Why did Ruth Fowler Iorio sanitize her homebirth photos?

blood

Ruth Fowler Iorio‘s 15 minutes of fame are winding down in classic homebirth narcissist fashion, with Ruth wailing about those mean people at Facebook who won’t host her exhibitionism:

Ruth Fowler tweet

But before she’s replaced by a new homebirth narcissist, I have some questions for her:

Ruth, why did you sanitize the photos are that are supposed to show the “messy reality” of homebirth?

Specifically:

Where is the photo of the postpartum hemorrhage with the blood pouring from between your legs?

Where is the photo of you deathly pale and slipping in and out of consciousness as you head toward hemorrhagic shock?

Where is the photo of your husband’s face, horrified and frightened, as it dawns on him that you may bleed to death and leave him as a widower with a new baby?

Where is the photo of the EMTs hustling you out the door, racing against time to save your life?

Where is the photo of you in the emergency room, with doctors and nurses struggling to start large bore IVs before you bleed to death?

Where is the photo of the obstetrician with his gloved arm in your vagina up to his elbow peeling off the remains of the placenta from your uterine wall, averting your certain death?

Where is the photo of you, not bonding with your newborn, but totally out of it from large doses of fentanyl?

I could go on and on, but I think you get the idea: where are the photos of the REALITY of homebirth?

Did you refuse to include them because they didn’t tell the story as you wanted it told, allowing you to make it seem like your near death was just a minor moment in your piece of birth performance art?

Did you refuse to include them as part of the never ending effort of homebirth advocates to hide the dangers of homebirth?

Or did you fail to include them because they didn’t exist, because near death has a way of clarifying things for all participants, so that they finally drop the cameras? Even narcissists and the friends and family of narcissists tend to put the camera down when they are sliding on your blood pouring out on the floor.

It doesn’t really matter why you failed to include the pictures that tell the REAL story of your homebirth and near death experience, but it is critically important for everyone to understand that those pictures, the most important pictures, are missing.

The REAL story of homebirth is that childbirth is inherently dangerous, that death is always only moments away, that giving birth at home is taking a terrible risk, and homebirth can never be safe.

Enjoy your 15 minutes of fame while it lasts, but I wonder:

What does it say about you, homebirth and narcissism that you are spending the first weeks of your newborn’s life, not nurturing him, but giving interviews, accepting accolades and tweeting endlessly … in other words, nurturing your own self image?

How about thinking about him as a newborn for a moment, not merely as a prop in your endless efforts to publicize yourself?

  • Les Boulder

    Why is everyone saying she’s so brave? One can’t see anything in the photos.

  • sj

    I agree – she was a complete moron and so is her husband. The two of them are attention whores
    plain and simple. They had no thought for the satety of their newborn and still don’t judging by some of their instagram pictures.

    • SD888

      They are both Narcissistic drug addicts. Ruth is a monster, much worse than Jared, who is no prize.

  • Amy Tuteur, MD
  • Dreah Louis

    Home Birth will never be as safe as a hospital. That’s the truth. I was so FOR home birth at one point of my life but in all reality the essence of home birth safety is completely gone and these midwives are failing and babies are becoming injured and are dying because most women agree that they are taking a risk when choosing home birth and most women complying with home birth say that babies die in the hospitals also. BUT BABIES DON’T HAVE TO DIE AT HOME. As a mother that has lost a child to home birth I’m telling the home birth mother advocate that although you may have had a good home birth or this may be your first home birth either way you may not be so lucky. If as a mother you are ever in the situation where you or your baby might die because some issue has occurred your body had no way of signaling for help, I’m pretty sure you would rather be in a hospital and have tried everything rather then being at home with minimum tools and training and hope to god your midwife can save you and your baby.

    • LynnetteHafkenIBCLC

      I’m so sorry for your loss. Bless you for speaking out.

    • Trixie

      Dreah, you’ve got a lot of courage to speak out about this.

      • Dreah Louis

        I can’t believe women affected by grimy midwives are so quiet

  • Karri Gonzalez Sensenig

    You all have fun. I’m moving on. Here’s my bottom line: Hospital births can be safe. Home births can be safe. Whichever you choose (and I don’t have a problem with either and have chosen both at different times myself) – choose the right provider because that is going to effect the safety of your birth experience far more than where you have your baby.

    • Siri

      If you have another baby, please consider a hospital delivery. All of us here actually want women to be empowered as well as safe, and to have all the information they need to choose what’s right for them. But 11% is a really unacceptable risk!

    • Happy Sheep

      Here is the bottom line: Care provider matters. A lot. But so does location. A carefully screened, low risk pregnancy done with a CNM with hospital privileges, less than 10 minutes from the hospital in a fully integrated system is the safEST type of homebirth, but it is not and never will be as safe as a hospital. Until there is a NICU, blood bank and surgical unit in your house, minutes will always matter and home will never be as safe.
      I don’t care about my birth experience, I care about having a healthy baby and mom, and an uninsured idiot with an online diploma is not going to give me that. when things go sideways, I don’t give a crap about my experience I care that the people who are caring for me can help me.

    • AlisonCummins

      How do you know in advance which home birth is going to be safe?

      • Dreah Louis

        you dont

    • The Bofa on the Sofa

      Hospital births can be safe. Home births can be safe.

      Drunk driving can be safe. Russian roulette CAN be safe. Heart attacks CAN be safe. Running across the street in heavy traffic CAN be safe. Etc.

      That’s a really dumb way to assess something, whether it CAN be safe or not.

      • araikwao

        I disagree with the terminology here: drunk driving is not safe. Just because an individual journey doesn’t end in a crash/injury/death doesn’t mean that episode of drunk driving was safe, only that the increased risk did not translate into disaster *this* time. All the factors that make drunk driving statistically more likely to lead to crash/injury/death (presumably delayed reaction times, etc?) were present on that journey, and therefore it was a less safe way to travel compared to the gold standard which is driving sober and alert/well-rested.
        I know what you mean though – none of those events lead to death 100% of the time, but to call them safe, I think, is misleading. More like, you may dodge a bullet *this* time, but the consequences are potentially disastrous.

        • The Bofa on the Sofa

          I know what you mean though – none of those events lead to death 100% of the time, but to call them safe, I think, is misleading.

          Take it up with Karri. She is the one that claimed that things “can be safe.”

          I was just pointing out that “can be safe” is a meaningless concept. Anything “can be safe,” the only question is how safe?

    • prolifefeminist

      “choose the right provider because that is going to effect the safety of your birth experience far more than where you have your baby.”

      One of the biggest problems with the CPM “credential” is that parents-to-be CAN’T reliably evaluate whether a CPM provider is safe or not. You can’t check to see if they’ve been sued for malpractice, because nobody bothers to sue midwives who don’t carry malpractice insurance. Looking to see if their license has been revoked is a joke, because assuming that their state even licenses lay midwives, it’s nearly impossible to lose your license when the decision to revoke it is up to your fellow midwife buddies. Checking to see what a CPMs death rate/transfer rate/complication rate is will lead you nowhere, because most (all?) states don’t require them to report those. And guess what – CPMs resist these common sense regulations because they don’t want to be told how to practice. Imagine!

      If I hire a CNM, I know she’s gone through nursing school, has clinical experience as an OB nurse, and has completed a master’s program in midwifery with all that entails. What do I know about a CPM? Nothing, except that she practices without oversight.

  • Karri Gonzalez Sensenig

    cPosting this statement: “I could go on and on, but I think you get the idea: where are the photos of the REALITY of homebirth?” after a list of the complications one person experienced with their homebirth is misleading.

    You should have said “where are the photos of the REALITY of *your* homebirth?” Because homebirth isn’t always that particular reality. Just like the complications that happen in hospital births aren’t always the reality of every hospital birth. 😉

    • Amy Tuteur, MD

      Yes, sometimes homebirth reality is far worse: brain damaged baby, dead baby, dead mothers. Where are those photos of homebirth?

      • Karri Gonzalez Sensenig

        Yes, and sometimes the homebirth reality is shoulder dystocia (as the reality of two of my homebirths was) and an umbilical chord that snaps while baby is being delivered (as in one of my homebirths). Both of which would have also happened in a hospital, and neither of which could have been resolved any differently in a hospital than it was here at home.

        And sometimes the homebirth reality is quite peaceful, has no complications, and goes off without a hitch. I’m betting you’re not interested in seeing those photos, though. Because that would be counter to your vitriol.

        The hospital birth reality also includes brain damaged babies, dead babies, dead mothers, just as it includes peaceful, complication-free realities where it goes off without a hitch.

        A homebirth has its place and time. A hospital birth has its place and time.

        And you are apparently not as educated as believe you are.

        • Amy Tuteur, MD

          Demonstrating that you were not a candidate for homebirth, had an incompetent midwife, and were willing to risk the death of a baby from shoulder dsytocia since you were at risk for a second shoulder dystocia after the first.

          Talk about someone who isn’t as educated as she believes.

          • Karen in SC

            Some home SDs are not resolved without injury to or death of the baby. Ms. Sensenig, you were lucky.

          • Karri Gonzalez Sensenig

            Some shoulder dystocia aren’t resolved without injury to or death of the baby either. Any baby that survives SD without injury or death is a lucky one – home or hospital.

          • Siri

            But by choosing homebirth with a known risk of SD, all you’re doing is reducing your baby’s odds of survival or freedom from permanent injury. How is that OK with you?

          • Karri Gonzalez Sensenig

            A very *low* known risk of SD. I only had one risk factor for SD – none of the others. And I had two pregnancies with no SD before the one that had SD. An OB and my midwife concluded the SD was not a result of my pelvic anatomy and was instead a result of how the baby came down (face up, not face down). Then I had another baby that came down that way and another SD. Again, this would have happened in the hospital as well and it would have been treated in the hospital the exact same way it was handled here at home. So tell me again how I reduced my baby’s odds of survival or freedom from permanent injury by giving birth at home?

          • Siri

            Because if they needed immediate resuscitation by a skilled team with access to all the necessary equipment, you’d made sure they wouldn’t get it!! You chose to have them far away from immediate help! That’s how.

          • Karri Gonzalez Sensenig

            So your issue isn’t with encountering an unexpected (and impossible to predict) SD at home, it’s having a homebirth at all?

          • Siri

            Not at all; I had a homebirth myself. But choosing to have a homebirth when you have a history of shoulder dystocia strikes me as incredibly irresponsible. And I am a qualified midwife.

          • KarenJJ

            The more someone keeps talking positively about homebirth and how safe it is the more they demonstrate that it is not… I find it amazing how much work they do for us in proving homebirth is not a great idea and that homebirth providers are either witless, gutless or sociopathic.

          • Daleth

            Karri, how can you call your second SD “unexpected and impossible to predict” when (1) you were told well in advance that you had a 1 in 9 chance of having SD again, and (2) your second baby was in the same face-up position that caused your first baby’s SD?

          • Susan

            Great points Daleth. One shoulder dystocia and malpresentation is definitely a risk for another. Also Karri, I agree, competent midwives can do much the same as we would do in the hospital to handle shoulder dystocia, but they can’t do cephalic replacement and C/S and they definitely can’t do all the steps in a neonatal resuscitation as well as a hospital. Only a few can intubate a newborn, very few homebirth midwives have this skill. I certainly never have heard of placing a UVC line at home and giving the meds. A neonatal resuscitation requires a team. More than just two midwives. I had a homebirth with two CNMs, they could intubate. Knowing what I know now about how a team works together in a resuscitation no matter how skilled they are two or three people just can’t do what a hospital can do. There is just no comparison. I would no longer have a homebirth at all. But any competent midwife, even if they do believe in homebirth, would NOT do a homebirth for a mom with a history of SD because of the limitations of resuscitation at home.

          • AlisonCummins

            Can someone address the assertion that the outcomes would have been identical in the hospital and that therefore there would have been no benefit to delivering there?

          • Karri Gonzalez Sensenig

            What would you like me to address? I am happy to. 🙂

            Is there a specific treatment for shoulder dystocia or a broken umbilical chord that hospitals can do that a CNM cannot?

            (You’ll notice the dear Dr. didn’t bother to address it – because there isn’t anything to address, it’s a fact.)

          • Medwife

            At the onset of a shoulder dystocia, I call for the NICU team and for all available RNs. The team is ready to resuscitate that baby including quick, skillful intubation and umbilical vein catheter placement. I can have lab products ordered in minutes. I can save that mother the need FOR blood products. I can start running a bag of IV pit.

            In short, I have resources: people and equipment. And I’m humble enough to call for them as soon as I need them.

          • Karri Gonzalez Sensenig

            And my CNM and her RN (it’s actually a practice of several CNMs and multiple RNs) are humble enough to make the call to transfer before they actually need to. In other words, if there are any indications there could be a problem developing, they make the call to transfer before the problem has developed because they don’t want a crisis in a home birth anymore than anyone else does.

          • Medwife

            But they didn’t risk you out after your first shoulder dystocia. And yeah, they should have. You were not an appropriate candidate for a homebirth after that complication.

          • Birthbuddy

            Risking out would be the sensible to do if they were that humble.

          • Siri

            That’s not humility; it’s hubris. Any practitioner worth their salt would have risked you out.

          • Siri

            Have you ever seen a baby injured from a bad shoulder dystocia? I’ll bet you haven’t. If you had, you’d know why being in hospital makes a HUGE difference. Yes, the drill is the same – but hospital staff are regularly updated in their ‘drills and skills’. And when a baby needs immediate attention, by a team of highly skilled staff, you’d better not be stuck at home.

          • Siri

            1) Immediate access to proper resuscitative measures and paediatrician; 2) Immediate access to help with any maternal complications, eg PPH, a bad tear etc.

          • Siri

            And, of course, proper monitoring in labour. And access to an epidural if shoulder dystocia is on the cards. I wouldn’t want anyone maneuvring a giant baby out of me without adequate anaesthesia…

          • Karri Gonzalez Sensenig

            Yes, after the first shoulder dystocia I was at risk for experiencing another. An 11-12% risk, to be specific.

            And why on earth would that disqualify me for a homebirth? There isn’t a single thing that can be done differently in a hospital for shoulder dystocia than can be done at home. (Unless, of course, you would be the OB who would advocate trying to shove the babies head back up in and doing a c-section – without anesthesia of course since there wouldn’t be time. *rolls eyes*)

            Oh, maybe you’re the kind of OB who would have told me to have a c-section after the first shoulder dystocia. Because, OF COURSE, it makes so much more sense to trade the 11-12% risk of shoulder dystocia for the risks of c-section.

            My state actually has very strict standards of who licensed midwives (CNM’s here) can do a homebirth with. I passed with flying colors and had none of the risk factors that would have disqualified me.

            Educate yourself some more. Or try and stump me with your vitriol. It won’t work, though.

          • Amy Tuteur, MD

            How do you know what would or would not have happened in the hospital? Are you an obstetrician?

          • Karri Gonzalez Sensenig

            No, I’m not an OB. So tell me, what does a hospital do for shoulder dystocia that a CNM cannot at home?

          • Birthbuddy

            Preparation by “fire drills”, knowledge of risk, training, team approach, immediate availability of expertise.
            What do NCB nutjobs do? Knit, rationalise away the diagnosis, delay transfer until stillbirth or try the upside down McRoberts named after one of their goddesses.

          • AlisonCummins

            This post might be interesting. The comment thread too. (There are a couple of more comments along the lines of this one.)

            http://www.skepticalob.com/2013/11/judy-slome-cohain-makes-a-video.html#comment-1139986687

          • MaineJen

            LOL!!!

          • Siri

            Weren’t you worried that your baby might need more resuscitation than a homebirth midwife could perform? In hospital, a paediatrician could have been present.

          • Karri Gonzalez Sensenig

            No, because my midwife brings resuscitation equipment.

          • PrimaryCareDoc

            It takes a team to run a true neonatal resuscitation. One midwife can’t do it all. And who’s taking care of you while she’s busy resuscitating the newborn?

          • Karri Gonzalez Sensenig

            The RN she brings with her.

            Yes, a team is required for true neonatal resuscitation. My oldest son had that team when he had a meconium plug (which thankfully didn’t cause any issues other than some transient tachypnea and no lung infection).

          • PrimaryCareDoc

            So that’s one CNM and one RN- still not enough to run a resuscitation and take care of mom, especially if there’s a PPH.

          • Box of Salt

            Karri “my midwife brings resuscitation equipment.”
            How often does she use it, or practice with it?

          • Siri

            How many babies has she successfully resuscitated? How often does she update her skills in a hospital setting?

          • Birthbuddy

            Has she been trained to use it?

          • Medwife

            Are… are you kidding? Shoulder dystocias are often followed by hemorrhage on the mom’s part, and need for resuscitation on the baby’s part. One of those things on their own at a home birth is daunting. Simultaneously they can be a monumental disaster.

          • Karri Gonzalez Sensenig

            Since when is around 11% (the risk of hemorrhage associated with shoulder dystocia) “often”?

          • Siri

            Would you send your child on a class trip where 11% of the children would sustain life-threatening injuries? 11% is a terrible risk! Oh, forget it – nothing anyone here can say will convince you that what you did was gamble with your own life AND that of your child. I like a good debate, but some things are just beyond disgusting.

          • PrimaryCareDoc

            Would you get on an amusement part ride where 11% of the time there is a fatal accident?

            Thought not.

          • Siri

            No, but she’d put her child on it. Because 11% is really low risk.

          • theNormalDistribution

            Oh dear, I lolled when I read this.

          • Karri Gonzalez Sensenig

            Hemorrhages are not fatal 100% of the time. Your logic is unsound.

            Not to mention that my CNM did all the same things here at home to prevent hemorrhage that would have been done at the hospital and would have been watching for the same signs they would watch for in the hospital. The one big difference would be that she would have reacted earlier than they would have in a hospital because we would have needed 5 minutes for the Medic to get here and another 10 to get to the hospital. So she would have made the call to transfer at a point well before it became life-threatening. And while making that transfer she would have given me a shot, massaged my uterus (which she does as standard course after any birth), applied pressure with packing, etc.

          • PrimaryCareDoc

            You’re living in a fantasy world. Seriously. Wake up.

          • Birthbuddy

            One by one your delusions will unravel Karri. Keep reading.

          • AlisonCummins
          • AlisonCummins

            Since always. One in nine is a common enough occurrence that you should act as if it will happen to you and act accordingingly.

          • The Bofa on the Sofa

            Isn’t 1/9 about the fatality rate of people who die trying to climb Mt Everest? (Actually, the overall rate is below 10%, and since 1990, it has been 4.4%)

            At least those people can say they’v done something that only 3500 others have done. As opposed to the achievement of a HB, which, until the 1900s, was pretty much the default outcome.

          • MaineJen

            Since…always. You realize that’s like, 1 out of 10, right?

          • theNormalDistribution

            Um. So c-sections are really safe. Quite possibly safer safer for you than spontaneous “uncomplicated” vaginal birth, and most certainly safer for your baby. You sound pretty ridiculous simultaneously chastising OB’s who would suggest a section because OMG THE RISKS OF C SECTIONS and in the other hand brush off the risks of shoulder dystocia. Those risks are orders of magnitudes apart.

          • Young CC Prof

            Yeah, if I had an 11% risk of dystocia, I’d just go for the section. Consider, the probability of serious harm to the baby from a non-emergency section is essentially zero. The probability of serious harm to the mother is less than 0.1%.

            Dystocia? All bets are off.

          • Siri

            I think the vast majority of women would take one look at the 11% risk and opt for a c/s – and be horrified if anyone suggested they ignore that risk and give birth far away from immediate help.

          • Young CC Prof

            Well, some people just don’t understand probability. They think <50% means not going to happen.

            My thumbnail rule is that, if it involves a 1% or greater chance of someone dying, don't freaking do it.

          • Box of Salt

            “Well, some people just don’t understand probability. They think <50% means not going to happen."

            Actually, I think most folks think that <99% = not going to happen to me.

            Most folks don't get this until they happen to be the 1.

            Most people doing risk assessment also seem to forget to consider the consequence – a 1% risk of stubbing my toe is different from a 1% risk of death, but they look at the odds and weigh them the same way.

            This comment is based on conversations I've had here in the comments section of this blog and other sites online.

          • Trixie

            With your last name and description of your state regulations, I’m about 99% sure you’re in Central PA. I’m curious which CNM did your home birth and what the OB she has a practice agreement with thought about you having another home birth after dystocia.

          • An Actual Attorney

            According to this site, http://www.shoulderdystociainfo.com/fetalinjuries.htm, which I can’t vouch for, SD results in a brachial plexis injury about 10% of the time. So for a 1% of injury to your baby, you don’t think a CS is reasonable?

            The website goes on to say that about 10% of those injuries are permanent.0.1% is pretty huge when you are talking about permenant injury to a baby and there’s very little downside to a CS.

            Wow. Math is hard for some people.

          • Young CC Prof

            That’s a 1% chance of brachial plexis injury PLUS the risk of hypoxia-related brain injury from a dystocia that’s resolved too slowly. Yeah, I’ll take the surgery.

          • Lisa from NY

            ” There are multiple reports in the literature of brachial plexus injuries following vaginal deliveries without shoulder dystocia, subsequent to breech deliveries, and even after otherwise uncomplicated cesarean sections.”

            Breech babies are also at risk.

          • Lisa from NY

            “The second most common injury suffered by infants following shoulder dystocia deliveries is a fractured clavicle. The incidence of this injury following shoulder dystocia is 10%.”

          • KarenJJ

            Good grief, it would risk you out of a homebirth where I live. What’s the point of saying “homebirth is safe” if you don’t risk anyone out of it? The only reason it is safe is because anyone with a risk factor changes provider to an obgyn and gets delivered in a hospital. That’s what would have happened to you where I live. A midwife wouldn’t take you on (unless you wanted to pay for Lisa Barret “non-midwife” to fly over) and you would be referred to the maternity hospital.

            This type of thinking is what makes homebirth safer in the UK, Australia, Canada etc. Taking gung-ho risks like you did is what makes homebirth so unsafe in the US.

          • OBPI Mama

            Wow. I had a severe shoulder dystocia at home and an injured child because of it… so yes, I chose a c-section with my other children so I wouldn’t have to risk another one of my babies’ life. My son almost died. Instead he spends his life in children’s hospitals, having to work hard to maintain the movement he has, having surgeries and 3 therapies a week. So yep, I risked 6-8 weeks of MY recovery from c-sections so my other children wouldn’t have to go through what my first son goes through…

            I can not believe you had another homebirth. You are very lucky to have healthy babies.

          • MaineJen

            “Yes, after the first shoulder dystocia I was at risk for experiencing another. An 11-12% risk, to be specific.

            And why on earth would that disqualify me for a homebirth?”

            Oh…I don’t know. If someone told me I had a 11-12% risk of something seriously awful happening to my baby or me if I tried to give birth at home, that *might* give me pause. But you know, that’s just me.

          • The Bofa on the Sofa

            Currently, the chance of dying if you have a heart attack is about 16%. I’m waiting for Karri to tell us that we shouldn’t bother avoiding heart attacks.

          • prolifefeminist

            Wait a second – “Unless, of course, you would be the OB who would advocate trying to shove the babies head back up in and doing a c-section – without anesthesia of course since there wouldn’t be time.”

            Can someone here with medical knowledge address this statement? I always thought that if a crash c-section is called for, mom quickly gets general anesthesia. I’ve never, ever, ever heard of a c-section in the US being started without anesthesia.

          • PrimaryCareDoc

            Yes, you’re right. Karri is full of it.

          • AlisonCummins

            I have. The OB needed to do an emergent c-section and wasn’t able to get the anesthesiologist to show up. She did the whole thing without anesthesia. The baby was fine.

            The OB, however, has nightmares. (Probably the mother too but I only know the story from the OB’s side.) The family sued the hospital and while they don’t blame her she was still named in the suit along with the anesthesiologist.

            She had a really nice little blog including a good post about forceps. After this incident she had a major depressive episode and closed down the blog. I don’t know what she’s doing now.

            So yes, it happens. It’s truly horrible and everyone regards it as a terrible failure, but it happens.

          • Amy Tuteur, MD

            I find that unbelievable, Alison. Where did you see an obstetrician do an entire C-section without anesthesia?

          • AlisonCummins

            I didn’t see it. The OB used to blog under Midwife With a Knife but took down her blog. The story was one of her last posts.

            This would have happened three or four years ago, maybe more, in the Pacific Northwest. I don’t know if you have the means to look up to see if a suit alleging anything like this ever went to court?

          • AlisonCummins

            Her forceps post was included in a 2007 carnival by a surgeon: http://rlbatesmd.blogspot.ca/2007/09/surgexperiences-105.html
            This OB still has her on her blogroll:
            http://obgynkenobi.blogspot.ca

            This is her debut post on an older site:
            http://medblogcafe.wordpress.com/2007/09/02/midwife-with-a-knife/

          • auntbea

            Wouldn’t this have to happen occasionally, if a baby were dying and they didn’t have 20 minutes to wait for an on-call anesthesiologist to get there? This is one of my biggest fears about delivering in the rural hospital where we now live.

          • AlisonCummins
          • prolifefeminist

            Oh, and 11-12% risk of SD reoccurring? I’d take a c-section over that. I was willing to trade the slight risk of rupture (1%, my OB estimated) to try for a VBA2C in a tertiary care center. But 11% of a serious complication like SD? Way, way too high in my opinion…I can’t even imagine taking on that high of a risk to my baby. Not to mention doing it away from immediate medical help (blood bank, actual peds resuscitation team, more than one RN to assist with maneuvers, etc etc etc).

        • Siri

          You had shoulder dystocia at home, and then chose to have another homebirth? Your midwife didn’t risk you out?

          • Karri Gonzalez Sensenig

            There was no reason to. And our state has very strict standards on who qualifies for a homebirth with a CNM. (Obviously the midwives operating without registration and licensing probably don’t bother to go by those guidelines. We use a licensed CNM who does.)

        • theNormalDistribution

          That’s lovely rhetoric. One problem**; Dr. Amy has never said that homebirth should not exist. She advocates for truth about the safety of homebirth and the qualifications of homebirth attendants. The problem with the coverage of this homebirth is that it paints a beautiful story of a safe birth, when the reality was quite the opposite. It’s just another homebirth lie.

          Maybe you have an accurate understanding of the risks and would still choose homebirth. Maybe many women would. But because of stories like this, because of all the lies, there are a great many women attempting home births who don’t understand the risks, and would never have considered it if they did. If you think that’s okay, then apparently you’re not as moral as you believe you are.

          **(well, not one, but I’m tired of explaining logical fallacies.)

          • Karri Gonzalez Sensenig

            Oh I want to be clear that I am NOT advocating this woman should have had a home birth. I actually don’t know anything about this woman Dr. Amy is talking about and only took issue with some of Dr. Amy vitriolic rhetoric.

            I agree there are people attempting home births that don’t understand the risks of childbirth and don’t know how to pick a qualified midwife.

          • PrimaryCareDoc

            You seem to be one of those people (that don’t understand the risks).

        • Box of Salt

          Karri “A homebirth has its place and time.”

          Yes. That was the 19th century and the beginning of the 20th century.

          ” A hospital birth has its place and time.”
          It’s now 2014. Why do you want to go backwards in time?

    • Anj Fabian

      I see the covers of magazines in the stores and I know they’ve been photoshopped and air brushed because that’s what sells. I can usually spot the usual smoothing in the face, the additional shading on the bust and so on. Once you know the tricks, they are easy to spot.

      I’m used to people writing their home birth stories in a way that “sells” home birth. I’m used to the common narratives, the messy and unpleasant parts being edited out or given as little mention as possible. I’ve even watched stories go through multiple versions, getting cleaner and more pleasant and almost always more inspirational with every retelling.

      I’ve read so many home birth stories that I can spot gaps, omissions, the sudden surge of positive adjectives when talking about a midwife, the careful, neutral tone when describing a problem, crisis or emergency.

      This story is no different. Hours of labor documented. The birth lovingly photographed, the posed shot in hospital. Missing are the photos of the spreading puddle of blood, the EMTs crowding the rooms, the bags of IV fluids, the units of blood, the label STAT put on every lab order, every blood order.

      STAT isn’t just a word tossed around casually at a hospital. It means that those orders get given top priority, pushed to the front of the line, all the other work, the orders, the lab tests, the patients have to wait so the STAT orders can be processed as quickly as possible.

      Why? Because those other patients aren’t in danger of dying while the seconds tick by.

  • Trixie

    I’m just throwing something out here, having read more of this woman’s writing, and her history of alcohol and substance abuse, plus the fact that she’s written about drinking during pregnancy and delivery — is it just barely possible that some or all of the motivation for a home birth was to avoid drug testing in the hospital?

    • Trixie
    • Susan

      Trixie I can’t tell you how many times I have wondered if some women home birth for that reason. Hospitals have protocols about who to drug tests and drug tests on babies are not something parents can legally refuse. Drug use is so incredibl y common and parents do become aware of what the triggers for testing are. They change doctors to avoid follow up all the time, sometimes they go to a hospital that doesn’t know the history, why wouldn’t they cloak the motivation for choosing a setting without access to drug testing as wanting ahomebirth?

      • Guest

        I wasn’t drug tested when I gave birth. It never even came up.

        • Susan

          Usually it doesn’t. There are criteria for who should be tested built-in to most hospital policies. Unfortunately, drug use and abuse is not the least bit rare in pregnancy

        • Trixie

          Neither was I, but I have no risk factors.

      • Trixie

        She did change doctors at least once according to her husband.

      • I know several that fit that mold. When I was at the hospital I heard enough to piece together that cps was visiting the room next to us because mom and baby had tested positive. It was pretty scary, but I can’t remember much, what with the newborn and the hallucinating from sleep deprivation. I know it sticks out in my memory, and I didn’t have anything to worry about. I can only imagine if I was hiding drug use.

        • Susan

          Lots of methamphetamine and THC in California. Seems like an increase in moms on Methadone too. Also it seems common to think pot is natural and not that bad. There is some evidence of neurologic changes an it shows up in high concentrations in breast milk. However, the evidence about alcohol is so powerful and scary that the dose doesn’t have to me huge to cause harm. It is increbible that the same person tweeting her whisky sours is patting herself on the back for avoiding an epidural.

          • Trixie

            I have a relative who’s been institutionalized his whole life because he was born with FAS. Now again, I realize that relative’s mom was drinking like a fifth of vodka every day, and one whiskey sour isn’t the same. There are responsible mothers who have very, very small amounts of alcohol occasionally during pregnancy. But for someone who’s an alcoholic, there is no “safe” or “moderate” amount of alcohol that you can have.

          • Mom2Many

            As a foster mom to infants that are almost always going through substance withdrawal, as well as being in the lives of many, many FASD children, the effects of maternal alcohol and drug use while pregnant are not pretty. In fact, from everything I have studied/learned, if you are going to be stupid while pregnant, in most cases doing drugs has less long term impact on your child than alcohol. (though the initial withdrawal is generally worse with drugs such as Oxy, and Cocaine)
            9 months without alcohol really is a lifelong gift to your child.

          • Medwife

            Meth, heroin and alcohol are such staggering problems in the pregnant population where I work that a UDS + for THC is almost not worth noting. Small potatoes, unfortunately.

    • attitude devant

      Been reading her blog quite a bit. She has quite the history.

      • Trixie
        • attitude devant

          Exactly. Poor kid. His parents seem served up from someplace I wouldn’t send my worst enemy to. OTOH they have managed to keep the chihuahua alive…

          • SD888

            Ruth FOUL-er Iorio is a HORRIBLE person. She is a Narcissist, a drug addict, and a monster. She verbally abuses anyone who dares question her continuous abuse of others and her hatefulness towards her own child. She is an evil ‘human being.’

          • attitude devant

            I’m wondering what happened to compel you to comment on such an ancient post. She certainly seems to be everything you say….

          • SD888

            I have known her personally for man years. She’s absolutely evil to the core. I feel so sorry for her child, whom she abuses. She’s continually e-begging online for her crappy photography and ‘writing’ projects (mostly railing about how much she hates Whitey, how ironic). Ruth has had so many run-ins with so many people, yet she STILL projects. The world is full of horrible people who try to make her life harder, because they aren’t as smart and thin and cool as she is. Endless rants. She got into a physical scuffle with cops because she’s so arrogant she thought she can put her hideous, yapping chihuahuas in a wagon and when they inevitably jump out, she doesn’t have to obey leash laws. She traumatized her son there in a public park when she began screaming profanities at the cops and they pushed her to a fence and handcuffed her. She wrote quite a bit about that on her Facebook. She’s a Narcissistic Sociopath. Rules don’t apply to her. Only the little people. (Anyone who isn’t richer, younger, more beautiful (EASY!) and more ‘educated.’

          • attitude devant

            She does display all the classic features of sociopathy and narcissism…. Do you know what she’s up to these days? I haven’t seen anything of hers published in a long time….and last I see she was going to have a web presence on http://www.theworldbreakseveryone.com but she seems to have lost control of that domain name. Sounds like a total mess.

          • SD888

            Yes, it’s pretty hilarious that she couldn’t even afford to keep the domain name. She probably spent that money on some lark. She travels all the time, yet claims she is ‘broke.’ She’s up to being a Toxic, Sociopathic Narcissist. Same old crap as usual. Manipulating and lying to get public sympathy. In one breath she says she is DEAD BROKE. Next, she’s E-Begging for ‘donations’ because her egoistic Narcissism ‘forced’ her to spend $40,000 on lawyers fees to keep her son away from his father (Who is no prize himself, being a Meth using druggie, but whom I admit is a talented photographer…which are a dime a dozen in LA). Mostly she talks about going back to the UK but CAN’T because the baby’s father lives here. She is moving on from her FAILED ‘career’ as a writer and is trying to be a photographer. Mostly she posts full frontal nudity shots of her son, which is totally immoral considering all the pedophiles in LA and who lurk online. Her photography is absolute shite. She is a spoiled and monstrous woman. She admits that due to her anorexia (and extreme venom toward any woman with even a pot belly) she spends tons of money obsessively exercising on expensive ballet classes, yoga courses, skin treatments, plastic surgery, and says that she is broke…could someone please ‘GIFT’ her a week or two of Blue Apron, please? She was renting out her dog shit filled guest house she rents, but kept getting into nasty attacks on the beautiful young French woman who rented a room from her for a month. Ruth cannot get alone with ANYONE. It says a lot that her own twin sister despises her and has cut off all contact. She also keeps trying to add to her menagerie of hideous mutts, asking people to ‘donate’ $400 so she can buy cat toys and adopt MORE pets (When she also says she doesn’t even have the money to pay vet bills for the two shitty, unhouse-trained dogs she has now, plus an obese cat that she has oh-so wittily named ‘Chairman Meow.’ Communism is so clever! Stupid woman. Greedy and money-oriented snob. She is a black hole. She is a lonely void. She has no real friends because other people are just for her Narcissistic Supply to use and discard. She praises them with one breath then spreads hideous lies and rumors about them with the next.

        • GiddyUpGo123

          Oh my, very first entry: out until 3am, drunk driving, strange people showing up at her house looking for crack, big whiny temper tantrum during which she throws food and breaks plates … It’s fiction right? These two new parents don’t actually behave that way do they?

          • theNormalDistribution

            Oh wow. Now I see why Bofa comparing homebirth with drunk driving wasn’t hitting home with Jared.

          • wookie130

            Sadly, I think it may be true, GiddyUp. Perhaps it’s embellished to a degree, or fabricated on some level for the dramatic effect, but one can truly sense the instability in these parents through reading the blog. Ruth may be a gifted writer, but her lifestyle is nearly that of a drunken transient, if you take her blog at face-value.

          • SD888

            No, none of it is embellished. She brags constantly about having earned a degree from Cambridge. She is an elitist, capitalistic snob wrapped in an ‘anarchist’ Communist facade. A complete phony and a horrible, horrible, abusive mother.

          • Burgundy

            Hope not, otherwise the baby will have breast milk full with alcohol and drugs…. Brest is the best, oh-ya.

      • Mishimoo

        I tried to read it, I really did. To me, it came across as the mind of an enraged, melodramatic, rebellious teenager splashed out for all the world to see.

    • Lynnie

      Just spent a few minutes reading her blog. That is definitely a possibility.

    • Dreah Louis

      Is that a FACT?

      • Trixie

        I don’t know her at all, so I can’t really say what’s a fact or not. But she does talk a lot about her alcoholism and drug abuse, as well as posting about drinking during pregnancy and labor. And, I hope I’m wrong. And I hope that, offline, people are helping her seek treatment, if she needs it, to remain sober and stable for her baby’s sake.

        • Dreah Louis

          I don’t know about the alcohol or drugs but she writes very well.

          • Susan

            I agree she does seem to be a gifted writer. I don’t respect a lot of her choices but does write about said lousy choices in a fascinating way. Hope the baby can get the brains without the oppositional defiant disorder.

          • Trixie

            Her writing style is pretty derivative of the writers she lists as inspirations. There’s nothing wrong with that, but I wouldn’t say she has an original voice. Instead she writes about shocking things to keep you reading.
            I find it interesting in one of her essays that she says she keeps people around that she’s broken up with in vase they might be useful to her.

          • GiddyUpGo123

            Ugh. I think she *could* be a gifted writer, but everything I’ve seen from her is completely over-written. It’s all really horribly pretentious and difficult to muddle through. I think it’s very possible to be a good writer who writes completely unreadable stuff. Yeah, she can put a sentence together–one that reads very well and flows very nicely, but that doesn’t mean it’s a good sentence. There’s a lot to be said for simplicity in writing.

          • Dreah Louis

            Everyone can’t relate to a troubled life so I can see if her writing isn’t of interest. I was basically bringing up the idea that regardless of the drug or alcohol use that all the women were talking about didn’t obviously have an affect on her ability to paint pictures with her words. That is a gift is all that I was saying regardless of how or what she talks about. I’m pretty sure you read a lot of her blog.

            🙂

          • Mishimoo

            I can relate, but seeing as her writing style is similar to way I used to think when I was 15 and is part of some of the muck I discarded when I was 20, I have no interest in muddling through it again. 🙂

          • yentavegan

            You write well too. I read your blog.

          • Trixie

            I agree

          • Dreah Louis

            thank u

  • Dr Kitty

    At home:
    PPH
    IM oxytocin
    Uterine massage (I hope)
    911 called
    EMTs arrive after a few minutes
    Still no IV access
    Arrive at ED
    IV access-fluids running
    Placenta removed
    IV uterotonics, antibiotics, analgesia
    Blood transfusions
    48hrs of observation

    In a Hospital:
    PPH
    Uterine massage, IV fluids
    Placenta removed
    IV uterotonics, analgesia
    Home within 24hrs.
    The end.

    • Martina

      Americans created scams to let them supervise labour and childbirth and now you are fighting for home birth to be banned…..i am speechless. That is how doctors try to steal the job to real midwives!
      In Italy they are promoting home birth because when women go to deliver at hospital many of them will get unnecessary c-sections and because hospitals are over crowded(especially midwifery ward ). I will go on the home birth blog and ask italian women if they had bad experiences with their home births. Will keep you updated!

      • Nobody here, not even Dr. Amy, want to ban homebirth. ALL OF US are against LYING LIARS WHO LIE to women and families about the safety of Home birth and the midwives that attend them.

        • Guest

          I’ve seen Dr. Tuteur’s video, which was enlightening about midwifery care in the US and I realize from that she’s against the lay midwives.
          The problem is, in reading this blog and the comments of a lot of the regulars, everyone sounds like they’re completely against homebirth, anywhere, anytime, in any situation. So that’s the perception when you first come to this blog and start reading. I know I had that idea until I read for a few weeks and went back, reading a few past posts. I now have a different view, but when some of the comments are very angry and/or scathing towards parents of a failed homebirth, it’s hard to remember that. I just keep having to remind myself.

          • Siri

            Like several other commenters, I HAD a homebirth, in the UK, attended by two highly knowledgeable and experienced community midwives. I felt safe and cared for throughout, the local Labour Ward was aware I was in labour, and my midwives would have called for an ambulance, nil delay, if anything started to look iffy. I wouldn’t have another homebirth (I’d be a grand multip for starters), and I’m appalled at the idea of CPMs attending high-risk deliveries in the US (and even low risk births can go drastically wrong, as in the case of Ruth Iorio).

            Amy’s aim isn’t to remove women’s choice, it’s to abolish the title of CPM and ensure women are told the truth about the risks they face.

          • Guest

            Like I said, that’s what it FEELS like though. It’s sometimes hard to keep in mind that it’s the lack of training that’s the issue when comments feel very much like “I told you so’s”.

          • AlisonCummins

            Yes, many of the commenters are professional and insightful while others like to point fingers and call people names. This is true.

            It’s also a little more complex. The lack of training and accountability of American midwives is an issue in many aspects of homebirth but one of the biggest is the refusal to “risk out” women who simply should not be giving birth at home under any circumstances, or to transfer women quickly as soon as things seem to be looking a little difficult. (Someone quoted a transfer rate of 40% I think? Referring to England I think?) Risking out and transferring is part of what makes home birth in other countries safer than it is in the US.

            When people think that home birth is safe then they will take inappropriate risks.

      • attitude devant

        Martina, you can’t compare homebirth midwives in Italy to homebirth midwives in America. Italian midwives are very well trained and follow good guidelines. That’s not the case in America.

        • Guest

          I think she can here. There have been a few studies done in Canada that conclude that homebirth here is as safe as a low risk birth in a hospital. Dr. Tuteur has said in the past that at least one of them is flawed and that homebirth is always more risky than hospital birth.

        • Martina

          Why don’t you fight to change that,the cause is that butchers one day decide to self teach midwifery and they are allowed to go assess home birth. Simple eliminate these improvised midwives….i wonder who created that. I have to do a little research

          • attitude devant

            Martina, what do you think we are trying to do here? That is exactly what this blog is about!

          • Deena Chamlee

            Martina in America the current issue at hand is about mortality and morbidity of innocent babies in the homebirth setting.
            There should not be HOMEBIRTH MIDWIFE as a title. There should be MIDWIFE and that title should be protected and regulated by ONE National Organization; The American College of Midwives. All midwives should be regulated by a national board that is appointed based on MERIT. This board should oversee the practice of all midwives who should be graduate prepared and practice by set standards /guidelines across all three settings: home, birth center and in hospital.
            Because one needs a graduate degree to admit to in hospital status any other type of midwife is not warranted
            Instead we have HOMEBIRTH ATTENDANTS calling themselves MIDWIFE and spreading carnage across the country without impunity. Harming the public and leaving them without any recourse. Many suffer from PTSD.
            INA MAY is an ENGLISH MAJOR who wanted to be a midwife. So she watched one birth in her commune on the FARM in Tennessee and others in her COMMUNE knew she wanted to be a MIDWIFE so they began to call her ONE.
            It is the biggest SCAM ever to exist, in my opinion, in the United States and Globally within the profession of MIDWIFERY.
            So in order to protect the public MIDWIFERY in The United States must STAND WITH HARMED FAMILIES and put a stop to such a practice.
            On the Texas border individuals calling themselves MIDWIFE are falsifying birth certificates for Mexican IMMIGRANTS. Seventy five of such individuals have been arrested. Anti-Social behavior has infiltrated the homebirth movement nationally and globally.
            I almost wonder if we all should take the data acquired and get the FBI involved if it cannot change without police involvement.

          • Susan

            Is there a link about the Texas midwives somewhere? That sounds interesting.

          • Deena Chamlee
          • Trixie

            That’s exactly what Dr Amy is trying to do. It’s complicated here, because each of the 50 states has different regulations.

      • The Bofa on the Sofa

        Speaking of creating scams…Are you familiar with the story of Ina May Gaskin and the CPM? She INVENTED a separate type of midwife and granted herself the title, so to avoid the requirements that are applied to real midwives.

        And you accuse doctors of creating a scam? HA

      • Trixie

        Doctors did not create the fake midwives. They created themselves. REAL midwives and obstetricians work together just fine, for the most part.

      • Dr Kitty

        Martina, I’m a GP in the UK.
        I don’t have a dog in the fight as far as making money is concerned because I don’t attend births.

        In the UK, 2 fully trained graduate midwives would have attended the Homebirth.
        They would have been able to start an IV and run fluids.
        They would have been able to deliver the placenta.

        But, and I think this is important, it probably wouldn’t have come to that because Ruth’s personal history and several issues during the labour would have risked her out and made the MWs transfer her to a hospital well before the PPH occurred.

        • no longer drinking the koolaid

          My point precisely. I’m a home birth midwife (CNM) and as I read her story, I kept thinking “Time to transfer.”. Okay, “Now it’s really time to transfer.” Finally OMFG, “Please transfer this woman!”
          The midwives missed a several points where this was no longer an uncomplicated labor/birth.

  • fiftyfifty1

    I would like to give a big thanks to one group of people who saved Ruth Fowler Iorio’s life. And they did it for absolutely free (unlike her midwife who got paid $4500 cash to do nothing more than call 911): The anonymous blood donors. Thank you very much blood donors! Ruth will not likely be sending any thanks your way, so I’ll do it for her. In a world without blood donors, her rash decision to homebirth would have bought her a very different outcome: Death or months of living with the disability of profound anemia, unable to care for her baby. So thanks for what you do!!!

    • Box of Salt

      I keep wondering what her blood type is. I’m hoping O+ or A+ since they’re the more common ones.
      http://www.redcrossblood.org/learn-about-blood/blood-types

      • guest

        AB+ is the universal receiver

        • Box of Salt

          Yes, and O- is the universal donor, and also very rare.

          • Trixie

            I’m O-, I really ought to donate more.

          • amazonmom

            I’m B neg. Puget Sound Blood Center calls me several times a month to donate if I let it go too long between donations. They did mark down my pregnancy and C/S date so they wouldn’t bother me until I was potentially eligible again.

          • Sullivan ThePoop

            I am also B- and all of my children have different blood types.
            As far as rarity from the most common, to the least common O+, A+, O-, B+, A-, AB+, B-, AB-

          • amazonmom

            Both of my babies are O pos. Rhogam is awesome!

          • Trixie

            You pharma shill. Don’t you realize you can change your blood type through special teas and enemas?

          • amazonmom

            Yeah but I’m a lazy parent who just goes the OB/hospital route for everything ya know? Oh and I make money off of fooling people because I work for a hospital.

          • Dr Kitty

            A+
            I can’t donate because my weight is below the minimum, but I’m on an annual deferral, just in case I ever get fat enough.

          • KarenJJ

            I can’t donate either due to a chronic condition and immunosuppressant medication. Very glad there are people out there that can. My husband has given blood – he’s needle phobic (although that’s changed now that one of the kids needs daily needles) and the nurses give him a small local anaesthetic so that he doesn’t feel the rest and can just look away.

          • Box of Salt

            I changed my blood type once via clerical error. Then we had to change it back.

          • Sullivan ThePoop

            Mine are O+,O-, and B+

          • Mishimoo

            So is my husband, but he’s terrified of needles. He’s working on it, slowly.

          • guest

            Yup, meant that to mean that she would be better off being A+ instead of O+ if it came down to it.

          • Young CC Prof

            Not rare, like 20% of the population is O-, and 40% is O+. AB is rare.

          • Box of Salt

            No. Where did you get your numbers? Mine came from the Red Cross link above.

            While it’s true that AB (+ and – each) is more rare than O-, it’s still fairly rare.

            This wikipedia article also puts O- at less than 10% of the population for every country listed:

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

            We can quibble about my use of the adjective “very,” especially in contrast to the ABs, but iO- is still not a big proportion of any population.

      • I’m B+, and I give 2-3 times a year. I’m close on the weight limit, so I can’t drive myself afterwards and always have to lie down with my feet over my head when I give. I have to pick a weekend where I’m okay feeling like crap for the rest of Saturday and first half of Sunday to go in and donate, plus my husband has to be available to drive me. It’s still worth it, though.

    • Karen in SC

      Since she has a blog, she should be appealing for blood donations to shore up the local supply that she depleted. Is she?

      Many folks after a car accident or serious surgery will ask family, friends, neighbors, etc. to give blood as a sign of appreciation.

  • PrimaryCareDoc

    Ugh. Now she’s on Twitter complaining about cost of her hospitalization. So, it’s OK to pay $4500 cash for a homebirth, but not OK to pay $23,000 for having your life saved. Personally, I think that an emergency room evaluation and emergency stabilization, manual placenta removal, multiple transfusions, 2 day hospitalization, not to mention the “ton” of fentanyl, plus the bonus of not bleeding to death… she got a bargain! Priorities, priorities.

    • Trixie

      What she’s doing is trying to drum up donations.

    • fiftyfifty1

      She paid her midwife $4500 to do nothing more than dial 911.

      • Trixie

        No, the husband said below that he dialed 911.
        I hope that midwife is one hell of a knitter.

        • KarenJJ

          Hopefully the baby gets a hat out of it.

    • Guest

      Wow. I couldn’t afford to have a baby in the US. I paid less for my car than she has to pay for her hospital stay!

      • Martina

        How can someone ask a patient to pay that much……

        • Meerkat

          Majority of people in the US have health insurance from their work. I paid a total of $500 for my C-section and maternity care. The rest was covered by health insurance. I can’t speak for all states, but I know that Massachusetts provides state sponsored health insurance for uninsured pregnant women. My friend had no health insurance, and the state covered the cost of all her prenatal care and delivery.
          From what I understand, Ruth did have health insurance that covered her hospital stay. CPM midwife services aren’t covered by health insurance.
          I do agree that the the whole insurance system is a problem, but going to charlatans instead of doctors is not an answer…

          • Trixie

            Massachusetts has better health insurance than most states.

          • Elizabeth A

            Yes. My total out of pocket cost for each pregnancy was $20. For everything from routine prenatals to ER visits for bleeding, ante-partum admission, ambulance rides, c-section, 32 day NICU stay… everything.

            I have really good insurance, even for Massachusetts, but I do not understand why the public interest in providing appropriate care to pregnant women isn’t obvious enough to make this kind of coverage standard.

          • Meerkat

            I didn’t realize how good Massachusetts insurance was until I moved to New York. I never had any problems with insurance when I lived in Boston. Doctors’ offices billed correctly and resolved any issues with insurance themselves, the insurance never made mistakes.
            I hate dealing with all of this in NY. Hate it. The insurance is in my speed dial. At least I can yell at them when them make mistakes, and they make many. But you know whom I hate even more? Doctors’ billing offices. Doctors here hate insurance and don’t want to make any effort to help a patient to resolve a matter with insurance, even if the problem is their own billing office. Resolving problems with billing offices is like pulling teeth.

          • Young CC Prof

            I would have paid $10 for all my maternity care, but I did require a few consultations with Maternal/Fetal Medicine. So I think it was $70 or so? My friend in Utah was uninsured when she got pregnant, but was able to sign up for Medicaid, and they took care of her.

            Now, there are some mothers who have no private insurance and, for one reason or another, can’t get care through the state. A study in New York City found that uninsured mothers were SEVEN TIMES more likely to die than insured mothers. (The death rate among Medicaid mothers was only slightly higher than private insurance.) The absolute risk was low for all groups, but that kind of relative risk is remarkable.

          • Meerkat

            I am surprised the risk isn’t even bigger than that. Having no health insurance is awful.

      • PrimaryCareDoc

        That’s not what she paid to have the baby- that’s what she paid to get her life saved after she almost bled out.

        Also note- she didn’t get health insurance until 2 weeks before the birth. She got a plan under the ACA and apparently UCLA is not in network for it. That’s why she’s getting the bill. If she had planned in advance and had a hospital birth in network, everything would have been covered.

        • Guest

          Well that’s a relief. With the cost of raising a kid, if it cost you $20,000 to have it no one could afford it! We’ve all heard horror stories of people being turned away at US hospitals because they have no insurance. It’s a relief to find out that some states cover it on their own.

          • PrimaryCareDoc

            It’s illegal for a hospital to turn away someone in labor. It’s a law called EMTALA.

          • AlisonCummins

            EMTALA means they don’t turn anyone away. It’s an unfunded mandate, which is one reason hospitals are so keen on charging as much as they can for other services, so they can cover the ER.

            I imagine some of these dynamics will change with the ACA.

          • Young CC Prof

            Actually, EMTALA isn’t entirely unfunded. There’s something called “disproportionate share” money for hospitals that serve particularly large uninsured populations.

            Unfortunately, the ACA has cut disproportionate share funding on the theory that almost everyone will have insurance now, which is creating a big problem in states that didn’t expand Medicaid.

            It’s complicated. I don’t entirely understand it myself.

          • Sullivan ThePoop

            My SIL last year paid $6,200 out of pocket for a twin C-section. The boys spent 3 days in NICU. I don’t think that’s bad. Oh and her insurance paid for her to stay after she was discharged.

          • Guest

            Ya…I tend to think our government should look after our health care. I’m a fan of universal health care as it is here in Canada. There are flaws, but I don’t think with the amount of taxes I pay that I should have to pay out of pocket for things like that.

        • Elizabeth A

          I think she has a perfect right to complain about her insurance – the ambulance probably took her to the closest appropriate facility. Health insurance with network limitations really needs exemptions for life threatening emergencies.

          • An Actual Attorney

            Generally, I would agree with you. But you know, maybe that would be something you should consider in “doing your research” about that hospital “just 5 minutes away.”

        • drsquid

          she later says she only has to cover $3000

          • Young CC Prof

            That sounds like a plausible uninsured bill after negotiation. My friend just got 80% off the “list price” of her surgery because she was uninsured and unemployed.

            Essentially, the hospital will usually ask for a sum they think the patient might actually be able to pay. Asking for the impossible and sending the patient into bankruptcy doesn’t serve anyone.

    • Meerkat

      I wonder what her insurance company is thinking about it.

  • Martina

    Live and let live! Leave this woman do what she wants to do! Are you all perfect? People full of judgements. Judge your own lives!

    • LynnetteHafkenIBCLC

      Right on! How dare people judge me for drunk drunk driving, giving my baby mountain dew in a bottle and letting my toddler play in traffic?! /s

      • Martina

        What a silly comparisons…….what in Italy we call “americanate”

        • Trixie

          Not silly — considering drunk driving is safer than home birth.

        • LynnetteHafkenIBCLC

          Seriously though, what is the difference? Feeding a baby mountain dew is not healthy, but has never caused injury or death, whereas homebirth clearly has.

          • Young CC Prof

            Um, if you fed a little baby significant quantities of Mountain Dew, he WOULD get quite sick and possibly die.

          • LynnetteHafkenIBCLC

            Well yeah, and the same is true for water (http://en.m.wikipedia.org/wiki/Water_intoxication); I was mainly referring to the occasional older baby or toddler you see around Walmart clutching a bottle of soda. Gross, but still safer than homebirth.

          • Young CC Prof

            Ah, yes, that’s different.

          • AmyP

            My mom used to feed my baby brother bottles of liquid jello. (I think it was mainly because he was underweight and couldn’t have cow’s milk.)

        • The Bofa on the Sofa

          Bring it on. Why is it a silly comparison? Show us how much you know about the safety of homebirth…

    • fiftyfifty1

      No one is trying to keep this woman from doing what she wants. She’s her own boss. In the United States you can give birth in a cornfield surrounded by gibbons if you want. But what you *can’t* do here is force people to agree with your choices and praise you for them. We call if “Freedom of Speech” and it’s actually written into our constitution!

      • Antigonos CNM

        Well…finding a cornfield full of gibbons might be a tad difficult…

        • Mel

          It’s the sequel to “Field of Dreams!”

  • Guest

    I just have to say: welcome to life in the 21st Century! I wouldn’t tweet or post on Facebook during my labor (I don’t really use a lot of social media anyway), but everyone tweets about everything these days. So really, everyone who posts endlessly on Facebook and Twitter are narcissistic. They want everyone to know what they’re doing at any given time. I don’t agree with it and I wouldn’t do it, but…herd mentality and the fact that celebs do it is hard to bypass.

    I know someone who posted a picture of their baby’s ultrasound on Facebook with a big arrow pointing to the crotch saying, “It’s a boy!” I didn’t think that was appropriate. I would also never post pictures of my daughter on the potty because I don’t think they’re appropriate. I don’t have a problem with photos of nursing, because that’s not sexual, but any pictures of genitalia…there’s too many crazies out there.

    • Meerkat

      You know, if it wasn’t posted on FB, it might as well not have happened, he he! Social media has become a real addiction for some people!

    • AlisonCummins

      Just to clarify… You think there are people who would be sexually attracted to an ultrasound?

      • Guest

        Maybe not, but it’s subjective. How will that kid feel when he gets older and sees that?

    • Antigonos CNM

      I knew there was a reason I don’t use Facebook or Twitter…

  • Siri

    Ruth’s post ‘The Unethical Pregnancy’ (from her blog) makes for interesting reading, and offers insight into her attitudes to pain relief in labour and to the women who opt for epidurals… her online fight with/attack on singer Sinead O’Connor has also attracted much controversy.

    • Trixie

      It’s also interesting that she describes herself as a narcissist in the about me section.

      • Siri

        Just as well – we’d never have guessed! :-b

      • drsquid

        sociopathic narcissist

    • attitude devant

      Her blog makes Jared and herself sound like real peaches. Glad I don’t know them.

    • I thought they only had a (couple?) Hundred or so followers before the messy, beautiful near exsanguination?

    • emkay

      Ugh… its PAINFUL reading

  • Dreah Louis

    There is so much that is missing that its disgusting. Why keep lying to pregnant women about home birth. I had to clean up my own blood all over my house, the walls, the floors the steps, the shower the bath tub while I had a brain dead daughter in NICU and a live twin at home with 3 other children.
    Midwives f****** up and ran never visited a day in the hospital. NOT 1 DAY. I had one TWIN baby that stayed at home and one baby transferred the midwife never showed up at all.
    The truth and reality is that you cant debate about a bad experience or even agree with a someone talking about a bad experience if you haven’t encountered OR had to deal with the results of a bad home birth experience. I HAVE.
    People disagree with the home birth truth setters because the argument has no merit to the home birth advocates.
    That hospital saved her life!
    That is why doctors hate midwives, they have to clean up their nasty mess.

    • Martina

      There is too much ignorance about home birth! I am sorry that many midwives are so incompetents in USA.

    • moto_librarian

      I am so very sorry.

    • Medwife

      I’m so sorry for that terrifying experience and the loss of your daughter. The behavior of your midwife is beyond words.

    • Dr Kitty

      I’m so very sorry for your loss.

    • Amazed

      I am so sorry for the pain your family is suffering.

      • Dreah Louis

        🙂

    • Mel

      I am so very sorry.

  • Lena

    Well that’s a bit harsh and likely reflects your own beliefs rather than having anything to do with Ruth’s experience.

    • wookie130

      Or not, Lena. It is not about Dr. Amy’s “beliefs” vs. Ruth’s “experience.” It’s about glorifying something that was disastrous in reality, and could have ended up tragedy for both Ruth and her baby. A lot of the disaster could have EASILY been averted by her choosing to deliver her child in the hospital, with a competent medical team available. Instead, Ruth is using her “experience” to gain attention and brownie points from the home birth crowd, when she should be focusing on the newborn baby that could have been lost in the name of her “ideal birth.” It’s disgusting, and I for one am thankful that Dr. Amy has shed light on all that is wrong with this gruesome scenario.

    • AlisonCummins

      What do you mean by “beliefs,” Lena?

  • Martina

    Dear Ruth,dangerous people are you and people like you! Homebirth is safe! Why hemorragie post delivery happen at hospital too? Why many fatalities happen at hospital too? Maybe because medicalized delivery is dangerous? There are many doctors making huge mistakes at hospital i know it for experience. Please STOP blaming it on home birth!!! You are ridiculous!

    • Martina

      This message was for Amy Tuteur and not Ruth!

    • Birthbuddy

      Troll alert!

    • Meerkat

      Why do NCB advocates have such poor spelling and grammar? Why don’t they use capital letters appropriately?

      • Trixie

        She’s from Italy

        • Meerkat

          All right, that’s a fair excuse. But it’s not only Martina. Every time an NCB proponent stops by to argue they write these really poorly spelled rants. And I am sure that unlike Martina, those people are native speakers!

  • Martina

    My boss delivered at hospital and she lost loads of blood without anyone realizing it.If it wasn’t for her husband visiting her at that moment she would be dead now! So please,do not blame this family because they chose homebirth and because they wanted to document it!
    FB called this documentary PORNOGRAPHY!!! I would make a complaint about that (crazyness!) instead!
    I do not understand why the porno videos are so considered normal and a constructive video about labour and delivery is considered a SHAME!
    Jared and Ruth you made the best choice to choose a non medicalized,natural way of giving birth. Remember that labour and delivery are unpredictable and a fatality can happen at home or at hospital (i have enough experience to say that!).
    Do not listen to these insane people! Only you and your wife know what is best for you two(and now you three). Do not allow anyone to tell you that you are not doing it right!!
    Congratulations on the beautiful birth of your gorgeous boy xxxxxx

    • Birthbuddy

      Martina, you do understand the concept of RATE, don’t you?
      Your argument that bad things happen hospitals too is stupid.
      Bad things happen 3-10 times more often at homebirth.

      • Martina

        Stop blaming this couple. Learn not to judge! i do not rate i see the reality of things!!

        • Birthbuddy

          No Martina, the RATE of bad things happening in hospitals vs. the RATE of bad things happening at homebirth.
          Oh my word!

          • Martina

            If there is a bigger rate of bad things happening at homebirth maybe because of incompetence of the midwife. I never heard these things in Italy,really. Anyway i wouldn’t sponsor a labour and birth at hospital because it is too medicalized.Women’s body know exactly what to do while laboring. There is no need of anything if not a good observation from the midwife. I am just sorry to hear many midwives are so incompetent. Saying that home birth is not safe it is crazy! You should put it other words maybe.

            Personally i don’t believe in rates…they are usually wrong they do not reflect what i see in the reality. I just observe things and treat them as individuals.

          • Birthbuddy

            Keep reading Martina.

          • Martina

            I just watched the video truth about home birth and i am shocked to see that in USA homebirth midwives don’t have a degree and they don’t train at hospital!!!
            No way! How can that be legal? Do parents to be know who is going to monitor them during labor?

          • attitude devant

            Ah! The nickel drops.

          • Martina

            But why saying homebirth is dangerous? These “professional figures” are dangerous…mind what you write Amy Tuteur! I wouldn’t be angry with the couples choosing homebirth because they may think those midwives are experienced and safe professionals to rely on

          • Birthbuddy

            Keep reading Martina.

          • Trixie

            Hence, the reason she writes this blog.

          • Trixie

            These fake midwives are exactly the kind Ruth delivered with. They have NO medical training, no education, and almost killed her.

          • Antigonos CNM

            There is virtually no regulation of midwifery education, licensure or insurance, standards of practice or requirements for legal documentation of births, continuing education — in short, depending on the state one is in, no supervision at all, in the US. Certified nurse midwives are in something of a different category, and are integrated into the medical system to a greater degree, but it isn’t because they are legally required to be but because they choose to be, in most cases. There is no national certifying body like the Central Midwives Board [has a different name now, I think] in the UK.

            Anyone coming from Europe is usually appalled at what passes for “professional” midwifery, and the bottom line is that the majority of American midwives do NOT want any supervision so they can do whatever their ideology tells them to do. Americans do the stupidest things in the name of “personal freedom”.

          • Deena Chamlee

            One Midwifery Organization, one national midwifery board that oversees practice of graduate prepared midwives in all three settings. MANA AND NACPM BARRED FROM THE US FOR ALL THE DEATHS AND FOR BLATANT LACK OF ETHICAL CODES IN THEIR STANDARDS.

            Then midwifery services can be brought into the greater healthcare system offering graduate prepared midwifery services across all three sttings: home, birtj center and in hospital. The setting for birth is dtiven by clients needs and desires..INFORMED CHOICE SHARED DECISION MAKING SHOULD BE CENTRAL THEME FOR OBSTETRICS.

            HOMEBIRTH SERVICES POST DELIVERY THAT ALLOWS FOR EARLY DISCHARGE. ITS TIME WE ALL GET POLITICAL AND MAKE IT HAPPEN!

          • PrimaryCareDoc

            Rate is not the Tooth Fairy or Santa Clause. You don’t have to believe it it. It represents reality, unlike our perceptions.

          • Alicia

            Martina, if women’s bodies “know how to birth”, then why was childbirth the #1 killer of women for the last several millennia? For thousands and thousands of years women and babies suffered and died until finally *medical* advances started to change that. It is a *scientific fact* that when humanoids started to walk exclusively upright the ability to give birth became more difficult due to the change in the pelvic opening. Apes, who have a differently shaped pelvis, can more easily give birth than humans can.

            Also, stop comparing what’s happening in the US to what happens in Italy. Two completely different countries. Having lived in both places, I know this for a fact.

      • Guest

        Lots of statistics can be interpreted in lots of different ways, depending on your bias towards the subject. Homebirthers will look at a study/statistical info and see one thing, while anti-homebirthers can look at the same study and see the opposite. Iv’e seen it in the comments of this blog.

        • Martina

          I feel you Guest.

        • Amy Tuteur, MD

          No, that’s not true. Statistics can be MISinterpreted in a variety of ways by people who don’t know much about statistics, i.e. homebirth advocates.

          • Guest

            So only homebirth advocates misinterpret the numbers? A GP or an OB would not be biased or misinterpret the numbers in a particular study/statistical paper?

          • The Bofa on the Sofa

            Please explain how Dr Tuteur has misinterpreted the numbers?

            All I have heard is an accusation that “statistics can be interpreted in different ways.” Yet, you have not shown that this has happened.

            Dr Tuteur does explain why the HB advocates’ interpretation of the outcomes are wrong (actually, most of the time it’s not about misinterpretation, it’s about completely ignoring them (see MANA’s refusal to even report the statistics on homebirth death rates).. If you think she is wrong, you are welcome to present what you got.

            Of course, the answer is, the statistics are so undeniable that homebirth advocates don’t even deny them. They just brush them off as insignificant. Now, you may claim that HB is “safe enough” for you, and I can’t argue. However, if you claim that the absolute numbers are trivial, or that “birth is as safe as it gets” then I will dispute it, because by any measure of risk in our lives, this is nonsense.

          • Guest

            Not speaking of homebirth at the moment. There were some discussions on past posts that have been read differently by the people who based the conclusions and Dr. Tuteur. I’d have to go back through all the posts from the last little while to find you specific examples.
            What it seems like is that everyone who posts here is all about informed consent, as long as that agrees with the recommendations on this site. If my GP tells me something different than Dr. Tuteur does, should I ignore her for what has been said on this blog? Because my GP would disagree with some of the things that Dr. Tuteur says.

          • Amy Tuteur, MD

            Really? What did your GP say? Let’s see if we can get to the bottom of it.

          • Guest

            She disagrees with the use of formula and c-sections unless medically necessary and also has told me that homebirth is safe (here in Canada). So I guess she’s checking out those studies that you disagree with.

          • Amy Tuteur, MD

            Her views on formula and C-sections are personal opinions. She’s entitled to them, but they have nothing to do with the interpretation of scientific evidence. Homebirth in Canada is much safer than in the US; that’s because midwives are appropriately trained (Canada banned the CPM) and transfer rates are high.

            So it looks like there’s no disagreement.

          • Guest

            So the posts you make are your opinions too? I thought they were facts that you would base a practice on? I must be misreading the posts. Or they are all facts based on scientific evidence. You’ve said in the past that the BC study was faulty (sorry I can’t remember why), so there is disagreement.

          • Young CC Prof

            Fact: Home birth increases the risk of death or brain injury to the baby.

            Opinion: Pregnant women should not be encouraged to birth at home.

            Blogs can have both facts and opinions.

          • The Bofa on the Sofa

            I want to get more to the bottom of it.

            Exactly WHAT is her position on the use of formula, and how does it differ from Dr Amy’s? Are you saying that she thinks mothers should be shamed for choosing formula or something?

            And “c-sections unless medically necessary” is a difference of degree, as opposed to kind. Every doctor will have a different opinion at what level the c-section will become an acceptable trade-off.

          • Guest

            If every doctor has a different opinion, then who do we listen to? This is where it gets murky. One doc may let a woman push for much longer than another one does, because they believe it’s the right thing to do. Some docs push for c-sections. Some docs are known as “pill pushers” who hand out prescriptions at the drop of a hat.

            And no, my GP wouldn’t shame a woman for the use of formula. But she agrees with the information that’s out there about the benefits of nursing and doesn’t think that women should use formula unless they can’t nurse for medical reasons. Example: a friend of mine had a breast reduction 10 years ago. Was unable to get her daughter to latch 3 years ago, pumped for 2 months to get her at least some breast milk, then went completely to formula. Medically necessary and totally reasonable.
            My cousin who chose to formula feed from birth because she wouldn’t be able to go out and get drunk while nursing. Not medically necessary, just selfish.

          • Young CC Prof

            Some c-sections do fall into a grey area. Sometimes, as with some VBACs, it’s grey enough that, time permitting, the doctor will explain the pluses and minuses and let the patient decide.

            However, for most deliveries, the majority of OBs would make the same call.

          • AmyP

            Would the baby have been better off if the cousin had been drinking and breastfeeding? It was actually somewhat conscientious of the cousin to not breastfeed if she was going to be drinking heavily. It would be terrible to pressure her into breastfeeding and for her to keep drinking hard. Consider how many women are heavy drinkers and/or drug addicts–it is not a good idea to shame them into breastfeeding.

            Also, we don’t even know if the cousin would have been successful with breastfeeding. A lot of women aren’t.

          • AlisonCummins

            It was actually VERY conscientious not to breastfeed. Kudos!

            If you’re selfish and you know it, make sure your children still have their needs met. That’s good parenting.

          • Guest

            She could have at least tried. If she went the whole pregnancy without drinking (none of the kids are FAS, so I assume she did, or got lucky), what’s a couple more months?

          • AlisonCummins

            There are lots of reasons to formula feed, most of them good. There are lots of reasons to promote breastfeeding and those are a mixed bag. (I’m not saying that women shouldn’t breastfeed: you don’t need lots of reasons to do something, you only need one.)

            What “only if medically necessary” means is that formula is available by prescription only. If your GP had had a baby during her residency, what would she have done? Gotten a fake prescription, dropped out of medicine or hired a wetnurse?

          • Young CC Prof

            And of course, who’s the arbiter of medically necessary? How about one bottle of formula every couple of days so Mom can get the occasional solid block of sleep, is that medically necessary? It might be!

          • Guest

            How about pumping if you can? I know not all women can, but that’s what I did.

          • LynnetteHafkenIBCLC

            Good for you…but maybe she doesn’t want to? Unless there is some kind of medical situation, one bottle of formula a day is not going to have any consequences for the baby.

          • Young CC Prof

            I’m actually exclusive pumping right now. It’s kind of awful, but it’s working for the moment. Again, works for some people, doesn’t work for everyone. And it’s important to keep formula readily available as a second choice, otherwise people start using various makeshifts which are not at all nutritionally appropriate.

          • AlisonCummins

            What does your GP mean by breastfeed exactly?

            For the first three weeks?

            Exclusively for eight months and then supplemented with water, juice and solids for another year?

          • AlisonCummins

            If you’re pregnant I would listen to your OB who is more likely to be up on the latest recommendations than your GP.

            I would much rather take advice from someone who attends hundreds of deliveries a year in collaboration with other experts than from someone who just reads about them or who only attends a few.

          • The Bofa on the Sofa

            What is your OB telling you that is different from what Dr Tuteur does?

            Her views are consistent with the mainstream perspective ot the ACOG. This isn’t Joe Mercola or Bob Sears here.

          • Guest

            If I wasn’t using a midwife, I wouldn’t see an OB until my third trimester unless I was high risk. My GP is qualified to attend me for prenatal appointments, but she doesn’t attend births. Another reason why I chose a midwife. Same care giver from start to finish and for 6 weeks after. Always available by phone, 24 hours a day. The way it should be. I can’t speak to OB care here in Canada except for what I’ve heard from other people. So I can’t speak to the availability or level of care provided. I do know I was less than impressed with the OB on call with my first child…

          • Guestll

            No, it is *not* the same caregiver in Canada, from start to finish. You have a primary RM and a secondary RM. You are also supposed to rotate through the practice at least once during antenatal care, with the objective of seeing most if not all of the clinic’s RMs. This is so that RM and Mom can become familiar in the event (and it happens way more often than you’d think) that your primary or secondary RM cannot deliver your baby.

            This is not markedly different from seeing an OB in practice with several other OBs. The notion that you are assigned one RM who becomes your BFF from start to finish and beyond is a myth.

          • Alexandra

            I’m from Canada, and this just isn’t true. With my eldest daughter, I saw my OB after the first ultrasound confirmed pregnancy (at the end of the first trimester) and then saw her for the rest of the pregnancy, with increasing frequency towards the end.

            For my second daughter, I started off using a midwife, and saw her at the end of the first trimester, and then cycled through four midwives for the rest of my time with that mode of care until I fired them and switched back to an OB in my third trimester. From then on, I saw only my OB for the rest of my care.

            Whether you choose a midwife or an OB/GYN, you get prenatal care throughout your pregnancy. The model of care does not change.

          • Carolyn the Red

            Same here (in Ontario). Now, if my chosen OB had not been able to see me by then, my GP would have done the first trimester screening, and the usual every four weeks checks until my appointment.

    • Monica

      Martina,
      These parents put everything out there and they are dangerous. Dangerous for glorifying what happened because everyone lived and is healthy now. Yes, bad stuff happens in hospitals too, mistakes are made in hospitals, but what happened to this woman was completely avoidable in the hospital because the time it took for them to get her to that life saving care she received IN THE HOSPITAL was delayed by being only 7 minutes from the hospital. No you need to understand it was more than 7 minutes from the time of the retained placenta until she was in a doctor’s care. Other people had to be pushed aside to deal with this emergent situation in the hospital emergency room when those resources would not have had to be used if she had been up in labor and delivery to begin with. This is irresponsibility is what it is. Hospitals and doctors are awful, but it was doctors and hospitals that were needed to save this woman and they are the ones who did. Not her black midwife, not her black midwifes assistant, and not her doula. They did what any one of us could have done, tried to slow the bleeding and called 911. Even the EMT’s did more by starting an IV which apparently Ruth was so against having, but ended up on. So don’t go telling us to stop blaming this couple and not judge while also making judgments yourself. This was not some beautiful perfect event, this woman almost died because of homebirth.

      • Martina

        You never judge that’s it! The woman who was supposed to be there to monitor her was not the ideal person to be there. Blame who allows these fake midwives,doulas etc. to assist women in labour. It is surely not homebirth itself being dangerous but these not trained figures .
        You say it was at the hospital doctors saved her ,ok,in fact you go to the doctor when you have a health issue don’t you?

        • Trixie

          They did lots of stuff wrong. They should have transfered her as soon as they noticed meconium.
          Yes, the fake midwives are part of the problem. But even a properly trained midwife (CNM) can’t handle every event that happens in a home birth in time to save every life. Home birth with a CNM is still about twice as risky as hospital birth.

          • Martina

            I disagree.i know the opposite: the outcome of home birth is much better than at hospital.Midwives i know have ages of happy home births. I never heard about catastrophes. Not every woman is eligible for home birth.Even if a woman is eligible for home births a good midwife will know when it is time to move on if things are not going well.
            If now she decided to have the baby at hospital and the same thing happened to her you wouldn’t be here saying giving birth at hospital is not good or that some doctors have been negligent,i am quite sure.
            My boss bled to death because the midwifery staff was too busy to check on her! Nobody says anything about this kind of negligence. Women in Europe are opting for home birth because of non caring of the medical staff of busy midwifery wards(i know something about it) and to have more peaceful labour.
            I would choose home birth if i could i can’t see any problem. Everyone can choose what they feel it is the best way to have their babies

          • Amazed

            Your boss bled to death? I thought she lost lots of blood?

            Same thing happened to my mother. She haemorraged a few hours after birth. An uncomplicated, unmedicated one. A big baby battering his way out – just the type of birth homebirth advocates sing praises to. If a cleaning woman hadn’t entered the room, my mother would have died.

            Do you know what made the difference? The fact that she was already in the hospital. Same with your boss. It really doesn’t matter why no one noticed the haemorrage starting because a woman can bleed to death after 10 minutes. If she’s discovered before losing too much blood, they save her at the hospital, just like your boss and my mum. If she’s discovered before losing too much blood at home, she dies because even 5 minutes of haemorraging followed by calling an ambulance and getting to the hospital mean those 10 minutes are over.

            At home, it takes a trip to the bathroom and making a glass of coffee to have your wife/mother/daughter/sister bleed to death before even being brought to the hospital.

            Not the same risk, especially with haemorrage.

          • Martina

            Ah so at hospital it doesn’t matter if they didn’t realized it…… Please invent some other stories !!! Women after delivery must be checked regularly. What made the difference is that the husband was there and saw the bed full of blood!

          • Amazed

            So had he seen the bed full of blood at home, he would have done what? Please tell us what woo magic you have in mind that would have stopped the bleeding?

          • Martina

            At home you are supposed to have someone competent monitoring you and checking on you. It is not possible to get things unnoticed when you have someone available all the time.

          • Amazed

            Did you read what I wrote? In the hardest of cases, postpartum haemorrage might lead to death in less than 10 minutes if not managed aggressively. It doesn’t matter who noticed it. What matters is the skills and MEANS for aggressive managements.

            Do midwives carry blood products?

            I am also quite curious what you mean by saying that I “invented” stories. What did I invent?

          • Martina

            The story you invent is the one that it doesn’t matter if the staff didn’t go to check my boss after birth. You said what made the difference was that she was at hospital….totally untrue!

          • Amazed

            Oh, so I said it didn’t matter? I said that they shouldn’t have checked her?

            I suppose I shouldn’t expect more understanding of someone who thinks the midwives she knows would totally tell her if they botch something and abhores the idea of a rate.

            I expect an answer, though: since she would have bled at home, too, and it was not a minor bleeding but a major one, what would have the husband and midwives done at home without the blood products she clearly needed? She would have died on her way to the hospital.

          • Martina

            Darling,she was not supposed to arrive at that point you know? I already wrote that when you have an alarming sign you just don’t keep a woman at home. Hospital is there when you have a problem. Do you undergo surgery or go to A&E if you are healthy? I don’t really understand why home births are not supervised by more than one professional but it is the doula and other unprovable people to manage labour and delivery.Why don’t you fight for this. It is unacceptable!

          • Amazed

            I clearly wrote that sometimes, the time between the first alarming sign and death is 10 minutes. One of the regular posters here experienced it firsthand. How does one survive that without aggressive management that midwives are not trained to do and have no means to do it?

            I wouldn’t fight for homebirths because even in countries where midwives are experienced and integrated into the healthcare system (aka Netherlands) ,low-risk babies tend to die more regularly under their care than high-risk babies whose mothers had OBs. I support the right of every woman to give birth at home if she’s fully informed of the risks but asking me to fight for something that places babies in elevated danger is too much.

          • Guest

            Hospital birth with a midwife for my first. After she was out and we were hanging out, I felt like I was bleeding a lot. My midwife was out of the room at the time, getting our paperwork in order I think, so I asked my husband to grab a nurse to see if it was a lot or just felt like a lot. She came into the room, asked if this was my first and when I said yes, she rolled her eyes at me and said, “You’re supposed to bleed”, then left the room without checking to see how much blood there was. I was shocked. I know you bleed after birth, but I wanted to know if it was a normal amount of blood. When my midwife came back, I asked her to check. She reassured me that I wasn’t hemorrhaging, but it felt like a lot of blood to me. Had I been hemorrhaging, I could be a statistic just because the nurse assumed I was a scared/stupid first time mom? Maybe she was busy? I’m not sure. Either way, it’s her job to check and make sure it’s normal and reassure me if it is.

          • Amazed

            Were you checked after giving birth? I mean, it’s bad enough to not address a patient’s concern but if she thought you hadn’t been assessed beforehand, it’s downright criminal. This “I know better so you’d better shut up” really isn’t the way to go but it’s never less the way to go than when the provider doesn’t really know because no one bothered to check.

          • Guest

            I was checked after birth and reminded that there would be bleeding (which I knew), but like I said, I just wanted to know if it was too much because it felt like a lot. I didn’t assume I was hemorrhaging, I just wanted to know for sure.
            Hasn’t turned me against hospitals because we did have a couple of great nurses that night, but I just loved my midwife and am using a midwife again with this baby. She always had time to explain whether it was normal or not.

          • Martina

            Exactly! Of nurses like that is full in here in England…..they are always annoyed by everything

          • Antigonos CNM

            Well, Martina, here is one Certified Nurse Midwife who HAS seen catastrophes and near-catastrophes. May I ask how many births you have attended in total? How many at home and how many in hospital?

            The fact is that EVERY woman who chooses to give birth at home KNOWS that there is a safety net in the form of hospital transfer. The assumption therefore is that homebirth is safe because someone will pick up the pieces if it all goes wrong–and that means that, despite assertions to the contrary [“homebirth is safe”] homebirth actually can be dangerous indeed.

            It’s not about beliefs, it’s about facts. And there are levels of seriousness regarding the consequences. You want to play Russian Roulette? One bullet in a gun that holds 6. Therefore your chances of shooting yourself in the head are “ONLY” 1 in 6, or 5 out of 6 times you will be OK. But you are very dead if you have bad luck and are the 1 in 6 who gets the bullet. It isn’t the same as, say, breaking a nail or even breaking a leg. Death has a way of being very final.

            What I read from this woman’s insane actions is that she doesn’t learn from her mistakes, and she will probably think she can do it again without any consequences. Her husband certainly thinks that nothing unusual happened. Both of them seem incapable of understanding what really happened. That’s sad.

          • fiftyfifty1

            “My boss bled to death because the midwifery staff was too busy to check on her!”

            “My boss delivered at hospital and she lost loads of blood without anyone realizing it.If it wasn’t for her husband visiting her at that moment she would be dead now!”

            My goodness Martina do women who hire you have bad luck with postpartum bleeds-one boss bled to death and the other nearly so! I suggest you seek out male employers in the future (or cross check you stories more carefully)!

        • Monica

          Yes, and guess what, pregnancy is a health issue. My body does not act at all like it does when I’m pregnant as it does when I’m not pregnant. So I go to a doctor for pregnancy because my body is not acting like it normally does.

      • Martina

        And then there are many emergencies because someone’s irresponsibility but when there is any emergency everyone else is pushed aside. No matter if it was an irresponsible person doctors MUST cure/save the patient without judging him/her. This is the abc of medical staff behavior!!!

        • Monica

          I’m aware of that Martina and that’s exactly my point. There are no props for the people who did their job and saved her life, it’s all about her midwife who did nothing but tell her to drink alcohol while in labor and catch a baby and maybe call 911. These people put this out there for the public and couldn’t expect it to not be criticized and judged. They are dangerous because they are not showing what really happened, what it really looked like when she lost all of that blood and the neighbors standing outside watching as the ambulance took them away. She’s blowing off the seriousness of what her condition was and is acting like she did it, anyone can. This is being glorified by ever homebirth advocate out there as a picture perfect birth and it was anything but. And it was far from being the true story of what happened. That’s the judgement, that’s the criticizing, that’s the points being made here. She is irresponsible for putting this out there is something to strive for. Just as irresponsible as the drunk driver who says I drove drunk and I’m fine. Irresponsible and judgment is well deserved! Because hopefully this will prevent another woman from trying it. At least we hope. Because the next woman might not be so lucky. The blood bank might be out of her blood type or the 7 minutes from the hospital might prove to be too far for her.

      • AlisonCummins

        Black? Where does that come into anything?

        • Medwife

          For some reason the author made a big deal about having a rare midwife of color attending her. Odd detail. However it may well have been doctors and nurses at the hospital saving her life who were black, too, of course. Perhaps Ruth did not understand that health care providers of many types can be black, white, Asian, Hispanic? This whole fiasco could have been avoided!

        • Monica

          I don’t know ask Ruth, it’s mentioned several times in her live tweets about her homebirth.

  • Dandee

    Who cares

  • Amy Tuteur, MD
    • Captain Obvious

      Apparently Ruth was a stripper and in AA. And she drank a whiskey sour while in labor. Is that one of the CAGE questions?

      “Ruth Fowler is a writer, former stripper, screenwriter, anarchist, and radical activist. She has written for the Village Voice, the Guardian, The Fix, and others. Her memoir, No Man’s Land, was published by Viking in 2008.”

      “I don’t judge my rich friends for not having to work if they are good, kind people making the most of their time on this earth in productive ways, or if they are good, kind people suffering in other ways. I judge them if they’re rich assholes.

      4. I am white, and therefore have white privilege. This has nothing to do with suffering from what I suffer from – which is severe reactive depression and self abuse, usually due to the stress and strain of being extremely poor and having no safety net in life. When I am working and able to pay my rent, I’m not depressed and I find it easier to stay sober.”

      • Trixie

        I wonder if you get a pass for being rich if you give her money to pay her hospital bill?

      • Trixie

        And here, she drinks more whiskey sours while pregnant. http://theworldbreakseveryone.com/the-unethical-pregnancy/

      • realityycheque

        In fairness, I don’t really understand what her history as a stripper has to do with anything?

        • Captain Obvious

          Oh, maybe the exhibititionism, trucker mouth, alcoholism.

    • Guest

      Here’s another “over sharing” post from that website:

      http://www.mommyish.com/2014/01/10/horrible-emergency-room-gynecologist/

      No pictures granted, but it’s everyone’s splitting hairs over this woman’s tweeting. There have been some fairly personal and graphic birth stories told on this blog, but no one seems to think it’s inappropriate. Is it the issue of the pictures? Or is it because she had a homebirth that required transfer to the hospital post-pardem, (obviously) proving the point of this blog? If she had tweeted/Facebooked her birth from the hospital, would that have been okay?

  • hurricanewarningdc

    Did she sanitize her photos? Of course she did. Birth is performance art – not this nonsense about health or safety! How dare you confuse the two or put this woman in that narrow, limiting box called “caring, concerned motherhood.” Birth is about the WOMAN not about some squirming prop, I mean, baby.

    • SD888

      She referred to her baby whilst pregnant as ‘The Beast’ and spoke openly about how she loved her nasty, biting, unhousetrained Chihuahua better. Sick woman.

  • attitude devant

    So here we have a man whose wife lost TWO-THIRDS of her blood volume at delivery, a low-risk delivery too, and he insists it was all just peachy and that Amy Tuteur is a fearmongerer. Wow. Way to not see what’s right in front of you.

    • almostfearless

      You know what though? In a year from now, when they finally process this and consider, maybe, for just a second, this wasn’t really safe, and that maybe, midwives with their lack of training, standards or accountability they are not as safe as those very midwives claimed… we will still be here. Hey Jared, a personal message: it took me two years. It takes others less time, some more. But don’t stop reading, looking and trying to understand what happened.

      • Maria

        Agreed. This just happened to their family. I do hope they have a chance to process it and seek out better information than they had before.

      • OBPI Mama

        Great words. It took me 3-1/2 years, almost fearless and Jared. It took a couple other homebirth trauma friends I know around that same time too. Humbling.

    • Wait so I already corrected you that it wasn’t even half her blood that was lost and you’re lying in a new post. Very ethical.

      • almostfearless

        You wrote Jared: “3 liters, roughly, 1500 weighed at the hospital and 1000-1500 at home.” and Attitude Devant here informed you, since you seem to think that’s not a lot, that 3 liters of blood is about 2/3 of her supply of 4.5 liters. You can google it. Even rounded up, 3 divided by 5 liters is .6 — she lost about two thirds.

        • That’s a not pregnant female. A full-term pregnant female averages 6-7 liters. You can Google it.

          • almostfearless

            Uh, google says 4-6 liters. Let’s say it’s 10 liters. Your wife lost 3. She had a blood transfusion. I am sorry that happened to her, but I don’t think you should be mad at the people here for pointing out that it’s not a good thing.

          • PrimaryCareDoc

            Google just gave me a range of 3.8 to 4.5L.

          • mtbakergirl

            We can all google! We are all experts!
            Now, who wants me to attend their homebirth?
            🙂

          • Trixie

            Reminds me of that one awful twin birth story in Australia where the midwife was googling how long it should take the second twin to deliver.

          • PrimaryCareDoc

            Right! And didn’t she come up with some answer of like, 2 weeks???

          • Trixie

            I feel like it was more than a month. Then she advised the couple to go have intercourse to bring on the baby while the first umbilical cord was still hanging out.

          • PrimaryCareDoc

            Here it is- http://www.homebirth.net.au/2011/01/twins-the-story-continues.html

            She told parents it was 47 days.

          • Trixie

            Man, that would make it confusing when it came to kindergarten cutoffs, wouldn’t it? What if one was born in August and the other in October?

          • mtbakergirl

            Apologies everyone for the joking above, this is really a horrifying topic, which I treat with the utmost seriousness 99% of the time. But I find a little black humor keeps me from going insane when I contemplate the complete lack of respect for life and health (not to mention the scientific process) that is so common in these stories.

          • areawomanpdx

            Ya, that “midwife” was Lisa Barrett.

          • Birthbuddy

            Ah yes Lisa, Lisa, Lisa, what a wonderful example she set for midwifery standards and homebirth safety. A true role model.

          • Bombshellrisa

            Only if you can knit! I don’t want some person holding the space and not knowing how to knit!

          • moto_librarian

            In other words, the actual OB is right, but we shouldn’t expect Mister “I did my research” to admit that he’s wrong.

          • Captain Obvious

            I bet his midwife told him that so that her blood loss didn’t sound that bad.

          • No, she called the EMT’s dummy, Can you read?

          • toni

            Do you understand that your wife was dying, Jared? People die from losing less blood than that. You almost lost her.

          • Box of Salt

            jarediorio “No, she called the EMT’s dummy, Can you read?”

            I can read. In your introductory post here your wrote: “I was actually taking all the pictures Amy, and I was concerned. I called the EMT’s as directed by our very professional midwife,”

            Now you say the midwife the midwife did it.

            Which is it?

            Finally, Jared: well wishes for your family. But I do hope that in the upcoming weeks and months you will come to understand just how lucky you all are.

          • A full-term pregnant female had 4 liters Doc?

            You sure?

          • PrimaryCareDoc

            No. I’m just saying what Google told me. You said to google it. 🙂 I’m not an OB. Haven’t dealt with that type of question in many years. Here’s the source: http://www.ncbi.nlm.nih.gov/pubmed/4075604

          • PrimaryCareDoc

            Oh, here’s one that says 5L.

            http://www.brooksidepress.org/Products/OBGYN_Morning_Rounds/Afternoon_Lectures/Obstetrical_Hemorrhage.htm

            Interestingly, the only things I find that say 6 L are midwifery sites. And one ridiculous midwifery site that says 10L!

          • PrimaryCareDoc

            And here’s a great calculator: http://www.manuelsweb.com/blood_loss.htm

          • theadequatemother

            Adults generally have 70 ml per kg of blood. That increases about 30% by term in pregnant women. Hence the range that is reported.

          • Birthbuddy

            You are suddenly an expert Jared?

          • Birthbuddy

            That bloody Dr Google, he just won’t be specific.

          • Captain Obvious

            Ok, Jared. You convinced me. You sold me. I was wrong. She may not have lost 2/3 of her blood. It was just f—ing 3 liters. I haven’t had a pregnant woman lose 3 liters in 21 years of practice.

          • attitude devant

            Jared is correct that I forgot to include the gestational expansion in blood volume in my calculations. But his argument basically boils down to: “You dummy, my wife was only half-dead, not two-thirds dead.” It is, one would think, a distinction without a difference.

      • Susan

        Really? Your hanging your hat on ONLY losing 3 liters? Getting blood is very rare in the hospital. We can almost always prevent the disaster from happening. This discussion reminds me of the McGlade midwife case in Florida where the mom did die and the dingbats on Mothering were saying that since she got to the hospital alive it was the hospitals fault. This was after the midwives were giving an unconcious woman gatorade enemas at home….
        (point being that hospitals are expected to be able to fix almost any homebirth trainwreck)

      • Captain Obvious

        She was transfused.

  • sarahh.rosanne@gmail.com

    Despite being personally appalled (although before knowledge and experience I was enthralled) by the idea of giving birth outside of a hospital in a country where there is access to sanitary medical facilities capable of providing emergency surgery, complex life support, blood transfusion etc.if things go awry, I support a woman’s right to attempt childbirth at home. However, I don’t fully understand the logic of the repeated statements pertaining to this story (and every other such horror story) that ” birth is usually safe and uncomplicated.” Complications in childbirth are very common at any risk level. If you were to apply the rate at which women experience postpartum hemorrhage to winning the lottery, I would be buying a ticket for every drawing because I would think those were excellent odds. It seems to a very perception of the math to say “it almost never happens”. It happens all the time. It happened to me. I don’t think it would be a statistically acceptable risk for most women if they had accurate information.
    OT, I went for my 6 week postpartum appt. this morning. After my son was born the attending suggested scheduled c-section if I planned to have more children, but today the CNM recommended that I “plan” a third vaginal birth with the certainty of rotational forceps being needed for the baby to descend (this would mean a third such delivery and all that entails- assuming that it was successful). Her thinking is that this would be preferable in terms of risk to a c-section … and I am very confused. What I was told was a necessity (c-section) is being framed as “riskier” and a “personal choice”. Am I under a mistaken impression that c-section is medically preferable,or is she a birth-nut- or some grey area in between? My first internal (and always sarcastic) thought was to ask “Because who needs avagina AND a****le, right? Seems superfluous!” but I am wondering if there is validity to what she says.

    • moto_librarian

      I think she is infected with woo. Forceps cause a lot of pelvic floor damage, and not all of us want “the body of a mother.” I would find someone else if you have a third.

    • PrimaryCareDoc

      I’d schedule a section in a NY minute.

    • attitude devant

      I do pelvic floor repairs. The consequences of this type of injury are miserable. Stop adding further injury to your pelvic floor. Get that c/s.

      • Siri

        This sounds like good advice, from someone with long experience in this field.

    • Medwife

      That sounds crazy to me. She thinks it’s a great idea to add a third forceps delivery? Yeah I wouldn’t see that CNM again.

      • fiftyfifty1

        Yeah, in my opinion planning for a rotational forceps delivery only makes sense if there is some contraindication to C-section. The one that comes to mind is a woman who expresses a desire to have a *very* large family. Doesn’t sound like the case at all with the poster.

    • Susan

      There may be some hospital/doctor that still does forceps rotations but my understanding is that those types of forceps deliveries are no longer recommended. I am not myself one of the anti forceps people… I think they have their place and have seen them used well. But that’s outlet forceps. Classes I have been to say that forceps rotations should be a thing of the past. I’d go with what the OB advised myself.

      • sarahh.rosanne@gmail.com

        `Thankyou to everyone who responded. I gave birth in a university hospital where forceps use is still routinely taught. Both of my children were delivered by faculty using Kielland’s forceps. My understanding is also that it is not usually recommended or even available and when we made the decision to allow it both times it was in the last moments of labor,faced with emergency c-section and general anesthesia. My babies came through fantastically but the recoveries have been barbaric.If we choose to have another child, I would like an easier birth, if at all possible. My feeling at this time is that I don’t think I can physically tolerate another pregnancy much less the birth. Then in the back of my mind, I would like a third child.

        • Elizabeth A

          My understanding is that the ease of recovery (from easiest to hardest) is:
          – Uncomplicated vaginal delivery
          – Uncomplicated c-section
          Other options here in the middle (maybe someone who knows more then me can comment on the relative ranking of instrumental vaginal deliveries vs. c-section with complications) and down at the bottom:
          – Dysfunctional labor followed by emergent c/s.

          There’s unfortunately no way to guarantee an uncomplicated vaginal delivery. There’s more you can do to increase the odds of uncomplicated c/s (like schedule it for pre-labor), but it’s still far from perfect.

          You’re only six weeks post-partum. You do not have to make decisions about more babies or not right now. And if you do make them, you can change your mind.

        • fiftyfifty1

          This is the question I would ask yourself: If I choose another forceps birth, who will be doing the forceps, the OB or the CNM? The answer of course is the OB. So the OB is the one who has done it before and who would actually have to do it again and s/he is telling you not to do it again. I would value that opinion very highly myself…..

    • antigone23

      It sounds like birth woo to me. I’m not an expert, but an instrumental vaginal delivery seems riskier for both the mother and the baby than a c-section. Which is why most doctors no longer do them. Personally my first birth involved extensive tearing and pelvic floor damage, and my second was an elective c-section. I will take the c-section any day of the year. I wish I could go back in time and have an elective c-section with my first as well because my pelvic floor is just never going to be the same.

    • Siri

      Anecdotally, I have seen women skipping ecstatically down the post-natal ward after a Kiellands rotational forceps, shouting how unbelievably much easier this recovery was than recovering from their c/s last time. (There were 2 em c/s needed simultaneously, and while the obstetric registrar took one to theatre, one of the consultants (rarely seen on the ward, ever) came in and did his magic on the 2nd one. Made me wonder why consultants don’t do more teaching, esp of skills that are vanishing).

      Anecdotally, I have seen women opt for el c/s after two vaginal deliveries, both with bad tearing. Some are glad they chose it (still painful, but more controllable), some regret it (just as painful or worse, for much longer).

      For many women, of course, planning an el c/s is very comforting and enables them to enjoy their pregnancy free from fear, anxiety or uncertainty. And there is always the possibility that their labour will start and go like the clappers, meaning the baby is out and the point is moot!

      I agree it’s early days to talk about your potential next pregnancy while your last one is so fresh i your min

      • Siri

        Mind (sorry). And I’d be wary of anyone who seems determined to persuade you to do one thing or another – your case IS highly unusual, very few women need forceps more than once in their lives, and only you can do the kind of risk/benefit analysis that’s needed here. Give yourself plenty of time, seek out information from professionals, friends and family, and remember there isn’t always ‘right’ answer; sometimes we just have to take the plunge and hope for the best.

        Good luck! And use us here as much as you like.

    • batmom

      Anecdotal, of course, but my forceps delivery was eight months ago and I have had to work my butt off (uh, literally) to rehab my pelvic floor. It’s still not all the way back but I can go running now. My sister had a C-section, and six weeks later she’s talking excitedly about getting back to exercising. I wouldn’t make any decisions now, were I you, but at least in our pair of cases, the C-section recovery was easier.

  • attitude devant

    Good Lord Jared, what are you complaining about? Your wife shared her birth for all to see and people are DISCUSSING it!!! What the heck did you THINK would happen, that we would all politely look away and discuss the weather?

    • almostfearless

      Yet, how disappointed she would have been if no one noticed her tweets. Not a single person. Sad. Apparently the expectation was “Praise me or else!”

      • Actually we only had a couple hundred followers each, mostly friends and family, people we know. That was our original audience, thanks for extending it though.

        • almostfearless

          To 2,000 followers? I can buy that for you on fiverr for $5. Don’t flatter yourself to think this is building your brand, exposure or your wife’s blog about living in a van and your rocky marriage.

        • Monica

          Twitter is not private and don’t act like you didn’t know that. You were tweeting with hash tags, you wanted the world to see, the world has seen after an article in huff post. Your baby is what 2 or 3 weeks old? You think Dr. Amy sat on this for all this time waiting for huff post to write an article about it? Dr. Amy didn’t extend this, you did. Your wife did. She is the one busy taking interviews with news sources instead of caring for and enjoying her new baby. But go ahead, blame Dr. Amy for this getting out to so many people. She’s used to it. But guess what? She’s right. These were carefully vetted pictures meant to show homebirth as a beautiful thing even when something goes wrong. You did not show the moments of pure panic and what your wife looked like when she was very very sick. This was a carefully chosen ad to promote homebirth as a safe and beautiful thing and what happened in her homebirth was anything but safe or beautiful.

      • emkay

        She’s now asking repeatedly on twitter for a book deal… LOL…

        • almostfearless

          Yeah because literary agents love to hire writers who have no book proposal and have polarized a large population of potential readers.

      • Captain Obvious

        Apparently, if you don’t praise her articles that she had wrote, you will get some backlash from her as well.

        http://gawker.com/5955447/ruth-is-heartless-but-the-world-breaks-everyone

    • Where did i complain about the discussion? Right, nowhere.

      I complained about the nonsensical fear-mongering from the Doctor here.

      • almostfearless

        In other words, Dr. Amy failed to praise you. You don’t mind discussion as long as it’s positive. “Fear-mongering” you say… you really expect us to believe this is you, out to save the world from Dr.Amy? Weird that it happens to be the day she talks about your child’s birth. This is 100% about you, defending your choices and shutting down discussion that doesn’t directly praise you and your wife for having a home birth and sharing it with the internet.

        • There is nothing to praise. It just is. Millions of women do it all the time. But conjuring images of a full hand vaginal violation as a reason not have a home birth is disingenuous in the extreme.

          • attitude devant

            As disingenuous as splashing your private event all over social media but leaving the bloody parts out?

          • BeatlesFan

            As is conjuring images of women being forced to have pain meds which result in drugged-up babies as a reason not to have a hospital birth.

          • Birthbuddy

            “full hand vaginal violation”? That sounds strangely similar to ” birth rape” . Clearly not effected by NCB rhetoric at all.

          • KarenJJ

            Most of us that have had vaginal exams have never called it a violation. Why do you think so differently about getting exams?

          • Mishimoo

            I wouldn’t call my CNM manually helping to reduce a cervical lip and helping my son’s head down from where it was hung-up in my pelvis to be a ‘full hand vaginal violation’, but then, I don’t define my worth by my genitalia.

          • Birthbuddy

            Millions of women, really?

          • Captain Obvious

            A medical procedure to stop hemorrhaging because of a retained placenta is labelled by you as a full hand vaginal violation? Yet Ruth readily proclaims over the Internet that she is a former stripper and went to AA? My priorities are so messed up.

          • Karen in SC

            What would he label a colonscopy or sigmoidoscopy? or a heart surgery? All medical procedures necessitating a gloved experienced hand inside a body.

      • Captain Obvious

        Your wife’s birth gave me fear of her almost not surviving.

        • attitude devant

          Captain, it is soooooo uncommon to give transfusions on the OB floor. When I think how low your hct has to be or how unstable your vital signs have to be for us to transfuse, I surmise that Ruth must have lost more than one half of her blood volume.

          • 3 liters, roughly, 1500 weighed at the hospital and 1000-1500 at home.

          • attitude devant

            Bingo! Average blood volume in an adult female is around 4.5 liters. So she lost TWO-THIRDS of her blood volume and it was no big deal to you. Holy crap. And you think this is better than c-section. What. A. Fool.

          • Except BINGO, pregnant woman have more blood than that!

            You’re so bright, you.

            Doc estimated nearly half her blood at 3 liters.

          • attitude devant

            So you know she lost half her blood volume and you think that’s fine. My assessment of your intelligence stands.

          • And you work in medicine and have no idea of the blood volume of the average full-term pregnant female. My assessment of your bullshit stands.

          • Karen in SC

            And you have no idea about the effects of an epidural on the baby.

          • mtbakergirl

            I cannot imagine my husband describing any situation in which I lost 1/2 my blood volume as “low risk”.

          • The pregnancy was low risk, not the blood loss.

          • mtbakergirl

            Too bad you decided to have a home birth, not a home pregnancy.

          • attitude devant

            Don’t you get it, Jared? That’s exactly why homebirth is not safe! Low-risk is fine, but birth can turn on a dime! Have you ever seen the fetal heart rate look great and then suddenly tank and stay low? Have you ever seen a healthy woman suddenly suffer from almost complete cardiovascular collapse from an amniotic fluid embolus and require 100 units of blood? Have you ever seen a healthy woman sudden suffer a complete abruption? I have! These things happen, and they are happen without warning!

          • We were willing to take that slight risk instead of risking a drugged up baby and unnecessary major abdominal surgery. We were one of the few home births with major complications afterwards. and the birth team did their job perfectly and all is well. So inherently unpredictable, yes. Dangerous, not so much.

          • mtbakergirl

            To paraphrase my earlier comment, I cannot imagine a situation in which my husband would describe me losing 1/2 my blood volume as “unpredictable, not dangerous”.

          • Mishimoo

            To be honest, if my husband did that and stuck to it despite being given information to the contrary, I’d probably leave him. If he didn’t care about me nearly bleeding to death, then he probably doesn’t care about a lot of other things.

          • PrimaryCareDoc

            Drugged up baby from what? Meds from an epidural don’t pass on to the baby at all. Whereas the whiskey sour that is drunk during labor…not so much.

          • That’s not exactky accurate Doc.

            Oh, and please tell me that you’re saying that a single whiskey sour hurt the baby in any way.

            Thought not.

          • PrimaryCareDoc

            Nah, it’s pretty much exactly accurate. And I doubt the whiskey sour hurt, although I can’t tell you for sure, since there is no good research about it. Unlike the research available regarding the safety of epidurals.

          • Except I already stated she didn’t want an epidural, which would have meant IV drugs which would have meant IV drugs, and drugged up baby. But keep arguing for something you think I meant.

          • PrimaryCareDoc

            OK. But why would she have had meds at all? If she wanted a natural birth in the hospital, she certainly could have had one. No one forces pain meds on people.

          • BeatlesFan

            You realize she could decline an epidural, right? Contrary to popular NCB rhetoric, OBs don’t tie laboring women to beds on their backs and shove epidurals and IVs into them while cackling evilly and counting their money.

          • moto_librarian

            Do you think that people just roam around L&D clamping women down and forcing them to have epidurals? You are nuts. I cannot believe that UCLA doesn’t pull out all of the stops to aid women desiring “natural” births. It is a tertiary care center. Hell, even in the South I was able to have an unmedicated birth with CNMs in the hospital. No one pressured me to have pain meds, and they took me through all of the plays to achieve a natural birth (different positions for pushing, allowed to drink fluids, no I.V., intermittent EFM, etc,). Was your wife just afraid she would cave and ask for drugs if the pain was too bad? If so, that sucks. Why does it have to be a fucking contest?

          • Susan

            UCLA is an awesome hospital and I bet the staff is thouroughly enjoying this blog. Nice save guys!

          • Trixie

            It’s easy to avoid epidurals in the hospital. You just say no and then they leave you alone unless you ask for it. I did it. It was fine. Also an epidural means you need an IV for fluids, not that they give you drugs in the IV.

          • Young CC Prof

            An epidural is drugs placed specifically in the space next to the spine, with very little winding up in the bloodstream. IV is drugs placed directly into the bloodstream. Either way, women are free to say no. Women deliver drug-free in hospitals every day of the year.

          • emkay

            She is BRAGGING about how much bloody fentanyl she got! she’s giving it to the baby in her breastmilk… avoiding a drugged up kid there alright… congrats

          • Birthbuddy

            IV drugs are not the only alternative to (evil) epidurals
            Jared.

          • Why is it one or the other? I had neither an epidural nor booze for my two hospital births. I have seen many women do the same. No one can force a mother to have an epidural. It’s a choice and a lovely one for those seeking pain relief.

            She didn’t want a “drugged up baby” but she wanted a drunk one? The blood alcohol level of a baby in the womb is higher than the drinking mother who is carrying him or her, and it stays in the baby’s system longer.

          • BeatlesFan

            So an epidural which won’t touch the baby = bad.
            Alcohol, which does reach the baby = good.

            Gotcha.

          • Maria

            Drugged up babies only happen with IV pain meds, not with epidurals (the meds from the epidural pass through the placenta in insignificant amounts) and as has been said before, there is a very good chance that your wife would not have needed a c-section. But this is all hindsight and you can’t know how things will turn out before hand. Labor and birth are different for every woman and each labor a birth that a woman experiences can be very different than the last. The common denominator is that labor and birth are unpredictable and can go from normal to high risk in the blink of an eye. Some may see that as risky/dangerous, but others may not. I see it as a risk I am not willing to take with my own health and well being and that of my baby.

          • BeatlesFan

            Well, you avoided the drugged up baby, almost at the cost of your wife’s life. I sincerely hope you think it was worth it.

          • Captain Obvious

            Whiskey sours. Blood transfusion contamination risk. Fentanyl risks. Cost for ambulance, hospital, transfusions. Did your midwife give you a refund? She didn’t finish the delivery.

          • Susan

            Jared, do you know how strongly we caution pregnant women not to drink? Drugged up baby and she’s drinking in labor? A long time ago alchohol was used to treat preterm labor. Sometimes the benefits of a drug outweigh the risks. But we KNOW alcohol is one of the drugs that is proven to be bad for the fetus now and we don’t give it. So it’s just crazy to be saying you risked not being where they can treat life threatening complications to avoid a drugged up baby… ( no one forces drugs in the hospital it’s always your choice… always ) and then tweet photos of your wife drinking in labor. Can’t you see that? DId they get social services to see you in the hospital? Drinking in pregnancy…not cool.

          • LynnetteHafkenIBCLC

            So what I’m wondering is…would you do this again with the next child? Knowing that your low-risk wife came this close to death? Why are you fine with letting a hospital throw massive interventions at her to save her life, but completely against letting them prevent the catastrophe in the first place?

          • me

            She could have had an unmedicated delivery, vaginal even, in the hospital. Lots of women do. I did twice. And no PPH, separation from my baby, or fentanyl either.

            Than again, I’m not a drama queen, nor am I a narcissist, and felt no need to tweet/facebook/podcast my L&D for the world to see. It was enough to have my husband there with me. I get the impression that your wife is reveling in her complicated delivery. She’s certainly getting a lot more attention than if it were truly straightforward (yawn).

          • Sullivan ThePoop

            No, Jared, you are not one of the few home births with major complications. You are one of the many.

            Also, your wife could have had a much less medicalized birth if she had been at the hospital in the first place.

          • theNormalDistribution

            What you don’t seem to understand is that “low risk” is a relative term. It was a low risk pregnancy, compared to high risk pregancy, not compared to having a slice of cake. All pregancies are risky. One would assume you might have realized this when your wife was almost exsanguinated. Apparently not.

          • Captain Obvious

            The pregnancy starts at conception and ends 6 weeks post partum. Ruth had a high risk pregnancy/delivery. There is an increased recurrence risk next pregnancy.

          • Susan

            Jared I think it’s just dumb. I agree with your OB that average is 6 liters at term… but I bet when her doc was saying half her blood loss she wasn’t saying that as a comforting fact. Losing half your blood is a positive?

          • theNormalDistribution

            You do understand that losing as little as half your blood can kill you, right?

          • wookie130

            Right. So no big deal.

            *snort*

            Do you HATE your wife? You honestly believe that this level of blood loss was part of the “beauty” of your son’s birth?

          • 8 idiots upvote a demonstrably wrong “fact”. Great site here, gotta go now.

          • Siri

            Today’s Special Offer: 100% Egyptian cotton kingsize fitted sheet with BIG FLOUNCE!! Paypal or credit card only.

      • moto_librarian

        I guess a little humility is asking too much. Many of the commenters on here have had normal births go very badly. Those of us delivering in the hospital had the problems resolved much more quickly because we didn’t have to transfer. The fact that your son passed mec should have been reason enough for a transfer; what would have happened had he and your wife both been in trouble? Have you given any thought to that? Having a blood transfusion does happen with hospital births, but not as often because things can be managed better. I myself did not need blood (barely) after a cervical laceration and pph that would have killed me at home. I also had a “textbook” natural birth up until that point. Stories like yours only prove the inherent lack of safety associated with homebirth.

        • Mine went a bit awry too, and my wife is till recovering, so I expect a bit of decorum but found none. Ah, well —

          Nothing bad ever happens in hospital.

          http://abcnews.go.com/Health/funeral-held-baby-allegedly-killed-forceps-delivery/story?id=21426453

          • attitude devant

            You expect decorum??!?!?! Your wife used the F word every other tweet and even the C word and flashed her genitals and her son’s genitals to the entire world and you expect decorum. That’s hilarious.

          • OMG genitals. Jesus, a bit prude no? The birth of my son was beautiful, nothing disgusting about it.

          • attitude devant

            I’m not the one complaining about the lack of decorum, dear.

          • Susan

            We who work in OB are fairly blind to genitals … and even cursing in the heat of the moment. But in 25 years of nursing I have never seen a woman in labor use the C word. If you have it together enough to tweet your labor you are making a decision to subject other people to your foul language. That choice illustrates her values and character.

          • Or it illustrates her upbringing in the UK where I’m sure every single OB in the country would assure is not an uncommon expression there.

          • Susan

            Not sure I buy that I have some prone to foul words UK friends but the C word I still have never heard from them. I know there are some big differences in though in what’s a swear word (.. the F bomb though is pretty much the same)

          • Comrade X

            The C-word IS much more common in the UK than in America – it is considered very rude by a lot of people, but it definitely lacks the misogynistic bite that I believe it still holds in the US. It is certainly not a word that is only spat at women. Although I do have a problem with the idea that parts of the female anatomy are used as insults and curses (but then, I suppose, so are words for male genitalia…) it does have a harsh, guttural, anglo-saxon sound to it that makes it onomatopoeically attractive as an expression of frustration or disgust. Neither male nor female genitalia are in fact disgusting or dirty, though, so I do still feel some residual guilt from a sex-positive and feminist perspective.

          • Siri

            No, even in the UK your wife’s chosen mode of expression comes across as foul-mouthed and unnecessarily rude; it’s very off-putting.

          • Trixie

            I gotta say, criticizing them based on their language choices is not particularly relevant. Who cares? There’s plenty to criticize regardless of whether she uses a swear word people don’t like.

          • Susan

            I really take offense to the C word… it’s ugly. And I read through her sweets and the swearing was gratuitous. But point taken.

          • Trixie

            Meh, it’s still just a word. Who cares. If a pregnant woman came in screaming the C word because it helped her get through the pain, would you treat her differently?

          • Susan

            No of course not. But, I could imagine politely asking a mom who wasn’t in a lot of pain but was just swearing a lot if she could limit it. I have a colleague who did that once. On the other hand, that’s exactly the sort of person most likely to get prickly so I probably wouldn’t. I associate that word with sexual violence and abusive men. I’ve heard a few women use it but they were not exactly nice people. On the other hand I agree with you that it really isn’t her character more just manners and courtesy. Mine weren’t so hot either with what I said so I am glad you said something.

          • Trixie

            I’m sympathetic to that word being triggering. I don’t use it myself. But, I think it is one of those things where language changes over time and that one might be gradually losing some of its bite.

          • wookie130

            Yes, yes, and YES. Thank you.

          • Monica

            And I’m sure your son will love when he is googled years from now all of the pictures of his mom giving birth to him. Why does no one ever think of what the child might want in the future? You want to see pictures of your mother giving birth to you? You want your genitals as a baby flashed all over the internet? This isn’t about being a prude, this is about doing our due diligence to think about what is in our child’s best interest. But you’re a new parent, I know you have all the answers and you know just how your son is going to feel about this 13 years from now. Please do come back in 13 years and tell us how he feels about his exhibitionist mother and her near death experience in his birth. But just so you know, what your wife had was not a perfect birth and what was shared was not everything that happened in the birth or immediately following. Just because you all lucked out and everything was fine doesn’t mean homebirth is ideal. And lets not forget that your wife would not be here today without the quick work of those hospital workers that you seem to think are so terrible because bad things happen in hospitals too. Where was the thanks to all of them? Nope, instead all we heard about was how your black midwife and assistant and doula were heroes. Thanks for letting us know the color of your midwife’s skin by the way, I know that’s very important information when it comes to a birth attendant.

          • I surely hope I never raise a kid who gives a fuck what pictures exist on the internet.

          • What an ignorant and disingenuous comment! This generation of children is growing up more tech savvy than ever. It’s a huge part of kids lives, and with major universities putting all their coursework online, it will only increase in importance. But your kid will not give a fuck.

            How will he “research”?

          • He won’t care what idiots say about his baby pictures. He’ll only listen to people who care about him, and show that, not deranged internet bullies.

          • Box of Salt

            jarediorio, “He’ll only listen to people who care about him”

            I hope for your son’s sake you’re right. You may be. After all, bullying is a big deal in the schools these days, and a lot of behavior that many kids had to put up with is no longer tolerated.

            Best of luck as you proceed through parenthood.

          • Susan

            Jared heads up, you can predict who your teenager will listen much less well than you can predict birth.

          • theNormalDistribution

            Right. Because children are never affected by the opinions of their peers.

          • Monica

            Oh look everyone, he can predict the future as well. Jared, even the best of parents can rarely make a teenager not feel insecure about things. Seriously, come back in 13 years, we’ll talk then. Because clearly right now you have all the answers on teenagers in all your weeks of parenting. You know it all. So I get it I’m just a seasoned mother of 4 ranging in age from preschool to teen so I know nothing. Clearly I must defer to your expertise in parenting teens.

          • wookie130

            Just how much control do you think you’re going to have over your son’s feelings? Would he be WRONG to feel humiliated, and shamed by the potential bullying that you may be setting him up for? Or perhaps could he be having a natural reaction to people making fun of him, and torturing him for the stupid choices of his attention-seeking parents?

          • Captain Obvious

            Your son will grow up and behave like you have, right. An adult who only cares about people who cares about you. Because you have been on this site for the last 24 hours not caring about what idiots are saying about Ruth on the Internet.

          • BeatlesFan

            Ooh, I want to play!

            My children are both going to be wonderful, beautiful people. My son will be a doctor and my daughter will be a lawyer. Neither of them will do drugs or drink or stay out past curfew.

          • Monica

            Talk to me in 13 years. I assure you that your kid is going to give a f**k about every little thing. But yup, you’re the expert. This was your first child? Well, that doesn’t even matter, when you have a teenager, then we’ll talk sweetie. Until then I assure you, you know absolutely NOTHING.

          • Teenagers are often known to give a fuck about the wrong things Monica.

          • Box of Salt

            jarediorio “Teenagers are often known to give a fuck about the wrong things”,

            You just shot your own argument in the foot.

          • Monica

            Exactly, but that’s the point. And he’s going to give a f**k about it because his friends are going to be teasing him about it. But hey what’s a little razzing from the guys, right? It’s all good and it’s not like kids are shooting up schools over less or anything here.

          • Birthbuddy

            You do like the old F word, don’t you.

          • LovleAnjel

            So being upset when junior high bullies find the picture of his teeny weeny baby peeny and post zoomed in versions of it everywhere to humiliate him? And constantly bring it up, hounding him at every chance about having a small dick, is giving a fuck about the wrong thing? Good to know.

            I think you have suppressed your memories of junior high school.

          • Trixie

            It makes it so easy to invite your 13 year old friends over, when they’ve just googled your mom’s pubes.

          • Captain Obvious

            Mom who used to be a stripper.

            “Ruth Fowler is a writer, former stripper, screenwriter, anarchist, and radical activist. She has written for the Village Voice, the Guardian, The Fix, and others. Her memoir, No Man’s Land, was published by Viking in 2008.”

          • wookie130

            I assure you…his seeing the gory details of his own birth on the web will not be the “wrong thing”, Jared.

          • GiddyUpGo123

            Oh my god seriously? Have you ever met any kids? Do you honestly think a 13 year old kid is going to just be able to shrug off all the cruel things his peers say to him when they see all those pictures of him all over the internet? You’re really just going to tell him to buck it up and deal with it, because it’s something you and your wife had to do in the interests of, you know, whatever it was in the interests of, and his future reputation and self esteem was just a necessary casualty in that worthy cause? You do know that children are very easy to hurt and cannot be expected to handle attacks from their peers with the same maturity as an adult, regardless of whether or not you as a parent think they ought to “give a fuck” or not.

          • Squillo

            Actually, I think having had his infant genitals on display will be the least of his problems, given that his parents started using him as a publicity stunt the day he was born.

            At least Balloon Boy’s parents waited until he was six.

          • well ok then

            Your wife almost bleeding to death live on twitter was “beautiful”?

            Do you not like her or something?

          • wookie130

            But the “F” and “C” words? Is this the language of people who just welcomed a new child into the world? And attitude devant is right…for you to expect decorum is ridiculous. Which part of your son’s birth was “beautiful”? The PPH? Or the retained placenta? Or all of that fentanyl? Seems fairly disgusting to me, seeing as all of that horror was highly avoidable in a medical setting with competent medical staff.

          • moto_librarian

            Oh, so you’re going to complain about tone?! How about answering my questions instead? What would have happened if both mother and child were in trouble? It happens. When my second was born, the NICU team was on hand because my son had passed light mec, and he got in trouble very fast while crowning. He needed some help, but because it was on hand, he was in my arms within 20 minutes. During my first awful delivery, my older son ended up in the NiCU for TTTN. There were lots of people around to take care of all of us. That is NOT the case during a homebirth. Acting like this was a “good” example of a homebirth only encourages other people to take stupid risks. I am not going to laud you for that.

          • BeatlesFan

            Nobody here said, nor to my knowledge has EVER said, that “nothing bad ever happens in the hospital”. Nobody. What IS said here, frequently, is that complications are managed much more quickly, thoroughly, and professionally in the hospital when bad things DO happen.

          • mtbakergirl

            To that I would add- when bad things happen, there are avenues for accountability and recourse.

          • BeatlesFan

            Yes, I was going to include that as well, but as Jared strikes me as the type who wouldn’t blame the midwife even if she sat on her ass knitting while his wife bled to death, I didn’t see the point.

          • Birthbuddy

            Also, bad things happen in hospital at a rate 3-10 lower than in homebirth.

          • Box of Salt

            jarediorio “Nothing bad ever happens in hospital.”

            That family in your link is publicly calling for a ban of forceps to prevent a similar tragedy happening again.

            You and your wife, on the other hand, are publicly claiming your wife had a successful low risk home delivery in spite of the fact she ended up admitted to the hospital for two days for massive blood loss, encouraging others to make the same risky choice you did.

          • Birthbuddy

            No Jared, it just happens more often at homebirth. One by one the delusions unravel.

          • Amy M

            I had a PPH in a hospital…but I didn’t need a transfusion because I was already in the hospital, so I got care literally in minutes and the staff prevented me from losing so much blood that I needed to be transfused. Why did I have a PPH? Because I had a long labor with twins….(which were vaginally delivered, no forced Csections here.) Hemorrhages happen….it is one of the most common complications of delivery in fact, so best to be where help can be had asap, is all we are saying.

    • Captain Obvious

      The whether or not Jared and Ruth should have tweeted her train wreck near death experience delivery.
      I performed a manual extraction of a retained placenta in the delivery room the other day. One dose of mefoxin, some uterotonics, and no transfusion. Baby stayed with the momma and left in one day. Yeah for hospitals.

      • attitude devant

        I attended a completely unhindered labor today. When mom had a brief period of uterine atony after delivery of the placenta, we used the saline lock we had in place to give her some uterotonics. Yay, indeed!

  • OBGYNRN

    from large doses of fentanyl?

    The portrait of Ruth on “large doses” (100ml I believe, which is actually a mild dose) of Fentanyl with Nye is in most of the online stories, she bonded just fine with him.

    I find it pretty ridiculous that you think death is just minutes away during birth in every single birth. Most births are uncomplicated, and perfectly safe to have

    ********************
    You are confusing ‘amount’ and ‘dosage’. ML vs MG or in this case with Fentanyl, MCG is more appropriate. Unless you do want to kill the patient.
    As for ‘death is just minutes away’. Have you ever gone swimming? Think about it. Everything is just great, peachy ken… UNTIL, something happens then death literally may be minutes away.

    • Bethany Barry

      I hesitate to reply to a comment that makes such limited sense, but since you made it easy–Swimming is a risky activity, which is why you should only jump in the lake if you are an experienced swimmer, in the presence of other experienced swimmers, and a life guard is on duty. You should’t swim in an unattended pool by yourself, unless you are an expert swimmer (and even then you are taking a risk). Non-aquatic mammals frolicking in water is inherently dangerous, so all reasonable precautions should be taken. I find it more relaxing to know that I am swimming in the presence of a well trained lifeguard. Just as I found it easier to have a “positive birth experience” in the presence of a trained medical practitioner.

      • So a midwife with a couple thousand births under her belt and 2 OBGYN’s throughout isn’t enough? We weren’t alone in the woods leaving it to chance. Stop the hyperbole, you sound idiotic.

        • theNormalDistribution

          What now? There were two OBGYNs at the homebirth? Why doesn’t it mention that in the article?

          • No two OBGYNS providing care throughout. Sorry, typing fast.

            No I just mispoke. 600-700 sounds right for her.

          • PrimaryCareDoc

            And do you really think that’s more than most OBs?

          • No, but plenty experienced for us. If we were high risk I’d have an OBGYN in a second.

          • PrimaryCareDoc

            See, but you’re proving our point here! First of all, her experience is equal to that of a 3rd year OB/GYN resident (who would not be allowed to attend a birth without supervision). Second, your wife was, as you say, low risk. However, she almost bled to death. Birth is a bitch. It doesn’t care how low-risk you are.

          • Trixie

            The difference, I imagine, is that the OB/GYN resident has actual training in the relevant science, and would probably be a bit scared to contemplate delivering a woman on her own because that OB resident would know the risks.

          • Amy Tuteur, MD

            You seem to be missing the point, Jared. Your wife was low risk but she experienced a life threatening complication ANYWAY. That’s because childbirth is inherently dangerous.

            By the way, here’s a story of another homebirth baby that the folks at Santa Monica hospital tried to save. Unfortunately, they couldn’t save him because “close to the hospital” isn’t close enough.

            http://hurtbyhomebirth.blogspot.com/2011/03/wrens-story-on-1st-anniversary-of-his.html

          • Birthbuddy

            It was only 7 minutes away, don’t you know…

          • Mom2Many

            Notice how your wife was low risk going into labour, but with the benefit of hindsight, she was obviously high risk?
            As in, should you get a do-over, knowing that she would have all of the complications she had, would you really choose homebirth?

          • The Bofa on the Sofa

            Why did you even have “a couple thousand” in your head?

          • theNormalDistribution

            I was being facetious. It doesn’t matter how may OBGYNs you had “providing care throughout”, they’re no good to you during labour if they’re not actually at the birth.

          • Bethany Barry

            He says elsewhere that they saw 2 OBGYNs throughout for, I presume, prenatal care, which is odd. Why two? And why didn’t you trust them to attend your child’s birth?

          • They don’t do house calls. One misinformed us of the odds our child had Down’s leaving a message that it was a 1 in 40 chance when the paperwork said 1/140 which is entirely different.

            The other was our backup, but we decided on the closer hospital with the blood loss.

          • Birthbuddy

            Why didn’t you just use Dr Google?

          • Birthbuddy

            That would be a fully medicated homebirth. It’s just not the same.

        • PrimaryCareDoc

          Even your midwife’s own webpage says she has attended only 600 births. And if you think that’s more than most OB/GYNs, you’re mistaken. Most OBs see that many in residency.

          • The Bofa on the Sofa

            Hey Jared, so where did you get the idea that she had “a couple thousand births under her belt”? Did she tell you that?

        • Captain Obvious

          Couple thousand? Wow!

        • Bethany Barry

          Every day in the US, about ten people die of unintentional drowning. 2 children under 14 years of age drown everyday. I think promoting swim safety is very important, because each year hundreds of mothers lose their children to accidental drowning. I am active in promoting “waterproofing” your children, and using safe practices in pool ownership. I care that being flippant about water safety costs people their lives. Being flippant about the risks of childbirth has also costs people their lives.

          • Mishimoo

            One of our doctors is ferocious about water safety, and asks every parent if/when they’re going to start swimming lessons. As he says, an autopsy on toddler that wandered into a dam was one too many for him. and unfortuntely, it didn’t stop there. (Ex-bush coroner)

        • Monica

          Oh wait now you had 2 OBGYN’s at your homebirth? Well that appears to be news that was conveniently left out. Or do you mean the 2 OBs were at the hospital which your wife transferred to and then saved her life that she conveniently forgot to mention how wonderful they were and thank? Using the swimming metaphor above, I can go swimming at a lake with my family and no lifeguard watching over us and be just fine, but that doesn’t make it safe or even as safe as swimming at a lake that has trained life guards. You got lucky, bottom line. Your wife almost died and she is very coy about it and overly focused on everything but her child. But then again birth isn’t about the baby, it’s about the experience, right?

    • Thanks for the distinction. The OBGYN in hospital said it was a mild dose. True or not?

      Yeah, and plane can fall out of the sky at any second, but they usually don’t.

      • attitude devant

        Funny, your wife said it was “a TON of fentanyl” (caps hers). And 100mcg is not a mild dose. It’s twice what we usually give for labor pain (when requested).

        • So when you give that, do you usually have problems with maternal bonding? Genuinely curious. Actual scientific literature preferred.

          • attitude devant

            That’s what people who eschew pain relief in labor (like your wife) claim. Myself, I prescribe the stuff so obviously I don’t agree. Come on, Jared! Don’t you see the internal contradiction in your family story? It is rather bizarre to have this whole natcherl labor thing going on and then say narcotics are A-OK after.

          • No, I think she didn’t want to have a needle in her back mostly. and she wanted mobility. Both being issues with epidurals.

          • PrimaryCareDoc

            You know it’s not a needle, right? It’s a catheter. Big, big difference. Also, most epis allow mobility.

          • So it’s a big needle. Great.

          • attitude devant

            You don’t know the difference between a needle and a catheter. Ok, then

          • Anj Fabian

            …the straight line about the needles he’s used to still stands there, lonely…

          • PrimaryCareDoc

            No. Not a needle at all. A catheter. A flexible piece of plastic. Jeez.

          • Yeah, I get it Doc, but thicker than needles I’m used to. It’s called humor, idiot.

          • PrimaryCareDoc

            That was humor?

          • Flexible or hard, it goes inside your back, no? No real difference to the lay person.

          • PrimaryCareDoc

            Yes, it goes in your back. But it’s a big difference. Something hard in your back (or in a vein, for that matter) would incredibly painful. You can’t even feel a flexible catheter.

          • obgynrn

            Actually…. there is a large bore, specially shaped ‘needle’ used to gain access to the intended space and then introduce the catheter… So I can understand the confusion.

          • Medwife

            Also the local numbing injection. That’s a small gauge needle though

          • Susan

            Is this a Breaking Bad reference?

          • Susan

            Oh gosh this reminds me of when we used Prostiglandin Gel and the doc asked for the large bore catheter he used to apply it. The Scottish nurse I loved working with said ” where does he keep his wee stiff thing”

          • Trixie

            So you just don’t get the epidural. It’s easy. I had a labor and delivery without pain relief because my prior epidural sort of freaked me out. There’s no one in the hospital who makes you get an epidural you don’t want. Although, if I’d had to have the tearing she had, and the manual extraction of the placenta, I sure as shit would have wished in retrospect that I got over my squeamishness and had the epidural.

          • Birthbuddy

            Mobile epidurals are available.

          • well ok then

            If you were genuinely interested in the scientific literature regarding pregnancy/birth/bonding/infant health, you wouldn’t have chosen a home birth. Nice try.

      • theNormalDistribution

        If the odds of planes falling out of the sky were as high as the odds of death during homebirth, I doubt you’d be doing any flying.

      • Susan

        Jared– 100mcg in a mom who had lost a lot of blood and is as thin as your wife I’d start with 50 and if she tolerated it ok then maybe the other 50. But it isn’t an unusual dose where I work… but I would have been cautious with it.
        ( Airline travel is not statistically anwhere NEAR the risk of perinatal death or damage at homebirth)

  • ismael

    I followed ruth fowler iorio’s birth story, i thought it was riveting and interesting. It seems the narcicissm is coming from people commenting on the story. Failed writers, haters,phantom do-gooders. Everyone has an opinion on ruth’s uterus and vagina. Maybe it/she should have suffered more, then we’d be truly able to say. “you met the criteria, you passed”
    But that will never be enough for the haters.
    People criticize her writing for being to “narcissictic” and now it seems to be the same for her home birth.
    It’s becoming quite obvious in 2014, this is the year of the “professional hater.
    Such as real or imagined doctors calling for more blood.

    IF this were a story about a dog and her litter, people wouldnt be crying foul, they want to know if she was ok.

    • Amy Tuteur, MD

      How could anyone comment on the story unless the narcissist posted her pictures live for the world to see?

      • ismael

        Prince william and katherine allowed pics of their child (not childbirth), knowing it would be carried and distributed to a million different outlets.
        according to you , that’ is narcicissm to the Nth degree?
        Where is the outrage? how dare they post pics of that tiny child? Look at all the money they have, are they using that poor kid for an ego trip?
        They get a pass.. The good doctor finds no fault with them.
        Haters pick and choose the “easy” targets

          • mark james

            …and out come the failed writers,

          • The Bofa on the Sofa

            What does you or your wife being a writer have to do with anything?

          • Amy Tuteur, MD

            ismael/jan/mark james: Stick to one screen name instead of trying to make it look like someone agrees with you.

          • Burgundy

            And you don’t know how to use a punctuation correctly.

          • Captain Obvious

            Sticks and stones, er, bad punctuation, won’t kill me, but a retained placenta hemorrhaging at home can

          • I didn’t even write anything. What a fantastic burn. *snort*

          • Siri

            Oh Kumquat, you must be devastated! Critique from mark james (his parents couldn’t afford capital letters) is critique indeed. Here, have a tissue. ♤passes tissue♡

        • jan

          skeptical ob or just “old bitter Ob”?

          • Birthbuddy

            Ooh, the trolls have all had coffee and come out to play.

        • Captain Obvious

          William and Katherine didn’t have a near death experience and post that everything was fine. They didn’t post naked pictures. They did thank everyone who helped with their delivery.

        • Houston Mom

          The baby is a future king. They shared the picture because their fellow citizens and a lot of the world at large were interested well-wishers. Mrs.Iorio posted the pictures to promote homebirth and midwifery.

        • Meerkat

          Prince William and Catherine are public figures, royalty. They were displaying the heir to the throne, as it has been done for decades. Before photos and public media the birth of an heir to the trone was announced by firing of the guns and in the newspapers. Before that, hundreds of years ago, it was done by town criers.
          Back then, a birth or a death of a future monarch was more than page six news. It was important because it meant possible political stability or upheaval, fight for the crown, and wars.

          • Kat

            I’m glad someone correctly spelled poor Duchess Kate’s name correctly. I don’t know why we care about a comment about the royal baby which doesn’t care enough to spell his mother’s name correctly.

          • wookie130

            Meerkat, exactly. Now Ruth and Jared’s photos are being compared to the action of royalty? Oh dear Lord.

        • Birthbuddy

          Prince william and katherine allowed pics of their child (not childbirth), knowing it would be carried and distributed to a million different outlets.
          I didn’t see Kates vagina anywhere.

    • Amy Tuteur, MD

      Who could possibly think this woman is a narcissist, exploiting her baby to promote herself?

      • Mishimoo

        #ThingsIDidNotNeedToSee.
        Is it just ours, or do other people’s babies wee everywhere as soon as the nappy comes off? I wouldn’t be game to feed without something underneath bub.

        • wookie130

          I thought the same thing upon seeing this! I am far too house-proud to not have a diaper on the baby, or at least a nice absorbent towel underneath. Good gracious.

        • Medwife

          My newborn pooped every time I nursed him for quite a while. Big, yellow breast milk poops! Yes, the diaper stayed on in my house.

        • Houston Mom

          I did that once to let my son air out. Pee fountain. Didn’t do it again. Kid never peed on my husband. I got it all the time.

  • I can answer these:

    Where is the photo of the postpartum hemorrhage with the blood pouring from between your legs?

    Where is the photo of you deathly pale and slipping in and out of consciousness as you head toward hemorrhagic shock?

    Where is the photo of your husband’s face, horrified and frightened, as it dawns on him that you may bleed to death and leave him as a widower with a new baby?

    I was actually taking all the pictures Amy, and I was concerned. I called the EMT’s as directed by our very professional midwife, who treated her as one would at a hospital, with drugs to make her uterus contract and release the placenta. Imagine that. She was cool and calm, and very doctor-like if you will, without the gruff bedside manner and fear fear fear rhetoric you are evidencing here.

    Where is the photo of the EMTs hustling you out the door, racing against time to save your life?

    I have photos of this, on my camera, which I haven’t downloaded yet, but it’s implied by any rational being with the hospital transfer that it would be by ambulance, so I think readers/followers got the picture.

    Where is the photo of you in the emergency room, with doctors and nurses struggling to start large bore IVs before you bleed to death?

    No one struggled with large bore IV’s, except the EMTS, who couldn’t get a vein. US being 7 minutes away from the hospital and all it wasn’t a big deal.

    Where is the photo of the obstetrician with his gloved arm in your vagina up to his elbow peeling off the remains of the placenta from your uterine wall, averting your certain death?

    Thankfully it never came to that, though it was close. Just a little more traction applied to the cord and the placenta was freed without needing to go to the OR at the about the hour-and-a-half mark. Why don’t you tell people that if she was in hospital, these are the same things that would have happened. That placenta wasn’t just going to come out because we were in hospital silly. Either the gloved hand or traction would have had to happen anyway, right? Okay, then, fear-mongering again.

    Where is the photo of you, not bonding with your newborn, but totally out of it from large doses of fentanyl?

    The portrait of Ruth on “large doses” (100ml I believe, which is actually a mild dose) of Fentanyl with Nye is in most of the online stories, she bonded just fine with him.

    I find it pretty ridiculous that you think death is just minutes away during birth in every single birth. Most births are uncomplicated, and perfectly safe to have at home. As ours was. The birth was fine, the afterbirth wasn’t. She didn’t put at risk our son any more than allowing him to cross the street by himself (looking both ways of course) in a few years would be.

    Why is the infant mortality rate so atrocious here? Why does almost every other industrialized country (with better birth outcomes to boot) trust midwives explicitly except when there are complications (which is exactly what we did!)

    • Burgundy

      You didn’t answer the questions. Why didn’t you or your wife include those pictures in the post? Are you going to say that you have time to upload all the “pretty” pictures but just happened that the ugly one are left behind?

      • The Bofa on the Sofa

        Yeah, “I haven’t gotten around to downloading the EMT pictures” doesn’t answer the question, it merely begs it.

      • I did, the photos you see were taken with a phone. I mostly used my camera.

    • Young CC Prof

      First, I want to say that I’m sorry your family went through such a traumatic experience, and I’m relieved that your wife and child survived. Still, you seem a bit misinformed about certain matters:

      “Why is the infant mortality rate so atrocious here? Why does almost every other industrialized country (with better birth outcomes to boot) trust midwives explicitly except when there are complications”

      Infant mortality is the wrong measure, for two reasons. One is that infant mortality includes all infant deaths up to age 1, and many of those have nothing to do with obstetric care. The other is that the USA actually counts newborn deaths more accurately. In other countries, a poor baby who’s born severely premature or with hopeless birth defects and draws only a few breaths before dying counts as a stillbirth, here it counts as an infant death.

      The correct measure is the perinatal mortality rate, that is, 3rd trimester stillbirths and newborn deaths added together. The USA does quite well on this, behind Sweden and Norway, but ahead of Britain, Ireland, and the Netherlands.

      And if your wife had given birth in the hospital, it might still have been traumatic, but she probably wouldn’t have needed a transfusion. I’m not asking you to take my word for any of this, just look at some sources outside of the midwifery community.

      • Granted, but I disagree. how about neonatal mortality, behind Slovenia, Switzerland, Spain, Sweden, Uk, Serbia, Slovak republic, Qatar, Portugal, Poland, and on and on and on.

        What does stillbirths in the third trimester have to do with home birth? As I said we had a midwife, a doula, 2 OBGYN’s and a medical family.

        Funny, both Sweden and Norway practice midwifery care model for low-risk pregnancies. Explain that one?

        • Burgundy

          All your questions/come back/answers/reply had been addressed in this blog before. Given you are a new dad, first time visiting this blog and have a little free time, why don’t you search the topic in this blog, read them then argue later.

        • fiftyfifty1

          “What does stillbirths in the third trimester have to do with home birth?”

          Measuring stillbirths is important because many stillbirths can be prevented by good obstetric care. In particular homebirth midwives have a terrible track record with stillbirths that happen while the mom is in labor. But they also have a bad track record with pre-labor stillbirths due to poor monitoring for conditions like pre-eclampsia and failing placenta.

          • But we had OBGYN’s as well as midwifery care.

          • moto_librarian

            And how did your OBs feel abut this little plan? They don’t usually work with CPMs, preferring to collaborate with real midwives (I.e. CNMs).

          • He was very supportive.

          • moto_librarian

            But he didn’t want to attend it, now did he? Ever wonder why that might be?

          • Captain Obvious

            Oh stop it, you didn’t have any OB/GYN at your delivery.

          • fiftyfifty1

            So you mitigated the risk somewhat of pre-labor stillbirth. The amount you mitigated that risk depends on how often you were seeing the OBs and how closely you were following their recs as opposed to the recs of your midwife. But you didn’t mitigate the biggest risk of all which is the actual birth. Statistically the riskiest day of a person’s life is the day that person is born. The second riskiest is the day a woman gives birth to her first child. Your wife very nearly became a real-time public example of that. But I’m glad she didn’t. My youngest sibling very narrowly averted death at her midwife attended homebirth (as a baby) after a picture perfect low risk pregnancy and labor. I’m very glad they were able to save your wife too.

        • Susan

          I don’t believe you are right about the neonatal mortality I have looked at those stats. I think you probably mean infant mortality…. which is up to 12 months and is a reflection of pediatric care too and is very affected by a myriad of factors.
          Stillbirths have everything to do with OB care. We can’t prevent them all but we can a lot with good obstetrical care. The ones we prevent the best are the very ones that haooen the most at home and almost never in the hospital because of monitoring… intrapartum stillbirths. The rates are coming out in Oregon because there are so many homebirths and it is studied and they are shockingly high.
          Your midwife wouldn’t have the education to be called a midwife in Sweden or Norway.

          • Amy Tuteur, MD
          • KarenJJ

            Did you read the death rate in the link you just posted? The death rate for the US is less then Slovenia and Portugal. It is the opposite of what you asserted above. Is this how you try to prove points? By stating something as a fact and then linking to random things and hope we don’t check it out ourselves?

            It is possible however that you looked at the wrong metric in your haste and instead left it on the Teenage Fertility metric? At any rate, your link doesn’t prove what you just said. The US has a lower death rate then both Slovenia and Portugal.

            It would also be interesting to know what the C-section rate is in Portugal and Slovenia.

          • Birthbuddy

            One by one, the illusions unravel.

        • Birthbuddy

          Quite simply, in this day and age a normal term baby should not die during labour (stillbirth). It is unacceptably high during homebirth. It is virtually zero in hospital birth.

        • Young CC Prof

          You need to look at stillbirths plus neonatal deaths for two reasons. One, as others said, stillbirths are sometimes preventable. My baby was at risk of stillbirth or intrapartum (during birth) stillbirth, my “evil” obstetrician intervened with a c-section at 37 weeks, producing a totally healthy baby.

          The second reason is that, like I said, some tragedies that would count as a neonatal death in the USA are counted as stillbirths in other countries. Carefully compare both numbers at once across the first world, and you’ll see what I mean.

          The reasons Sweden and Norway have us beat are mostly about poverty and inequality. They have very low poverty rates and provide excellent medical care to everyone. We have high poverty rates, and a huge number of our bad outcomes occur among the poor or uninsured women.

    • almostfearless

      “I have photos of this, on my camera, which I haven’t downloaded yet, but it’s implied by any rational being with the hospital transfer that it would be by ambulance, so I think readers/followers got the picture.”

      I have a camera and when you download your photos, all the pictures download. Why would some of your photos from that point (the EMT transfer) be on your camera, but photos from afterwards be downloaded and then uploaded online?

      • Because all of the photos you see in the article are taken with a phone. Haven’t downloaded them because i’m busy hanging out my kid.

        • almostfearless

          I understand that. So I guess you’ll upload them later?

          • I plan on it, yes.

          • almostfearless

            Great, so you’ll let us know when those missing pictures are online and update the huffington post press coverage you received so that people have the full picture then? Your wife will tweet them too? Where should we look to find those missing photos?

          • almostfearless

            Maybe… since you know… you have time to be here… writing comments… you could just plug in your camera and download them now. I bet it won’t take long.

          • Arguing with you is more fun. I need a break and not ready to cull through those just yet. Been all birth all the time over here.

          • Susan

            Jared… love to see you come back you actually are a bit more intellectually honest than the typical natural birth proponent that comes here to educate us. Seriously though, go enjoy your baby they are only brand new once and wherever they are born they are precious miracles. I hope you read Hurt by Homebirth and google McGlade and homebirth … you’ll see how lucky you really are.

        • almostfearless

          Enough time for this pic…

        • Birthbuddy

          Freudian slip?

    • OBPI Mama

      I am glad your wife and son are okay. Unfortunately, it’s just impossible to know that your birth will be the one to go perfectly and be safe at home. I thought mine would be… my first son was a homebirth, a severe shoulder dystocia, an almost dead baby, but instead he ended up with a lifelong birth injury once he was brought back to us. I’m thankful he is alive, but I am saddened he lost the chance of being a typical kid. As for me, I am fortunate to have not needed as much medical attention as your wife. It did take 3 years to feel healed, physically, from extensive tearing and the tailbone has never healed. I wish your wife better healing.

      I do believe a shoulder dystocia increases the risk of PPH. Your son’s birth was complicated because of that s/d and I hope your wife is very thankful that your son’s shoulder dystocia was resolved quickly and didn’t cause him injury.

      Count your blessings. Best of luck on this parenting journey! And please read up on shoulder dystocia if you and your wife decide to have another baby (there is more of a risk with subsequent babies).

      • Thanks, and you’re right, there is no way to tell. Our midwife has delivered more babies than most OBGYN’s and has dealt with shoulder dystocia numerous numerous times. We made an informed decision to trust her experience as being equivalent to OBGYN’s in instances of minor complications (not to us, or to you, very sorry about your son, I imagine I would feel the same way).

        Despite what Doc Amy here says, we weren’t unprepared for complications in the slightest, saw OBGYN’s throughout the pregnancy, had a backup hospital (7 minutes away) etc… Oh, and ruth’s Dad is a doctor, mom’s a nurse, and they were good with our choice as well.

        • Amy Tuteur, MD

          Jared, you are living in a dreamworld. Your “midwife” hasn’t delivered more babies than most OB-GYN’s, not even close.

          In fact, she isn’t a real midwife. She is a lay person with a credential that was made up by other laypeople who wanted to be midwives but didn’t want to get the education and training necessary. The CPM credential is not recognized by ANY other first world country because CPMs lack the education and training of midwives in ALL other industrialized countries.

          You didn’t make an informed decision since you are clearly still woefully uninformed.

          Homebirth kills. Even MANA (the Midwives Alliance of North America) knows homebirth kills. That’s why they won’t release their own death rates. Do you know that? If not, you weren’t informed, were you?

        • Susan

          Most OBs have done as many deliveries as your midwife by the time they are allowed to call themselves OBs. And in any other first world country your midwife would not be allowed to call herself a midwife.

        • Birthbuddy

          Backup hospital 7 minutes away. Sorry that one is too easy.

        • Happy Sheep

          A shoulder dystocia isn’t a minor complication, it is a serious complication that can and does lead to disability and death, and as stated already can lead to serious morbidity for mom, including life threatening PPH.
          If you knew anything about OBs and math, you would know it is impossible for your midwife to have seen more births than anyone other than a new resident in their first week. Only if you midwife was a CNM with hospital priviledges work this be possible.
          Your parents, relatives and you were seriously misled by your midwife and by the homebirth movement and I am sorry for that. It is blatantly obvious that your midwives lied to you and are continuing to lie. You were lucky that the complications Ruth had were resolved, please search this Site for the story of a women who had a stuck baby they couldn’t get out, who had to ride to the hospital with her child hanging between her legs. That nightmare could have easily been you. Even in the hospital, sometimes a baby is so stuck they have to do a c section, which clearly can’t be done at home.
          Again, I am happy that you’re son and wife are doing well, but please stop insisting it was all no big deal and minor complications. Luck and the proximity of a fantastic medical team are the only things that protected you from tragedy. Where is Ruth’s thank you to them??

    • Maria

      I am very happy that your wife and son are doing well. No one would wish this experience on anyone, regardless of their opinion of choices that person made leading up to the birth. Having said that, I feel I need to gently challenge one of the statements you made.

      “Most births are safe and uncomplicated, and perfectly safe to have at home.” It is true that most births are safe and uncomplicated, but the implication that your story makes is that having the same birth in a hospital would involve a lot of fending off pushy doctors and nurses who would try to force you and your wife to accept pain meds or other “interventions” that you had decided ahead of time would not be necessary. I wish you could accept that an unmedicated, peaceful birth is just as attainable in a hospital as it is at home. OBs and L&D nurses are not the enemy of the midwifery model of care. It is the incompetent and undertrained CPMs and lay midwives (that other industrialized countries don’t allow to practice) who are the reason why this blog even exists. Your midwife was a professional, but some are not and there are enough stories out there to illustrate that point. If your goal is to bring more attention and support to the midwifery model of care as it exists in other industrialized nations, you should be taking this time to study how the lack of proper education and regulation of midwives in the USA is the biggest problem within the system.

      • I agree… usually. But in our specific case, Nye starting off Occidental Posterior before turning, an epidural and c-section would have been pushed for in most hospital settings. And the pain of back labor due to posterior would make being stuck in a hospital bed with an IV pretty unbearable. She needed to move a lot.

        Our doctors and nurses were unbelievably good at UCLA, and whaddaya know — with none of the judgement and nastiness of Doc Amy here either, which was great!

        • The Bofa on the Sofa

          Our doctors and nurses were unbelievably good at UCLA,

          Interesting. So why did your wife go out of her way to praise the midwife, her assistant, and the friggin doula, and not these “unbelievably good” doctors and nurses who saved her life?

          Was that more of her bullshit “political statement”?

          • Burgundy

            Because those unbelievably good doctors and nurses don’t serve any purpose for her story.

          • She’s actually done just that, and plans to write more about it as well. She’s not anti-hospital at all.

            She also has no control over what other journalists decide is the story they want to write.

            Hospitals are very good at what they do. Dealing with serious issues and emergencies. Not so good at keeping uncomplicated pregnancies uncomplicated unfortunately.

          • Box of Salt

            Jared “She’s actually done just that, and plans to write more about it as well.”

            Sorry. She blew it already, because the public thanks should have been done immediately, along with the praise for her out-of-hospital attendants — not as an afterthought, especially after others have criticized her for leaving iit out.

          • Monica

            Good God man, several people on here have told you I experienced similar things in my birth in the hospital and I didn’t have to have anything I didn’t want or be tied to a bed, but you are still saying hospitals ruin uncomplicated pregnancies. Oh you man are something else and wow, are you sure you love your wife? I don’t know sounds like you were pretty okay with her suffering. It’s too soon for you to know I guess just how many problems your wife is going to have because of all of these complications,but maybe down the road one of you will wake up to see this probably wasn’t the ideal birth experience.

          • Mariana Baca

            Except that is not true, especially in this case. Lack of active management of the third stage made your wife’s labor complicated when it didn’t need to be. At the hospital, it would have been a routine birth. By your own admission the hospital would have been better at keeping this uncomplicated delivery uncomplicated, while the homebirth caused a small problem to escalate to a stay in the ICU.

        • Amy Tuteur, MD

          How do you know what would have happened in a hospital, Jared? Have you been to medical school? Have you delivered babies? Have you analyzed the scientific literature on childbirth? No, no, and no, right?

          Let me guess: you “know” what would have happened in the hospital because that’s what other homebirth advocates told you, and you believed it instead of asking for for proof.

          • You’re still not answering Amy. Why don’t you tell me what would have happened with a retained placenta in a hospital setting. Please. My ObGYN told me and my midwife told me that the same techniques would have been used.

            Simple question. Correct or incorrect?

            If correct, what does this have to do with the “dangers of homebirth”? Nothing, that’s what. It’s just fearmongering and illogical appeals to authority figures instead of actual facts.

          • Amy Tuteur, MD

            Incorrect. The placenta could have been removed immediately, avoiding the near death experience and the transfusions necessary to save your wife’s life as well as the two day hospital stay to recover from the near death experience.

          • You’re still not answering Amy. HOW would it have been removed?

            With a gloved hand, no? Surely you’re not saying that the gloved hand of the 6 foot 3 Italian OBGYN would have been “better” than the transfusion ( which was a safety precaution and borderline unnecessary as her blood levels weren’t terrible considering the loss she sustained).

            So these images you paint of the gloved hand inserted into the vagina with scraping, etc — would have happened anyway, yet you disingenuously use it to demonstrate the dangers of home birth…

          • Bethany Barry

            I had my placenta manually removed by a nice Jewish doctor (you have a problem with tall Italian OBs) with a gloved hand. It took about a minute, it hurt a lot but I could take it, and when it was over I was fine and dandy and nursing my son. I took an ibuprofin. And ate a turkey sandwich.

          • Karen in SC

            The SAME thing happened on one of my births, even down to the Jewish doctor. Missed out on the sandwich though.

          • Bethany Barry

            The sandwich was the second best part (the baby was the best part). The nurse even went and got me extra mayo.

          • KarenJJ

            The turkey sandwich part really makes that story.

          • auntbea

            Italian? What does that have to do with anything?

          • Birthbuddy

            Birth rape, birth rape birth rape, just call it what it is Jared. (Sarcasm) One by one ….unravelling.

          • PrimaryCareDoc

            You really consider a transfusion after a 3L blood loss as boderline unnecessary? FYI- blood levels in the setting of acute hemorrhage are useless. They mean nothing, as it takes time for the Hct to equilibrate after a massive loss. Anyone with any medical training knows that. That’s why her levels “weren’t terrible.”

            Perhaps a nice case of Sheehan’s Syndrome would have been better. You can Google it. 🙂

          • Medwife

            Not necessarily. The standard of care in the hospital is to give pitocin immediately after the baby is out and to deliver the placenta with gentle cord traction as soon as you see signs of placental detachment. This is known as “active management of the third stage” and it significantly decreases the rate of PPH and decreases blood loss in women who don’t hemorrhage. I don’t know the exact time sequence of events at your son’s birth, but very few home birth midwives do it. They hold the space and watch and wait until the placenta comes out and/or blood starts to pour out. That can be up to and beyond an hour after the baby is born.

        • Maria

          Hey, I know back labor. It hurts like you wouldn’t ever be able to understand. But, if your wife didn’t want an epidural, should would not have gotten one. She could have had a saline lock in place, but no IV if not needed. Therefore, she could have moved around. As for the c-section, who knows if they would have decided it was medically indicated or if they would have given it a bit more time, but I can guarantee you would have received a very clear explanation as to why they were recommending it and what the risks/benefits were. You would have been able to make a very educated decision.

          • We know the whys and whens and are educated already. So, surely you know that epidurals actually increase the likelihood of the necessity of a c-section.

          • Amy Tuteur, MD

            No, they don’t. The scientific evidence shows otherwise.

            And what’s so bad about a C-section anyway? Do you actually think that a shoulder dystocia, major perineal tear, retained placenta, blood transfusions, etc., etc. are better than a C-section?

          • Why yes, we do. But that’s besides the point as most low-risk pregnancies will not result in the things we experienced.

          • The Bofa on the Sofa

            You are a moron. Seriously, if you think that a blood transfusion is really better than a c-section, then it is that simple.

          • BeatlesFan

            Would you still be saying that if she’d died? If your son died? If your wife needed an emergency hysterectomy and couldn’t have more children? Would you still be comforted by knowing she avoided a c-section? If your answer is yes, I have to ask: WHAT is it about c-sections that are so evil? I can get not wanting one, but why do you feel like it’s the worst possible scenario?

          • Captain Obvious

            So Ruth was just the unlucky one, so naive.

          • OBPI Mama

            I can’t believe you said that… shoulder dystocias are killers. I almost lost my son to one. Instead he can’t move his arm right, has therapies, and surgeries and shoulder and back deformities… I tore to kingdom come and sex was painful for 3 whole years because of it. I can’t sit through a church service without wincing in pain from my tailbone that broke when my midwife reached her hands in me to pull my son out. … SO I have to strongly disagree that a shoulder dystocia is better than a c-section. I’ve had 3 c-sections since that horrible birth… Scar tissue pain after my 2nd c/s was a walk in the park compared to that vaginal birth (and I was blessed enough to have it removed during my 3rd c-section and haven’t had pain since)!
            I think you might find your perspective and views may change over the years… it took me 3-1/2 years to come to terms with what really happened and the poor choices I made.

          • fiftyfifty1

            epidurals don’t increase c-sections. A great summary of the studies surrounding this can be found on a great blog called The Adequate Mother.

          • attitude devant

            QED. If you’re going to cite a twenty-year-old article in a fast-moving field, you really do know nothing about reading research critically.

          • Captain Obvious

            1993. Wow

          • Birthbuddy

            BINGO!

          • fiftyfifty1

            Did you notice the date on the top of that study? Why quote a study from a generation ago and ignore the mountain of studies that show the opposite? I’m asking you that seriously, not rhetorically: why have you latched on to that one old study and not the many newer and larger studies? Is it that you are unfamiliar with the literature and have only seen this one study (likely handed to you by a NCB zealot)? Or is it that you prefer the methodology of this study to others (in which case tell us why and we will all have a great scientific debate about it–there are a number of OBs and anethesiologists and statisticians who post here)? Or is it that this study is the one study you can pretend somehow justifies your wife’s rash decision to birth where she did? You know, the decision that almost cost her her life?

          • Maria

            Per fiftyfifty1 below, here is the link.

            http://theadequatemother.wordpress.com/epidurals/

            You clearly don’t have the time right now (new baby and all), but when you get the time please read this with as open a mind as say you have. You say your wife is not anti-hospital, yet you still assert that you cannot have an uncomplicated birth there. Anecdotes are not proof, but I had an uncomplicated birth in a hospital, as did my sister (both of hers), as did most of my friends. Some of us had epidurals, some didn’t, but none of us had “complications”. But maybe you feel getting pain relief is a complication. I think it is a treatment that is available to those who want it.

          • C T

            So don’t get one if you’re worried about the risks, but you don’t have to stay home to avoid one. It’s actually quite easy to give birth in the hospital without an epidural these days. Why start at home and have a messy, dangerous transfer when you can do the whole thing at the hospital?

          • BeatlesFan

            NO THEY DON’T.

            Does anyone have Bingo yet?

          • Trixie

            The reason why there’s a correlation here is that longer, more painful labors also tend to be the ones where things happen that necessitate a c-section. My first labor, the baby was OP, and his head was tucked under so he was presenting at the back of his head almost near his neck (is there a term for that?). My water brooke before active labor started. I had horrible back labor and searing pain. After 20 hours we decided on a c-section, having only dilated to 3 cm. I needed the epidural by about 10 hours in. The pain was unimaginable.

            My second labor, the baby was perfectly positioned, labor progressed quickly, and while it still hurt, a lot, I didn’t need the epidural. It was still within my ability to tolerate, plus I never got so exhausted.

            The epidural didn’t cause my c-section. The baby’s position caused both the pain that necessitated the epidural, and the eventual c-section.

          • Medwife

            Your baby was OP and it sounds like “asynclitic”. That makes for a hellish, non progressing labor.

          • Trixie

            Yeah, I thought the term might be asynclitic, but then I thought that maybe only applied to sideways, not rolled under like his head was. He was born with a ring from my cervix on the very back of his head near his neck, so I’m sure that’s how he was presenting. Thanks!

          • Birthbuddy

            Possibly “deflexed” OP?

          • Birthbuddy

            One by one, the illusions unravel.

          • fiftyfifty1

            “As for the c-section, who knows if they would have decided it was medically indicated or if they would have given it a bit more time”

            Not even a question. By her description, this woman had a very nice straightforward labor. It lasted only 12 hours and didn’t stall. Her labor progressed faster and easier than an average first labor. *Many* babies start off OP and rotate as labor progresses. I would go so far as to call it an actual variation of normal (unlike breech)! OP presentations are only a problem if labor is not progressing. An OB wouldn’t have batted an eye at this labor, much less suggested a c-section.

        • mtbakergirl

          I am so glad that everything turned out well for your family. However I do have to note that it challenges the implied assertion that you, “did your research” (aka know more than or at least as much as an ob) when you persist is saying occidental (refers to the western world) rather than occiput (referring to the part of the skull that is pressing on the cervix) posterior (baby coming out facing the navel rather than the spine).
          I realize that this is a quibble, but I do find it quite illustrative.

          • But I do know the actual condition and I’m typing pretty fast keeping up with 4 threads or so in real time trying to answer your questions — and what would have been advised in hospital, so yeah, you’re quibbling a bit, but thanks.

          • mtbakergirl

            Fair enough, I just found it striking that your wife made the same mistake when writing about it, “Nye was occidental [sic] posterior. He flipped to come out but shoulder dystocia ripped me apart.”

          • That’s probably where I got it!

          • mtbakergirl

            My point, regardless of the origin, is that the word occiput is 1st year anatomy. This is not a mistake an OB would make, or repeat, in 1000 years, because they are actual experts.

          • Birthbuddy

            Or maybe from the midwife (in her experience)?

        • fiftyfifty1

          “Our doctors and nurses were unbelievably good at UCLA, and whaddaya know — with none of the judgement and nastiness of Doc Amy here either, which was great!”

          So if they are so nice and non-judgemental and non-Amy-like, why not give birth in the hospital? Occidental [sic] posterior babies are born spontaneously all the time in the hospital. You are not confined to a hospital bed with an IV. My baby was malpositioned and I had terrible back labor and they encouraged me to move around and find the best position for me. You believe a lot of myths!

        • Bethany Barry

          I am sure the medical team that saved your wife’s life was very good. I’m sure they were kind and professional and competent. They are expected to be, it’s their job. So why not give birth in the hospital in the first place?

          I also experienced a long back labor (twice!), as well as shoulder dystocia and a retained placenta when I bore my son this summer. The medical professionals who handled my “normal” delivery were able to resolve each complication without “tearing me apart,” so to speak. I was also permitted to walk around freely until transition, at which point I wouldn’t have wanted to be anywhere but lying down. This, granted, is my personal experience and not statistically significant. But a lot of assumptions are being made here about what hospital birth is really like. Informing women that they won’t have choices in hospitals does not help them learn to advocate for their own wishes in a hospital setting (which is where many attempted home births end up anyway).

          • No not many Bethany, Home birth transfers are actually very rare.

          • attitude devant

            Ummm. No, no, no, Jared. I receive homebirth transports on a regular basis. Not rare at all. As for what an ideal transport rate is, look up the Birthplace study—it’s easy to find. This study of homebirth in the UK showed a 40% transport rate AND a 2 x increase in the risk of death for babies born to first-time moms.

          • Birthbuddy

            Wrong again Jared, approximately 20% will (or should) transfer. One by one the illusions unravel.

        • moto_librarian

          There is a big difference between a heplock and an IV. And just what do you think would have required her to be stuck in bed? Have you even been at a hospital delivery? It’s the same old broken record as usual.

        • Karen in SC

          I had an OP presentation in the hospital with no epidural. Nothing was pushed on me and I could get into any position I wanted. It is possible.

        • prolifefeminist

          My first baby was OP and I delivered him OP after ten hours of active back labor. Unmedicated. In a hospital. With a heplock. I spent almost my entire labor in the jacuzzi tub, on the birth ball, or walking around. The standard party line that these things are discouraged in most hospitals is a myth. I’ve given birth to five babies in five different hospitals (including a pre labor home birth transfer), and never was I pressured to accept pain medication or told I had to stay in bed. Even while on EFM during my attempted VBA2C, the nurses encouraged me to sit on the birth ball and move around. I bought into the lies and found out after the fact that most hospitals aren’t the horrible places I was told they were.

        • Monica

          And you know what? If you met Dr. Amy in the hospital she would have done what needed to be done to save your baby without any judgement and nastiness too. Because she is a professional. What you see on the blog is a persona that she needs to have to make it clear how very dangerous this stuff is. She can’t sugar coat things. Doctors are great, but not great enough to deliver your baby? It’s all just a show, admit it. FYI, hospitals do not tie you to a bed. I had back labor with my last birth, had to have an IV because I had Group B strep and was also a vbac so needed close monitoring. I was not “tied” to a bed with any of that. I was standing with a nurse holding a monitor to my stomach and a pole which had my IV bags. They were going to put an internal monitor on my baby, but the nurse suggested I lay on the bed on my left side to work through the final bit of cervix so I tried it and before I knew it they were breaking down the bed and I was delivering my baby girl safely into the doctor’s arms. Spent the rest of my hospital stay happily nursing my little one and only on ibuprofen for the pain. So don’t act like you know what would have happened to your wife in the hospital because you have no idea, but remember it was the doctors and the nurses at the hospital who saved your wife’s life and you should be eternally grateful for that because the bottom line is her life would not have been at risk from so much blood loss had she been at the hospital to begin with.

          • wookie130

            I completely agree…the hat Dr. Amy needs to wear on this blog is most definitely not the SAME hat she wore while actively practicing medicine, and delivering babies. Her voice (albeit “meeeen” to some people) needs to be heard on the issues surrounding the dangers of homebirth, because she is trying to make a POINT, and has succeeded in doing so several times over. It’s about saving women and babies.

        • Mishimoo

          I didn’t have anything pushed at me for my 3 persistent Occiput Posterior deliveries. There was never any mention of caeserean except by me during antenatal appointments because I wanted to discuss all options prior to delivery in case of emergency. The CNM did offer to get me an epidural for the last one, but that’s because she’s a kind professional that wants me to be as comfortable as possible. She also noted that I’m an outlier – most women would be (very understandably) screaming with pain and asking for an epidural. I’m one of the very few women that she has seen in 20 years of practice that just zones out during back labour.

    • Amy Tuteur, MD

      Congratulations on your new son and on dodging a bullet. I would say that you were clueless that your wife was truly in danger of dying, but the fact that you deliberately excluded the photos that demonstrated the horror of postpartum hemorrhage shows that you and Ruth do have some awareness.

      Please extend my thanks to Ruth for making my job debunking the myths of homebirth so much easier. She has helpfully demonstrated that homebirth is about self-absorption and narcissism and she illustrates better than I could that when homebirth advocates claim homebirth is safe what they really mean is that it is incredibly dangerous.

      • C’mon Amy, I answered your “questions” — scared to answer mine?

        Why don’t you tell people that if she was in hospital, these are the same things that would have happened. That placenta wasn’t just going to come out because we were in hospital silly. Either the gloved hand or traction would have had to happen anyway, right? Okay, then, fear-mongering again.

        Why is the infant mortality rate so atrocious here? Why does almost every other industrialized country (with better birth outcomes to boot) trust midwives explicitly except when there are complications (which is exactly what we did!)

        In case you want to do some research one day:

        http://www.homebirth.org.uk/homebirthindex.htm

        • Amy Tuteur, MD

          “Why don’t you tell people that if she was in hospital, these are the same things that would have happened.”

          Because they wouldn’t have happened. It is highly unlikely that she would have needed blood transfusions if she started bleeding in the hospital.

          I’m sorry, Jared, I know that a homebirth website assembled by lay people for other lay people seems like “research” to you, but it isn’t. Research involves reading scientific papers, something you clearly did not do.

          I the past two weeks alone I have written about or heard about:

          a homebirth that ended with a baby’s severe brain damage
          a second homebirth that ended with the baby on ECMO (heart lung support)
          a third homebirth that ended with a brain dead baby soon to be disconnected from life support
          your wife’s postpartum hemorrhage

          And that’s just in the past 2 weeks!

          Homebirth is dangerous. It kills babies and it kills mothers. The only people who don’t seem to understand that are homebirth advocates themselves, who are more interested in exposing themselves on the internet than on safety.

          • Sure, and that never happens in hospital right, Amy? Except no one talks about that.

            Oh, and the lay-persons website I referenced — all the actual links are to scholarly publications. Take a minute.

          • Amy Tuteur, MD

            Actually, I’ve never seen anything like that in a hospital in a two week period, and I’ve worked in hospitals that did thousands of deliveries a month.

            The death or disability of a term baby in a low risk situation is vanishingly rare in the hospital.

            By the way, did you ever do any independent research? Or is all your “research” served up by people who profit from homebirth?

          • Captain Obvious

            Of course complications happen in hospitals. Look at the rate of complications and you may realize your ignorance. Again, I posted this above. I just managed a retained placenta at the bedside after birth in minutes, no transfusion, no separation from baby, no ambulance cost. How many resources, interventions, and health care dollars did your family incur because of your stunt birth?

          • Birthbuddy

            One by one, Jared’s indoctrinated NCB illusions (delusions) unravel.

    • The Bofa on the Sofa

      Most births are uncomplicated, and perfectly safe to have at home.

      And most drunk drivers arrive safely at their destination, with no incident at all.

      Doesn’t make drinking and driving acceptable.

      Then again, drinking and driving is a lot safer than giving birth, regardless of where.

    • Amy M

      The infant mortality rate is so atrocious here (in the US, where I live) because of the poverty rate, and the fact that poor don’t have access to health care. But infant mortality measures include from birth to one year of life. I think you are talking about perinatal mortality rates, which, in the US, are actually quite good. They include what? up to 7 days? or is it 28days? of life, and are a better measure of obstetric care. The greatest perinatal killer in the US is prematurity, and so far no one, midwife, nor obstetrician has come up with a way to prevent that (though good prenatal care certainly decreases the risks).

    • theNormalDistribution

      Firstly, infant mortality is not the appropriate metric; you are just repeating another homebirth talking point without actually understanding what it means (and therefore why it is irrelevant). Dr. Amy probably didn’t answer you because she’s tired of answering ignorant questions. But you can read what she would have said here:

      http://www.skepticalob.com/2011/08/infant-mortality-is-wrong-statistic.html

      Secondly, you have completely missed the point of the questions you answered. Read the last five paragraphs again. Those are the questions you should be thinking about.

    • Captain Obvious

      ” by our very professional midwife, who treated her as one would at a hospital, with drugs to make her uterus contract and release the placenta. Imagine that”
      You are first supposed to get the retained placenta out before you give the uterotonics! If you give uterotonics and the uterus tries to clamp down on a partial expelled placenta, you will still bleed and now you will have a harder time reaching in there with your hand to remove the placenta. In the hospital, at the bedside, with an epidural, you can easily reach in and remove the offending bleeding placenta, THEN give uterotonics to get the uterus to contract. Your unprofessional midwife couldn’t get the placenta out, have uterotonics that only made some of the uterus contract, the areas where the placenta was would still bleed and a transfusion was needed. You do believe everything your midwife tells you. She is just covering her ass. Glad everyone is alive. But at least realize she was lucky.

      • Medwife

        Wait- active management? I start bolusing pit when the baby’s out. It has not been shown to increase rates of retained placenta. If she starts hemorrhaging with the placenta still in the answer is get that placenta out before more uterotonics, is that what you mean?

  • attitude devant

    This underscores what a careful piece of artifice your typical birth narrative is. I’ve always been fascinated by the emphasis placed on heavily scripted and edited birth stories by the NCB world. In fact, the Birthingway School of midwifery in Portland even had a required course in birth stories. I’ve had the opportunity to watch several birth narratives take shape on some blogs I follow, and the typical post takes shape over several months, with impressionistic brief initial thoughts being slowly shaped into a more acceptable form, conforming to certain norms regarding pain, the importance of midwifery care, and so forth. All aspects of the event become pregnant (sorry!) with meaning.
    Ruth Fowler Iorio IS a writer. Her degrees from Cambridge are in literature, English AND American. Ergo, best to view this effort, like all literature as a piece of artifice, not a representation of reality, no matter what title she puts on the finished product.

  • stenvenywrites

    I had placenta pre via with my son. When the first, “sentinel” bleed occurred at 26 weeks and I was put on bed rest in the hospital, I realized that the risk of severe bleeding was pretty serious. But that second bleed, when I stepped out of a shower and a dinner-plate sized splot of bright red blood just splashed out me, shocked me. I lost a unit and a half of blood in the amount of time it took them to get me UPSTAIRS in the hospital, I cannot imagine how traumatic it would have been to experience that without any expectation or preparation, and for such an extended period of time. This lady was damned lucky. Too bad she’s too busy showing off to be grateful.

  • Leyla

    It’s no surprise that she’s deceiving the world. Because she is deceiving herself.

    • The guilt is overwhelming, even though I really did believe home birth was safe I still screwed up. I’m very grateful + lucky even though things went horribly, at least my family is physically fine.

  • Dr Kitty

    You know how bad it looks when you spill a glass of wine?
    If you need more than a unit of PRC, you’ve lost 1800-2500mls of blood.
    That is the equivalent volume somewhere between 2.5 and 3.5 bottles of wine. Imagine pouring 3 bottles of red wine on your bed and floor.
    That is what her house looked like, but instead of wine it was blood.

    Not so much “sanitised” as “completely unrepresentative of what happened”.

    • Lynnie

      Thanks for the graphic, yet accurate description. I was a housekeeper at a hospital for a few years and one day a nursing student accidentally dropped the iv bag for a blood transfusion. It splattered everywhere and it looked like someone was killed. Seriously, made slasher films look tame.

    • Burgundy

      My two big dogs (both 80+ pounds) got into a fight in the kitchen once. One nipped the other’s ear. Blood was everywhere and took me 3 hours to clean up. The injured dog required 2 stitches and did not need any blood transfusion. The Vet explained that since the ear had a lots tiny blood vessels there, blood shoot out faster and that was why it looked worse then actual. If that “little” amount required that much clean up for me, I could not image the effort required to clean up the that much blood.

    • to be fair blood is much thicker than wine so it wouldn’t spread as far (and would clot up upon sitting instead of running everywhere), but its still a damn lot of blood.

      • Dr Kitty

        In a PPH you’re BLEEDING.
        The blood doesn’t trickle or ooze, it FLOWS.
        So, unfortunately, it does run everywhere before it gets a chance to clot.
        It runs off the bed and drips on the floor, it makes puddles and it splashes…THEN it clots.

        I’ve been at major PPHs and seen patients with serious stab wounds. The PPHs were messier (mostly because you can’t apply pressure to the wound or use tourniquets).

        • omdg

          PPH is messier because there’s an open door to the outside of your body. With a stab wound you bleed mostly on the inside, and often the increase in intra-abdominal pressure will tamponade the bleeding.

        • but its 2-3 times thicker than wine, so it acts differently. I’ve read a bit about blood spatter forensics..

          this isn’t even that important of an argument, its still a ton of blood that looks horrible.I was just trying to say its not exactly like wine.

          • Birthbuddy

            I wouldn’t drink it.

    • She only lost 1000-1500 at home, the rest at hospital.

      • Burgundy

        How did you measure them? 100-1500 is a pretty huge gap.

      • Captain Obvious

        “Only” 😉

      • Dr Kitty

        So, 2 bottles of wine then.
        So much better than my guesstimate, right?

    • TwinMom

      How sobering. I received 9 units of PRBC.

  • Kathleen

    This:
    Did you refuse to include them because they didn’t tell the story as
    you wanted it told, allowing you to make it seem like your near death
    was just a minor moment in your piece of birth performance art?

    Have you read her piece in the HuffPo Parenting Site? That’s exactly what she’s done – oh, blah, blah…I bled a lot and had to be rushed to the hospital because birth is just so “crazy.” No big deal having actual experts save my life after foolishly endangering it by not trusting those same experts in the first place.

  • Susan

    Absolutely spot on Dr. Amy. All those posters at Feminist Breeder wouldn’t be so jealous if she had documented the truth about what a postpartum hemmhorage, emergency transport, manual removal and getting blood are like. She’s a “journalist” and self promoter who wanted to tell a story and she edited reality to create the story she wanted to tell. I was flabbergasted reading TFB comments of envy– I suppose because I can get a pretty clear mental image of what’s missing from her photo essay. She’s going to have more blood on her hands, figuratively now, because some woman out there will be inspired by her highly cherry picked photo essay to follow suit. ( and her language really speaks volumes about what sort of person she is… who on earth wouldn’t be embarrassed to use the C word on a blog with a large audience. I guess her baby didn’t exactly win the mommy lottery)

  • Jay Cee

    Brava, Dr. Tuteur

  • Or maybe that reality is just a little too hard for her to really face right now – I’m going to bet they exist, only because she seems like the sort who would have hired a photographer for the event.

    • Amy M

      I think her husband IS a photographer, though I suppose he’d likely be the first to drop the camera if he noticed blood pouring out of his wife. At least, I hope so.

      • Still surprised they wouldn’t have an outside one – but, clearly her husband doesn’t really matter, so why should he be in any of the pictures?

      • Birthbuddy

        I think her husband IS a photographer, though I suppose he’d likely be the first to drop the camera if he noticed blood pouring out of his wife.
        Apparently not.

  • OBPI Mama

    The pictures not taken or not posted (hopefully they were too busy dealing with the emergency to take pictures… as it happened in my birth too) really do sum it all up. I can’t believe her foul mouth. She really should just be focusing on her baby, on healing, and how incredibly blessed she is to experience being a mommy.

  • Margie
  • GiddyUpGo123

    Someone who uses the “C” word automatically loses all credibility with me. If your only argument against a person is that you can call them by one of the worst words in the English language, then you don’t have an argument. You’re just a hater with a foul mouth who can’t come up with anything better to say.

    • Houston Mom

      I hate that word. NCB types act like they are so pro-woman but then they show their true colors with outbursts like this and Yoginimomma with her butch remark.

  • moto_librarian

    If she is like me, she probably has few memories of anything beyond the start of the transfer in the ambulance. I vividly recall the manual examination of my uterus and the fundal massage, but mercifully, I blacked out before they ran my I.V. I briefly remember the anesthesiologist asking me to tell him when I started to feel the pain medication (blessed fentanyl), and I recall looking at the lights as I was wheeled down the hallway to the OR. I gave birth at 5:44 pm, and have no real memories until 10 pm. By then, our son was in the NICU for observation, and I was actually glad that I could sleep awhile more.

    Her husband likely isn’t so lucky. One of the most difficult conversations that I ever had with my husband was serval weeks after the birth when he told me that he was terrified that he was going to leave me. Hr told me about sitting in the delivery room alone with our son while I was in surgery, and it broke my heart. My husband has already been widowed once, and he found himself wondering if he was going to be left alone to raise our son. Even though I know that I did the right thing by giving birth in the hospital where this situation was managed effectively, I still feel guilty as I wonder about whether or not my choice to deliver without pain meds played a role in the cervical laceration. I could not control my pushing at all, and I wonder if that caused the tearing. My husband is y best friend, and I regret how scary this was for him.

  • I don’t have those pics, but I do have ’emergency skills training: estimating blood loss” photos from a local DEM school.

    http://instagram.com/p/dIxWAArp82/

    I was kinda appalled because they were teaching breech skills at this workshop, and the utah direct entry midwifery act says that those are not supposed to be handled by midwives. ever. (unless of course they are unlicensed, then they can do whatever. good job, legislators….)

    • The Computer Ate My Nym

      How do you estimate blood loss in a birthing pool? My first thought was to get a hct on the water and then multiply by pool volume, but that can’t possibly be how it’s really done.

      • lol no, that would require at least a tiny centrifuge. its not natural child birth if you need electricity, right? I’m pretty sure they were learning to do this by sight (bwaahaha).

        • Amy M

          I suppose they could measure the exact volume of water they put in the
          pool to start and then measure what they pour out of it. I guess some
          of that would be amniotic fluid, but it would give some idea. Of
          course, there’d be some loss, whatever stuck to the woman as she got out
          of the pool or if any sloshed over the side. I’d make those liners
          like glass measuring cups, marked so you could see how many liters were
          in the pool, and you could account for displacement when the mom gets
          in.

          Another thing would be to set up the pool on top of a
          portable scale that could handle that much weight and record the weight
          of how much water went in, the weight of water + mother, then weight
          post birth to whichever measurement makes the most sense (whether or not
          mom is still in the pool.). Maybe a scale like they have at vet’s
          offices like a big pad so the really big dogs can get on it easily.

          It
          was pretty straightforward in the hospital for me: massive clots
          everywhere and I was losing consciousness, so they followed what I
          assume is standard procedure for PPH and did uterine massage and gave me
          pitocin and oxygen. They were able to stabilize me in a few minutes,
          so they drew some blood and measured hematocrit, and probably a few
          other things, to determine whether or not I needed a transfusion, rather
          than relying on eyeballing the puddles of blood all around the room.
          That alone should be enough a reason to be in a hospital for those lucky
          enough to have access to one. PPH is relatively common.

          • Burgundy

            Are you kidding? You are asking CPMs to do math? That is intervention!

        • LovleAnjel

          If you estimate water volume, you could then get an idea by how dark red the water is. But that would take inordinate amounts of experience.

      • Medwife

        You can’t. You can only judge by maternal symptoms which is no good at all, as postpartum women tend to have stable vital signs and be fairly asymptomatic until they’ve lost an immense amount of blood. I would think the key thing is to get mom out of the tub as quickly as possible after the baby is born so that you can deliver the placenta on dry land. Try not to let her or yourself fall on the way though, whilst dodging puddles of water and blood.

        • Susan

          True. And there is lots of evidence that estimating blood loss visually, even when experienced, is often inaccurate. Every class I have ever been to on the subject says we need to be weighing blood loss much more frequently and sooner than most of us really do.

        • The Computer Ate My Nym

          Biohazards and fall hazards all over the place…

      • Aussiedoc

        You can’t.

        Our local protocol for water birth includes mum coming out of the bath for delivery of placenta for precisely that reason,

  • stacey

    Now those are some pics that would be worth seeing.

    • Lynnie

      I was just thinking if I was weird because I wanted to see those pictures. The sight of blood doesn’t bother me. My two summers working in a fish cannery and my years as a housekeeper in a hospital drove that out of me (well, my love of tv shows life Bones and NCIS as well). It would have been interesting to see how much blood is OK for a “safe” home delivery.