Paging Dr. Freud!

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Freudian slip?

  • The nonSensical OB mocker

    Wow you have no life. It’s a wonde why so many people hate you and think you’re a big fat joke

    • Amy Tuteur, MD

      I thought you had flounced Vegan Mom.

      I guess you just can’t stay away.

  • Expat in Germany

    Really, what kind of doctor prefers herbs which are only anecdotally supported to medicines which have been studied and cleared by the FDA. Wait, why was the FDA created? Oh, snake oil salesmen and Upton Sinclair style food processing plants.. now I remember.

  • Expat in Germany

    I just looked through a bit of Aviva’s portfolio and she plays to the fears of the nature people while encouraging them to do what they want to do. -If it is right for you- don’t vaccinate, do use herbal remedies to treat pertussis and other diseases, but if your kid looks really sick, seek medical help. Vaccines aren’t responsible for all of the reductions in infectious diseases.. Trust me, I’m a doctor, I read some studies and made some wacky interpretations. Confirmation bias conspiracy theory central. Is she mentally ill? Trying to become a thought/cult leader? I find it abhorrent. Does she really think that frontier woman medicine is necessary and desirable in the US? She isn’t much of a thinker if she really believes (as she wrote) that thimerosal is really dangerous. It takes quite a ‘scientific mind’ to ignore several epidemiological studies involving millions of people studying the complication rates of vaccines with and without thimerosal. To get an idea of her vaccines book, I saw that it got glowing praise on mothering.com and the amazon reviews complained that it was out of date. Two thumbs down.

    • Expat in Germany

      http://avivaromm.com/files/articles/GrowingProfHerbalPRactitRomm.pdf
      She was pre-med in college at age 15 and really into new agey stuff. Doogie Howser on Crystals. Now she feels that the times have caught up to her. She is aware that the natural stuff is a potent marketing trick and that docs can’t compete time wise with hour-long herbalist or midwife appointments. She thinks members of MANA and the American Herbalists Guild should be integrated into standard medical practices. I would agree that such consultants could provide a cushion to keep docs from having to consider every person’s placebo demanding aches and pains and sniffles – but only if they were ethical and don’t really believe in the stuff they are selling. It is just that believing in it is a major problem because therein lies the path to stupid decisions. The profit motive paves the way to unethical decisions. Aviva thinks that embracing this stuff is the way forwards and that she can control the magical thinking herbal idiocy and make it safe. I think it is not adequately controllable and that it is the path to using idiots to placate idiots and waste a lot of time and money.. Especially if insurance covers it. I think there should be specialists in hypochondriac medicine who refer out to placebo dispensers, but I don’t think it should be mainstreamed.

      • Expat in Germany

        If I’m reading her bio correctly, she was a CPM and an herbalist long before she became an MD. After her stint as a 15 year old pre-med student, she went off of the rails into the herbs and crystals. She writes 30 years practicing medicine, but she only just finished her internship in 2010. Has she even finished her residency at Tufts? No dates on her CV. How can she call herself an OB and a pediatrician without completing residencies in both? All of her books were published long ago, before she had any medical training. Still hocked on her site, though.

  • momonucleus

    The way you present yourself is unprofessional. It is hard for me to get past this to the content of what you are trying to say…

    • KarenJJ

      It’s a blog. If you want professional, then you can make an appointment with one.

    • PJ

      I have to say this mystifies me. Is your power of analysis really so modest?

  • Amy Tuteur, MD
    • I don’t have a creative name

      Nearly all of them sound hysterical and irrational in their responses. This is typical. ” hell bent on doing whatever she can
      to limit the rights and abilities of women and mothers to what she
      personally believes is acceptable and within her crazed internal medical
      guidelines.”

      I’d like this woman to give even one example of how Dr. Amy has tried to limit anything. She is a voice of opposition to the notion that giving birth with no access to emergency medical care is as safe as giving birth WITH access to that care. This is not the same as lobbying for law changes. In what way is speaking out against a movement trying to “limit” anything? The only limits I’ve seen are the many women on that thread who are talking about petitions and protests to try to prevent Amy from saying words they don’t like. Hypocrites, as usual.

    • suchende

      OMG you never finished your residency? I know it’s true because the poster above me said it’s true! All of my assumptions are CONFIRMED!

      • Guest

        Also, I just adore the ACOG change.org petition. ACOG isn’t a governmental organization you effing morons.

    • Bombshellrisa

      ” So tired of this divide in healthcare. It’s like just move on and let people do what they want.” Oh yes, and when your homebirth goes south, what do you insist is just 10 minutes away? That would be the hospital, full of staff and evil interventions and all carrying malpractice insurance to insure you can sue after letting you do what you want didn’t work.

    • There are just so many things wrong there. The TFB thinks that there are lots of obs who support homebirths but “they’re probably all too busy attending births to show up to the circus.” But don’t worry, it will probably be “a hot topic of discussion at the birth activist retreat this weekend in Salt Lake City.”

      Or there’s the TFB saying: “She simply hates women. She demonstrated that over and over again. And now the ACOG is giving a soapbox to someone who hates women. So, spend your birth money wisely ladies!”

      Is the implication of the “birth money” line an inference that if a person goes to an OB they’re supporting the ACOG and Dr. Amy, and a wise mother knows not to spend her money that way? Nevermind what might be best for your child, make sure you boycott those wicked women-hating OBs.

      I’m a woman. Even at the times when Dr. Amy writes things I disagree with, or when she insults a position I hold, I don’t interpret any of it as her hating women. TFB gives women such a bad name.

      • Amy Tuteur, MD

        As others have noted, the comments are comedy gold.

  • Mel

    Aviva,

    You are an incredible woman! Kudos to you for all you do to empower women to safely birth their babies where THEY see fit. If the medical community would join hands with midwives as they do in some other places in the world, birth would become safer and women could maintain their autonomy with safety in the forefront.
    You are a treasure to women everywhere Aviva!

    This above post was ridiculous but I’m glad it allowed such a wise, articulate and well educated women to make her points to your followers.

    • Alicia

      And yet nothing you say changes the fact that there are under trained and untrained midwives out there allowing women and babies to be injured or die. Birth is NOT inherently safe. Advancements in medicine have made it safer to those who have access to them, but this NCB movement is a stupid backward step. The end.

      • Mel

        Have any of you explored what the midwifery model is like in some canadian provinces, say like in Ontario? They are not CNMs, but midwifery is a regulated health practice and RMs offer a choice to women to birth either at home or in hospital. Home births are not the norm by any means yet there are registered midwives attending home births and providing women with natural childbirth options both at home and in hospital.
        I’m going to agree that untrained midwifery practice can be a slippery slope…thereby my comment that women need safe, empowering options which a well trained midwife can provide. The US would be well served to explore this above stated model and satiate the needs of all women, both those who want safe home births and those who enjoy sticking their noses where they don’t belong to interfere with a woman’s right to choose what is best for her family. Sadly people who perpetuate the fear of childbirth in general contribute to the lack of options in many US states.

        • Expat in Germany

          “Right to choose what is best for her family” What about right to informed consent? What about keeping the non evidence based stuff out of medicine instead of inviting it in? There are Canadian midwives who post on here, lamenting how infected some of their colleagues are with unjustified beliefs. The only midwifery model that I know of where excess death is avoided is that of Germany (best perinatal mortality rate in Western Europe), where midwives work in hospitals with an OB there for when the CFM trace looks worrisome. CFM is required as is calling the OB when pushing is taking a long time. The OBs do all of the prenatal care and risk assessment. (Yes, there are some home birth midwives in Germany and they re strictly regulated and are accountable to oversight boards, but their stats are still three times worse than the hospital births). Compare that with the Netherlands, which has the worst perinatal mortality rate in Western Europe and where the midwives do the risking out and home births.

        • Expat in Germany

          “Right to choose what is best for her family” she wouldn’t choose it if
          A. She knew that it was more dangerous than necessary
          B. She knew that the costs would be greater than expected. Not a good financial bet.
          C. There wasn’t a cultural movement patting her on the back.

    • Bombshellrisa

      Plenty of OBs have midwives as part of their practices. These Certified Nurse Midwives are educated and trained to specialize in women’s healthcare. It’s the home birth midwives with little or no education and training who wonder why doctors refuse to back them up.

    • suchende

      “If the medical community would join hands with midwives as they do in some other places in the world, birth would become safer and women could maintain their autonomy with safety in the forefront.”

      Let me tell you about all the parts of the world where MDs “join hands” with traditional midwives to stop them from senseless deaths due to lack of modern obstetric care and “care” that amounts to superstitious nonsense. And for some reason, some people in the first world want to see us revert back to superstitious nonsense. Cinnamon breath, anyone?

    • I don’t have a creative name

      If the medical community would join hands with midwives

      They already have. Certified nurse midwives.

      What you mean is, they should join hands with untrained birth junkies who are utterly useless in an emergency. The doctor would have nothing to gain from this, and everything to lose.

      Try again.

  • Aviva Romm, M.D.

    Hi Amy,

    Clearly we have the same goals – healthy mommas and healthy babies. On this I believe we indisputably see eye to eye. Surely the ways to achieve this goal are multifaceted. Home birth is the norm in much of the world. Having spent a month practicing OB in Haiti last year, I saw a very stark reality in which most women cannot access the hospital for birth because of logistics (poverty!) which make this impossible in most communities. Midwives, competent in home birth skills, are a life line for these women and their babies. And many are highly competent. I support the World Health Organization and the International Confederation of Midwives in the goal of well-trained midwives to serve the diverse needs of women world-wide. Should women choose homebirth as an option in the US, they also have a right to competent midwifery care providers, respect from the obstetric community, and safe transport options. ACOG and the AAP have fully supported this position. I believe I truly do understand where you are coming from and do not disagree with some of your posts that I’ve read in the past. From your vantage point you’ve likely seem some disasters. I have as well. I’ve also seen them in the hospital. However, I see that it is partly the complex politics around birth and women’s autonomy that sometimes fosters a less than optimal situation in which competence levels vary amongst midwives, that there is a free for all in who calls herself a midwife, and transport decisions that are not optimal and sometimes come too late. This is not the way it has to be and the medical community could help to improve options for women. And to address your direct comments to me, yes, I have known Ina May Gaskin personally, have for 25 years — and know that some of your points about her personally are incorrect. Perhaps someday we’ll sit down and have a lively dialogue about birth! I do not think this is an ideal medium. Thanks for taking the time to write. Over and out on this thread for me. Warm regards, Aviva

    • ratiomom

      Women in Haiti would give anything for the opportunity to have their babies in a hospital with trained medical staff. They get cardboard shacks and untrained providers instead. Why you believe that we lucky women who have all that should strive to share in their misery is beyond me.

    • Clarissa Darling

      “Home birth is the norm in much of the world. Having spent a
      month practicing OB in Haiti last year, I saw a very stark reality in which most women cannot access the hospital for birth because of logistics (poverty!) which make this impossible in most communities.”

      Great, so the solution to poverty in Haiti is to make home
      birth with uneducated providers and lack of modern technology the norm in developed countries too. If those poor Haitians can continue brining babies into the world that way, so can we!

      Please Aviva, continue to make tourist trips to disadvantaged parts of the world and then come back and “educate” us white middle class ladies about how to best emulate the noble natives you encountered. Perhaps next you can promote the Sub Saharan African famine diet as a great way to shed post-partum pounds!

      • KarenJJ

        “Home birth is the norm in much of the world. ”
        Where? In areas where the majority of women have a choice and access to quality medical care?

        No. Not in the UK, not in The Netherlands, not in Australia, not in Canada, not in Italy. Where is this ‘norm’ of homebirth? It’s in countries where women HAVE NO CHOICE!! What would happen if we could give all women the option of quality medical care and the option of a free government funded and integrated homebirth? I’d suggest it would be exactly like the country I live in where the vast majority of women would still choose a hospital.

        • Amazed

          This. Homebirth is the norm in the places where there isn’t much of a choice.

          • KarenJJ

            “Let them eat cake” indeed. It’s an argument that makes me see red very quickly. “Oh but look at all the women one hundred years ago that were happy working in the home, having many, many children, cooking and cleaning and not going to school – it was the norm” and completely ignoring that they had no choice in the matter – she’s doing the equivalent here.

            Unless she’s talking about countries where women do have choices. In that case her information is out of date as it is not the norm anywhere where women have a choice.

          • Amy M

            KarenJJ–Not sure how to ask privately, but I had a question about the rare autoimmune disease. I am willing to give you my email or something, if you are willing to answer my question.

          • KarenJJ

            Sure. Happy to talk about it offline. Are you online now?

          • Amy M

            Dang, we keep missing each other. You are in Australia, no? Part of the problem I am sure. (I am in the US, east coast) Mostly, I just couldn’t remember the name of it, which I am trying to pass along to someone else.

          • KarenJJ

            Yes. I suspect we’re 12 hours out of synch and unlikely to be online at the same time.

            I’ll pop up an email address but will delete it when you see it.

            karen1003 at gmail dot com

          • KarenJJ

            Just saw the time where you are. Will post later when you’ll likely be up.

          • KarenJJ

            AmyM – up now. post when you see it and hopefully I’ll spot it on my emails via my phone.

          • Amy M

            STill up?

          • KarenJJ

            Got it and replying.. It’s a bit lengthy 🙂

          • Amy M

            JUst sent you an email….

    • Bombshellrisa

      Perhaps you could suggest to Ina May that she is projecting the wrong image, since I formed my opinion of her independent of Dr Amy or anyone else here. Anyone who wishes to be respected in the medical community should not be suggesting that fondling the breasts or clitoris of a laboring patient is appropriate.

    • Dr Kitty

      Respectfully, is Ina May a competent provider?
      How do you know?
      At what point since she started delivering babies in the 1960s did she become a competent provider?

      We’ve moved away from apprenticeship in medicine for a good reason- it is unacceptable to have on-the-job training without oversight or accountability when lives are at stake.

      CPM is an unacceptable “qualification”, and attending births at home without lifesaving medications, malpractice insurance or a backup plan with an OB is reckless at best and downright dangerous at worst.

    • Amazed

      Competent health care provider? Sure. Just not the ones you endorse.

      If my gyn talked about my “puss” the way your friend Ina May does, if he was so fond of my (remakably nice) breasts, I’d be running away before you could say “But wait!”. As it is, I feel completely safe with this middle-aged, privileged white man who tells me to lift my own breast instead of touching it, let alone petting it. But Ina May – I would not let her touch me even with a pole.

      Your friend Ina May comes across as a sexual predator. And frankly, I have little trust in your professional abilities as well, Aviva, since you support this behavior and call it professonal.

    • Expat in Germany

      Way to distance yourself from your -friend of US home birth midwives- image and portray yourself as an -international champion of midwifery for the poor-. Do I detect a subtext of -champion of poor mothers in the US who choose home birth for financial reasons-? Why not -champion of improving poor mothers’ access to hospitals-? The home birth story is no longer that of the pioneer hippie women living in the woods with no money and no hospital access. It is of women traveling far and wide, paying extra, and staying in a motel near a birth center in order to avoid the local hospital and get the birth experience that they read about in spiritual midwifery. They are shooting for counterculture and just-like-hippie-mom points. Those women don’t need an “atta girl” from a Yale MD for doing something which is more dangerous than necessary. That is how your brand is being used. Maybe you should rethink it.

  • Aviva Romm, M.D.

    Dear Amy,
    While we may have differing opinions on home birth, clearly this was a typo inadvertently posted by my assistant that you are using gratuitously.
    While we may also have different opinions about Ina May Gaskin, we cannot deny that the Gaskin Maneuver is now a recognized obstetric practice, used in hospitals and described in Up-to-date for the management of shoulder dystocia. As a medical doctor myself (Yale, Tufts), I strongly believe that a respectful attitude will do more to protect the safety of home birth mothers and babies than vitriol and divisiveness. I respectfully ask you to remove this and not use my name or post in this way.
    Thank you,
    Aviva Romm, MD

    • Amy Tuteur, MD

      I don’t doubt that it was a typo, Aviva, but I’m not joking about Gaskin having blood on her hands.

      She is a deadly charlatan who let one of her own children die. She is a cult member, and for all practical purposes, a cult leader. Homebirth kills babies; you know it as well as I do. CPMs are ignorant clowns; you know it as well as I do.

      Gaskin did not invent the Gaskin maneuver. In a classic colonialist move, she appropriated it from poor women of color in South America and took credit and garnered fame without giving anything to the real inventors. Moreover, If you’ve read the literature, you know that it is no more effective, and possibly less effective than other maneuvers.

      I have great respect for your formal training, and education, but not so much for the fact that you’ve decided to cash in by peddling “wellness” to the gullible.

      Have you seen these quotes from Spiritual Midwifery?

      ‘Don’t let the head suddenly explode from the mother’s puss. Coach the mother about how much and how hard to push. Support the mother’s taint with your hand during rushes. It helps the mother to relax around her puss if you massage her there using a liberal amount of baby oil to lubricate the skin. Sometimes touching her very gently on or around her button (clitoris) will enable her to relax even more. I keep both hands there and busy all the time while crowning … doing whatever seems most necessary.”

      And:

      “Sometimes I see that a husband is afraid to touch his wife’s tits because of the midwife’s presence, so I touch them, get in there and squeeze them, talk about how nice they are, and make him welcome.”

      And:

      “I might want to have a cunt one day and a twat the next. On the third day I might decide that pussy is my favorite word.”

      Are you going to tell me that you are honestly proud to have this woman as your colleague and friend, a woman who is grossly unprofessional and transgresses personal boundaries? If so, then a typo is the least of the problems here.

      I strongly believe that deadly quacks like Ina May must be stopped, and she and the other ignorant CPMs are not going to be stopped by a respectful attitude. I’m sorry, but I can’t be respectful toward people who view dead babies as collateral damage in their efforts to get a birth junkie high.

      What are you doing to protect innocent mothers and babies, Aviva? I can see what you are doing to promote the perpetrators, but I really want to know what you are doing to protect the victims.

    • suchende

      “I respectfully ask you to remove this and not use my name or post in this way.”

      And I respectfully ask that people stop trying to silence their critics instead of standing up for their positions on their merits. That’s a cowardly, disgusting response to criticism.

      • Squillo

        And blaming errors on their assistants (or summer interns.)

        • suchende

          Yeah, all class over here, huh?

  • I don’t have a creative name

    Yes, she does. None more so than that of her own baby that she deemed unworthy to try to save.

  • XLhz

    Hmm…I’d guess it’s been around as long as there have been homes, and births, and women. But something being around a long time, by itself, does not make it provably good or desirable. Because while nothing may be more “natural” than having a child at home, neither is dying in childbirth. As official records of the number of women and babies who did die in delivery before the advent of modern obstetric practices will clearly show.

  • MichelleJo

    Brilliant slip!

  • Antigonos CNM

    The “homebirth movement” hasn’t been here longer than I think, because it pre-exists hospitals by centuries, if not millennia. Finally, however, human beings developed a safer way to have babies so homebirth was, deservedly, relegated to where it belongs: in prehistory.

    • Spiderpigmom

      It seems clear that he “homebirth movement” is extremely recent. in the sense that until recently, no one in their right mind would have chosen to give birth at home if a safer alternative existed. I doubt people from the prehistory would have turned their nose at a safer way to give birth. They would have known first hand what sky-high perinatal mortality rate and horrendous birth injuries are like.

  • Amy Tuteur, MD

    OT:

    Why are natural childbirth advocates so desperate for validation that they need to pretend that celebrities are mirroring their own choices?

    http://www.mirror.co.uk/news/uk-news/royal-baby-news-kate-middletons-2079299

    • Jessica

      I didn’t think an 11 hour labor for a first time mother was particularly noteworthy.

    • EllenL

      The Duke and Duchess are too sensible (and too private) to let any “movement” hijack the birth of their baby.

      All we know is that the birth was in a hospital and two OB’s were in attendance.

      Not much there for the NCB nuts to work with; they will have to make stuff up.

      • MichelleJo

        The amount of media coverage there has been for a news story that would have taken up a few sentences at most is staggering.

        We know 1) She gave birth in the Lindo Wing of St Mary’s hospital in Paddington, London. 2) She entered the hospital at 6am, gave birth to a boy at 4.24 pm weighing 8 lb and 6 oz.
        3) The family of three left the hospital the next evening with William driving them away. The end.

        • theadequatemother

          we also know she met with Christine Hill for labor prep…and she is apparently very no nonsense,not loved by the NCB movement, and lets all her girls know about the “ghastly parts of labor.”

          • The Bofa on the Sofa

            So it seems that the attempt to make this sound like a great NCB is pretty much an act of desperation, attempting to grasp anything they can.

        • Mom of 2

          6-7 am is when we start inductions, at least where I work, and around 4 pm is pretty typical delivery time for a primip induction…so it absolutely could have been a scheduled induction. Wouldn’t that blow the minds of the NCBers…

          (said by someone who thinks scheduled elective induction is a swell way to give birth. I loved mine and if I were a princess I’d ask my dr for one!)

    • MichelleJo

      We don’t even know how long Kate was in labor anyway. We only know when she entered the hospital. She could have been having contractions for a day or two before that. And we don’t know that she “hypno-birthed”.

      Besides, while 11 hours is OK, it’s not a particularly fast labor. My first labor, with my husband by my side, was four hours beginning to end and I was NOT relaxed. I was panicky and sobbed throughout the whole thing. I had been to an NCB childbirth class which actually unprepared me. The intensity of the pain took my breath away, and I was terrified of having an epidural.

      So my opinion for what it’s worth; 11 hours is not fast, and being relaxed does not speed up labor.

      • Amy M

        I agree. I was pretty relaxed throughout the labor and delivery of my babies, I had an epidural for the last third of it which certainly facilitated that…still took 22hrs.

        • theadequatemother

          what does it mean to be relaxed during labour? For me, feeling relaxed usually involves a beach chair, a sun umbrella and a really frosty beer….or some variation thereof. I wasn’t screaming and panicking when I was in labour, but I wouldn’t call that relaxed.

          When I got the epi I was euphoric (ah…so nice to have no pain but left over endorphins).

          but relaxed? I dunno.

          I dilated in 3.5 hours and the first hour of that I only had 3 contractions. I shudder to think what would have happened if I’d hypnobirthed…;)

          • Ainsley Nicholson

            With my second delivery, I went from 5cm to birth in no more than ten minutes- the nurse literally checked me and left the room, and a few contractions later my son was born…no-one with medical training was in the room, my sister caught him. Those last few contractions hurt.

      • MaineJen

        11 hours did not feel “fast” to me either 🙂 And I think “relaxed” is a relative term…

      • moto_librarian

        My first labor was less than 12 hours from start to finish. Water broke around 6 am, not real contractions until noon, baby born at 5:44 that afternoon. The last four hours were sheer hell thanks to my decision to have a “natural” childbirth.

        I had prodromal labor with my second for nearly two weeks before the CNM took pity on me and stripped my membranes to get active labor going. I got the epi as soon as I was admitted (5 cm.) at 2:30 pm – baby was born at 4:39 the next morning. I was indeed quite relaxed and slept through most of that labor. It was so much better than the experience with my first.

    • Amy H

      I guess I’m more worried about how the baby was(n’t) strapped into the carseat! Evidently the nurses there can’t hold you hostage until you get it right… I would say the chances of royalty getting into a fatal car accident our very poor, but then again…

      • Wren

        We had to have a car seat to leave the hospital as we were in a car (taxi the first time, our own the second) but the nurses didn’t check we could use it.

  • stacey

    HA! Perfect!

  • HM

    Bet she’s regretting that!

    It’s scary- she seems like such a trustworthy person. Many people probably wouldn’t think twice about trusting a physician educated at Yale. It also seems like she had her beliefs set before she attended medical school, and obviously, nothing she learned there changed her mind! It’s interesting how she advertises herself as a physician, gynecologist, pediatrician, midwife, and herbalist (plus girlfriend, grandma, and inspiring, empowered woman, which is obvi).

    • EllenL

      “Advertises” is right.

      She would like to be your doctor, motivational speaker, favorite author (of 6 books) and teacher for her Distance Learning Courses ($2,150 for Herbal Medicine for Women, for example).

      She’s not so much a doctor as an industry.

    • Tim

      I can’t imagine anyone that completed a proper pediatric residency, and thus watched scores of babies die in the NICU could end up like this.

    • quackwatch

      even yale is not immune to the almighty quacktivist

  • KumquatWriter

    HAH! Freudian slip: when you say one thing but mean your mother.

  • Anj Fabian

    OT
    So when will court rule?

    • Amy Tuteur, MD

      It could be today, 6 months from now or a year from now. There is no way to know.

      • Anj Fabian

        Hey! Those are my tax dollars at work. I want results!
        😛