Natural childbirth advocates desperate to pretend Duchess validated their choices

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I could almost feel sorry for natural childbirth advocates. They have such low self-esteem and are so desperate for validation of their own beliefs, they have resorted to pretending that Duchess Kate mirrored their own birth choices.

The Duchess may be the wife of one heir to the throne and the mother of another, but even she cannot escape the pathetic need of natural childbirth advocates to judge and demean. The Duchess has modeled the best way to handle natural childbirth advocates; she has ignored them and refused to reveal private details of her pregnancy and birth. Therefore, NCB advocates have been forced to resort to pretending.

It started as soon as the pregnancy was announced. Twitter was full of NCB advocates fantasizing the the Duchess would have a homebirth. Unfortuntately for them, that was never in the cards. The Duchess, like any mother anxious to get the best possible care for herself and her child, gave birth in a hospital, and with obstetricians, not midwives. It seems as though when it’s REALLY important to ensure the survival of mother and baby (because they are part of the royal family), midwife led care is viewed as unacceptably second rate.

Oh, well. At least they can still pretend that the Duchess insisted on a natural birth. Despite having no idea of the Duchess’s due date, NCB advocates waxed rhapsodic that she didn’t have a post dates induction. Unfortunately, even an obstetrician I respect fell for that gambit. (The great Kate wait is a lesson for maternal health providers and pregnant women alike, as if the Duchess’s obstetricians would have hesitated for a microsecond to induce or proceed to immediate C-section if there were even a tiny hint that the little prince were at risk of oxygen deprivation.

Since the birth Twitter has been buzzing with NCB advocates speculating about whether the little prince had delayed cord clamping and whether he was or will be circumcized. It is assumed that the Duchess will breastfeed, so speculation centers around whether she will breastfeed in public (not likely).

But for sheer desperation and idiocy, you can’t beat today’s piece by Dr. Miriam Stoppard in the Mirror, Royal baby news: Kate Middleton’s quick childbirth shows she was relaxed during labour.

News the birth was quick suggests Kate was relaxed and not anxious during labour.

She apparently used a method called hypnobirthing to stay calm and visualise a straight forward birth.

Having Prince William at her side coaching, supporting and reassuring her during labour must have made a huge difference…

I hope the midwife laid the baby on Kate’s stomach soon after the birth so he could hear her heartbeat and smell her skin…

I guess if you are going to fantasize, you might as well go all the way and pretend that the birth was attended by a midwife even though it was reported that it wasn’t.

Stoppard has absolutely no idea how long the Duchess’s labor lasted since she doesn’t know when it started, but no matter. It’s so much more satisfying to pretend that it was quick and easy.

Stoppard has no idea whether or not the Duchess was relaxed or why. “Relaxing” during has no impact on length of labor and there is no scientific evidence that hypobirthing benefits anything other than the wallets of hypnobirthing purveyors.

For all we know, the Duchess received an epidural the minute she came through the door, and relaxed in comfort until the baby was born. But who cares about reality when pretending provides a much better boost to fragile self esteem.

You know what I didn’t see in the months leading up to the royal birth and in the days since? I haven’t seen anyone other than NCB advocates speculating about the details of the birth. I haven’t seen any women fantasizing that the Duchess would have an epidural like they did, or would opt for a maternal request C-section, or would request active managment of the 3rd state of labor. Most women don’t need anyone, not even a Duchess, to validate their childbirth choices.

Which makes it even more remarkable that natural childbirth advocates apparently need everyone to do so.

  • kira fox

    it is amazing how “fads” always come back. Let’s take natural birth options for instance. Once it was a must because there weren’t any medical drugs that could numb your body while giving birth. But today people are trying to stay clear of drugs. Personally I think that is a good thing 🙂 Anyway Congratulations I heard the baby is wonderful!

  • JMH

    Dr Tuteur,

    Thank you! I’m currently an OBGYN resident and starting to feel suffocated by all of the Midwifery publicity- including in the hospital. Finding your blog today was great to know that there are some scientific OBGYNs out there that do not bow to the fear and financial incentives midwifery throws at them.
    I’m bookmarking your blog to all of the desktops in the department.

    • An Actual Attorney

      JMH — Thank you! Please keep fighting for the sanity and the science!

  • Melissa

    You’re being as judge mental as you claim natural birth advocates are! Ladies, don’t listen to her psychobabble, or anyone’s else’s for that matter. Do what YOU feel is right for you

    • Anj Fabian

      “feels right”?

      So…..what resources would you recommend to women?

  • SophieT

    The Daily Mail article I read on this, that I see has been commented on below, was nauseating. You’d have thought she had given birth to Christ the way they were warbling on. Its the usual story, lets make inflammatory remarks to make women feel inferior because of this ‘expectation’ from NB advocates that this is women’s ‘big chance’ to prove their worth, the moment they’ve been waiting for to get it right, and of course, lets use the perfect Princess in the process to hail as the ideal women that all others should compare to.
    How the heck does anyone at all know what went on in that private labour ward? Even if she did have midwife care, she had an 2 or 3 obstetricians at her disposal throughout her pregnancy and labour, and a neonatologist. The best Drs money can buy – no wonder she was relaxed. Ill bet it had eff-all to do with hypno-birthing and more that she had the best MEDICAL care money can buy, not that we know anyway. She may well have been writhing in agony like the rest of us, but no lets martyr the poor girl just to promote your cause and speak speculation and desperation as the truth.

  • Anna

    Darn those natural birth advocates…they were actually right this time:

    http://abclocal.go.com/wls/story?section=news%2Fhealth&id=9189008

    • Ainsley Nicholson

      So much for their theory that you can’t have a natural birth in a hospital….

  • Amy,

    I am sorry I could not locate your email address so I could contact you in a more appropriate way.

    There is a birth center in Utah that is doing some very dangerous things. I doubt you would care much about my story of misconduct with them (its about sexual abuse and forced examinations), but recently at the same birth center the staff failed to catch the baby and it landed on its head. The midwives put a hat on the baby and pretended that it never happened. There were other complaints about technical skill that I found before and posted on my website. The birth center trains midwives and the college does nothing in response to my complaints. I need to do everything in my power to publicize this before they kill a baby or a mother. I thought that skeptical OB readership may be able to help shut this place down somehow or at least make it known that these things are going on. I have called a news station to try and get them to pick up the story but I don’t know if they are going to do it. Lawyers won’t touch the place because they lack malpractice insurance, and in my case the midwife wasn’t licensed so its a grey area legally. They have ignored my lawyer completely.

    This place is owned by the first woman to get a CPM certification in utah, so she has been at this for decades. Inexperience isn’t an excuse. I can’t find out what happened to her old clinic because it was before the internet was widespread.

    I am respectfully requesting that people don’t deride me for my choice to go there, I have PTSD from it so I relive it and pay for it every day. They said it was a safe place for a person like me and they lied.

    • Expat in Germany

      No one would deride you for that here. I’m sorry that you are suffering. I hope someone here has an idea of how to help you. I read your blog and my heart breaks for you.

      • I don’t have a creative name

        you can reach Dr. Amy at DrAmy5 at aol dot com

        I am still cringing at the baby falling on the floor. The only thing I have for these people who want to catch babies but refuse to get proper training for it is hatred. I am very sorry you were mistreated and that Ester is hiding behind the veil of midwifery to abuse other women. I noticed she is a DEM (surprise, surprise), and that she is a native of Argentina with a German name. Many of the Nazi’s fled to Argentina after WWII to escape prosecution. Makes me wonder if she’s Nazi-descended – might explain some things!

        • Expat in Germany

          One thing that jumped out at me in the blog was the description of the midwife’s jagged fingernails after the exam. Not wearing gloves sounds like it might be illegal.

          • she was wearing gloves, they were vinyl ones though so you could see through them.

          • Expat in Germany

            It still sounded awful.

          • thanks for your understanding. It was the 2nd worst thing thats ever happened to me. #1 was rape. If my baby had not been okay I don’t think I would be here.

          • Expat in Germany

            The more I read, the more horrible it gets. You are brave for trying to put together a case against the center. The story of the woman who had her robe taken from her so that she was left naked to give birth in front of a room full of strangers who were just there to watch and learn. Then they watched and did nothing as the baby fell onto the floor and bruised its head. and the mother trying to stand up unassisted, feeling humiliated and slipping in blood. There is something really, really wrong with this picture and I fully understand why you tried to involve the police. I hope that more women come forward to make a case and stop this from happening.

          • I spent a couple weeks ignoring everything and that story is what I found when I went to check where my stats are at when you google ‘better birth utah’. I was floored. I thought they would try to be more careful after all the trouble I’ve caused them.

            edited to add: I was also surprised that they didn’t have any precautions on their hardwood floors. How hard would it have been to put a few towels underneath her?

          • Serenity

            Read up on PowerBirth. It sounds like that is what they were doing. It happened to me too, 13 years ago in St. George with Elizabeth Camp (Smith). Lydi Owen, a midwife in Vegas, “invented” it (in quotes because it was done in pre-obstetric times too, but it’s ineffective), and since then she and the midwives she trained have taught that method to many in the West. It involves manually dilating the cervix, which is just as painful as it sounds, without informed consent, passing it off as just an exam. They see PowerBirth as a tool to use for slowly-progressing labors to save people from an eventual c-section (because a c-section is seen as the Worst Thing Ever — of course you and I got the c-section eventually anyway).

            After a long time laboring and little progress, my baby had some distress and I transferred to the hospital. I was shocked when I had my first vaginal exam by the male OB — it was so short and comparatively painless! I commented about it then, and to the midwife a year later when I discussed my birth with her. She said that her exams were more painful because hers were “helping” more. She also made me labor in painful positions because she thought the pain meant that the laboring was more productive. She really liked the value of pain and treated me like a drill sergeant, not the caring comforting midwife that I had been sold pre-labor. She, like your birth center, had told me that I didn’t need a doula because she provided those services.

            And like you, I didn’t get a refund. I hear all the time people saying that home birth is cheaper than hospital birth. That may be, especially if you don’t have insurance, but ONLY IF you don’t have to transfer. If you transfer your cost is doubled, and there is like a 10% – 15% rate of transport (higher for primips, higher still for VBAC). And you get kicked out of the natural birthing peer group that you grew to depend on so much when pregnant. At least you and me got a healthy baby–the ones who didn’t get that really get a raw deal.

          • Expat in Germany

            But it is important to note that power birth midwives don’t typically touch clitorises. That comes from Ina May Gaskin and is much worse especially if the mom is not expecting or asking for it as seems to be the case at this midwife training facility. The fact that they take vulnerable laboring women’s clothes without consent and touch them without consent at this facility tells me that people should be arrested.

          • I don’t think that she touched me that way out of some misguided attempt to help my labor. She was visibly angry with me and knew I had a sexual abuse history. She denied me food to get this exam performed- how psycho is that? I strongly feel that she was trying to punish me or get me to leave bc she already had my money and disliked that I was being difficult by refusing to take her advice without question. My therapist has suggested to me that she probably has done this many times, this isn’t the kind of behavior that just presents itself after a decade of practice. I also doubt it has much to do with ina may, because this midwife worked in argentina for a decade before coming here, it seems unlikely to me that gaskin is used as a main resource in latin america. From what I understand gaskin traveled to latin america in order to learn from midwives there.

            thanks for the info on power birth everyone, I will check into it.

          • Jocelyn

            I am so, so sorry. I just read your story and am disgusted at the behavior of the midwives. I am so sorry they abused you this way.

          • This stuff shouldn’t happen

            Wouldn’t that just take the cake: if Gaskin’s button rubbing methods originated with german Nazis in South America!

          • I want to be very clear about this- I don’t care if its a method that works or doesn’t or if its silly or anything else, I care that this was done to me without my consent. If NCB people want to try that with their midwives with discussion I have no problem with it. Ester did not seem (to me) to be a person who tried weird things like that though, she told me to go get an epidural ffs.

          • This stuff shouldn’t happen

            Sorry for the stupid conjecture. What she did was horrible sexual abuse. I think that by leaving when you did, you escaped worse treatment. She wasn’t happy that you were standing up for yourself and not being passive to her abuse.

          • Expat in Germany

            More hurt by power birth stories are here: http://midwiferyramblings.blogspot.dk/2010/12/victims-of-power-birth-speak-out.html
            The midwives who practice this sound like psychopathic sadists.

          • Lizzie Dee

            Well, if you are a psychopathic sadist, getting paid to watch someone in pain and having the power to stop them do anything about it must be terrific.

            I would have thought that the normal human instinct would be to want to alleviate suffering, not celebrate it. Throw in the sexualising of childbirth and some very murky waters could lurk underneath all this “niceness” and support.

            (And don’t bother telling me those women in the You Tube videos AREN’T suffering. The may convince themselves that there is some point to it, they may “cope” with it, or forget it in the delight of a baby, but I would take a whole lot of convincing that it doesn’t hurt nine and a half times out of ten.)

          • Expat in Germany

            They aren’t just watching women in pain, they are personally contributing to it by manually dilating a cervix. It is like a doctor sticking a hand in a non anesthetized wound and stretching.

          • Expat in Germany

            I just have to write that I’ve had 3 babies and I’ve never gotten -checked out- for a minute and 30 seconds as you described. It was a non emergency situation and she didn’t stop when you told her to. During the final stages of birth, and they were trying to get one to turn, hands were up in there a lot, but never for more than 5 seconds in he early stages. I think the police dept needs a visit from an ob. and a lawyer.

          • The detectives supervisor told me there were ‘difficulties’ in prosecuting it criminally bc I consented to an exam so it is hard to determine what was supposed to happen and what wasn’t. SO basically I can never go to a gynecologist ever again knowing that they can do this to me too and I will have no recourse.

          • Expat in Germany

            If a male ob had done what you described, there would be a case. I hope through your work to out this center that you get some good help to deal with this. I really admire how you’ve reacted.

          • KarenJJ

            Is Utah an area where power-birthing is practised by some of the lay-midwives? I hope this is not someone encountering this..

          • Serenity

            Yep, see my reply below.

          • KarenJJ

            Poor woman 🙁 Someone should do an expose on this. It sounds horrific.

          • theadequatemother

            I’m not a gynecologist, but I am a physician, and when I was trained, if the patient says, “no,” and its not life or limb, you stop what you’re doing – immediately. There are gynes that specialize in abuse survivors, if you could find one of those then you won’t necessarily have to forgo potentially useful health maintenance/ treatment.

            I’m about to read your story, I suspect it’s going to keep me up most of the night.

          • Dr Kitty

            EVERY SINGLE TIME I do a vaginal exam or smear test I say “if you want me to stop, just say “stop”. Consent can be withdrawn at ANY TIME.

            If someone looks uncomfortable I’ll ask “Do you need me to stop?”, and if they say “no”, I’ll ask “are you sure, because there is no problem if you need to stop”. I don’t want there to ever be ANY question of consent- I don’t want to harm or traumatise women and I don’t want someone ever to feel that she couldn’t speak up.
            I am not the exception.

            Talk to a gynaecologist- explain your history, explain how examinations are triggering and fill you with anxiety- allow them the opportunity to tell you how they can make it better.

            I have ladies who need me to use tiny “virgin” speculums , or who’ll take some valium before an exam, and I’m just a GP- gynaes probably have even more tricks up their sleeves.

            Please try and find someone nice for your well-woman care- you deserve the best health, and someone who respects your wishes is a good start to getting it.

          • You know, it would be a lot easier for me to trust again if the hospital had been decent, but they weren’t. The ob there shoved a catheter up into my uterus without asking after I consented to AROM. She was everything I tried to avoid by going to a birth center, too. I don’t feel like any medical setting is safe anymore.

          • Alenushka

            OMG. My dentist does it during routine cleaning and filling. I can stop anytime if I am not feeling up to it.

    • AB

      Wow. I used Better Birth for my first child (ended up transferring to a hospital during labor, though.) While my midwife was far from perfect, I now feel fortunate I didn’t have that kind of horror story…

    • moto_librarian

      Sexual abuse at the hands of healthcare providers is inexcusable! I think this is every bit as disturbing as dropping a newborn on the floor. I am so very sorry that this happened to you.

  • Louise

    The following report is intrusive and some parts may be speculative but the details of the medical team will be correct. Kate was attended by a team of four midwives and it appears the baby was delivered by Midwife Jacqueline Venkatesh with other midwives and doctors present in the room. This is what I suspected, as at all the private, consultant-led births I have attended in NHS hospitals the private consultant, who is collecting a fee of thousands, is present in the room but the NHS midwives, who receive no extra fee at all, provide all the hands-on care. I thought it may have been different in Kate’s case as I didn’t know if Marcus Setchell, due to his weird, semi-ceremonial position as ‘Royal Gynecologist’ would actually deliver the baby himself but it sounds like they stuck to standard procedure with the midwife delivering the baby, with the professor of midwifery and various doctors standing by. So the birth was attended by a midwife despite ‘Dr. Amy’ (why not Dr. Tuteur btw?) claim that midwifery care is ‘unacceptably second rate.’

    http://www.dailymail.co.uk/news/article-2380237/11-hours-labour-natural-How-serene-Kate-sailed-textbook-delivery-goes-perfect-birth-hoping-for.html

    For what it’s worth I don’t give a fig how Kate gave birth, or indeed about the Royal family at all, but I resent Amy bashing British midwives whilst clearly understanding nothing about our maternity system.

    • Lizzie Dee

      Nitpicking. No-one is going to have a problem with properly trained midwives acting in collaboration with/under the supervision of an OB.

      Some of the midwives I came across were superb, and trusted by the doctors. Some of those my daughter came across were a menace – though the “old school” one who delivered her was fine. The attitudes of some of those on that Student forum, with their disdain for pain relief and enthusiasm for non-intervention was scary.

      • Louise

        That student forum is largely a self-selecting group of fringe nutters. When I started my course we were specifically told by the lecturers to treat it with skepticism. Certainly no one on my course posted there, and they aren’t reflective of any of the students I studied with or midwives I worked with. I used to go there for advice on the application procedure before I started uni, but I don’t think I ever bothered with it once I got in.

        • fiftyfifty1

          The “Not all of us are like that” excuse has never reassured me much. How does a woman in labor determine whether she has drawn a good one or one of the nutters? How can she protect herself?

          • Louise

            Well, if the midwife is not respecting your wishes and you don’t feel comfortable with her, ask for another one. You have every right to do so. FWIW, the numbers posting on that forum are a tiny percentage, and I have not known any midwives like that IRL.

          • fiftyfifty1

            Have the presence of mind and energy to advocate for myself in labor? I barely had the presence of mind to know which way was up! I am glad you feel that UK midwives, on the whole, are trustworthy. I do think that providers who continue to provide their patients excellent care despite the obstacle of poor funding are admirable. But what Dr. Tuteur says about the head of UK midwifery advocating for “normal birth” does make me very concerned. I personally see no *inherent* value in the concept of “normal birth”. As a mother I want to aim for “both of us healthy in the long term”. Of course nice straightforward, uncomplicated vaginal births are wonderful! But this outcome happens largely by luck of the draw. It’s not the sort of ideal that one can STRIVE for. It’s like saying that people who don’t need to be treated for sickle cell anemia have better outcomes than those who do. And then “solve” the problem by hiding your head in the sand and stopping testing and treatment of sickle cell.

    • PJ

      Your scenario may be true, but come on, the Daily Mail? You can’t take an article there as evidence of anything.

      • Louise

        The Daily Mail may be a hate-filled sh*trag but they aren’t just going to make up the names of the medical/midwifery staff who attended the birth. I still can’t imagine for a second a consultant would get his hands dirty (so to speak) actually delivering a baby for a normal vaginal birth when there is a midwife in the room to do it instead, even if he/she is the one collecting the massive fee.

        • PJ

          It’s hard not to imagine a consultant making an exception for this particular baby. But who cares? It’s all speculation anyway.

    • Amy Tuteur, MD

      Natural childbirth advocates despearate to prove that the Duchess validated their choices. Thanks for a perfect example.

      • Louise

        Oh, c’mon. I hardly think the Daily Mail qualify as natural childbirth advocates. For my part, I’m not a natural childbirth advocate and certainly don’t need a Duchess or anyone else to validate any of the choices I’ve never been in a position to have to make anyway. I was simply pointing out that your sneering that midwives were not good enough to deliver the Royal baby was in fact erroneous, and that you shouldn’t comment on systems you don’t understand.

        • Amy Tuteur, MD

          Good try, not buying it.

          You have demonstrated a classic NCB technique: ignoring multiple published sources in favor of the one (poorly regarded) source that differs from all others, but supports what you desperately wish to believe.

          • Louise

            I’m not a natural childbirth advocate. I’m just someone with experience of working the UK maternity system who understands that consultant-led birth does nor mean what you think it does in this context.

            I got fed up of midwifery and left for a more interesting (to me), better paid career abroad and am not that interested in birth related issues any more. However I have the highest respect for all my former colleagues who are prepared to work so hard at such a noble job for 26 grand a year and don’t like to see them sneered at.

            I hadn’t been to this blog for years. I just saw loads of natural childbirth types using the royal birth in a rather sad attempt to advance their own pet causes and though ‘bet Dr. Amy is doing the exact same thing yet somehow thinks she is different to them.’ And guess what, I was right!

          • Captain Obvious

            Louise, what is your take on American Homebirth midwives? Most people here would admit properly trained midwives in other countries with backup in a hospital is not that bad of a choice. Then you have what this blog is really about, the American, land of the free to do as you may, Homebirth midwife.

          • Louise

            From what I have read about them they appear to be undereducated, under-trained, woefully lacking in experience, dangerous and more than a little nutty. If Dr. Amy reserved her diatribes for them I wouldn’t care in the slightest. I simply took umbrage at her belittling hardworking, professional British midwives when she clearly has no idea how the maternity system back there works

          • Expat in Germany

            The point is that consultant LED care was chosen and not midwife LED care. Who cares who caught the baby? Who was calling the shots?

          • Louise

            I don’t care. I was simply responding to this:

            “I guess if you are going to fantasize, you might as well go all the way
            and pretend that the birth was attended by a midwife even though it was
            reported that it wasn’t.”

            I just find it amusing that ‘Dr. Amy’ berates others for their ignorance whilst feeling free to comment on matters she doesn’t understand. And that as soon as I saw those articles in the Telegraph, Guardian etc. I just KNEW she would be doing exactly the same thing from the other side of the fence.

          • Expat in Germany

            apparently most sources imply that a doc caught the baby by emphasizing the consultant led care and you found one tabloid that points to a midwife doing the catching and you believe it because that is what usually happens in average consultant led births. I don’t think anyone knows for sure and making claims either way amounts to what Dr. Amy wrote: fantasizing about who caught the baby.

          • Louise

            Dr. Amy (that name drives me nuts! It’s so folksy-American-faux-cutesy. It’s Amy, Dr. Tuteur or Dr. Amy Tutuer. Dr. Firstname is not a thing!) certainly implied she knew who had caught the baby.

            For my part I have certainly never fantasised about Kate Middleton’s vagina and I’d like to keep it that way thank you very much.

          • fiftyfifty1

            Here in the U.S. the verb “to attend” used in a medical situation means “to lead”, it doesn’t mean “to be there”. The medical professional calling the shots is “The Attending”. So midwives may have been there, they may have done much or even all of the manual labor, but that doesn’t mean the birth was attended by a midwife. It was attended by the Consultant. Is this the way the verb is used in the UK?

          • Louise

            No, it isn’t. I guess that’s why consultants in the US are called attendings? Always wondered about that. Thanks for clarifying. Amy did suggest it was an absurd fantasy that a midwife would have handed the baby to Kate though, which it clearly isn’t, as a midwife will definitely have been there.

        • JayBee

          Yeah, you’re not a natural birth advocate but you think there’s no problem if women are denied epidurals and c-sections on request. And you think that “uncomplicated deliveries” should be handled by midwives. Because you have a special crystal ball that tells you exactly which delivery will be uncomplicated. YOU are the reason that midwives have such a bad reputation amongst people with a brain. You can’t think beyond your agenda and you live in constant denial.

    • Expat in Germany

      She didn’t write that midwifery care is second rate, but that midwife LED care is inferior to doctor LED care. Who calls the shots when things aren’t moving along nicely?

      • Louise

        But midwife led care is not inferior as long as the midwife has the judgement and means to collaborate/transfer when necessary. This post was clearly saying that of course no one would have let a midwife near the royal birth. When in fact it is obvious that Kate would have had a team of senior midwives present. Yes, they were overseen by a doctor but I bet when the queen gets her teeth cleaned there is a dental consultant there as well as the hygienist. Doesn’t mean it’s actually necessary.

        • Expat in Germany

          Teeth cleaning is not as dangerous as birth. I would say, of course the midwife would not be calling the shots. The consultant would be up to date on the latest research and would be the one watching the clock, watching the efm trace, checking the position of the baby, and deciding on what to try next. Pitocin or another hour of pushing?

          • Louise

            I am sure that in this case the doctor would be calling the shots, although I doubt they would have bothered to have a professor of midwifery there unless she was also being consulted. But if you know anything about midwifery in Europe you will know that midwives are obliged to demonstrate that they are up to date on the latest research as a condition of their continuing employment and registration. Of course, they don’t have the same breadth and depth of knowledge as a consultant obstetrician, but that would hardly be relevant in the case of the uncomplicated birth this appears to have been.

          • Expat in Germany

            I’m sure there was plenty of political jockeying to get close to that hospital room and we have no idea if the birth was complicated or not, only that it was consultant led. You choose to believe the uncomplicated birth with a midwife fantasy just as Dr. Amy described in her post. There is no good evidence about who did what and if a midwife did the catching, so what?

          • Louise

            Oh for God’s sake! I don’t care who delivered this or any other baby, as long as it was someone competent. I just didn’t like seeing my former colleagues sneered at from a position of ignorance, so called Amy out on her hypocrisy.

          • Amy Tuteur, MD

            Obviously you care a great deal. Otherwise you wouldn’t have felt the need to come here and “correct” my post with information from a British tabloid, which is contradicted by every other published report.

          • Louise

            Um, it doesn’t contradict any other reports. All the reports say the same thing. Kate had a consultant-led birth with both doctors and midwives in attendance. No one knows who delivered the baby, but it is certainly possible that it was a midwife, as this report implies.

            I am only here arguing with you for the very same reason I was on the Daily Mail website in the first place (same reason I go to Fox news and Alex Jones’ websites too.) On a Sunday evening, when I’m bored, I like arguing with strange, paranoid people on the internet. It’s harmless fun.

            I do object to your ignorant sneering at my former colleagues and our precious and currently under-threat NHS though. In that I am entirely sincere.

        • Amy Tuteur, MD

          Midwife care is ALWAYS inferior if the midwife believes that “normal birth” is something that should be promoted.

          Get a grip, Louise, babies and mothers are dying left and right in the UK because midwives are more concerned about their turf and “promoting normal birth” than anything else. The head of RCOG is a clown who actually gave interviews about the Netherlands’ “fabulous” perinatal mortality rates when the rates were hideous. She had no idea of the truth since she never bothered to look.

          Promoting process over outcome is all about midwives and is grossly unethical.

          Midwifery care iis promoted by the government because it costs less. And it costs less because it is worth less.

          • fiftyfifty1

            Harsh, but true.

          • Louise

            Amy, have you ever actually met a British midwife or obstetrician? Set foot in a UK hospital? British midwives do NOT value over outcome. As the standard maternity providers in an overstretched, under-funded and under-staffed system system they take the flack for the failures of the successive governments to get their priorities straight. You seem to think pressure groups represent the people actually working on the ground.

            For someone who so values your critical faculties so seem very easy to uncritically accept the right-wing press an their politically motivated mauling of the NHS.

            Maternal mortality rates in the US are appalling, so your OB-led system can’t be that superior.

          • Amy Tuteur, MD

            Really? Anyone who has a campaign for “normal birth” promotes process over outcome.

            http://www.rcmnormalbirth.org.uk/practice/

            And Louise, I thought you knew better than to promote canards like the “hideous” maternal mortality rates.

          • Louise

            It’s not ‘Campaign for Normal Birth Even Where Inappropriate and/or Dangerous Even It Goes Against The Wishes of the Mother.’

            Anyway I never joined the RCM. I joined Unison because they are a proper union and the RCM woman that came to our uni seemed a bit snotty to me anyway.

          • Amy Tuteur, MD

            It’s a campaign for a process as opposed to an outcome.

            Can you imagine the uproar if obstetricians launched a “campaign for episiotomies” or a “campaign for cesaeans.” Or how about cardiac surgeons launching a “campaign for triple bypasses”? A campaign for unmedicated vaginal birth without interventions is every bit as offensive and unethical.

            There is nothing better, safer, or healthier about unmedicated vaginal birth. It’s just midwifery turf, so midwives are promoting it.

          • Louise

            Are you suggesting a vaginal birth is not safer than a caesarian for which there is no medical indication? Personally I am fine with a caesarian entirely at maternal request but I don’t think you should be able to have one on the NHS unless you have a psychiatrists note for extreme tocophobia or PTSD. In the UK every woman receives all her maternity care free at the point of need from highly trained, well-qualified midwives but you seem to think a system whereby doctors charge thousands to attend births at which they are often not needed because a properly trained midwife could do the job just as well, and which still (or more likely for that very reason) produces appalling levels of maternal mortality is somehow superior.

          • Expat in Germany

            Nobody here objects to midwives catching babies. What people object to is midwives who don’t properly risk people out and respond to complications. It is like an infection in the entire field that cannot be ignored. Until the infection is cleared, docs are going to be the safer bet. Germany has pretty good outcomes and the hospital rules over midwives and doctors alike with an iron fist leaving little room for them to exercise personal philosophies like a “campaign for normal birth (midwife autonomy)”. The drive for autonomy should be questioned at all levels of medicine.

          • Louise

            ‘What people object to is midwives who don’t properly risk people out
            and respond to complications. It is like an infection in the entire
            field that cannot be ignored.’

            Maybe in the US but not the UK. There midwives simply take the flack for the failings of a system working people have fought hard for decades to create, protect and preserve and which is currently being destroyed by the bunch of sociopaths that form our government.

            Despite which birth in the UK is still incredibly safe. I am currently dating an American and if he ever knocks me up there is NO WAY I would give birth in the US. I would be on the first plane home for a free birth in an NHS hospital with an NHS midwife and all the gas and air my lungs can accommodate, thank you. Nothing would induce me to deliver or raise a child in America.

          • Expat in Germany

            See Dr. Amy’s comment above about the 1/3 of maternal deaths.

          • moto_librarian

            So you’ve never had a baby, Louise? How convenient. It’s quite easy to proclaim what you will do until you’ve actually experienced labor and delivery. My hospital started using gas again (in the U.S. – gasp!), and guess what? The people that I know who have used it said it really did nothing for the pain, but simply got you high enough to not care anymore. That was my backup plan for my second birth had I not arrived in time for an epidural, because it had to better than nothing.

            Your attitude towards MRCS is also quite revealing. Like the typical NCB advocate, you completely ignore the problems that can occur during a vaginal birth. If I had known that my cervix was going to be torn during my oh so natural birth, resulting in a severe pph, surgery, and a very long recovery, I may have opted for a c-section. I seriously considered that option with my second, but after frank conversations with my midwives (gasp! an American who used a midwife!), I opted to try for another vaginal birth. Thanks to an epidural that helped me to control my pushing, I had a painless birth with no complications. May you be so lucky if you ever have children.

          • Amy Tuteur, MD

            Don’t move the goal posts.

            I’m saying that RCM promotes a process, not an outcome.

            And I’m saying that there is nothing better, healthier or safer about vaginal birth. The mere fact that you had to resort to asking about maternal request C-sections means that you acknowledge the truth of that statement. There is NO medical reason to promote “normal” birth.

            There have been dozens of infant and maternal deaths resulting solely from the unwillingness of UK midwives to hand over patients to those who are more qualified than they are. A recent confidential review showed that fully 1/3 of maternal deaths are at the hands of midwives who didn’t recognize or didn’t refer patients that were high risk. That’s because British midwives promote a specific process over safety. They promote THEIR personal interests over the interests of mothers and babies.

            British midwifery is a mess. It’s been hijacked by ideologues like Cathy Warwick, Soo Downe, Sheila Kitzinger and others promoting midwifery by the most ludicrous means possible.

            By DEFINITION, a provider who promotes a process as opposed to an outcome is unethical.

          • Louise

            ‘A recent confidential review showed that fully 1/3 of maternal deaths
            are at the hands of midwives who didn’t recognize or didn’t refer
            patients that were high risk. That’s because British midwives promote a
            specific process over safety. They promote THEIR personal interests over the interests of mothers and babies.’

            Any proof at all of a causal links between those two statements? I’m not saying none of those deaths occurred for that reason but do you have any proof that ideology/self-interest was a major factor in that figure, as opposed to the service being overstretched and understaffed, particularly in London?

          • Wren

            Actually, I have wondered about that too. A third of deaths being due to midwives not recognising or referring high risk patients isn’t actually evidence for a certain ideology causing that, is it? If those deaths were at the hands of doctors would a certain ideology automatically be at fault?

            I was, once upon a time, a student nurse planning to go into midwifery in the UK. I spent all the time I could as a student working with midwives in London, I volunteered in the antenatal clinic at my then local hospital (in south London) and I have had shared care between the midwife team, my GP and an OB for both of my pregnancies. In that time, I ran into a very few midwives who were unwilling to refer high risk pregnancies or who put process over safety. In fact, it was rare enough I can only think of two who might qualify. I was, I will freely admit, denied an epidural with my second but only because the anaesthetist was in theatre and I was already at 10 cm. It was not due to ideology from what I could tell, but time and limited resources leading to not having a second anaesthetist available at that time.

          • Louise

            ‘And I’m saying that there is nothing better, healthier or safer about
            vaginal birth. The mere fact that you had to resort to asking about
            maternal request C-sections means that you acknowledge the truth of that
            statement. There is NO medical reason to promote “normal” birth’

            Umm…I never said there was? Confused.

          • Karen in SC

            There are risks to vaginal birth as well. Why shouldn’t any woman be able to have a MRCS if that is her choice?

            I have also read that the campaign in the UK is leading to refusal of epidurals as well. That’s cruel. There is no reason to feel pain when it can be alleviated. Kidney stone patients can do without but no one is campaigning to refuse pain medication for those patients.

          • Louise

            Because if there is no medical indication for a surgical delivery, which is considerably more expensive, why should a woman get one for free in a system that is already overstretched financially?

            And epidurals are not refused because of the RCM. They are refused when there are not enough anesthetists and midwives, as the front line care providers, get the blame.

          • Amy Tuteur, MD

            I take it you are totally opposed to homebirths for the same reason: they are very resource expensive in a system that is already overstretch financially.

            And Louise, you are destroying your credibility if you expect anyone to believe that the RCM does not encourage its members to talk women out of epidurals or “forget” to call the anesthesiologist.

          • Louise

            I have NEVER known that to happen. Where I worked, if a woman asked for an epidural, the anesthetist was called immediately. I one didn’t show up immediately it was because they were all tied in theatre.

            As opposed to homebirths, I guess that would depend on the model. The way the community midwifery team was organised in my trust, homebirths were not a stretch on staffing levels. But then we didn’t have very many. It might have been different if we had more. Tbh there isn’t enough demand for them to be a serious drain on resources.

          • EllenL

            If women can’t get epidurals because there are too few anesthetists, then why don’t midwifery leaders and organizations in the UK use their clout to lobby for more?

            After all, they are in charge of maternity care.

            I have never heard any of them even mention this need publicly.

            And that’s a problem. They are in charge, and effective pain relief is not a priority to them. I don’t think it ever will be. It conflicts with their core philosophy.

          • JayBee

            Just go away. You are advocating a system that denies woman choices based on cost all the while criticising another for forcing procedures on women based on cost. You are a hypocrite and you don’t deserve an opinion on women’s healthcare.

          • Poogles

            “Are you suggesting a vaginal birth is not safer than a caesarian for which there is no medical indication?”

            Honestly, the differences in risk and safety between a vaginal birth and a scheduled, pre-labor, CS are pretty minimal, there’s just a difference in types of risk and who is shouldering most of the risk – mom or baby.

            I would prefer a MRCS, personally, because I want to eliminate certain risks (shoulder dystocia injuries, cord prolapse, forceps/vacuum injuries, episiotomy or vaginal/cervical tears, nerve damage to baby), and reduce other risks (oxygen deprivation, intracranial hemorrhage, damage to my pelvic floor). The increased risks of a pre-labor CS (wound infection, PPH, TTN, increased recovery time, blood clots) are totally worth it, to me, to avoid the risks of vaginal delivery, especially to the baby. And since I will likely only have 1 child, risks to future pregnancies don’t really weigh very heavy for me.

          • JayBee

            Yes, Louise a vaginal birth is NOT safer than a planned c-section at 39 weeks. The NICE research has demonstrated the same. The rates of morbidity and perinatal mortality were lowest with planned c-sections and not with vaginal births which could end in forceps, ventouse and/or emergency cesareans.

          • Louise

            Hmmm…you think maternal mortality rates in the US reflect a healthcare system that’s working, do you?

          • Amy Tuteur, MD

            Why don’t you explain it to me, Louise? What are the leading causes of maternal death in the US? How have various causes changed as a proportion of deaths over time? How does the US calculate maternal deaths? How have those calculations changed over the past 15 years?

            Surely you know the answers to these questions since you are quick to use maternal mortality as an indictment of US obstetrics. Wait, what? You don’t have a clue as to the answers to any of these questions? Why am I not surprised?

          • Louise

            I am not blaming US obstetrics, I am blaming a system driven by the desire for financial gain that does not provide free, universal healthcare and suggesting that a) the routine use of OBs for normal, uncomplicated deliveries is part of that system of inflating costs and that b) people who live in glass houses shouldn’t throw stones.

          • Amy Tuteur, MD

            The same questions apply when you are blaming “the system.” So what are the answers.

          • Louise

            Oh come on. You can’t expect me to come up with the answers to America’s completely screwed up healthcare system. That would take a thesis, not a blog post. What I will say is this. The routine use of OBs for normal uncomplicated deliveries is a misuse of resources which unnecessarily inflates the cost of maternity care. And also that what is wrong in the UK is not the model used, nor the use of midwives, nor some ideological plague infecting midwifery. It is underfunding, plain and simple. We spend half the percentage of GDP you do on healthcare whilst providing universal coverage and yet look at the difference in outcomes. I think the NHS does pretty damned well considering.

          • Karen in SC

            But uncomplicated birth is only uncomplicated until there is a complication. Duh, of course, that’s obvious.

            I personally think that generally the NHS midwifery model, with in-hospital birth, is a better use of resources when no ideology gets in the way. There is still the issue of the midwives missing a complication, though.

            No mention in this thread yet about malpractice and lawsuits. A handicapped child in the UK will be able to get health care, but could bankrupt a family in the USA. Also, there can be lawsuits over an injury or death of a baby which don’t happen in the UK. Our model of using the best qualified to get the best results can be partially attributed to this.

          • Louise

            You think lawsuits don’t happen in the UK? Are you kidding?

          • JayBee

            Of course they do. They happen when untrained registrars use outlawed, and medieval tools like rotational forceps on babies and end up killing them. Then the parents sue the NHS and guess what happens after that? NOTHING. Because it’s bloody difficult to sue the NHSs successfully.

          • Amy Tuteur, MD

            You say a lot of things, but you provide proof for none of them. You are simply repeating NCB tropes without having any idea whether they are true or not.

          • Louise

            You say lots of things without providing any proof. You claimed babies are ‘dying left and right’ in the UK due to midwives valuing process over outcome, yet you have provided no proof for this assertion whatsoever. The fact that the RCM has a ‘Campaign for Normal Birth’ does not prove that a single avoidable maternal death has occurred because midwives valued normal birth over patient safety, but if you have some evidence, please feel free to share.

            For what it’s worth I don’t consider myself a NCB advocate. During my training and short career I loved working on the high-risk unit and found community and the in-hospital low-risk birthing centre pretty dull in comparison. Not that I don’t value those settings or the midwives working in them, but they didn’t appeal to me. The fact that I was due a mandatory six month rotation to those clinical areas was one reason I jacked it in tbh. I liked the pace and variety of the high-risk unit.

          • JayBee

            OK, I’ll give you that stats. Britain has a stillbirth rate of 11 babies a DAY. Higher than most European countries and higher than the “selfish” land of the free USA.

          • PollyPocket

            Many Americans would take issue with the notion that the very best and most well trained providers were unneeded for THEM.

            Perhaps it’s a cultural difference, but on this side of the pond life and limb are paramount, damn the cost. And some practices are much more expensive than alternative practices in countries with government directed healthcare. But if it’s me or my family member who needs those expensive interventions, throw the kitchen sink at them!

          • Louise

            But I don’t think British women see midwifery care as substandard. Of course they want access to a doctor if needed, which the NHS provides, but they are quite happy to have a midwife for an uncomplicated pregnancy and delivery because they understand a doctor is unnecessary in those circumstances. I have heard many complaints about overstretched midwives not being able to give enough attention to them during labour, but never a complaint about being under the care of a midwife.

            That said, in broader terms I do think Americans are more selfish and individualistic than Europeans. I have spent the last few years in an expat community, mainly socialising with and dating Americans, and even among those who think of themselves as liberal/left wing, that still seems to be the case, both on a personal and ideological level. Although of course that is a generalisation. That said, it would of course be ridiculous to claim that people in any country value the lives of themselves or their children less than those in any other.

          • JayBee

            Louise, women are not given a choice in the UK. Whether you want to or not, you have to go with midwife led care because the government has decided that it is cheaper and therefore better. I am all for universal healthcare because I too believe that anyone being denied healthcare because they can’t afford it is horrible. But that has nothing to do with midwives v/s obstetricians and is an entirely separate issue. There is a reason that Obstetricians are called into the room when things get out of hand- because OBSTETRICIANS ARE MORE QUALIFIED. Secondly, a low risk pregnancy/labour can become high risk in no time at all and with very little warning. What then? The routine use of obstetricians during childbirth is something that should at least be offered to all women. Every woman should be free to choose her healthcare provider based on her needs and preferences. To deny her that choice based on cost-cutting is as despicable as forcing a choice on her in an attempt to make money.

          • Expat in Germany

            After reading this site, I know some of the answers: racial makeup and maternal health (heart disease and diabetes) are big factors. Cesarean rate plays a negligible role (despite that being a central tenet of NCB dogma). So, it isn’t us obstetrics at the center of the mortality problem. There are surely cost savings and efficiencies to be had in any system, but cost wasn’t what we were talking about. A dangerous philosophy and a drive for autonomy infecting midwifery were at issue.

          • Louise

            And seriously ‘Get a grip, Louise, babies and mothers are dying left and right in the UK.’ Yeah, it’s just like Niger back there! Jesus.

  • Guesteleh

    Amy, any plans to write about Atul Gawande’s latest New Yorker article? Sample quote:

    The global problem of death in childbirth is a pressing example. Every year, three hundred thousand mothers and more than six million children die around the time of birth, largely in poorer countries. Most of these deaths are due to events that occur during or shortly after delivery. A mother may hemorrhage. She or her baby may suffer an infection. Many babies can’t take their first breath without assistance, and newborns, especially those born small, have trouble regulating their body temperature after birth. Simple, lifesaving solutions have been known for decades. They just haven’t spread.

    Many solutions aren’t ones you can try at home, and that’s part of the problem. Increasingly, however, women around the world are giving birth in hospitals. In India, a government program offers mothers up to fourteen hundred rupees—more than what most Indians live on for a month—when they deliver in a hospital, and now, in many areas, the majority of births are in facilities. Death rates in India have fallen, but they’re still ten times greater than in high-income countries like our own.

    • Amy Tuteur, MD

      Possibly.

      What I found most interesting about the piece is how lay people (and some healthcare professionals) can’t understand things that they can’t see. They can’t see antibodies so they don’t “believe in” vaccines. And they are completely clueless when it comes to things that have been abolished by modern medicine, imaging that they never existed at all.

  • I don’t have a creative name

    Somewhat OT: Reading this article made me want to stick my finger in my brain. I may not like everything about how this country is run, but damn am I grateful to have been born an American. The lives these women lead… just unfathomable to me. http://www.nytimes.com/2013/07/14/opinion/sunday/kristof-where-young-women-find-healing-and-hope.html?_r=0

    • ratiomom

      Wow, that one certainly packs a punch. Those NCB nutters who believe that pitocin or a C-section is the absolute worst thing that can happen to a woman should be forced to work in that hospital for a while.

  • anonymous

    I don’t get the midwife comment from the article…was there even one there?

    • Karen in SC

      I think it’s wishful thinking. The report I read had 2 OBs attending.

      • anonymous

        That’s kind of what I figured. Making something from nothing seems to be the way for most of these loons.

    • R T

      Her mother is/was a midwife so technically yes!

      • Elizabeth A

        I thought her mother was an air hostess.

        • R T

          All the uk papers keep saying she’s had midwifery training, so I’m not sure!

      • EllenL

        According to the Daily Mail 7/10/13: (regarding Carole Middleton):

        “The 58-year-old received emergency midwife
        training at a British Airways training centre in 1976.

        During the training Carole learned how to
        cope if a passenger should go into labour while onboard.

        Carole attended BA’s Cranebank centre in west
        London in 1976, and learned to cope with a whole host of emergencies.”

        This doesn’t make Carole Middleton a midwife. Papers also said she would be at the birth; she wasn’t.

        • suchende

          If DEMs are “midwives,” I guess flight attendants with some midwifery training might be too.

          • R T

            Lol!

        • EllenL

          I’m very sure that if a woman went into labor on a flight, the first thing a flight attendant would do is get on the intercom and ask “Is there a doctor on board?”.

    • Louise

      There is always a midwife present at any birth in the UK. Even if an obstetrician leads the delivery, there is still at least one midwife, usually more, there. We don’t have obstetric nurses, midwives fulfill that role if there is an obstetrician led birth. Even if it is a c-section, the doctor hands the baby straight to the midwife who then either presents the baby to the parents or takes it it to the resuscitaire immediately if necessary. Kate was attended by the Lindo Wing’s senior midwives as well as her 2 doctors, and it would have been them who would have laid the baby on her after delivery.

    • Michelle

      Yes, according to our local newspaper there was four midwives in attendance over two shifts, so just like every other UK woman she had midwifery care. If delivered in the US L&D nurses would no doubt have been used to provide ongoing care over labour in conjunction with any physicians in attendance.

  • stacey

    “It seems as though when it’s REALLY important to ensure the survival of mother and baby (because they are part of the royal family), midwife led care is viewed as unacceptably second rate.”

    EXACTLY

    MWs are cost cutting measures for us plebs.

    • Guest09

      I believe that CPM led care unacceptably second rate (correction: second rate is about twenty rates too high), however CNM/CM led care I believe is very high quality. Their in-hospital outcomes more than demonstrate that. Many of the ones I know have also had a very heavy hand in training OB residents, and many OBs also speak very highly of them. They are the most educated midwives in the first world. British midwives (I’ll admit I don’t know much about them) are directly prepared right out of college, but I believe still provide more than “second rate” care to their patients.

      Personally, I don’t care who she gave birth with. I don’t have access to her records (nor would I want to), but I’m happy that she had a safe and healthy birth.

    • ratiomom

      I`m afraid you are right. Female doctors don`t go for midwife-led care. Even in the midwife-led model of care, they use their network and medical knowlegde to obtain OB-led care.
      The CNM curriculum is so saturated with NCB woo that the quality of the care they ultimately deliver is substandard. That`s what happens when you use `Midwifery Today` as a source of scientific education, and have people like Hannah Dahlen write your textbooks.

  • JP

    Perfect birth, schmerfect schmirth! When are NCBers going to start shaming women for not having a perfect conception? I’m not just talking about the obvious preference for natural conception versus in vitro (which totally would be unnatural “fertilization rape” because, duh, eggs know how to get fertilized and implanted in the uterine lining), but also the proper conditions under which a wombyn should conceive to reduce the risk of traumatizing your baby and thereby weakening your mother-baby bond from zygotehood. (Sorry, but I just don’t love my test-tube baby as much as the others!) Surely, this is an area where wombyn can only find freedom of choice by enlisting the bedside assistance of an unlicensed midwife to help them remember how conception is meant to be: a nice, quiet home conception with your partner, your midwife coaching you and telling you what to do (or putting her hand up there to make sure you’re fertile first), maybe a photographer to catch the special moment when little Quinoa was created…

    (Also, be sure not to wear a hat during conception. It lets your chi escape through the top of your head, when you should be channeling it down into your womb.)

    • wookie130

      This was beautiful. I snorted coffee out my nose at “little Quinoa.” LOL!!!!

    • GuestB

      Quinoa – My Imaginary Well Dressed Toddler Daughter!

    • Hannah

      Hold on… Wombyn? That is possibly the single greatest word I think I’ve ever heard.

    • Petanque

      Ah, if I’d known I shouldn’t have been wearing a hat I needn’t have wasted all that money and effort on IVF!!
      Why didn’t anyone tell me this before, are the doctors trying to keep it a secret?

  • ASDF

    lol i was “relaxed” during labor…after the epidural. and they put the baby on my stomach before clamping the cord- in the hospital. people are dumb.

  • Lisa from NY

    Princess Diana was induced for William

    http://www.people.com/people/package/article/0,,20395222_20718889,00.html

  • They look happy, whatever they did, or did not do – it worked for them and they are bringing home a healthy baby. I really don’t care what individual choices they made – what would be far more interesting is the process they used to make them. I imagine it’s probably something like – “we had a conversations with our care providers about what are options were, they advised on the risks and benefits of those choices, we asked some questions and we made our decisions based on that information.”

    I really admire that they aren’t spilling the beans about everything….because none of it is anyone’s business….

  • KarenJJ

    They look very happy and the baby is just beautiful 🙂 I hope they’re going well at home. Loved seeing the post-baby bump! I still have one even after.*mumble* years….

    • MichelleJo

      I’m surprised at Kate. 27 hours after birth and she still has a BUMP? The rest of her looks were easy to take care of. They sneaked a hair stylist, a make up artist and a manicurist in through the same door that Kate did.

      • Antigonos CNM

        Since she is so slender, I am not surprised at all. It takes a little more than 3 weeks for the uterus to shrink to its pre-pregnant size and return to its normal place in the pelvis. The average woman looks as if she is in her 6th month after birth.

        • R T

          My stomach was pretty flat after my csection, but I had plenty of extra bumps every where else lol!

  • Sterrell

    I will admit that I’m a bit surprised that there wasn’t more woo involved. I just finished reading a biography of Elizabeth II, and apparently she is a great believer in homeopathy, combined with traditional medicine, and Prince Charles is very into all-organic, non-GMO, etc. However, a big tenet of the same book was the need for the monarchy to create and maintain an air of mystery about themselves and their personal lives, so kudos to them on doing so.

    Also, these bloggers writing all these “open letters” to the Duchess are completely delusional nutters. Do they seriously think that she’s going to open the computer, read their inane ramblings on some distant corner of the interwebz, and then bow-down to their all knowing momma-wizdoms? Seriously?

    • KarenJJ

      Ha – because she has so much time to sit and read now 🙂

    • Lizzie Dee

      And the first requirement if you marry into the aristocracy is still an heir and a spare. Do you think George would have been the first name on her list if she did not have to have that idea at the forefront of her mind?

      I hope she got some say in the matter, and that she can wrest some kind of normal life from the rigid protocol.

  • Amazed

    Oh my, I really thought the bit about the midwife was a satirical input of Dr Amy’s *shame-faced*.

  • Lena

    I’m genuinely relieved that the royal family is so private that it’s unlikely that Kate will reveal any details. I’m so sick of the need people have to analyze the way people give birth.

    • Amazed

      If I am to analyze Kate’s birth, I’ll have to say… pain relief. After all, the royal family has a tradition dating waaaay back in time. Queen Victoria was very adamant that she really, really wanted/need/was going to get drugged through the birth of her children, churchmen be damned. Traditions are important!

      • Antigonos CNM

        Yes, general anesthesia was already available, but doctors posited that it would interfere with bonding, although they didn’t call it that, unless a woman suffered in labor. Queen Victoria got some whiffs of chloroform with her last birth, and loved it — and for decades chloroform was called “The Queen’s Anesthesia” and it became quite fashionable.

        • NeuroNerd

          I’ve actually read that Queen Victoria HATED pregnancy/birth/breastfeeding, and had little to do with her children until they were two. The exception was her final child, Princess Beatrice, who she had under a sort of twilight labor (labour, I suppose). She adored baby Beatrice, bathed her (which she didn’t do with other children), and was closest with her of all her children.

          • rh1985

            I wonder if the pain/misery interfered with bonding for her? I could see how that could happen.

  • Lizzie Dee

    The bit I find interesting – about the only bit I find interesting – is that Kate has gone home to mum!

    • Christina Maxwell

      I think it’s sensible, their new apartment isn’t ready (asbestos was found, delaying the rebuild) and they are obviously a close family. I hope she comes back soon as the Duke of Edinburgh will want to see his first great grandson but is too ill to travel.

      • Dr Kitty

        Umm hmmm…
        90 something year olds don’t usually have “exploratory surgery”, that’s what MRIs are for.
        If you open up a very elderly person, it is generally for more than a quick look-see.
        I’m not sure how much longer the Palace will be able to keep his diagnosis private, but I suspect it is serious.

        • Christina Maxwell

          Yes Dr. Kitty, exactly. I fear he doesn’t have much longer.

    • Elizabeth A

      Well, it seems sensible under the circumstances. Their house won’t be ready for a few months, and Wills has two weeks of paternity leave, and then has to finish up a military tour of duty (not sure how long that is). Someplace comfortable where Kate has lots of help and the baby has doting grandparents sounds lovely. She can do all the adjusting to a new baby and figuring out breastfeeding (if that’s what she wants to do) out of the public eye, with people who absolutely will not sell her out to the press.

      My fantasies are as purely invented as the NCB set: I hope her parents occasionally walk the baby at night so Kate can sleep, and that she can always find someone to hold the babe when she wants a shower, and when Wills gets back from flying search and rescue missions in, what, Wales? I hope he gets an afternoon to play with the baby (since I’m sure he’ll have missed the baby – this is my fantasy, I decided), and then they get grandparental babysitting for a romantic evening by themselves. Which I don’t want to hear about. I just want to believe my fairy tale.

      • Antigonos CNM

        You forget servants. I paid a postpartum visit on the wife of the Vice-Chancellor of Cambridge University, and the mother of Hippolyta Clemence Riley-Smith was lying in a huge 4-poster with tester while the nanny presented the baby to me for inspection. Kate will sleep at night, I’m sure.

        • Lizzie Dee

          Well, yes. Kate isn’t a middle class woman desperate for validation somehow, she is an UPPER middle class woman. Maybe not too posh to push, but about as posh as you can get in this country. I read yesterday that she won’t have a nanny, but find that a bit hard to believe. She will have access to things the rest of us could only dream about. And she doesn’t exactly have to worry about this child’s future job prospects, does she? A very abnormal childhood and an absentee husband kind of go with the territory.

          They are an attractive couple, and it is a pity that their immense privilege will have a considerable downside.

          • Dr Kitty

            The British upper classes have traditionally had the kind of iron-clad self belief and robust self image that allows them to do whatever the hell they want and not to feel bad about it.

            In other words- rich posh people often dress extremely eccentrically (and scruffily), say whatever crosses their minds (often using language that would make a sailor blush) and don’t give a damn about what other people think.

            If you see someone if Harrods wearing an old pair of slippers, a battered tweed jacket unravelling at the seams and jeans covered in unidentifiable stains shouting at the shop assistants, rather than being a bag lady who has wandered in, they probably own several castles.

            Princess Anne, gloriously resistant to makeovers, horsey and blunt to the point of rudeness as she is epitomises the type.

            I have no doubt that this baby was born and will be cared for exactly the way that the Royal couple choose to, and that they really couldn’t care less how any of us feel about it.

          • Antigonos CNM

            I’m willing to bet that when she resumes her duties as patroness of a number of charities several months from now, a nanny joins the entourage, no matter what she says now. Royal women don’t have the privilege of being SAHMs. It may seem like trivia, but their lives are highly programmed — remember Diana’s social calendar?

          • fiftyfifty1

            If the Duchess is upper middle class, who is upper class?

          • Antigonos CNM

            I think the reference was to her previous social class. Prior to marriage, the Middletons weren’t even minor nobility. The Spencers are [and are an extremely ancient British family as well] Kate wasn’t raised, most likely, in a family where the biological mother relegated most of the child-raising to someone else. I do in fact know several professional women in the middle class with live-in nannies. If you are a doctor, MP, or lawyer, the demands on your time can be such that it is impossible otherwise.

          • Lizzie Dee

            Those who have been rich for generations, and inherit rather than earn.. As someone once said, if you have had to BUY your furniture, you don’t count.

            Snobbery alive and very well at the top ends of Brit social class.

          • LukesCook

            Someone whose recent forebears don’t include coal miners and air hostesses and whose family didn’t make their money flogging party tricks (not in the last century or so, at any rate). Someone who didnt need elocution lessons before being permitted to speak publicly. Silly as it is, at least it’s not as silly as a linear wealth scale.

        • fiftyfifty1

          I sincerely hope that you just made up this name etc. It’s very uncool to publish details about patients in a public forum.

          • Antigonos CNM

            Precisely what details did I reveal? That i made a postpartum visit? All new mothers are legally under midwife care until they are 10 days PP in the UK and are visited at home after discharge from hospital.

            The name was real, but she long ago gave it up for something entirely different. [I don’t blame her] This was 40 years ago.

            It was also made clear to me that, as an NHS midwife, I should have gone to the servants’ entrance, which was a bit rich, since at that time her father had not yet even been knighted [he was, later]

          • fiftyfifty1

            I’m shocked really. Perhaps this is a cultural difference? Here in the United States if a healthcare professional revealed the name of a patient he or she had treated in a public forum without permission from the patient, that alone would be grounds for discipline. To go on to reveal details of their private life (e.g. snarky comments about who did or did not get up out of bed, servants, furniture etc) would get you fired for sure.

          • Elizabeth A

            But you didn’t just reveal that you made a post-partum visit. You also revealed the name of your patient, and details about her furniture, childcare and household arrangements.

            Under federal law in the U.S., you would be prohibited from revealing the name of the patient, the persons present at the examination, or anything seen or discussed during the visit, except in very specific legal circumstances. It doesn’t matter that this was 40 years ago, that everyone gets home visits, and that the patient’s name has changed. It matters that you revealed all of that information, easily traceable to the patient, without permission.

            Even if it’s legal to disregard patient privacy in this fashion in the UK, the tone of your post is hugely unprofessional. If NHS midwives habitually make this kind of comment in public, I would not want one in my house.

          • Lizzie Dee

            It was 40 years ago, in another country in more senses than one, and this was not medical detail. Maybe unprofessional, but hardly shocking.

            Toffs don’t much care what the “staff” think.

          • Elizabeth A

            I didn’t say it was medical, but it sure as hell was PERSONAL.

            “Toffs don’t care what the ‘staff’ think” – have you checked? Do you know that *these* toffs don’t give a damn? Or are you just guessing, based on preconceived notions and your desire to indulge in mean gossip?

            Additionally, these patients may genuinely not give a damn, but if I thought that visiting nurses might talk about me like this, I would not let them into my house. I am not, so far as I know, part of the class discussed, but neither you nor Antigonos is displaying the least bit of judgment or discretion here. If I thought you might behave the same with me, I’d lock the door and pretend to not be home. I wouldn’t take your calls. You’d never see me.

            Care providers who behave like this actively undermine public health in their communities.

          • Kalacirya

            It’s a faux pas sure, but you’re being absolutely absurd if you are insisting that Antigonos is actively undermining public health in her community (which I believe is currently in Israel) by revealing a minor personal detail about a medical visit in 1970 in the UK. It’s not true and it’s insulting. Your righteous indignation is unwarranted here.

          • Elizabeth A

            Oh, well, so long as she’s moved countries, it’s fine for her to piss on her old patients?

            Respectfully, I disagree that my indignation is unwarranted. This crap is exactly what the NCB crowd talks about when they argue that actual medical professionals can’t be trusted.

          • Kalacirya

            You claimed she people like Antigonos, including Antigonos herself, actively undermine public health in their communities. That’s a load of bullshit in this particular example, a complete stretch.

            But by all means, continue being highly antagonistic to that anonymous person on the internet that you don’t actually know. Extremely effective, I’m sure you’ll really show her.

          • Elizabeth A

            I said what I said because I believe it to be true, and I’ll stand by it – when visiting nurses talk like that about their work, people lock their doors to visiting nurses, and the end results are bad for public health. Unless you believe that those nursing visits in fact have no value, in which case, why send a nurse out to do them at all?

            I have a longer internet acquaintance with Antigonos then I do with you, by a lot, and in general, she’s not like this. When people I know say idiotic things, I call them on it to their faces, as I have done here. I have no idea what the overall effect of calling Antigonos out will be, but I have a pretty good idea of what the effects of NOT doing it look like.

          • fiftyfifty1

            I think Elizabeth A makes a great point. Public health nurses can make a big difference in the health of communities when they do home visits. But the #1 problem they run into is lack of patient trust–they get turned away at the door because the patients are afraid that the nurse will judge them and “tell on” them. And that’s just what Antigonos did.
            How would you feel if you knew that you would be visited by a nurse and that she could make public criticisms about your mothering abilities? Would you feel comfortable letting her in your house?

          • Kalacirya

            If she was going to make that comment about my personality, 40 years after the fact, without divulging my personal medical information, I’m not even going to begin to care. Sorry, no outrage here, your questions aren’t going to spur it either.

          • fiftyfifty1

            Do you seriously think that here on the Skeptical OB is the first time Antigones has spread this particular gossip? Doubtful.

          • Kalacirya

            Am I going to speculate on the possibilities? No.

          • fiftyfifty1

            But in a sense you did speculate by assuming the info was only revealed 40 years after the fact. I think the average patient upon seeing what she wrote would not think “Oh, well she observes a strict 40 year policy” but rather “This is a midwife who doesn’t respect privacy. Who knows what she might say.”

          • Kalacirya

            I am making no assumptions. I’ve made a conclusion based on only what has been presented to us, and not attempting to fill in the details with fantasy that I’ve concocted. You can sit there and imagine that Antigonous is a horrible health service provider because she actively gossips about many her patients, but that’s quite a conclusion to come to from a single data point.

          • fiftyfifty1

            It’s not what *I* think about her that matters, it’s what the *patients* think about her. Patients are afraid medical professions will gossip about them. It can be a barrier to getting the care they need. So when medical professionals go and do just that, it is something that is problematic. I called her out on it. How many times does a healthcare provider have to do something unprofessional before you think it is OK for others to call them out? The reason we are *professionals* (unlike CPMs, is because we do have standards. We need to be able to accept criticism about this. I got reprimanded by the head of the department at the beginning of my career because a patient overhead me dictating on another patient in my office when the door wasn’t completely closed and it made her uncomfortable and so she made a complaint. Does that mean I was a bad person or a bad doctor? No. But it did mean I needed to change what I did. I learned from that. Patients care about privacy. They care a lot.

          • Kalacirya

            Well considering that Antigonos is retired, I don’t suspect that any future patients will be thinking much of anything about her.

            I never said that saying what she did was the proper thing to do, but I did take umbrage on the insistence that she ruins public health efforts with her single statement about the snobbery of an over-privileged woman 40 years ago. It’s an exceedingly antagonistic way to make a point, and it only works on the other person if you manage to shame them into feeling they’ve done wrong, which clearly failed with Antigonos because she responded to the initial outrage that she doesn’t see that what she said was in the wrong.

            So if you’re grandstanding here because you want to make the point that you won’t let someone breach ethics while you’re around to see it, then fine. But as to why you are arguing with me, I don’t know. I am certainly done speaking to you about it.

          • Amazed

            Great, now I’ll know what to do each time I have a little problem with the secretary or one of my editors: I’ll talk to their boss! No talking to them, no pointing out that I am not comfortable with something they did. I’ll just complain to the boss and I’ll expect them to admire me for it. Sure, they might get in trouble that could be avoided but who cares? I want my rights! They make me uncomfortable!

          • fiftyfifty1

            I do approve of what that patient did. Sure, she could have just poked her head in my office and told me herself that “I can hear you”. But she didn’t know me and perhaps she was intimidated to go and open my door uninvited. So she left the feedback in the box we keep by the exit for just that purpose. Yep, I got reprimanded. But her negative feedback was warranted and I’ve learned from it.

          • Amazed

            You would have learned if she had tapped on the door and told you that she could hear you, I imagine.

            Sorry, I see your example as nothing but a minor abuse of the system on this patient’s part. Especially since she didn’t bother to tell you in person. I have no problem with the fact that she didn’t approve but the way she acted is a problem to me.

            I am someone who is shy, sometimes painfully so. It took me years to learn to hold a telephone conversation with strangers with some confidence. That’s why I think it’s so important to address the right person. Sure, make a complaint when you’re safely away is waaaay easier. It’s also craven and losing someone’s time to read your complaint and then take measures.

          • Elizabeth A

            How is it any kind of abuse of the system to use a patient comment box that the system placed by the door in the hopes that patients would use it?

            Hospitals frequently do a lot of work to solicit comments from patients. Why should patients NOT respond to those efforts?

          • Amazed

            Because I imagine it was a one time thing. I really don’t want to think that doctors are in the habit of leaving doors ajar so next patient can hear the current one’s details. Because I suppose it was an accident. Because it was hardly representative of the type of care the provider offers. Because I am a big believer in fixing the small things on personal level before you complain. Because you can create unjustified trouble for the wrongdoer if the supervisor had spilt their morning coffee or whatever.

            Because I believe that in a sea of minor complaints some more serious ones might be overlooked.

          • Elizabeth A

            I spend a lot of time in a hospital these days. They are doing a lot of work to find out what patients think of them, and respond to that. They send me surveys. They pay people to call me. There’s a 24-hour patient advocate I can call. The supervisor attitude on the kind of incident that fiftyfifty is talking about is that patient reports are an important means of making sure that dictation-with-the-door-ajar type accidents happen rarely, and remain unrepresentative of care.

            As a supervisor in other contexts, if fifty individual people tell my employee that she’s doing something that bugs them, the next thing that usually happens is that I mysteriously lose fifty customers and have no idea what’s going on. Whereas if JUST ONE of those people tells me, I can actually fix it. That will be trouble for the employee, yes (whatever she was doing wrong, it was probably easier then doing it right), but not unfair, unjustified, or abusive trouble.

          • Amazed

            That might be the case but only if you assume that after being warned by one or two people that something is not quite right, the employee keeps doing it wrong. Between something that seems like an accident unrelated to actual practice – like leaving the door ajar – and something troubling me about my care I know which one I would complain of.

            Last time I saw someone wanting to complain, we were both sitting in front of the doctor’s office and she was throwing a fit that she wasn’t being seen in a timely manner. Which was true. Only, we were in the ER for a follow up visit. Since we were both treated there after our respective accidents, we could pay out of pocket to a doctor of our choosing, or come back after an appointment and still get bumped by whatever emergency came around.

            This day, we waited for more than 2 hours because of a child rushed there by ambulance. I don’t know what the case was but literally every doctor in the ER – or almost every one – was there. I do think we were not treated unjustly and in truth, I don’t know whether she complained either. But I think that if she had, it was a good waste of someone’s time.

          • Elizabeth A

            But if I use the complaint box, I don’t have to assume that dictattion with the door ajar is a one time accident, I can just rest assured that someone with actual authority will try to make sure it is.

            (Also, dictation with the door ajar type accidents do affect patient care, by making it much harder for patients to talk openly with their doctors.)

            If I assumed a person would make the same mistake over and over despite complaints I wouldn’t hire her, but tif I was wrong in hiring, or trained her badly, I would like to find out.

          • Amazed

            “But if I use the complaint box, I don’t have to assume that dictattion
            with the door ajar is a one time accident, I can just rest assured that
            someone with actual authority will try to make sure it is.”

            Sure, if you take it so seriously. I just don’t see it as serious enough to merit such measures. Between taking it so overly seriously and tapping on the door and saying “Sorry, the door is ajar”, thus saving myself from having to listen all details about someone else’s bacterial infection, I know what will do.

          • Amazed

            I REGULARLY spread gossip about publishing houses who don’t pay in time or don’t pay at all but try to get you work for them again with payment delayed in not so near future. I gossip about them in front of my boyfriend. I gossip about them in front of my parents. I gossip about them in front of new colleagues whom I don’t want to see working hard for a month or two and go away empty-handed as I did.

            I don’t respect privacy at all although I sign a contract that I’ll keep things private.

            Of course, yesterday I started spreading the gossip of a new publishing house that respectfully pointed to me that the amount of money I expected to make was less than what I should get. My math betrayed me and they w

          • Elizabeth A

            Amazed, I think passing on info about who treats their freelancers decently and pays on time is a valuable use of gossip in professional circles, and I certainly don’t think that you, as a freelance writer, have an obligation to protect employers who screw you. There is certainly no expectation that you do so. You don’t work in health care, though, and yes, healthcare is different.

            Back when I worked in a profession with confidentiality requirements (accounting), we were warned that if you screw with client confidentiality, you damage it permanently. As an accountant, the requirements on me for client confidentiality are different from those applying to doctors or lawyers, but there is this element in common: if you violate that confidentiality, you cannot then, somehow, get it back. If I post on the net about a client who is trying to break the law, I cannot then tell a judge that I’m unable to testify about that client, or, potentially, any client.

          • Amazed

            Well, if they cared what the ‘staff’ thought, “staff” wouldn’t have been notified that she should have used the servants’ entrance, especially since it was a one-time visit and “staff” wouldn’t return to hurt their feelings by using the wrong entrance meant for privileged people again.

            They didn’t see a visiting nurse, they saw another servant. Servants gossip. That’s the way of life.

            Of course, I am not entirely serious. At the same time, I do think you’re blowing this out of proportion. Was it an indiscretion? Most certainly. Did it have something to do with mother or baby’s medical condition? Hardly.

            Is patients’ arrogance covered by professional integrity? You can tell me to wait in the dog’s house and I am obliged to keep silent about this?

          • Elizabeth A

            Yes, patient arrogance is covered by professional integrity, and it doesn’t have an expiration date.

            Medical professionals have many options for dealing with unreasonable or irrational patients, including private grousing to coworkers, reporting the issue up the chain, and quitting the case. That’s not a complete list. There is no patient behavior that entitles you to waive confidentiality in favor of gossiping about how mean they are on the open internet.

            We ran the reverse of this discussion on This Week in Homebirth Idiocy when we agreed that it sucks that real professionals don’t get to defend themselves from NCB whining about how terrible they are. It does suck from time to time, but that is how it goes.

          • Amazed

            Well, I am relieved that you do give the right to private grousing. Reading your posts, I was left under the impression that once you step over the line between professional and private, no matter the circumstances, you’ll be justly fired.

            Again, I see that as a minor gossip 40 years after the event. Not as shocking as if it happened a few days ago. Not terribly professional, of course. And in no way “defending” oneself. It might be taken as a “defence” if it is posted immediately after a patient’s complain.

          • Lizzie Dee

            It is gossip for sure but what is mean about it?

            If she were talking about someone she saw last week, or habitually gossiped for the fun of it then of course that would be unprofessional. A bit surprised the name was given, but just don’t see this as shocking.

          • fiftyfifty1

            “It is gossip for sure but what is mean about it?”
            1.Implying that the mother is too spoiled to get out of bed. This woman is postpartum, yet she is immediately judged. Wow.
            2. Disparaging the mother for not doing her own mothering but rather having the nanny do it (it reminds me of the way that bitter SAHMs claim that working parents have their children “raised by strangers”).

          • Lizzie Dee

            Dear me, what moral high ground. Quite correct, of course – professionals should not gossip. None of us should gossip, and none of us should listen to gossip.

            I took this more or less along the lines of “The rich are different from us…” And, taken in context, weren’t we all gossiping just a little bit?

            It seems to me unlikely that this mother, or her daughter, would give a toss for what a midwife thought. Having a four poster and a nanny does not automatically make you a terrible mother.

          • Amazed

            I saw nothing of the condemnation you saw. Just a little juicy gossip. Might be because of all women with children that I know I don’t know a single one who wouldn’t have loved to lie in her bed and recover after birth while someone else presents the baby for inspection.

            I think it’s sad that we’re so lost in this “strong woman” nonsense that each time a little coddling is mentioned, there is always someone who takes it as an insult hinting that the mother is lazy. Doesn’t everyone love a little rest? What’s wrong with it?

          • fiftyfifty1

            So Antigones meant it as a compliment? She was just sharing the good news of this woman’s good fortune with an audience of well-wishers? Sure.

          • Amazed

            Haha, I doubt it. I said how I saw it – just a little juicy gossip.
            It’s really all in the eye of the beholder – when the beholder stops to think of it, that is. I certainly didn’t. I just chuckled at the name, so whatever Antigonos meant was lost on me.

          • fiftyfifty1

            Ah, so passive aggressive is your style. You admit Antigones’ comments were not a form of well wishing. Yet you get “sad” when people take note of the insults implicit in her statements. Why it’s just juicy gossip! No aggression there, no indeed! It’s the same tactic as those who make racist or sexist statements and then get “sad” that other people can’t “take a joke”.

          • Amazed

            Black and white much?

            You can keep getting high on your own high moral ground as much as you want. I, on the other hand, will keep thinking that gossip can be barbed, and well-meaning, and mean, and whatever. And yes, I do think it’s sad when people are so fixed on seeing attacking mothers for not being heroic enough wherever they look. This particular comment, I took as pointed against those who believe (naively, in my opinion) that Kate will refrain from using the means available to her for help in childrearing.

          • fiftyfifty1

            “It was also made clear to me that, as an NHS midwife, I should have gone to the servants’ entrance”
            Well why not use the service entrance? That’s what you were doing after all, providing a service. Clearly you are not a dignitary or a family member, and you are certainly not their friend.
            So do you gossip about all your patients in public or only the ones who wound your pride? Or maybe only the ones that you can name-drop about?

  • Zornorph

    I’ll tell you one thing – I’m sure that mother and baby didn’t have the ‘birthy smells’ left on them very long.

    • rh1985

      Ahaha!!!

    • Oh no the HATS!

      I bet they put a hat on that baby. Someone call Carla Hartley!

    • Bombshellrisa

      Looks like they weighed the baby too and put clothes on him. Child abuse!

  • The Computer Ate My Nym

    But…I thought a natural birth in the hospital was impossible, especially with an OB attending and ready to slice and dice at any minute. The home birthers need to pick one fantasy and stick to it.

  • XLhz

    The lack of extensive details about her delivery seems to indicate that the duchess does not feel the specifics of her birthing experience are anybody’s business but her own.

    Please don’t anybody tell Alpha Parent… 😉

  • MichelleJo

    ” The Duchess has modeled the best way to handle natural childbirth advocates; she has ignored them and refused to reveal private details of her pregnancy and birth. ”

    I think the crowds outside the hospital had picked up on the fact that they were letting on exactly what they wanted but no more. Besides for the nappy question, there weren’t any personal questions at all.

    Go back 31 years and Prince Charles is standing on the very same steps after William’s birth. “Was it very painful?” someone called out. To which Charles (to his credit, yes) answered, “have you ever had a baby? Well go try it!) At least the Duke and Duchess weren’t treated with that kind of ‘curiosity’.

    • Antigonos CNM

      Either Atlantic, or Salon [sorry, no link right now] featured a photo of Diana and Charles as they left the hospital, and below it, a photo of Kate and William. What a contrast! How times have changed!

  • Dr Kitty

    I know I’m a dinosaur from the age of actively managed labour, but she was admitted to the hospital at 05:45h and delivered at 16:24h.
    Which means she was bang on 1cm/hr with 60-90 mins for second and third stage, assuming she was admitted at 2-3cm after some time at home insuring contractions were regular and it wasn’t a false alarm. Of course it could have been quite a LONG time at home, and she could have been more than 4cm on arrival.
    Not so much “quick” as “average”.

    But as I say, I studied OB in the Coombe in Dublin, where an active labour was never allowed to last longer than 12 hours and partograms meant something.

    On a personal note, I love my OB/ Gyn. He’s amazing.

    • fiftyfifty1

      “from the age of actively managed labour”
      Are you saying that the age of actively managed labor is over then? Don’t they do it any more in Dublin and if not, why not?

      • Dr Kitty

        I have no idea what they’re doing in Dublin now, labour was actively managed in the Coombe as of 2005 (you could opt out if you wished and that was explained on admission), but my NHS OB training left me feeling that it was definitely no longer the done thing, and considered anachronistic and weird, so for all I know they have moved on.

        My experience as a medical student was that women LIKED the active management of labour. Knowing that one way or another 12 hours after admission you would have a baby in your arms was a comfort, access to epidurals wasn’t limited and the hospital prided itself on both a low primary CS rate and a high VBAC rate.

        • AmyP

          How important is it to keep labor under 12 hours?

          • Elizabeth A

            In answer to your question, AmyP, I have no idea. I don’t think very – it’s not like awful things automatically happen after the 12 hour mark.

            However: I do firmly believe that there’s no benefit to having (or forcing) a woman to labor for ages on end, just so that things happen “naturally.” (FWIW, I think a labor can be let go on much longer if the mother has an effective epidural and there are no indications of fetal distress. In that circumstance, Mom can sleep if she wants, and save her energy for when she needs it. Unmedicated labors have less flexible limits – pain runs a person’s energy out faster.) At some point, you have to acknowledge that things aren’t going to plan, and steps need to be taken. The Coombe famously did that on an institution-wide basis, most hospitals go case by case.

          • Klain

            When I did the prenatal classes at the hospital, they told us the
            average first labour was 14 hours, therefore anyone under that thought
            they had done well.

          • Dr Kitty

            AML involves AROM on arrival and pit to augment contractions as soon things start falling behind 1cm/hr for primips or 1cm/30min for multips.

            It is pretty much the definition of “cascade of intervention”, second stage never lasted longer than 2 hours (1 hour labouring down with an epi and 1 hr of pushing was the absolute max) and yet, the way I saw it practiced there were surprisingly few CS (when I was there the hospital, with a tertiary NICU and a a lot of very complex perinatal morbidity, had a total rate <25%).

            It is a VERY different way of managing labour compared to NCB, and it was hugely popular with patients.

            You have to remember it came into being in a Catholic hospital at a time when the average Irish woman was having between 4 and 8 babies and anything like a CS which potentially limited family size was a very definite no-no. Having a clock running was helpful at ensuring you could manage your beds on the (very busy) labour wards, and the pit augmentation was aimed at improving the chance of VB, not decreasing it!

    • Antigonos CNM

      I also thought the labor was so textbook in length that it was unlikely everyone sat around twiddling their thumbs.

  • Elle

    My favorite detail is that Kate’s husband was WITH her during the birth, and presumably not out playing cards like some royals of the distant past. Sounds like a great start to me! The rest of the stuff isn’t so important as long as they’re both healthy.

    • SkepticalGuest

      Hadn’t even thought of that. It seems so normal these days for dad to be there, but you are so right. In days past, dad would’ve been out playing cards, hunting, boozing, womanizing. It hardly matters how the baby came out–as long as he’s out safely, mom’s well-being is respected, and dad is there to begin this life-changing journey with his family.

      • The Bofa on the Sofa

        Nah, dad was pacing in the waiting room, ready to hand out cigars…

        • MichelleJo

          My Dad can still remember pacing the halls 40 years ago when the other dads were discussing which booze they had waiting to celebrate. He absolutely hated it, as he has never and still doesn’t drink and was just sick with worry about my mom.

          • Dr Kitty

            My father was waiting outside the Operating theatre when I was born, then went round the corner to the pub for a drink to celebrate while my mother was recovering from the general anaesthetic and ended up getting locked in overnight due to a bomb scare-Belfast in the early 1980s was an interesting place!

          • Amazed

            My father was AWAY because of his job so he MISSED the event. Imagine this. The first time he saw me, he decided that I was brain-damaged because there was no way for a normal head to be so huge and so… wrong (I was vacuum-assisted delivery). No smelling of head, nothing. He just came back in time to take my mom from the hospital (she had nothing of the post-partum belly Kate sprouts and she sure as hell did not look as radiant as her. She looked like the very sick woman she was, the pictures are scary, although she could head from hospital to beach without worrying about her weight.) So, my dad came back for the evil things like bathing baby, changing baby, and bringing baby to mom when baby cried from hunger (if it was something else, he soothed me himself). All in all – just in time to ruin bonding. I was parented as unattachedly as it comes. Clearly, that’s why I now live in another city. The only reason I still come to visit is that I was exclusively breastfed, so there was a tiny part of bonding.

        • Lizz

          Mine was right next to Mom in the blue paper overgown thing and hat that apparently they made all the father’s wear even though I was a vaginal birth. I was a bad labor and he requested a hand x-ray after. If I remember though Mom did injure his hand in some way though.

      • Christina Maxwell

        My father was accidentally there when my sister was born in 1966, he didn’t enjoy it one bit! She was an accidental VBAC and arrived very quickly indeed.

      • Just A Guest

        My husband wasn’t present when our kids were born. He was downstairs outside the hospital chain smoking. He was scared sick. If I’m going to be honest, there is a part of me that didn’t miss him while in labor. He really does think I’m some kind of birth goddess or something. The last time he saw me, he would be leaving me on the labor floor as my mom or sister told him it would be ok and we’d let him know. Then when he saw me next, he had missed all the water breaking, mucous plug, blood, sweat, screaming, etc. I was one of the lucky ones I guess and never pooped while pushing, but I never would have wanted my husband to see that if I did. We waited until everyone was cleaned up and I had been stitched. When he would see me next, I’d be holding this pretty looking baby and I would have put my makeup on and I looked like it had been so easy. I did miss him right afterwards. It would seem like it took forever to get ready to have him come back. The family rule was what happens in labor stays in labor and my husband to this day does not know all the details. We don’t find out the sex of our babies ahead of time and I have always asked that the providers don’t say a word about it. With our last kid, I managed not to look until after the bath and they brought back the baby and hubby came back upstairs and we got to check together. (Yes, our kids all had that scary first bath before their father could smell them. They’re scarred for life, but hey, they’re clean!)

  • Amy M

    Those NCB people who have been publishing these articles for weeks now are so pathetic. They’ve also been using the Duchess as a prop for lactivism. One writer in particular (can’t remember her name) wrote several articles about how the Duchess should breastfeed because she needs to set an example for all the other women, blah blah blah. I also saw some of the articles discussing how disappointed these nuts would be if she had a Csection…’cause you know, it is way more important that she use her vagina than the heir to the throne be born safely.

    I don’t follow the doings of the royal family in general, but from the little I’ve seen, the Duchess seems like a smart modern woman who will take advantage of the fact that she has access to the best medical care in the world. If she were likely to take risks with the baby’s life, she wouldn’t have had 2 OBs on call, and a private wing in a hospital, etc….I’m sure they have a private pediatrician living in their house or whatever to make sure that child is thriving and getting whatever medical attention it may need.

  • CanDoc

    My absolute favourite part of the entire Royal Birth is how Kate and William have chosen to reveal the details: THEY HAVEN’T. The essentials are there: gender, time, reassurance that he’s healthy, and now a name. The nonessentials: Vaginal? Cesarean? Forceps? Episiotomy? Epidural? Skin-to-skin? How about a big fat NONE OF YOUR BUSINESS. 🙂 Very happy for the couple. Maybe we could all learn something from their example on this issue.

    • Amy M

      Oh? What’s the name?

    • Amy M

      never mind, found it on google.

    • SkepticalGuest

      I believe they also released the weight of the baby (pretty standard), and we can infer from the duration of her stint in the hospital that she didn’t have a c-section.

      We can also infer that, however her birth went down, it wasn’t that bad for mom. I had an awful vaginal birth, and I couldn’t walk to the bathroom without help for days. (Lots of 2nd degree tearing and also torn pelvic ligaments.)

      It also goes without saying that few moms can manage to look so fabulous so shortly after giving birth 😉

      • Lisa from NY

        She lost weight before the pregnancy, and she threw up a lot during the pregnancy itself.

        Of course, the health of the baby is more important than how she looks.

      • Elizabeth A

        I sincerely loved that you could see her post-partum belly in those leaving the hospital shots. There she is, 24 hours after giving birth, glowing like we all wish we did, and proving that they mean it when they say you should expect to wear maternity clothes home from the hospital.

        • Frequent Guest

          That was my favorite part of the whole thing, and made me love Kate even more than I already did. She is just a normal (well, as normal as she can be) first time mother, leaving the hospital with her baby and the father, leftover belly-pooch and all. I love it!

        • anon

          I look at her, and I know that she had stylists making her up for as long as it took to make her look that gorgeous when leaving the hospital, but there is no stylist on earth who can remove the need for mesh panties and ice packs. I can think of few things I wanted to do less than walk through a throng of photographers hwen leaving the hospital after my babies were born, bless her heart.

          • Elizabeth A

            I can think of few things I’ve *ever* wanted to do less then walk through a throng of photographers, but Kate has always been game for that kind of thing.

            I’m sure there was a stylist, and probably painkillers to get her through that photo op. It was a nice, loose dress. Good choice.

          • Lizzie Dee

            I hve zero interest in the Soap Opera versions of our Royals, but, bored, scanned through some photos. Kate did look lovely, and thrilled to bits. Prettier and more confident than Diana, in the picture of her included. They BOTH wore blue dresses with polka dots – how odd.

      • KumquatWriter

        Not true. I had a c-section and went home the next day. I was so sick (I felt so bad when I heard Kate had HG!) and in so much pain from the pregnancy, the CS was *nothing*. Literally; it felt like I’d done WAY too many sit-ups. Nothing more, no complications.

        • fiftyfifty1

          That’s how it felt for me too: “too many sit-ups”. Sore, yes. In pain? No.

    • Lisa from NY

      Prince William and Harry were both born via C-section because their father, Prince Charles was busy playing polo.

      Princess Diana had to schedule the C-sections around Charles Polo games.

      • Karen in SC

        why not? if that was their choice, it’s their business

      • fiftyfifty1

        I would be interested in any link you might have to proof of that….

      • theadequatemother

        Don’t make it sound like prince Charles was in a beer hockey league with his buddies. These polo matches are organized and commitments made a year or more in advance and are generally related to charity events. Perhaps Kate had to schedule her birth around prince William’s polo match which was less than a week before she delivered.

  • Antigonos CNM

    And apparently there have been comments regretting that she didn’t deliver in an NHS hospital…

    In point of fact, Kensington Palace could have been fitted out with an entire “hospital wing” to allow her to deliver at home had she wished; there certainly is enough room there to accomodate everybody and everything. But the royals, ever since Victoria, have been eminently sensible regarding birth.

    • Hannah

      She gave birth in a private wing of a large NHS hospital:

      http://www.imperial.nhs.uk/privatehealthcare/lindo-wing.html

      http://www.imperial.nhs.uk/maternity/ourservices/st-marys/

      This is actually quite sensible if you’re someone for whom money is no object. That way you get the luxuries and discretion of private healthcare, as well as your pick of high level medical providers with the safety net of a large teaching hospital that deals with the full range of the maternity population.

      Purely private maternity hospitals tend to serve a small number of relatively healthy women, and tend not to provide high level emergency care, as it’s expensive and unprofitable. In fact one of the more famous private maternity hospitals, The Portland, had a run of maternal deaths a few years ago:

      http://www.telegraph.co.uk/news/uknews/1390810/Another-Portland-Hospital-mother-dies.html

      http://www.guardian.co.uk/uk/2000/aug/06/antonybarnett.theobserver

      • Christina Maxwell

        I refused to go to the Portland 29 years ago when I had my eldest, there was a lack of acknowledgement of emergency situations and the carpets were dirty! I went to the Wellington (which sadly no longer does births) which was a better choice as they had an ICU etc.

    • Elizabeth A

      Since Princess Charlotte, actually. Victoria’s many aunts did not forget, and weren’t interested in history repeating itself.

      • Frequent Guest

        “Much of Charlotte’s day to day care was undertaken by Sir Richard Croft. Croft was not a physician, but an accoucheur, or male midwife, much in fashion among the well-to-do.” (source: Wikipedia… I know, I know…)

        Geeze, history repeating itself much?

        • Elizabeth A

          Very familiar.

          Croft blamed himself for not using forceps (or not using them early enough) – he was concerned he might injure Charlotte. He committed suicide shortly thereafter. He was an expert in what he did for his time, but the baby was transverse.

      • Antigonos CNM

        I’ve got some funny stories about my interview at Queen Charlotte’s Maternity Hospital, named for the poor woman who died in childbirth, but they aren’t relevant to the discussion…

  • Guilt-Free

    Isn’t it ridiculous and sad? That women should still be obsessing about other women’s means of delivery and sanctifying their own? It is definitely related to low self-esteem. I believe it’s a variant of unaddressed post-partum depression–maybe even psychosis. I wish I’d have had this insight, AND this website, to help me realize this FASTER when I was bullied in a very ugly way by a home-birther after my C-section births. I was vulnerable and post-partum at the time. I didn’t have the perspective. I just ended up feeling not good enough and second guessing myself and my births. Fortunately, I ended that quickly and told her to get lost. I then did my own bit of investigating to realize exactly how much of an unethical quack she was, with a history of bullying other women AND their children as well. The thing about Kate Middleton is that she is not likely to join this birth cult. She simply birthed her baby and I’ll wager that she’ll move on with grace, like classy, decent, intelligent women often do. Were she to sit around in the context of her royal life, and obsess about the day that she delivered vaginally, and then seek to preach to others about what they should/should not strive for in their births, her staff and co. would be having a few words with her and probably seek some royal counseling for her. Everyday women who fall prey to this bunch of birth groupies don’t have staffs to look out for them. But, they do have this website! So, once again, thank you Dr. Amy for addressing this issue.

    • CanDoc

      Here, here. Thank you, Dr. A.

      • Christina Maxwell

        Yes indeed, nice one Dr. Amy!

    • Ashley Wilson

      Yes indeed! This website helped me a lot in finding my voice to tell the NCB quacks I was surrounded by “No! Piss off! I don’t like you and you sound crazy.” I can’t imagine what the rest of my pregnancy and delivery would have been like had I not found this blog and finally stood up for myself.