Lamaze promotes misinformation about C-sections; is it deliberate?

No optimal C-section rate

I realize that it is difficult to keep up with the obstetric literature, but I don’t think it is too much to ask that an organization that boasts about being evidence based should at least check to see that their recommendations are based on CURRENT evidence. There’s really no excuse for Lamaze International to promote an optimal C-section rate that has been withdrawn and discredited. That raises the question: is Lamaze promoting misinformation because they are so out of touch with what the scientific evidence shows, or are they promoting misinformation deliberately because they’d prefer misinformation that they like to accurate information that doesn’t serve their agenda?

I’m referring to the infographic promoted by Lamaze in today’s post on Science and Sensibility:

Lamaze Infographic highlighted small

I used the magnifying glass to highlight the untrue claim:

“DOUBLE what UNICEF and the World Health Organization recommend.”

There’s just one teensy, weensy problem; actually it’s a very big problem. The World Health Organization (which UNICEF relied on) WITHDREW that recommendation 4 years ago, acknowledging that there was NEVER any data to support it.

In Monitoring emergency obstetric care; a handbook, published in 2009, the WHO admitted:

Earlier editions of this handbook set a minimum (5%) and a maximum (15%) acceptable level for caesarean section. Although WHO has recommended since 1985 that the rate not exceed 10–15%, there is no empirical evidence for an optimum percentage or range of percentages …

Where did that “optimal range” come from. It appears that Marsden Wagner, MD, a former WHO official, simply made it up. Wagner essentially admitted that there was no evidence when he published a paper in 2007 that claimed to be the first time anyone had attempted to correlate international C-section rates with outcomes.

The bottom line is that Lamaze International is aggressively promoting misinformation. The only question is whether Lamaze touts misinformation out of ignorance or as a deliberate attempt to mislead women.

In either case, it highlights that Lamaze International, far from recommending evidenced based practices, either doesn’t keep up with the evidence or chooses to misrepresent it. If you can’t belive Lamaze on a basic issue like this, how can you possibly believe anything else they have to say?

  • Guest

    My biggest concern about a high CS rate isn’t the first cesarean necessarily, but the subsequent ones. If I am not mistaken, the rates for accreta, percreta, previa, rupture, surgical complications, etc go up with each additional cesarean, but feel free to correct me if I am making incorrect statements. So say a woman has a cesarean for breech, abruption, or some other pregnancy specific reason, and she wants more than one or two children. From a safety perspective for the health of the mother and future children, doesn’t it make sense as a preventive to offer a TOLAC?

    And another question I have is when you are talking complication rates for surgical deliveries, when does the morbidity to the mother start to exceed safety rates for fetuses? I am decidedly *not* a stats person, so I am not sure that the question is being phrased in a clear way.

    • rh1985

      If it’s safe, offer it, but don’t require it. My max is pretty much two kids (a third would only happen if I won the lottery) and I’m pregnant with my first who I am strongly considering might be my only though it’s way too early to decide that. If I need a c-section for this baby and do ultimately have a second child who I am 99% sure would be my last baby, I’d just want to go right to a repeat c-section because it would be be what I am most comfortable with.

    • kumquatwriter

      That generally *is* when a TOL is offered, as far as I know, especially if the mother wants to attempt a VBAC. I don’t think that has much of anything to do with the overall C/S rate. In any event, every pregnancy should include a discussion with her OB about risks/benefits of vaginal and c/s birth. I mean, every pregnancy is different, including subsequent pregnancies.

      • Guest

        The correlation I see is if more women were being offered the option of vbac, then the overall CS rate would decrease.

        • MaineJen

          Maybe. But I also don’t think you should take the *option* of a repeat C section away from the moms who aren’t comfortable with the idea of vbac. “More education” does not necessarily result in more women choosing vbac. And as someone else said, each case is different.

          • Guest

            Of course not, but it seems way more common for doctors to recommend a repeat cesarean. I mean, I am positive that happens, but it seems way more common for a woman to be denied the option of vbac than forced to try for one. As an aside, in my area (a major metropolitan city), there aren’t any major hospitals that do not have 24/7 anesthesia available or have vbac bans in place because of that. The issue is more finding a provider who will support a TOLAC. Full disclosure is I am a vbac mother, with one cesarean and two VBACs. I *do not* think that every woman should have a vaginal birth or anything so absolute as vaginal birth is good and cesarean is bad, but I *am* concerned about what a high cesarean rate means for maternal health and the higher rates of complications for mothers undergoing multiple repeat cesareans.

        • The Bofa on the Sofa

          We were technically offered the option for a c-section, but it would have required going to a hospital that was equipped to do it safely, an hour away.

          That’s the problem. How many VBACS are not being offered because the hospital does not have the resources to do it safely? No amount of “education” is going to change that.

        • anion

          Eh. It’s possible. But I know a few women, including myself, who were offered VBAC and declined.

          Not every woman will jump at the chance.

        • Josephine

          I’m pregnant with twins and have been offered the option of a VBAC a few times now (barring baby A being breech of course), and have politely declined. I think it’s great that they offered, but it doesn’t interest me.

          Maybe some women just like c-sections, especially planned ones.

          • KarenJJ

            Same. I chose against a VBAC. Actually most women I know chose against a VBAC. The vast majority of women I know were planning on having 2 kids at most, so the consideration of future pregnancies becomes a moot point.

          • Josephine

            Right. I think family size should affect one’s decision for or against a VBAC if it’s available. For me, I’m closing up shop after this so those issues had no relevance for me either.

        • Lizz

          I know this is older but I know I had to turn down doing a TOL 3+ times. A lot of women where I am are pushed to try and hospitals have a fairly high VBAC rate but we still have a c-section rate of about 24% overall last time checked.

  • Ellie San Martin

    I can’t find the previous Dr. Biter link but I wanted to say that it shows exactly what I had previously written: that in CA, the baby pretty much has to die to find a malpractice lawyer that will take your case. He was not in a hospital, so no binding arbitration & he killed the baby. If there are other cases from CA in which the birth was in a hospital and the baby lived, I’d love to see them. Please provide.

    • Squillo

      In less than a minute (because I can’t be fussed to spend any more time doing your “research” for you), I found these from the Sacramento area:

      Medical Malpractice for Cerebral Palsy – Fetal Injury Failure to Perform Cesarean Section – $1,000,000

      Defendant hospital and physician’s failure to properly monitor or detect fetal distress during labor and delivery caused hypoxic ischemic encephalopathy, a condition characterized by brain damage due to lack of oxygen. This case settled for the defendants’ insurance policy limits of $1,000,000.

      Medical Malpractice for Injury to Child During Birth – $1,400,000

      Defendant hospital and physician’s failure to properly monitor or detect fetal distress during labor and delivery caused hypoxic ischemic encephalopathy, a condition characterized by brain damage due to lack of oxygen. During the lawsuit, we discovered that the defendant hospital employees had changed the key medical entries of the child’s distress, attempting to avoid legal responsibility. This case settled for $1,400,000.

      • Susan

        What is so annoying about this is the truth is that if the baby dies it’s much harder to get an attorney to take the case. It’s a damaged baby case, “bad baby case”, that the med/mal attorneys salivate over. But I suspect what Ellie is upset about is she can’t find an attorney to take a case in which there are no real damages at all.

        • Clarissa Darling

          I’d take her case for the right price. I’m not a real attorney but, that shouldn’t matter since it’s not a real story.

  • Ellie San Martin

    I have been a lightning rod for anger & insults & this was not my intention. Apologies if you felt personally judged or insulted, & kudos to you if you were entertained. All sides should be considered on a vital issue of life and death like childbirth. I have learned some from the responses here, which was my intention.

    As a side note, many NCB advocates and those who promote home birth are far too extreme for me. Try to go for the moderate middle & you will draw ire from both extremes. Although when I comment on NCB sites I am treated much more respectfully for questioning the extreme stances.

    Few here are willing to consider that one of the reason many women seek the care of competent midwives in hospitals over that of OBs and attempt to avoid c-sections is that they have been treated disrespectfully and had very upsetting previous experience with some OBs who do not treat them as whole human beings but as fools who are irritating to deal with when they ask questions or share personal experiences, which is exactly how I was treated in this comment section. It sometimes, sadly, drives these women to dangerous extremes of homebirths, etc. Some OBs respond with a need for statistics and data instead of treating the woman’s concerns as a human.

    • kumquatwriter

      This isn’t about homebirth. This isn’t about natural childbirth. This is about YOU. YOU. ARE. A. LIAR. A pathetically bad one at that! You didn’t hurt anyone’s pwecious wittle feeewings (that’s phonetic sarcasm). Save your apologies for people who believe your astonishing heaps of bullshit – THEY deserve to be apologized to.

      We ARE the moderate middle. You have been treated MORE than fairly, had
      your questions thoroughly answered, and done nothing – NOTHING – but
      lie. And lie. AND LIE. You lie with links. You lie with the pig-headed wall of outright stupid you’re hiding behind. You don’t answer any questions, you dodge and scurry and backpedal. Oh, right, and you make shit up.

      • Ellie San Martin

        If you think you are the moderate middle, I’d be interested to see what your idea of an extreme c-section advocate anti-NCB anti home birth site is.

        • kumquatwriter

          Notice how you just avoid facing your own lies? PATHETIC.

        • The Bofa on the Sofa

          .If you think you are the moderate middle, I’d be interested to see what
          your idea of an extreme c-section advocate anti-NCB anti home birth site
          is.

          Calling your bluff. Please provide ANY comment here that is actually anti-natural childbirth.

          Note: “It’s ok to have a c-section” or “the information spouted by an NCB person is crap” is NOT “anti-ncb”

      • Mrs Dennis

        Come on Kumquat, this is beneath you! I’m not convinced Ellie IS a pathological liar; and even if she is, this level of nastiness is not constructive. I really admire you as a writer, and I know how easy it is to get carried away with righteous fervour, so this is intended as constructive criticism. Stop, take a deep breath, and let it go.

        • kumquatwriter

          Hey, thanks for the compliments Mrs Dennis. Don’t worry, I’m also pretty done with this particular troll. I’m pretty sure I’ve gotten every bit of case study I can out – and what a great practical exercise in digital footprinting!

          I don’t take it as negative commentary either. I think we’re all going along (including me!) because we’re so damn dumbfounded that she keeps coming up with more. Always good to remind each other when we’re getting carried away (and no, I don’t think your comments are disingenuous – not at this point in the evolution of this troll). So thanks 🙂

    • Susan
      • Ellie San Martin

        citation?

      • Mrs Dennis

        Come on, people; you’ve let yourselves be carried away a tiny bit. This thread is very ugly, and does no one any credit. It’s become ‘let’s annihilate Ellie at any cost’, and it should have stopped ages ago. Please stop it now. Live and let live.

        • LibrarianSarah

          To be fair, it would have stopped ages ago if Elle stuck the flounce. I checked in here yesterday and everyone was talking about the new Alpha-parent post. Elle came back here and asked for more and it seems disingenuous for you to scold everyone here for giving it to her. I could be wrong, but I don’t believe that you are a regular commenter here. This is not a “live and let live” kind of place. People get called out on their shit here and are asked to provide evidence and sound reasoning when they make a claim. Elle came in with a smug attitude and made a lot of claims that she couldn’t support. As a result, she made an ass out of herself and continued to come back for more. This thread would have been dead if Elle didn’t keep bringing it back to life.

          TLDR: Elle is a big girl and is getting what she puts out.

          • Mrs Dennis

            Doesn’t matter how often I comment, I can read, and I’ve been reading this blog very carefully for years. I knew I’d lay myself open to accusations of disingenuousness, but you’ll notice it was only this morning I decided to comment, as it had tipped over from heated debate to all-out nastiness. I know what it is to get carried away with righteous zeal, and as an outsider to this thread, felt impartial enough to comment now. I stand by what I said. I also notice that as the thread gets nastier, the number of people posting gets smaller. I assume that means more reasoned commenters refrain from adding to the ganging-up. And yes, ultimately, this IS a live-and-let-live kind of place, if the alternative extreme is annihilate-specific-commenters-at-all-costs. The computer key is more versatile than the flaming torch.

          • Susan

            I appreciate that Mrs Dennis. I definitely have taken offense to Ellie’s posts. I saw on her teacher facebook place that she can write more logically in that context. I suppose I find her perplexing. If it reads as nasty I think I will take a break from it. The Ellie business has nothing to do with the subject at hand (birth breastfeeding etc ) and more to do with her style.

        • Clarissa Darling

          I’ve been following Ellie-gate since the beginning. Until now, I hadn’t said anything to her directly because I didn’t want to “feed the troll”. However, she’s come back time and time again presenting her asinine stories which, in my opinion, make a mockery out of the women who’ve posted genuine experiences of trauma and loss. I wouldn’t have spoken up if I weren’t willing to bet money that what she says is BS. I’m quite sure she loves the attention she’s getting irrespective of the fact that it’s been all negative and that’s why she keeps coming back. I personally don’t care to continue the discourse with Ellie–other posters can do as they please. It’s not because I feel sorry for her (I agree with LibraianSarah she’s getting what she gives out) it’s because it’s clear to me she has no interest having a genuine debate, is only out to create drama and as long as she can continue to get the attention she craves, she could drag this thread on forever.

          • anion

            Yeah, I’m starting to feel like there’s no candy left in the Ellie pinata.

            I remain horrified for her students, though.

          • Clarissa Darling

            Same. Let’s hope she’s not tenured.

          • Box of Salt

            anion “I remain horrified for her students”

            I am particularly bothered by the fact someone who claims to teach English typed “are u just screwing with me” in a public forum.

          • AmyP

            Could have been worse. It could have been “R U.”

        • FormerPhysicist

          I agree that it needs to stop. Not really because of her.

          In her squirming to find a believable story, she is naming real people, and libeling those doctors. If we can prevent that by ignoring her, we should.

    • Box of Salt

      Ellie San Martin “I have been a lightning rod for anger & insults & this was not my intention.”

      Since you are still reading, I’d like to give you a piece of advice, which I am borrowing from a fellow commenter. Pablo’s First Rule of the Internet:

      When you post comments on a forum, always assume that there is someone reading who knows more about the subject than you.

      • Ellie San Martin

        As I said, I’ve learned some, and I assume that experiences are varied and broad. But my no one in this comment section knows more about my personal experiences than I do, and I’ve been insulted regarding them.

        • Clarissa Darling

          Ellie–I had you pegged for a liar from the moment you started posting your nonsense back on the old thread. So far I’ve mostly stayed out of it because I don’t think trolls like you need to have fuel dumped on their fire, though it has been quite entertaining to watch you and other posters go back and forth. By now, it should be clear to you that no one cares whether you’ve been insulted over your fabricated personal experiences. I don’t think you care whether you’ve been insulted either. For one thing, there is nothing real for you to be insulted about (except that we all think you are a terrible story teller). For another thing, you know what most people do when faced with a whole group of people who are continually insulting them-LEAVE. If you were soooo offended you’d have given this nonsense days ago. You obviously love the attention you are getting here. I don’t think you even care that everyone knows your story is fake, you’ll keep this little drama going for as long as you possibly can because you have nothing better to do with yourself. What’s the matter with you? Let me guess– your mom had an incompetent doctor who dropped you on your head when you were delivered!

    • Young CC Prof

      No, we weren’t insulted. We were often entertained, yes.

      A point about the moderate middle. On many issues, there are extreme positions. In politics, the best answer usually IS somewhere in the middle, but in science, sometimes one “side” is just wrong.

      And no, we don’t know about your personal experiences, but we do know that a lot of what you described is impossible or nearly impossible, hence leading me to the conclusion that you don’t understand what actually happened, either. If someone claimed that he jumped over a two-story building, I’d assume he was lying or confused just the same way.

    • Squillo

      You got the response you did because you came in here with an initial comment that used deliberately inflammatory language–surely someone with a degree in rhetoric would understand that–then proceeded to make statements of fact that were so wrong as to be laughable, interspersed with anecdotes that became increasingly hard to believe.

      If you learned anything here, I hope it was that you know a great deal less than you think you do.

    • Playing Possum

      Erm, maybe it was describing women as ‘devolved’ and using words like ‘murder’ that caused that response.

      Your sample size is low even exaggerated. You sound like you’ve seen birth and fertility through a happy lens. You haven’t seen enough to see the rare and unpredictable and devastating events that happen with a big enough sample size to even the healthiest, well cared for women. You know, women like you and your friends? It is your cohort that can take unnecessary risks like homebirth and breech and vba9c, because you’re already lucky (alright maybe not the vba9c).

      The sample size of the professionals on this board? You can’t even imagine. It is not the glowing pregnant friends who see the cord prolapse, the fulminant gbs that kills in hours, the abruptions, the unrepaired tears. It is the professionals who see it, manage the tragedy, maybe tell a massaged story to avoid destroying a grieving parent, and all the while trying to care for all their other patients. So maybe you’ve been treated brusquely. Did you ever think that maybe your medical practitioner has been traumatised themselves, and has seen what that trauma does to their patients, and they desperately don’t want to see that happen to you? Maybe their ‘fear’ of a dead baby is based on experience?

    • Captain Obvious

      No one here is feeling judged or insulted. You are just an idiot. Nearly every NCB site deletes any comment that doesn’t praise their beliefs. Your stupid comments have been left up here. Your comments actually provide an example of the ignorance out there. Most NCB sites do not propose they did home births because of bad experiences in the hospital, but rather ignorance and just trying to show one up-manship mentality. I am sure a few might say they had a bad experience in the hospital, if so goto a different doctor or hospital. No where else in life ( construction, lawyer, accounting, etc) does one feel they got a bad experience so the way to fix that is to goto an undereducated layperson with a greater risk of mortality. That is just stupid.

    • moto_librarian

      Have you shown an iota of respect for the women here who have had traumatic birth experiences that would have been improved by c-section? Did you bother to read my comment about my friend who should be parenting a vibrant 2-year old son, but is instead mourning him because her uterus ruptured during a VBAC attempt? Forgive me if I’m not too concerned about your feelings being hurt when you are to arrogant to consider your own behavior.

  • anh

    To be fair, they did cite a WHO bulletin that does state the the “WHO recommends…” maybe it’s the WHO that needs to get its act together. I tried to comment but I seem to be being ignored

    http://www.who.int/bulletin/volumes/85/10/06-039289/en/

    • EllenL

      The article they cite was published by WHO in the Lancet in 1985. (Look at citation #1 at the bottom of the article.) That used to be the position of WHO.

      As Dr. Amy has pointed out, WHO has abandoned that rigid recommendation. There was no evidence to support it.

      I wish the NCB community would acknowledge the change. They still quote the old WHO position, because it serves their purposes.

      • Dr Kitty

        The WHO has not abandoned 15%.
        It has suggested that as only 15% of pregnancies suffer serious complications it remains a threshold which should not be exceeded, rather than a target to be aimed for.

        It does not, in any way, take into account the individual preferences or desires of women, nor the differences safety profiles between delivering in resource rich and resource poor environments.

        >40% of women in China have CS. For the vast majority it will be their only baby. Labour and vaginal birth are seen as unnecessarily risky. There is no concern about future pregnancy outcomes. Preserving future fertility is not a concern. Personally, I do not see the Chinese CS statistic as unreasonable given that set of circumstances.

        So what if a threshold has been exceeded? Prove the harm done as a result.

        • Dr Kitty

          Southwestern Nigeria has the world’s highest incidence of twins (44/1000 pregnancies, which is almost 5%, and about 10 times higher than their rate in Europe).

          If the WHO accepts multiple birth as an indication for CS, the safe rate for Southwestern Nigeria must surely be at least 3.5% more than the recommended 15% rate?

        • KarenJJ

          So does this mean that 15% was never really going to be an achievable level considering that currently nobody can predict with high accuracy which mothers and babies will be in trouble or not until after the event?

          • Young CC Prof

            Ding ding ding!

            Once you have enough surgical technology that the risk of death to the mother is negligible, and enough ultrasound and fetal monitors to reliably identify POTENTIAL problems, you’re going to get a c-section rate above that 10-15%.

          • prolifefeminist

            CC Prof, you said that so much more succinctly than I did. 🙂 I’m in the middle of studying for midterms…clearly I’m trying to procrastinate as much as possible by writing wordy posts!

          • prolifefeminist

            And sometimes you won’t even know if it was “necessary” after the event either, because the best c/s is the one that prevents a problem from becoming catastrophic in the first place, not the one that rescues an injured baby or worse after the fact.

            Isn’t that the complaint of most “unnecessarean” mothers – that the doc called for a section and then removed a healthy, pink, crying baby? Why on earth would you want to wait until that baby is blue and unresponsive?!

        • prolifefeminist

          “differences in safety profiles between delivering in resource rich and resource poor environments.”

          One of the things about resource rich environments is that you have the technology available to not only detect a potential problem, but also to perform c/s with a high degree of safety. That combination means that when the choice is between a possibly brain damaged or dead baby vs a small risk of harm to the mother from surgery, the vast majority of moms will choose the surgery.

          In resource poor environments, where c/s are far less safe, the evidence of harm to the baby must be much stronger to outweigh the risk to the mother. Jeevan’s blog provides many, many examples of this – for example, the severely anemic mother with a distressed baby who may have to wait it out because the surgery is simply too risky for her. Sure, this lowers the c/s rate, but at what cost?

          The “problem” of having a great deal of lifesaving yet imperfect technology is that you’re forced to make a decision when the signs start to suggest that baby or mom may be in trouble. Having information like that means you have to act one way or another, and guess what – that means you’ve gotta “own” the outcome of that decision. NCB advocates claim that they’re taking ownership of their births, but they’re refusing monitoring because it isn’t 100% perfect. They seem to be demanding a level of certainty that just isn’t possible – they want to know for SURE that a baby is in trouble before moving to a c/s. But that currently just isn’t possible. Their solution is to shun the monitoring – because if you don’t know there might be a problem, you don’t have to decide how to fix it.

          A better solution is to gather as much information as you can, and, in conjunction with an expert trained to interpret and apply it, make the best decision with the information you have available at the time. Birth is to respected, not trusted. It has the power to bring forth life and also to maim and kill. That’s the reality. Ignorance is not bliss. When it’s a matter of life or death, it’s far better to err on the side of caution and be wrong than to throw caution to the wind and find out too late that you should have been more careful.

          • jenny

            This, this, this. NCB has this weird inverted relationship with perfection. Strive for the perfection that no one can control in the “perfect” natural birth….. reject what that could truly help because it’s not “perfect.” But it feels like having control.

          • fiftyfifty1

            I agree with everything you say. The one thing I would like to add is this: monitoring (EFM) has a bad name in NCB circles because of the perception that it gives bad information or “false alarms”. I would argue that it does neither. It actually provides very accurate information. Lates and Variables (late decels and variable decels) really do show what they show: that the baby’s is being deprived of blood flow and oxygen. What the EFM *can’t* tell us is how long your baby can tolerate this level of stress without permanent damage. The decision to deliver vaginally vs CS is then up to clinical judgement (e.g. this baby is oxygen-deprived but delivery is likely to occur soon and it is unlikely that significant permanent damage will occur between now and then) and parental tolerance of risk of death/disability.

  • Ripley_rules

    This is slightly off topic, but if accurate shows how the desire to lower C-section rates at all costs can lead to terrible tragedies:

    http://stlouis.cbslocal.com/2012/10/15/lawsuit-doctors-intentionally-concealed-decapitation-of-baby-during-delivery/

  • kumquatwriter

    I’m
    enjoying this immensely. I have quite a bit of experience with
    pathological liars, particularly on the internet. Dr. Marc Feldman, who
    originated the diagnosis “Munchausen by Internet” (I’ll shorten to MbI) actually commented on a
    blog post I wrote about that condition. Make no mistake, I’m a
    layperson with only an undergraduate degree who writes from personal
    experience. But I do keep up to date on quite a bit of research, and
    strive to stay aware of what experts are saying. But enough about me.

    In about 30 minutes (including an intermission), here is what I have learned about you.

    Although
    you claim you teach History, your LinkedIn shows that you teach High
    School English. This is consistent with the (expired) certifications I
    found searching http://www.ctc.ca.gov/lookup.html

    Not history.
    English. Aside from the fact that my bile rises that an English teacher
    would actually claim that “sarcasm is spoken, satire is written,” this
    matters because it is an irrelevant and easily provable lie.

    Pathological
    liars are unable to be honest about even mundane and unrelated details.
    Teaching English or teaching History are about equal as far as they
    fail to qualify you to educate *anyone* about childbirth. Ergo, this is a
    totally irrelevant thing to even bother lying about.

    A
    cursory search of your name brings up Facebook and Google+ accounts –
    all of which only show you being friends with your husband. Which is not particularly important, although for such a very active circle of birthing women you
    know the intimate details of, definitely suspect.

    Your story
    not
    only has a lot of holes and a fantastical amount of unlikely drama and
    traumatic events, your habits of dodging questions and your
    ever-changing backpedaling are all red flags. You started out writing
    about yourself (on other posts by Dr. Amy) but quickly switched to
    talking about high numbers of friends with bizarrely specific issues.
    Finally you’ve settled on your “sister” and HER dramatic life or death
    moment. Not at all uncommon for someone with MbI – in fact, it’s fairly
    standard behavior. Jump around until you find the right story for the
    audience so you suck up as much attention for yourself as possible. I
    notice that in the time I’ve taken to write this post, you’ve gone back
    to talking about your OWN terrible traumatic birth and such.

    It actually struck me yesterday, when I read your comment concluding “I don’t know if the numbers cross, but if your 31 friends who liked ice
    cream were among the 55 friends who had gestational diabetes, I’m sorry
    for their inconvenience and suffering deprivation too.” That joke is too
    smart for the character you’ve been cultivating, with your “what? Like,
    1 in 100 means 100%? I can’t comprehend statistics or rate or numbers!”
    replies. I’m sorry, the math in that snotty little barb is above the
    “Ellie” you’ve been pretending to be.

    I’ve
    broken down your claims about your sister. All I did was scroll through
    your comment history (click on your own name. Look! Everything you’ve
    written!) and made a note of each point you made. The article you
    provided to support that Victor Valley Community
    Hospital closed shows that only the operating rooms closed, not the
    hospital. Further, all the
    information about the hospital changing hands shows that it was becoming
    a for-profit hospital to save itself from financial ruin. The ratings
    of the hospital health-wise are not particularly good, but nothing like
    what you’ve described. I was able to locate an OB/GYN, Dr. Vijay Arora
    (Not Aurora) working at
    VVCH. A
    cursory scan of Dr. Arora’s reviews show he probably has a strong
    personality, as the comments are sharply divided. People clearly love
    him or hate him.

    So, here are your claims, Ellie.
    I’m not going to bother pointing out the blatant errors and
    absurdities. Oddly
    enough (I’d say ironically, but you don’t even know what satire is), I
    started at the bullet list, and it’s tone is quite different. But that’s
    okay. I still have the original file of copypasta.

    ****

    Mystery Sister (henceforth Mystir) is in labor.

    Evil OB thought it was taking too long.

    Evil OB lied (to whom?) that Mystir is dilated to a 5.

    Two nurses said Mystir was dilated to 8.

    Evil OB Inaccurately recorded her height as 6 inches “higher” than it was

    This caused Mystir’s “anesthesia” for the c-section paralyzed her lungs and put her in cardiac arrest.

    Evil OB did “anesthesia” by himself.

    Mystir and Baby Mystir were okay, so they couldn’t sue.

    The medical board wasn’t interested in the complaint.

    Even though they had records and nurses.

    Because the whole hospital was shut down.

    Actually, Evil OB didn’t record her height wrong, it’s just a sloppy 0 that looked like a 6.

    Evil OB moved to Victor Valley Hospital.

    Evil OB estimated Mystir’s weight off by 30lbs.

    It wasn’t cardiac arrest, it was a “code blue” and Mystir had to be resuscitated before the c/s could be completed.

    Mystir stopped breathing (because she started breathing again)

    Two nurses confirmed she was “fully dilated” by the time the c/s started.

    Evil OB listed it as “Failure to progress” “Large baby”

    Evil OB refused to explain what “distress” meant

    Evil OB claimed heart rate was dropping.

    Evil OB stormed off and said he “cant wait all day”

    Evil OB didn’t return for two hours.
    The epidural was already in (apparently placed by an anesthesiologist) before the surgery

    The anesthesiologist was “gone” (apparently before ensuring the epidural was correctly placed)

    Evil OB did the c/s without an anesthesiologist.
    Evil OB went ahead with the surgery after the anesthesiologist left. (separate comment)

    Two nurses explained that Evil OB often “lied about these things” to finish his shift early.

    Evil OB only allowed women to deliver vaginally if it was <1 hour.
    The nurses thought Mystir and Ellie were super awesome.
    The medical board won't take any complaints as hospital was shut down.
    The hospital was Victor Valley Community Hospital.

    Ellie and Mystir's insurance refused their claim because it was "standard."

    Ellie has spoken to "lawyers" about filing med/mal and claims to be told it was hopeless.

    Ellie has heard from several parents of students who have attempted to file…something.
    Most of Evil OB's patients are young teenage girls.**

    **I
    included this because MbI often include various forms of child
    abuse/exploitation in their fictional backstory or the backstory of
    their sockpuppets. So it was a flag.

    • KarenJJ

      The weirdest one was blaming the incorrect information the ob gave to the anaesthetist for the over-dosing that led to the medical emergency, except the ob was the one that did the dosing and an anaesthetist wasn’t present?

      • Dr Kitty

        It just read like someone who had hear that a high spinal could cause breathing problems, but not how, or why.
        Then they decided to run with it…and kind of forgot their audience (who know the difference between cardiac and respiratory arrests, and epidural and general anaesthesia, and the duties of an OB and and an Anaesthetist for a bloody start).

        Ellie is not worth responding to.
        Either she’s real (which I doubt) and incorrigibly uneducatable, or she isn’t, in which case DNFTT.

        • Ellie San Martin

          No, I found out about high spinals after this happened because I wanted to know what almost killed my sister and avoid it since I was 4 months from giving birth myself

          • Dr Kitty

            Right…
            But “IDK what he did…it wasn’t GA”.
            If you KNEW about high spinals and that is what happened to your sister, then THAT is what a normal person would have said.

            “My sister suffered a respiratory arrest after her epidural was topped up with a spinal for her emergency CS and the block went too high. I blame her psycho OB”.

            Like that.

      • Ellie San Martin

        we got that info from a nurse, but as I said, don’t have the records to verify. & one of the nurses (who did not provide a statement) may have been an anesthesiology qualified nurse (CNA)

    • Karen in SC

      Excellent work, Kumquat! I knew it was sounding fishy, but I like to give people the benefit of the doubt.

      • kumquatwriter

        The thing about MbI and pathological liars is that they *count* on getting the benefit of the doubt. The predatory ones will exploit that benefit as much as possible – if you call them out, they’ll just use plausible deny-ability – or “oh, I mis-spoke/you misunderstood” to undermine your suspicion.

        Another trick they use frequently is to post links that “confirm” their identity, because most people see the mere offering of confirmation as enough. Most people won’t actually go see if she has a teaching cert, or google the hospital, because why would somebody lie and present data that contradicts it?

        It’s a hydra of lies. A Lydra, if you will.

        • kumquatwriter

          Not to say we shouldn’t extend the benefit of the doubt – most people ARE telling the truth, or something like it. That’s why I don’t do a post/breakdown of every lying liar who lies here (that and who has the time for THAT bs?), just when something REALLY sticks out.

          Thanks for the compliments, all who’ve posted them 🙂

          • prolifefeminist

            Kumquat, you rock my world – nice work!! How awesome that we have our very own bullshit detector here – and such a ridiculously thorough one at that! 🙂

    • anion

      I mentioned the LinkedIn etc., and she replied below insisting she teaches history. So I did a search on the website of the school her FB shows her teaching at and found that no, she absolutely does NOT teach ANY history classes (if you go to the school’s site and click “Catalog,” you can search by teacher):

      https://hlpusd.blackboard.com/webapps/blackboard/execute/viewCatalog

      And as a writer, everything about the idea of this woman teaching English makes me want to cry. Not just the issues with comprehension etc., but the basic grammar/punctuation errors and poor word choices, too.

      • Ellie San Martin

        as stated previously, in full disclosure, that catalog is old, not to mention I’m on maternity leave, and have taught at 2 other schools previously.

        • Happy Sheep

          But you said you ARE a history teacher – and you are not, you are a teacher who has taught some history classes = LIE

    • anion

      Don’t forget, too, that she mentions not being sure what anesthesia was given:

      “…the epidural was already in, but the anesthesiologist was gone so idk what the OB did, I don’t think it was general anesthesia, but it paralyzed my sister’s lungs[.]”

      • Dr Kitty

        Because CSections proceed without an anesthetist in the OR…NEVER.
        Pregnant women have high risk airways, you don’t start cutting without an anaesthetist at the patient’s head.
        NEVER, EVER EVER.
        Total BS.

        • Squillo

          I can’t decide if that was my favorite part of the story or if it was the bit about the MBOC not taking the complaint about the doc because the hospital was closed down.

          • Ellie San Martin

            whatever it was, she already had an epidural & it led to 2 different code blues, which she only remembers not being able to breathe, passing out, & her husband had followed the baby & my mom was shoved out the door

          • Squillo

            So in other words, you have no idea about the anesthesia.

          • Ellie San Martin

            I know it was an epidural, 4 hours previously, and then when they rolled her into the OR, 2 code blues

          • Squillo

            So all the other things you wrote were lies or errors.

          • Dr Kitty

            Right…
            Ellie, would you like to take this opportunity to retract ANYTHING?

            You know, the bit about the OB doing his own Anaesthesia?

            Or the transcription error and wrong weight estimates that were never double checked by the anaesthetist (who, as the person administering the drugs is responsible for ensuring the dose is correct, and therefore is responsible if the wrong data is used for the calculation)?

            It is possible that topping up an epidural by placing a spinal caused a high block and respiratory muscle paralysis leading to a respiratory arrest. It happens in about 1% of spinal anaesthetics. It is more common if an epidural has already been in place. It is a complication you are warned of before you sign the spinal consent form. They have drills for it. Often it just happens and nothing was actually done wrong.

          • Dr Kitty
          • Dr Kitty

            Sorry, incidence is much less than 1%, but it is definitely not vanishingly rare (reading too fast).

            One of my interview questions for an OB job was a role play where you’re in the middle of a CS and the patient complains she can’t feel her arms and stops breathing, and it was a run through of the high spinal drill (although they were mean and turned it into a full cardio respiratory arrest after you got the baby out, to prove you knew your ALS algorithm).

          • Karen in SC

            great background information, never knew any of that. Thanks!

          • I don’t have a creative name

            That was a waste of time. All you need to save the patient is seaweed and Shepherd’s Purse.

          • kumquatwriter

            Now its two code blues, eh? As for your pitiful “oh, you made that up” defense? You really do have pitiful reading comprehension if you can’t read your own writing. As for time? About two hours all together – and that’s been good work study for me. The one who is studying how to track someone’s digital footprint.

            And no, I have not lived a charmed life where I’ve never known grief or trauma. Although people who really have worked through their traumas and losses? Don’t hysterically post about it on random, barely tangentially related threads. And can usually recount their traumas coherently.

            I don’t regret any time spent on this. You’re a useful case study. And I’ve learned even more when I misidentified another user as you. I don’t mind admitting my mistakes. That’s one of many ways we learn. And learning to separate “suspicious” things from actual evidence is hugely important. Plus, your relentless, determined idiocy is nicely preserved here, which may help other rational readers in the future – both in seeing through your incompetent arguments and in seeing how easy it is for a person with the right knowledge to expose a liar like you.

          • Susan

            Ellie Mae I say we start taking bets on how many nurses we can schedule for psychiatric care by roping out the IV & removing monititor, pressing the nurse button as many times as possible for intermittent monitoring, then chat them up about how many students I talk out of nursing because their coworkers will be no better than gossiping mean girls. Do u suggest I not put in our birth plan?

          • anion

            What kind of person does that?! I guess it’s just hilarious to waste the time of nurses who could be caring for other patients. Who cares about those losers who need their nurses, right? Or the nurses who want to do their jobs? It’s all about you and your performance art.

          • Dr Kitty

            “Whatever it was” strongly implies you didn’tknow much about high spinals.

            I vote lying liar who lies.
            No more responses.
            Stick the flounce next time.

    • Durango

      Oh well done, Kumquat! thanks for putting it all together. The “ob did the section without the anesthesiologist” and “the nurses said the doctor often lied about whatever” were the red flags to me.

      Munchausen by Internet–had heard of it, but what a strange phenomenon.

      • Susan

        and we have the nine days in the NICU for no reason whatsoever and the social work consult because she questioned the staff to add to the list now.

        • Tim

          Well you know, NICU’s just don’t have enough legitimate patients, so they have to fill in the gaps with babies who are there for no reason to make sure they make enough money.

          • Susan

            This brings to mind a case of where I was in a position to know the story behind a loony internet poster. She made the most outrageous posts on every doc rating site she could. Doctor actually had to file a police report because of her non internet stalking. The worst thing is the doctors can’t defend themselves because it’s against the law to violate HIPAA so basically someone can say almost anything on these doc rating sites and unlike a hotel or a plumber who can tell their side of it there is no recourse for a doctor. This is not the same person but the style is very similar.

          • Tim

            Luckily it’s usually so full of histrionics and nonsense (much like this poster) that anyone sane and reading the reviews can hopefully seperate the wheat from the chaff. You probably don’t want patients who woudl read a story like this and believe it

          • Susan

            Very insightful Tim! Last thing any doctor wants is to be the loon magnet in town. Seen more than once a self righteous wacky patient fire the doctor off the case and the doctor practically dancing with glee whilst the one who is now stuck with the patient bemoans his fate.

          • KarenJJ

            My current specialist has a poor rating from one person. Apparently he was dismissive about her ideas of using complementary medicine. Sounds like my type of doctor actually.

          • Ellie San Martin

            which is exactly why half of his patients love him. They feel rescued from TOL by his offer of a c-section & had no complications

          • prolifefeminist

            And stingy health insurance companies just LOVE to pay for expensive NICU stays for babies whose only diagnosis is having a parent who asks too many questions.

          • Ellie San Martin

            I would think so! but not Kaiser!

          • Ellie San Martin

            That’s what I said!

        • kumquatwriter

          That was about her own birth/daughter, so I didn’t include it. I was careful to exclude comment s that weren’t directly about the Mystir story, lest she have a tiny foothold to claim I’m full of it. 🙂

      • Ellie San Martin

        I can’t remember who pointed out that some nurses are qualified to do anesthetic work if the epidural is in place. I just learned that.

    • Squillo

      She’s clearly using the “snowflake method” of story-building.

    • Burgundy

      Good Job! I feel her story was made up but couldn’t put my fingers on. I lost interested half way through her seas of commons. After reading her first 3 commons, I felt she is fishing for real life details for her story.

      • Ellie San Martin

        nope, It’s regrettable enough that I’d rather forget because I’ve worked through forgiving.

    • kumquatwriter

      I notice that she’s changed her facebook name to “Ellie Mae”

      Because that means she’s INVISIBLE! It’s not like facebook automatically assumes you’re looking for her by her full name…

      • Karen in SC

        Faeredae from the other thread deleted her Disqus account – isn’t that what happens when the name is replaced by “Guest”. Too bad I forgot her last name, wonder if she’s a doula somewhere.

        Claribel Rodriguez did the same thing. Don’t want to stand behind their words.

        • Burgundy

          Faeredae something Miller….

          • kumquatwriter

            How intriguing! According to google, Ellie Mae’s maiden name was Miller. This is in one of the top results, btw – I saw it last night and made note, though I didn’t include it as I thought it irrelevant. NOW however…

          • Burgundy

            My sister married to a Miller, it is a very common last name. I will give my benefit of doubts.

          • Ellie San Martin

            yes. But the only Audrey I know is my 2 yr old niece

          • Susan

            Ellie, please, don’t name your minor niece on the web when you post your real name and your real maiden name. I think the posters here are safe but there are rotten people in the world and honestly either your life is an open book or you have decided to play a cruel joke on the person you are impersonating.

          • Guest

            Audrey

      • Ellie San Martin

        Um, I’ve had that fb name as long as I’ve had a profile. I chose to enter a different name in disqus

    • attitude devant

      Oh man, kumquat! You da bomb! Seriously!!! MWAHHH!!!

    • Bombshellrisa

      Is it too soon in our relationship to say “I love you”? Cause right now, I think I do!!!

    • Ellie San Martin

      Many of those things are either things I never wrote that you are inferring (nurses thought we were super awesome) and out of order and if put together not contradictory. But I am surprised I have struck such a cord with you that you dedicated this much time to altering the order of the story and picking out minor vague areas to assume that I’ve gone to as much trouble to make up a story. Since you don’t seem to understand that traumatic events (like possibly losing a family member) might cause someone’s memory to become vague & I had no records to go by, I’m merely glad that you cannot relate to such trauma.

  • Busbus

    Umm, I would like to ask a personal, related question. What is the data behind C-sections for big babies? So, my personal story is a relative who is pregnant right now and who told me that her regular OB-Gyn told her that if the baby is shown to be 8 lbs on ultrasound, she wants to do a C-section. (My relative did not like this and wants to switch doctors now.) Now, not knowing much about the topic, that does seem a little excessive…right?? Is this standard? What’s the science behind big babies, risk and c-sections? Am I missing something? Thank you!

    • Young CC Prof

      Good question! Simply, big babies are more likely to get stuck on the way out. They are more likely to suffer birth injuries and more likely to be unable to pass through the birth canal at all. (cephalopelvic disproportion.)

      8 pounds isn’t terribly big, 9 pounds is generally considered the border of oversized and dangerous, but keep in mind babies can gain a pound a week in late pregnancy, and ultrasound estimates aren’t perfect.

      Of course, the exact risk depends on the exact circumstances. Is this her first baby? If she had prior labors, what happened? Does she have gestational diabetes or has she gained a lot of weight? (GD seriously increases the risk of excessively large babies.) Is she very close to or past her due date? Is there a reason the OB thinks the baby is likely to be overweight?

      • Busbus

        Thanks, Young CC! This is her first baby. My relative is maybe a little overweight, but no GD as far as I know. She still has some time – I think this came up in a general discussion of how the birth will go, not due to specific risk factors.

        • Busbus

          I think she said that she has gained a lot of weight during the pregnancy so far, though.

          • EmbraceYourInnerCrone

            Take my story for what you will but I would have prefered a C-section. I am 5 feet tall and have a small frame. My baby’s head was not measuring too large for my pelvis and everything was looking good. She started experiencing distress late in the delivery and there was meconium in the waters.(I also experienced some tearing at this point) As she was far enough down the birth canal they did an episiotomy and used vacuum extraction to deliver her faster. The OB had called in the NICU team when he saw that she was probably going to be delivered in distress. She was not breathing right away and had to be resuscitated. She turned out to weigh in at 8lbs 15oz. She’s 19 and in college doing great. But I think a scheduled C-section would have been a LOT less stressful for both of us(and guess what, recovering from all those stitches while trying to care for a newborn is no fun when they are in your perineum either!) Would rather have had them in my abdomen but that’s me.

          • Dr Kitty

            My OB told me that he would recommend a CS if the EFW was more than 7lbs6oz, because not only am I a small person, but I have a wonky pelvis that is bolted together, so all the pregnancy hormones in the world wouldn’t give me a normal sized pelvic outlet.
            At 38w the EFW was 7lbs but her head hadn’t dropped into my pelvis AT ALL.

            She turned out to be 6lbs 3oz, which, apparently was still too big for me. I’m happy I opted for the CS rather than to roll the dice.

            Point being, 8lbs might be an individual threshold for this person based on some particular factor in her history or examination.

          • Busbus

            Thanks to everyone who posted to answer my question, here and above!

        • anion

          Your relative can certainly seek a second opinion–from another qualified OB–if she doesn’t want a section, but it’s always good to be prepared for the possibility and to know that it’s really not that bad! I’ve had two sections. Recovery was pretty easy with both; the first day wasn’t great but after that it was okay, honest, and you can barely see the scars. Plus, I avoided tearing and all of the other possible issues that can stem from vaginal delivery, which was nice. And, you know, I ended up with a beautiful, healthy baby.

          But before she switches she should have a real talk with the OB about it and ask whatever questions she wants to ask. She may find herself feeling a lot better about the whole thing.

          My OB estimated the weight of my first at “not quite nine pounds.” (I didn’t end up with a section because of weight, but because I was induced at term [per my request] and she didn’t drop). I didn’t have GD but also gained a lot of weight with that pregnancy and had to do the three-hour-horrible-orange-drink test because my first GD test came back borderline; it sounds as if your relative is perhaps in a similar situation, which is why I’m replying here. My OB was confident I could deliver vaginally, although I wasn’t thrilled with the idea–I’m pretty tiny.

          She ended up 8 lb 6 oz. So my OB wasn’t far off. And really, the OB isn’t mentioning the possibility of a section because he just feels like it. He (or she) is mentioning it because it may be necessary to prevent all sorts of horrible things happening. The OB’s priority is a safe delivery where both parties end up healthy and alive. That’s what really matters, in the end.

    • rh1985

      I want a c-section if a larger baby is predicted, I’m on the smaller side and I think I have some factors that I think might give me a higher than normal chance of more severe tearing – something I am going to talk over with my doctors.

    • Ellie San Martin

      circumference of head is a more accurate measurement from ultrasound technician and also more useful in predicting struggles in labor (since it is always the largest part of the baby. Shoulder dystocia can be dealt with in many ways that are not as risky as a c-section. But if she doesn’t want advice and seems overwhelmed, a c-section could be a better option.

      http://www.ncbi.nlm.nih.gov/pubmed/23132481

      • KarenJJ

        ” Shoulder dystocia can be dealt with in many ways that are not as risky as a c-section.”

        Can they? Which ways can it be dealt with?

        • Squillo

          Ways that result in 2-16% morbidity in the neonate and 3.8 to 11% morbidity in the mother.

        • Dr Kitty

          An elective CS prior to labour is safer than an emergency CS during labour and an emergency CS following Zavanelli for SD.

          I suspect Ellie thinks all SD resolves with the “Gaskin” manoeuvre.

          • Ellie San Martin

            what’s that?

          • theadequatemother

            the “gaskin” manouver is what you mentioned above – turning the woman on her hands and knees and asking her to push in that position. There are a few other ways of trying to free a shoulder dystocia and we drill them in hospital (whole nursing and OB team) via simulation because it is a complication that has such power to maim (both baby and mother) and kill (generally just the baby). And you can’t always get that baby out. Sometimes you have to try to shove the infant back up and take it out via CS. The odds of doing that in time to prevent injury and or death are poor.

            Very poor.

            Your idea of this complication only involves the uncomplicated, easily resolved kind. That’s, unfortunately, not the only kind we see.

            If my baby was measuring big I’d take the CS any day. If my labour was prolonged or my pushing phase was prolonged I’d take an early/ pre-emptive cs any day. I have a friend right now that had a mostly easily resolvable shoulder dystocia with her first…I guess other than the horrible pelvic floor damage she sustained…her kiddo is fine. She’s completely torn about what to do with her second. For me, that decision is easily made. CS all the way.

          • prolifefeminist

            Wait a minute – you’re giving out advice about shoulder dystocia, but you’ve never even heard of the Gaskin maneuver??

            Ellie, please. Stop for a minute. Take a deep breath. Think about what you’re doing. Realize that spewing incorrect medical “advice” on the internet can have real life consequences on real mothers and babies who read your words and believe them. They shouldn’t, but they do. So be responsible.

            Being responsible = listening to the experts who actually know how to resolve and prevent SD.

          • Ellie San Martin

            I was asked & I responded. I was told by that particular OB that that movement (she didn’t name it) was one way to deal with it, but I’ve never heard of preventing SD- unless you prevent vaginal birth by performing a c-section. Several of the OB’s I spoke with had not performed very many vaginal births or emergency c-sections, because for the past 15 years or so of their practice, they had done nothing but elective c-sections during their shifts, which would account for their lack of recent experience

          • anion

            You talked to “several” OBs who’ve barely performed any vaginal births because for fifteen years or so they’ve done almost nothing but elective c-sections?

            An outrageous lie.

            Names of those OBs, please.

          • Ellie San Martin

            John K. Moran
            Il Woo Park
            Patricia Bajamundi

          • kumquatwriter

            You have named three Obstetricians who exist. Your point being? None of these doctors have any sanctions, or even complaints against them. I find it extremely unlikely that doctors in a NCB-infested area like the one you describe who did virtually nothing but C-sections would have raving, whining reviews about how terrible their trauma was. Oh, but I’m sure you have a steaming pile to explain that too.

          • Susan

            Someone’s just got to fax that unit this conversation…

            Kaiser Permanente Downey Medical Center

            9333 Imperial Hwy.
            Downey, CA 90242 Directions Phone Number

          • anion

            Kaiser Permenente has a 17% section rate:

            http://www.calhospitalcompare.org/profile.aspx?h=170&c=7

            (It has a 76% breastfeeding rate and VBAC is routinely available, too.)

            Yet Ellie claims that there are at least three OBs there who oversee vaginal deliveries so rarely they’re not even sure how.

            Ellie, you realize that by naming those doctors and claiming such a ridiculous statement was made by them, you have opened yourself to potential claims of libel?

        • Mac Sherbert

          That must be why during my repeat C-section my OB said “Aren’t you glad we ended up doing it this way, baby has broad shoulders?” (The baby did have broad shoulders and was a surprise 9 plus lbs.! No GD. I passed the test we flying colors. So, yes I was thrilled I never went into labor and ended up with a RCS!)

          This was an OB that was perfectly fine with a VBAC and never attempted to talk me into a c-section and even offered to attempt to induce labor, if I wanted.

      • Young CC Prof

        I don’t know much about how the accuracy of ultrasounds at Kathmandu medical college compares to those around here, but shoulder dystocia is NOT a good thing. Back in the day, they sometimes had to resort to breaking the baby’s collar bone.

      • Squillo

        Do tell us, Ellie, what are the risks of c-section vs. shoulder dystocia and the rates at which they occur?

        • The Bofa on the Sofa

          Include a breakdown of baby size

        • I was under the impression that there is not a reliable way to predict shoulder dystocia. ??? GD was the only significant correlation I could find.

          • Squillo

            AFAIK, previous SD is another significant risk factor. The point is that the ways of “dealing with” SD, as Ellie would have it, entail waiting for a life-threatening emergency to happen rather than preventing it. It makes a great deal of sense to this layperson to consider c-section in cases where there are known risk factors, as questionable as those may be.

      • Dr Kitty

        Oh, Ellie, babies whose mothers have GDM can be bigger around the abdomen than the head. They are at particular risk of Dystocia.

      • guest

        Want to know about the worst night of my career?– a totally unexpected shoulder dystocia ultimately relieved by a zavanelli maneuver and emergent C-section. Baby died. Want to know how many women or babies I’ve had die at C-section (with the exception of those infants with known lethal anomalies or extreme prematurity)? None. When you’re trying desperately to get a baby out, having already resorted to breaking a clavicle, attempted to break a humerus, cut a large episiotomy, and tried every position imaginable while knowing that the minutes are ticking by and the baby is hypoxic you can tell me how shoulder dystocias can be “dealt with in many ways that are not as risky as a C-section”.

        • Ellie San Martin

          An OB at Kaiser told me that if the patient is mobile, if she can be put on her hands and knees that the movement of the pelvis will often free the shoulder. She also said that if the patient is not mobile, there are ways to manipulate the mother’s pelvis.

          • theadequatemother

            did you read guest’s reply – ie the parts about trying every position imaginable (which would include the hands and knees, mcroberts, suprapubic pressure), cutting a big episiotomy, trying to deliver an arm, breaking the fetal clavicle etc etc….That Kaiser OB’s response is like a “pat pat, there there dear, don’t worry your pretty little head about it.”

            can you imagine a big episiotomy, OB hands pushing into your flesh trying to get a fetal arm out…all without any analgesia because there isn’t time?

            Those scenes are horrible, they keep me up at night and when you lose the infant anyway…after causing all that trauma to the mother…its really…well, it’s just…

          • rh1985

            Great. I’d rather have a c-section than potentially damage my baby and have abnormally bad tearing/damage in that area. I’d MUCH rather have an abdominal incision to heal from.

          • Marni

            You are really an idiot. Please work on your reading comprehension skills.

          • Squillo

            You do realize that “an ob told me” is not the basis for a deep understanding of shoulder dystocia and that every time you offer a morsel of wisdom like “[s]houlder dystocia can be dealt with in many ways that are not as risky as a c-section” you make yourself look foolish and arrogant?

          • Ellie San Martin

            do you realize that “a c-section is the solution to most problems and a 30% rate is not high (adjusted to 20% of 1st time births)” sounds foolishly impatient and narrow minded? (Especially when c-sections themselves have many additional risks?)

          • Squillo

            I’m still waiting for you to provide the relative risks of shoulder dystocia and c-section and the rates at which they occur. That would actually be germane to the discussion.

          • Amazed

            Do you realize that “an OB told me” is no justification for being so smug? You have no leg to ask other “do you realize” when you didn’t even know what the bloody Gaskin maneuver was? You fail even at NCB, Ellie, because that’s something your fellow NCB know-nothings swear by. Of course, it isn’t half as effective as they think and would like you to believe but at least they have heard about it.

          • Ellie San Martin

            Apparently I did know it, but not by it’s proper title. Wow, NCB advocates are now “know nothings.” Glad to see that we’ve advanced beyond the political rhetoric of Tammany Hall. BTW, what exactly caused you to interpret which comment I made as “smug.” The fact that I had an opinion at all in the face of an OB comment on a blog?

          • Amazed

            No, you did not know it. What happens in the hospital when the clock ticks, the baby is stuck, and every minutes matter? What would you do, Ellie? Let me guess: you’ll start explaining what the maneuver is, losing time and baby’s brain cells.

            Names matter, Ellie. I would think that as a teacher, you would know that.

            What makes me think you’re smug? The fact that you are making wrong assumptions spoken with authority when all you have is “an OB told me”. Shoulder dystocia is the nightmare of every OB and midwife worth their salt, especially when it cannot be resolved easily. I suppose that you either didn’t hear the OB right, or didn’t understand him/her right. Given your grandiose failings at reading comprehension, I’d wager that you have troubles with listening comprehension, too.

          • Karen in SC

            Flippant much? Performing the zavanelli maneuver is the last resort, all other methods have been tried and failed. Hilarious how you are trying to “teach” an OB.

            Maybe we need to give out some English teaching tips – you know, to make things fair.

            #1. Moby Dick is way too long, assign Billy Budd instead.

            Who else wants to play?

          • kumquatwriter

            But she’s a HISTORY teacher, weren’t you listening to her?

            I don’t like to feed trolls, but I love to point out lies.

          • Ellie San Martin

            according to new common core standards, only 30% of the curriculum is literature, and that is highly encouraged to be “deep” not lengthy. Therefore many administrators are dumping whole novels completely in favor of short excerpts. We will not have a very well read generation

          • kumquatwriter

            I notice that you have not responded to my observations. How unsurprising. I do hope Dr Amy will be checking your IP address as well.

          • Ellie San Martin

            how would it help to know that I used my work computer once and then my home computer?

          • kumquatwriter

            You’re an English teacher, you say? Oh wait, no, you lied about being a history teacher.

          • Happy Sheep

            I thought you said you were on mat leave, how are you at a work PC when you are on leave?

          • anion

            Especially not when we have English teachers who are incapable of effectively communicating in and reading English.

          • Ellie San Martin

            I don’t mean to “teach” & OB. My opinion was requested & I gave it.

          • Box of Salt

            Ellie San Martin “My opinion was requested & I gave it”

            You are extremely arrogant if you believe that Busbus’ question was directed to you.

          • Ellie San Martin

            it was a response to one of my comments…?

      • theadequatemother

        I love the part if your comment where you say a cs is better if she doesn’t want advice or feels overwhelmed…it’s like no informed patient could ever chose a cs over a trial of labour in your worldview!

        It’s interesting how these biases come out, isn’t it?

        I’ve had some terrifying moments with shoulder dystocia too.

      • Captain Obvious

        ACOG states EFW > 5000g for nondiabetics, and EFW > 4500g for diabetics can request ECS. And no, the HC is not always the largest part of the baby. SD is common when the AC>HC, thus the dystocia. Many babies die or are injured attempting vaginal birth that otherwise would have had no injury if CS was done. Check out my next post of real lawsuits posted in just one year. And these are only a few that get entry into the journal.

        • Gene

          My 2nd child was 11lbs (5kg exactly). Even though everything went well, I think in retrospect that I probably should have scheduled a section… No trauma from birth, etc, but I would not do it again because I think the risk to my kiddo would be too great.

      • Captain Obvious

        1) WHEN SHOULDER DYSTOCIA WAS ENCOUNTERED
        VERDICT A $5.5 million Iowa verdict was returned.

        2) ERB’S PALSY AFTER SHOULDER DYSTOCIA
        VERDICT A $1.34 million New Jersey verdict was returned.

        3) FORCEPS DELIVERY INJURES MOTHER’S PELVIC FLOOR
        VERDICT A $1,716,469 Illinois verdict was returned, which included $484,000 to the patient’s husband for loss of consortium.

        4) LARGE BABY WITH CERVICAL SPINE INJURY
        VERDICT A confidential Texas settlement was reached.

        5) DID OB’S ERRORS CAUSE THIS CHILD’S INJURIES?
        VERDICT A $1,314,600 Iowa verdict was returned.

        6) 12 LB, 7 OZ BABY, BRACHIAL PLEXUS INJURY
        VERDICT A $1,174,365 Ohio verdict was returned.

        7) EXCESSIVE TRACTION BLAMED FOR NERVE INJURY
        VERDICT An Illinois defense verdict was returned.

        8) BRACHIAL PLEXUS INJURY AFTER SHOULDER DYSTOCIA
        VERDICT A $72,500 Texas settlement was reached.

        9) ZAVANELLI MANEUVER; BRACHIAL PLEXUS INJURY
        VERDICT A Georgia defense verdict was returned.

        10) Pelvic injury from the McRoberts maneuver?
        VERDICT A $5.5 million New York verdict was returned.

        11) 1. Severe birth asphyxia: cerebral palsy and seizures
        Verdict: The insurance company ultimately paid $10.15 million.

        12) 4. Shoulder dystocia, uterine tachysystole complicate vaginal delivery
        VERDICT A $3.55 million Idaho verdict was returned.

        13) CHILD’S ARM PARALYZED DESPITE MOTHER’S EXPRESSED CONCERN
        VERDICT A $1.6 million Ohio verdict was returned against the ObGyn group.

        14) MIDWIFE “PULLED TOO HARD”; CHILD INJURED
        VERDICT A $950,000 North Carolina verdict was

        • Karen in SC

          Captain, have you ever read about these cases in any detail? Would you say most of these came down to OB judgement and it just went wrong? Or incompetence? or some of each?

          • Captain Obvious

            Some of each

        • Ellie San Martin

          Could you share any from CA? I’d be very interested

          • Captain Obvious

            Google Dr Robert Biter

          • Dr Kitty

            So you can use the details to fabricate a more believable story for Babycenter or MDC or something?

          • Captain Obvious

            You are really missing the point. These are samples of actual SD cases that do happen everywhere, including CA. Gaskins maneuver (which she learned from Peruvian midwives and decided to name it after herself), may work, but is not a guarantee. Post arm delivery after first trying mcroberts and suprapubic pressure is quicker with better chance of success.

          • Ellie San Martin

            thank you, that is helpful to know

    • Karen in SC

      Here is another perspective from a blog written by a mother who had PTSD from her first delivery and requested a c-section with her second. She writes about investigating, now that she has healed, what a forceps delivery is like, then compares to a c-section.

      http://peaceoutofpieces.com/2013/10/15/click/

    • Sullivan ThePoop

      8lbs doesn’t sound right to me. I have known a lot of people to have an 8lb baby no problem. Is something else going on?

  • Maybe there hasn’t been an established optimal rate, but I am sure that it exists. I don’t think it should be thought of as an optimal rate of c-sections, more like the care protocols with the best outcomes and the rate of c-sections that goes along with it. C-section rates vary so wildly from place that I bought into a lot of the conspiracies about it when I was pregnant. I am genuinely curious about the reasons…

    • KarenJJ

      I’m sure it also changes due to changes in obgyn knowledge and technology, changes in patient demographics and health and changes due to the number of women requesting the procedure.

  • Ellie San Martin

    Does it really make sense that 1/3 of women have “devolved” to be murdered by or murder the babies that grow in them unless rescued by an OB performing a timely c-section?? What is Dr. Amy’s take on single layer stitching of c-sections and the pitifully low VBAC rate??

    • Bystander

      C-sections are also prevent disability and serious injury. Over a lifetime, a woman’s chances of dying, losing a baby, having a baby with disabilities acquired as a result of difficult labour or suffering a serious injury herself are pretty close to one third. Human life is hard: a high wastage rate is inherent in the system and it’s only recently we’ve changed that.

      There is a *LOT* of pain out there, which people with ready access to obstetric care simply don’t see. With c-sections being safer now than they’ve been any time, why wait until disaster is manifest before acting?

    • LibrarianSarah

      Did you just refer stillbirths or interpartem death as “murder?” Do you have how insulting that is to anyone who has gone through that? That is a horrible thing to say and you should feel bad. Shame on you

      • KarenJJ

        This type of insult coming from NCB posters is embarrassing for them.

        “Devolved” indeed.

        Anyway, it’s not that 1/3 of women are having c-sections, but that 1/3 of babies are born via c-section. Your actual chance of having a c-section as a first time mum is much lower, even more so if you are low risk to start with. The c-section for births is higher then the c-sections for women because women are having repeat c-sections. I skewed the stats because I had 2 c-sections.

        That said around 50% of pregnancies end in miscarriage and humans are still around, so it is perfectly consistent for there to be a high number of deaths.

        Finally, some women are actually choosing to have a c-section. I had no interest in having a VBAC. It might not be what others choose but it was the right choice for me and I’d be grateful if people like Ellie San Martin were to keep their nose out of my business.

        • Ellie San Martin

          I didn’t mean to poke my nose into your business as I thought we were commenting on a topic (although I understand it’s a very personal topic). I’m glad you are happy with your choice and had all the options you needed. If you look at my original comment I refered to VBAC’s so it’s probably more accurate to be suprised that around 20% of women’s bodies are considered “incapable” of giving birth safely.

          • KarenJJ

            Not sure how you were poking your nose into my business? At any rate, more accuracy is better. Can’t think why you’d be so surprised though? My body was “incapable” of giving birth safely. Plenty of women’s are. Around 6-10% of Australia’s population has a rare disease which are mostly due to faulty genetics and around 50% of pregnancies are thought to end in miscarriage.

      • Ellie San Martin

        I feel bad that you took it that way, as it was not my intention. I’ve never heard of or seen a statistic of stillbirths that could have been prevented with a C-section so I had not considered that. I don’t feel ashamed but I hope you can accept my apology. I was refering to the idea that somehow C-sections are necessary becuase the babies are too big for the mother to give birth, and clearly a C-section is preferable to an 19th century craniotomy, or the death of the mother, I only know 2 mothers who truly required c-sections and know over 40 who regret theirs and felt coerced into it. I also don’t see the data to support that all c-sections performed are life or death issues.

        • Karen in SC

          Baloney! It’s all been said but comes down to risk and judgement. How large a chance does it need to be before you, Ellie San Martin, judge a c-section to be allowed? 10% chance of demise or HIE, 20%, or 50% or higher.

          Who you haven’t met yet are women who lost a baby during labor and say, I wish I would have scheduled that c-section, I’d been holding my live baby now. Those mothers exist.

          • Ellie San Martin

            I’m sorry for your friends who have lost their babies. I do know two women who had still birth but it wasn’t because of labor, it was because the baby inexplicably died in the final weeks and I agree that it’s tragic

          • Karen in SC

            But you didn’t answer my question.

          • Ellie San Martin

            For myself? my child? When the OB or midwife takes the choice away from me or has no time to discuss options. If they give me 10 min to discuss with my husband, most of the time I will pray & trust that God will carry us through. I wish I had done more of that with my daughter instead of allowing myself to be intimidated by the hospital into being separated from my daughter. I still don’t understand why a hospital would send a baby home with a mom who had a c-section after a day but keep my non-symptomatic daughter in a NICU for 9 days. I’ve had several doctors go over the record & no explaination yet.

          • Karen in SC

            If you believe you experienced poor treatment please make a complaint to the OB and the hospital. Many facilities will have a patient advocate. Sorry that happened to you but it shouldn’t indict the entire profession.

          • Ellie San Martin

            I did. That’s why they called social workers to ask us why we don’t trust the hospital to care for our baby.

          • Karen in SC

            Sadly, I have read a lot of tragic birth stories that include the mother fervently praying for her child to be alright – as she is rushed to the ambulance, or rushed to the OR for a crash c-section. But still the baby died. I’m sure those parents wished they had an opportunity to act earlier.

          • anion

            How is your decision to pray instead of having a rational discussion the fault of the OB?

            And personally, I’d be grateful they kept my baby in NICU at even the slightest chance it could be necessary, rather than whining about it. They discovered a minor heart murmur with my first in the hospital. It was a bit scary, and we went to see a pediatric cardiologist twice for ultrasounds and EKGs. It ended up being a fairly common infantile murmur which resolved itself, but I’m sure not complaining that they made sure everything was okay before sending us home instead of just saying, “Eh, I’m sure she’ll be fine,” and then having my baby die because of it.

            I’m sorry your baby spent nine days in NICU, but I am stunned at the idea that it would have been preferable for the medical personnel to just shrug and hand her over without being sure everything was fine.

          • Ellie San Martin

            But the baby you describe had SYMPTOMS. My daughter had NONE. NOTHING. NADA. The neonatologists and pediatricians simply said that they wanted to monitor her. Why? Because they wanted to monitor her. Consult with other doctors and pediatricians sharing her record: they want to monitor her. You can sign her out against medical advice if you want. What’s the medical advice? to leave her in the NICU to be monitored. I hated to feel so frustrated around so many needy babies and parents, & I felt awful my daughter was taking up a bed. but no symptoms, nothing, just to be monitored.

          • Young CC Prof

            And because you’re psychic, you know she would have been fine if she’d been sent straight home with no extra antibiotics. Maybe yes, maybe no. If I were you, I’d just be glad she did go home fine after a few days of extra monitoring.

          • anion

            Not “the baby [I] describe[d],” MY baby. And you have, once again, completely failed to understand my point, which is that I would rather my baby be monitored and checked and watched over than have something happen because they didn’t bother to do that monitoring and checking.

            You said you were GBS+ (among a few other complications). That means there was a *medical reason* for them to monitor her in the NICU. The fact that you didn’t like it, or that you are too obtuse and cavalier to understand it, doesn’t mean the reason didn’t exist.

            You personally might have preferred to go right home with your baby and then have her die from preventable complications, but most of us do not feel that way. You can say all you like that we’re just cowed by that silly fear of infant death, but you tell me what’s more rational: Making sure medical care is provided in case it becomes necessary, or sticking your fingers in your ears and shouting “LA-LA-LA-LA-I’M-GOING-HOME-BECAUSE-THAT’S-WHAT-I-WANT-AND-YOU’RE-JUST-BEING-MEAN!” because you know better than all those silly fear-based medical professionals who’ve actually seen what can happen?

          • Ellie San Martin

            no. what other complication did I mention? I had had 7 doses of IV antibiotics while in labor when the recommended minimum is 4. So either they skipped a dose near birth and tried to cover their mistake (in which case, of course, please give her the antibiotics, but according to hospital protocol, the antibiotics did not have to be given to her in the NICU & could have been given in my recovery room).

          • Susan

            Ellie, you are either lying or leaving out something relevant and embarrassing. Nine days in the NICU for no reason and the social worker simply because you questioned your care, in addition to your online personality….. make me smell a rat.

          • Young CC Prof

            I would imagine that the doctors explained exactly why they were keeping the baby in the NICU, and Ellie didn’t understand and/or stuck her fingers in her ears, so to speak.

            Professionally, I deal with a lot of individuals’ problems. Not medical problems, but problems. I listen carefully to the individual’s explanations, but generally DON’T assume that they are complete or entirely accurate. It’s pretty rare for people to lie, but often they are confused or explain poorly.

          • Susan

            I too think people rarely lie and often, especially patients under stress, don’t hear. I hope that my impatience with this one troll and her bizarre comments didn’t make it appear I am as intolerant of my patients as I am of her trolling. I am actually the nurse my former manager used to assign to the most difficult and/complaining patients because I am able to remain kind. professional and respectful of the rights of even the most difficult patients. Some reward huh?
            However, the nine day stay and social work complaint are fishy. Now usually the social workers want to see any family with a baby in the NICU for more than a day or two, so that could be the only reason. But a lot of times the firing of doctors, long NICU stay, and anger about social workers are red flags for behaviors that most patients would be loathe to admit to and with so much not adding up, and the just highly annoying frequently wrong but never in doubt nature of the Ellie blog I wonder what really might be behind all this with Ellie.

          • Ellie San Martin

            I am not lying. The 1st 3 days was for the antibiotics, then an additional 7 for observation with the circular reasoning I gave. I’m still in a dispute with Kaiser about it because I have told them that I will drop it if they give a reason, like missing one of my doses of IV antibiotics, but I think they don’t want to admit to that & realize I have no basis to sue due to the arbitration agreement & that my daughter is still alive.

          • kumquatwriter

            Please, tell us all about what you think the hospital protocols are.

          • Susan

            Interesting that the people you are supposed to teach have the same opinion of you as you do of the people who try to help you….

            Easily the WORST teacher I have ever had. Childish, played favorites, had a messed up system, and just not very knowledgable. I corrected her grammar/spelling.

            Quality 34%

            sometimes she is just rude to us… and what is with her wacked up grading system?

            Quality 46%

            06/06/03

            A genuinely good person, but she just doesn’t explain things. You think her class is easy and then you look at your grade…Can be rather annoying.

          • Ellie San Martin

            I didn’t want to be flippant toward those who have had to suffer through an infant in the NICU whose life was in danger but someone made an insensitive comment in our VBAC thread earlier akin to “maybe we should offer c-sections to all 1st time moms so they can experience the safety of a VBAC.”
            So in this situation, with an exception for and respect to those who have had an infant with a life-threatening illness in the NICU, maybe all parents should be ensured the safety of an extra week of observation in the hospital nursery while they go home and recover away from their infant.

          • moto_librarian

            Your baby had something going on. My older son (the “natural” delivery at 38 + 3) spent two days in the NICU with TTTN. I never noticed the grunting sounds, but an observant nurse did. And you know what? I’m damned glad that they were monitoring him closely. Just because you didn’t notice any symptoms doesn’t mean that there weren’t any.

          • moto_librarian

            Really? They kept an unsymptomatic infant in the NICU for 9 days? That is such total horseshit. Clearly, we are not getting the full picture from you. NICU care is astronomically expensive, and they don’t put healthy babies in there.

          • anion

            She avoids most questions, because she has no answers.

          • jenny

            Ellie, my baby died because of an intrapartum (during birth) injury, and boy do I wish I could have had the opportunity for a c-section. And I am, by far, not the only one who has had this experience. How, exactly, do you define a necessary c-section? Because from where I’m sitting, it is plain foolishness to say I need a bona fide emergency to prove I needed that c-section. Give me a risk profile over an emergency any day. Once you get to “emergency” every minute is precious.

          • prolifefeminist

            Exactly, Jenny. I had a c/s because the OB suspected placental abruption. Before rushing me said into the OR, he said it was possible he would get in there and find out he’d been wrong and everything was fine, but did we really want to take that risk? Of course not – it wasn’t even a question. There was an abruption, but my son survived. If there hadn’t been an abruption, it still would have been the best decision to have the c-section. That’s not a risk anyone should ever take. You don’t wait around to see what happens when death is one of the real possibilities.

          • Ellie San Martin

            wow, so sorry.

          • jenny

            This 10000x. How close does to death or injury does it have to be? How much of an emergency?

        • LibrarianSarah

          I’m sorry but you are not an ob and you don’t have the right or ability to decide who’s c-sections were “truly required” or not. You are basically the birth equivalent of a Monday morning quarterback. It is easy for you to sit there and dismiss c-sections an not “truly required” when you are not the one who is going to be sued for all your worth if something goes terrible wrong. Hindsight is always 20-20 so if you have a crystal ball that tell which births will result in catastrophe and which will turn out “fine” feel free to hand it over.

          • Ellie San Martin

            The numbers bear it out. Why are so many c-sections performed for “failure to progress at around 5pm or 8pm? I’m speaking in reference to several mothers themselves who regret agreeing to the c-sections.

          • The Computer Ate My Nym

            Why are so many c-sections performed for “failure to progress at around 5pm or 8pm?

            Reference?

          • Ellie San Martin

            Most of the statistics don’t separate between pre-scheduled c-sections and emergency or those chosen for failure to progress or other reasons, so the statistic is difficult to differentiate between scheduling it ahead of time for 5pm or 8pm, & when an OB just wants to go home. But of those I know who have unplanned c-sections that are not emergencies, the OB put the pressure on around those times.

          • The Computer Ate My Nym

            So you don’t have any references that show an increased rate of c-sections at 5 pm and 8 pm. Got it.

          • Ellie San Martin

            Guttmacher institute but as I previously mentioned, it’s easy to argue with that number

          • The Computer Ate My Nym

            Where? I did not find this claim after a brief search of the Guttmacher site.

          • anon

            I don’t think OBs get into this field for a 8-8 shift. Your friends lie to you

          • LibrarianSarah

            Citation needed

            And you didn’t address any of my points.

          • Ellie San Martin

            Most of the statistics don’t separate between pre-scheduled c-sections and emergency or those unplanned and then chosen for failure to progress or other reasons, so the statistic is difficult to differentiate between scheduling it ahead of time for 5pm or 8pm, & when an OB just wants to go home. But of many I know who have unplanned c-sections that are not emergencies, the OB put the pressure on around those times.

          • Karen in SC

            You know or you know someone who knows? OBs don’t count on regular hours, and I’ve NEVER heard of that and I may be a lot older than you and know of many more births. One of my own children was born around midnight and I went in at 4 am for the other and my OB was already there. You are just repeating a myth to justify your opinion. Not fact. Sorry.

          • Ellie San Martin

            It’s not myth & I’m perfecctly willing to change my opinion. Were your children born vaginally or C-section?

          • anon

            My children were born at 7 am after 24 hours of labour following SROM, 6 am 22 hours after induction due to PROM and at 11 pm following induction for post dates. The last was even a Friday. In my experience and from what I know there is a fault with your claim, most OBs are called in for their patients births and are not just waiting at the hospital. They come in to check on their patients but don’t just hang out in the lobby waiting. Secondly if they are an at the hospital constantly during their shift OB, then when their shift is over they would just leave, and the next OB on shift would take over. No need in either situation to worry about how fast things are progressing for OB convenience. Lastly, OBs get scheduled days off like everyone else, and also like everyone else i’m quite sure these are the days they schedule events like golf if they choose on.

          • Tim

            and since ellis is the type who loves Anecdata so much, here’s mine.
            We went to an OB affiliated with our midwives at 41wks, for a biophysical profile & non stress test. This was at oh… 1 in the afternoon on a thursday. Later on in the afternoon, we were back at the midwifes office, and the OB called to tell us that the radiologist who read the ultrasound suspected that our baby was asymmetrical IUGR, and she (the OB) recommended that we induce because it was possibly due to placental breakdown, and if that was the case the baby would be losing weight, and the longer it went on, the less likely it would be that she would tolerate labor, as well as the risk of being stillborn. So she had us go home, get our things, and come back up for her to induce. We got back to the hospital around 11pm, got checked in, and she examined my wife again and debated with herself the relative merits of cytotec vs pitocin, and decide dthat she thought my wifes cervix was soft enough already to just go to the pit. So around midnight she started the pit and went home. She came back in a bunch of times in the middle of the night to check in, and was around hourly again starting in the morning. My wife was ready to push around 9pm or so, and the baby was born at a few minutes past midnight after 3 hours or so of pushing.
            24 hours of labor, 3 hours of pushing, and she amazingly, never tried to just butcher my wife up like beef cattle so she could be off to do things she found more interesting than safely delivering the baby of TOTAL STRANGERS that just happened to drop into her lap the day before. There was no talk of anything other than vaginal delivery until the last 20 minutes or so of pushing when she said that there was some decreased variability and late decels on the strip and she needed my wife to get her out quickly so that she wouldnt have to do an extraction.
            So there’s your anecdata. She even came to see us and held my wife while she cried when we were waiting for the transport team from boston childrens to get our daughter ready to move. Heartless monsters in a big rush indeed.

          • LibrarianSarah

            So you’ve got nothing and you pulled that information straight out of nowhere.

          • Ellie San Martin

            I got 68% from the Guttmacher institute but I see the lack of specificity in the number, coupled with the many women I know who had an unscheduled c-section at that time of day or scheduled it ahead of time for that time of day

          • EmbraceYourInnerCrone

            Not all hospitals have anesthesiologists in house all the time, also they maybe working on another case, so if an OB thinks its beginning to look like a C/S is needed they might want to try to make sure they have one on hand if needed. Just one reason a lot of OBs don’t want to wait too long to decide to go ahead with a C/S.

            People in my family who had C/S: Niece twice, once due to large head, one due malpresentation of head/arm. My mother placenta previa and transverse lie, my aunt large baby w/shoulder dystocia. My Sister in law, crash C/S due to HELLP syndrome/kidney failure/Pre-E(they waited as long as they could at her request to give her daughter a chance).

            Sure I guess their OBs could have waited until they were really, really, really SURE that a C/S was necessary. Of course by then the baby could be dead or suffer permanent brain damage…

          • Karen in SC

            Yes, OBs know that recovery from a crash section is physically harder, and may result in depression or PTSD.

          • Young CC Prof

            Good point. If my OB said, “I can let you try natural labor, but there’s about a 50% chance you’ll need a c-section in the end,” I’d probably say just schedule it. A calm, scheduled c-section is SO much safer for the mother and easier to recover from than hours of labor followed by crash section.

          • Jocelyn

            You’ve got to be kidding…you honestly think obs perform more c-sections at certain times of the day because their shifts are ending? You’ve got to be kidding.

          • Tim

            Becase most women go into labor in the wee hours of the AM , and thus, would be considered failing to progress 15-18 hours later when they were not dilating steadily? Do you think that people go into obstetrics because it’s a get rich quick scheme? There are much less hectic specialties that typically keep regular office hours (and pay much more money too!) that these Dr’s could have gone into. Unless you know, they were actually interested in taking care of women’s reproductive needs, and willing to deal with all the crap that goes along wtih it.

          • Ellie San Martin

            you think 15-18 hours is a prolonged, non-progressing labor??

          • Young CC Prof

            If there hasn’t been any progress the past few hours, yes, 15-18 hours is non-progressing. It’s not the total length of labor, it’s whether the labor is going anywhere, and how well mother and baby are tolerating it.

          • Tim

            No, I KNOW that 15-18 hours without progression is a prolonged, non-progressing labor. One can labor for 15-18 hours with steady progressive dilation, or one can labor for 15-18 hours with sporadic/poor or no dilation. One is “normal labor” , and one is “stalled/non progressing labor
            Again, there are dozens (literally) of medical specialties a Dr could go into that pay better than Obsetrics AND don’t involve insane hours. People don’t get into Obstetrics because they are expecting a nice cushy 9-5 gig and then dramatically find out there is nutso hours and insane amounts of work that go into it.

          • moto_librarian

            I will have to bow out of this conversation because your complete cluelessness is infuriating, I suffered a cervical laceration and massive pph after the oh-so “natural” birth of my first child. I would have had a c-section in a heartbeat had it meant that I could have avoided that. It left me so afraid that we almost didn’t have a second child. It’s nine of your business why women choose to have c-sections, and you have yet to produce even a shred of actual evidence to support any of your claims. I am also feeling particularly raw because I am watching a friend mourn her son who should be a vibrant 2-year old, but was instead born still because her uterus ruptured during a VBaC attempt. So spare me your sanctimonious bullshit about OBs pushing c-sections for convenience.

          • BeckyA

            Omg, moto. I’m so sorry for your friend.

          • moto_librarian

            Many of you know of whom I speak. She is doing a lot of advocacy about childbirth loss and against homebirth, but she is hurting so much and it just kills me when some idiot like Ellie parachutes in here and bitches about the c-section rate.

          • anion

            Oh, moto. How awful. I am so sorry for your friend, and that you had to go through what you went through as well.

          • prolifefeminist

            I’m so sorry for your friend, moto. How unspeakably sad.

          • The Bofa on the Sofa

            But the “Monday morning quarterback” comment isn’t even 20/20. Consider, for example, a breech presentation. Let’s say for the ease of argument that breech has a 5% problem rate. That means that it can be delivered just fine 95% of the time. So if 20 women have a c-section for this reason, then that means that 19 of them didn’t actually need to be delivered by c-section.

            The question is, which one did? The problem is, not only can you not tell beforehand, you also can’t tell afterward, either, since the problems do not occur until labor. So in this case, hindsight tells you … nothing. You can’t distinguish the “necessary” from “unnecessary” c-sections even after the fact.

            The reason is that objective of c-sections is to prevent problems, not resolve them. If you do a c-section before a problem has occurred, and it prevents a problem, there is no way that you can know that. You only know that you did not have a problem with the c-section. You cannot say that you would or would not have had a problem vaginally.

        • Captain Obvious

          So the only necessary CS is one where the baby or mom is truly in a life or death situation? Ugh. Do you only wear your seatbelt when you decide to speed 95 MPH? A judgement is made that in experienced hands that labor is not proceededing well or the FHR has onimous patterns that if continued to labor either baby or mom has a substantial risk of harm. I weigh the risks and benefits of continuing to labor vs proceeding with CS and because of the current situation I now feel CS has become safer. Women are now assessing the risks of vaginal birth like urinary incontinence, pelvic organ prolapse, a wider loose vagina or worse dysparunia as a result of third or fourth degree lacerations, fecal incontinence or fistula. These women are choosing CS birth electively over a spontaneous TOL.

          • Antigonos CNM

            The seat belt analogy often is based on “I’ll use it if I intend to speed”, therefore, if I’m driving within the limit, I don’t need one. Well, that’s fallacious, if someone else hits you. Very occasionally a woman goes into labor knowing that, for some specific reason, she is more likely to have a C/S than the average, but most do not. That doesn’t mean that a perfectly OK low-risk pregnancy can become a raging emergency in minutes through no fault of the laboring mother’s.

          • DaisyGrrl

            I have a relative who refuses to wear a seatbelt unless she’s driving on the highway. Her reasoning is that she’s never heard of a person dying in a lower-speed crash so she’ll be fine. Also, the governnment is trying to take her freedom by forcing her to wear a seatbelt.

        • prolifefeminist

          Here’s the thing. Medical science is not perfect. Technology is not magic. Doctors can use all the tools they have to try to ascertain whether a baby is in trouble or not, but there is NO foolproof way of knowing FOR SURE. So you have to take the information you have at hand and make a safe decision – the best one you can make.

          Case in point – I was in a car accident at term. I was taken to the hospital, where I thought I’d be monitored for a while and sent home. But I had a nagging crampy pain near the top of my uterus, so my midwife (CNM) called in the OB. Then the FHR tracing became very worrisome – loss of variability and pseudosinal pattern, even though the rate stayed normal. The OB took one look at that, and combined with the upper abdominal pain and history of motor vehicle accident, said we needed to do an immediate c-section. He said that it appeared that the placenta was tearing away and the baby was in danger of bleeding to death very quickly. He said they could get in there and find out that they were wrong, but was that a chance we wanted to take? OF COURSE NOT. Not in a million years was I going to sit and wait to see if my baby bled to death inside me.

          So we rushed down to the OR and my little boy was out within minutes, and sure enough, the placenta had begun to tear away. Careful monitoring, an OB who quickly and clearly spelled out the risks, and a willingness on my part to submit to what might in retrospect have been an “unnecessary” surgery were what saved his life. If they’d opened me up and everything was fine, would I have been upset about my “unnecessarean”? Nope. Not one bit. All you can do is make the best decision based on what you know at the time, and nothing more. And it would have been the right decision no matter what the outcome.

          • Karen in SC

            What a great story!! With such a happy ending, too.

            I fell at 8 months and stayed overnight in the hospital. All precautions were taken, ultrasounds, blood work. I don’t remember any FHR monitoring but it was 20 years ago.

    • Wren

      Yes, it completely makes sense that a high number of babies and even mothers are likely to die or be seriously injured through birth. Have you no sense of history? Have you never seen the high numbers of men who remarried after their first wife died in childbirth historically? Wow.

      Exactly what should the VBAC rate be? (I had one, and it worked out just fine. I don’t have a problem with women who want a VBAC and are good candidates having one.) If you are describing a rate as “pitifully low” then you must a) know the rate and b) have an evidence-based better rate, right?

      • Ellie San Martin

        Actually I teach history and women’s health history is a particular interest of mine that I research in my spare time. Including in my own family as weIl as friends, yes, I know that there was not as much insight into how to prevent the dangers accompanying childbirth. Most would think that with modern insight into eclampsyia, vitamin D to prevent rickets (& therefore cefalopelvic disproportion) & modern ability to move the breech fetus in utero would drive the c-section rate down. Although granted the ultrasound to learn of placenta previa could increase the c section rate, though I don’t see by an equal amount.
        As for VBAC rate, it should be available as a choice that isn’t frought with fear if OB’s are properly stitching the c-sections performed (which is why I mention double layer stitching). I know that unless the woman can choose a VBAC for her 2nd birth, then she has no choice for her 3rd, which also drives the rate up. As for what the rate SHOULD be, I will simply point out that in many areas it’s not available, period. So a woman must travel long distances to have VBAC as an option, which is sad.

        • Karen in SC

          Who told you or where did you read about OB’s improperly stitching c-sections?

          • Ellie San Martin

            in a piece from the Orlando sentinel, & I’ve had several friends who discovered it after the fact when they wanted to try a VBAC & were denied

          • Karen in SC

            Not finding much in PubMed, plus I’m not an OB. But I did find a 2003 study done in Croatia that concluded: “The best uterine scar is the one after using one layer interrupted
            Vicryl and Dexon suture. The worst healing results were obtained after
            two-row interrupted and continuous sutures using catgut.”

          • Ellie San Martin

            given that I wonder why OB’s would deny a VBAC based on the mother having previous single layer stitching as a reason…unless they were making it up because they simply want to deny the woman a VBAC

          • Karen in SC

            there are other characteristics of the scar that matter: thinning, adhesions are two that I am aware of. If you don’t have a transcript of the conversation, how do you know exactly how it was explained?

        • anion

          Once again, large numbers of us do not WANT VBACs. Why do you keep insisting we should be having them?

          • Ellie San Martin

            I insist that you have the choice, maybe have to endure a question like, “why are you sure?” from a 3rd party other than the OB

          • anion

            Why? Do you think being asked “Are you sure?” by some nosy stranger is going to make me decide I want to do something I don’t want to do? Do you think I’m too dumb to know what I want, and I need your interference or I’ll just make some dumb decision like the moron I am? Hee, giggle, I’m just a girl, how do I know whether I want another c-section? Well, my Magic 8-ball told me it’d be a good idea so that’s what I’ll do!

            Why should I have to give up even one minute of my time to discuss my body and birth decisions with someone else, just because you prefer VBAC?

            Go have your own VBAC, busybody. Go consult a third party about all of YOUR decisions (that is actually probably not a bad idea for you). I’m going to be over here with the grown-ups who are paid the respect of A) being assumed to know their own minds; and B) being allowed their own decisions.

        • anion

          According to LinkedIn you do not in fact teach History, nor are you degreed in History. Are you giving incorrect info here, or there?

          (And psst…design trademarks aren’t the same as word trademarks, and you can get in serious trouble for using the R-in-a-circle to claim a word mark [not design mark] you don’t own. FYI.)

          • Tim

            She sounds like she teaches history of the “and lo, 6,000 years ago the lord spoke and saw that the universe was filled with light, and he looked upon the light and declared it was good” sort

          • Ellie San Martin

            I never said I taught theology?

          • Ellie San Martin

            what is Linkedln?

          • anion

            Don’t be disingenuous. You know what it is, because you’re on it.

          • Ellie San Martin

            I just found that site, & somehow it has a profile of my name which lists two past jobs…idk how that happened. I didn’t say I had a degree in history but I do teach it. If you want to look up my credentials I passed all of the exams to get a credential in it. CA allows this through the CSET exams.

            http://www.ctc.ca.gov/lookup.html

          • anion

            That site shows English credentials (in the form of a standardized test, but I did see your BA as well, which is not in history or really an academic subject at all, on LinkedIn), but none in History. Your Facebook and Twitter both list you as an English teacher. There is no mention of history on there anywhere. An additional search of the course catalog at the school where you teach shows you teaching zero history classes. Are ALL of those sources inaccurate, then?

            You have to create a page on LinkedIn, it doesn’t happen spontaneously and it is not Created by an Intelligent Designer.

            (And BTW, I am not joking, and I am not being snide, about the trademark thing. Claiming a word mark you don’t own is illegal. It CAN get you into trouble.)

          • Ellie San Martin

            I never claimed to have a degree in history, I have taught it in conjunction with English in the past, not this year. Social Science is history in CA & I do have a credential for that from a standardized test. English Rhetoric is not an academic subject now? I really don’t get the LinkedIn thing…maybe a friend created the profile or in responding to a friend’s request, I inadvertently allowed a profile? What in the world is the trademark thing??? how would I have any need of a trademark??

          • Ellie San Martin

            I in the interest of full disclosure, I’m on maternity leave now so I don’t technically teach anything for these months.

        • moto_librarian

          I truly hope that you are joking when you claim to research women’s health history.

        • Young CC Prof

          *eclampsia
          *cephalo-pelvic disproportion

          The rest is not even wrong.

        • wookie130

          You don’t teach history.

          Ellie San Martin, everyone. The gift that keeps on giving.

          • Ellie San Martin

            I don’t currently. I have in the past and I’m credentialed to teach it. 11th grade English is American literature and requires units of history be a part of it.

    • yentavegan

      perhaps in your more evolved world, we should be all walking around with leaking fistulas instead of c/sec scars?

      • Ellie San Martin

        No. I happen to believe that this world is intelligently designed, but I don’t really understand your point…?

        • kumquatwriter

          A perfect summation of this entire conversation.

          • Agreed.

            Anyone that believes in intelligent design in this day and age is impervious to reason.

          • Ellie San Martin

            Ah, so clearly, the primordial soup came from the big bang

          • LovleAnjel

            You don’t know what those things are, do you?

          • Ellie San Martin

            the primordial soup is the inexplicable 1st organic particles, & big bang is the bizarre explanation for how it came to be. Neither of which can be proven through scientific evidence or experimentation, & are therefore articles of faith in science.

          • Tim

            They abso-frigging-lutely are not examples of faith in science. People work every day trying to find ways to reproduce those conditions or pprove them wrong or find other explanations. That’s what science IS. Faith would be sitting down and going “welp that’s good enough, I believe that” and moving onto something else.

          • Ellie San Martin

            which experiments have reproduced the conditions of the big bang or reproduced the primordial soup?

        • Elle

          I believe this world is intelligently designed too, but you can’t deny it’s also fallen and has a lot of problems. Cars are intelligently designed too, but that doesn’t mean they don’t break down and malfunction… which is why it’s so important to have mechanics.

        • Box of Salt

          Ellie ” I happen to believe that this world is intelligently designed”

          How do you reconcile the large maternal and infant mortality rates throughout the centuries prior to the last one with the characterization of the way a woman is “designed” as “intelligent”?

          Why wouldn’t an intelligent design include *low* mortality rates for reproduction?

          • Ellie San Martin

            not if humans don’t investigate the existence of microbes

      • Ellie San Martin

        is the fistula comment meant to refer to single vs. double layer stitching of c-sections??

        • yentavegan

          You posited the question, and forgive me I am paraphrasing, speculating if 1/3 of our population has devolved to the point that doctors must perform surgery lest their baby or themselves die..
          I am suggesting that devolution is not altering our physiognomy but modern people do not tolerate putrid leaking holes from the anus to the vagina due to a prolonged difficult labor and birth. And yes, they are not uncommon in developing nations and yes our fore mothers suffered this humiliating childbirth injury.

          • Ellie San Martin

            exaclty why modern understanding of birth should not coerce women into c-sections out of fear. I’ve had several friends who almost died of nicked bladders, 12 cm hematomas & so much else from unscheduled C-sections that an OB coerced them into for “failure to progress” without giving other options. It’s not the scar I’m worried about, it’s that C-sections are taken seriously as the life-saving godsend they are instead of applied as a cure-all on an assembly line for any impatience or uncertainty during birth.

          • The Computer Ate My Nym

            Given that the rate of bladder laceration in a c-section is something around 2 in 1000, you either have a lot of very fertile friends or they have some very incompetent OBs.

          • Ellie San Martin

            I say incompetent and overwhelmed OB’s (depending on how you define “fertile.”) If you define fertile as around 3-4 children each, then yes, both.

          • anon

            I call option 3. She is incompetent with facts as she seems to miss they don’t hold water when they’re removed from your ass. 753 of my friends think she is making her numbers up, and these friends are people with blogs she has never actually met.

          • Bombshellrisa

            But those ARE documented risks. Anyone who sits down with their doc for 5 minutes and says “I want to talk about the risks of a C-section” will hear about the actual risks (a discussion that should happen before a woman is ever in labor, even if she doesn’t want a section and/or has never needed a section at any of her other deliveries). Same if you want to talk about the risks of vaginal delivery.

        • Lisa Cybergirl

          This explains what a fistula is.
          http://www.fistulafoundation.org/whatisfistula/

    • Captain Obvious

      You do know the difference between the Total CS Rate being about a third, and the Primary CS rate being around 15-22%? When VBACs were in their hay day in the 90’s, so was it’s morbidity and mortality. What do you believe an optimal VBAC rate be? Explain the TOLAC vs VBAC rate first. Then explain who should be allowed a TOLAC, and where should it occur, hospital or home?. What is your take on Homebirth midwives not even using suture for lacerations at Homebirth? What is is take on using seaweed for lacerations at Homebirth? What is your game on the higher perinatal mortality with Homebirth as evidenced by the 2005 BMJ study, Judith Rooks CNM report, 2013 AJOG study, and CDC data from Oregon, Colorado, and other states. Not to mention, what is your take on MANA not releasing their neonatal mortality rates from their 28,000 delivery MANAstats?

      • Ellie San Martin

        I’ve never heard about home births denying needed stitches, despite several friends having one, but that certainly sounds ignorant & negligent. Seaweed sounds absurd. I personally don’t feel comfortable with home birth, but the friends I know who chose it chose it out of fear and desperation at the inhumane treatment they recieved from OB’s at the hospital. That is something I think should be remedied, rather than further trying to layer on the fear & guilt, when the guilt lies with an OB who mistreated his/her patients & hides behind statistics and hospital policy. My game is that if the medical community addressed their hospital maternity procedures & didn’t treat laboring women like illogical ignorant fools endangering their babies by simply asking a question or asking to have choices over their own bodies, women would not be desperately & fearfully driven to home births. & for a multigrad with no risk factors & a hospital/OB immediately available, why not allow her that choice without judgement?

    • anion

      1. It makes sense if you look at history. There’s no “devolution.” There are more lives saved.

      2. “Pitifully low” VBAC rate? Does it not occur to you that one big reason for a low VBAC rate is that women do not want VBAC? I sure didn’t, with my second. My doctor–one of those evil OBs–suggested it and I shot that right down; no interest whatsoever. Or are you suggesting that I should have been forced to VBAC against my wishes in order to live up to some arbitrary ideal you have in your head? Should I have been strapped down and forced to endure labor and delivery despite the risks, in order to please and impress you? Why do you hate women so much? Why are you so determined to make us endure pain–and potentially lifelong complications like prolapses, incontinence, fistulas, etc.–when there is a perfectly fine alternative? Why are you so determined to steal choice and autonomy from other women?

    • The Computer Ate My Nym

      The short answer to your question is yes, it makes perfect sense. The longer answer…
      Evolution doesn’t produce a perfect organism. It produces a “good enough” organism. Emperor penguins fail to transfer their eggs from the mother to the father for incubation something like 50% of the time. That doesn’t matter because they transfer them often enough for the incubation by the father to be more likely to produce a living penguin than the malnourished mother incubating the egg. Similarly, if enough women give birth to enough living babies, it doesn’t matter if 1/3 don’t make it. The species continues.

      So that’s the population level. That doesn’t really explain the individual level, though. One would expect that women who tend to need c-sections would have died out because they either died in labor or couldn’t produce offspring. But there’s a critical assumption being made in that statement: that the need for a c-section is genetic and it is the “fault” of the woman who is pregnant that she needs a c-section. Sometimes it’s a fluke. The placenta happens to implant in the wrong place. The fetus randomly turns its body or head wrong. The cord is looped badly by accident. In these situations, the mother or baby or both may die, not due to any genetic failure but due to chance. No evolution occurs because there is no gene to be eliminated.
      Finally, the modern situation. Assuming some causes of c-section are genetic-say, a uterus that is slightly malformed and tends to turn the fetus to undeliverable positions or a tendency towards longer cords that are more likely to wrap around the fetus’ neck or inability to dilate properly, for speculative examples. In the past, these genes would have been maladaptive as women who had them would tend to not be able to give birth to living children and survive and so the genes would tend to decrease in the population. Now, with easy c-sections, the same genes have no evolutionary disadvantage at all: few women have more than 3-4 children anyway and it’s easy enough to have 3-4 c-sections. So the same genes are no longer causing deaths.
      One could take it even further: Suppose-and this is entirely speculative-the genes that cause, say, poor dilation in labor and a higher chance of failure to progress, also decrease the risk of premature labor and therefore loss of a second or third trimester fetus or birth at a time when survival is unlikely and survival without major neurologic complications essentially unknown. Then women who had this gene become MORE likely to have viable offspring and it becomes a “good”, adaptive gene-for this environment.
      There is no “devolution” only adaption that works or doesn’t work for a certain environment.

      • Ellie San Martin

        Intelligent design doesn’t design perfect organisms or perfect circumstances & choices either. Neither does such a high rate make “perfect” sense. Apparently it makes “good enough” sense to you. As some other commenters pointed out, (& I should have originally considered) due to repeat c-sections, the rate of women having c-sections is more like 20%. But I also pointed out, wouldn’t modern medical insight decrease this c-section rate, due to increased vitamin D preventing rickets (& therefore cefalopelvic disproportion), better monitoring of pre eclampsyia, knowledge of how to turn the breech fetus in utero, better stitching of 1st c-sections so that VBAC’s are safer etc?

        • Karen in SC

          Rickets may contribute to CPD, but it isn’t the only factor. There are four basic shapes of normal female pelvises (though I don’t know the percentage distribution), and the baby may end up with DNA for extra large head.

        • The Computer Ate My Nym

          It’s not so much “modern medicine” as not working dawn to dusk in factories without access to sunlight that has decreased the rate of rickets. We don’t know how to prevent pre-eclampsia so no to that one. Better monitoring and awareness of pre-eclampsia probably increases the rate of c-sections-and of good outcomes. Turning a breech in utero rarely works and I’m unaware of any particular new information on how to do it better, so not really there either. And VBACs simply aren’t up to the safety of repeat c-sections yet. Sorry.

          I’m not sure what your point is about “intelligent design”.

          • Ellie San Martin

            managing pre eclampsyia is better than being suprised by full blown eclampsyia out of nowhere

          • Ellie San Martin

            16 of my personal friends have been able to turn a breech baby in the last 2 weeks. My point is that an intelligent designer, (God if you will) designs our bodies and brains, just as an intelligent OB designs a C-section.

          • anion

            Goodness, your friends are so very, very fertile, aren’t they? Baby showers in your group of pals must really be something, with all those hundreds of pregnant ladies turning their breech babies in utero and being forced at gunpoint to have c-sections and being bullied and improperly stitched. It’s amazing how you remember right off the top of your head the exact numbers, out of all those friends, who’ve dealt with each unique little situation.

            You know, twenty-three of my friends were thrilled to have c-sections. Another forty-seven wanted sections but couldn’t get them, and then seventeen of them had pre-eclampsia and fifty-five of them had gestational diabetes and eight of them had twins. And thirty-one of them especially liked ice cream.

            Also, what if six was nine? Wouldn’t you mind?

          • LibrarianSarah

            I’m going to go out on a limb here and state that people who believe in creatio.. I mean “intelligent design” don’t usually use birth control.

          • Ellie San Martin

            LOL! “Contraceptive use is common among women of all religious denominations. Eighty-nine percent of at-risk Catholics and 90% of at-risk Protestants currently use a contraceptive method. Among sexually experienced religious women, 99% of Catholics and Protestants have ever used some form of contraception. [6]” http://www.guttmacher.org/pubs/fb_contr_use.html

          • Bombshellrisa

            We are Not talking about natural family planning where a woman tracks her cycle.

          • Ellie San Martin

            neither is Guttmacher

          • Happy Sheep

            But most religious women accept that evolution is logical and how we all came to be. In general intelligent designers are in the minority. You did not answer the question.

          • Ellie San Martin

            Is there something wrong with fertility? ‘m at that stage in life, & I actually remember because I was always intently praying for them through it all. I didn’t say gunpoint. sorry about your 47 friends who were forced at gunpoint to labor in pain with no medication at home without the relief of a C-section, but I’m glad they and their babies survived. I don’t know if the numbers cross, but if your 31 friends who liked ice cream were among the 55 friends who had gestational diabetes, I’m sorry for their inconvenience and suffering deprivation too.

          • anion

            I find it utterly terrifying that someone as tone-deaf and unable to understand written communication as you are is a teacher.

            Seriously.

            That’s not even taking into account your refusal to look objectively at facts, or your insistence that your opinions equal truth, or your refusal to acknowledge anything which does not agree with your particular worldview (you did not answer a single one of the questions I asked you in my original reply. Should I write them again, in much more simple language, so you can understand them better?), or your reliance on anecdota that sounds more like something culled from a Victorian novel (those are books of fiction–made-up stories–that take place during the Victorian era, which was 1837-1901, and stories like the ones you’ve told about offensively patriarchal doctors desperate to cut women open weren’t uncommon then. Unlike now) than anything actually happening now, today, in modern hospitals, or the things you keep stating as fact which are completely wrong. All of those things are bad enough on their own, but they combine into a sort of perfect storm of intellectual ineptitude.

            (P.S. Because I can picture you rubbing your head in confusion, and because I don’t want you replying to a point I didn’t make because you failed once again to comprehend the written word…yes, I am saying you’re not very bright. And if that upsets you? Then quit telling me what to do with my body, or that what I have done with it was wrong. I’m very glad I had two c-sections; I had no interest in VBAC, and all the busybodying and finger-waving you can do won’t change my mind.)

          • Ellie San Martin

            I’m happy for your health and happiness with your choice, I’m sorry you misunderstand my comments as judgement on you, and I pray you would allow women who would make a different choice than you the same support rather than judgement. I appologize for not answering your questions, I will attempt to do so. But my suspicion is that you cannot comprehend a person who would look at the same data you do and make a different choice.

          • anion

            Oh, now, don’t do that. I’m not misunderstanding your comments as judgment on me at all–and if I did think you were judging me I wouldn’t give a rat’s–and I’m happy to support any woman who wants to VBAC as she makes her VBAC attempt. Because, see, their decision to VBAC isn’t a personal affront to me, whereas the “pitifully low” number of VBACs apparently is so to you.

            And, again, unlike you I certainly can comprehend people making different choices than me. I can even understand them making that choice having seen the same data. But you have not, as your comments here show very clearly; you are unaware of most of the factual information being discussed and rely for your opinions on your thousands of fecund friends and the detailed charts you keep–with transcripts of private medical discussions, apparently–about their pregnancies and deliveries.

            Would it be supportive and non-judgmental, then, if I lobbied for a law whereby women desiring VBAC must meet with a non-OB third party who will ask them, “Are you sure?” And presumably justify that decision to a stranger whose business it is not? What other medical procedures would you like to see this “third-party-overseer” policy enacted with? Mole removal? Transplants? Cosmetic surgeries? Bypasses? Prostate surgery? Or is it just women who should have to answer to someone else, and if so, is that just regarding birth or should I have to check with somebody else before having, say, my deviated septum fixed, or laser surgery to correct my vision (sadly, no one “designed” me with perfect vision; in fact, without correction I am legally blind. Can you tell me why I have “devolved” from my ancestors? Why was I not Intelligently Designed to see better? Why am I defective?

          • Ellie San Martin

            are you really comparing a c-section to mole removal or cosmetic surgery?? you’ve made my point. I’m sorry about your eyes, mine aren’t great either. But we were given brains to overcome the crueler choices of evolution. I hate to have lost you in a hunter gather world without optometrists

          • anion

            No, it’s not a direct comparison, and no, I have not “made [your] point.” I knew you’d zero in on that because you can’t actually answer my questions.

            You didn’t answer them, you know. Yet again.

          • Ellie San Martin

            please restate them

          • anion

            I just did, above. In addition, they all still exist here in the discussion. They haven’t disappeared, and you can easily go and re-read them and provide answers.

          • anion

            BTW, you do know that moles are often removed because they are or could be cancerous, right?

            Or do you think that’s just those evil doctors making you fear cancer so they can slice you up and go play golf?

          • Ellie San Martin

            since skin cancer runs in my family, i’ve had them removed but then recent (last 5 years) dermatologists have explained that this is unnecessary because moles don’t become melanoma, melanoma is sometimes mistaken for moles

          • kumquatwriter

            Got it. Jesus likes optometrists. Can’t stand Obstetricians. Makes total sense, because there is NO WAY God mean for us to be nearsighted, but he never meant for us to use our brains to help women and babies, you know, live.

          • Ellie San Martin

            where did you get that Jesus doesn’t like obstetricians? If some optometrists were performing unnecessary lazer surgeries for patients who might lose some sight & then caused the person to lose eye functions you would not find that objectionable?

          • Bombshellrisa

            Mole removal is a lot like a C-section : it’s something you can only pronounce “unnecessary” in retrospect.

          • Ellie San Martin

            actually if it is a true mole it’s always cosmetic. melanoma spots are sometimes mistaken for moles, but were never moles. but now you’re stretching it so anion doesn’t appear as flippant as s/he was.

          • KarenJJ

            Is there a topic on here that you don’t know anything about?

            “melanoma spots are sometimes mistaken for moles, but were never moles.’

            WTF? I’m unfortunate enough to have some knowledge of skin cancer and melanoma and you’re wrong.

          • KarenJJ

            OK, this was driving me nuts.

            30% of melanoma comes from moles, however the chance of an individual mole developing into cancer is very small because there are so many of them. There are also common moles and dysplastic moles (didn’t find reference to “true moles”) and common moles only become cancerous in very rare cases.

            http://www.melanoma.net.au/Melanoma/moles.htm

          • anion

            Except I wasn’t being flippant. It’s a serious question: What other procedures and surgeries do you believe should require third-party approval? I listed a number of them, from serious to more minor, in an attempt to discover where you draw the line. You can focus on one of the many procedures I listed and denigrate it in an attempt to avoid the question all you like, but the rest of us are not so easily distracted and will still ask for your answer.

            Do you believe, then, that someone whose doctor thinks a mole is potentially cancerous, and who thus wants it removed, should have to meet with a third party who will ask her if she’s really sure she wants to have it removed and why? Or is it just women choosing c-section who are too dumb and scared to make their own decisions?

          • Ellie San Martin

            no, that could be 3rd party too I guess, but then I’d be buying into your comparison of a c-section to removing a mole, which I don’t

          • anion

            I didn’t make that comparison. I have stated twice now that I was not making that comparison. No one but you thinks I was making that comparison.

            So you DO think that a person should have to explain to a third party their reason for wanting a mole removed? What about the other procedures I mentioned? Does it matter to you if the person desiring the procedure is male or female, or should both genders be required to meet with some other person to justify their decision to have whatever procedure it is done?

          • Ellie San Martin

            I’m not going to insult your intelligence by quoting yourself back to you. read your comment again. yes, a 3rd party should be available for psychological consult on all genders (including Transvestite, hermaphrodite or anything else) in any case that involved internal or reproductive organs

          • anion

            Jesus Christ. I really need to stop replying to you, because you are the thickest moron I’ve encountered in a while and it’s totally pointless. I know what my comment said; I’m not the dimbulb who keeps pretending she didn’t say what she said and misunderstanding basic sentences that my twelve-year-old daughter would have no trouble parsing.

            Quit changing the parameters. You *never* suggested a “psychological consult.” You said women who don’t want to try VBAC should have to talk to a third party–you never once said a psychiatrist or psychologist or, in fact, listed any sort of qualifications you think this third party ought to have–who will ask if they’re sure and why. That is not remotely a psychological consult, nor would it appropriately be considered so. (BTW, the word you’re looking for is “transgender” or “transsexual,” not “transvestite,” but whatever; I shouldn’t expect you to have any clue what you’re talking about.)

            But it’s good to know, at least, that you think a man with prostate cancer who decides in conjunction with his doctor that he would like to have surgery ought to have to make a second appointment with someone else to justify that decision to them. At least it isn’t just women you think are too dumb to make their own decisions about their bodies (although I guess I can’t blame you for thinking everyone else has as much trouble as you, given your lack of ability to see your own incompetence).

            I’m done replying to you. You’re a waste of my time. You’re a lying liar who tells obvious, ridiculous lies, and who thinks because you’re not smart enough to remember them no one else is either. You remain convinced, though, that you’re the smartest girl in the room despite all evidence to the contrary, which makes you simply tiresome and irritating, like a song I hated the first time being played over and over again in the next room.

          • Ellie San Martin

            I am not the smartest woman in this proverbial room or any room for that matter. But I am a woman and a human being who deserves to be treated as such by my healthcare providers. Your attitude is exactly what no human being deserves while in labor.

          • jenny

            But you aren’t in labor right now. You’re posting on a message board, on the internet. These people are not your caregivers.

          • Susan

            Ellie, I wouldn’t be too worried that you are going to insult someone else’s intelligence…..

          • Squillo

            Oh? Define “true mole” for us.

          • Eddie Sparks

            Actually, a true mole is only cosmetic NOW. A naevus (mole) can become dysplastic, and a dysplastic naevus can become malignant in THE FUTURE. Up to 50% of melanomas arise from dysplastic naevi.

            So the comparison with regards to CS is even more apt. Even when you remove a naevus or a dysplastic naevus you may not know whether it was one of those that was going to become malignant or not. And you can never know.

            Just like the pink, screaming baby born from a CS. You will never know whether it was one of those who might have been injured or died without the CS. Or not.

            Also, the comparison isn’t flippant. Melanomas kill people.

            (Yes, I’ve been reading and DNFTT. But it’s an important point for people in general to avoid becoming complacent about moles. Moles need to be monitored. Like babies during labour. Just different time scale.)

          • LibrarianSarah

            Oh please you haven’t quoted any actual data yet. You just spouted on about your friend’s cousin’s sisters OB. Even if you have read the data. I doubt you would be able to understand it judging solely from the amount of failures of reading comprehension you’ve displayed in this comment section alone.

          • Bombshellrisa

            Reminds me of Kelly-still waiting to hear what her “source with ACOG” said and of course her “stats and data” (because as you will remember she quoted her own deliveries and those of a few friends as her knowledge base)

          • Ellie San Martin

            no, I said the OB dept at Kaiser in So Cal. Actually, it’s that I doubt most statistics after seeing how easily they are manipulated and inaccurate, able to prove 2 opposites.

          • Ellie San Martin

            As for your intelligence, you strike me as smart but overruled by emotion, so I would encourage you to consider topics more objectively and human beings as whole beings, including their emotions and spirits in addition to their biology instead of assuming they are simply screwed up machines to be fixed. As a teacher, I try not to consider my students as vessels to be filled with information but as human beings who are in need of guidance from people in all walks of life, of which I am merely one among many, thank goodness. My job is not to clone myself.

          • anion

            Hmm. Overruled by emotion, but thinks of people as just machines to be fixed.

            Sure. That’s logical.

            I’m not the one using terms like “devolved” here, or implying strongly that women who have c-sections are “defective.” That’s you. I’m not the one attempting to steal the autonomy and dignity of other women by implying they can’t make their own decisions and need a third party to double-check with them, because the silly things might say they want one thing while secretly wanting another.

            One of us doesn’t see thinking, feeling humans here, maybe, but it isn’t me.

          • Ellie San Martin

            well, evolved would assume positive changes, so I was relaying what women feel conveyed to them by an OB telling them their body simply won’t push out a 9 lb baby (who turns out to be 7lbs). do you think every person on the planet has no problem speaking up to an educated person demanding an answer right away? I meant that a 3rd party could ask them how they feel since the OB clearly has no time to hear it. “I’ve been doing this for 20 years. You can’t have this baby, it will die if you try. I could explain if you really want, but what time should I schedule your c-section?” doesn’t leave many women feeling like they have room to think without risking further ridicule.

          • anion

            Please try to keep your arguments straight. That’s not remotely what you said or suggested before. Ad plenty of OBs do in fact have time to hear it, and explain it. My OB, for instance, would have liked to see me attempt VBAC and was visibly disappointed when I nixed that before he could even stop discussing it. I never felt pushed out of his office or as if he didn’t have time. I know lots of women who felt the same.

            As for the quote above… Where do you live, Stepford? A doctor who behaves that way toward his patients, in this day and age (when something like half of all OBs are women, btw), would soon find himself without any (unless he’s a medical genius, in which case some women would put up with his rotten bedside manner in exchange).

            Personally, I think being assertive enough to ask questions about one’s own healthcare is rather an important life skill, especially if one intends to raise children, but that could be just me.

            Tell me, does your religion encourage you to ascribe evil motives to everyone on the planet, especially doctors, or have you come up with this one on your own?

          • Ellie San Martin

            It was in Victorville, CA, & most of his patients were young teenage girls. I don’t attribute evil motives to very many people, even in the cases I’ve described I didn’t speculate as to motives. My guess would be that these OB’s are impatient and overwhelmed, neither of which are “evil.”

          • kumquatwriter

            Fun fact: Evolution assumes “adaptive” changes. Not “positive.”

          • Ellie San Martin

            thanks for the correction. I will make sure not to make that mistake again

          • Tim

            Otherwise known as “See: Sickle Cell Anemia”

          • LibrarianSarah

            I’m sorry but the “you’re emotional so I win” argument is such bullshit. It is the opposite extreme to the “you’re mean so I win” argument. It makes the argument all about style instead of substance. At least the “you’re mean” people don’t give the victory to a clinical psychopath which is what you’d have to be to not get upset about issues where lives are at stake.

            People are emotional. Arguments get heated and people get pissed off. But the augments aren’t won on the basis of who shows the least emotion just as they aren’t won on the basis of who gets the most upset. They are one on the basis of evidence which you have none. My 56 friend that I could have just pulled out of my ass is not evidence. The plural of anecdote is not data. You are done here.

          • Ellie San Martin

            I’m not trying to win. I’m trying to share another point of view that you are unwilling to consider because your fear of fetal death overwhelms your ability to consider other options. Many psychopaths don’t kill, they simply maim or play with other’s lives without regard for those people as human beings: as in “I don’t feel like dealing with a long labor, it’s easier to just cut the baby out.”

          • Young CC Prof

            My fear of my child’s death makes it tough for me to consider other options? Sounds like the response of a normal decent parent.

            Now, even when someone raises that ultimate fear, a good parent should be able to think about how high the risk of death actually is, and whether the proposed intervention could actually work as claimed. However, the risk of death when a fetal heart monitor detects distress is about 1%, which is large enough to be worth worrying about, and c-section will neatly eliminate that risk as long as it’s done correctly in time.

          • anion

            Yeah, those psychopaths, always doing stuff like going to school for eight years and spending hundreds of thousands of dollars, just so they can enter a healing profession and maybe get the chance to cut some people open. As opposed to, you know, just cutting people open for fun.

            If you think having a c-section is anywhere near as damaging to someone’s life as having close involvement with a psychopath can be, you are very sheltered indeed.

            And you know, as has been said here before…what if I decide, eh, I’m not going to put my kids in carseats or buckle their seatbelts? I’m not going to buy into that manipulative fear! I’m going to consider all of my options, and the odds are my kids will be perfectly safe if they sit on the armrests while I zip along. Nobody’s going to scare ME into seatbelts and carseats; I’m going to consider all of my options, including tying them to the roof (the sunlight will help prevent rickets, which is a huge bonus)!

          • Ellie San Martin

            wow, such a powerful and accurate analogy…lol! because strapping your child into a seat is as difficult as opening your internal organs for surgery on the chance it’s safer than the alternative. & comparing labor to placing a child on the armrest of a moving car, clearly the exact same thing. I never wrote ob’s were psychopaths, nor all ob’s or even most are incompetent or impatient, but there are many to be wary of, as is the case with midwives.

          • anion

            You never wrote OBs are psychopaths?

            “Many psychopaths don’t kill, they simply maim or play with other’s lives without regard for those people as human beings: as in “I don’t feel like dealing with a long labor, it’s easier to just cut the baby out.””

            Can you explain how you didn’t mean to imply that OBs are psychopaths in the above? You are directly saying that “I don’t feel like dealing with long labor, it’s easier to just cut the baby out” is the statement and action of a psychopath.

            At least my post was hyperbole, not a statement of fact.

            (BTW, it’s “OBs,” not “OB’s.” The apostrophe is possessive, not plural.)

          • Ellie San Martin

            I did write that…I wrote “many” in the attempt to show that I don’t apply it to all, but perhaps “some” would have been clearer. What do you think of ALL HB midwives? that they are completely uneducated and willfully endanger women & babies? so I guess we balance each other out.

          • anion

            Good lord. You clearly said that “I don’t feel like dealing with a long labor, &c” is the statement of a psychopath, and is the sort of statement OBs make. You clearly said that those psychopaths who are not out killing people are instead maiming people and playing with their lives by performing c-sections you don’t like–that is actually what your “many” referred to, is the psychopaths who are not murdering people. It did not in any way qualify “OBs,” it qualified “psychopaths.” And ultimately it’s not particularly important, because again, you were calling OBs who perform c-sections which you–in your infinite wisdom and with your BA in “Rhetoric” clutched firmly in your little fist–do not think are necessary, psychopaths. The number of them doesn’t matter so much, although you have strongly implied a number of times that most c-sections are unnecessary. Which means most sections are being performed by psychopaths. Hey, it’s your argument and statement, not mine.

            I really ought to give up on trying to make you understand what you have said, and what I am saying, because you are clearly incapable of the most basic logic.

            Now, let’s see. It’s tempting not to answer your question, or to reply with some sort of obfuscating nonsense (as is your method), but since I have a brain capable of rational thought, I’ll answer. As a kindness, to show you how it’s done.

            I do not think that ALL HB midwives are completely uneducated and willfully endanger women and babies. Evidence–that stuff you eschew in favor of ridiculous anecdotes and your personal “instincts”–do, however, bear out the fact that a large percentage of them are, and do. Evidence shows us that even with a highly credentialed HB midwife (which is a minority of them in the US), the risks of labor and delivery are much higher for both mother and baby. Evidence shows us that many HB midwives lack the knowledge necessary to safely deliver babies if even the slightest complication arises; that they personally refuse to accept scientific evidence; and they are not capable of understanding how those lacks can do great harm, which means that their willful ignorance is indeed willfully putting mothers and babies at risk.

            See, that’s the difference between us, Ellie, or at least one of them. I form my opinions based on evidence and facts; I don’t condemn an entire profession because one guy wasn’t very nice to me and it made me really mad that I lacked the knowledge to understand why he did what he did so I decided it was his fault instead of my own in order to preserve my opinion of myself.

            I don’t come in here and lie, and lie again (we’ve caught you in two so far; I bet there are more), and misrepresent things, and prove my lack of understanding of and knowledge about the subjects discussed over and over again. I’m not the one who didn’t know what a fistula is, or who grasped onto some random bit of information about uterine stitching like a talisman because it was something I heard somewhere that I thought sounded smart and I couldn’t understand what it really meant. I’m not the one who has demonstrated again and again that I lack basic skills in reading comprehension and written expression–I know you don’t believe that’s true, given what you teach, but I’m afraid it is.

            And I’m not the one claiming to know a whole bunch about a subject that I actually know very little about.

            That’s all you.

          • Ellie San Martin

            considering 92% of births in the US are overseen by OB’s in hospitals and (adjusting the 20% c-section figure) 1 in 4 of those are C-sections, a concern regarding impatient, overwhelmed OB’s performing unecessary c-sections that women don’t want covers a MUCH larger number of births than women coerced into home births.

          • Susan

            Ellie, honestly you seem like you are probably a nice person but you post things that are flat out false with certainty and perhaps a little introspection is in order on your part. The post about lawsuits “the baby has to die” is absolutely the opposite of how it really is. And post about the fetal heart rate was never less than 140? If you had expertise in the area you would be appalled at your statement. Some of the scariest monitor strips I have ever seen meet that description. Implying that OB’s are psychopaths who don’t want to deal with long labors whilst you spout off information right and left that is absolutely wrong makes me wonder about the validity of all these women you know with all these problems and what really might have happened in these cases. Seriously I ask you to consider that you may know a whole lot less about labor and delivery than you think you do.

          • Ellie San Martin

            Thank you for the personal compliment. Can you tell me about lawsuits & medical censures in cases that have not killed or permanently injured the baby?
            That’s why I asked that OB to describe the distress, but he chose to stomp out & let my sister labor another 2 hours. I don’t mean all OB’s, but there are certainly some to be concerned about. I am very wary & consult with several to be sure because of all I’ve seen. & since I teach high school, I’ve heard even more horror stories about how young teenage girls are treated.

          • Bombshellrisa

            What about the word DISTRESS doesn’t make you pause and realize there is something WRONG and it could get worse? Who asks a doctor to “describe” distress, unless they think they could possibly know more than a doctor about what it “really” might mean?

          • Ellie San Martin

            I don’t know much, but I refuse to be guided by fear & I trust my instincts regarding obnoxious and intimidating know it all providers.

          • anion

            In other words, “I refuse to listen to people who’ve spent years studying and practicing medicine, because a BA in a non-medical subject means I know way more than them, and my instincts are better than any knowledge.”

            Is that what you teach your students? That, for example, their instinct to cheat is better than actually learning?

          • wookie130

            Your trust in your “instincts” better be more reliable than your ability to cite truth and real information. Your “instincts” will also never save you in the event of a bleed you cannot stop, a baby stuck in your pelvic that cannot come out, or any other number of grisly and completely real scenarios…but those “obnoxious and intimidating know it all providers” could save you. You think about that.

          • Ellie San Martin

            I would not be under the care of an obnoxious know it all. I am under the care of an educated, humane and caring OB, whom I trust, because when I’m treated poorly in prenatal check ups, I refuse to see that provider again. & if I’m treated poorly in labor, that provider is banned from my room and I have back up.

          • Susan

            And I bet they do the happy dance in the hall after being fired too! I would feel lucky to be banned from your room if you are remotely like your online persona.

          • Ellie San Martin

            That’s fine. I never had to ban anyone from my room because I did copious research on all of the providers on staff at the hospital and am able to choose them ahead of time. I passed this info on to fellow moms who are making similar choices and now 2 of those OB’s have been transferred to another hospital. If they do the happy dance, that makes about 10 of us.

          • rh1985

            you’re darn right I’m afraid of fetal death. I had a $20k IVF. I had bleeding for several weeks in the first trimester. Now I have to have an extra ultrasound because of a strange looking placenta. You bet I will do ANYTHING to increase the chance of a healthy live birth of my very wanted baby who I have been scared to death of losing several times already.

          • anion

            Best wishes for you and your baby, rh1985.

          • rh1985

            Thanks. she has been growing well and looks physically healthy. I think it’s probably more of a precaution at this point but I’d rather have doctors who are too quick to send me to a specialist, than too slow.

          • Amy Tuteur, MD

            And you strike me as the classic uneducated, gullible person so beloved of homebirth midwives. Not only are you stunningly ignorant, but you have no idea how ignorant you are. You are a perfect illustration of the Dunning-Kruger effect.

          • Young CC Prof

            Yep. In fact, unlike many crunchies suffering from Dunning-Kruger, this one actually has trouble with reading comprehension.

          • Ellie San Martin

            Since you are no longer practicing or held to any medical standard by any medical board, much less in psychology or psychiatry, nor are any of your claims held to peer review, I won’t take it too personal. Why did the science based medical blog drop you?

          • Bombshellrisa

            Guess you didn’t read Dr Amy was recently asked by ACOG to speak at their conference.

          • Ellie San Martin

            yes I did, that’s also how I found that she has not released any statistics from her practice nor has she chosen to go back into practice or submit her claims for peer review or done any research of her own. Guess spouting inflammatory language on a blog is easier

          • KarenJJ

            “Why did the science based medical blog drop you?”

            Now your colours are showing.

          • kumquatwriter

            “so I would encourage you to consider topics more objectively and human beings as whole beings, including their emotions and spirits in addition to their biology”

            …as long as their emotions and spirits are the same as yours.

            “As a teacher, I try not to consider my students as vessels to be filled with information but as human beings who are in need of guidance from people in all walks of life”

            …because information might make them realize that intelligent design is fatally flawed and that science actually does work.

          • Ellie San Martin

            intelligent design IS science. look it up. & having the same emotions & spirits give us unity as human beings…we all feel the instinct to preserve life, and sadness when it is lost, for example. Also frustration at lost opportunity, bullying by those meant to care for us, etc. NOT sharing these things, I would argue, makes us either severely mentally ill or inhuman

          • The Bofa on the Sofa

            ntelligent design IS science. look it up

            Pretty much, by definition, it is not.

            One of the most important properties of any scientific hypothesis is that it must be testable. In particular, it must be falsifiable, in that it must be, in principle, able to shown to be incorrect.

            So tell me, what observation, if it would be made, would show that intelligent design were incorrect?

            Nothing. There is not a single thing that could ever falsify that something was intelligent design. Even if we had a perfectly detailed and viable evolutionary explanation for everything, you could STILL always say, “Well, a designer made it look that way.”

            That is why it isn’t science, but is religion.

          • Ellie San Martin

            As is the primordial soup & the big bang. Also articles of faith because the experiment cannot be tested or repeated.

          • Squillo

            I would hope that, as a teacher, you would have at least a passing regard for facts. Unfortunately, you’ve shown yourself here to be shockingly cavalier about them.

          • anion

            I’m not emotional, I’m passionate, and am able to effectively communicate that passion. I’m not the one who keeps changing her arguments, misspeaking, and getting all confused because facts are too hard, and I’m not the one who keeps talking about defectiveness and behaving as if there’s something physically wrong with women who don’t give birth vaginally. That’s you.

            And as a teacher your JOB is to fill those student-vessels with information.

          • The Computer Ate My Nym

            My point is that an intelligent designer, (God if you will) designs our
            bodies and brains, just as an intelligent OB designs a C-section.

            I’d fire and probably sue any OB that did a c-section as badly as the “intelligent designer” designed our bodies and brains. Why the appendix? Why no backup method of decreasing blood sugar? Why this huge floppy factor VIII gene that breaks at the least provocation and is critical for hemostasis? Why wisdom teeth? And so on. The human body’s a real mess, truth be told.

          • Ellie San Martin

            why the female orgasm? pretty useless too. We don’t know everything

          • The Computer Ate My Nym

            What makes you think that the female orgasm is useless? Without it women wouldn’t like sex as much, wouldn’t bond with their sexual partners, and would have less support during child rearing resulting in fewer surviving children. Very explicable evolutionarily.

          • Ellie San Martin

            they would still like it & do it as in many other species in which females have no orgasm, or even nerves in the genital area. Why would evolution care if we bond? so evolution requires men to support women and therefore makes them inherently financially unequal?

          • The Computer Ate My Nym

            Not sure how you determine whether animals of another species like sex or not and really not going there.

            Why would evolution care if we bond?

            Human babies are dependent for a long period of time. It’s hard for one person to care for a baby to the point that they are able to survive on their own (much less to the optimal time for independence) without help. Things that make people want to stay together and raise babies together are pro-adaptive in most situations because more of their mutually raised babies will survive. Got it yet?

          • Ellie San Martin

            determined by lack of nerves in the genital area. Also true of wolves, who pair for life but have lack of nerves in the genital area, as do other Mammalian species such as lions and monkeys who live in a community that care for the young rather than only one father.

          • The Computer Ate My Nym

            Reference?

          • Ellie San Martin

            really? I thought that was common sense to anyone with 5th grade science or a visit to the zoo?

            http://animals.nationalgeographic.com/animals/mammals/rhesus-monkey

          • anion

            Visiting the zoo taught you that animals have no nerves in their genital areas? Did you actually GO to the monkey house?

          • Ellie San Martin

            no, that monkeys don’t pair bond but live in promiscuous community

          • anion

            “…lack of nerves in the genital area, as do other Mammalian species such as lions and monkeys who live in a community…”

            That’s a direct quote from you. You’re saying very clearly that you believe lions and monkeys have a “lack of nerves in the genital area.”

          • Lisa Cybergirl

            I am extremely skeptical about ANY mammals not having nerves in the genital area. Good grief, how do they know if they have to pee?

          • The Computer Ate My Nym

            Um…your link says nothing at all about vaginal innervation in Rhesus monkeys. So it’s not just unconvincing, it’s irrelevant.

          • Lisa Cybergirl

            A note from Miss Pedantic here: “innervation” is when something GETS nerves or energy; “enervation” is when something LOSES nerves or energy.

          • The Computer Ate My Nym

            other Mammalian species such as lions and monkeys who live in a community that care for the young rather than only one father.

            …which do not include at least one species of great apes known as H sapiens.

          • kumquatwriter

            “Oh, you’ll do it and you’ll like it, your pleasure is irrelevant.”

            That sounds awfully rapey to me.

          • Ellie San Martin

            exactly why God designed humans (with souls) to have orgasms (& to birth the babies grown inside them 95% of the time, I might add)

          • anion

            Even the briefest look at historic death rates for women and babies in labor/birth, and a look at the current homebirth deathrates, shows that women are not “designed” to “birth” the babies inside them 95% of the time.

          • The Computer Ate My Nym

            Not to mention that at least 50% of conceptions, possibly as high as 80%, fail before a clinical pregnancy (i.e. one that the woman notices) is established. And the high miscarriage rate in “nature”. Human reproduction is not really the part of biology that makes the strongest case for intelligent design.

          • kumquatwriter

            That is a pretty damn stupid circular argument, even for you.

          • Ellie San Martin

            not if the opposing view is that humans are evolved animals

          • kumquatwriter

            Well of course someone citing “intelligent design” thinks female orgasm is useless.

          • Ellie San Martin

            it’s called satire. If you google intelligent design, one of the proofs is the female orgasm. That’s like saying of course a person who believed in science thinks bacteria is imaginary.

          • KarenJJ

            What if you’re a scientist that believes in bacteria AND female orgasms?

          • anion

            Not to mention the theory that uterine/vaginal muscle contractions during orgasm actually work to help push/pull semen into the uterus, thereby providing a greater chance for fertilization.

            There’s a reason women tend to be more easily aroused and more orgasmic in the time surrounding ovulation.

          • prolifefeminist

            Mine aren’t useless. They keep me coming back for more. My husband likes that. So do I. See how that works?

            Anyway, female orgasm boosts mood. Better mood increases overall happiness. Happiness creates a better life experience. I’d hardly call that useless!

          • wookie130

            If you’re a woman who has never experienced orgasm, I suppose you would deem the whole thing fairly useless.

            For those of us who are orgasmic, good grief, is it ever useful….

          • Ellie San Martin

            if you consider yourself a spiritual & emotional being, of course. But as an evolved animal, science can’t seem to place a use on it.

          • MichelleJo

            “The human body’s a real mess, truth be told”
            To someone who believes in intelligent design that’s fine. It makes like difficult. Life wasn’t supposed to be a bed of roses.

            It’s like someone getting stuck in a maze without realizing it and wondering why the park didn’t get someone who knew how to make a straight path to do the job.

            Granted I’ll get a few down arrows for this one, but who says you have to be popular or use the best turn of phrases?

          • Karen in SC

            Most babies turn ON THEIR OWN in the last two weeks.

          • Wren

            And some turn the wrong way. Mine did. Head down (by feel and by ultrasound) then flipped to feet first. There are risks to turning a baby that late that should not be ignored. We discovered mine had flipped when I was already in labour and my water had broken, but even if we’d found it earlier I’m not sure I would have taken that risk over that of a planned C-section.

          • Mac Sherbert

            My first flipped late as well. Breech position not discovered until water broke followed by induced labor!

            I was perfectly fine with the c-section. What I can’t figure out is why everyone else seems to think I should be upset that I didn’t have the chance to flip the baby back to head first. Healthy baby and Healthy me = Happy Me, Happy Baby and very Happy Dad!

          • MichelleJo

            “16 of my personal friends have been able to turn a breech baby in the last 2 weeks.”
            Boy, I wish I was that popular. 16 personal friends who had breech babies, and breech babies that turned. What percentage of pregnant women do that. And ALL your personal friends have been pregnant? I assume not. So out of interest, how many personal friends do you have? To give you the benefit of the doubt it was probably meant 6. I have a regular number of personal friend, and between us we’ve produce a lot of babies (average 8 babies per woman). I can only think of one who had one breech, and in her case, it turned into breech at the end, not the other way around. Sorry, but your statements are sounding more and more implausible.

          • moto_librarian

            Okay, you are full of shit.

          • Mac Sherbert

            You are aware that there are risks to turning the baby? Right? I believe Dr. Amy has a post about that, in which she lost a baby. ?? No time to find it, but it stuck in my head because my first baby was breech.

          • prolifefeminist

            Omg please stop with these insane claims that our bodies are perfect because they were intelligently designed. Yes, I believe we have a creator, but I’m not foolish enough to look at the world around me and decide that everything is perfect because it was designed by God. Hell-o! Imperfect world here, remember? Because the way my appendix blew up and needed to be cut out in the middle of a hurricane last year is some pretty nice proof that our bodies and this world aren’t perfect. The severe preeclampsia I suddenly developed is another. So we can either stick our heads in the sand and pretend everything is lollipops and rainbows, or we can live in the real world, where Shit Happens. And deal with it. Intelligently.

          • Lisa Cybergirl

            God has kind of a sick sense of humor, and tends to play Can You Top This? with Mother Nature.

          • I don’t have a creative name

            LOL. 16 in 2 weeks. Can’t you at least make your stories believable?

          • The Computer Ate My Nym

            Yep. And the treatment for pre-eclampsia is delivery. By the safest and most convenient means available. Only in unusual circumstances is delivery delayed for a woman with pre-eclampsia. (Though it should be pointed out that not all women with pre-eclampsia go on to c-section. Many deliver “naturally”.)

      • Ellie San Martin

        I failed to see the “see more” option, so again, I apologize. I don’t see the need to answer questions (?) that I didn’t see before (the comment seems to be further explanation of evolutionary connections to needs for c-sections)…we will have to agree to disagree that c-sections are preferable solutions with even the slightest doubt. Many times women are treated as a faulty incubator rather than a co patient with the baby.

    • The Computer Ate My Nym

      the pitifully low VBAC rate??

      I’m not Dr. Amy, but what I have to say about it is, VBAC is associated with higher risk of neonatal death and other serious neonatal complications.

      • Ellie San Martin

        So you feel it should never be an option for anyone?

        • The Computer Ate My Nym

          No one should be lied to and told that it is as safe as a repeat c-section. No one should be forced or coerced into taking VBAC as an “option”. I strongly suspect that most women, given full information, will choose a repeat c-section, prioritizing their child’s life and health over the risk of another scar. Thus, there will be a “pitifully low” VBAC rate. If some individuals make a different decision, that’s fine with me. As long as they understand the risk they are taking.

          • Wren

            I chose a VBAC, but was told I was an excellent candidate as the reason for my C-section was a non-repeating one (footling breech position), my baby was estimated to be on the small side (she was 6 lb 6 oz at 39 weeks, her brother had been just 7 lb 5 oz at 40 weeks, 6 days) and I was otherwise healthy. Had my C-section been for failure to progress, a big baby or something likely to happen again, I would have been signing up for a second one.
            I don’t think that a comparison of VBAC vs ERC without taking into account the risks of the specific situation is actually terribly useful. I’d say the same about vaginal vs C-section deliveries in general.

        • The Computer Ate My Nym

          Do you believe that women should be forced into having VBACs if they are uncomfortable with the idea? Or coerced into them by claims that they’re perfectly safe and that only someone “devolved” or “too posh to push” would consider an ERC?

          • Ellie San Martin

            No, but I think that women who want a VBAC shouldn’t be coerced into a repeat c-section. What is “too posh to push?”

          • The Computer Ate My Nym

            Do you think that telling women, accurately, that their babies are at increased risk of dying if they have a VBAC is “coercion”?

          • Ellie San Martin

            “Increased risk” is too general, & “dying” covers only the worst case scenario. If that increased risk is from half a percent to a full percent of aspirated breathing at birth (but survival), then yes, that’s coersion. & isn’t the woman in more danger than the baby in a VBAC?

          • The Computer Ate My Nym

            Asking for more information is nearly always reasonable.

            The relative risk of dying is 0.39 for a ERC versus VBAC, that is, a baby born by repeat C is about 40% as likely to die as a baby born by VBAC. Babies born by ERC also had a 0.4 RR of serious neonatal morbidity (birth trauma, apgar 1.5 L was lower in the ERC group.

          • Ellie San Martin

            so…does that mean a VBAC baby’s risk is 61% higher? that figure is confusing. I’ve never even heard of a baby dying in a VBAC, nor has any of the OB’s I’ve talked to, with 207 years experience between them.

          • anion

            There are stories of such instances right here on this blog, if you look.

          • The Computer Ate My Nym

            If you take a ratio such that the VBAC baby’s risk of dying is set to “1” then the ERC baby’s risk is 0.4. In other words, about 2.5x lower.

          • anion

            Wait, I’m confused. Are those OBs who’ve never heard of a VBAC death the same OBs who refuse to allow VBACs because they want to play golf, so they instill terror into mothers to force them to submit to the knife?

            They told you they’ve never heard of a VBAC death but tell their patients “you’ll die if you do this?”

            My goodness!

          • Susan

            Ellie, that’s another completely bizarre statement. If you haven’t heard of a baby dying in a VBAC you have done little research. I flat out don’t believe you that you know OB’s who have never even heard of a baby dying in a VBAC. That’s just nuts.

          • Ellie San Martin

            Kaiser. Call them and ask their OB department. They give statistics but I couldn’t find one who had ever heard of a particular case. I’m glad to read the guest because it broadens my understanding

          • prolifefeminist

            If Kaiser OB’s have never ever ever even heard of a VBAC fatality, then they must think that VBAC’s are the safest way to give birth, like, EVER. So are they pushing all of their patients to have VBAC’s, or what?

            What about first time moms – will they offer them c-sections so they too can someday experience the incredible safety of VBACs?

            No? What’s that you, say – – – oh, those OB’s are telling moms that VBACing is too dangerous to attempt?

            Your statements make no sense.

          • Guest

            Then those OB’s aren’t doing many VBACs and/or getting very, very lucky. I’m pro-VBAC, I encourage a TOLAC (trial of labor after cesearean) in all women who appear to be good candidates. I’ve only refused to offer women TOLAC if they met specific criteria (prior classical incision, multiple prior c-sections, breech). The majority of my patients who would be good candidates for TOLAC still choose repeat c-section after a detailed discussion of the risks, benefits, and alternatives. I’ve also seen 3 uterine ruptures due to VBAC–all 3 babies died, all 3 patients had life-saving hysterectomies. This is in a hospital with 24-hour in-house OB-dedicated anesthesia.

          • Karen in SC

            wow, were those TOLACs in the operating room? I recognize that HBAC is risky but never thought that a baby could die in a hospital VBAC….

          • guest

            No. TOLAC occurs in routine L&D rooms. The first sign is often sudden, sustained fetal bradycardia and/or loss of fetal station. Even if you assume the deceleration is immediately noticed, several minutes will be spent on intrauterine resuscitation measures (O2, side positioning, stopping pitocin, placing internal monitors, etc). In the best of circumstances the diagnosis and call for stat c-section probably takes 3-7 minutes. Then, a 2-3 minute transport to the OR, 1-2 minutes for prepping and draping, 1-2 minutes for induction of general anesthesia, 30 seconds-1 minute from incision to abdomen. In a massive uterine rupture the placenta and fetus have generally detached entirely from the uterus and are floating in the upper abdomen, exsanguinating. At a minimum, 10 minutes of blood loss at that rate is lethal. More frequently a uterine rupture is much smaller with less fetal blood loss and less likely to result in demise.

          • Ellie San Martin

            have you seen this when the previous c-section(s) may not have been necessary or emergent (since it’s a VBAC)? I recently had a friend whose son lived but she had an emergency hysterectomy during a VBAC. Her 1st c-section was because the OB was impatient with a 13 hour labor, 2nd was scheduled because of the 1st, & nearly killed her with a nicked bowel, which is why she didn’t want another c-section. I feel awful for women who have so much trauma related to their births!

          • Sullivan ThePoop

            I don’t believe the stories of doctors becoming impatient. I had my son at 35 weeks 5 days because I was leaking fluid. I was no where near ready, but they induced my labor and let me labor for 30 hours before I had him. No one ever even mentioned a C-section because everyone was doing fine and even though it took forever it was always moving along.

          • Susan

            I agree. But what she wrote is that she had never HEARD of a baby dying at a VBAC and neither had any of the OB’s she had talked to. The notion of an OB not ever hearing of a baby dying at a VBAC is absurd or terrifying. I vote for absurd given her other posts.

          • prolifefeminist

            I wouldn’t want to place myself under the care of an OB who’d never even “heard” of a VBAC fatality. That tells me that he either a) hasn’t delivered enough babies to have been exposed to such an event; b) he doesn’t keep up with the literature/doesn’t educate himself on how these fatal cases unfold and HOW THEY CAN BE AVOIDED; or c) doesn’t speak to his colleagues. Or all three. Either way, that’s not an OB I’d ever hire.

          • Ellie San Martin

            I didn’t

          • Ellie San Martin

            wow. those are pretty catastrophic ruptures. how sad. I will keep that in mind

          • DaisyGrrl

            What part of uterine RUPTURE sounds like it wouldn’t be catastrophic??? Seriously!? My mind boggles.

          • Ellie San Martin

            “It is usually asymptomatic and does not require emergency surgery.”

            http://www.patient.co.uk/doctor/Uterine-Rupture.htm#

            “The overall risk of perinatal death due to uterine rupture was 6.2 percent. The two studies of women delivering at term that reported perinatal death rates report that 0 to 2.8 percent of all uterine ruptures resulted in a perinatal death (Guise 2010).”
            This was from an NIH VBAC conference report but I couldn’t get the link to work. I interpret this to mean that IF there is a uterine rupture, then the risk of death is 6.2%

          • KarenJJ

            You quoted out of context.

            That quote was from the section on incomplete rupture.

            The relevant section for what people are talking about is this

            “The initial management is the same as for other causes of acute fetal distress – urgent surgical delivery.”

          • Ellie San Martin

            incomplete what? did you write “rupture?” as in, a rupture that is not catastrophic?

          • LibrarianSarah

            Not really. A “pretty catastrophic” rupture is when both mom and baby died. Or when baby died and mom lost her uterus. Babies dying during ruptures is hardly unusual.

          • Sullivan ThePoop

            Yes, I was going to say that of the 3 people I have known to have a uterine rupture during labor only one of the babies lived.

          • Karen in SC

            You know who else is hovering in the background, evaluating risk? The medical malpractice insurers.

            No one has mentioned it yet, but if there is a small chance of a bad outcome and the OB wants to do a c-section, but the mother wants to keep waiting…since there’s such a small chance, etc. That mother will probably still sue for malpractice if the OB was right.

          • Ellie San Martin

            actually in CA there is no ability to sue unless the baby dies. Even severe injury is not grounds for suit & the awards are limited so severely that most women don’t bother. But I agree that it is a major part of the problem.

          • The Computer Ate My Nym

            actually in CA there is no ability to sue unless the baby dies.

            Are you serious? What is your data for this claim? Two seconds on google got me several California based lawyers who specialize in birth injury lawsuits.

          • LibrarianSarah

            Her ass as is the basis of all her claims.

          • Ellie San Martin
          • Jocelyn

            The article you reference says nothing about “only being able to sue if a baby dies.” It is simply talking about CA’s monetary cap for non-economic damages in medical malpractice suits; i.e., the money you can get from pain, suffering, inconvenience, etc. In CA, the most you can get for non-economic damages is $250,000.

            Economic damages, such as the money it would take to care for a physically injured or brain-damaged baby, remain unlimited.

            You can sue whether the baby lives or dies, and, in fact, will probably be rewarded a lot more if the baby lives because your economic damages are likely to be much higher.

          • Ellie San Martin

            you have none because the baby doesn’t work or earn. mom is already on medical leave from work.

          • Young CC Prof

            Economic damages for severe birth injury = lifetime cost of care for a disabled child, including medical treatment and basic life care. That’s lots and lots of money. Again, you don’t understand civil law at all.

          • Jocelyn

            Economic damages extend to more than lost wages. They include things such as past and future medical bills and therapy. So, yes, for an injured baby (or mother) that will requires medical help, there are economic damages.

          • prolifefeminist

            Um…this comment made me laugh in disbelief. If a baby is disabled, a court can and does award damages to compensate for the loss of future wages that that baby would have earned. Same goes for the mother. That is completely separate from an award to pay for past and future medical bills.

            Honestly, I’m not trying to be mean here, but *usually* when a person is as utterly clueless as you seem to be, they sort of suspect that they are and don’t keep making ignorant and erroneous statements about subjects that they clearly, clearly don’t understand. I’m actually a little bit embarrassed for you.

          • Squillo

            Repeating the error of citing an ABC-news article about a limited section of the statute does not make you correct and it does not make you look any better informed. In California, you can sue whether a baby dies or not. You can be awarded three types of damages (that I’m aware of):

            Compensatory (aka economic) damages: That is the cost of caring for an injured person, and, in some cases, the cost of lost wages. There is no limit to the amount you can recover in California.

            Non-economic damages: (sometimes known as pain and suffering.) This is what your article is referring to and these are capped at $250,000 in California.

            Punitive damages: These may be awared in cases where a plaintiff can prove that a provider acted fraudulently or with malice.There is no cap on these i California.

            The California statue provides limitations on what percentage of a med-mal award attorneys can take: Up to 40% of the first $50,000.00, 33.3% of the next $50,000.00, 25% of the next $50,000.00, and 15% of damages exceeding $600,000.00.

            All of this is very easy to find. If you bother to look.

          • Ellie San Martin

            what you CAN sue for and what a lawyer is willing to work with you to sue for are two different things. Call up an ambulance chaser & see if he wants to take your claim. I’ll give you one of my coworkers examples: wife was left to push by herself for 2 hours, no nurse, no OB. OB marches in, says it’s time for c-section. By the time they get in, they realize he’s actually in terrible distress, so in a rush, they slice his main artery in his arm. But he lives, mom is stitched up. Insurance agrees to provide counseling for mom, & BTW, you signed an arbitration agreement with our hospital agreeing not to if we offer a settlement.

            http://www.huffingtonpost.com/spencer-aronfeld/arbitration-agreements-medical_b_1263951.html

          • DaisyGrrl

            First, hospitals and doctors in your area sound so dangerously incompetent I’m amazed that people leave the hospital alive. Second, you really don’t seem to understand how citations work around here.

            You tell a frankly incredible story and then use an article about medical malpractice in Florida (not even for OBs!) as your evidence. What?! I clicked the link expecting something local to you and about malpractice in obstetrics. Usually, when people link to articles to back up a position, it’s on point.

            You have been a very entertaining addition to this thread. I can’t wait to see where your next flight of fancy takes us.

          • Clarissa Darling

            I used to be friends with a girl who turned out to be a
            compulsive liar. At first I thought she was a nice person and I felt bad questioning stories because, you know, some people really DO have extraordinary things happen in their life. As our friendship continued I started to notice that more and more of what she said didn’t add up. When I questioned her about it, the stories would change ever so slightly to allow for an explanation and eventually the things she made up just got stranger and stranger. I’m starting to feel Déjà vu reading all these comments……

            And the continual posting of totally irrelevant links is just
            bizarre.

          • Ellie San Martin
          • Squillo

            That must be why there are so few med-mal lawyers in California and why OB med-mal insurance rates are so low.

            BTW, you have every right not to sign an arbitration agreement.

          • Ellie San Martin

            yes, and that hospital then has the right to refuse you service

          • PrimaryCareDoc

            Actually, if you’re in labor, the hospital does NOT have the right to refuse you service. It’s called EMTALA.

          • Ellie San Martin

            exactly why many women stay home to labor so long and wait to go into the hospital

          • prolifefeminist

            No, a hospital doesn’t have the right to refuse you service if you’re in labor or have an emergency. Google EMTALA. It’s been law since 1986.

          • Squillo

            Unless you’re in labor.

          • Ellie San Martin

            which is why so many women resort to home births and birthing centers or choose to simply wait until the last minute to come in.

          • Squillo

            Really? How many? And can you enlighten us with the number of hospitals that require patients to sign arbitration agreements?

          • Ellie San Martin

            Most statistics are around 10 yrs old, this is the most substantial and it’s 15 yrs old. The studies often only cover how often arbitration is actually used, not how often it is offered or required. unless you can find something, I’d be welcome to it. Most of my So CA area is so saturated in Kaiser (which requires a signature if you are a member) so that’s why I write about them.
            http://scholarship.law.duke.edu/cgi/viewcontent.cgi?article=1036&context=lcp

          • Squillo

            That’s really interesting, but it has nothing to do with the question I asked you.

          • Ellie San Martin

            are u just screwing with me because you want to demonstrate lack of reading comprehension? I repeat, I can’t tell you how many because most statistics are old and not specific.

          • Squillo

            No. I asked you a direct question on the off chance that you might be able to demonstrate that you had any idea what you were talking about. The proper answer, when you don’t know the answer to a question, is “I don’t know.” Not posting a link that has nothing to do with the question.

          • LibrarianSarah

            See this is why we look up information before we make claims instead of making claims and digging around in order to find information that is somewhat related to the information we pulled from our rectums.

          • Ellie San Martin

            ask them for a list of suits they won & how they got around the arbitration and which hospitals

          • Young CC Prof

            Nope, sorry, in all states, especially more litigious ones like CA, you can sue for injury to a baby that might have been caused by birth trauma or other failure of obstetric care. In fact, the payout for a severely brain-damaged child requiring a lifetime of care will generally be HIGHER than the payout for a dead one.

          • Ellie San Martin
          • Young CC Prof

            Jocelyn explained below why that article has nothing to do with what you just said. If a careless obstetrician resulted in a brain-damaged baby, you could sue for the lifetime cost of care (maybe several million dollars!) plus $250,000 for pain and suffering.

          • Ellie San Martin

            that’s exactly what the article said. But that OB will not pay for the care. The hospital or malpractice insurance will. And it will likely not affect his/her medical license.

          • Young CC Prof

            No, doctors do not pay malpractice suits out of their own pockets. Most of them don’t have $5 million in cash just lying around. However, if the malpractice insurance makes a large payout in a particular doctor’s name, that doctor’s premiums will go up, and if a doctor has too many lawsuits, he’s probably not going to be a practicing doctor for much longer.

            This is how liability insurance works. Just like car insurance, really.

          • Amy Tuteur, MD

            Severe injury is not grounds for a lawsuit? Are you saying that no one can sue for a brain injured infant? Now you’re making up legal claims just like you’ve been making up medical claims. Do you actually check what’s true and what’s not or do you simply write whatever pops into your head?

          • Ellie San Martin

            no, I’ve spoken to lawyers about filing medical malpractice & heard from several parents of students about what they have attempted to file.

          • KarenJJ

            Funny how you keep on receiving advice from professionals that is just so wrong. Doctors, lawyers.. Very strange.

          • Young CC Prof

            It’s like they say about relationships, or jobs for that matter. Anyone can have one go sour, and it’s probably not your fault. If several in a row go wrong, you’ve got to look at the common denominator.

          • Squillo

            Before trying to teach folks here about a law, you might want to actually read the law: Cal. Civ. Code 3333.2.

          • PrimaryCareDoc

            Are you familiar with John Edwards? He ran for president. You might want to review his legal career.

          • Ellie San Martin

            lol! yes, & as far as I could tell, never practiced in CA

        • Bombshellrisa

          What is up with the “all or nothing” attitude so often displayed? Combative much?

          • Ellie San Martin

            I’m wondering that myself. Do you see computer ate nym’s comment as allowing for VBAC in certain circumstances (that do not include an ignorant patient willing to risk her infant’s life)?

          • KarenJJ

            She didn’t say nobody should have one, she said they have a higher risk. There is a higher risk to driving, but people still choose to do it. I’ve taken higher risks myself in discussion with doctors and they’ve not always been happy with my choice but agreed it was a valid and ‘safe enough’ option.

            Homebirth can also fall into that category. It’s not up to me to decide for anyone what to do, but I will want to make sure that they are certain they know the real risks and aren’t just relying on wishful thinking.

          • Bombshellrisa

            I don’t see it as anything other than a fact based on statistics. There are risks to being pregnant and risks with both vaginal and C-section births. It doesn’t mean that everyone needs to start jumping conclusions (pregnancy is BAD! C-sections are BAD! VBACs are BAD!) it just means that you have to discuss with your doctor your personal risk factors so you can make an informed decision. That doesn’t mean that it will be the answer you want either. Your doctor isn’t obligated to reassure you that you were designed to be pregnant or give birth or that your body knows what to do or that since your friend had X, Y or Z happen, you will or won’t.

          • The Computer Ate My Nym

            As I said overtly in so many words, if a woman understands the risks and benefits and wants to go for a trial of VBAC that’s her decision and none of my business. It’s when women are not told the risks or are coerced or shamed into VBACs because we have a “pitifully low VBAC rate” that I am concerned.

    • Young CC Prof

      1) Your language is inappropriate.

      2) It is not true that ALL c-sections would have prevented a death or serious injury. Some of those babies would have been fine had labor continued naturally. However, the risk existed, there was no way to find out in advance which babies would be OK and which would die. At this point, if we’re doing 100 sections to save one life, it’s worth it.

      • Ellie San Martin

        apologies for the language. do you mean 100% c-sections? by that logic, we should force all people to have a perfectly balanced intravenous diet to prevent them from making flawed dietary choices and risking their lives through coronary disease.

        • Young CC Prof

          No, but I am saying that most women will opt for a c-section if there are indications that the baby is in danger. Even if the baby “might” come out OK.

          • Ellie San Martin

            Considering those statistics, no one would ever drive a car on a public road given the numerous risks.

          • Karen in SC

            Rates of accidents are much lower than 1 in 100, which is what that example was illustrating.

            So, if informed by an OB, “Based on fetal monitoring, and other medical indications, your baby appears to be in distress. There may be a small chance, about 1 in 100 that the baby won’t make it,” you would NOT get a c-section.

            That is the point of that example. 99 of babies in those same conditions would have been okay. Who wants to be that 1 in a 100?

          • Ellie San Martin

            um, citation for auto-accidents being 1 in 100? “distress” is so broad, and can cover so many things. My sister’s OB said her son was “in distress” because his heart rate was “dropping.” I asked him to show me where on the monitor (because I had been watching like a hawk & his heart rate was never below 140). He grunted, ripped off the monitor paper and stomped out of the room muttering about how he couldn’t be expected to “wait around all day.”

          • Young CC Prof

            The probability of getting in a car accident on any given day is far, far less than 1 in 100. Your lifetime risk of experiencing at least a minor a car accident is close to 100%, but only about 1% of all deaths are due to MVAs. (2.5 million people die each year, 2,900 in MVAs.) You can further lower your risk by wearing a seatbelt, maintaining your breaks, and driving prudently.

            I accept the 1% lifetime risk of car accident death as the price of being able to get to work, pay my rent, and generally be a part of life. But a 1% risk of my child dying right now, today? From something I can prevent? I’d be willing to endure a section to avoid that.

          • yentavegan

            Shame on you for being part of the problem. You ought not perpetuate the myth of the” eager to rush a c/sec ob/gyn”. How long is too long ? Did you read Katie’s story about the loss of her baby? Do you think that maybe if she had had a fetal heart monitor for Natalie that she would have a living infant ?

          • Ellie San Martin

            wow, are you Catholic? lots of SHAME running around here. is that really a myth? No I haven’t read it, could you link it here. a fetal heart monitor is standard for all births and I can’t understand why a birth wouldn’t have one present?? I’ve never even heard of not having access to a fetal monitor?

          • Karen in SC

            It’s today’s post here.

          • yentavegan

            Why should your sister’s ob share any information with you? do you think your sister’s OB was somehow obligated to consult you, a lay person, on what he felt was medically necessary?

          • Ellie San Martin

            no. this story is merely a story and I’m not saying that all OB’s would act like him. But he lied, and she was glad that I caught him. He also endangered her life by lying that she was dilated to 5 when 2 other nurses said she was dilated to 8, then inaccurately recording her height as 6 inches higher than it was so that the anesthesia for the c-section, paralyzing her lungs and putting her in cardiac arrest and endangering her son.

          • yentavegan

            I understand your distrust in ob/gyn’s is based on your sister’s near death experience. I hope your sister was able to get answers regarding the quality of the care she received for the birth of her son.

          • Ellie San Martin

            we found out that his common practice was to only deliver vaginally if it took less than an hour. The nurses were impressed that my sister held out for 8 hours against his intimidation. (with the help of my mother & I) She will not work with that OB anymore. That’s all we can do because the medical board would not take complaints (despite the nurses giving us written statements) since the hospital he was working in was shut down.

          • Young CC Prof

            Okay, it sounds like your sister received seriously substandard care, especially if he decided to use general anesthesia himself without an expert and royally overdosed her!

            Now, I say “if” not because I think you’re lying but because it’s become clear that you don’t read terribly well and often misunderstand things. You may not entirely comprehend what happened that day.

            If the state medical board won’t act, try complaining to his current employer. It might be a bit tough to make a malpractice claim, since no permanent economic harm was done, but I imagine your sister’s insurance wound up paying extra for this incompetence. Try getting them involved through subrogation.

            The mistake you’re making is to generalize the behavior of this guy to all OBs. The fact is, screwups like you are describing are very very rare in a hospital setting.

          • Ellie San Martin

            I don’t generalize, I know many good OB’s who would never use such obnoxious and inflammatory language as Dr. Amy, she sounds like the OB, Dr. Aurora that endangered my sister.
            We talked to insurance, they didn’t seem to care because for some reason, they felt the claim was “standard.”

          • anion

            Google tells me it’s “Arora,” not “Aurora.”

          • Squillo

            The medical board wouldn’t take a complaint against a physician because the hospital was shut down?

          • PrimaryCareDoc

            Ok, this just confirmed to me that this whole story is complete and utter bullshit.

            The OB did the anesthesia himself? Bullshit. Never happened. CAN’T happen.

            The nurses said the OB often lied so he could “finish his shift early”? Bullshit. OBs don’t work “shifts.” They do what they have to do and when they’re done, they’re done.

            The state board wouldn’t take a complaint because the hospital shut down? Bullshit. Didn’t happen. State medical boards have nothing to do with hospitals. They don’t care if a doctor was practicing in a hospital or in an office. I guarantee that if an OB was attempting to practice anesthesia, leading to a cardiac arrest in a patient, the board would not say, “Oh, the hospital has since closed. Too bad, so sad.” They’d be holding an emergency hearing to proactively suspend that doctor’s license.

            So, I’ll repeat, bullshit. All of it.

          • KarenJJ

            I agree. And I wonder where else she is telling such a BS story. I hope she’s not getting enough info from here to make it more plausible elsewhere.

            And there’s no way she is a high school teacher. Americans surely aren’t this desperate for teachers.

          • Ellie San Martin
          • KarenJJ

            That would be assuming you are posting under your own name and haven’t pinched someone else’s either to hide your own identity or to embarrass someone else.

            It’s not personal. It’s the internet and I’ve been on it for a while now. You don’t post like a teacher and your story is full of holes and your “knowledge” is misunderstood or half-truths.

          • kumquatwriter

            Depending on which of the listed might be “Ellie”, you’re either not currently certified, or certified in something completely different than you have claimed. Please, do keep showing your cards.

          • Ellie San Martin

            did you try last name? my legal 1st name is Elysabeth

          • kumquatwriter

            Of course I tried your last name, that is literally the only required search criteria. As my session has timed out in the database, I will have to look again some other time.

          • KarenJJ

            Curiousity got to me. Elysabeth San Martin is listed (surname = San Martin), but I still don’t believe that this person posting is actually a teacher – evidence points to the contrary. I had a couple of pretty “out there” teachers (an ex-cult member with hippie tendencies being one memorable one) but even they could read and comprehend text. The evidence we’re seeing for that here is lacking.

          • anion

            I believe she’s a teacher. I do not believe at all that she is a good one.

          • Susan

            I looked up the Facebook profile last night and found an Ellie Mae with the same picture that loves lots of right wing stuff, pro life stuff and Ina May and birth stuff so that sort of fit with what she has been writing. On the other hand you have made an excellent case for why her posts are nuts and I would be taking my child OUT of her high school class for sure. I too have dealt with a couple pathological liars in my life and have found it shocking. I am stunned that she still is trying to teach fetal monitoring to those of us who do it for a living. Yikes!

          • anion

            No, sadly, she is. Confirmed by Facebook, Twitter, and LinkedIn.

            Of course, she has already lied here twice about A) What she teaches; and B) Not knowing what LinkedIn is. So that’s something to keep in mind.

          • Ellie San Martin

            His name was Dr. Aurora, this was the hospital. I made a previous comment explaining that my sister’s epidural was already in place by an anesthesiologist.

            http://www.vvdailypress.com/articles/rooms-38176-shut-amid.html

          • kumquatwriter

            “But a knowledgeable source said the violation related to how surgical instruments are cleaned and sterilized.”

            That article has NOTHING to do with your increasingly ludicous story.

            I’ve got a few minutes and I’ve been copying all your posts about this supposed event. All together, it should make for some entertaining “spot the backpedaling”. It’s a fun game to do with both persistent trolls and pathological liars.

          • Ellie San Martin

            wow. So a hospital fails to sterilize surgical instruments properly, and you assume they must hire a crack staff & *I’m* the one making stuff up to cover for a personal story, for which I am not professionally responsible. I was not in the OR, but there were no other doors out, & I only saw the OB & 2 nurses, & then 2 more nurses (with nurses name tags) when the code blue was called. Make of it what you like, my sister was so traumatized she refused to ever see that OB again & no one could verify having seen the anesthesiologist after he gave her the epidural 6 hours before the c-section

          • Captain Obvious

            Your either mistaken, or a CNA (nurse anesthetist) came in there. The anesthesiologist doesn’t have to be there as long as a nurse anesthetist is.

          • Ellie San Martin

            that is possible. Thank you for that insight. Her medical records were all lost so we had no way to verify other than our memory of name tags and if I saw an “N” I assumed it was just nurse in general.

          • kumquatwriter

            AND they lost her records? But you had OH so MANY records that you took to all the meeen old lawyers who refused your case! What happened, Ellie?

          • Ellie San Martin

            We took her prenatal & postnatal records that we had copies of, as well as many written statements. But we had no records from the hospital of the birth.

          • kumquatwriter

            From whom do you have written statements?

          • Susan

            LOL I heard the Church Lady when I read that too. Have you read this gem Kumquat?

            http://www.ratemyteachers.com/elysabeth-miller/34702-t

          • Ellie San Martin

            My sister, her husband, my parents, my other sister, SiL, myself & my husband, 2 of her friends who were there and 3 nurses. Basically all who were present and willing to write statements.

          • Captain Obvious

            Records cannot all be lost. Your story is bull

          • Ellie San Martin

            I agree they are not lost, they were probably purposefully expunged.

          • Captain Obvious

            Again, I call bullshat, if the records were lost, then a lawyer probably would take your case. Lost records does make the hospital look suspicious. Come up we some other lies Ellie.

          • anion

            But there was an earthquake! A terrible FLOOD! LOCUSTS!

          • kumquatwriter

            Dogs and cats living together! MASS HYSTERIA!

          • kumquatwriter

            No. I think *you’re* “the one making stuff up” because you told outright lies that were contradicted both by the very article you’re citing. I don’t have ANY opinions about the hospital in question or it’s staff. I am talking ONLY about YOU, Ellie San Martin. You are lying, and your reading comprehension is appalling.

          • Ellie San Martin

            how did the article contradict me? My sister didn’t get an infection but a hospital shut down for failing to sterilize OR equipment would cause me to think that there could be other problems. So you would not form an opinion about a hospital that VERIFIABLY doesn’t sterilize it’s OR equipment. For one, all of my sister’s medical records were lost. But this wasn’t a problem for the OB or anesthesiologist, who simply blamed the hospital, which was already shut down (for failing to sterilize OR equipment) and then ownership transferred.

          • kumquatwriter

            Because the hospital didn’t shut down, it changed ownership/management for financial reasons, you colossal nitwit.

          • Ellie San Martin

            For those who lived in the area, it shut down for a month. & you REALLY think those “financial reasons” had nothing to with numerous settlements over infections from improperly sterilized OR equipment?

          • kumquatwriter

            If you actually read (and comprehend! That part matters!), there is plenty of documentation of the entire process that led to the hospital changing hands. Or shutting down for a month. No, they shut down wings here and there to refurbish, they had some problems that definitely needed to be addressed. Nobody’s defending the hospitals. We’re just repeatedly pointing out your lies. It’s fun – because it’s very, very easy.

          • Ellie San Martin

            ok, so is it at all possible, that the hospital and its staff were part of the problems that definitely needed to be adressed, & that in the last 2 weeks before the eminent transfer, they lost all semblance of competent treatment, knowing that they would not be held accountable & many were losing their positions anyway? remotely possible?

          • Jocelyn

            No, it’s not remotely possible. So whichever group you try this lie on next, cut that part out of your story.

          • Susan

            Bombshellrisa, I love Kumquat too. “Colossal nitwit” ROFLOL….

          • anion

            *its* OR equipment, not *it’s*.

            And now there WAS an anesthesiologist present?

            BTW, that’s a nice generic reply there, about “what makes novels great.” Really, is that what makes great novels great? Wow. Did you copy that line directly from a third-grade textbook? It doesn’t answer my question, but of course, you’re not really capable of that anyway.

          • anion

            Okay, so now you can’t verify absolutely that the anesthesiologist wasn’t there and the OB handled the anesthesia, and you don’t actually know what caused the “Code Blue” because you weren’t there. (And an anesthesiologist can disappear for six hours–it’s lucky no one else needed him, isn’t it?)

            I get that you think you’re very, very smart, but I’m afraid you’re not at all. You’re a verified liar, and aside from the moral failures that indicates, your reading comprehension and written communication skills are both so very poor that were one of my children in one of your English classes, I’d be fighting tooth and nail to have them switched to a teacher who can actually read and write.

            (You still haven’t said what your favorite novel is and why, btw. Tossing a few author names from an Overview of American Lit syllabus out there–and claiming O’Toole as “recent”–doesn’t cut it. I am genuinely very interested in hearing what you think makes a particular novel great. Don’t make excuses about what administrators want you to teach; a teacher of English should like to read and should read outside their own syllabus.)

          • Ellie San Martin

            I like pretty much any title by those authors. I meant O’Toole is what I’ve read recently, which is outside my syllabus. What makes novels/literature/plays truly great is that they speak to the human soul in a timeless way and cause us to question ourselves.
            I never said I could verify, I didn’t realize this was a case study. As I mentioned, that’s why the medical board wouldn’t take the case. My BiL & Mom were in the OR & got shoved out. Why is it so hard to believe that a hospital which was shut down for failing to sterilize OR equipment would screw up other things as well? Like losing medical records. None of my sister’s exist and the OB blamed the hospital, which was already shut down and then ownership transferred. As I said, the nurses told us that most patients either dropped their babies shortly after arrival or came in for scheduled c-sections or got them within 4 hours of arrival.

          • Dr Kitty

            Every OR I’ve worked in had patient access through one side and access to the staff changing areas via the scrub room through the other side.
            A single door is unusual. But whatever.

          • fiftyfifty1

            I, also, have never seen an OR that did not have 2 doors. This way the nurses can be wheeling in the patient on his or her hospital bed through one door as staff can enter through the other door without creating a traffic jam or contaminating their just-scrubbed selves.

          • Gene

            I’ve been in several ORs where there was a single set of double doors leading to the operating theater, including L&D. So a single set of double doors IS possible. But I agree: BS on the rest of the story.

          • Gene

            Now, you know that there could have been a NURSE anesthetist performing the anesthesia? And that women can be physicians? I’m constantly called a nurse (I think it’s my kind and caring demeanor) and not a doctor, even after I introduce myself as such.

          • Squillo

            Do you actually read any of the links you post?

          • Amy Tuteur, MD

            How do you know he lied? You have no idea how to interpret fetal monitoring. You seem to be under the false impression that only a slow fetal heart rate is a sign of distress.

          • Ellie San Martin

            because he was never interested in describing any other kind of distress and 2 nurses explained that he often lied about these things to finish his shift early.

          • KarenJJ

            This is such an odd story and the contradictions and back-pedalling are now happening – your sister’s height was not estimated wrong, but was written poorly – it makes us think that there are other things you have been misrepresenting in your account of this.

            In my experience nurses and doctors don’t bad mouth other medical professionals to patients. I’ve received some pretty awful care in my time, most I’ve had is one specialist call it an “indictment of the medical profession” and my GP did a double take about one piece of advice I received from a different doctor. And I’ve once had a hint from one nurse about trying a different doctor. But I’ve never heard one, let alone two nurses bad mouth a doctor like that in front of a patient.

          • Dr Kitty

            You know that the person with responsibility for the anaesthetic is not the OB, it’s the anaesthetist…

          • anion

            I suspect she means that the OB gave the wrong info to the anesthetist, but I wonder where the OB was supposed to get the info? Mine never stood me against a wall with a marker or anything :-), he asked me how tall I am. If I–or my husband, perhaps–told him I’m 5’7 instead of the accurate 5’2, it’s not his fault. (I’m not saying Ellie’s sister gave the wrong info, just that we don’t know who introduced the height error.)

            I always thought weight was the important measure for anesthesia?

          • Dr Kitty

            It is weight, usually, yes.

          • anion

            Thanks!

          • Susan

            I have been taught that actually it is height that matters in dosing a spinal/epidural. Still, I am skeptical that what she describes is truly a “cardiac arrest”. High spinal would be a lot more likely.

          • Tim

            If I have learned one thing in the last year and a half, it’s that nobody in the gen pop knows the difference between “cardiac arrest” and a “heart attack” , or that there is any difference at all. (I sure didn’t!) Something has me wondering whether this person knows what she is talking about, since she’s pulling out every silly obstetrician strawman possible (lied about EFM strip, walked away vocalizing that he couldn’t be expected to “wait around all day”, tried to MURDER HER SISTER, etc)
            And the Anesthesiologist just apparently went along with this little murder scheme and managed to not be able to tell that there was a HALF A FOOT DISCREPANCY in his/her patients height. Sorry, but I don’t care the scenario you are in, anyone on earth can tell the difference between a 5’2″ woman and a 5’8″ woman, or a 5’6″ woman and a 6′ woman. The story would have been a little more believable if it wasn’t such a huge amount that would be patently obvious to anyone looking with their eyes.

          • Tim

            If I have learned one thing in the last year and a half, it’s that nobody in the gen pop knows the difference between “cardiac arrest” and a “heart attack” , or that there is any difference at all. (I sure didn’t!) Something has me wondering whether this person knows what she is talking about, since she’s pulling out every silly obstetrician strawman possible (lied about EFM strip, walked away vocalizing that he couldn’t be expected to “wait around all day”, tried to MURDER HER SISTER, etc)
            And the Anesthesiologist just apparently went along with this little murder scheme and managed to not be able to tell that there was a HALF A FOOT DISCREPANCY in his/her patients height. Sorry, but I don’t care the scenario you are in, anyone on earth can tell the difference between a 5’2″ woman and a 5’8″ woman, or a 5’6″ woman and a 6′ woman. The story would have been a little more believable if it wasn’t such a huge amount that would be patently obvious to anyone looking with their eyes.

          • Ellie San Martin

            I never write that he tried to murder her. These are not straw men and I wouldn’t believe it either if it hadn’t happened to her in front of me.

          • Tim

            So you’re telling me that the OB just placed an epidural himself, without an anesthesiologist?
            Can one of the OB’s here please confirm, if this ever happens? Do they even train you to do that during your residencies? Would a hospital pharmacy just mix you up a bag of epidural anesthesia because you wanted it? Would any insurance provider reimburse you for this? Genuinely curious, as I’ve never seen that.

          • FormerPhysicist

            I have heard of cutting without anesthesia but only in a dire emergency. I think there was a commenter here that had a c/s without anesthesia, or perhaps it was just without working anesthesia. Now THAT’S a warrior mom.
            Irrelevant to Ellie’s misinformation, anyhow. She specifically claimed injury from anesthesia performed by the OB.

          • Ellie San Martin

            no, the epidural was already in, but the anesthesiologist was gone so idk what the OB did, I don’t think it was general anesthesia, but it paralyzed my sister’s lungs

          • Squillo

            If he went into the OR and did a c-section with no anesthesiologist he would have no hospital privileges today.

          • Ellie San Martin

            it was a code blue in which she had to be resuscitated before the c-section could go forward and it got so bad they almost performed the c-section to save my nephew before she was breathing again. 2 nurses confirmed my sister was fully dilated by the time they rolled her into the OR. She had been in labor 8 hours, he was 6lbs 7 oz. This OB listed this as “failure to progress on a large baby.”

          • Ellie San Martin

            she’s small and 5 feet tall, he had all of her records and never asked, but wrote a screwy 0 that looked like a 6 & then estimated her weight at 160 (I guess he was counting pregnancy) when it was 130, 110 pre pregnancy

          • KarenJJ

            So it was poor hand writing, not an incorrect height estimate? And the anaesthetist didn’t pick up on that?

          • The Computer Ate My Nym

            If he did the anesthesia himself then how could the bad handwriting cause the error? He surely knew what he wrote. This story isn’t adding up.

          • theadequatemother

            It depends – weight based dosing is a good starting point for general anesthesia. With general you can always titrate in more drugs. For spinal, which is a single shot technique there have been tons of studies looking at how to modify doses for women at the extremes of height and weight and correlations between level and dose based on those two factors are very imperfect. What it does correlate well with is spinal fluid volume – but you can’t MRI everyone prior to labour to estimate that! If someone was very small or very tall, or sometimes in super morbid obesity there is an argument to be made for using an epidural which can be titrated.

          • Sullivan ThePoop

            Yes, weight is the issue.

          • Ellie San Martin

            yes, but he is responsible to give accurate info to the anesthesiologist, and he’s responsible to work with a trusted anesthesiologist, & in this case we found out that he did it himself, but since both my sister and her son lived without permanent injury, we couldn’t sue and the medical board was not interested in the complaint, despite proof from records and nurses. Probably because that whole hospital was shut down 3 weeks later, though that OB just moved on to another hospital. (Victor Valley hospital, under new ownership & converted this year.)

          • KarenJJ

            My mums obgyn lied on her medical record and she made a complaint to the state medical board. This was in the 70s and not in the US, so not sure if it’s relevant for you.

          • anion

            How did you “find out” that he did it himself? Was your sister not there? Did she not know who was in the room and who was administering her spinal or epidural?

          • moto_librarian

            So assuming your story is true, which I doubt, was your sister grateful that you talked her into delaying the section until it was a true emergency?

          • Ellie San Martin

            She was traumatized and resents it entirely, refused to ever see that OB again (even for her post-partum follow up) because she felt it was not emergent and that the mistake regarding her anesthesia (whomever made it) almost killed her.

          • kumquatwriter

            I call shenanigans once again. Somebody get the brooms!

          • Box of Salt

            She’s already started backpeddaling the OR story – in another comment she admits she was not in fact in the OR with the sister during the code blue.

          • Ellie San Martin

            What gave you the impression it was a “true” emergency? That was one major point of my sharing the experience, that the c-section was unnecessary and endangered her life.

          • anion

            Oh, are we anti-Catholic now, too? You’re a real delight, aren’t you.

          • Jocelyn

            We should throw in some other religions, too, just for fun. Maybe some races or disabilities as well.

          • anion

            A fine idea!

          • Ellie San Martin

            SHAME SHAME on you!

          • anion

            You’re right. Shame on me for still expecting you to understand sarcasm when your reading comprehension is so demonstrably poor.

            I’m genuinely curious, Ellie, and this isn’t a trick question: What is your favorite novel and why?

          • Ellie San Martin

            sarcasm is spoken, satire is written

          • kumquatwriter

            No. That is also wrong. Words have meanings, and facts have sources. To wit:

            * Sarcasm is praise which is really an insult; sarcasm generally involves malice, the desire
            to put someone down, e.g., “This is my brilliant son, who failed out of college.”

            * Satire is the exposure of the vices or follies of an individual, a group, an institution, an
            idea, a society, etc., usually with a view to correcting it. Satirists frequently use irony.

            Source: academic.brooklyn.cuny.edu/english/melani/english2/…/irony.pdf‎

          • anion

            Once again, the idea of you as a teacher, especially of the subject you teach, terrifies me.

          • Ellie San Martin

            I particularly enjoy Fitzgerald, Twain & recently, O’Toole

          • anion

            So…what is your favorite novel, and why? Or even, what is it you particularly enjoy about those (very different) authors, and which books of theirs are your favorites? You can toss author names at me all you like, but you’re not actually answering my question…

          • Ellie San Martin

            SHAME on you!

          • Jocelyn

            Either you are a master of irony (and if you are, I have to say that your comment is very clever and did make me smile), or you don’t understand it at all (which is less fun, but oh well).

          • Ellie San Martin

            no, but I was surprised the the copious amount of SHAME thrown on me & perhaps should have referenced another religion? I can’t see it being a logical scientific argument that I should feel shame for presenting an alternative viewpoint

          • Jocelyn

            I was joking about referencing other religions…no derogatory comments of ANY religion are appropriate here.

          • Dr Kitty

            And not so smart to ask YENTAvegan if she’s Catholic.
            But hey, we’ve been spared anti-semitism, so far.

          • Dr Kitty

            Ok, so you don’t know that some HB midwives attend births with nothing but a fetoscope.
            Educate yourself, mama 😉

          • Ellie San Martin

            I’ve been to 3 home births, and several consultations, and the midwives I see have ALWAYS brought 4-5 full suitcases of equipment & medication, including several different ways to measure fetal heart rate. It would be foolish to hire a HB midwife who does not provide all of these things.

          • KarenJJ

            What’s in the suitcases?

            The homebirth midwives here transfer care to the hospital when it gets complicated. But where I live they are fully trained, registered, hospital integrated and accountable. They are also provided for free for those that want a homebirth and are low risk.

          • Jocelyn

            It would be foolish to hire a HB midwife at all.

          • Bombshellrisa

            A homebirth midwife usually uses a doppler to listen to fetal heart tones. If they do listen, that is. It can be an indicator of rate, if they aren’t picking up the maternal heart beat instead. You would be amazed how many midwives don’t place the doppler correctly.

          • wookie130

            “wow, are you Catholic? lots of SHAME running around here.”

            I know that Ellie the Troll is gone (for now), but this little remark here just put the nail in the coffin for me.

            Ellie, I would like you to know that I find you COMPLETELY VILE, and positively offensive to my not-so-delicate sensibilities.

          • Ellie San Martin

            SHAME on you, judging another human being as “completely vile” based on the fact that you disagree

          • anion

            Oh, Ellie, we have plenty of other reasons to find you “completely vile.” The anti-Catholic crack is just the tip of the lying, moronic little iceberg.

          • moto_librarian

            You know, I am not a doctor, but even I know that FHR isn’t just about the baby’s heart rate. There actually SHOULD be some variability in the tracing. So maybe you should do a bit more research before claiming that your sister’s OB is a liar.

          • The Computer Ate My Nym

            1 in 100 fetuses showing fetal distress on a monitor will die if not given a timely c-section. More than that will be injured including cerebral hypoxia.

          • Ellie San Martin

            what is defined as “distress?”

          • KarenJJ

            I can’t find it and don’t have time to keep looking but there was a fantastic post by Dr Amy about continuous fetal monitoring and how the variations in the strip are read.

          • Karen in SC
          • KarenJJ

            Thanks! That’s the one. One of my favourites and eye-opening. Especially for someone like Ellie. I had no idea either.

          • Ellie San Martin

            Yeah, I knew that. It’s still about 90% related to heartbeat. a constant heart rate around 150 without any changes doesn’t show any other distress on a monitor. other signs would be from movement and exams of the mother, etc. Is there a comparison of monitored babies whose mothers received pitocin & mobile mothers who didn’t?

          • KarenJJ

            Bless your heart.

          • Susan

            Frequently wrong but never in doubt…..

          • Dr Kitty

            Wrong.
            A constant Hr of 150 shows loss of both short term beat to beat variability and loss of long term variability. it is NOT reassuring and is an important sign of distress.

            http://www.fetalmonitorstrips.com/learn_more.html

            “Clinically, loss of beat-to-beat variability is more significant than loss of long-term variability and may be ominous.Decreased or absent variability should generally be confirmed by fetal scalp electrode monitoring when possible.”

            From here:http://www.aafp.org/afp/1999/0501/p2487.html

            Also- DO YOUR OWN RESEARCH.
            The fetal monitor strips site is the fifth link on the first page if you Google “foetal distress heart rate”, with the first four being Babycentre, Wiki, patient.co.uk and a Labspace educational module for midwives in Africa that is pretty short on detail.

          • KarenJJ

            Might I respectfully add DNFTT.

            I normally do love a bit of troll-baiting but this one is of a type I’m wary.

          • Dr Kitty

            I know, but I don’t like to leave that kind of ignorance about for some unsuspecting punter to read in future.
            No further plans to engage with “Ellie”.

          • The Computer Ate My Nym

            a constant heart rate around 150 without any changes

            …is a bad sign. Loss of variability is a sign of stress.

          • Ellie San Martin

            around 150 meant (to me) variation between 140 & 160, sorry to be so unspecific

        • anion

          How in the world did you get “There should be 100% c-sections” out of Young CC Prof’s reply? How did you even manage to be confused about Young CC Prof’s meaning?

          • Ellie San Martin

            “if we’re doing 100 sections to save one life”

          • anion

            Yeah…I know which sentence was so obviously difficult for you to parse and understand, I’m just mystified that it was so.

          • Amazed

            God. I wish I had read this reply before I lost my time to read the whole thread.

            And you’re the one to talk about shame being thrown at you? If I had wrote something like this reply, I would have dig a hole to bury myself in. No wonder you rely so much on anecdotes.

          • theNormalDistribution

            Math question time: if we have to do 5000 c-sections to save 50 babies, what percentage of deliveries are c-sections?

  • birthmyass

    We need a higher c-section rate not a lower one!! What are these crazy people talking about?

    • Young CC Prof

      Perhaps we shouldn’t be counting c-sections at all. Perhaps it’s just not a good measure any more. After all, whatever you measure is what winds up changing, and the c-section rate isn’t the important thing.

      When you go counting, say, wound infections after joint surgery, the obvious goal is to reduce the infection rate, and the ideal infection rate is zero. When you’re counting whether people with a chronic disease are getting appropriate follow-up, you want to bump that rate to 100%. But it’s not clear at all what the best c-section rate is, so maybe we should just not measure at all.

      Instead, maybe we should just measure outcomes, especially bad outcomes that weren’t obviously unpreventable. Count the intrapartum deaths, stillbirths or birth injuries in newborns, and the infections, tears or surgical complications in mothers. Maybe we should measure whether mothers are satisfied with their pain control, or whether they leave with basic parenting skills in hand.

      Heck with the c-section rate, since sometimes it’s the best option and sometimes it isn’t.

      • KarenJJ

        I agree. Wouldn’t health outcomes and patient satisfaction be better measures then counting the actual specifics?

    • The Bofa on the Sofa

      I find it funny that these folks take so much pride in how much they sacrifice for their children, constantly wearing their babies, how moms are supposed to put up with the hassles of breastfeeding if they are struggling, and how dad can just go sleep in the other room if he doesn’t like having the baby in the bed. But ask them to trade a little bit of mother morbidity in order to ensure their baby is born alive? Oh, we can’t have that. That’s evil! Mom might have an uncomfortable scar!!!

      Bleeding nipples? Deal with it. An extra day in the hospital after a c-section? In the words of young Elphaba, “Horrors!”

      • antigone23

        That’s because it’s not about maternal morbidity at all. It’s about ideology and childbirth as religion.

  • Too many women have csections. Period.

    • KarenJJ

      You might want to try adding a little more evidence to support that statement on this particular site. I’m totally convinced when a stranger on the internet writes the word “period” after a statement, but others on here aren’t as easily convinced.

    • Wren

      What is the right number?

      Which mothers should risk their babies’ lives to lower that number?

      Which women should risk their own health to lower that number?

      I’m telling you right now, I am very grateful to have had a c-section for my first rather than roll the dice on whether he would manage a footling breech delivery without harm.

      • The Bofa on the Sofa

        Kathy of course has no interest in an actual dialogue about this, but the question is, of the women who had c-sections, which is apparently too many, ’nuff said, should not have had one? How would you know?

        Undoubtedly there are women who are having c-sections that would not have to have them, but the question is, how do you determine that beforehand?

        If we knew beforehand that a c-section would not be necessary, we can tell people that. But if you can’t tell them that it won’t be necessary, then you have to make a choice.

        As has been pointed out, as the c-section becomes more and more safe, the tradeoff is going to go up. C-section or forceps? That has not been a question historically. Now, it is.

        • Amazed

          The problem is, in theory everyone knows that “the c-section rate is high” but when faced with the possibility that their own children MIGHT need a c-section, most mothers say, ‘OK, let’s do it’ and so they contribute to the rate because in retrospect, it might have indeed been unnecessary. Other mothers insist on “vaginally till the end” and feel vindicated if their children turn out OK – as if OBs and nurses are so very fond of pulling out dead or blue babies. And of course, there is the third kind of mothers who insist on “vaginally till the end” and when they draw the short stick, wail that no one told them and of course, if they had been truly informed, they would have had this so very necessary C-section. Then, some of them sue.

          But of course, too many women have c-sections. Period.

          • Lisa from NY

            The problem is that some women skew the statistics.
            1. Women with multiples (both natural and fertility meds)
            2. Women whose pelvises are too narrow
            3. Women with Pre-e
            4. Large babies bc women gained to much during pregnancy
            5. Mothers have Gestational diabetes – so large babies
            6. Cord around babies neck – heart rate plummets
            7. Baby facing wrong way during labor
            8. Previous C that did not heal properly
            9. Older mothers – weaker uterus

          • Wren

            Count me in those numbers. In fact, count me in twice even though I only had one c-section. My son was a footling breech and my daughter wrapped the cord around her neck, though it wasn’t a problem until the very end. Suddenly there were a dozen people in the room, I pushed her out and they all melted away as she was clearly fine. If it had been a problem a little earlier in the process, c-section number 2 it would have been.

      • Lisa from NY

        As my friend with the ten kids and 5 Cs (triplets, twins, twins, twins and a single) said, “Should the doctor just not let them out?”

        • KarenJJ

          Wow, I wonder how she found having a singleton after so many multiples?

      • Young CC Prof

        Given the current c-section safety record, if we’re doing 100 sections to save one baby from death or serious birth injury, we’re coming out ahead. If the other 99 were “unnecessary,” but ended in a healthy mother and baby, who cares?

        Now, it might be useful to be able to more precisely determine which deliveries are going to turn out well and which won’t, but doctors have to make decisions based on the information they actually have.

    • antigone23

      I had an elective c-section. And you know what? After my physically traumatic vaginal delivery that took almost a year to recover from, it was awesome. Easier to recover from, and overall cheaper because I didn’t need follow up surgery or physical therapy. In efforts to reduce c-section rates, it’s women like me who would be refused c-sections and be made to suffer. So, bite me.

      • Lisa from NY

        That’s because you did not have eight of them.
        I have a friend whose pelvis will not allow her to give birth naturally. After her eighth C, she developed a bad hernia and needed surgery (which she says is more painful than her Cs).
        She probably skews the statistics, though.
        I have another friend who only had five Cs (the first 4 were multiples, no drugs, unplanned). She did not have any problems, though. (She also skews the statistics.)

        • Young CC Prof

          I think a few months back, Dr. Amy found a study that showed that complications start to go up if you have more than 3 c-section deliveries. Of course, most people nowadays just don’t have that many kids. However, if a mother is planning a very large family, that might be a reason for the doctor to try a bit harder to avoid a section the first time around. If a mother is only planning a couple kids, it isn’t such a consideration.

          • Josephine

            All my doctors actually asked me how many children I wanted every time a c-section was discussed. At the time I was planning to have 3 at most, more likely 2, so it wasn’t a huge consideration for me anyway, but that’s definitely something that should come up for women who want a big family.

        • anion

          I’ve had two c-sections, and about two years ago I had emergency surgery for a ruptured ulcer. Given a choice, I’d have a dozen c-sections before going through the ulcer surgery again. I was up and walking around the same day with my babies, and pretty much done with severe pain after the first couple of days. I couldn’t get up for a week with the ulcer and spent two full weeks in the hospital with an IV in my neck, a tube down my nose into my stomach, drainage tubes, more IVs; I was still in pain almost constantly despite the morphine-on-demand drip; I developed a massive hematoma in the incision which required a second surgery… The whole thing was a nightmare.

        • Karen in SC

          Your first friend had a choice to not have eight children.

          Also, developing a hernia as a post surgery complication, even some years later, happens to folks with all sorts of abdominal surgery.

        • rh1985

          Well, it can certainly be a consideration of the mother plans a lot of children and the c-section were truly elective, but if she can’t give birth naturally, then she has to decide whether to have less kids or risk a larger number of c-sections. Personally, I want 1-2, even if I won the lottery three would be my max, so I don’t think that will be a consideration for me either way. I’ll go with whatever is less risky for my specific birth.

          • KarenJJ

            It’s a personal choice if she wants a lot of children these days, but having lots of children was not a given even in the days prior to c-section. My great grandmother had ten kids, my grandmother (who wanted a large family) had three increasingly risky pregnancies and many losses due to being RH negative. Even if I’d wanted a large family, it would never have been an option for me in the past, and although having had 2 c-sections, the c-sections aren’t really what is limiting the number of kids I have.

        • Josephine

          It’s my understanding that anything more than 3 or 4 is not the greatest idea.

    • DaisyGrrl

      Well I’m convinced. Nobody in the history of ever has explained that too many women have c-sections. Now that you have, I’ll take your internet medical and statistical knowledge as gospel.

      Everyone, Kathy on the internet has spoken! No more c-sections unless she deems it necessary!

    • anion

      You are incorrect. Period.

      • KarenJJ

        It’s only the start of the conversation, not the “period”. To work out if the number of c-sections is actually a problem and why and what we can do about it if it is the next step. One option I’m not keen on is to sacrifice the health or life of my babies so that someone can reduce the c-section to some arbitrary rate. One option that I think would be great would be a way to better predict which babies are handling it well enough that they don’t actually need the c-section to get them out. I’m all for technical solutions, not political solutions.

        That said, I’m not helping anyone reduce numbers anyway because as soon as I found out I was pregnant I was at my obgyn’s office saying “I want a c-section and I have absolutely no interest in a VBAC”. Thankfully with my medical history he was happy to do so and he gave me a couple of dates.

    • wookie130

      Define “too many”.

      And then after that, define how many c-sections would be ideal for women to have.

      Oh, that’s right. It can’t be done.

      • araikwao

        It’s too many for Kathy’s liking, and that’s what matters.

  • Sue

    So much pseudoscience on that site: the Six Steps are a load of nonsense. Already de-bunked here many times.

  • NC Lurker
    • Sullivan ThePoop

      Wow! I don’t even know what to say. Why would she do nothing like that? I like the way NC is all about consent though.

      • NC Lurker

        It’s hard to tell if the deaths occurred in NC or VA; if NC, it would have been illegal for her to attend and she had been in prior hot water for births that went poorly.

    • Amy Tuteur, MD

      I hadn’t seen that she finally lost her license, but she was notorious in NC and I wrote about the second death that she presided over.

      • NC Lurker

        I had seen/heard other stories of dead and injured babies but not these two particular cases. So sad.

  • wookie130

    When my husband and I took Lamaze classes in January of this year in preparation for the birth of our daughter, I really expected it to be the old stereotypical “hee hee hoooo” pushing/breathing techniques you see in the childbirth classes in movies. Well, honestly, there were moments where we were choking back silent laughter, as it quickly became a rather hilarious New Age experience that we clearly did NOT sign up for…at one point, we were practicing patterns of movement that was supposed to help with moving labor along, such as the slow dancing thing, the bouncing on the birthing ball, rolling on the birthing ball, while our partners massaged us with these wierd wooden rollers…and the instructor (a DOULA), played this seriously stupid pan-flute renditions of Slayer and Metallica music. I wish I was joking. And then out came the forceps, epidural needle catheter tube thing, vacuum dealy, and other tools of the trade, so we could pass them around, and the instructor could scare us into “doing what was necessary to avoid” the need to use any of those instruments. About two weeks into the class, I discovered through an ultrasound that I needed a c-section, due to marginal placenta previa, that just didn’t want to correct itself. Upon sharing this with the instructor, she just gave me sad eyes, and told me she was “sorry.” Sorry for WHAT??? That I wouldn’t have to endure all of that hooey she had been describing to me, and that my baby would arrive quickly, safely, and uneventfully? C-section? After the Lamaze class, I’d gladly sign up for a c-section ANY DAY of the week.

    • Susan

      That would have made a great scene in a movie… pan flute!

      • Mrs Dennis

        Spinal Tap?

        • KarenJJ

          LOL, dial my epidural up to 11 please!

    • Antigonos CNM

      When I became a Lamaze instructor, back in the early 70s, what we learned was a series of breathing exercises designed to lessen the need for IV medication, which did depress babies. That was IT. No other topics — and I was taught by the doyenne of Lamaze herself, Elizabeth Bing [whose only child, btw, had been born by C/S]

      How sad to see how Lamaze has deteriorated. Of course, the advent of the epidural has made the technique nearly irrelevant.

    • Sue

      I expect a bit too much pan flute might make a descending child change its mind and go back in…

      Anyone know of any studies using pan flute to stall pre-term labor?

      • KarenJJ

        Trouble trying to recruit patients as I understand it.

    • C T

      “Bouncing on the birthing ball”? Please tell me you’re kidding. I’ve used birth balls at three of my births and found them helpful, but when I was talking to my OB before my last birth, she got a scared look when I mentioned birth balls. It turns out that a laboring woman at the hospital had been literally bouncing on the birth ball and caused the cord to detach, killing the baby in utero. I had to reassure my OB that I would not bounce. (Labor came on so suddenly that we were lucky to get to the hospital that time, so the birth ball was completely forgetten. 🙂 )

      • wookie130

        Yeah, I don’t know if we were “bouncing” on the balls per se, but we were rolling on them…undulating on them, if you will. Good grief, how frightening about the cord detachment in utero thing, though. Oh my goodness…

    • yentavegan

      Ok, you pro lay midwife/homebirther’s out there, did you read the part about wookie 130 having a routine ultra-sound? Do you get now how a routine ultra sound saved this mother’s life? Routine ultra-sounds are not bad, dangerous or alarmist. Ultra-sounds are safe modern tools that real doctors and real certified nurse midwives,(med-wives) have access to in order to sake guard the health of their patients. Ignorance is not bliss.

      • DaisyGrrl

        but but but…autism!

      • Tim

        Out of everything, not getting ultrasounds done is, to me, the absolute stupidest worst decision out of all of the things people to do to be more “natural” with their births. I don’t think people realize just how many things can go wrong with their baby and/or their uterus during gestation, and how common they actually become when you start to add them all up. It’s utterly insane to me.
        Look, even if there was a risk of autism (which there has been zero evidence to show there is) , do people even realize the alternative? Do they have any concept? 1 in every 33 babies born in the US has some kind of birth defect. ONE IN THIRTY THREE. That is not RARE – that is common as dirt.

        • Amy M

          That’s how we knew there were twins at 7wk. Probably would have figured it out eventually, but I sure am glad we were armed with that info way early on.

        • Young CC Prof

          My cousin’s 7-month-old was born with hypoplastic left heart syndrome. Because of a routine ultrasound, he was born in a teaching hospital with a neonatal heart surgeon standing by. His mother had months to research the condition, begin to cope emotionally and prepare to fight for her child, and find the best hospital and surgeon in the region. He was on oxygen the minute he was born, never turned blue, and had a successful Glenn repair by 4 months. He’s now pink and meeting developmental milestones, and probably going to have a fairly normal life.

          Without that ultrasound, he would have been born in a neighborhood hospital 100 miles away, and might possibly have gone home and died before diagnosis. Certainly his first days would have been stressful, possibly involving a helicopter ride. The delay in treatment might have caused any number of complications.

          • Tim

            And there are 4,000-4,500 other babies just like him born with a Critical CHD that requires almost immediate surgical intervention to repair or palliate each year. And 45,000 total that are born with a CHD of any kind, and require at least monitoring and/or medication to track progress and make sure they are ok.
            When I tell people this , regarding the importance of ultrasounds, HLHS is one of the things that is forefront in my mind too, because in many cases now, they can actually do in utero catheter procedures to balloon the aortic valve, resolving the stenosis, and stopping the progress of hypoplasia. But again, you have to KNOW, and to KNOW, you have to get your ultrasounds like you’re supposed to.

          • prolifefeminist

            I’m glad your cousin’s baby’s story had such a happy ending! This is exactly why I did whatever non-invasive (ie, no risk) prenatal testing that was offered to me. No, it wasn’t so I could abort if there were anomalies, as several relatives wondered. I wanted to a) make sure I delivered in a hospital with the right specialists if there was a problem, b) be able to take advantage of any prenatal treatment there might be, and c) emotionally/financially/logistically prepare ourselves.

            I just can’t wrap my head around the “ignorance is bliss” approach to pregnancy. You have a rapidly developing organism attached to the rapidly expanding, vascular organ of another organism – SO much can and often does go wrong. Why would you NOT want an early warning?

        • Lisa from NY

          The statistics are worse with IVF + ICSI (in vitro with sperm injection). These have a 10% birth defect rate (although age of parents is issue).

        • Lisa from NY

          And Autism is not counted as a birth defect.

      • guest

        Unfortunately, in my state Medicaid does not cover a routine screening/anatomy ultrasound. A high risk condition such as smoking, advanced maternal age, drug use, late prenatal care, etc is required for providers to be reimbursed. The majority of my patients with Medicaid probably meet at least one of these criteria; however, as an obstetrician I feel that it’s important and just write off the cost for those who don’t meet criteria…but I’m just a “money-hungry” OB who plans to C-section everyone at 4 pm so I can get to my golf game. Without routine ultrasound I would have missed the fatal cystic hygroma, 2 missed miscarriages, mono/di twins, and 2 low-lying placentas I had last week alone (I have a very busy OB practice!).

        • FormerPhysicist

          Damn. Can you keep a pack of cigarettes in your office and sent women out of the office to light one and take *one* puff? Then they’ve smoked during the pregnancy.
          Only half-joking.

        • Josephine

          So did you do these ultrasounds in between jaunts on your yacht/exotic vacations or what?

          • araikwao

            Between golf games, i’d guess 😛

        • Dr Kitty

          I could *spit*.
          Denying USS to your most disadvantaged patients is not good care. Medicaid got that one wrong. Big time.

          NHS you get a booking scan at 10-13 weeks and an anatomy scan at 18-22 weeks, with more if indicated.

          • Tim

            The problem, is (like many things here in the US) that the specifics of Medicaid programs are left up to the states – the federal government provides funding, but the states implement their own programs, with their own rules and restrictions. Some are wonderfully funded and provide for most things, and some states are more along the “fuck you, got mine” method of caring for the poor.
            For a perfect example, see what is going on right now with the ACA – there was provisions for expanding medicaid coverage, in which the fed would provide almost all of the funding for individual states to do so. Many states took them up on this, and have expanded their medicaid programs generously as a result. There are also many states that said “help our poor people? OVER MY DEAD BODY OBAMA” , and refused the money.

        • Tim

          Oh, and by the way. Thank you. Thank you for taking advantage of your privilege to do a good deed for the underprivileged. I’m sure you don’t hear that as often as you deserve to.

        • The Bofa on the Sofa

          I don’t have any real basis for it, but I would not be surprised if “financially disadvantaged” would be a very important risk factor in pregnancy. Probably a correlation not causation issue, but a strong correlation nonetheless.

          • Tim

            Like the Rick Perry’s of the world give a spit. The only time they will notice or care about anything having to do with poor people is when they are no longer there to clean their houses and do their landscaping for them.

          • The Bofa on the Sofa

            But it’s a medical justification.

            If having X is a risk factor, then those with X are justified to have extra screening.

          • Tim

            It’s only a “risk factor” if the people in charge of medicaid’s rules for that state, decide it is.

  • Tanya

    So do you believe that there is a C-section rate that should NOT be exceeded? i.e. is 30% too high? 50%? How about the 95% cesarean rate in Brazil? Can you honestly tell me that this is best practice? Primum non nocere…

    • Amy Tuteur, MD

      I can tell you that I am outcome oriented, not process oriented. The actual rate is irrelevant. What’s important is the rate that is consistent with the lowest level of both maternal and perinatal mortality.

      • Young CC Prof

        And the reason the rate has gone up in recent decades is that it has gotten safer. A good doctor will cut when the risk of harm to the mother or child from continuing labor outweighs the risk to the mother of surgery, and right now, c-sections are pretty darned safe.

        • Sullivan ThePoop

          True, My nephew who is a surgical resident said he was surprised when he learned that elective C-sections are the most straight forward, uncomplicated surgeries done today. He said the way people talk about them in the general public and reality are so very different.

          • anion

            When I mentioned to my FIL’s girlfriend that I was hoping for a c-section, she was horrified and gave me the whole “That’s MAJOR SURGERY” thing, with details of how much pain I’d be in and how I’d be barely able to move and blah blah blah.

            I had two. Recovery was fine. About two years ago I had emergency surgery for a ruptured ulcer; I can tell you, I’d rather have a section any day of the week. The ulcer thing was MAJOR SURGERY. I had tubes sticking out of me, had to be fed through an IV, and was in the hospital for two weeks. My sections were cakewalks compared to that.

          • The Bofa on the Sofa

            My wife’s recovery from her laproscopic appendectomy was more of a struggle than from either of her c-sections. Esp the second, where they preemptively addressed her post-op nausea.

            I always tend to think that having a baby around helps diminish the pain, in addition to the pain killers.

          • anion

            Heh, the funny thing is, when I finally left the hospital I mentioned to my husband how unfair it was and how odd it felt: I’d had abdominal surgery, therefore I should have a baby to take home.

          • The Computer Ate My Nym

            Any surgery that breaches the abdominal cavity is considered “major”. But that doesn’t mean high risk or probable difficult recovery. Most planned or even uncomplicated major surgery is quick and easy to recover from. It’s the complicated emergencies like a perfed ulcer that get messy…

          • Antigonos CNM

            Anecdotes are not data, but I had 3 C/Ss within the space of 3 1/2 years. The first was done after 48 hours of very strong contractions without any progress. 10 days after the C/S, I flew to the US with my son so my mother, terminally ill, could see her first grandchild before she died. At the time, it did not seem an extraordinary thing to do. With my second and third C/Ss, I had equally swift and uncomplicated recoveries.

            Four years after my last C/S I had surgery for an ectopic pregnancy, and my tubes were tied at the same time. I definitely had more post op pain than with the C/Ss, and a year ago I had a hip replacement that took me almost 3 months to recover from completely. Give me a C/S any day.

            A C/S usually takes about half an hour, “skin to skin” if there aren’t any complications. I’ve scrubbed on hundreds. The baby is out within 3 or 4 minutes [or less] of the initial incision: skin, muscles, peritoneum, uterus, bingo!. It is definitely not a minor op, yet it is certainly not what I’d call major surgery.

    • Amy Tuteur, MD

      I see you are a Lamaze certified childbirth educator. Do you think it is okay for Lamaze to supply misinformation about C-sections to women?

    • attitude devant

      Wow. Can I just say how much I hate people who clearly have no idea what they are talking about quoting the Hippocratic Oath at me? You believe, as a matter of faith, that there is some ideal (i.e., low) percentage of C/S. Why do you believe that? Anyone who does OB can tell you there are tradeoffs to C/S and vaginal birth, both for mom and baby. Why can you not see that what is optimum might vary from decade to decade and locale to locale? Do you really think I enjoy doing all the extra post-op care and paperwork that goes into a C/S? I don’t get paid one cent more for it.

      • Susan

        LOL so true. The OBs I work with love a normal vaginal delivery without a tear or epis most of all! Why would someone want to do more work, spend more time for less money (and them have people on the internet cheap shot them about getting to a golf game)?

        • anion

          My OB was disappointed by my obvious preference for a section, especially my second. He didn’t chastise or argue–oh, I loved that man, he was so sweet and funny–but it was clear he would have liked me to have a vaginal delivery with my first and would have liked me to try VBAC for the second.

          But not even for him would I give it a go. 🙂

      • Captain Obvious

        I like to use the analogy of TAH and TVH and LAVH. All three accomplish the goal of removing the uterus. But not everyone can have a TVH (NSVD) safely. Some need laparoscopic assistance and some just need abdominal approach. How do some women expect everyone to be able to have a NSVD.

      • The Computer Ate My Nym

        I don’t get paid one cent more for it.

        Seriously? That’s dumb. A c-section involves at least 2-3 more follow up inpatient visits, wound care checks, post-op monitoring…and they don’t pay you for all the extra work? What are the insurance companies thinking giving you that sort of disincentive to perform c-sections?

        • attitude devant

          It bears repeating: OB care is paid as a global fee. No matter whether the labor is short or long, intervention-free or highly technical, I get the same flat fee for pregnancy, labor, delivery, and post-partum care. And that’s fine. I prefer not having financial incentives one way or the other—the decisions are made based on what is best for that mom and that baby.

          • The Computer Ate My Nym

            It seems to me that you currently have an incentive to not intervene. Intervention costs you (or your hospital) money, in the increased time of hospitalization if nothing else. Or does the hospital get paid more for a longer stay? (If not I’m surprised that they aren’t pressuring you to avoid c-sections.)

    • theNormalDistribution

      I’m not a doctor, but I would definitely recommend not exceeding 100%.

      • Kerlyssa

        What if it’s twins, and you leave one in by accident?

    • Karen in SC

      do you have any evidence that Brazilian women are being forced into c-sections that they don’t want? Any evidence at all of “harm”? Both methods of birth have risks.

      • attitude devant

        Actually, one of my great regrets was that during the “everyone must have a trial of labor” days of my residency, I refused a Brazilian immigrant a CDMR. In her worldview I did her a great wrong. I feel that I should have been more sensitive to her cultural background and less driven by the prevailing ideology.

      • auntbea

        http://www.bmj.com/content/324/7343/942

        Plus, some Brazilian women ask for them because sterilization is a preferred method of birth control and the doctor can just tie the tubes while he’s in there. Actually, sterilization is so popular that it peaks around election time — politicians pay for the procedure in exchange for the womens’ votes.

        • Karen in SC

          thanks for the link. I don’t have the background to fully evaluate it, but I was struck by this statement:

          What is already known on this topic: Women’s preferences for caesarean sections are understood to result from lack of knowledge and psychological aptitude to handle vaginal delivery and its consequences.

          I didn’t like that statement, sounds biased to me.

          • auntbea

            I just noticed the statement that women believe vaginal birth represents low-quality care.

          • anion

            I’m fascinated by the idea that if c-sections were completely elective, huge numbers of women would choose them. I wonder if that’s at least partially behind the propaganda against them?

          • auntbea

            Which, of course, raises the question: if huge numbers of women chose them, so what?

          • KarenJJ

            And condescending. Plenty of preferences for c-sections are not due to a lack of knowledge, nor a lack of psychological aptitude. I’d even go so far to say the vast majority.

          • KarenJJ

            Ah OK, the link is specifically about the culture of giving birth in Brazil. I don’t know enough about it. The phrase ‘psychological aptitude’ still reeks though.

          • FormerPhysicist

            I was just about to post that.

          • The Bofa on the Sofa

            Lack of knowledge?

            My wife was not keen on going through labour, because it hurts! That’s not lack of knowledge. In fact, the incorrect ones are the ones who insist that childbirth is not painful, and it is only the modern propaganda that makes it so. You have to be in complete denial to see that that is not true, in general (as I have said, childbirth was recognized as so painful 3000 years ago that it was considered a punishment from God)

            And lack of “psychological aptitude”? Really? So is it that they are weak? Or too posh to push? Trying to figure out which part of the psychology is lacking there.

            Yeah, can you get a little more insulting?

          • realitycheque

            I would say that increased knowledge, not lack of is what has led me to desire a c-section for my second.

            First birth was awful, and that experience, coupled with the aftermath both opened my eyes to the sheer amount of bullshit in the world of NCB, as well as to the reality that an elective Caesarian wouldn’t traumatise me, make me a “cop out” or somehow permanently damage my relationship with my baby, or the child him/herself.

            If I had known then what I know now, and wasn’t going into birth being told to fear obstetricians because they would assault me and cut me open without hesitation (and because of sheer greed/laziness/ignorance from ‘never having viewed a normal birth’), hence ruining my bond with my baby forever, destroying our breast feeding relationship and subsequently my child’s long- term health and IQ, I probably wouldn’t have ever had a vaginal birth to begin with.

          • fiftyfifty1

            So if it’s “lack of knowledge”, then why do so many female OBs and OB residents say they would prefer to have a scheduled CS? And a lack of “psychological aptitude to handle vaginal delivery and its consequences”? Frankly a vaginal delivery is a psychological walk in the park compared to the psychological challenges of completing medical school and a 4 year OB residency. Now the desire to avoid the consequences of a vaginal birth–that is actually a true motivator. A desire to avoid pelvic organ prolapse, 4th degree tears, shoulder dystocia, birth asphyxia, fecal incontinence and the other risks that are specific to the vaginal route of delivery is not a sign of ignorance or weakness. This is a perfectly rational choice!

    • Amy M

      Where do you draw the line though? I am pretty sure there is evidence (Dr. Amy and the other OBs here can back this up?) that deliberately backing off on Csections/withholding them in, for the sheer purpose of lowering the rates, will lead to increases in mortality rates, for both women and neonates. Is that acceptable to you? And who cares if a woman has a C section that she DESIRES, even if it wasn’t “medically necessary?” If she’s gone over the risks and benefits with her doctor and given informed consent, and all goes well, and she’s happy with the outcome, and everyone goes home healthy, what’s it to you?

    • Sullivan ThePoop

      Elective C-sections are at least as safe as vaginal birth so if that is what the women in Brazil want why not?

      • realitycheque

        I was under the impression that c-sections held slightly elevated mortality risks for mother, whilst lowering overall mortality for the baby. Or is this just one of those correlation/causation issues?

        • Sullivan ThePoop

          Elective C-section are different than emergent C-sections which do have a elevated risk for mother.

    • Antigonos CNM

      It depends entirely on the population the hospital has in its L&D unit. A low risk unit should not have a high rate, but a unit which specializes in high [and extremely high] risk SHOULD, for the safety of the baby and the mother, have a very high rate of C/S

      Managing birth is like a smorgasbord: not everyone chooses the same food, because some people like one thing or the other, some are hungrier than others, etc. The “correct” C/S rate is impossible to define.

    • The Computer Ate My Nym

      Again, it’s not enough to say “too many c-sections are being performed.” Which c-sections are unnecessary? Why? What evidence is there that outcomes would improve if there were fewer c-sections? How good is the evidence? What outcomes are being studied? What are the risk/benefit tradeoffs?

    • Lisa from NY

      But should you tell a woman whose pelvis is too small, “No C section for you. Just die in childbirth.”
      Or a woman whose baby’s heart rate is plummeting bc detached cord, “No C section for you. You can try for a live baby next time.”

      • anion

        Sorry, we’ve already filled our arbitrary c-section limit for the year. Next time, aim for a due date in the first three or four months of the year–well, if you survive this one, of course.

  • Squillo

    OT: Robert Biter has apparently cross-filed against Scripps Memorial in the med-mal lawsuit that Amber and Michael Lukacs brought against him and CPM Heather Lemaster in the homebirth death of their son, Ace. His cross-filing charges the causes of Ace’s death were not related to homebirth or his care, but rather “ill fate” and “sub-standard medical care by the attending Scripps Memorial physicians.” The latter, according to the cross-complaint, is that the docs administered an “unreasonable” 21 minute wait until “medical staff confirmed intrauterine fetal demise”. Scripps has demanded a jury trial. (Lemaster is not listed as party to the cross-complaint.)

    This is in addition to the fraud suit he filed in April against Scripps and several of its physicians, charging that they conspired to ruin his career by imposing unreasonable oversight requirements on his hospital practice, making him undergo biased peer review, and forcing Scripps staff to alter medical records to make him look bad.

    In other news, as of Oct 1, Biter no longer has a licence to practice medicine, having let it expire. It’s unclear to me if that means the MBOC complaint filed in December as a result of the Lukacs case will never have a hearing. It also appears that he has let his board certification in Ob/gyn lapse, as I can no longer find him listed in the ABMS site.

    • Anj Fabian

      Jury trial?

      Bring it on!

      • Dr Kitty

        So, are we allowed to call him “Dr” Biter now?

  • Amy M

    And they ALWAYS lump all the C sections together, never distinguishing among first time mothers, repeats C’s, emergencies, pre-planned for whatever reason, maternal request, urgent (as in non-emergent, but it became the best course of action later in the game), etc. Yeah, that’ll add up to 30% when you average it all together….with some hospitals having a much higher rate and some with a much lower. These people have no critical thinking skills whatsoever, and they rely on their audience having none either.

  • batmom

    The hospital where I delivered has a 22.7% C-section rate. Others in the area have 10-15%. The big University-affiliated hospital has a rate of 25%.

    But what does that mean, really? Surely it’s relevant that the hospital where I delivered and the University hospital have level-3 NICUs and that high-risk patients tend to go there if they can.

    What about a provider’s rate? A CNM attended me until fetal distress required forceps, and her partner the OB. He was then the attending on my L&D; had the forceps failed he would have done the C-section. Does that make him *worse* for stepping in? Does it make the CNM better because I don’t show up in her stats?

    My point: even if we knew what the ideal rate was (which we don’t), it would be very hard to figure out how to use that knowledge as a health care consumer.

    • KarenJJ

      ” it would be very hard to figure out how to use that knowledge as a health care consumer.”

      So very true!

      I don’t care what the c-section rate is in general. As long as I have access to a c-section if I need it or want it.

  • Thank you for this post…I’m so frustrated by the statistic that won’t die!

  • Dr Kitty

    OT
    Locally, we’re dealing with this at the moment.
    http://www.bbc.co.uk/news/uk-northern-ireland-24474353
    http://www.bbc.co.uk/news/uk-northern-ireland-24458241

    I can share my thoughts if anyone is interested.

    • The Computer Ate My Nym

      Please do.

      • Dr Kitty

        Well, you asked for it.

        What we had here until recently was a huge grey area with a DADT culture. Basically, two sympathetic OBs would decide that someone with a fatal foetal abnormality, or a history of postpartum psychosis or whatever had a “significant risk of severe and permanent disability” if the pregnancy continued, and it would quietly be taken care of here and coded officially as an “early induction of labour” or something similar. That was the situation up until about 2years ago.

        Then the department of health brought out guidance that specifically said that foetal abnormality alone is not sufficient grounds for TOP, and required reporting of all abortions including details of the justification.

        Which meant that DADT no longer works. OBs here now have no choice but to abide by the letter of the law.
        TBH, I think that most OBs are hoping public outrage at the result will change the law. It sucks for the women caught in the middle, but realistically public will is the only way to make this happen, and for that you need stories like the ones I linked to.

        • Amy M

          I feel so badly for those parents and others like them. What a terrible situation to be in in the first place, and to have to make such a decision, only to have the govt step in and try to dictate their options (forcing them to leave the country) and then publicize the whole matter. I hope that at least this sort of thing leads to a change in the law.

        • The Computer Ate My Nym

          foetal abnormality alone is not sufficient grounds for TOP

          To me this is saying that abortion is unacceptable but infanticide is ok. If you force a woman to carry a pregnancy to term despite the fact that the fetus has anomalies blatantly incompatible with life then you’re creating a situation where a newborn WILL die, probably in a good deal more pain than the fetus would have experienced with planned termination. Where’s the benefit? It won’t save any viable fetuses from abortion and will just cause unnecessary suffering. Is that the point?

          • Dr Kitty

            It’s based on theological belief basically whereby intentionally ending a pregnancy early is a sin, but allowing “nature to take its course” is fine, even if the second option causes more pain and suffering to all concerned.

            No.
            I don’t get it either.

            Most Northern Irish people (who often consider themselves Pro-Life) understand that in such situations a termination is physically safer for the woman and may be emotionally easier to cope with than carrying a doomed pregnancy to term.

            Of course some women will choose to continue such pregnancies, and that may be the best decision for them. It just shouldn’t be the choice mandated by law.

          • The Computer Ate My Nym

            It’s based on theological belief basically whereby intentionally ending a
            pregnancy early is a sin, but allowing “nature to take its course” is
            fine, even if the second option causes more pain and suffering to all
            concerned.

            I’ll start taking them seriously when they allow nature to take its course when they get kidney stones.

          • Young CC Prof

            Yeah, that’s pretty cruel. I’ll admit, abortions for survivable defects like Down Syndrome or moderate spinal bifida give me the willies morally, but if the child is going to die very soon after birth? It’s the mother’s choice whether to carry to term and then say goodbye, or just end it as soon as possible, and I couldn’t possibly say either choice is wrong. Personally, if it were me, I’d want to end it.

    • Burgundy

      Yes, please!

  • Dr Kitty

    “Reduce your risk of caesarean and push for better care” implying strongly that CS=worse care. Nice.

    In my case CS was absolutely the BEST care.

    Lamaze have an agenda, and it isn’t actually healthy women and babies.
    It’s selling stuff, and the stuff they sell is NCB classes and breast feeding paraphanaleia.

    • theadequatemother

      It’s pretty explicit too – one of their six things to do for a healthier birth is to take a Lamaze prenatal class!!

      You know what made my birth healthy? A decisive OB with skills and judgement and access to advance medical technology. And antibiotics. Without those things I would probably be dead and my son would possibly have some preventable challenges to deal with.

      • Sullivan ThePoop

        I consider my labors pretty uneventful, but that is because of modern medicine. My 1st late, had to be induced, pre-E, started to have a seizure in labor and had to stay in the hospital for 9 days when I was feeling fine and bouncing off the walls because my blood pressure wouldn’t come down 10 points systolic. My 2nd I had early and induction took 30 hours, but only 4 was once my water was broken, that would have been huge trouble if I had lived through the first. My last I got high systolic pressure again but only after I started pushing, which seemed to take forever because they made me lay on my left side. Granted they told me I could wait to push because nobody was in a hurry, but F that came to my mind and it was not easy, but I finished it before the meds kicked in. I only stayed 48 hours that time. Still, if somehow I manged through the first two that could have done me in too. Oh, and I forgot I am Rh- with only one Rh- child. So, even if I had survived none of my children would have.

    • Burgundy

      Lamaze was the only birth class that I could take with my hospital. I don’t understand why. The class I was in the Woo encouraged us watching BOBB in a hospital facility. The most useless workshop that I ever attended. I wished the hospital could have offered birth class other than Lamaze.

      • anion

        Our Lamaze class was ridiculous. I remember at one point sitting on the floor with my husband and my pillow and thinking, “This isn’t particularly comfortable now, how is it supposed to be better when I’m in labor?”

        Then I looked at all the other women with their pillows, all with the same “Seriously, WTF is this supposed to do for me?” look on their faces, and thought, “Well, at least it’s providing the Hubs and I with some extra giggles once a week. It’s sure not doing anything else.”

        • Burgundy

          Uh, wait a minute… My husband still owns me the massage that I suppose to get from him at my first kid’s labor. I should ask him to “keep his words” tonight (it is only 2 labors and 6 years latter, not too late right?)

          • anion

            It’s never too late!

        • AmyP

          Yeah–now that you mention it, what were the pillows for? I’ve had three babies now and I’ve done the classes twice and I have no idea what I was supposed to do with the pillows.

          A better, more realistic set up for a L & D labor classroom would be to provide every pregnant woman with an L & D bed and an IV stand to pull.

      • Sullivan ThePoop

        I only took lamaze classes when I was pregnant with my first in 1989. They were all about breathing and your partner supporting you. Some preparing for what to expect. That was it. When did it change so drastically?

        • Burgundy

          When the woos took over? I took it in 2006.

        • EmbraceYourInnerCrone

          I don’t know about the rest of the U.S. but when I had my daughter in Southern California in 1984 my Lamaze class was taught by a retired nurse who appeared to be very much into the “crunchy” side of things. Spent a lot of time talking about the “evils” of formula feeding, the “evils” of disposable diapers. And then there was what I saw as the ridiculous breathing exercises..maybe they help some people but they didn’t do much for me. I only had the one kid but, if I had it to do over I would have gotten the epidural when I got to the hospital and I would have enjoyed watching TV or reading a good book rather than trying to “breathe” through the contractions. Also would have hidden more snacking in my hospital go-bag. I had the shakes after giving birth and I was STARVING by the time breakfast was served.

          Also, my advice: don’t eat too much after you go into labor, you may be seeing it again when you hit transition, bleurgh. And eat lots of prunes after you deliver, you will be happy you did..

          • Sullivan ThePoop

            Yeah, I took mine in the midwest. I guess it took a while to get here.

      • Clarissa Darling

        Can anyone tell me why, WHY on Earth a hospital would endorse this kind of birth class? I’ve avoided all the birth classes at my hospital–I don’t trust them due to hearing too many stories like this! I work for a financial services company and I can’t imagine that they would allow me to run a workshop in their name encouraging investors to sign up for latest Ponzi scheme! The hospital is supposed to be where you go for sound medical advice, it makes absolutely zero sense for them to offer classes aimed at misleading women about medical procedures. What’s next? Hospitals handing out copies of Dr. Sears’ alternative vaccine schedule to new parents?

        • Clarissa Darling

          BTW this isn’t entirely a rhetorical question. If anyone who works in a hospital has any insight as to why they would be offering classes like this, I would really be curious to know. Could it be a cost issue, that
          they don’t want to hire and train their own staff to run the classes so the rely on organizations like Lamaze to do it for them? With the highway robbery prices that get charged for some of these classes, that seems unlikely. Also, I’ve heard of suspect information being given out at birth classes by nurses as well. I’ve taken first aid and other health workshops at hospitals with nary a hint of erroneous information so why do birth classes seem to be the exception?

          • Amy M

            I am going to guess that the classes are privately run, and they just rent the space in the hospital, and the hospital personnel don’t actually know what is being presented. A friend of mine took a birth class in the hospital that presented some incorrect or biased info (I don’t remember the exact situation) and she complained to the hospital. They didn’t seem to realize what the class was all about and said they would look into it, saying they didn’t endorse that sort of thing.

          • Clarissa Darling

            Not a lawyer but, it sounds like a potential liability issue for the hospital to not even know what goes on in the classes. Even if they are not running the class, they are giving patients the impression they endorse it by allowing it to take place in their facility. I couldn’t even post on the net and disclose what company I work for without the standard “the views expressed here are not the views of XYZ co” disclaimer. Seems like these classes should at least come with some sort of an “information provided here does not reflect the views of General Hospital and is not intended to substitute for medical advice provided by your doctor” kind of waiver.

  • kumquatwriter

    Anti-CS propaganda is 90% of what ruined MY birth experience. But since i don’t toe the line, I’m an unperson to “activists”

    • Not all “activists” – you are very much so a person in my books, and one who matters a great deal.

    • Sullivan ThePoop

      Think about it like this. They are taking one moment in time and escalating it to some ridiculous height because they have nothing better to do. You on the other hand know that no one moment in your child’s life is that important and you get on with raising them.

  • Burgundy

    It is like how Creationism keeps saying since we have a “missing link”, therefore, the evolutionary theory must be fault.

    • Sullivan ThePoop

      That argument once had a little merit because our understanding was very lacking before modern molecular genetics, but not for at least 35 years.

      • Burgundy

        Exactly! My husband and I went to a local creationism museum just because. It was very amusing.

  • auntbea

    I tried to point out a statistical error on an earlier post and they responded by telling me they didn’t need a statistics lesson. Well, then, I ask, why did you make such a stupid error? Either you don’t understand, or you DO understand, but you would rather just lie.

    • KarenJJ

      Hospitals have been responding to requests and new evidence, with options in the delivery rooms (we had birth balls, stools, private baths and showers, skin to skin, delayed cord clamping etc etc available).

      Homebirth midwives have been sticking their fingers in their ears and singing ‘lalala’ and taking increasing risks with their patients and performing outdated and dangerous practices, and they can’t have any of this pointed out to them, ever.

      • Karen in SC

        And midwives SAY they use EVIDENCED BASED practices. And I have never learned what any of those practices are!!

        Liars.

        • KarenJJ

          Whatever Ina May Gaskin says apparently…

  • The Computer Ate My Nym

    When people talk about the “high c-section rate” and “unnecessary c-sections” I sometimes ask them which c-sections were unnecessary and how do you know? I have yet to receive a good answer.

    • Amazed

      A friend of mine says her first section was necessary because they broke her water to find it green. Her second section was necessary because her doctors recommended it and since she had experienced both the pain of vaginal birth and the pain of a c-section in a single birth, she was extremely happy to miss the vaginal part this time.

      So, necessary. Not that it would wash with the NCB crowd but yes, to her they were both necessary.

    • Young CC Prof

      That’s what I was trying to explain to my mother. A large number of c-sections (not sure how many exactly) are done because of fetal heart decelerations, implying the baby might die or suffer brain injury if labor continues too much longer.

      Now, some of those babies would probably have delivered naturally without harm. Of course, no one has any idea which ones! And if you knew your baby might be in trouble, why on earth would you take the risk?