Natural childbirth advocates don’t respect Nature


All of us familiar with the idea of falling in love with an illusion, an idealization of a person instead of the person as he or she really exists.  As psychiatrist Neel Burton writes:

Idealization involves overestimating the positive attributes of a person, object, or idea and underestimating the negative attributes; but more fundamentally, it involves the projection of our needs, desires, and fantasies onto that person, object, or idea. The classic example of idealization is that of being infatuated, when love is confounded with the need to love …

In contrast to the illusion of love, real love involves loving the person, object or idea for who or what they really are. In other words, mature love requires respect.

Natural childbirth advocates have fallen in love with an illusion of Nature. That illusory love of Nature is fundamentally disrespectful, because all negative characteristics are ignored. Natural childbirth advocates don’t love Nature. They love the illusion of Nature that they have created to meet their own needs.

Natural childbirth advocates like to say that Nature designed women to give birth. Nature doesn’t design anything and Nature does not create perfection. Traits and abilities are subject to natural selection mediated through the survival of the fittest. An organism perfectly adapted to one environment may turn out to be an utter failure when the environment changes as it inevitably does.

Nature is imagined as benign by natural childbirth advocates, but “nature is red in tooth and claw.” Death, violent and agonizing is a fundamental, ineradicable feature of the life all animals, and human beings are no exception. Claiming that natural childbirth is safe because we wouldn’t be here makes about as much sense as claiming that humans never kills each other because if they did we wouldn’t be here. Death in childbirth is as common as death in war and we’re all still here.

Natural childbirth advocates are hubristic. They imagine that because they love Nature, Nature is obligated to love them back. They imagine that because they worship Nature, Nature won’t visit calamities on them. They prefer to ignore the fact that Nature is responsible for earthquakes, typhoons, snake bite and disease. They imagine Nature as a gentle breeze when it is in reality a heartless, selfish force, operating to the rhythm of its own rules and completely unconcerned with the wishes and hopes of human beings. Trusting birth not to kill your baby makes about as much sense as trusting a typhoon not to kill your baby. Pretending that your affirmations have the ability to affect the outcome of childbirth is like pretending that your affirmations have the ability to stop an earthquake in progress.

Obstetricians, in contrast, have profound respect for Nature and her power. Because they have orders of magnitude more experience of childbirth than anyone else, they are intimately familiar with the death dealing ways of Nature. It is Nature that creates miscarriage, stillbirth, pre-eclampsia, Rh disease, massive maternal hemorrhage and hypoxic brain damage. The incidence of most potentially fatal childbirth complications has changed little over the years. The only thing that has changed is our ability to treat and sometimes prevent these otherwise fatal complications.

Natural childbirth advocates like to whine that obstetricians “play the dead baby card.” Damn straight, because without obstetricians 7% of babies and 1% of mothers will die in and around childbirth … and that doesn’t even count the 20% of established pregnancies that will end in miscarriage in the first trimester. Obstetricians aren’t foolish enough to pretend that complications are rare or that they can be wished away by affirmation. Obstetricians, unlike smug natural childbirth advocates, know that Nature is far more powerful than they are.

Trusting birth is like trusting a tiger. Both are wild, unpredictable and uncontrollable. People who work with wild animals show their respect for them, their power and their ability to deal death by taking preventive measures. Obstetricians know that childbirth is wild, unpredictable and uncontrollable. They show their respect for childbirth, for its power and its ability to deal death by taking preventive measures. We would judge anyone who chose to enter a tiger cage without protection as foolish beyond measure. Anyone who chooses to give birth without protection is just as foolish.

Mature love requires respecting the object of that love for who or what it is. The worship of Nature among natural childbirth is not mature love, because it lacks fundamental respect for the reality of childbirth, and of Nature itself. Natural childbirth advocates have fallen in love with an illusion. Unfortunately, the consequences can be far worse than a broken heart.

293 Responses to “Natural childbirth advocates don’t respect Nature”

  1. April 10, 2014 at 11:00 pm #

    OK so wow! It would take a lot of time reading through the comments here!! But I really wouldn’t agree on several points here. Natural Childbirth doesn’t necessarily mean that those who practice it love nature to such an extent. It has always been a choice for mothers like me who delivered my babies through natural birthing but I opted to have my OB beside me.

    Here’s a helpful book about a crash course on natural birthing, might help you guys out!

  2. guest81
    November 20, 2013 at 5:26 pm #

    I come from a family of doctors and OB is my choice for my
    pregnancies. However, during my hospital birth of my son – I had to be very
    vocal and negotiate with my caregivers every step of the way.

    I had to push to delay my induction a few days – my OB
    wanted me to be induced as soon as I reached 40 weeks.

    At the hospital, I had to fight to be allowed to go home
    after my induction to labor at home as opposed to all alone in a shared room.

    Then I had to argue to delay the water bag breaking. I had
    to argue to delay the Pitocin. I had to argue to delay the Epidural.

    In the end the only thing I didn’t argue about is following
    the nurses prompt to push. Pushing went well and my baby was out in about ten
    minutes – but I ended up with third degree tears. I believe if I argued to slow
    down the pushing, a lot it would have gone better. That’s my opinion, no need
    to know for sure.

    Then while I was on the epidural, Pitocin and hooked up to
    every medical device under the sun – my own OB (who is normally a wonderful
    person) came into my room, checked me and said not much has happened in the
    last couple of hours – get mentally prepared for surgery.

    It is a relatively disheartening thing to hear in the middle
    of all the commotion.

    So, in the face of an actual medical emergency – 100% I agree OBs and hospitals are awesome. But
    the medical profession can sometime have a one size fits all attitude that does
    not help mothers.

    And those that are thinking that I was tempting fate arguing
    for the things I mentioned above, I want to point out that at no point in my
    pregnancy was there a problem. My pregnancy and my baby were always doing
    well. So the only reason the hospital
    advised me the way they did was because that’s the way they advised pretty much

    So – berating and discounting everything natural birth
    advocates say is not the solution. Incorporating the wisdoms of women all over
    the world, midwives, etc. into the medical practices is, in my opinion, the
    best way to proceed.

    Why does it always have to be either/or? And honestly – even
    the medical profession’s opinions have changed SO much in the last fifty years –
    who’s to say it won’t evolve more in the future?

    • guest81
      November 20, 2013 at 5:42 pm #

      I read every medical journal I could get my hands on during my pregnancy AND read Ina May’s and other mid-wife books. However, I don’t want to search the Internet for links to my findings right now. Here is a cool interview with an OB that talks about some of the “one size fits all” medical practices – that really need to change.

      • Young CC Prof
        November 20, 2013 at 6:57 pm #

        There’s quite a bit wrong with that article, actually. For one thing, he’s heavily focused on the time curves and makes it sound like obstetricians are all about stopwatches and don’t pay any attention to the patients!

        Nowadays, electronic fetal monitoring allows hospitals to focus less on the length of labor and more on the important question: Are mother and baby holding up well? If mother and baby are still strong, they’ll let labor go on quite a bit longer than the old guidelines call for. But if the fetal monitoring shows baby is in distress, the doctor knows and can intervene right away.

  3. Jenny Star
    November 20, 2013 at 8:09 am #

    “without obstetricians 7% of babies and 1% of mothers will die in and around childbirth”
    Only 7%? I ask because of an old family bible we have, as well as other family history we have – collected over many years – that seems to indicate a 25-33% chance. Or maybe those were including the first year of life as well. (One of my great great grandmothers had 17 children. 5 of them died before reaching one, and I’m pretty sure a few of those died the day they were born.)

    • Trixie
      November 20, 2013 at 9:21 am #

      My great-grandmother had 15 kids, and none died in childbirth, and 13 lived to adulthood. That’s a pretty stunning success rate, now that I think about all the things that could have gone wrong.

  4. Lisa
    November 19, 2013 at 12:41 pm #

    Jajaja, this one made me laugh!!! Of course childbirth is unpredictable, but obstetricians cannot control it. And that’s the problem, they want to control childbirth, to standarize care with routine interventions, even though they threaten the normal course of childbirth. All extremes are bad. I wouldn’t give birth unassisted, but do you really think you can control birth with all those intervention. How about evidence based decisions? Have you read all those papers that prove the benefits of natural childbirth vs. unnecessary procedures? Of course not!!

    • S
      November 19, 2013 at 1:05 pm #

      Obstetricians do seek to end up with as healthy a baby and mother as possible, but i don’t understand what you mean by “control birth.” Can you elaborate on that, please?

      Obviously all procedures carry risk, so it’s not a good idea to do them unnecessarily. No one will disagree with you here, but i suspect we will disagree on what we consider necessary and unnecessary, and in the way we weigh risks and benefits.

    • PJ
      November 19, 2013 at 1:48 pm #

      “Have you read all those papers that prove the benefits of natural childbirth vs. unnecessary procedures?”

      Care to give an overview then (not link salad, please)?

    • Happy Sheep
      November 19, 2013 at 9:47 pm #

      I would like to see the peer reviewed, we’ll done papers you claim that show what you claim. How exactly would those be done? Some women are left completely alone and if they or their babies die so be it? I call bs. You want to give birth without pain relief in hospital, have it at. You want to imply those who choose pain relief are risking their babies, you better have some crazy good proof.

  5. Chuck Cirino
    November 18, 2013 at 12:31 am #

    Childbirth is NOT a complex medical procedure. My sons were both born at
    home. I delivered the second one myself. We did it out of choice and
    I’d do it again given the opportunity. Dr. Amy Tuteur, your scare tactics are lost on those of us who have done the research and gone through the experience.

    • Young CC Prof
      November 18, 2013 at 12:52 am #

      About 90% of babies ARE born normally with little or no assistance. The other 10% need medical care, so, congratulations, you got lucky. Since you took an utterly pointless risk with your sons’ lives, I’m glad it worked out for you. Please do not encourage other people to emulate your choices, as some of them will die as a result.

      • Wren
        November 18, 2013 at 2:48 am #

        Why does that seem to be so hard for some people to grasp? In the majority of cases, all goes well, or well enough. Most people do not want to be in that group for whom it does not go well, especially if medical intervention is not immediately at hand.

    • anonymous
      November 18, 2013 at 10:15 am #

      No, basic childbirth is not a complex medical procedure. Come back to me when you’ve read up on nuchal cord, twins, etc.

      • S
        November 19, 2013 at 1:23 pm #

        Yeah, i can’t relate to Chuck’s experience at all. Reading my husband’s old med school OB handouts made me so grateful for my OB. Liver dysfunction in pregnancy? I couldn’t begin to follow that. Shoulder dystocia — I think i’d happily give up a toe or two for a guarantee that i’ll never be on my living room floor with my husband’s inexperienced hand inside me trying to jiggle a baby free. Plus i could’ve gone a lifetime without knowing symphysiotomy is an actual thing.

    • The Bofa on the Sofa
      November 18, 2013 at 10:24 am #

      Congratulations on your babies.

      However, I would like to introduce you to Wren, who commented below. She lost her baby during childbirth, your supposed “NOT a complex medical procedure.”

      How do you explain her loss? Is it her fault? Did she do something wrong? Because you apparently think that it can’t be her due to a complicated childbirth…

    • Jenny Star
      November 20, 2013 at 8:10 am #

      Congratulations to your sons and wife for surviving your arrogant idiocy!

  6. Samantha Anderson
    November 15, 2013 at 7:33 pm #

    Since you enjoy writing about/to extremists, here’s one for you.
    Obstetricians are power-hungry God-complex meddlers who can’t wait to get their hands into a woman’s womb.
    Birth belongs in a hospital, I’ll go for that. But asserting that doctors are the only people who are certified to care for birthing women because they’re the only ones who “respect nature” is ignorant. One can “advocate” for natural childbirth and still be nearby to help if something should go wrong. Treating childbirth like every woman needs a doctor is a waste of time and a lot of money.

    • Stacy21629
      November 15, 2013 at 8:38 pm #

      Why would you advocate for “natural” childbirth when, as Dr. Amy has pointed out, “natural” childbirth oftens end with the death of the baby and/or mother?
      And she’s never stated that doctors are the only people certified to care for birthing women…but they don’t “advocate for natural childbirth” in the way in which you are using the term because they know the potential risk. Dr. Amy is contrasting those who know the potential risks of “natural” childbirth with “natural childbirth advocates” who bury their heads in the sand…and then bury the dead babies too.
      I had a medication-free labor with my baby in August with a CNM…who diagnosed and then stepped out of the way for the OB when my daughter developed decels. And I was THRILLED to have it so. I wanted a live baby far more than the experience. THAT is how “natural childbirth” should work.

      • Samantha Anderson
        November 15, 2013 at 8:44 pm #

        “as Dr. Amy has pointed out, “natural” childbirth oftens end with the death of the baby and/or mother?”
        I’m sorry, is Dr. Amy the second coming? Could you specify some actual statistics instead of what “Dr. Amy said”? Take a look at Sweden. Their childbirth practices are enviable. They rarely perform interventions, and their babies come out just fine, WHOA that is just amazing.

        • Stacy21629
          November 15, 2013 at 9:27 pm #

          So you deny that women or babies ever die in labor?
          I don’t need stats for something so fundamental. I’m not talking percentages, I’m talking a fact of nature. Babies die in labor. Mothers die in labor.

          I’m a multip with now 2 completely healthy pregnancies and no other complications. My baby was fine. She could have been brain-dead or 6 feet under if she had her decels in my living room.

          • Samantha Anderson
            November 15, 2013 at 9:35 pm #

            My problem is with the use of “often”.
            Also never said that the living room is the proper place to have a baby.
            You have a problem with comprehension, no?

          • Vyx
            November 15, 2013 at 10:29 pm #

            Death rates go way down when mothers and babies have access to life saving intervention. Is perinatal death something that happens ‘often’ in the first world? No. Without access to treatments, often probably is the correct word choice, a 7-9% death rate is significant.

            Even in non-emergent situations, things can go bad rapidly and with little warning. You seem to be saying that birth at home is not a good choice, I don’t think anyone here would disagree with you. But, I think you are receiving negative feedback because you are disparaging women who have chosen to take advantage of potentially life-saving technology or comfort measures during labor and delivery.

            Birth is not inherently safe. Good thing we have doctors and OBs who make it seem that way.

          • LibrarianSarah
            November 17, 2013 at 8:34 pm #

            From what I gather, you seem to think that women should give birth in a hospital but shouldn’t make use of the staff or technology that makes giving birth in a hospital safe and/or comfortable. At least until some arbitrary level of neccessity is reached.

            If you are not going to use an OB/monitor/epidural etc. you might as well be at home.

        • November 15, 2013 at 9:50 pm #

          Completely natural childbirth (that is, no interventions at all) ends in death for the baby 7%-9% of the time and 1% of the time for the mother.

          That’s a pretty hefty risk you’re advocating. OBs are the only people trained to do a lot of the things that save lives, such as C-sections, which means they are the best people to have with one while laboring.

          • Samantha Anderson
            November 15, 2013 at 9:52 pm #

            The way you word that sounds like interventions that are NECESSARY would not be given if they were needed. No idiot would ever say such a thing.

            I never said OBs shouldn’t be nearby if something should go awry.

          • Stacy21629
            November 15, 2013 at 9:58 pm #

            If you read some home birth death stories it doesn’t take very long to find a mother that is against a particular intervention even in the face of obvious fetal distress. It takes only slightly longer to find a CPM actively encouraging a mother against interventions in the face of obvious fetal distress.
            Folks that swallow the mantra hook, line and sinker absolutely WILL deny or delay interventions their child needs.

          • Samantha Anderson
            November 15, 2013 at 10:00 pm #

            You guys just must know a whole lot of psychopaths that I have never met, in over 10 years of being moderately “crunchy” and social.

          • Stacy21629
            November 15, 2013 at 10:07 pm #

            What was the last home birth or natural labor death story you read?
            I know that when I was in the thick of the natural child birth mindset I don’t think I read a single one. I read tons of hospital “horror” stories, but not the flip.

          • Samantha Anderson
            November 15, 2013 at 10:10 pm #

            I do not believe that the home is the wisest place to have a child.
            I do believe that birthing a child as naturally as possible is wise. Not going out into a field and squatting, but going in with the mindset that you are going to allow your body to do what nature has designed it to do as long as it’s doing a good job. Running through the doors screaming for pain relief and monitors all over your body, in the absence of a purpose for monitoring, is wasteful of resources that could be used for someone else. Why are we always crying for epidurals and birthing on our backs to allow a nice route for tearing straight through to the anus? I may never figure it out.

          • Karen in SC
            November 15, 2013 at 10:12 pm #

            what statistics do you have to support that birthing on your back causes 4th degree tears?

          • Stacy21629
            November 15, 2013 at 10:18 pm #

            If you squat to push, where exactly does your anus move to such that tears are prevented?

          • Samantha Anderson
            November 15, 2013 at 10:22 pm #

            Are you really so dense that you can’t imagine how a 7 or 8 pound baby coming out of a woman lying on her back causes more tears *below* its head. Please say no. Please say no.
            (the answer is gravity)

          • Stacy21629
            November 15, 2013 at 10:26 pm #

            However did I manage – not once but TWICE?
            It’s the path of least resistance, regardless of positioning.

          • Vyx
            November 15, 2013 at 10:35 pm #

            Ah, so you are using your imagination to dispense medical advice. Guess I didn’t need all those A & P courses, and I should probably stop reading that medical literature.

          • Samantha Anderson
            November 15, 2013 at 10:36 pm #

            You’ve pointed out that you have taken college classes, and that you read. Good for you.

          • Vyx
            November 15, 2013 at 10:36 pm #

            And you can imagine things, guess we’re even?

          • Samantha Anderson
            November 15, 2013 at 10:39 pm #

            I think you’re confusing imagination with common sense. They’re similar, but not the same.

          • Vyx
            November 15, 2013 at 10:42 pm #

            Now, I was just using your word choice, as you used the word imagine first. Common sense has been wrong so often, that I prefer to use controlled trials to determine whether something is likely or not. And the evidence does not seem to support your common sense position that a laboring woman on her back is more likely to tear to her anus.

          • Eddie Sparks
            November 15, 2013 at 10:45 pm #

            I was going to suggest randomised controlled trials, but didn’t think it would make any difference.

          • Box of Salt
            November 15, 2013 at 10:49 pm #

            Samantha Anderson “I think you’re confusing imagination with common sense. They’re similar, but not the same”

            Are we all speaking English here? You’re the one who’s confused if you think they are similar.

          • LibrarianSarah
            November 17, 2013 at 8:25 pm #

            I think it was Einstein who said “Common sense is the collection of prejudices acquired by age eighteen.”

          • November 15, 2013 at 10:49 pm #

            Um, thinking of the squatting position, there’s also quite a lot of pressure on the back part of the vaginal canal. I don’t see how squatting would prevent tears if the primary reason for tears is gravity. Squatting would actually increase tearing because instead of gravity being a mostly neutral force, it would accelerate the baby coming out and force it out faster than the woman’s perineum could expand.

            Are you sure you’ve thought this all the way through?

          • Samantha Anderson
            November 15, 2013 at 10:51 pm #

            Notice I never said anything about “squatting”. 😉

          • Eddie Sparks
            November 15, 2013 at 10:52 pm #

            So, women shouldn’t give birth on their back. Women shouldn’t squat. Women shouldn’t lie on a bed. How exactly SHOULD women give birth?

          • Samantha Anderson
            November 15, 2013 at 10:55 pm #

            I didn’t say “not lying on a bed”. I said “not on your back.” Any way you position yourself you can tear, but with proper support and guidance it can be at a minimum.

          • Eddie Sparks
            November 15, 2013 at 11:06 pm #

            And now you are dispensing medical advice.

            “I’m a human being, with my own brain and the ability to judge whomever I please, whenever I please, based on whatever I please.”

            Please, be my guest. Judge away. Sprinkle your judgements liberally with insults and offensive statements. It will make those people reading your judgements so much more likely to take you seriously.

            You have failed to reply to the question as to what exactly would cause you to rethink your opinion on these issues. I don’t believe that there is anything I can say that would make any difference.

            I have grown bored with this conversation.

          • Samantha Anderson
            November 15, 2013 at 11:07 pm #

            Please, be my guest. Judge away. Sprinkle your judgements liberally with insults and offensive statements. It will make those people reading your judgements so much more likely to take you seriously.

            It’s funny you should say that, because that is EXACTLY what this blog does, in as offensive and condescending way as possible. Thank you, thank you for saying it exactly how I wanted to.

          • Stacy21629
            November 15, 2013 at 11:18 pm #

            Quote me the F-bomb in any blog post.

          • Ennis Demeter
            November 16, 2013 at 7:14 pm #

            You’re debating a highly educated group of commenters and you are in way over your head. That is why you feel condesecended to.

          • Bombshellrisa
            November 16, 2013 at 7:52 pm #

            It was the Google it on the other thread and the “gas pain after nachos” thing that put it over the top for me. At least throw out those stats and studies the trolls usually post here to “prove” their point.

          • Bombshellrisa
            November 15, 2013 at 11:22 pm #

            Come on Eddie-on all fours!! Since we are animals and all : )

          • Stacy21629
            November 15, 2013 at 11:27 pm #

            Except of course that most quadripeds give birth laying down – dogs, cats, horses.
            Maybe Samantha imagines herself a giraffe.

          • Bombshellrisa
            November 16, 2013 at 12:07 am #

            Yes but ELEPHANTS don’t (according to Gloria Lemay) and chimpanzees use reverse gravity (according to Ina May Gaskin) so it’s either all fours or hanging from a trapeze for a truly natural experience!

          • Eddie Sparks
            November 15, 2013 at 11:27 pm #

            And clearly gravity will work for you rather than against you in that position because…. oh.

          • November 15, 2013 at 11:02 pm #

            Well, if you’re not on your back and you’re not squatting, how exactly are you giving birth?

          • wookie130
            November 16, 2013 at 7:27 pm #

            We’ve unfortunately noticed a lot of other things you’ve said, however.

            So, apparently squatting is out, lying on our back is out, getting pain relief at 3 cm makes you insane, and being dilated to 3 cm feels like nacho-induced gas pains.

            Congratulations, you are the cake-taker du jour.

          • Captain Obvious
            November 17, 2013 at 9:09 am #

            Whether you are in a birthing tub, all fours position, or squatting with pain control it is harder to control your urges to push the baby out hard and fast, because it hurts. The pressure and ring of fire makes you push after and harder to get it over with. This causes more lacerations because the speed of the birth is not controlled well by a woman in pain. An epidural gives that woman the edge to intermittently push allowing time to stretch and tear less.

          • FormerPhysicist
            November 16, 2013 at 7:18 pm #

            OMG. The gravity of a birthing infant pushing downward is orders of magnitude smaller than the pressure exerted by the uterine muscles pushing the baby out. Science fail.

          • Captain Obvious
            November 17, 2013 at 9:05 am #

            Imagine a woman squatting to deliver a baby…. Ok? Got that image? Now rotate that image 90 degrees… As you can now see, that is the position of delivering in semi fowlers with her legs supported by husband and mother. Same position. Gravity isn’t going to help or hinder. Ina may even wrote about a monkey birthing in the trees upside down, and the baby monkey still came out.

          • Stacy21629
            November 15, 2013 at 10:21 pm #

            And women cry for epidurals because labor FREAKING HURTS!

          • Stacy21629
            November 15, 2013 at 10:28 pm #

            In addition, women scream for monitors because, as it turns out, it’s comforting to know that your baby is alive inside you. I’d rather not wait until there’s meconium pouring out of me to wonder, “hmm, baby appears in distress, I guess there’s a purpose for monitoring now.”
            However do you expect the OB you seem to have waiting in the wings to know when to come to the rescue without monitoring?

          • Samantha Anderson
            November 15, 2013 at 10:31 pm #

            You know what Stacy? I don’t want monitors wrapped around my belly and wrist and arm, and to lie on my back and be a “good, quiet patient” until a doctor kindly delivers my baby for me. There are ways of monitoring a baby without looking like a patient in an ICU. And yes, many women DO forego the EFM because they want to be up and around and not just lying there like a beached whale for the whole day. Are those women irresponsible for not wanting to be hooked up to every device man ever invented to “monitor” their fetus?

          • Eddie Sparks
            November 15, 2013 at 10:37 pm #

            Have you even seen an EFM? They are wireless nowadays. Like phones. Mobility is encouraged. And unless there is an indication, or the mother requests continuous monitoring (which some mothers LIKE), it is intermittent.

          • Stacy21629
            November 15, 2013 at 10:38 pm #

            She probably thinks they still shave and give enemas…

          • Stacy21629
            November 15, 2013 at 10:37 pm #

            If when they put the monitor on there are significant decels that could have been going on for who knows how long, yes, that choice is irresponsible.
            In my own case, I have no idea how long my daughter’s heart rate was depressed because we were only checking with a doppler. I thank God a more serious issue was not overlooked because I initially didn’t want the bother.

          • moto_librarian
            November 16, 2013 at 1:48 pm #

            So you deny even a baseline strip and intermittent monitoring? Have you ever heard of telemetry EFM units? Do you really think that most hospitals make you lie flat on your back if you haven’t received pain medication?

          • Trixie
            November 16, 2013 at 3:29 pm #

            Have you ever been hooked up to EFM? You can move around plenty. Also, usually you can unhook for like 20 minutes at a time to labor on the toilet, shower, walking around, etc. And they encourage that as long as everything looks good.

          • Ennis Demeter
            November 16, 2013 at 7:10 pm #

            I don’t think she has ever given birth.

          • Mishimoo
            November 16, 2013 at 9:57 pm #

            With my last labour, I had wi-fi CFM towards the end, which I was grateful for because it showed the late decels while I was pushing, and meant that the dread I was feeling and the urge to get this baby out NOW wasn’t a tired overreaction to a ‘natural process’. I could move about as much as I wanted, but by that point all I wanted to do was sit quietly in a supported, modified squatting position. Why? Because that’s how I cope with back labour over severe lumbar lordosis with persistent occiput posterior position + a pitocin drip that I requested to help me get from 9cm to completion because I had been in transition for 3 or so hours by that point and I was tired. Being quiet had absolutely nothing to do with being a good patient and everything to do with conserving my energy for the pushing stage.

            My CNM offered to get me any pain relief I wanted at that point; even an epidural. I didn’t refuse out of misplaced pride or uneducated beliefs, I refused because my experience is that pain meds do nothing for me and it wasn’t unbearable. That doesn’t make me superwoman, it just makes me someone with an oddly high pain threshold.

          • November 15, 2013 at 10:28 pm #

            I assume you think giving people morphine for broken bones is also a stupid waste of resources. Same for people dying of cancer, recovering from surgery, in agony from sickle cell anemia, or any other form of pain.

            If you think pain relief is generally a waste of resources, just say so. If you think pain relief is a good thing, why would you deny it to people who are arguably suffering the worst pain known to humankind? It’s so bad that ancient peoples called it a curse from God, for crying out loud. Broken bones got nothing on labor, from what I understand; if pain relief for the former is a good thing, why would pain relief for the latter be a bad thing?

          • Samantha Anderson
            November 15, 2013 at 10:35 pm #

            Never said it was bad. Asking for it when you’re dilated to 3 is insane. Lying in a bed strapped to an IV and a catheter and an EFM and expecting a baby to come flying out of your vagina is insane. But go ahead, get that epidural for the pain you’re experiencing that’s barely worse than some gas after eating nachos!

          • Box of Salt
            November 15, 2013 at 10:41 pm #

            Samantha “Asking for it when you’re dilated to 3 is insane”

            It’s insane for you to think you can judge another person’s pain and need for relief from it.

          • rh1985
            November 15, 2013 at 10:42 pm #

            It’s insane for you to assume you know exactly how much pain someone else is in.

          • Bombshellrisa
            November 15, 2013 at 11:21 pm #

            I am seriously committing that to memory so I can scream it out should I be stuck with another NCB nurse from hell when I deliver In February. I could barely remember my own name last time, much less convince the nurse to help me get pain relief. So much for “natural”

          • Stacy21629
            November 15, 2013 at 10:42 pm #

            As a natural birth guru, surely you know that people dilate at different rates? That person at a 3 could be experiencing severe pain and deliver in 1 hour.
            My recent labor I was <5cm when I was crying and regretting my decision to have a med-free birth again. Baby was born 2 hours later.

          • Samantha Anderson
            November 15, 2013 at 10:43 pm #


          • Stacy21629
            November 15, 2013 at 10:48 pm #

            Well since you were there, I must be wrong. @@

          • Eddie Sparks
            November 15, 2013 at 10:51 pm #

            Who are you to suggest what level of pain a woman is experiencing? Epidurals are not pleasant to receive. Any woman considering having a large needle inserted into her spinal column is clearly in significant pain. I would HATE to be supported during labour by someone who minimised my pain and told me that my desire for pain relief was unfounded.

          • Samantha Anderson
            November 15, 2013 at 10:52 pm #

            Good to know. When you go into labor, I’ll know not to expect your call.

          • November 15, 2013 at 10:54 pm #

            Okay, I’ve never had a baby, so I’ve never experience that pain. But! My menstrual cramps are so severe that off birth control, they incapacitate me for 2-3 days. I had a standing prescription for Vicoprofen when I was in high school because of them. Doctors don’t give out addictive narcotics to teenagers for funsies.

            My mom, whose menstrual cramps are like mine, told me the only thing worse than cramps was labor. That doesn’t sound like gas pain to me … considering that getting my period pre-BC meant lying on my bed curled up into a little ball of agony and nausea, and labor is supposed to be worse, epidurals sound just lovely.

            Who are you to judge when a woman decides she doesn’t like being in pain and asks for an epidural, anyways? And before you say you totally didn’t judge, “Why are we always crying for epidurals” and “get that epidural for the pain you’re experiencing that’s barely worse than some gas after eating nachos!” are extremely judgmental statements.

          • Samantha Anderson
            November 15, 2013 at 10:56 pm #

            I’m a human being, with my own brain and the ability to judge whomever I please, whenever I please, based on whatever I please.

          • November 15, 2013 at 11:01 pm #

            Yes, yes, of course. Now tell us why we should give a shit about your opinion when it’s clearly just an expression of your judgmental attitude towards other women, instead of a well-informed idea predicated on what is actually best for women and their autonomy and alleviating their suffering?

          • Samantha Anderson
            November 15, 2013 at 11:02 pm #

            You don’t have to give a shit about anything if you don’t want. It’s your choice to reply.

          • November 15, 2013 at 11:06 pm #

            Oh, but I reply so the lurkers can see just exactly where you’re coming from. Peeling back the layers so your contempt for other women comes through loud and clear is the best thing I can do to prevent anyone from taking you seriously.

            If you actually want to convince us that you are correct, you should have some data or evidence to back up your claims. Toning down the judgmental attitude would help, too.

          • Samantha Anderson
            November 15, 2013 at 11:19 pm #

            Why should I have data or evidence? Your leader Dr. Amy loves to make blanket statements like “attachment parents don’t bond with their children.” Why hold others to a different standard?

          • Stacy21629
            November 15, 2013 at 11:24 pm #

            Have you no understanding of satire?
            There are TONS of data on this blog. You demanded stats above and have provided none.

          • November 15, 2013 at 11:25 pm #


            She was writing satire.

          • Samantha Anderson
            November 15, 2013 at 11:28 pm #

            I understand satire, and find it hilarious. She doesn’t write well if that was her idea of satire.
            Perhaps should go back to gynecology. Not many jokes there, eh?
            Or maybe there are more, who knows.

          • November 15, 2013 at 11:37 pm #

            Or maybe it’s not funny because she’s satirizing your beliefs?

          • moto_librarian
            November 16, 2013 at 1:46 pm #

            Or maybe you are just an idiot.

          • MichelleJo
            November 16, 2013 at 2:40 pm #

            Of course you don’t like her satire. Cos it’s about you.

          • Stacy21629
            November 15, 2013 at 11:16 pm #

            “You don’t have to give a shit about anything if you don’t want. You’re the one replying.”
            Why are you here on this blog then?

          • Samantha Anderson
            November 15, 2013 at 11:18 pm #

            I wanted to see what kind of fools comment on Dr. Amy’s silliness after seeing something of hers elsewhere.

          • Dr Kitty
            November 16, 2013 at 7:47 pm #

            Direct translation: “I’m a troll, feed me”

          • Box of Salt
            November 15, 2013 at 11:08 pm #

            Samantha Anderson “and the ability to judge whomever I please”
            And you complain that doctors have a God complex?

          • Samantha Anderson
            November 15, 2013 at 11:10 pm #

            No. You have a brain and your own attitudes and opinions as well. That’s not a God complex. Every human being makes judgments of others every day. Every single day. It is normal and healthy to do so.

          • Vyx
            November 15, 2013 at 11:36 pm #

            The characteristics of a god-complex are usually listed as.
            -Being arrogant
            -Engaging in bullying
            -Being judgmental

            -Being convinced of your own infalliability

            This is certainly applicable to lots of doctors, but there’s a saying about glass houses and stones.

          • Box of Salt
            November 15, 2013 at 11:44 pm #

            Samantha “That’s not a God complex.”

            If you cannot see the irony of your complaining others have a God complex while casting judgement on others simultaneously on multiple subjects on more than one blog post, I feel sorry for you.

            “It is normal and healthy to do so”

            I disagree. I do not believe that being as judgmental as you seem to be based on the comments you’ve posted this evening is healthy.

          • Trixie
            November 16, 2013 at 3:08 pm #

            “When you know better, you judge better.” There’s a Facebook group you should join. They’d love you there.

          • Amazed
            November 16, 2013 at 3:52 pm #

            Fine. Then, I’ll use my right to judge the woman who thinks that just because she’s achieved something by having a completely natural birth, she has some insights into other women’s bodies and thresholds of pain.

            Judgment: it doesn’t matter what birthing cows say. Why should anyone care for the opinion of someone who loves pain, can’t bond to their children, and think the beauty of birth is the process and not the outcome?

          • MichelleJo
            November 16, 2013 at 2:37 pm #

            True, but people who judge people whenever they please, are not particularly nice people to be around.

          • Vyx
            November 15, 2013 at 11:05 pm #

            Women who receive epidurals early in labor show increased satisfaction with their birth experience as compared to women who don’t. In addition to the psychological benefits of pain relief, there have been demonstrated physiological benefits as well, such as improved maternal cardiovascular and respiratory health and acid-base status for the fetus.

            There was also a study done recently that found that women in active labor who were dilated to 4 cm, rated their pain at an average of 8 on the pain scale, certainly not equivalent to gas pains. Also, many women choose to have an epidural in place before pain levels reach excruciating as it can make placement easier for both the mother and anesthesiologist.

            Every woman is an individual though and pain levels can vary significantly even in early labor. Some women will do just fine without any or with alternate methods of pain relief. Not having an epidural is almost always an option, why are you disparaging women who make choices that differ from your own? No one here is forcing you to get an epidural, or saying you were wrong to not have received one.

          • Bombshellrisa
            November 15, 2013 at 11:17 pm #

            They don’t usually place an epidural when dilation is only three-it’s hard to get admitted at that point.

          • Box of Salt
            November 15, 2013 at 11:46 pm #

            Actually, if your water has broken and you’re GBS positive, you’ll be admitted to receive the IV antibiotics, regardless of dilation (been there, done that).

          • Bombshellrisa
            November 16, 2013 at 12:00 am #

            That’s true-but it’s not like anyone can scream for an epidural and be given one at three.

          • Box of Salt
            November 16, 2013 at 2:12 pm #

            I guess I was special. But I didn’t scream: I asked, and I got one, against the not-before-4-cm guideline at that time.

          • Trixie
            November 16, 2013 at 3:05 pm #

            I was offered one at 2 (ruptured membranes).

          • moto_librarian
            November 16, 2013 at 1:45 pm #

            Some women have a lot of pain at 3 cm. How is any of your business to decide when she should get pain relief? Frankly, it’s far better that the baby NOT come flying out of your vagina – or didn’t you know that a lack of controlled pushing can cause horrible tearing? Personally, I was dilated to 3 cm. both times well before active labor started. It wasn’t painful for me, but who am I to judge? Get off your high horse.

          • MichelleJo
            November 16, 2013 at 2:32 pm #

            ” Lying in a bed strapped to an IV and a catheter and an EFM and expecting a baby to come flying out of your vagina is insane.”
            Thanks for the compliment. It happened to me several times, just minus the catheter. And I’m 2x insane because I ask for an epidural at 3 cm. If I know that I want one, because labor is going to get a lot more painful than it is at 3 cm, why not have it put in a calm relaxing atmosphere, rather than being held down to keep still when I am in agony later on? By your logic, we should only put an operative patient under GA when he screams as the scalpel slices his flesh.

          • Trixie
            November 16, 2013 at 3:02 pm #

            Hi. You must have had fairly easy births. Bully for you! Your subjective experience surely must dictate what all other people do with their own bodies!

            I asked for an epidural when I was dilated to 3 cm. After 12 hours. Of back labor. On prolonged ruptured membranes. With a posterior baby. Maxed out on pit because my doctor was trying to avoid what she must surely have known would eventually end up as a c-section. But you’re right,the pain was all in my head and I was just insane.

            My next labor, I did with no pain relief. I also had a baby in the right position and a labor that was 10 hours start to finish. And you know what? My pain during that labor never got as bad as my pain at 3 cm with my first.

            And you know what else? It still hurt like hell. I don’t regret my choice to have a birth with no epidural, but I sure as he’ll don’t judge anyone else for choosing pain relief at any point.

          • wookie130
            November 16, 2013 at 6:36 pm #

            You just shot down any shred of credibility with this response, Samantha. In your PROFESSIONAL opinion, when is the BEST time for a woman to ask for an epidural? Would waiting to be dilated to a 5 or 6 be more to your taste? Why is getting an epidural at any point “insane”? And who are these women expecting a baby to come “flying out” of their vagina? Pain is relative to the individual, and I’m glad that you find “the pain” that others experience “barely worse than some gas after eating nachos.”

            I’ll tell YOU what is insane. People who think they have the right to tell other women that doctors are unnecessary during birth…contrary to what some forum or online source told you, birth does happen to be a medical event, and even if it’s going well, it can go tragically WRONG in a matter of seconds. Let’s stop pretending that birth is some kind of mystical, ethereal, New Age experience, and a way to feel “empowered” and journey. It’s a means to an end, and that end is a baby and mother who are ALIVE and HEALTHY when it’s all said and done.

            Do you have any idea how many women in other parts of the world would GIVE ANYTHING in the middle of their birth experiences for real obstetric care and pain relief?

            And here you are, belittling those who are fortunate enough to have the PRIVILEGE and BLESSING of interventions, pain relief, and access to doctor care.

          • Certified Hamster Midwife
            November 16, 2013 at 7:06 pm #

            What the heck kind of nachos are you eating?

          • Josephine
            November 16, 2013 at 10:55 pm #

            I seem to have missed the part where you have experienced every woman’s birth ever. Weird.

            Different people have different pain thresholds and sensitivities and bodies and uteri.

          • Captain Obvious
            November 17, 2013 at 8:57 am #

            So nice of you to belittle so many women’s birth experiences of how much pain they perceived in one generalized statement.

          • The Bofa on the Sofa
            November 18, 2013 at 10:35 am #

            Asking for it when you’re dilated to 3 is insane.

            You are an asshole.

            Lying in a bed strapped to an IV and a catheter and an EFM and expecting a baby to come flying out of your vagina is insane.

            Under what conditions SHOULD we expect a baby to come flying out of our vagina?

            I don’t even know what this comment means.

            And I won’t bother repeating your second assholish comment.

          • moto_librarian
            November 16, 2013 at 1:43 pm #

            If you don’t at least get a baseline reading on a monitor, how will you KNOW if something is wrong? And what in the hell is the problem with asking for pain relief? You do realize that one of the core tenets of feminism was advocacy for pain relief during labor and delivery, right?

            I get really tired of you smug NCBers who think you know every damned thing. I have given birth twice – once “naturally” and the other with an epidural. Care to guess which birth left me with a torn cervix and a pph that could have killed me?

          • Ennis Demeter
            November 16, 2013 at 6:59 pm #

            have you ever given birth?

          • Captain Obvious
            November 17, 2013 at 8:53 am #

            Women’s bodies have at least a 20% infertility rate, at least a 20% miscarriage rate, a high risk for complications during pregnancy and labor including hemororrhage, per-eclampsia, infection, preterm birth, congenital anomalies, inability to go into labor by 42 weeks needing induction, need for pain meds, and need for cesarean. This leaves you less than 20% of women who may fit a diagnosis of low risk attempting natural births. I would like a doctor there. If it goes well she’ll have an easy time with the delivery, if something comes up, I won’t have to wait for delays to get a doctor there. Would you want a lay lawyer with you in court, and then consider transferring to a good lawyer if needed? Why do you not consider your child important enough to start with someone knowledgable to handle any issue that arises?

          • November 15, 2013 at 10:16 pm #

            May I direct you to the Hurt by Homebirth website? It’s a heartbreaking place, just FYI. It’s where parents of children who were killed or seriously injured by homebirth post their stories. It doesn’t take many to make you realize that homebirth and extreme “crunchiness” kill people.

          • Bombshellrisa
            November 15, 2013 at 11:16 pm #

            I wouldn’t call them psychopaths but I was doula and trained to be a homebirth midwife with the most well known practice in my state. Even now, homebirth train wreck transfers these women dump at the ER doors are affecting me, and I don’t have contact with them professionally anymore

          • The Bofa on the Sofa
            November 18, 2013 at 10:33 am #

            So what’s the problem?

            You seem to railing pretty hard against a strawman.

          • November 15, 2013 at 10:10 pm #

            I don’t understand your position, I guess. Why have the underqualified midwife at all, then? OBs do care about women and women’s autonomy and patient autonomy and all those good things, and are better qualified to spot things going wrong and to fix them than a midwife. Your definition of “natural childbirth” means vaginal and without drugs but with the option of drugs and other interventions if the mother so chooses and/or it becomes medically necessary, right? Why wouldn’t you want the most qualified person, which is an OB, to be there with you?

          • Samantha Anderson
            November 15, 2013 at 10:12 pm #

            The ideal situation is to have someone there to monitor your birth, and should the need arise, a doctor is nearby (as happened with my third, incidentally). Birth is most times not an emergency, and shouldn’t be “treated” by a doctor unless it IS an emergency.

          • Eddie Sparks
            November 15, 2013 at 10:19 pm #

            Doctors treat and care for patients in non-emergency situations ALL THE TIME. Why would pregnancy and birth be any different?

          • Samantha Anderson
            November 15, 2013 at 10:21 pm #

            Because there isn’t anything WRONG with a normal, healthy birth. You’re comparing apples to oranges. Doctors are available in situations where somtehing is awry, wrong, bad, unexpected. A healthy, normal birth is not an illness to be treated.

          • Stacy21629
            November 15, 2013 at 10:23 pm #

            So I take it you forego all pediatric wellness visits and never have a physical exam yourself? No yearly well-woman’s visit? No pap smears? No mammograms? Afterall, there’s nothing wrong. Why do you need a doctor?

          • Samantha Anderson
            November 15, 2013 at 10:29 pm #

            That’s a good try, but I never said that a doctor should not be present, or even nearby. Why are we so terrified that we need a doctor holding our hands through birth? I guess this is why the holy Dr. Amy has her following.

          • Stacy21629
            November 15, 2013 at 10:31 pm #

            Why do I want a doctor holding my hand? Oh, just a trivial little thing like my baby’s life.

          • Ennis Demeter
            November 16, 2013 at 6:58 pm #

            Yeah, it’s not like it the highest stakes thing in my life or anything.

          • Stacy21629
            November 15, 2013 at 10:32 pm #

            Again, what was the last birth death story you read?

          • November 15, 2013 at 10:42 pm #

            Because birth is terrifying. It’s painful and long and could kill you and/or the baby you’re trying to bring into the world.

            Births are almost always normal and healthy … until they’re not. That chance of something going wrong is scary. It’s not worshiping anyone (and no one here worships Dr. Amy- the very idea is absurd) to acknowledge that fact.

          • S
            November 15, 2013 at 11:57 pm #

            Dr. Amy supports CNMs working in hospital along with OBs.

          • Amazed
            November 16, 2013 at 3:46 pm #

            Who on earth said a doctor should “hold our hands through birth”?

            Methinks you’re setting a false dichotomy and you’re putting words into Dr Amy’s mouth. She never wrote that ‘hospital” means doctors and only doctors. But I guess it’s easier to create a strawman and fight him valiantly than address the actual points.

          • Captain Obvious
            November 17, 2013 at 8:45 am #

            How do you believe lay midwives trained in normal birth only can recognize when something goes wrong to transfer you to a doctor? How many Internet stories post that their lay midwive believes that AMA, FTM, breech, HBAC, twins, etc are just variations of normal? How many don’t get appropriate fetal monitoring, even when intermittent? I post to you many cannot recognize when something is needing a doctors are until its too late.

          • 1personvoice
            November 20, 2013 at 5:24 am #

            Why are women being called chicken for not birthing at home?

          • Eddie Sparks
            November 15, 2013 at 10:30 pm #

            Doctors are also available in situations where everything is perfectly fine, but people are wanting information, reassurance, screening tests, preventive medicine, well-being checks, ante-natal and post-natal checks, etc. etc. Midwives, nurses and other health care professionals also provide care in these situations. Its not a competition.

            A healthy, normal birth can be (and frequently is) attended by a doctor without…. well…. Actually, I’m not sure exactly what you are suggesting that doctors do in such situations that is so bad?

            In addition, as Feminerd pointed out, doctors have an important role in preventing emergency situations from developing.

          • rh1985
            November 15, 2013 at 10:36 pm #

            I’d prefer to be monitored and cared for by a professional who is trained in what to do if something does go wrong – a doctor.

          • Samantha Anderson
            November 15, 2013 at 10:38 pm #

            Well there ya go.

          • The Bofa on the Sofa
            November 18, 2013 at 10:31 am #

            How do you know if something isn’t fine if you aren’t monitoring properly? How do you respond to something being not just fine if you aren’t prepared?

            The first step in being able to intervene “when something goes wrong” is being able to recognize when there is something that isn’t right. The way to do that is to monitor properly.

          • FormerPhysicist
            November 16, 2013 at 7:07 pm #

            Well, I’ve never had one of those. I’ve had three lovely, healthy children, but no healthy, “normal” births.

          • 1personvoice
            November 20, 2013 at 5:21 am #

            But what if you’re 10 minutes away from the hospital and you need immediate emergency services. Seconds count in those cases. Low risk is not no risk. There are no guarantees, no one can see the future. Most people don’t gamble with their children’s health.

          • November 15, 2013 at 10:23 pm #

            Birth is one of the most dangerous things most women in Westernized countries will ever do. Seriously- you’re more likely to die in childbirth in the US today than you are to get hit by lightning (and most people struck by lightning also survive). No, it’s not usually an emergency, but given that ~600-700 women die per year, 30,000 nearly die, and over 1 million are permanently injured in the US alone, I think better safe than sorry. The whole point of having an OB there is to prevent emergencies. If it gets to the bloody screaming OMG OMG everything is going to Hell phase, usually someone has already failed.

          • dance commander
            November 16, 2013 at 2:38 pm #

            No, it’s not usually an emergency, but given that ~600-700 women die
            per year, 30,000 nearly die, and over 1 million are permanently injured
            in the US alone

            Do you have a link for that. I think I had it at one time, but now I can’t find it:((

            I am currently debating some people who are arguing that pregnancy only disfigures, it doesn’t disable, like, ever, and that it’s not right to ‘murder a child’ as preventative healthcare.

          • November 17, 2013 at 12:55 am #

            “That means each year in the U.S., about 700 women die of pregnancy-related complications and 52,000 experience emergencies such as acute renal failure, shock, respiratory distress, aneurysms and heart surgery. An additional 34,000 barely avoid death.”

            Data modeling suggesting 21/100,000 US maternal mortality rate

            In 2004/2005, 1.7 million women per year suffered adverse health effects

          • dance commander
            November 17, 2013 at 12:16 pm #

            Thank you kindly!

          • The Bofa on the Sofa
            November 18, 2013 at 10:28 am #

            If you have an emergency, you have gone too far.

            The whole goal of interventions is to PREVENT emergencies. We want to avoid emergencies, because they are, by definition, the most dangerous times. I prefer to avoid dangerous situations myself.

          • guest81
            November 20, 2013 at 5:37 pm #

            But how far should doctors and hospitals go to prevent emergencies? You can never eliminate all risks. And even procedures that are preventative and meant to avoid emergencies – carry their own risks associated with them.
            Unfortunately, no doctor can predict the likelihood of an emergency occurring in the case of a normal, run of the mill pregnancy.

          • 1personvoice
            November 20, 2013 at 5:17 am #

            I believe a place to be monitored while birthing with a doctor nearby is called a hospital.

          • Samantha Anderson
            November 15, 2013 at 11:09 pm #

            re: “Hurt by Homebirth”

            I have visited that site. It is truly heartbreaking to read of deceased babies and makes me want to go hug my own healthy baby right this minute. I would never, ever consider a homebirth (although I know several women who have had great ones). Although everything is SUPPOSED to go right, and I’m a young, active, healthy woman, I would never be 25 minutes away from emergency care. Ever.

          • Bombshellrisa
            November 15, 2013 at 11:58 pm #

            They can also diagnose the degree of tears and stitch them up properly. I think I have watched “A Walk to Beautiful” too many times to rail against “evil interventions”.

        • Bombshellrisa
          November 15, 2013 at 11:12 pm #

          But homebirth in Sweden is rare, women have better access to prenatal care and the midwives there are highly trained. It’s sad, but race and socioeconomic factors are part of intervention rates in the US.

          • Samantha Anderson
            November 15, 2013 at 11:14 pm #

            Then what we’re really railing against is racism and untrained “experts” and poor prenatal care.

          • Stacy21629
            November 15, 2013 at 11:21 pm #

            “Then what we’re really railing against is…untrained ‘experts'”

          • Bombshellrisa
            November 16, 2013 at 12:14 am #

            It would be silly for Dr Amy to rail against things like choosing to birth without an epidural, breast feeding and choosing to carry your baby everywhere (Since she wrote about doing all those things). Puts things on this blog in the proper light if people are willing to read a little before imagining they “know” what she is saying.

          • Vyx
            November 15, 2013 at 11:22 pm #

            Ummm….yes? That’s kind of the point of this blog.

          • Samantha Anderson
            November 15, 2013 at 11:25 pm #

            But there’s no wiggle room. You’re either a psycho attachment helicopter parent or you’re what? When you consider yourself pretty “crunchy”, fairly attachment-style, breastfeeding, and you visit a blog like this it is extremely polarizing. No one will ever change their attitude after reading something as condescending as “Attachment parents don’t bond with their babies.”

          • Vyx
            November 15, 2013 at 11:29 pm #

            Perhaps you are reading this post literally instead of as satire, then?

          • Stacy21629
            November 15, 2013 at 11:31 pm #

            Ding! Ding! Ding!
            3 votes for satire! Woo!
            There’s gotta be some kind of prize, right?

          • Bombshellrisa
            November 15, 2013 at 11:52 pm #

            I can’t believe one of us didn’t scream BINGO on the other thread-surely we filled a card of some kind over there (ok ok, not the homebirth bingo card. Anyone here want to create a lactovist bingo card?)

          • November 15, 2013 at 11:33 pm #

            Since that was never said in any seriousness, unless the crunchy, attachment-style, breastfeeding parent is completely incapable of understanding satire, I see no reason this hypothetical person would be scared away or offended.

          • Stacy21629
            November 15, 2013 at 11:33 pm #

            “No one will ever change their attitude after reading something as condescending as ‘Attachment parents don’t bond with their babies.'”
            Obviously, calling them “stupid” and “Ignorant” works better.
            I find natural birth websites rather polarizing – especially since they exist in a vacuum and filter out dissent.

          • Ennis Demeter
            November 16, 2013 at 6:51 pm #

            When you warn women they are risking their babies’ lives, apparently you are being polarizing.

          • Stacy21629
            November 15, 2013 at 11:36 pm #

            It’s also interesting to note that you could park a Mack truck in the amount of “wiggle room” YOU allow women in terms of labor, positioning, monitoring, pain medication, feeding.

          • Bombshellrisa
            November 15, 2013 at 11:50 pm #

            Definitely railing against the poor or inaccessible prenatal care and the goofy lay/direct entry/CPM midwives.

          • Name
            November 16, 2013 at 2:09 pm #

            why is race a factor, don’t you offer the same help to non whites as whites in america?

          • Bombshellrisa
            November 16, 2013 at 3:43 pm #

            Immigrants and people of color are less likely to have access to medical care, prenatal or otherwise. Meaning that any preexisting conditions are not diagnosed and well controlled before pregnancy. So it’s more likely for them to end up having complications and needing interventions.

          • Jenny Star
            November 20, 2013 at 8:12 am #

            Waaait, I thought pregnancy was so easy and natural that there was no need for evil outside medical help. You can’t have it both ways.

      • Lisa
        November 19, 2013 at 12:48 pm #

        Natural childbirth oftens end with the death of the baby and mother??? Really??? Your sources are a little bit wrong. Netherlands have one of the better childbirth outcomes, they birth mostly at homes, they have midwife care, not obstetrician, they just take care of high risk women, that’s why they are for. In USA the % of homebirths is less than 1% and the outcomes are very bad for a First World Country. Don’t you think there’s something wrong with USA’s maternity care? Of course not, as your source of knowledge is Dr. Amy.

        • Poogles
          November 19, 2013 at 2:00 pm #

          “Netherlands have one of the better childbirth outcomes, they birth mostly at homes,”

          Wrong and wrong. They do not birth “mostly” at home, and low risk women who birth at home with a midwife have a HIGHER death rate than high risk women who birth with OB’s in the hospital. See this article Dr. Amy wrote, making sure to read the actual studies she links to (wouldn’t want to just take her word for it, right?):

    • Antigonos CNM
      November 17, 2013 at 12:58 am #

      Obstetricians are power-hungry God-complex meddlers who can’t wait to get their hands into a woman’s womb.

      Even female OBs? More women are going into OB these days than men. [Which makes me wonder about this “birth rape” nonsense: can a female OB “birth rape” another woman?]

      • Trixie
        November 17, 2013 at 2:10 pm #

        Although not terribly common, women can sexually assault other women. Although it’s a moot point since birth rape isn’t a real thing anyway.

      • Bombshellrisa
        November 17, 2013 at 2:53 pm #

        I guess if cervical exams and routine OB interventions that are defined as birth rape then any OB, male or female, is capable of being accused of it.
        Ina May Gaskin is guilty of sexual assault during the birthing process, and these followers of hers refuse to call her out on it.

    • Something From Nothing
      November 20, 2013 at 7:58 pm #

      It is extremely hurtful from my perspective to read those words. I’ve given more than half my life to the care of women through my training and work as an ob. ” power hungry?” “God complex?” My work makes me feel a lot of things, but powerful, isn’t one of them. As for god complex, well, that’s pretty easy to say, but it’s pretty meaningless. I’m humbled by the enormity of what I experience through my work on a regular and ongoing basis. I really find it hard to believe that you feel that way about the people who choose to dedicate their lives to the practice of obstetrics.

  7. Teleute
    November 15, 2013 at 5:39 pm #

    Also, consider how many mammals cannibalize their defective young. Do Mamabears belong eating every baby born with jaundice (is that even safe?) or a cleft palate? Then again, perhaps eating the placenta is simply an attempt to recreate this.

  8. meglo91
    November 15, 2013 at 2:31 pm #

    I cannot like this post enough. Nature is a bitch. Nature is not to be trusted. I trust science.

  9. Dr Kitty
    November 15, 2013 at 2:10 pm #

    OT update: all went well today, my OB says I should consider myself fertile!

    My daughter and I have been dancing around the living room for the last hour, and I have been reconsidering whether I have the stamina for a second!

    • S
      November 15, 2013 at 3:06 pm #


      • S
        November 15, 2013 at 3:10 pm #

        Shit, missed the punctuation, makes it look sarcastic!

        I meant, Hooray!!!

    • Bombshellrisa
      November 15, 2013 at 3:19 pm #

      Woo hoo! Thinking fertile thoughts for you!!’ That part about dancing sounds like fun!!

    • Mishimoo
      November 15, 2013 at 5:28 pm #


  10. Deborah
    November 15, 2013 at 11:49 am #

    You could argue (and the HB midwives certainly will) that dairy cows are a poor example of nature because of how they’ve been bred. But I challenge you all to look at a true example of nature in action, the spotted hyena. 10% death rate for first-time moms, and for those who survive, 50% death rate for the cubs in that first litter. Nature is a bitch.

  11. Esther
    November 15, 2013 at 12:44 am #

    Homebirth death in Israel attended by a CNM, death due to hypoxia from cord around the neck (sorry, only Hebrew link):,7340,L-4453658,00.html . Antigonos, have you heard anything else about this?

    • Antigonos CNM
      November 15, 2013 at 4:24 am #

      I generally don’t read the Hebrew press, but I’ll check out your link, thanks.

      • Antigonos CNM
        November 15, 2013 at 4:37 am #

        OK, read the article. For one thing, since all licensed midwives in Israel are the equivalent of CNMs, I’m not surprised to read that one attended the labor. I know several who attend women in the area mentioned [name of town or village not specified]. I have worked with a couple of them in years past when the hospital I worked for allowed staff midwives to accept private patients. If the midwife was one of these, she is a competent midwife, but, as always at home, there is no way to do EFM, and intermittent auscultation of the FHR may not disclose fetal distress. The article itself is rather vague. Length of labor, whether the mother was a primip or multip, number of times the cord was around the neck, how long it took for the paramedics to arrive, whether the midwife immediately attempted to resuscitate the baby [she should know how] are among the things the article does not describe, so it is hard to really know what happened.

        It just goes to show why home birth is not really a feasible proposition no matter how low risk the patient, how skilled the midwife, or how quickly transfer can take place. Romantic — yes, possibly, but not really sensible. In hospital, a baby born blue and limp would be in a pediatric team’s hands within seconds, intubated and getting O2 and other resuscitative measures almost immediately — and might have been born by emergency C/S if monitoring showed more than type 1 decels.

        • EmbraceYourInnerCrone
          November 15, 2013 at 9:44 am #

          My 21 year old nephew was born in hospital in similar circumstances(cord wrapped tight around his neck twice). He ended up being fine. The difference being that my sister had constant EFM and when they detected the problem the OB had the equipment to deal with it and, an NICU team available to work on the baby as soon as he was born.

          I realize however that my sister was lucky enough to be delivering with an OB, in a University Hospital with a Level III-C NICU.

          A smaller local hospital or rural birth center would not have all of the things that were available to her…

          • Antigonos CNM
            November 15, 2013 at 12:55 pm #

            In this instance the key factor was EFM, because there are decelerations which are typical of cord around the neck, or occult prolapse. Generally, when we see such type 1 decels, nothing happens immediately except that everyone keeps an eye on them. Should they become a more serious form of deceleration, type 2 as it is called, or if the beat to beat variability is reduced or absent [auscultation cannot show this], then it is time to move quickly to get the baby delivered. So what is needed — and this can be available in a small hospital — is EFM, and professional staff who know what to do. A birth center, where a woman has to be transferred to a larger hospital for C/S, is just about as bad as a home birth, unless the woman is transferred very early on.

            For some years I worked at a “cottage” hospital which did not have an NICU. We did have some high-risk patients on bedrest, but we transferred them almost with the first contraction to a hospital with an NICU, since the best incubator is the uterus. When a woman delivered so rapidly that transfer was impractical, we did have the staff and facilities to stabilize the infant, and then transfer via ambulance, even when the baby was being ventilated. On occasion the Head of the NICU at the receiving hospital was on hand for the delivery so he managed the care from the instant the baby was born.

        • MichelleJo
          November 16, 2013 at 3:00 pm #

          And guess what the first comment is…”Babies die in the hospital too.”

          • Antigonos CNM
            November 17, 2013 at 12:55 am #

            In fact, Israel’s neonatal morbidity and mortality stats are better than the US [which, after all, is a MUCH bigger country without a free antenatal care service for all women, so it’s not all that surprising]

            This, however, seems to have been a totally preventable death, which is one reason it is so horrifying.

  12. Young CC Prof
    November 14, 2013 at 9:36 pm #

    Actually, this xkcd perfectly explains why the popularity of homebirth midwives may not be a fair measure of their quality:

  13. guest
    November 14, 2013 at 8:01 pm #

    Just saw that Jill and Jana Duggar (from 19 kids and counting) are training as lay midwives and promoting it on their TLC show.

    • Trixie
      November 14, 2013 at 9:00 pm #

      Oh, wonderful. Just what I want, people who don’t believe in science and don’t believe in the MMR vaccine delivering babies.

      • MichelleJo
        November 16, 2013 at 3:04 pm #

        Didn’t know they were anti-vax. She DID have her babies in a hospital and regular ultrasounds.

        • Trixie
          November 16, 2013 at 3:25 pm #

          Not all of them. She had a bunch of home births too. They are against the MMR because of the aborted fetal tissue cell line thing.

    • Zornorph
      November 14, 2013 at 9:00 pm #

      Well, that family is expert on getting laid, anyway.

      • Antigonos CNM
        November 15, 2013 at 4:38 am #

        Maybe they should be training sexologists, then.

      • The Bofa on the Sofa
        November 15, 2013 at 11:14 am #

        We don’t know that. Maybe they are experts on determining their ovulation cycle? All we know is that they have had sex at least 19 times.

        • Trixie
          November 15, 2013 at 1:36 pm #

          Well, two sets of twins and one miscarriage, so, 18 times.

          • MichelleJo
            November 16, 2013 at 3:02 pm #

            two. One after Josh, one a couple of years ago.

          • Trixie
            November 16, 2013 at 3:25 pm #

            You’re right.

    • Stacy21629
      November 15, 2013 at 8:50 pm #

      Gotta love the commenter that just has to throw in her birth video. Like everyone on the thread is interested in seeing her vagina. Oy.

  14. Cellist
    November 14, 2013 at 7:40 pm #

    Completely OT.
    IVF-Doc happy for me to transfer either 1 or 2 embryos.
    I’m 32, healthy, (IVF due to hubbies illness, and side effects of treatment, after 5 years we are almost at the finish line! yay!).
    Any thoughts as to whether to transfer 1 or 2?
    Feed back would be great!

    • Young CC Prof
      November 14, 2013 at 9:15 pm #

      Did the doctor give you odds on each embryo implanting? And how upset would you be if both embryos took?

      • Cellist
        November 15, 2013 at 12:31 am #

        I’d be thrilled if both embryos took! We always planned on 4-5 children. But having a family that size is obviously less likely now.

        • Antigonos CNM
          November 15, 2013 at 4:42 am #

          34 is not ancient. How long have you been in treatment? If you were 38 and had been trying for 5 years, it would be different.

          • Bombshellrisa
            November 15, 2013 at 10:42 am #

            On a side note: thank you! I know my chart says “elderly” pregnancy because I will be four weeks over 35 when my baby is born in February and I know advanced maternal age is no joke but DANG! If I have to hear about how “old” I am at one more doc’s appointment I am going to scream.

          • amazonmom
            November 15, 2013 at 11:01 am #

            Yes, I’m 38. I think my OB is the only one that doesn’t remind me of that! She just tells me what I need done.

          • Bombshellrisa
            November 15, 2013 at 1:55 pm #

            What is funny is it’s the PA in my doc’s office who keeps talking about it, not my doc. I have found its one of the hazards of going with a practice of younger docs. I miss my “older than dirt” OB and her experience with high risk women (she delivers at Swedish First Hill-over 7,000 birth there a year, you are gonna get experience whether you want to or not)

          • amazonmom
            November 15, 2013 at 5:20 pm #

            Yeah, my doc has 3 grown kids and I guess would be considered an older doc. We did have a small discussion about my age in the beginning. She didn’t get too excited about it! She likes to point out my risks of complication versus the risks for the highest of high risk patients I tend to deal with. When all you see is sick patients you to tend to forget that things usually go well!

          • Deborah
            November 15, 2013 at 11:32 am #

            I write “advanced maternal age – barely” in the chart for situations like yours.

          • Antigonos CNM
            November 15, 2013 at 1:01 pm #

            I gave birth the first time at 33, the last at 38, so you are still a “youngster”. In my case, after 48 hours of strong but dysfunctional labor, the OB said that I didn’t have a cervix but a “Rav-Bariach” which is the name of a brand of steel security door. In my year in the UK, anyone over 30 giving birth for the first time was an “elderly primip” which I thought was a bit much.

            With today’s much improved early prenatal testing, 40 is no longer the distinct cut-off date it used to be. True, conditions like Down Syndrome are still much more prevalent over 40, but unless a woman has a strong aversion to the idea of abortion for any reason, a termination can usually be done very early. Even the most fervent pro-choice woman generally finds ending a pregnancy [where it is legal] once she’s felt fetal movements very traumatic.

          • Bombshellrisa
            November 15, 2013 at 1:49 pm #

            I did have a Harmoni test done-I would have followed up with an amnio if needed-but I agree, terminating at that point would have been traumatic for me. I have a lot of women in my family who gave birth in their mid 30’s and into their 40’s. While I don’t want to have that give me a false sense of security, it also offers a little perspective.

    • L&DinSoCal
      November 14, 2013 at 9:27 pm #

      Transfer 1 and be thrilled. I’ve seen so many losses of IVF twins at 18-24 weeks. These mothers always wonder, “what if? What if I hadn’t pushed the envelope? What if I had been satisfied with one?” Of course it probably will work, but the morbidity and mortality rate of twin gestation IVF pregnancies is higher than with singleton IVF.

      • Cellist
        November 15, 2013 at 12:33 am #

        I think that is what I am moving towards. My heart is saying two, but my head is saying (yelling?) one.

      • Carolina
        November 15, 2013 at 10:04 am #

        Is the morbidity/mortality of IVF twins higher than non-IVF twins? If so, why?
        (haven’t gone to that form of ART yet, but I may be getting there soon, so I’m curious).

        • Amy M
          November 15, 2013 at 10:50 am #

          My guess is that embryos that would otherwise not have been conceived (with possible genetic mutations) might end up implanting, but not making it to maturation. That might be more likely with older women as well as if the father has poor sperm quality. Also, the population of people who turn to IVF includes women who have various issues like blood clotting disorders/autoimmunities and other high risks for miscarriage, and many have had previous miscarriages.

        • MichelleJo
          November 16, 2013 at 3:38 pm #

          I think there is a higher morbidity with IVF twins. I’m not an expert or professional on this, so don’t do anything based on what I say, but when I lost a spontaneous-non-identical-twin pregnancy quite early on, I got weary of answering, no, this was *not* an assisted pregnancy. At one point, a doctor asked me that same question three times, as if I might have forgotten or something. So it would seem that if it was an assisted pregnancy, it would have been far more expected.

    • Alexicographer
      November 14, 2013 at 10:46 pm #

      The Cochrane Collaboration has addressed this: .

      To hit the highlight — “Conclusion:
      Repeated single embryo transfer appears the best option for most women undergoing ART. Most of the evidence currently available concerns younger women with a good prognosis.”

      My own read of the data (IVF mom at an older age, I did have 2 put back but never more, going against the advice of my doctors in insisting on so few. But I was entirely clear that for me personally there were possible outcomes far worse than never getting pregnant.) is that additional embryos (likely more than one and certainly more than 2) don’t increase the likelihood of achieving a pregnancy much if at all, but do increase the likelihood of a problematic pregnancy — if one is realized at all — dramatically.

      Good luck to you, whatever you decide.

      • Cellist
        November 15, 2013 at 12:39 am #

        Great link – thank you!

        “I was entirely clear that for me personally there were possible outcomes far worse than never getting pregnant.” – That is a really, really, good way of putting it. 🙂

        • drsquid
          November 15, 2013 at 4:18 am #

          i put back 2. both stuck, went 38 w 5 days and went into labor at 3am on the day i was to be induced. vaginal delivery (with vacuum assist for baby b). so there is my anecdata.

      • Cellist
        November 15, 2013 at 12:51 am #

        Great link! Thank you!

    • Antigonos CNM
      November 15, 2013 at 4:40 am #

      What does your doctor advise? I know that some OBs advise transferring two, as it somewhat improves the chances of one surviving to term [or two!], but you should really base your decision on what the OB says; he is, after all, the expert.

    • Amy M
      November 15, 2013 at 7:48 am #

      My personal anecdata: I transferred one on the advice of the RE, at age 31. I now have identical twins.

    • Kerri
      November 15, 2013 at 8:31 am #

      I transferred two, but only one took. Even now knowing the struggles with twins (bed rest, NICU, etc), I still think I would have gone with two. However, I think it would also depend on the quality of the embryos (I think mine were “Excellent/Good” and if you have any left to freeze (I didn’t). Good luck! I know this is so so stressful. Hopefully it is almost over…

  15. November 14, 2013 at 5:10 pm #

    And like most infatuations – it will have a tendency to lead to heart break.

  16. Elle
    November 14, 2013 at 4:58 pm #

    Great analogy, and this parallels so well with the “real food” movement too. Organic food is nice if you can afford it, but it sure won’t solve all the problems many claim it will. People still had many of the same health problems before pesticides as they do now.

  17. OBPI Mama
    November 14, 2013 at 4:38 pm #

    While I tend to lean towards “natural” remedies first (plain yogurt on bottom rashes, olive oil with garlic in the ears for ear infections, peppermint oil for headaches, etc), I never blindly trust it’ll work. Many times it does, but there have been times it doesn’t and so what do I do? I go to the doc for the big guns (meds). The thing is… these are non-emergency situations when trying the non-medicated treatments isn’t life-threatening. With my son’s birth injury, I do take him to the pediatric chiropractor… but I also take him to therapies and to specialists at children’s hospitals. I cringe at how I trusted birth so blindly. We farm for goodness sake and somehow I believed nature was more kind to people than livestock. How foolish I was. I will never trust nature again with life and death circumstances again. Very good post, Dr. Amy.

    • Trixie
      November 14, 2013 at 6:18 pm #

      Pediatric chiropractor? You don’t let him work on your child’s neck do you?

      • OBPI Mama
        November 15, 2013 at 7:01 am #

        Very rarely does she mess with his neck. Usually it’s his back and hips and arm. Because of his lack of mobility in his arm, it locks up sometimes (even with ROM exercises) and creates compensation in his back. I made sure to ask his children’s hospital specialists and therapists if it was okay to take him to her and they said, “Yes, it’s fine. You might not see anything from it, but it’s fine.” We go once every 4 weeks, so it’s not a 3x a week thing.

  18. Trixie
    November 14, 2013 at 1:44 pm #

    I know a woman who just had her third child. She was attempting her second VBAC, and everything was progressing normally, until the baby suddenly turned transverse and the cord prolapsed. Thank goodness she was in the hospital, they had the baby out in 5 minutes and everyone is fine.

    • Tracey
      November 14, 2013 at 4:22 pm #

      Thank goodness they were ok. This makes me think of homebirth in the UK, which I am desperately worried about as people seem to assume it is safe. I was told by NCBers that the operating theatre takes 40 minutes to set up so it doesn’t matter if I needed to transfer. Rubbish! If an emergency happened in the hospital, it wouldn’t take 40 minutes to set up the theatre!!

      • Kate B
        November 14, 2013 at 5:43 pm #

        That’s true Tracey. It seems to be assumed in the UK that homebirth is safe and that there’s good evidence proving it’s safety.
        I think homebirth in the UK is undoubtedly safer than homebirth in the US. Our midwives are all medical professionals, and the equivalent of US CNMs; two midwives must attend the actual delivery and high risk births will not generally be attended at home, unless the mother is paying for an independent midwife.
        However, the ‘you-can-always-transfer’ trope bothers me, because when things go wrong in childbirth they can go wrong very quickly and ten minutes can make the difference between life and death.
        What if, for example, the baby’s shoulders were stuck? How easy would it be to transfer a woman in this condition to hospital? What if she started hemorrhaging? Or suffered a placental abruption? Minutes count in these situations.

        • Ob in OZ
          November 14, 2013 at 6:04 pm #

          What you have written is what I assume should always end any discussion about homebirth. There are a few rare events in which minutes matter, and they are typically unpredictable in that there are no risk factors at the time. Unless your home is attached to the hospital, you will never get to the operating room in time to minimize the damage. Every hospital that does obstetrics has the ability to go from decision to incision in less than 30 minutes, and almost all in less than 15 for a true emergency. Sometimes problems can be fixed or minimised while waiting (like meds to control bleeding, stop contractions, etc) that are only available in the hospital which is great because even 15 minutes is too long when a babies brain function is on the line.

          • Allie P
            November 14, 2013 at 11:29 pm #

            I always just want to link to the birth story on Young House Love, in which a healthy, organic-food-eating, non-drinking mid-twenty-something primip with an uneventful pregnancy suffered a spontaneous simultaneous cord prolapse and placental abruption in the hospital (during normal, unmedicated labor) and nearly died despite the baby being born by emergency CS a mere minutes later. You can eat all the kale you want to eat. S* happens. That mother did everything “right”, including choosing to have her baby in a place where, if the S* happened,, there were people and facilities that could save her daughter’s and her own lives.

        • Sue
          November 15, 2013 at 3:04 am #

          We know the actual UK outcomes from the Birthplace Study. That’s how we know that, despite having a tight risk-out policy, and a 40% transfer rate, primips still had 3X excess neonatal mortality.

          We have similar data from Australia, with formally supervised (small) HB services.

          And they didn;t measure of report the disability…

          • MichelleJo
            November 17, 2013 at 3:53 pm #

            Nice to hear what my survival chances were. I am a UK home birth survivor. My Mom’s GP was supposed to deliver, but apparently I was already yelling while he was coming up the stairs. There was an NHS midwife there. I also don’t know what my birth weight was because the way I was weighed was by my Dad standing on the bathroom scales and then me being handed to him. They reckon I was around 7 lbs. I don’t think my mom thought she was doing something reckless though. I was her third birth after two uncomplicated births and it had been a normal pregnancy. And a doctor was going to deliver. She did it because she hated the only maternity hospital in that part of the country, and thought what she was doing was safe. I can’t imagine her having bragged about it, and she’s certainly not the NCB type. I don’t need to enunciate on this board why it was still pretty risky, but no-one told her so. (It was before the days of water births – luckily for me.)

        • Tracey
          November 15, 2013 at 3:30 pm #

          It is so nice to hear so many people point out that rare things do actually happen. Something may be statistically safe, but rare things do still happen, with devastating consequences if you’re in the wrong place.

      • Lynnie
        November 14, 2013 at 7:32 pm #

        When I worked in the hospital, we always kept one of the ORs ready for c-sections.

        • amazonmom
          November 15, 2013 at 1:34 am #

          That’s just what I was going to say, we have an OB OR ready to go at all times.

      • Young CC Prof
        November 15, 2013 at 1:52 am #

        Maybe they’re thinking of their friends’ semi-emergency c-sections, where it DID take half an hour to an hour to get everything set up, precisely because it wasn’t a crisis yet.

    • L&DinSoCal
      November 14, 2013 at 9:37 pm #

      I’ve been a labor nurse for 17 years. I’ve seen four uterine ruptures during TOLAC. Everyone lived, two women had hysterectomies and one was in critical condition for over a week. There’s no way of knowing how many suffer from PTSD, but it surely takes it’s toll on the patient, family and staff. “Everything was progressing normally”….until it didn’t. That is the problem with homebirths. Sometimes nature wins and what should be “normal” is now life threatening. Home birth is to who’s glory? Bragging rights for the parents? I doubt any mother of a child with cerebral palsy after a homebirth retells her heroic story of birth as performance art with much enthusiasm. I save the life of a baby at least once a month. I save the life of a mother a couple times a year. Homebirths are for narcissistic fools.

      • Trixie
        November 14, 2013 at 10:24 pm #

        To be clear, she had already had a successful VBAC — so she was low risk as a VBAC candidate this time around. From what I understand she did not rupture and it was due to the baby changing position.

        But, I also had my VBAC in the hospital, and it was so nice knowing the OB and anesthesiologist were right outside the door if I had needed them in a hurry.

      • Antigonos CNM
        November 15, 2013 at 4:44 am #

        “Everything was progressing normally”….until it didn’t.

        That is the total, absolute, crux of the issue.

  19. Mel
    November 14, 2013 at 1:41 pm #

    Maintaining a belief that trusting nature leads to positive birth outcomes requires not being around many births. Humans and dairy cows have a lot in common in this respect.

    Looking back at our records, here’s why I don’t trust “Nature”.

    Out of the 1st hundred births this year:
    19 assisted births – use of obstetric chains/calf puller and/or the vet.

    88 live calves
    16 still-born calves
    2 calves born brain-dead but breathing
    Four dam fatalities within 24 hours.
    Two dam fatalities between 25-3 weeks.

    (These numbers are crappy, really. We had a bull that was producing terrifying large calves which lead to some horrible, horrible births. Thankfully, we only used him for 2 months before a bull that we raised on our farms and knew the genetics of matured.)

    Without assistance, the numbers would have been closer to:
    66 live calves
    34 dead calves
    2 brain-dead calves
    19 dam fatalities within 24 hours.

    • Certified Hamster Midwife
      November 14, 2013 at 2:06 pm #

      Curious, how many of these were twins?

    • Trixie
      November 14, 2013 at 2:17 pm #

      But don’t you realize that cows won’t grow babies their bodies can’t deliver? Those are just variations of normal!

      • OBPI Mama
        November 14, 2013 at 4:20 pm #

        memory of pulling a calf with a tractor comes to mind… this variation must have been because she she was stressed out though. And she had low self esteem in her body… she should have believed in her ability and her body would have been able to deliver the calf! DUH!

        • Antigonos CNM
          November 15, 2013 at 4:53 am #

          Death is a variation of normal.

      • Mel
        November 15, 2013 at 8:37 am #

        Especially if dead is a normal variation of alive!

    • AmyP
      November 14, 2013 at 3:10 pm #

      My family ranches on a small scale and I think our numbers are generally better, but my dad and grandpa have been very careful over the last few years about using bulls that produce calves of the appropriate size. (I remember a lot more calf-pulling back when I was a kid.)

      Very few women size up prospective mates with this issue in mind. (“The babies in your family are all over 10 pounds? Check please!”)

      • Awesomemom
        November 14, 2013 at 3:34 pm #

        My mother in law had all small babies because she has a ridge in her uterus that would eventually mess with the placenta. She had two still born babies because the placenta implanted too close to the ridge and things went bad too early for anyone to do anything about it. So I could not have used my husband’s birth size to judge the size of our offspring which all ended up being big with giant heads. Thank goodness for csections.

      • Mel
        November 15, 2013 at 8:27 am #

        Yeah, we were in a Catch-22 situation. During that period, we were in the process of financing a heat detection system when our previous bull failed due to an injury. Normally, we’d have a suitable bull available but none of our bulls were quite tall enough to breed the cows yet. We AI’d the cows that came back into heat then used the bull for clean-up. The bull we bought had a decent pedigree of calving ease, but for some reason his calves, especially bulls, were huge – and badly prone to hip-lock. Oh, yeah, and he threw around 75% bull calves – a major disadvantage for a dairy bull. My husband made the call to sell the bought bull as soon as one of our home-bred bulls got tall enough which probably saved 30 dams or more.


        • The Bofa on the Sofa
          November 15, 2013 at 10:06 am #

          Oh, yeah, and he threw around 75% bull calves

          How does that happen?

          • Mel
            November 15, 2013 at 11:19 am #

            The trick is that some bulls – especially young bulls – are so excited by getting to mate that they are very effective at breeding cows as soon as they go into heat. If a cow is bred right at the beginning of the heat cycle, the mucus levels in the reproductive system is still copious and sticky. In those circumstances, the lesser weight of the Y bearing sperm lets them move faster than the X bearing sperm.

            We usually put a young bull with heifers. The bull is raring to go, but the heifers are confused by the whole heat cycle thing so it takes more time for the bull and heifer to figure out the process. By a few hours into the heat cycle, the mucus consistency is much more fluid and the gender ratio moves back to even.

            Mature cows have more experience being bred and are much more willing to be mounted and bred by a bull. (The family tells a story about a 8 year old Brown Swiss who was 6 feet at the shoulder being bred by a 4 foot at the shoulder Holstein young bull within 30 seconds of the bull being moved into a group. All four of his feet were off the ground, but the cow got pregnant.) Mature cow + young bull = lots of male calves. That’s what probably happened with this bull.

            Some sires do tend to produce more Y sperm than X sperm (and vice versa). To prove that, you need to examine the sperm or use it in AI where the timing of breeding is set up to avoid the early breeding male penalty.

            Every AI producers dream dairy bull has calving ease, great milk producing daughters and throws more daughters from non-sexed sperm. If it’s homozygous polled (all calves are born without horns), you’d make millions.

    • OBPI Mama
      November 14, 2013 at 4:05 pm #

      So glad you bought a different bull! We also farm and my ob/gyn thought it was funny I asked if the husband’s birth weight, like bull’s birth weight, matters when it comes to offspring size. After the biggest smile and chuckle, he said no… but I still think he’s wrong!!! haha. DH was 10.3 and my babies average that. After a shoulder dystocia with my first, so thankful for c-sections… and for not being a cow!

      • Mishimoo
        November 14, 2013 at 5:49 pm #

        I asked the same question and was answered with “We don’t quite know because there are many factors to consider.”
        I was 9lb, 15oz, my husband was 5lb, 1/2oz – our kids have gradually gotten bigger, but I was expecting them to be giants to begin with. I was pleasantly surprised: eldest was 6lb, 3oz; second was 7lb, 6oz; third was 8lb exactly.

        • Young CC Prof
          November 14, 2013 at 9:18 pm #

          As far as I understand it, the family’s size genes (which you can judge perfectly well by looking at the adults) play a role in birth size, but gestational age and uterine environment are also key factors.

          • Antigonos CNM
            November 15, 2013 at 4:51 am #

            The father’s size definitely was a factor in the years following WWII in Japan, when Japanese women had children that were too big to be born vaginally, which had been fathered by US GIs. However, a more decisive factor, IMO, is pelvic configuration. I was once told by an OB I was dating that I had “a pelvis a Mack truck could go through” [this is regarded as a compliment if made by an OB], but when I had my children, in spite of my anterior iliac spines being far apart, the interior diameter of my pelvic inlet made it impossible for them to go through.

          • rh1985
            November 15, 2013 at 5:45 am #

            Do you know anything about the correlation between size in utero (percentile) and size at birth? Assuming no complications that would make the baby grow too much or too little develop (like IUGR or GD), is a baby that’s average sized for its age at every ultrasound likely to be average sized at birth? My baby has been within a few percent of the 50% at all ultrasounds so far and I wonder if that means I’m likely to have an average sized baby or if the growth pattern can change a lot in the final trimester.

          • Young CC Prof
            November 15, 2013 at 8:19 am #

            Immediately after I got pregnant, I found a study that found that in White/Asian couples in the USA, the probability of c-section when the mother is Asian is almost twice as high as if the father is.

            I’m white, husband is Chinese and tiny. When I go out with his family, I feel like a tall blond stork in a flock of crows. Also, I don’t have GD. Hence, crystal ball suggests my baby will be small, and the women in my family tend to bear pretty easily.

          • Burgundy
            November 15, 2013 at 11:28 am #

            Maybe there is something to it. I am Asian and my husband is white. Both of my daughters are over 8 pounders. Both of them are in 95% for height. I did not have a c-sec but I am tall for Asian.

      • Ob in OZ
        November 14, 2013 at 6:08 pm #

        In your Ob’s defence, your husband’s birthweight doesn’t “matter” in that it does not influence the size of the baby enough to say you should do something (u/s, c-section) based on his birthweight. If he called you or compared you to a cow, well then you should use the chains on him!

      • Mel
        November 15, 2013 at 8:35 am #

        February and March this year were horrible. I stopped asking my husband about calves born each day because so many of them were still-born bull calves. We went from a bull calf average size of 90 pounds to 130 pounds. We had three bull calves over 150 pounds. My husband rarely cries, but seeing so many dead calves and losing cows after birth took toll on him.

        We haven’t had any kids yet, but my husband’s family seems to produce 9-10 pound linebackers. No GD, just babies born with very wide shoulders. The women in the family laugh that the babies in the family think they are cows rather than humans. I’m planning on C/S’s so whatever happens will be fine with me.

    • Antigonos CNM
      November 15, 2013 at 4:52 am #

      Hey, but nature is perfect! :Your cows obviously didn’t read the right books or go to the right classes!

      • Mel
        November 15, 2013 at 12:43 pm #

        I keep telling my husband that we should buy “Zoophonics” for the cows.

  20. Zornorph
    November 14, 2013 at 12:58 pm #

    I have said this before, but I don’t trust or like Mother Nature. We are not friends and if she had her way, I would have never had children. My son is a rebuke to her and the idea that something is better just because it’s ‘natural’ (whatever the hell that means) is total foolishness in my eyes.

    I can very much enjoy taking a walk in the forest and enjoying nature, but I’m well aware what a b!tch she is and would never trust her at all.

    • The Bofa on the Sofa
      November 14, 2013 at 1:09 pm #

      It’s not that Mother Nature is a bitch, it’s that Mother Nature doesn’t give homo sapians special treatment, and treats us like all the other creatures in her kingdom. Her problem is that she is exceedingly fair. We humans are subject to the same laws as bacteria.

      I have to say, I don’t hold it against Mother Nature that she doesn’t treat humans special. So it’s not that I expect bad things from Mother Nature, I just don’t expect her to protect me from the bad any more than she does any other creature.

      A pot belly pig and I jump out the window of a tall building, we will splat on the sidewalk at the same time. Unless we jump out of a window on the ground floor, of course.

    • rh1985
      November 15, 2013 at 12:14 am #

      I have an artificial baby too. I’m assuming you used IVF since I think your surrogate was gestational? I used IVF with my eggs donor sperm.

      • Zornorph
        November 15, 2013 at 12:21 am #

        Yep, gestational surrogacy via IVF. Throw in PGD in there as well ’cause I wanted a boy. Wasn’t going to leave that up to the whim of nature.

        • rh1985
          November 15, 2013 at 2:01 am #

          That makes sense – I wanted a girl, if I was a single man instead of a single woman I’d probably have wanted a boy.

  21. Guesteleh
    November 14, 2013 at 12:28 pm #

    Did you see this in the NY Times? Car mechanic invents new tool to relieve obstructed labor. It’s based on a technique for removing a cork from a wine bottle.

    • Zornorph
      November 14, 2013 at 1:12 pm #

      How dare he steal from women the right to use their super-powered vaginas to push out their babies? They just need to trust birth and they can crap out their special snowflakes by orgasaming, burning essential oils and listening to the encouraging words of a doula. They don’t need a man – a mechanic no less! – to invent something to rip their babies out of them like MacDuff. That would totally ruin their birth experience. How dare he!

      • Guesteleh
        November 14, 2013 at 1:18 pm #

        I know you’re kidding, but check this out from the comments:

        And then there is the time honored tradition of not lying on your back in childbirth unless you are in a movie, or in modern medical hands. Squatting, standing, sitting in a special chair designed for birth, on hand and knees – all these positions facilitate birth. While it would be great to lower the c-section rate, the vast majority of c-sections in the US are voluntary and for the “convenience” of the mother and / or doctor. So it would be quite easy to lower the c-section rate by permitting them only when medically necessary. Of course, this would lessen the profits for the doctors and hospitals. Wouldn’t want that to happen.

        But then, an awesome reply!

        Although I agree that we do too many Cesarean Sections in the US, I strongly disagree with the rest.

        You don’t think we’ve tried squatting, standing, sitting in chairs, or on hands and knees? These techniques have been tried around the world, and despite that millions of newborns and hundreds of thousands of mothers die in childbirth every year around the world.

        I have delivered babies in rural villages in Kenya, Ethiopia, Eritrea, Uganda, and Somalia. (such as Bombo, Kakamega and Moyale).

        I can assure you that I’ve attempted every one of your techniques and more… and still had to watch as the infant died. I’ve watched women tear and bleed out because they can’t get the child through their birth canal.

        Too many people think that “natural” means safe. Although natural childbirth is preferred, there is a very high complication rate, and when there is a complication it happens quickly and the end result can be devastating.

        I cannot describe how life-altering this treatment will be if it is
        successful, and pray that it is offered at prices reasonable for the world’s impoverished peoples.

        • Nashira
          November 14, 2013 at 2:58 pm #

          “I cannot describe how life-altering this treatment will be if it is successful, and pray that it is offered at prices reasonable for the world’s impoverished peoples.”


    • Trixie
      November 14, 2013 at 1:46 pm #

      That is so awesome. I don’t even have anything snarky to say about it.

    • November 14, 2013 at 8:17 pm #

      I was going to post this when I saw you already had. It looks like a simple, life-saving device. Yay engineers!

    • Antigonos CNM
      November 15, 2013 at 4:55 am #

      I have the article bookmarked but haven’t read it yet. I get mental pictures of screwing a giant corkscrew into the baby’s head, sort of a giant internal electrode used in fetal monitoring.

  22. Rachelle
    November 14, 2013 at 12:09 pm #

    I have an uncle who did everything “right.” He regularly exercised, never smoke or drank alcohol, maintained a healthy weight throughout his life, ate a diet full of fruits and vegetables with low amounts of meat, had medical check-ups as recommended, knew his family medical history, etc. Nature didn’t care. He still died of colon cancer at age 60, less than 4 months after a colonoscopy indicated problems. Nature doesn’t care if you do things right, or if you “worship her,” or if you don’t believe in complications. Bad things happen even when you do everything right. It happens with cancer, it happens with childbirth, it happens with mental illness.

  23. PrecipMom
    November 14, 2013 at 11:04 am #

    I wonder how much of NCB enthusiasm relates to too small a sample size. I’ve been a mom for over 10 years now, but in the first half of that roughly I just didn’t come across any moms who had any actual bad outcomes. Not that they were explicit about at least. That has changed the longer time I’ve spent around pregnancy and birth.

    Now I know a significant number of women who have had stillbirths, who encountered complications that shouldn’t really happen if the “design” works predictably if you just do things “right.” Home birth and rejection of preventative care in birth only works if you believe that if you just do things right, the design is sound enough that you won’t encounter problems. Once you accept that people do things “right” all the time and still have complications, the idea of willingly being away from where you can intervene to prevent a complication or cut it off before complication becomes catastrophe becomes unconscionable.

    • Karen in SC
      November 14, 2013 at 11:53 am #

      When I first got out into the working world, I heard of two stillbirths. One happened to a co-worker and was probably due to undiagnosed GD. Another was due to an infection, and I never got any details, but now I am guessing it was group B strep.

      Both those conditions are now tested and babies dying from GD or GBS are very rare. Except in mothers who “trust birth”.

    • Antigonos CNM
      November 14, 2013 at 12:19 pm #

      I’m sure my attitudes have been shaped by my “good luck” [!!] in being involved in lots of both potential and real catastrophes. The result is to take nothing for granted. As a doctor once said to me, “births are only ‘complicated’ or ‘uncomplicated’, and that is only in retrospect”. I am sure so much of the NBC nonsense comes from never having seen what I, and other professionals, have. If a midwife attends only 50 births a year, compared to the same number [or more] per month, how can she regard herself as truly “experienced” in every possible complication?

    • The Bofa on the Sofa
      November 14, 2013 at 12:49 pm #

      My oldest sister’s first pregnancy, corresponding to the first grandchild for my folks, ended stillborn at 41+ weeks.

      My folks now have something like 20 grandkids and 10 great grandkids, and every one is considered a treasure. One does have developmental problems, so even besides the first, we have not gone through unscathed.

      We don’t take anything for granted in our family.

    • Young CC Prof
      November 14, 2013 at 12:56 pm #

      That’s exactly the problem, I think. In nature, 90% of babies are born without problems. If you do even minimal prenatal testing and accept only lower-risk women, you can do better than 90%.

      In most industries, if 90% of customers are satisfied, you’re doing pretty well. If 5 of your friends tried a restaurant and all five thought it was great, you should eat there, too. However, in most industries, the unsatisfied customers are irritated, not seriously harmed or dead.

    • Allie P
      November 14, 2013 at 1:09 pm #

      I actually don’t know how I had as rosy an outlook as I did. I worked at an OBs office for many years, and I heard about bad outcomes from time to time, I saw lots of miscarriages in files. But I knew that bad outcomes during the actual BIRTH process was very very rare (especially among the patients of the OB office, who of course had good prenatal care). I worried about miscarriage, I worried about congenital defects that might be uncovered during the scans, because that’s what I saw in the office. I never worried about the actual birth. Then again, I was not one who viewed interventions/surgery during birth as a bad thing. It was just one possible occurrence that might happen. Induction, episiotomy, drugs, c-section — whatever it took for there to be a healthy mom and baby, I didn’t even think of it. So when I was alone the night before my baby’s birth (because I was so blase, I sent my husband home) and the baby had a bad reaction to my induction medication and they had to stop it and put me on oxygen (everything’s fine by the way, thank heaven for CFM that can monitor for possible problems WHILE I SLEEP), I was like “Oh, wait. This is dangerous. Turns out I want my husband here after all.”

    • MichelleJo
      November 14, 2013 at 1:36 pm #

      I was wondering recently why so many of my friends and women I knew where having problems like pre-term birth, GD, stillbirth and more. It never used to be like this for us ten years ago. But then I had to ask myself, well how old was I at my last birthday? Advanced maternal age is no joke. Bad outcomes increase in your age group as time goes on.

    • Carolina
      November 14, 2013 at 1:55 pm #

      Since August, I’ve had three friends lose late term pregnancies – 34 weeks, 36 weeks, and 40 weeks (baby died in utero the day before his induction). I was stunned. Nature is not kind.

    • Lynnie
      November 14, 2013 at 2:58 pm #

      That is probably a reason I don’t “trust birth”. I know personally too many bad outcomes. I can think of 3 late term deaths of babies of close personal friends and family members right off the top of my head with out even trying. Then there are the early miscarriages. Not to mention the positive outcomes after difficult pregnancies, inductions, NICU stays, blood pressure issues, RH incompatibility. Then there was my own body’s stubborn refusal to get pregnant for years and the desire to have the healthiest and safest birth possible, I chose to not trust my flawed body and take all the precautions I could, even induction (which is the one thing I told my CNM that I DID NOT want, ironically). I know that I did the right thing by trusting actual medical professionals rather than “trusting birth”, which has been known to kill.

    • moto_librarian
      November 14, 2013 at 3:20 pm #

      In the past year, I have had one friend who had to have her twins delivered at 32 weeks because of twin-to-twin transfusion syndrome that was detected thanks to ultrasound. Both babies are doing great. I have another friend who developed pre-e that rapidly evolved into HELLP. Emergency c-section for her 35 weeker (who didn’t even need NICU time), and aside from some lingering issues with high blood pressure, mom is fine too.

    • Sullivan ThePoop
      November 14, 2013 at 5:19 pm #

      Bad outcomes are often mitigated by medical care. I always considered my births to be pretty trauma free, but without modern medicine they would have all been disaters.

      • Young CC Prof
        November 14, 2013 at 9:30 pm #

        Good point. I’ve had a number of bad obstetric stories in the past year or so among my friends, but all of them ended in a living mother and baby.

        Without modern medicine, of the 4 of them, we’d have one mother AND baby definitely dead, one baby dead a couple days after birth, one probably OK, and the fourth one unknowable, but quite possibly another two deaths.

        Instead, I have four friends raising beautiful babies.

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