Homebirth hater? No, but here’s what I do hate …

Hate

I’m often accused of being a homebirth hater, as if that means that what I write about homebirth should be discounted. Apparently homebirth advocates believe only those who love it should be allowed to write about it.

The truth is, though, that I don’t hate homebirth. Homebirth is a choice that every women is entitled to make and I would never ban the choice even if I could.

I don’t hate homebirth, but here’s what I do hate:

1. I hate preventable deaths of babies.

I freely admit that I have a soft spot for babies and I absolutely abhor the idea that some babies are dying because their mothers have been convinced that homebirth is safe when it is not.

How many babies are dying?

If you look at the data from Oregon on planned homebirth with licensed midwives (the most comprehensive data ever collected on American homebirth), we find that the death rate at homebirth is 800% high than comparable risk hospital birth. While 0.6 babies/1000 die at hospital birth, fully 5.6/1000 die at homebirth. That means for every 1000 babies whose mothers choose homebirth, 5 will die preventable deaths. Even though homebirth is a fringe practice, that means that more than 100 babies die each year simply because their mothers chose to deliver them far from the expert personnel and emergency services that would have saved their lives. I hate that.

2. I hate preventable brain injuries.

While death is, of course, the worst thing that can happen to babies whose mothers choose homebirth, it’s not the only disaster to befall them. A poster to be presented at next month’s meeting of the Society of Maternal-Fetal Medicine demonstrates that the risk of brain damage due to lack of oxygen is 18 times higher at homebirth than in the hospital.

Yes, babies born in the hospital do suffer brain damage, too. But for every 100 babies who suffer brain damage in the hospital, 1800 suffer brain damage at home. I hate that!

3. I hate that the Midwives Alliance of North America (MANA), the organization that represents homebirth midwives, has been hiding their own death rates for the past 5 years.

(MANA) has assembled a database of over 27,000 homebirths attended by their members. They publicly boasted about a low C-section rate, low intervention rate and a low prematurity rate. How many babies have died to achieve that low C-section rate? For the past 5 years, MANA has REFUSED to release the death rate. You don’t have to be a rocket scientist to suspect that those death rates are hideous.

Even MANA knows that homebirth kills. They just don’t want American women to find out.

I hate that.

4. I hate that homebirth midwives (CPMs, LMs) aren’t real midwives, just lay people who couldn’t be bothered getting a real midwifery education.

The CPM and LM designations were made up by laypeople and awarded to themselves, despite the fact that they lack the education and training of all other midwives in the industrialized world. In the UK, the Netherlands, Canada, Australia, etc., you need a university level degree to practice midwifery. In the US, you need a master’s degree in midwifery. In contrast, the requirements of the CPM were “strengthened” in September 2012 to require a high school diploma.

Most women have no idea of the vast difference between real midwives (certified nurse midwives) and self-proclaimed “midwives.” I hate that.

5. I hate the fact homebirth advocates lie about the safety of homebirth in other countries.

Homebirth advocates are forever proclaiming that homebirth and midwifery in other countries leads to lower mortality rates. They point to the Netherlands, but the Netherlands has one of the highest mortality rates in Western Europe, and the perinatal mortality rate for Dutch midwives attending low risk births (home or hospital) is HIGHER than the mortality rate for Dutch obstetricians caring for high risk women.

They point to the UK where the system is led by midwives, but that system is experiencing a terrible crisis. A recent government report was scathing in its assessment that UK midwives put the lives of mothers and babies at risk.

They point to Australia where midwives published a study claiming to show that homebirth is safe even though their study found that homebirth had a death rate 5X HIGHER than comparable risk hospital birth.

I hate those lies.

I could go on and on, but I suspect that I have made my point.

I don’t hate homebirth, but I do hate that babies die preventable death and sustain preventable brain damage all because their mothers were fed lies about the safety of American homebirth, the safety of international homebirth, and the vast differences between American homebirth midwives and midwives everywhere else in the first world.

The only thing that surprises me is that homebirth advocates don’t hate those things, too.

  • leah

    I had two successful home births and I did it because I believe it is the safest choice for myself and my babies. If I have another child, I will have him or her at home, if I’m not a high risk pregnancy. I felt so safe doing a home birth because if anything were to go wrong, or feel wrong, or look wrong, my midwives were trained to call an ambulance and get me to a hospital. Every midwife who’s worth anything would have the same system in place. I would much rather be in the comfort of my home if I can, and not in a gown or bed someone might have died in yesterday.

    • AlisonCummins

      It is never the safest choice.

      RE calling the ambulance: http://www.skepticalob.com/2012/05/pediatric-er-doc-homebirth-5-minutes.html

    • Bombshellrisa

      “In a gown someone might have died in yesterday” how many people say that? So there are droves of women dying in those ugly gowns specific to L&D with the open front so you can nurse? They don’t use the beds that break down with the leg supports in other areas of the hospital either. When I gave birth last week, everything and everyone I would need or my baby would need in case things went wrong were either right in the room, outside the door or easily available in the L&D unit. Not 10 minutes away, with only a midwife and her assistant to assess if they felt with their limited knowledge that I would need to be transported.

  • Felicitasz

    Very-very useful post. Thank you.

  • Elizabeth

    Thank you for writing this. My sentiments exactly.

    I did give birth at an alternative birth center with Certified Nurse Midwives twice. My birth experiences were fine and my babies were very healthy. Unfortunately, one of their back-up doctors was the Stuart Fischbein creep, who subjected me to an absolutely horrific experience during a miscarriage between child 1 and child 2.

    It should not be illegal to give birth at home. The only woman I know who did so, did it by mistake! Baby was fine, but she said it was rather upsetting at the time, because it happened so fast and her older child was there, and all the nice arrangements made in advance did not occur.

    I do have a lovely young friend who is considering a home birth. She is not pregnant, but was born at home despite the fact that she was the fifth child of a woman who had had a C-section, and a subsequent VBAC. This birth was attended only by lay midwives and fortunately turned out OK. My friend’s mother was (I am told) a very sweet, but very clueless and incompetent person, who died of uterine cancer because she resorted to herbal medicine rather than having a hysterectomy.

    Enough said.

  • Claudia

    I had 1 hospital birth and 2 homebirths. I despise and resent the hospital experience and the way they mistreated me when I had a straightforward, uncomplicated, unmedicated birth. I HATE the fact that you CANNOT have a natural birth in hospital. They forced and IV on me, they forced a blood pressure monitor on me (although my pressure is fine), they forced me to submit to pelvic exams when I did not need to, they did not believe it when I told them I am at 10 and needing to push, they had to “check” again, they forced me on my back when I told them I want to squat, they were shouting at me to push when it was absolutely unncessary because my body was not numb and it knew exactly what to do, and they took blood at the height of labor because my OB forgot to forward my labs and they had to “assure” themselves they I had no HIV!

    So yes, I love homebirths, I am planning another one in a few month, and I love my awesome and very capable lay midwife, who educated me more about birth that all the OBs I ever met put together. Sure, I’d go to the hospital IF I could give birth my way, the natural way. If midwifery was ever unavailable, I would deliver at home, on my own, no one in attendance rather than subject myself to another hospital experience. I find dr. Amy’s post offensive and unbalanced.

    • Trixie

      Why are you indignant about being screened for HIV? also, how did you know your blood pressure was fine if no one had checked your blood pressure?

    • fiftyfifty1

      You seem clear on why you want a homebirth: you hate all the little things they require in the hospital.

      You seem clear on who is attending you at home: a lay midwife (some women are under the mistaken impression their homebirth midwives have actual medical training).

      Hopefully you are also clear with the fact that giving birth at home increases your baby’s chance of dying by at least 300%.

      You see for me, I’m not against homebirth. I just don’t want women going into it under misconceptions. I hate when women get lied to. Sounds more like in your case you know the pros and cons and you’ve decided the added risk is worth it for you. It’s a free world and that’s the way I like it!

    • Happy Sheep

      You are embodying the entitlement and narcissism that Dr Amy is talking about, you know that right? Nowhere in your tirade did you even mention your baby, or your baby’s safety.
      You hate and despise what seem to be pretty routine things? You were forced to have your BP measured and have labs drawn? Both of those are for your protection, and the HIV status is vital for your HCPs too.
      Did you know many women with PIH and even Pre-e feel “fine”? Unless they took your BP, how would they know? And really? a BP cuff inspires hatred? For all 60 seconds it is on?
      Are you aware that many HIV+ people do not know they have HIV? Are you aware that some people will lie about their status? They also had to type and match your blood in case of emergency with that draw, and considering you were in labor, a blood draw would usually be inconsequential compared to contractions. I had triple peaking nonstop contractions, I didn’t even notice the draw, or the IV for that matter.
      You say your lay midwife taught you more than the OBs did, but how do you know what they are telling you is actually true and science-based with GOOD research to back up the claims? I’ll give you a hint, it isn’t.
      I am glad that your home birth went well, and I am sorry that you were displeased with your hospital experience, but I would trade a blood draw, BP tests and coached pushing for an increased chance of a live, non damaged baby any day.

  • Guest
    • deafgimp

      Would you mind summarizing it? It’s not accessible to me.

  • Guestll

    I hate the cultural appropriation, the noble savage bullshit, and that this movement was ever conflated with feminism.

    • Guestll

      I also hate that it reeks of elitism.

  • stacey

    I need to post this, then bookmark it, so that everyone that says this to me can read it. This perfectly illustrates the issues I have with HB, and the surrounding community.

  • sarahh.rosanne@gmail.com

    Sorry OT: The other day I strayed from my usual facebook etiquette of sharing pictures of my children and such and linked this article http://www.skepticalob.com/2013/08/lactivism-and-viciousness.html. My son has been having some feeding difficulties the last week or so (forcefully vomiting breast milk) and I had switched him to partial formula after being told by a lactation consultant that he was “just lazy and needed to learn that he had to fight for every bite of food he gets in this world” (nice way to view a sick, hungry baby on a nursing strike.) I shared my story, against my better judgement and a fair weather friend whom I have not seen since the beginning of my pregnancy, and has bailed on recent dinner invitations, commented “I don’t agree with your decision, but I love you.” After I replied that this sounded like something an evangelist says to their gay son before throwing them out of the house, because it does, I received this sanctimonious e-mail:
    Sarah,

    By spreading a negative message about these “fascists” in an open forum such as facebook you are no different from them and the insensitivity that has obviously hurt you.

    Your anti exclusive breastfeeding hatred is hurtful to women who have fought hard for their rights to breastfeed, a population of exclusive breast feeders (who far out number the radicals of whom you are referring to) that would support whatever decision worked best for whoever’s family.

    I think you should realize you are talking about a minority, when it comes to talking about a group of women that show no compassion or understanding for other women’s decisions,

    You are reading and posting sensationalized stories….there is no media on stories talking about compassion and understanding….those stories don’t get hits on websites.

    And if you are letting one experience speak for all breastfeeding women and or consultants, then again you are no diff from whom you are attacking. And all there will ever be is a disconnect between us on this issue.

    AND all we exclusive breastfeeders want (all 16 % of us) is for the supplementers and formula feeders to stop using their capable bodies as their excuse.

    There is no truth in 3/4 of the population of women’s bodies not working or not able to breastfeed. There would be no human race.

    Just own up to it, just SAY “i did not want to do something that hard.”

    Just SAY “i did not want to make that great of a sacrafice…I have sacraficed enough”

    Just SAY ” I PUT MY NEEDS FIRST!”

    and then we exclusive breast feeders would all be like ” Damn I admire her, she is my idol, I wish I was that smart…as we whip our extreme sleep deprived co sleeping boobies out…or as we hook our tits up to a pump so our caretakers can feed our babies while we work.

    AND in your terribly insulting rants you are spreading incorrect information. There IS a statistical difference between babies who are breastfed and babies who are formula fed. There are statistical differences in adults who were bottle fed and those who were breastfed. That is why there is such a movement to convince people to breastfeed. Also, majority of formula feeders are undereducated and in poverty. Therefore allowing government programs to pay for majority of their formula… AS an environmental activist and a tax payer- please majority of women try to breastfeed.

    You failed to mention that you have a breastfeeding friend that offered council to you with Claudie, and who offered to be there while you were in labor with Walt(not an easy task) . In other words we lactivists can be very compassionate. I do not hate formula feeders or women who choose how they want to birth. So, you cannot hear me above whatever in you makes you feel guilty. Throw your guilt away- no one else is judging you for your choices. I feel as if I offered you my time and a piece of my life and in your disgust you have spit in my face. You said to me you wanted to breastfeed that is why I offered anything. If you had ever said I want to formula feed, I wouldn’t offer any advice, cause I don’t know how to formula feed. Maybe these things are crazy to you, but to me they are how I support women, all women regardless of their choices.

    PS. ALL HAIL BREASTMILK! Please quit with your insults to our amazing bodies!! All of our amazing bodies!!! Formula feeders, Breast feeders, Combo feeders, Cow Milk Feeders, ETC…. Those who choose not to reproduce-let’s stand together.
    Actually, I just chose to delete you, not because I do not like you, I love you and I respect your decisions. But, I would delete anyone ranting about taking women’s voting privileges away, or racists, or anti lactivists. I am happy with my choices, and I have no prejudices towards other fantastic mothers, and do not need these horrible rants in my life.

    • moto_librarian

      Well, isn’t she a charmer? She is quite the projectionist if she thinks that lactivists aren’t the real bullies in this picture. And why does she think she had the right to be at your son’s birth, and that she was making a huge sacrifice in offering to be there? And then she ends it with a flounce and unfriended you so she can be the hero of her crunchy friends. You don’t need friends like these.

      • sarahh.rosanne@gmail.com

        I have been officially exiled from the local “circle of crunchy mothers who have nipples and can hula hoop.” Like I said, fair weather friends.

        • I I think we need t-shirts

        • Mishimoo

          You can’t hula hoop either?! I thought I was the only one!

          Now for the serious:
          Keeping doing whatever it is that you need to do to be a happy, healthy mum that has a happy, healthy baby. Hope everything gets easier soon!

        • Trixie

          Just as well, now you can feed your baby GMO Cheerios in peace. Also probably less risk of exposing your baby to vaccine preventable diseases.

          • deafgimp

            Hah! re: the diseases.

            Besides, everyone can feel good about feeding non-GMO Cheerios. Oats have always been GMO free, there’s no modified oats out there. Cheerios at least admits that but people kept on asking for it so that’s why they are putting it on their packaging. They can’t guarantee the other stuff isn’t (like the honey nut cheerios or chocolate or multigrain) so those don’t say GMO free.

        • Young CC Prof

          Heck with ’em. No one gets to judge MY feeding choices unless they were there when I made them: In the NICU, watching a team of nurses try to start an IV on a five-pound baby with collapsed veins.

        • Medwife

          I lol’d at hula hoops.

        • almostfearless

          Wow her email was stunning. You know I tandem breastfed two children — a newborn and a 3 year old — and I used a little formula to do it. Some days my oldest just drank too much but as a second time mom, I knew what the sound of a hunger cry sounded like so I gave the newborn some formula. Like 4 times in the first 6 weeks. It didn’t interrupt the breast feeding and it let me continue to tandem BF. By this woman’s standards I’m at once SUPER CRUNCHY for you would not believe the positions I breast fed two child at once… and also A TOTAL FAILURE. This is why I don’t use any labels and don’t join any groups that have a lifestyle requirement. At six months my youngest started wanting solid foods, so she quickly weaned herself… each kid is different. My first didn’t eat solids regularly until after a year and LOVED breastfeeding for a long time after that. Do what works!

    • Young CC Prof

      Good to know she has no prejudices towards other mothers, which is why she needed to write a couple thousand words about how terrible their choices are.

    • Amy Tuteur, MD

      We could play lactivist bingo with that screed. Is it public? I’d love to quote from it.

      • sarahh.rosanne@gmail.com

        Unfortunately it is not public outside of the context of the comment. It was a private message. I removed the senders personal information so as to respect her privacy. I wish that she would have just posted it in the comments section and I would have happily changed the settings to publicize my page.

        • AlisonCummins

          You can share any email, message or let you receive. It belongs to you and you can do whatever you want with it, including sharing it or giving it to someone else. You don’t need their permission. You aren’t their priest, lawyer or doctor.

          • theNormalDistribution

            If I could upvote this twice, I would.

        • Guestll

          She didn’t reply that way in your comments because although she’s an arrogant twit, she’s not entirely stupid. No, she just hit you with a passive-aggressive one-liner instead, and saved her vitriol for behind closed doors.

          I really loathe this woman.

    • nomorequestionscatherine

      “I have no prejudices towards other fantastic mothers”

      So does this imply she does have prejudices towards you?

      I’m open mouthed in a combo of disgust & amazement at her. I want to LOL and cry at the same time.

      I think she did you a great favor by deleting you.

      • Beth

        My favorite part is this: “throw your guilt away – no one is judging you!” You know, a whole paragraph before she calls you the moral equivalent of a racist or someone who wants to take women’s voting rights away.

        She should win some kind of award for lack of self awareness. I mean….just …..wow.

    • yentavegan

      I feel as though I might cry over the narrow corner your friend has painted herself in. She will regret the things she wrote. You Sarah, on the other hand will find yourself in the good company of mothers who do not confuse their self worth with their mammary glands.

    • Trixie

      Uh, I’m part of her speshul 16% club (or I was) and I say fuck that shit. She’s an idiot. I’m sorry.

      When my babies forcefully vomited breast milk, it had to do with my massive oversupply. Taking care of the excess milk took care of most of the feeding difficulties (gassiness, latching/unlatching, crying while nursing) we had. Maybe that’s a possibility you’ve already considered, and of course it’s none of my business, but I thought I’d throw my experience out there just in case.

      • sarahh.rosanne@gmail.com

        I have a forceful letdown, but then when I feed him the expressed milk, he is also vomiting unless it is mixed heavily with human milk fortifier or formula. It looks very diluted even when they seem to have been almost emptied. I’m trying some different things with compression and massage. I’ve been told foremilk/hindmilk issues and I have a lot of cysts, but then of course the next “professional” would say “that’s a myth.” I’m just happy that he is fed and happy. I would like to reintroduce him to the breast but I’m fearful of causing him a lot of unnecessary discomfort in order to fill what is essentially my emotional want, so I’m pumping for now and helping him latch at night while he’s drowsy,after I’ve pumped and he seems content with that for now.

        • Trixie

          Well, it sounds like you’ve explored the possibilities and have found a system that is working for now. There’s nothing wrong with wanting to continue to nurse, if you’ve found a way that is working for him for now. Of course, there’s nothing wrong with stopping, either.

        • Young CC Prof

          “I would like to reintroduce him to the breast but I’m fearful of causing
          him a lot of unnecessary discomfort in order to fill what is essentially
          my emotional want.”

          I feel the same way right now. My baby is thriving on expressed breast milk, and, to my delight, I’m producing enough to satisfy him pumping just 4 times a day. (When my supply was smaller, we were mixing breast milk and preemie formula.) My mother keeps trying to “help” me reintroduce him to the breast, but I don’t think it’s going to work and I don’t think it’s necessary. He HATED the breast, and I hated the hourlong nursing sessions that were 75% screaming.

          Exclusive pumping is NOT a feeding plan I ever expected to use, but for the moment, it’s working for us. If my supply drops or I can’t deal with so much time at the pump, we’ll do more formula again.

          I always thought I would breastfeed and love it. But it’s not about what I want.

          • Trixie

            You know, it’s wonderful that you’ve found a method that works for you. It is possible that as he gets stronger and more efficient with a bigger mouth that moving back to the breast would be no big deal for him, so if it’s something you still are interested in in a few weeks or whatever, it might end up just working out. Pumping is a lot of work when you’ve got a newborn and are recovering from surgery. You’re a champ!

    • theNormalDistribution

      All I can say is fuck this, fuck this, fuuuuck this.

    • ngozi

      that.was.weird.

    • Burgundy

      Wow, does your ex-friend has any accomplishment other then breast feeding her baby?

    • Melissa

      You ever notice how the happily married people tend not to bother their single friends about how they need to settle down, it’s the ones with the disastrous marriages who are part of the “married people are better” bandwagon? It’s because people who are really happy with their life decisions don’t feel the need to convert everyone else to their way of thinking. That’s what came to mind when this woman gets so upset about the fact you dared to tell your story on your facebook. If breastfeeding was truly something she was happy about then she wouldn’t get so upset when she read your update. But clearly she is miserable doing it and is only keeping it up because she’s bought into the idea that breast is best and that being a good mother means to be exhausted and miserable.

      Also, WTF is up with that PS? Breastmilk is amazing but everyone is awesome and we should stand together, so I’m deleting you because by telling your story you are no longer worth standing with? Huh?

      • sarahh.rosanne@gmail.com

        Her children are actually beyond the breastfeeding years so her miseries have at least met a lull in that regard. It’s funny, I don’t think it has ever occurred to me to recruit anyone to any aspect of my lifestyle or belief system (as an adult) accept coaxing my husband to organize his side of our shared closet and put his clothes in a hamper. Which is precisely why I do not recruit other young women into the institution of marriage. But it’s totally fantastic. Everyone should try it! Childbirth too!

    • Lori

      I’d file that under the category of, “whaaaaat?” Seriously, that is like guano-grade crazy. Anyway, being a ‘sclusive breastfeeder myself a few things jumped out at me. First, what’s with all the weird offers to attend your birth? Kind of an imposing offer I thought. Does she really regard herself as some sort of guru because she BFed her kid/kids? Also, the obsessing about what you should say and how exactly you must be wording this excuse and apology letter she envisions you’ll be writing to announce your breastfeeding resignation (I just checked the handbook, you have 30 business days by the way). Just, LOL at her telling you the proper language to use to ensure your sufficiently excoriate yourself for your failings, I mean, gosh, why can’t you just ADMIT you’re a lazy failure who doesn’t want to try that hard!! Wow, its just hard to put into words how rich that was, it is almost too much, and from a friend too, like are ya sure she wasn’t hacked or something? Or tomorrow she’ll email and be like, “hahahahha, you got punked sucka!” I have a friend who would do something like that. Anyway, thanks for the laugh, and please let us know how it turns out. =P

      • sarahh.rosanne@gmail.com

        She has retracted this message and assured me that she is simply passionate about women’s rights … or somethin’ like that. She also assures me that I am still loved. The gift that keeps on giving.

        • Mishimoo

          Translation: “I read Skeptical Ob, noticed you mentioned me and am doing my best to dig my way out of this situation.”

          • KarenJJ

            Hopefully she keeps reading then.

        • theNormalDistribution

          That horrifying garbage she spewed has nothing to do with women’s rights.

          :/

        • KarenJJ

          So passionate that she’ll try to humiliate other women’s choices? The road to hell being paved with good intentions and all…

        • The Bofa on the Sofa

          unfriend her.

          Life is too short to piss around with assholes like that.

        • Amazed

          Women’s rights to be cows? Sorry but that’s how I envisioned BF mothers after reading her email. Cows with tits for long term use who suffer in silence their Great Sacrifice but oh, they are so happy with their choices and hail other Fantasic Cows.

        • Rebecca

          No, just no. Some words can’t be unsaid.

        • Bombshellrisa

          I watched a show on Food Network about the 50 greatest “fast foods” ever. Formula was mentioned and it was referred to as “women’s lib in a can”.

        • Lori

          Oh geez, to be so completely loved by such a tolerant friend must give you warm fuzzies! I hope she reread her vicious diatribe and feels super awkward about it.

    • antigone23

      Really, she’s so supportive and compassionate and doesn’t care what other people do, but feels the need to let you know that she doesn’t agree with your supplementing with formula—why? Exactly what purpose does such a statement serve except to hurt you? And then she feels the need to write this long, nonsensical screed. This woman is toxic with an unhealthy fixation on breastfeeding and it’s good she’s out of your life.

    • stacey

      Wow, what a stupid bitch.

      I am sure FF Moms would love to say “BF just didn’t work for my family, no biggie.), if it wasn’t for people like that bitch.

      I am embarrassed to admit I EBF my DD, and am still BFing her at almost 2 yrs (and probably will for awhile thereafter), because other moms start apologizing about not BFing! They start covering themselves before the attack they are sure will follow, that is how often they get shit for it. And I never bring it up. They usually do, after seeing DD run up to me for nurses. I EFF my DS, so I really don’t GAF how you feed your baby, as long as its healthy, and you aren’t giving them something hazardous (like raw milk or tons of liver).

      (Im sorry, I cannot even come up with a better, smarter, wittier thing to say to this piece of garbage. It must be because I was FF. My damn lazy mom, adopting me at 10 weeks, she should have induced lactation! All my problems are because of this. HA.)

      • sarahh.rosanne@gmail.com

        I was breastfed until I was almost 4. This was early 1980s, the south, tearing my mothers blouse open in the Piggly Wiggly. I came into motherhood believing there was no other way to feed a baby. I was naive and internally judgmental of those who couldn’t or chose not to breastfeed (but just sanctimoniously compassionate enough not to verbalize this- as opposed to what I now feel is a more authentic sense of compassion). When I had my first child I brought all of that judgement down upon myself and it is something I struggle with. It still makes me a little happy though (also envious, guilty etc.- being totally honest.) to see babies nursing in public. I am not skilled enough to keep my baby latched on in the grocery store, nor would he allow it, but I’m happy that it is “socially acceptable” in a way that it wasn’t then.

        • Medwife

          I just don’t want anyone to feel bad for how they nurture their babies. That doesn’t seem like an unreasonable expectation.

      • Siri

        Or fed you baboon milk. Baboons are easy to find and keep, and I’m told their milk is delicious. Or perhaps your mum felt she’d already sacraficed (sic) enough. Actually, you can feed a baby any liquid at all, provided you add chalk to it to make it look like milk.

    • Maria

      Wow. Just…wow. I particularly like the “Just SAY “I PUT MY NEEDS FIRST!” part. The all caps makes it that much more judgmental. It just makes my skin crawl since in reality you are putting your child’s needs first by making sure he isn’t starving! I mean, really. I live in a very crunchy area and I have never gotten a lecture from anyone about how I fed my baby. This woman clearly is one of those who thinks they need to “educate” everyone on this thing that they have decided is the end-all, be-all of parenting.

      • rh1985

        Plus if the mom isn’t happy, it isn’t exactly great for the baby…

    • RandomChickGuest

      Wow… what a freakshow. I hate to think that an idiot like that probably believes she represents women who EBF. (To be clear, she. does. NOT.) I guess she *must* love you… since she oh-so-thoughtfully deleted you so she would no longer be a burden on your eyes. You know, when you’re rolling them. Are you and your little dude doing better now that you’ve found what works for you? That’s awesome. And that is ALL you should ever hear from another human about the choices you make for you two!!

      • sarahh.rosanne@gmail.com

        Thankyou. He is excellent. We are expecting a .07 point drop in his IQ (distastefully joking) … but it’s probably for the best because were it not for that he would likely grow up to take over the world 😉

        • Siri

          Is it too late to feed him placenta? That might restore his IQ.

          • araikwao

            But wait, then he wouldn’t be exclusively BF!My head hurts..

    • thankfulmom

      Wow…I’m sorry this “friend” has such a hard time with moms who formula fed. I have a dear friend who is a LLL leader and I’ve never gotten flack from her over using formula with some of my kids or having them in a hospital.

      I asked her to be with me for the birth of my youngest, but my dh didn’t give her enough warning/time to get to the hospital. He kept telling her it was going to be a long time yet. She visited me and my baby in nicu (and said all the right things). Drove me to the nicu and picked me up because she wanted to help me. She also sent one of her girls over to spend a day at my house helping while I spent the day at nicu. For over a week she brought home cooked meals. This is the kind of friend a mom (or anyone) should have.

      • sarahh.rosanne@gmail.com

        That is a genuinely good and helpful friend! “I will come to your birth if you ask me to”, is like an imposition that you aren’t quite sure what to do with.

      • I get the sense her problem isn’t with friends who formula feed – its friends who refuse to do so in some kind of closet and with the appropriate degree of shame.

        • An Actual Attorney

          “Closet” is the right word. That rant reminds me of the religious right wing who “love” me, and “accept” that I’m gay, but tell me I’m destroying children’s lives and should be closeted on my way to Hell. Which is where I tell them to go as I go about my out, married, raising a kid life.

          • I want to thank you for refusing to conform to what the most ignorant among us would have you do – in that way you might prevent others from being just as ignorant. There’s nothing like a stunning counter example to prove the fools wrong.

    • araikwao

      Speechless..

    • SK

      I am so sorry. What an attack! I have blocked people for less on facebook.

    • Aussiedoc

      Wow. That’s unbelievably hurtful.

      Any wonder I’m too scared to give my kid a bottle in public!

      • rh1985

        Well, my baby will have to have bottles in public. I’m torn between ignoring anyone that’s rude, or giving an equally rude reply.

        • Guestll

          Ignore. A day later, a week later, five years later, none of it will matter.

          • When people are rude to me I either stare em right in the eye and say nothing until they go away, or I act like they don’t exist. That way I don’t really engage w/them but they still feel stupid.

          • sarahh.rosanne@gmail.com

            I’m very snarky but I only successfully reply to “bullying” one in ten times, 1 in ten I stumble over my own snark and start crying and 8 times I roll my eyes and move along. I feel like my rate of successful snark is statistically significant though.

        • Siri

          Do you speak a foreign language? My foolproof method for dealing with unwanted approaches is to paste an enormous grin on my face and say, ‘Sorry, I don’t speak English’ in another language. You don’t have to be fluent, just memorise a phrase. Always works.

        • sarahh.rosanne@gmail.com

          Just expose your breasts and start talking about oppression and liberation. It really works 😉

      • OBPI Mama

        I used to hate giving my babies bottles in public. Especially because before I realized my boobs are defective (lack of milk glands), I would judge women who bottlefed (Cringe. I know, it’s so horrible. I had a lot of growing up to do). I got humbled, but I know what some women are thinking and it’s the pits. By the 4th bottlefed baby, I was just over trying to be discreet as I mixed up the formula and water and shook the bottle… I have 4 healthy kiddos who were all formula fed and I’m thankful for that “poison” that saved my babies lives!!!

      • sarahh.rosanne@gmail.com

        I am still at that place with the bottle where I feel like I’m on the fire escape of my college dorm smoking a joint, and I know it’s silly because I bottle-fed my first child and had gotten past that phase. It is especially ridiculous because I live in an area where the vast majority of babies are formula fed by 12 weeks. It’s strange when you’ve grown up in a culture, or in my case a sub culture, where so very much importance is placed on breastfeeding. My insecurities are disproportionate to reality.

    • Guestll

      I don’t even know what to say to this, other than I’m sorry that you had to be the recipient of such smug and hostility.

      I’m in her “all 16% of us” and on behalf of the others, we apologize for her extreme assholery. I would bet my house that this wildly insecure jerk has major issues that have nothing to do with breastfeeding.

    • Siri

      Horrible rants? Hello Pot, my name is Kettle. With friends like that, who needs enemies? That is vicious; bonus points also for treating you like that when you are exhausted from pregnancy, childbirth and caring for a tiny baby. I hope you’re able to rise above it and trust your ability to do right by your children. Better an open-minded mother who formula feeds than a judgemental one who breastfeeds. And notice how she makes ‘formula feeders and supplementers’ sound like terms of abuse?

      The bottom line is, you’ve done nothing wrong. And you deserve better friends than that.

    • Dr Kitty

      Another one of the 16% who thinks your frenemy was totally out of line.

      As long as your baby is fed appropriately, and you’re both happy, I don’t give a damn about the specifics.

    • Zornorph

      To use one of my Dad’s cruder expressions, tell her to throw her tits over her shoulder and squirt milk up her @ss.

      • OBPI Mama

        Oh gosh, that made me laugh! I can not believe that fair weather friend… what a piece of work.

    • Amazed

      I can’t believe it. Is this person for real?

      And then we all lament the fact that the world is full of bullies who insist that everyone accommodate them but they don’t accommodate anyone because their fantastic mothers cannot teach them anything else but be a bully.

      I pray the woman really goes back to working full-time. Less chance to turn her poor children into mini-hers.

      Does she sound happy to you (generic you?). Because she sure as hell doesn’t come across this way to me.

      • sarahh.rosanne@gmail.com

        She’s fulltime and her kids are weaned. She asserts that she is happy … so one can only speculate.

    • batmom

      Oh, good grief. She needs a hobby so she gives up on the breastfeeding Olympics. Crochet, maybe, or baking little cupcakes. How absolutely pathetic.

      I hope your son is feeling better soon. Poor little guy.

    • BeatlesFan

      I have three things to say in regards to this:

      1) Your baby is being fed, and that is what’s important. Period.

      2) Reading that made me so angry, I want to reply to your so-called “friend” and rip her a new one.

      3) Please, please, please, copy and paste this onto Facebook so any mutual friends can read for themselves how this sanctimonious know-it-all talks to friends she “loves”. If she feels so strongly about it, she shouldn’t mind her feelings being shouted from the virtual rooftops, right?

      • Amy

        Seconding the idea about reposting on Facebook!

      • sarahh.rosanne@gmail.com

        I did copy it to my wall but very soon after I removed it after considering that many of my 180 facebook friends (over whom I apparently hold such profound influence as to move them to eradicate breastfeeding with a linked article) are elderly relatives and work associates. I did receive two messages asking what a lactivist was. It’s a dairy cow, I will tell them.

    • Meerkat

      Ha ha ha ha!
      Your friend needs to put away her boob for just a few hours, and go get a massage. Then again, massage won’t cure crazy. I like how she lumped all EBFeeders into one group, like we are some noble female Knights Of The Boob. “We are noble Knights of The Boob, fighting for the right to breastfeed!”
      Bullshit. I have been exclusively breastfeeding my son for the past 16 months precisely because it has been relatively easy. It’s not an achievement or a sacrifice. In fact, this time last year I looooved our marathon evening cluster feedings, because they gave me a chance to catch up on Dr. Amy’s blog, and was a great excuse not to cook dinner. I still breastfeed because both my son and I finally really enjoy it.
      Breastfeeding just is. It either works or it doesn’t. My breastfeeding succeeded because of my biology and right circumstances, not hard work. You know what was hard work? Sleep training. That was hard, and I am damn proud of it.

    • Amy

      As an exclusive longterm breastfeeder myself, I am disgusted by your “friend.” And she does NOT speak for me. As an exclusive breastfeeder, what I wanted (and got!) was time to pump at work, full stop. What other women chose to do for whatever reason they chose it was not and is not my business, so no, I don’t “want” them to admit anything.

      I’m also a high school math teacher. I’ve been teaching for 12 years, so my sample size is in the thousands at this point. There is NO statistically significant difference between the achievement levels of students based on what they were fed as babies.

    • Dawnie

      Wow, what a bitch. I received a similar letter from my sister-in-law, except the topic was parenting instead of breastfeeding. Can’t stand people who won’t mind their own damn business.

    • auntbea

      Happy to say it. I PUT MY NEEDS FIRST. Secure your own mask first, and all that.

      Does she also believe overweight people shouldn’t post pictures because they are insulting to people who have worked hard to lose weight? Or maybe people shouldn’t post high school graduation pictures, since I worked hard to get my PhD?

    • Your life is better without her in it…

    • Sullivan ThePoop

      Wow! I think there is something in her that makes her feel guilty. Why would anyone do that?

  • These are meaningful things to hate and to work towards getting rid of…I don’t think the NCB community has really thought about what would happen if they got rid of the things that they claim to hate…

  • Ash

    Jezebel.com has an ad on the top of their page promoting discussion of “The Business of Being Born” at a later date because it will no longer be on Netflix streaming soon.

    I kinda want to watch BoBB to see the BS for myself but I don’t want to give it more views on Netflix.

    • Awesomemom

      Don’t bother unless you like killing your brain cells or need a movie to put you to sleep. It was seriously a total snoozefest for me.

      • ngozi

        What is really worth watching is the way they have to rush that woman at the end to the hospital. You would think that would make a lot of people think twice about homebirth.

    • Mariana Baca

      There is some interesting stuff about twilight sleep (nothing a trip to wikipedia won’t tell you), but it is clearly placed there to make you think hospitals haven’t changed in 100 years. The rest is about what you’d expect — hospitals bad, homebirth great, emergencies can be dealt with or transferred to hospital, there are some hospitals/ob that are crunchier and will cooperate with you.

      The BoBB series that comes after that is truly unwatchable, though. Even more woo filled and has a scene with them gifting Ina May Gaskin with a vibrator.

      • Spamamander

        Ok, I was going to go to bed, but now I’m afraid Ina May + vibrator is going to haunt my nightmares.

    • Dreah Louis

      The BOBB the executive producer Ricki Lake had to do A BOBB 2 because she misled the homebirth community. She said she had to make a second documentary because she had to clear up that in all reality most of the births were at birth centers not at home
      Now that’s sad.

    • Zornorph

      You can see it on Youtube, you know. I think I managed about 15 minutes before turning it off in boredom.

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

    • stacey

      Speaking of BOBB, I recently removed from my friends home, the actual copy of BOBB that caused her to want HB. That HB ended in the tragic, negligent, and IMO, criminal, death of her healthy, full term, son. BOBB and Birth Without Fear were the 2 things that made her choose HB at 32 or so weeks. Without BOBB, she wouldn’t have found BWF, though they are equally to blame.

      What should I do with it? It needs a fitting end. I will even record the demise and post it.

      • Sally RNC-NIC

        A Homebirth at 32ish weeks? That’s a premature birth! Was she aware that a 32 week infant would require a great deal of support, both in the short and long term? Did a midwife agree to deliver her at home, at only 32 weeks? That is extreme negligence!

        • rh1985

          I read the post as she decided at 32 weeks to switch to planning a homebirth.

      • araikwao

        A high-powered blender, perhaps? Burn with blowtorch? Run over by a semi-trailer? Semi-trailer then blowtorch then blender?

      • Dr Kitty

        Smash it with a hammer.
        Please.

        • Trixie

          How about taking the pieces along with your friend’s birth story and mailing them to Ricki Lake?

          But like, in a way that isn’t creepily threatening.

      • KILL IT WITH FIRE.

      • Young CC Prof

        Hmm. Disk or videocassette? Either way, I’m thinking that running it over with a car might be a good start. (If it’s a disk, put a little stone under it before you run it over, to make sure it breaks.)

        Then, drop the shards off of something high.

    • Mishimoo

      My best friend’s mum tried to get me to watch it while I was pregnant with my youngest so that I could “understand how I was taken advantage of in the hospital and make a better choice (home birth) this time.”
      I let her rant for a few minutes, gently reminded her that she was with me for the birth of the eldest in the hospital (72 hours of contractions, lots of walking, position changes and showers, occiput posterior with nuchal hand, great apgars, immediate skin-to-skin, breastfeeding within 5 minutes, delayed cord clamping, maternal request for post-delivery pitocin + vitamin K, etc), and she never bothered me about it again.

  • Ainsley Nicholson

    “But for every 100 babies who suffer brain damage in the hospital, 1800 suffer brain damage at home.”

    Is this really correct? The way the brain-damage article states that the increased risk of needing neonatal brain cooling as a rate per birth (I think it does), then the statement above needs to be corrected to account for the low percentage of births at home, right? We know that the risk of death is much higher for home births, but it wouldn’t be correct to say that “for every 100 babies who die in the hospital, 500 die during a homebirth”…we know that the absolute number of babies who die in hospitals is larger because the vast majority of all births occur in a hospital.
    Someone correct me if I’m being stupid….I think the statement above might be the mirror opposite of the homebirth advocate’s “but more babies die in hospitals than die at home!” error.

    • theNormalDistribution

      No, you’re right. It would have been better to say “But for every 100 babies who suffer brain damage in the hospital, 1800 would have suffered brain damage at home.”

      • The Bofa on the Sofa

        I don’t even think that works right. I think it would be better to be “for every 1800 that suffer brain damage in a homebirth, only 100 would have suffered brain damage in a hospital.”

        It’s akin to Amy’s “two out of three who die at home would not die in a hospital” line.

        • AlisonCummins

          “Seventeen out of every eighteen babies who suffer brain damage during a home birth would not have suffered brain damage in the hospital.”

        • theNormalDistribution

          I agree, that’s better. I was just trying to change the meaning without drastically editing the phrasing. There are many better ways to say it.

  • Allie P

    I hate the fact that the NCB industry lies so pervasively that even those who distrust woo can’t tell the difference and get sucked in. I hate that people are being told they are acting safely and responsibly (“hospital is only 5 minutes away” “doctors are scare-mongering” “birth choice” “variation of normal” etc) when they are actually tricked into making unsafe decisions. All you have to do is read about that baby (Wren?) who died of GBS+ strep infection a few hours after birth and read how his parents mistakenly thought choosing homebirth was like buying at Whole foods — it was fancy organic birthing. But Whole Foods still needs to conform to public health standards and FDA standards in their food. What they were really buying was black market unsafe food, and they didn’t know it.

    • mydoppleganger

      I find that many rogue homebirth advocates have a chip on their shoulder about authority/trust/past trauma of some sort. I’ve never been a homebirth advocate but my own hurdles with the whole birth thing has made me have to realize how naive I can be. It has made me look into the reasons why I would feel so drawn into the whole culture. Acceptance?Insecurity? Need for the feeling of accomplishment? Hmm.

      • They sell the illusion of control over birth. Everything will be okay if you are Good Enough. Sounds like home to people with an eating disorder or a trauma history. Its a large number of women, too. I think something like 1/4 of women experience some kind of abuse in a relationship, and most of the time its before or during ages where pregnancy is possible.

      • KarenJJ

        Definitely. It was my lack of trust of doctors and hospitals that led me into the woo side of things. At the Hypnobirthing course I was on there was another woman that had a terrible phobia of all things medical and childbirth.

      • Melissa

        I think it’s all those things. There’s also people who may pick homebirth because of something practical (i.e. no insurance and afraid of being able to afford a hospital birth) but buy into the woo to justify it. The only person I know who ever did homebirth had previously had children removed because of her drug abuse and I suspect homebirth was a way to avoid drug testing. But she said it was about keeping things natural and promoting bonding. I’m not saying that all homebirths are like this, just that some people have practical concerns which they don’t voice because they aren’t socially acceptable.

  • OT: That moment when what you think what happened proves to be what actually happened. So in the view of those here, should head nurses be substituting their juddement for that of Dr.’s and patients? They do in Victoria with respect to maternal request cesareans! http://www.kidsinvictoria.com/forum3/viewtopic.php?f=36&t=3764918

    • theNormalDistribution

      That’s it. We’re moving to Vancouver.

      • Don’t leave me here with these crunchies!

    • Dr Kitty

      I hope Tikitorch was talking nonsense.

      Because the idea that a Dr would schedule a CS and a nurse would then make a value judgement that the patient didn’t “deserve” to have the surgery and bumping it to the bottom of the board, I can’t see it happening…well, I can see it happening and then being discovered and the nurse fired and disciplined.

      You are, BTW, totally correct that there will usually be a medical indication listed for MRCS. My CS, BTW was listed as “maternal request, maternal spina bifida, relative CPD, induction not appropriate”.

      One of the reasons women request CS is because of previous abuse or sexual violence, and I don’t really think it is the business of the nurse in charge of the OR schedule to know such personal details, in addition the OB or patient may prefer to simply put “MRCS” or “tokophobia” as the listed indication.

      The OB and the patient want the surgery done today…find a slot…make it happen…job done.Yours is not to reason why (unless someone’s life or limb is at stake and you need to juggle the board) and then you call the OB and ask if they think their patient can wait.

      • Sadly, I don’t think she was – she claimed to be an OB nurse (later edited). That combined with my personal experience, and I come to the conclusion she’s not talking nonsense. If it is the case, she has no idea what kind of harm she’s inflicting.

        • Dr Kitty

          That is…wow…
          The idea that a nurse who doesn’t know you would feel she knew enough to decide it wasn’t in your best interest to have a surgery when your doctor who looked after you throughout your pregnancy and decided it was best for you…talk about overstepping professional boundaries.

  • Lisa from NY

    If I say “Let me hit my baby’s genitals with a hammer” it’s to jail I go. But having a vaginal breech baby and banging it’s genitals with my bony pelvis is heroic.

    • Zornorph

      If I had a hammer, I’d hammer out danger, I’d hammer out a warning, All over this land.

  • Lynnie

    I hate that home birth advocates take pride in the fact that home births have lower rates of prematurity. For some reason that really annoys me, like wanting to shout expletive language in their face, close to full on rage. What mother in her right mind, when having preterm labor, would chose to labor and give birth at home? Um, I’m pretty damn sure that even the crunchiest of moms would run to the hospital when having contractions at 30 weeks or there abouts. I’m sure there are some people who would try to stop them “naturally” at home, but I sure hope that any sane person would realize that something is wrong and there needs to be (oh no, not the dreaded “I” word) interventions to stop labor or the baby will needs a lot of extra care once born. I know there are a lot of other stats that home birth advocates claim as a result of home births that are a lot of BS, but that one really grates at me more than the rest.

    • Young CC Prof

      Definitely agree. Absurd misuse of statistics.

      They also sometimes cite a lower preterm stillbirth rate. Again, mother probably went to the hospital when things started going very wrong long before the due date.

    • Trixie

      Yeah, MAJOR logic fail.

    • lucy logan

      where do people say that? thats idiotic

      • Lynnie

        http://www.pureheartmidwifery.com/advantages.html

        “These
        are just a few of the many benefits of choosing homebirth as an option
        for the nurturing of your pregnancy and the ideal setting for your
        birth. However if you are considering a homebirth you should also know
        that a common misconception is that homebirth is a far greater risk than
        birth in an institution. The Centers for Disease Control (CDC) reports
        that babies born at home are less likely to be born preterm and have a
        low birth weight compared to babies born in the hospital. Contrary to
        popular opinion, evidence-based research shows that homebirth is safer
        in most instances. In addition, with the Texas primary cesarean rate
        around 25 percent and secondary at the uppers of 30-35 percent, Midwives
        allow you to have the most non-intervention in your labor and birth
        allowing for the lowest risk of an unnecessary cesarean. With
        midwife-assisted deliveries, the rate of cesarean sections is less than
        half of the national rate which is 12% versus 25% as reported by the
        Public Citizens Health Research Group. Midwives also have lower infant
        morbidity (disease) and mortality rates. The National Center for Health
        Statistics reports that Midwife-assisted deliveries are 19% lower in
        morbidity and mortality rates than Physician-assisted deliveries. “

        • nomorequestionscatherine

          I had deja vu reading that. I just found & was reading that website last week. It’s just amazing the things they’ll say.

        • araikwao

          “evidence-based research”??! Enough to say they don’t know what they’re talking about..

    • The Computer Ate My Nym

      I sure as hell hope that even the crunchiest of moms would run to the
      hospital when having contractions at 30 weeks or there abouts.

      You’d think. But the CDC wonder statistics show some births at home at under 30 weeks.

      • The Bofa on the Sofa

        That has to be basically it happened too fast to get to the hospital, though, right?

        Unintended homebirths still count as homebirths.

        • The Computer Ate My Nym

          Some of them are listed as attended by midwives. Though I agree that most are probably unintentional, too fast to get to the hospital type experiences.

      • areawomanpdx

        Is this a search done with “other midwife” present? Because if so, HOLY SHIT. I do know someone who started having contractions at 24 weeks and was told by her homebirth midwife it was no big deal. Good thing she eventually went to the hospital in spite of the midwife’s advice, where her undiagnosed twins were born.

        • My brother died shortly after his premature birth, because the OB at the time (1976) refused to do anything to stop my mom’s premature labor. He also told her my brother was Stillborn, so she didn’t even get to see him. Ah, the 70s

          • amazonmom

            🙁 My maternal grandmother had a stillborn baby at term, she was never allowed to see him. She only knew it was a boy because a nurse risked her job to tell my grandparents. It was the late 1940s. Grandma almost disowned me for going into neonatal nursing until I explained things weren’t done that way anymore.

          • KarenJJ

            There was some terrible things that happened to women in the 70s. My mum’s story isn’t as bad but made her terribly angry about the obgyn that she saw. I don’t think she really saw past it all until I had my first and she could see all the info I had, the choices available and the choices I could make during labour.

    • SkepticalGuest

      Any reputable homebirth midwife does not ALLOW premature homebirths. The clinic we went with had a strict policy of NOT delivering any pre-37-week baby at home.

      Granted, there are some crackpots out there delivering preemies at home, but as long as there are some (relatively) sane homebirth clinics doing what ours did, then of course there is a lower rate of prematurity.

      Not to mention that the reputable clinics won’t deliver multiples at home–not even twins–so that also skews the preemie numbers.

      There is no magic about seeing a CPM that makes your baby stay in longer.

      • SkepticalGuest

        In other words, correlation does not equal causation.

      • Mariana Baca

        “There is no magic about seeing a CPM that makes your baby stay in longer.”

        I think the implication they are trying to make is because a CPM is willing to wait until post-dates instead of inducing or not electively inducing, there are no babies being born “accidentally” premature. But I don’t think the records would show those as premature anyway.

    • L&DLaura

      We had a preterm homebirth mom come in to our hospital. 31ish weeks. Contracting, bloody show and 3 cm. We needed to transfer (small hospital). Anyway. She fought us tooth and nail. Didn’t want an IV. Refusing magnesium. Didn’t want to transfer. What the heck? Why did you come to the hospital? She eventually got transferred. They stopped labor and she went home. Then wrote a letter stating how horribly she was treated by us.

  • mydoppleganger

    One issue I’ve been dealing with is that my pelvis is locked and it’s a small pelvis. One doctor told me quite frankly he does not see how the baby can engage at this point. I appreciated his frankness on the matter. Of course, when looking up small pelvis on the net, I find many NCB’s saying it’s more a matter of affirmations and positive thinking to overcome this hurdle. However, to also fight the medical staff and the situation. I don’t see that as very relaxing. My attitude is “if it happens, great. If not, I will be fine with a section.” One person even said this would not be an issue if I chose to home birth. I find that all the time I’ve spent allowing myself to participate in the idea that vaginal birth is ideal has created more mental strain than just going with the come what may of life. I remind myself that my pelvic region does not determine my value as a person and a Mom. Hearing the support of my non NCB friends in regards to my section allows me to understand that it’s a small amount of folks who obsess over vaginal birth, not the whole world. That is a more liberating feeling than the “do or die” goal over a natural, vaginal birth.

    • mydoppleganger

      Another issue I’ve found troubling is the constant advice to war with docs and med staff. It seems many natural birth groups say IF you go to the hospital to be prepared for war. I’m not interested in that, holding on so tightly to this dream to not be flexible. For a person like me, it only causes more stress and regret. I’m wise enough to choose a doctor I trust, but also know there needs to be compromise in the situation. So many VBAC(especially) mamas I’ve witnessed hit the last few weeks of pregnancy with a sense of urgency and feeling attacked by the doctors. I’ve read stories of home birth transfers that blame the doctors and the women seem so depressed/victimized afterward. I keep reminding myself that I can’t control the weather. I can have hopes and dreams, but like anything, it goes a bit easier when I’m not obsessed over total control of said situation.

      • Dr Kitty

        FWIW I made a decision to have a CS partly because I knew with my tiny, weird, cyborg pelvis that it was the one way I had total control and my body couldn’t let me down.

        Knowing I could choose the day, go in and safely have a baby with the minimum of fuss and pain beforehand mattered more to me than a vaginal birth (and given my issues VB was a long shot).

        Whatever you decide, and whatever happens, I hope that your baby arrives quickly and safely and in a way that you can accept.

        • mydoppleganger

          I’m putting myself into a place to be positive and peaceful about it. I realize “peer pressure” I have allowed has made it more difficult to easily accept the right choice. We are scheduling my 41 week csection with my favorite doctor, and I will be excited to know this baby’s bday. If labor begins before then, great! But I’m coming to the place of actually RELAXING and not obsessing over it. I’ve gotten plenty of advice to induce labor via natural methods, but I’m not very certain it would help a baby engage if the pelvis is not agreeable.:)

          • Medwife

            It sounds like you’re in an ideal frame of mind. Early congratulations on your new little person 🙂

          • Dr Kitty

            Yeah don’t try and induce labour with an unengaged presenting part (not that you would, you’re very sensible)…bad plan…very bad plan.

          • Can you elaborate? I was induced at 39 weeks for GD/PIH and my son was disengaged…

          • Medwife

            Where I work, we will generally try induction with an unengaged baby, but it’s not a great success indicator for a vaginal birth, at least with a first time mom.

          • mydoppleganger

            Thankfully, my OB practice will not attempt a VBAC via induction. They tend to err on the safe side, which I am thankful for. *I’m a vbac option patient.*:)

          • Dr Kitty

            Risk of cord prolapse and not a great chance of success, especially a first baby.

          • KarenJJ

            My obgyn scheduled a c-section for me at 41 weeks when my first was not engaged at all. I went into labour at 5am, two days before the scheduled c-section. I laboured at home until my waters broke, when my husband rang the hospital and was told to have some lunch and then come in (why? I’ve never thought that advice was a good idea in retrospect – it was incredibly awkward trying to eat something while leaking fluid and contracting and I wasn’t the least bit hungry..).

            We got to hospital and they found some meconium and that I hadn’t dilated and the head hadn’t engaged. My obgyn gave me the option to continue (knowing that I really wanted a drug-free vaginal birth), but I wasn’t the least bit interested anymore now that my baby was showing a sign of distress (the heart monitor was fine though). He wouldn’t try and induce without the baby being engaged in case the cord came first.

            So I had my c-section after all, my baby was healthy, recovery was OK and better then the laparoscopy I’d had previously due to the anaethetist controlling the nausea better.

      • Trixie

        You know, there are areas of the country where it’s really hard, or impossible, to access doctors or hospitals that will do a TOLAC. There are a lot of complex reasons for that, but I do wish that every low-risk woman who wanted to attempt a VBAC could attempt one in a hospital. I was an ideal candidate and I still had to switch providers to get the chance to VBAC. The alternative, of course, wouldn’t have been a home birth for me, but I do see how some women get pushed in that direction, even if they don’t start out buying into all the NCB woo.

        • Karen in SC

          That’s a resource issue and sometimes, that’s the breaks. It’s still a decision of safety vs. some other priority.

          • Trixie

            For women who want to have large families, and who have to have a c-section early on in their reproductive lives, lack of access to VBAC in a hospital is often what drives them into HBAC.

    • AlisonCummins
      • mydoppleganger

        Wow! I need to read that again! 😀 My hubby does not care if how the baby comes out, he just wants us both healthy. He reminds me that he is not “thinking” less of me over this. (BTW, we are both c-section baby alumni!) Thinking how at the end of my life, I would hope no one would reference my biggest accomplishment being my private parts has helped me. So much NCB literature that is made to help and inspire and the backlash is making birth about accomplishment, determination, and spirit that one can fully manipulate and control.This weekend I finally kicked up my feet and just said “it’s all good. No matter what.” I clearly know this is a “first world problem” to cry about this and that I will probably not care too much about how it happens once I am out of the pregnancy mind VORTEX. Gotta have a sense of humor, be thankful, and enjoy the ride. Thanks again for posting that link. I’m printing it out and reading it everytime my mind tries to mess with me.

    • sarahh.rosanne@gmail.com

      It can be difficult to tell how pelvic size and shape will affect each individual birth, but positive thinking and affirmations are not going to reshape bone. I’ve tried! I hope that the birth, however it happens, goes very well for you and the baby.

      • Antigonos CNM

        Pelvic inlet and outlet MUST be within certain parameters for the fetal head, even a small fetal head, to pass through. Certain positions of the head, such as brow presentation, CANNOT, no matter how one tries, go through even an adequate pelvis. This isn’t a matter of positive thinking; it is fact.

        If a great deal of medicine is chemistry [and it is], a great deal of OB is mechanics. If the hole something must go through is smaller than what must go through it, it can’t be done.

        • EmbraceYourInnerCrone

          My daughter the engineer would probably say “Physics, How the F does it work?”

        • mydoppleganger

          The only information I’ve really gotten from all the “birthy” sites is that the body can open/we only grow babies we can birth/ etc. I should not be surprised that pelvic stuff has never been discussed, despite it being such an essential part of vaginal birth. My first baby did not engage but it was a posterior presentation induction at 38 weeks. It did not occur to me that the first baby may have not engaged had the pregnancy went longer.

          • Antigonos CNM

            There IS cartilage between the two parts of the pelvic bone, and it does soften in pregnancy, and can spread –a little. But not much. Certainly nowhere near as much as some people think.

            Another example of a little knowledge being dangerous.

            Whenever a primigravida begins labor [at term] with an unengaged presenting part, it should raise questions. Conversely, with multips, it is quite normal.

        • nomorequestionscatherine

          It drives me nuts to see women on message boards encourage the fallacy that “we don’t grow babies we can’t birth”. They reject the idea of a doctor telling you, based on their physical exam, that you will be unlikely to have a vaginal birth as a lie and flat out BS from the Dr when these are women who have never seen the other members of the board let alone vaginally examined them as their Dr certainly has.

          Why does the Dr feed you this BS? Well to scare you into scheduling a c-section for their convenience and their pocketbooks of course.

          “Don’t let the Dr scare or pressure you into a c-section or induction. Make them let you go until at least 42 weeks!”

          “Any Dr who will allow maternal request c-section is a horrible practitioner and should have their license revoked or be sued for malpractice!”

          And on and on. BS, the whole load of them. These are people who are generally not homebirthers either, the NCB woo has just penetrated so wide and deep.

          • Young CC Prof

            Exactly. Should you blindly accept your doctors’ word for everything? No. Doctors can be wrong, don’t be afraid to ask questions or get another opinion.

            However, the probability that a board-certified physician who has actually examined you is right about your health is orders of magnitude larger than the probability that some random person on the Internet who’s never even seen you is right about your health.

          • nomorequestionscatherine

            Ding ding ding.

            And the irony is that, while they often encourage not believing or questioning the doctor, they take with blind faith the info online from lactivists, Dr. Sears, Ricki Lake, NCbers, etc.

            Double standard much?

      • mydoppleganger

        I keep getting the “You’re not thinking positive enough! You must not be affirming enough! You must not be praying enough!” Bangs head on desk. I’m gonna be quiet and not talk about it to my NCB pals for my own sanity.:)

        • I hope that works. It’s a lousy ssituation, “friends” who pull this crap

      • The Bofa on the Sofa

        It can be difficult to tell how pelvic size and shape will affect each individual birth,

        I agree.

        You know what’s even harder? Making that determination without actually actually knowing the size and shape of the person’s pelvis, which is what these people are doing.

        • sarahh.rosanne@gmail.com

          I would be inclined to think the doctor’s assessment is coming from a place of compassion and rational observation. He’s willing to wait and see what happens because he understands there are variables, where as those people are ignoring the possible incompatibility and making an absolute judgement based on personal mythology.The doctor is taking the more “liberal” and “holistic” stance on how best to manage the situation.
          This is how I view my own experience with both camps. One was offering constructive solutions for all possibilities and the other was saying “go suffer in a bathtub and if it doesn’t work, it was your fault”.I think if I had seen an OBGYN before either of my children were born,(instead of my CNM practice where most discounted pelvic measurements or internal exams- although I am still grateful to them for recognizing the need for assistance when the time came) he or she probably would have appreciated the condition of my pelvis. It’s a good thing to be aware of beforehand and to temper your expectations accordingly.

    • yentavegan

      Let us be your non-NCB support village aunties. You can have all the crunch without the crazy!

      • mydoppleganger

        Thank you! Nothing stresses me out like trying to make something happen I can’t control. “Are you talking to the baby?” Of course I am. I am sure he is saying “Mom, I can’t friggen fit!”

    • Trixie

      Hey, doctors have told me since my teens what a nice wide pelvic girdle I have. Like, apparently it’s ideal for childbirth. But my first baby still didn’t fit, even though he was just average size, because of the position of his head. Despite my evolutionarily ideal pelvis, I still would’ve likely died in childbirth before successfully reproducing if it were left up to nature. You can’t control it, and good for you for recognizing that.

      • mydoppleganger

        That makes me feel better! On the internet so many blogs are written to say the whole pelvic bone thing is just a deceptive lie from doctors. It helps me to hear from other women who have experienced the same hurdle.:)

        • The Bofa on the Sofa

          On the internet so many blogs are written to say the whole pelvic bone thing is just a deceptive lie from doctors.

          If you have actual concerns about the practice, bring them up with your doctor. Tell your doctor this is what you’ve heard, and what do they have to say about it?

          Of course, that is based on the assumption that you don’t presume your doctor to be lying to you. And if you do think your doctor is lying, you better find a different doctor.

          • mydoppleganger

            I believe him. It makes sense to me. He also said he could be wrong, etc. My main mistake is reading too MUCH about everyone else’s birth experience blogs/thoughts. Thanks to Dr. Amy I realize I’m reading other people’s views and not actual research, so I’ve done this to myself 100 percent.:)

          • The Bofa on the Sofa

            As I noted below, he’s not necessarily perfect in his assessment, but he’s a lot more reliable than random people on the internet who have never met you or know the size and shape of your pelvis.

            If you aren’t one who buys the conspiracy theories, then the claim that “the whole pelvic bone thing is just a deceptive lie from doctors” should be a sign that you can’t take it seriously

            Even if there are legitimate concerns, someone who says that can’t be trusted.

          • mydoppleganger

            Agreed!

      • amazonmom

        I could birth a bus my doc jokes. Too bad my babies have done dumb things like breech/cord first and trying to grow to the size of a bus….so it’s modern medicine and its c sections for me! I don’t trust birth at all.

        • Trixie

          It really amazes me that my great grandmother had 15 live births on the farm. That’s a lot of times to beat the odds.

          • The Bofa on the Sofa

            I’ve been doing some genealogy stuff lately. My mother is the 13th of 14 kids. Three of them died at birth.

            My dad’s mother was 12/13, I think.

            I also have a great-great-Grandmother who died due to complications of childbirth. She is the only one of my ancestors back to that generation who died in childbirth, but that is still 1/15. Granted, my grandparents tended to have a boatload of kids, but even assuming they all had 10 births, that means that 1/150 births resulted in a maternal death.

            I don’t like them odds.

          • Trixie

            Yeah, on my husband’s side there’s an ancestor who had like 9 kids, and one lived to adulthood. NATURE!

          • MaineJen

            My great grandma had 8 kids (I think!) at home…4 survived to adulthood. 3 died shortly after birth due to rh incompatibility (what they used to call ‘blue babies’), 1 died at age 3 from pertussis. Ah, the good old days…

          • amazonmom

            My great grandma had the same amount of births on a farm in South Dakota. All of the bubs lived but the triplets. The twins were fine.

          • Trixie
          • The Computer Ate My Nym

            69 kids? Holy FSM! The Duggars aren’t even in the running, are they?

          • Trixie

            I wonder how many thousands of direct descendants they have today!

          • Dr Kitty

            That was the first wife…he had another 18 with the second wife!

          • The Bofa on the Sofa

            I doubt that list is anywhere close to exhaustive, especially below 20.

            My wife had a classmate who was the youngest of 18. Not on the list.

          • Trixie

            I’m sure you’re right about that. I know a set of identical quadruplets who aren’t on Wikipedia’s quadruplet list.

          • The Bofa on the Sofa

            See the “supercentenarians” website

            http://www.grg.org/Adams/E.HTM

            They scour the globe looking for examples, and even then they admit that they probably only have about a quarter of the ones who are currently alive, much less those from history.

            BTW, I find that page fascinating. Currently, there are only FIVE people known to be left who were born in the 1800s. 14 who were born in the 19th century.

            Although it hasn’t been near as fun since Besse Cooper died at the age of 116 years and 100 days back in Dec 2012.

          • amazonmom

            It was the 60 plus entries that made me feel dizzy lol

          • Trixie

            They must have had adequate nutrition, for her to be able to gestate so many babies, and for them to all live. I wonder how the babies were all fed.

          • amazonmom

            Oh my lord!

          • Dr Kitty

            Oh, that list did give a worse reason to have a baby than to get a healing HBAC…to have as many children as possible in 10 years to get a $125,000 bequest from an eccentric millionaire and “practical joker”.

            http://en.wikipedia.org/wiki/Great_Stork_Derby

          • realityycheque

            Prolapse and incontinence… all that I can think of.

    • Young CC Prof

      At the beginning of my pregnancy, I kind of took for granted that I’d have a natural birth, and that natural birth was a worthy goal in and of itself. Under medical supervision, of course, but minimal interventions.

      By my 8th month, it was clear that a safe natural birth was just not in the cards. Luckily, by then my involvement here and in other parts of the skeptical community had changed my mind significantly about NCB.

      My c-section was no big deal, and the resulting baby is perfect. Although it’s hard to type with him asleep on my chest :).

  • I hate how midwives prey on vulnerable women & fear of childbirth to make money. I hate how midwives band together whenever one of them kills somebody.

  • attitude devant

    I hate that advocates for home birth seem to be incapable of independent thought. Interacting with the Iorios this last week I was just astonished at the way they parrotted the usual crap spouted by the NCB mainstream, apparently unexamined and undigested. whereas in other areas subjects they take pride in thinking outside the usual parameters. What’s up with that? Is this the paradigm: If it goes against current scientific thought it must be true?

    • The Bofa on the Sofa

      Is this the paradigm: If it goes against current scientific thought it must be true?

      Pretty much. It’s “mainstream” anti-establishment group-think.

    • OBPI Mama

      A lot of my friends homebirth and they take the midwife’s thoughts like the Bible… and I’m thinking, “You are doing exactly what you accuse mainstream women of doing with doctors, but with midwives!” AGH! No reading up or investigating further… a midwife’s word is to be trusted… sigh.

      • Karen in SC

        any change in opinion from your neighbor who homebirthed and almost bled out, similar to Ruth Fowler Iorio?

        • Karen in SC

          oops that was for Lisa from NY….I guess Disqus is mixing it up today!

  • multimom

    OT question, but this is the place to ask. CDM, doesn’t mean certified by the state does it? And there’s no guaranteed medical training right? And there are no national standards for direct entry midwives right? Got a friend on a way crunchy board asking about using one at home. Sigh.

    • Ra

      CDM is a direct-entry midwife. Meaning there’s no guaranteed medical training. Their training is highly variable and there really aren’t any education standards to speak of.
      Some states license CDMs–but that doesn’t really mean anything. There’s practically no difference between a licensed CDM and an unlicensed one.

  • Amy Tuteur, MD

    Jennifer Margulis with an excellent example of the lies I hate:

    http://fearlessparent.org/radio-blog-fearless-medicine-on-home-birth/#.UtQbrmyIyiI.twitter

    • Amy M

      Check out the ultrasound one from December…quite a gem. Another genius suggesting u/s causes autism and C-sections.

      • The Bofa on the Sofa

        Ultrasound causes c-sections?

        Is this a case of “ignorance is bliss”? Because you can call me crazy, but “US gave us information that indicated we would be better off with a c-section” is a pretty silly objection to make.

        • Young CC Prof

          Ultrasound “caused” my c-section, and I’m sure glad it did! (It did NOT cause the problems that led to the c-section, just made us aware of them and better able to make the safest choice in birth plan.)

          • Kathleen Neely

            Its nice to know before you are dilated to 8cm that the baby is in a breech position…

          • Young CC Prof

            Especially when the baby’s butt is so little he might start coming out before you’re even fully dilated.

        • MaineJen

          Isn’t this the main reason they are against fetal monitoring during labor, too? Because the monitor might pick up decels or other troubling patterns, which could lead to a C section? That always baffled me. Like, if there is a troubling pattern…don’t you want to *know* about that?? Don’t you want to be proactive and head off trouble before it’s an emergency? Or do you want to stick your fingers in your ears and go “lalala?”

          • AlisonCummins

            The version I heard was that fetal monitoring increased c-sections without decreasing perinatal mortality. That is, it’s one of those things that sound good in theory but when you look at it empirically it doesn’t actually pan out. That happens a lot, so it’s not actually insane.

            (That was twenty years or so ago. I imagine we have better data now. Also I don’t know if the research that assertion was based on also looked at Apgar scores, and if they were affected.)

          • Young CC Prof

            There was a study that found that. It got a lot of press. However, it was underpowered, and later studies found that for every 100 c-sections due to suspicious EFM, one intrapartum death is averted.

          • AlisonCummins

            Thanks. Yes, I expected we had better data now and that the standard of care is based on the data.

            Just saying that it’s not insane to want to avoid overdiagnosis. (Ignoring good new data in favour of old bad data — now we’re getting somewhere.)

          • The Bofa on the Sofa

            Moreover, there is more to EFM than just preventing death, right?

          • Young CC Prof

            Yes! It can also prevent brain damage from hypoxia. Not sure of the exact numbers there.

            Heck, EFM might even reduce maternal morbidity, by replacing dangerous crash c-sections with much safer urgent, non-emergency c-sections. Of course, I have no evidence there.

          • fiftyfifty1

            Wow, I had no idea that the numbers were so good on this. One baby saved for every 100 c-sections done for just suspicious strip! I would want that c-section right away. When would you ever accept those odds? Would you let your kid on a roller coaster that killed 1 out of every 100 kids? I would undergo a hell of a lot worse than a simple c-section to protect my kids from that sort of risk.

          • Young CC Prof

            But again, to people who don’t understand statistics, a 1 in 100 risk sounds like something that’ll never happen to them.

        • Amy M

          Yep. That’s pretty much it…they make a case for remaining ignorant because of “all the false positives just leading to anxiety and we can’t do much about most of the issues found on u/s anyway.” (and according to them, the u/s might cause autism! and left-handedness!)

          I had lots of ultrasounds during my pregnancy because we were on the lookout for TTTS….I know I wanted to know if something was wrong, not wait until one or both of my unborn children was dead to find out. We did get one left-hander out of the deal, but both of their grandfathers are lefties too, and they (the grandfathers) had zero ultrasounds, so I am going with genetics there. And neither child is autistic, for a whopping n=2 anecdata story.

        • Are you nuts

          I think stethescopes might cause irregular heartbeats too.

          • Dr Kitty

            And sphygmomanometers cause hypertension…

            (I just wanted an excuse to write sphygmomanometer)

          • The Bofa on the Sofa

            And you couldn’t figure out a way to include borborygmi?

          • Fuzzy

            No, no, no: EKG leads cause arrythmias, and CT scans cause head bleeds.

          • fiftyfifty1

            Knowing the word “borborygmi” causes borborygmi. If you don’t know the word, you just get a loud growling bowel noise from time to time like everyone else.

          • araikwao

            Totally audible borborygmi as I read your comment, ha ha! (Possibly more likely due to the dinner I just ate, but hey, correlation equals causation, right? 😛 )

    • Trixie

      (I think you mean Anne Margolis?)

      • Amy Tuteur, MD

        I found it because Jennifer Margulis is promoting it.

        • theNormalDistribution

          Please please please call in during the show!

    • The Computer Ate My Nym

      Erg. She starts out with “Something is urgently wrong with the way that American women are giving birth.” She cites US maternal and infant mortality as proof (yes, infant mortality is the wrong stat, but let’s not even worry about that for the moment.)

      What’s wrong with how women in the US give birth? Well, what is distinctly different about the US compared to every other industrialized country and quite a lot of “third world” countries? Oh, I’ve got it: Insurance! The US doesn’t have full health insurance. Could the problem with how women in the US give birth be that they do it without adequate prenatal care and support? Nah…can’t be…

  • Pregnancy, birth, and motherhood: the dark little corner that feminism forgot about and biological essentialists decided that they’d pretend that what they had to sell was “feminism” applied to the area.
    Real feminists don’t let women make choices based on lies and bullshit.

  • Mel

    I find it darkly ironic that a lot of the same stupid tropes used in teaching and farming get trotted out in medicine.

    *Myth:Education is over-rated!
    Rationalizations: I finished HS, so I can teach my kids through HS. Anyone can raise animals. Birth is natural.
    Worse-case outcomes: 19 year-old who’s testing below 4th grade in the cores; vets responding to a “crock-pot” birth – calf’s been dead for 3+ days in utero, dam is toxic and panicked; everyone is trying to work in a muddy, dark pasture endangering the cow and vet. Doctors responding to a dead baby and dying mom.

    Myth: Back in the good ol’ days, no one needed _______ but everyone did fine.
    Rationalizations: Well, I’m not good at math or science, so I don’t need to teach that to my kids. Cows recovered from mastitis before antibiotics. Women gave birth long before OB’s.
    Worse-case outcomes: After two generations, no one knows how much math/science is missing. Cows die. Women die. Babies die.

    • Mel

      Plus, all professionals should be more than willing to help out to fix your mistakes for free.

      Because catching your 19+ year old kid up in science is a piece of cake!

      Because there’s jack s#$t we can do for that calf whose mother died 48 hours ago since the window for colostrum is closed.

      Because PPH+DIC and a mostly dead infant with no medical history is easy-peasy fix-up

    • Trixie

      Survivors are a terrible sample group, right? It’s like the old, “we never had car seats, and we’re fine!” As if the bodies of children in the ’60s were impervious to the laws of physics. The truth is that those who are not fine, aren’t here to talk about it. You weren’t safe, you were just lucky.

      • The Bofa on the Sofa

        IOW, the whole “everyone did fine” claim is nonsense.

      • The Bofa on the Sofa

        I would add, the “everyone did fine” claim is even a lie among the survivors. For example, like most of my age, I had chicken pox. In discussions of the chicken pox vaccines, you get the comment “I had chicken pox and turned out fine.”

        Yeah, I turned out fine, but then again, it royally sucked. Two weeks of a miserable rash. I wouldn’t wish that on anyone, and if we can easily avoid it, you want to.

        Just because the chicken pox didn’t kill me doesn’t mean it wasn’t awful and something to avoid.

        • Lynnie

          I was SO GLAD my son was vaccinated against chicken pox. I have a friend whose 2 children had chicken pox while we were visiting them. Those children were miserable. My son, not even affected. He doesn’t do sick well, and my husband doesn’t do well when our son is sick either.. Even if it only saves us from the inconvenience of a sick child, it was totally worth it.

        • Trixie

          Chicken pox was awful for me. I got them in my genitals and my mouth and my scalp and behind my ears. I remember hallucinating from the fever.

          Not only can I spare my kids that, but I can spare them from getting shingles later in life, too. That’s something “natural” immunity can’t do.

          • R T

            The Chicken Pox vaccine does not prevent shingles later in life. However, It may lessen the symptoms and complications.

          • Ceridwen

            Source? The research I’ve seen so far supports a lower risk of shingles later in life with vaccination. The CDC page on Varicella supports this, though I can’t tell where they got the information from.

            “Chickenpox vaccines contain weakened live VZV, which may cause latent
            (dormant) infection. The vaccine-strain VZV can reactivate later in
            life and cause shingles.
            However, the risk of getting shingles from vaccine-strain VZV after
            chickenpox vaccination is much lower than getting shingles after natural
            infection with wild-type VZV. For more information about how natural
            infection with wild-type VZV causes shingles, see Shingles Overview. Lab testing is needed to determine if a person got shingles from vaccine-strain VZV or from wild-type VZV.”

            http://www.cdc.gov/vaccinesafety/vaccines/varicella/

          • AlisonCummins

            Can you expand on that? I thought that shingles was your old chickenpox virus that had been hiding out for decades deciding to sneak back out along a nerve, so that if you never had chickenpox by definition you couldn’t get shingles.

            If you had chickenpox but you haven’t been regularly exposed to kids with chickenpox througout your life then your immunity might fade and you might might let your old virus back out, so you can get a booster specifically to prevent shingles.

            If you never had chickenpox then you can get a chickenpox vaccine.

            Am I mistaken?

          • Trixie
          • Lisa from NY

            Thanks tons for recommending this site. I thoroughly enjoy blogs by educated people.

          • Trixie

            He made me realize all the reasons why I was wrong to fear GMOs.

          • MaineJen

            I still have a bump on my scalp that hurts when I accidentally run my comb over it or touch it. Thanks, chicken pox.

          • Are you nuts

            I never got chicken pox as a kid so I was first in line to get the vaccine when it came out! My aunt had chicken pox in her 20s and it was terrifying.

          • Guestll

            My husband caught them at 14 and had them everywhere, including under his foreskin. Total agony, per his words.

        • Young CC Prof

          My cousin got chicken pox as a tiny newborn. 3 weeks in the hospital, then-experimental antivirals, but hey, she’s fine NOW, so it doesn’t matter, right?

        • The Computer Ate My Nym

          Chicken pox didn’t kill me, though there were moments when I felt like that might have been the better outcome (and I had it at 4 or 5). But it still threatens me with shingles. Why should I want my kid to take that risk, even if I were sure that she’d get through the acute infection ok?

          • AlisonCummins

            There’s a shingles vaccine. Pricey but I think it’s recommended for anyone over 60.

        • araikwao

          I’ve treated a baby who had a stroke as a complication chicken pox. Baby was NOT fine.

          • Young CC Prof

            A lady I know, mother of 3 young kids, developed permanent epilepsy from shingles. It was pretty bad.

    • Kathleen Neely

      2 generations of common knowledge. ..

  • Are you nuts

    I wonder what the statistics would look like if only CNMs or doctors attended homebirth, there was a very narrow scope of patients accepted for homebirth (eliminating breech, VBAC, multiples, etc), and very strenuous standards of care were in place, and followed, for when to transfer. I wonder if the risks could be brought down to the point of being nearly statistically insignificant.

    I can’t imagine giving birth anywhere BUT a hospital, but I am sympathetic to women who are fearful, for whatever reason, of being in a hospital. It would be nice if these women could make an educated decision without navigating the minefield of sketchy providers with no standards or accountability.

    • Luba Petrusha

      Unlikely, because when disasters happen they can happen really fast (massive abruption, etc.), and it’s not like you can do a c-section on the kitchen counter.

      If you were to compare ALL hospital births (including high risk) to all home births (risked out to low risk only), then perhaps the statistics would be similar

      • Certified Hamster Midwife

        You can do a c-section on the kitchen counter, but not if you want the mother to live.

        • The Computer Ate My Nym

          I think there have been cases where that was done and the mother lived. Wasn’t there one woman who managed to give herself a c-section?

          • Certified Hamster Midwife

            Well, there was that novel where (spoiler alert!) a lay midwife goes to prison for inadvertently killing a woman with a home c-section.

            http://www.amazon.com/Midwives-Oprahs-Book-Chris-Bohjalian/dp/0375706771

          • Medwife

            Spoiler alert: she goes on trial but is acquitted after her daughter destroys evidence! Oh how I raged at that book…

          • areawomanpdx

            The woman in Mexico who gave herself a cesarean. This article states she is the only recorded woman to have done it and lived, but there have apparently been other attempts. http://usatoday30.usatoday.com/news/health/2004-04-07-self-caesarean_x.htm

          • jenny

            Had to read more, found this:

            http://www.theunnecesarean.com/blog/2009/11/2/ines-ramirez-perez-and-the-mythical-self-cesarean.html?currentPage=2#comments

            From the comments:
            “I think what this says is…OB’s aren’t the gods they want us to think they are, if a rural woman in Mexico with assumedly no formal training can do a c/section on herself and survive, with *no* signs of long-term damage or infection (better than some OB’s do with years of experience, huh!)! Being a little far fetched here I know, but what if someday all pregnant women were *taught* this skill and how to do it safely…then we couldn’t say homebirth was dangerous due to lack of cesarean availability. Surely no doctor would advocate that as there goes their livelihood…but I can see a time when that *could* happen. Probably wouldn’t hurt to know how, huh.

            Ok, I’m off in la la land, I realize. But that was my overall thought – if she can do it w/o formal training, why do the OBs go around denouncing homebirth and proclaiming they’re the only ones that should be allowed to deliver babies, as if they’re gods? Apparently, birth *is* as safe as life gets…”

            WHAT THE ACTUAL FUCK.

          • The Computer Ate My Nym

            Um…what? A desperate woman takes a couple of shots of tequila (or whatever it was) and takes a knife to herself and manages to survive, therefore we should teach everyone how to do that to themselves?

            Also, did they miss the bit where the woman in question told her older child to call the hospital right after she did it? Maybe that’s why she survived, hum?

            And I’ve yet to see an OB declare him or herself a god. Well, maybe Biter, but no one else.

          • PrimaryCareDoc

            Hahahahahahahahahaha.

            I’m dying here. I’ve read some stupid stuff over the years, but that one might outdo them all.

          • jenny

            Right??? I was like, wow she REALLY missed the point. I read through the woman’s story from multiple sources and it was so brutal that I was crying. And this assclown just thinks, “Wow, she survived, guess birth really is safe.” And women should be taught how to do diy c-sections. The mind boggles.

          • PrimaryCareDoc

            OK, I actually just read the article, and if what she took from it was, “C-sections are easy-peasy and all women should be taught to do a self-section,” she has some serious reading comprehension problems.

            Maybe we should teach people how to perform appendectomies on themselves. Oh, and how about self-CABGs? Then we wouldn’t have to worry about people dying of heart attacks!

            That commenter needs to learn how to perform a self-brain transplant.

          • Trixie

            Slicing open your own abdomen is just a variation of normal!

          • areawomanpdx

            OMFG. I have no words.

      • Are you nuts

        I guess my question is, how many homebirth deaths/bad outcomes are because of the spur of the moment disasters like abruptions, and how many are due to lack of education, failure to transfer when indicated, or being an inappropriate patient to begin with.

        • Trixie

          I think a lot of them can be prevented. Not all, of course, but if everyone who had a home birth did it with a team of two CNMs, was low risk to begin with, and transfers actually happened at the first sign of a problem, we wouldn’t be reading anywhere near as many of these stories. There would still be some stories of preventable death and injury, of course.

        • Antigonos CNM

          It is a very good question. In a place like the UK, you have a sort of “captive population” — all midwives must keep legal records, and are licensed by a national authority. But in the US, all the data is going to be flawed because a great deal of data will never be reported. We know about the births which go wrong only because the women wind up in hospital, but even tracking down the midwife and finding out what her level of instruction is can be difficult. And some women who should never deliver at home are lucky, and do so without major complications and so are under the radar.

    • Karen in SC

      But that is the process in the UK and Netherlands and still the statistics show worse outcomes for those homebirths with a highly qualified caregiver, strict risk out criteria, and transfer protocols in place.

      • Are you nuts

        Good point. That may answer my question.

        • Antigonos CNM

          I am not sure. In the almost 40 years since I was in the UK, the entire midwifery situation there has changed drastically. There were NO direct entry midwives then, and apparently nowadays it is just the opposite, even though the course is supposed to be good enough to compensate for not having a nursing degree. NHS staffing has gone down to the point that the patient load is untenable. What were model programs seem to have fallen victim to a combination of woo and economic strictures, and the statistics reflect this.

    • Why is it that for a woman requesting cesarean without medical indiccation out of fear the stock answer is: offer counselling, but for a woman requesting homebirth who is low risk, the stock answer is: have at her! Statistically speaking the woman requesting the cesarean is making the safer choice (relative to homebirth)…so why are we so keen to enable one but not the other?
      I also think there’s a consumer protection and advocacy role that needs to be played – and for whatever reason government is reluctant to do that. It is a bit mind-blowing as to why – do policy makers hate women and children that much?

    • Trixie

      There are some accredited CNM birth centers that do this, and have very good outcomes. Generally the CNMs also have hospital privileges, backup OBs, and transfer agreements in place.

    • fiftyfifty1

      The study that best addresses your question is called the Birthplace Study. Dr. Amy has reported on it previously. It took place in the UK. It found that as long as a woman was NOT a first time mother, and as long as her current and ALL previous pregnancies and births were 100% healthy and uncomplicated and as long as she lived close to the hospital and was attended by 2 university trained British CNM equilivents who were fully integrated into the hospital system and those midwives transferred at the first sign of trouble, THEN the difference in neonatal mortality between home and hospital was not statistically significant. Not so with first time mothers. Even with transferring at the first sign of trouble (40% were transferred), the babies of first time moms had a 2-3 times excess mortality.

      • Are you nuts

        Cool, thanks! Would be nice if women considering home birth had access to correct information.

  • I hate that, if you point any of these facts to a friend planning a hb, you’ll get told that they don’t appreciate you assuming THEIR baby will die. :-/ Because I’m a wizard and my understanding of basic statistics is a CURSE on their baby.

    • The Computer Ate My Nym

      That seems to be the implication. It goes with the whole “if you hear the word ‘epidural’ you won’t be able to deliver naturally” meme: basically a way to keep women too scared to look at the data objectively.

      • DO NOT THINK ABOUT A GIANT PURPLE ELEPHANT

        • The Computer Ate My Nym

          Oddly, the first image I got when I read this was a small pink elephant. Subconscious, u r weird…

    • Mel

      Apparently, “I’m so glad you and the baby are healthy! Have you followed up with your GP and pediatrician?” is both callous and mean if said to a home birth mom.

    • OBPI Mama

      Last year I got accused of being a fear mongerer and just trying to scare a pregnant woman I know planning to have her first homebirth/3rd child. She ended up being a shoulder dystocia, hospital transfer… mom and baby were okay though. She quickly apologized to me, lamented about how she had been so wrong, and now is also walking the balance, with me, about warning about the dangers of homebirth and being friends with many women who choose it. It’s rough!

    • The Computer Ate My Nym

      At the same time, there have been successful lawsuits because OBs told women with high risk situations (i.e. breech) that there is an increased risk of a baby dying during delivery in this situation, but not explicitly saying that their baby could die. You can’t win.

  • Ra

    I hate when they say that “OBs are only in it for the money.” I have met many, many, many compassionate, empathetic, and intelligent OBs who chose their line of work because they are passionate about the well-being of women and infants. Becoming an OB is a LOT of work. It requires extreme sacrifices. If they were really just after money, there are a lot easier ways to get rich.

    In the end, physicians really only end up making slightly more money than teachers when you calculate in the student loan debt, working hours, etc. You can see more here: http://benbrownmd.wordpress.com/ . This is not to discount the value of teachers (I love teachers! They are vital! My own mother is a teacher!); but, to say that the income difference isn’t really as much as it seems.

    • Are you nuts

      Yes, there are much better ways to “get rich” in today’s economy than becoming an OB.

      • The Bofa on the Sofa

        I heard this morning about an upcoming workshop describing a “three step approach” for flipping houses. I didn’t quite understand how much farther it was going to go than

        1) Buy a house
        2) Remodel it
        3) Sell it.

        • 1) buy a house CHEAP, ideally one with mostly cosmetic issues.
          2) Remodel it, focusing on making it pretty.
          3) sell it at a higher price.

          About as far as I could take it…

          • The Bofa on the Sofa

            Yeah, I guess if you want to add a “successful” caveat to the process, you would need to include that.

    • Aussiedoc

      Thank you. It makes me so ANGRY.

      I’m a GP obstetrician. I don’t do Caesars, I call in a colleague. So I actually LOSE money when I recommend a Caesar. Does it stop me? No. Because strangely enough I got into this for the well being of my patients and because I love the work.

      Believe me, there are far better ways to make money with a medical degree that dont involve being out of bed constantly and away from my family. You do this out of love.

  • AuberryShortcake

    The lies are what kill me about homebirth. It is like a cult, where you must believe ehat you are told and never question. I have two women in my infertility group that constantly spout how homebirth is safer than low risk hospital birth. The thought of people working so hard to have children and then subjecting them to the risks of homebirth make me crazy, but the woo is so deep that nothing anyone else says seems to reach them.

    • The Bofa on the Sofa

      Ask them, what is it about homebirth that makes it safer? Fewer interventions? If that’s what they think, then in what way are interventions less safer than not intervening? Yeah, a c-section has risks, but what are they compared to the risks of not doing a c-section?

      Or is it the evil epidurals?

      Call their bluff. What babies that die in the hospital would survive at home (and how often do they happen)?

      • AlisonCummins

        I think by “safer” they mean “less likely to result in an intervention.” They don’t actually mean “less likely to die or be permanently injured or disabled.” This is only “safer” if there is no risk of death, injury or disability to begin with.

        Or rather… they’re reading stuff based on the model of safety from intervention and naively assume that what’s meant is safety from death, injury and disability.

        • The Bofa on the Sofa

          I think by “safer” they mean “less likely to result in an intervention.”

          I agree.

          That’s why I added the part about, what about intervention is less safe?

          You even see this in terms of HB safety stats. They tout the “lower chance of an intervention.” However, that begs the question of why lower rates of intervention are desirable in the first place.

          • DaisyGrrl

            I once asked that question on a mainstream media site that was reporting on the latest “midwives are awesome!!1!” study. I specifically wanted to know why the provision of epidural pain relief was considered a negative intervention for the point of this study (or at least for the way the media was reporting the study).

            I had a man explain to me that I needed to watch the Business of Being Born because it would explain to me how epidurals will lead to the downfall of civilization or something.

            Several others chimed in with the wonderful “it’s a different kind of pain and therefore better” trope. It went downhill from there.

          • sarahh.rosanne@gmail.com

            I’m pretty sure that a woman who has a forty five minute labor, whilst swimming with her dolphin midwife, or whatever, is experiencing a different kind of pain than the woman who is suffering in agony from an obstructed labor. They like to tout this singular “experience” of “a different kind of pain”, or say that it is a matter of perception. There is a whole spectrum of suffering that they refuse to even acknowledge. I especially love when a man has an opinion on the matter of pain in childbirth- that’s just adorable.

      • The Computer Ate My Nym

        MRSA gets tossed around a lot. It’s not at all clear to me that the risk is higher in a modern hospital with good hand cleansing compared to a home birth midwife using the same birthing pool over and over again and no gloves, though.

        • Certified Hamster Midwife

          That’s an unfair comparison, though, because generally a homebirth midwife only sees one client, sometimes for days at a time. She might be in contact with several clients at a time in a birth center or if she has multiple labors at once, but still not the same as the number of patients who could theoretically pass infections in a hospital.

          And come on, facts pulled out of one’s ass aren’t good if you’re trying to be the science-based medicine side. Families either buy their own pools and toss them or buy their own clean liner for a rented pool.

          • The Computer Ate My Nym

            It’s a fair complaint. If I may revise, I’d claim that the story of the midwife who gave her client flesh eating bacteria demonstrates that it is possible to get a nasty infection at a home birth (I’ve seen claims otherwise) and admit that everything else is complete speculation on my part until/unless I can provide supporting data.

          • Amy Tuteur, MD

            Hospital acquired MRSA is not much of a threat to term babies. The real infectious threats to term babies are pathogens that live inside the mother like Group B Strep and herpes.

          • fiftyfifty1

            Yep. Every medical student, even the ones planning on being radiologists or psychiatrists or geriatricians learn the GBS mnemonic: “Group B is Bad for BaBees”

            (meanwhile, homebirth midwives learn the wisdom that nothing bad can come from the sacred yoni that garlic can’t fix)

  • The Computer Ate My Nym

    I hate the deception. I don’t like it if women decide for reasons of their own to have a home birth, knowing the risk, but I really hate it when they are lied to and told that it’s just as safe as having a hospital birth–and sometimes that lie comes back to haunt them in the form of damage to themselves or their infant. (Or even just the little things: The realization that now their home is a place they associate with terrible pain or the mountain of laundry that the new mother must do or the dishes the midwife left.)

    • Lisa from NY

      Exactly. Crunchy people boast how midwives can deliver breech babies, neglecting to mention (Thanks, actual attorney) 10% risk in cervical fracture, 10% risk in SD, and risk of harm to boy genitalia from banging against the pelvis during contractions.

      None if this included in neonatal death stats.

      • Karen in SC

        Yes, all that PLUS risk of head entrapment and death. 🙁 It hurts to contemplate those poor babies.

        And anyone who doubts that boy genitalia risk need only to watch a few breech homebirth videos on Youtube. Those parts are the first out…

        • I take it I’m not the only one who’s been haunted by that story.

          • Certified Hamster Midwife

            And we don’t even have penises!

          • The Bofa on the Sofa

            I refuse to even look.

          • I don’t have one of my own, but I did make one that I spend an extraordinary amount of time keeping clean, dry and healthy. And there’s also one I’m on friendly terms with. Damage to or loss of either would be very, very sad.

      • slandy09

        Which is interesting, because in my state, licensed midwives are NOT allowed to attend breech births and are required to transfer breech cases to an OB. Of course, in my state (Utah) midwifery licensure is voluntary, so we have CPMs who don’t get licensed so they can attend breech births at home. It’s how Valerie El-Halta (or however you spell her name) was able to practice here.

        • The Bofa on the Sofa

          And it boggles the mind.

          Real, licensed professionals are unwilling/not allowed to do breech deliveries at home because they are too risky. Therefore, the solution is to resort to someone less qualified.

          It makes no sense at all.

          • realityycheque

            My Australian HB midwife (CNM equivalent, I believe) who appears to have quite a positive reputation amongst the local HB community openly referred to breech as a ‘variation of normal’ and would have gladly attended breech/twin home births if the opportunity arose. I’m hoping she’s somewhat of a fringe-y extremist, but I am beginning to get the feeling that this risk-dismissive attitude is creeping into the mainstream.