The National Center for Health Statistics published Births: Final Data for 2012 last week and homebirth advocates are crowing about the increased rate of homebirths.
From the report:
“Out of hospital deliveries represented 1.4% of births in 2012. Of the more than 50,000 out of hospital births, about two-thirds (65.6%) occurred in a residence (home), and 29.0% occurred in a freestanding birthing center. The number of births occurring at home, 35,184, was the highest since reporting began for this item in 1989.
Jennifer Margulis boasted that Oregon led the nation with the highest percentage of homebirths at 2.4%.
I can’t decide whether these women are clueless or callous or both. There is no cause for smiley faces or pride when an increase in homebirth means an increase in homebirth deaths.
In the last few years, there has been an endless stream of data and scientific papers attesting to the fact that homebirth dramatically increases the risk of newborn death (3-10 fold) and brain damage (18 fold). Nowhere is the scale of the disaster more apparent than in Oregon in 2012 where 5/1000 homebirths ended with babies who died preventable deaths to achieve the nation’s highest percentage of homebirths.
If Oregon is indicative of the toll of homebirth it means that in 2012, approximately 175 babies lost their lives because their mothers were more concerned with where they gave birth than whether their babies lived or died. That doesn’t even count the babies who sustained permanent brain damage or other injuries as a result of their mothers’ decision to give birth far from the medical personnel and equipment that would have saved them.
Let me repeat that: 175 babies DIED and possibly hundreds more were permanent impaired in 2012 alone for no better reason than because their mothers put their desire for a specific birth “experience” ahead of the wellbeing of their babies.
Rather than boasting, Ricki Lake and Jennifer Margulis should be crying tears of shame.
OT: Has anyone done a complete debunking of “Ina May’s Guide to Childbirth”? I can find bits and pieces on this site, but I would love a resource that goes through the book as a whole to point out/address the errors in it.
Me too. I would be better equipped to refute the claims Ina May Gaskin promotes if I could have a handy resource guide. For now, I remind myself and others that IMG is a celebrity and a personality, She is not a trained medical professional. She is not a nurse. Not a certified nurse midwife.
She’s not a CNM?
I threw out my copy! I’m debunking the business of being born on my exhomebirthers wordpress blog though.
I guess Ricki Lake didn’t watch the end of her documentary, The Business of Being Born. If that didn’t turn you off from a homebirth…
the total risk is .05 percent- and thats in the most dangerous locale. so for most people the odds are in their favor. whereas the chances for unnecessary interventions is rather high in a hospital (indeed depending on how we define unecessary one could say its nearly guaranteed).
so looking at it based strictly on the percentage points without a statistician’s eyeview, homebirth doesn’t appear as such a risky gamble.
As for “the risk to your child”; at that point it isn’t a child, it’s a fetus and in my opinion a woman is under no moral obligation to do anything she finds detrimental to herself, for the sake of a fetus.
This sentiment however is socially unacceptable so many people prefer to rely on the odds being more or less in their favor.
whereas the attitude in the hospital basically is to intervene on the mom even in the case of remote risks to baby- partly because they know that the same woman will change her mind quick after the delivery, but also because of a culture treating birthing woman as wards.
the solution is to change hospital culture
Which is where we ultimately differ.
My “foetus” I.e my full term baby boy current,y sleeping next to me? The hospital could have dragged me over hot coals to guarantee his safety. (They didn’t FYI. Some syntocinon for incoordinate contractions and an epidural I requested, otherwise a fairly normal birth). Had the evil, evil monitoring shown any issues I would have shouted for the Caesar well before they did,
Because as far as I am concerned the “remote risk” of my beautiful baby boy being dead or brain damaged is worth any scars on my body and any dent in my birth experience. It was one day in my life. It’s the rest of his.
As an obstetric practitioner myself – I don’t intervene because of any fear of litigation, I do so because I assume everyone feels the same way as I do. That preserving a birth experience is important, but nowhere near as important as the safety of mother and baby. And privately if you honestly value a vaginal birth more than a live baby, yes I am going to judge your moral values.
They are ”treatments’ not “interventions”.
Intervention is a word used by NCB to label it BAD,
Interventions are also, incidentally, usually procedures that NCB’s are unable to perform.
that is incorrect; intervention is standard medical and nursing terminology.
You are rather naïve, aren’t you. The NCB cult love word games. How about “birth rape” as another example.
i agree that birth rape is a term to be avoided as it minimizes criminal rape, and unfairly imputes sexual and criminal motives to the medical professionals when there are none. that said, we should learn from this that many women do feel traumatized as if they were raped. Bear in mind that an estimated 25% of american women are survivors of sexual assault/ abuse and birth can be retraumatizing event. i learned to always keep that in mind when caring for ALL women and accord the utmost dignity, respect and autonomy.
All women should also be accorded the truth about risks of homebirth.
”intervention is standard medical and nursing terminology”
Nope. Treatment is.
ok i’m not a dr so i’ll pass on the medical terminology argument. standard nursing technology. read any, absolutely any article in any area of nursing.
not when a c/section increases maternal mortality 3 fold (albeit incredibly low in absolute terms) and morbidity extensively. its a question of what risks you want to take.
agree that most people agree with you, and most mothers will willingly assume risks for their unborn children. it all depends on how remote the risk is. and frankly that is a subjective judgement, what level of remoteness is significant or not. there are some levels of risk that are so extremely miniscule that almost no one bothers with them, for example the risk of paralysis by an epidural anesthesia. labor induction on the other hand has well known risks, yet many patients and doctors choose elective inductions anyway. the level of risk one is willing to undergo is not a fixed fact.
i myself accepted an induction, epidural and episiotomy, 2 of 3 based on a risk v. benefits analyis via statistics available in scholarly research, based on statistical, and one for my own comfort. you guess which. nobody blasts me as lazy, pampered, selfish or foolhardy despite the minimal risks.
So what’s your problem? Avoiding c-section was a big priority for you and you managed to do it. You’re generally hostile to interventions, but willingly accepted some yourself… What exactly is the point? Why bother coming here and grousing about the state of things unless you’re just looking for an opportunity to affirm your own set of choices– which are as individual and arbitrary as those of anyone else (and which no one here particularly cares about so long as you got competent, safe medical care and a good outcome)?
Reference?
Depends on what morbidity…look at the rates of pelvic floor repair, hysterectomy and incontinence treatments in women who have had vaginal births compared to women who have only had CS.
Women who have had CS are trading an abdominal scar and a short term risk of increased bleeding and infection for a long term reduction in pelvic organ prolapse and incontinence (which usually requires surgery to repair…with a risk of bleeding and infection and a scar).
VB might be saving you from surgery in the short term only to make it more likely down the road…
Anecdote- my mother had 4 CS, and in her mid 60s has no issues with her pelvic floor and still has her womb and ovaries. My mother in law had three uncomplicated VBs and a hysterectomy and bladder repair at 47 because of severe prolapse and has ongoing issues as a result, almost 20 years after the surgery. From my practice, that isn’t an unusual scenario.
i would be interested in reading more about this.
For starters: http://www.obgynnews.com/news/video-library/single-article/one-in-five-women-undergoes-urogynecologic-surgery/a823f17c13a78f0b39b61b6ec0299bca.html
I’m in my 30’s and have already had a repair, thanks to vaginal birth. So I’ve managed to trade “major abdominal surgery” for “major pelvic surgery” basically. Wish I’d been given a choice.
My mom had multiple repairs needed in her 40’s due to three vaginal deliveries. For years before that, she struggled with urinary incontinence. And yes, she did lots of Kegels.
When I started having my kids, I had no idea how costly vaginal delivery is in terms of health repercussions. I’m still glad I was able to do vaginal deliveries (as it means I have more flexibility with regard to family size and the initial recoveries were faster), but thanks to those vaginal deliveries, I started seeing a urologist when I was 29 or 30.
There needs to be more awareness as to what the trade-offs of different types of deliveries are.
As one of the OBs pointed out above, the number of CS needed to prevent a prolapse is 8.
An uncomplicated CS costs the NHS 500 pounds more than a SNVD.
A hysterectomy, TVT, course of pelvic floor physio, incontinence products, HRT, urodynamics, multiple appointments with urologists and gynaecologists and GPs..costs a lot more than 500 pounds, but not everyone who has a VB will need all of that
If you factor all of that stuff in, for those who need it, CS ACTUALLY costs the NHS something like 73 pounds more.
Pauline Hull has the numbers.
http://cesareandebate.blogspot.co.uk/p/about-me.html
wait, so it’s okay to cite relative risk for this, because it helps your cause, but not for homebirth complications, where it hurts it? you really are out for an argument, like your name suggests.
And even with that, she seems to be saying that OBs should wait until they are 100% sure the c-section is needed, so then that mom not only gets all the risks of a c-section, she has a high probability of a damaged or dead baby too.
If my OB had waited until he was 100% sure that a c-section was needed, the best likely outcome for me and my child would have been ICU stays and possible long term morbidity and/or death. My “possibly unnecessary” c-section led to us leaving the hospital together 3 days after the procedure.
If OBs waited until a CS was 100% necessary, they would probably still have better rates than home birth CPM, considering that 1. CPM dont have the tools to identify the problem 2. Once they realize a CS is necessary, mom & baby are at least 30 minutes away from an OR.
How terrifying is that?
ha ha you got my name
Once again you are repeating standard NCB tropes that are incorrect. C-section does NOT increase maternal mortality 3 fold. Women who have C-sections have a higher mortality because of their underlying medical problems (heart disease, severe pre-eclampsia, etc.), not because of the C-section that attempted to save their lives.
This is such an important point.
Expanding on that point, emergency c-sections happen only when bad things are going on (even in a previously low risk pregnancy in a woman without pre-existing conditions.) Bad things are associated with adverse outcomes. For example, a c-section might be performed for chorioamnionitis. If the c-section was delayed too long, the mother might die of sepsis. But that would be because of the pre-existing infection, not the c-section.
you’re kidding, right? you don’t believe that major abdominal surgery is an independent risk factor on its own??? btw the literature on most heart conditions reccommends to avoid surgical delivery except for obstetric indications. just sayin
It isn’t a question of what “I believe.” It’s a matter of looking at what the scientific evidence actually shows.
Try it sometime. I guarantee it will be enlightening.
“Major abdominal surgery” is redundant: any abdominal surgery is considered “major surgery”. That being said, the answer is nearly always “compared to what”? I don’t know the numbers, but it’s not clear to me that planned c-section with regional anesthesia would be higher risk than second stage of labor for someone with cardiac issues. Pain and stress increase the cardiac workload and would be risks for a heart attack in a woman with pre-existing heart disease. Not to mention the potential risk if she had a PFO and a venous blood clot…But this is speculation on my part. Do any of the OBs out there have the actual numbers?
not so, the literature on pulmonary hypertension and so forht reccommends vaginal delivery with epidural and vaccuum.
Cool. Want to give some references?
And if the choice is between an epidural, episiotomy and instrumental delivery or a CS with a spinal, I’d take the CS any day (which is exactly what I did).
“btw the literature on most heart conditions reccommends to avoid surgical delivery except for obstetric indications. just sayin”
Oh course. But we’re not talking about PFO or mitral prolapse or other piddling “heart diseases” are we? There’s no medical indication to schedule a c-section for those. The women who are at risk have *major* heart problems. Like the recent link somebody posted of the pregnant woman who had a cardiac arrest while (luckily) visiting her friend in the hospital. She had an emergency c-section then and there. I suppose wise Dr. Kisarita would have said “Whoa team, hold on here, my understanding of the medical literature is that we should have her try for a vaginal delivery here as she doesn’t have an obstetrical indication. just sayin”. Sign me up to be cared for by you Dr. Kisarita!
for mitral prolapse alone, and even with regurgitation, no particular interventions are called for. i don’t remember about PFO. cardiac arrest is obviously an extreme circumstance.
“cardiac arrest is obviously an extreme circumstance.”
Yep, the sort of extreme circumstance that leads to death. Which is exactly Dr. Amy’s point.
Eisenmenger’s Syndrome? PPCM?
Current literature advises the NECESSITY of adequate analgesia during labour and advises epidural as the best option, but that it is contra-indicated
in the anticoagulated. It suggests CS only for obstetric indications OR when delivery has to be expedited for maternal cardiac decompensation.
For Eisenmengers, second stage of labour is problematic and many advise instrumental delivery to reduce maternal pushing.
http://www.heartdiseaseandpregnancy.com/pdf/phy_es.pdf
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2700591/
So, your options might be a planned CS or an epidural and maybe mid cavity forceps….oh and the 50% chance of dying either way.
Realize also that the recommendation for any one condition may be to avoid CS because of increased surgical risks, but it is not always possible to do so. A woman with a congenital heart defect may be statistically better off with a VD, but in her individual case other factors may make that impossible, or may make CS, despite the extra risk, the best of several bad options.
”kisarita” – why do you keep ”just saying” when you clearly don’t know what you are talking about, and keep making stuff up.
This is not just a supportive ”mommies’ ” forum – it is a discussion amongst rational people, many of whom are health care professionals. We don’t care what you reckon off the top of your head.
Thank you! This was exactly the case in our family. My sister in law had C-sections with both her daughters, due to severe pre-e/HELLP syndrome.
She had other health issues before she ever became pregnant, and had been advised in her teens that pregnancy was not a good idea. Both pregnancies resulted in a relatively healthy but premature baby girl, they are both adults now and doing great. They are great people and I am happy to know them. Unfortunately my SIL died of a stroke at the age of 42…
A recent study compared a group of first-time mothers, some planning vaginal birth for head-down babies with no special risk factors, some planning c-section for breech babies with no other major risk factors.
They choose breech fetuses as the reason for c-section because, unlike other indications, it doesn’t make the surgery itself more dangerous. Placenta previa, for example, makes vaginal birth deadly, but it makes c-sections a bit tricky as well.
The breech babies delivered by scheduled c-section had FEWER complications than the control group. There was no difference in adverse maternal outcomes.
Could you give a link to the study? One question I would have is the number of patients. With maternal mortality being measured in the per 100,000, it would have to be a very large, probably population based study to get a real idea of the maternal risks…but that’s just a fussy caveat. It’s pretty clear that a planned c-section in a low risk woman is, well, low risk.
Hah, you hit the weakness on the head. The control group, vaginal birth, was 30,000, but the planned c/s group was only 1,000, which means it WAS underpowered to detect a difference in maternal mortality or even severe morbidity.
Still, when a sample of 1,000 is underpowered to detect a risk, it’s a pretty small risk.
“not when a c/section increases maternal mortality 3 fold”
Not “increases” but rather “is correlated with an increase”. Correlation is not causation. The confounding comes from the fact that many women with life-threatening conditions need c-section (e.g. eclampsia, congestive heart failure, uncontrolled maternal diabetes with macrosomic infant etc). These women are at higher risk of death and skew the numbers. So far, studies of planned c-sections on healthy women have NOT showed an increase in mortality. We also need to take into account long-term mortality risk. I avoided c-section with my first birth….but ended up with a birth injury that will require me to undergo at least one *major* surgery and possibly as many as 3 surgeries in the future, all under general anesthesia for repair. A c-section would have been much much safer for me.
Please clarify, so similar to late term abortion for instance.
http://kumquatwriter.wordpress.com/2011/08/26/what-late-term-abortion-looks-like/
Hugs to you, Kumquat. You write beautifully about your little Isaac. Although a couple of the commenters make me want to go and get my flamethrower…
I will join you with the flamethrower…..
Hug!
My beef is with the NCB practise of late term abortion.
My comment was directed at kisirita.
<3 you are amazingly brave.
Thank you for sharing your experience!
Depends on how you define unnecessary indeed. My son was just delivered by c-section, and there’s a good chance that I could have pushed him out vaginally. I estimate that the chance he would have been seriously harmed or killed if I had is about 10%.
This means that 90% of women in my position had “unnecessary” c-sections. However, we don’t know which they were! Since at most 1 woman in 1,000 will experience a serious complication from a c-section, I guarantee you most of them will choose the surgery eagerly.
In general, doctors do c-sections when the potential risk (to child or to mother) of a vaginal delivery outweighs the risk to the mother of surgery. Because c-sections are now so safe, this happens fairly often. Basically, if you do 100 c-sections to save one baby, you’ve come out ahead. Most mothers agree.
Yes, I do believe that the autonomy of a pregnant woman takes precedence over the needs of a fetus, even at term. But most pregnant women at term will freely choose to protect the fetus even at a slight risk to themselves. That’s why it’s so important for mothers to be properly informed.
there are few absolute guidelines as to what constitutes a necessary c/section, much depends on the comfort level of the individual provider and not hard science, and s/he will influence the patient according accordingly.
i refused the c/section that was being pushed at me, but then again i have some knowledge of the field. 99 sections to save 1 baby? not acceptable to me if i’m one of the 99.
c/sections aren’t entirely complication free for neonates either.
All a game of odds and it depend which ones you want to go by.
99 sections to save 1 baby? not acceptable to me if i’m one of the 99.
How do you know you will not be the 1 out of 100? Are you willing to live with the consequences if you are?
It’s an exercise in risk assessment, isn’t it? I am choosing not to have my arthritic hip (due to hip dysplasia) replaced at this point, because I live in a developing country that doesn’t do all that great with hip surgery.
The pain won’t kill me. Not having a c-section when it’s necessary can kill, both mother and baby depending on the circumstances.
not having an epidural won’t kill you either. but in very rare circumstances and epidural can lead to death or prolonged debilitation. clearly the risk of an epidural outweights not having an epidural. yet most of us are confident that an epidural is ok (myself included) because the absolute risk is so tiny. its all a matter of what risk level you consider significant or not.
not having an epidural won’t kill you either.
Well, probably. An epidural in place can help you avoid general anesthesia if it does come to an emergent c-section and thus avoid the higher risks of general. And it’s not impossible for people to go into shock from pain alone. I’ve never heard of someone dying of the pain of labor (only wanting to), but I can’t see that it could be said to be impossible.
Severe pain in labour can lead to PTSD and an inc risk of PPD. So yeah, if you factor in suicide it is
Yes, of course it is all a matter of what risk level you consider significant. One would have to know what the actual risk is before being able to make an accurate assessment, however.
Would you refuse an operation if you had appendicitis? Not all persons
with appendicitis, or even peritonitis, die if the appendix is not
removed
Furthermore, the standard doctrine in surgery is that if you aren’t taking out 10% normal appendixes you’re not doing enough appendectomies because you’re missing some appendicitis*. If you were in the hospital with all the symptoms of appendicitis, would you want your doctor to refuse to do an appendectomy until s/he was sure that it was needed, risking perforation, peritonitis, and all the other complications of appendicitis?
*At least, it used to be. Not sure if this has changed with better imaging.
I’m one of the 10% with a normal appendix-of course I had all the symptoms of appendicitis because of the big ovarian cyst which had ruptured. I didn’t get a scan becaùse I was too unwell and all the textbook signs of appendicitis were there. Also, because I told them I didn’t care if it wasn’t appendicitis, but could they just stop fannying about and go in and have a look.
Since they also removed all the fluid sloshing about my abdomen when they took out my appendix I felt much better after the surgery. I know that if I have pain in that area again it can’t be appendicitis, which is good too.
I realise not everyone would be thrilled, but my “unnecessary” appendicectomy was, all-in-all a good thing.
”kisarita” – are you claiming that you knew in advance that you were ”one of the 99″? If so, you must share that special knowledge!
And no, cesarean birth isn’t ”complication free” for neonates, but overall neonatal outcomes are better than for vaginal birth. If you have ”some knowledge in the field”, you must know this, surely.
Not to mention that VB is not complication free either.
c/s were the least complicated for my last 3 children. Something about how they got to be born breathing, with a heartbeat, and without a lifelong injury made it really worth the risks to me… Wish I would have realized this was important prior to my homebirth…
And kisarita talks of maternal risks over fetus risks… I went that route. I put my own needs over my first son’s (a fetus at the time), like you thought I should, and guess what… I now spend a lot of my life dealing with the injury my son received as a result of that. Now I think, what was 6-8 weeks of a c/s recovery and the risk of scar tissue compared to the last 6 years of my family and I living a whole different life (and more years to come)??? I now sacrifice a boatload of time, money, and energy to that injury. Not meaning to sound sacrificing… I do it because I love my son and want him to be as typical as possible. But it just burns me up to talk about the risk to the “fetus” so non-challantly. You might not want to risk a c-section, but the NCB community doesn’t tell you that you then might be risking your waking existence to the effects your vaginal birth might have your child for the rest of their/your life..
-1 trauma homebirth, 3 beautiful c-sections
glad everything worked out for you!
One of her children has an injury from homebirth – her point is that it DID NOT work out for her son!!! Are you really that dense and callous?
sorry about that. i read too fast.
You cannot be serious.
no special knowledge, but i’m aware of the wide range of opinions among dr’s as to what contitutes fetal distress that would indicate an urgent c/section and I could see that my doc’s opinion was far more to one side than the other. (she even hinted to me as much at one point.)
Again, given the gray area, wouldn’t you rather err on the side of too early/unneeded than too late?
in that case, we’d have an 80% c/section rate (with a concurrent rise in maternal mortality). even the medical community agrees that a 30-35% c/s rate that we have now is way too high. you want me to be more pious than the pope?
the solution is more research so that we have more precise determinants- which is being done, slowly slowly.
Where on earth did you pull the 80%? You’re making up numbers.
Your solution is more precise ways of knowing, but what are providers supposed to do in the meantime? Err on the side of too early, or too late? And what if there is never perfect information?
80% of fetus’s will show at least some signs of possible distress during labor. can’t remember which article i got that from. but you’re right, it probably wouldn’t lead to and 80% c/s rate.
1. A 30%ish c-section rate appears to lead to excellent outcomes already. You’re just making the 80% figure up because it sounds outrageous to you.
2. Women may increasingly *choose* c-sections, as they become more aware of the risks and benefits of each type of delivery. Do you believe they should have this choice or not?
Okay, if we are looking at this completely selfishly, what if the c-section would save our baby from a serious brain injury? Is it in your self interest to spend the rest of your life caring for a brain injured child, or spending a few extra weeks recovering from surgery, but not have the financial and physical burden of caring for a disabled child?
So, for your “error on the side of caution” you’d rather have a c-section that was too late/no c-section and catastrophe than an unneeded c-section? For the “game of odds” I’d like to have an unneeded c-section and a healthy baby.
Statistically, c-sections are SAFER for babies than vaginal deliveries. The main complication that the baby faces is TTTN, but that can happen after a vaginal delivery at early term as well (it happened to my “naturally” born eldest son, who made his appearance at 38+3). A couple of days in the NICU primarily for observation are far preferable to a brain-damaged or dead child, IMO.
Not acceptable to ME if my BABY is the 1.
What the hell IS a “necessary” c-section? Who determines what the “right” reasons are for having one, and what the “wrong” reasons are? You? Ummm…no.
I loved my c-section, and it was determined a bit after the fact that I probably could have had my baby vaginally also. It was done as a precaution, and I don’t regret one thing about it. My baby arrived safely, and it was a wonderful birth, no matter which way you slice it. Pun intended.
“99 sections to save 1 baby? not acceptable to me if i’m one of the 99.”
Wow…that’s cold.
Yeah, I’m having a really hard time wrapping my head around this one. C section just isn’t that bad.
We have had this discussion before-anyone remember Carrie saying something like this?
Yes, Carrie cited 1 in 1000 as unacceptable. I have screen shots since that was back when this site had the old commenting system where it was possible to folks to delete the entire thread, but they’re not on this computer.
Both kisarita and Carrie are disgustingly callous about the family whose baby needs the c-section.
Until we have some way to see into the future, there is no such thing as an “uneccesary c-section”.
There is such a thing as an uneccesary risk, though.
And when you decide that the odds you want to “go by” are a significant increase in risk for your baby instead a small increase in risk for you, you’re taking one.
Congratulations on the safe arrival of your son!
I hope you have a quick recovery and that he sleeps long and often!
You would think that a nurse would understand the concept that the goal of intervention is to prevent emergencies, not resolve them. If it gets to be an emergency, then you waited too long.
I think most homebirth mothers change their mind about risk to the baby – note the many stories with a mad dash to the hospital. And in my opinion, that is an excellent reason to do the c-section!! The medical providers can be sued and also hate to stand by and watch life be lost.
If you know all the risks and still want to prioritize the birth experience, regardless of outcome to the fetus, then I say go ahead and have an unassisted birth. After all, the odds will be in your favor, and you are under no moral obligation to do anything detrimental. Why pay anyone?
You are comparing the risk of death of a newborn baby with the risk of having some medical procedure to minimise risk? Seriously?
Do you understand the concept of magnitude? Many women are happy to accept an increased risk of interventions to avoid the small chance of an event of catastrophic magnitude.
You’re not, apparently (though it seems that you were willing to accept some? I’m unclear on your position, honestly), so you were motivated to avoid a c-section and you acted accordingly. Maybe that was the right choice for you, I don’t know. I don’t care. Who knows? What I do know is that your opinion and preference does not make it right for other women and their babies. You can be smug about hating c-sections if you want, but understand that many other educated, informed women view the odds differently, and their conclusions are no less valid than yours.
my position is that a homebirth is a valid although slightly riskier option, as the overall risk remains rather low and risks in hospitals are not negligible either. I am not the one who is being smug and invalidating anyone here.
i suppose with one exception- the woman who just had a c/section that she would have rather avoided. I’m sorry I responded in that way. I’m unhappy with my birth experience and the way it turned out, and the thought that it was probably necessary is comforting, so It probably wasn’t a good idea to respond the way I did.
I suppose thats why i’m visiting this blog- to sort of seek validation for my experience but this blog and its commenters are so extreme its having the opposite effect on me.
as for my personal choices; i chose a hospital birth because my preferred nurse-midwife (the one with the best stats and the most experience) risked me out due to living on a 3rd floor walkup (albeit 2 blocks from a hospital), and i respected her judgement.
Well, I find your belief that a full term fetus is significantly distinct from an ex-utero infant of the same gestational age kind of extreme (and morally suspect, though I agree that *legally* the mother’s rights and well-being are paramount).
I also find your preference for accepting the risk of a catastrophic, life-altering event in order to avoid medical interventions, many of which are minor inconveniences (and which many other women actually prefer to have), pretty extreme also.
But again, it doesn’t matter what each of us believes is better. There is no choice in childbirth that guarantees a perfect outcome. It’s all about knowing and understanding risks so that you can make a truly informed choice. I would not personally choose homebirth, for a number of reasons, but I don’t have anything against other women choosing it so long as they are truly informed and have skilled providers. There are too many cases of women choosing home birth because they only hear one side of the story, suffering a trauma or tragedy that they didn’t think was possible, and that just isn’t acceptable.
i would agree with that. i had a lot of pros and cons in my desire for a homebirth and decided to go with a very professional and very cautious midwife with outcomes comparable if not better than most hospitals. i have to say that while i was disappointed that she risked me out a part of me was relieved as well.
I’m glad you had a midwife who risks people out. I’m also very sorry that you had a cruddy birth experience. My (hospital) birth sucked, although I’m okay with it and not traumatized. I sympathize.
I’m sorry you had a bad birth experience.
Ah ha, now the smoke clears… Your hereto fore dependable CNM risked you out solely based on your living conditions?! How far along your pregnancy/financial relationship with her were you? I can imagine that abrupt change would have a overshadowing impact on your perception of labour and delivery. I am not trying to be smart alecky either. Did your CNM leave you hanging for months on end or did she professionally hand your case file over to a trusted hospital based CNM/OB/GYN? Was she unable to attend your birth b/c you were in a hospital?
To make a comparison… I depended heart and soul on my beloved husband to attend the births of our children. If for whatever reason, valid or not, he could not be there with me I would have felt lost, powerless, frightened and a twitch paranoid. I can imagine that for a mother who established a warm relationship with her midwife those same feelings would prevail.
Living conditions were definitely part of the vetting standards I was taught in the UK. They were pretty minimal, but a woman could absolutely be risked out if her home did not meet certain criteria–and also if she could not arrange for someone to be with her 24/7 for the first 10 postpartum days.
“Unnecessary interventions”. Like RRLT, EPO, black and blue cohosh, moxibustion, acupressure and accupuncture appointments, prenatal massage, rebozo scarf, garlic in the vagina, sex and nipple stimulation to start contractions, Webster technique, hypnobabies, Bradley classes, protein diet, watertub therapy/birth, doula, laboraid, etc?
“As for “the risk to your child”; at that point it isn’t a child, it’s a fetus and in my opinion a woman is under no moral obligation to do anything she finds detrimental to herself, for the sake of a fetus.” Why even get prenatal care then? Just show up for delivery.
you wont get an argument from me about most of those things; most of those things are interventions that like all interventions, should be used with caution if at all. not including sex, of course. i regret having used accupressure on my own before my baby was ready to come out- didn’t really believe it would work!!!! but then, that intervention used again in the right time saved me from a c/section- dilated from 3 cm to 10 in less than 2 hours. of course it could be coincidential.
Do you oppose mammograms, Pap smears, blood pressure monitoring, blood pressure medication, etc. on the grounds that they are interventions and most people won’t experience the complication or disease they are designed to prevent? What’s the difference between mammograms for women (most of whom won’t have breast cancer) and fetal monitoring for fetuses (most of whom won’t have fetal distress)?
i haven’t objected to fetal monitoring anywhere amy, don’t put words in my mouth, but there are ways to accomplish it with less interference. read my post also where i called for more precise diagnostic criteria.
as for mammograms, if large and ever growing numbers of women were having lumpectomies due to false positives, we might have to reconsider mammography reccomendations. I don’t believe we are there though.
angelinea jolie had a prophylactic mastectomy which i think is over the top, but hey maybe thats the new trend.
Angelina Jolie had a prophylactic mastectomy because genetic screening told her she was one of the rare unlucky women with an 85% lifetime risk of cancer. For the “average” woman, prophylactic mastectomy is over the top.
Personal risk: With accurate diagnostic information, it’s not subjective at all.
I think everyone would like “more precise diagnostic criteria,” but in the absence of that are we to simply to throw our hands in the air and give up until some future time when everything is perfect?
Also, veering OT, but the mammography/breast cancer diagnosis/treatment issue is very heated at the moment. If you want to do without screenings in order to avoid over treatment, I think that’s a reasonable choice, but it’s disrespectful to be dismissive of the difficult choices made by high-risk women, many of whom have personally experienced the devastation of breast/ovarian cancer in family members and are desperate to avoid the same suffering. Personally, I’d take the risk of unnecessary biopsies, and I hope no policymaker ever uses population-level data to prevent me from doing what is right for me as an individual.
A little population level data: For women over 50 with stage I breast cancer, the 5- and 10-year relative survival rate (i.e. probability of surviving if the average person of equal age is set to 100) is 110. That’s right, you’re less likely than average to die if you have a stage I breast cancer than if you don’t. Presumably, this is because women in whom stage I breast cancers are found are receiving better medical care than average and getting regular screening and treatment for other problems. Nonetheless, the relative survival goes down abruptly for stages 2 and, especially 3 and 4. How badly do you want to avoid that “unnecessary” biopsy anyway? What are you willing to risk by waiting for the cancer, if it’s there, to get large enough to be detected without mammography?
I’m not following. I said I’d personally prefer the risk of unnecessary biopsy and overtreatment to that of not detecting cancer early and having it progress to the stage where it has a poor prognosis.
You’re not following because I wrote confusingly. Kisrita has been arguing that “unnecessary” interventions of any sort are bad under all circumstances. I meant to simply enhance your point that sometimes “unnecessary” interventions are the less risky course but ended up mixing the two points and being confusing. Sorry!
Oh, thanks for clarifying. Names are not displaying correctly sometimes too, which makes it even more confusing.
a biopsy is not the same as a lumpectomy.
True. Also true – tissue removed during a lumpectomy is usually also biopsied. Seems pretty common to just do them both at once if the lump is smaller or easy to access surgically.
Your point?
Depends on the size of the mass. Sometimes an excisional biopsy (just take it all) is the simplest thing to do.
My aunt died of breast cancer at the age of 36, leaving behind her 9 year old son. Her son didn’t fully believe in her death until her coffin was lowered into the ground, and then he hurled himself in the hole, grabbing the coffin, wailing and screaming in grief. He had to be sedated for several days. I would cut off my limbs if it meant sparing my child this kind of loss and seeing him grow up. Angelina Jolie made the only decision that a loving and responsible mother would do—she took care of herself to make sure her kids wouldn’t end up orphans.
Unnecessary lumpectomies? Yes, please, if it means survival.
Um, sorry if this is none of my business, but have you been tested for BRCA and other potential genetic forms of breast cancer? Please do so, if not.
She was not a blood relative, she was related by marriage.
That is the bottom line: it could have been coincidental. And, it’s unproveable because the subject cannot both be affected and unaffected by a particular “intervention”.
The only thing is that acupuncture/acupressure has been shown, repeatedly, in well-constructed studies, to have absolutely no effect greater than placebos.
Slow….clap. Standing…applause.
>”As for “the risk to your child”; at that point it isn’t a child, it’s a fetus and in my opinion a woman is under no moral obligation to do anything she finds detrimental to herself, for the sake of a fetus.”
Wow. That is reprehensible. If the woman intends to allow that fetus to become a child, she absolutely has a moral obligation to take on small risks (normal interventions) to ensure that the child has a chance at a healthy life. If she doesn’t want to, she has the legal right and shouldn’t be jailed for exercising that right, but it is still a reprehensible decision.
I will agree this far: I don’t think a woman should be legally forced to do anything for the sake of the fetus. That sort of law just never leads anywhere good.
OTOH, I do think that she has a moral obligation to a fetus that she has let gestate for 8 or 9 months. This moral obligation shouldn’t be enforced legally simply because we have no way of doing so that wouldn’t lead to a worse oppression, but she does have a moral obligation to any fetus that she intends to bring to term to try her best to bring it to term as healthy as possible.
Moreover, I think that medical providers have an obligation to provide accurate information to women who are pregnant. Quite a number of women who have posted here have said that they would never have undertaken a home birth if they hadn’t been convinced that it was safe. The NCB movement, the Ricki Lakes and Ina Mae Gaskins of the world, actively lie to women to try to convince them that home birth is safer. That should not be allowed and should, at the very least, be countered whenever possible.
As far as “unnecessary interventions” in hospitals, you’ll have to be more specific: What interventions are you talking about, why do you consider them unnecessary, and what is the evidence that they are forced on women? I’m open to the idea that hospitals are imperfect places and that the experience of giving birth in a hospital could be improved. But I can’t see any reasonable plan of action without further information.
“the total risk is .05 percent- ”
Um no, recheck your math. The risk of DEATH ALONE is 10 times that! 1 in 200 babies dies at homebirth in Oregon, almost always a preventable death. And that doesn’t count the kids with brain injuries. A woman is under no legal obligation to birth anywhere she doesn’t want, and you argue she isn’t even morally obligated to do so. You are certainly correct she is not legally obligated and for the sake of argument, let’s assume you are right that she isn’t even morally obligated. But don’t you think a pregnant woman might like to *know* that her risk of having a brain-damaged baby is 18 times higher at a home birth? Because it may be a fetus now, with no moral claims on the woman….but once the thing is born it’s now a baby, and my goodness how the moral and legal obligations do mount up! Now the grim reality sets in and you can kiss any fancy philosophical arguments goodbye.
Epic fail.
Huh? Of course no woman should be forced into any medical procedure or intervention against her will. She also should not be forced to carry a pregnancy to term if that’s not what she wants.
However, going out a wild, wild limb, most women who have made it to term probably want to deliver a healhy baby. I’m extremely pro-choice, but when I was carrying my very wanted child, she was my baby. I would have done anything to protect her before she left my body (and thereafter). I wanted to know how best to do that.
This is about accurate information. I have to assume that most women carrying babies to term want those babies to survive birth in the best condition possible — it’s not about treating them as incubators, but rahter giving them information they probably really, really want/need. Thus, we convey accurate information about the risks of homebirth.
I’ll take it a step further, because it’s been making me mad all day. I *did* terminate my first pregnancy (catastrophic birth defects). He was my BABY when he was a fetus inside me and when he was an “aborted fetus” in my arms. My living son was just as much my BABY from embryo to healthy newborn (and still is, especially when he’s all rosy and sleeping). This thing about women having “no moral obligation to the fetus” is important legally and all well and good in theoretical debate, but I find it disgusting that you repeatedly use it to justify *a bunch of scare tactics about hospitals and cesareans* And it’s this stupid, stubborn blindness causing all these dead and damaged babies!
I think most people think it’s a child. A beautiful, wanted child.
I’ll take it a step further, because it’s been making me mad all day. I *did* terminate my first pregnancy (catastrophic birth defects). He was my BABY when he was a fetus inside me and when he was an “aborted fetus” in my arms. My living son was just as much my BABY from embryo to healthy newborn (and still is, especially when he’s all rosy and sleeping). This thing about women having “no moral obligation to the fetus” is important legally and all well and good in theoretical debate, but I find it disgusting that you repeatedly use it to justify *a bunch of scare tactics about hospitals and cesareans* And it’s this stupid, stubborn blindness causing all these dead and damaged babies!
Exactly this. Every time.
Kumquatwriter <3 to you.
Having read the whole thread, I’ll say this: I don’t think your unnecessary fear of a caesarean should get in the way of the facts that mothers need when deciding where and how to plan a delivery.
I would think homebirth raises the risk to the mother somewhat as well. I wouldn’t be comfortable with the risks of a HB for either baby or myself.
Talk to me more about this last paragraph: “whereas the attitude in the hospital basically is to intervene on the mom even in the case of remote risks to baby- partly because they know that the same woman will change her mind quick after the delivery, but also because of a culture treating birthing woman as wards.”
Help me understand what you mean. Examples would be helpful, if you have an accredidation that may support this generalized perception based on experience and witness to numerous events, that’d be great. Also, any EBP or peer-reviewed scholarly articles focusing on the interventions hospitals (and by that I assume you mean the PEOPLE in the hosptial, and not the building itself, but please, clarify that as well) implement on the mothetr when the baby MAY be in a remote risk.
You go, then I’ll go.
P.S. Bad news….when a live birth is taking place, that little person has officially graduated from fetus to neonate. If the kids on the way out and has a heart-beat, it’s a person! YAYAYAYAYAYA!
Please remember that an intervention free vaginal birth carries its own specific set of risks. Vaginal Tearing is one example of a risk specific to the mother in an intervention free birth, one that can occur both home and at the hospital.
Not to mention a fistula-“A Walk to Beautiful” was on Nova tonight. None of the women featured in that documentary had any interventions available to them during labor and delivery.
At the hospital I gave birth in, the goal is for every woman to have a safe vaginal delivery and they strive a little too hard in my opinion to avoid unnecessary interventions. Pain medications are at the patient’s option and they do not have any “routine” procedures except in specific circumstance. For instance, when my water broke, there was meconium so they put a fetal monitor on me. They don’t even insert an IV as a matter of course, and I wish they did because I ruptured my clitoral artery during the birth and the IV had to be inserted in a hurry in order to get some pain meds into me while they sowed me up (I had a drug-free birth NOT BY CHOICE, but because it was too late for drugs by the time I got to hospital. I was already 10 cm and bearing down). I could have avoided a lot of pain had they inserted an IV as soon as I got there instead of waiting to see if it was needed.
“As for “the risk to your child”; at that point it isn’t a child, it’s a fetus and in my opinion a woman is under no moral obligation to do anything she finds detrimental to herself, for the sake of a fetus.”
Your little rant is really really scary.
Why have children then??? If a woman feels she has no moral obligation to the child she carried for 10 months, why bother? Why not abort the pregnancy early? What happens when that child is born? Will she suddenly feel ” moral obligation” to do the right thing?
How will such a woman feel about her “moral obligation” to get up several times per night to feed and change her infant? Not to shake him when he screams and screams for hours?
I seriously think that any woman who feels that she has no moral obligations to keep her children safe and happy shouldn’t have them. We have that choice now. Giving birth is not an accomplishment. Maybe you should run a marathon, climb Kilimanjaro, or learn Chinese. Those would be accomplishments without lifelong commitments.
I’m a few glasses of wine in, so maybe I’m being more aggressive than I would be, but this comment is horrible. As the very intelligent other commenters have pointed out, this argument does not make sense.
By my reading, this comment only makes sense if this person hoped to use the political opinions of the commenters here (assuming all of us are aggressively pro-choice, which I do not believe is true. I think we’re a diverse group. I wish trolls would respect that about us.) to twist our point of view and make us agree with homebirth.
However, it is incredibly important to note that there is a huge difference between an unwanted fetus in the first trimester or even the beginning of the second, and a full term baby. This reason is actually biparted, at least in my philosophical understanding. For one, full term babies, especially full term babies being homebirthed, are WANTED. Because of that, it’s incredibly necessary to treat the child not as a fetus and as a child. Furthermore, by the time a baby was full term, it is not a fetus. I am aggressively pro-choice and I also hold a degree in philosophy with a focus in ethics. Abortion ethics often come up in ethics courses. Anyway, there are very intelligent arguments about why full term babies are not human beings with personhood, which are aggressive arguments, but none of them refer to the baby as a fetus, only as not a person. Fetuses are developing mammals. Full term babies are not fetuses. There are great arguments as to why we should not assume babies have personhood, but none of these arguments (that I have read) claim the babies are fetuses.
I point out this issue with this commenter’s vocabulary, because I think this commenter is using the term “fetus” to illicit a response from pro-choice individuals, as if we all just accept the idea that anything some random person calls a fetus does not deserve to live or has the right to be aborted under any circumstances. As a pro-choice individual, the assumption that I do not care about full term babies is offensive. (And there’s a huge amount of ethical weight placed upon the woman’s desire for a child. I’m confused by the original comment’s assumption that women have homebirths because they want dead babies, which is how it read to me.) Pro-choice is about the right to abort a fetus, so maybe the commenter hoped that by incorrectly calling full term neonates fetuses would make us all be okay with the increased death rate in home birth.
Also, I was born 6 weeks early. My mom’s labor was horrible, and I almost died. Was I still a fetus? I wasn’t full term, nor out of my mother’s uterus. Even when I exited said uterus, I continued to develop while I was in the NICU. By the original definition here, was I still a fetus? Even outside the womb? Should my mother have just walked into the NICU, disconnected me from the machines, and proceeded to smother me? After all, I was just a fetus.
I know I’ve been inarticulate, but this is an evil comment. It’s attempting to manipulate one political perspective to agree with an unconnected perspective. It also posits a really evil conception of life.
Congrats! Your child is more likely to die by homebirth than to be kidnapped in the US! (According to this link 115 kids were kidnapped by strangers: http://www.freerangekids.com/crime-statistics/).
Killed by a kidnapper, or just kidnapped? The link doesn’t work for me.
Fixed the link, not sure if my other comment went through but it’s 115 kidnapped by a stranger and 50 killed.
Your child is more likely to die during hospital birth than be kidnapped by a stranger too, so not sure what that is supposed to prove.
1.4% of babies were born at home. So this tiny percentage of births are more risky than ANY child being kidnapped at ANY age by a stranger in the US. Protecting your kids from predators is a big priority for most parents. I don’t know, maybe that’s not convincing to you, but we spend a lot of time talking about “stranger danger” and actually homebirths are much, much riskier.
I love FreeRangeKids.com
I do too but I can’t read her site any more, it’s too depressing. We have been living overseas for the last few years and it’s so different. Little 6-10 year olds walk past my house everyday on their way to the park.
I don’t love Free Range Kids. The reason is is that I feel it’s yet another Parenting Cool Club, like Attachment Parenting. Even the names have similarities: If you’re not an Attachment Parent, that means what? that you’re an unattached parent? And if your kids aren’t Free Range, then they are being raised crammed in tiny cages like chickens with their beaks cut off or something? I don’t need some web site encouraging me to believe that I’m doing it right and all the other sheeple parents are doing it wrong (I’m already enough of a dick as it is, you see).
Oh, I agree there. I don’t I’D as “free range” But I love the site for its information, and the general idea. 🙂
This.
Well, yeah, but that is just because birth is the single most dangerous day of a child’s life. So any kind of birth, even the lowest risk birth that takes place in a hospital is still going to be riskier than the chances of kidnapping.
Looked at another way, the _increase_ of risk you accept by deciding on a home birth is almost certainly much, much higher than the risk for your child to be abducted at any time during their first 18 years of life.
Someone with better math skills please chime in:
115 “classic” child abductions in 1999
>70 million kids (0-18) in 1999 (see http://www.childstats.gov/americaschildren/tables/pop1.asp)
gives you a risk of approximately 0.1643 thousandth (!) of one percent, or 0.0001643% risk per year, which adds up to a cumulative risk of 0.002957% over 18 years (can you just add that up?).
If we assume that home birth increases your child’s danger of dying by even just 1 in 1000 (or 0.1%), you are choosing to accept a risk that is 33 TIMES higher than the risk of your child being the victim of a “classic” abduction at any time during their childhood, all in just one day. Correct?
Therese, if it was “just because birth is the single most dangerous day of a child’s life”, then the rate of homebirths wouldn’t be 175 in a year, it would be closer to 20 and we wouldn’t even be having this conversation.
Perspective.
Completely OT, may not be totally appropriated; but I searched on the web and could not find anything about parasite cleanse other than a whole bunch of herb sup companies “testimonies”. My co-worker talked about it today and would go spend a bit high amount of cash on the products because she believe that 95% of us are full of parasite and she need to clean them out from her body with the herbs. I know we have so many medical professionals here, maybe someone could point me to the right direction? Thank you!
I know someone like that, trying to clean out the “monsters inside” with diatomacious (?) earth. I know that is spelled incorrectly, but that is the only thing i have ever heard about a parasite cleanse, I haven’t heard about herbs to correct it.
Diatomaceous earth is great at killing any bug with an exoskeleton and is safe for human consumption. I use it all the time when I get ants around the cat food. It’s so safe they put it in flour to keep it from getting infested — we eat small amounts of it all the time. But it says right on the label, it’s only effective when dry. It would have zero effect on any worms or whatever in your gut.
Isn’t it an inhalation hazard? I’d like to use it around our house…
Yeah, you shouldn’t breathe in huge clouds of it or stick it in your eyes, but putting it around the gaps in the trim where the ants come in seems to work fine, and I just vacuum it back up after a few days. It comes in a bottle with a little nozzle tip that seems to keep it from flying into the air much.
I use it in the bedding of my chicken coop to reduce the numbers of mites and fleas. It produces a lot of dust so I dust the straw bedding outside of the coop and put the bedding in the coop during high wind days so the coop has a lot of ventilation.
In case of a real infestation, I’d get chemical for deworming.
Diatomaceous earth is merely a physical absorbent – like clay or charcoal.
Years ago Fullers Earth was used as an absorbent for people who had been poisoned – it’s just a type of clay from Surrey – purified and sterilised – that physically binds chemicals. Activated charcoal does much the same, and has replaced Fullers Earth.
Can’t see how it would kill parasites, though – unless you flooded your gut with it and physically washed them out.
I think it is a new thing….
It seems to be effective in killing cockroaches. So if she has intestinal cockroaches…
Penn & Teller did an episode on “Detoxing” and interviewed a Parisitologist. http://m.youtube.com/watch?v=8QZYnatIhp0
Thank you. My co-worker is slowly buying into alternative med woos. I want to pull her back but don’t even know where to start.
Would she be amenable to some simple medical information? Ask her if she has had a stool sample that showed parasites and identified them. IF not, she could read up on some simple info on the various parasites – easy to find on the net.
She won’t go to any doctor. She just believe that her guts has parasites that need to be detox out 🙁
If you had actual worms, herbs wouldn’t kill them. Deworming medication would.
I wish there is an alternative med site like Dr. Amy’s to NCB. Searching for one :/
Bad Science by Dr. Ben Goldacre is good http://www.badscience.net/
Just read his article about psychic, so spot on. I used to do the fortune telling tricks with my friends at the party, full on cold reading BS, but they totally believed I had the gift. ( now I play poker, haha).
Sciencebasedmedicine.org is my favorite. Lemme check if they have some “parasite” deconstructions.
http://www.sciencebasedmedicine.org/parasites/
http://www.sciencebasedmedicine.org/the-detox-scam-how-to-spot-it-and-how-to-avoid-it/
http://www.sciencebasedmedicine.org/colon-cleanses-a-load-of-you-know-what/
Thank you. I feel bad, you just had a baby and you are helping me. Don’t worry about it too much. I will do more research on the web. This is a pretty good start.
Trying not to think about my baby right now. We had to take him to the regional NICU hospital for jaundice and leave him there, probably for a couple of days. He’s going to be fine, his numbers are way better already, but we HAD TO LEAVE HIM THERE.
So. People being Wrong on the Internet. (http://xkcd.com/386/) Much more something I know how to deal with.
So sorry! I know he will get excellent care though. Is this related to the IUGR?
Maybe? I can’t imagine being born under 5 pounds helped.
Hug! My older one had jaundice when she was 5 days old and we had to take her in for couple days. Totally understand what you mean. She came home with very nice rosy color. Your baby will be fine 🙂
This might keep you busy. My coworker emailed me about Dr. Bob Beck. Man, I see a train running away.
That is… How is it possible that anyone believes any of that?
Although, “frequencies to harmonize and relax the brain,” those totally exist. My speaker system is working great right now, though, so I don’t see why I have to buy something from him just to listen to music.
Young CC Prof, hope your little one gets better quickly.
Hugs. It will be ok.
Oh my goodness. Poor baby, poor mom and dad! I’m glad his numbers are improving. Try to use the time to recover, but I’m sure you’re worried sick even though he’s in good hands.
Sending warm wishes your way!
Make sure to take a picture of him bright yellow with a white piece of paper next to him for comparison. My daughter has a gruesome picture of herself as a neonate wearing only a diaper all stretched out and looking IUGR (although she was technically slightly above the limit) and yellow. She is fascinated by it!
We missed the opportunity to get such a picture, alas. We brought him home a little while ago! In 24 hours, his bili went down from 21 to 10.7 and stayed there.
Without going into all the details, the NICU staff were uniformly awesome. I am slightly pissed at the other hospital as I really believe this situation could have been avoided.
Still, baby came back. That’s the key thing.
So glad that his levels came down and that he’s home with you! Hope everything goes smoothly from now on. 🙂
Bet you’d swap a photo for the real young man any day! So glad he’s back in your arms; hope all is well from now on. I do think not letting you stay with him was needlessly cruel, but then I’m a Scandinavian living in the UK, so am unfamiliar with the US system. Very best wishes and vibes.
In this particular unit, parents are allowed to visit at any hour of the day or night. However, it’s one great big room with at least a dozen very sick babies in it, and the only place to sit is a chair next to the crib or incubator, so you can’t stay 24-7. And since we couldn’t exactly hold a baby who needed to lie under the ultraviolet naked, and I was practically hysterical with exhaustion, we decided that getting a little rest and coming back was the only reasonable choice.
That makes perfect sense. Enjoy your treasure, hope you get some sleep every now and then!
Congratulations! Sending you and the baby good wishes!!!
Aren’t we full of parasites, as in, we’re supposed to be? That’s how digestion works.
My brother also got severe GI problems traveling around southeast Asia.
(He suspects Laos was the problem.) He came home, went to a travel
medicine clinic and was treated with broad-spectrum anti parasitics, at
which point his health improved.
Parasitic infections exist.
They are uncommon among people who drink clean water and wear shoes, but
they are real. Luckily, they are pretty easy for modern medicine to
diagnose and treat.
We are in San Diego CA, I doubt she has an actual case of parasite. She starts sounding like my aunt who took alternative med instead of regular cancel treatment and subsequently lose her life. My coworker talked about how big evil Pham just want to make money and won’t look into the “simple treatment” blah blah… My aunt had that speech 4 years ago.
I also doubt this woman has actual parasites.
You might like the book Snake Oil Science.
Will look into it 🙂
Also uncommon amongst those who eat their pork properly cooked..
Home birth, 911.
Hospital, code blue,ECMO.
Blood has GBS.
My crappy attempt at poetry to vent about the recent homebirth disaster of an acquaintance. I hug my son tighter and am glad I protected him from woo.
Nice poem, terrible story.
The woman on my birth month club who was planning a home birth did it, so I can breathe now on her behalf. On the plus side, the midwives did test her for GBS and even ran antibiotics when she turned up positive. On the minus side, they let her push for 5.5 hours without attempting transport, which is freaking terrifying. Luckily, the baby was born OK. Then they wound up transporting Mom to stitch tears. (At least they told her she needed immediate repair. Hopefully they brought the baby along just for assessment.)
I wonder if this is the same disaster I just heard of. The first one I know.of .for 2014. Postdate 42+2, HB, oxygen deprivation. Mom avoided interventions, but baby gets to suffer everything modern medicine has.
They really ought to.keep track of these disasters too, and add the costs of the NICU and ECMO to the HB tally. A few of these would eliminate any supposed savings from HB. hat’s not even counting the lifetime of care for a severely brain damaged baby.
HB babies sure are using a LOT of ECMO. Ironic.for a group that shuns interventions and “allopathic” medicine….
Exactly. ECMO is about as un-freaking-natural as it gets in the NICU. Grrrrrrrrrrr. Poor, poor baby. Breaks my heart.
Yikes. Is the baby really on ECMO? How are the parents? Do they feel horrible or are they defending everything? Super curious. Also, I’d love to hear more about exactly went down at the delivery and the hospital transfer. I’m assuming some time had passed before they took the kiddo in? Gaaaaaaaaaawwwwwwwww! (That’s me being exasperated and trying to not drop f-bombs all over the place.)
I don’t know anything else, but I sure hope the midwife didn’t miss anything.
GOD I want to see that kid’s CBC w/differential and his first ABG. (Sorry, NERD ALERT!)
OT: Growing up unvaccinated:
http://www.slate.com/articles/life/family/2014/01/growing_up_unvaccinated_a_healthy_lifestyle_couldn_t_prevent_many_childhood.html
I am so glad you posted this, I needed to hear this today! Someone I otherwise am a good friend with ruined my perfectly lovely Downton Abbey premiere party by giving out her “natural flu shot” recipe and talking on and on about how she wishes she never had her children get so many shots. After all, she only ever had a couple growing up and look at how well she turned out. I would have liked to have her as a resource after my baby is born to help me out and have her daughter be my babysitter. She didn’t want to hear about what having the flu while pregnant can be like or what a baby with pertussis sounds like. It’s perfectly reasonable to be worried about a newborn contracting pertussis in this area-and I would love to know what the equivalent of a “natural flu shot” would be for a newborn or infant. Can’t give my son a shot of lemon juice, garlic, ginger and pineapple.
I would also like to add that my friend was talking about all the “risks” of vaccines and said “what is in a flu shot anyway?”. Yeah, why don’t you build a case against something that you obviously know NOTHING about. I said that since she is so into boosting the immune system to fight stuff, a flu shot or Tdap should be something that she should be all for.
Oh man. If I was pregnant I would’ve asked her to leave. Maybe we will get lucky and someone on Dowton Abbey will die of a vaccine preventable disease this season.
I wish I could ask her to leave sometimes. I could never forgive myself if my baby did get pertussis because I didn’t get a shot or because my husband wouldn’t. My friend said her kids don’t like getting shots. Which makes me wonder if they have gotten many at all, because I am a big baby when it comes to getting shots and having blood drawn and I could not feel a thing when I got my flu shot or my Tdap.
What is interesting about this friend is how AGAINST homebirth she is. She also doesn’t really care about natural when it comes to birth. She had interventions with both of her babies and didn’t seem to care, she said her cervix just doesn’t dilate without pitocin, she wanted an epidural because she felt like she would do better with one and she feels that women do better when attended by skilled staff.
I was thinking it would be so sad but right for the time period if one of the Downton tots contracted a disease that we routinely vaccinate for now.
For kids, they have the nasal flu spray, so there’s not even a poke.
I wish I could get that.
That is true-I will suggest that to her. I just get the feeling that she isn’t going to let her kids be vaccinated. She said that it isn’t an issue because they home school now.
As opposed to other people’s kids, who love getting shots? Since when does a child liking a shot or not have anything to do with it? When you’re the parent you vaccinate them whether they like it or not. Don’t get me wrong, I feel a twinge too when they get a shot, but I use rational thought and get over it. Does she also let them ride around without car seats because they don’t like them? Ugh. I’m sorry.
It sounds like she started hanging out with a fringe homeschooling group and decided she needs to fit in.
My kids didn’t mind their shots at all – because they knew that they would get ice cream afterward.
Oh sure, it hurt when it happened, but they got over it quickly. We just played the distraction game.
But ok, kids don’t like the ouchies of shots. I’m sure, then, that they will be just fine with 3 months of coughing with pertussis, or 2 weeks of fever and rash with the chicken pox, right?
She needs to grow up and be a parent.
Yeah, I guess I’m talking about a baby or young toddler who can’t understand the concept of a reward after. For the most part, vaccination is all done by age 2 (except for annual flu), until they need boosters to start kindergarten.
If the kids are too little to understand the concept, then they also aren’t going to be afraid of the shots. So that whole “my kids don’t like shots” would be mom’s projection.
I disagree. Both of my kids definitely knew what was going to happen by their 15 and 18 month visits, when we walked into the office. Again, it didn’t change my behavior as far as vaccinating them, but they knew we were at a place where things hurt.
My older girls ask if they’re having a needle every time we go to the doctors, because they want a lollipop!
There was a little boy getting a shot at the pharmacy when I was refilling my prescription. His mom reminded him that since he got a shot, he could pick something out (it’s a fantastic local pharmacy with a great toy and candy selection!) and the little boy told her “But it didn’t hurt! Does that mean I DON’T get a treat?”.
Awww, what a cutie!
Our 6 month old had his vaccinations this morning, he yelled for maybe 5 seconds with each. We made the doctor’s day by vaccinating, he’s an older fellow (70-ish) that has worked in rural areas + as a bush coroner, so he’s seen some pretty sad things.
My kid loves vaccinations. He cries and gets scared right at that moment, but otherwise he’s enthusiastic and always includes vaccines when he’s playing with his doctor kit – which did come with a (toy, duh) syringe!
I also told my three year old that she would get ice cream after her flu shot. When we went to Target’s flu clinic and found out that they don’t vaccinate children there, I told her that she would get ice cream after we made an appointment at the pediatrician, where she could get her shot. That led to an epic meltdown on the car ride home, with my daughter sobbing, “I want to get a shot now! I…. want … to … get … a … shot…. now!” I swear, I am not making this up.
On a side note, in our family of four, we’ve had one case of pneumonia and one case of lab-confirmed influenza A (in my seven month old son), plus possibly a mild version of the flu for me, all in the last week while visiting family. We are staying with three other relatives, one of them pregnant and two
over 60, who got sneezed and coughed at on a daily basis. Thank Gd every single one of us have been vaccinated – my son just three weeks ago, as soon as he was old enough – which is no doubt the reason that his (and my suspected) case of the flu were so very mild. My toddler daughter didn’t even get the sniffles. I can’t imagine what a nasty turn this vacation could have taken if we hadn’t all been vaccinated. That was one pediatrician/pharmacy appointment that paid off!
Yeah… the day my kids hit me up for a puppy after a blood draw, we’re getting a dog. Thus far, I’ve managed to conceal my true feelings, and they’re content with stickers.
I drag my crying and kicking daughter to the flu shoot clinic every year. Then she discovers the nose spray vaccine and is ok with it. I am with you, my kid will cry is not a good reason at all.
My mom took my sister and I (and Grandma) in to get flu shots one year when I was in third grade and sis was in kindergarten. Sis cried for half an hour, and would NOT let the nurse give her the shot. I was pissed off and bored, especially since nobody would let me walk across the street to Michael’s instead of sitting in the clinic. But Mom waited her out–she said if sis didn’t get the shot now, she’d never get any shots again–and once the nurse gave it to her she said “That wasn’t that bad.”
Then Dad came in later that night and the nurses saw his last name and were all like, “So you are [sis’s] father, hmm?”
You can ask her to leave. You’re pregnant and she’s not vaccinated and it’s flu season.
My daughter doesn’t like riding in the car seat. She cries even! Is it cool if I just let her bounce around the back seat then?
Funny, considering some of the most obnoxious anti-vax moms I know also act like they are going to call CPS if your kid isn’t rear facing until kindergarten.
I keep holding my breath, waiting for little George to die of a vaccine-preventable and/or antibiotic-treatable illness.
Didn’t Matthew’s former fiancée die of flu?
Good point!
We just had our first known flu fatality for this season in my area. A 41-year-old woman.
Fuck nature.
There have been five here since Christmas, seems to be affecting the young more this year. There have been many pregnant women admitted to the hospital because of complications from the flu.
Ugh. My layman’s non-scientific guess is that it’s because the dominant strain seems to be H1N1, and younger folks tend not to have antibodies to it.
I’ve heard that the dominant strain this year is descended from the H1N1 in 2009 that caused so many complications in pregnant women that year. It might be something about the strain itself.
ehr… it doesn’t sound like your primary concern is preventing deaths.
Oh, of course. Now you’re going to argue that the flu vax causes death. Wonderful.
Um…it’s a fictional show. When characters die on soap operas, no actual human beings are harmed.
My otherwise-healthy 46-year-old sister has been in the ICU for 10 days (including a couple days in a rotating tube bed) thanks to pneumonia brought on by influenza A. She didn’t get a flu shot. I took my procrastinating, pregnant self out on Monday morning and got the flu shot as soon as I could.
I’m sorry to hear about your sister.
I hope she makes a speedy and full recovery,
I sent the link offlist to Dr. Amy, thinking she might want to comment on it. Great article!
I’d been trolling the internet for an article or blog on what it’s like for children who never got vaccinated by choice. I work in an area with a high percentage of recent immigrants from Mexico. What I noticed was that my teenage parent students got their children vaccinated. When I put up a bulletin board about the importance of vaccinating babies and children, my students were really confused. They kept asking me “You mean people don’t vaccinate their children?” Me: Yup. Students: “Why? Don’t they care about their children?”
Now, I give my Biology and Anatomy classes a reading guide / project on vaccine preventable diseases. I enjoy it because there’s always a kid who – having slept through my introduction – blurts out “I’ve never heard of these before!” My response: “Exactly. That’s why we get vaccinated.”
Vaccination refusal is a luxury. So is refusing proper medical or obstetrical care. Those who come from parts of the world, or have been too poor to afford decent care, are gung-ho to be vaccinated, to have their babies in hospitals, to use all the advances of modern medicine. I often had to explain why certain tests or treatments were superfluous rather than talk my patients into them.
This was a great read. As a person with a lot of crunchy associates (we’re homeschoolers), I was very recently horrified to learn how many kids in our group weren’t vaccinated. Honestly, it’s making me reconsider taking my children back. Sad thing is, they were equally horrified to learn we vaccinate (and on schedule, no less).
Another homebirth death at mothering.com 🙁
http://www.mothering.com/community/t/1354234/thinking-about-a-uc
in the caul and born sleeping? it was “beautiful”? and the siblings witnessed?
thats gonna require some therapy later, im sure. poor kids.
So lovely. Seems like she enjoyed having a stillbirth so much she wants to do it again. I just don’t get it.
omg someone on there wanted to UC after 3 c-sections.
mothering.com has still not changed my user name, but forbids me to post with my current name. wtf is that about?
She’s got a smiley face after “born sleeping.” No mention of grief, meant to be, would have happened in a hospital etc. I really don’t think she is using the term in the way it usually is used.
She probably just means actually asleep? Except, while she thinks her baby was asleep, I am guessing unconscious and baby had been in trouble but was revived. But not a death, most likely.
I also cannot imagine that this means what it sounds like?? Nobody could possibly put a smiley after such a message, right??
Yeah,that was exactly what I was thinking.
Also, natural birth types keep talking about this ideal of a peaceful birth, and I would imagine that they might see a birth so gentle (as if being twisted an squeezed out a vagina is ever going to be that gentle) that a baby could sleep right through it without waking right away as the most peaceful sort of birth ever.
yeah, I thought that was a bit confusing too, especially because of the comment below it. That commenter didn’t seem to interpret it as a stillbirth either.
The euphemism used frequently in the natural birth circle IS “born sleeping” for a stillbirth. Sometime it’s born still, but I’ve read “sleeping” several times.
I know, that’s why I was/am confused. I assumed she meant a still birth, from that wording, but as indigo-sky points out, there are hints that may not be the case.
Oh my god, I hope she wasn’t smiling about a stillborn baby
I don’t think it died…Monserrat Blanco pointed out that she mentioned an 11mo old in another post and the dates added up.
In another post she says she has a 11 month old baby , if I am not getting the dates wrong, that would be the “sleepy” baby.
This blog has really raised my consciousness of c/s, VBAC, and homebirth rates reported without other outcome measures like, hello, maternal and neonatal morbidity and mortality. People see these homebirth numbers and think that because the rate of seriously bad outcomes is so low on average, OF COURSE nothing bad happened in all these home birth. Equivalent or better outcomes are assumed. Not a safe assumption, clearly.
Yes, that seems to be the norm, doesn’t it? When I had my second home birth, my CPM midwife gave me an information sheet with a table that compared the rates for c-sections, episiotomies etc. between home and hospital births for some years (probably from the data that MANA released? There was no source). Conspicuously missing from that table was any data on morbidity or mortality. At the time, I didn’t even notice it – it was only later, after I had started to read on here and other places, that I went back and reviewed the information she had given me. When I hired her, I believed that data such as what she had shown me (and which I had seen other places, too) showed home birth to be a reasonable alternative to hospital birth, with some real advantages for mother and baby over hospital deliveries. Everyone I talked to – or everyone I chose to believe – said the same thing, and I never thought to seek out any outside information on mortality rates. I did not know that I was in an echo chamber, and I was naive (or dumb) enough to believe that “established” NCB organisations wouldn’t publish something that wasn’t generally true. I was convinced that I was doing the right thing.
The other day, I looked at the website of a birth center, and there again, they had statistics on their transfer and c-section rates, but nothing on morbidity or mortality.
Since birth centers see relatively low numbers of patients compared to hospitals, it’s quite possible they don’t have any mortalities. Especially if they’re run by CNMs who transfer appropriately.
Yes, let’s hope that’s the case!
Plus, statistics mean very little when you are dealing with a sample size of 1 – delivering your baby.
OT: On “breast is best” and guilt. http://offschedule.blogspot.com/2014/01/breast-is-best.html
Such a common experience and one that is glossed over by so many. Glad she found a sensible LC at the end.
Just sad. This brings to mind a story about my great grandmother. She lived on a small farm outside of Atlanta and birthed her babies at home. I’m sure that she would’ve preferred to deliver safely in a hospital setting but they weren’t exactly rich and that’s just the way it was. Any way, there happened to be a huge snow storm when she went into labor with her last baby (she was in her early 40’s, by the way). When she finally gave birth, they realized there was something wrong with the baby and because they couldn’t drive their car through the snow, my grandfather and uncles set out for the doctor on horseback. By the time they got back with the doctor, the baby had died. I’m not certain as to why he died but knowing some facts, there’s a good chance that had she been in a hospital, the baby would’ve survived. So, why in the world would we want to go back to this? My grandmother had no choice and in the end, she suffered dearly. Today, we can walk into a hospital with a really good chance (in a normal, healthy pregnancy) of coming out with a healthy, happy baby. Why all this romanticism around birthing at home?
There’s so much romanticism of birth, and it is very easy to get drawn into it all because it’s a good feeling. Some people protect themselves from the reality of homebirth deaths because it means giving up that warm feeling and the NCB support network. It can be very cult-like.
I’m sorry, I didn’t mean to be heartless by not acknowledging your great grandmother’s loss. I got carried away thinking about the romanticism. I’m very sorry she and her family had to suffer in this way.
I don’t get it either. So sad what happened to your grandmother’s baby. Even today I would be worried if my family still lived in rural Vermont as they used to, trying to get to the hospital in the middle of a howling snowstorm is no fun.
My maternal grandmother had eight children. Only the last two where born in a hospital, her third baby was stillborn(she was 19 when he was born), she says most likely he died due to Rh incompatibility. Her mother, my great-grandmother died in childbirth, at home, at the age of 20, trying to deliver her second child. The baby died too…
Nobody in my family romanticizes child-birth even now
meant to say your great-grandmother, sorry typing to fast..
My guess is that you can afford to be romantic about birth when you’ve never watched a newborn die.
A few times a year on our farm, a calf is born that has suffered soon-to-be fatal brain damage due to hypoxia during labor. The most recent one had no pain reflexes and no purposeful movement. The calf did, however, have a beating heart, a slow respiratory rate and instinctive thrashing leg movements. Since it wasn’t in pain, we let the dam clean the calf up then moved it into a warm pen, covered it with a blanket and waited for it to die. As I’m sure you guessed, these kind of days suck. It sucks worse when the calf has a pain reflex and we need to euthanize it. You logically know it’s the right thing to do, but it feels horrible.
What I can’t wrap my head around is choosing to give birth to a human baby with the same primitive level of technology as cattle herdsman have.
having been present as a nurse at births both in and out of hospital, i’ve seen complications that could only be dealt with in a hospital, and completed home birth and birth center births, which were in fact, gentle and beautiful. My wish is that hospitals would function more like birth centers and have the best of both worlds.
Could you define “gentle?”
I had about as ideal a “natural” birth as you could imagine, and everything went great, but I wouldn’t say I was exactly peaceful through the process. It hurt like hell and I shouted a lot and swore at people. Did I do something wrong because I wasn’t “gentle” enough?
My uncles are all farmers. One them actually says how tough it is being a farmer when you are an animal lover. Best of luck to you at the next round of births.
because of the traumatic aspects of hospital births; in particular loss of autonomy which for many people is traumatic, and privacy around one’s most private, personal areas. For many people that is traumatic. In fact the recent Israeli study on Childbirth PTSD included as one of its primary reccommendations how hospitals need to increase respect for patient’s modesty. it is common for people to emerge from hospital births physically well but emotionally traumatized.
And with live babies.
No it is not common to emerge from hospital births physically well but emotionally traumatized. That is a lie.
my what a well reasoned refutation.
well, I know scores of women who gave birth in a hospital and only one case of PPD. A friend who had a water birth in a birth center had PPD. Doesn’t seem at all “common” to me either.
ppd- and trauma- not the same thing although they often overlap. I had trauma feelings (subclinical) but no PPD. also, i didn’t go around sharing these feelings with everyone I saw, so most people i know wouldn’t have guessed either.
it would definitely be interesting to see a real scientific study on this though.
in my professional experience, it wasnt part of my job to follow up over the long term with the patients- so my impressions, is, as yours, based on the experience of myself and my acquaintances.
So all anecdotes then?
“Subclinical” trauma feelings?
You mean, like, feelings you didn’t feel? How did you know you had them?
I assume that means feelings of trauma not bad enough to qualify as PTSD, which is definitely a thing.
it is common to leave the hospital after giving birth being able to walk, perhaps a bit sore in ones’ crotch and elated at bringing home your healthy infant. That is what is common here in the USA.
yes, thankfully that is more common.
She’s right. You are just making it up as you go along. If you want us to believe anything you are saying, you have to provide scientific evidence. Your personal opinion is not particularly valuable.
Well, my cousin said she was traumatized by the birth of her son in the hospital. I don’t know the details, but I think there were complications and she didn’t have an epidural, so I think it was the pain.
Untreated pain can be traumatizing, but the NCB movement is encouraging more women to go without pain relief/encouraging providers to discourage pain relief, so I think they are actually increasing the amount of trauma.
It also probably didn’t help that her mother was acting bizarre throughout the process and diagnosed with a tumor that turned out to be brain cancer the next day.
Her plan is to have an epidural next time 🙂
That does sound pretty traumatizing, all together like that!
It was only about two weeks ago, too.
Actually, the birth was what got her mother in the hospital to be diagnosed. The brain cancer probably would have killed her within a week without that, so hospital birth saves lives, and not just of mother and baby!
Yeah, that’s what I thought. It was only about two and a half weeks ago, too.
Actually, her giving birth was what got her mother to the hospital to be diagnosed in the first place–which was good, because if she hadn’t, she might not have lived another week. So hospital birth saves lives, and not just the mother and babies’.
I had my baby 3 1/2 weeks ago and I was feeling pretty traumatized by it. Because of precipitous labor causing unrelenting extremely painful contractions that went to fast to get my very much wanted epidural. Then we had several complications including a shoulder dystocia that was a big fear of mine and a huge part of why I wanted the epidural in the first place. I refused the narcotic pain relief because I knew baby was coming fast, so I got to experience all the wonderful maneuvers to free my baby with absolutely no pain relief. Those maneuvers included McRoberts, suprapubic pressure and finally the midwife and OBs hands inside me trying to release my sons arm, which is what finally worked.
It was incredibly painful, plus frightening because I knew what was happening as soon as I heard the directions being given to the nurses helping. Everything turned out ok in the end, no damage done to me or baby and he was delivered within 2 minutes, so incredibly grateful to the ob, who had been popping in and out throughout my very short labor because she was concerned at the speed we were progressing. She also tried really hard to get me my epidural, but I just went too fast. Anyways for the next week everytime I breastfed my after pains would get strong and I would start having flashbacks to labor and delivery, not fun and made me pretty reluctant to nurse my sweet boy. Thankfully this is my last child!
Anyways my point was that, yes untreated pain can definitely cause a trauma response, and only because I was able to process what happened to me by talking to my midwife and ob did I likely avoid PTSD. Well that and being fairly mentally healthy to begin with, mostly from reading this site and having a good understanding of the things that can go wrong and how the doctors will help.
Oh I should mention, I delivered in a hospital that utilizes a team of midwives, OBs and MFM that work together, there is always one midwife and one ob on the floor, with more on call. Small hospital with only enough beds for 8 women max and each woman gets one on one nursing care.
While I could believe that in a culture of Orthodox Jewish women who practice modesty and family purity might have problems with the exposure inherent in a hospital birth, I have a very difficult time thinking the same about women who may be posting a lot of pictures of themselves on Facebook and instagram – without regards for modesty.
do you really believe that represents most women? few of us even in mainstream culture show expose our vaginas in public, and certainly not touched.
I’m not very modest so I will just bow out of this conversation. I don’t see anything traumatic in a healthy woman being examined by medical professionals when necessary.
in my professional practice, not even birth, I have encountered this, albeit rare. and there remains a difference between and exam and an ongoing process involving much handling and not at one’s own choosing.
Could you please give a specific example of exactly what scenario you’re so upset about? It strikes me that the women who are most likely to have an actual humiliating or violating experience with a medical practitioner during birth are the ones who are least likely to home birth — lower economic class, minority women.
NCB nutjobs seem quite happy to display their vaginas in videos of their homebirth on the internet (very very public display).
Or should that be pubic display?
i don’t believe thats the norm. in fact i participated in an out of hospital birth in which the patient- an all american- had all supportive staff (myself included) leave during exams by the midwife.
I am a pretty modest person by nature, but I never felt overly exposed or that I lacked autonomy when I gave birth to my daughter. I felt cared for by the nurses and doctors. I felt respected. I spoke up for myself and didn’t encounter any pushback. If I had asked everyone to leave the room when I was being examined, they would have done their best to comply. At the very least they would have turned around to provide as much privacy as they could under the circumstances. Having said that, the pelvic exam during my labor was not unlike my annual pelvic exam, which most women should be familiar with regardless of how they feel about them. I know there are many women who have had experiences in life that make any pelvic exam feel like a violation, but I also know that most doctors and nurses will do the best that they can to mitigate those feelings. You are painting with very broad strokes here.
Excellent.
It’s true-try getting through a “I gave birth at home/in a birthing tub/in a stream” story and I dare you to find one that DOESN’T have a naked pic in it.
In my experience here locally, hospitals that serve populations of women who are especially religiously modest, DO make all kinds of accommodations, with extra modest gowns, allowances for head coverings, etc. They do cultural sensitivity training. I’m not buying that most hospitals out there are not sensitive to women who desire extra modesty.
I was raised with extreme modesty rules and also have body image issues, but the examinations didn’t really bother me. I think it’s just the way my brain is – “This is needed for safety reasons + kind, sensitive CNM + closed room + it isn’t sexual = no need for embarrassment.”
I’d also like to point out that there is very little autonomy in having your gall bladder out, or a breast tumor removed. I had both of those things before giving birth so the standard operating procedures of a hospital was familiar to me. My sister and sisters in law, on the other hand, chlidbirth was their first foray into the hospital.
Neither of those involve the release of huge amounts of oxytocin, which I imagine would heighten emotions.
Isn’t oxytocin the “pleasure” hormone? If so, by this reasoning, those procedures had even more potential to be traumatic. Interesting view.
I will say I had extremely heightened emotions re: the breast tumor, plotting out how I would spend the five years I hoped I could get. It turned out to be benign.
Oxytocin is released during orgasm but it’s an oversimplification to say that it’s a pleasure hormone.
Something that made homebirth more appealing to me was a friend’s description of his child’s birth, where what seemed to him like random strangers would come in and give his wife vaginal exams without introducing themselves.
Introduction, explaining the need for the exam, and requesting permission to perform it are important things to do and it really doesn’t take that long. Easy to do in most situations but a tired, hurrying provider can forget. We forget that we do exams all the time but women aren’t usually getting them all the time!
As you surely know, the authors of the Israeli study reported that the most common factor cited by those suffering PTSD was unrelieved PAIN.
The irony – when the rate of maternal request cesarean increases there’s widespread outrage at women who decide to opt out of nature’s birth plan, even though there’s no evidence of an increase in risk of death or lifelong disability associated with maternal request cesarean, but when the rate of homebirth increases, something that is clearly associanted with an increase in risk to the baby of death and lifelong disability, there is widespread applause. It’s almost Orwellian. But let’s go on pretending that the MRCS moms are the selfish ones.
There is so much irony in NCB philosophy – enough for a book, I bet!
I’d buy that book! I laugh when NCB types claim to be pro-choice!! Only if it doesn’t involve pain relief, c-sections, and hospital birth in general of course.
Not all of them. “Crunchy Conservatism” is a thing. A lot of them are pretty consistently anti-woman from opposing artificial birth control and abortion to considering it a woman’s biological destiny to have natural births, breastfeed, and do nothing but mother their kids,
“even though there’s no evidence of an increase in risk of death or
lifelong disability associated with maternal request cesarean,”
Not to mention plenty of evidence they actually decrease many risks, especially for the baby; but that’s heresy, so we mustn’t acknowledge it.
I really wish some journalists would take the opportunity to confront her on camera about it. That would be gold.
emailed mother jones and anderson cooper. I hope something comes of it. Probably won’t, but its worth trying, right?
Mother Jones probably wouldn’t dare. I’m sure she refuses to answer questions about this on the record, anyway.
I just try whatever I can think of. I didn’t just talk about ricki lake, I talked about MANAs death rate mystery and NARM giving grieving moms the runaround and the horrible stats from 2013. Its a story that really has everything that the media usually wants, right? I am really shy and reserved IRL but I shove it down to try and do *something*. You never really know what will work and what won’t until you try it. I hope someone here with real connections to journalists can help more.
I am a journalist. Any outlet willing to touch this would have to be okay with pissing off the very vocal homebirth community. They’d also need the resources to do research and have a reporter or someone on staff with the expertise to understand the statistics themselves.
But you’re not going to see a HOMEBIRTH KILLS BABIES! headline on CNN anytime soon, and a story about a tiny professional organization collecting but not releasing statistics is kind of obscure and dry. At best, they’d just give equal time to Dr. Amy and Ina May and call it a day.
ProPublica or This American Life might be able to do something interesting with it. The Freakonomics show/podcast would have fun with this, too–they love doing things where common knowledge recommends one thing but their analysis indicates another.
Remember that it isn’t that NO ONE is covering this — the stories that just Dr. Amy have been interviewed for/featured in are on the sidebar of this blog.
My media dream is a documentary produced by Michael Moore.
His films have been so effective at halting globalization, dismantling capitalism, ending gun violence and keeping Bush from being re-elected…. Yes, his films generate a lot of attention, but I’m not so sure they really change anyone’s mind.
The freakonomics guys messed up pretty bad in their car seat analysis, though. And they’ve been debunked on a few other major assertions (abortion lowering the crime rate, for example).
Thanks for the tips. I had seen so many exposes of things like scientology that I thought NCB would be easy to expose by comparison.
The This American Life people freak me out ever since I read about their extremely human aggressive pit bull and their weird indignance about having to muzzle it in public.
Uh, that’s only one person, the founder of the show. The dog belongs to his wife. Should she have it killed, or just lock it in their Manhattan apartment all the time?
—
No, they should learn and they should make sure the dog learns to accept that the dog must be muzzled in public if they are going to keep the dog. Although I’m not sure that a dog that has bitten at least seven people while living with this couple is the right dog in the right environment.
Shall we ask Jennifer Margulis what the rate of home birth is if we leave out Portland? After all, she says the death rate is low as long as we leave out Portland….
Actually, if most of the home births are happening in Portland, it’s possible the death rate outside of Portland is zero. Of course, in that case, the denominator would be too small to mean anything. The technical (statistical) term for that is “underpowered.”
Mathematically speaking, you are correct. Unfortunately, we have good reason to know that such is NOT the case.