Are homebirth advocates stupid? Gloria Lemay thinks so.

cargo cult plane

Homebirth midwives don’t have a motto, but if they did, I propose the following:

Nobody ever went broke underestimating the intelligence of the homebirth advocate.

If you think that’s not snappy enough, they could just shorten their motto to this:

There’s a sucker born every minute.

Don’t believe me?

Consider today’s post from Gloria Lemay, the Canadian version of Australian killer midwife Lisa Barrett:

I discourage routine ultrasound and recommend that dopplers and imaging devices be kept well away from the developing fetus.

But women still want to see how the baby is doing inside the uterus, so she offers them a nonultrasound solution. (The picture is NSFW, but only because it will make you laugh out loud, so be prepared before you click on it).

This is part of the growing amount of cargo cult science in homebirth midwifery.

What is cargo cult science?

Physicist Richard Feynman coined the expression in his 1974 commencement address at CalTech.

…In the South Seas there is a cargo cult of people. During the war they saw airplanes land with lots of good materials, and they want the same thing to happen now. So they’ve arranged to imitate things like runways, to put fires along the sides of the runways, to make a wooden hut for a man to sit in, with two wooden pieces on his head like headphones and bars of bamboo sticking out like antennas –he’s the controller– and they wait for the airplanes to land… So I call these things cargo cult science, because they follow all the apparent precepts and forms of scientific investigation, but they’re missing something essential, because the planes don’t land.

More familiar examples of cargo cult science include the TV shows Gilligan’s Island and The Flintstones. The Professor on Gilligan’s Island used coconut shells to mimic all sorts of technology, like telephones, and, because it looked like the item of technology, it worked like the item of technology. Similarly, when Wilma Flintstone vacuumed her living room floor with a baby mammoth on wheels, we were to assume that because it looked like a vacuum cleaner, it functioned like a vacuum cleaner.

Melissa Cheyney and Oregon homebirth midwives were the first to employ cargo cult science in homebirth midwifery by creating Auscultated Acceleration Testing, the cargo cult version of the non-stress test (NST).

Now Gloria Lemay has gone them one better with the cargo cult version of ultrasound. Just like real ultrasound it creates an anatomically detailed image of the developing fetus. You can send pictures of it to your relatives and friends and post it on Facebook just like other women post their ultrasound picture.

Here’s what I’m puzzling over: Does Gloria Lemay think that homebirth advocates are morons and will find the image useful? Or does she think they are such simpletons that they will actually believe that there are benefits to the image? Or is it supposed to be a statement? Other women may expose their babies to ultrasound, but I can find out everything I need to know with a drawing.

In any case, she is certainly operating by the motto that there’s a homebirth sucker born every minute.

  • http://Www.awaitingjuno.blogspot.com/ Mrs. W

    Gloria Lemay – she should be a fictional character, what she spews is absurd, the fact that people take it for truth is tragic.

  • Kimberly
    • Deena Chamlee

      I know Linda Glenn CNM worked with getting this implemented. I guess my critique would be small sample size and the need for further study.
      Implementation of a technique, even though it seems to be more sensitive than a NST , explicitly states more study needed. Unfortunately, because we know fetal monitoring increases cesarean rates.

      • Karen in SC

        Unfortunately?

        • Deena Chamlee

          Yes it would be a benefit if there was a test that assessed fetal well being with appropriate specificty and sensitivy that allowed for clients not to be charged 150 dollars for the read of the test and another 150-300 dollars if an afi or bpp is also needed. This doesnt count the cost if the client must be seen as an outpt on labor and delivery.

          Thinking outside the box does not have to be only a midwifery thing.

          • Stacy21629

            When my daughter had decels at our home birth, we transferred for the delivery. I was SO HAPPY to have that belt on my belly to give the OB a constant window into my abdomen and what was going on in there. I would have been SO HAPPY to have a C-section if it meant my daughter would be alive and healthy. When the hospital liasion offered to remove the fee for the monitoring I told her to leave it on – I WANTED to pay for that. $150 to know my child was ok? That’s really the price people are willing to sacrifice their children for?

          • Deena Chamlee

            I know sweetie how sad. We have all have paid such a heavy heavy price especially you poor families. I am truly truly sorry for all the tragic pain and despair caused because of midwiferys dysfunction. I wish I could fix all of us each and everyone of us.

            But I am powerless except for doing everything I can think of to make things right. I am trying every avenue I can think of to make it stop and I pray my my transformation because of Amy, causes transformations amoung other CNMS and other CNMS transforms other CNMS.

          • Stacy21629

            “I know sweetie how sad. We have all have paid such a heavy heavy price especially you poor families.”
            What?
            My daughter is fine. I was saying that, in the moment, monitor away. I WANTED to know that she was going to be ok. I’d have been 100% ok with IFM as well, even if it lead to a C-section. Because a C-section would not have been an “unfortunate” outcome. It would have been a GODSEND if she was dying inside me and it saved her life.

          • Deena Chamlee

            I saw decels at home and transfer and would have had a csection to save her as you did not get to the hospital in time.
            I am not against csections.. But I guess many are.

          • Trixie

            Shoot, I paid $150 this weekend for my kid’s ear infection because it was a Sunday. Would have been $40 on a Monday but it’s a small price for him not to suffer for 24 hours.

          • Stacy21629

            No kidding. I get frustrated sometimes treating routine stuff like ear mites in the ER on a Saturday night…but I know that the cat is MISERABLE and I understand folks not wanting to wait until Monday. I always tell folks – it’s a small price to pay for comfort/reassurance/whatever.

      • Stacy21629

        It also DECREASES neonatal mortality.
        Priorities, I guess.

      • http://kumquatwriter.wordpress.com/ Kumquatwriter

        With all due respect, why keep demonizing cesareans? SO WHAT if raises the cs rate? It also raises the survival rate! Cesareans are NOT a poor outcome. I am getting so damn sick of cs apologists and fussing over the cs rate that I’m starting to see red every time it comes up. Do you have ANY idea how much shit you get from NCB people for having a cs? Truly? That you don’t even get to share your birth story unless you howl about needing a healing vbac or how bad it was? That people will tell you to your face that you never gave birth, you had a surgical extraction? Or that you’re less of a mother? That you must not have bonded? That any problem your child has will be dismissed as your fault because cesarean?

        • Deena Chamlee

          Not demoralizing just stating fact, well studied well known.

          • http://kumquatwriter.wordpress.com/ Kumquatwriter

            But you do, if you say “unfortunately it raises the cesarean rate” because that is NOT UNFORTUNATE UNLESS CESAREANS ARE BAD. How can you not get this? Did you read the comment?

          • Deena Chamlee

            I did not mean it in such a manner. I meant unfortunately because it would create a different avenue for fetal surviellance. Wow we are all so messed up from the abuse that reactivity is all we know when it comes to communicating.

          • http://kumquatwriter.wordpress.com/ Kumquatwriter

            I’m not just being reactive, I’m pointing out how you are still adding to that abusive mindset just by insisting raising the cs rate is unfortunate.

          • Guest

            There *are* situations where increasing the cesarean rate *is* unfortunate because of rising rates of accreta, percreta, rupture, etc with the increasing number of cesareans and individual may have. Say a woman wants a larger family, 4-6 children or so. It *is* increasingly dangerous for that woman. If you reduce the number of cesareans an individual woman has, then you reduce the overall rate, right? This is way more of a complicated issue than cesareans are bad/good and vaginal births are bad/ good. It’s just not that simple IMO.

          • Deena Chamlee

            You do not know me and you are messed up because immediately because i am a midwife I am inferring an abusive mindset

          • http://kumquatwriter.wordpress.com/ Kumquatwriter

            Actually, I have tremendous respect for you and how you’re coming out of that mindset. I’m trying to point out an aspect you might not be considering. You don’t know me either, and I’m plenty messed up, but those things are both irrelevant.

          • Trixie

            I’m not messed up from abuse, as I’ve never been abused. Can’t speak for anyone else. It sure seems to me like you don’t like fetal monitoring because it increase c-section rates. I guess you’d rather just not know?

          • http://kumquatwriter.wordpress.com/ Kumquatwriter

            I bristle at people with legit PTSD getting called “messed up” as well, and if we ARE messed up, it doesn’t invalidate our responses. It might just mean we have reasons, eh?

          • Deena Chamlee

            Nope didnt say that trixie read it again

          • Deena Chamlee

            I get it now. I had to read again what I wrote. Alternative methods of monitoring is not a bad thing, in my opinion. Because many times when patients are on EFM, the nurses sit at the desk and pine over the strips. many times increasing the rate with their concern.
            Anyway I understand now what you are saying. I typed it quickly and my thoughts were freely going through my head as I typed.
            Sorry.

          • http://kumquatwriter.wordpress.com/ Kumquatwriter

            Apology accepted, and thanks. I 100% empathize – I’ve done it many times myself. And I agree that a lot of us are pretty emotionally battered from our experiences with NCB – and I cannot stress enough how impressed I am with your journey out. I’m blunt and inclined to swear a teensy bit, but I don’t aim to offend. And I did not mean you were being abusive , it’s totally about the NCB hive mind, which you are outside of :)

          • Something From Nothing

            For what it’s worth, when I read your comment, my first thought was that you think of a caesarean as a bad outcome. I didn’t know that you are a midwife, and I hadn’t read any of the replies. I agree with kumquat writer on this one. And having now read through the replies, your comment about being reactive as a result of abuse is as passive aggressive as it is irrelevant to the discussion.

          • Deena Chamlee

            Ok let me try again.
            I am not one out there screaming about the csection rate. I look at the client’s I serve and their csection rate. Not that I would have managed them any different because if a csection is needed I am consulting. The obs csection rate is none of my business. I mean really, who am I to say you should have or should not have performed a LTCS?
            If ACOG thinks the rate is too high then it is for ACOG to address. I think we have been so dysfunctional for so long both fighting and no one listening that it is easy to misunderstand each other.
            Studies show EFM increase csection rates. Does that mean I do not believe in EFM of course not. It is just what studies show. I actually think the portable Hewlett Packard’s would be a great option for intermittent monitoring in the home. They are small and very light. And that is if homebirth will actually be in our future, after everything is said and done.
            Does that make sense?

  • Deena Chamlee

    OK I have not done a lit review regarding water birth in many years. And Amy I obviously missed your blogs addressing this matter. There does not need to be any evaluations of data, you have the data.
    Take that data and present it to the World health Organization who is addressing midwifery globally and bar any further use of this method. More than likely others are profiting from this method of birth. I have attended god knows how many and never had an issue, that being said, you have the data present it.
    You know what you are dealing with present every study good and bad and follow the lead of Ireland.

    • Young CC Prof

      Have I ever mentioned how much love and respect I feel for people who change their minds when presented with new information? Because yeah.

      • Deena Chamlee

        I read the citation so fast I did not notice it was done in 1999. My God I did not read this in grad school. Nonetheless, now you all have peeked my interest. Therefore, let me do a literature review and then make a stand.

    • Trixie

      Yes, thank you Deena for maintaining an open mind.

  • Laura

    And furthermore, what about the woman with placenta previa who has no ultrasounds in pregnancy and is planning a homebirth or, God forbid, an HBAC. She starts bleeding at the end of her pregnancy or in labor, and then what?!?!

    • LMS1953

      The chief fault with the HB mentality is the pervasiveness of absolute risk assessment versus relative risk assessment. Hence, you can’t tell them anything. It is a kind of Kevin Bacon Effect. Within the crunchy clutch of HB hens, there are enough degrees of separation (placenta previa being relatively uncommon) that nobody knows somebody who knew somebody who bled out from a placenta previa that it is not a palpable risk for them.

      • Young CC Prof

        I’ve read a few of their communities. They say, “I want a HBA3C! Any success stories?”

        And of course there are a few. And what the original poster doesn’t realize is that if anyone tries to say, “I tried that and I ruptured and the baby died! Don’t do it!” the naysayer will be deleted.

        So, the poster, who suffers from a lack of critical thinking skills, concludes that since 2 women did this successfully, it must be safe, and she’ll be successful too.

        It’s the flip side of the people who panic over child predators if they hear one news report about a kidnapping 1,000 miles away. Anecdote over data, numbers aren’t real. The risks you need to worry about are the ones that you hear about, right?

        • Karen in SC

          A favorite saying in our house: “Even a blind squirrel can find a nut.”

          • Trixie

            Blind squirrels don’t survive at all. Nature.

        • Amy M

          I found one on MDC (from several years ago) asking about homebirth of triplets. Someone brought up a story that was printed in the Elizabeth Noble multiples piece of trash and used that as proof that homebirth of multiples and HOMs was a good idea. Several people stated they couldn’t figure out what the risks could possibly be. One sensible person pointed out that 1)she’d had a prior Csection and 2) she was carrying more than 20lbs of baby, so rupture was a huge risk. She’d gone post-dates (supposedly) and with multiples, that’s a lot of stress on placenta/s, body. She mentioned the possibility of TTTS if any of them were id, and the increased risks of GD and pre-e with multiples. She mentioned that positioning with multiples is often an issue, and that abruption is a greater risk. Did any of this sink in? Nope. The only women who agreed with her were the ones who’d had multiples with OBs in hospitals. It is UNBELIEVABLE over there.

        • CognitiveDissonaceHurts

          It is very very disturbing that negative outcomes are being deleted.

          • Young CC Prof

            I’ve tried to post in those areas. And NOT the way I post here, very carefully and tactfully. I still get moderated and deleted about half the time.

    • Elizabeth A

      Having had *exactly* the placenta previa convo with a number of women who are planning unassisted birth, or pregnancy with no medical care…

      They will tell you that placenta previa is very rare, and that “silent” previa (a previa with no bleeding prior to term) is even rarer. They believe that they would know, either instinctively or based on external evidence, if previa was an issue, and that they therefore do not have to worry.

      The statements in the first sentence of that paragraph are true. The statements in the second sentence are not. And even if they were, I’ve seen women come to MDC with questions about bleeding, and discount previa as a possibility because a previa with no symptoms is really unlikely, utterly disregarding the fact that bleeding is THE external symptom of placenta previa.

      My case of placenta previa was spotted at a routine second trimester ultrasound, and while I tried very hard not to worry about it at that point, about eight weeks later, knowing that I had placenta previa meant that I was informed enough to go to the hospital immediately when I began bleeding, and tell the doctors there exactly what was going on. Because I knew in advance, I had a plan of action, and was able to assure myself appropriate care, and that was far better for me and my family then it would have been to NOT have the information and NOT know what to do. I had never heard of placenta previa before I was diagnosed with it, and I don’t think that’s uncommon.

      • Stacy21629

        I ran across this in a book recently – “Better Off”. The author and his wife were expecting a baby and planning a homebirth. The wife’s dad was a doctor I think and expressed some misgivings about not even having an US – the author wrote that placenta previa was diet related. @@ I want to rip the pages out of that book…

      • Danielle

        Common enough that my mother had it when I was in utero! There, now all the Home Birtherss reading this page know one person who knows one person.

  • Laura

    That adorable cartoon picture doesn’t show placenta location or amniotic fluid. Last time I checked, those things were really important, too. How can someone actually take that cartoon seriously?

    • Anj Fabian

      And that’s the real question.

      I still have my tiny printouts – with some of the important data printed on it. The image is nice, but the important stuff are all the numbers – the date, estimated gestational age, measurements.

      The boring stuff that real health care professionals use to determine if they need to step in or not.

  • Deena Chamlee

    There is certainly nothing wrong with being challenged by our colleagues in regards to waterbirth. Just like the breech trial was flawed, and now ACOG is recommending vaginal breeches for select clients.
    So I guess midwives should not take this as defeat but instead ponder is there any truth to the cry. I do not see why large scale clinical trials would do nothing but advance the use of water immersion.
    I guess all of us will need to continue to strive at looking at ourselves. And hope that in our future obs and midwives will actually begin to not only respect each other but become open to learn from each other.

    • LMS1953

      I can see why large scale clinical trials for water birth would be nothing but unethical. ANY case of aspiration pneumonia in the water birth cohort would be completely predictable and unforgivable – and they WILL happen as a case described by Dr Amy has shown.

      • Deena Chamlee

        are you a provider? If not I do not think such a comment is warranted. I did my thesis on a retrospective analysis regarding outcomes of mothers and fetuses who chose waterbirth. I cant remember off the top of my head the exact number but I reviewed data complied over 5 years. No aspirations noted.

        • Young CC Prof

          Did you count cases of hyponatremia? Or compare Apgars between groups?

          • Deena Chamlee

            I did not look at hypernatremia because when I ran the data this was not a cofactor that was found in any of the cases. of course this was in the year 2001. Apgars were not found to be a significant variable influencing outcomes either.
            The only variable that had a significant difference was cervical dilatation at time of initial immersion. If the client was placed in the water less than 4.5 centimeters augmentation with Pitocin was found to be increased, hence, water immersion was no longer an option at that time in 2001.
            But we already knew this because many times latent phase is treated with water immersion and contractions space or become nonexistent.

          • Guestll

            Cord avulsion?

          • Deena Chamlee

            nope. This was during 2001. The data was from 1995-2000. The criteria for immersion were quite strict at that time.
            There were should dystocia’s where the patients were removed and delivered in the bed. This number was quite small however. But to this day I will not attend a suspected macrocosmic baby. Although we all know some dystocia’s have nothing to do with size of the baby.

        • Trixie

          He’s an OB.
          I gotta say, from my non-expert perspective, water birth seems really stupid. If laboring in water feels good to the mom, and her water hasn’t broken, I think that’s great.
          When my toddler has pooped in the bathtub she was sharing with her brother, my reaction has been to freak out, shower everyone off for like half an hour, and obsessively bleach things with like a half gallon of clorox for the next hour. And that didn’t even get in anyone’s face. Why would I submerge my newborn in water I just pooped in? At any other point in your child’s life, that would seem insane. So why is it okay when they’re at their smallest and most vulnerable?

          • Deena Chamlee

            I did not say I love attending waterbirths did I? In fact, I don’t. I am soaked, my knees hurt, my back hurts and I definitely do not scoop the poop unless forced to because I don’t have someone helping me.
            The bottom line for me is the birth isn’t about me it’s about the woman’s choice. So I attend them and no one would ever know I was in pain and wished that instead of birthing in the awkward tub she would choose land. You know “surf and turf”. I do not attend births in the tub if macrosomia is suspected. I do not care to get a shoulder dystocia in a tub full of water with limited ability for mobility.
            I am all about looking at data, do you need a randomized trial. I do not think so, run the data for outcomes at large centers across the United States and if aspiration, hypernatremia, poor apgars and whatever other co factors one suspects is an issue. Then, let it be.
            But to state a whole lot of endorsement by any major group shows one more time that MDs must keep midwives in their respected place. Superior, inferior and that I resent. And it also suggest extremely poor leadership at ACOG and AAP.
            I can see before this whole mess is sorted out, that politics will be played by many. And that is not in the best interest of anyone who is attempting to change a very messed up, abusive system that is in need of a complete overhaul.

          • CognitiveDissonaceHurts

            I was reading about a midwife talking about how it is impossible to do any perineal support with water births because of the awkward angles and if that is what you want, then you’d have to get out of the tub for the actual delivery. It was the first time I thought about how physically hard that type of birth must be on the mw.

            I “enjoyed” labouring in the tub but my mw was very clear that I had to get out for the pushing stage so she could see what was going on.

          • Karen in SC

            In obstetric knowledge, CNMs are inferior to OBs, as are RNs and DDSs and DVMs. They have a different skill set that is appropriate for a low-risk birth, and that IS their PLACE. I’m all for keeping them there.

          • Deena Chamlee

            No one is inferior to anyone; If one has appropriate self esteem. And if one has appropriate self esteem one does not have the need to make others feel inferior.
            CNMs are independent practitioners who collaborate/consult and refer with MDs for the benefit of the patient’s well being.
            There will always be shared autonomy with MDs because midwives with appropriate boundaries know that in order to render appropriate care she/he must respect their knowledge base and educational preparation.
            RNs are not inferior to CNMs they just have a different job description.

          • Karen in SC

            As I noted, it’s not personal, it’s the KNOWLEDGE. I stand by what I said.

          • Deena Chamlee

            I stand by what I said also. OBs are surgeons of course they have a vast amount of knowledge that CNMs do not possess but that is the beauty of having humility. Humility and appropriate boundaries for practice standards does not equate to inferior.
            It equates to safety for everyone involved. This has been a glaring deficiency within our current midwifery leaders. Thus, all the fighting and unnecessary mortalities and morbidities.
            Instead of having humility and admitting wrongs done, there is denial, manipulation of others reality, fraud, chaos, trauma, abuse,. Anything but a self inventory . The profession, the public, and our colleagues have all paid the price.
            But instead of referencing as inferior by our colleagues because of the dysfunction, one should understand sick yes inferior no.

          • Karen in SC

            Humility because the knowledge is not there. Do dental hygienists have a problem with adhering to appropriate scope of practice?

            Again, I am not using it as an insult. My chemistry skills are superior to my students but inferior to a PhD chemist. I don’t whine about it.

          • Deena Chamlee

            I am ok with us disagreeing. I don’t feel as if I have been insulted. I just process and think differently.

          • Haelmoon

            I really wish we would stop focusing on OBs being surgeons. I do a lot more than operate on moms, I spends 80-90% not operating. I have a huge clinical skill set that does not require an operating room. There is WAY more to OB than just the delivery, please don’t demean the speciality!!

          • Deena Chamlee

            The more I say the worst it becomes. Did not mean to demean anyone. But you are a surgeon which takes skills that midwives do not have. That is all I was attempting to convey. Anyway, I am going to shut up now and watch TV.

          • Haelmoon

            Deena, I didn’t me to call you out or anything. I am an OB, but I really don’t spend much time operating. Yes we train as gynaecologists as well as OB, but what we do in maternity care is very little operating. They is so much focus on how babies are delivered, but most of the care I give is before the actual delivery. I rarely attend the deliveries of my high risk patients, that is not the only important thing. It matter how we monitor them, how we infrorm the patients and when we deliver. I w visit most of them postpartum (when I am available), because I care more about the outcome than the process.

            I care for moms and babies, I don’t just surgically remove babies (for the record, my colleagues don’t think of me as a surgeon, when I diagnose an accreta, I joke with my patients that I am going to invite a “real” surgeon – urogynecology, gyneonc or urology’ to the birthday party)

          • Laura

            When someone has more training and experience than you do professionally, you must defer to them in making decisions IN SOME CASES for the best outcome for the patient. If professionals use their experience to be rude or arrogant with their colleagues then shame on them. But still, there is a place for acknowledging more experience, training and knowledge.

          • Deena Chamlee

            Of course there is Laura. My goodness they are physicians and we are nurse practitioners. They have more education, more training and more responsibility. It is reality. This is why instead of not listening and hearing what they are crying out, wisdom would prove listening and working together for a better, safer future would protect the public
            .
            I know it must be hard to grasp but not all midwives are homebirth midwives.

          • Laura

            It’s not hard for me to grasp at all. I am in nursing school and aiming to go to a major university to get my Master’s in Midwifery and Women’s Health. I will be a hospital-based CNM. I’m sure you didn’t mean to be demeaning by your tone, but it sure did sound that way.

          • Medwife

            Say you have a general cardiologist. Is he inferior to an interventional cardiologist or a cardiothoracic surgeon? That’s not how most people would phrase it. But he can’t treat, say, STEMIs. You have to call in an interventionalist to save your bacon. At the same time, not everyone needs an interventional cardiologist. If you have chronic hypertension, you’re fine with a general. If interventionalists see everybody, from venous insufficiency to pacemakers to massive MIs, they would be completely swamped.

            Medicine is a team sport. No one on the team who is being SAFE and looking after the best interests of the patient is “inferior”.

          • Stacy21629

            So the pimply highschooler with his first job in an auto shop is not inferior to a mechanic with 30 years experience, he just has a different job description?
            You’re nuts. I would NEVER want someone with that (hubris) mindset about medical care and expertise attending me.

          • Deena Chamlee

            Stacey its ok, that is choice. I am not sure why many are hung up on semantics of inferior except to get a reaction out of the midwife. I am not inferior, I am not superior. Different profession that definately needs obstetrical expertise. In fact cant practice without it. I value docs I work with, I am grateful to them for being present for me. But inferior never enters my mind, respect does.

          • Stacy21629

            With regards to your obstetric skill set – would you say you are inferior, equal or superior to an OB? THAT is what we are talking about.
            Of course there should be equal respect as coworkers – just like I respect my veterinary assistants and veterinary nurses. But my assistants are INFERIOR in skill set and I prefer to have a nurse on my ER cases.
            That you cannot acknowledge a difference in obstetric skill set is alarming.

          • The Bofa on the Sofa

            This reminds me the recent poster who figures she has a biology degree, so all she needs to be a midwife is some pharm classes.

          • Deena Chamlee

            hey Bofa

          • Deena Chamlee

            Of course there is a difference in skill set. Once again I am not an OB. I am a midwife. I think you all know that we need you all to practice.

          • Trixie

            No one said you were an inferior person. Your obstetric knowledge, while great, is inferior to an obstetrician’s. That’s why, for example, you don’t deliver high order multiples or perform c-sections. Why is this even a question in your mind?

          • Deena Chamlee

            Yes my skill set is inferior, Do you all feel better. I thought I had made that clear by saying I need obs to practice.

          • Stacy21629

            Except you didn’t make it clear. You said “No one is inferior to anyone” in response to Karen saying “In obstetric knowledge, CNMs are inferior to OBs”

            Can you see how your initial claim that, touching obstetric knowledge, you are not inferior to an OB would be alarming?

          • Deena Chamlee

            Stacey I think everyone in this forum including myself have been traumatized and trusting a midwife is not easy. I do not even think in such manners if my skill sets are inferior because that is a given. I am not a surgeon, and that is what I was trying to convey. I do not compare myself to an obstetrician. It is like comparing apples and oranges. I am a midwife who is not disordered and I am sure that is different for everyone in this forum.
            But I just don’t compare myself, there is nothing to compare.

          • anion

            “No one is inferior to anyone, if one has appropriate self esteem?” Are you serious? What does self-esteem have to do with actual quality? I know lots of morons who feel great about themselves; that doesn’t mean they aren’t still intellectually inferior to many others. Not being a medical professional myself, I can’t accurately read an ECG; my knowledge in that area is inferior, but I’m not going to get huffy when someone states that simple, basic truth, because it is in fact the truth–and it’s a truth which doesn’t affect my “self esteem” one way or the other, actually.

            CNMs don’t know as much as OBs. Their knowledge is inferior. A CNM with “appropriate self esteem” would, IMO, acknowledge this instead of getting her panties in a twist because someone stated a fact she doesn’t like. My mom is an RN; she’s a very good nurse with 20+ years experience in the ER, and she’s proud of herself for that (as we are all proud of her), but she’s never claimed she knows as much as an MD, and she’s never whined about being kept in her “respected” place (you mean “respective,” btw) because someone states that obvious fact.

            (Oh, and no one said RNs are inferior to CNMs. The statement was that RNs, like CNMs, DDSes, and DVMs, are inferior to OBs in their knowledge/standing in this particular area. But hey, if you think you, as a CNM, are exactly as qualified as an OB and the only difference is they perform surgery, go head and write someone a script for a Level IV narcotic, and see how that goes.)

            Also, I don’t have to be a healthcare provider to recognize that a proposed study is unethical. If someone suggested giving babies open wounds and smearing them with mustard to see what might happen, and if perhaps doing so would create a new generation of mustard super-babies, I think anyone with a brain can see that’s unethical. Are only healthcare providers allowed to have opinions about the Tuskegee Experiment, for example?

          • Trixie

            But why would you attend it if it’s risky? Isn’t your professional judgment about what is and isn’t safe also an important factor?
            Are you giving mom information about the risks?
            Even if you scoop the poop, isn’t the water contaminated by that point?
            The truth is that physicians have more extensive training and education than CNMs. It’s not putting anyone in their place to point out facts.

          • Deena Chamlee

            Trixie honesty is important to me. There is a hospital consent form but after discussing things with you all I realize it is woefully inadequate. I am going to do a litature review tonight and then I can honestly give an opinion. I realize my profession has shortcomings and I dont trust blindly as I once did in my carreer. I guess you could say I have experienced a transformation. This means if others arecrying safety issues, there probably are safety issues. I do not believe midwivez are being persecuted, I believe we have created our own circumstance. So to answer if I attend high risk in the tub, of course not.

          • Trixie

            I’m glad to hear you’ll look into it further.
            My point is that water birth inherently introduces risk. A baby can aspirate poop water.

          • Stacy21629

            “The bottom line for me is the birth isn’t about me it’s about the woman’s choice.”
            WRONG
            The birth is about HAVING A HEALTHY MOM AND A HEALTHY BABY AT THE END.
            If you think it’s about the “woman’s choice” – that’s exactly the problem.

          • Deena Chamlee

            There is midwifery and there is obstetrics. Two totally different professions with different education, training and beliefs. If one cannot accept the difference and accept each other’s contributions to womens health this is a very normal response. If my care and beliefs are not what you agree with or seek, then seek elsewhere for the provider that is a good fit for you. It’called choice.

          • Stacy21629

            Did you read the recent “Confessions of a Medwife”? They don’t have to be all that different.

          • Deena Chamlee

            I was a high risk labor and delivery nurse for 16 years before I became a midwife. Thus, if an intervention is warranted and informed consent is given I initiate. I am probably more a “medwife” than midwife. Or so says my last boss. She claimed I was the most medically interventive midwife of the six of us. Once again I think this was to shame me. But I gave her no reaction either.

          • Trixie

            I would not want a midwife whose beliefs were vastly different than an OB’s. I would find that very frightening. I would hope that facts and evidence have more to do with care than beliefs.

          • Stacy21629

            Exactly.

          • AlisonCummins

            Facts are not up for discussion. If you believe something, it should be because it’s true. If it’s true, you and an OB should be able to agree on it.

          • Laura

            I was listening to a woman’s birth story. She related that two nurses were arguing over different approaches to when and how she should push her baby out. You know the saying, “There are many ways to skin a cat?” Nothing gruesome or morbid intended, but in some cases that can be true for decisions regarding labor and birth, too, whether you are discussing a situation with another nurse, md or cnm.

          • Trixie

            Well, sure, the woman has the choice to give birth in the water — or anywhere — but Deena has the choice not to attend her because it is too risky. And Deena has the responsibility to truly inform the woman of the risks of water birth, so that the woman is making an informed choice.

          • Medwife

            Attendants also have the right and responsibility to practice universal precautions, and you just can’t do that at a water birth. They’re not done at my facility, but I was a nurse at several, and those armpit-length gloves STILL don’t keep the water out. Of course known hepatitis/HIV carriers are ruled out, but obviously, care providers are at increased risk of exposure to many pathogens.

          • Trixie
          • Trixie
          • Amy Tuteur, MD

            The discussion about waterbirth can be reduced to two questions:

            Would you completely immerse your head (eyes open, of course) in the fecally contaminated bloody water of a birth pool in the aftermath of a birth?

            The second question:

            If you wouldn’t for a moment contemplate immersing your head in a pool of water with feces floating in it, why do you think it is a good idea to force your baby to do so?

          • Deena Chamlee

            Amy dont want to put my head under it is enough with the gloves up to my armpits.

          • toni

            Maybe an enema should be a prerequisite for water birth. Would that solve it or is their danger in any aspiration of any fluid?

          • toni

            there*

          • LMS1953

            Yes. Bath water is just that – water. It is hypotonic as it has no electrolytes. I guess you could fill th tub with Pedialyte and be OK, but when a baby swallows water into the stomach or lungs, it can dilute the blood and the sodium level falls. Hyponatrium can cause mental confusion, obtundation, seizures, coma and death from neurological complications. There can be heart conduction defects and kidney damage. Just leave water birth to whales and porpoises. Humans do best on terra firma
            I had to do an lol at you suggestion of an enema. Back in my residency circa 1980 we still had a 3S standing order (sh!t, shower and shave). Within 5 years that ritual had fallen completely out of favor and the use of LDRs was on the rise.

          • CognitiveDissonaceHurts

            That standing order was one reason why crunchies in the 70s and 80s wanted to “take back birth”. I did have an enema for my first birth (hospital) and it was an awful experience.

          • toni

            I agree they shouldn’t have been mandatory but I think they should still be offered.

          • toni

            But if they swallow (meconium free) amniotic fluid, that’s okay? Because you can see them do that on the ultrasound. What are LDRs? I googled but got nothing.
            I had an enema when I delivered last spring. They didn’t offer I had to ask but they still do them. Unlike CDH below it didn’t bother me that much and it was totally worth the five minutes of discomfort to not crap myself in front of everybody. That’s a very common worry amongst expectant mothers that they will disgrace themselves like that so I don’t understand why enemas are so derided.

          • Young CC Prof

            They swallow amniotic fluid all day long during later pregnancy. It’s safe because it’s sterile and isotonic, that is, it has the right amount of salts.

            Also, by the time babies emerge, many of them are already trying to breathe, so the baby can wind up aspirating the water, which can cause breathing problems.

            Water birth proponents claim that this can’t happen because babies start to breathe only when they feel cold air on their faces. Some cite mammalian diving reflex, which only applies to cold water. The mere existence of meconium aspiration syndrome proves that this line of reasoning is nonsense.

            No one has done the right kind of study to measure how common hyponatremia or aspiration are among water-born babies, but anecdotal evidence confirms the risk is real. Prior to the AAP/ACOG joint recommendation above, the top google hits for water birth safety claimed there was NO added risk to the baby, which just isn’t true.

          • Young CC Prof

            Ooops, there WAS a solid safety study mentioned above.

          • Trixie

            LMS, you’ve just invented the next natural birth treend — Pedialyte birth! Of course, you’ll have to rebrand, because ttthey all hate pedialyte. How about — “a gentle solution of purified water and sacred ancestral halite, GMO-free, chemical-free, and mined from within the earth’s own womb, in the Himalayan mountains, birthplace of the Dalai Lama”?

          • Deena Chamlee

            Lol it is what it is. and it aint what it aint

        • LMS1953

          I am an OB/GYN. I completed my residency in 1983.

          Retrospective analyses have a tendency to have selection bias and be underpowered – witness your inability to even estimate the number in a thesis you likely spent many hours on. A prospective study would not get past an institutional research approval board since it would be unethical.

          I recall that Dr Amy has made mention of documented cases of neonatal death from hyponatremia and aspiration pneumonia as consequence of HB water birth.

          • Deena Chamlee

            Run the data at large centers like I said below. And we don’t need to get nasty with each other. I don’t care to attend them anyway. And I think I spent 45 minutes.
            There were multiple cofactors that were crossed analyzed with multiple variables. The cohort was approximately 400 births, and at the time losses were not being associated with water births.
            Anyway, seems one more thing to disagree on and really I think MDs and CNMs should run the data to find the truth. If Peds, OBs and CNMs agree that the data is ominous then it should be barred.
            Just like dangerous high school graduates calling themselves midwife and leaving a horrific wake of destruction in their path without remorse should be barred from ever laying a hand on a patient again.

    • AlisonCummins

      There are several Skeptical OB posts about water birth. This is one of them: http://www.skepticalob.com/2009/02/whats-in-water-at-waterbirth.html

      From that post:
      Perinatal mortality and morbidity among babies delivered in water: surveillance study and postal survey was published in the BMJ in 1999. Out of 4,030 deliveries in water, 35 babies suffered serious problems and 3 subsequently died. It is unclear if any of the deaths can be attributed to delivery in water. However, of the 32 survivors who were admitted to the NICU, 13 had significant respiratory problems including pneumonia, meconium aspiration, water aspiration, and drowning. Other complications attributable to water birth include 5 babies who had significant hemorrhage due to snapped umbilical cord. In all, 18 babies had serious complications directly attributable to waterbirth. The risk of serious complications necessitating prolonged NICU admissions was 4.5/1000.

      Hospitals in Ireland recently suspended the practice of waterbirth after a baby died from freshwater drowning after delivery in a waterbirth pool.

      • Deena Chamlee

        I have not read this, thank you Alison. Then what the h** are we doing? Bann waterbirth. Water immersion only. Surf and Turf.

        Seriously, this needs to be discussed with the World health Organization since they are addressing midwifery nationally and internationally.

  • Anj Fabian

    OT
    In the event that Dr. Tuteur doesn’t use this post, I present a free birth story.
    There are many interesting and educational pearls in this narrative, but I’m sure you will all appreciate that the happy couple chose to get a 13 week ultrasound…
    .
    .
    …so they could discover the gender of their baby.
    http://doublethink.us.com/paala/2014/02/07/my-freebirth-story/

    • Captain Obvious

      May still be difficult that early. http://www.baby2see.com/gender/external_genitals.html
      Would be more accurate to draw some blood for a harmony test to determine gender.

      • LMS1953

        There was the implied snarky implication that everything she did with her unassisted prenatal course and HB was just perfect and the one time she used medical technology (a 13 week sonogram to determine fetal gender), it was WRONG. Maybe it’s just me, but I have a hard time determining the fetal gender of a 13 week miscarriage with direct visual inspection. Maternal estrogens make the clitoris and labial relatively hypertrophied whereas the penis and scrotum are not much bigger at that stage. Any declaration of fetal gender I make on a 13 sonogram comes with a lengthy “save your receipts” disclaimer.

        • Haelmoon

          Its easier on ultrasound than on examination of a miscarried fetus. The size of the phallus doesn’t matter, its all about the angle it point – up is a boy, down is a girl. If you can get the proper image, its highly accurate and reproducible.

      • Jessica S.

        Personal anecdote: – I found out we were having a girl in an US done at 13 wks, but I wasn’t expecting to find out, I was there for the US portion of the integrated screening. She asked me afterwards if I want to know, b/c she could tell. She handed the print out to another tech who confirmed her guess, but they both cautioned “don’t go shopping yet!”. I couldn’t figure out what they were going off of, b/c the “picture” was a side view. When I got home, I did a little research and wound up on the same site you linked to, but on the page about a study done on gender identification based on sagittal view and the angle of the pubic region. Fast forward to what seemed like a lifetime later, we confirmed at the anatomy scan two weeks ago that it is indeed a girl! :)

        • Jessica S.

          (But speaking to the original point, 13 weeks is still really early!)

        • Haelmoon

          Captain Obvious is right, the Harmony or Panorama tests are non-invasive and can determine sex as early at 10 weeks (test takes on average ten days). But this test is still $800 and not covered in Canada. I will sex fetuses at 12-13 weeks, especially where gender matters (x-linked conditions and Congenital adrenal hyperplasia) with high rate of accuracy (none wrong yet). In appropriate centres, the sexing is accurate (http://www.ncbi.nlm.nih.gov/pubmed/16493625).

    • Young CC Prof

      Link isn’t working for me.

      • Anj Fabian

        Not sure why. It’s taking a few seconds to load for me.

        • Anj Fabian

          Here’s her c-section for breech ‘experience’ complete with the usual tropes – paternalistic OB, evil hospital, interrupted bonding, drugged up baby, and eye ointment causing BFing issues.

          And a cute, healthy baby as a footnote.
          http://doublethink.us.com/paala/2012/07/19/my-first-birth-cesarean-for-breech/

          • Durango

            I bet she was a real peach to care for in the hospital good times.

          • LMS1953

            Considering how peachy she was to order dad and daughters out of the house only to plead for him to come back in 20 minutes. And, dang it, the camera wasn’t on the tripod!

          • Anj Fabian

            For the breech?

            She probably didn’t present any differently than the average patient. It was after she spent time educating herself that her POV changed.

    • araikwao

      Well she had one, so obviously EVERYONE should.

    • Danielle

      Ugh. Typical narrative. The doctor was just running unnecessary tests, just hoping they could find something wrong rather than trusting her strong body, rather than ensuring that she was low-risk and was staying there.

      Then, what do you know, she wasn’t low-risk anymore! (What, I thought that was not possible!) And the doctor doesn’t want to take chances (she mentions absolutely no danger associated with a breech birth). Ah, but actual medical concern is not the real reason: the doctor just wants the baby out by Friday night.

      (Curious: why is that so often used as an explanation? All the hospitals run on weekends, do they not? At my hospital, all the OBs/nurses seemed to work 12-hour shifts. So when one goes set of staff goes home, they’re just replaced by the next set. There’s no meaningful difference between 2 am and 2 pm, or between Friday and Saturday. Doesn’t matter to the hospital one bit when the woman delivers, does it?)

      • LMS1953

        Recent studies have shown an increase in morbidity for “emergency Repeat C-sections” as opposed to “Elective Repeat C-sections”. The 39 week rule has caused an increase in the “emergency” cohort – emergency typically being defined as “coming in in labor” or SROM and not fetal distress or a ruptured uterus. Humans tend to function better when the sun is up as opposed to 0200, no matter what “shift” they are trying to acclimate to. There are preset biorhythms from several million years that are hard to overcome by punching in on a time clock. Typically, the OB takes call from about 1700 Friday to 0800 Monday where a 0200 weekend C-section is particularly draining. We had a saying in residency, “You can teach any first year resident how to do a C-section. In the next three years, you learn how to do one in your sleep.”

        • Danielle

          Good point about biorhythms and outcomes. I’m also quite curious about the difference in risk between planned and emergency c-section. I don’t know if that will ever be relevant factor in a future pregnancy, but its a detail I’ve logged away after reading this site.

          All this conceded, I think the HB narrative that doctors are pushing women to deliver before 5pm on Friday just to get home and eat dinner/take vacation/play golf does not hold much water. The assumption is that there is some financial or personal benefit to the doctor in making sure a woman delivers on a weekday or in the afternoon, and that the doctor’s personal preferences are trumping patient care. But at a major hospital, the doctor goes home and care is picked up by the next shift. So its not like that roast in the oven is actually a big enough factor to be accounting for thousands of ‘unnecessary’ c-sections…even if OBs have some secret, undisclosed affection for roasts.

      • Deena Chamlee

        Strong body seriously? What makes a strong body different than an average. I thought it was about position, pelvis, providers comfort attending a vaginal breech. Nag Strong body crap is all about shaming put up that wall and walk away.

    • mythsayer

      She is so stupid that she doesn’t even know that 13 weeks is insanely early for a gender ultrasound. Was she trying to do everything wrong?

  • Jessica S.

    As many others have already pointed out, it’s a hell of a lot harder to convince a pregnant woman that she’s “low risk” if she’s had an ultrasound that informed her she’s anything but. So whether they do it will malicious intent or b/c it comes with the woo-filled territory, eschewing ultrasounds is a foundational part of keep the racket going.

  • Sue

    Ah – she seems to have missed something quite fundamental….the ultrasound image shows the baby moving, its tiny heart beating – ie that it is ALIVE!

  • Danielle

    These pencil sketches can only appeal to someone who thinks the only purpose of a ultrasound is for mom and dad to see the baby. Forget that! Not that I didn’t love getting a printout, but I want to see that the baby is healthy & know if there are any problems.

    The only reason for not wanting to get a diagnostic test is if you believe that ultrasounds or other tests somehow cause damage. No doubt that belief is widespread with the home birth crowd: even the mainstream natural birth literature nods that direction. Specifically, I am thinking of a passage in Dr. Sear’s pregnancy book where he essentially says, “No study shows that ultrasounds are harmful, but we really can’t know if they are safe. So one should be cautious about having them without a good reason.” (That’s a paraphrase, but I am fairly certain that its an accurate representation of the quote. If anyone wants it, I can go find the actual page.)

    I can’t go along with that kind of shoulder-shrugging about diagnostic tests: Yes, if they merely told me things I can’t change. But they can tell the doctors things that would directly bear on the baby’s outcome. Sign me up!

  • Dr Kitty

    I have a seriously wonky pelvis and spine. My sister died when she was a day old from Congenital Diaphragmatic Hernia that was undiagnosed until she was several hours old (scan were not so great in the early 80s).
    While my parents are great at raising kids, they’re not so hot at making ones with all the components in the right places :)

    Damn right I didn’t leave my OBs office at 13 weeks until we saw an intact spine and skull and a heart and stomach on the right side of the diaphragm.
    I would not have been able to cope without that information.

    I wanted ALL the info, so I could make the best choices and do the right thing.

    My feeling is that people who are totally determined on a particular course of action, new data won’t change their minds.
    Turning down information is mainly done by people who know that they aren’t really sure they can stick to Plan A, and might be tempted to go another way.

    This is a way of making sure anyone who might question if HB is really best never gets the opportunity to find out it might not be.

    • Mishimoo

      I was the same about ultrasounds – my family has a history of neural tube defects and my husband’s family has a history of polycystic kidney disease. I really can’t understand this fear of ultrasounds.

      • Lost

        I had a fear I had a anatomically broken baby. Ultra sound alleviated my fears.

        People have different motivators.

      • Medwife

        Hell, I was breach and my mom had several pelvic X-rays to confirm my presentation. X-rays! I’ll take an ultrasound over radiation, thanks.

    • Lynn

      I am so sorry about your sister. God bless her.

      • Dr Kitty

        Thank you.

  • Anne

    Knowledge is power.

    If the women don’t have the knowledge and ultrasound (or any other medical investigation) provides, they lack power.

    I am sure this is a major factor in the reluctance of HBMW to recommend investigations.

    • Anne

      Sorry- AN ultrasound, not AND ultrasound

    • Young CC Prof

      Going back to their definition of “high risk.” Women who get few to no diagnostic tests in pregnancy are far less likely to get bumped into high risk and out of home birth. As long as you don’t do tests, though, everyone is low risk, right?

      • The Bofa on the Sofa

        I’m pretty sure this is what it is all about.

        • Sue

          In the book The House of God, this principle was described as ”if you don’t take a temperature, you don’t find a fever”.

          It’s another version of sticking your fingers in your ears and LALALAing.

  • LMS1953

    For a least a couple of decades, I have used this cut-out to put up next to the ultrasound image or atop the gravid belly to illustrate presentation, basic anatomy, placenta previa, etc. Moms really appreciate it and I give them a copy to take home to repeat the demonstration. For $16 it would make a nice countertop demo for the different stages of pregnancy. I guess CPMs don’t go for the ACOG recommendation that a fetal anatomical survey be done around 18 to 20 weeks. My typical patient usually asks when she is going to get her 4D ultrasound. I can’t imagine even the crunchiest homebirther wouldn’t want at least one ultrasound in pregnancy. A 7 to 9 week transvaginal ultrasound is the single most valuable test/data point I can obtain in prenatal care. Nothing else compares.

    • C T

      Believe it. I know some who forego any ultrasound at all.

      • Amy M

        Yeah. Because left-handedness is the sign of the devil. (they think u/s increases incidence of lefties. Maybe it does…who cares?)

        • Trixie

          If it increases your chances of left-handedness, then maybe it increases your chances of becoming President!

    • Klain

      Can you explain further? I always thought the most valuable ultrasound was the 18-20 week one, while the really early one was just a dating scan.

      • fiftyfifty1

        ’cause knowing sure dates is just that valuable.

        • Dawn

          Yeah, I found that out with this pregnancy. I got pregnant before I had my first postpartum period, so we had nothing but my very sketchy memory of when my husband and I had had sex to date the pregnancy with. I was glad my doctor did an early ultrasound to give me an accurate due date, otherwise I don’t know how we’d have figured one out.

      • Elaine

        I was wondering the same. Assuming that the mom was charting, she would know her ovulation date within a day. Of course, some OBs don’t put any stock in that and insist on a dating ultrasound while kvetching about how inaccurate LMP dating is… and that bugs me. I did refuse the dating ultrasound with my first because I knew my dates, and got a lot of crap from my then-providers about it.

        Charting is not woo. It is observing objectively quantified physiological markers to measure a hidden physiological process. Now if mom comes in saying “I just have a feeling that I ovulated on X day”, I can see not necessarily trusting that so much.

        • Young CC Prof

          I was charting with ovulation detector test strips. I had a normal period, ovulated on Day 12 of my very regular cycle, had sex on days 12 and 13, and the next time we got around to sex, I was definitely already pregnant.

          I think my dating scan was kind of overkill. (Of course, many women AREN’T sure six different ways like I was. And some people are totally certain and still wrong. I suppose it’s worth checking.)

          • Elaine

            Heck, I think sometimes the dating ultrasound is over-relied on and can be dangerous. My friend had one that showed she was only 5 weeks along but LMP dating showed her at 7 weeks. The doc kept telling her that she would probably miscarry, even while she was explaining to him that she couldn’t be more than 5 weeks along anyway based on the timing of pertinent activities. I have heard about women who are sent for a D&C when ultrasound shows them to not be as far along as they thought; if the mom isn’t educated enough to know that she could have conceived later than her LMP date says, and the doctor is too much of a doofus to recognize that either, then a D&C could be done in a pregnancy that might have turned out to be perfectly viable and just younger than the doc thought it was.

        • Box of Salt

          Elaine, “Assuming that the mom was charting, she would know her ovulation date within a day”

          For many women, that’s probably not a good assumption.

        • Dr Kitty

          Oh honey.
          You know 50% of pregnancies are unplanned?
          Often a contraceptive has failed.
          Often women haven’t the SLIGHTEST idea when their last period was, except it is a bit late, and only a vague idea when they might have conceived.

          Charting is done by a minority of women actively TTC.
          Not so much the ladies who can’t keep track of when they got their last Depo Provera…

    • CognitiveDissonaceHurts

      In my crunchy circle, no one had ultrasounds and we all had lots of babies.

      • Karen in SC

        Are you saying that no one in your circle had a baby with any condition that would have been better known in advance? And no breeches, no placenta problems? No multiples?

        Small sample size doesn’t mean much, sorry. You can toss 25 heads in a row – the probability is still 50/50.

        • Young CC Prof

          I think Cognitive Dissonance is saying that many people do reject ultrasounds, not that it’s necessarily a good idea.

          • http://www.antigonos.blogspot.com/ Antigonos CNM

            Ultra-Orthodox women here in Israel often refuse ultrasounds on the grounds that “whatever God gives us, we accept”. Since they wouldn’t agree to a termination for any reason, what’s the point? I can understand the viewpoint, even if I don’t agree with it. After all, babies did get born, and even survive, before ultrasound technology. Like most tools, the point is to use it sensibly. I know doctors who do a U/S at every prenatal visit, because the patients like it, not because it is necessary. That’s, you should pardon the expression, overkill.

          • Jocelyn

            Plus, ultrasounds can help detect problems that can (and should) be addressed immediately at birth. They might not want to terminate, but they can have a surgical team standing by to do an immediate heart operation (as my friends’ son had).

          • T.

            What about being ready in case of problems? Say, a baby with a congenital heart defect that needs to be born in a hospital with a high-level NICU.

          • Young CC Prof

            Well, some people don’t realize that a large number of the things ultrasounds can detect are treatable, perhaps through surgery soon after birth, or manageable through more intense obstetric care, like placental problems, or just plain good to know, like twins or a due date that’s not at all what you thought.

            I used to mostly associate ultrasound with termination for defects, at least until I learned more about what it can reveal. And I’m pretty solidly pro-choice, but termination for defects (other than the rapidly fatal sort, anyway) gives me the willies morally. It may be inconsistent, but that’s just how I feel, so I do get where those folks are coming from.

          • Amy M

            We had so many u/s because my twins are id and the OB was looking out for TTTS. TTTS can be treated in utero in some cases. Also, it was u/s that found the cervical shortening/funneling that was signaling impending pre-term labor, so we took steps to attempt to keep the babies in as long as possible as well as getting the steroid shots in case those failed. Yay u/s!

          • Anj Fabian

            …and how was it determined that your twins were mono/mono or mono/di or whatever..?

            [channeling the Church Lady]
            Could it be ……ULTRASOUNDS?

          • The Bofa on the Sofa

            nd I’m pretty solidly pro-choice, but termination for defects (other than the rapidly fatal sort, anyway) gives me the willies morally

            Being pro-choice is manifested in the support of the right to make choices, not in the choices we make for ourselves.

            There is nothing in a pro-choice position that requires one to want to have an abortion under any circumstances.

          • http://www.antigonos.blogspot.com/ Antigonos CNM

            “HaShem yishmor” Literally, “God will guard [against]” or “God will provide”.

            It does vary a bit, of course. But many don’t do anything, and assume that if God wants the child to survive, He will see to it. Most haredi women do deliver in hospitals with complete facilities, however.

          • http://thefresstyler.blogspot.com/ Hannah

            A lot of these women just don’t know.

          • http://thefresstyler.blogspot.com/ Hannah

            You know I always find kind of bizarre about that? From a chalachic perspective, they could be seen to be doing the wrong thing, if they’re potentially missing out on something that would put the mother at risk as well. The welfare of the mother is hugely important (not in an airy fairy birth experience way, but in a ‘if the choice is between the mother and the fetus, we choose mother’ way). Not only that, I don’t think there’s anything chalachically wrong with knowing what’s what to be prepared medically and emotionally.

            When I talked about home birth, and birth in general, with my Rebbetzin, who has had seven children, she said that God gave us the option to choose safety so why would we choose otherwise? She was more worried that my husband had a pram in the house already (though technically that’s a cultural minhag, not a Jewish law).

            If a baby dies, it might be ‘God’s plan’ if you happen to have that belief in God, but not if humans have stood in the way of intervention. These women who stand in the way of intervention are kind of like that old story with the dead guy asking God why he let him die in a flood, and God says ‘but I sent you XYZ (rafts, boats, life preservers) , and you turned it all down saying I would save you’. When their baby dies and it was ‘God’s plan’ why don’t they look at medical intervention as the life preserver?

          • http://www.antigonos.blogspot.com/ Antigonos CNM

            I tend to agree with you, and there is a very fascinating discussion of fetal/maternal rights in “Contraception and Abortion in Jewish Law” [Friedman]. But where haredim are concerned, each group follows its own rabbi, and some are almost unbelievably retrograde in certain areas, including being anti-vax as well as being against fetal testing of any sort. There was a recent measles outbreak among a particular haredi community here because an unvaccinated, and infected, child visited from the UK.

          • http://thefresstyler.blogspot.com/ Hannah

            Yeah. We were actually talking to our reasonably modern orthodox rabbi about it last night (and the general dramas re: Haredim and the army etc) and he said they literally have made up laws or basically are having a cultural regression in their fervour to follow everything to the ‘letter’, especially when that’s not really how Judaism works. Particularly when it comes to things relating to women.

            It’s so strange. My husband and i were saying that our great-grandparents/grandparents were frum, ‘to the letter’, and were still able to function in a modern and changing society and embrace the good changes (like medical care, vaccinations etc). It beggars belief.

          • CognitiveDissonaceHurts

            Right.

        • CognitiveDissonaceHurts

          I was responding to the comment “I can’t imagine even the crunchiest homebirther wouldn’t want at least one ultrasound in pregnancy.” We were all pretty hard core NCBers and eschewed the suspicious ultrasounds. Who knew what they would do to the baby? I remember being told that they babies were afraid of them and that to their little ears, it would sound like a freight train coming at them, from which they couldn’t escape.

          As I look back, I honestly don’t recall any babies that had any problems. The most significant issue was that once I wasn’t sure of my dates, and so we thought I was 43, and so was induced at home, only to find out that the baby was covered in thick vernix and didn’t seem to be overdue at all. I always felt guilty that I had caused that baby to be born before being really ready. A dating us could have saved us all from a lot of stress and anxiety and several unsuccessful rounds of castor oil. “Why am I not going into labour???”

  • guest
    • The Bofa on the Sofa

      “The practice has been going on without a whole lot of endorsement from any major group.”

      HA! HA! HA!

      Now midwives are going to be up in arms since he didn’t consider MANA to be a “major group.”

      • araikwao

        And I just saw a picture of French midwives lying about on a road in protest at not being recognised as the same level as doctors and dentists

    • Coraline

      Oh, thank you for posting that article!

    • araikwao

      My tired eyes read Gisele Supermodel Sanctimommy’s husband described as “celebrity quack”, lol

  • InvisibleDragon

    If I face-palmed as hard as this deserves, I’d give myself a concussion. I cannot believe that anyone could possibly believe that a pencil sketch is as good as an ultrasound. Of course, I also cannot believe that some people actually believe the crap that spills from those idiots. Holy luddites!

  • Trixie

    Here I thought, before I clicked, that this would at least be the Spinning Babies style belly painting where they try to sort of figure out what position the baby is in. But no, it’s the same picture for everyone!

    • The Computer Ate My Nym

      So much for personalization.

  • Anon1

    I’d be happy to send anyone a cardboard picture of a baby for the even lower price of $9.99!

    • Lost

      Pah. In 2009 I sent my dad a whole book of his unconceived grandson, courtesy of Time.com publications. Full text, and everything.

  • The Bofa on the Sofa

    Are homebirth advocates stupid? Gloria Lemay thinks so.

    The rate of homebirth in the US is on the order of 10x less than likelihood that a person thinks the moonlandings were faked.

    It’s hard to get an estimate of the number of people who believe in “chemtrails” but honestly, I think that is less than the HB advocates.

    Then again, given the number of people who fell for the “fake snow” nonsense last winter, which is predicated on chemtrails, maybe I am wrong.

    Then again, if it ultimately ends up being debatable whether HB is more popular than chemtrails, then that is certainly sitting out on the fringe.

  • The Computer Ate My Nym

    I wonder if the NST for that poor baby that died of complications of oligo that was ostensibly “perfect” was really the midwife version. That would explain a lot about why they didn’t pick anything up…

    • Young CC Prof

      It must have been, since she was using a handheld device to listen to the heartbeat rather than actual fetal monitoring equipment. We don’t know WHAT she did that she called an NST, but it couldn’t have been the real thing.

  • BeatlesFan

    Of course she discourages ultrasounds- ultrasounds have the possibility of showing a concern which would risk the mother out of having a homebirth! Naturally, she can’t say that, so of course they are dangerous/cause autism/will turn the baby into a serial killer, etc.

    I’d love to say “I can’t believe that anyone will listen to this moron”, but sadly, there has been more than enough evidence that there are plenty of women out there who do.

    • Sullivan ThePoop

      Two different articles came out today about how a small majority (57%) of Americans believe in medical conspiracy theories.

      • Mariana Baca

        I was upset the 6 conspiracy theories weren’t listed. Only fluoridation, cellphones, vaccines and the FDA. I want to know the other 2! :)

        To be fair, a majority did not believe all these theories — minorities believed in each or a few individually.

        • Sullivan ThePoop

          The CIA deliberately created HIV and infected African Americans with it and GMO is a conspiracy to thin the population or population control.

          • http://thefresstyler.blogspot.com/ Hannah

            I am not happy about GMOs/Monsanto but my reasoning is largely to do with the economic implications of them.

          • Trixie

            Many GMO crops have very positive economic impacts for farmers.

          • Mariana Baca

            Yeah, I guess it is the painting a broad brush sort of condemnation. Charging people for accidental airborne cross pollination with patented genomes is either underhanded or exploiting a legal loophole. But then there are lots of GMO improvements that make plants hardier, easier to grow and more productive.

          • Young CC Prof

            Whether one particular company engages in shoddy business practices has nothing to do with whether their product (which is also made by other companies) is harmful.

          • The Bofa on the Sofa

            Whether one particular company engages in shoddy business practices

            As opposed to the farmer who, intentionally, collected seeds from plants that had blown in, and then planted a whole field with them. He claimed it was an “experiment.” The courts, otoh, saw it as intentionally using the genetically modified seed without paying royalties.

            Which it was.

          • Trixie

            Actually, in Bowman vs. Monsanto, they hadn’t blown in. He purchased soybeans grown by his neighbors at the mill and planted them. Then he saved the Roundup-resistant plants and used their seeds. He was intentionally trying to find a loophole around Monsanto. He wanted to use the technology but he did not want to have to pay for it himself. When he got caught, he tried to spin it as accidental. The Supreme Court ruled against him unanimously.

          • Mariana Baca

            I agree!

          • The Bofa on the Sofa

            Charging people for accidental airborne cross pollination with patented genomes

            http://www.npr.org/blogs/thesalt/2012/10/18/163034053/top-five-myths-of-genetically-modified-seeds-busted

            “But as far as I can tell, Monsanto has never sued anybody over trace amounts of GMOs that were introduced into fields simply through cross-pollination. (The company asserts, in fact, that it will pay to remove any of its GMOs from fields where they don’t belong.) If you know of any case where this actually happened, please let me know.”

          • Mariana Baca

            that is good, at least!

          • The Bofa on the Sofa

            I don’t presume to know much else about Monsanto, but I have heard that “Monsanto sues farmers for accidental use” many times. What you discover is that most of the time, people are referring to the one case, and there’s a lot more to it. The farmer in this case is not the poor, innocent victim he tries to make himself out to be.

          • Rochester mama

            Often times the farmer is using his own second generation seed, which is prohibited in the use agreement.

          • Coraline

            Thank you for this! I have learned so much from reading this blog and the comments.

          • Trixie

            Charging people for accidental pollination has never actually happened. It’s a myth.

          • http://thefresstyler.blogspot.com/ Hannah

            Yeah, there have been short term gains, and the product is hardier. Long term, the seeds have risen in price exponentially and reuse of the seeds is not allowed as part of the patent agreement. That’s fine, they can stipulate what they want, but when they have control of the vast majority of seed production then there’s an economic issue as far as I am concerned.

            It’s been a long time since I have read heavily into it, I studied Monsanto for an economics unit in about 2005 and haven’t paid a huge amount of attention since that point other continuing to have the same opinion. I’m happy to be correctly informed, though :)

          • Trixie

            I do agree that food sovereignty is an important issue that bears watching, especially in less developed areas of the world. But I have not seen evidence (other than evidence promoted by anti-GM websites) that, for example, bT corn seed prices are rising exponentially. Sure, seed prices are somewhat higher, because they contain patented technology, but many farmers find that the tradeoff in productivity, reduced pesticide and herbicide use, reduced water, the ability to go no-till, etc. are trade-offs they are willing to make.
            Meanwhile, the anti-GMO activists are doing their best to kill lifesaving projects like Golden Rice. They’ve got blood on their hands with that one, as far as I’m concerned.

          • http://thefresstyler.blogspot.com/ Hannah

            Oh, I have been pretty careful to avoid sources that are obviously anti-GM and like I said, this is based on the outcomes of my research 8 years ago. I will have to do some more reading, I guess.

          • Trixie

            I suppose it is possible that they’ve risen — but again, it’s a free market, and everyone is free to buy seed from whomever they want. If Monsanto makes its seed too expensive, they risk losing market share.

          • T.

            I add to those fear the “What Will Happen In Case of War” ones, because any country that relies on foreign-based food is doomed in such a case, and war is always a possibility.

          • http://thefresstyler.blogspot.com/ Hannah

            Good point. That hadn’t even occurred to me!

          • The Computer Ate My Nym

            It’s been too late to worry about GMOs since people first invented corn.

  • Ra

    Does she also have non-imaging solutions for mammograms and Pap smears?

    • Ra

      Meant to say non-imaging or non-invasive. I know Pap smears aren’t an imaging test. :-)

    • Trixie

      Sure! They just hand you a picture of a healthy cervix!

  • http://www.pediatricinsider.com/ Roy Benaroch MD

    It’s sad that these people want to deny an unborn baby the opportunity to have a prenatal diagnosis that could allow lifesaving intervention. As a pediatrician, I will tell you that sometimes these ultrasounds find treatable conditions, some of which can be fatal or catastrophic if unknown. An early-recognized spinal cord defect can be repaired (or at least managed correctly from the instant of birth), allowing a child to walk; critical heart defects known in advance can be immediately treated. These things are (to say the least) a HUGE issue when babies are born without advance notice.

    Sure, do dumb things to yourself if you’re an adult. But why would you want to hurt your kid? I don’t get that.

    • Young CC Prof

      Any NUMBER of problems with the baby can be treated either in utero or immediately after birth for better outcomes. My cousin is alive today because his heart defect was diagnosed at his anatomy scan. Sonograms can also find issues with the placenta or umbilical cord that put a perfectly normal fetus in grave danger during later pregnancy or delivery. (Some of those issues also endanger the mother.)

    • Lisa from NY

      I have a friend whose ultrasound alerted her doctor that the baby would need immediate care due to congenital heart defect. Had it not been for the ultrasound, the baby would have died within two days.

    • CognitiveDissonaceHurts

      “why would you want to hurt your kid?”

      But we were told that having an UC would hurt our babies, and so we didn’t have them.

      • Sue

        CD is right – this is not a rational decision about pre-natal diagnosis, it’s an IRRATIONAL fear of harming your baby with ultrasound.

        How they can imagine pediatricians as part of the conspiracy I find difficult to understand (same as the anti-vaxers). Why would doctors and nurses who dedicate their lives to improving the health of children give advice that would harm them? Or are they just not very bright? Or easily brainwashed? (Warning: rhetorical questions).

  • anh

    again, I know swearing isn’t the favorite thing here but….christ on a gluten free cracker this makes me want to fucking vomit. what a patronizing piece of shit. what the fucking shit is the woman going to say to the new mother cradling her dead baby who could have been saved by surgery while in utero. or even just by taking precautions before the baby was born.

    It’s not just that she’s ignorant about sonograms, it’s that she’s using childish props to assuage a mother’s genuine concerns. UGH. no!!!!

    If there are any natural birth enthusiasts lurking here…women 2 or 3 generations before us would have PRAYED for the options we have now. They would have BEGGED for pain relief. they would loved to have the interventions we have. Stop with this nonsense. ultrasounds aren’ t hurting anyone!!!

    sorry if I sound crazy. for some reason that woman’s blogpot really set me off

    • The Bofa on the Sofa

      It makes me think of the comment that someone made the other day, on a completely different topic, but is completely appropriate here:

      “What the fuck is wrong with you people?”

      (My apologies to whoever said it that I can’t credit you directly, but I just want you to know, it was great)

    • http://thefresstyler.blogspot.com/ Hannah

      I’m fine with swearing. I didn’t realise it was not looked upon well here, oops!

      I have had this discussion with my grandmother a number of times. She just doesn’t get the NCB movement or the anti-vaxx movement. ‘Why on God’s green earth would we want to go back to that?’ was exactly her phrasing.

      • Amazed

        “They are mad!” My grandfather isn’t a man who speaks just because he enjoys the sound of his own voice, so that’s what he had to say about the anti-vaxx loonies. The picture I could have taken of his face when he realized that there WERE anti-vaxx loonies… WHO could happily use it to promote vaccinations.

    • Houston Mom

      My grandmother had her babies at home because they were poor and lived in a rural area. She was a tough lady – teeth pulled, toenail removed with no anesthetic later in life. I remember her telling one of her nieces who was expecting a baby to take whatever drugs the doctor could give her.

    • http://www.antigonos.blogspot.com/ Antigonos CNM

      Gloria Lemay doesn’t like ultrasounds because [1] she can’t do them, not having the expensive machine or knowing how to operate it, and [2] she can’t interpret the results, not having the knowledge.

      Therefore, she “knows” they are unnecessary and dangerous.

  • Squillo

    So if I draw a picture of Lemay behind bars…

  • Are you nuts

    Hmm. Here I thought the purpose for my prenatal ultrasounds was to look for down syndrome markers, make sure the heart is beating strongly, look for abnormalities… Silly me! Now I know it was just for a souvenir photo.

    • anion

      Well, if you’re someone who thinks MDs really don’t know anything more than lay midwives (or even less) and all that “medical procedure” stuff is just a clever illusion in order to make money, you probably DO think it’s just for a souvenir photo.

      Because everything in pregnancy is all about YOU, and the baby is irrelevant.

      Sigh.

  • Young CC Prof

    You know, the baby egg kit she’s using actually looks really cute. I can see why a pregnant woman or midwife might want it. Often, the actual ultrasound pictures aren’t that clear or detailed! I remember at my 8 week dating scan, the picture didn’t look like anything to me. It was a black ball with an oval-shaped grey blur in it.

    So yeah. Having beautifully detailed actual-size pictures of fetuses in your office is cool. The problem is in claiming that showing your patients anatomy drawings is a substitute for actually complying with the standard of care and performing the appropriate diagnostic tests.

    • Dr Kitty

      I have an 11 week scan pic in which my kid is clearly holding up 2 fingers.

      It’s either a nice hippy peace sign…or the extremely rude British V sign.
      Knowing my kid, I strongly suspect the latter.

      • Sue

        When I do basic ED ultrasounds, beyond about 11 weeks, I always manage to get an image that shows the baby waving hello. Cures almost any symptom.

  • PrimaryCareDoc

    Did anyone catch that she took that picture so the mother could “prove” to concerned friends and family that she wasn’t carrying twins and there was nothing else wrong (as the mother looked to be carrying large)?

    That’s great. Nothing like hearing someone’s concerns about the health of you and your baby and then mocking them to their face.

    • Amy M

      yeah, that sure proves it all right. Sigh.

    • Jessica S.

      I wondered why she was holding up one finger (I only looked at the photo). This just makes both of them look stupid.

  • http://thefresstyler.blogspot.com/ Hannah

    It would be farcical if it wasn’t so terrifying. It feels like she should be at home maniacally laughing, wondering how long people will believe her little prank. Except it’s not a prank and babies are dying.

    I just don’t see how anyone with even a base level of intelligence can think that this is reasonable?

    I just can’t, today. This is making my brain hurt. Maybe I should stop using it so much (and I don’t even think I do, really).

  • Zoey

    Just out of curiosity, does anyone know if Gloria Lemay is still attending births as an illegal midwife? Or just dispensing her burning stupidity on internet?

    • theadequatemother

      I wish the justice system had been able to keep her incarcerated longer.

      • Haelmoon

        She is still involved with pregnant women in BC. I had a patient recently quote her about why my ultrasound of her oligo, 41week breech baby was inaccurate. Apparent, Gloria knows better than I do – “palpation” shows normal fluid.
        Thankfully, the story has a happy ending – elective section for oligo breech baby (baby was breech and oligo).
        She doesn’t understand ultrasound at all. She told my patient that fluid estimates on ultrasound are always wrong. However, I agree that fluid estimates are just that, estimate. It doesn’t matter the exact amount of fluid, but the whether there is too much or too little. When I cannot find a single pocket to measure, that is definitely oligo. If I have two small pockets of 2 cm each (AFI 4), its more debatable. Gloria does not understand that we get the limitations of ultrasound, we are not stupid.

        • Young CC Prof

          And the same applies to size estimates. Yes, everyone, especially doctors and ultrasound technicians, understand that estimating fetal weight on ultrasound is far less accurate than actually weighing the baby. However, they generally ARE accurate enough to identify unusually large or small babies. If the doctor says your baby is ten pounds, he might be only nine. But I really doubt he’s seven pounds.

          • The Bofa on the Sofa

            And he could also be 11

        • Amazed

          I am sorry for being obnoxious but what the hell is going on? Hael, aren’t you a HIGH RISK obstetrician? If someone needs to forget that Gloria Lemay exists, it’s your patients. High risk women go to you AND her? My god.

          • Haelmoon

            You be surprised the number of patients who “consult” with other “specialists”. I routinely have women ask me about recommendations made by a naturopathy or acupuncture and even homeopaths!! It is a very different work out here, and I have learned to just ignore it when is it safe to do so, but I will talk up against practices I think are unsafe.

            I also see general ob consults too, so some of these women are not truly high risk, but I have been surprised by the number of women who are paying out of pocket for additional “support” for their pregnancy.

            We have a real problem with the woo here. It is now common that we have to discuss with women (particularly those who have been to a particular prenatal class) why active management of the third stage really is an option, but a planned course f management – they want the so call physiological management. I just say NO. If I am doing a c-section or a forceps, that is automatically included, it is not up for discussion. If they don’t want it, I dont want to be involved in the delivery.

          • Young CC Prof

            The general OB consult thing is good. My obstetrician has a solo practice, but she often sends her patients to MFM over at the hospital for testing and consultations. It worked out rather well. I was diagnosed with a complication at 32 weeks and was able to get monitoring from them while continuing to see her.

  • Amy M

    http://wisewomanwayofbirth.com/60/

    Here’s one for Gavin Michael.

    • http://thefresstyler.blogspot.com/ Hannah

      “Women are having their births wrecked”

      I am so fucking sick of it being all about ‘their birth’.

      • Jessica S.

        It’s absolutely disgusting.

    • Karen in SC

      Disgusting!

      • Amy M

        I read through the comments…there are no follow-ups, but I wonder how many of the women who wrote in to say they were post-dates, with low fluid and were refusing induction/Csection ended up with happy endings? (by our standards, meaning a healthy baby and mother.)

    • yentavegan

      Makes me feel like weeping in disgust. These so called midwives are dangerous.

    • OldTimeRN

      “Woman are having their births wrecked”

      SERIOUSLY?

    • anion

      That is, in fact, the very “lying in a glass tub” analogy that Christy mentioned in her Midwife Today question on Facebook.

  • The Bofa on the Sofa

    The Professor on Gilligan’s Island used coconut shells to mimic all sorts of technology, like telephones, and, because it looked like the item of technology, it worked like the item of technology.

    Alright. Them’s fightin’ words.

    a) Professor Roy Hinckley never made a telephone, out of coconuts or anything
    b) The stuff he made didn’t “mimic” technology, it WAS technology and it DID work, because the Professor knew how they worked and found ways to do it. The coconuts were just the casing, he found the proper materials on the island (usually on the other side of the island). He knew that he needed long chain hydrocarbons to absorb the alpha radiation of the radioactive vegetables, and he knew how to make a battery from natural substances.

    You don’t say anything against the Professor in my presence.

    (Can I add that Russell Johnson was a great person, too?)

    • Karen in SC

      Yeah! And I really thought a baby wooly mammoth would be great as a vacuum cleaner, too. :)

      • The Bofa on the Sofa

        Yeah, I didn’t get that either. The woolly mammoth is not meant to mimic technology. It worked as a vacuum by a completely different mechanism than our modern versions.

        (BTW, it’s way OT but I’ve been meaning to say it: Can I just say how happy I am to have our new Roomba, Otto 2.0? Our old one died right about the time we moved last fall, and I have been so lost without him. Finally, regular vacuuming again! I tend to keep him busy)

        • http://thefresstyler.blogspot.com/ Hannah

          I really need a Roomba. No matter how much my husband touts the Dyson’s superiority, the thing is a beast and I cannot be bothered with it at the best of times, let alone while pregnant.

          • The Bofa on the Sofa

            We were able to get a pretty good model (not the high end of the line, but a 660, I think, still a lot better than our old 440 model) from BB&Beyond with a 20% discount.

            As a vacuum, I suspect the Dyson is “superior” but you can’t program you Dyson to clean the floor on its own every day.

            And when Otto backs out of his docking station, he goes “Beep! Beep! Beep!” like a truck backing up. And when he’s done, he goes back and parks back in place.

          • Dr Kitty

            Our Dyson died.
            It was replaced with a knock off Roomba (Vileda cleaning robot) and a Vax lightweight upright.
            We’re very happy.

          • Mariana Baca

            I got one of the tiny dysons. It is super easy to carry and I love it. I had a roomba, but it was an early model wit ha faulty battery. But, there are too many obstacles in my house of a roomba to be a good device for me, so I didn’t replace it.

          • http://thefresstyler.blogspot.com/ Hannah

            I had the Dyson Animal in Australia and loved it, but I didn’t have carpet, I think I will look into one again. Our full-size Dyson is just too much vacuum.

          • anion

            We had a Dyson. My husband loved it so much he refused to let me use it. Only he got to do the vacuuming. :-)

        • Sue

          I just LOVE Flintstones technology.

          My favourites include:
          - the camera, which contained a little birdie who would draw a picture of the scene
          - The shower, which was a mammoth spraying water out of its trunk, and
          - pie-making day – an assembly line where Wilma used the feet of a bird to puncture the air holes in the covering pastry.

          (Yay – I finally get to join in with Bofa on pop culture!)

      • KarenJJ

        When my mum’s group had meet ups at each others houses in the early days I noted that those with the cleanest floors under the high chair also had dogs.

        • Mishimoo

          We have indoor weimaraners; I can vouch for the clean floors!

        • AlisonCummins

          That is definitely a use we put our dogs to. When something drops on the floor while cooking, call the dogs and it’s taken care of instantly. My brother (a bachelor) has his dog rinse the dishes before washing them.

    • Trixie

      Let’s add the Professor to the list of People I’d Rather Have Deliver My Baby Than a CPM.

      • The Bofa on the Sofa

        Hey, I’d take “The Professor When He Was Put In a Trance By a Hypnotist and Stood Out in the Rain for 2 Days” over a CPM.

    • Susan

      Forget Ginger v Marianne because among the males there was no choice but PROFESSOR ya baby…..

  • Stacey

    Jan Tritten’s comment to Gloria Lemay’s sharing the “egg post” on Jan’s Facebook page: “Awesome. The work you do is so so so important!”

    • Durango

      Festival of Stupid, indeed. lol

  • Therese

    I suppose seeing a drawn to scale image of their fetus might be interesting, since ultrasounds don’t really give you that. Hopefully, they have a macrosomnic version of the images as well, since that would be applicable to about half of their clients.

  • Amy M

    How about this one?
    http://wisewomanwayofbirth.com/7-step-recipe-for-creating-an-autistic-child/

    She thinks u/s causes autism/brain damage. Of course she thinks most things cause autism/brain damage, so its pretty easy for her to get off the hook if a baby born under her care later turns out to have brain damage or autism. I’m sure however, there are children with brain damage/autism whose parents managed to avoid all 7 things. I wonder what she has to say to them?

    • The Computer Ate My Nym

      Why is autism that thing to be most feared in the world in the NCB movement? I mean, yeah, it can be nasty, but it’s not as bad as death or severe hypoxic encephalopathy or viral encelphalopathy. Autistics can do quite well and lead happy, productive lives. Why fear it more than brain death or measles?

      • Amy M

        Beats me. I hate how they jump on the “autism is all mom’s fault” bandwagon too.

        • InvisibleDragon

          In my case, it was, going back several generations. But the schizophrenia was all from his side. -snicker-

      • http://thefresstyler.blogspot.com/ Hannah

        I fear autism, because I worry about how my husband and I would cope. I am sure that I would, but I do fear it. Just like I fear a variety of other ‘issues’.

        However, that’s not stopping me from vaccinating or having ultrasounds for 60 seconds each time I visit the OB.

        A friend of mine was horrified that I will have had, total, about an hour to ninety minutes of ultrasounds when all is said and done. She told me my baby would be autistic and have hearing issues. Given that she’s a homebirther (admittedly a reasonably sensible one), I took her concerns with a grain of salt.

        • Amy M

          I had at least 10 u/s, for my twins. They can hear fine, and are not remotely on the autism spectrum. Also, autism does not run in our family and my husband and I were both relatively young when the children were conceived/born. Genetics and parental age are the more accepted hypotheses about ASDs as far as I know.

          • http://thefresstyler.blogspot.com/ Hannah

            I tend to think the ‘crisis’ is overblown, anyway. My mother is a teacher and she said the rate of kids who would normally just a bit ‘painful’ (her words, not mine, she loves most of her ASD kids) who are now being diagnosed as Aspergers is kind of startling. A friend of mine’s daughter was just diagnosed because she was being a bit frustrating, after some ENORMOUS life changes, and my mother ended up begging her to get a second opinion because based on her training the little girl was showing zero signs of behaviour issues.

            For people who think that everything to do with birth is a ‘variation of normal’ they seem to be pretty damn eager to put their kids in a diagnostic box. As long as the diagnosis doesn’t come from, you know, an actual doctor.

            Disclaimer: I don’t mean to take away from all ASDs diagnoses, I actually think over-diagnosing it is making things harder for the kids who actually have it.

          • yugaya

            There may be some cultural factors at work also – like something that is considered to be worthy only an observational remark given at kindergarten preschool evaluation exam in my country (age 6) how a child will need to be individually monitored and assisted to achieve successful socialization during the first four years of primary school (7-11) would probably get ‘translated’ into a spectrum diagnosis if that child moved to USA or UK.

          • http://thefresstyler.blogspot.com/ Hannah

            Yeah, for sure.

          • Mel

            Plus, my twin sister is deaf. We never had prenatal ultrasounds – nor did Helen Keller.

        • Young CC Prof

          It is perfectly reasonable to fear having a child with special needs. It’s hard.

          What’s weird is fearing autism so much MORE than other hazards, including birth injury, SSPE, congenital heart defect or death.

          And there’s no evidence linking autism to obstetrical tests or interventions of any type. (Slight link to obstructed labor, though.)

          • http://thefresstyler.blogspot.com/ Hannah

            Yeah. I fear All The Things. Yay anxiety.

          • Young CC Prof

            I suppose one part of the whole naturalist movement is the promise of control, that there’s no need to fear as long as you do everything right.

          • http://thefresstyler.blogspot.com/ Hannah

            Oh, absolutely! I think that’s a huge part of what motivates the women in my birth group online who are almost rabid in their suspicion of modern obstetrics. They don’t seem to be inclined to be anti-vaxx or anti-ultrasounds, thank goodness, but they seem to think the US hospital system is out to fail them and that the key to a successful birth is to ‘trust their body’, meaning that they have control over the situation.

          • Young CC Prof

            Actually, I’ve looked at ICAN’s Facebook page a few times. (I keep telling myself not to go there again, but it’s like a train wreck.) I saw a few posts from women whose births were traumatic by any reasonable standard: Crash c-section, baby in the NICU, didn’t even see the baby for hours and hours. The weird part is that they’ve decided that the reason they feel traumatized is that they had a c-section, and the key to a better experience next time is to VBAC.

            It’s like, “You know, it really sounds like your baby being at risk was the problem, not the manner of delivery.” But maybe they’ve convinced themselves that the baby was at risk only because of the c-section? I don’t get it.

          • http://thefresstyler.blogspot.com/ Hannah

            I have tried and tried to work out what the logic is and can’t seem to do it.

          • Angela

            I think this desire for control is why I got sucked into some woo with my first pregnancy, despite having a terminal degree in a biological science. I have a type A personality, and, for the most part, planning and preparation had served me well in previous life endeavors. Plus, I’d had a few bad encounters with physicians in the past and was smart enough to recognize some of the legitimate problems/shortcomings of modern U.S. medicine. All my preparation (Bradley class, running, doula, prenatal yoga) for an unmedicated birth (in a hospital with a CNM!) very quickly went out the window at 41+1 when a BPP showed an AFI of 1 and when even the lowest dose pitocin caused decels. Baby’s urgent C-section revealed a triple knot in the cord so bizarre that even the OB remarked that he’d never seen anything like it in his entire 22 years. So much for being in control and doing everything “right.”

        • The Computer Ate My Nym

          Yeah, I was very relieved when my small one started talking, which meant that she did not have severe autism. But there are so many other things to fear…I think autism may be one of the big ones right now because there’s no known way to predict it or protect against it. So you get a lot of superstitious behavior to try to prevent it. I just wish people would restrict themselves to not quoting MacBeth during pregnancy or something rather than going with dangerous acts like refusing vaccines or giving birth at home.

          • http://kumquatwriter.wordpress.com/ Kumquatwriter

            “The Scottish pregnancy?”

          • anion

            HA!

          • Siri

            Lol! When is a Dunce Inane? When you decide to burn’em woods. Sorry.

        • VeritasLiberat

          There are at least 3 posters on the autism spectrum on this very board.

          • http://kumquatwriter.wordpress.com/ Kumquatwriter

            More than that; plenty you can’t even tell.

          • The Computer Ate My Nym

            Yeah, how do you tell if someone’s autistic in a medium where there are no non-verbal cues to use? We’re all effectively autistic on the internet. (Yes, even with smileys. Smileys are just pictographs.)

          • http://thefresstyler.blogspot.com/ Hannah

            One of whom commented and said it was an understandable fear and that she was relieved when her daughter spoke for the first time as it likely ruled out severe autism.

            I also fear major depression, anxiety and true OCD in my children, and how I would cope with it, because I know what a struggle it was for my parents to deal with my brother and I having said issues.

            As I clearly said, I fear all issues, autism being one of them. It’s mostly anxiety about my ability to cope with it.

          • Amy M

            I don’t think you are awful. I had similar fears. My husband has ADHD. Odds are at least one of our boys will be diagnosed with it. I am a little sad about it, not because he isn’t “normal” but because life will be harder for him and for all of us than it needs to be. I wish I could make life easier for my husband and for my son/s, but that is not in my power, so we have to play the cards we are dealt, you know?

          • http://thefresstyler.blogspot.com/ Hannah

            Thank you. I was so upset all last night thinking I had been hideously insensitive when that wasn’t my intent at all.

      • Amy M

        Also, I got all 7 and my children are neither brain damaged, nor autistic. (lots of u/s, didn’t/don’t eat organic, pitocin and epidural in labor, vacuum assist for one of them, vaccines, formula.) My I wonder how we were lucky enough to be spared./sarcasm.

        • The Computer Ate My Nym

          I got 5/7 (didn’t induce and she got a total of one bottle of formula in her life) and…the child is neurotypical. NEUROTYPICAL? Where did I go wrong? (I’m aspie and my partner is social but geeky so we weren’t expecting a social butterfly…)

          • Mishimoo

            My husband and I are rather introverted, so of course we seem to have ended up with 3 extroverts.

      • Mariana Baca

        Because they want to latch onto a doomsday scenario modern society is causing, and the only diseases that have really have any dramatic increase are those that we only recently started diagnosing. This is why it is a crisis to diagnose so many kids with adhd (which requires taking evil, evil meds!) and it is a crisis that there are so many kids with autism. Must be modern society that is causing this! And since modern society doesn’t provide an “easy fix” for autism, double points on it being the worst thing ever.

    • Sullivan ThePoop

      If you want to blame something for autism then anything that was on the rise when autism seemed to rise could be seen to correlate.

      • The Computer Ate My Nym

        Autism is caused by the increase in the size of the mid-Atlantic ridge.

        • Sullivan ThePoop

          Someone told me it was ‘new’ television technology

          • Amy M

            No it’s global warming and the decrease in piracy.

          • Young CC Prof

            https://xkcd.com/925

            And autism causes ultrasounds?

      • anion

        Watching The Simpsons while pregnant clearly causes autism.

    • Mariana Baca

      There is no way to avoid all the things people claim causes autism. As a last resort, blame wifi and cellphones since it is impossible to avoid those in modern society. I think people just use “I don’t understand technology” -> “this technology must be bad”.

    • Karen in SC

      I’d like to see a graph of the number of autism diagnoses per year vs the number of unspecified mental retardation diagnoses (excluding Down Syndrome). It seems to me that when I was growing up some of my friends had siblings or aunts/uncles that were MR and I seldom hear of anyone these days.

      This is just a theory based on my admittedly limited observations.

      • Guesteleh

        The contribution of diagnostic substitution to the growing administrative prevalence of autism in US special education:
        http://www.ncbi.nlm.nih.gov/pubmed/16585296

        Prevalence findings from special education data do not support the claim
        of an autism epidemic because the administrative prevalence figures for
        most states are well below epidemiological estimates. The growing
        administrative prevalence of autism from 1994 to 2003 was associated
        with corresponding declines in the usage of other diagnostic categories.

        • Karen in SC

          I am a GENIUS!!

          • araikwao

            Certified Profession Genius, perhaps? It adds an air of legitimacy to your claim

          • Beth

            I’ve long suspected the same thing, Karen. I think many of the kids being diagnosed with autism today would have been diagnosed with mental retardation in the past. It’s much more socially acceptable to have a child with autism than one with MR.

          • The Bofa on the Sofa

            Wile E. Coyote
            Super Genius

        • Sue

          Of course there are much tighter diagnostic criteria for developmental delays and behavioural issues these days – there is so much more that can be done to help these kids. Also, a diagnosis is often an entry to special benefits or educational support – so the number of diagnoses goes up – surprise!

      • AlisonCummins

        Yes, that’s the diagnostic substitution theory. It’s pretty clearly a major factor. I’ll see if I can find that graph.

      • AlisonCummins

        Diagnostic substitution and autism discipussed by a prominent autism researcher: http://deevybee.blogspot.ca/2012/06/autism-epidemic-and-diagnostic.html

        I was looking for a nice chart by Prometheus of A Photon in the Darkness but the site is down.

    • Dr Kitty

      In the case of one of my patients, his autism is from his HIE.
      We know that FOR SURE because his identical twin, who didn’t have HIE, also doesn’t have CP and autism.

      I suspect that HB, with increased risk of HIE and mild hypoxia might increase rates of autism.

    • Aki Hinata

      My formula fed child has no brain damage. My ADHD child was breast fed and not induced. My next two were born with the help of pitocin, with no brain damage. Boy, I guess I really dodged the bullet! I did things off the list with all of my pregnancies and of my five children, one has ADHD, which his father also happens to have. Genetics, maybe? What a flippin moron!

  • Mel

    So when I get an echocardiogram, these are the equivalent – especially if I’m holding them in front of my chest?

    Perhaps I’m reading too much into a photo, but does the mom look less than convinced in the picture to anyone else?

    • Are you nuts

      Someone really should call operators of echocardiograms, CAT scans, MRIs, etc and tell them there is a better solution. Think of the money we’ll save!

      • Dr Kitty

        Sure! Just enlarge a few prints from Gray’s Anatomy and hold the over the relevant body part!

        Anyone who has ever dissected a cadaver or been in an OR will know how little anatomical models look like real people.

        • KarenJJ

          Are you telling me that I don’t have a heart with pretty colours and easy to read labels with arrows showing what is going where?

        • Vera

          Despite owning several anatomical texts, I was bitterly disappointed in the wet lab that the various organs weren’t at least vaguely coloured like the pictures. Not that the prosections were much better, given the tech could’ve coloured the resin. Anatomy is so disappointing in real life.

  • Young CC Prof

    Right. Because the only reason to do an ultrasound is to have a pretty picture of your unborn child so you can photograph yourself holding it up to your belly and send it to your friends and family. Oh wait! You can also find out if it’s a boy or a girl!

    There probably are pregnant women who believe that, but I sincerely hope there aren’t very many.

    • moto_librarian

      I loved seeing what my babies looked like on ultrasound, but for me, knowing that they were developing normally was of far greater importance.

    • Sue

      Wait – how to have an unmedicated birth: attendant holds up cards showing picture of anesthesiologist and epidural equipment, pics of vials of drugs, pics of mothers laboring with a smile…

  • Alenushka

    Last year, the theme of Burning Man festival was Cargo Cult. Homebirth Camp would have been a good fit.

    • http://thefresstyler.blogspot.com/ Hannah

      There’s always this year.

      • http://kumquatwriter.wordpress.com/ Kumquatwriter

        So much for a drug free labor…

        • http://thefresstyler.blogspot.com/ Hannah

          Zing.

  • Spamamander

    Coffee through the nose HURTS. Thankfully it had cooled off !

  • The Computer Ate My Nym

    **Blinking bemusedly.**

    Um…what? Did LeMay really just suggest giving women a drawing of a fetus as an alternative to ultrasound? And anyone believed her?

    • Mel

      A mass produced pre-purchased picture of a fetus….

    • Squillo

      Why not? Lemay is a fake midwife, why wouldn’t she give a fake ultrasound? Actually, I’d feel safer having my birth attended by a drawing of a midwife than having Gloria Lemay.

      • Young CC Prof

        Oh, man, now I have a mental image of one of those life-sized cardboard cutouts of an NCB leader, standing in the corner of a delivery room, knitting needles in hand.

        • The Bofa on the Sofa

          Awesome.

          Standing next to Spock.

        • Trixie

          Cardboard cutouts: safer birth attendants than CPMs.

    • The Computer Ate My Nym

      Wait. It’s worse than I thought. The woman in question was seeking an ultrasound because she was concerned about the possibility of twins. So she got a picture of one fetus and was told that that proved all was well. Is it wrong of me to hope that she delivered two very healthy babies at the end of this pregnancy?

  • moto_librarian

    Just when I thought that it was impossible for NCB advocates to come up with anything dumber, Gloria LeMay steps in with this gem. I think that maybe I’ll hire my four year-old as a non-ultrasound technician. I’ll bet he could come up with his own version of what a fetus looks like in utero…

    On a serious note, this attitude against routine testing angers me so very much. My midwives adhered to the scope of their practice, and while they certainly didn’t force anyone into testing, they strongly recommended an early ultrasound for dating, a 20 week anatomy scan, and GD testing. They also listened for the heartbeat over doppler, checked my weight, my BP, my fundal height, etc. at all of my prenatal appointments. This is how you gather actual data to determine whether or not a pregnancy is remaining low-risk. This is also how you avoid potentially lethal surprises. Why even bother with a midwife if this is all that you’re going to get?