Who’s afraid of Dr. Amy?

terrified

Yet another battle of wits with unarmed opponents.

TFB on ACOG conference

 

Ohmigod! Ohmigod! Ohmigod! Dr. Amy will be speaking in a venue where we can’t delete her or ban her. What to do? Duh, try to censor her, of course!

 

TFB on ACOG conference 2

 

Thus saith self-proclaimed “public health scholar” Gina.

Lots of homebirth advocates are afraid of me. My personal favorite explanation comes from Katie Prown. It’s a blast e-mail sent out by The Big Push for Midwives, bemoaning my influence, because of my:

highly negative, but to the average person, highly plausible, comments.

Highly negative and highly plausible … and highly accurate.

Why are homebirth advocates so afraid of me? Navelgazing Midwife said it best:

It’s really important for people to know that Dr. Amy isn’t going anywhere and that she will continue to be used as a source protesting Certified Professional Midwives and much of home birth. I know women who begin reading an article or post and if Tuteur is mentioned, abruptly end their reading session. Dr. Amy has been a source in over a dozen articles, from the Los Angeles Times, the New York Times and Time.com; it’s unlikely she’s going anywhere…

As much as Dr. Amy Tuteur makes some people crazy, she has proven she is not a force to ignore. While I have issues with her delivery and am unsure about all she professes as fact, the woman has things to say that need to be heard and she’s going to be heard, whether we like it or not…

As one commentor on NGM’s site noted:

I am profoundly uncomfortable with all the Amy-bashing that goes on. Granted, the woman is strident, vocal, and opinionated, but what the heck?, since when are we all supposed to be shrinking violets? I suspect that she makes people profoundly uncomfortable because she zeroes in on all the stress points in midwifery care like a homing missile. Uneven/inadequate training? Check! Lack of accountability? Check! Absence of informed consent, good backup, timely transport? Check, check, check! She pushes people to address issues they’d rather gloss over. And THAT in my opinion is why she is so reviled.

It’s the same reason why every major professional homebirth advocate refuses to debate me. They know the facts are on my side. They know they’d be eviscerated in very short order.

And as NGM pointed out, I’m not going anywhere. If you’re a homebirth advocate constantly spewing nonsense, you should be very, very afraid.

  • thanksforthelaughs

    I’d love to publicly debate with you…..I’d shoot you down like a pigeon (metaphorically speaking of course)

    • Karen in SC

      Then do it! Email’s up in the top corner. I’m sure it can be arranged.

    • Amy Tuteur, MD

      That’s why you are posting anonymously, right?

      • MysogynisticOPH

        Oooh don’t tempt me! I’d have you running as fast as your fat little legs can carry you crying to your mummy. Seriously, I’m surprised an old fart like you even knows how to use the Internet!

        • Amazed

          I was just hoping that you’d come up with something creative *sigh* Really, what’s the problem with you internet trolls? Can’t you progress further than the level of a school bully? Or is it just a NCB thing? I swear, I sometimes despair of the quality of trolling on this site. Must have spend the first 10 years of your lives sucking at your moms’ boobs and missing anything beyond them, like truly caustic speech.

        • Amy Tuteur, MD

          You’re not tempted; you’re afraid. That’s why you’re hiding behind a screen name.

          • MisogynisticOPH

            I’m afraid of your thunder thighs knocking me over as you flee from your mediocrity

          • fiftyfifty1

            Fat and old. Wow, what terrible insults. Nothing in the world could be worse than not staying young and thin forever.

        • Squillo

          Q.E.D.

    • PJ

      I think you’re full of hot air.

  • ngozi

    I find Dr. Amy a whole lot less offensive than Fox News (if you can call it that) Network!
    If this is supposed to be a free country, why can’t Dr. Amy express her ideas like anyone else? Oh, I guess freedom is only for people who believe like you do…

  • Ainsley Nicholson

    So what you are saying is that poor women (of whatever educational background) are not going to get quality medical care no matter where they give birth, so they are choosing birth attendants that might not have much medical training but are at least going to be nice to them? It would be profoundly disturbing, if that were the case. Noone should have to make that sort of choice. Please provide your source for this information, as I can’t find any documentation supporting your claim.

  • Poogles

    “Also, soliciting a few of your groupies to fill out an on-line survey is not research, it is propaganda.”

    So then, where is your research to back up your original claim that “[t]he number one reason [women choose homebirth] is poorly paying/no insurance.”?

  • Dr Kitty

    For all the people who dislike Dr Tuter’s tone.
    Is she factually wrong?
    Is she libellous?
    If you think she is, can you give concrete examples?

    Does your complaint actually boil down to the fact that she calls CPMs out on being woefully under qualified, unaccountable and oblivious to the fact that they are?

    I don’t always agree with everything Dr Amy writes, but I’m woman enough not to feel that I need everything sugar coated or couched in “supportive” language.

    I spend most of my professional life dealing with the NHS default mother-nothing but nitrous for delivery, formula from birth.
    I don’t judge

    • Karen in SC

      I’d take a hit of nitrous oxide during a pap smear and blood sticks. Think that will come to pass? Please?

      Not sure why the US does not use nitrous oxide. I skimmed an article and a few abstracts and it’s not clear. Maybe since some women will still want to get an epidural it was thought to be an unnecessary in between step.

      • theadequatemother

        I use nitrous all the time for IV starts in the OR (cos I’m a nice person).

      • Older Mom

        I have often wondered the same thing. Dr. Amy, any insights? It would be a blessing for us lady folk!

        • Amy Tuteur, MD

          I don’t know why nitrous hasn’t been used in OB in the US. It is an interesting question.

          • Sue

            Just some accident of history, I suspect. It’s also widely used in Australia, particularly in labor but also for things like painful procedures in emergency medicine, or changing burns dressings etc. Cheap as chips, onset and offset fast, easy to administer.

          • attitude devant

            I always suspected it was a turf issue. In many US hospitals the (privately owned, for-profit) anesthesia group actually owns the tubing that carries the anesthesia gases AND the delivery equipment. So, even if I wanted to, I can’t offer nitrous to my patients.

          • theadequatemother

            interesting…in many of our LDRs the nitrous is not piped from the wall, there is simply a tank strapped/ secured that has a hose with a mouth-activated regulator on it.

            Maybe because our hospitals are old…:)

      • Susan

        And for mammograms! I think a bit of nitrous would be a great thing for that! Ouch!

      • Due diligence

        Coming from a country where nitrous is used, if it was adequate analgesia for childbirth, we would never have invented epidurals. It’s ok for pain in transition to full dilatation, but no many women would prefer to suck on nitrous for a long painful labour ifnthey had access to epidurals

        • Louise

          The simply isn’t true. Obviously there are cultural differences at play (I saw that working in a very multicultural unit in the UK where a large proportion of women were recent immigrants) but while there are many women who want an epidural to eradicate the pain completely, there are also many who do not feel the need for this and just want to take the edge off it. It is a matter of personal preference, and I see no reason why it nitrous oxide should not be available as an option. As someone who enjoys taking it recreationally (NEVER when I was working, to be clear, only ever at parties and festivals) I wouldn’t choose to give birth without it! Even if I had an epidural, and still be puffing on the gas and air!

        • moto_librarian

          My hospital recently started offering nitrous again (large university medical center in the States). I talked to several women who had used it because it was my backup plan in case I arrived at the hospital too late for an epidural with my second child. They said it didn’t do anything for the pain, but that it got you high enough that you didn’t care.

    • Some people are sensitive for one reason or another. I don’t think that Dr. Amy has an obligation to speak any way except the way she thinks is most effective, but I also do not think that people who are sensitive or turned off by her tone have anything wrong with them. I am saddened that there are not more people who are sharing the information Dr. Amy has with sugar coating so perhaps it will reach more people.

      • Elizabeth A

        I’ve done a lot of carefully saying similar things, in polite terms, and self-policing my tone on various birth and parenting forums, in the hopes of reaching, well, anyone. I have largely failed. The tone is fine, but no one’s listening.

        So one of the defenses for the tone is that it sure does get attention. Sugarcoating can help people tune you out.

        • I just remember being extremely sensitive during my pregnancy. I really couldn’t handle much negativity or even bluntness. I don’t think its typical, however.

    • KB

      As a paediatric and neonatal nurse I’ve cared for many homebirths gone wrong and would never never advocate homebirths, they’re totally unsafe in my humble opinion. As a mother I did want a natural vaginal birth without any drugs in a hospital for so many reasons not least to conform to societal and I have to admit the nursing professions expectations but my baby girl at 39 weeks never engaged, was IUGR thanks to placental issues, CTGs were equivocal at best and her health had to come first. My birth plan became an elective caesarian to avoid an emergency caesar and despite what some of my nursing collegues & family said to me before and after it was a beautiful positive experience because I chose for it to be that way. I made an educated decision for the health of my baby and myself as a health professional and a mother at the recommendation of my obstetrician whom I respected and I believe I made a relatively selfless decision. What I find disgusting is that some other mothers and some of the midwives felt they had the right to question my decision ” why did you have a caesarian?” Noone ever asks why did you have a natural birth and believe me there are plenty of children I care for who wouldve had a better life outcome with an early induction or caesarian. As for Dr Amy needing to sugar coat it I actually don’t think the information would reach more people if it was sugar coated people choose to believe what they want to believe but I for one am glad there someone out there with the guts to tell it like it is. I’m with Dr Kitty I don’t always agree with everything Dr Amy writes but I was damn glad for her blogs when I was 36 weeks pregnant looking at a potential elective caesar for medical reasons and felt like the world was against me for making what was honestly one of the hardest choices I’ve ever had to make.

    • MichelleJo

      I don’t see what is wrong with the tone at all. After all, she is responding to ridiculous claims, and approval of clown like actions and performances. It would actually give them some credence if they were taken seriously and argued with politely as a viable option to the conventional way of doing things.

      Let’s say one of these ‘activists’ or ‘advocates’ stands up and claims that all babies born on the 1st of August will be boys. Would that also be required to be discussed in a professional, polite way? It would get what it deserves, brushed off like a fly, incur some howls of laughter, and a few choice words from Dr Amy (if she can be bothered). Certainly they wouldn’t expect Dr Amy to engage in polite discussion about it.

      Well, many of their claims are just as ridiculous, and deserve no better. “Birthing space”, “your baby knows when to be born” blah blah blah.

  • sorry please ignore, mistaken post

  • Forgot My Disqus Login

    I know am terribly immature and (too) easily amused, but I just came across this fabulously funny picture of a “water birth”, and my first thought was to share it with my fellow Dr Amy supporters: http://iwastesomuchtime.com/on/?i=78415 🙂

    • yentavegan

      hahahahahahah. and I am a vegan!

  • Dr Kitty

    Why do some women chose home birth?
    Because women are not a homogenous group, but are individuals with different beliefs and priorities and needs.
    I was recently given the option of staying awake and having needles stuck in my cervix, but being able to drive home afterwards, or having a GA and having to be picked up and driven home.

    I don’t mind needles, I’m not squeamish and I don’t want my husband to miss work, so I’ve chosen option 1. Other women with other priorites would choose differently. No big deal and no judgement, because we’re given all the information needed to make our choice.

    HB isn’t like that-some women are making choices based on incomplete or inaccurate information.

    SOME women choose HB because they honestly believe it is “as safe or safer” than hospital birth. It isn’t, and knowing that, they would opt for hospital.

    SOME women choose CPMs because they honestly believe that they are the same as CNMs. Knowing that they are not, they would choose not to deliver with them.

    This site puts accurate information out there. If people don’t like the tone, they are free to look elsewhere.

    • Alenushka

      Exactly. I would be under GA. I have high tolerance fr pain but I have so much of it in my life that anytime I can avoid, I take it. I do not care about my husband work since he is an ex.

      • rh1985

        if I need a c-section, I am torn between begging for general anesthesia (severe fear of surgery and being awake while being cut open, no fear of surgery in general just the awake part) or trying to suck it up because there is a fairly high chance I will decide not to have any more children and I’d completely miss the birth of possibly my only child.

        • Lizzie Dee

          The idea of being awake is bizarre and scary, the reality is not. Can you put a block on your imagination, and kind of sing la-la? The preliminaries are weird, but my daughter was out so quickly, and “being there” is well worth it. I had both, and hated the GA. My memories of the second are 100% positive. If you explain to the docs, maybe you can practice some techniques for staving off panic.

          Here’s hoping you avoid it anyway.

          • rh1985

            I am early in my pregnancy (two months) so I won’t know for a while… it’s a possibility I’m afraid of because I seem to be narrow (that’s why I am worried already), but I’m hoping that things will stretch later in the pregnancy or maybe I’ll have a baby that’s on the smaller end of a healthy weight range.

        • EB151

          I recommend an iPod in the c-section. Very helpful. Talk to your partner and arrange some things. Do you want to be told when they’ve started? Do you want to be told when the baby’s arrival is imminent? — And then let the team talk to your partner and your partner talks to you only about stuff you agreed you want to hear, and otherwise, you just jam out to whatever and close your eyes. It will be like you’re not even there, I swear. On the last one, I asked each of my closest friends to send me a song for the birth. My partner loaded it to my iPod and I had so much fun listening to each song and guessing who sent it and why. Very distracting. GOOD LUCK!

          • I don’t have a creative name

            That’s a great idea.

            The idea of being awake during surgery did not bother me. I hope you can get to a point of being ok with it – I fear you would have massive regrets about missing her birth due to your own anxiety. Plus you’ll be dopey and groggy for a while even after waking up and may end up really missing the first day or two. I just don’t think it’s worth it. I know I can’t talk you out of anxiety, but I hope you can maybe gain some trust in the process by knowing there are so many of us who had wonderful experiences with our c-sections. If there is anything I can tell you about it that you think would help, please don’t hesitate to ask.

        • Dr Kitty

          Talk to the anaesthetist- they may be able to give you something for anxiety.

          I don’t know if it is something you need to consider, but opting for GA would mean your partner or support person can’t be in the OR, so neither of you would witness the birth.

          Obviously, if you can’t face a spinal or epidural, you can’t, but if you can, knowing that you would have someone you love holding your had and talking you through it might help.

        • rh1985

          I am a single mom by choice (pregnant with donor sperm) so if I wanted someone there it would probably be my mother.

          • EB151

            My first was under general anesthesia. It was fine. But I did like it better the next time when I was awake and it was nowhere near as horrible as I thought it would be. The spinal has morphine in it which is very calming, lol. But really, it’s just a day. Do whatever works for you and move on to the good stuff. And congratulations!

        • Elizabeth A

          I can’t say what will work for anyone but me, but I was absolutely terrified of c-section, and yet found mine (under local anesthesia) to be a very peaceful and healing experience. There was really no doubt in my case that the c/s was necessary (placenta previa, with hemorrhage), and, wow, morphine.

          Even if you are conscious, if the anesthesia is doing it’s job, it is quite possible to be blissfully unaware of what’s going on on the other side of the curtain.

        • Antigonos CNM

          In my first labor, an epidural was attempted, but failed, so when it came time for the C/S [48 hours without a single cm of dilatation], it had to be done under GA. I’d had GA before, for removal of impacted wisdom teeth, and so it didn’t scare me. Since then I’ve had 4 additional surgeries with GA [2 more C/Ss, salpingectomy for ectopic, hip replacement], and frankly I love it. The iPod suggestion was made for the hip replacement, until I pointed out that my history [plus a ruptured disc in my back] really did not predispose me to an epidural. Once I told the doctor that I’m also a very bad back seat driver, and that I REALLY didn’t want to hear the drill, no more objections were raised. Never had a problem with any of the expected side effects. Granted, in many ways, an epidural is better, but GA ain’t bad!

      • Dr Kitty

        I’ve agreed to the cervical block on the understanding that if I can’t handle it they’ll give me some Midazolam and phone my husband.
        This procedure is the one thing standing between us and having another child- at this point I’d probably agree to it sans pain relief!

        • moto_librarian

          I hope all goes well, Dr Kitty!

          • Dr Kitty

            Thanks!

    • KarenJJ

      Exactly. And some women are misled by poor information and some women are sociopaths or so invested in an ideology they can ignore the dead babies, even their own. This blog aims to shake the first out of their complacency and denounce the second group. Sometimes I feel Dr Amy has it wrong with some of those she denounces, but I’ve also been wrong about that one to when one of them showed up in the comments here with further disturbing ideas.

      You can’t treat women as an homogenous group and homebirth especially seems to have such a broad range of motivations. They’re not all victims of some great hospital/medical conspiracy and not all lay midwives are caring citizens that would jump at the chance to update their skills and improve the outcomes of the baby’s they deliver. When you start to query whether some of the women that are choosing homebirth are ambiguous about having the baby and whether for some midwives watching a birth is more a compulsion or a monetary exercise then caring for two patients, you start to question whether there really is a dark side going on in homebirth that people aren’t talking about. Except Dr Amy.

      A few years ago I’d have never written that, but being a mother and a professional in a different field, I’ve now seen plenty of red flags in homebirth that people like Dr Fogelson shouldn’t be pandering to.

  • MichelleJo

    While it is true that this site has converted many former NCBers, and has even saved babies lives, there is another aspect to it, which is huge. The percentage of home birthers is tiny, but there is a very large percentage of women who use their own intelligence to work that it is safer to give birth in the hospital then at home. But they still feel like they are missing out on something ‘special’, and are also affected by the NCBers zero tolerance of any procedure whatsoever. They feel like they are ‘giving in’ when asking for pain relief, and they are putting their own wants before their baby’s health. They feel disappointed and at fault if they end up with a surgical birth. If breastfeeding doesn’t work out they get this niggling feeling that if only they had kept trying a little longer it would have worked and they could have given their baby a healthier and more loved life. They feel that they have shortchanged their babies if skin to skin contact doesn’t happen immediately, and it will affect ‘bonding’. (The whole concept of ‘bonding’ with babies is invented and ridiculous, and is relatively new. Let’s leave bonding to the chemicals, from where the word was taken, and stick to human interactions, which are called relationships.) There are no short-cuts to love. Love between a parent and child evolves with time and includes real feelings which are different with every child, not specific actions like skin to skin contact.

    Every woman ought to feel unreserved joy when they give birth to a healthy baby. The NCB movement have replaced that joy with guilt. Thank you Dr Amy, for returning the joy to which every mother deserves.

    • I don’t have a creative name

      So well said!!!

      • wookie130

        An absolutely golden comment!!! This pretty much sums it up, doesn’t it?

  • melindasue22

    It drives me crazy when people get all strange about Amy calling herself a doctor. She earned the degree, she is a doctor. Anyone who earns a doctorate has earned that right. She doesn’t pretend to be a licensed physician or anything. I called my professors with PhDs Dr. So and so. That us her appropriate title.

  • Melisa

    I would have sought out homebirth midwifery care for my second pregnancy if it were not for this blog. Why? Because homebirth culture made me feel bad about how my first delivery went. It wasn’t even a c-section. But who was I kidding? I loved having pain relief. I feel at peace with my first delivery now and I don’t care what those people think about me any more.

  • Amy Tuteur, MD

    I wonder if Nick has berated Orac of Respectful Insolence for his lack of respect toward his anti-vax colleagues. Or is his tone trolling reserved for only women?

    • Captain Obvious

      So he does live in a glass house? He has relocated several times throughout his career never achieving more than an Asst Prof and his on line testimonials are worse than the national average. He should focus on improving his office throughput and attention to his patients and less time on politics and outside adventures.

    • KarenJJ

      I don’t know about Orac, he might get worded to death, but maybe he should pop over to Pharyngula and tell him that he should be more considerate and inclusive of biologists that believe that evolution doesn’t exist.

    • Karen in SC

      I find his sudden appearance on this blog quite suspect as well. If he was truly interested in helping women, why hasn’t he commented before on your posts that discuss vaginal tearing, VB versus CS and other topics in his area of expertise? ( Female Pelvic Medicine and Reconstructive Surgery)

    • stacey

      Of course its only for women, as we all know, a strong woman is a BITCH, while a strong man is, well, a man, to be worshipped for their straight talk…

      Pitiful Nick. Pitiful. Get a clue.

    • MLE

      It’s self aggrandizement via jumping on the anti-Amy bandwagon. I am sure he has noticed how the NCB ladies fawn over male Drs who pander to them.

  • Amy H

    I am very possibly one of the women you have saved from having a homebirth. Admittedly, I was still in the early stages of thinking about it, but I was pretty serious. From the time in my early teens that I heard some people were giving birth at home, I was sure that was what I wanted to do. My only point of decision was whether it would be foolhardy to do it with my first child.

    I was busily “researching” on the internet, and I was very sincere. I googled “safety of homebirth” a lot of times, and was quite satisfied by the “studies” I found. I think one of the places I was reading a lot was… well, I can’t find it but (OT) did you know if you google “homebirth blogs” “Hurt by Homebirth” and “Skeptical OB” are on the front page now? Congrats! Anyway, I was reading one that does a pretty decent job of masquerading as educated and objective. I got BOBB and watched it.

    Finally I decided I should actively look for the opposing side, since I wasn’t running across it. Who else would I have looked for but “Dr. Amy,” the nemesis I had seen repeatedly mentioned? I came here pretty confident, but that changed within the first few hours. I can tell facts when I see them.

    My one-year-old had his first birthday earlier this month, and he is extremely healthy and intelligent (IMO LOL); we had a wonderful birth in comfort with an epidural with no side effects; baby was wide-eyed and alert; they did an hour of skin-to-skin as soon as they toweled him off; he breastfed without a hitch until I realized at 9-10 months that we were done, and I’m not interested in whether anyone besides he or my husband consider me a success or failure. Thanks.

  • practicing woman

    “I spend most of my time teaching at a Emory University”

    and before that U. So Carolina, and before that U. of Hawaii. Asst Prof for 8 years and 3 different places. Never advancing. Hmmm

    http://www.linkedin.com/pub/nicholas-fogelson/9/b0/771

    Maybe its all the time he spends on the software company that isn’t working out.

    http://www.hooahsoftware.net/

    Or maybe its his lack of research skills.

    http://childbirthtruthsquad.wordpress.com/2010/08/25/143/

    or his lack of patient skills

    http://www.healthgrades.com/physician/dr-nicholas-fogelson-xkr66/patient-ratings

    Experience with Dr. Fogelson Level of trust in provider’s decisions 2.6 5 responses worse than national average

    How well provider explains medical condition(s) 2.6 5 responses worse than national average

    How well provider listens and answers questions 2.6 5 responses worse than national average

    • PollyPocket

      I think the personal attack is a little uncalled for. While I certainly can’t speak to the world outside of academic medicine (I’m so sheltered, LOL), not “advancing” after a number of years does not indicate a lack of mental prowess or even a lack if ambition. The politics in any academic hospital are unreal. Sometimes, principled providers choose not to advance so as not to compromise the things they believe in. I am reminded of Dr. Jennifer Gunter who left a prestigious academic post when her department would not back her up about failing a student after the student got a lawyer. (The while story is on her blog, and very thought provoking.). I personally know of a phycisian who was being primed to take over as the head of plastics at an academic hospital. He insisted on failing a resident, and was not allowed to do so, so he resigned instead. (That resident was passed. He was recently arrested for waterboarding his mistress. The doctor who felt he should have failed said, “I always knew he would end up killing people. I just never imagined he would take such a direct approach.”)

      Online anonymous patient scores are not always the most reliable. Some people will get on their own page to inflate their scores. Or disgruntled ex-employees may get on and trash your ratings. Just food for thought.

      • KarenJJ

        I agree. None of the above counters Dr Fogelson’s point of view that Dr Amy is unprofessional and that it is appalling that she will be speaking at an ACOG conference. There’s plenty to disagree with there without digging for more dirt on him.

      • Alenushka

        Yes, but reviews on healthgrades etc have nothing to do with politics. Patients are not satisfied with him.

        • Certified Hamster Midwife

          In theory, he could have thousands of happy patients and just a few who are annoyed that he didn’t do everything according to their wishes. In theory.

  • Kelly

    These folks have every right to be apprehensive. This blog is inflammatory, ineffective for anything other than angry mob mentality, and just plain mean. I realize that some call this “tone trolling” but tone is extremely relevant in relation to producing a message, enacting change, and overall effectiveness. I have yet to be given real cause of why this blog is meant to be taken seriously other than by the choir it preaches to. The supposed claim, message and purpose of this blog is to save women and children from making poorly uniformed choices about their birth. It clearly does none of these. Why is it a shocker that people are concerned?

    • suchende

      Many voices make up any movement. The choir preachers energize the base. The moderate voices pander to the unconverted. The dissenters keep everyone in check.

      People love to tell Dr. A she should change her tone. Why? To lower her web page traffic? To avoid stepping on toes (rarely do well-behaved women make history)? To try to politely, oh-so-gently, point out that women, for whatever their reasons, are putting their babies lives at risk and even killing them or causing permanent brain damage? Why can’t she, why can’t many, impassioned healthcare providers shout from the rooftops, “YOU ARE ACTING LIKE IDIOTS!”

      I consider myself a moderate voice. Even a home birth apologist, at times. But my God, I would never want Dr. A to change her tone.

      • The Bofa on the Sofa

        Whenever I see the “she needs to be nice” comments, my thought is, well, so you agree she is correct. Great.

        • Anj Fabian

          If you look at the range of “tone” across the birth/home birth/birth choice spectrum, Dr. Amy isn’t as extreme as the other end of the spectrum.

          Let’s look at Sisters in Chains, where the birth community rallies around, supports and defends birth workers who have faced censure, lawsuits and criminal charges because their actions and inactions have led to injury and death.

          The polar opposite to that would be to insist that every birth worker involved in a death or injury should be prosecuted. It doesn’t exist here.

          The “birth choice” movement insists that all options should be equally available to all women, everywhere.

          The polar opposite would be to insist that women be allowed no choice, no voice in their reproductive health care. It doesn’t exist here.

          TFB can try to portray SOB as extreme, but it isn’t.

      • Squillo

        I agree wholeheartedly about the necessity of having a variety of voices, but I must add that it wasn’t moderate voices that changed my “middle-of-the-road” attitude to vaccination. It was the aggressive folks who called me an idiot that made me go look for things to prove that I wasn’t an idiot, dammit! Guess what I found?

    • Eddie Sparks

      “The supposed claim, message and purpose of this blog is to save women and children from making poorly uniformed choices about their birth. It clearly does none of these. ”

      Have you even read the comments on this blog? Many women post here thanking Dr Amy for helping them make better informed choices about their birth. Let alone the readers who don’t post.

      It clearly does these things.

    • Jessica

      I started reading this blog and Hurt By Homebirth in the fall of 2011, when I was newly pregnant. I’d originally contemplated giving birth at the nurse midwifery center in town (run by CNMs, but still), and spent a long time thinking about whether to try to go pain-med free. The stories I read on these blogs, plus the comments from those who are decidedly non-woo, helped me change my mind. In the end I was considered high risk, and I fully embraced all sorts of interventions. It was not necessarily a pleasant birth experience, but I don’t regret one damn thing about it, because my happy and healthy baby more than made up for it all.

    • R T

      I started reading the blog because so many natural birth advocates talked about Dr. Amy. I was a doula and was born at home myself. I was horrified at first and there are still posts I could do without, but it completely changed my views. I’m still supportive of homebirth for truly, low risk women with a qualified care giver and close proximity to a hospital. I am not supportive of DEM or the dangerous high risk births occurring at home. I know it makes you feel better to think every one here had always hated home birth and weren’t changed by this blog, but it just isn’t true!

      • Lizzie Dee

        I don’t hate homebirth. I just don’t understand why anyone in their right mind would want to do it. If anything, joining in this insane debate when for years I was unaware that the world had gone mad and a natural, painful, risky birth at home was now some highly desirable “dream”, this blog and the facts it contains has to some extent convinced me that if people want to take that foolish gamble they may, after all, stand a better chance of getting away with it than I originally believed.

        What I really hate is this romanticising of birth as some kind of achievement or test. I hate the smugness and the blindness. I hate that the point of it – the baby – has got lost. I hate the hypocrisy and stupidity of wanting to be warrior women while simultaneously bleating about the vital role of “support”. I hate with a passion the idea that women – all women – should be defined in this way, that wishful thinking has taken the place of reason. Yes, mothers matter too. Yes, there are problems in hospitals. Deal with those, for pity’s sake, as adults not spoiled children chasing a “dream”.

        If Dr. Amy ever starts sugar coating the hard realities, I am out of here. Don’t think that is likely, though.

        • The Bofa on the Sofa

          joining in this insane debate when for years I was unaware that the
          world had gone mad and a natural, painful, risky birth at home was now
          some highly desirable “dream”,

          Make no mistake, it hasn’t and it’s not. At least for more than 99% of the world.

          If you set your bar at 1%, there are a lot of really, really crazy things out there. Shoot, 6% of americans think the moon landings were faked. That’s like 10 times more than the homebirth nuts.

          That’s how extreme homebirth is. Only 1 in ten Moon Landing Hoaxers will do homebirths (actually, that’s not right since homebirths are women only, and I don’t know the male/female breakdown of moon landing hoaxers, but it’s a funny comment)

          • Renee

            Oregon has 4.5% of births OOH. Some of them are in the hospital owned birth center. In Eugene, it is about 1 in 10.

            This is still not a majority. Even with Medicaid paying for LDEM HB and BCers!, they cannot get a majority.

        • R T

          As you have pointed, most people can get away with home birth despite the risks. Personally, I feel the risks are low enough when done in the optimal conditions to make it a valid choice for some women. For some women it is a much more pleasant way to give birth. They feel more comfortable at home away from the institutional environment of a hospital. I personally understand the appeal. I didn’t enjoy my months in the hospital. I wish I could have had such an easy pregnancy and labor it could have occurred at home. I was incredibly high risk though. However, I agree it is absolutely ridiculous for anyone to claim it is the better way and the way most women should be striving to give birth. I think it horrifying women are attempting home births with twins or after multiple csections or with a history of severe PPH etc. and under the “care” of lay midwives with inadequate to no training. I don’t want to see home birth go away. I want to see it safer! Yes, the risk will always be higher at home, but it can be lower and like the choice to VBAC, when done safely the risk is low enough to make it a valid choice for birth.

        • prolifefeminist

          “Yes, there are problems in hospitals. Deal with those, for pity’s sake, as adults not spoiled children chasing a “dream”.”

          Perfectly said! I think one of the most insidious things about the NCB movement is how it demonizes hospitals and hospital staff. No, hospitals aren’t all perfect places with perfect people running them, but that’s because they’re run by humans, who aren’t perfect to begin with! It’s paranoid to believe that doctors and nurses are all in on some big conspiracy to screw over their patients.

          My MIL is like this – she really, truly believes that doctors “just don’t care what happens to you,” a statement that I find that incredibly sad. We have enough doctors in the family to know up close how much hard work and dedication it takes to become a physician. How does one then make the leap to believing they’re all just in it for the money/prestige/power/whatever? I guess it’s because sometimes there’s a poor outcome…but good god – don’t people realize that sometimes, despite everyone’s best efforts, that bad things happen? Or that – gasp – doctors are still human AND LIKE THE REST OF US, still make mistakes sometimes? I mean, no one ever likes it when they’re the one the mistake is made on, but why is it so hard to understand that they do happen sometimes – despite the best intention and effort?

          Anyway, back to your statement…yes, it’s high time people grow up and stop throwing temper tantrums because a nurse offered them pain medicine that they don’t want, or bc visiting hours were too short. Some hospitals here and there do have some pretty annoying policies, but for the most part, US hospitals are pretty damn patient-centered. I, for one, just try to remember how fortunate I am to live in this century, and to have access to modern medicine…when so many across the world do not.

    • Prolifefeminist

      Kelly, a little over two years ago, I fully intended to become a CPM. I enthusiastically attended Midwifery Today conferences, send donations to the Big Push for Midwives, wrote and called politicians to lobby for HB, and counted down the days til I could start my training. I had planned a HBAC with my previous pregnancy with CPMs.

      I found Dr Amy’s blog after reading about it on a homebirth support network when I was pregnant again and seriously considering a HBA2C. When I first started reading here, I was taken aback – shocked, really. Nowhere else did I hear or read the things I read here – and at first it was pretty pissed off. I thought, “how dare she!” – what an obnoxious loudmouth!

      Thing is, I’m a curious person. And no matter how turned off I am by a messenger, I’m never turned off to the message. I simply HAD to follow up on the outrageous claims she was making about lack of uniform standards for CPM training, homebirth vs hospital mortality and morbidity rates, the mortality statistics MANA is keeping secret, and so on.

      What I found out blew my mind.

      I follow facts, not figures. And let me tell you, following the facts to find out the truth about homebirth safety in the US did not lead me to where I thought it would. I not only chose CNM/OB care for my next birth (a VBA2C attempt in a tertiary care facility), but I turned away from a lifelong dream of becoming a CPM myself after recognizing that the training is sorely lacking and the emergency backup system completely unsafe – and I could not in good conscience put precious lives and health at risk.

      So you see, this blog does change minds and hearts. It changed mine – and I tell you, if you’d told me a few years ago where I’d be standing today, I would have laughed in your face. My mom, sister, aunt, and best friend have all had homebirths. I was born at home. The final straw for me was finding out that MANA refuses to this day to release the death rate for the 20,000 homebirths it has collected data on. I remember signing the consent sheet to be included in that study – and here they won’t even tell us how many of our babies died! What are they hiding, I had to ask?

      Ask yourself the same question – will you follow facts, or will you follow a figure? Will you search for the truth, or will you be satisfied with repeating slogans that sound lovely but have nothing behind them backing them up?

      My last pregnancy – the VBA2C one – ended up causing severe and sudden complications that required a premature birth. The early warning signs were caught by my alert and competent team of CNMs and OBs and all of their “high tech” monitoring equipment and lab tests. My child and I are healthy and alive today because of their professionalism and expertise.

      I thank Dr Amy for forcing me to open my eyes. I pray that you will keep reading here with an open mind, and maybe, just maybe, allow her to open yours too.

      • Frequent Guest

        Thank you for sharing your story!

    • areawomanpdx

      I started reading this blog years and years ago, back when it was “homebirth debate,” after someone hate-posted it in the livejournal breastfeeding community. This was the first place I found online where I wasn’t being told that I wouldn’t be a “real woman” until I pushed a baby out of my vagina. Where real evidence was disseminated to readers who actually had the ability to read the studies being discussed, think critically, and critique them intelligently and eloquently. Where clear BS was being called out for what it was. That is why I keep reading. Dr. Amy’s tone has become more strident over the years, but I don’t blame her. Watching babies die because of a constant flow misinformation is maddening.

      You should also consider for a moment that if you posted a similar comment on TFB or any number of NCB websites, it would be deleted in minutes. Dr. Amy allows her dissenters to have a voice, too.

      • wookie130

        Sing it, Areawoman!

        Kelly, one little thing did stand out to me in your comment above. It was that you stated that the purpose of this blog is to “save women and children from making poorly uninformed choices about their birth.” Well, you are wrong.

        The children do not have choices, only the mothers of these children. The babies, if they actually did have a choice about their birth, would not choose a lot of the dangers surrounding home birth, just so that their mothers can fixate on their “perfect birth experience” well into the future. I am positive there are many babies that have been lost to home births gone wrong, that would choose to be HERE today, and to be alive.

        I would agree that this blog isn’t for everyone. If you want some feel-good smarmy fluff, I wouldn’t recommend it. But, if you’re seeking the TRUTH about NCB and home birth, and can handle reading the research and studies that throw it’s safety out with the bathwater in the ol’ birthing pool, than read on.

    • I also found this blog when I was considering homebirth. The tone immediately bothered me (and often still does) but I couldn’t find fault with most of the logic, and couldn’t find any reasonable arguments from the other side (just a lot of: nah uh).

      Honestly I still think this blog is unnecessarily abrasive, but the truth is the tone isn’t about communication, it’s about traffic and persona. If there weren’t so many people out there ranting about this blog, hate-linking and saying: whatever you do, don’t read THIS, it’s pretty likely it would have been buried in the voices of homebirth advocacy, much like the other, more moderate voices on the web tend to be.

      • Karen in SC

        Agreed! There are several great blogs (on the blogroll) discussing homebirth and hospital birth where the “tone” is much more moderate, even nice, if you please. The information is basically the same as Dr. Amy has shared in the past. Rarely does the comment count on each post go over 10. Sometimes, there are no comments, which pains me as I think they are very well written!

      • Squillo

        Precisely. I’m a liberal, but I’m not stupid enough to dismiss folks like Rush Limbaugh or Ann Coulter–or even TFB–as ineffective just because I don’t like their messages or they way they deliver them. The method of delivery is absolutely key to their undeniable success in getting their messages across.

        I don’t always like the way Amy delivers her message either, but you’d have to be an idiot to suggest it doesn’t get attention, and getting attention is the number-one obstacle to putting a message across in an ever more crowded marketplace.

      • Amy H

        DItto.

      • Certified Hamster Midwife

        I’ve been thinking lately how there needs to be an equally combative blog taking down alternative-medicine cancer “cures” and other nonsense peddled to desperate people. No one really hate-links Quackwatch unless they are an actual practicing quack.

        • Lisa from NY

          You’ve got to see the Tick repellent alternative called Niacin. It doesn’t work, so puts you at risk for Lyme disease.

          • Certified Hamster Midwife

            Then you end up with “chronic Lyme” and on broad-spectrum antibiotics for years on end!

        • Elizabeth A

          Orac is so on that. It’s just beautiful.

        • Allie P

          Respectful Insolence.

    • Squillo

      If it’s ineffective, why are people concerned?

    • Amy Tuteur, MD

      This blog is incredibly effective, in any way you care to measure it: traffic, comments, private emails sent to me, media appearances.

      Th effectiveness measure I value most, however, is just how incredibly afraid homebirth advocates are of me. They wouldn’t be petrified if they weren’t utterly convinced of my effectiveness.

      Oh, and one more measure of effectiveness: you are so concerned about what I write that YOU are here trying to change MY mind.

      • Kelly

        Yes, I am trying to change your mind because I am sympathetic to your point of view; I am sympathetic to the idea of preventable deaths. There is plenty of reason to be angry about women and children dying when they don’t have to. But getting angry is an energy that needs to be applied toward a productive way of creating change, instead of chaotically unleashed. You are a scientist, and rely on reason, rightfully so. I want a voice of reason, but reason, or logos, means nothing without ethos and pathos if you want to actually have a meaningful message, a persuasive and scholarly argument. Your rhetoric and tone only point to inflammation. I am thrilled there are people who have been validated by reading your blog, but you have divisively created an us versus them. I see a lot of talk about dead mothers and babies, which understandably will motivate more moderately minded people to dismiss homebirth. But your target audience seems to homebirth “wackos,” who are only reinforced in their convictions when you blast them, because they are forced into a corner where they have to put their money where there mouth is, and “trust their bodies.”
        So call me crazy, but there is a part of preventative medicine called “harm reduction,” so there is a proven method that can actually prevent dangerous behavior. Instead of insulting people, why not keep your tone as reasonable as your logic? Are you even able to engage in a conversation, or only blast and ridicule from your high horse? Your powerpoint on the homepage about CPMs versus CNMs as well as how to read statistics, is truly informative.

        As of now you are basically the Glen Beck of the birth world. An embodied, reductionist, rage.

        • auntbea

          I really don’t think the Glen Beck analogy is apt. I, for one, have never seen Dr. Amy fake-cry.

          • Guestll

            “I really don’t think the Glen Beck analogy is apt. I, for one, have never seen Dr. Amy fake-cry.” Gold. GOLD!
            Listen, Kelly, if you’re still reading — I’m yet another reader whose life was changed in a good way by coming here. Frankly, I think the “Amy is so meen” bullshit is just that. It’s also profoundly sexist. You don’t like her tone. Okay. I didn’t like my former Reproductive Endocrinologist’s tone very much. Didn’t stop her being an expert in her specialty (old broads like me) and though I found her abrasive, inflammatory, and occasionally downright rude, she was there to get me pregnant, not be my friend.
            The first email I sent to Dr. Amy was written in the middle of the night, nursing a newborn, feeling a bit overwhelmed. She replied warmly and personally and I thought, wow. She’s kind.
            My hideous RE came in on her off day and wordlessly held my hand at my first ultrasound at 7 weeks, after three miscarriages in less than a year. My husband couldn’t be there and I was terrified of hearing, yet again, things don’t look so good/the sac is too big/the heartbeat is very slow. I thought, wow. She’s kind.
            Don’t be so quick to dismiss Amy based on her tone, Kelly. I get it coming from twits like Dr. Nick (see below) but you seem like a reasonable woman.

        • Karen in SC

          There ARE blogs that are reasonable in tone that get much less traffic – judging by the few comments left. Check the blog roll – didn’t I post this to you already?

          Or start your own blog!

          • KarenJJ

            That’s what I find odd. If you feel passionate enough about the issue to come on here and try to change Dr Amy’s mind, why not also use some of that passion to disseminate the information in way that is also suitable to for the audience that you have in mind? There’s been a few that have done this and they are great blogs. It’s true that they don’t get as much traffic, but a few posts that are more reasonable might be easier to link to?

          • Kelly

            I feel passionate because this was one of many blogs I looked at to inform my choices, and I am continually shocked by how transparent the issues are, yet most don’t want to see them. I will not start my own blog because I am not a medical expert, but I am a language and cultural expert. Is for my own curiosity but also hope to make a reasonable point.

          • Kelly

            Why is this traffic thing relevant. It all depends on who the traffic comprises and more importantly if something changes because of it. The only people who seem to be trafficking are those who are taking sides and fighting to the death. This is fruitless, and immature.

          • Poogles

            “It all depends on who the traffic comprises and more importantly if something changes because of it. ”

            And multiple people have already told you that people who are planning HB’s, have had HB’s, advocate for HB’s etc. have all come here. And that quite a few of them *changed* their stance on HB, to some degree or another.

            So, right there, what you feel is the most relevant and important aspects have been covered – the blog draws people from all points on the spectrum and changes a lot of minds in the process. So it seems your criticisms are actually pretty baseless.

        • Poogles

          “I am thrilled there are people who have been validated by reading your blog,”

          It is NOT just people being validated! This blog has actively changed many, many minds. This blog has likely SAVED LIVES (there are posters who were planning a HB, read this blog, decided to go to the hospital instead and then had very complicated deliveries that could have easily proven fatal if they had attempted delivery at home as planned).

          “But your target audience seems to homebirth “wackos,” who are only reinforced in their convictions when you blast them,”

          Or not, as a few posters have pointed out. There have been quite a few HB “wackos” (myself included) who came here and were “blasted” and, instead of it reinforcing our convictions, caused us to question them and seek out more information. Many of us then went on to change our stance on homebirth.

          This blog may not reach *every* HB’er or NCB activist, but it definitely has quite a large effect and has changed many minds.

    • Mom of 2

      I’m another one whose heart and mind regarding birth, breast feeding and mothering were utterly changed by reading this blog. I started working as an L&D RN and I was pretty disappointed that it appeared that nasty dr Amy was 100% correct. I wanted her to be wrong, but i opted for the hospital with my 1st because I couldn’t get her message out of my head. Good thing she didn’t sugar coat it, or I wouldn’t have remembered it, and might have lost my son, who suffered a cord prolapse in labor. I went from a person who was disappointed when I heard someone got an epidural or I saw formula in their diaper bag to not giving a shit about any of that, and just being happy about healthy moms and babies. (Oh how I hate admitting I was like that). And I’m a much happier person, not stressing about how I or others give birth or feed our babies. And I LOVE epidurals now, for the record. (formula too).

      In particular, I cannot understand how someone could read even one of the stories on Hurt by Homebirth and still consider delivering at home. The raw pain felt by those parents is enough for me to never ever consider it. Nothing, NOTHING is worth your child’s life. Nothing.

      Oh, and I also realized that dr Amy isn’t nasty at all, just angry about preventable deaths. And how can you not be angry about that? In fact, if I ever get to meet her in real life, and I hope I do, I will give her a hug, show her pictures of my kids (one of which might be dead without this blog and her unforgettable tone) and tell her thank you for making a difference.

    • Witty

      You keep posting responses about how ineffective this blog is, how the mean tone turns people away, and how you aren’t clear what its purpose is. And every time you do, people answer your questions and explain to you how exactly this blog has helped them.

      Are you purposefully obtuse or do you just copy and paste the same comment on each blog post without reading anything?

    • Amy H

      It was effective for me and helped me make informed choices about my birth. That’s not to say I haven’t seen some people nearly attacked (mostly in comments) who seemed fairly receptive to the ideas here before they were put on the defense. I think I saw more of it in the past. Sometimes it can get out of hand but we need to be adults, take the information presented, and make some difficult decisions.

      I’ve been too busy taking care of my live, healthy baby to write up a post for Happy with Hospital Birth, and I think that counts as a success.

    • Bambi C

      This blog helped me after the death of my daughter. I was alone and cast aside from the very people that encouraged me in my homebirth because I wasn’t ok with my baby dying. You’re not allowed to question your child’s death and you certainly are not allowed to speak up in any way, shape, or form. Amy gave us a voice. We got a wonderful support system, too.

      • Dr Kitty

        Bambi, you’ve always been someone whose bravery I admired.
        Mary Beth’s story touched so many hearts.

        • Bambi C

          Thank you, Dr Kitty!

      • EllenL

        Thank you, Bambi, for continuing to speak up.
        Best wishes.

    • JabJab

      I always crack up when people start calling Dr Amy “mean”, thinking that this negates what she has to say. Calling her a bully when she points out the insanity of women shrugging off their babies death. What you call mean, i call honest. What you call a bully, I call someone not afraid to point out seriously messed up priorities some of these women have.

    • amazonmom

      When I was a miserable mess postpartum with my first child, I found Dr Amy’s blog. Up until then I thought I was a miserable excuse of a parent because I had failed at every aspect of parenting the extreme NCB movement believes in. Her tone broke through my misery and convinced me that indeed science was on my side. Her style wakes people up to reality in a way that being all polite and nice never can.

    • Allie P

      Yes, this blog is so inflammatory, giving voices to loss moms who have been deleted and banned from every other venue for telling the truth about the horrors they have suffered. This blog is utterly ineffective for providing the truth about the actual homebirth stats to counter the lies and the misinformation machine. This blog is SO MEAN for pointing out the facts. Why let facts get in the way of nicety and magic?

      Give me a break.

    • theadequatemother

      I think the tone of my blog is pretty moderate. But when I have tipped over the sacred cows of the NCB movement I’ve been called all kinds of nasty names by these “sensitive” “speshul snowflakes.”

  • practicing woman

    Perhaps Fogelson should not be allowed to speak. As you all know, he is not a practicing woman. He makes his attempt to have a public life out by mansplaining all over the internet.

    However, he is a practicing OB because a) for men, the standards are now are much, much lower b) his lack of success in research or other career paths due to his inability to grasp basic research concepts on which he regularly pontificates.

    Why do some women “choose” homebirth? The number one reason (movie claims notwithstanding) is poorly paying/no insurance. Some choice. Disrepectful, incompetent mansplaining clinicians are all that women in these situations often get and it’s little better than nothing.

    Oh, but supporting this would mean he would no longer have to do the Medicaid, HMO, and uninsured deliveries. And if he forms a mutual admiration society with the midwives, they will both get the praise and recognition that neither can get from legitimate medical professionals nor the average pregnant woman. They both get higher paychecks too!

    Who cares if an occasional lower income infant dies when the unmet expectations for ego-stroking and cash of minimally competent, but privileged Americans is at stake!!

    • Ainsley Nicholson

      I really hope this comment is a satire of commenters on other sites. We are better than that.

      • practicingwoman

        The only comment being satirized was his. And if you don’t care about poor women and health inequities, that is hardly “better”.

        • Ainsley Nicholson

          Dr Amy has stated repeatedly that most women choosing homebirth are “wealthy white women”. Do you have evidence to the contrary?

          • Expat in Germany

            I’ve been wondering about that and ended up on babycenter reading about women who were deciding between 0-3k hospital deductibles and 2-5k homebirth services. These are ladies with insurance. The financial argument is not good even with a big deductible. The ones with Medicaid don’t get homebirth paid for unless they live in one of 9 us states. It doesn’t look like a bargain because the midwives often add extra charges over what Medicaid pays, while if you are in the hospital, you’re covered. Not a good financial argument there either.
            If you have no insurance and earn too much to qualify for Medicaid (you earn more than 2,333 usd per month and you don’t have kids) then the difference between home and hospital birth is several thousand dollars, but with the 10-20% risk that you might end up paying twice – midwife and hospital. Walk on the wild side. That shouldn’t be a choice families have to make.

          • prolifefeminist

            “That shouldn’t be a choice families have to make.”

            Exactly. This is why the US needs a free public healthcare system.

    • Jessica

      Homebirth is the choice of middle-class, older, white, college-educated women in the US. Surveys on why these women choose homebirth put cost factors pretty low on the list. http://oregonstate.edu/cla/anthropology/reproductive_lab/sites/default/files/Boucher_2009.pdf

      • Lizzie Dee

        I have just followed your link, but not yet read through the whole thing. Getting past the list of authors and the first paragraph has already raised my ire. A group of woo filled “professionals” have consulted 168 of their equally woo filled mates and written a study that apes the style of rather more reliable research. Without any trace of irony at all, they state that the main reason for choosing homebirth is “safety”. I will go back in a minute, clench my teeth and wade through the rest of this propaganda disguised as information, but for now I wonder why they did not include anything about the 99% of women who have more sense!

        • Jessica

          I glanced at it briefly since it was the only study I could find in quick Googling at 10 PM that addresses the reasons women choose homebirth. I don’t doubt that it’s not great research, but I have yet to see anything cited by practicing woman that backs up her claim that the number one women choose homebirth is due to cost.

      • suchende

        …in the US. I am sure practicing woman is referring to the rest of the world, where women home birth due to lack of choice or because alternatives are still new and scary to them. I say that because 1) it’s true and 2) she references American privilege.

  • If this site is down tomorrow I’ll just go ahead and assume Gina filed a takedown notice for using her twitter avatar without permission.

  • As a member of ACOG and a former member of the Hawaii district, I am rather appalled that Dr Tuteur has been invited to speak. She is not a practicing obstetetrician, and as you all know has seemed to make her public life out of bashing the natural birth providers in this country. As an obstetrician, I agree with many of Dr Tuteur’s points. What I do not agree with is the lack of respect she shows her colleagues, both inside and outside of the obstetrical profession. Her constant use of ad hominem attack against natural birth providers is below the station of a medical professional.

    What she doesn’t seem to want to address is this: Why is it that despite the improved perinatal outcomes associated with hospital birth, a subset of America chooses to deliver at home? That is the real question, and unless we can answer it and address it, we will continue to occasionally lose an infant to a homebirth gone wrong. Attacking those who choose to deliver at home or those who choose to attend those births will never bridge the gap between us, and ultimately will only drive more people to deliver at home.

    • Amy Tuteur, MD

      Says the guy who collaborated with Stuart Fischbein, Bedside Man, on a letter to an OB journal. What kind of respect do you show to women when you collaborate with someon who was found guilty of sexually exploiting a patient, and has been reprimanded by the Medical Board for not understanding the seriousness of his offense of for seeing himself as the victim?

      • Kind of typical ad hominem for you Dr T.

        Dr Fischbein and I agree on a lot when it comes to birth. I do not condone his behavior in that matter.

        • Amy Tuteur, MD

          You’re joking, right? You, who just parachuted in to express your dismay that I am speaking at an ACOG conference specifically because you disapprove of my personal behavior, have the gall to accuse me of an ad hominem because I pointed out your behavior?

          Do you know what chutzpah is?

          • Oh yeah I have lots of it.

            I don’t disapprove of your personal behavior. I disapprove of your professional behavior. I suspect that when you speak at the district meeting, you will not use the kind of inflammatory language that you use in your writing, because you realize that it would not be well received in that setting. When you blog as a physician, you are expected to be a professional, but you don’t act as such, and for that reason I I’m surprised you were asked to speak at a regional meeting.

            And in truth, I had no idea that Stuart Fischbein had slept with a patient when I co-authored the letter with him. We communicated professionally. I probably would have written it on my own had I realized the potential issue the co-authorship would bring.

          • Captain Obvious

            You put about as much research in picking a co-author as many women research choosing Homebirth.

          • I have authored and co-authored many papers, and can assure you that investigation of whether someone was sanctioned by the board has never been a part of the process.

          • Captain Obvious

            So says a woman who believed Homebirth was safer than hospital birth. Or that her body won’t grow a baby bigger than she can deliver. Or why is it important that her Homebirth midwife be licensed or carry malpractice insurance or carry pitocin or have an OB backup.
            You’re probably wishing you could just delete your posts and say you were never here, right. I would if I were you.

          • KarenJJ

            My obgyn wiggled his fingers and said ‘ooobly- goobly’ to me when I told him I’d been to a hypno-birthing course. Most women aren’t fainting in the street when they come across a differing opinion, even if it is derogatory. One thing I respect about Dr Amy is she is at least consistent and forthright in her views and doesn’t pussy-foot around an opinion in case it hurts someone’s feelings. She gives a lot more respect to her audience’s ability to hear her information and opinions as a responsible and reasonable adult then most other bloggers.

          • auntbea

            Hold up, so can you clarify for me? In deciding whether Nicholas Fogelson is professional enough to speak at ACOG, should I or should I not consider the series the recent posts in his blog in which he appears to have trouble dressing himself appropriately for work?

          • KarenJJ

            It’s about clothes, auntbea. Girls like that sort of stuff.

          • auntbea

            I couldn’t remember. They took away my girl card a long time ago.

          • Oh I can dress up for a talk 🙂

          • auntbea

            Yes. My point had nothing to do with your questionable understanding of what it means to be professional while blogging as a physician and everything to do with my concern that you might wear the wrong tie to a presentation.

        • Laura Thomas

          I respect your ability to parse through the “message vs messenger” dilemma, Dr. Fogelson. I think that applies more to personal relationships, though. To be linked professionally to someone who has been severely disciplined by his state’s medical board is an entirely different matter. Perhaps the “take home lesson” is to be more scrutinizing about who you are aligned with professionally. We live in such a fish bowl world with the internet that it is more necessary than ever to extremely cautious. Just about everything we write, say and do could be uncovered at anytime, anywhere and by anyone. The opportunity for misunderstanding is rampant. And I agree with you that at times Dr. Amy’s tone is off-putting, although apparently for some it has been helpful. I have learned a lot from your blog and appreciate your contributions to informing and educating lay people like me about matters that are important to you.

        • moto_librarian

          HE IS AN OB WHO SEXUALLY EXPLOITED A PATIENT!!! Are you unfamiliar with the common trope in NCB circles about obstetricians and “birth-rape?” You claim that you want to know why some women don’t trust doctors and hospitals, yet you choose to collaborate with someone whose behavior is the very thing that some women object to about hospital birth?

          If NCBers were really interested in helping to reform obstetric practices that they don’t like, they would push for tort reform. That is the elephant in the room regarding VBACs – even they know it – but it’s far easier to tell women to “trust birth” and have a HBAC in a kiddie pool in their living room. I believe that if a woman really wants to give birth at home, it is her right. What I will not support is the idea that she can demand a medical professional to condone it. I firmly believe that if the CPM and DEM were outlawed, fewer women would take on these risks because no one would be available to attend to them. We all know that it’s a false sense of security anyway since most CPMs are completely unprepared to deal with a serious complication like a uterine rupture.

    • Laural

      As an RN and health care consumer I have to say I am rather disgusted by your comment. As you should know before making your comment, one of Dr. Amy’s primary missions is to dispel some of the current mythology of the NCB movement, the driving force behind why a subset of well educated white women choose to give birth at home.
      This goal does not drive more to deliver at home, rather it helps those who seek true information to make an educated, informed, decision about the risks they are taking when they choose homebirth. That is a gift.
      Dr. Amy is a passionate doctor who cares deeply about women and babies and their welfare. She displays extraordinary courage in pointing out the pitfalls and inconsistencies in lay midwifery and shedding light in areas that would continue to be unexposed if it were not for her.
      As a practicing medical professional it would not be appropriate for you to treat your patients the way she calls out some of the despicable lay practitioners on her blog, but her mission and calling is different than yours at this point in her life.
      If you witness her speak you will be impressed by what an utter professional she is. She deserves respect for her tireless work and commitment to women and babies and having her speak is timely and appropriate.

      • Monica

        Stick around, read more of the comments here. See how many women are grateful to Dr. Amy for helping them see the truth about home birth. At least she’s speaking up about it. What is it you’re doing? Whining that she was chosen to speak at a conference.

        • I spend most of my time teaching at a Emory University.

          I don’t disagree with Amy, in most points. I disagree with the way she presents her points.

          Laural – I have seen her speak, and agree that she presents herself well. What I find vexing is why she doesn’t do the same online.

          • Monica

            Well, while you’re busy teaching Dr. Amy is also busy teaching. Teaching the public the fundamental flaws that exist in the home birth community. When you have spent as much time as she has dealing with the attitudes in the NCB community on a daily basis with the censorship and plenty of ad hominem attacks, then you can discuss how she handles herself online. Because quite frankly she’s incredibly popular and clearly sought after to speak on this topic by numerous publications and groups. You’re just as bad as everyone else trying to prevent her from getting her message across. What makes yourself worse is that you should know better!

          • Guilt-Free

            I have heard Dr. Amy speak in interviews and on programs. She is certainly very professional in her word and her demeanor. Her blog and her personal edge in educating, challenging and exposing is perfectly appropriate to the subject matter. Her straight-forward and bold manner in taking on these controversial issues is not meant to be a tea-party. It’s meant to make people think even if doing so might be uncomfortable at first. I have followed this blog for quite awhile. After many posts, my thought has been: ‘Somebody had to say it. It’s about time.’

          • Prolifefeminist

            As a pregnant mother, it was Dr Amy’s startling, in-your-face tone on this blog that got my attention. I would’ve breezed right by if she hadn’t been so forceful. And I would’ve had that HBA2C I was thinking about, and my CPMs would’ve missed the subtle signs of the sudden, severe preeclampsia I developed at 31 wks that necessitated an immediate delivery…a delivery that thankfully resulted in a live, healthy baby and mother.

            You have to have a different tone online than in person – don’t we all know that?

            I, for one, am profoundly grateful for Dr Amy’s abrasive style – it likely saved my life.

          • The Bofa on the Sofa

            Wow, so ANOTHER tone troll?

            Thank you for you concern, Nick.

          • Starling

            You see, Dr. Fogelson, a sweetly reasonable or dryly academic tone is much less effective online, strange as that may seem. I think that’s why Dr. Amy chooses to get more and more outrageous–it brings visitors who come to hate and stay to be convinced.

            I myself was enough into the woo to be interviewing midwives when I first came to this blog. I came because TFB had accused Dr. Amy of posting blog entries hoping her child would die. I thought, “Wow, crazy internet drama!” and came on over to gawk. But TFB was lying, and Amy was interesting, even if she was saying things I disagreed with. The more I read, the less I found myself disagreeing.

            If you’re going to blog and hope your enemies read, you HAVE to be outrageous. What’s appropriate for ACOG is not effective in doing what Dr. Amy does. It’s okay that you find it off-putting, but know that it works.

          • Bambi C

            We all have different ways of broaching topics. Her approach, it works. It fires people up and gets them talking.

          • Sue

            ”What I find vexing is why she doesn’t do the same online.”

            An insightful person might say ”I’ve seen Amy present in person, and she presents herself well. She clearly uses a different style in her blog – I guess it must be a more effective style for that medium. If she manages to get the message across to all these people, good luck to her.”

            There. Get it?

    • Guilt-Free

      This blog is vital because everyday, women are attacked and demeaned by the natural birth fanatics about their personal birth choices. This harms women everyday in many ways. Dr. Amy has stepped into an estrogen-dominant hornets nest of hooey, misinformation, and unnecessary deaths to challenge this dangerous and questionable ideology and it’s devotees. This here is a woman’s job. The complex female dynamics and subtleties are those that will fly right over the average male’s head, though I have no doubt that male OB-Gyn’s can do a wonderful job in their profession. My OB is male. But, stepping into a woman-cult of birth ideology and navigating those murky waters requires the insight and skill and wit of a woman. Particularly, a highly educated female OB-Gyn. Regarding males, it’s worth noting that fathers are also victims in these tragic losses. They have unnecessarily lost children to the natural/drug-free/home/unassisted birth fanatic ideology. They have lost their voice in the picture in the same way that Nicholas Cage was trapped and voiceless in Wickerman. If anything, men should have an uprising on behalf of fathers. Maybe a male OB-Gyn should consider taking on that task instead of attempting to silence a female colleague who is doing a stellar job of raising awareness on this vital issue.

      • PollyPocket

        Thank you! I think you captured what I was trying to say above perfectly.

    • RowanVT

      You really have to ask this question: ” Why is it that despite the improved perinatal outcomes associated with hospital birth, a subset of America chooses to deliver at home?” The answer is not immediately obvious to you?

      In this country, a depressingly large number of people believe the earth is around 6,000 years old. There are a number of people who think that God practices better medicine than doctors… and their children die as a result. There is still the belief that women can “ask to be” raped by wearing a skirt, and then that they can’t get pregnant from ‘actual’ rape because the body has ways of shutting it down. Many people believe that reiki works; that someone can channel cosmic healing energy and fix all your health problems.

      Your argument fails to take into account the vast amount of stupidity possible in the populous of this country.

      • Lisa from NY

        Like “Think positive and nothing will go wrong.”

    • attitude devant

      How dare YOU be so disrespectful, Nick!?!? Dr. Tuteur is senior to you, she is much more influential than you, and you are appalled that she is speaking at a conference, while YOUR only standing in this matter is that you used to live in Hawaii? Please.

    • Antigonos CNM

      I think there are a number of reasons why women — a few women, at any rate, because the total numbers are really very low when the total number of births are considered — choose to plan a homebirth. One is undoubtedly the sense of autonomy it seems to give them. Add to this a perceived insensitivity and/or fear of hospitals [“I’m not sick and hospitals are where people go to die”, “I’ll be forced to submit to painful procedures” — autonomy again, btw], and a romanticism about homebirth [“It’s nicer” — I really do think most primips have NO idea of the fuss, pain, and mess of birth]. And there is a financial factor. The cost of birth in the US is huge, and even insurance does not usually cover it all.

      In fact, there are times when I wonder why the demand for homebirth is as low as it is, given the incessant propaganda that women are designed for birth, that birth is not in any way pathologic. How many women today actually know someone who died in labor? More can relate stories of women whose babies did not survive, but even that is quite rare, for an otherwise low-risk term pregnancy. It’s like measles and other “vanished” diseases: the public forgets what “vanished” them and what it was like when they were rampant.

      Everything has been turned on its head. Once, women perceived midwives as inferior to doctors [and even female doctors were not in “the same class” as male doctors who were the “real experts”]. Hospitals were perceived as the MODERN way to go, cleaner, better technology, etc. Babies were the focus of giving birth — the reason women risked their lives. Now midwives — the generic term masking a horde of unqualified, or poorly qualified pseudo-“experts in normal birth” — have been extolled and we are told that doctors choose process [the inevitable “cascade of interventions”] over the person; the “experience” of birth is far more important than the outcome of the birth itself, and the baby is really sort of a side-effect: grand if it’s OK but karma is karma, doncha know. IMO, that’s sick. And it is a luxury. We now have a degree of control over our fertility which previous generations of women could not even imagine. We can choose to have, or not to have, as many children as we want, in most cases. We cannot imagine what the life of a woman was like, even for those of similar social class to ours today, even so recently as 100 years ago, and so it seems terribly romantic. But it sure as heck wasn’t romantic to be forced by societal pressure to marry [and marry quite young], be pregnant almost constantly for 20 or more years, undergo agonizing labor repeatedly with the constant fear of death hanging over one, anywhere from a third to half of one’s children dying under the age of five being considered more or less normal, if not from birth, from childhood disease, and quite possible to die oneself before menopause, if not from childbirth, from the exhaustion that occurred from chronic health problems directly related to the arduousness of simply being a woman: inadequate rest and nutrition while coping with demands of housework in an age of low technology, husbands, and raising a large number of children. TB and anemia were rife. It wasn’t romantic at all, even when one could afford servants.

    • PrecipMom

      Why do some of us choose home birth in spite of the evidence? Because we were lied to and manipulated, Dr. Fogelson, and had no idea that there actually *was* an improved perinatal outcome in choosing a hospital. We bought the 2005 BMJ telling us that we were as safe or safer at home. That’s why many of us chose home birth instead of hospital. And now we feel lied to and betrayed by the care providers that Dr. Amy attacks, because too many of us have seen too many dead or injured babies that never needed to suffer those fates if they had been in a reasonable care setting.

      I had 3 home births with the last one ending in near catastrophe. I never would have chosen it in the first place with informed consent and the data that has made it increasingly clear that home is a riskier choice. It would have remained a nice idea but not something I would have chosen because I care more about a live and whole baby than I do about avoiding a hospital setting where you can’t predict the nurse assigned to you. And I wish that there were more in the medical profession who showed enough backbone to tell me the truth instead of sugar coating and “I’m sure it’ll go great!” and referring people to a home birth CNM with not so great outcomes.

      • prolifefeminist

        This times a million. I’m glad things turned out ok in the end with your last home birth.

        I was misled as well by my homebirth midwives, who touted the 2005 BMJ article as proof that the HBAC I was planning was safe – “as safe or safer” than the hospital. Even the backup OB that my midwives suggested using (he was “homebirth friendly”) did me a huge disservice by vaguely mentioning “it’s your choice” when he agreed to serve as backup. What he SHOULD have done was educate me – he should have told me the truth about the safety of homebirth vs hospital. Instead, he hid behind “choice.” A lot of good that would have done if the shit had hit the fan.

        This wouldn’t be such an issue if the HB/NCB crowd wasn’t out there spewing utter lies about the safety of homebirth. OB’s who work with homebirth mothers should never assume that they’ve been fully informed – and it is the OB’s duty to make sure that they know the risks of OOH birth.

    • Captain Obvious

      “She is not a practicing obstetetrician”.

      I have been to many ACOG and other CME conferences and speakers are from all walks of life. I have listen to MDs, PhDs, CNMs, JDs, billing and coding experts, retired MDs who can share their experience, and I have even seen a cancer survivor speak at on engagement. So why is Dr Amy not practicing anymore have to do with being able to be a speaker?

      • Squillo

        The argument might have some weight if Amy were invited to give a clinical presentation, but it’s a general session.

        What I suspect some folks object to is the idea that the engagement lends legitimacy to Amy’s arguments. That’s a reasonable argument; “she’s strident and doesn’t play nicely” isn’t, even if it’s cloaked in an accusation that she’s “unprofessional”–an ironic observation given that Dr. Fogelson complained in the same breath about her status as a non-practicing OB. Is she a medical professional, bound by the same rules of professionalism as a practicing OB, or is she not?

    • PollyPocket

      I understand where you are coming from. I agree that there have been some ad hominem attacks made that simply aren’t necessary, as the arguments against homebirth and untrained midwives are so strong on their own.

      With that being said. The tone of this blog is par for the course. In my experience, the reason women tend to do dangerous, illogical, and painful things is because of the constant judgement from other women. There are several posts on this blog that demonstrate that phenomenon. The passive-aggressive, demeaning, and judgemental words and actions of other women is pervasive. Health, wellness, and academic performance of children are paramount on the list of things that women judge each other on. This pressure, coupled with the herd mentality of the “natural lifestyle” folks is the one and only reason women put their lives and the lives of their children at risk.

      I have learned so much from this blog. Not just about the dangers of homebirth, but about my attitudes towards other women and what is truly important as a parent. I used to judge other women for not breastfeeding, or for other choices they made parenting of in their personal lives. This blog has really opened my eyes about how judgemental I once was, and has helped me to become a more tolerant individual. I can’t thank Dr. Amy enough for advocating for all women the way she does and for cultivating a community of acceptance among women.

    • stacey

      Oh Nick. Get a clue.

      Women choose to birth at home because of web sites, forums, blogs, NCB and HB advocates in their communities LYING to them. Straight up. They don’t think the hospital has good outcomes, they think HOME does. Her opponents need “bashed” because they are laymen spreading LIES that KILL.

      They think ALL you OBs are LIARS that want to hurt them and “cut them up” (CS) for money. They think HB is as safe, or SAFEr. They truly believe MWs are superior, even the ones that have never been to school.

      This is NOT an argument among professionals, it is among self professed birth junkies and their followers, and the few people that bother to oppose them. It is one that is happening on the web, not in doctor offices. Dr Amy is doing the best possible thing- getting people to read her. ANything less gets ignored.

      Please tell me you go to Orac and scold him for not playing nice with Anti Vaxxers, and go to PZ Meyers and scold him for not being nicer to creationists. No? Then leave Dr Amy alone.

      • I don’t, because I think the Anti Vaxxers are completely nuts, and that there is no god.

        The natural birth folks, in contrast, are a wide variety of people of varying levels of scientific following, some of which are quite reasonable and point out some of the very real deficiencies in obstetrics practice, and some of which are plain nuts. To serve women, we need to build bridges, not break them down.

        I suppose if Amy’s goal is to keep women who are on the fence from delivering at home, then maybe her tone is right.

        I want something different. I want women who choose to deliver at home to realize that they are trading a margin of safety for their birthing choices. I also want to know what it is about obstetrics practice that really turns them off, and to figure out how we can provide for them in a way that is acceptable to them and at the same time optimize their pregnancy outcomes. With that goal in mind, I think that Amy’s rhetoric is very harmful.

        • Amazed

          Since Dr Amy’s position isn’t that homebirth should be exterminated, I find your post lacking any standing.

          Since we have the comments of AmyH, RT, PrecipMom, Mom of 2, and some others under this very post, showing just how harmed they were by Dr Amy’s rhetorics, I take it that you’re a writer, not a reader.

          Since I’ve been following PrecipMom’s movement from home to home but safe to hospital where it’s safer, I call bullshit on your entire hypothesis. PrecipMom was not on the fence, she was firmly on the home side and your being gentle and considerate did not change her mind.

          Since you still claim that women should be free to make choice without mentioning anything about informed choice, after all that was written here.. I’ll keep my opinion for myself since I am quite bad-tempered those days and I am not sure I can stay decent.

        • EllenL

          “If women are going to choose to deliver at home, then there needs to be hospitals that are going to accept without attacking them for their choices.”

          I have read many blogs, articles and messages on baby boards of homebirth mothers who transferred to hospital for emergency care – and in every single case they were treated with professionalism and compassion. These mothers have praised the dedication and extraordinary efforts of hospital staff trying to save their babies and protect the health of the mothers. I think you do American doctors, specialists and nurses a great disservice in suggesting otherwise.

          • You read blogs, articles, and messages on baby boards. I work on a labor and delivery as an attending physician, and have done so at five different hospitals over my career. In many cases transfers are accepted with grace, but I can assure you that in many cases they are not. I’ve seen it many times.

          • I was not treated with professionalism or compassion. Not trying to negate other people’s experiences, just sharing my own. I was treated terribly by virtually everyone involved with my care, and I am pretty sure it is because I transferred in.

          • Jocelyn

            Just curious, and if you’re comfortable sharing, what hospital were you transferred to? I’m somewhat familiar with the hospitals in SLC/Utah counties, and like I said, I’m curious.

        • PollyPocket

          EMTALA?

          Hospitals do accept homebirth transfers. They have to by law.

          And compassion, or bedside manner depends solely on the individual. I have spent my entire professional career in level one trauma centers and I have not met a single nurse in a trauma center who would treat a grieving or suffering parent with anything other than compassion. After all we take care of the drunk driver who kills a family of four and them hits the call light q15minutes for more dilaudid. Or the person with about 2 square inches of skin on his body because his meth lab blew up, with his toddler inside it.

          At least I don’t have to worry about a homebirth mother hurting my kids. They are generally content to hurt their own.

          I will say (and I may be crucified for this), that the L&D nurses who took care of me when I gave birth in the hospital were quite a different bunch. Perhaps this is a reflection of my hormonal state at the time, but they were very judgemental and patronizing. They seemed to get caught up on very insignificant details (like the number of minutes baby spent on the breast) and the frequency with which I requested my PRN NSAID. My coworkers who have given birth have had similar experiences. I appreciate the L&D nurses very much, but there certainly seemed to be a unit culture that I think any new mom might feel bothered by.

        • KarenJJ

          “I suppose if Amy’s goal is to keep women who are on the fence from delivering at home, then maybe her tone is right.”

          So you recognise that you have different goals. Your goal of reaching those women that are so deep into homebirth ideology and so against hospital birth that even knowing there is a higher risk to their baby’s life and health that they’d still choose to take that risk, is admirable. Good luck with that. I’ll be interested if you have much success or have ideas as to how to reach them.

        • Lisa from NY

          It doesn’t take long for a woman to bleed to death after giving birth, even in an immediate transfer, simply because midwives don’t give pitocin to prevent a PPH.

        • LukesCook

          Somebody bring me a sick bag and a tooth brush. So much syrup.

        • Expat in Germany

          Until you make a distinction and say that cpms have no right to exist, no one will listen to you here.

        • KarenJJ

          “I want something different.”

          So you’d like to convince the hardcore homebirthers?

          Good luck with that. I’d be interested in how you would encourage someone to try giving birth in a hospital once you’ve explained that there is an increased risk to them and their baby’s lives and their health. What success have you had thus far?

        • Sue

          ”I suppose if Amy’s goal is to keep women who are on the fence from delivering at home, then maybe her tone is right.”

          Yep – and many posters here have given personal evidence that this is true.

          But what makes you think there should only be one approach, or one style, to helping improve decisions about childbirth? Amy has chosen her style, and has evidence right here that it works.

          You can choose your own style too, and join in the campaign. If you want, tell families you are the ANTITHESIS of Dr Amy. Whatever style you choose, though, you’ll be doing well if you convert as many people as Amy has. Good luck in your campaign to stop babies dying – it can use anyone who is willing to make the effort.

          But also think about this: Amy must have about the best knowledge of this sector of the obstetric literature going – she has TIME to keep up with it. And she’ll be talking to obstetricians – providers, not home birthers. What better person to speak to obstetricians in this area – someone excessively polite person whose practise is so busy that they can;t keep on top of the literature?

        • I know everyone is hating on this comment but I really appreciate that someone is interested in figuring out what is turning women off from the hospital. I would not have gone to a midwife if I thought the hospital was a safe place for someone like me. My assessment proved correct once I ended up transferring there.

        • prolifefeminist

          “I want women who choose to deliver at home to realize that they are trading a margin of safety for their birthing choices.”

          This blog is ALL about driving that point home. In fact, when I was pregnant and considering HB, this blog was the only place that blew apart the dishonest claims by the HB crowd that HB is “as safe or safer” than hospital birth. That lie is one that’s repeated over and over on message boards, at midwifery conferences, in articles, and by midwives themselves. If you want women to realize that HB is less safe, then you need this blog to keep proclaiming it loud and clear.

          “I also want to know what it is about obstetrics practice that really turns them off, and to figure out how we can provide for them in a way that is acceptable to them and at the same time optimize their pregnancy outcomes.”

          I think this is very refreshing to hear. I think you need to keep a couple of things in mind. The NCB movement sets up very unrealistic expectations, which most all OB’s will never be able to meet, and many of those women then turn to home birth midwives to have those “needs” met. Of course hospitals/OB’s should provide reasonable things like compassionate bedside manners, newborn rooming in as desired, support for breastfeeding as desired, freedom of movement in labor when possible, patient preference for visitors and privacy, etc. Stuff like that is very reasonable.

          It’s when you have an entire movement (NCB) that starts whispering in mothers’ ears that “you are less of a mother if you use pain relief” or “you won’t bond properly with your baby if someone puts a hat on him” or “doctors just want to cut you open” or “epidurals cause autism” or “antibiotics are a terrible idea for treating GBS – if you’re smart, you’ll stick garlic in your vagina.” When you have an entire movement perpetuating these ideas, you WILL have women showing up at your hospital with unrealistic, unsafe expectations. Or worse, those women won’t show up at your hospital at all, because they’ll be so convinced that it’s the worst place to have a baby that they’ll turn to an undertrained midwife instead.

          I fully agree with you that the climate for VBAC’s is totally ridiculous in many parts of this country, and that definitely needs to be changed. No one should be forced into surgery they don’t want. There are also those OB’s out there who just really aren’t very pleasant, or kind, or skilled…but I do think they’re in the minority.

          So in general – what is it that’s turning women off about obstetric practice? Most of the time, it’s NCB. Counter that, and I think you’ve solved a HUGE chunk of the problem.

          • KarenJJ

            A lot of women feel out of depth in a hospital. They feel anxious and are afraid of the loss of control that happens when you become a patient. They are scared of something going wrong or of something painful happening that they can’t stop. Dealing with the anxiety and loss of control is one thing that doctors could do better with patients. NCB pretends to have the answers but they really don’t and can make the anxiety worse.

          • Being in the hospital is scary. You feel like you’ve lost control because, in many ways, you have. I’ve never been pregnant, but I’ve been in for other things (mono so bad my throat almost swelled shut and I was severely dehydrated from not being able to swallow without severe pain). It sucked. I knew the doctors had my best interests in mind, though, so even though I had given up some control and was scared and in pain and my mind was fuzzy from fever and dehydration, it wasn’t at all traumatic or anxiety-inducing in the way you mean. That seems to be in part because I wasn’t expecting the stay to be anything but healing.

            TL;DR: Doctors may be able to help with anxiety, but the patients also need to stop being scared for no good reason.

        • I find Dr. Amy’s rhetoric bracing. Sometimes you need to call a spade a spade- when someone is lying, you don’t call it a difference of opinion. You call out their lies. Dr. Amy has repeatedly stated that she thinks homebirth is a bad idea, but women should have the ability to have one if they want one. However, they must be informed about the risks and they must have qualified health care providers with them, not DEMs and CPMs with minimal schooling and training. It sounds like you agree with her. You just think she says things too angrily. That is what we call tone trolling. Stop it. All it does is silence people.

          Do I agree with everything on this blog? No, I don’t. I can’t evaluate a lot of the medical stuff (I’m very much a layperson), though I have a pretty good background in statistics so that much I can do. Some of the things that get blasted on this blog just don’t seem like that big of a deal to me. I’m not even really the target audience- I wasn’t really aware homebirth was a thing, I would never do such a stupid risky thing anyways, and I’m immediately wary of anything that smacks of woo. I’ve still learned a lot about pregnancy, labor, and delivery, as well as options for pain relief, that will be of great help if/when I have children in the future. The fact that Dr. Amy isn’t all nicey-nicey … well, I read JT Eberhardt, and Greta Christina in part for their abrasiveness too. They, like Dr. Amy, tell it like it is, and I for one appreciate that.

        • AllieFoyle

          Dr. Fogelson, I do appreciate reading your point of view, but I wonder if you are open to reconsidering your position.

          All this concern over Dr. Amy’s “tone” is misplaced at best and harmfully Orwellian at worst. This site is unique among pregnancy/birth sources in the depth and breadth of information and free discussion on offer.

          I dearly wish it had been available to me when I was pregnant. Like other mothers-to-be, I was excited, frightened, hungry for information, and eager to do what was best for my baby. Alas, all I could find were websites, books, and magazines that promoted a particular point of view, one that stressed the superiority of doing things naturally and glossed over the possibility that anything about childbirth was or could be inherently dangerous or traumatic. This POV is heavily over-represented, and in many venues its tenets cannot be questioned, and so women are told the same lies, misrepresentations, and half-truths over and over again to the point of brainwashing. As a thinking human being, I wanted more balanced information, more real knowledge, and less ideology.

          {What I desperately wanted was an elective cesarean– despite everything I had read about the supposed benefits of natural birth, I felt that a surgical birth would be safer for my baby and less traumatic, physically and emotionally, for me. Unfortunately, because of this pervasive ideology and lack of respect for women’s bodily autonomy, I was forced to have an induction without pain relief instead. It was traumatizing and inhumane for me, dangerous for my child. I was left incontinent, damaged, and morbidly depressed. I went through useless but humiliating physical therapy, counseling, and ultimately reconstructive surgery. And for what? To satisfy someone else’s ideology.}

          I’m just an ordinary mom, not a doctor or midwife, but I am so grateful that sites like this one and Awaiting Juno and Cesarean Debate have begun to give voice to the women who are disenfranchised by the push toward natural childbirth at all costs. As a mom and former patient, I’m disgusted by the hypocrisy and cruelty displayed by those other sites and their fake concern with something as inconsequential as “tone” when people’s lives and health are at stake.

          I find the urge to be understanding and accommodating of women’s needs commendable, but I think you should ask yourself if you are favoring the desires and needs of a small but vocal minority (that propagates dangerous falsehoods and doesn’t tolerate dissent) over the best interests of many other women and babies.

    • LukesCook

      Why do a subset choose to deliver at home? Because there will always be a subset of whackjobs. And the rest are lulled into a false sense of security by doctors who should know better making it their business to validate quacks and snake oil because they like being popular with the girls.

    • Meerkat

      I can’t speak for all women who choose home birth, but two of my acquaintances told me their reasoning for wanting one. One woman told me she dreamt that her baby visited her and said that his name was Rain (the name has been changed for privacy reasons, but the real name is as creative as my pseudonym) and he wanted to be born at home.
      The other woman said that she was afraid of the hospital germs. She gave birth in a kiddie pool at home, because it is so much cleaner.
      Need I say more?

    • fiftyfifty1

      “She is not a practicing obstetetrician [sic]”

      Hold it, you’re the same guy who says further down that Ina May Gaskin is a good speaker! Is she an obstetrician?

  • guest

    I happen to think Dr. Amy is pretty damn awesome.

    • guest

      I’d like to add how I first found Dr. Amy’s website:

      I was searching for risks and downsides of waterbirth, because I hadn’t seen anyone ever talk about them, even other doctors. I came across one of Dr. Amy’s pages about how there are very real risks where babies can even die.

      The “tone” was nothing but a breath of fresh air to me, because it was such a relief to read something from somebody who made so much sense and supported their claims with real evidence. Waterbirth seemed like an obviously unwise choice to me, and my thought was validated.

      I probably wouldn’t have come back to the site; I never really considered a homebirth or anything like that. However, I looked at the feminist breeder for a time (not since the whole lawsuit kerfuffle), and she kept talking about Dr. Amy. So, thanks Gina! I am happy you reintroduced me to Dr. Amy, because I think she is doing brilliant work. Dr. Amy, you are right to measure your success by how pissed off your opponents are, because not only are they listening to you, but also they are quite plainly directing their former supporters (like me) to you!

      • Sue

        As I’ve outlined before, I came here after seeing a complaint about Amy’s blog from an anti-vaxer. A couple of years ago now, and I haven’t left.

        You see, Nick Fogelson? Amy’s style upset an anti-vaxer. Their ire caused them to mention this site, which brought more traffic. I’ve used information linked here to help spread evidence-based information. So the style works, no?

        • Lizzie Dee

          One of the things that drove me mad when I was pregnant, and still annoys me now, was the “Don’t worry your pretty head about that” sugar coated approach.

          My great niece is now past 40 weeks, swelling up rather a lot and is getting the “probably nothing” routine, with her next appointment a week away. “Probably nothing” is reliable most of the time of course, and avoiding unnecessary anxiety is important, but I think it is also responsible for more disasters than interventions are.

          Syrup may be nicer but vinegar does have its uses in clearing up cloying, sticky messes. Are we adults in search of facts, or children needing reassurance?

  • CanDoc

    ACOG’s in Hawaii this year? Man, you guys get all the good meetings. So, SO glad you’ll be presenting, Dr. A. Makes me want to make the (20-hour) trip! Love this piece, it’s like waving your flag high and clear so your opponents know you’re out there, you have an army, and you’re not afraid. 🙂 Woot!

    • Antigonos CNM

      Frankly, Dr. Amy, I wish you’d arrange for your presentation to be videotaped, and then put up on YouTube for all us unfortunates who have to remain at home. It would be an excellent way of spreading your message.

      • Esther

        Seconding the request!

  • guest

    I detect a fair amount of misogyny in some of the anti-Dr Amy rhetoric out there. I really believe that if she were male and said the same things, the homebirth zealots would disagree with her, but they wouldn’t hold the same level of venom for her. They don’t like her because she breaks their view of how women and mothers “should” behave. A lot of the tone on sites like mothering is “oh, moms must be supportive of each other and their birth choices!” and the people who argue that we must support all moms are often the same ones who talk about crap like “women’s intuition” or “women’s ways of knowing.” All of that boils down to a bunch of embarrassingly retro gender essentialism. Women apparently are supposed to use intuition rather than worrying our pretty little heads over science. And we must all join hands and sing kumbaya and pretend there are no bad ideas, because we are apparently too fragile to handle vigorous debate and examination of our ideas and their basis (or non-basis) in fact. It’s all so much BS. Yes, we should be respectful. But while I respect every mother’s right to make choices about her birth, I also don’t have to agree with those choices. I can’t imagine a world where men are told to smile and nod their heads like a bobblehead doll rather than objecting when someone tells them something factually wrong, and it’s sexist to say women should behave that way.

    TL;DR version: A lot of the folks objecting to Dr. Amy’s tone probably wouldn’t hate her nearly as much if she were male. And that pisses me right off.

    • Eddie Sparks

      This, and this again.

      What are we meant to be teaching our daughters? “You are intelligent, independent, capable of evaluating a variety of information and positions and coming to your own conclusion. You have every right to be making these decisions for yourself based on the available evidence. But it’s OK, you don’t have to. Just do whatever you feel like and if anyone is rude enough to disagree with you, just put your fingers in your ears and pretend that you can’t hear them. Because, just, well, you know, how dare they!!!”

      That’s not feminist, nor even simply respectful of women. It is patronising, demeaning and disempowering.

    • Mishi

      A lot of the tone on sites like mothering is “oh, moms must be supportive of each other and their birth choices!” – Unless you willingly have a hospital birth, intervention, and/or a caeserean. Then you’re fair game, regardless of the reasons behind your choice.

  • Sarah

    YES! I wanted to fist pump the air after reading this. It’s not about ‘bashing home birth’ or being ‘mean’ – its about informs consent so that women can make their own choices! And informed consent means knowing the real facts about home birth- the lack of training for direct entry midwives in the US, the lack of accountability, the increased risk of perinatal death. Until the NCB crowd learns what medical ethics and honesty are, we need Dr Amy!

  • Guest09

    Can these women who are so upset about you presenting also take note that Ina May Gaskin was a keynote speaker at last year’s ACNM annual conference. I mean really?! When it comes to education, credentialing, and fraud doesn’t that just take the cake. Not to mention hypocrisy.

    • fiftyfifty1

      Holy buckets, are you kidding?!!! Ina May? That’s it, I am officially done with CNMs until they clean house.

  • Forgot My Disqus Login

    Dr Amy – I am certain that for every person who reviles you, there’s a whole bunch of us who admire and appreciate what you do.

    And yeah… the fact that they’re even thinking about trying to stop someone from speaking at a professional conference speaks volumes about their “cause” and about their ethics and values.

    • KarenJJ

      They should be encouraging it. If Dr Amy really says completely nutty things that can’t be backed up with some strong evidence, she’ll get strips torn off her at a conference.

      • Sarah

        Karen- these women have conferences that are basically big echo chambers and patting each other on the back sessions- they wouldn’t have a clue what goes on at a professional conference!

        • KarenJJ

          What’s the fun of that?

  • WhatPaleBlueDot

    Thank you for all your work.

  • mydoppleganger

    When I first got into natural birth blogs, I was warned to avoid that “viper Dr. Amy’s blog.” Naturally, that made me want to check it out. *Guess I trusted my curiosity there.* For several blogs I was horrified, until I realized that there was something more to it. Especially when I became disenchanted with the PRESSURE of the movement and began to question how important X and X were anyway.
    It’s funny how life works. So many of us Dr. Amy readers came to natural birth because we felt hurt and cheated. Some of us got burned out and went to Dr. Amy’s blog after we felt hurt and cheated from the natural birth movement in terms of peer pressure and intensity. Who helps those who are burned out on the movement?
    The movement has become increasingly competitive and away from reason all together. I would gladly be in it, if I felt more of a balance to the conversation.

  • Jenn

    Also off topic, but I’ve been reading the comments. What a lot of the VBAC people don’t seem to be understanding (and their doulas and midwives aren’t helping them at all by telling them this is safe) is that after a CS, or if you’ve had to have any uterine scraping after a birth, there is an increased risk of placenta acreta, increta, or percreta. When you have scar tissue on the uterus, the placenta will finger in there and attach, making it harder to deliver the placenta, and the mother can bleed out. I had an increta with my daughter, and am grateful I had a knowledgable OB who was able to immediately assess and treat my situation. If I had been at home under the “care” of an untrained midwife who likely would not have known what to do when my placenta didn’t detach, I’d be dead, my husband a widower, and my two beautiful children would not have a mother. Just a thought…

    • mydoppleganger

      I agree. . For me, I would like to avoid the post c-section recovery, but I am more than willing to consent to a c-section should it seem in the cards. I also did not realize recovering from a vaginal birth could potentially be so painful with so many stitches*or other situations*. No one told me that in natural birth. It was more “a vaginal birth is always going to be easier to recover from.”

      • GiddyUpGo123

        Recovery from a c-section really depends on the person. I’ve had many people tell me their c-section recovery was easier than recovery from a vaginal delivery, and vice versa. I’ve done both and did not find one really more difficult than the other. After the c-section it was inconvenient to have to avoid lifting heavy things for six weeks, but that was all really. My only advice is, if you have a section, to take the four days in the hospital (or whatever your hospital/insurance allows). Don’t be tempted to go home a day early. It’s really tough to sit up from a flat bed after you’ve had a c-section, and you do a lot of sitting up in bed after you have a baby. Those electronic beds in the hospital make it a lot easier.

        • AnotherOB

          Exactly. I’ve done both and I think they were both great and both difficult, but in different ways. I hurt more in the first few days after my c/s, but improved MUCH more quickly than after my VBAC. Two weeks after my VBAC my laceration (second degree) was still nearly as painful as the first day. All in all though, I prefer the VBAC as it just was a more enjoyable experience (with an epidural), being able to hold my daughter immediately, nurse right away, have my hubby, mom, and mom-in-law (!) in the room. It really was lovely, and across the hall from the OR, just in case 🙂

      • Ashley Wilson

        “I also did not realize recovering from a vaginal birth could potentially be so painful with so many stitches*or other situations*.”

        OH MY GOD YES! I didn’t want a c-section purely because of the recovery, but honestly, going to the bathroom after my vaginal birth was the most painful thing ever and the pain killers did nothing to help. Nothing helped. I would cry and bite down and bare with it. That was the only thing I hated about my birth/recovery. Loved my epidural. LOVED my catheter! Pushed for less than 15 minutes. But god damn that hurt so much. I was literally crying every time and it took so long for it to stop hurting despite being only a very very small tear.

        • suchende

          Oh, but recovery from vaginal birth is SO much easier. I mean, unless you have 3rd or 4th degree tearing.

          • Lizzie Dee

            When I had my children, the custom of early discharge was not yet universally in place. It was ten days for a vaginal birth, two weeks after CS. (If you were lucky. My sister was kept for three weeks after her relatively unproblematic, all natural (epidurals not yet commonplace) vaginal birth because of a persistent low grade infection.) Consequently, I was well able to observe the progress of my fellow patients.

            Ages ago, I posted a comment on here that my recovery from the second CS seemed a lot smoother than those more “fortunate” than myself. A few hours of misery, then more or less OK, compared with those wandering around bent double clutching their rubber cushions. I got told off for my lack of sympathy, empathy, profound admiration of their wonderfulness or something and was a bit surprised, because I thought my comment was a fairly neutral observation.

            Swings and roundabouts. My view is that birth is a bugger, not an achievement, and that the physical miseries of the first couple of weeks are, like everything else, a matter of luck entirely unrelated to wonderfulness or degree of preparation.

            Kate looked lovely – very “natural” – wonder what she felt like?

      • Guest

        “Always going to be easier to recover from” On my third, my butt fell out of my butt by a lot. It happened after being told to push as hard as I could. After several weeks the anal prolapse went back in without surgery, but it was really painful and the lidocaine I got didn’t help at all. I fear having another baby would cause a permanent problem down there.

  • mydoppleganger

    I noticed something. When I read natural birth blogs (especially from the most vocal natural birthers) I get stressed out, my jaw tenses. Reading the stories of “OMG this doctor” and “I will not consent to *insert laundry list here*” makes me feel anxious. It preps a person to be frightened, fearful, and to resist any change of plans. Most of all, it makes the vaginal birth thing have so much expectation on it. You can see how readers comment “I hate hospitals, never go to one period.” For a group that promotes positive thinking, there is an emphasis on being highly fearful and even angry of something. How many women who now feel “birth rape” have been duped into feeling that way due to these blogs?

    I actually find Dr. Amy’s blog to be the calm in the chaos and I have empathy for the medical staff whom will work with me while I give birth. Not going in with a giant chip on my shoulder. I am sure my doc is not prepping the OR just to “show me whose boss” and make a little extra money. It’s freeing and HEALING to let go of such specific expectations in a world that has challenges in each experience. I may just be a tad happier for letting go of such specific outcomes.:)

    • I don’t have a creative name

      Beautiful.

      Going in with no expectations other than a healthy baby and healthy mom, no chip on your shoulder towards hospital staff, is so very liberating. Life really is 10% what happens to you and 90% how you deal with it.

      I had 3 c-sections and loved all of them. I still fail to see how anything that put my beautiful, healthy baby in my arms could be a negative. An NCB cultist who had identical experiences to mine but expectations of a typical NCB’er would probably feel angry and bitter about it for the rest of her life.

      • mydoppleganger

        My birth plan is to go in with a thankful, open spirit. I want to be able to crack jokes in tough situations. *I’m a hoot during vaginal examines LOL*. I am not going to approach staff like they are vultures, but rather people I can get along with. I think things can go better if people sense you trust them and value their time. No one wants to serve someone who treats them like scum for no apparent reason.

        C-sections are one of the few operations where the patient could be belittled for by their peers. Do we shame those who have open heart surgery or take meds during a root canal? No, we treat them with empathy. Why have C-sections become a source of shame and guilt in the NCB community?

        Clearly, we need to move past pushing shameful feelings and back to reason. As women, our virginity should not define us, our way of giving birth should not define us. *I am not even a card carrying feminist and I feel this way!*

        Going back to grade school, if someone does not like you because of something you cannot control anyway, maybe you shouldn’t be friends. I want true friends who like me for my spirit and mind, my character-not hanging out with because of my vagina’s accomplishments. *LOL*:)

      • GiddyUpGo123

        I am so grateful I had all my babies without ever having been exposed to all that NCB crap. I didn’t even know you were supposed to have a chip on your shoulder when you went into the hospital to have a baby, haha.

        I also loved my c-sections. In fact I think I loved them more than I loved my vaginal deliveries because I got that extra time in the hospital, just me and my baby … no demanding older kids, and someone to bring me three meals a day. 🙂

  • OBNurse

    I would give my right arm to go to Hawaii and hear you speak! Will pass on to my OB friends!

  • Courtney84

    Completely OT: but better here than babycenter. I have an appointment scheduled with a new OB next week. I’ll be 19 weeks, and will most likely be transferring care to her. I know that it’s not rational, but I feel very guilty about leaving my current practice. They helped me get pregnant, and managed my slightly complicated first trimester. But one nurse told me only women with implants can’t breastfeed, another nurse told me to trust my body (regarding my anxiety about losing this pregnancy after two miscarriages), and there was a less than satisfying run in with the office’ CNM regarding thyroid testing (pre existing hypothyroidism) only t have the doctor call me to send me for blood work later that day… There’s no reason to feel bad about leaving, right? I mean it’s not like we’re friends I’m just a customer, right?

    • Captain Obvious

      Previous office, compassionate care includes accurate information and trust. Women with implants can nurse. Option for closer surveillance after previous losses may not prevent another bad outcome but may make you feel better being seen more often to hear the heart beat. Rather than trust your body, maybe be seen more frequently until out of first trimester. Having practice protocols the MD and CNM agree on is helpful for you to trust their experience. I have patients who come to my office because of my nurse! They joke around (I hope) that if she left, so would they. The doctor may benefit to know why you left for quality assurance throughout the office. Regarding new office, how do you know they are not as discombobulated?

      • Courtney84

        The thing is, I’d probably need to go back to this doctor to get pregnant in the future. So I’d be unlikely to tell him I left during because of a combination of small things that weren’t the end of the world. I’d tell him I was leaving because he’s on vacation for a week and a half overlapping my due date, and was more comfortable with a female OB. Both of those things are true (in treating my fertility problem it was lab work and meds, so he never examined my pelvis prior to pregnancy).

        I don’t know the new practice is less discombobulated, and that stresses me out a little because … It just does. I tried to pick someone new who delivered at the hospital I most preferred (my current doc does not) and other things I could reasonably search for on the Internet. I called and talked to her nurse for a few minutes and didn’t hear anything off putting or woo-tastic in that brief encounter so decided to go ahead and schedule an appointment. I was drawn to this practice because it’s five female OBs, zero midwives, and they proclaim in their website that one of their five doctors will deliver your baby even if its a weekend or holiday. I am due Dec 28th so that is more important to me probably than someone with a non holiday

        • R T

          I prefer a male OB! They are in general more compassionate and gentle in my experience! My male OB told me he was in complete awe of women and everything they have to go through with pregnancy and birth. The female OBs while still great, were BTDT and not so impressed lol!

          • Courtney84

            I don’t think there is anything wrong with seeing a male OB/GYN. I had a bad experience with a male gynecologist in college, and I’ve had a couple female gynecologists over the years that I’ve really enjoyed having for a doctor. It’s definitely a personal preference thing, not a one being better than the other, in my opinion.

    • R T

      What?! Did she give you a reason why women with implants can’t breastfeed? I lived in Los Angeles for 10 years and worked as a doula there. It was rare for a breastfeeding woman not to have implants! It was never the cause of any breastfeeding issues in any mother I knew.

      • Courtney84

        No, she did not. She also didn’t say no women with implants can breastfeed. She asked at my initial appointment how I planned to feed the baby. I said I intended to breastfeed, but had read that women with infertility were more likely to be unable to breastfeed or have difficulties. Her response was that that is not true, and the only women who truly can’t breastfeed have implants. WTF?

        • PollyPocket

          I’m a plastics nurse. The VAST majority of women with implants can breastfeed. The only exception is in the case of a periareolar incision if the nerve endings to the nipple have been cut or the ducts have been cut (if the nipples are erect, the nerves are intact). With all other approaches, the surgeon should be BEHIND the breast, never in it.

          Also, there is no evidence that breastfeeding with implants is dangerous, saline or silicone filled.

          I hope that puts your mind at ease a little. I’m sure you can contact your surgeon if you have any questions about your specific case, it’s a VERY common question.

          • fiftyfifty1

            I read it to say that Courtney doesn’t have implants, but rather infertility and the nurse said something like “Infertility won’t cause low milk, the only think that causes low milk is implants”. Courtney knew that was wrong information.

          • Ashley Wilson

            That’s how I took it too. Sounds like the nurse is just a little too woo filled and a little under educated. I would speak up, if not for any other reason than to spare some new mother with low supply the speech of “you could nurse if you really wanted to. There is no such thing as low supply”. Blarg. That’s a hot button issue for me.

          • Courtney84

            Exactly! I know women with implants should not typically be unable to nurse merely because they have implants. I also know that there is some information out there suggesting that some types of infertility can also mess with the hormones for milk making. C’est la vie. I’ll make the best of it.

          • suchende

            I was unable to BF with “ideal” placement/incisions. I now believe I had IGT, which is why I got the implants. I would guess a lot of LCs and moms have the causation mixed up.

      • Laura Thomas

        Ha! That is so funny! You must have worked on the Westside of Los Angeles. Here in the San Gabriel Valley where I live none of the women I know, except two (one for medical reasons) have implants.

        • R T

          Yes, actually, lol! Attended deliveries usually at UCLA or Cedars Sinai. I’ve actually only ever been to Pasadena in the San Gabriel Valley. I had to look online at the cities and that’s the only one I ever been in the valley!

    • Ainsley Nicholson

      You may want to mention these incidents to your OB, since it sounds like your concerns are about the nurses rather than the OB. Your OB will want to know if there is anyone in the office that is driving patients away! I complained about a nurse in my pediatrician’s office one time (because she was really slow at giving shots and she stuck one of my babies twice with the same needle), planning to stay with the office but avoid that specific nurse- within a few months she had been let go- apparently I wasn’t the only one to complain!

    • GiddyUpGo123

      That sounds so achingly familiar. I loved my OB but some of the nurses at his practice (and in the hospital) were so lame. One of them questioned me for having an elective c-section with baby number three (as if it was any of her damned business) and a nurse at the hospital told me to throw away my formula samples because “they aren’t even fit for your dog.” Which made me feel oh-so-awesome two weeks later when I had to start supplementing because my baby was losing weight on my pathetic milk supply.

      • fiftyfifty1

        Well I guess she was right about formula not being fit for your dog; baby formula has too much lactose for a dog. Formula is made to fit the specific nutritional needs of *human babies* you see.

      • amazonmom

        I really wish nurses who don’t know their ass from a hole in the ground would just keep their mouths shut! There is no room for Judgy Mc Judgersons in healthcare.

      • Antigonos CNM

        The “shidduch” [match] between health care provider and patient is so individual that I never offer only one name when asked to recommend someone. As long as the person is qualified to take care of you, you should be completely comfortable if you realize that you need a different provider and the current relationship just isn’t giving you the care, support, and interaction you need.

        My daughter had her first prenatal appointment with a doctor I know to be very good, professionally, indeed, and one who is requested by many women. After she sat in his office while he dealt with telephone calls for 20 minutes before even saying “hello” or “excuse me, this is an urgent call”, she got up and walked out. “He’s not for me” she said. “During my appointment time, I expect him to be focussed on me” and I think, knowing my daughter’s personality, that she was right. The list of initials after his name did not impress her as much as the feeling she got that she was irrelevant to him. But plenty of patients dote on him. Different folks, different strokes!

    • No there is no reason to feel guilty, but I’m exactly the same way (and I can’t even blame pregnancy hormones). I’ve put off switching allergy/asthma specialists for a year because I feel guilty, and was only able to finally do it after inventing a bunch of “it’s not you, it’s me” excuses.

  • Courtney84

    So I still never get how it is that according to these people a correspondence course in midwifery and being present for 10 deliveries makes you a midwife, but doctor Amy is no longer a doctor because she no longer practices or maintains her medical license? If your long beloved family doctor retires is he not a doctor? Of course not! They are all so ignorant and/or out of touch with reality.

    • Captain Obvious

      Would you not ask your retired aunt beautician for a haircut or perm? Would you not ask your retired uncle mechanic to help look at your car? Would you not ask your retired brother contractor to help build your deck? Etc etc etc. But doctors, specifically Dr Amy, lose all their knowledge about medicine when they retire. Some professionals may lose touch with some contemporary practices if they don’t continue to read up on current literature, but everyone knows Dr Amy continues to site articles and research that come out, sometimes before the article is even in print. Pro-Homebirth fanatics claim Dr Amy would never get published in a peer review journal, but they are too ignorant to realize that is not her goal, that she sites articles/studies that are already in peer reviewed journals or data from respectable agencies, and the absence of data from agencies (MANA) that are trying to hide facts.

      • Courtney84

        Just for fun: my retried uncle mechanic has saved me thousands of dollars over the years!

      • Older Mom

        I agree. I would gladly turn to a retired family doctor for medical advice. Though unlike with the mechanic or beautician examples, I wouldn’t let my retired OB aunt deliver my baby. On the other hand, if I had a precipitious labor, couldn’t get medical help to be before baby was out, and she were there, I’d be delighted to have her help.

  • Guest

    For those of us who don’t have the good fortune to be able to fly to Hawaii (how exciting!!!), is the a way to secure a copy of the presentation? I see that you are also presenting with a partner (or are they two separate presentations?). Will he also be discussing HB? I am also wondering (since the affiliates are failing to address it or legislators for that matter) if you will be using OR and CO outcomes as a part of this presentation? Sorry, I am sure you don’t want to give too much away, but there are those of us from these states hoping that it will shine a more national light on these issues and put some pressure on protecting families.

    • Guest

      And by copy I mean video after you present, not prior:)

    • Gene

      Agreed. Would love to see the power point presentation!

    • Amy Tuteur, MD

      I’m giving a talk on homebirth by myself and participating in a panel on controversies in obstetrics. I’ll be happy to share the Powerpoint after the meeting. There isn’t anything in it that I haven’t said a million times before on the blog, though.

      • Susan

        I am really interested in seeing it and I wish I could be there. I have been to that hotel and you should have a fabulous time! I don’t think nurses can go to ACOG meetings anyway…. maybe you’ll get invited to speak somewhere we are welcome!

        • Susan

          oops looks like nurses can attend! Cool 🙂

  • I don’t have a creative name

    I really like that comment from the commenter on NGM’s site. She GETS it.

    In other news, I just read a vbac2 story that had me shaking my head. It was done in a hospital, but the mom went on and on and on about dreams come true and finally feeling healed and complete and paragraph after paragraph of blah blah blah about her feelings about delivering vaginally, There was only ONE sentence about the baby, and it was only mentioning the stats and gestation.

    Hey, she’s happy with the birth, good for her. But I like this site for being a counter to this mindset, that this is THE way. For all the moms who feel like failures for not “getting” their vbac, this site offers up the idea that it is NOT failure, that doing what is right and safe for your baby is never failure. I appreciate that. Reading these screeds from women who post as though their other children’s births were such massive disappointments and ruined their lives up until their vbac’s gets so depressing.

    • Jessica

      I also get really frustrated when I read posts on Baby Center, The Bump, or women’s pregnancy blogs. I read a blog post the other day that has me shaking my head. The mom went on this long rant about medical interventions during labor, and said she is declining pitocin for any reason whatsoever. Even while waiting for the placenta to deliver. She didn’t understand why her doctor commented “I don’t want you to bleed to death,” because you know, her body is made to deliver the placenta. No understanding of how PPH can happen and how pitocin can prevent it.

      This woman is pregnant for the fourth time, but it’s the first time she’s made it past the first trimester. She had to use IVF to get pregnant. She is now 39 weeks and on bedrest due to increasing blood pressure. You know, my blood pressure was high throughout my pregnancy and stable, and if my doc had suggested I go on bedrest at 39 weeks, I would have said, “Screw that. Let’s start the induction now.” In fact, I was induced, and sure I had pitocin and Cytotec and an epidural, but I did deliver vaginally and my son was born HEALTHY. He is now walking and starting to talk and at 13 months old is the light of my life. And I got pregnant easily! I hate now NCB downplays the real risks of pregnancy and childbirth and leads women like this blog author – someone who regards her pregnancy as a real miracle – to overlook those risks because the fear of pitocin and a C-section is somehow worse than the risk of a dead baby.

    • R T

      At least it was in a hospital and if that’s the way it made her feel than who am I to say she shouldn’t feel that way! I’m glad it was done in a save environment and she’s showing other women you can have the experience in a hospital! I would be cringing if it was a HBAC2!

    • R T

      Here ya go, HBAC2 of a footling breech, who has trouble breathing http://community.babycenter.com/post/a43487416/hba2c_breech now this makes me SMH. Midwife was Gail Tully of Spinningbabies fame.

      • I don’t have a creative name

        ” I hired the doula I met at the ICAN
        meeting to be my advocate in the hospital for me. She really wanted me
        to still consider a homebirth. She felt my baby’s position and he was
        breech.”

        GAH!!!!!!!!!!!!!!!!!!!!! Frickin’ untrained doula morons who don’t know the meaning of the term “scope of practice”!

        “She checked me and I was 6cm and she was
        feeling a foot instead of his scrotum that we had been feeling the for
        the last few prenatal appointments.”

        I just

        That’s not

        But it’s

        “I was checked and I was sure I had ripped it hurt so bad but, I hadn’t at all!”

        Surely your CPM didn’t miss anything! How wonderful!

        And Rain, I do get that there are levels of idiocy, and the lady I mentioned was on the far lower end of that, because she did what was safe for her baby. But what bothers me is her attitude about her prior c-sections vs her recent vbac, and the shame and hurt felt by women reading that who “failed” at their vbacs. Be happy with your birth experience, great. But it’s not more important than the baby. I just want some balance.

  • Poogles

    And they’re still repeating to each other the ridiculous-on-it’s-face lie that Dr. Amy never even finished residency…the crap they will come up with to try and discredit her. SMH.

  • stacey

    I just love how their first reaction is “How do we stop her from speaking?”
    Really? Censorship is the first place you go when you hear an opponent?
    I guess I ought to expect this from TFB, queen of web censorship, and her admirers….

    • theadequatemother

      if Dr Amy is really WRONG about the data and has some personal vendetta that is not backed up by evidence, the LAST thing she would do is agree to speak to a room full of very educated people that understand obstetrical care, have knowledge of the current literature, epidemiology and statistics…because her interpretation, if it was heavily biased, would be torn apart during the question period.

      So if GCC and crew are right about her and right about homebirth, they should encourage her to go to this meeting and get absolutely destroyed. debating the run of the mill HB/NCB advocate is a piece of cake. They are so clueless that it degenerates into ad hominem attacks very quickly. More work is required to prepare to speak to educated peers.

      • KarenJJ

        That’s what I was thinking 🙂 If you’re going to present to a bunch of experts, you’re going to need to be able to make convincing arguments and back it up with evidence.

        Would love to see Ina May Gaskin do a presentation at the same conference. Perhaps her breech one. She can tell them that ‘often breech babies just slide out’. I’m guessing she’ll get awkward silence and not so much applause at this particular event.

        • Actually I think that most OBs would applaud such a talk. Most lament the loss of breech birth on the back of the flawed Term Breech Trial.

          Ina May Gaskin has been invited to give medical Grand Rounds in major academic centers, and has been well received.

          • fiftyfifty1

            Dr. Fogelson, perhaps you could invite her yourself to your institution. She can teach you the “button” technique.

          • Bombshellrisa

            Or the shaking the apples one. Those two ought to spark a lively discussion.

          • Ainsley Nicholson

            Could you comment on what was flawed about the Term Breech Trial?

          • fiftyfifty1

            Yep, still waiting for Dr. Fogelson to tell us what was flawed…..still waiting…..

          • KarenJJ

            And yet you have a problem with Dr Amy being “unprofessional”? Have you read Ms Gaskin’s book??!?! Are you sure you have a problem with Dr Amy’s “tone” or is it just because she is unpopular amongst some people?

  • anonymous

    Wow…I’m envious of you Dr. Amy. You get to speak in Hawaii, in September none the less, my favorite month there. Hope all goes well and none of these nutters tries to crash the thing.

  • Anonymous

    God, the old “unlicensed” line. Congratulations Amy, you are now up there with Dr. Steven Barrett. That’s the line that the alt-med nutters use to bash him. Unfortunately, they don’t seem to realize that letting your license lapse is not the same as being “unlicensed.”

    I really, really hope someone explains to Gina that this is NOT helping her court case.

  • Amy M

    It also seems, at the beginning of that thread anyway, that they actually thought the other OBs invited an OB (in this case Dr. Amy) to educate them about homebirth or discuss it or whatever, and unwittingly invited the wrong one. As though any of the OBs at that meeting would consider homebirth in the US as it stands a realistic option. I was having trouble wrapping my head around that one for a minute…these people really live in a bubble.

  • Guilt-Free

    Keep doing what you’re doing Dr. Amy. While these women carry on with their narcissistic birth agendas, somebody needs to speak up for the well-being and safety of the babies! That’s what you’re doing. ‘Sociopathic’ is caring more about your ‘birth experience’ than the health/safety/LIFE of your unborn baby. ‘Sociopathic’ is shunning the best that modern medicine/technology has to offer in saving mothers and children in place of stunt-birthing.

    • PrecipMom

      It’s not just the well-being and safety of the babies at stake. It’s the well-being and safety of the mothers too, many of whom are lied to and have no idea of the reality of what they are choosing.

      • Guilt-Free

        So true!

  • I, for one, am very happy you are not going anywhere – we need to hear what you have to say, the health of women depends on hearing the other side of the issues. In the absence of Dr. Amy, too many might not hear that Homebirth has risks and that modern obstetrical practice has benefits.

  • Karen in SC

    Has GCC’s lawyer read the post where she called Dr. Amy a sociopath? And the others where she again is trying to silence Dr. Amy’s right to free speech, and I think, right of free association?

    Amazing! It’s as if GCC herself has not read all the court documents and doesn’t understand what the case is really about (like most of her readers).

    She keeps calling Dr. Amy a bully, but what is she?

    • Oiuy

      She’s a lawyer’s nightmare come true. These kinds of posts can still be used as evidence, right?

      • Older Mom

        You could see her as a lawyer’s dream come true. It all depends on whose side you’re representing!

    • I am rather shocked…she seems the kind of client Mr. W would grumble about, warn, and then probably, dismiss.

  • Elizabeth A

    I’m pretty sure that, whatever GCC thinks, the ACOG is clear in their understand of the distinction between “unlicensed” and “retired.”

    • Amy Tuteur, MD

      I don’t know why she thinks they don’t know who I am; THEY invited me. Many obstetricians follow the blog.

      • EB151

        I also don’t understand why a bunch of laymen think they have any business having an opinion on who addresses the ACOG. It’s a little like having some random high school kid telling my literature group of graduate-level readers what book to discuss. Huh? Plus — and I know this will sound a little freaky-deaky — having a highly contentious person speak is part of an informed debate. The idea is not considered really good until it has been publicly scrutinized using measures of logic, data, and method. That’s what scholarship actually means, not having a strong gut feeling and writing passionately about it.

        • KarenJJ

          Honestly, if Dr Amy’s ideas have no merit and are actually batshit crazy and the rantings of a narcissistic sociopath, then speaking in front of a bunch of doctors is really the last place she would really want to be.

      • stenvenywrites

        How many follow hers, ya figure?

        • Bombshellrisa

          I guess anyone who is willing to pay to read her “scholarly” ramblings.

  • attitude devant

    Once again, Gina can’t get the simplest facts straight. It’s an ACOG district meeting, not ACOGs annual clinical meeting. She probably doesn’t even understand the difference. Amy, I sure as heck wish I could be there to shake your hand and thank you for all you do. As it is, I’m going to be elsewhere on my honeymoon.

    • Amy Tuteur, MD

      I’m so sorry that I won’t see you there, but thrilled about your impending wedding!

    • Amazed

      Addi, I wish you all the best.

    • Karen in SC

      You mean you can’t honeymoon in Hawaii??? come on!! LOL

    • Congrats Addi – thrilled to hear of your impending wedding! Wishing you and your spouse all the best in the years to come….

    • Dr Kitty

      Best wishes for a long, happy marriage to you and your soul mate!

      Hope you have a wonderful and relaxing honeymoon too!

    • attitude devant

      (blushes) Thanks everyone. We are very middle-aged but very happy with each other. As for honeymooning in Hawaii, Paris was the gentleman’s pick, and who am I to argue?

      • Christina Maxwell

        Congratulations Addie, long life and total happiness to you both. I love good news!

    • theadequatemother

      congrats!!!!!!

    • Jessica

      Congratulations!

    • Captain Obvious

      Congrats. One ignorant poster is trying to make a big deal that it is going to be in Maui. That it is like, elitist much? Well, Hawaii is in district VIII, and it is their district meeting. Now if it were in Paris…

    • Bambi C

      Congratulations, Addie!! Much love to you!!

    • KarenJJ

      Congratulations!

    • KarenJJ

      You’re probably not looking to fill your itinerary too much, but if you like the sort of hot chocolate overload that is super rich, super gooey and leaves you feeling warm hearted a decade later I can definitely recommend going to Angelina’s Tearoom near the Louvre (just don’t bother with getting the tea). http://www.angelina-paris.fr/en/#/home/