The claim of being “educated” about childbirth is the surest sign of ignorance

Shouting with a megaphone

What does it mean to be educated in a particular discipline?

Whether that discipline is architecture, anthropology, or law, being educated generally means years of study, thousands of hours of experience, and intimate acquaintance with the specialist literature.

Medicine is like that, too. It involves four years of college, four years of medical school, 3-5 years of hands on training for 80+ hours per week, countless textbooks and intimate knowledge of the relevant medical literature. No layperson is educated in medicine. The idea is simply ludicrous. Therefore, when a layperson claims to be “educated” about a particular health topic, like childbirth, or vaccination, or autism, you can be virtually assured that a stream of absolute nonsense will follow.

When a lay person claims to be “educated” about childbirth, she certainly doesn’t mean that she went to medical school, has hands on training caring for pregnant women, or is familiar with the obstetric literature. So what does she mean? When a layperson proudly claims to be “educated” about childbirth she means that she has adopted a cultural construction of “education” that has little if anything to do with actual knowledge of the topic. It means that she has ignored those who have actual education and training and crowd sourced her decisions by reading books, blogs, websites and message boards written by other lay people who are often equally ignorant.

Why have natural childbirth advocates confused defiance for education?

‘Trusting blindly can be the biggest risk of all’: organised resistance to childhood vaccination in the UK (Hobson-West, Sociology of Health & Illness Vol. 29 No. 2 2007, pp. 198–215) explores cultural construction of being “educated.” As the title indicates, the authors focus on vaccine rejectionism, but the principles apply equally to natural childbirth advocacy, autism cures, and any other form of alternative health.

When advocates of vaccine rejection or natural childbirth claim to be “educated,” they are not talking about actual scientific knowledge. Indeed, the scientific data is generally ignored. The claim of being “educated” on vaccine rejection or childbirth simply stands for a refusal to agree with health professionals and refusal to trust them. Agreement with doctors is constructed as a negative and refusal to trust is constructed as a positive cultural attribute. As the authors of the paper explain:

Clear dichotomies are constructed between blind faith and active resistance and uncritical following and critical thinking. Non-vaccinators or those who question aspects of vaccination policy are not described in terms of class, gender, location or politics, but are ‘free thinkers’ who have escaped from the disempowerment that is seen to characterise vaccination…

This characterization of vaccine rejectionists or natural childbirth advocates can be unpacked even further; not surprisingly, vaccine rejectionists and natural childbirth advocates are portrayed as laudatory and other parents are denigrated.

… instead of good and bad parent categories being a function of compliance or non-compliance with vaccination advice … the good parent becomes one who spends the time to become informed and educated about vaccination…

… [vaccine rejectionists] construct trust in others as passive and the easy option. Rather than trust in experts, the alternative scenario is of a parent who becomes the expert themselves, through a difficult process of personal education and empowerment…

When a vaccine rejectionist or natural childbirth advocate claims to be “educated” on a topic they don’t mean that they have any education on the topic at all. They simply mean that they are defying authority. In their world, trusting experts is a mark of credulity, while ignoring expert advice is a sign of independent thinking and self-education. But, of course, since they don’t really know anything about the topic, they are inevitably forced to rely on the advice of propagandists, charlatans and quacks.

The person who proudly claims to be “educated” on vaccination offers as proof the fact that he ignores the expert advice of pediatricians, immunologists and virologists and embraces the teachings of … washed up Playboy Playmate Jennifer McCarthy. In their delusion, vaccine rejectionists fail to appreciate the irony. Far from being “educated,” they are unbelievably credulous.

The woman who claims to be “educated” about childbirth offers as proof the fact that she ignores the advice of obstetricians and pediatricians and embraces the teachings of … washed up talk show host Ricki Lake, or laypeople like Henci Goer or bloggers who’s only claim to “expertise” is that they have personally experienced childbirth a few times. And consistent with the Dunning-Kruger effect (described in the aptly named paper Unskilled and Unaware of It: How Difficulties in Recognizing One’s Own Incompetence Lead to Inflated Self-Assessments), the women who think they know the most, actually know the least.

If the goal of being “educated” isn’t acquiring knowledge, what is it? The ultimate goal is to become “empowered”:

Finally, the moral imperative to become informed is part of a broader shift, evident in the new public health, for which some kind of empowerment, personal responsibility and participation are expressed in highly positive terms.

So natural childbirth, is about the mother and how she would like to see herself, not about childbirth and not about babies. In the socially constructed world of natural childbirth and homebirth advocates, parents are divided into those (inferior) “sheeple” who are passive and blindly trust authority figures and (superior) rejectionists who are “educated” and “empowered” by taking “personal responsibility”.

A lay person’s claims to be “educated” about a health topic is really a claim of defiance. The person is proudly defying the recommendations of health experts with years of education and years of training in order to credulously accept the bizarre conspiracy theories of people who have little or no education and training in the relevant discipline. When a natural childbirth advocate claims to be “educated,” she means that she has thoroughly read and blindly accepted the propaganda of other people who are equally uneducated.

When someone tells you she is “educated” about childbirth, beware! There is no surer mark of ignorance on the topic than the proud claim of being “educated.”

 

Adapted from a piece that first appeared in August 2009.

  • Kayleigh Herbertson
    • Karen in SC

      Skimmed the first blog – it’s full of NCB lies. Women in the US do not have the highest maternal mortality in the world. Obstetrics is the reason that the US is one of the healthiest places to give birth.

      Put “maternal mortality” into the search engine, Read other posts here. Then go to The Learner on this blog roll. There are at least two OB blogs from Doctors without Borders though I don’t have links handy.

      When you read, remember that beliefs are not facts. Get to the source of the information and judge for yourself.

    • Captain Obvious
    • Young CC Prof

      The headline says, “How many women die in childbirth,” The statistic in the article is “maternal mortality,” which is not just deaths from childbirth but any death related to pregnancy or childbearing.

      In the US, we define maternal mortality very broadly. Pretty much ANY medical death of a pregnant or recently postpartum woman is now counted as a maternal death, even if she actually died from salmonella or from a heart condition that predated the pregnancy.

      This makes it very hard to compare US numbers to numbers from other countries. In fact, in any first world country, it’s extremely rare for a woman to go into labor reasonably healthy and die during or immediately after the birth.

  • Sue

    in the anti-science world, ”educate yourself” is about as scary as ”open your eyes!”

  • Pillabi

    Hallo, I’m an Italian mom, now pregnant; first of all excuse me if my English is not correct.
    A question: I’ve been told about a somewhat “recent” study about the damages caused to uterine muscle fibres by the assumption of iron in pregnancy. According to this study, iron would stiffen (?) the fibres, disturbing normal contractions during labour and creating troubles to placental expulsion.
    Unfortunately I haven’t been able to understand whether this study is focused on a particular integrator used in Italy, or in general on iron assumption.
    Anyway I was wondering if you had heard about this theories and what you think of them.
    Your post made me think about this, because the claim of the person who told me about the study was more or less: “when your gynecologist tells you to take iron, he just follows the old praxis, because he simply DOESN’T BOTHER to read recent studies…”

    • Young CC Prof

      That doesn’t make biological sense to me. There are hazards to excessive iron consumption, but even in folks with a genetic disorder that makes them unable to eliminate iron (hemochromatosis) the excess is stored in the liver and other organs, not normally in muscle tissue like the uterus. Even if there was somehow extra iron in the muscle fibres, why would that make them stiffer? The iron would be dissolved and possibly oxygenated. I’m getting a mental image of little tiny iron bands around the uterus, and that’s impossible.

      Anemia is much more serious, since it contributes to the risk of postpartum hemorrhage.

      By the way, my obstetrician didn’t just order me to take iron. When I told her it was making me sick, she looked at my bloodwork and said, “OK, you probably don’t need it anyway.” (This is rare, by the way. I just happen to absorb iron much better than most women.) And at today’s appointment, she was telling me about a brand-new change in recommendations regarding vaccines.

      • Tim

        anemia can also lead to dangerous/damaging arrythmias , which are not really ideal in a pregnant and/or laboring woman.

        • Pillabi

          Anemia being a serious risk is not called into question, but I get the impression that the praxis (in Italy at least) is to give iron to almost every pregnant woman, even when their bloodwork is just slightly under “normal” levels, which (someone says) could be considerated physiological in pregnancy. You take iron because it makes no harm anyway, except perhaps sickness or diarrhea.
          But if it comes out that iron DOES HAVE contraindications, perhaps the praxis should change and women should take it only when they are at serious risk of anemia.
          Disclaimer: I’m not a doctor and I don’t have a clue if what I’ve just said makes any sense!
          I’m just asking!!!

          • Young CC Prof

            The policy here is to recommend iron for pretty much all pregnant women, also. It’s possible to take too much iron and suffer negative health consequences, but that’s generally seen only in a small child who eats a whole bottle of vitamins when the parents aren’t looking, or possibly in men or post-menopausal women. The fetus soaks up a lot of iron, and it’s really pretty tough for a pregnant woman to overdose.

            Also, I wasn’t able to find the study you described, but it just doesn’t sound like it makes sense. Stiff uterus or stiff muscles in general are not a symptom of iron overload.

          • Pillabi

            Thank you very much, you’ve been really exhaustive. Next time I talk to that person I’ll try to find out more about this “study”, just out of curiosity.
            Anyway, before reading your explanations I already felt somehow skeptical about this iron stuff but I couldn’t figure why — now I know it. The risks described follow the good old pattern: “this is an unnecessary intervention that will prevent your magical tools (uterus, placenta…) from working the way they are supposed to according to the sacred Laws of Mother Nature”… I’m exaggerating, of course, but that’s what I perceived between the lines…

          • Pillabi

            But there’s something else I would like to point out, now I think of it. I know pregnant women who take loads of pills: integrators, which already contain folate and iron, AND iron, AND folate, AND fibres… It’s really hard to me to believe they need all those things. I’m not suggesting there is an obscure conspiration between obstetricians and pharmaceutical industry (even if many would believe it), I just think there are certain women who need to be given drugs and to undergo endless series of examinations to feel sure and well cared for. I guess doctors understand it and try to give everyone what makes them (the patients) more comfortable. Perhaps there is no harm in it, but I feel THIS is an example of unnecessary and wrong medicalization.
            What do you think?

          • Tim

            I assume by integrators you mean vitamin supplements? (Sorry, don’t know if the italian word for vitamins translates weird into english)

            I know that Iron at least, is VERY poorly absorbed by most people from supplements – in order to keep her levels normal, my wife had to take a ton of iron supplements. (She couldn’t eat much meat during her pregnancy, as her nausea was very bad, and there’s only so many green vegetables someone can eat in a day) It took a lot of supplements to keep her levels even in very low normal range.

          • attitude devant

            The Italian for vitamin is ‘vitamina’—Pillabi is NOT Italian.

          • KarenJJ

            LOL. The internet seemed to get nuttier then ever in 2013.

          • Pillabi

            Pillabi is totally 100% Italian but she is very very pleased that you find her American English too perfect to believe it! 😉 why should anyone pretend to be Italian? Folks, I really don’t get what’s wrong with you. If you are chasing a troll, well it’s not me.
            I know perfectly what’s the Italian for vitamin, but since you are so good at Italian, you should also know that when it comes to pills we normally talk about “integratori alimentari”, which I incorrectly translated into “integrators”. ok?
            And if you are so desperately puzzled because Pillabi isn’t an Italian existing word, well I don’t think it exists in any other language, but since it’s just a nickname I thought I was free to choose a made-up word my little kid keeps on repeating all day. Satisfied? Or should I send you all a copy of my passport to show my nationality? But in the end: why does it bother you so much?!?

          • Tim

            Yeah, I looked on google translate after and saw integratori is translated as “supplements” , so I can see where the mistake came from. Dr Amy has already resolved this little mystery as not a mystery everyone, so I think it’s time to get off her case.

          • Young CC Prof

            Some pregnant women actually need massive doses of iron just to avoid becoming really anemic. Others don’t. There are blood tests the doctor uses to tell how much is needed.

            As for folic acid, the ideal dose in pregnancy is 800 mcg per day, but you don’t want to go too much over.

          • The Bofa on the Sofa

            Others have explained the iron and folate, but the fiber is a consequence of the iron, which causes constipation.

          • Sue

            “Bloodwork” is an American expression, “”Pillabi” . And as I said before, Italian does not have the letter ”x”. You appear to be outed. Addio.

          • Pillabi

            Sue, I don’t get a word of what you mean. “Bloodwork” is a nice American expression, totally new to me, that I’ve learnt from the previous comment of Young CC Prof. What’s the matter with the letter “x”? And by the way, “scoprito” means nothing in Italian: the verb scoprire is irregular and its past participle is “scoperto”. If you mean that you’ve discovered I don’t know what about me, you should use the female form: “scoperta”.
            But what do you mean at all??!?? Please be clearer!

          • Sue

            No, “Pillabi”, none of that made sense. Your ”praxis” will need to change to honesty.

            Oh, and look up this Italian word: scoprito

    • kumquatwriter

      Posting this at the very beginning – this “Pillabi” is Ellie. I’m almost certain.
      Another thing that people with MbI do is come up with a cast of
      supporting characters. Often “:foreign.” This poster, “Pillabi” does
      *not* write like a non-native speaker. Notice, particularly if you click
      on all her posts, that the “accent” vanishes. Also, the author uses stylistic things like WHICH WORDS are in ALL CAPS that are very American. Her agenda is immediately apparent (again, just click on the name and read for yourself). The writing style is very, very similar, with a bad fake Italian accent pasted on like a Mario costume. I mean, FFS, according to a friend of mine, ‘practicare’ is Italian for “practice.” Her use of “praxis” makes it pretty clear she’s faking.

      Besides, Pillabi isn’t a very italian name – it’s a city in Bangladesh. Pity she’s not brighter, because it’s also an anagram of “i.p. alibi” but I seriously doubt she could come up with that.

      Also, note the crude attempt to satirize “NCB” types, pretty transparently backhanded. Also pretty classic MbI.

      • attitude devant

        I speak Italian and have many Italian friends and patients and the comic-opera type mistakes this woman makes with her English are NOT the types my Italian friends make. She also chooses words (‘troubles’) when an English synonym exists that is closer to Italian (‘difficulties,’ close to the Italian ‘difficile’) and would be the likelier choice. I am VERY suspicious also. Pillabi, che fai qui? Vaffanculo!

        • Sue

          Agreed. “Praxis”? There is no ”x” in the Italian alphabet.

          • Pillabi

            but there is in Latin. praxis is a Latin word which exists also in English ans is very close to Italian “prassi”. that’s where the mistake came from.

          • Dr Kitty

            Pillabi, do you work?
            It’s lunch time in Italy now and it was very late at night when you posted yesterday.

            Italians, BTW learn British English, not US English, at school.
            “Mom”, “anemia”, “diarrhea”, “medicalization” and “gynecologist” are US spellings.
            “Blood work” is a specifically US term.

            Your English grammar gets better, not worse, the angrier you are.

            Anyway, Dr T can check your IP and see if you’re in Italy.

          • Pillabi

            Let her do it, please. Since you are so interested in my private life, no I don’t work, I’m in maternity leave; last night I went to bed at 1am because I was very interested in reading the blog; I can switch from British English to US English, at least in spelling, for example colour/color… quite good uh? You know, we learn English at school and at University and we watch American series and we read both English and American blogs here in Italy, could you believe it?

            As I’ve already pointed out, I’ve learnt “bloodwork” from a previous comment. Quite incredible that an Italian woman can learn a new word, isn’t it? (“isn’t it?” = question tag, pretty British English, sorry)

            The way you are judging me is incredible.
            Traduco: il modo in cui mi giudicate è incredibile.

            Sono italiana, non sono Ellie né nessun altro; volete che scelga come nickname “Spaghetti”? Che vi canti l’Aida? Che suoni il mandolino?

            Why are you all wasting time with this nationality stuff instead of answering my comments on the topic?

            Please Dr T check my IP
            Per favore Dottoressa T controlla il mio IP

          • Guest

            PS: I’ve already pointed out that I’ve learnt “bloodwork” from a previous comment; you know, Italian can learn new words.

          • Captain Obvious

            Care to provide a link to that study? Please don’t bring up evidence for discussion without providing a link to it.

          • Pillabi

            I didn’t bring up any “evidence”, I told I had heard about such a study and since I could not find it in the internet I asked the EXPERTS to give me more information if possible. That was exactly the topic of the post, wasn’t it?

          • Dr Kitty

            It’s half past 3. Shouldn’t you be back at work? Especially since you were up typing here until 2am.

          • Amazed

            Hey, Dr Kitty, easy here!

            In my school, it was definitely British English but I constantly read books with both spellings. I write ‘Mum’ and “Mom”, ‘vapour’ and “vapor’. Besides, I regularly get the grammar mistakes of the author I am translating at the moment… Is there a shot for it?

            The commenter might be or not be from Italy but the things you point out don’t mean a thing,

          • Dr Kitty

            It just seems weird that someone who learned one set of spellings would take the time to alter them for her audience, but not to check words like “practice”.

            Anyway, Pillabi could at least try to convince me she was Italian by explaining why someone from Milan will make fun of someone from Florence who likes to drink Coca Cola with a very short straw, and why they’d both make fun of someone from Livorno.

          • Durango

            It’s been established that Pillabi is, in fact, commenting from Italy, can we now move on please?

          • KarenJJ

            I try to alter them (pacifier/dummy, diaper/nappy) and am forever mucking it up. Similar to for spelling. I work for a European multinational, but we are directed to write manuals etc in American English. Not sure whether it’s a French way to stick it to the English or some other more practical reason. At any rate inconsistent spelling/terms could point to a tired mum that is trying to type around a set of toddler fingers.

          • Pillabi

            why don’t YOU check “practice” and discover the surprising wonder that “praxis” is an existing English synonym, even if not used? Instead of poking your nose in my private life and keeping on spitting your prejudices about Italy?

          • L’avventura

            Oh no, Pillabi, this won’t do at all. Dr. Kitty was inquiring about regional prejudices WITHIN Italy, And you clearly don’t know them. Which is very odd indeed. Not looking very good. Even I, a native American, know what the answer to her question is, and you do not.

          • Pillabi

            Didn’t it struck your mind that I perhaps CHOSE not to answer to what sounded to me as a mean provocation?

            Try for a moment to BELIEVE that I’m really Italian and try to understand what it feels being attacked from a bunch of people on things like: the way I speak/spell English, if I work or not, what time I go to bed, if I know my country at all. Does it sound nice to you? It isn’t. And moreover, all this stuff is completely OT.

            By the way I wouldn’t call “la coca cola con la cannuccia corta corta” a regional prejudice, since it’s just a little, silly joke about pronunciation of “c” in Tuscany I myself played sometimes with some friends from Florence.
            This perhaps could be interesting for a native American who knows so much about Italy.

          • attitude devant

            Allora, va bene. Sono contenta. Benvenuta a Skeptical OB! Ricominiciamo come amice?

            To let everyone else in on the joke, Florentines aspirate the ‘c’ to an ‘h’ sound, so that the above phrase is quite the tongue twister. The resulting joke is similar to (and as dully inoffensive) asking the man from Harvard where he likes to leave his automobile. I’m sorry you were offended. I thought it was a smart way for Dr. Kitty to give you a chance to prove yourself, but I can see why you were annoyed.

          • kumquatwriter

            He’d pahhk the caaah in haaaahvaaaahd yaaaahd.

            My cousin grew up in boston, teaches ESL, has lived in California for over 20 years…and still pahhks her caaah.

          • Amy Tuteur, MD

            Please stop harrassing Pillabi.

            And please stick to one screen name.

        • Pillabi

          If you were better at Italian you’d know that your last word is EXTREMELY impolite (sorry for using capital letters, I understand from kumquatwriter it’s very American…) and not to be used in a normal conversation among people who just want to share information and opinions. I like Dr. Amy’s blog a lot, read it every day, and I am really upset to get attacked this way the very first time I choose to comment.
          At this point I’m afraid there’s nothing I can say to convince you I’m not a fake, but never mind, at least I’ve received some piece of interesting information from the two only people who have chosen to listen to me instead of insulting.
          PS you may think Italians are very ignorant but be sure 90% of us knows what “troubles” mean…

      • Jocelyn

        kumquatwriter, I love you. I just want you to know.

        • kumquatwriter

          Aww thanks. I think you’re pretty special too 😉

      • Sue

        More anagrams of ”Pillabi”:
        A bi pill

        I bill pa
        I lap lib
        Ail blip
        Bail lip
        (reference – Andy’s Anagrams)

      • wookie130

        It most certainly is Ellie, Kumquatwriter.

        Ellie, I would really like to know what your objective is in coming here, and attempting to debate with people who have far more experience and education in these issues than yourself.

        You see, I’m a teacher also – I teach special education. And because I am a teacher, I don’t attempt to argue that I know more than an obstetrician, a nurse, or any other medical professional about medical issues related to birth and the like. I do believe that there is a huge difference between being “informed” and “educated”, and the fact that you feel that you are better educated in issues related to childbirth than a lot of the medical professionals that do post here, and you feel that you can challenge the broad knowledge base that these professional possess, is embarrassing, and arrogant.

        I am sorry that you dislike those in the medical profession, and that you feel that you know more than they do, as a high school English teacher. I am personally thankful that we have doctors who can take care of people and provide care when it is needed, and I appreciate all of the long hours, money, and personal sacrifice they have dedicated to that cause.

        Back to my original question, though…why are you here? You think you know more than anyone, you don’t seem to like doctors much, so…

        • Amy Tuteur, MD

          No, it’s not Ellie and the commentor is from Italy.

          • Pillabi

            THANK YOU

          • wookie130

            I apologize, Pillabi. We’ve had one particular poster that does seem to be popping up on various comment sections of blog entries, and she’s been interjecting some really strange commentary around here as of late. So, being as you’re not Ellie, please excuse my accusation, and accept my apology.

          • Pillabi

            It’s fine

          • Clarissa Darling

            Ok guys, I know we had one troll in here who most likely was a compulsive liar but, let’s not get suspicious of everyone. Dr. A does a very good job of catching and calling out people who post under a different name. As I said in a previous comment, I had a friend IRL who was a compulsive liar. Sometime after that friendship had ended my husband became friends with one of his new co workers. Well, the first time he told me something I thought was a slightly unbelievable I way over reacted as a result of my sensitivity. Luckily, he forgave me and him and my husband are still friends.
            I only speak very poor tourist Italian but, have been to Italy a few times and as far as I can remember the “x” is still on the keyboard. Maybe Praxis is nothing more than a typo. Remember there can be innocent explanations for inconsistencies as well.

            Sorry If I sound like “mamma Clarissa” giving you all a scolding, I’d just hate if people get too mistrusting as a result of the recent interaction with Ellie the troll. From my perspective it’s good to give people the benefit of a doubt until they display multiple reasons not to.

          • kumquatwriter

            Absolutely – it’s very easy to go over the top, which is why I don’t call them out very often – in fact, I believe this is the first time I’ve actually posted that I suspected someone was the same person on this site – and I posted why I suspected as much.

          • Clarissa Darling

            IDK, Ellie struck me as someone who was desperate for attention but, she didn’t strike me as someone who was smart enough or devious enough to go to great lengths to concoct a whole new persona. Not saying those people aren’t out there but, consider that if Ellie had thought it through she easily could have posted under the name of someone who really was a history teacher for example, to make her lies more plausible. She was dumb enough to claim in a forum full of doctors, that numerous people she knew were the victims of gross malpractice that, based on the details, would only have occurred on daytime television and which laypeople, including myself, could easily see through. I think she was hoping for her stories to generate shock the way they would on NCB blogs aimed at women who truly believe in the myth of Dr. Frankenstein, OBGYN. I don’t personally feel Ellie’s MO is consistent with one comment by a poster saying they are Italian and inquiring about a study they’d heard of. We know those goofy pseudoscience “studies” are out there, and who better to ask than a bunch of doctors? Maybe I’m being the gullible one here–just my 2 cents!

          • kumquatwriter

            No, you totally have a fair point. The reason I thought/suspect its one person is because Ellie’s posts seem *deliberately* stupid – there were slips where smart seemed to peek. The mo is unusual – I don’t think Ellie IS MbI – yet anyway. She seems like a n00b at this level of deception. Give her a few years of learning/screwing up and getting busted, and you just may see her improved and fooling people longer.

            As for Pillabi, even if she *is* in Italy and isn’t Ellie, she still doesn’t write like a non-native English speaker. I can’t do an IP mask to demonstrate right now because I’m.on a mobile and I also have a kid home sick from preschool so using the “big computer” isn’t possible either. If I have time this evening I will.

            That’s the hardest part about dealing with MbI and pathological liars – they’re slippery, dishonest and make it harder to trust ANY new users.

            No, I’m not 100% sure they’re the same person, and I don’t think you’re gullible – you are being a much appreciated voice of reason/skepticism. Those are important, obviously 😀 And if my position can’t be defended against any questioning….well, I sure as hell would rather go “oops, my error” and learn more than go ahead with erroneous info! I mean, that’s why I’m here 😀

          • Clarissa Darling

            Ellie’s stupidity is the one thing I actually might give her the benefit of a doubt about. I agree she said some things which sounded like she was playing dumb. At the end of the day though she did very little to make her stories believable when that easily could have been accomplished by a smarter, better liar. Like you said, the MO is weird. She’s a low level deceiver and in my opinion, not savvy enough to do things like block her IP address when she didn’t even bother to block her LinkedIn account. As far as the English goes, Pillabi’s writing does improve in later posts but, this could just be due to more careful editing. I still see subtle mistakes which indicate her English is not perfect. I looked up the word “Praxis” in the dictionary. I was surprised to learn it’s an English word meaning established practice. That seems consistent with someone trying to translate a word meaning medical protocol. In my experience, non native English speakers often use words that are technically correct according to the dictionary but, which native speakers wouldn’t choose for the same sentence. I certainly can’t prove they aren’t the same person but, I just want to make sure Pillabi gets a fair shot. Again, sorry if this sounds preachy but, IMHO better to err on the side of wasting some time replying to Ellie under another name than to discourage a sincere new poster. If it’s Ellie, I’m sure her true colors will not take long to appear!

          • Pillabi

            “non native English speakers often use words that are technically correct according to the dictionary but, which native speakers wouldn’t choose for the same sentence”
            exactly!
            if someone had just told me “nobody around here says praxis, the world you are looking for is practice” I would have appreciated a lot.
            😉
            It’s so hard to speak correctly a foreign language

          • anion

            It’s not always easy to know if it’s okay to correct a non-native speaker, honestly. Some people can get very sensitive being corrected. (Just as many are grateful, but not knowing immediately which type a particular person is, I think most of us will err on the side of caution and just not mention the errors.)

            I’m not touching any of the other stuff, just saying please don’t think you weren’t corrected because people don’t care or want to help; it’s because we don’t want to hurt your feelings or seem like pedants (even those of us like me who are in fact pedants).

            (BTW, since you asked:

            It’s so hard to speak correctly IN a foreign language;

            It’s so hard to speak a foreign language correctly.

            I’m going to take you at face value, and say your English is excellent, actually. Far better than I could do in Italian. And I wish you and your baby the very, very best!)

          • Pillabi

            As far as I’m concerned, I love being corrected by native speakers, since they are the most reliable source to improve one’s knowledge of a language. But you are right, not everybody reacts the same way.

            Your explanations, compliments and wishes are really nice, thank you. Unfortunately some other commenters chose not to “err on the side of caution” and decided my “strange” English was the proof I was a half-mad troll and hacker that changes her nickname and IP in order to pretend to be another person.
            Well never mind, next time instead of beginning with “I’m Italian” I’ll begin with “I’m from Mars”, so nobody will doubt it.
            😉

          • kumquatwriter

            Internet’s full of half-mad hackers that *do* use such tactics, which is part of what I’m studying. I would rather be wrong and say so – and evidence says I am, so there you go. I apologize – hell of an entrance, though! And kudos to you for riding out the suspicion. Benvenuto!

          • Pillabi

            Graze!
            I feel like a teenager who has eventually succedeed in being accepted by her mates in the new school… 😉

            PS “BenvenutA”, since I’m a woman; sorry for correcting you, but if I wouldnt, Sue or Attitude Devant would pop up and say “you see? she’s not Italian otherwise she would have caught the mistake!”

          • kumquatwriter

            Damn, and the site I used specified otherwise. Stupid internet. I wondered, since O isn’t usually a feminine ending (je parle francais un peu, mais n’est pas tres bien). Which, I guess, is pretty darn funny. Hell of a hazing to go through, but we’re a pretty friendly bunch when we’re not on a Troll Hunt 🙂

          • Pillabi

            I’ll be generous and give you all a second chance… 😉

          • Susan

            Welcome Pillabi, I was sort of busy when all the accusations were flying but I was posting with the Ellie problem and it’s easy to see the we might be on guard. So sorry you didn’t received a warm welcome it’s actually a very smart and interesting group of regulars here ( just a darn suspicious bunch…skeptics?)

          • Squillo

            I won’t inflict my opera Italian on you, but welcome, and brava for weathering the inquisition with good grace.

          • attitude devant

            “Praxis” is not incorrect. It’s just that it would only be used in an academic discussion, as in a treatise on the philosophy of science. Your English is overall quite good.

          • Clarissa Darling

            For what it’s worth, I believe you are Italian and your English is quite good. I commend you for having this skill to comment on a complex topic and make yourself understood with the exception of an obscure word. Now we’ve both learned something about the meaning of the word Praxis 🙂 I’m sure I couldn’t order dinner in Italian without using several questionable words/phrases! I’m glad you stuck around long enough for the anti-Ellie hysteria to subside and I’m sorry if it upset you. As an aside: For me, this thread has provided valuable insight into the power of suggestion. It goes to show how a somewhat plausible suggestion can influence a group of people who buy into it to focus on speculations and theories that confirm their beliefs and shift away from simpler or more rational explanations that go against it. This is how conspiracy theories and pseudoscientific beliefs get started (on a much bigger scale of course)!

          • Pillabi

            Your point is fair, but I think there is something more to it.

            Here, among sensible people, the “hysteria” has quite quickly subsided and, once you’ve read my rational explanations, suggestion has lost its power.

            The result would have been different among people incapable of rational thinking or of accepting criticisms. They would keep on demolishing every explanation I could give or simply refusing to listen to them. That’s the key factor, in my opinion, that makes possible for conspiracy theories and pseudoscientific beliefs to prosper…

          • kumquatwriter

            I’m rather proud of our boards – skeptical, but willing to look into more data and change opinions when we’re shown to be incorrect 🙂

          • Clarissa Darling

            I completely agree. Many people who believe in pseudoscience claim to be “open minded” when they are the opposite. Being truly open minded means being open to changing your beliefs when they don’t stand up to scrutiny. I think anyone can get initially sucked in by an interesting suggestion. I know I have and I’ve got the money wasted on various “treatments” to show for it. It’s really interesting to me how some people end up hooked while others will eventually see reason. So glad the people who read this blog are mostly the later!

          • Susan

            I

            I sort of scrolled over this but I didn’t think it was Ellie either mostly because the question wasn’t on a homebirth bingo type issue. I found it almost a scary thing because about 4 clicks and you know a damn lot about Ellie. I even saw a “rate my teacher” on her and yes, the students were saying she was flighty and disorganized and didn’t make sense… and her facebook she was a hard core right wing pro life with a fan of doulas and Ina May. So I just think she was real, and really the dim bulb/dull knife she came off as.
            Poor Pillabi but good we are ok with saying we were wrong.

          • Pillabi

            “she still doesn’t write like a non-native English speaker”

            Provided that I AM non-native, I’m still confused whether I should take your linguistic and psychological analysis as a compliment or an insult.

            Anyway, a nice “Sorry for the mistake, Pillabi, and welcome to the blog” would do.

          • kumquatwriter

            Certainly – I don’t want people to be harassed because of mistakes. Or any reason – harassment is not good. I apologize for that, and for the tearing apart of your writing style. I guess you should take it as a compliment? There’s a lot more examples of your writing since the original handful of posts, which is a nice illustration of why a too-small sample size can skew the outcome of a study.

            I definitely didn’t expect this to be a stick of dynamite in the koi pond.

          • Pillabi

            What hurt me most was not your comment, but the people who, after that, got bossy about knowing Italian, and Italy, and what an Italian could or couldn’t do. THAT was harassing. You were not one of them and please feel free to check the autenticity of my IP if you like.
            By the way, how’s your kid?

          • kumquatwriter

            Doing well, thank you, and back to school next week (thank goodness)! You had the unfortunate luck of coming in at juuust the right time to catch the backlash against Ellie (as I’m sure you’ve noticed!) and set up some flags. Again, glad you’ve stuck it out, because I would not want to run someone off who just gave a wrong impression. And no, I’m not going to trace your IP – Dr Amy did that already. Although I will at some point post under a foreign IP on this board – now it’s just a demonstration, not an attack. I’ll come from France or something 🙂

          • Pillabi

            What do you study exactly? I’m curious…

          • kumquatwriter

            Working slowly but surely on Cisco Network Certification with an eye to be a CEH – Certified Ethical Hacker. My husband is a network administrator who is currently learning penetrative testing – I get my education for free because I’m learning along with him – though I initially wanted to pursue Cisco networking way back in 2001.

            I also am a cult survivor and have a degree in psychology, so my “pet” hobby/specific area of interest is “Catfishing” and Munchausen by Internet. I’m also an author and blogger when my son lets me.

            🙂

          • MaineJen

            I am fascinated by Munchausen by Internet. There was an excellent article about it a while back (New York Times? I think…dealt with cancer networking boards and the MbI fraudsters who infiltrate them, claiming to be sick), and ever since I read that I am much more wary, not only of people on the internet who claim harship after hardship and seem to be fishing for charity, but also posters on comment sections who seem to hold extreme radical views. Why go on a messge board with a deliberately inflammatory statement unless your intent is to then sit back and enjoy the carnage? Some people have too much free time, and a sick sense of humor…

          • MaineJen
          • kumquatwriter

            That’s one of my favorite articles on the topic, actually. And here’s my own post on it…

            http://kqcrazytrain.wordpress.com/2012/01/18/munchausen-by-internet-the-case-of-mike-feigen/

            (My new blog layout has finally gone live, by the way 🙂

          • Burgundy

            Hey as a non-native English speaker, I live in CA over 10 years and went to College in San Diego. Your writing is way better than me. (it is a Compliment)
            Welcome to the blog.

          • wookie130

            Bah, you’re right, Clarissa. It was looking funky to me for a moment, and we should not be getting suspicious of everyone.

            I stand corrected on the above statement I made to Ellie. Well, if Ellie is still lurking about and happens to see the above comment, I suppose I still stand by it, only truly addressed to the REAL Ellie, not Pillabi.

          • kumquatwriter

            It is also possible to use an ip proxy to mask your location or make it appear you’re coming from somewhere else. It’s not difficult to do, there are even some programs that will do it for you.

      • Karen in SC

        Praxis is also the name of the tests that teachers take nationwide for certification.

        • Dr Kitty

          Where I am, Praxis is a local charity providing support to people with mental illness, learning disability, dementia and acquired brain injury.

      • Captain Obvious

        Awesome!

    • yentavegan

      24 years ago when i was pregnant with my 3rd child, the Natural/Anti-c/sec childbirth support group i attended discussed how pre-natal iron supplements made newborns appear jaundiced by day 3. I was advised to stop taking iron supplements in order to avoid having my perfectly normal newborn diagnosed with physiologic jaundice.
      My take home message to you is ignore the hooey from non-scientists. If you like your Ob/gyn discuss your concerns with them, but expect your ob/gyn to be current with all relevant studies. Don;t be surprised if your Ob/gyn is ignorant of studies being done or published in fringe journals.

      • Pillabi

        It’s precisely what I was trying to find out: whether that “study” was relevant or not. And I think you are right.

    • attitude devant

      To get back to your original question, some of your confusion may be deriving from the high number of Italians with abnormal hemoglobin (hemoglobinopathy). In certain of these disorders iron is the exact wrong thing to give. Do you have a hemoglobinopathy yourself?

      I’m glad you lurked and now post here, but I’m confused: Italian obstetrics and midwifery are the best in the world (particularly in Bologna—I learned everything I know about ultrasound from the Bolognese), so I’m surprised you would find our blog interesting. Do you see much alternative medicine in your OB care?

      • Pillabi

        Luckily I don’t have hemoglobinopathy. My question was out of curiosity after a midwife told me about that study. I istinctively felt skeptical about it and wanted to find out more…
        Your second question hits the point: alternative OB care around here is getting more and more popular, with all its corollary: homebirth, lotus birth, prolonged breastfeeding, epidural = evil, co-sleeping, babywearing, attachment parenting… That’s why the usual topics of this blog are perfectly interesting for the Italian public as well.

        Care provided in hospitals is surely high-level, but it’s getting trendy to say that in hospitals you’ve felt not respected, disempowered and all the usual stuff, even when you are healthy and have delivered a healthy baby.
        I think there remains a substantial difference between the situation in US and in Italy, as far as I know: homebirth midwives in Italy must have an academic training and must have assisted a number of childbirth in hospital before getting the licence. There is a strict protocol about “low risk” and I don’t think the majority of midwives would perform homebirths out of that boundaries.
        Even though the practice of homebirth is quite strictly regulated, I personally find it scary and dangerous that more and more people are following these trends and despise medicine and science.

  • AL

    Have any of you seen this? She was 42 weeks and feels “rushed.” Here’s to being “educated”

    http://www.huffingtonpost.com/rich-polt/on-the-birth-of-her-baby-_b_3791903.html

    • Young CC Prof

      I wanted to cry, reading that. She has no idea that she sounds like a whiny toddler to folks who understand the actual realities of birth, as opposed to the parallel-universe realities. I don’t even really understand what was so disappointing about her experience! That she was induced at 41W6D rather than 42 weeks?

    • Eileen

      Wow, that was one of the most egotistical interviews I’ve ever read. I guess it just frustrates me that people try to make childbirth into some sort of Olympic event. Who really CARES how your baby came into the world?! Just be thankful that you’re ok and, most importantly, your BABY is ok! I think all this “natural childbirth” hype is really setting mothers up to have unrealistic expectations, and I personally think a lot of PPD could be attributed, at least partly, to that. My mom had to have an emergency c-section when I was born almost 30 years ago. She never, ever considered it negatively; she was always grateful that I made it through. The birth itself didn’t matter at all whatsoever…it wasn’t the childbirth that mattered, it was the CHILD, and you can bet she’d do ANYTHING to make sure her child was ok. Why WOULDN’T moms want to err on the side of caution when their baby’s health is at stake? I have a friend who was shattered by her emergency c-section for her first; she thought it was unnecessary. Maybe some c-sections are unnecessary in the strict sense of the word, but wouldn’t you rather err on the side of caution?! What mother wouldn’t instantly jump before a train to save her baby, and yet when it comes to childbirth, somehow it’s all about the mother and not about the baby? How selfish are we women today? It’s just frustrating to me that something that is TRULY a non-issue is made into some huge “empowerment” ritual. Why can’t we just leave labor and childbirth to the experts who have dedicated their lives to this field, and trust that they know what they’re doing? Why can’t we put the focus where it belongs–on the BABY and on our new PARENTHOOD–rather than childbirth, which doesn’t really matter at all? Evolutionarily speaking, isn’t the POINT just to make sure the mother and baby survive?! What’s all the hullabaloo over the means to that end?! I know this was a bit of a tangent, but I personally went from someone totally caught up in the craziness of the natural childbirth movement, to realizing the ridiculousness–and danger–of it all.

    • MaineJen

      “I’ve been told I look like Keira Knightly.” So she is induced a day before hitting 42 weeks, her baby is born without incident…and her complaint is what?? Not getting it all 100% her way? She’s comparing herself to those who fought for a woman’s right to vote? Nope. Nope, nope, nope. You don’t get to devote a 501 c3 charity to helping people get their own way all the time, every time, even when it’s unreasonable or dangerous.

    • CanDoc

      Modern narcissism at its finest.
      And 10 minutes of my life wasted reading it that ill never get back.

  • Captain Obvious

    OT, Lets help her out…
    http://community.babycenter.com/post/a45206617/treatable_conditions_detected_through_ultrasound

    Meningomyeolcele prenatal repair. MOMS trial
    Twin to twin transfusion syndrome-> cautery of vessels
    Oligohydramnios-> follow, deliver if poor BBP or with IUGR
    Absent or reverse diastolic flow on an IUGR baby-> deliver
    Any neonatal tumor that may benefit by CS delivery vs NSVD
    Identify a previa-> CS
    Identify an accreta-> CS at major university
    Isoimmunization hydrops-> in utero fetal transfusion, PUBS
    Discordant twins after certain gestational age-> deliver
    LGA greater 5000g-> CS
    Acardiac twin-> terminate the one
    Identify a lethal anomaly-> consider inducing once identified
    Identify higher order of multiples-> selective reduction
    Extreme symptomatic polyhydramnios-> therapeutic amnio

    • Tim

      I think she’s specifically looking for examples of birth defects that can be corrected in utero if detected soon enough. At least that’s the impression I get

      • Young CC Prof

        Diaphragmatic hernia, and bone marrow transplant for immunodeficiency.

      • Elizabeth A

        Omphalocele – can’t be corrected in utero, but can be corrected after delivery, if you do a pre-labor c/s and have the correct supportive resources and surgical teams available.

    • Dr Kitty

      CHAOS- ex utero, intrapartum treatment procedure (EXIT)
      http://www.sciencedirect.com/science/article/pii/S0022346897901846

  • This is just nonsense. I would think that as someone who has worked in medicine you would know that there are patients who are experts in their disease and doctors who believe completely irrational things about medicine. The facts should speak for themselves (and they do).

    • KarenJJ

      I am an expert in my disease. The symptoms, treatments available and long term prognosis. Every time I meet a new doctor (unless they’re an immunologist at the teaching hospital and they’ve read my file) I get asked to explain my syndrome. I’ve even had one baffled opthalmologist ask me what the mechanism was behind the nerve damage he was seeing (and the reason he was baffled was because everyone was baffled including all the specialists and professors I’d left behind at my previous hospital when I moved away). I’ve actually had a couple of doctors now ask me if I’m in the medical field. I’m not – not even close.

      Thing is my knowledge is very narrow and specific to one incredibly rare syndrome that almost every other doctor in my country has never come across (one of my specialists did a survey country-wide and came up with one in a million occurrence of diagnosed patients). The actual pathways, how the drugs interact and effects of vaccination etc and other potential underlying issues I actually don’t know much about. What if my daughter got pneumonia? How would it present? What would we do about medication? What should we be doing with her to treat it? Will she need to be on an IV? What should we be doing about live vaccines, which are contra-indicated for her medication? All things I’ve asked the real experts about.

      I’ve honestly never had a problem with a doctor being “educated” by me about the syndrome. The vast majority of those involved in our care have been curious, interested, and the most common question I’ve had – especially from younger doctors – was “how were you diagnosed”? – which I take to mean “what could I do to spot something like this in a patient?”.

    • Ceridwen

      Patients can be better informed about really specific things than their doctor in certain circumstances. But what they aren’t able to do is use that information in the context of treatment the way a doctor can, even when extremely well informed.

      As an example: I had a subchorionic hematoma during my pregnancy. Being a scientist and a bookworm I immediately went out and learned as much as I could about that condition. Including by going and reading the actual studies that have been done on them. I could tell you more about it and give you more specific information about what happened in the studies of them than my doctor could have. But I don’t have the ability to integrate my knowledge of that one specific condition into my pregnancy as a whole and all the other things going on. And I won’t without going though a medical education and training program.

      I use my knowledge to help me have informed conversations with my doctors about my conditions and if I disagree with them I ask them to explain their position. I’ve found there is almost always a good reason for them to think the way they do and that if I approach it with the attitude of “I’ve obtained a lot of information about this but I need you to help me figure out how it should influence my care” rather than “I know more about all of this than you (which is just not true)” things work out quite well. That latter attitude is the one I see most of the people claiming to be “educated” present, and Amy is right, they are NOT educated the way they think they are.

  • Guest

    But what do we do about people who went through the rigors of training, and then dedicate themselves to spreading misinformation?
    This was on my fb feed recently:
    http://www.mindbodygreen.com/0-11253/why-you-probably-dont-need-a-flu-shot.html

    I think there’s an intelligent discussion to be had about flu shot effectiveness. But this is not it.

    What always strikes me about stuff like this is that people will go on and on about how they don’t trust the authority of doctors, but then when they find one who backs up their cockamamie beliefs, they say, “Look! It’s a doctor!” Okaaaaaay, but what about the 99% of doctors who think this person is full of it? Brainwashed, every last one.

    • Tim

      It’s really really hard to deal with I think, because sometimes the Dr who decides to stand apart from the crowd and do something crazy turns out to be brilliant. But the decision of whether they are crazy or brilliant is best left up to other Dr’s I think, rather than the general public. It’s too hard to really tell the difference between nutty behavior and brilliance otherwise.

      • Young CC Prof

        Within the past century or so, I can’t think of too many maverick geniuses who stayed outside the fold for more than a few years. Since they were right, they were able to accumulate evidence to support their position, and convince a few other researchers to test their hypotheses as well. The rest was history.

        • Tim

          The one that immediately springs to mind is Bill Norwood – Dr Norwood and Dr Lang published their paper on the eponymous surgery in 1983(? I think 83), but it took a long long time for it to become standard operating procedure, and most hospitals spent years still recommending “compassionate care” for babies with HLHS, because it’s a really hard surgery to do and it takes a lot of skill to get it right without killing a huge % of the patients. But you are right, it generally does not take long for most to come around, and a surgery that requires the utmost in skill is a special case.
          As far as vaccines go, that ship has sailed – if there was some huge problem, there would be huge numbers of Dr’s onboard long before now. The crazies are just noise – nothing stopping crazies from getting MD’s and DO’s sometimes unfortunately.

          • Guest

            It is tricky, right? I totally agree that sometimes the outliers are the ones questioning assumptions and making needed and meaningful change. But sometimes they are just the ones trying to sell 80-dollar jars of probiotics.

          • yarnbarf

            Or from getting a medical degree, then going crazy.

          • Young CC Prof

            Or from getting a medical degree and then selling out to the profitable business of branded quackery. Those might be the most dangerous ones of all, because they’re very smart and entirely sane, and therefore can be incredibly subtle and persuasive.

        • KarenJJ

          The one I’m thinking of is Dr Barry Marshall and stomach ulcers being caused by bacteria. More evidence found and as far as I know it’s mainstream now.

          • Young CC Prof

            But the thing is, it really didn’t take that long for the gastroenterology establishment to believe them. (It took longer for results to reach the GI on the street, longer still for the rest of the medical profession, and decades for the general public.) The results of the antibiotic protocols were just so dramatic and easily replicated, though, that folks who were really paying attention were convinced pretty quickly.

          • KarenJJ

            http://discovermagazine.com/2010/mar/07-dr-drank-broth-gave-ulcer-solved-medical-mystery#.Ul4VetLimKE

            I don’t know how quickly these things get taken up, but he expresses frustration with how long it took for the knowledge to filter through and how the information was initially received by GI doctors.. He also mentions how some of the general public (pilots were mentioned) had figured it out and had come to him out of the knowledge that he could cure stomach ulcers.

            He hints at some of the frustrations that conspiracy theorists like.

          • KarenJJ

            I should add that it still doesn’t give much hope to those that love conspiracy theories, because this particular “crackpot idea” has been integrated into mainstream medicine within a generation. Homeopathy, on the other hand, is increasingly out in the land of crackpot ideas.

          • Certified Hamster Midwife

            What an amazing change that was. That knowledge could have saved my grandfather decades of flavorless food.

  • Houston Mom

    I know a vaccine rejectionist father who claims to be “educated” about vaccines. I was nervous having his unvaccinated child around my newborn and tried to talk to him about how dangerous his behavior was. So he checked with his “expert” the homebirth midwife who delivered his kid in the bathtub at home. Meanwhile he plays in a band with a VIROLOGIST who he did not consult with at all.

    • Ob in OZ

      too funny

    • Young CC Prof

      Come on, what could a virologist possibly know about vaccines? They just mess with test tubes. Delivering babies in bathtubs, now, THAT’s proper training.

  • anon for this

    Shit, I’m a lawyer and sometimes I don’t feel “educated” on the law.

    • WhatPaleBlueDot

      Don’t feel bad. I’ve got a nice pair of master’s degrees and I become more painfully aware of how little I know every day. Luckily, I’ve long been admired for owning being wrong.

  • sarahh.rosanne@gmail.com

    I’m so sick of the term “personal responsibility” being used in relation to unforeseeable medical emergencies (especially pertaining to childbirth). Where does “personal responsibility” come into play during a postpartum hemorrhage? What was my level of personal responsibility when I was barely conscious with my baby lodged in my pelvis? Personal responsibility applies to many medical decisions but it is often a buzz-phrase that suggests a lack of compassion and common sense on the part of the user. If the alleged goal of the natural birth movement is to bring about choices, compassion or societal respect for women, using terms like personal responsibility serve to the contrary.

    • The Computer Ate My Nym

      Where does “personal responsibility” come into play during a postpartum hemorrhage?

      Some of the odder lay midwives attempt to stop hemorrhage by politely asking the woman who is bleeding to death to stop bleeding. I’m not kidding, though I wish I were.

      I think the term “personal responsibility” is one that the NCB movement uses to try to shift blame: Your baby died? Well, you should take responsibility for the decisions that led to it (and not think about who else might be responsible, like, for example, the supposed professional who did nothing to prevent the death.)

    • LibrarianSarah

      “Personal responsibility” is one of those key phrases that lead me to start to tune out and write off the person as a douchebag. There are exceptions of course but 9 times out of ten when someone uses the phrase “personal responsibility” it is code for “I am completely blind to my own privilege and have no idea how lucky I am. Also, when it comes time for me to take responsibility for my own actions I’ll through a fit that would embarrass the average toddler.

      “Political correctness” is another one. But in that case it’s usually code for “I want to act like a racist, classist, sexist, ablitist, homophobic, etc. asshole without other people calling me out on my bullshit.”

    • Young CC Prof

      Definitely, there’s a place for personal responsibility in medicine. If you have a chronic illness that requires daily management or lifestyle changes, it’s the doctor’s responsibility to teach you how to do it (or refer you to the nurse educator or dietician) but your responsibility to actually do it, or ask for help if you don’t know how or can’t manage it alone. If you are contemplating an elective surgery that actually is a choice, like whether to have your knee replaced, you should learn as much as possible about both options.

      But in a true medical emergency, unfortunately you have to trust the professionals. There’s just no time for anything else. Report what you’re feeling, make sure they know about allergies and preexisting conditions, and let them do their job.

    • T.

      I think people have a responsability because, ultimately, it is their lives and their choices. So if you are, sayd, a JW and you prefer to bled to death than to accept transfusion, then it is your responsbility and your choice. As long as you are aware that you will indeed die, of course.

  • attitude devant

    A very nice reply to our troll from yesterday. She was so ignorant she didn’t even know she was ignorant. My favorite part was her saying the baby couldn’t be in distress because the heart beat never dropped below 140. Uh-huh.

    • Antigonos CNM

      This is why I don’t like the concept of “intermittent auscultation” with a Doppler instead of occasional EFM for at least 15 minutes. A non-professional probably wouldn’t understand absence of reactivity or beat to beat variability even if they viewed and EFM strip, but you certainly wouldn’t discover it with the occasional 30 second use of a Doppler.

      • If I were to plan on a vaginal delivery – I think I’d prefer use of EFM. My unplanned vaginal delivery had intermittent ausculation – and frankly that disturbs me now, and it really disturbs me knowing my daughters cord blood pH was 7.0.

      • yentavegan

        when i was educating myself in preparation for my healing vbac the experts in the local ICAN group taught me to
        a. labor at home for as long as possible
        b. refuse routine IV
        c. refuse EFM
        d. refuse ARM
        e. refuse to lie down
        all these standard practices are interventions. Labor and birth can be disrupted, prolonged and made more painfull if I allowed the hospital staff to treat me in this routine manner.

        • yentavegan

          In retrospect I was brainwashed by these ‘clucking hens’ and I dodged a bullet.

      • AB

        I bought into the idea that intermittent monitoring was just as effective as EFM. Of course, it wasn’t until we transferred to the hospital that it was discovered my baby wasn’t tolerating the contractions very well, and my midwife hadn’t noticed with her occasional 30 second Doppler checks…

      • Ob in OZ

        Could not agree more

      • batmom

        EFM saved my son, who pinched his cord 15 hours into labor when my water broke (and the nurse rolled me over to see if that would help with the decels.) She had him up and off the cord while the room flooded with nurses and they readied me for an emergency C-section. (Then his heart rate came back, and 7 hours later, he was born vaginally w/ forceps. I’d trust birth if it wasn’t a total asshole.)

        • KarenJJ

          “I’d trust birth if it wasn’t a total asshole.”

          love it!

          Would you trust an ex-husband or ex-friend that cheated and lied? Why would you “trust birth” when people die from giving birth.

  • Guest

    So really, what is the balance between “Well, I really don’t need to know anything because my doctor has this covered” and “I know better than they do because I saw Orgasmic Birth and read Spiritual Midwifery”? I am asking a sincere question. I do consider myself informed as a patient to a certain degree, though not in a position to make medical decisions about birth/ prenatal care without medical input. There are (unfortunately) some providers with medical degrees who are either spread too thin or perhaps aren’t all that detail oriented that let things slip or may present information in a way that is rather biased. Unless you are “informed” or “educated” to a certain level, how will you know what questions to ask? Or when you really *should* be questioning a provider, and it does happen. I’ve had a few situations where something was recommended where the recommendation was entirely inappropriate and was backed up by a second and third opinion. The way this article is phrased, it sounds like you are condemning women for wanting to be partners in their care. Am I reading this incorrectly?

    And if the whole NCB crowd is a poor source of information, perhaps you can point women in credible, useful sources of info?

    • Tim

      You should strive to be informed to the level you are capable, but just to let your ego sit down and shutup when you know damn well that someone who knows a lot more than you is talking. Ask questions of your providers, try to learn more, but never let yourself think that you are suddenly the equivalent of someone who has been practicing for years after going through extensive training, and try not to second guess them so much. If you have a provider who refuses to answer basic questions and help you understand your condition more, find a new provider – that one is not worth having unless you’re the person who wants to just go on being blissfully ignorant of everything.
      Treat it like a student teacher relationship – don’t be afraid to ask questions if you want to understand a little more, or if you’re scared of something, but don’t be rude and insist you know better either. It’s all about keeping your ego in check. You might even be surprised sometimes how willing Dr’s will be to explain things to you in ways you’ll understand better
      My daughters cardiologists are good examples, and will use a lot of analogies to mechanical pumps and valves and how the physics of what is going on could relate to such a thing to help me be as informed as I want to be about her condition. When one of their decisions scares me as a parent, I ask for clarification, but I try my absolute hardest to make sure I’m not second guessing them,because i have no intention of doing so (how do you second guess the top rated department on earth?) – they know I’m just a scared parent, and are always willing to patiently explain things. I know I can’t hope to ever understand all the intricacies of what is going on in there, because it takes years of study to do so, but I want to be informed to the limits of my capabilities because its my kid on the line.

    • jenny

      I think the situation you describe is very difficult one to be in. Over the last few years, I have been working to develop a relationship with our HCPs. So my daughter’s pediatrician and I have built a relationship of trust, my hospital CNM and I have a relationship of trust. In general I feel they are both attentive and detail oriented, listen to me, and are cautious in a way I appreciate. If they make a recommendation, they are careful to explain what and why in a way I can understand. We have medicaid, so we don’t have a bazillion options, and it’s of course easier to have options among PCPs vs specialists, but I think one of the best things a person can do, if possible, is find a primary care doctor or NP they feel they can trust. When we were making major treatment decisions for my daughter who had a brain injury, we talked about our options with the neonatologists, because they were the experts, but we also talked with our pediatrician because he was able to help us understand the options. I think once you have someone you trust, it can be easier to find a second opinion, because you can be referred by your trusted provider.

      • Tim

        Dr’s at teaching hospitals are usually a good option too if you’re looking for someone who will explain things – they are used to it. A lot of the time at our various appointments, we’ll get to be part of the Attending explaining something to a Fellow, or the Fellow explaining somethign to a Resident, and including us in the discussion.

        • jenny

          Yes, I got more information about kidneys than I ever could have imagined from talking with the fellows and listening to the rounds. Guest, if you like information, residents and fellows are great people to talk to, although you won’t (and probably shouldn’t?) get any interpretation. That was frustrating but in retrospect I appreciate it.

          At one point, we participated in a study that was being run by one of the neos, and because of that, he couldn’t tell us whether or not to choose it. He gave us a lot of information but said it had to be our choice. That’s when I asked our pediatrician what to do, because my boyfriend and I did not feel qualified to make a decision like that without more guidance than “here are the risks and benefits.” We didn’t feel qualified to interpret that information. Otherwise, we relied on the neos to help us make all the rest of the important decisions.

          • KarenJJ

            The main specialists I’ve seen for my immune system issue have both been professors at their local universities and they’ve been great with explanations.

    • Amy Tuteur, MD

      It’s just like in any other field: credible, useful sources of information are the experts in that field. That doesn’t mean that all the experts will always agree; that’s why you should get a second or third opinion if you are still confused or unsure.

      Who would you trust to design a bridge, an engineer or a person who has driven over several bridges? Who would you get to defend yourself against a lawsuit, a lawyer or a person who has been sued multiple times? The same thing applies to childbirth. You can trust the information from an obstetrician and you can’t trust the information from a layperson whose “expertise” is having given birth to several children.

      • Guest

        More specifically, I meant written sources of information related to pregnancy and birth. Obviously there are many, many (mostly entirely stupid) books on pregnancy and birth. Are there ones that actually are good and comprehensive that aren’t aimed at the lowest common denominator or so dominated by medical language that the average (somewhat intelligent) person wouldn’t understand? But with more detailed information than Internet sources provide.

        • Rochester mama

          I love Mayo Clinic’s books and website for patient information. But I’m biased and live in Rochester and use them for primary care. I am not a healthcare professional but I used to work there as well on the business side of things. As an OB patient they strike a great balance between “this is a special life event for you and we want you to have a great experience” and “this could go wrong at any minute”.

          • Ob in OZ

            For the topics they cover, the patient information section on uptodate.com is a reliable source. Most often just saying “I don’t understand” will get a Doctor to slow down and explain better, and may have a booklet about a specific topic on hand. Every visit ends with “do you have any questions” just to make sure both of us are done. Finally, many hospitals, medical practices and obstetric societies have websights that are reliable. The best I’ve seen come from SOGC (canada). ACOG (USA) has patient info but not for free, and the medical info is for members only ($$$). RANZCOG (Australia and New Zealand) and RCOG/NICE guidelines (UK) have guidelines for free but are significantly influenced by budget and midwife led care that they don’t always advise the safest option, but more likely the most cost-effective option (for them ,not you). These can be heavy with medical jargon, but your doctor should take the time to answer questions related to the information you’re reading (even the crap), or you should get the second opinion and stick with them if they answer your questions. Good luck.

          • KarenJJ

            Actually that’s awesome. One of my doctors gave me some info from uptodate, but looking at the website I could actually purchase a subscription for myself for a week if I wanted to. Good to know in the future if I feel I need it.

        • Dr Kitty

          Pssst, Dr Amy wrote a book in 1994 called “How your Baby Is Born”.

          • Courtney84

            I currently have that book out on inter-library loan! I also just read Birth Day. It was written by a pediatrician named Mark Sloan. I thought it was a mostly good read.

          • Young CC Prof

            I read Birth Day a couple months ago. Loved it! I should probably read Dr. Amy’s book, too. Maybe when I’m done cleaning the nursery. (TIRED!)

        • Eileen

          I understand what you mean. At the OB/GYN practice where I’m a patient, they hand you a bag with the American College of Obstetricians and Gynocologists’ book, “Your Pregnancy and Childbirth Month to Month.” I think that’s a great thing for my practice to offer, and I think more practices should consider doing something similar.

  • Zornorph

    Ugh, the term I hate most is ‘do your research’. Of course, when people say that, they really don’t mean it – they mean to find a website that supports their point of view and blindly accept what is presented there. Here’s the thing; I don’t WANT to do research. I would rather pay other people to do that for me, though in this day and age, much of what you would need to pay a doctor to tell you can be found for free on numerous mainstream websites. I would rather spend my time reading the latest Stephen King book (Dr. Sleep – it’s good, check it out – the sequel to The Shining!) than to be researching if vaccines are safe or not.

    • Happy Sheep

      I hate when they say they have done hundreds of hours of “research”. This usually means participating in anti vaxx message boards and websites.
      It never ceases to amaze me that people do not seek out the other side of an issue once they have found what they like to hear. How hard is it to type homebirth risk or antivaccination refute into Google?
      Whenever I hear a claim that seems plausible to me, a layperson, I try to find a further explanation or an analysis done by a knowledgeable source, that is actually how I found this Site.

      • kumquatwriter

        Interesting – most of us regular readers/commenters say we LEARNED on this site, but I’m not sure anyone has called it “research” beyond “I was researching and then I found this site and learned…”

        • Happy Sheep

          I don’t call it research either, I call it trying to grasp an issue. I also don’t think reading opinions about said research makes me educated in the subject and I think that is why I never really got sucked into the woo, I know my limitations.

          • Amazed

            Research. Oh my!

            To this day, I still remember getting earlier than usual, having my coffee in three gulps and running for the library to be among the first to enter because during examinations, there weren’t enough booths for everyone. So, the program was: you go there and if you’re lucky, you’ll enter in the next fifteen or so minutes. Then, you start ordering specialized literature, professional magazines and wait to have them delivered to your table. You take notes. You see references, so that’s another pile of books you need to check. Damn it, you thought this annoying thing was this way and here it says it it that way? You have to copy the article so you can have a better look at home where you can reason what the hell it is.. Rinse and repeat. Here go the last money you have as a student for a very long time. You keep reading, copying, taking notes, trying not to imagine the horror of not starting the next day with a cup of coffee because of all the copying you need to pay for.

            Wait, what? The book that you have in your list as recommended reading doesn’t exist? Damn those professors, they are so absent-minded. Remember, that’s the age right before internet enters the stage so you cannot check what the title of the bloody book is.

            The work time of the library is now over. You head for home and call the professor. He doesn’t answer the phone. Damn it once again, tomorrow morning you have to drag your sorry ass at the university to get the title of the book right and then back to the library to wait for your turn to occupy a booth because by now you’re, of course, late.

            Notice that I haven’t even started on the knowledge you already have before you head for the library.

            Now, it’s simple: you start your PC, read some Lamaze magazines, cherry-pick a few articles, find a miwife who sounds friendly and arrange a meeting.

            Research done.

      • C T

        I think I first encountered this site because I was searching for information on homebirth risks. I live in Colorado and have some homebirthing friends (one studying to be a CPM, sigh) and was feeling a teensy bit defensive for not opting for homebirth since I have fairly fast and easy labors. This site did wonders to build up my confidence in my decision. Then a few months later, I met up with a homebirthing acquaintance who had lost her baby to a bad homebirth (which showed up in the hospital stats, of course, since a C-section had to be performed and the baby died after being taken off the machines) a month before my baby was born. 🙁

      • Poogles

        “It never ceases to amaze me that people do not seek out the other side of an issue once they have found what they like to hear. How hard is it to type homebirth risk or antivaccination refute into Google? ”

        Exactly! And that is how I found this site, and learned I had been lied to/misinformed by the NCB/HB crowd. Also how I found Respectful Insolence and realized my vaccine fears were also completely unfounded.

    • Elizabeth A

      I hate the “do your research!” advice too.

      I did a ton of research on labor and birth, and all of it was useless. I read the wrong stuff, and then I got hit by a complication that was barely touched on in the stuff I read, and in the end, I wound up flung into the hands of merciful strangers. It worked out fine.

      I recognize that I’m talking from a position of privilege here, because I live in Boston, where you can’t parallel park without hitting a teaching hospital, and my mom is a doctor, but when I turned up with cancer, I did hardly any reading. I went to the hospital I’ve been going to since I was a baby. I called my mom to let her know what was going on, she checked out the doctors on my case, and I went with their recommendations. Mine was not a complicated case for decision making (a little complex in treatment, but courses of action were clear). I didn’t even bother with a second opinion. This is not how people tell you to get medical care (certainly not everyone has a relative who roomed down the hall from the Oncology Chief back in the day) – I read nothing, researched nothing, and questioned very little. I do not have to know hardly anything about my treatment, besides when to show up (I happen to know a bit more then that, I can even sound technical to laymen), but it actually does not matter the slightest bit how much I know. I have not adopted this course because I’m blindly trusting or generally stupid. There are a load of other things that are my job, the medical stuff is someone else’s.

      I think that if the general public had better mechanisms for sorting good doctors from poor or mediocre doctors, this would be a more popular route. The fear, of course, is that you’ll end up with a bad doctor, and therefore get poor treatment. It would help a ton if there was more information about surgical outcomes, lawsuits and complaints available to the public.

  • Mel

    I find it really odd that my high school students are far more realistic about the dangers of childbirth and of not vaccinating their babies than many ‘adults’ on the internet.

    My kiddos have often lost multiple family members at a young age due to violence, untreated diabetes, SIDS etc. They understand more clearly than many more wealthy white people that life is not fair and horrible things can happen to anyone.

    I made a bulletin board one time with the title “My mommy loves me lots! I know this because she makes sure I get my shots.” The students were baffled. I had so many students ask me what kind of parent would NOT get their children vaccinated. My reply was “Very self-absorbed ones.” The students would shake their heads in disbelief and wander away.

  • anh

    I’m a professional expert on a specific area of the world (advanced degrees, years of overseas experience, fluency in several languages) I go insane when people read a few articles and try to tell me what is what. When I first got pregnant I started to challenge my ob on a number of issues before I figured out I had become the tool I had always despised!
    Reading blogs or advocacy websites that support your position is not education

  • Why can’t there be a middle road? I think an empowered patient is one who is informed of the available options (by a qualified health care provider – or at the very least by information that has been vetted by qualified health care providers) and is empowered to make the medical decision for themselves. Unfortunately, large numbers of women are being led astray by “Childbirth Educators”.

    • Tim

      “Informed enough to know better” – there, I’ve coined a new term. It means you’ve bothered to do more investigation than a lay person would normally do, have gotten a baseline level of knowledge so that you don’t feel totally lost and stupid when discussing things with your Dr’s, and it has led you to believe that you really ought to leave importance decision making up to those who know better.

  • Dr Kitty

    I remember as a medical student being in awe of the interns, and thinking how much they knew.
    And then being an intern, and painfully aware how little I knew, and being in awe of the SHOs and SPRs.
    And then being an SHO and being aware how little I knew and so on…

    Medicine is deceptive-you just get a handle on something and then the evidence changes or it doesn’t work out in a real life case for whatever reason and suddenly you realise that you have to do more work.

    TBH I don’t know if it is the arrogance or the hubris of NCB that upsets me more.

    • Sullivan ThePoop

      Science is like that. You can know everything there is to know about an aspect of some topic, like replication and then they find out very recently that an entire part of the replication machinery is swapped out all the time. Or type 2 diabetes on a molecular level and then find out, also relatively recently, that there is a lot of protein aggregation involved.

      • Dr Kitty

        My particular wake up call was the newsletter sent by the MDU (one of the biggest indemnity providers in the UK).

        As my mother is a Dr she used to get it, and I remember reading the case studies (which are actually called “cautionary tales”) as a teen who wanted to be a doctor one day and thinking “OMG how could anyone make that kind of stupid error!”.

        Now I read those cautionary tales and think “I could so easily have done that!” Or “OMG I HAVE done that, thank goodness I didn’t have that outcome!”.

        Good Drs, even excellent Drs, are not infallible. I know that on a real, personal, gut wrenching level. I have lain awake worrying about decisions I wish I could go back and do over-even if no-one actually came to harm.

        But the idea that the practice of medicine is so easy that a few hours on Wiki and Google will give you all the tools you need to diagnose and manage any illness…it’s not just wrong and dangerous it is horribly insulting.