There seems to be a big problem with telling the truth in the homebirth/natural childbirth universe.
Yesterday I wrote about the lactation consultant who lies to her patients about her vaccination status, assuring them she has had a pertussis booster when she has not.
I’ve written in the past about the homebirth midwifery guide that advises lying to your patients about what procedures and medications you use.
Wendy Gordon, CPM, a member of the MANA Division of Research (and placenta encapsulation specialist!) included a bald faced lie in her effort to discredit the study that showed that homebirth increases the risk of a 5 minute Apgar score of zero by nearly 1000%.
Now Improvingbirth.org seems to be having trouble with the truth. Their latest infographic appears to include yet another bald faced lie. The graphic states very plainly that “the most births per day in the U.S. occur on the Tuesday before Thanksgiving.” There’s just one itty bitty problem. It’s not true and it isn’t even close to being true.
A data table compiled by a Harvard economist reveals that the most popular birthday of the year is actually September 16, and that the entire month of November includes no days that are among the most common.
Matt Stiles, data journalist at NPR, turned the table into a fabulous chart, seen below:
The most common birthdays are dark and the least common are light. It is easy to see that the Tuesday before Thanksgiving isn’t even close to being the most common birthday. I can’t imagine where they got that faux “statistic.” Perhaps they simply made it up.
According to the Improvingbirth.org website, their mission is:
To bring evidence-based care and humanity to childbirth.
Really? They might consider the fact that statements that are flat out false are not “evidence-based” at all.
If you cannot trust homebirth and natural childbirth websites like Improvingbirth.org to tell the truth about even the most basic, easily checked statistics, how can you trust them to tell the truth about anything?
Addendum: Improvingbirth.org is not the only natural childbirth organization to make this claim, so I wondered where it originated. I suspect it came from here, Births by Day of the Year. It’s a critique of the heatmap I posted above. There, the data is posted by day of the week superimposed on day of the year. Take a look at the last graph with represents the year 2000.
What’s immediately obvious is that numbers of births per day follows a pattern that cycles each week. Tuesday has the greatest number of births and Saturday and Sunday have by far the least. This has been known for some time and appears to be driven by scheduled C-sections. Simply put, the most common day of the week to schedule a C-section is Tuesday, presumably because the mother will be discharged from the hospital by the weekend when there will be many family members and friends available to help her. No C-sections are scheduled on the weekend. No inductions are scheduled on the weekend, either, making those the days with the least births each week.
There is also an observable pattern around holidays. Holidays which result in days off for the staff also have no elective C-sections or inductions, lowering the number of births for those days. Where did the rest of the births go? They were switched to the days before or the days after. So there’s no evidence that the overall number of C-sections or inductions has changed because of the holidays, only the days on which they are scheduled have changed.
In the year 2000, the day with the highest number of births is indeed, the Tuesday before Thanksgiving, but in other years, it is the Tuesday before or the Tuesday after Christmas or New Year’s Day. So there is no question that the Tuesday before major holidays and the Tuesday after have the highest number of births, BUT that’s NOT because of medically unindicated inductions. It merely reflects the holiday trend superimposed on the weekly trend. There are no scheduled C-sections or inductions on major holidays. Any delivery that was going to be scheduled ANYWAY is moved to a day that is not the holiday.
So, the Improvingbirth.org statistic is misleading because in most years it is factually untrue, and because it does NOT reflect additional inductions as implied by Improvingbirth.org, merely inductions moved earlier or later by a few days.
Finally, it is extremely misleading because the statistic that counts is mortality, not the number of babies born on any given day. Improvingbirth.org has provided no evidence of any kind that ANY babies or mothers are harmed by these schedule changes and there is no reason to believe that there would be any impact on mortality by scheduling changes of a few days.
The ultimate irony is that natural childbirth advocates are forever wailing that obstetricians “play the dead baby card” by warning of bad outcomes as a result of refusing interventions. Not only is Improvingbirth.org use the very tactic that they claim to despise (“Don’t be a Thanksgiving statistic!”) hypocritical, it is actually worse. In contrast the obstetricians’ warning, which is actually true, Improvingbirth.org’s warning is factual false. There is no evidence that more babies are born on Tuesdays before and after major holidays has any impact on mortality or morbidity.
My comments are directed to the title of this post about the difficulty in telling the truth and related issues with home birth midwives.
Full disclosure: I am a medically conservative, and trained in hospital based OB/GYN as well as free standing GYN clinic. I choose to NOT take chances with people’s lives.
Remember that the baby is simply a parasite. The baby goes where the mother goes. The baby has NO CHOICE or voice in any decision making. YOU choose poorly, the baby pays the price. So, what do you want? A live birth / healthy outcome OR some tailor made quasi feminist performance art in the birth of your kid?
So, back to telling lies and half truths by non professional midwives. Why do they do it… because it is a part of their pattern in life. They take the quick route to paradise. Why spend 12 years or more becoming a QUALIFIED OB/GYN doc? Why spend 6 years or more to become a Certified nurse midwife?
When the quickest route to paradise (you do know where ‘paradise’ is, right) is to become a doula / lay midwife (direct entry midwife). Take a few mail order courses, hook up with another woman who has a semi legal home birth practice (you pay her to assist her, to get the ‘training’) and then in a year or so, you yes YOU can start out on Craigslist with your own home birth practice.
The telling of lies comes from taking the short cuts in life. It is a pattern. Take the quickest route possible. But, then there are those pesky statistics that keep coming up about poor or bad outcomes in home births.
What to do what to do…. Why do what the government does! SPIN IT. That is right, pick out the favorable parts and ignore the rest. Who will check anyway (well, other than Dr. T of course).
Now, please sit down. I am going to make my usual observation and comment that I have been making for 20+ years. Some people seem to take objection to it, but so far, I have not been proved wrong.
If there was a way to REMOVE the intimacy / nudity from the situation, then THOUSANDS of women working in the arena of women’s healthcare would simply leave! The general public has no idea how women’s healthcare is used and abused as an avenue for some women to explore their own sexuality and boundaries, all with a cloak of legitimacy provided by a uniform and or a title, whether that title is real of not.
You baby’s health and well being depends on YOUR CHOICES…. make good choices. Have you figured out where ‘paradise’ is yet? LOL…
“If there was a way to REMOVE the intimacy / nudity from the situation, then THOUSANDS of women working in the arena of women’s healthcare would simply leave! The general public has no idea how women’s healthcare is used and abused as an avenue for some women to explore their own sexuality and boundaries, all with a cloak of legitimacy provided by a uniform and or a title, whether that title is real of not. ”
Huh? I don’t get this part. Can you spell out more clearly what you mean? Who exactly are you saying is using the field of women’s health to work through their own sexual issues?
I think that’s what s/he’s saying and I think it might be a point. What’s the appeal of intimate women’s health care in a woman’s home? The baby appears to be an afterthought. The actual health of the woman herself appears to be an afterthought. Money seems to be a bonus and perhaps one of the big motivators, but what’s the appeal beyond that whereby homebirth midwives get so defensive about any attempts to regulate it? Perhaps there is some sort of ego also tied up in it but the intimate nature of women’s health care also makes me wonder.
But I think she is saying this is a big theme among all healthcare workers who work in women’s health. I just don’t buy it. First they said this about gynos back when they were all male. They made them all out to be perverts. Now she is apparently saying that the female providers are perverts too. I know a lot of gynos, even more family physicians, a few CNMs, a number of midlevels who work at family planning and/or STD clinics, and of course lots of nurses in the field. I have yet to meet one who I thought chose the field as a front to have access to naked women so they could “explore their own sexuality and boundaries”.
As a family physician, I do a lot of pelvic exams/breast exams/testicle checks/prostate checks. Like most physicians I’m pretty busy. We’re rushing between rooms, answering pages and phone calls, filling out paper work, doing e-refills, dictating. When would I have the time to “explore my own sexuality and boundaries”? Please, I barely have time to breathe. The sooner I get done with the exam the better. But s/he thinks we’re in there getting our jollies. So weird.
But these people are all operating within regulated environments. I do wonder about people involved in women’s health care that operate outside regulated environments. I do think people can be passionate about women’s health care and they try to do their best for women and their babies and there isn’t a sexual element, but I do wonder about those that are outside of those areas. I’ve been wondering it ever since Dr Amy posted that stuff about Ina May and ‘stimulating buttons’ or whatever it was. Some of these providers show an astonishing lack of boundaries and an amazing ability to manipulate the emotions of their patients.
I suspect we probably agree – I took the comments from ObgynRN to be largely about homebirth midwives, not people such as yourself.
So women’s healthcare is mostly a cloak for frustrated, closeted, abusive lesbians? That really makes no sense. Why not stick to the facts?
Looks like I might be a Christmas induction statistic, or possibly New Years. 32 week ultrasound shows borderline IUGR, possibly related to a placenta that isn’t functioning optimally. Got weekly follow ups with MFM now, fun times.
Well, what happens happens. They’ll keep measuring, and if he doesn’t fall further percentile-wise I’ll keep carrying. If he does, then we’ll get him out where he can be stuffed full of food and oxygen all on his own.
Poor little baby!
Best wishes!
All the best for the next weeks of pregnancy, feel free to keep us posted!!
Thanks, I will!
Best of luck!
People get bored in December and January, hmm?
Funny, this is totally consistent with my practice (and probably many practices). Patients LOVE Tuesday deliveries (especially before a long weekend.) Consider, home in time for the weekend with friends/family to help, the day before and the rest of the week in with care for other kids arranged, and if something happens that you get bumped, it’s usually just until Wednesday, so similar considerations apply. (And no, naysayers, these aren’t social inductions. Our induction guidelines are loose (39-40 weeks for term induction, 41-41+3 for post dates), so there’s almost always some flexibility.. and women like Tuesdays.)
My last kid was a Wednesday induction (it was exactly 39 weeks, which was our local cut-off). I was out by late Friday morning, so I had my husband’s help the entire weekend.
I didn’t lose ANY writing jobs. I was INVITED to join SBM; I didn’t like the lack of control over my posts, so I quit.
Can you please explain to me how the fact that I am retired affects the facts I present? Or are you just another critic like this?
http://www.skepticalob.com/2013/02/dont-listen-to-dr-amy-because-she-hasnt-practiced-in-years.html
Truth first,
I didn’t lose ANY writing jobs. I was invited to join SBM; I didn’t like the lack of control over my posts, so I quit.
Please consider :
1. Dr. Tuteur is no longer licensed as a physician. The Massachusetts Board of Medicine reports that her license expired in 2003.
2. Dr. Tuteur has lost two jobs in the past year as guest writer and Science Based Medicine. This was due to her attitude and because she writes things knows nothing about. – no recent knowledge.
3. Dr. Tuteur facts are shaky. If the studies she cites include unattended births in homebirth statistics… well you already have a problem.
Look, I know nothing about #2, except to say, you think that was her “job”? Like, that was all that was keeping the lights on? I’m pretty sure everyone over at SBM writes because they feel passionate about it, and that they barely make any money at it, and possibly lose money keeping the site going. And I’m pretty sure the same goes for SOB.
Science Based Medicine contributors are volunteers. From the log-in help page:
“we are working as fast as a volunteer-powered organization possibly can to fix the bugs”
http://www.sciencebasedmedicine.org/about-science-based-medicine/help-with-logging-in-commenting/
Truth first “2. Dr. Tuteur has lost two jobs in the past year as guest writer and Science Based Medicine.”
Dr Tuteur stopped writing for the Science Based Medicine blog in Feb 2010. This is not within the past year (this is Nov 2013, almost 3 years later): http://www.sciencebasedmedicine.org/dr-tuteur-has-decided-to-leave-science-based-medicine/
When you’re going to accuse someone else of having shaky facts, it’s best to check your own before posting.
Not to mention that she didn’t “lose” that job – she resigned. She has addressed this before.
Here’s the Skep OB announcement: http://www.skepticalob.com/2010/02/i-quit-sbm.html
I posted the SBM link first to avoid suggestions of spin.
And so what was the second job? Se forgot to add it.
And I should probably check my math: It’s over 3 and a half years from Feb 2010 to Nov 2013.
1. So? They don’t use a Neuralizer and erase your memory when you retire.
2. Not true – she resigned more than a year ago
3. Clearly, your reading comprehension is sorely lacking, given that Dr. Amy gives very thorough breakdowns (including links!) demonstrating how and why she has reached the conclusions she has.
A lot of “unattended births” aren’t as unattended as you think. When things go bad during a homebirth, the midwife *POOF* turns into a friend who was hanging out with the laboring woman so she can’t be held accountable for anything that went wrong.
Please consider:
1) Everyone here knows that Dr. Tuteur is not longer practicing medicine. That however does not mean that she is no longer a Doctor, MD or OBGYN. She still as the education and ability to keep abreast of the advancements in her field
2) According to Dr. Amy and SBM this is wrong, so you’ll need to provide some proof of this
3) If you had any ability to read studies and interpret data you’d know that the posters here are more than capable of looking at these studies, looking at the sources and data and crunching the numbers to see if what Dr. Tueur posts is indeed correct.
4)If you have any actual proof of your claims then I suggest you bring the proof. But you won’t. You’ll drop in, say some stuff like this and leave. We are the type of people who want to see proof of claims made. So if you really want to sway us then the best way to do that is to show us some numbers.
So fanks fer brinin’ us da troof, Goofy!
And my H on my keyboard keeps getting stuck so if you see any glaring typos try adding an H and see if that fixes it.
For (3) do you have some specific examples you can refer us to?
http://www.sciencebasedmedicine.org/dr-tuteur-has-decided-to-leave-science-based-medicine/
“over the last several weeks it had become clear to both the editors of
SBM and Dr. Tuteur herself that, although Dr. Tuteur had routinely been
able to stimulate an unprecedented level of discussion regarding the
issues we at SBM consider important, SBM has not been a good fit for her
and she has not been a good fit for SBM. Over the last few days mutual
efforts between the editors and Dr. Tuteur to resolve our differences
came to an impasse.”
September 16? Let’s see….hmmm – ah! Great way to celebrate Christmas, even for an atheist like me!
My OB actually had no problem scheduling me for an induction on the weekend because he was going to be on call anyway. Of course I didn’t end up being induced until that Monday because there are only three rooms in our L&D unit and they were all full up that weekend. Hmmm I wonder why the staff didn’t just send them all home so they could go play golf?
Speaking as an ex-deliverer of many babies, I have to say that I don’t play golf, have no desire to do so, and don’t even understand why anyone would want to do so.
When I did deliver, it was a 24/7 responsibility, and cross-coverage in this rural area was not appreciated. It was a case of stay at home for the month before a patient was due. I’m not sorry I stopped that nonsense a couple of years before the province imposed that change, as I was delivering 50 miles from an anesthetist and an OB. That’s not safe and I knew it, so I stopped. The locals hated me for ending a tradition, but I have always responded by pointing out that tradition resulted in individuals like that guy there, scissoring his way down Main Street. The reality of birth in a hospital without interventions is very much like home birth with a well-meaning idiot in attendance. I’m so happy to be shot of it.
Update: they updated their graphic, pretty much based on Dr. Amy’s analysis of the Harvard data. LOL
My kids were both born on Tuesdays. It was my obgyn’s “surgery” day at the hospital I went to. Which was incredibly convenient the first time around, because I’d gone into labour naturally on the Tuesday and ended up needing surgery instead to get her out. And second time around it was just scheduled in to his “surgery”day.
All those summer birthdays! Good times in the winter, I guess.
I wonder how the pattern looks for the Southern Hemisphere?
What else can you do in the winter when its too cold to go out? 😉
My induction was on a Saturday. I was already post-dates and no one wanted to wait. Our RM missed her son’s second birthday party. When I apologized, she said, “It’s okay, I’ll see him later, *just be sure to let me cut an episiotomy and perform a high forceps if we don’t get things rolling by 6 because I wouldn’t want to miss his dinner and bath.”
*may not be true
Just goes to show the value of long winter nights – more time to make babies. 🙂
hahahahahaha once again, amy, you have demonstrated that you just sit on your ass all day and scour the internet for things to criticize to make yourself look smarter since you don’t actually PRACTICE medicine! how about YOU get YOUR facts straight? ummm ImprovingBirth.org is NOT a homebirth or natural birth advocacy organization. At all. You, yourself stated their mission statement in this very post – please tell me how “bringing evidence-based care and humanity to childbirth” has anything to do with WHERE a woman gives birth or whether she chooses medication or not during labor? Also, why do YOU care so much about where or how other women (whom you don’t know, nor affect your life) give birth?
What makes these trolls so nasty, and foolish? Gosh did lmaw03 read her own link?
This is a serious question for poster lmaw03.
Why do you post comments like this, beginning with “hahahahahaha” and following with insults and all-caps?
Do you honestly think that reasonable people are going to take you seriously after that? Do you even think about how others will read your post?
Nevermind the fact that she didn’t even use a capital at the beginning of her sentences where it belongs. In the Internet world of “grammar nazis” I don’t understand why that isn’t called out more often. Misplace an apostrophe, forget a common or use the wrong “there” and people come out of waterworks to correct you. But not using any capitals which actually makes you comment harder to read is just ignored. Someone explain that to me.
In my city, Improving Birth held a protest rally outside the hospital with the highest CS rate. The hell they aren’t a natural birth advocacy organization.
I’m going to make a crazy prediction: this highest-rate hospital either serves the most deprived part of the city, is a tertiary-care center, or both? And Improving Birth has no idea why this matters?
Level III NICU. Of course.
Clearly, the mere presence of high tech medical technology raises the c-section rate! Therefore, NICUs are bad.
Probably has the most births and the largest L&D unit too?
The problem is that they are lying. Their “evidence” is wrong. Amy is simply pointing that out. Over use of inductions is a NCB issue. If it were a real evidence based site it would not find that inductions are over used at all, because the real evidences points to them not being over used. Thus wrong data=NCB malarkey
Do any of you NCB parachuters actually KNOW what the term “evidence-based care” means? It doesn’t mean massage the data until you come up with an answer that meets your preconceived notions.
They probably view feelings (theirs) as “evidence”. If they feel strongly that inductions or C-sections are bad, that is evidence that they are.
It took me a minute to really even figure out what point they were trying to make. I guess it’s that the eeeeevil doctors will coerce moms who otherwise would have labored naturally into having an induction so those evil doctors can enjoy Thanksgiving dinner? Frankly, if my due date was Thanksgiving week I might actually ask for an induction a week before that because I’d much rather be lying on the sofa in a tryptophan coma with my baby than in the hospital in labor while everyone else was stuffing themselves with turkey and cranberry sauce.
at the possible risk of harming your baby or having a cesarean? really??
Please explain the risks to the baby of induction at 39 weeks. Please explain how induction increases the rate of c-section.
Please include citations.
Yes. Because I’m fairly sure having an induction doesn’t pose any actual “risk” to me or my baby, whereas the risk of upsetting my poor martyred mother by unfairly forcing her to change her Thanksgiving plans would be unacceptably high.
Those two things are not related. Having a cesarean is not inherently harmful. Plenty of us grown up, educated women have them – and somehow, even if it isn’t a fun experience, manage to get on just fine without having to make an entirely new baby to VBAC it away. C-sections SAVE babies on a regular basis. Further, there just isn’t evidence that induction “harms” babies. You don’t know what you’re talking about. At all.
Erm, neither of those things are inherently brought on by induction. If they do happen it’s because there were issues before hand, like inducing due to high blood pressure but the blood pressure gets too high during labor. And inductions don’t damage babies. Of course I’m always open to new evidence, so please provide your sources for those claims.
FACT: Ceserean delivery is statistically safer for the baby. The mother bears the (tiny) increased risk.
I’ll believe they are balanced and just want evidenced based choices when they make one of their catchy cool scary poster about homebirth midwives, correlation with perinatal mortality scores, low 5 minute apgars and seizures. I swear lately the phrase “evidence based’ makes me always…. always… demand to see the evidence.
I picture Dug from “Up”, instead of saying “squirrel” and everyone looking up, we should just say “DATA!”…huh, huh? where?
I feel the same way about “I’ve done my research!” I swear, the only people who use that phrase are rabid NCBers and anti-vaxxers- and their “research” typically consists of provably untrue “facts” from mommy blogs with some anecdotes thrown in for emphasis. As soon as someone says “I’ve done my research”, I automatically dismiss anything they have to say, and move on.
Good point! I’ve never heard a doctor use the phrase “I’ve done my research”. I’ve heard “I’ve gone through the medical literature for this condition” and “we followed up with the vaccine specialist at the Children’s Hospital” and “I’ve checked with the research team in the US” – all for something quite unusual. I’ve not heard “I’ve done my research”.
People are so willing to cancel elective surgery before holidays, so they can be with their families, that I lucked out with my hip replacement, which was done on Erev Passover, after someone canceled, and didn’t have to wait a couple of months. Got out of the cooking, too.
I was having problems with gallstones and needed my gallbladder out years ago. It was not emergent (though that surgery can be), so I was scheduled in the first slot available. It was just before a holiday which gave me extra time to recover, but that was mainly coincidence. Who cares? It was going to happen sometime, the sooner the better.
Wow! They actually changed it!
“UPDATE! ALERT! * We got majorly dinged on posting a “stat” about the popularity of birthdays that someone passed along to us and we didn’t look into very hard, although it appeared to have more current data (1994 to 2001) than the standard data everyone else passes along (1973 to 1999). Anyway, we’d hate for anyone to be misinformed about the popularity of a birth date! Lord knows what kind of trouble that could cause. But, the popularity of a birth date wasn’t really the point. So, we made a new infographic that kind of cuts to the chase about what we were really trying to say. Enjoy!
NEW INFOGRAPHIC: https://www.facebook.com/ImprovingB…/posts/573755236031302″
It’s still false. And shows a complete lack of understanding of how hospitals work. Doctors are scheduled to be at the hospital whether you go into labor on Thanksgiving or not, they will be there for the woman who had no medical or personal reason to be induced. They will be there for the woman who miscarries, the one who spent all day puking in her potatoes and is now dehydrated, and they will be there for the patient they had to admit to the hospital on bedrest who started having contractions at 25 weeks. They don’t get to leave the hospital. Even if they did, it’s not like they get to sit down and enjoy a meal with their family because they could be called in at a moments notice.
My month-long hospital bed rest stint went from Dec 10-Jan 8. So, a number of holidays in that time period. While it is true I rarely left the room I was in, I noticed a number of personnel coming in and out of my room at all hours every day I was there, as well as many of them passing by in the hall. They had rounds every day early in the morning, I know because I heard them as they passed my door. I saw the on-call OB every day, as well as whatever resident was around and several nurses. When things went pear-shaped, even MORE people turned up, regardless of what day it was–weekend, holiday, snowstorm (it was a bad winter that year)—-there was no shortage of medical people. The people who say these things have no idea what they are talking about. They should spend a few days hanging around a hospital, just watching, maybe get educated for real.
My midwife delivered me and three other moms in a row the night my daughter was born, then she got up and went to church and came by in her Sunday clothes to check on all of us. Either you get the hospital doctor/midwife or some practitioners even come when called. Mine drove 8 hours in a snow storm with my first to get back to me so she could deliver me. She is a very busy midwife and I adore her.
But there was still an on-call OB and a slew of nurses there with me while I waited for her
My 4 year old (TODAY!) came on the day before Thanksgiving of his own accord, at the hospital, attended by a CNM. No one spoke of inductions or time limits. The on-call doc from our family practice clinic, where he receives well-child care, came to our hospital room Thanksgiving day to check baby out before we went home. He was so kind and genuinely excited for us that I never would have known if we were taking him away from his family. Same with the CNM on call that day who checked me before discharge. Some of my sweetest Thanksgiving memories.
They might not have been taking time away from their families – my mom is a doctor (Infectious Diseases), and so were my godparents (OB). They scheduled a joint family Thanksgiving feast for Friday every year, and took holiday call.
Until I was twelve, I thought Thanksgiving was a Friday holiday, and the Thursday off was to give people cooking time.
Was the new infographic taken down? Facebook says it is no longer there.
I think it must have been because it’s gone for me too. I guess they realized that they actually had no point after it was shown that more inductions don’t happen before holidays. From what I recall when I saw it in my feed they were saying that they just “heard” about a lot of people being induced….when in actually they were most likely just paying more attention to the stories because they believed inductions before holidays to be true.
Hmm, that sounds like a reliable, unbiased way to colect data..
“Holidays which result in days off for the staff also have no elective C-sections or inductions, lowering the number of births for those days. Where did the rest of the births go? They were switched to the days before or the days after. So there’s no evidence that the overall number of C-sections or inductions has changed because of the holidays, only the days on which they are scheduled have changed.”
This is exactly what these memes are alluding to: that these apparent medically necessary c-sections and inductions are being scheduled around the holidays to suit the staff holidays. Which means, that they are not quite as medically necessary as touted, and that women are not in fact, required to have them for the safety of their babies if they can be put off or pushed earlier. You stated this exactly but did not see the pattern or what it means in terms of evidence-based practice.
No, you seem to have misunderstood. We are talking about scheduled C-sections and inductions, not emergencies.
Let’s put it another way. I would expect to see the same pattern for ANY non-emergency surgery, that they would clump on certain days of the week, and that there would be extra procedures before a holiday and none on the holiday.
They aren’t inducing babies on Tuesdays to prevent them from being born on a holiday, they’re just getting all of the week’s inductions/sections taken care of on Tuesdays. If I needed a scheduled c-section, a Tuesday sounds fine to me.
I am due on a Friday-which also will be Valentines Day. If we schedule a c-section, it probably would be for a Tuesday. It wouldn’t be because my doctor doesn’t want to deal with me at five o’clock on Friday and miss her valentines day. It would just be her usual surgery day (Fridays are OR days too) and it would get me out of the hospital by the weekend (that is all me. I don’t want to be in the hospital over the weekend).
Tuesday is actually a better day for a surgery. There was some research about, other things being equal, which days have worse outcomes for surgical procedures. Much like the similar studies on cars for which day produces the most lemons, iirc Tuesday and Wednesday were ideal and the other days declined. The reasoning is that, for people who don’t work weekends, they might be a touch rusty on Monday, and tired by Thursday and Friday.
When I was considering scheduling a section, I calculated Tuesday morning around 10 as best for me – it would have let me send my underfoot kid to daycare, and have him brought by to visit me and the new baby before dinner. Then I could spend a few days in hospital while DH handled the parts of the underfoot kid rodeo that daycare didn’t cover, and I could come home Friday, be settled on the couch before the toddler got home, and have my mom come spoil us all weekend.
In the final analysis, I had an emergent section at 1 in the morning on a Thursday. If I were having another kid, I’d probably pursue the Tuesday at 10 a.m. plan in preference to a VBAC.
ETA: I also knew from antenatal experience that the OB floor afternoon snack cart had cake on MWF. I wanted to maximize chocolate cake. Hospital bedrest has so few highlights that you have to take what you can get.
With respect, I think you’re not getting it. Suppose a woman is going to schedule a C-section or an induction. This is going to happen, for some mutually agreed upon reason. Perhaps she’s post-dates, or can’t risk going into labor naturally.. Then — given a choice of dates, the woman and her doctor pick a day that isn’t a holiday or over a weekend, because they want to get the best care. Maybe they pick a Tuesday because in the event she progresses to a section, she’ll be home on a weekend with extra help.
In other words, an induction can be medically necessary without being emergent, and that allows a choice of days made for sound medical reasons. My sister just opted to be induced two days ago at 40w6d because she felt more comfortable inducing on a weekday, and didn’t want to risk 41w4d by waiting till Monday. (As the cord was wrapped around her son’s neck and shoulders, as it turned out, she wound up with a C-section at Friday at 4:30, but I swear it wasn’t for anyone’s golf game. They’re all doing great.) She definitely wasn’t going to go to 42, over Thanksgiving — but not because the doc didn’t want to miss pie, and not because the induction wasn’t medically indicated.
Exactly. My doctor ultimately scheduled my induction for a Friday. It just so happens to be a day he does not see patients in his clinic, and he only had one surgery scheduled early that morning. Since I wanted him at my delivery (and he did NOT just come in to “catch” the baby), I was more than happy to accommodate his schedule.
Kae Murphy ” women are not in fact, required to have them for the safety of their babies if they can be put off or pushed earlier.”
Can you imagine that safety might involve a window of time that should not be exceeded, but is not limited to one single day?
Exactly. With baby #3 I was going to hit 42 weeks on a Friday. They tentatively scheduled induction for Monday. I went into labor on my own on Friday anyway, but certainly there is “wiggle room” in non-emergency (but still medically indicated) situations.
Yeah, it seems that their objection is that doctors are doing inductions or c-sections _before it is an emergency_!!!!!!
How dare they? I mean, don’t they know they are supposed to wait until things go all fubared before they act? They seem so fixated on preventing bad things from happening that they just don’t let nature take it’s course.
(BTW, think about that last sentence for a while – that’s classic if I do say so myself)
Right – medically necessary is NOT the same as an emergency. A footling breech baby will be fine waiting an extra day or two.
And what of the poor pregnant mothers and their families? Is it even remotely possible in your little world that THEY might not want to deliver on a holiday? And a medically necessary C-section that is being scheduled in advance? That means the CS needs to happen before a vaginal birth occurs – while it isn’t an emergency – and therefore there is adequate time to plan a day earlier or a day later or whatever. Why is this SO HARD to comprehend??
No, emergency surgeries would be done on a holiday regardless. Repeat c-sections and inductions due to being over due can be moved a few days but are still medically necessary. What the meme was saying was that they were done to keep the mother from going into labor on those holidays. Inducing and delivering them would cause them to not be in labor on the holidays. No one is inducing people for no medical reason just to enjoy a holiday. As stated many times, someone has to be there all the time anyway. So it’s not big deal if you come in in labor. In fact it likely keeps them busy and makes the time pass, just like any other job.
I know that NCBers think that every single woman who has had a previous c-section must desperately want to have a VBAC, but it seems that this is not the case. If you are planning on having a repeat c-section, why wouldn’t it be scheduled on a day when your OB expects to be in surgery anyway? And do you really think that a woman who walked into L&D on Thanksgiving day with clear signs of HELLP wouldn’t be delivered immediately?
Not all women are VBAC candidates, either. A C/S done for cephalopelvic disproportion almost certainly rules out even a trial of labor in a subsequent labor. There are certain minimum diameters of the pelvis which absolutely determine whether a term fetus’ head can pass through it. Most CPD however is relative: either the baby is unusually large [macrosomia] or in a position that cannot deliver vaginally [such as brow presentation], or the woman is unusually small [in the UK, we noted the woman’s shoe size on the chart – something that greatly amused a number of my patients who didn’t understand why I asked]
If a C/S was done for true “failure to progress”, a trial of labor may be indicated, but especially as the mother gets older, dystocia tends to recur, and meanwhile the baby is stressed. Any attempt to augment ineffective contractions put the scar of the previous C/S at risk of tearing away from the adjoining uterine tissue.
A woman who has had a C/S for fetal distress, or placenta previa, or any condition which generally does not recur, might choose to try for a trial of labor and a VBAC, but not all doctors are willing to take the risk. No one wants to chance a dead or severely damaged baby and a woman who, after hysterectomy, can no longer bear children. However, if one is working with a population which wants very large families, such as the ultra-Orthodox in Israel, there is a lot of pressure [1] not to rush to C/S in the first place unless the mother already has quite a few children, and [2] to opt for VBAC since, if it’s successful, that can mean there will be no limitation on the number of subsequent pregnancies.
My only relative to have a VBAC only had the prior C/S because she had appendicitis, and they took the baby and the appendix out of the same incision. The VBAC went fine.
Do you feel the same way about all non-emergent surgeries, or just the ones involving OBs? Tonsilectomies, wisdom tooth extractions, breast reductions, joint replacements, hysterectomies… the list goes on. All of those are surgeries which would be medically indicated, yet non-emergent. If an oral surgeon or orthopedist scheduled one of those procedures around a holiday, would you accuse them of not practicing evidence-based care?
Honestly, one is meant to believe that of all the medical fields these doctors could have picked, they picked obstetrics, and then were shocked to find out babies come at all hours?
Of course if you had a choice, you’ll pick not being in a hospital over a major holiday. I don’t want to be there when the nurses with the most seniority are most likely to be off. I want the A team.
My mum (a nurse) used to do Christmas shifts fairly regularly. It seemed to coincide with her mother in law being in town.
That might be enough of a reason for me to go into nursing.
Oh no, I’m the least senior nurse and I just HAVE to work instead of staying at your house Mom in law. Yup, used that one 🙂
Wow. Finally a reasonable explanation as to why nearly all the kids my small, multi-grade class had their birthdays in September. Mystery solved. Thank you.
my daughter’s birthday, september 10th, is apparently super common. Must be something to do with the weather turning cold and me wanting to snuggle with my husband in November/December. I assure you all no one was rushing to induce me or anything of the like.
My nephew was born the Tuesday before thanksgiving. One of the happiest days of my life (I had just flown back from grad school and I was there in time to be there when he was born). They weren’t rushing anything. My SIL was having contractions and with a slight placenta previa they were worried he was too big. 9 lbs 12 oz. she’s tiny. so happy safe c-sections exist. He is 9 today 🙂
Totally OT: I’ve submitted my story (recovery and early post partum period) to this person; http://ethnographyofamericanbirth.wordpress.com/comment-page-1/#comment-25 in an effort to balance things out a bit. She’s clearly NCB leaning, and I suspect she’ll just discard my contribution, where I stressed how awesome the hospital staff was and how much kindness and respect I received there. I believe she has pre-conceived notions and will likely only publish stories that align with them, but I made the effort. I also asked to remain anonymous if she DOES use any of my stuff, since I don’t want my name in an NCB book. I submitted a comment on her website, basically saying “hey I think birth in America is NOT a problem, at least not if you are white and middle class” and we’ll see if she lets that one stand. I also mentioned, in my private email to her, how thrilled I am in retrospect, that the hospital I had my babies in wasn’t BFHI. (hee!) Anyway, I guess people are free to write with whatever bias they want, but if she is trying to get people to question their assumptions regarding birth in America, maybe she should start with herself.
It’s a shame we can’t have a more honest discussion of genuine issues people have had without validating NCB nonsense. It’s a shame that we can’t have a site like this that is balanced :/
Yeah. I was totally polite to her, and told her the truth, just my true story is probably not what she wants to hear, or believe. I also think that there’s probably tons of women, a lot here on this site, who had similarly great experiences with medical personnel, and if enough of them find her I wonder if she’ll change her mind?
Definitely, I don’t like the repeated glowing references to home birth. I do have to say, however, I like the questions from her “feeding” section:
“What are the implications of infant feeding in a society that heralds breastfeeding through scientific research, but then undermines it by its lack of national maternity leave?
What causes mothers to judge each other so harshly about how they feed their children?
Why is there so much advocacy for breastfeeding, but little to no advocacy for prenatal nutrition?”
It sounds like she does understand some of the real issues, both the fact that breastfeeding is being pushed to an extent that the science may not justify, ahead of other public health issues around infancy, and the reasons that some women who want to breastfeed wind up not doing so.
I agree. Honestly, mostly I talked to her about the early days after my sons were born and the onset of PPD. While I do think birth in America is pretty great, I don’t think recently post-partum women in America are treated very well (poor system of leave for working women, little respect for SAHMs, and perinatal and post-natal mood disorders not taken seriously enough) and I told her so. There are a few areas where we need to change assumptions and make improvements, imo.
What likely happened here is that the site runner most likely had a birth with no emergencies or a successful VBAC so her ideas of birth are skewered towards NCB. But then she also likely had feeding issues that made her more open minded to the very real issues with nursing. So maybe she is one who can have a decent conversation and be open to new data and change if her feeding portion is more balanced.
Do let us know if she publishes you.
ZOMG I just realized that there are ZERO births on February 30 or 31!!! Statistically, that odds of that happening due to random chance are virtually nil. It’s proof that OBs engineer ALL births to fit their filthy schedules. I’ll go email Wendy Gordon RIGHT NOW so she can give this bit of fact the publicity it deserves.
I scheduled my induction for Saturday. Mostly because an OB I really like and respect was on call that day. Being able to schedule my child’s birth had lots of benefits for both of us, my spouse, my extended family and my toddler….oh and the family pet too!
I love love loved my induction. Being in control the whole time, and getting epidural before the pit made for a pain free and relaxing birth. Baby started crying before he came out so I knew he was OK early on, the small change in fetal heart rate was fixed with some oxygen and the worst thing that happened was that my left leg was so numb I had to hoist it into the stirrup with my arms and some help from DH. T’was glorious . If I had the power I’d make everyone’s birth like that, I would.
Same here. Epidural before the pit, dimmed the lights and me and hubby dozed on and off for a few hours. (It was 12-3 AM).Then baby appeared with a second stage tooshort to be timed – the notes just said one minute – bliss. So much for the chorus “epidurals lengthen labor!”Inductions make for long painful labor and often end in c-section.” I must have been out of town the day the did the survey.
I have often seen the phenomenon of a cervix suddenly relaxing after an epidural takes effect. I don’t know of any physiological reason why it should be so, but it does happen. Then everyone says, “Now if you’d just waited a bit longer you wouldn’t have needed that epidural” but that’s not true.
My son was born on a Tuesday. I went in to my CNM appointment on a Monday and she decided we needed to induce because of my blood pressure (she consulted with a MD to make the decision) and the induction was started Monday evening and Tuesday around noon, my son was born.
This is pertinent to my family, because my scheduled c-section (baby is breech, not a candidate for ECV) is scheduled for this Tuesday! They schedule it for the 39th week, so there wasn’t much choice. I’m actually quite happy with the date though. It makes sense to me that if a section has to be scheduled, it ought to be scheduled at a convenient time!
Congrats and good luck! My induction was my favorite birth. Making plans rules!
Makes sense, I think, to do it on a Tuesday, because then you should be home by the weekend, right? Good luck!
My first section was for the same reason. Congrats ahead of time!
Best of luck! My c-section was on a Tuesday (in my 39th week) also, and I was discharged that following Friday morning! I actually chose the day of the week, however, based on which OB in my OB/Gyn practice I wanted to do the surgery…she happened to be on-call that day. I had the option of doing it on that Monday, but I really, really wanted that particular OB to do my c-section.
You only have about 2 more days to go! I hope everything goes smoothly, and you have a speedy recovery! Enjoy your new little bundle, just in time for Thanksgiving. I hope someone brings you a plate of awesome food, because I was absolutely ravenous while I was in the hospital!
Now that I’ve thought about it my last birth was on a Tuesday too. The ones that were not induced both came on a Sunday
I just added an addendum demonstrating that Improvingbirth.org’s claim is misleading on more than one level.
Hang on, is Thanksgiving in the middle of Hannukah this year?
Ooh…dreidels and turkey…fun!
Thanksgivikkah. Someone actually made a chanukiah shaped like a turkey, but since this doesn’t happen again for a few hundred years, it will be totally irrelevant for a while.
I had no idea this was happening.
Yep – this means I can’t put bacon in the stuffing this year.
So, I am a proud meat eater but recently someone was cleaning out the apartment below my store and there were some frozen foods the landlord offered me. One was a box of veggie bacon. I never thought this was possible but it was not half bad. Might be something to vamp up your stuffing while being kosher
Turkey bacon?
First night [candle] of Hanukah is Thursday, 28 November, this year. It’s never happened before, and it won’t happen again, according to one article I read, for another 75,000 years. So go out and buy a “Menurky” [TM]* and enjoy Thanksgivukah.
*The “menurky” is a Hanukah candlelabra that looks like a turkey. It was developed by a 9 year old American Jewish boy and his father patented it and arranged for commercial production.
I believe someone has actually created a turkey latke, but it doesn’t sound very appetising. Here in Israel we eat jam donuts [suf ganiyot] more, anyway.
First day of Hannukah is Thursday, 28th November, making the first candle on Wednesday, the night before. Butit is unusual to have Thanksgiving and Hanuka (any night) at the same time. It is very rare for t to start in November, if it has ever happened before at all.
It’s so funny because the date changes every year. If this were really true it’d be glaringly obvious.
This is obviously nonsense, but even if it was true SO WHAT? Who wants to go into labor on Thanksgiving, especially since its a holiday where many people travel to see family.
The fight againsi induction is pure NCB- a hate for what they cannot offer or control. I wouldn’t trust that site to even get the date correct.
But they do induce – with castor oil and ale smoothies! My crunchy friend wanted more control over the birth dates of one of her children due to her spouse’s schedule so her CNM gave her the recipe.
Another double standard example. Don’t induce, but if you do, do it by having the massive trots.
No, induce by “natural” means, not scientific ones. That’s the joke–medicine is so magical anyway, that this is simply a “variation of normal”. That it is ineffective escapes their lunatic thinking. I really think it is fear of the apparently incomprehensible. People who use this “method” don’t understand the action of either castor oil or prostaglandins. And it certainly is cheaper to take castor oil than be hospitalized and induced properly
I don’t think taking anything is natural. Putting non-food in ones mouth is un-animal-like
When I was overdue with my son, of course I had fun with all the recommendations to walk, eat spicy food, etc. One of my NCB friends pulled me aside and said, “I don’t know if you’ve heard about castor oil, but don’t do it.”
“Because nothing would improve my mood like adding the shits to my prodromal labor?”
“Exactly.”
I took caster oil with my second pregnancy but I had been so constipated it just worked me poo normal like at making…No joke. It was a relief. The stuff works!
I tried castor oil at 40 weeks with baby number 2. Guess who didn’t go into labor until 2 weeks later anyway? I never made that mistake again, but I sure was relieved that it didn’t work! TMI, but my a$$hole was so sore after all that pooping no way I would have handled labor very well. Yikes!
The concern (or sanctimony) is so overblown. The due date for my second son was December 2. I was 3 cm dilated before Thanksgiving; we had our bag with us at the family dinner. The fact that it could be Thanksgiving or a day before or after never occurred to us and was never mentioned by my OB. (actual birthday 12/9)
Same with my daughter who was due 12/3. We usually go 1.5 hours away to my husbands house for dinner but that year I was too close to birth for me to feel safe going that far. We put on Thanksgiving with my best friend and her kids and husband. It was so small and intimate and the first year that we had pulled off Thanksgiving all by ourselves. I still remember how special that was. Thanks for reminding me 🙂
My son was due dec 2 and born dec 9 as well!
Wait wait wait. Both your kids were born after their due date and so was my daughter (12/6)….so where were the evil doctors coming to induce us? I thought CNMs and OB would not let women go past 40 weeks?!?
My daughter was born at 40 weeks 5 days. My OB must be really bad at math if she was plotting to get baby delivered before 40 weeks!
My first was due Jan 24, born Feb 8 (OB).
Second was due Nov 18, born Dec 2 (CNM).
Third due May 18, born June 1 (CNM).
First, my kids apparently hated their due dates so much, they held out til the following *month* (lol), second, no, armed guards did not show up to my house or at my appointments ready to cart me off to my forcible induction. That is all 🙂
Mine were due in Feb, born in Jan, but we had a scary round of pre-term labor on Dec 24. We all (me, husband and doctors) thought we’d be having Christmas Eve/Day babies for sure. They would have been 32wks. Thank goodness they faked us out and waited another month. Least fun Christmas Eve EVER.
I guess that tops my Christmas Eve with the stomach flu, and the 45-minute drive home from my parents’ house with no bathrooms in between. *Takes off crown, passes it to Amy M*
I spent the Christmas I was pregnant working a 13hr 8am to 9pm day shift as a medical SHO, didn’t eat lunch or dinner because people tried to die at inopportune moments so I didn’t get meal breaks (thankful for the biscuits and chocolates donated by relatives) and vomiting into any handy receptacle because of hyperemesis.
Fun times!
All right, you and Amy M can fight over the Shittiest Christmas crown. I am starting to appreciate my stomach flu 🙂
Wendy Gordon has no idea what she is talking about. Especially in the hospitals her own area (which happens to be mine too). She probably doesn’t even know what a hospitalist is, and doesn’t understand that since there is always a doc there, nobody is inducing or sectioning for their own convenience so they can be somewhere else.
Of course, if you refuse the CS or induction, you could become an altogether DIFFERENT type of statistic.
My elective CS was on the 9th of July.
The 12th of July is a public holiday here, with much reduced staffing levels, and the maternity hospital I delivered at is on an interface, so is often surrounded by youths throwing missiles and petrol bombs at the PSNI and each other on the 12th. There are also parades, and resulting road closures.
I think my decision NOT to wait until after the 12th, just in case I ended up giving birth in the car in the middle of a riot, or having an emergency CS in a hospital with a skeleton staff was perfectly sensible.
Please stop the word diahrrea coming out of your mouth! If you are gonna say something please base it on evidence based research not in your bias of being a OBGYN! Both midwives and doctors work towards improving the health of mothers and babies… We really dont need a never ending rant of who is best!
You are say you are a professional… Then prove it. When I read your articles something inside me tells me that maybe, just maybe, you hate midwives so much because you secretly wanted to be one…
Open your eyes woman! The reality is that midwives also save lives and THERE IS CURRENT RESEARCH that proves home birth is safe, however, people need to check credentials from BOTH midwives and doctors before receiving care. It is up to mothers to make an informed decision of ANY care they receive…
Now I can flush the toilet….
Or you could simply work on reading a little more of this blog so you understand who Dr Amy is referring to when she speaks of a certain pattern of practice and behavior in midwives. I can tell you just read a little and started commenting with both barrels blazing, as you have totally missed the message.
Flush yourself down the toilet, Hagatha.
HAHAHAHA!
Dr. Amy hates midwives because she secretly wanted to be one. That’s a new one! I’m sure going to medical school was her second choice after her dream of being a lay midwife was crushed when she realized midwifery’s rigorous educational requirements and training process.
Yeah, she probably cherished that hope of reassuring women “birth is as safe as life gets” all through high school and was ashamed she didn’t drop out and pursue her dream (because at that time, no high school diploma was needed).
What is your problem? This comment is word diahrrea. Do you have another source that disputes the data compiled by a Harvard economist?
Do you apply the same rigorous standards to your midwifery that you do to your grammar?
What a female friendly person you are to refer to her as “woman”. BTW. She backed up her sources and did you know that Dr. Amy actually had many many certified nurse midwives who consulted her when she was practicing? She believes that CNMs are great practitioners. Did you know it was harder to become a midwife in 1900 than it is now? These old school midwives that people like to pretend CPMs are, were actually rained in all the newest allopathic medicine available. My Great grandmother was one and she didn’t carry a bag of hoo-doo. CMPs in those days would have been called Granny women and it was implied that they knew nothing about birth other than they had seen a lot. I don’t see why it’s Dr. Amy’s fault that you can read studies and have to rely on people to lie to you to find out what they say. If you’d actually read those studies or were even capable of doing the math involved, you’d realize how silly you sound right now.
“You hate midwives so much because you secretly wanted to be one… ” Bahahaha! Silly Dr. Amy accidentally got too much training. Can’t get dumber after the fact. Guess what? She prolly could start practicing midwifery right now and call herself that.
Yeah, because so many people wash out of CPM training and decide to go to medical school and do a residency, instead. I myself decided to become a lawyer when I couldn’t pass the entrance exam for bartender school.
There is damn good money in bar-tending if you don’t mind living like a vampire.
If September 16 is the day of the most births, then it looks as if a LOT of people are making whoopee around Christmas and New Years!
There was a baby boom in New York City 9 months after the blackout.
Snopes says otherwise: http://www.snopes.com/pregnant/blackout.asp
I did read an article a few months back, though about all the “superstorm Sandy” babies. Not sure if they would be considered a boom, but certainly some people had nothing better to do. 🙂
Thanks. I had always assumed that story to be true.
My son missed 11/11/11, by 6 years.
My aunt was born nine months to the day after my Grandfather returned from WWII
I saw a Bar Mitzva invitation hanging at work which was to take place on 11.11.11. From my viewpoint from across the desk all I could see was 11.11.11 in bold size about 36, the rest of the information could only be read close up. Seems they were more excited about this than the fact that their son was becoming Bar Mitzva. It’s only a number that represents a DATE, nothing more for goodness sake. I had a friend who gave birth on 01.01.01 and didn’t realize until I pointed it out to her. She was far more into the fact that she had a new baby boy.
Well, technically that chart isn’t ideal for answering the specific question of “Tuesday before Thanksgiving”, because that day doesn’t fall on the same calendar date every year. Any signal from that day could get lost in the noise of 26 years’ worth of data. Same with Easter. It does work for examining trends around Christmas and New Year’s though – and those do look as though they’re present.
American Thanksgiving is always in November, and not a single day in November ranks among the most common birthdays of the year. So, the chart neatly debunks the claim that the Tuesday before Thanksgiving is the most common birth day of year.
Not really. In the last 5 years, Tuesday before Thanksgiving has fallen on November 24, 23, 22, 20 and 26. If there was a “blip” on that date each year, the other four years would have no such blip on that calendar day, which could bring down the average to about an average birthdate.
I´m not saying the flyer is accurate, I’m just saying that the data presented here aren’t ideal for refuting it.
If we’re going to nitpick, re-check your calendar for that Nov 20th date. That didn’t happen.
Plus the years for the infographic are 2000 through 2009, so the last five years of Turkey Day dates aren’t the ones you need to look at.
I’m comfortable with saying the data shown here (from the NYT column) do not support the claim by Improving Birth (Tuesday before Thanksgiving).
I’m sure we can pick it apart more thoroughly with the correct data. If you want to convince me that the non-existent blip got washed out, find the correct numbers.
I might take a longer look at it later. But that’s going to have to wait until after the Dr Who premiere. I have children who need fish fingers and custard for lunch.
If you’re going to nitpick… Thanksgiving 2012 fell on November 22nd, so the Tuesday before did indeed fall on Nov 20th.
Oops! I read Thanksgiving dates – my eyes skipped over “Tuesday” as she and I were cross posting (and as the end of my comment indicates, I’m multi-tasking).
My apologies to Kristjana.
The Tuesdays in question from 2000-2009 include: Nov 21, 25, and 27 each twice, and Nov 22, 23, 24, and 26 once.
The highest ranking for any of those days is Nov 21 at
#199. The remaining dates ranks’ range from 340 to 358. Without looking any further for now, I don’t think we can make excuses for the original claim through the idea that the changing date will wash out the effect.
The dates that would cover those days before Thanksgiving are some of the lightest on the whole chart. If one year was higher than any other day in the year, the rest of the years might average out, but they’d be unlikely to bring it down to levels that low.
Thanksgiving is the 4th Thursday of November. The actual date cycles between Nov 22 and Nov 28. Therefore, the Tuesday before is between Nov 20 and Nov 26. Among those dates, the 20 and 21 are about as popular as the rest of Nov, but there’s a significant drop off at Nov 22. If their claim was correct, the drop off would not be as dramatic (however, unfortunately, the NYT link doesn’t provide the actual numbers, just a popularity ranking, which means we can’t tell how dramatic the drop truly off is with just the data provided).
I wonder if they chose to pick on the “Tuesday before Thanksgiving” because (one) it’s more difficult to verify, and (two) because they know condemning social inductions before Christmas and the end of the year (tax babies, as mentioned) is a much harder sell.
If we assume an equal number of children “should” be born the week of Thanksgiving every year, and that births are induced on the Tuesday before Thanksgiving to avoid births on Thanksgiving day itself – let’s choose easy numbers and say 10 babies should be born on thanksgiving, of whom 8 are induced on Tuesday instead. Well, that would leave 2 babies born on Thanksgiving each year. But because the date cycles – another year, 8 babies would be born on Tuesday before Thanksgiving which now falls on the same calendar day as our earlier example year’s Thanksgiving. You have now completely washed out the signal and ended up with 5 babies born on that calendar day on average.
It varies so widely. I once did one shift a week at a particular hospital, and for 6 consecutive weeks not one woman showed up at L&D in labor during my shift. The 7th week there were 14 deliveries in 8 hours — my 8 hours, as it happened.
You’d have to have a lot of data to establish a trend.
I am a very strong believer in the professionalism of doctors and don’t for one minute believe L&D staff are out to “get” women or to induce them so they can make it to golf on time or get Thanksgiving off. I also hate it when people make up statistics or manipulate data to fit their needs. But to refute it, we can’t manipulate data to fit OUR needs.
But that chart, while not as specific as one might want, does refute the claim of most babies born on the Tuesday before Thanksgiving than any other day of the year.
And if I remember the story of poor Vylette Moon correctly, the only ones concerned about Thanksgiving then were the awful awful midwives who let that poor baby die so they could eat turkey with their families.
My doctor at my practice is on call this Thanksgiving, regardless of whether she has patients likely to deliver. She’s the coverage for the office (a group of five OBGYN). Even if they have no patients “due” then, pre term labor happens. It’s not like they are midwives who are going to say well none of my patients are due to deliver, so over the river and through the woods I go. Nope, someone had to be available for the office’s patients. I meet the doctor who’s on call Christmas Day at my next appointment, just in case.
I imagine that the most accurate data would be births per day of the year with a regression analysis for days of the week. Tuesday is the day of the week with the most births, but other holidays besides Thanksgiving vary the day of the week from year to year. The most accurate data would correct for that.
Agreed – that would be interesting.
Here’s more data:
http://thedailyviz.com/2012/05/18/how-common-is-your-birthday-pt-2/
I’m betting the New Years/Christmas trend has more to do with people pushing to get the baby born in this calendar year so they can get the deduction than it does with OBs being vacation-happy.
Not to mention if deductibles have already been met.
This is me, forget the taxes, I don’t want to have my whole deductible met again in the fist week in January! We often don’t come close to meeting the deductible in a year’sworth of medical bills. Bishop score pending, I’m signed up for a “social” induction on Dec 26 at 39w6d.
But the fact that November itself does not have any common birthdays means it could not be true.
That chart definitely doesn’t show what the flyer is claiming… but it still doesn’t look great. Those two pale days before July 4th would have been a better horse for the crazies to beat since that one does look suspicious. The wide bands around Turkeyday and Xmas (and the ramp-up and fall-off between Xmas/Jan 1) suggest that doctors/mothers don’t want to induce then either — or maybe that hospitals are understaffed around those weeks? How precisely does it work, folks-who-work-at-hospitals? (It also looks as if people deliberately try to have babies on Feb 14th, which is cute!)
I wonder how consistent this is from year to year. The chart include 26 years’ worth of data. All it would like is for some random date (my first thought was nine months after Sept 11 2001, not that it’d work for the Thanksgiving claim), to spike a single date for that year. It’d be obscured in the 26-year span but give wackjobs the chance to make their claim and have it be but a half lie.
We have the same amount of openings around thanksgiving, Christmas, and New Years as we do the rest of the year. Families tend to refuse elective inductions and c/s offered too close to those dates if they have a choice. The one time you try and reduce core staff on Christmas you will get a horde of laboring women twice the size of your busiest day the rest of the year! (I’m not superstitious that often)
How precisely does it work, folks-who-work-at-hospitals? It’s not just staffing; most folks don’t really want to be in hospital over holidays if they can avoid it, especially a big “family” holiday like Thanksgiving or Christmas. A lot of hospitals give patients home leave if their condition warrants it, and not just obstetric patients. But when I was at Cambridge in the 70s, there was a bit of a scandal when the Radcliffe Infirmary in Oxford announced that any woman due to deliver over Christmas could ask to be induced prior to the holiday, and the reason given was that fewer staff would be working the actual holiday [although many would be on standby at home if there was a flood of births].
In my first year of nursing school, the lights all along the Eastern seaboard went out, just as I exited the subway at Union Station [1964]. 9 months later it was hell on wheels in the labor and delivery unit.
Wars can do it, too. There was a big upswing in deliveries in Israel 9 months after the end of both the 6 Days’ War in 1967, and the Yom Kippur War in 1973. [Israel has predictable busy periods, since there are a couple of times during the year when weddings, which are religious, are prohibited. Everyone seems to make up for lost time afterwards. One of the periods is after Passover, for roughly a month, and another is for three weeks in the summer. L&D units don’t let midwives take vacations 9 months later, on the average]
Antigonos, the Northeast blackout was 1965, not 64. I have friends who are blackout babies born in Sept ’66.
http://www.history.com/this-day-in-history/the-great-northeast-blackout
Makes sense –I began nursing school in Sept.’64 and it most definitely did occur during my first year. The hospital (Beth Israel in NY) had its own generator, but we were instructed to remain in our lightless dorm on the chance we’d have to help on the wards. Being newbies, we were thrilled at the idea. In the event, we weren’t needed.
The hospital I just did a clinical placement at was a busy public suburban hospital, but not as big as the inner city hospitals. The O&G team included 6 consultants and 6 registrars, plus residents, interns, midwives and nurses. All of the consultants worked part-time at the public hospital and part-time in private practice. Two of the registrars were part-time and job-sharing as they had young families. The roster was very complicated.
The roster included 24/7 onsite coverage by at least one registrar and 24/7 on call coverage by at least one consultant. In addition there was 24/7 coverage of at least one operating theatre for emergencies, including theatre nurses and anaesthetics staff, although that was for surgical emergencies as well as for emergent c-sections.
On Tuesdays, Wednesdays and Thursdays an extra operating theatre was designated for “elective” c-sections. It had double-coverage by consultants and registrars, plus nursing and anaesthetics staff rostered on especially for those days. As a public hospital there were no maternal request elective c-sections. All were medically indicated, but not emergency situations.
Similarly, medically indicated but non-emergency orthopaedic operations, hernia repairs, gynaecological surgeries, abdominal surgery, etc. etc. etc. was scheduled according to rosters to ensure that there was always the facilities and the staff available. All of these operations were also medically necessary, but not emergencies.
In addition, inductions were scheduled for Sunday through Thursday, because there were more midwives and nurses rostered on Monday through Friday. Neither inductions nor c-sections were scheduled on public holidays or the day before public holidays, as the extra rostered staff wouldn’t be available.
So, overall the number of births would show a distinctly non-random pattern. What could be scheduled conveniently was definitely scheduled conveniently, so as to maximise available staff members and thereby maximise patient care.
It’s an interesting chart. February 14 is darker than the rest of the month, possibly reflecting a parental request for that date when a scheduled induction/c-section is needed. Same with the end of December. I doubt doctors and nurses care if your baby is born before or after New Years, but parents don’t want to shell out for a new deductible and they get an extra year of tax deductions. Nothing wrong with doctors accommodating these requests!
So Pre-Thanksgiving baby is a myth but tax babies are real.
If there were pre thanksgiving babies, seems like parental requests would be a factor too. If I knew I needed a scheduled c-section or induction, and that window fell into thanksgiving week, I’d see if I could choose Tuesday or Friday. I know a couple of people who were due at the end of the year and required scheduled c-sections anyway, so chose the 27/28/29. My point is these trends could be the results of completely reasonable parental requests rather than evil doctors.
It probably depends on which days are surgery days for your doc too. My doctor’s surgery days ARE Tuesdays and Fridays.
I think tax babies can’t be completely dismissed, considering that December 30th is one of the darkest days on that chart. The pre-Thanksgiving days don’t show up that way. In fact, if you look at it, they’re some of the lightest days on there.
Yep! My 12 year old’s birthday is January 5th. His older brother was born January 21st the year before. They don’t have a lot of birthday company, heh.
Of course. This is probably like the “statistic” they’re always posting that Friday at 5pm is the most common time for cesareans. A whole bunch of BS.
My first c/s was at 5pm on a Friday, but that’s because I was a last minute addon due to medical necessity. The homebirthers love to tell me how I could have refused it….
The same home birthers whose babies you save after they have to transfer from Puget Sound birth center? Haha what a bunch of idiots. They seem very clear (in their own minds) about refusing things and then come off sounding stupid because they have no idea what is really necessary.
They probably would go nuts if they knew my doc was on vacation that Christmas. She warned me about it in case I went into labor the two weeks she was gone in December. I felt contractions coming on that Christmas Eve and told my daughter to stop it! That our doc was not there, the horrid snowstorm would make it a 2 hour drive to the hospital, and she was not going to be able to complete with Jesus when it came to sharing a birthday! Contractions stopped immediately. She was a C/S on January 9.
Mine too!!
Generally speaking, if the hospital does not have a dedicated OR for C/Ss, they like to have elective C/Ss first thing in the morning. The rule is to begin, when possible, with “clean” cases, and operate on “dirty” [such as intestinal surgery] at the end of the day to reduce unnecessary possible infections. Of course, an emergency C/S takes precedence over scheduled ops any time.