off that I didn’t attempt to further explain anything. I just decided then and there to go elsewhere. I don’t have a problem with a 41 w policy. But you ought to be careful to make sure you get the dates right. If a patient offers information that tells you u/s would be the more accurate date, why not at least hear them out? I just figured she was a good GYN, but a terrible OB… I don’t regret switching…

          • fiftyfifty1

            If that’s a terrible OB, sign me (and my unborn baby) up!

          • Eddie

            While I get your point, that you want an OB who is cautious and who wants to take every precaution to be sure things end safely, and I agree with you on that, I would definitely consider changing providers if I were treated very rudely, if my concerns were dismissed without discussion. (Whether I’d change or not would depend on my whole history with that provider, not solely on one event.)

            I liken it to parenting, in many ways. A parent often has the right to entirely dismiss silly or stupid things their kids ask for. (“Why CAN’T my boyfriend spend the night?” “When I turn 15, can I have a new car?” “I want to drop out of high school.”) I won’t blame any parent for dismissing out of hand some things their kids ask for. Kids can certainly be difficult. I know patients can be as well. But it’s just not productive to be dismissive. It’s more productive to interact, to discuss, to give reasoning, to have a two-way conversation — to the extent that a child or patient makes it possible.

            I’m not going to pretend this is always easy. I’m not going to pretend it is always fair. I understand that I am asking a lot, that I am asking for something that sometimes requires uncommon maturity. But IMHO it will just about always be more productive.

            If a doctor cuts me off and won’t even listen to my concerns, I will consider finding another doctor. As I’ve mentioned before, my family has already had two ER visits effectively caused by doctors who refused to investigate concerns I brought to them. This doesn’t mean I’m smarter than any doctor. I don’t pretend to be able to diagnose. But I do expect my doctors to listen to me and to discuss my concerns in a productive fashion. If they dismiss my concerns, I want at least some explanation, and at least as long as I am talking in a productive fashion, I expect my doctor to respond in kind. I’m not going to ask for journal articles or proof that they are right. I just want to be taken seriously and to be treated with respect.

          • fiftyfifty1

            Absolutely. But in my experience with my collegues I don’t know a single one who is “a good GYN, but a terrible OB”. On the other hand I know a lot of patients who are great patients when I tell them something they want to hear and terrible ones when I don’t…

          • Eddie

            Fair enough.

          • Lizzie Dee

            Different people have different definitions of what is respectful though, don’t they? Quite a few posters come here to complain vociferously that discussing bad outcomes is disrespectful, telling them that unfounded beliefs are not the same as facts is disrespectful – and finding some posts unintentionally comic is definitely disrespectful. I sometimes think this is one word that has a different meaning in Am. English. Respect is something that you earn not demand, and as someone has pointed out failing to agree or failing to acquiesce isn’t always disrespectul.

            If a doctor is excessively rude or dismissive to the point where you no longer trust them then finding someone else makes sense, but failing to agree that a known risk does not apply to you on the basis of a pet theory which may or may not be valid isn’t automatically disrespectful.

            I had forgotten, but I had a similar problem to Me in reverse. A short cycle, a last period that was sparse and a bit “off” – and a baby that needed to come out. Dating from the scan made a lot more sense than LMP. I thought doctors also took that as more reliable, but it seems not.

            Me might have got a better response if she had explained that the risks of epi/pain troubled her more. Me’s case started out as being that going postdates was no big deal, but then changed to “but I may not have been 42 weeks anyway”. It was her tone, not just her argument that was provocative. There is a difference, in my opinion, between “Stress tests were reassuring, my baby was fine” and “MY stress tests were brilliant, so ya boo to risk.”

          • Lizzie Dee

            Following on from the above, I thought the startling increase in stillbirths was after 40, not 42. (And starts to rise before 40). In my family, given our strange histories, we are far more scared of postdates than prematurity.

            I have a question: is the placental failure always easy to spot through NST? My daughter’s EFM traces could look quite normal between the
            catastrophic decelerations, as lack of variability is not that obvious. I seem to have read of women who had lost a baby in spite of reassuring test results.

            When I had mine, placental function tests(hormonal) were still done – mine were bleeding awful, fell off the bottom of the scale. As far as I know these were abandoned because newer tests were thought to be more reliable. Are they, always?

          • me

            “I thought the startling increase in stillbirths was after 40, not 42.”

            I’d love to see the answer to this! All I have ever seen suggests twice the risk at 42 weeks, with truly startling jumps after week 43. I’d love to see some recent stats on this topic.

          • fiftyfifty1

            Stillbirths actually start to increase at 37 weeks. But there are risks to early term deliveries so a population-wide policy of inducing at 37 weeks would be a bad idea. The nadir of risk to baby on a population level seems to be 39 weeks. Dr. Amy has written a couple of posts about this already including graphs of the stillbirths each week.

          • Eddie

            I found at least one of those posts … http://www.skepticalob.com/2010/10/ina-mays-acolytes-spew-misinformation.html where Dr Amy reports on and links to this report:

            http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_08.pdf

            Dr Amy’s analysis is well worth reading.

          • fiftyfifty1

            I don’t know anything about old tests of placental function. There are lots of blood tests you do now to look for liver and platelet involvement of preeclampsia but I don’t know about any historic blood tests. But the answer is no, placental failure is not easy to spot with NST or any other test. I mean sure, if the strip looks bad and the fluid is really low and the fetus shows no movements and poor doppler blood flow of the placenta, yes then things are looking bad. But subtle changes, no those won’t be seen. We know the risks of stillbirth/placental failure start to rise early, even before most babies are “fully cooked” and just continue to rise. Sure, it’s nice to pass the NST and other fetal wellbeing tests, but that’s by no means a guaranty. The extra mortality that happens as you continue past your due date happens DESPITE doing these wellbeing tests. This is why it is standard of care to recommend induction by 41 weeks at the latest. Each day is nothing but an unneeded risk to baby, and a woman that brags about passing the wellbeing tests with flying colors is doing nothing more than basically bragging that “there were no OBVIOUS signs that my baby is yet compromised by my choices”.

          • Ainsley Nicholson

            I don’t think that the definition of “disrespectful” differs so much between American vs. British english…I think it differs between subgroups (subcultures?) that define it various ways.

          • me

            “Me might have got a better response if she had explained that the risks of epi/pain troubled her more.”

            Maybe you’re right about that, but unfortunately I never even got to bring that up. As I said, I was too busy picking my jaw up off the floor. I was truly flabbergasted at the OB’s response to what I thought was a simple question. Maybe I’ve just been extremely lucky, but that was the first, last, and ONLY time in my life I had ever been spoken to like that by a HCP. It was a twilight zone moment and it effectively stopped me from asking any further questions or offering any further info about my history. And if I don’t feel comfortable asking my doc questions, it’s time to find a new one!

          • Eddie

            I sometimes think this is one word that has a different meaning in Am. English. Respect is something that you earn not demand

            This sent me to a dictionary, where I realized just how many different meanings are buried in the one word, dependent upon context. I’d hoped my meaning was clear in context, but perhaps not, given how routinely the word “respect” is misused and misunderstood. You provided several examples of misuse.

            If I politely and non-confrontationally bring a concern to my doctor, plumber, tax adviser, lawyer, financial planner, or any other professional with whom I am exchanging money in return for professional services, and I am talked down to or rudely cut off, I am not being treated with respect. Does anyone here actually disagree with this?

            I am paying for expertise. If I am wrong about something, I expect to be told so. That’s their job. But tell me so in a manner that is not insulting or rude. Remember: the premise is that I am myself being polite, non-demanding, non-confrontational and respectful.

            When I am wrong, I expect at least some explanation. I shouldn’t be treated like a petulant child unless I’m acting like one. And even then, ideally I shouldn’t be treated like that, but we are all subject to human nature and we all have “off” days. But seriously, I don’t admire my kids for saying, “HE started it.” So why would I admire a professional, an adult, for that attitude?

            You said, “It was her tone, not just her argument that was provocative” and I wonder how you know that? Why do so many people assume the tone she started out with in this forum is necessarily also the tone she started out with in that doctor’s visit? When she says this is not the case, do you assume she’s lying, or that she was unaware of her tone?

            Are the people responding to “me” really unaware of how much her tone has changed from her first posts in this forum through her current comments? I give her credit for hanging around and continuing to explain herself in the face of persistent attack. I don’t think I would have done so.

          • theNormalDistribution

            You know what they say… Hearing one side of the story can be worse than not hearing either.

          • Eddie

            I’ve never heard that phrase before. It’s a good one.

            But of course I get the point. I wasn’t there. I don’t know what happened. (And I have never claimed to.) “me” could be deliberately misrepresenting what occurred in the doctors office, or she could have perceived something different from what happened. I get that.

            I get that doctors have a set of patients who are very difficult to deal with, who are demanding, strident, outrageous, nutty, who cannot be challenged, who think they are smarter than the doctor, whatever. If it didn’t violate professional ethics, I’m sure a page by doctors like notalwaysright.com would make for entertaining reading … if you find it entertaining watching a train wreck. (Looking at reality TV, a lot of people clearly find that entertaining.)

            What surprises me, however, is that several people here are stating as fact what happened in that office when they weren’t there. Come on. Aren’t we better than that? When we do that, it just makes us appear as the unthinking extremists we are routinely mischaracterized as.

          • me

            Thank you for this! I may be a lot of things, but I don’t believe I’m close-minded :) I’ve read thru all the responses (even one’s that got personal or even insulting) and tried to see the points being made. I went into my appt with an open mind, wanting to learn more about this relatively new trend that could impact my care. I expected a discussion with my doc; not be dismissed, talked down to, or treated, as you aptly put it, as a petulant child.

            One reason I’ve been reading this blog for years is that it makes me think and reconsider my own POV. And the comments section can be even more helpful than the blog posts themselves. I don’t regret the choices I made, but you all have made me realize that my choices weren’t exactly as rational as I had previously thought them to be. You’ve also made me consider my former doctor’s POV with a different light…. I wonder if she saw my two 42 w pregnancies and assumed (erroneously) that I had refused induction or browbeat my other two HCPs into “letting” me go that far. It would have been nice if she asked the details rather than assuming, if that is the case. But it would explain the tone – maybe she was trying to let me know in no uncertain terms that it wouldn’t be up for discussion with her… IDK. I still disagree with her approach (it ended up backfiring, really), but maybe she got the notion that I would fight with her over it by misinterpreting my history.

            At any rate, it’s ancient history…

          • KarenJJ

            I have really enjoyed the back and forth in these comments. I too have had my own issues with health providers and been trying to unravel my own issues and thought processes. I understand a lot of what you mean with not feeling listened too, understood and being taken aback from the conclusions drawn that seem to not believe what you are saying. Being treated like a hypochondriac, drug seeker, attention seeker was very offputting. I often didn’t realise in what way I was being dismissed until after the appointment.

            I find skepticalob very helpful to try and understand the point of view from the medical side. From the patient side I feel like I’ve seen the best and some of the worst. I hear a lot of similar stories from other parents and patients with rare diseases. Of misdiagnosis, accusations of mental instability and parental neglect or Munchausen’s by proxy.

            I really think that is part of why alternative medicine is so popular. My experience of alt-med is that you are immediately believed and validated and then given something to try and manage better. It does make you feel that you know your own body and mind. My other experience with alt-med is that it is a complete croc and money-spinning rort and they have no idea of what a chronic disease looks like.

            The only other time I’d felt truly understood by a doctor – outside of alt-med – was when I spent an hour talking with Professor of Immunology about why I thought I had a disease that at best count only affects one in a million people.

            I know other people called it “Dr shopping” here but I still find it very important to find doctors that you can have an honest and productive discussion with. A second opinion can help with that. In the medical system I’ve found I’ve really needed to feel like there are people in my court that can help put my needs forward. I’m not a medical person and the system can be hard to navigate.

          • Eddie

            A belated comment, but an early girlfriend of mine dealt with a lot of the same reactions you describe. She was once accused of “maybe” being drug-seeking. Her family definitely doctor shopped, because it seemed so difficult in that part of the US to find a solid, reliable, reasonable doctor who could treat her specific condition.

            She could be belligerent when in pain, and that was clearly fingernals-on-the-blackboard to some of her HCPs. But she lived in a state that was so overreactive about narcotics that in my not so humble opinion, chronic pain was routinely undertreated by doctors legitimately worried about losing their license.

            Like you describe, I see what some people like in alternative medicine. On the surface, it’s very appealing, and one has to be more educated or less gullible to see that most alternative medicine goes no deeper than the surface.

            They misdiagnosed my gf’s bout with Lyme Disease for months before finally catching it — at a time where it was getting quite a bit of press, in a part of the country where it was common. (Her “normal” health problems presented some of the same symptoms, so I understand the miss.)

            People dealing with things that are even less well understood, or for which medical science has no cures, I can see why they would be attracted to some charismatic person who shakes their hand, looks them in the eye, assures them that they know what is wrong and how to fix it. (Which is, of course, why we have to go after people peddling snake oil. They prey on the desperate.)

          • Lizzie Dee

            Interesting – and yes, this does clarify that attach a different meaning to respect, as something which is not automatic.

            I am the mother of a disabled child (person) By definition, for a lot of professionals, that means I am an idiot, or a poor benighted creature who must be handled carefully. If I want respect, I do have to patiently get past these automatic assumptions.

            You mention “politely” expressing your concerns – and yes, one does have a right to demand equal civility in return, and to be listened to but I would call the lack of it rudeness not lack of respect.

            As far as Me goes, you are right to challenge my assumption that anything could be assumed about her part in the reported incident from her tone here, One does not have to assume that someone is lying to think that this story might have two versions. Me was upset and disappointed; she believes very strongly in an argument that her doctor didn’t accept. The doctor should have respected the strength of her feelings, but clearly didn’t respect the argument. Would a respectful refusal have been acceptable, or did me still want respect for her theory/her own way?

            I do agree that Me’s tone shifted, and that hanging in to defend herself is commendable.

          • Eddie

            I would call the lack of it rudeness not lack of respect.

            This may indeed be a difference in usage between the UK and the US. When my children say (in effect), “You must respect me,” that is where I respond, “Respect has to be earned.” But on the other hand, “to be treated disrespectfully” is understood to mean that the other person was rude. A corruption of that, of course, is the “modern” phrase, “He dissed me.”

          • me

            Hey, if you prefer to have your doctor dictate your care/treatment without offering any explanations, much less bothering to find out what your preferences are and attempting to educate you on your options, that is your prerogative. I do find it odd that there is so much propaganda about patients’ needing to advocate for themselves and ask question and be proactive in their own care, but when you DO ask questions and try to learn, some doctors (like this one, I can give you her number if you like) act like you’ve insulted the very fiber of their being by daring to question their authority…

          • fiftyfifty1

            On the other hand you act insulted that SHE questioned your “authority” regarding your dates and your beliefs about family history being a factor. Respect goes both ways. You say she had previously been an a good listener and a good explainer. You feel she changed all of a sudden when she was dealing with OB rather than Gyn. Are you certain it wasn’t you that changed?

            Your story and my story are very similar. We both have long cycles. We both had a traumatic first delivery that entailed a long painful recovery (actually I will never be fully recovered, I will always struggle with urine and fecal incontinence because of my vaginal birth). Both of us had what sounds like some PTSD-like symptoms after our births. Both of us hoped for very different outcomes with subsequent births and put a high premium on our recoveries.

            But I didn’t expect my OB to go against standard practice and change my due date based on just my intuition. I provided her with basal temp and OPK info so she could change my dates safely. I also had an intuition that I would deliver early based on my first birth that went at 38+1 and asked to be scheduled for my (pelvic floor preserving) elective c-section at 38 weeks because I really wanted to avoid going into labor and delivering vaginally by mistake. She absolutely vetoed me on that and refused to schedule before 39 weeks. She reminded me of the risk (*extremely* rare but real) of serious or even fatal lung problems for 38 weekers. There were no benefits to the baby to offset that risk, only potential benefits to me. “You’ld never forgive yourself” she said “I’m scheduling you for 39 weeks”. End of discussion. I respected her for that. Could I have doctor shopped and found a doc willing to section me at 38? I know I could have. But one of the things I hire a doc to do is to think straight when I’m not able to. And then to tell it to me straight.

            It ended up that I did go into labor spontaneously after all at 38+4. My doc canceled a noon meeting and rushed over. Right before she made the opening incision, she checked me one last time. “If I decide this baby is too low to deliver 100% safely abdominally, I’m going to have you deliver vaginally”. I respected her for that decision too. But the baby wasn’t and I got the section I wanted. The whole experience turned out to be the best day of my life (so far).

          • me

            “You feel she changed all of a sudden when she was dealing with OB rather than Gyn. Are you certain it wasn’t you that changed?”

            I honestly don’t believe I did. I went into the appt elated (it didn’t take very long to conceive this very much wanted child). I did want to discuss postdates pregnancy, as it had proven an issue in prior pregnancies, and I wanted to know how she typically handles that situation. I had concerns about the accuracy of LMP EDD, and I had hoped to discuss and share with her what had happened in prior deliveries. I never got the chance.

            The difference between your doctor and my former one seems to be that yours bothered to explain her rationale and it sounds like, while she disagreed and vetoed your desire to schedule c-section prior to 39 weeks, she actually listened to you and took your concerns seriously.

            I wasn’t looking for someone who would cater to my whims no matter how nonsensical. I was looking for someone who would take the time to answer questions, address concerns, and (in a non-emergency situation) explain their rationale. As I said before, I knew there was new evidence that 41 week induction might be better than waiting until 42 weeks to induce. I knew, based on that, that I might be hard-pressed to find someone willing to wait. And I was okay with that. I just wanted to find someone to listen to and address my concerns.

            Now, I know you (and others here) may disagree with the midwifery practice that allowed an “exception” in my case. I don’t doubt that had they felt concerned at any point, they would have insisted, with the same vociferousness as your OB did, that I do what was safest for my child, even if it meant giving up the potential benefits to me.

            Given that my history with my former OB was limited to a couple of well woman checks, it’s not as tho I ended a long-standing, good doc-patient relationship over one incident. It was really only the third time I had seen her in my life. Cutting ties wasn’t a big deal. And my whole experience ended up being wonderful. At the end of the day, it’s probably just as well she behaved the way she did. If she hadn’t things could have gone much differently.

          • The Bofa on the Sofa

            I was so taken aback when she cut me off that I didn’t attempt to
            further explain anything. I just decided then and there to go elsewhere

            So you were lying when you said above that you quit your OB because he/she said that “nothing good happens after 40 weeks”?

          • me

            Actually I said I fired her “after [she] said that very thing”. It was one of the things in her rant that stood out and I remembered her saying it. When the poster I responded to brought it up, it brought up that memory. I saw it as part of her way of shutting down any dialogue. For whatever reason she didn’t want to discuss my concerns or answer my questions and it stuck out as a buzz phrase utilized for no other reason than to shut down the conversation.

          • auntbea

            I agree it was rude of her not to hear you out and explain why she was still planning to induce. But what people here are trying to point out is that your family history of late labor doesn’t negate the fact that going post-dates increases the risk of stillbirth. Actually, there isn’t much you could tell her about your history that would negate the fact that going post-dates increases the risk of stillbirth. So she ignored the information because the information was not relevant.

          • me

            She ignored the information because she had these policies that allowed her to take her thinking cap off ;) I don’t mind the idea of policies being in place to provide guidance. That’s smart. But don’t outsmart your common sense. “We don’t change dates unless u/s is off by more than 7 days” Well, mine was off by 6 days. All. three. times. “We don’t let anyone go beyond 41 weeks” Great, but then it would be nice to be sure that the due date is as accurate as possible, right?

            I was providing her information that put into question both of those policies. Had she listened to me and still believed what I was telling her was irrelevant, fine. Discuss that with me. Don’t repeat your policy like a mantra. Treat me like a human being (the one in the situation who has the most to lose, btw) and explain *why* you think the additional info is irrelevant. I likely still would have gone elsewhere, but at least she wouldn’t have come off as an unthinking bitch…

          • Amy Tuteur, MD

            How long are your cycles (from the first day of one period to the first day of the next)?

          • me

            About 32 days.

          • Amy Tuteur, MD

            Every cycle?

          • me

            Yes. Baring extreme stress or illness, of course. But most of the time (like, 90%) I can predict my next period down to the day (when I was younger I could often predict the time of day – morning, afternoon, or evening – it was nice to know when I should wear a pad to bed, saved hell on the sheets).

          • Amy Tuteur, MD

            Okay, so there’s no reason to believe that you ovulate 6 days late based on your cycles. Do you have any objective evidence that you ovulate 6 days late, like a positive OPK test (ovulation predictor kit)?

          • me

            The conception dates of my first child as well as my third. My husband is military and travels extensively at times. My first was conceived after he returned from a TDY, three weeks after my LMP that cycle. My third was conceived right before a deployment (with two young children in the house we didn’t have many “opportunities”. So, sad as is, lol, there was really only one possible date that cycle – again, 3 weeks after my LMP. Less objective, but I will share it – we TTC #2 for over a year. during that time we focused our efforts on day 14 of my cycle. After about 10 months of failing to conceive, we stopped focusing on the calendar so much and just had sex when we felt like it. Now there were a few possible dates that cycle, I admit, but I think the one that got the job done was about three weeks after LMP. Further evidence for this was the fact that I took a digital HPT on the day I expected my period, and it came up negative. A week later it was positive. I figure I was too early for the pregnancy to be detected the first time. I know the luteal phase isn’t supposed to vary much, but if my follicular phase is a tad longer than average, and my luteal phase is on the shorter end of normal, this could result in day 20 ovulation, rather than day 14, which would explain the consistent 6 day discrepancy.

          • Amy Tuteur, MD

            None of that is objective evidence. As far as I can tell, there is no objective evidence that you ovulate 6 days late. Your doctor didn’t believe you because there is no objective reason to believe you.

            Indeed, you have to invoke two different ovulation problems in order to explain it, making it very unlikely.

            You think you ovulate on day 20, but nothing you have presented supports that, so you are almost certainly wrong. That’s why she didn’t believe you and why no other gynecologist is likely to change your dates based on what you believe.

          • me

            Why am I almost certainly wrong? Why is knowing the day we had sex (the only date in the cycles in question) not “objective”? How is it that a 19-20 day follicular phase and a 12 day luteal phase (both within the bounds of normal ranges) are considered “ovulation problems”?

            I do appreciate your taking the time to review the facts here. I would like more explanation as to why you are so certain I am wrong. Thank you for taking the time to explain this to me!

          • Amy Tuteur, MD

            The average follicular phase is 14 days and the average luteal phase is 14 days. Variations in length of the follicular phase are common. Variations in the length of the luteal phase are unusual. Variations in both at the same time are rare.

            It is hardly surprising that you must present objective evidence in order to make a diagnosis of a rare phenomenon. Objective evidence would include OPK results, temperature charting, hormone levels, etc. You don’t have any objective evidence for your claim.

            If you are correct, it will be easy to prove it. Use OPK kits for a few cycles and pinpoint exactly when you ovulate. I suspect that you will be surprised.

          • me

            Well, we don’t plan on having any more children, and I just got my first PP period this month (breastfeeding), so it will take a few cycles to get regular again. But it would be interesting to try that. I just have a hard time believing I conceived my first child on day 14 (or day 18 for that matter) considering my husband didn’t return home from his trip until day 21 and eggs only live 12-24 hours. Can you explain how I conceived his child on day 14 (or even day 18) when he didn’t return from his three week trip until day 21? Same goes for child #3; we had sex the evening of day 20… if I had ovulated on day 18 the egg would have been dead by day 20. I’m not sure how uncommon it is to have a 32 day cycle (from what I understand cycles up to 35 days are “normal”), or how uncommon to is to have a 12 day luteal phase (from what I understand 12-16 days is still considered “normal”). It is extremely normal, expected really, to see variation in the follicular phase. So I’m not sure how “rare” these “phenomenons” are. Nothing I’ve seen suggests that anything about my cycles it outside the realm of “normal” ranges. Can you link me to further information?

          • Amy Tuteur, MD

            The problem is that women make mistakes all the time about when they had sex and some women lie about it, too (if they are cheating). No doctor could rely on that alone when diagnosing a rare phenomenon.

            Like I said, it is not impossible that you have both a prolonged follicular phase and a shortened luteal phase, but you can’t expect a doctor to reach that conclusion in the absence of objective evidence.

          • me

            Okay, that’s fair enough. And I was aware enough that women claim to know when they conceived all the time and end up being wrong about it, so I didn’t even bring that up to her (not that she gave me the opportunity to, but I digress). What I tried to point out to her (but she cut me off) was that all three early u/s said the same thing, and that was a little too “coincidental” for me. The first two times, okay, coincidence. But when the early u/s w/ #3 put my edd the same 6 days later than LMP as the first two kids, well, let’s just say I told people (including my CNM and the kids’ pediatrician) ‘my due date is May 18, but this will be a June 1 baby’. Guess who just had her 1st b-day 16 days ago ;)

            Maybe if I had charted and could have presented that to the doc she would have considered that info, but the way she cut e off and talked over me, I kinda doubt it…

          • fiftyfifty1

            I think the whole point is that you were not the person in the situation with the most to lose. That person was your baby :-(

          • me

            Um, out of the two capable of discussing options and making decisions..But I see you’re still being deliberately obtuse…

          • me

            Um, I never said that. You are misquoting me (deliberately), then arguing against something I never said. I believe that is straw man fallacy. As for cherry picking out of context, please elaborate.

          • Expat in Germany

            paraphrasing, I should’ve used brackets. fiftyfifty mentioned it above: your problem was post dates, you were quoting statements pertaining to early induction for macrosomia.

          • m

            She brought up macrosomia as a reason I should have induced. I offered a link to a statement by the AAFP that states that suspected macrosomia (which my third child didn’t have and was never suspected of anyway) is not a reason to induce. That’s all.

          • Expat in Germany

            I’ll rephrase, your problem was post dates with over 9 lb babies and you picked out statements pertaining only to pre 40 week induction for macrosomia to defend your choice to not get induced prior to 42 weeks plus however many days. You can’t separate things like that.

          • me

            Only one of my children was over 9 lbs, and only by 2 oz. Late u/s weight estimate did not reveal her actual weight, she was est. to be about 8.5 lbs. We were all a tad surprised when she was weighed at birth. At any rate, I had no difficulties in delivering her, and, at a first trimester prenatal with my 3rd child, we had no reason to suspect macrosomia (was much too early to even think about it). We absolutely discussed the fact that there would have to be tests of fetal well being (part of which includes BPP, which obviously involves u/s) and had that revealed a “suspected macrosomic baby” I’m sure this would have been considered in deciding on treatment options. At any rate, my third child was nearly a lb smaller than my second and nowhere near macrosomic, no matter what definition you choose to use. The ironic thing, my second L&D, with my “huge” baby, was the easiest and least painful of the three. But that is neither here nor there.

          • fiftyfifty1

            No, I brought up your DATES as a reason to induce. One of the dangers, as Captain Obvious pointed out, of going past your due date is that it increases risk of having a macrosomic baby, among many other risks. For example, a 9#3oz baby (similar in size to your second) has about a 10% chance of having shoulder dystocia, and just because you birth one macrosomic baby fine doesn’t mean the next won’t have dystocia, it depends on the angle of the shoulders when baby comes down. You had felt that going to 42 weeks had shown no ill effects on your babies, but that was not true and I was pointing that out. Inducing to avoid the risks of going *overdue* is a totally different issue than a *predates* induction for suspected macrosomia. Conflating the two showcases your ignorance. You are unable to even interpret the guidelines you link to!

          • me

            Fair enough. I wasn’t sure what you were getting at before. Yes, child #2 met one of the two definitions of macrosomic. Had #3 been suspected macrosomic, I am reasonably sure the CNMs would have wanted to induce me sooner. Tho without a time machine, I can’t say with certainty. As it stood, she was a full lb smaller than her older sister, nowhere near macrosomic, so it’s kind of a moot point.

          • me

            There was benefit to me. I never claimed there was benefit to the baby. The risk to the baby was small, the benefit to me was, IMO, enough to offset that small risk. I’m not advocating that every woman who finds themselves 41 w pregnant do what I did (as I’ve clearly stated numerous times in this thread). I shared my story only to demonstrate that the doom and gloom and hysteria being thrown around here is a tad ridiculous – the vast majority of pregnancies that exceed the due date will result in uncomplicated deliveries of healthy children. I never said my choice was superior to any one else’s. Only that it was the right choice for me.

          • Expat in Germany

            It was the right choice for you because you had irrational beliefs (beliefs based on no evidence) about how painful induction would be relative to waiting for labor to start naturally until 43 weeks 3 days. You irrationally thought that there was a benefit here. You also had innaccurate beliefs about how well you and your doctor know when you ovulated.

          • Guestll

            Except there are demonstrable advantages to waiting to have children.

            There are no demonstrable advantages to waiting until 42+3 for induction.

            FWIW, I was almost (try not to clutch your pearls too hard) 40 when I had my first child. Delaying childbirth was a decision that I made, and I own it. I also went to 41+5 before agreeing to induction. That was also a decision I own, except unlike the former, it’s one that I regret. I also passed NST/BPPs with flying colours, had zero issues (other than NVP) during my pregnancy, and my daughter was born healthy.

            With dry skin, long nails, a skinny, long body, no vernix, and a placenta that was giving up the ghost.

          • me

            Well, see now, you regret it because your daughter had obvious signs of postmaturity (which is a separate diagnosis than simply being postterm, just as being premature is different than being preterm). All three of my children were born with plenty of vernix, nice and plump, not much lanugo left, but some, and the placentas all looked wonderful, no signs of calcification. Had my first child been born at 42+1 with signs of postmaturity, obviously I wouldn’t have been willing to wait so long with numbers 2 or 3. And while you don’t see an advantage to waiting for labor to begin on its own, I certainly did. I won’t go into all my reasoning (two reasons -first, exercises in futilty hold no appeal to me and no matter what I share I know you all will minimize and trivialize and oversimplify to the point of absurdity, so why bang my head against the brick wall; and second the only opinions other than my own that matter here are my husband’s and my HCP’s and they both understood and respected my reasons for waiting, so I don’t feel like I need the approval of random broads on the internet that weren’t there and had no stake in the situation), however, to me the risks of waiting seemed reasonable in light of the alternative. I feel I made the right choice. For me. I don’t expect others to necessarily agree, much less make the same choice, however there was nothing irresponsible in what I did. And I resent the histrionics you all are engaging in. The vast, vast majority of pregnancy that exceed the EDD (even by more than a week) end up with no complications and healthy babies. Yes, the risks are somewhat elevated, but not so much as to make it as risky as you all are presenting it to be.

          • Lizzie Dee

            Not sure that your first fact is accurate. Some risks may increase with age, and in nature stillbirth might be one of them. Don’t have any figures at my disposal, but one thing I rapidly Googled said that used to be the case, but with improved care isn’t anymore.

            The issue here is whether putting off
            children until you are past forty and putting off having an induction are the same kind of decisions – which they are not. I think quite a lot of mothers find themselves older rather than actively choosing for it to be that way. Both have risks, and people are entitled to make their own decisions about reactions to those risks and ways of managing them. I think what most of us have trouble with is the denying that there was a risk – because it turned out OK for you.

            My daughter was induced at 35 weeks because of pre-e getting out of control. I am pretty sure her body wasn’t ready to go into labour, and I was apprehensive for her and her baby. It went well and quickly. in the middle of all sorts of risks. Bad things DON’T happen most of the time, but when they do having taken avoidable risks must get tough.

          • me

            I do believe the improved care includes inducing between 39 and 40 w, at the point that the rate of stillbirth is at its lowest.

            And I never denied that there was a risk (please point out where I said there wasn’t). I said it is a small risk (it is) and one I was willing to accept. I realize not everyone is willing to accept it. Mainly I was responding to the hysteria – all the doom and gloom and the notion that it’s some big, devious, horrendous risk to be monitored carefully and wait until 42 w to be induced. In one of my very first posts, I absolutely mentioned that we weren’t planning on waiting forever (there were clear “deadlines” all three times), and I absolutely agree that a pregnancy that exceeds 41 weeks should not be delivered outside the hospital (help is too far away). How that turns into me being some kind of stunt-birther who only waited “so long” to impress other people, I’m not sure…

          • fiftyfifty1

            One of your plans included waiting until 42+3 to be induced, another 42+2. This is indeed stuntbirth territory, especially considering your history of macrosomic baby.

          • me

            Um, 9lbs 2 oz is not macrosomic for a non-GD. It’s awfully close, but not quite. And there was no difficulty in delivering her (slight tearing (2 stitches), no SD, no excessive bleeding, much less PPH). Now, it depends on which definition you use, but most large cohort studies use 9 lb 4 oz (or larger) as the cutoff for macrosomia.

            Besides:

            http://www.aafp.org/afp/2001/0701/p169.html

            “Suspected fetal macrosomia
            is not an indication for induction of labor, because induction does not
            improve maternal or fetal outcomes.

            Labor and vaginal delivery
            are not contraindicated for women with estimated fetal weights up to
            5,000 g in the absence of maternal diabetes.”

            So even if my child had met the definition of “macrosomic”, induction is still not indicated, and a TOL is not contraindicated up to over 11 lbs, per ACOG. She was nowhere near 11 lbs.

            As for going two or three days postterm being “stuntbirth”, please link me to the ACOG policy statement that states that no woman should ever, under any circumstances be “allowed” to go beyond 42 weeks. TIA! (but I won’t be holding my breath)

          • fiftyfifty1

            The definition of macrosomia is independent of GDM status
            and is defined at greater than 4000g (8lb 13 oz). It is associated with a
            number of risks to mother and baby. Going overdue is a well established cause.

            So let’s translate what you did into a non-medical scenario:

            You are travelling in your car with your baby strapped in
            her carseat and are stopped at the head of a bridge by a structural engineer:

            Engineer: Warning, we have studied this bridge and I have
            found it has a 1/500 chance of collapsing with each car that goes over it.
            Therefore I am going to re-route you on a detour to your destination.

            You: But the last time I went over this bridge it didn’t
            collapse, so it won’t this time either. Besides, the last time I passed over,
            the engineer didn’t seem to think it was
            so risky.

            E: We have new data since the last time you passed over that show the risks are higher than anyone
            realized. You were lucky last time. This time you might not be. Also, the last
            time you crossed, the bridged really groaned (i.e. macrosomic baby), that makes
            me even more worried about collapse.

            You: That noise didn’t seem like a groan to me, I’ll make up
            my own definition of a groan thank you very much! Besides, many members in my
            family have crossed this bridge safely, so it’s not as risky for those of us in
            my family.

            E: No the 1/500 risk applies to everybody. Please just take
            to detour!

            You: I don’t wanna take the detour!! It’s not as pretty and
            it takes longer! And I planned on getting some pictures at the scenic overlook
            to show my friends so they will know how awesome my trips are!

            E: Please, it’s not worth it! It’s a 1/500 risk.

            You: The overall risk may be 1/500, but you don’t seem to
            understand that *I’m* going to be one of the lucky 499/500. Besides, even if
            the car does collapse into the river, I know how to swim.

            E: But your baby CAN’T swim and is helpless strapped in the
            back!

            You: No wonder American kids suffer from anxiety disorders
            with people like you around! If you won’t let me cross, I’ll find somebody with
            LESS expertise than you that says it’s fine. Look, here’s a draftsman (CNM) who
            says “Yeah, it’s risky but I can’t stop you so go ahead”. And to REALLY show
            you, I’m going to strap even some EXTRA weights onto my car (go to 42 +3) to
            PROVE to you how stupid all your fear-mongering was….See, I did it! I was right
            and you were wrong and I have the scenic pictures from the overlook to prove
            it!

          • me

            Um, I didn’t make up the definition of macrosomia. There are two definitions that get thrown around, and while my middle child met one of the definitions, she did not meet the other. And there were no complications related to her size (no complications at all). I provided a link for where I was getting my stats. Not sure why you are accusing me of making anything up. Accuse the AAFP (who got their info direct from the ACOG) if you will, but I made up nothing.

            I notice you cannot find the ACOG policy that dictates mandatory 41 week induction for all women regardless of circumstance. You can make up fanciful hyperbole all you like, put your research where you mouth is. Show. Me . The. Policy. I’ve provided you with links demonstrating that, while the action does carry an elevated risk, the ACOG does allow for expectant management of postterm pregnancies. If you have access to something that contradicts that, I’d be happy to look it over.

            As for the CNM saying, “I can’t stop you”, well, stop making things up. I discussed postterm pregnancy in the first trimester. Had she thought it was such a dangerous endeavor, she had plenty of time to counsel me against it. She never tried…

          • me

            Question about your amusing example: If the risk is 1/500 for each average mid-sized sedan that passes over the bridge, but I’m on a bicycle, therefore decreasing my risk, but the engineer refuses to consider that fact, does that change anything?

            I ask because all three times early u/s put my EDD 6 days past what LMP put it as. I doubt that’s coincidence. If you use the u/s EDD I was only 41+1 with my 2nd and 3rd children at delivery. Is 41+1 stuntbirth?

          • Expat in Germany

            you are not on a bicycle. that is called delusion. and you are changing your story, now you were 41 weeks and not over 42 weeks? early ultrasound has an error of plus minus a week.

          • me

            I’m not crossing a bridge either… it’s called an analogy ;)

            I stated in my second or third post that early u/s with all three of my pregnancies put the EDD exactly 6 days past what LMP put it at. The OB I fired refused to consider that, as do all of you. I didn’t change my story – I laid out the facts in the first couple of posts. Whether you chose to actually read them or not is out of my hands. Yes, 6 days is within the margin of error, but that, combined with what I shared about my cycles, should have at least been considered. And it was, but not by the OB whose practice I left.

          • Expat in Germany

            nobody wants to argue about a misunderstanding with an OB, it is your statements about general rules for post dates that everybody takes issue with. Maybe your OB just had a policy of staying on the safe side (whatever is later U/S or LMP). If he induced you at 41 weeks per LMP, and you were really at 40 weeks per ultrasound, all was optimal. If he listens to you and has a policy of going to 42 weeks and your egg didn’t drop when you thought it did, he could accidentally end up letting you go to 43 weeks by inducing you at 42 weeks. He didn’t want to take that risk, and I don’t blame him. It wasn’t like he was going to induce at 40 weeks when you were really 39.
            Since the thread is long and the important stuff got buried at the end, I’ll summarize: nothing good happens after 40 weeks for the baby and somebody cited something that showed that c section rates actually go down if you induce earlier rather than later (42 weeks), so nothing good happens for the mom either.

          • Expat in Germany

            I checked your earlier posts and you are changing your story. You wrote, and I quote “And yes, I was sure of my dates”.

          • me

            I was sure of my LMP (what I meant by ‘my dates”). I have been keeping track since June 20, 1991. ;)

            But LMP isn’t always the most accurate measure. When you have something that might be more accurate, why ignore it offhand? Especially when it showed LMP might have been “off” by the exact same number of days each and every pregnancy? Seems a little too consistent to be coincidence. That is what I meant by my “personal history”; not just that I had gone “overdue” before without incident (tho that is part of my personal history as well and should be considered), but also what my previous early u/s’s said. Sorry if that wasn’t clear. Offically, since they “couldn’t” change the date, I was 42 weeks. Unofficially, based on u/s and what I knew about my cycles (and tried to tell the OB I fired, but was summarily ignored) I was likely 6 days earlier than 42 weeks.

          • Expat in Germany

            none of this was implied in your initial posts. I re read them. (I’m starting to get the feeling that commenting is like a video game for people who like to play with words)

          • me

            From my second post (which was elaborating on why I personally felt comfortable going 42 w past LMP):

            “Personally, I think I just ovulate a little later in my cycles than average (I do have somewhat longer cycles than average, but not long enough for them to change the wheel of when).

            With all three the u/s put the due date 6 days past what the wheel of when said, but still within the margin of error so they didn’t want to change
            the EDD. That all being said – I switched providers because none of this apparently made a difference to her…” {“her” here being the OB I fired}

            Really? None of that was implied in my initial posts? Cuz it seems to me that you’re right. It wasn’t implied. It was **flat out stated in black and white**. No implications necessary. But you would have to actually take the time to read what I wrote… I feel like reading comprehension is somewhat selective around here.

          • Expat in Germany

            You are right, you didn’t change your story, the thread got split and this shows up at the very end. But even if you know your cycles backwards and forwards, there is still about a week’s worth of uncertainty in both ultrasound and guessing when ovulation occured. Your doc may have just had a policy of staying on the safe side and choosing whichever date was earlier (if they are within a week of one another), knowing that with a 41 week induction policy, she wouldn’t end up inducing anyone earlier than 40 weeks. And that is optimal, because nothing good happens after 40 weeks for the mom or the baby. C section risk goes up. Stillbirth risk goes up. If she took your advice, there was a chance that she might have induced you at 43 weeks.

          • Lizzie Dee

            I think the reason your post has got the reception it has is that your point about uncertain due dates got lost in your insistence that others overreact to the risk. It came across a bit as “There may be a risk, but I am different, it isn’t much of a risk anyway, and you are all being ridiculous.”

            It is news to me that doctors sometimes reject u/s dating – and I remember belatedly that this was a factor in my own problems – the opposite to yours, because my daughter needed to come out early to avoid stillbirth.

            Is assessing risk ever more than optimistic or pessimistic guesswork, though? When my other daughter turned out to be GBS+ I found the statistics quite reassuring, but she would furiously ask me if I could guarantee she would not be the one on the wrong side, and absolutely refuse to be consoled. I took a large risk consciously in having a second child. Was I being selfish or irresponsible? Well yes, maybe – but they don’t seem to be quite the right words. You took a risk but minimised the best way you could, and so did I. The selfish tag belongs to those who deny the risks or exacerbate them perhaps, but NCB encourages that, advocates for it. I’d go for foolish rather than selfish, and the 1 in 500 who ALSO believed that they would be fireproof pays such a high price. We all dodge bullets and attributing it to superior wisdom can be provocative not to mention wrong.

            Doctors are guessing, too – and I would rather have a pessimist than an optimist myself. In your case and in mine, uncertainty over dates complicated matters. Turned out OK for you, not for me.

          • fiftyfifty1

            So why are you linking me to a Family Practice paper from 2001 that focusses on early induction for suspected macrosomia? This is not the relevant issue in your case. The OB you fired was not discussing inducing you for macrosomia. You weren’t far enough along to even be macrosomic at that point. She was discussing her policy for postdates management of labor. Going past 41 weeks has been clearly shown to increase risk of of C-section and doubles risk of meconium. But you didn’t care. For you those risks didn’t matter apparently. The 1/500 risk didn’t bother you either. You were comfortable going even to 42+3. You have declined to tell us your reasons for refusing timely induction;you feel they are between you and your husband.That is your right. And each and every woman in the United States also has the right to refuse any piece of pregnancy care that her little heart desires. Nobody but you is the boss of you! And that’s the way it needs to be legally. But you seem to think this audience should agree that your choices were good scientific ones, when all of us versed in the literature know they were not. Nobody outside of NCB circles is going to praise you for your petulance.

          • me

            “So why are you linking me to a Family Practice paper from 2001 that focusses on early induction for suspected macrosomia?”

            Um, because you mentioned macrosomia.

            “But you didn’t care.”

            According to you. Certainly I cared. Had I not cared I would have fudged my LMP date. Or refused prenatal tests of fetal well being. I did care. I also felt I wasn’t as far along as LMP suggested, had information that backed that up, but the OB didn’t want to consider it. The CNM was willing to consider it, and while she couldn’t “officially” change my EDD, the u/s EDD was at least a factor she considered in making decisions. I did mention that it wasn’t just the OB’s policy, it was that, coupled with the abject refusal to consider all the data available.

            ” But you seem to think this audience should agree that your choices were
            good scientific ones, when all of us versed in the literature know they
            were not.”

            I’m not looking for approval or praise (the only people who need to be happy and comfortable with my decisions were myself and my husband). What prompted me to share my story in the first place was all the hysteria I saw here surrounding pregnancies that exceed 40 weeks, when the vast majority of the time, things turn out perfectly well. I realize now that you all don’t want to hear the stories that end uneventfully. It’s easier to scare people when you blow risks out of proportion.

            The lactivists do that too…

          • Clarissa Darling

            “the lactivists do this too”

            Except that there is not a 1/500 chance that my child’s life would be threatened by feeding them formula. You made a choice that put your baby at risk. A small risk I will give you that but, logically
            speaking, even the smallest of risks is not justified if there is no benefit to outweigh it. I could take an over the counter pain pill even if I don’t have any pain and say “oh but the risk of side effects was so miniscule that it it’s not a big deal”. It would still be illogical for me to take a pain reliever to alleviate pain that I don’t have. The size of the risk is not the point. The point is that the risk is there and the benefit is not. Since you have not explained what benefit there was (other than to say that you personally perceived there was a benefit which is not the same as there being a measurable or proven benefit) you cannot expect people to accept that you made a sound
            decision.

            Of course people have the legal and ethical right to make medical decisions for themselves, even if their choices are risky or illogical. But, you seem to want people to accept that your choice was sound and logical as evidenced by your multiple arguments
            and data that you are providing to try and back up these arguments. If it is really enough for you that you and your husband made the choice you thought was best, then why not just leave it at that? You don’t need to provide backup data and evidence for a choice that you don’t care to explain or justify to others. However, if you do want to convince anyone that your choice was logical and well thought out, you are going to need to discuss the specific benefits (whether real or perceived) that you found outweighed the risk you took. Otherwise, the entire discussion is one sided and pointless.

          • me

            Wow! A reasonable response :) You’re absolutely right, a small risk without corresponding benefit is illogical. I saw benefit in being allowed the opportunity to go into labor spontaneously. I know my reasons will be poo-pooed and belittled without sharing them, as the majority here seem to think any consequence short of death is irrelevant, so I decline to participate, as I didn’t think I would die had I been induced. The data and arguments I have presented were only to show that my actions, and those of my care providers, were not outside the realm of what the “authorities” or the science say is acceptable care for postterm pregnancies. I suppose at this point we will have to agree to disagree about whether my choices were reasonable. My only other point (really my main point) is that the hysteria over postterm pregnancy (likening it to dodging bullets or throwing babies off cliffs or other “stuntbirth” practices that carry far and away more risk) is ridiculous. Only my opinion, so again, I suppose we’ll have to agree to disagree.

            I do appreciate your reasonable, respectful, response tho!

          • fiftyfifty1

            Are the moms of MADD also in hysterics? What you did was statistically
            much riskier than drunk driving. Maybe instead of outlawing drunk driving they
            should take a more individualized approach. Like if a woman has driven drunk
            once or twice before without incident, she should get a pass…or maybe if there
            are a bunch of people in her family who have made it home safely while drunk
            then she should get a pass. I mean, maybe she’s a really good driver all things
            considered! She had her reasons for not calling a cab! How unfair of those
            hysterical MADD mothers! What total sanctimonious bitches!

          • me

            No. But they should test her BAC before convicting her, dear.

          • me

            Wanted to add: When someone is accused of a crime (like DUI) they are entitled to:

            A trial (often before a jury of their peers)

            Legal representation

            To face their accuser and have their side of the story represented

            Be presumed innocent until proven guilty beyond a reasonable doubt

            To appeal

            To have the judge consider any extenuating circumstances prior to sentencing

            The way I see it, this OB wanted to be judge, jury and executioner, wanted to ignore any reasonable doubt, and not offer me any means of even presenting my case, much less appealing her decision.

            And, actually, yeah, the moms of MADD are also in hysterics, and have gone way too far in recent years. Even the founder of the organization, Candy Lightner, has broken ties with them, stating:

            “[MADD] has become far more neo-prohibitionist than I had ever wanted or
            envisioned … I didn’t start MADD to deal with alcohol. I started MADD to
            deal with the issue of drunk driving.” (Washington Times, 2002)

            But I don’t think you really thought thru that analogy either….

          • Eddie

            I hope you understand that the reason OBs object to going post-date is that they deliver enough babies that they are guaranteed to see the extra deaths if they routinely allow their patients to go post-date. Depending on her age when she starts, a midwife may not deliver enough babies in her life to statistically see the difference. An individual mother certainly will not, she’ll either be lucky or unlucky. I can understand an individual being willing to take the risk (as long as they are monitored closely enough). I can also understand an OB not wanting to go there, because she or he knows that the increased risk is high enough that s/he will otherwise see more stillbirths, given how many babies they deliver.

            Even if you don’t include that the OB can get sued if the baby dies, even if the mother refused induction.

            How often have we heard stories reported here where a doctor or nurse started to cry when reporting bad news?

            About an older mother vs a post-date mother … as Lizzie said, they are not equivalent choices. I get your point, that there are a variety of things that add to risk, and that they are not all treated identically even when they add the same level of risk. But not all choices are created equal.

            Society judges the fairly low risk of death from drunk driving pretty severely. The same with the risk of texting while driving. There are plenty of things drivers do that increase their risk, and these things are not treated the same. Maybe it’s not even fair in some cases. But not all choices are equal.

          • me

            I’ve said it before, and I’ll repeat it here: I understand that OBs and CNMs must make their own decisions wrt what they are comfortable with, be it going to 42 weeks, VBACs, TOL for twins/breach, etc. I’m not opposed to a doctor/mw saying “that’s not something I do”. But own it and be honest about it. My former GYN’s policy on induction was partly what led me to find a new provider; the greater issue was her refusal to look at the facts of my individual case, including her own u/s data. I guess I could have fudged my dates, but I’d rather find a provider willing to “give me” that extra week, than be a liar. I mean, had I lied about my dates and, god forbid, anything had gone wrong, maybe they wouldn’t have been so prepared and who knows what harm may have come from that. As it stood, knowing I was 42 weeks, I was carefully monitored before and during labor, and everyone was prepared for the possible risks. that seems safer to me.

          • me

            “I hope you understand that the reason OBs object to going post-date is
            that they deliver enough babies that they are guaranteed to see the
            extra deaths if they routinely allow their patients to go post-date.”

            I kinda wanted to address this, because on the surface it seems a legitimate reason to have a ‘induce ‘em all at 41′ policy, but let’s do the math:

            Historically, only about 10% of pregnancies go to 42 weeks in the first place. With early u/s dating that number drops to about 3%. Let’s call it 5% for the sake of argument. If an OB attends 1000 deliveries a year that means about 50 patients each year would potentially get to 42 weeks. If all of them opt to wait until 42 weeks to see if labor will begin on its own, that means that OB would see 1 extra stillbirth in 10 years attributable to 42 week induction policy. And let’s face it, the majority of that 5% will opt NOT to wait (most women begin asking about induction much earlier than that and would not be willing to wait and see). So maybe the real number would be closer to 1%. That’s about 10 patients/year, in which case it would take 50 years, attending 1000 births per year, before a given OB would see that policy bite him/her in the ass.

            Now don’t get me wrong, losing a patient (especially a young patient or a baby) is devastating. And I understand why some OBs don’t want to lose a single extra baby in their career. I really do get it. But let’s not pretend having a ‘we can give you to 42 weeks if you remain low risk and pass tests of fetal well being, and if you *want* the extra time’ policy would leave babies dropping like flies in any given OB’s practice.

          • Amy Tuteur, MD

            The problem with your “reasoning” is that you assume (incorrectly) that the only disasters that an obstetrician sees are those of her own patients. Most obstetricians attend morbidity and mortality conferences that review every potentially preventable bad outcome. That’s one of the greatest strengths of obstetrics vs. midwifery.

            For example, when I was in practice, I didn’t merely see the bad outcomes for the patients I delivered. I also learned about and attempted to understand the bad outcomes of every one of the nearly 10,000 women who delivered in the hospital that year.

            The death of any term baby from preventable causes is a major disaster and all obstetricians in that hospital will know about it. In contrast to homebirth midwives and homebirth advocates, obstetricians NEVER dismiss the death of a baby by insisting that “some babies” die.

          • me

            Okay, and that’s a valid statement. I’m not sure why you bring up HB midwives to me, I’ve never considered HB and I believe women should be risked out of HB (assuming they can meet all the other requirements, which in the US would be next to impossible anyway) if they exceed 41 weeks.

            Like I said, I get that OBs want to minimize the stillbirth rate. I really do. Do you get that we are talking about a small risk impacting a small subset of pregnant women? Do you advocate denying informed consent to these women? Since you seem better than that, I will assume you understand that it is unethical to force a patient to undergo an induction against their consent. I didn’t spring my preferences on this OB at my 40 week visit. I asked early on so that we would both have time to “fire” each other if we didn’t see eye to eye. I then sought out a second opinion and found a provider at a more qualified hospital that would be agreeable to a less aggressive post-term management style. Did I take a risk? Yes. I was aware of the risks. Maybe I’m not as risk averse as many here, and that’s okay. But using histrionic language and telling me I’m a stunt birther who dodged a bullet, well, save the hysterics for a situation where it is warranted (like the 43 weeker who insists on delivering at home without being monitored).

          • Amy Tuteur, MD

            Do you get that obstetricians treat each woman as an individual and therefore are not particularly comforted by the notion that “most women” won’t have a specific complication? I don’t think you get it at all.

            You have absolutely no idea of the risks you took or the risks that any woman is taking. That’s fine except for the fact that you think you know what you are talking about when you literally have no idea.

          • me

            “Do you get that obstetricians treat each woman as an individual and
            therefore are not particularly comforted by the notion that “most women”
            won’t have a specific complication?”

            They do? Because mine sure as hell didn’t. (TIC – I am certain most OBs and CNMs for that matter, do look at the individual and consider all the data they have, however the OB I fired simply refused to do so. Which is a hige reason why I sought out a different provider.)

          • me

            “hige” should be “huge”

          • Expat in Germany

            “this ob wanted to be judge, jury, and executioner.. not even letting me present my case” was pretty inane. Your persistent argumentativeness and I know better attitude evidenced by this thread made it pretty obvious why any ob would not want to -hear you out-. So you found a CNM who was happy to pat you on your head and say, “whatever you want, dear”. Maybe she did it because she didn’t want to see another mom slip further down the risk spectrum and into the arms of the lunatics waiting on the other end. I have a CNM friend who regularly gets presented with “research” by her patients and has learned how to nod and smile.

          • me

            LOL. Yes because as we all know people always act exactly the same way in anonymous online forums as they do in real life.

            Oh. Wait….

            Look, you don’t have to believe me. If I thought I “knew better”, why would I consent to an early u/s in the first place? Why not just fudge my LMP date and make sure it remains a non-issue?

            The reality is I’m extremely non-confrontational IRL. When I started to say something about the two previous pregnancies having u/s’s that were off by the same number of days and she interrupted me, I spent the rest of the appt with my jaw open. I could tell from her demeanor and attitude that she was not going to listen, much less consider, *anything* I might say about it, so rather than get into a debate (which, IRL, I am very uncomfortable with and would never do) I ‘took my ball and went home’.

            I found a CNM (actually a practice of 9 CNMs affiliated with a nationally recognized teaching hospital, but who’s counting) who listened to my concerns and explained *why* they couldn’t change the EDD, but who was also willing to see how things went and give me options. I never presented her with any research… I merely asked what their postdates policy was, and she told me that, while they prefer to deliver by 41 weeks, if tests of fetal well being are reassuring and mom prefers to wait, they let her wait. I didn’t need to defend my position – her policy was in line with what I wanted to do in the first place. But I’m sorry that’s so hard for you to believe.

          • Expat in Germany

            my ob got stern with me when I was being all paranoid about cholestasis. It is part of their job. Everyone reacts differently.

          • me

            Um… I asked her “I have two previous pregnancies that went to 42 weeks. How do you usually handle pregnancy past the due date?”

            She said, “I like to induce by the due date, but if you are still comfortable and the baby is doing well, I can give you until 41.”

            I then pointed out that the u/s put my EDD at May 24 (rather than LMP May 18) and started to say that my previous three had early u/s’s that gave the same kind of result wehn she cut me off and said, “We don’t change the due date unless it’s more than a week off. Nothing good happens after 40 weeks..blah blah blah” (I was too busy scraping my jaw off the floor at this point to do much more than stare, besides, I’m especially bad at confrontation while wearing a paper gown and a smile, so I went to find someone who would actually listen to me, not necessarily agree with me. Happily, I found someone that did both).

            My point being, I wasn’t at all confrontational, I just wanted to discuss something that might happen down the road. Maybe she was having a bad day. maybe she just witness a stillbirth postdates, or reviewed one and was feeling raw over it. Who knows. All I know is she was extremely unprofessional and she lost a patient over it (and that patient’s private insurance).

          • Expat in Germany

            like I said, everyone reacts differently. She sounded reasonable to me.

          • me

            Well, tone is difficult to convey in typeface. *What* she said wasn’t “unreasonable”. Cutting me off mid-sentence and getting all curt and snappy was unreasonable. Let’s not forget – this was at my 8 week visit. I was asking questions about a, at the time, hypothetical scenario. It was not an emergency. I hadn’t waited until 40 weeks to spring my history on her (then I could see drawing her ire). she really had the opportunity to do some patient education, but she was too busy alienating me by going all psycho-bitch. I don’t know if it was truly stupid (why would you deliberately alienate a patient at an early prenatal?), or if she was manipulating me (maybe she looked at my history and hoped I’d go elsewhere; 2 postdates pregnancies, one 9 lb baby…. maybe she just didn’t want to deal with that and took the opportunity to act like an unruly toddler in the hopes that I would go packing… if that’s the case, okay, she was incredible smart, lol). At any rate, I still don’t know what bug crawled up her butt and died, exactly. And I don’t care. Even if I hadn’t found a provider who would let me go to 42 weeks, anyone would have been better than her.

            When I compare that visit and her reaction to my first visit with the midwives, well, it’s night and day. I asked the same initial question, to which the CNM responded (and I’m paraphrasing, this was nearly two years ago): “The only “policy” we really have is that we don’t induce prior to 39 weeks without a medical indication. We typically induce by 41 weeks, but we have certainly had mothers who wanted more time, and so long as test of fetal well being are reassuring and there are no other concerns/complications we can go to 42″

            She then proceded to ask ME questions. Questions about my cycles, about my previous pregnancies and my previous deliveries, about the condition of my first two children at delivery. She ended up taking a MUCH more thorough history. My answers likely are what gave the midwifery practice more confidence that A. I likely wasn’t as far along as LMP would suggest, and B. while my previous pregnancies *might* have been postterm, the babies were not postmature and the placentas had continued to function well. And maybe that’s why these “rogue” midwives (lol) were willing to practice all “fast and loose” (double lol).

            As for me, I simply appreciated being spoken to like an adult and having my questions and concerns be taken seriously. I was also much more impressed with the thorough history the midwife took. Honestly, given the differences in the two hospitals, I was likely safer at 42 weeks at the hospital I ultimately delivered at than I would have been at any point at the smaller hospital… not that location has any bearing on stillbirth, but wrt other potential complications.

          • Amy Tuteur, MD

            How reasonable and respectful were you? It sounds like you were sure that you knew more than she did and you didn’t hide your contempt.

          • me

            I asked one question and began to ask a follow up when she cut me off. She effectively shut down the conversation at that point and I asked no further questions nor offered any further info (I didn’t see the point – I avoid arguing with crazy people).

            FWIW, I was aware that a study had come out after the birth of my second child and knew there was some evidence to suggest that inducing at 41w might be better, but I wanted to discuss it in terms of my case and what it meant for me. I was looking for a dialogue. I had concerns about the accuracy of LMP due date as well as concerns about the complications surrounding my first delivery and recovery. I know in this forum I haven’t been meek or mild ;) but IRL (especially when in a paper gown, lol) I really try to avoid confrontation. IDK why she jumped on my shit the way she did. I could throw around theories, but at the end of the day, I’ll never really know. What I do know is that the same questions, posed in the same tone and manner, did not offend the provider I switched to, in the least. So you can feel free to blame me for her over-the-top reaction, but I was there. I know how it went down. I still to this day wonder WTF happened.

          • Expat in Germany

            The way you are obsessing about this tells me that her treatment of you really upset you. You have some irrational ideological issues, but I’ll ignore that for now.:

            I had a similar reaction to someone who treated me in a contemptuous fashion after I had sent her information which challenged her beliefs. I felt bad and angry at her and I went to my sister to hear that I was right and that the contemptuous person was wrong, but instead she told me that I was out of line for arguing about something I shouldn’t have argued about (a friend’s choice to do a homebirth with untrained support in this case). I was sure that my correctness with respect to facts trumped any wrong with stepping on my friend’s beliefs. Regardless of who is right, what you need to deal with are the emotions, not the facts. My friend didn’t want to be challenged and neither did your ob. On that basis alone, you were out of line. If I was right or your OB was right is immaterial to the issue of the emotions.

          • me

            You are correct. It was very upsetting to me. As I said, I had never been treated that way by a doctor, had only heard stories of people who had. And it seemed so unwarranted; I had merely wanted to discuss my options should I go postdates. I didn’t march in with a chip on my shoulder looking for a fight. It was quite stunning to me that she responded the way she did.

            That being said, I wanted to address this, “My friend didn’t want to be challenged and neither did your ob. On that basis alone, you were out of line.”

            You challenging your friend’s “beliefs” is wholly different than my asking questions of my doctor about a medical situation that may impact my care. I would expect a friend to get pissy if/when they are “challenged” on their beliefs, especially if the person challenging them isn’t directly impacted by those beliefs; it’s a NOYB situation. A doctor, OTOH, should not only be able to accept being “challenged” (if you can even call it that), but should welcome the opportunity to answer questions, address concerns, and educate the patient about the risks and benefits for different treatment options. That’s their JOB.

            Your friend is right to tell you to mind your own business and go piss up a rope when you challenge her beliefs. The treatment proposed by my HCP *is* my business and I have a right, nay, an obligation, to ask questions and make sure I understand the proposed treatment plan. My doctor has an equal (if not greater) obligation to answer my questions and make sure I understand the proposed treatment plan.

            Apples and oranges. I just wonder, on what planet is it “out of line” for a patient to ask questions about their own healthcare? Really, wtf?

          • Expat in Germany

            It isn’t apples and oranges. You were challenging your ob’s belief in her authority when you pushed irrelevant information into her face and demanded a reaction. She had had enough of your unasked for information, just like my friend had had enough of my unasked for information. Culturally, maybe you are spoiled by the customer is always right atmosphere of consumer culture, but from your ob’s perspective, you were paying for her to interview you and to make a diagnosis, not for you to tell her a million irrelevant facts. Her time is expensive.

          • Expat in Germany

            the difference between how your ob reacted and how my friend reacted is telling. Your ob merely cut you off, professional. My friend lashed out and blocked me from her facebook.

          • me

            Lol. I love how you are framing it to suit your own argument. She “merely” cut me off, proceeded to rant like a lunatic, and it was very clear that she didn’t want to be asked any questions about anything. Your friend has no obligation to endure you being a buttinski. OTOH my doctor does have a moral and legal obligation to make sure she gets my informed consent. Which means I get to ask questions before I consent to treatment. Even if she finds that “insulting” or “inconvenient” or a huge waste of her own time. TS. It’s her job and she gets paid very well to do that job.

          • Expat in Germany

            what did she say in her rant exactly? after all of this time, I still have no idea! My friend called me nuts and proclaimed harrassment.

          • me

            At this point I would be paraphrasing, and as I said before it wasn’t merely what she said, but the tone with which she said it. I was so taken aback by her tone and the fact she interrupted me that I couldn’t tell you verbatim what she said. No, she didn’t call me names. But by the end she was practically yelling. It was very clear that she doesn’t take well to anyone questioning her decisions, at least that was my impression. And on the one hand I understand that a “mere” patient is waaaay down here and the good doctor is on some high-in-the-sky pedestal and should never have to explain their Decisions (well, not really, but I can see where someone might think that), the fact is, in medical decisions the patient has a right to have things explained to them in terms they can understand. If you think having to explain your decision to a lowly little patient is beneath Your Authority, then it’s time to get a job in a lab where the mice don’t ask questions.

          • Expat in Germany

            you didn’t write what she said, just about her tone.

          • me

            This was nearly two years ago. I remember some of what she said, but I’d be lying if I said I remembered all of it. I remember being too shocked to even become angry, until I got home and related it to my husband, lol. I don’t recall her calling me names or using any profanity. Again, sometimes is not what is said but how it is said. And, no, I’m not some delicate flower either. Her tone and manner were nasty enough to knock a buzzard off a shit wagon. Totally uncalled for.

            Besides, I’m smart enough to know that even if I told you she dropped several f-bombs and accused me of being an idiot who didn’t want my child to live, you’d still claim not to see anything unreasonable in what she said ;)

          • Expat in Germany

            whatever.

          • me

            :)

          • Expat in Germany

            and if my friend had called me nuts and harassing after I had told her that I was pregnant and upset over some traumatic birth related coordination problems that were becoming apparent in my son, you would still think she was reasonable. Sometimes both parties are out of line. You stepped on your OB’s toes and I stepped on my friend’s toes by telling her that my son wouldn’t have lived if I had chosen a non-hospital birth, as I almost did.

          • Expat in Germany

            to complete the thought, the difference between the two scenarios is that you were trying to convince someone to take on more risk for a baby and I was doing the opposite.

          • me

            Two things: I don’t know the full details of what beliefs your friend held that you were challenging, so I could only respond to the generic info you gave me (for all I knew you were providing her with info about evolution being fact, because she believes in creationism). I don’t know enough of what transpired to say whether your friend was reasonable or not. But it’s irrelevant because they are two entirely different matters – you are not your friend’s doctor. What your friend does wrt her choices in childbirth do not directly impact you or your children. If she asks for your opinion or advice, that’s one thing. If not, it’s really NOYB.

            Second, You were trying to convince your friend of your beliefs. I was asking questions of my HCP to try to ascertain what the risks to my child really were. I wasn’t trying to change my providers mind…. it never got that far, and I wouldn’t bother even if it had. And that was a lot of what was so upsetting about it. I should be able to ask follow up questions. I should be able to ask for an explanation of a policy that might directly impact my care. I would think doctors would be 1. used to that, and 2. willing to educate the patient, as educated patients are generally more complaint. I was paying this doctor to answer my questions. Were you paying your friend to listen to you?

          • Expat in Germany

            I was not my friend’s doctor and you were not your doctor’s doctor. If your doctor asks for your opinion or advice, that is one thing, if not it is really NOYB. On the issue of payment and follow up questions, perhaps your meter had run out. I wasn’t even face to face with my friend. She could’ve just politely dropped out of the private conversation we were having on facebook, but your doctor couldn’t do that.

            “I wasn’t trying to change my doctor’s mind.. it never got that far” but clearly your doctor sensed that was the direction you were moving in and she stopped it.

          • me

            Oh. So now she’s psychic. Well, then she should have “sensed” that by bitching me out unnecessarily she would lose a patient. Cool. Then it obviously came as no surprise to her ;)

          • Lizzie Dee

            No. If she was rude and nasty and left you feeling really upset I’d see a lot wrong with it and find your search for a substitute reasonable But if she had told you she would not do what you wanted nicely, wouldn’t you still have been upset? I may have misunderstood, but your early posts implied that the risk you took was trivial. That isn’t the same as saying “I took a risk, but I had good reasons for doing it.”

            When I look back at the risks I ran with my second pregnancy, I think I took them far too lightly. Like you, it worked out OK – better than OK – but I wasn’t thinking all that clearly.

          • me

            “But if she had told you she would not do what you wanted nicely, wouldn’t you still have been upset?”

            That’s a good question. I honestly don’t know. I liked the idea of going to a hospital that was literally 8 minutes from my home (had to take DD#2 there for stitches once, it really is lovely to have an ER so close by!). Up to that point, I had liked this doctor. No, I didn’t *want* to be induced, and I suppose I wouldn’t have been “happy” to hear it exactly. I would have raised my concerns about induction as well as my concerns about the epidural complications I had had w/ DD#1. However, I was aware that as a multip (who by 41 w, based on LMP, had a “favorable” cervix) induction need not be as difficult or painful as it was as a primip with an unfavorable cervix. Anyway, short answer – I wouldn’t have been *as* upset, obviously. Would I have stayed with her? IDK. I’d love to tell that yes, I would have stayed with her, but I’m honestly not certain. I know I wouldn’t have gone home and immediately started checking out the other hospitals in the area and searching for other providers, lol. In some ways, I think her being an ass was a blessing – it did motivate me to put the better, safer hospital over the closer, more convenient one, and I do think that was a good move, no matter what.

            At any rate, we’re not planning more children. But if we lost our minds, lol, and decided on a 4th, I would definitely try charting or using OPKs to pinpoint the ovulation date more precisely and objectively. If it really is safer for me and my child to accept induction because I’m past 41 weeks, okay, I’ll deal with the fallout (if any). But if I’m not as far along as LMP suggests, well, I’d want to know that too. And moreover I’d want my HCPs to know that.

          • me

            Two problems with your argument: First, I didn’t “push” anything in her face. I began to inquire about the significance of having early u/s’s consistently put my EDD 6 days past LMP EDD when she cut me off. So, no I wasn’t challenging her “authority”. I was wanting more info about my healthcare. How could she have “had enough” of my “unasked for” info? She never gave me the opportunity to give her any info in the first place. That was the problem.

            Second, she has no authority over me. She has authority over her practice and herself and can choose to fire a patient who refuses whatever treatment plan/medications/surgeries she might suggest, but she does not have the authority to dictate what a patient does. That violates informed consent.

            As for her time being expensive: My insurance premiums are expensive too. And those 15 minutes belong to me. I wasn’t wasting her time or asking millions of questions (you deliberately misrepresent the situation). I was trying to make sure the informed part of informed consent was met before agreeing to a treatment plan. That is part of what she gets paid to do. And violating informed consent is not only unethical, it is illegal. She has a moral and legal obligation to answer my questions, even if they had been millions in number and totally irrelevant (which they weren’t, but I digress.

          • Expat in Germany

            I meant authority in a different sense.

          • me

            In what sense did you mean it?

          • Expat in Germany

            Like when a person “speaks from authority” they are speaking with a deep understanding of a topic.

          • me

            Okay. Maybe she took my asking a follow up question as a sign that I doubted her authority on the topic. I guess I’m used to doctors that seem to appreciate it when patients ask questions – a patient that understands their diagnosis and “gets” why the doc is recommending a certain course of treatment over another is much more likely to comply with doctor’s orders than one who doesn’t understand. I’d never encountered a doctor who seemed to think a patient asking a question was somehow questioning the doctor’s “authority” in any sense of the word. I don’t think this is very common at all. Quite the opposite.

          • Expat in Germany

            I think it is relatively common in obstetrics. Exhibit A: skepticalob.com

          • me

            ?? You think Dr Amy believes those who come to her website and ask questions are questioning her authority? (and I’m not talking the occasional NCB-nutter who thinks they know more than the doctor, I mean real people who have come here asking for more information about a topic Dr Amy has posted about or that is being discussed in the comments)

            I’m not following you…

          • Expat in Germany

            There is a whole spectrum from NCB nutter to lady who just got some wrong info off of the web (maybe you are an example of this) but OBs deal with that day in and day out. Since NCB and homebirth proponents base their entire industry on undermining doctors’ authority, it isn’t surprising that when an OB catches a whiff of it in the air, she tries to shut it down. Maybe she over reacted in your case but you didn’t show any understanding of her predicament either. She knew that with some people, the questions just keep coming and she didn’t want to have to explain the fine points of her reasoning because you weren’t in medical school.

          • me

            Fair enough. I think she over reacted (obviously). At the end of the day I found providers who were willing to listen to me and weren’t offended by the mere act of asking a couple of questions. I ended up having a wonderful, uncomplicated delivery and a healthy baby. She lost a patient. I guess we’re even ;)

          • Expat in Germany

            the skeptical ob is a reaction to those who question the expertise of doctors while trusting in quacks.

          • me

            Maybe you misunderstood what I meant. I’m not saying it’s uncommon for people to question the expertise of doctors; obviously that happens. I’m saying it is (IME, anyway) uncommon for doctors to interpret a patient asking a question as an affront to their expertise or some sort of indictment that they are not an authority on the given topic. Quite the contrary; virtually every HCP I’ve ever encountered was pleased to answer any and all questions I’ve had. And even if they weren’t, they never let on that they weren’t.

            Now, maybe this OB had just had a string of NCB-nutters come in recently attacking her credibility and just wanting to argue. Maybe she looked over the brief history the nurse took and made assumptions about me that were nether true nor fair. Maybe she was having a bad day. Maybe someone burnt her toast that morning. Who knows? Whatever the case her behavior was unprofessional and she lost a patient over it.

            All I do know is that if I had thought that I had “all the answers”, I would have fudged my LMP by adding 2 weeks to it, refused early u/s (it was something this doc offered, not required), and, if induction still was recommended for some other reason, just not shown up for it. Believe me I’ve seen NCB “advocates” suggest all of the above…. Instead I went to my doctor to ask questions and get more info about something that had changed significantly since the birth of my prior child. Radical, I know ;)

          • Eddie

            I’d say it stronger than that, that this site is a reaction to those who reject the expertise of doctors while trusting in quacks. If it was merely questioning the expertise, it would be possible to have a conversation about it.

          • Ainsley Nicholson

            One phrase I find very useful when discussing something where both people have useful (and perhaps incomplete) information is “can you help me understand…?. For example, “Can you help me understand why you are uncomfortable with changing my estimated due date even when I am quite certain which day the baby was concieved?”. Since it doesn’t come across as a challenge or argumentative, I often get a much clearer understanding of the other person’s perspective, and I find out if they really understood what I am trying to express.

          • me

            It really never got to that point. I started to point out what u/s said about my dates and before I could get the question out she had already interrupted me and started in on her ranting. At that point I figured she was a lost cause (and a mental case, lol) and by the time I got home I knew I would never go back to see her. No one wants the crazy doctor that can’t even keep it together in non-emergency situations ;)

          • Ainsley Nicholson

            Sounds like a really frustrating situation.

          • me

            I want to point out one thing, that up til now I saw as irrelevant, but since you are attacking my character here, it becomes relevant:

            I didn’t ask to go beyond 42 weeks. Had they told me, “You need to be delivered by June 1, regardless.” I would have accepted that without question. At my 41w appt, when the NSP and BPP came back reassuring, they said I’d need to come back June 1 for another NST and BPP, and they set a tentative induction date of June 4 (42+3), assuming the tests of fetal well being were again reassuring. I accepted that, but I did not ask for, much less demand, those extra 3 days. They offered it, and I accepted it. As it turned out I didn’t need it, but your insinuation that they just gave into my “demands” so I wouldn’t “slip further down the risk spectrum” is off base. I didn’t demand anything. All I asked for was 42 weeks, they were willing to give me that, and then some.

          • Expat in Germany

            apologies, I was inappropriately giving the CNM the benefit of the doubt. You dumped your OB for someone who flies more fast and loose.

          • me

            LOL. Or maybe, just maybe, there was evidence that I wasn’t 42 weeks along in the first place that the other OB wasn’t able to see because she didn’t even listen to me.

            But I’m sure that a Level III teaching facility that is consistently one of the top ranked in the US News & World Report’s annual Best Hospitals rankings, is Magnet certified, and is one of the most respected women’s hospitals in the country is very concerned about what some dude on the internet thinks about their nationally ranked midwifery program ;)

            Yeah….

          • Expat in Germany

            the evidence wasn’t good. Did you read what Dr Amy wrote about follicular and luteal phase?
            The act that it was a good hospital is what led me to give the CNM the benefit of the doubt.

          • m

            Yes I read what she wrote. I suppose if you hone in on any one single fact of my history, in isolation, the evidence isn’t “good”. The whole is greater than the sum of its parts. When you put everything together, the evidence that the u/s EDD was more accurate is fairly compelling. Compelling enough at least for this midwifery practice to give me more time.

          • Expat in Germany

            it is compelling to you, but not to those who have thoroughly studied the issue.

          • me

            It was compelling to a group of CNMs…

            Question, does it matter that I was still bfing when I conceived my second and third children? FWIU lactation can shorten one’s luteal phase. I didn’t share that with the OB (never got the chance), but I did let the CNMs know. Maybe that was the difference?

          • Expat in Germany

            what is compelling is that the group of cnms had a higher tolerance of risk and a different education than your ob. Unscientific NCB stuff has infected mainy strains of CNM.

          • Amy Tuteur, MD

            Don’t change the subject. We’re not talking about your OB. We’re talking about the claims you made about risk. You are wrong in your assessment of risk of the way in which obstetricians should address risk.

            You don’t have the slightest idea how or why obstetricians think like they do, and it is your ignorance that leads you to make the inane claims that you have made.

            You’re central assumption, that you are “informed” about risks is factually false.

          • me

            What claims did I make about the risk of stillbirth at 42 weeks that are wrong? I never said OBs “should” do anything other than what they are comfortable with. And I’ve been talking about my OB this whole time, so I’m not sure why you are ignoring the subject.

            What inane claims have I made? Please be specific.

          • fiftyfifty1

            I will admit that my comparison of your actions to dodging a bullet was histrionic. Your actions had a 1/500 risk of death whereas an individual bullet has only a 1/333,000 chance of causing a human death. My appologies to the NRA.

          • me

            You do realize that the phrase “dodging a bullet” deliberately invokes images of being in a cross fire. Okay, the act of randomly walking down the road minding your own business and catching a bullet are slim. But you were trying to make out my actions as tho I deliberately waltzed in between to parties actively exchanging gunfire. That’s what I mean by histrionic dear. But you are being obtuse now. I think we’re done.

          • fiftyfifty1

            Yes, it is obtuse to consider all bullets, rather than just the ones that are shot at people. If you consider only fired rounds, the risk increases greatly. The U.S. has about 7,500 gun murders per year, while emergency rooms see about 80,000 visits per year for bullets that hit the person but don’t kill them. How many bullets are fired and miss their mark for each that hits a person? Now that statistic I could not find anywhere! I’ll ask one of my gangster patients the next chance I get. But until then I will guess somewhere between 1:10 to 1:50. I base that on when I worked in a bad neighborhood. Our clinic got caught in the crossfire of 2 different shootings where nothing got hit except the side of our building for a total of 5 bullets that hit nobody (off topic: if you hear gunfire I recommend you dictate lying on the floor rather than sitting at your desk unless your office is a windowless one, better safe than sorry). Anyway, if my 1:50 estimate is correct, then that translates into actually BETTER than 1/500 odds for “dodging a bullet”. Now if my 1:10 estimate is correct, “dodging a bullet” has nearly a 1/100 risk of death, which I admit is quite a bit riskier that refusing induction, in which case I apologize to you.

          • Eddie

            What you say is reasonable. I have two points:

            1) As Dr Amy said, medical practitioners discuss their failures to figure out what went wrong and to figure out how to prevent it from happening again. Thus, they’re exposed to far more failures than just those from their own practices, and

            2) There are many different causes of additional risk, of varying levels. Here, we are talking about one source of risk in isolation. But a practicing OB will see many patients in many different situations, and will have to deal with many additional causes of risk.

            I didn’t spell this out in my comment, so you correctly criticize my math. You’re right that any one individual source of risk, in isolation, may require years or even decades before one additional mother or baby will die who is being attended to directly by that OB’s practice. But once you add in the rest of them, the picture changes dramatically. This was in my head, but I didn’t spell it out. My fault.

            the majority here seem to think any consequence short of death is irrelevant

            First of all, the vast majority of regular commenters here are not participating in this conversation at all, so we don’t know what they think. Quite a few people don’t like direct personal conflict, so won’t enter into the middle of a heated conversation like this, no matter what they believe or how strongly. But also, quite a few regular commenters here do talk about the non-death consequences of their childbirths, either to them or to their children. So I disagree with you on that.

            Keep in mind that this thread is primarily between a small group of people, and that many of the replies (such as mine) are really to tangential points expressed in individual comments.

            I’m not criticizing you for going post dates. I’m not telling you what you should or shouldn’t do or have done. People make all kinds of choices in their life where they willingly take on risk or even willingly have their family take on risk. I believe in informed consent. I may or may not disagree with a choice another person makes, but that doesn’t mean they shouldn’t have the right to make that choice. And anyway, my approval is pretty irrelevant outside a small circle of people.

            If I were an MD, i have no idea what I’d say. Maybe, from that perspective, I would feel very differently. I honestly cannot know. As a lay person, if the actual risk was (to pick a number) 1/500 and you understood that risk, accepted it, and took it, then that is your choice. That is informed consent. I believe this whole thread got going when it appeared that you rejected that risk, that yes it was generally true but didn’t apply to you.

            I found this analysis by fiftyfifty1 particularly compelling:

            But actually familial factors are not a special reason, they are the “regular”, most common risk factor for going postdates. You have genes that make you relatively insensitive to the “get me out of here” signals that a term baby and placenta put off. It’s a problem that runs in your family.

            Your first OB, going by what you say, should have been more polite. Maybe that OB was just rude. Maybe that OB just had a patient lose her baby and had temporarily lost all patience with her or his patients taking on additional risk. Reality is probably between those two extremes; I won’t even speculate on where because it would be extremely silly for me to do so.

          • me

            “Maybe that OB just had a patient lose her baby and had temporarily lost
            all patience with her or his patients taking on additional risk.”

            That thought occurred to me. And I’m not unsympathetic. The bad outcomes do tend to stand out in our minds more than the good ones, and there are many situations in life where we can be ‘once bitten, twice shy’. Had she taken the time to listen to me and/or explain why she was so adamant about her policy, while I can’t guarantee I would have stayed under her care, I at least wouldn’t have felt like she was blindly following some policy without regard for the particulars of a given case.

            At any rate, what fiftyfifty said, that I must suffer some genetic condition that makes me less sensitive to the signals that start labor… I do believe the burden of proof lies on her. What is the name of this condition that strikes a full 3% of the population? What is the diagnostic criteria? Pray, tell… enlighten me. I have three daughters, and of whom might have inherited this condition. I’d love to know more about it and see if her diagnosis of me actually fits. Unless of course she is making things up as she goes along…

            As for your first two points, you are correct… doctors do review each others cases and are exposed to far more negative outcomes than those they personally oversee, and no, you cannot logically look at a single risk factor in isolation because life doesn’t work that way. And I do understand that an OB is going to be reluctant to “allow” a woman to take a chance, even when the risk is fairly small, because they see so many negative outcomes.

            I’m not saying that my choices were superior in any way. I did what was right for me, I knew there was a risk and accepted that. I haven’t gotten into the benefits of my choice because I really don’t feel like having them dissected by people who weren’t there and didn’t have anything on the line (it’s too easy to criticize other people’s choices when your not the one left holding the bag at the end of the day). So at this point I believe this conversation had dwindled to the point there isn’t much left to talk about. I appreciate your thoughtful and respectful replies tho :)

          • Wren

            Obviously it is your choice to refuse to share the benefits as you perceive them, but you do recognise that as it stands you are effectively making an argument for taking a risk without any benefit and many here aren’t going to agree with that. It really doesn’t come across as significantly different to the risk taking often discussed on this board.

          • me

            Fair enough. I’ll keep it simple. When I was induced with my first the sudden onset of extremely strong ctx was unbearable. I opted for an epidural (no biggie, I hadn’t ruled one out beforehand and it didn’t upset me to have to get one). I suffered some complications related to the epidural that impacted both my delivery and my recovery (it, fortunately, didn’t have any negative effects on my daughter). I was concerned that induction would mean another epidural and I was afraid history would repeat itself wrt those complications. I wanted to go into labor spontaneously to increase the chances of avoiding the epidural, and the negative effects I experienced the first time.

            Before the attack begins I will say three things: First, I realized then, as I realize now, that maybe I could have had epidurals without a repeat of the complications, but they were severe enough that I really didn’t want to take the chance. Second, I knew that I may have found spontaneous labor to be just as, if not more, painful than induction, and I could have ended up with an epidural anyway, but I wanted to do everything possible to avoid it… I guess I felt that if spontaneous labor is that bad, so be it, but to deliberately make it harder than it needs to be just didn’t make sense in light of wanting to avoid a repeat of the complications that occurred the first time. Third, I knew, as a multip, induction may not have been as bad the second or third time around and maybe I wouldn’t need an epidural if I was induced. But, well, see #2.

            Now, I know that this will be minimized and trivialized to the point of absurdity. I will be accused of putting my own “experience” or “comfort” or “preferences” above my child’s life. All I can say to that is the complications the first time were bad enough that a 1/500 risk of my child being stillborn sounded reasonable by comparison. If you can’t wrap your head around that, you are extremely lucky.

          • Expat in Germany

            so, you perceived that there would be a benefit to letting labor start naturally at 42 weeks 3 days instead of inducing. The question should be: who gave you this information? It sounds like the kind of stuff you see on natural childbirth sites, not on medical sites. If the benefit that you perceived was real, I don’t think as many people would argue with you. But I don’t think most people here would agree that benefit was real.

          • me

            “so, you perceived that there would be a benefit to letting labor start naturally at 42 weeks 3 days instead of inducing.”

            You’re oversimplifying, which is why I didn’t want to even go down this road, lol. First, my labor began spontaneously at 42 weeks (not 42+3 – that would have been my induction date), based on an EDD that I thought was likely “off” by about 6 days. In reality, tho I can’t prove it, and I was within the margin of error, I was likely only 41+2 when labor began on its own and my scheduled induction date would have put me at 41+5.

            Second, yes, I did see benefit to spontaneous labor. Mostly in terms of the likelihood of needing another epidural. Obviously there are no guarantees either way (some women who get induced don’t need pain meds, many women who labor “naturally” end up needing pain meds… I really do get that), but for me it was about increasing my odds. Basically I was more afraid of the complications of the epidural that I had went thru the first time repeating themselves than I was of going either close to, or a few days past (depending on what date you use) 42 weeks. It wasn’t just based on anything I’d read/heard… more on my own experience.

          • Expat in Germany

            so, you just ignored all of that info that Dr, Amy gave you about follicular and luteal phase defects and you continue to -see- benefits where there is no evidence that they exist.
            A long time ago, links to papers showing that you have a lower c section risk if you induce than if you wait for post term spontaneous labor were given and ignored. That doesn’t say anything directly about pain (your central concern), but I bet the problems that bring about c sections are more painful than induction contractions. If you write that you made your decisions based on an irrational fear that induction would be more painful than waiting until 42 weeks plus 3 days, I think that pretty much closes the topic. The problem is the insistence that the choices were rational and evidence based.
            I personally hold an non evidence based belief that early inductions are easier than posterior labor or macrosomic babies because I have experience with the latter and not the former, but I recognize that it is irrational.

          • me

            “so, you just ignored all of that info that Dr, Amy gave you about follicular and luteal phase defects…”

            What did I ignore. Dr. Amy acknowledged that it is possible that I ovulate on day 20 of a 32 day cycle. I suppose I could do an OPK for shits and giggles, but that seems a bit ridiculous to prove something to strangers on the interweb, especially since we’re not planning anymore children. Not having perfect 28 day cycles complete with a 14 day luteal phase doesn’t mean there are “defects”. What my cycles are like are completely within the bounds of “normal” ranges. I’m not sure what exactly I’m “ignoring”.

            My “central concern” wasn’t pain. It was complications from an epidural (specifically that the complications I had the first time would repeat themselves). I acknowledge there was a chance that I would find spontaneous labor just as painful as induced labor, but fortunately that ended up not being the case (well, it was as painful, but only at the very end, so it was far more tolerable). I wanted to avoid the epidural to remove the chance of the same epidural side effects from recurring and I didn’t want to make my labor any harder on myself than it had to be. When we were approaching the tentative induction date my CNM and I discussed “kinder, gentler” induction methods to try to mimic a slower-to-build labor, just in case I ended up needing to be induced.

            Since I was very low risk for a c-section either way (being a multip) concerns of c-sections were secondary, at best. I didn’t ignore the study that showed lower c-section risk at 41 weeks…. but complications that lead to c-sections don’t always involve pain (think fetal distress) anyway so I’m not sure what you’re getting at there. I’ve seen those same studies criticized for various reasons, so rather than base my decisions on a few studies, I’d prefer to look at what the recommendations are. To date (or at least at the time, maybe things have changed in the last year or so), they still don’t consider you “postterm” until 42 weeks, and there is nothing forbidding people from going the full 42 weeks. Yes, the risks increase, and many providers prefer to induce at 41, but that is “level C” recommendation.

            While we’re sharing irrational beliefs – I have a belief that macrosomic babies are less painful than smaller ones. My second labor (of my “giant” 9 lb 2 oz baby) was far and away the least painful, not to mention the fastest. ;)

          • Expat in Germany

            she wrote that it was possible but unlikely and since it wasn’t backed up by objective evidence (peeing on a stick), it shouldn’t be taken into consideration as you continue to do.
            Your central concern was pain because you didn’t want to need an epidural to deal with it. And from what you have written and cited, it is not at all clear that you understand the recommendations. Where in the ACOG recommendations does it say that planning to go to 42 weeks 3 days with a history of macrosomia is a good idea? The service that doctors provide is access to -the big picture- Without it, we could all just use Dr. Google.

          • Expat in Germany

            You don’t think that an increased rate of c section correlates with increased pain compared to an induction. And there is no evidence either way on something so subjective, so there is no point in arguing about it. The benefit to you of not inducing would be avoiding something you are irrationally afraid of at the expense of doubling or quadrupling the risk to your baby. The question becomes: to what degree should we indulge our irrational fears when it comes to medical stuff. I don’t think we should.

            If I were to try to convince you that your fear was irrational, I would say that c sections post term trend with obstructed labor which hurts for a longer time than regular labor. I’ve had both types. One is like pulling off a bandaid with a few bloody murder screams and the other is more teeth rattling, extended torture. I shared a room with induction moms and one did report that she went from zero to 100 mph in under an hour with blinding, brain splitting pain, yes, but their labors were only 3 hours start to finish, with 6 lb babies. I pushed for longer than that with an ineffective epidural and an almost too big baby. I was jealous of them and thought, induce me early next time! But that was irrational.

          • me

            Well, that’s fair. And to understand I think you need to consider that my induced labor (the one I was afraid of having a repeat of) was a total of 18 hours (by far my longest). Of that, 12 hours was cervidil (overnight), which produced mild to moderate, manageable ctx, but I couldn’t sleep thru them, so by the time the pitocin was started I was already exhausted. The cervidil got me from 0 cm to 3 cm. When the pit began I went from mild/moderate to transition level pain instantaneously. This lasted 5 hours, the last 3 of which I had the epidural, one of the complications being incomplete relief. It did bring the pain down to a more manageable level. Until it was time to push, that is. I pushed for an hour and the pain in second stage was comparable to my “natural” deliveries (in other words, no relief provided by the epidural). Of course, that doesn’t even get into the recovery and that whole nightmare.

            So, rational or no, I was really reluctant to go down that road again (hell, it took over a year to be willing to consider getting pregnant again after all that). Contrast that with the birth of my second child: 7 hours of active labor, only the last 2 of which were really painful, but not as painful as those first 2 hours of pitocin. An hour of pushing, but without the pitocin it felt like I had more of a break between ctx and I felt much more “in control”. And after delivery I felt great. On top of the world great. Slight tear (2 stitches) and within a few days I felt “normal” again, as opposed to still being in pain and recovering 8-12 weeks after my first delivery.

            Is it any wonder I was wiling to wait and try to have a repeat of #2 when I was expecting #3?

            So I concede what I did may not have been “rational”. But no one could promise me that induction would be easier or that an epidural wouldn’t give me the same complications with my third child. In looking things over (and this conversation has helped me view things in a different light – that is one of the things I like about this site), perhaps you all are right. But at the time, I couldn’t wrap my head around willingly going down that first path again. Not after the second path had been such a Sunday stroll in the park followed by balloons and Skittles…

          • Expat in Germany

            Your descriptions of your first two labors are identical to those of my first two, except I was never induced. With my first, there was transition level pain starting at about 3 cm. I was shaking and I did not have pit. Not atypical for a primi, I learned. The epidural gave some relief until they turned it off for pushing. My second labor was only really painful at the end and pushing took 15 minutes. My third labor with a short and fat baby was similar to my second until the part where I had to push for 3 hours and was almost ready to give up. I had been warned that ultrasound predicted a big baby, but I went to 40 weeks anyways. Inducing at 39 might’ve saved me all of the pushing. If I hadn’t gone into labor until 41 or 42 weeks, she would’ve been a csection for sure. Our experiences color our perspectives and an OB has a lot of experience.

          • theadequatemother

            Did you ever speak to an anesthesiologist/ have an anesthesiology consult in the next pregnancy, about your epidural complications, their risk of re-occurrence and possible alternative techniques?

            As one myself I am wondering how we could have better helped you, especially when it came to planning the management of future labours.

          • me

            I spoke with the CNMs that attended my subsequent deliveries and they did talk about alternatives to the epidural, as well as the fact that it wasn’t likely to repeat itself should I need/want an epidural in the future, but no, no one suggested an anesthesiology consult. It probably would have been a good idea, and may have changed the way I perceived the risks and the way I approached the deliveries, but it’s not something that was offered, or even occurred to me, at the time.

          • Captain Obvious

            Increased risk for meconium, low fluid, poor placental function leading to late decelerations during the stress of labor, stillborn, larger babies since babies still grow 1/4-1/2 pound per week. Planning a delivery is like planning anything in life. You have find a happy medium to avoid the risks of the extremes. Anencephalic babies tend to go post dates for a biological pathological reason. Maybe your family shares that pathological problem. Maybe waiting for labor to start in generations to come will end up with a catastrophe that could have been prevented.

          • me

            No meconium w/ any of them. Plenty of fluid. Good sized, but not huge, babies (8lb 4 oz, 9lb 2 oz, and 8lb 5 oz). No signs of distress during any portion of labor. Personally, I think I just ovulate a little later in my cycles than average (I do have somewhat longer cycles than average, but not long enough for them to change the wheel of when). AFAIK there is no history of birth defects in my family (and with a long line of nurses on both sides, I think they’d know, at least in the last few generations). With all three the u/s put the due date 6 days past what the wheel of when said, but still within the margin of error so they didn’t want to change the EDD. That all being said – I switched providers because none of this apparently made a difference to her – she liked her blanket policy and no amount of information would change that. I also had discussed induction with my CNMs for both the second and third babies, and had set tentative induction dates (42+2 and 42+3, respectively), but went into labor on my own just prior. So, no, we weren’t planning on waiting forever. The actions taken by my first OB, as well as my the CNMs seen with both the second and third babies were well within ACOG guidelines. Take it up with them….

          • fiftyfifty1

            ACOG recommends delaying induction until 42+3? Can you give me a link to that guideline?

          • me

            http://peachykeenbirth.com/acog_pb55.pdf

            “Management of low-risk postterm pregnancy is contro-
            versial. Because delivery cannot always be brought
            about readily, maternal risks and considerations may
            complicate this decision. Factors to consider include
            gestational age; results of antepartum fetal testing; the
            condition of the cervix; and maternal preference after
            discussion of the risks, benefits, and alternatives to
            expectant management with antepartum monitoring ver-
            sus labor induction.”

            Maternal preference is clearly stated as a factor to consider. I was young (under 30), NSTs and BFP looked great, had no other complications, and the first time around my cervix was not ready (even at 42 weeks, but even more so at 41). The second times, my cervix was “favorable” but the ACOG (despite the claims of NCB advocates) does not look favorably on forcing procedures on women against their informed consent. It is interesting to note:

            “In studies on postterm pregnancy in which women with favorable cervices were managed expectantly, there was no indication that expectant management had a deleterious effect on the outcome…”

            Yes, one recommendation states that women with a favorable cervix and no other complications should be induced “promptly”, however it is important to note that that is a “level C” recommendation – based solely on consensus and opinion, rather than on good scientific data. It is important to note that nowhere in this bulletin does it say “OMGifyougomorethan2dayspastyourEDDyouwilldieyourbabywilldieyouruteruswillexplodeandtheearthwillspinoffitsaxisandflyintothesun!!!!!eleventy11!!

            Quite the contrary. It is very reassuring that the vast majority of pregnancies exceeding the due date, and even exceeding the 41 week mark will end with uncomplicated deliveries and healthy mothers and babies. But I’d wager you all already knew that. ;) It’s just easier to slam others for choosing differently than you if you pretend they made some horrible, devious, utterly dangerous choice. That being said, I do agree that a delivery occurring after 41 weeks has no business being done at home (just as VBACs, multiples, breeches, and other elevated risk women should not be delivering at home).

          • antigone23

            Well, my OB said the same thing. And it’s true. The risks to the baby go up with no benefit to the baby in staying in longer. The only slight benefit is the possibility of a better birth experience for the mother, but that is debatable since several studies have found that the csection rate is actually lower in the induction group than the expectant management group. http://www.ncbi.nlm.nih.gov/pubmed/22696345 http://www.ncbi.nlm.nih.gov/pubmed/19687492

            Some women just don’t seem to go into labor on their own, at least not within a reasonable time period. My mom went to 42 weeks with 3 pregnancies. All had to be induced. The last ended in c-section after over 30 hrs of labor (macrosomic baby, got stuck). We were fortunate to be born healthy with no complications, but there was no real benefit to waiting so long to induce. So I’ve never bought the “baby picks their birthday” argument because none of us would be alive if left to that.

          • Lizzie Dee

            Do babies continue to gain weight rapidly after 40 weeks? Or does it slow down because placentas always start to fail? I can understand women fearing induction, but I would fear the consequences of not having one a lot more.

          • antigone23

            I think it depends, there is an increased risk of macrosomia in post-due pregnancies but there’s also an increased risk of placental failure which would mean the baby wouldn’t grow. I know someone who was under the care of CNM who was reluctant to induce before 42w, and IMO did not offer the monitoring she should have gotten in late pregnancy. Her baby was born 5lbs at 42 weeks because her placenta was not working right, probably wasn’t working right even before her due date.

          • Charlotte

            Actually, the earlier you induce the more likely you are to avoid a c-section.

          • me

            Statistically, yes. But there was improvement in my bishop’s score between my 41 w visit and my 42 w visit. Not a big improvement (went from 0 cm 0% firm and high to 0 cm 0% “softer” and lower), but an improvement nonetheless. Now, I know thinking has changed since then (about 6 years ago), but as a FTM, I think my doc knew it was a 50-50 shot either way. Giving me that extra week may have made the difference. And maybe not, I don’t possess a time machine ;) But I do remember him telling me at the 41 w visit that he “would have offered to induce by now, but your cervix is nowhere near ready”. As the head of OB at a major hospital with 20+ years experience, I took his word for it ;)

          • Expat in Germany

            The rate of death from a base jump is 1/2000. Needlessly worsening your baby’s odds to 1/500 doesn’t sound that great anymore,right?

          • me

            Actually, it still sounds quite reasonable…. Just because something else people choose to do is less risky doesn’t change the numbers involved here.

            And I’m not sure where you got your stats – I found a stat of 44/1000 death rate for base jumping…. 3.3/1000 for sky diving, 3.8/1000 for hang gliding, and 104/1000 for attempting to scale K2.

            But so what? What does that have to do with the price of tea in China?

          • Expat in Germany

            it is easier to understand the risk if you frame it in terms of what if would be like to throw your baby off of a cliff a few extra times.
            http://www.ncbi.nlm.nih.gov/pubmed/17495709

          • me

            Now we’re throwing babies off cliffs?

            Do you even listen to yourself? rofl

    • Lexi Nicole Whitman

      1st off, like a few others have said, it’s one thing if the woman is sure of her dates, but on top of that the “40 week ESTIMATED DUE DATE” Is is just that, it’s an estimate AND it’s based off the idea that every woman has a 28 day cycle, which we all know isn’t true! So it’s also true that a woman with a 40 day cycle could EASILY go past the “40 week mark” without it causing harm because it’s an estimate.

      • Amy Tuteur, MD

        Or she could EASILY go past the mark and cause harm because it’s an estimate. Isn’t that equally true?

      • Dr Kitty

        Or, the cycle she conceived she could have ovulated at day 14 instead of day 26.

        Where on the MDC boards will you EVER see anyone advising a woman with 21 day cycles that if she gets to 42weeks she’s actually 7 days further on than that?

        NCB doesn’t EVER suggest a time limit.

      • PJ

        Isn’t that what dating scans are for?

      • anon

        But not really- I don’t have 28-day cycles, and my doctor based my due date on my date of ovulation and my seven-week ultrasound. Based on that, it doesn’t actually matter how long my cycle is. The take-home point is that placentas have an expiration date. So can you go past 40 weeks exactly? Sure, for the most part, you can. Two of my three were born at 40w2d. But there’s a difference between that and 42 weeks, and that’s the real issue. Babies don’t even know how to operate their hands, how the hell do we think they know when they’re supposed to be born?

      • Captain Obvious

        Good prenatal care starts in first trimester. Any good health care provider does take into consideration the woman’s length of her menstrual cycle. Every prenatal record template asks the length of her cycle and every doctor knows you get your period 14 days after you ovulate. A first trimester sono is accurate to plus or minus six days. A first trimester sono tells you 1) if the pregnancy is viable, 2) how many babies there are, and 3) whether your menstrual dating is accurate. Only a fool declines first trimester sonos. As many as 30% of EDD get changed by sono. We optimally want a baby to deliver between 36 and 42 weeks, or better 37 and 41 weeks. Issues occur before 36 and after 42, so we want good dating.

        • Victoria

          “Every prenatal record template asks the length of her cycle and every doctor knows you get your period 14 days after you ovulate”
          I am not sure that is correct. I think it is your luteal phase (time between ovulation and menstruation) that remains static and not the time between end of menstruation to ovulation. Luteal phase can vary person to person. Mine is nine days. Clearly a woman who ovulates at day 14 and menstruates at day 28 has a longer one.

          • Charlotte

            Yes, it varies. 14 days is just an average, with 10-16 being the normal range. I tend to ovulate on day 18 and have a 9 day luteal phase. It’s on the short side, but long enough to not have had any trouble conceiving.

        • antigone23

          Unfortunately from my experience doctors are reluctant to change the due date unless it’s more than a week off. I conceived, via IUI, on CD 21, making the standard “dating wheel” that they so love a week off. My first trimester ultrasounds were 6 days off the LMP dates, so one day shy of the one week mark. Both my RE (who was THERE when I conceived) and my OB insisted on keeping the inaccurate LMP due date when my LMP DOESN’T MATTER when I know exactly when I conceived. I honestly don’t get this obsession with LMP and found it very frustrating.

          • Eddie

            Wow, did they give a reason for wanting to stick with LMP?

          • antigone23

            No, they just said “we don’t change due dates unless the difference is more than one week.” Which I guess makes sense if we’re talking 2 days, but if you have a more accurate date, why not use it? It just became frustrating when we were discussing induction dates because I knew that I was a week less far along then their charts indicated, and I knew that could make a difference.

          • AmyM

            I don’t know…I did IVF, so we know exactly when the eggs were retrieved, fertilized and transferred. (Retrieval date is stand-in for ovulation) The only thing we don’t know is exactly when it implanted (or split) but even that we can narrow down to within 3 days based on the zygosity of the twins, and the chorionicity.

            Despite all of that, at the first u/s, what should have been 6w5d, the embryos measured 7w5d, and that’s the EDD that stuck. Maybe they time traveled.

          • Elaine

            That’s why I refused to give an LMP date and when pressed gave a day 2 weeks before my ovulation date. I got the distinct sense once I gave an LMP date they would latch on to that and not consider anything else. (It was only three days difference anyway, but it’s the principle of the thing!)

          • Laural

            Craziness! I can’t believe they did that with IUI!

            This pregnancy my first trimester U/S was +6 days from my LMP; which was consistent with what my husband and I told the doctor- that we abstained from day 8-18 and that I did those ovulation sticks from day 8 on and never got a +. Due date is still based on LMP.

            If my due date is off I wish it were the other way as I worry about making it to the hospital in time and have never gone past 38 weeks.

        • BeatlesFan

          Some places don’t offer routine first trimester sonos- we didn’t have one with DS. Our only sono with him was the 20-week. We had been TTC, I had just come off the pill so my cycles were regular to the hour, and there was only one possible day we could have conceived- so perhaps they thought dating wasn’t necessary? I did think it was odd we didn’t have one, though.

      • Eddie

        The estimate is not based on an assumption of a 28 day cycle. That is apparently something some people say to each other, but modern medicine is well aware that cycle length varies and they take that into account.

        To think otherwise is really to assume that the whole medical industry is simply ignorant.

      • MonaLisa

        I went to 42 weeks (dated with TVUS at 8 weeks, not LMP- actually would have been 44 weeks if I had not had a first trimester us) with my first child. I was deep in the woo, I desperately did not want to be induced, my cervix was unfavorable, BPP and NSTs looked fine, doctor was ok with it, and I smugly went into labor the night before my doctor was going to have me induced. I had a lovely natural vaginal delivery, and it was a nice experience (minus the tearing). But. But but but. I now realize that I was taking a very unnecessary risk. I did an extensive review of the available literature on pregnancy outcomes with postdate pregnancy as part a project for my OB rotation. I really wanted to find articles to support what I had done, because I really wanted to believe that I had made the right decision (at the time, I glanced at the Cochrane review, but mostly I listened to my doula, and I thought I was “informed”). In every article that had a still birth, it was in the group that was not to be induced until 42 weeks. I could not find an article with stillbirth or perinatal mortality due to induction, or even significant morbidity to the baby (of course). Stillbirth is such a rare event, these studies aren’t large enough to show a statistically significant difference in still birth. But still. I hate that I risked my baby like that, all because I was so afraid of induction/c-section. I would have 100 C-sections to ensure that my daughter is alive and healthy. I ache with love for her, and to think that I put my birth experience before her well being…well, it makes me sick.

        • Lizzie Dee

          In every article that had a still birth, it was in the group that was
          not to be induced until 42 weeks. I could not find an article with
          stillbirth or perinatal mortality due to induction, or even significant
          morbidity to the baby.

          What you are saying here is so important I think you should keep right on saying it and post it to every NCB forum going.

          Stillbirth may be rare. Having narrowly avoided that myself, and having a niece still missing a child lost a lot of years ago, it doesn’t seem rare enough to me. It may be only my over-sensitive impression, but people do sometimes seem to shrug it off sometimes under the heading of “not meant to live, unavoidable” and clearly sometimes it is. But I don’t know how you would live with the idea that if you hadn’t gone post-dates, your child would have been OK. The statistics may make it a risk worth taking, but it terrifies me.

          I do have to live with the knowledge that what happened to my daughter wasn’t inevitable, and that is hard. But she lived, her life is good, we have her here with us. If I had lost her…no point in saying I couldn’t live with that, because you have to.

    • realityycheque

      Wait, you’re telling me other primates don’t chug castor oil when they get sick of being pregnant? *shock*

      • PJ

        One thing that never ceases to amaze me is how people in

        natural remedies can be so sceptical about medical treatments that have been tested exhaustively, and whose risks are known, and yet be so willing to use ‘natural’ remedies that have had little, if any, testing for both efficacy AND safety.

    • sleuther

      Same with the women who think formula is poison, but think nothing of getting mail-order “domperidone” (prescribed off-label, if at all) to increase their milk supply, or random herbal tinctures to do the same.

      Anything could be in those pills and tinctures….

    • araikwao

      Kind of along the same lines…was reading my OB/GYN textbook the other week, and was amused to notice in the chapter on pain relief in labour that all modalities are listed under the heading “Analgesia”. Yes, there are subheadings of pharm and non-pharm, but in reality, breathing techniques, hypnosis, massage and TENS are all analgesics, just as much as NO/air and epidurals. So even the hardcore NCBers are still giving birth with analgesia.

  • amazonmom

    A friend who wants to eat “her” placenta called me up today. She wants to know why her doctor doesn’t know that red raspberry leaf tea controls gestational diabetes. I told her the doc mentioned using real medications if her GD is no longer manageable by diet. It seems like RRL tea is now some miracle drug that can strengthen the uterus, bring on labor, and control gestational diabetes. Thank god it does none of those things. The same midwives that suggest the tea brings on labor also say its good for GD at any time in pregnancy. If it brings on labor WHY WHY WHY would you give it to someone with a less than term pregnancy? HEAD DESK

    • Bombshellrisa

      Typical-the midwives caring for my friend suggested bed rest and red raspberry tea for her preterm labor. Funny they didn’t caution her about flying to Hawaii even though they had her on bed rest. They also suggested kale smoothies. To “bring on” her labor at 41w3d they suggested the same stuff and told her to go walking. They also suggested energy drinks during her 36 hour labor and six hour pushing stage before she transferred to the hospital. (Sound familiar? PSBC’s midwives strike again)

      • amazonmom

        YES sounds really familiar unfortunately.

        • Bombshellrisa

          It’s good that there are more hospital based CNMs now, and at good hospitals. The best of both worlds-the model of care desired with the safety net of technology right there if you need it (and awesome in room massages you can schedule. Swedish Medical Center in Issaquah has that service and amazing whirlpool tubs)

  • S

    I’ve seen big fat rude barn kittens butting in to nurse after their younger siblings were done. The mothers were bony, half-starved looking little things, and i don’t know why they put up with it. It looked ridiculous. It’s probably worth mentioning that these cats had access to cat food most of the time.

    My toddler’s so long and gangly, sometimes i feel like one of those mom cats.

    • S

      I better add before someone gets offended — I don’t find nursing toddlers ridiculous in the least (I usually do enjoy nursing mine). Or grown cats making kneading and nursing motions (so cute!). But those big kittens looked like they ought to at least bring their mom a mouse for her trouble.

      • me

        I remember our cats (they lived outside) doing something similar. The first litter was about 9 months old when the next litter was born. Mama cat ended up nursing the older ones too. My mom would occasionally chase the older ones off with a broom, lol. I find nothing wrong with tandem nursing (not for me, but whatever) or nursing toddlers (nursed my first two til age two, my third just turned one with no signs of stopping) in general, but no, it’s not usual in nature, and no, it doesn’t make you superior in any way.

  • Optimistic Guest
  • ol

    In nature (or ancient times) women didn’t have the choice how to give birth, didn’t have an opportunity to alter the tradition. There was one possible way – as your friends, sisters and mothers did.

    • Bombshellrisa

      They also didn’t have the option of limiting their pregnancies to just one or two.

      • Dr Kitty

        Well they did, but it wasn’t a GOOD way.

        Mistletoe, slippery elm, pennyroyal, tansy, ergot, sharp implements and massage…

  • AmyM

    Who is credited with inventing lotus birth, and why is it called lotus birth? (and why did ANYONE think that was a good idea?) So gross and smelly, I would think.

    • S

      I believe they oil and salt it. Like jerky. Pee-marinated jerky.

      • BeatlesFan

        *retch*

    • AmyM

      I have found some of the answers:

      1) Who is credited with it: (according to these brainiacs at http://www.lotusfertility.com/Lotus_Birth_Q/Lotus_Birth_QA.html) ” The birth practice of the early American pioneers who produced some of the
      hardiest children known in American history… and valued everything they had. Also called “Umbilical
      Nonseverance.” The baby, cord, and placenta are treated as one unit, as they are all originate from the same
      cellular source (egg and sperm). ”

      I am not sure how they know the Pioneers did this, unless those hardy Pioneers left detailed records. I suppose that is possible, but doesn’t seem very likely.

      Also:”the modern islanders of peaceful Bali, a beautiful culture that
      esteems beauty in all things, still continue the ancient practice of extended-delayed cord clamping-severance
      (typically 2-5 hours after the birth) and have many full Lotus Births at home and in birth centers.”

      2)Why is it called Lotus Birth? “The practice of “Non-severance”was revived by modern Yoga practitioner parents who were exploring
      natural birth in the 1980s and thus began to be called “Lotus Birth”, connecting the esteem held in the east
      for the Lotus to the esteem held for the intact baby as a holy child, with a great esteem for practices that
      support birth without violence.”

      3)”Their greater capacity for relaxation, compared to nurslings who had early cord severance and placenta loss, is
      apparently a metabolic foundation for life, and makes teething and other developmental stages much less
      distressful. It could be concluded that Lotus birth gives babies lifelong coping skills.”

      Number 3 is why we should all embrace Lotus Birth. The rest of that site is ridiculous, with lots of made up crap, and claims that homebirth with no interventions and no intentions of cord-cutting never have any emergencies and lead to happier babies and better bonding, and babies who shiat gold, yada yada, etc.

      • VeritasLiberat

        The Bali connection is bunk. In Bali they bury the placentas shortly after birth, by the doorpost of the house.

        • AmyM

          That whole website is bunk…I’m not surprised they are normal in Bali and dispose of the placenta like the medical waste that it is.

      • CourtneyTX

        I would guess that children of people that practice lotus birth learn “lifelong coping skills” as a part of being raised by the type of people who practice lotus birth.

        • T.

          You just won the internet. Best comment ever.

      • Dr Kitty

        Don’t they also have a tradition in Bali of filing the incisors flat?
        Nothing peaceful or natural about that

  • Ainsley Nicholson

    Unassisted childbirth: I’m reminded of an anecdote I read in a book (maybe one of Jarad Diamond’s?) about visiting a tribe in the Amazon that still lived the way its ancestors had…this particular tribe prized individual responsibility and the right of self-determination much higher than most tribes in the area, and the women would always give birth unassisted. The author described how one young woman went into labor while he was visiting, the baby got stuck, the young woman’s cries for help went unanswered all night long, and both mother and baby were found dead in the morning.

  • Mel

    The beauty of arguing with people who use the word “all” is that you can disprove them using a single anecdote.

    Posit: All mammalian species eat placentas for some kind of positive reason.
    Refutation: Cattle don’t. They clean the baby off, then move the calf to a new area away from the placenta. Why? Cattle are herbivores so they don’t have the right type of teeth to rip the placenta into bite-size pieces. If they do try to eat it, they have to swallow it whole. Their necks are so short relative to the size of the placenta that if they try to eat the placenta, it can block their airway and the cow can smother. (I wish I was making this up. I’ve had to wrestle placentas away from cows and one time reach into the cow’s mouth to clear the placenta.) So why would a cow eat a placenta? For the same reason toddlers eat dirt: it’s there.

    The main reasons that I have heard of that animals do eat placentas fit into three categories – the placental hormones aid milk production; eating the placenta prevents the scent from attracting predators to the area; eating the placenta. The first reason doesn’t happen in humans. I’m not too worried about my baby being eaten by a wolf. Last reason: I prefer Reese’s Peanut Butter cups.

    • Karen in SC

      Are there any studies that show placental hormones aid milk production? Are there indeed any placental hormones at all? If there are any, do they survive being digested in the acidic environment of the stomach? Maybe the mechanism of beginning milk production in the breasts depends on the placenta fully leaving the body of the mother. Maybe the placenta contains a reasonable amount of iron from the blood, but why not take an iron pill instead?

  • Spiderpigmom

    Statistics from countries with no widespread access to medical care tell us that what’s natural is a dead baby, a dead mother or both. I can’t fathom how advocates of “natural” childbirth manage to ignore that.

  • lucy logan

    im guessing no tandem nursing in nature has to do with basic limits to caloric intake and expenditure. its too risky for moms.

    • Ainsley Nicholson

      I’m guessing that it has more to do with the breat-milk composition needs of a tiny infant being differant from those of a toddler. Concurrent nursing of primate twins or higher order multiples (mostly non-primate) is quite common in nature.

      • LynnetteHafkenIBCLC

        I would think it has more to do with the inability of the mother to move with a giant toddler and a newborn tandem nursing. In indigenous cultures and in nature mothers work while nursing infants.

        • Ainsley Nicholson

          That too!

        • AmyM

          I thought it also had to do with the mother often not conceiving again until the the older child was weaned. I know that women can certainly conceive again while nursing, but nursing can suppress cycles for some, so in those cases, there would be no overlap.

          If there was overlap, I think Lynnette makes a good point that they’d make the toddler walk and the infant being carried would get the breasts all to itself. And while a human mother might try to tandem nurse twins, there are tons of examples in history of infanticide of one of a set of twins (especially if one doesn’t appear normal or healthy), for fear of not enough milk to sustain both.(I’ve been reading Jared Diamond recently too.)

          • Wren

            I know breastfeeding can suppress ovulation, but in most cases it will only do so for a relatively short time. In my case, I know it stopped working early enough that I was pregnant again before my son, who despised solids at the time, was 9 months old. I breastfed my daughter to 35 months and my period (and presumably ovulation) returned years before I weaned her. I’ve frequently heard that nursing older children (3-5 year olds) allows for a 4+ year gap between children naturally, but I don’t think there is any actual evidence for that in humans in general.

          • lucy logan

            depends quite a lot on caloric intake

      • LukesCook

        When food is scarce, it makes no sense to waste nutrients through the inevitable inefficiencies in the process of converting the mother’s food to breast milk, and then breast milk to usable nutrients in the toddler’s body, when a toddler is quite able to cut out the middle man and convert food to nutrients itself. Multiple infants aren’t able to do so, and concurrent nursing isn’t a “luxury” that can be given up in the same way that toddler nursing can be given up to ensure that there is enough food to go round for a new infant.

        • Ainsley Nicholson

          Well put. I speculate that the toddler would continue to derive benefit from breastmilk, and the mother would continue to allow it to a certain point, if there was no newborn in the picture who needed the milk more.

          • Ainsley Nicholson

            Basically, we are all re-stating what Dr Amy said: Breastmilk is reserved for the youngest child.

      • amazonmom

        The lactation center at work gets plenty of calls from women who despair that their milk supply has completely dried up since becoming pregnant. They want Reglan and/or Domperidone desperately. Not even our pretty darn crunchy breastfeeding center will consider using those when the mother has low supply due to a normal physiologic phenomenon. The women get so offended that a baby friendly hospital would even suggest that breastfeeding has come to its natural end, and they need to consider using donor milk or formula if the nursing child is less than one year old.

        • AmyP

          So sad!

          I understand though in the case of pregnant mothers with infants. I recently met a woman with a 7-month old who was also 4-months pregnant with twins. That’s kind of a bummer for the older child, but on the bright side, if you switch to formula at three months old, the big baby shouldn’t miss it.

          • amazonmom

            It is sad because the poor moms are just trying to do their best. We do our best to get moms to come in for a face to face encounter when this happens because the face to face support really does seem to help moms feel better about the situation.

      • Therese

        I don’t think so. At least in humans, breastmilk gets “re-set” with the birth of the new baby, so the new baby would get the type of milk it needs.

        • Ainsley Nicholson

          Exactly. If breastmilk gets “reset” like you describe (I believe it does, and amazonmom’s comment below supports that also) then the new baby would get the type it needs. If this type is more energy-intensive to produce than what a toddler needs (likely), then the mother wants to reserve it for the youngest child. It is a more complex issue than simply how many calories are needed to breastfeed two offspring. If there is no new baby on the scene, the mother may continue for a while longer to nurse a toddler, or even two, who will continue to derive benefit from being nursed.

  • Rachel Mills

    Dead babies and mothers are very natural. They have accumulated lots of those.

  • http://Www.awaitingjuno.blogspot.com/ Mrs. W

    Perhaps “Extreme Child Birth” is a better moniker for what is being passed off as “Natural Child Birth” – seems far more fitting does it not? Doing things that are clearly dangerous for the express purpose of impressing your peers and getting a better adrenaline rush.

    • Eddie

      Especially when you’re talking about those who UC and then put the video on YouTube, I think you captured it! All we need now is the reality show. (Please, no network take this idea seriously. I’ve already lost enough brain cells catching bits of what my teens watch on TV.)

    • Michellejo

      How about “Stunt Child Birth” or “Cool Child Birth”.

      Not all of their nutty practices are dangerous. They’re just mad. I can’t imagine enjoying eating a placenta cut, but it’s probably not dangerous. Same for having a birth photographer or having your naked toddler in the bloody pool with you.

    • The Bofa on the Sofa

      Except that you have to call it Xtreme.

      So it is XCB

    • araikwao

      Yeah, I’m thinking Superior Child Birth. Because that’s what’s implied..