First world achievements

Hand holding a TV remote

You’ve probably heard of first world problems.

As the website First World Problems explains, “It isn’t easy being a privileged citizen of a developed nation.”

Consider:

The sun is too bright for me to read my iPhone screen.

Or:

I tried to unlock the wrong Prius today. Twice.

And my personal favorite:

I can’t find the remote.

There’s a corollary that you probably haven’t heard about: first world achievements.

That’s when a privileged denizen of the first world brags about dealing with her first world problems. For example:

I’m so proud of myself for reading my iPhone screen even thought it was sunny.

Or:

Even thought there were lots of Prius’ in the Whole Foods Parking Lot, I immediately unlocked my own Prius.

Or:

I was able to find my TV remote without help.

Or, my personal favorite:

I am so proud of myself for having an unmedicated childbirth.

As you can see, first world “achievements” aren’t achievements at all. They are what passes for an achievement among privileged women who don’t have real achievements and have to make some up to feel good about themselves. They are all variations on the same theme: Look at me! Here’s how I dealt with the “problem” of the luxuries in my life.

Unmedicated childbirth is the paradigmatic first world achievement. Any woman could do it. Most women who have ever lived have already done it, and most women who give birth around the world do it each and every minute of each and every day 24/7/365.

Do natural childbirth advocates consider unmedicated childbirth an achievement for an Afghan teenager? No. How about for a woman who accidentally gives birth on the side of the road because she didn’t make it to the hospital in time? Nope, not an achievement for her. How about our grandmothers, great grandmothers and other female ancestors who gave birth without pain medication? No, it wasn’t an achievement for them, either.

Clearly, it isn’t experiencing the pain that is the “achievement”? So what are these woman boasting about? They are boasting that they had access to effective pain relief but they refused it.

And not just any pain: It’s not an achievement to refuse Novocaine for a root canal, and it’s not an achievement to refuse general anesthesia for an appendectomy. That’s considered foolishness.

And not just any pain relief: It’s perfectly acceptable, indeed entirely compatible with natural childbirth, to reduce the pain of childbirth by lying in a kiddie pool filled with fecally contaminated water.

So if it’s not the ability to tolerate pain (since women who have unmedicated childbirth because they have no other choice haven’t achieved anything), and it’s not simply enduring pain (since NCB advocates wouldn’t consider unmedicated migraines or kidney stones to be an achievement) and it’s not the refusal of pain relief per se (since no NCB advocate thinks it is an achievement to refuse anesthesia for surgery), what is it?

It’s their own special, carefully defined, easy to accomplish “achievement”:

I was presented with a luxury option and chose to forgo it.

We’re supposed to be impressed by that?

Frankly, I’d consider it more of an achievement if you learned to program the remote.

  • wookie130

    I guess my only comment is that I’m proud of my child, and I’m proud to be her mom. I don’t care how she got here, or whether that process required pain relief or not…I’m just a proud mother, and I’m happy she’s here safe and sound.

  • Antigonos CNM

    “Frankly, I’d consider it more of an achievement if you learned to program the remote.”

    I can program the remote with no trouble whatsoever. One of the big mysteries of the universe, however, is why my husband, after 35 years of marriage to me, has never conquered this bit of technology. It must be related to the missing branch on the Y chromosome… or maybe because my husband has never given birth?

  • Antigonos CNM

    It’s worth remembering that the entire NCB movement started with a simple goal: when the only form of analgesia in labor consisted of IV medication [or occasionally IM], which passed through the placenta very quickly and had depressive effects on the baby, breathing and other techniques were supposed to make it easier to cope with contractions without meds. At the time, no one idealized unmedicated birth, it was just that there was NO safe option apart from IV analgesia. In fact no one suggested that there was some inherent benefit to feeling the contractions, just that there was no alternative back then. I remember when several doctors in my hospital returned from tours of duty in Vietnam and had become skilled in caudal anesthesia and it was hailed as a huge advance, to be supplanted by the epidural shortly thereafter.

    Now there seems to be this sort of “Birth Olympics” where the goal is to suffer as much as possible — for no particular physiological reason or benefit. I bet Third World women would give their eye teeth for a MEDICATED birth! Why celebrate masochism if one doesn’t have to?

  • Guest

    See, this is the kind of stuff where you lose me. I kinda nod along agreeing with you a good amount of the time, and then… you write something like this. I just don’t see the the point in ridiculing women for a very personal choice. By all means, get mad when women try to push their birth choices on other people, but being nasty when someone choses not to get an epidural just seems like a complete waste of time. Who cares if it makes someone proud? Keep in mind that I am not talking about the extremist a-holes who think that is the *only* way to do it and oush their bizarre ideas on others, but normal everyday women who chose to go without meds for their own reasons. Quite frankly, if someone isn’t making it your business, it really isn’t any of your business.

    I have three births under my belt. One cesarean, one medicated vaginal birth, and one unmedicated vaginal birth. I am proud of myself and am grateful for all three for different reasons. No matter how you bring your children into your family, whether via cesarean, adoption, surrogacy, medicated birth, or unmedicated, I think it is an achievement. There are challenges, pain, and sacrifice involved in however a child enters the world and a family and I don’t think belittling any one of those is acceptable.

    • fiftyfifty1

      I don’t see her point as being about belittling unmedicated birth. Two of her own births were unmedicated, so why would she ridicule a choice she made herself? What is ridiculous is thinking unmedicated birth is an achievement worth preening yourself over. That’s all I read her saying.
      What does she say specifically that you feel is demeaning? Because I’m not seeing it.

      • Guest

        “I am so proud of myself for having an unmedicated childbirth.

        As you can see, first world “achievements” aren’t achievements at all. They are what passes for an achievement among privileged women who don’t have real achievements and have to make some up to feel good about themselves. They are all variations on the same theme: Look at me! Here’s how I dealt with the “problem” of the luxuries in my life.”

        You guys don’t think this is belittling? Um, okay. I will say again *who cares* if women are proud of themselves for having an unmedicated birth?? This choice is being belittled as a first world luxury. So is having the time to spend an entire article writing about such. And so is having the time to comment on such an article. Yet, here we all are. It is hypocritical to make such a criticism.

        Listen, the argument that someone couldn’t belittle something that they experienced themselves doesn’t hold water. I had a cesarean. It was necessary and needed even if it wasn’t planned or wanted. That doesn’t mean that I can’t write opinion after opinion treating women poorly who *choose* that option as the easy way out, chosing it for convenience, or whatnot. One has nothing to do with the other.

        Only one side of the argument is being presented here. There are other reasons women chose to not have pain medication in labor. Both time that I relieved pain meds in labor, it appeared to have an affect on my baby’s heartbeat. I chose not to have pain meds because I was doing fine without them and didn’t want to have an issue with the heartbeat again. Plus the epidural caused a headache and nausea and it wasn’t worth it to me. I also can’t take very many pain meds orally because the make me vomit for hours. So you guys can scoff all you want to, but I am indeed proud of the choices I made. And even though I have shared my story here for sake of clarification on why I feel pretty strongly about this topic, I still maintain that it is none of your business if someone isn’t making it your business.

        • KarenJJ

          If I wrote that I was proud of having had a c-section would you say it was silly being proud of something that was largely outside of my control and something that is not really much of an achievement when I compare it to other things in life, like learning to parallel park (for example).

          • Guest

            No, I don’t think it is silly to be proud of having a cesarean whether it be by choice or necessity. Good for you for making a call that worked for you, your baby, and your family. Like I said, I had a cesarean too. It wasn’t something that I was expecting or wanted, but when it became necessary, it was a no brainer. I am proud of putting the needs of my baby before my mine.

            Most of this, to me, is primarily about mindset. Shit happens, none of us know what is going to happen in birth (or life), but I embrace the mindset of being proud of and owning my circumstances and choices. I just don’t see anything wrong with that.

          • fiftyfifty1

            So let me see if I have this right: you’re basically saying that we should be proud of ourselves for however our labor turns out. For example, if we have a C-section we should be proud of doing that. And if the baby is born vaginally we should be proud of that. And if we say “no thanks” to pain meds we should be proud of that. And if we decide that pain meds are what we want in labor and ask for them, we should be proud of that choice too?
            Because if you are arguing that all safe choices are fine choices that we deserve to be pleased and proud over, I don’t think that anybody is in disagreement with you. What Dr. Amy thinks is bad is a woman who says “I’m proud of refusing meds and it was an accomplishment, but it wouldn’t have been if meds had been involved”. Because that sort of believe system is a hallmark of the spoiled.

        • fiftyfifty1

          ” This choice is being belittled as a first world luxury.”
          The choice to forego pain relief is not what’s pathetic, what’s pathetic is the belief that making that choice somehow makes you special or “accomplished”. If you made that choice for your own personal reasons and have never felt the need to inform those around you about your choice, then you don’t fall into the camp that Dr. Amy is criticizing. On the other hand if you do enjoy finding situations where you can manage to drop that info into the conversation, or if you use your unmedicated birth as a sort of self pep-talk story to remind yourself of your superior mothering…..well, that’s pretty lame.
          “And so is having the time to comment…”
          Yep, having access to pain relief in labor is a luxury. So is access to computers and the free time to use them. But that’s not the point. The point is that it’s pathetic to preen yourself over rejecting a luxury. Shall I preen myself and praise myself every time I decide not to go on the computer? If so why?

          • LibrarianSarah

            My computer broke down and I have yet to bother to replace it. NOW TELL ME HOW SPECIAL I AM!!!!!!

          • Kumquatwriter

            You are my friend, you are Special! You are my friend! You’re SPECIAL to me! You are the only one LIKE you, you are my friend! I LIKE YOU!

            –music & lyrics by Fred Rogers

        • Kumquatwriter

          *I* care, because I have consistently been dismissed/disparaged/outright bullied because I had a c-section, because I believe hb is not safe, because I vaccinate, because we sleep-trained our son… And still the “natural mamas” wail that we even DISCUSS these things!

    • Keepin’ it Real

      I totally agree with what you are saying, and sometimes I feel the good doctor contradicts herself. On one hand, I really get the sense that she just wants women to make safe and (truly) educated choices about childbirth, but respects that women are individuals and that not all the choices will be the same. That goes for her support of a woman’s choice in how she chooses to feed or parent her child; Dr. Amy seems to advocate that we shouldn’t judge.

      Lately, though, a lot of her posts have been incredibly critical of women who do choose natural childbirth or breastfeeding. I’m one who opted for a natural birth for my first child, and now that I’m pregnant again, will likely do the same this time. (Of course, I accept that birth is unpredictable, and I keep an open mind based on how it goes.) It was for my own personal reasons, and I don’t wear it as a badge of honor, brag incessantly, and certainly, I don’t judge other mothers for their choices. I also breastfeed exclusively, and again, that’s something I felt was good for me, my daughter, and our family.
      I really like Dr. Amy and I believe her message about home birth is so right on, so essential, and so NEEDED in this world of pseudomedicine on the internet. That said, I really hope she’ll lay off the criticism of women who do choose some natural parenting options, as we are not all slaves of the “woo.” Many of us are intelligent, practical women, who are just doing what works for us.

      • stacey

        She isn’t critical of those that BF or forgo pain meds. At all. (You know she BF all 4 of her kids as well as had 2 unmed births, right?)

        She IS critical of those that push lactivism by spreading misinformation and trying to limit moms choices.
        She IS critical of those that think skipping pain meds makes you superior, and of those that spread NCB by misinformation, and attempts to limit moms choices.

        I think you may be mistaking factual writing about BF and unmed childbirth with criticism of those things.

        • fiftyfifty1

          “I think you may be mistaking factual writing about BF and unmed childbirth with criticism of those things.”

          I think that’s it. Women have gotten so much over-the-top praise for these things from certain sources for so long that if somebody says “hey it’s not all that”, that lack of expected praise is interpreted as an insult.

      • Guestll

        Natural parenting options. Do you not see how even the language is offensive? Natural. How you choose to birth and feed is natural. So if I choose an epidural and formual, what are my choices? Since they do not fall on the “natural parenting” spectrum?
        Many of us here make choices that would fall on this spectrum. We just don’t feel the need to label it.

        • LibrarianSarah

          Supernatural. Your choices are supernatural because you are a ghost or an angel or bigfoot. I’m leaning toward you being a bigfoot everyone knows that angels can’t use the internet and you wouldn’t be able to type without some sort of corporeal form.

          Though if bigfoot was discovered he’d just be another animal and everything animals do is natural. So as a bigfoot your choices are natural.

      • Something From Nothing

        As opposed to the ” unnatural” parenting choices? You don’t brag incessantly, implies that you do brag. Dr. Amy’s point is that it isn’t something to brag about. If you have an adequate pelvis and labor goes well, the baby will come out eventually regardless. That isn’t in and of itself an accomplishment. If you chose natural childbirth for personal reasons, then why share it with anyone? In my experience, women who announce that they gave birth without drugs, look at you expectantly, waiting for the congratulations, and good for yous. It baffles me. I completely disagree with you and guest and think you are both missing the point.

    • Bodnoirbabe

      She’s not belittling people who choose not to use pain medication for their births. She’s saying that if you choose to do that and then BRAG about it, like you’ve accomplished something, then you’re a priviledged idiot.

    • DaisyGrrl

      I don’t see her as ridiculing women for their choices, but rather ridiculing the treatment of these choices like some kind of accomplishment worthy of a merit badge. It is a rather fine line, but the distinction is there nonetheless.

      Women and babies around the world die every day for lack of access to interventions that are frowned upon by the NCB community. Most of us readers are fortunate to live in societies where these interventions are readily available and relatively safe. It is not the case for the vast majority of women. So to treat an intervention-free birth as anything other than normal (since most babies are born this way even today) and lucky (the odds of things going wrong are still relatively high) is a bit silly. It’s a personal choice to forgo effective pain relief. Many of the other interventions frowned upon by the NCB community also have great benefits. There’s a reason why vitamin K shots are standard.

      But aside from the matter of personal choice, there’s also damage being done by the NCB movement. By promoting the belief that every woman can give birth naturally, they’re setting women up to fail. When a mother is told throughout her pregnancy that she’s made to give birth and the outcome is entirely in her hands, she is left to believe it’s her fault that a c-section was needed. That she was in too much pain and wanted an epidural. Many women then go on to blame themselves for things that were entirely outside of their control and that’s not fair to them. NCB promotes itself as being feminist and woman friendly, and that’s not really the case at all.

      • Guest

        I would say that just because interventions, pain meds, surgery, etc are available doesn’t mean that we are all obliged to use them if they aren’t necessary from a safety standpoint. Just because most of us have an excess of food available to us, doesn’t mean we should eat it all. All I am saying is that birth choices are not a one size fits all proposition. I think that bitching about women being proud of themselves for going without an epidural is every bit as stupid and ridiculous as bitching about women being proud of themselves for getting an epidural. I have plenty friends who prefer to get pain meds at the firs sign of contractions and are vocal about it. Who the hell am I to have an opinion about that? That’s how I look at opinions like these.

        • The Bofa on the Sofa

          I would say that just because interventions, pain meds, surgery, etc are available doesn’t mean that we are all obliged to use them

          Great. Who says we are?

          Nice strawman, though.

          • Lizzie Dee

            Do you know anyone who had a CS because they thought they were obliged to? You may wonder afterwards if it was absolutely essential, or re-write the course of events to avoid the shame of not being wonder woman, but you would have to be simple minded to acquiesce out of politness

        • Guestll

          Is there a growing subculture of women who endlessly discuss their epidurals? Are there books, blogs, forums, films, photographers, doulas, an entire industry –devoted to the joys of medicated childbirth?

        • fiftyfifty1

          “Just because most of us have an excess of food available to us, doesn’t mean we should eat it all.”

          Tisk tisk on those people who cave in to the temptation!

        • Paloma

          I don’t think she is ridiculing anyone for the choice of an unmedicated birth, but the fact that they use it as some kind of achievement. You can choose to not have an epidural but boasting about it is completely different, and that is what the post is about. At least I see it that way. Also, the fact that there is a group of people who are encouraging women to see medication and any medical process related to childbirth as something to be ashamed of is part of why this post is written. If someone decides to go for no meds, good for them, but thinking it is some kind of achievement… not so much.

    • Box of Salt

      Why is criticism automatically belittling if attitudes towards birth is involved?

  • Amazed

    First world failure here! I don’t have a zumba workout on Sunday when my time of month made an early appearance, so I caved in and took a pill to fight the pain instead of enduring it as my sisters in the third world do. I am a total failure.

    Worst thing is, it wasn’t even a strong pain and believe me, I do know what menstrual cramps are like. I just didn’t want to be uncomfortable, so nature went out, pill came in.

    I am so ashamed.

  • Susan

    My first thought…we could make a skit like this about OB…

    http://www.youtube.com/watch?v=QYyGoxnRqrQ

  • R T
    • Mama Bear

      Seems like a good system of descriptive labels to me. My kid was ‘early term’ they called her full term, but she was very small (5lbs). The impreciseness of the labels always bugged me a little.

      • R T

        At 37 weeks my son was already well over 8lbs lol!

    • fiftyfifty1

      I’m sure she’s seen it. It’s a big enough announcement that it made general news not just specialty medical news. They’ve been talking about making this change for awhile now, so all the OBs knew it was coming.
      I don’t know Dr. Amy’s opinion about it, but my own opinion is that it’s a good change, but I don’t like the reporting they’ve done. It makes sense to make this change because we are able to date pregnancies more accurately than we used to be able to, and we know even more about the risks associated with, say, 37 weeks or 42 weeks than we used to. But the reporting has been crap. From what I’ve seen, the press has spent a lot of time talking about the dangers of early term and warning about the risks of inducing then. They have spent much less time talking about the risks of 41+. And they have spent no time at all talking about the potential benefits of inducing early. The reporting perpetuates the myth that there is some perfect risk-free gestational age to aim for, when the truth is that the risk of stillbirth starts to increase *before* the risks of prematurity have gone away. Dr. Amy has written some very good nuanced posts on that already.

      • R T

        Thats what worries me! The push to not deliver before 39 weeks is already bad enough. I had GD, was dilated to 5 cm and had horrific SPD, placental issues and my doctor refused to schedule my csection even one day before 39 weeks. He said the hospital was under public pressure due to their csection rate before 39 weeks and really pushing the doctor not to do them before 39 weeks. I went into labor at 38 weeks anyway.

        • Young CC Prof

          Exactly. Early-term babies are at higher risk for neonatal problems, but they aren’t at higher risk of death or serious complications the way tiny preemies are. When pregnancy complications or threatened preterm labor occur, doctors should be able to weigh the benefit to the child of continued gestation against the risk to both parties.

          Supposedly this is about stopping elective early delivery, but that was never terribly common to begin with. A few women did it around the middle of the last decade, a few newspapers and magazines wrote about it, and now everyone’s acting like this is a major public health problem. And focusing on the not-really-elective early deliveries when they run out of truly elective ones to disapprove of.

          • fiftyfifty1

            “Early-term babies are at higher risk for neonatal problems, but they aren’t at higher risk of death or serious complications the way tiny preemies are”

            No, actually there is some increased risk of death and serious complications. 37 week babies, even 38 week babies sometimes do die of complications of underdeveloped lungs and other “preemie” issues. It’s very rare, but it happens. Then again, some placentas are already old and failing by 37 weeks. There is no risk-free window to shoot for. I sure wish there were!

        • Jen

          It’s so important that the Ob/ hospital takes into account the condition that Mum and Bub are in, as well as Mum’s history. I’ve gone into spontaneous labour with both my children at 38 weeks, both healthy and good sizes. I imagine that if I had a third and required a c-section, I would be pushing for a booking between 37 and 38 weeks, and my Ob would support that.

          • Karen in SC

            There is a tragic story here about a woman who went into labor a short time before 39 weeks. Her hospital was strictly enforcing the 39 week policy and her labor was stopped so she could get to that magic day. Ultimately, her baby died. That is what hard line policies yield. I hope this new info on dating doesn’t harm mothers and babies.

    • Young CC Prof

      Another thought: Maybe this has to do with a greater precision of due dates. Even one generation ago, many many women couldn’t guess their due date to better than a couple weeks.

      My mother now thinks both of our due dates were wrong. I was supposedly a week late, then I popped out less than seven pounds. My brother was born on his supposed due date, but he was almost two pounds bigger than me, with post-dates skin and nails.

      Now, I literally know within a 36-hour window when my child was conceived, so the greater precision in gestational age is actually meaningful.

  • guest

    Dr. Amy – I keep wishing you’d write a post or series of posts not just bashing NCB (and I guess also homebirth, altho it seems honestly pretty out there) but helping women think through the various information they are told. I got such divergent advice from my OB versus the NCB community, and the NCB crowd does kind of make it out like the MDs are hiding something or have ulterior motives. My OB was great, but didn’t seem able to really give me solid info on pros and cons of various things.

    All that to say, I delivered my first baby a year ago and I wanted to try to an “all natural” non-medicated birth, not for bragging rights, but because the NCB community had me convinced that an epidural would slow labor, or cause a fever, or affect baby’s positioning negatively, etc., and that all those things would lead me to a c-section. I didn’t want a c-section. I’ve always dreamed of giving birth vaginally and that was my strong preference unless there was risk to baby and then of course, get them out of there by whatever means necessary!

    I had a pitocin induction (major loss history, GD, thrombophilia issues made my OB legitimately nervous and therefore induce at 39 weeks on the dot). I made it through several hours of back to back and sometimes overlapping contractions and vomiting before I caved and asked for the epidural. I ended up with a c-section 36 hours in because of failure to progress.

    Things I would have loved to have information on to be the “other side” to all the NCB propoganda I was hearing:

    1. Does an epidural slow down or stop labor?

    2. Does being confined to bed (b/c of epidural) make baby less likely to be in optimal position to descend?

    3. Does fear prevent or hinder cervical dilation?

    4. Do epidurals cause fever in mother and therefore cause danger to baby or lead to c-section?

    5. Overall, does epidural use increase risk of c-section?

    I don’t know if the answers to these questions are know, but I think a lot of women would really be interested in the answer. There are many women considering non-medicated delivery who aren’t just looking to brag but are actually attempting to do the best for themselves and their babies.

    • attitude devant

      These things are actually known. I suggest you read Gilbert Grant’s book “Epidural without Guilt” for a nice breakdown. It’s free on Kindle, and only $12.09 in paperback from Amazon. I keep a copy in all my exam rooms.

      • guest

        thank you.

    • The Bofa on the Sofa

      OBs are in a difficult position. I’ve mentioned it before, it is basically impossible to debate loons like this, because they have no qualms about making up stuff, aka lying. Doctors think they have the high ground, because they have reality on their side. That is irrelevant.

      What happens is that the loon side just start spewing out a huge list of made up nonsense accusing the scientists side of being uninformed, or part of the conspiracy.

      The doctor, after staring in disbelief at all the nonsense that the person just said in two minutes, has two options. You could go, point by point, and explain how it is wrong. Of course, given the extent of the nonsensical content, it would take you hours to try to refute it. OTOH, you could just pull a My Cousin, Vinny and say, “Everything that person just said is bullshit.” Either way, the response from the other side is the same – see, look how defensive they are. And even though some of the explanations might be fair, not all of them are adequate. See, they are just lying to you.

      This type of practice is extremely common. Even though the description of it as the Gish Gallop originates from the creationists, it similarly applies to anti-vaccinationists, for example. The #1 problem is that there is no way that you can effectively debate someone who is not honest.

      • guest

        not sure if you’ve just called me a loon or not…but am going to let it go, either way. but, moving on, I am a resesarch scientist working in mental health and people I work with (both patients and other providers) have erroneous ideas all the time about treatment or mental illness that are based on fear or misinformation. I find actually that people respond quite well to the evidence. If there are numerous points, a faq sheet would be great and go a long way toward educating folks without using so much of the OB’s time. I think you can definitely effectively debate – give the information if it exists. the other side (the NCB crowd) is making a whole lot of racket in this case and when the science community doesn’t speak up (except to name call), it doesn’t really help.

        • auntbea

          Dr. Amy has actually addressed most, if not all, of your questions (the post on the cervix not being a sphincter was awesome.) You should be able to search for them on the side bar.

          But I am interested to know, in your mind, what the “science community speaking up” would look like. There are plenty of websites out there with reliable information, like Mayo or ACOG or AAP. Since those provide general information, websites like Respectful Insolence have sprung up to directly attack tropes, often the same ones over and over again. But since we can’t force people to read those websites, Dr. Amy and others will even go on to other people’s websites and debate people on their own boards (until they get banned, that is.)

          What should they be doing instead to make the science more accessible?

          • guest

            I’ve been to Mayo and ACOG and AAP. Haven’t seen info that directly refutes the silliness I was told over and over by my doula, hypnobabies instructor, etc. I wish I’d known about respectful insolence – never heard of it, actually, although I now see it in dr. amy’s blogroll.

            I guess I’ve mostly come here, to this website, for “the other side” and 90+% of the posts are attacking without citing the actual literature. at first i found the attacking very off-putting, but now seeing the data about homebirth death rates, I see why she finds it hard to refrain from an insulting tone (this is one point she has made over and over and that has hit home, although I was never considering something as risky as a homebirth or even a birthcenter birth). Her tone, however, does turn off a lot of people who might otherwise be swayed to her side.

            you’re right – dissenting opinion isn’t welcomed in most of those NCB forums, and that wasn’t where I was getting my information anyway, it was from face-to-face encounters with folks in the “birthing” community who i hired because my OB didn’t have time to answer questions and the hospital where I delivered doesn’t offer any kind of class or tour. I’m probably dull, but I’d love a chart outlining the NCB claim and the evidence for or against it. something easy to read and digest. with no name calling or snark. just the facts with the data cited to support it.

            I do recall the sphincter post, but i don’t remember anything in it about the literature, more a belittling of the ina may’s idea. i’ll have to go back to it.

            I am really bummed if I missed information about the pros and cons of an epidural. I really would have loved to have an epidural hours earlier if I hadn’t worried it might screw everything up and head me toward a c-section (which of course my doula, etc., told me i ended up with b/c I caved and got one), in addition to agreeing to the induction itself. My OB just said, it’s better that labor is well-established before getting an epidural.” but i never knew what well-established meant. i just took it to mean to try to hold off as long as I could.

          • auntbea

            I’m confused. Did you ask your doctor what he meant? Would he not give you more clarification? Did you just not know how to decide whether he or the doula was right?

            I would assume that part of why Dr. Amy doesn’t go into this regular obstetric stuff very often, is because you have an obstetrician who knows this information and is supposed to share it with you.

          • guest

            That’s as clear an answer as I got. I tried. what I heard in the answer was that it could prolong labor if gotten too early. now not sure what was meant. To be fair, it seemed the OB was always VERY pressed for time and rushing in and out. I had a list of questions and I would try to ask 1 or 2 each visit, with the hope that by the end of the pregnancy, I’d have gotten through most of them.

          • Stacey

            guest-
            I am designing a business that would address the growing need for high quality, evidence based, information as well as community around pregnancy, birth, and early childhood. Will you answer a few questions for me? Moms like you are my target market 🙂

            If your OB office had offered a free educational component (some classes covering exactly the stuff you are talking about), would you have been interested in taking it? Would you prefer online or IRL?

            Would you participate in community events, like coffee groups, due date clubs, and baby showers, etc, organized via your OBs practice and other local OBs/ hospitals as well?

            Would you have found a related Facebook/Google plus group, where you could ask questions, and also interact with the other moms in your area, useful? Would you participate?

            I see a need for an organized, coherent, evidence based, community for moms to have access too. Some areas don’t even have accurate childbirth education, let alone coffee meet ups.

            Why not offer these things, organized through the OBs office? I have a fee based subscription model that would add all of these things to an OBs offering, without ANY increase of work for the OB themselves.
            Its time to counter the nonsense, with a better alternative.

          • Karen in SC

            Stacey, such a good idea. It irks me that some sites claim evidenced based information, yet offer the opposite. I hope you can get yours to stand out and that you are successful.

          • Renee Martin

            The difference is that mine isn’t just a website. It’s a network of classes and community events, an OB can subscribe to it in order to offer the program to their patients. I think it wil fill a need, and should offset some of the woo.

          • Box of Salt

            I think this is a great idea, and needs to go national. Are you fundraising yet? I suspect you need an endowment.

          • Kumquatwriter

            90% of the articles are attacking?

        • fiftyfifty1

          So you’re a research scientist. Did you consider pulling any of the research yourself? It’s not in your field, I know, but still….Or asking any of your physician colleagues for a good recommendation for an OB if you felt yours was too pressed for time? What was it about the woo that drew you? Why a doula etc?

    • Maria

      The Adequate Mother wrote a series of posts on epidurals and addresses a lot of the misinformation out there about them. The information is out there, readily available and backed by scientific studies. Unfortunately it is often buried under a lot on not-so-scientific information on Dr. Google.

      http://theadequatemother.wordpress.com/epidurals/

      • guest

        thanks! Wish I’d asked you guys BEFORE I delivered!

    • yentavegan

      I am not a doctor. I am a recovering NCB devotee. I can answer your questions as a lay person,
      Some mothers find that the epidural facilitates labor. Some mothers believe that the epidural slowed their labor down.
      many mothers spend labor entirely in bed. Many mothers feel safe and protected while lying down.
      The cervix is not a voluntary muscle. Pain can make a mother fearful. Some mothers find that the epidural takes away all pain and then the mother feels relaxed and in control. But there is no way to control or alter your uterus’s ability to contract in a manner that speeds up delivery.
      The relationship between epidurals and fevers is not causative. mothers burned fevers during labor before epidurals were invented. In the past, before epidurals and c/sec, mothers labored for days without progressing. Sometimes the mothers developed fistulas from the uterus to the colon. Sometimes failure to progress meant that both mother and infant required graves.

    • thepragmatist

      There are actually quite a few informative posts around here about baby’s positioning and birth “interventions” such a pitocins, discussing risks and benefits and the data we do have. Take a look around. My favourite one was on tearing. By favourite, I mean, I still think about it from time to time and feel sick to my stomach. Ha.

      • KarenJJ

        There’s one on pelvic shape that I liked. And also another on what happens to the placenta after birth and why placenta is not able to oxygenate blood effectively anymore.

      • realityycheque

        If it’s not too much effort, perhaps these entries could be made more readily accessible by creating some sort of a list such as ‘Debunking NCB myths’ which includes the lies they spread, followed by links to the blog posts Dr. Amy has written about them? It could be placed in the sidebar as a permanent link.

        I know there have been times before when I have wanted to find a particular piece of information in the archives and struggled to find it; having a list like this might be a useful tool, not just for others wanting to disprove misinformation to loved ones, but for women who may be falling down the rabbit hole to have all the most important pieces of information in one place?

        i.e. the list could include

        NCB belief 1: Fear causes pain during labour.

        Rebuttal: Link to article

        NCB Belief 2: Your body won’t grow a baby that is too big.

        Rebuttal: Link.

        • stacey

          I agree. The search function is hard to use. I often cannot find the informative posts I want to use as reference.
          Using links from this site will usually ensure you lose your argument with the NCBers, but hopefully, it will bring fence sitters in.

          • Karen in SC

            When I have used information from the site, I will share the original source that Dr. Amy provided, or find the same stuff on WebMD or the Mayo Clinic site or the CDC.

      • Mishimoo

        Oh goodness, that reminds me about explaining to my younger brother that episiotomies are done to help avoid worse tearing. He took a video on youtube seriously and I had the joy of dispelling all of the myths. At least he asked though!

    • Amy Tuteur, MD

      Here’s my question: Why did you consider lay people reliable in the first place? If I understood that, I could be far more effective in promoting accurate information. As it is, I am drowned out by a bunch of nitwits who repeat the same things over and over to each other and never stop to consider that they have no idea what they are talking about. Why does anyone pay any attention to them?

      • fiftyfifty1

        Because their message is simultaneously simple to grasp, reassuring and flattering. Because the truth is none of those things.

        • This applies to all fields.
          People will always prefer comfortable lies.

        • Anj Fabian

          Some of the websites I’ve seen for CPMs are impressive in their ability to consistently say “Bad things do happen, but we don’t dwell on that. Instead let’s talk about what we can do for YOU.”.

          Serious risks are given as little mention as possible, while warm reassurance abounds. The net effect is that while anxiety is minimized, so is full informed consent. If there are no adverse events, then the woman is left with the feeling that there was never any danger.

          If anything bad does happen, then the woman is taken by surprise and can be needlessly traumatized.

          • Young CC Prof

            And of course, 90% of the time, low-risk women have a perfectly fine birth without medical intervention. If they’re really steeped in NCB myths, they might find the pain surprising, but they get through it. Which means the midwife has plenty of positive stories to share.

            Most of the time, if you’ve talked to several people who tried something and loved it, you should try it too. However, this assumes the people who didn’t love it simply walked away disappointed. In this case, the consequences of a bad home birth are… yeah.

      • indigo_sky

        I think part of it is that lay people put a lot of time and effort into putting together reasonable sounding explanations and background material to support that what they are saying is true. You don’t have to trust them so much to be experts when you can see it all laid out there for yourself (and don’t know enough to be able to tell that some of these reasonable sounding explanations are based on misrepresentations at best and outright falsehoods at worse).

        Doctors, on the other hand, tend to rush through a lot of explanations and basically leave it as “because that is how it is.” For basic stuff anyway, it’s been my experience that people with high risk pregnancies seem a lot more satisfied in general that the doctor is taking the time to explain risks and possibilities to them as well as how things will be handled and why. And it’s understandable with the low risk patients – doctors are busy and should be answering basic questions, but they don’t really have the time to spend hours with each patient going over the background and research and basics for every single test or thing they do.

        The entries I find most valuable in this blog are the ones where you do a lot of just that, such as where you show different tracings and explain what the nurses and doctors are looking for.

      • guest

        I didn’t necessarily think the lay people were reliable. But they (+BOBB) successfully undermined my trust in the medical world enough to not know what or who to believe (that plus listening to horror stories on the insensitive and overly-medicalized for no good reason treatment by OBs to my mom and other women in her generation – enemas, shaving, forceps for no reason, huge episiotomies, etc.).

        • fiftyfifty1

          Hey, the liberal use of forceps is a big part of what kept the c-section rate so low and the results relatively (for the time period anyway) good in a time when c-sections weren’t as safe as they are today. I would choose a c-section for myself over high or mid forceps any day. But 50 years ago that wouldn’t have been the right way to bet.

          • guest

            good point.

        • auntbea

          Well, but then how could Dr. Amy or anyone posting these answers on the internet have changed your mind? Why would you trust them?

          • guest

            I trusted the med establishment a lot more than the woo. not without question, but of course there is trust there. if I had no trust in the med establishment, I wouldn’t have given birth within in.

    • fiftyfifty1

      How I wish that fear prevented or hindered cervical dilation! Preemies would be prevented!

    • stacey

      Question- Did you ask your OB any of these questions? I am sure they could explain them to you.

      Why would you go to laymen to get answers? Would you do this for other types of specialized knowledge?

      I think the problem is contained in your post- if you already mistrust the whole medical establishment, than you won’t want to get info from them. This means you have cut out most legitimate sources, so its not surprising that whats left is woo nonsense and outdated info.

    • Guest

      The Adequate Mother has addressed your questions 1 and 5 on her blog (see the sidebar for a link) – she’s an anaesthetist/anesthesiologist.
      Edit: oops, scrolled down and saw Maria beat me to it – sorry!

    • fiftyfifty1

      I understand that you are disappointed that your OB couldn’t or didn’t take the time to give you the sort of detailed info you were wanting regarding pain relief options and birthing positions. It makes sense that that would be off-putting to someone like you who doesn’t like to gloss over details. On that same note, I am wondering about your level of satisfaction regarding the guidance you received from the NCB community regarding your serious history of pregnancy loss, gestational diabetes and thrombophilia. Did they provide the sort of solid info you deserve on the various pros and cons of your options regarding these issues?
      tl;dr version- Lady and baby survive a very high risk pregnancy due to the knowledge and skill of the OB, but lady can’t shake the feeling that she should have followed the advice of the washed up talk show host anyway.

      • guest

        The advice from all sides was lacking detail (OB) or problematic (NCB community). From OB, I craved more information or to be pointed in the right direction of that information. The hypnobirthing instructor had lots of “information,” but it was laughably silly in some instances and adversarial toward the medical establishment almost always, and the combo seriously made me doubt the premise of her whole enterprise. The doula (recommended by my OB) was bright and reasonable but had lots of advice (e.g., try vaginal garlic to try to be GBS negative!) that differed from my OB, and whose evidence I also wasn’t sure of. The OB would come in each visit and cheerily ask, “Was I sure I didn’t want to just have an elective C?” I was sure, and the repeated questioning made me doubt her as well.

        So I always followed the advice of my OB, because obviously she was the most credible, but at the same time, it concerned me she kept suggesting elective major surgery that I didn’t want when all looked like I should be able to deliver vaginally (shouldn’t that be the default unless I didn’t want it or there was some clear indication I couldn’t tolerate labor?). I wasn’t ever completely sure that I truly needed to be induced before my body was ready. I was super careful about my diet and only gained 18 lbs the whole pregnancy (but was still on insulin overnight), all of my NSTs and growth scans looked good. Baby was not LGA… Looking back, I have come to feel that the only way to know that I had needed the induction might have been a fetal demise. And so I’m glad we were super cautious and I was induced. Still sad about the c-section. But ever so glad the baby is here safely.

        • fiftyfifty1

          Your OB wanted you to have a doula and recommended that specific one? Yikes! I wonder if she realizes what woo she is recommending! Or was it more that you wanted a doula and she recommended this one maybe because she was more reasonable than some others she had met?
          As to the vaginal birth being the default, maybe yes, maybe no. OBs know from experience that inducing a nullip at 39 weeks, especially if cervix is unfavorable, can frequently turn into a protracted exercise in futility followed many hours later by a CS anyway resulting in an exhausted mom and baby. It’s possible that you might have lucked out and had a nice fast easy induction, but the odds weren’t great. And in the end the OB was right: you didn’t. On the other hand waiting past 39 weeks so that your body could be more ready with a medical history like yours? A super bad idea. You had 3 separate major indications for not doing so: major history of pregnancy loss, insulin dependent GDM, thrombophilia. Yikes! And I know you know that because your post mentioned fetal demise. Some women (and most NCB promoters) totally have their heads in the sand about the possibility of IUFD. The NCB types are all about obsessing over totally unimportant details like birthing position because, frankly, that’s all they can do. On the other hand I can pretty much guarantee you that your OB’s first and foremost thought after meeting you and learning your health risks was “Oh holy fuck, this pregnancy has a real risk of ending not just with a dead baby but a dead mom as well. I’m going to do every last thing in my power to get these 2 through alive”. She may not have shown it, but she was sweating every minute until the 2 of you left the hospital safe and sound together.
          I know a natural vaginal birth was your goal. I understand why because that’s what I wanted too: getting to experience what it was like, a less medicalized experience, an easier recovery. But it wasn’t in the stars for you (or me). Luck of the draw gave you major risk factors for IUFD. Even though you clearly worked super hard on everything you could control like diet and blood sugar control, a straightforward pregnancy and delivery just wasn’t what fate sent you. And that’s why I hate NCB’s lies. They tell women that if they think “right” and do “right” that it will all turn out “right” and that’s a cruel cruel lie.

          • guest

            Yes, yes, yes. All of it. Thank you – this is helpful to read and helps me to continue to process the experience a bit and come to terms with it, to let go of the propaganda and embrace the reality. Still trying to get my heart to line up exactly with my head (which fairly matches to what you’ve written). Still not always quite there. But then again, I wouldn’t then or now risk my child’s life to find out, which seems the only way to have “known” for sure. Also, the further out from the delivery i get, the more it dims in importance. What is most important? Hands down, this vibrant and amazing child who graces me with her presence.

            As for how I came to have a doula, I mentioned i was thinking of hiring one about 25 weeks in, when i began to believe I might actually have a living child, and the OB said, great idea, I love this particular woman. Turned out that woman had also been my SIL’s doula. I also knew she’d worked at my med center a bunch and played well with others, which was critical to me. the last thing i wanted to deal with was extra tension because of some artificial adversality between the doula and the medical staff. and thankfully, that wasn’t an issue at all.

            Thanks too for reminding me about the high-risk nature of my situation (altho funnily enough, i didn’t have a high-risk OB). I know this, and yet, my situation was “normal” to me by that point. Looking at it with some perspective, I think pretty much I am a reproductive disaster. Everything from conceiving (seven IVFs), to staying pregnant (six losses), to giving birth (failed induction followed by C), to breastfeeding (couldn’t latch, failed SNS, etc.) has been extremely challenging. It is thanks mostly to medical science (IVF, insulin, tons of monitoring) + perhaps some of the experimental less-evidence based stuff I ambivalently turned to after 6 consecutive losses (e.g., acupuncture, IVIG), that I have a living child.

            You’d think with a medical history and pregnancy like mine I would have automatically said – just do the elective c-section, thanks. Looking back, I think that without realizing it at the time, I yearned for some kind of redemptive experience after all of the technology to get there and all of the loss. I just wanted something to happen the way it was “supposed” to. I had a very hard time accepting that I couldn’t deliver vaginally and needed a c-section, and subsequently couldn’t breast feed no matter how much effort I put into it (I ended up pumping exclusively for a year).

            I think i need to focus on the fact that what fate had in store for me was a childless existence. It is only with gads of medical technology, excellent care, and a whole lot of luck that I am fortunate enough to be a parent.

  • Lisa the Raptor

    With me, it was more of an endurance thing. Like could I torture myself for a really long time and not give up. I was 20 though, and dumb. lol. There is no point to it. I was once told by a NCB advocate who had a Masters Degree that her natural child birth was the most empowering thing she ever did. Really? Self torture is empowering? By that rationality anorexia nervosa should be empowering.

    • Kayleigh Herbertson

      Except one is mental illness, the other is a personal choice. People who suffer from eating disorders really don’t consider themselves to have a choice in the matter.

      • Lisa the Raptor

        I don’t know. Maybe there is a bit of masochism mixed up in there?

        • fiftyfifty1

          I think you are on to something here. Some AN (anorexia nervosa) patients talk about getting a high from the pain of the hunger and getting a paradoxical sense of emotional power when they feel weak and hungry to the point of fainting. Many of them, especially during the first few years of the illness, also insist that they have a choice in the matter (even though it’s obvious that they don’t).

          • Lisa the Raptor

            You mean like having a “birth orgasm”? Maybe that’s the promised high? Or the Oxytocin buzz they are supposed to get? We should ponder this more.

      • Captain Obvious

        Could they both be mental illness, even a little bit?

  • stacey

    I was presented with a luxury option and chose to forgo it

    This is exactly what they are doing.

    • Amy M

      That’s what I think of camping.

    • Captain Obvious

      I love that comment. Now I have read NCB saying they don’t want the baby to get the pain meds. So they are probably fine with pain meds for surgery or oral surgery, as long as they are not pregnant. Would they refuse pain medicine or anesthesia for surgery or oral surgery or kidney stones if they were pregnant?

      • guest

        probably not, unless they were delivering right then. I was repeatedly warned that narcotic meds would hinder my baby’s ability to latch immediately after birth and that if that got screwed up we’d never successfully breastfeed…

      • PoopDoc

        I imagine that it is very painful to be squeezed through a birth canal. The facial bruising on some of these babies looks so sore… Frankly I’d be cool with my kid having a little something on board if that was happening to them.

      • Renee Martin

        They are all up in arms over legit use of pain meeds in labor, but don’t mind smoking pot all through pregnancy, sometimes even labor, and all though BFing……

  • Mel

    Fine. Two can play at this game:

    I’ve never gotten polio, diptheria, measles, mumps, rubella, tetanus or whooping cough!

    I’ve never transmitted any of those to anyone else!

    I’ve never gotten a waterborne illness!

    I’ve never gotten malaria!

    I’ve prevented conception using hormones!

    I have a real life!

  • SkepticalGuest

    Wow! I failed on both end. I had an epidural AND I can’t program the remote.

  • I don’t have a creative name
  • lurker

    I had an accidental home birth- we called my mom to come watch the older kids thinking it would still be an hour or 2 before we actually went to the hospital. She arrived 30 minutes later to find an ambulance in the driveway and 2 young paramedics delivering my son in the living room. Yeah, that brings real appreciation to what modern medicine can do.

    Also, this goes back to your point the other day about why, dumb as it is, we can’t make home birth illegal- I’d sure have hated to be investigated over a legitimate accident!

  • Monica

    Oh no no no Dr Amy you see we’re still wrong. According to a certain someone we all know who despite her limited life experiences thinks she’s an expert on all women around the world including in 3rd world countries, they do in fact want to birth without pain medication because they see it as a “family event”. Therefore they don’t want the “cold medical system” involved. So nope, we don’t even get to call it a 1st world problem or achievement for that matter.

    Either way, nope my 2 natural births were no more an achievement than my c-section or my vbac with a little pain medication. It was all a means to an end and I didn’t do anything naturally because that’s what I chose to do or because I was trying to prove some point to people, but because I just so happened to have two quick and relatively easy labors. Whenever my birth story of my two oldest came up I always told people if I had longer than 2 hour labors I would have asked for pain meds. You know, I probably also used less pain medication than some women do after my c-section. Shall I go out and gloat about that because I have a higher tolerance for pain than some women do? That’s what this boils down to. Not an achievement at all, she just didn’t get to a point where it was too much for her to bear.

  • SarahSD

    The interesting thing, to me, is that their thinking is decidedly not “I was presented with a luxury option and I refused it”, but instead, “I managed to avoid the oppressive hijacking of my birth experience by trained medical professionals”. Framing medicine as the enemy is necessary to transform statement #1, which sounds ridiculous, into a point of pride.

    • Amy M

      Yeah, it doesn’t work with migraines. I had, probably the worst or 2nd worst one I’ve ever had last week. It included vomited, numbness, tingling and (minor)loss of movement in my hands, dizziness, overall horrible feeling and of course searing pounding pain in my head. I was sitting on the bathroom floor hoping to die. It was way worse than the birth of my children. Obviously, I survived. What an achievement!

      In this case, I wasn’t presented with a luxury option, because there wasn’t one, but those medical professionals…they sure didn’t oppressively hijack my migraine experience! Nosireee!

      • EmbraceYourInnerCrone

        Had one of those last month,and the MEEN medical professionals took aware my all natural migraine experience by giving me pain meds that worked and anti-nausea drugs so i could stop barfing for the first time in 24hrs. Coincidentally the pain meds brought my blood pressure down as I wasn’t in agony any more. Yay for modern pharmaceuticals! If some one wants to go no meds, thats their decision but I think, for at least some people, pain can raise your BP and disrupt your ability to concentrate. Certainly true in my case.

        • thepragmatist

          The evil medical establishment gives me the capacity to be able to lift my son and drive again. F them! I should be out there deriving my own medicine by mushrooms I found in the woods, but I wouldn’t be able to drive out and then hike up to the sunny glades of the hinterland (ok, well, it’s more like the rainy rainy slippery mush of the Canadian outback) and pick said magical herbs and mushrooms because I wouldn’t be able to see, walk or drive for pain. Don’t even get me started on that evil psychiatrist who took away most of my anxiety and made it so I could hold a coherent conversation with other adults.

          • KarenJJ

            Huge fan of the evil medical establishment here. Heck I’m even part of it now (a paper about me was recently published – I’ll now enjoy my evil role as “anonymous proband”).

  • Zornorph

    Well, those unmediated birthing crunchzillas would probably be hiding the remotes and the Ipads so that their special snowflake couldn’t have any corrosive ‘screen time’ to mess up their perfect brains.

    • SkepticalGuest

      So wait…how do we get from acknowledging the madness of NCB to chastizing people for limiting or banning screen time? There is ample scientific evidence for medicalized childbirth and at least some evidence that very early screen time (before 2 years old) and too much in the preschool years actually is impacting their little brains.

      On this, I agree that the science is developing, especially with regards to interactive devices (like the iPad), which are more problematic for toddlers and preschoolers than straight-up TV due to the dopamine hit.

      Disclaimer: we did no TV until about 2.5, when we transitioned our son to watching 30–60 min/day of slow-paced DVDs (think Winnie the Pooh, Bob the Builder). It’s his (and my) down-time because he doesn’t nap. We don’t own an iPad, but when we’ve borrowed one to use on the plane, it was like baby crack and made him CRAZY afterward.

      • Zornorph

        Well, I plan to raise my son on episodes of Dexter and the ‘Saw’ movies.

        • stacey

          I got DS an iPad when he was in the NICU still, and he could use it by the time he was 9 mo old, and DD2 could too. I never limited TV either- for content or amount- though the kids rarely get to pick whats on.

          I also allow them free outdoor play all day, and have no limits on the number of friends they can have over (chaos often results). I provide *all* the kids with outdoor toys and bikes.

          Somehow, both my kids find TV time to be as desirable as time outs, and won’t touch the iPad unless trapped in a car or airplane. As long as they have the ability to play outside with friends, and ride bikes, thats what they want to do.

          I think some kids may just love TV, but more often, I think they choose it because the other options they have are boring. Who can blame them? Most neighborhoods I go in have many kids, but not one is outside. Who wants to play outside all alone?

          • Zornorph

            I’ve seen friends who used a TV as an ‘electronic baby-sitter’ and whereas I don’t see the harm once in a while, I knew one kid who would veg out for hours watching the screen. I have no intention to allow anything like that, but a bit of TV or Ipad every so often is harmless.

          • Dr Kitty

            My kid watches TV.
            I’m fine with it.
            She’s four and an only child and so it has helped with her development.
            Curious George and Doc McStuffins are current favourites.

            Her IPad games have basically taught her to read.

            We live in Ireland, where this time of year it is dark and cold by the time she gets home from daycare. Riding her tricycle outside is not an option, she’s tired after running about with other kids all day and I’m fine if she wants to veg out with the man in the yellow hat for an hour.

            Since she is also perfectly capable of building a space rocket throne and a hospital-restaurant-museum (don’t ask) from furniture and blankets when the mood strikes her, I can’t see any problem.

          • Amy M

            Yeah, and sometimes that’s the only way to get dinner made or take a shower, w/o someone getting injured or the house getting burned down, if there is no other adult in the house. If they are watching a show, I know where they are and what they are doing, and that they will be occupied for at least 23 minutes.

          • EmbraceYourInnerCrone

            Exactly, my husband was deployed all the time when our daughter was a baby/toddler and I was active duty also but with a desk/9 to 5 job. During the day she was at a home based daycare where TV was not allowed and she played , often outside with other kids. When I got home after our initial 15 minutes of what did you do/learn today, I needed to fix us dinner and other stuff. She always enjoyed a half hour of Sesame Street, the Puzzle Place, Blues Clues or the dreaded Barney (hey, she learned the clean up your room song from him!) I also tried to get her toys that made her think/imagine: doctor kits, baby books, finger paints, toddler tool kits. We spent a lot of our time together at the park or doing art on the back patio. As she got older we let her watch other stuff than PBS but limited how much and what. Sadly now that she is in college she watches reality TV way too much, but as she is studying physics I guess she needs the downtime!

      • Amy M

        I think he just meant the extremes they go to, and the internet boasting like “oh my snowflake doesn’t even know what a tv IS because we don’t have one!”

        I’m with you on the ipad. My SIL gave us one last Christmas, theoretically a family gift, but the children commandeered it to play games. They got addicted, and generally behaved like punks after playing with it, so we took it away. Initially the tantrums were epic, but they’ve mostly forgotten about it. We’ll occasionally take it out for things like long waits, or if we were to go on a plane, but on a day to day basis, its up on a high shelf.

        Regular tv, we monitor and limit, but I’m ok with them watching as long as it is appropriate and not too much. I didn’t want them to see tv before 2, but I think they did. Oh well, what’s done is done.

      • Kumquatwriter

        Screen time is like anything else – different strokes for different kids. Our son has lots of screen time – daddy is a network engineer and mommy is studying Cisco, so computers are a huge part of our lives. He’s thriving on it – has been teaching himself to write (he figured out the basics of reading too). Obviously, his screen time is, well, screened -contents wise – and he’s very active and loves to play outside and run and socialize. In fact, sitting down and focusing on his letter games and such has *increased* his attention span.

        ETA: he also plays with stacey’s kids, see her comment below 🙂 her kids don’t care for tv, mine does but will pick outside play over it most of the time.

        • Guesteleh

          My kid gets lots of screen time for similar reasons and his behavior is fine, grades are fine. We read him three books a night. He gets lots of exercise at his afterschool program and in a weekend tae kwon do class. And since he’s obsessed with Minecraft some of his screen time is even creative. We don’t have cable TV so most of his TV watching is via YouTube and Netflix. He’s really into fan-made vids and is starting to make some himself.

          I gotta say the smug around no screen time is really off-putting. If it works for you, great, but don’t assume your children are superior to other kids solely because they don’t watch TV.

      • Susan

        I agree that limiting screen time is smart and it’s probably a great analogy. Somehow the analogy makes my sort of fried from just finishing ACLS testing brain think of those Waldorf dolls with no faces and the only toys without colors crowd….

      • auntbea

        Is there evidence about TV watching from which we can draw a causal inference, or is it still just observational at this stage?

        • thepragmatist

          I don’t know if you can check out “Campaign for a Commercial-free Childhood” but they’ve got a pretty good grasp of the literature. It was actually the consumerism that drove me + the studies related to language development (and I do believe they have been replicated multiple times now). My kid has tantrums at the store… if he can’t buy me flowers. That’s right. Flowers. Has no clue what any of the characters are from any shows. Someone asked him who his favourite character from Cars was and he said, “Mama!” I know eventually I will have to let him delve into pop culture but for now I am pretty happy with things the way they are. The shows he has watched when ill have been old musicals and Pingu. Pingu doesn’t have a product line and kind of reminds me of being on LSD. Not that I would know that that is like.

          • auntbea

            We showed my daughter Pingu once, because her cousins love it. I couldn’t stand it. Now she watches Sesame Street on Netflix when she gets up in the morning and Mommy and Daddy are staggering around trying to get ready for the day. She has yet to figure out there’s a product line. I sometimes feel guilty about it. She seems to be developing fine, but she’s my first, so I don’t have anything to compare her to.

          • stacey

            I am against commercials for kids as well. We do allow screen time, but only content without commercials. We have no cable, and run everything via mac laptop, so this is easy.

        • thepragmatist

          Also, just anecdote, I know, but I can tell the kids who come here who get a lot of television from their play vs. the kids who do not get much. I recently had the very weird experience of picking up my son from a friend’s house. Her three year old was watching a show ABOUT playing. The kids on the show were playing, imaginatively, and the 3YO was watching this, slack-jawed, while my kid was over in the corner, alone, playing with trucks, and the trucks were building a store of some sorts and talking to each other. In that moment it crystallized for me WHY I was sticking to my guns on this one… I’ve never seen that particular child engage in play that was imaginative. I’ve seen him engage in parallel play, but not play WITH my son, either. I really think TV especially limits play.

          I do not count computer time (not playing games) as screen time. Skype with Grandparents and the like. Looking at photos. Listening to music.

          • Mishimoo

            More anec-data: My friend’s kid is not allowed any tv/computer at home. Every time he comes over and there is a screen on, he is hypnotised by it. We don’t control screen time and our kids can take it or leave it. They also seem to play more imaginatively than the screen-free kid. But then, our kids are a lot less restricted in general than the other kid, so that might have something to do with it too.

          • auntbea

            I never had much TV as a kid – we only had PBS. When I got access to cable in college, I was so transfixed, I would shush people during the commercials.

          • Happy Sheep

            My son has alot of screen time and my kindergarten teacher sister in law always comments on how imaginative his play is. He does also tend to not really sit and watch shows unless he is sick or tired. I think it depends on the child.

      • thepragmatist

        We do no screen time and it is FANTASIC. No bugging me for commercialized crap at the store. Child will play without intervention or coaxing for sometimes hours at a time. He can play at a level 2 years older than his peers and amazes child development people who always ask me what I am doing. I am, sadly, one of the few people who actually sticks rigidly to the “no screen time” rule and my son has had less hours of screen time than I can count on my hands– all associated with periods of time where he had to stay quiet but awake, like post-op. I love the results of no screen even though I’ve fielded a lot of sheer abuse from family/friends who think it is some sort of neglect to just say no… on perusing the offers out there on children’s television one night I felt even more strongly. My child has made his acquaintance with a few movies, though. We watched Matilda after a surgery and he talked about Maltida for a long, long time.

        • fiftyfifty1

          So I don’t limit my kids’ screen time at all and never have, and I have one kid who is an exceptional student and one who is average. Both seem like happy healthy kids. I didn’t have a t.v. growing up, my husband did and watched hours on end. Both of us seem ok. Anecdotes =/= data.