How you can tell that another woman’s C-section was unnecessary

Young Woman holding Magnifying Glass

A favorite parlor game among natural childbirth advocates is determining whether a stranger’s C-section was necessary. Figuring it out is only half the fun. Once you decide that the woman had an unnecessary C-section, you express ostentatious sadness and distress that she, poor thing, is not as educated as you are.

Gina Crosley-Corcoran, the Feminist Breeder, demonstrates how it’s done:

It’s incredibly difficult for me to overhear a pregnant woman talking about how she had to have a cesarean last time because her baby was “too big” and now they’re giving her an “automatic” repeat cesarean at 38 weeks. I have no judgment about this individual woman, it’s just so painful to hear this story again and again. I say this as a maternal child health scholar and as a woman who vaginally delivered 2 nearly 10 lb babies after a cut-happy OB gave me a cesarean the first time for a “big” 8 lb baby. Why don’t more women know about the overuse and abuse of cesareans? Why are some doctors still doing this shit?

Determining that the stranger’s C-section was unnecessary ✓
Expressing distress ✓
Bemoaning the stranger’s lack of education ✓
Mentioning your own ample pelvis and how many babies passed through it?  That’s the cherry on top.

Well, I’m here to tell you a secret and considering that I am an obstetrics “scholar” (the relevant discipline, not public health) I ought to know.

Come closer and I’ll whisper in your ear exactly how you can tell that another woman’s C-section was unnecessary.


Here’s the secret:


No one, least of all someone who isn’t even a medical professional can determine whether another woman’s C-section was necessary or unnecessary.

First of all, the woman may not be disclosing the real reason that she had the C-section. Thousands of C-sections are performed each year for active genital herpes. The herpes virus can easily be transmitted to the baby as it passes through the vagina, leading to encephalitis, sepsis and death. For obvious reasons, not many women are comfortable announcing to their mother-in-law, their boss, and their next door neighbors that the reason they had a C-section was because of active genital herpes, so they make up some other reason, including claiming that they simply preferred a C-section to a vaginal birth.

Second, even an obstetrician cannot tell if a woman’s prior C-section was unnecessary unless he or she has access to the medical records and can examine the patient. Unless you put your fingers inside her vagina and measure the diagonal conjugate, intertuberous diameter and prominence of the ischial spines, you have no idea whether her pelvis can accommodate a large baby or not.

Third, while public health information about large populations can inform treatment of individual patients, it tells us nothing about the appropriate treatment for a specific patient. So even if we were to conclude that the contemporary C-section rate is “too high,” we cannot draw any conclusion about whether a C-section was necessary or unnecessary for a particular patient.

There’s another aspect to this that is equally important and generally overlooked by natural childbirth advocates. Sometimes I can tell (or I think I can tell) that a procedure a patient has undergone was not necessary. I do not share that information unless it is directly relevant to planning future treatment. Who benefits when you tell a patient that you would have cared for her differently? Certainly not the patient. Now she distrusts her previous provider and her own judgment in choosing that provider. Now she has to wonder whether things could have been different, but she has no way to fix what happened. Sure, when I was practicing, I could make myself a hero and tell a mother that my C-section rate was so much lower than many other obstetricians, but what does that do for her? Nothing.

Who benefits when a random stranger tells a woman that her C-section was unnecessary. Certainly not the woman. The only person who gets something out of it is the one who imagines that she is superior and would never have been duped.

And when it comes to accurately assessing whether an a specific C-section was necessary for a specific woman, a self-proclaimed public health “scholar” is no different from a random stranger. Studying health on the population level has NOTHING to do with treating individual patients. It makes about as much sense as a military history “scholar” telling a soldier on the ground in Afghanistan how to react when an insurgent starts firing on him. The fact that the historian has studied the battles of Thermopylae and Waterloo is not particularly relevant in an emergency situation.

The bottom line is that only an obstetrician can tell you whether a C-section was unnecessary, and then only after he or she has reviewed your records and examined you.

Random strangers can’t tell at all.

343 Responses to “How you can tell that another woman’s C-section was unnecessary”

  1. Regrets
    June 15, 2018 at 10:00 am #

    I just learned my c-section was not necessary…or it was and they lied in the records. Just because some moms need it doesn’t make what they took from me, from my husband, and from my son, any less relevant. I got a c-section because they don’t know basic troubleshooting for a live birth with no signs of fetal distress. I also know a woman who lost her baby that, in retrospect, may have been saved if she went right to the OR. Same hospital.

    Fighting extreme views (it’s extreme to project so much on another woman’s experience – I couldn’t care less about how your baby was born as long as YOU are ok with it) with extreme stories and views of your own doesn’t solve the problem with maternal care in the US. Saying other countries have it worse (and they absolutely do) doesn’t mean we should continue to allow fear of liability to trump actual patient care. Yes, c-sections are sometimes necessary…and yes, we are a also cut-happy country.

  2. Guest
    April 23, 2014 at 1:30 am #

    I am just now discovering this website, and oh how i wish I had found it sooner. I had 3 c-sections for my 3 breech babies (I have a bicornate uterus), and I never once doubted that having a c-section was the right thing to do. However, I have been in the uncomfortable position of having to defend the method of delivery many times from nosy acquaintances who were horrified, judgmental, angry at my doctor, and always wanted to know if we had tried x, y, or z in order to avoid surgical birth.

    It has been 6 years since my last baby, and I STILL get probing questions from people. I am sick to death of having to justify myself to people who are uninformed about my particular circumstances (which were actually much more complex and dangerous than just breech presentation). I am sick of their ‘pity’, sick of the attacks, sick of the condescension.

    THANK YOU DR. AMY for this website. Thank you for your voice of reason amidst all the craziness. Thank you for being my voice! I finally feel validated and supported and triumphant! 🙂

  3. Cat10
    March 25, 2014 at 11:17 am #

    Thank you for this post! I had a planned c-section with my first pregnancy because my daughter was in breech presentation. You will not believe the comments I get from people when I tell them that I had to have a c-section. One OB nurse even had the chutzpa to tell me that “in other countries” even first-time mothers are delivering breech babies naturally. I told her that, yes, in a developing country this was probably true due to lack of adequate medical care for mothers.

    I am tired of having to justify myself for something that was totally out of my hand.

    • Ash
      March 25, 2014 at 11:41 am #

      In the words of Monty Python, I encourage you to respond to these rude comments with “I don’t want to talk to you no more, you empty headed animal food trough wiper. I fart in your general direction!”

    • anion
      March 25, 2014 at 12:03 pm #

      Don’t justify yourself! You did nothing wrong, (And had your section not been medically indicated, you still would have done nothing wrong.)

      Next time someone makes a comment about it, either give them a tight smile and say, “I’m very happy with my baby’s birth,” or a freezing look and an, “Excuse me?” Or, of course, any combination thereof.

      Follow those with a blank stare if they continue to try to discuss it, and/or a quick subject change.

      You could also try a wide-eyed, overly fascinated, “Really? Tell me MORE! My goodness, I never knew that! Wow! How *interesting*,” and so on and so on, and let them babble while you take a mental nap. You could ask them where they practice, so you can go to them with your next pregnancy, if you’re feeling especially snarky. (the key there is to then look genuinely befuddled when they say they’re not a medical professional, and say things like, “Oh, I’m sorry, I thought since you were second-guessing my doctor you must be one as well.”)

      (Obviously, some of these depend on how well you know the person speaking, whether or not you’ll ever have to see or speak to them again, and how comfortable you are. But seriously, remember: You do not have to justify anything to anyone. It is none of their damn business. Your body is not a public commodity whose use is up for debate or analysis by all and sundry. And you do not have to discuss it or listen to such discussions, at all, EVER. The people making those comments to you are being rude, and you aren’t required to entertain rudeness–even “well-meaning” rudeness.)

      I had two sections and loved both of them; I had zero interest in vaginal birth and even less interest in pain-med-free birth. There’s nothing wrong with c-sections. They’re awesome. They save lives, and lots of women are very happy with them.

      (Oh, and if it’s still recent enough, I’d complain about that OB nurse. Contact the Nurse Manager at the hospital and complain to her, too. The nurse had no business making any sort of comment like that to you. And complain to your OB, absolutely, definitely, asap; s/he should know that his/her patients are being encouraged to doubt his/her care and decision-making.)

      I hope that helps!

      • Cat10
        March 25, 2014 at 12:05 pm #

        Thanks! You are absolutely right, I should not justify myself.

        • anion
          March 25, 2014 at 12:23 pm #

          It’s very hard, I think, when people say things like that, not to start justifying or explaining. We feel accused, and often we’re so taken aback that the first instinct is to explain. It took me a long time to remember that I always have the option to simply refuse to discuss whatever topic. You don’t owe these people any kind of explanation. Stay strong! 🙂

        • The Bofa on the Sofa
          March 25, 2014 at 12:28 pm #

          While it is unfathomable that you should have to justify yourself, I would add that, it’s none of their business whether you even had a c-section in the first place.

          Is this something you are volunteering?

          I see folks with babies, I say, “Oh what a lovely baby!” If they are new, I might comment on how big they are, or how they are so cute when they are tiny, or that they have a ton of hair. I will find out when they were born. I WON’T ask about how they were born, or if you are breastfeeding. I can’t understand who would, but apparently there are those who do.

          • Young CC Prof
            March 25, 2014 at 1:15 pm #

            With a very new baby and a mother that you actually know, one might ask something like, “How was the birth,” a polite and nonspecific question that allows for as much or as little information as the mother wishes to provide.

            But yeah, if the baby is more than a few weeks old, or the mother is a stranger or near-stranger, why would you ask? And why would ANYONE ever press for details?

          • The Bofa on the Sofa
            March 25, 2014 at 1:33 pm #

            “I hope everyone is ok and healthy!”

            (unless I have any reason to think otherwise)

    • Young CC Prof
      March 25, 2014 at 12:19 pm #

      The NCB movement is so weird about c-sections. The doctor is evil for doing such a horrible thing to the mother! But the mother was weak for agreeing, because it’s the easy way out? That’s SO inconsistent.

      Either c-sections are safer and easier, in which case doctors are doing a good thing by offering them, or c-sections are harder and riskier, in which case mothers who consent to one in order to protect the child are being brave, not stupid.

      Whatever. Your body, no one else’s damned business.

  4. Sue
    March 15, 2014 at 3:41 am #

    In my specialty, one of the most common decisions is how far to investigate a relatively well-looking person presenting with chest pain that is suspicious for acute coronary syndrome, and whether to send them home.

    Current guidelines are fairly risk-averse, and can can reduce the chance of an ”adverse cardiac event” (not just death) to about 1% over thirty days. But not zero. And to do that, we end up with some false positives who go on to have invasive testing, with a risk in itself.

    How many of those work-ups are ”unnecessary”? In retrospect, the majority of them. The problem is, we don’t know in advance. That’s the point.

  5. Nell Q
    March 15, 2014 at 1:49 am #

    As a health services and public health scholar myself (with a Ph.D and a research job in a medical school and a health policy shop), I find that this action is unconscionable and should result in professional alienation AT THE LEAST.

    Public health and health services research are good for a lot of things. They are part of how we determine evidence-based guidelines for how to deal with a variety of problems. They also allow us to begin to determine models for effective care and ways to move beyond severe health disparities and out-of-control costs. They also help us figure out where the system is failing patients as groups, and what models of care can best meet those patients’ needs.

    They do none of these things without reliable data. Not a one. Claiming your credentials in a way that gives you authority, and then proceeding with analysis that ignores every single thing about how you were taught to responsibly come to conclusions is a major violation of professional ethics, and should be met with consequences that match the gravity of those violations. She’s not just undermining one mother or one provider, she’s undermining the value of research itself at a time when we desperately need to be communicating that value more clearly to the people who make policy and the public at large. It’s disgusting, malignant, and she should know much better.

    • Sue
      March 15, 2014 at 3:44 am #

      Interesting word, ”scholar”. Doesn’t it essentially mean ”student”? (from the Latin word for school).

      An anti-vaxer in Oz had to stop calling herself ”PhD researcher” when in fact she doesn’t yet have her PhD – she is a student.As is GCC.

  6. March 12, 2014 at 10:10 pm #

    When the subject of my c-section with my second baby comes up, people often give me “the look” and I can tell they are already judging. That’s when I tell them that my baby was 12 lbs 8 oz and then I enjoy the shocked looks on their faces. I am 5’7″, 135 lbs when not pregnant so everyone (including me!) has a hard time believing I could have a baby that big. My c-section was absolutely necessary and because of it I got a perfectly health baby without a single complication for him or me and we both went home exactly 2 days after. Aside from a couple nurses who acted like idiots because they had never seen such a big baby before, I had a wonderful experience, got to hold my baby while the doctor stitched me up and had no trouble at all breastfeeding. For my third baby, I planned a scheduled c-section at 39 weeks. That was by far my easiest and most relaxed birth of the 3. I was extremely careful, ate right, exercised daily and only gained 35 lbs and I still had a 10 lb 9 oz. baby. I did not have GD with either pregnancy. I felt so guilty after the first c-section, believing it was my fault that he was so big because I gained more weight than I should have and I was reading all kinds of natural birth crap online that made me feel even worse. I don’t feel that way anymore and I don’t care what anybody thinks about my c-sections. I have two perfect healthy boys because of it!

    • Jessica S.
      March 12, 2014 at 10:23 pm #

      Holy-moly! My 10 lb 10 oz boy seems quite tiny in comparison! Your story sounds so much like mine! I gained more weight than desired but my doctor told me that most of baby’s size is genetic, a small percentage is affected by mom. I read that in a few of the common preg books, too.

      This cracked me up: “Aside from a couple nurses who acted like idiots because they had never seen such a big baby before”

      Same with our nurses! Everyone kept saying “he looks like a one month old! you should see him compared to all the other newborns!” I kid you not, one nurse actually said “He’s so alert, like a one-month-old, that’s it’s kind of creepy.” I wasn’t offended, but I did snicker to myself over her choice of the word “creepy”.

      • Michele
        March 12, 2014 at 10:50 pm #

        My OB joked “Congratulations, it’s a 2 month old” when he delivered my 10 lb 2 oz baby. The only regret I have about my c-section is that I didn’t do it sooner.

        • Mer
          March 13, 2014 at 1:37 am #

          Mine said the same thing, except she said 3 month old. I cracked up when they told me his weight!

      • March 12, 2014 at 11:06 pm #

        Yay for big babies! My first baby (girl) was a dainty 7lbs 10oz. so we were not expecting to have such a big baby the second time around and it was a total shock when they announced his weight. One nurse begged me to let her take my son out to the desk to show all the other nurses because nobody could remember a baby that big ever being born at that hospital. I said no! I can laugh about it now but I really felt like a freak at the time. I think we just won the genetic lottery with him, at 2 1/2 years old he is still 99th percentile for height. Even though he is shorter than big sister and 2 years younger, sometimes people ask me if they are twins!

      • Amazed
        March 13, 2014 at 10:59 am #

        “Oh my, she’s so tiny!” That’s what my mom thought when she first saw her friend’s one-month old baby. It still weighed less than my mom’s own 9 and 10 pounders did at their births. Mom was blessed with having healthy newborns. Not so healthy self. No GD here either, just a husband who towers over her hugely.

        No one thought to offer my tiny mom a c-section, even with her 9 pound experience and her being mostly belly this time around. She was simply left to push him out which she did effortlessly. Everyone was happy. Not so happy later when she bled almost to death. I kid you not, she claims she saw the tunnel of light and all that and the first thing she heard when she woke up was “There is none!” That was either about pulse or blood pressure.

        But yeah, elective c-sections are evil.

    • Jessica S.
      March 12, 2014 at 10:28 pm #

      BTW – I’m pregnant with #2, halfway through, and have gained 10 lbs so far. Last time at this point I had gained more than twice that. So, hoping that I’ll stay within an average gain this time, I’m SUPER curious to see how big this one will be. It’s like I’m running my own little experiment. Except I’m fine with two, so it’ll be a very weak study. 😉

      • Trixie
        March 12, 2014 at 10:51 pm #

        I gained over 50 lbs each time (and I am normally a healthy weight) and had average, 7 lb babies. No GD. I think a lot of it is out of your control.

      • Mer
        March 13, 2014 at 1:36 am #

        My last pregnancy that ended with a 10 pounder had me with 0 total weight gain. Each of my previous 2 pregnancies had me gaining only 15 and 10 lbs respectively and ended with 9 lb babies, it’s a reverse correlation! The less weight I gain, the more my baby gains! Jokes aside, my family is part Norwegian (we have some uncles still living there) and my husband and his siblings were all large babies so I guess its just genetic. I’m done though because if they keep getting bigger like this I might end up with a 12 lb baby like Jessica L!

    • OBPI Mama
      March 13, 2014 at 6:27 am #

      Mine got bigger the more I tried to eat healthy and no gd either! haha… first 9lbs.8oz (Shoulder dystocia). the 2nd kid, I worked out 6days a week, ate a strict diet 6 days a week and then let myself eat a full carb meal on the 7th day (like mexican food), only gained 6lbs. that pregnancy and got a 10.3 lber. Followed the same protocol with #3, but gained 12lbs and he was 12.3! All their blood sugars were perfect (they check all big babies), just big babies. I wonder if so much protein contributed at all to it… Then I had a baby girl (gained 15lbs) and she was a tiny 8.8!!! I loved getting a baby under 9lbs… it felt like I had an actual newborn! haha

      • MJ
        March 13, 2014 at 8:59 am #

        I know what you mean, OBPI Mama. My first son was 9lb7oz, which I put down to diet-controlled GD (his sugars were perfectly fine). Second son, not a whiff of GD but still over 9lb.
        My last son, no GD again, was induced at 37w+1 and he came out a pretty robust 8lb. My husband joked that finally he had a baby he could hold in one hand! He felt so very teeny. I reckon a few more weeks in there and he would have been another nine pounder.

        • March 13, 2014 at 9:42 am #

          generally speaking, each susequent baby weighs a couple hundred grams more than the one who preceded it.

      • Jessica S.
        March 13, 2014 at 9:41 pm #

        How funny! And very interesting. I’m pregnant with a girl now and I wonder if she might end up smaller than my son. But I learned not to invest in newborn size clothing. 🙂

        • Young CC Prof
          March 13, 2014 at 9:55 pm #

          That is funny! Mine took 3 weeks to grow big ENOUGH for newborn clothes! (And we went through a lot of swaddle blankets waiting for him to get big enough for newborn diapers to fit without leaks.)

          • Jessica S.
            March 13, 2014 at 11:03 pm #

            What a tiny peanut! I ended up giving away two packages of newborn diapers b/c it wasn’t worth trying! 🙂

          • Young CC Prof
            March 13, 2014 at 11:23 pm #

            He was 4 pounds 13, with a nine-inch waist! Then he discovered eating and doubled his size in less than two months. I also wound up with newborn diapers to spare, because he just grew so much faster than we expected.

        • araikwao
          March 15, 2014 at 4:43 am #

          Ha ha, I have a picture of my son in hospital in a newborn-sized all-in-one. I couldn’t do up all the studs, so he is quite obviously bursting out of it. I didn’t realise he’d be THAT big!!

    • Tamara
      March 15, 2014 at 2:38 pm #

      I gained about 50 lbs each time and weights were 6lbs 15oz (41w), 6lb 3oz (39w) and 6lb 11 oz (38.6w)
      And I can’t imagine trying to push out anything bigger!….but twice as heavy? Oh no…sign me up for the c-section!

  7. yentavegan
    March 12, 2014 at 9:18 pm #

    At an ICAN meeting I was told that it is possible to give birth vaginally even if the herpes virus is active. I just needed to take that leap of faith! PS… I took no such leap and opted for a c/sec. Thank you Science! Leap of Faiths are for Bible Stories, not herpes.

    • Medwife
      March 12, 2014 at 10:14 pm #

      Sure you can. The baby will just get herpes and be permanently disabled or die. But yeah, it will have come out vaginally.

      • March 13, 2014 at 9:50 am #

        To me that ranks with the idiocy of refusing Rhogam, which I have encountered because the father has an Rh negative parent so there’s “only” a 1 in 4 chance for antibodies and “it doesn’t always happen anyway just as some folks have 4 boys in a row although theoretically each conception is 50/50 for sex”.

    • Jessica S.
      March 12, 2014 at 10:30 pm #

      I think we should make a shirt with that saying:

      “Leaps of Faith are for Bible Stories, not Herpes! GO SCIENCE!”

    • areawomanpdx
      March 13, 2014 at 2:29 am #

      Ya, if the baby gets herpes, the mortality rate is 50%. That shit is not something to mess with. Even the crunchiest CNMs I know are all about cesareans for patients with herpes outbreaks. WTF.

  8. JennG
    March 12, 2014 at 4:18 pm #

    Today is the 10th anniversary of my Emily’s birth, which was completely botched as Dr. Amy has posted here: A c-section totally would have saved her life.

    I recently have been watching someone I know go through a stillbirth loss (totally different kind of situation) and I just wanted to say again in a bit of a non-sequitur that I really, really hate how mothers end up carrying so much weight when things go wrong. It’s hard enough without it. There may be a rare sociopathic mother and some who take risks that are a bit over the line, but if any mother could know, for sure, that a c-section would save her baby’s life (or any other intervention) I am sure that mother would do it. And not knowing that does not make her guilty either.

    The way that we discuss interventions as if they are unnecessary is really problematic, to me. But I totally, deeply understand why mothers are coming into labour focused on avoiding them, and it is the fault of the discourse around them.

    I continue to really appreciate Dr. Amy’s work in continuing to have the conversation, and to have it at an emotional pitch at times, because that is how the discussion operates online. Just wanted to put that out there again.

    • Ash
      March 12, 2014 at 5:42 pm #

      I am so sorry for your loss.

      • Amazed
        March 12, 2014 at 5:55 pm #

        Jenn, each time I see your posts, they make me tear. What happened to you and Emily was senseless, cruel and so very preventable. I am so sorry.

    • rh1985
      March 12, 2014 at 6:17 pm #

      I am so sorry for your loss.

    • Carolyn the Red
      March 12, 2014 at 7:35 pm #

      Your story just horrifies me, and it seriously shook me out of any residual natural childbirth concerns. Thank you for sharing it, and I’m so sorry for your loss.

    • March 12, 2014 at 8:59 pm #

      I am so sorry for your loss. It horrifies me that people allowed this to happen in a hospital. I am sitting here crying after reading her story.

    • Jessica S.
      March 12, 2014 at 10:48 pm #

      Oh, Jenn – your story made me weep. The world is a little less bright without your Emily in it. I’m holding you and your family tightly in my thoughts today, on this anniversary.

      I just had to paste this quote from your story, b/c I found it so profound:

      “Let’s get the arguing out of the way here: Yes, my baby died in hospital. However, she did not die due to a cascade of interventions. She died due to a negligent cascade of non-intervention.”

      You are brave and wise.

    • Sue
      March 15, 2014 at 3:48 am #

      Thanks for the perspective, JennG. It makes GCC seem even more idiotic.

  9. anh
    March 12, 2014 at 3:58 pm #

    when TFB starts ranting about “privilege” and how “patriarchal” the US medical system is I want to scream. She has no idea.
    I spent a year living in the khaleej in the middle east. One of my best friends was from Chad, but had spent her whole life living in one gulfi country and had given birth to her first two children there before moving to another gulf country where she and I met. Her first two births were unmedicated…not out of ideology, but because she had NO IDEA PAIN MEDICATION WAS A FREAKING OPTION. Most likely because she was African the doctors didn’t feel like they should let her know what her options were. She was 17 for her first birth and under the hospital’s policy she wasn’t allowed to have anyone with her.

    She and I were getting close when she was pregnant with her third kid. After an appt she said to me “they kept telling me I could have xxxxx, what the heck is xxxx?” My Arabic is very good but I had zero idea. She kept asking me so I did a bunch of research…they were offering her the option of an epidural. I explained this to her and she laughed like crazy. She said there was no way something so magical could exist.

    I visited her in the hospital after the third birth. Also unmedicated because no one took the time to explain that she had options. I asked how it was and she said “ugh, that was freaking terrible!!. She then asked me (she spoke zero english) what “Keeeeb buuuushing” meant. All her nurses were Filipina, either didn’t know or didn’t care that she couldn’t speak English.

    But sure Gina, nurses encouraging suffering women to get epidurals is so misogynistic! keep telling yourself that. Or maybe get on a freaking plane, talk to women who are true victims of oppressive patriarchal societies, and then maybe your asinine blog will be worth something

    • Jessica S.
      March 12, 2014 at 4:00 pm #

      Perspective, it’s a grand thing!

    • March 12, 2014 at 4:47 pm #

      I have never, ever understood how NCB and the feminist movement have intersected in the way that they have. I have always felt that the idea that women should have to suffer to birth is deeply misogynistic, not that offering pain management was.

      I have discussed pregnancy and birth at length with my grandmother. I don’t think that things like twilight birth etc were that common in Australia at the time (she birthed in the 40s, 50s and 60s) but she said that she dreamed of giving birth to her large babies with easier options (her smallest was my father, at nearly 9lb…) and her mother, who lost a baby during birth, would be perplexed by this rejection of intervention on the part of many women today when she labored at home with only a lay midwife to help her. She just does not understand it. Neither does her sister, who also lost a baby due to cord wrap issues in the early 60s.

      My aunt, who was a missionary in Bangladesh in the 70s and 80s, and gave birth at a Red Cross hospital, said that women were surprised then that any help was available. According to her contact with the region since, not a lot has changed, and these women cannot imagine a world in which child birth could be safe and relatively painless. How a world like that is misogynistic is just beyond my comprehension.

    • March 12, 2014 at 9:38 pm #

      It is kind of impossible for the medical system to not be patriarchal when we live in a freaking patriarchy. “Its worse over there!” doesn’t excuse it, and there are plenty of real care disparities that hurt women and non-white people all the damn time.

      • Trixie
        March 12, 2014 at 10:57 pm #

        Sigh. I can honestly say the patriarchy is not and has not ever kept me down. Now, I’m white, educated, and middle class. I am sure it’s a whole different ball game under other life circumstances, but I don’t think all women in this country suffer universal repression by the patriarchy. And those most likely to NCB are also the least likely to be actually oppressed or disadvantaged.

      • anh
        March 13, 2014 at 3:57 am #

        I might have said the same thing when I was a college student and didn’t have the experience I do now. But I’ve lived in many places all over the world and I cannot say in good conscience that we as US women live in a patriarchy. It’s not that it’s “worse” over there…it’s a whole other ball game and I think it’s insulting to the real “sisters in chains” when we try to liken our experience to theirs.
        Yes, there are patriarchal elements of our society. But the giant difference is there is a system in place to challenge it. You for instance are able to get a day (or several) in court to challenge abuses done to you. Do you understand that is would be unheard of elsewhere? The very fact that patient advocates exist is practically revolutionary.
        I’m not saying we shouldn’t rally against patriarchal and misogynistic practices in our world, but to call the US a “patriarchy” just sounds absolutely absurd to me when I’ve lived places where my friend got deported because she had the guts to report a rape or where unmarried women can’t leave the country without their father’s permission until they are over 40.

  10. NursingRN
    March 12, 2014 at 3:31 pm #

    I shared my son’s birth story on a forum relating to pregnancy and childbirth (it wasn’t “Mothering”) I shared how although I wanted so badly to have a “natural, un-medicated” birth I ended up having a stat section because after laboring for about 30 hours, ruptured with mec, I developed a temp of 102, started puking, and got tachy- right around the time my as of yet unborn son also became tachy. At that point I was so out of it, hurting and miserable (even after I gave in and got an ITN) I really don’t remember even signing the consent for the section. I just wanted my son to be alive. The OB told me that he was “sunny side up” which is why my back felt like it was going to explode every time I contracted and yet didn’t dilate past 3cm. The first time I met him he was in the special care nursery getting an IV in his scalp for antibiotics for chorio. All of these terms I now understand well since I work in OB.

    The response of the forum? Not “oh I’m so sorry your poor baby had to have an IV in his head and you got so sick!” It was “oh that’s TERRIBLE that they didn’t follow your birth plan! They spooked you into a cesarean! Women spike fevers in labor all the time- and epidurals are notorious for making women vomit!” The only thing they said that I put credit in was that someone should have taught me positions to help get him out of OP. But it was never “I’m so glad your son is okay now!” They totally made it all about ME and MY experience! Needless to say most of these women were pro-homebirth, pro free birth, and the head moderator was a Doula who kinda thought she was smart or something.

    • The Bofa on the Sofa
      March 12, 2014 at 3:56 pm #

      Your son is ok now, yes?

      • NursingRN
        March 12, 2014 at 4:59 pm #

        Oh gosh yes! He’s five (*and a half!* he would insist on adding) years old now. He needed 48 hours of antibiotics and then he came up to the regular postpartum unit to stay with me. My OB even told me while I was getting prepped that he was sorry it went this way but he was sure I would be fine to have a VBAC with my next. My next was a section too- which I decided on once we got to the hospital, because at that point I could read the tracings and saw she was having some late decels, there was already thick mec (my water broke at home) and I was dilated to a whopping 1cm. It was a good call on my part because she was jittery, her blood sugar was very low, and when they tried to give her some formula to bring it up, she went dusky and desatted to the 70’s. Mec aspiration pneumonia is what they called it. But again, after 24 hours of antibiotics she got to come up to be with me. Easy peasy. Baby is alive. Mom is happy.

        • The Bofa on the Sofa
          March 12, 2014 at 8:16 pm #


          My older son is 5 1/3 now.

          • Trixie
            March 12, 2014 at 11:00 pm #

            Mine is 5 7/12!

        • yentavegan
          March 13, 2014 at 8:53 am #

          Your labor and birth story should be mandatory reading for anyone considering an OOH birth. Medicine and science spared your family the pain and anguish of maternal/fetal death. If not for our collective advances how many more of us would be scarred, mournful and barren?

    • March 12, 2014 at 4:52 pm #

      I hope your son is okay.

  11. guest
    March 12, 2014 at 3:24 pm #

    My c- section was completely necessary, but done too late.

    • Karen in SC
      March 12, 2014 at 3:40 pm #

      So sorry to hear that.

    • An Actual Attorney
      March 12, 2014 at 3:53 pm #

      I’m so sorry for your loss.

    • FormerPhysicist
      March 12, 2014 at 4:45 pm #

      I’m so sorry.

    • moto_librarian
      March 12, 2014 at 5:20 pm #

      I am so very sorry.

    • yentavegan
      March 12, 2014 at 5:51 pm #

      I am so sorry!

    • JennG
      March 12, 2014 at 9:22 pm #

      I’m so sorry guest. My link is above…me too, except I didn’t have one in the end anyway. It’s a sucky club to be in.

      • Guest
        March 14, 2014 at 4:08 pm #

        I am so sorry for your loss. Your story is heartbreaking.

        This is exactly how I feel….

        “It never crossed my mind – so much for positive thinking! – that she could be dying and birth attendants not quite realize it. I thought we were crossing the finish line. I didn’t know how subtle the early signs are, or how twisted thinking can get when the goal is to not do something that should, in fact, be done. I wasn’t aware these things still happen to families. (Once they do, the stories come out though.)”
        It never crossed my mind either. It’s so hard because there really are not many of us in this club (thanks to highly skilled doctors). It’s been 3 years for me and I struggle everyday. I still can’t wrap my head around it. I’m not sure how to look up your info, but would love to e-mail/talk to you.

    • Jocelyn
      March 12, 2014 at 10:39 pm #

      I’m so sorry.

  12. Carolyn the Red
    March 12, 2014 at 3:06 pm #

    I don’t really care if my c-section was necessary. My OB didn’t push, just said he thought a vaginal delivery would be difficult, and we might not get any further in 3 hours of pushing. I decided I’d pushed enough, and he seemed relieved.

    I was back to normal after 4-5 weeks (I started back to pipe band practices, and started asking what I could do to find my lost fitness). I’m sure I had a faster recovery than some, but I expected the “best case” recovery to be a lot worse (Maybe having a little ab strength to spare helped?) I still don’t give a single fuck about the limitations to my future fertility, either.

    • rh1985
      March 12, 2014 at 3:32 pm #

      Agreed. I don’t want a big family anyway. I had a c-section three weeks ago for my first child. I want either no more kids or just one more but not for a few years. So I am not concerned. I was driving after two weeks and I feel pretty good now, just need Advil because it’s still a bit uncomfortable.

      • Jessica S.
        March 12, 2014 at 4:08 pm #

        Your story is just like mine! I’m preg with number 2 and, the good lord willing everything continues to go well, I’m D-O-N-E. We happen to be having a girl (we have a wonderful boy, 3.5yrs – what a hoot of an age!) so I guess that worked out well. To be honest, I’m a tad terrified of having a girl! I was a nightmare as a teenager – both for my parents and for me, just being a teenage girl is torment in general. 🙂 It will be fun to experience one of each, but I definitely think my max mother efficiency tops out at 2. 🙂

        • Carolyn the Red
          March 12, 2014 at 7:09 pm #

          I’m leaning towards two, myself, but one is nice so far. It’s so much easier and more fun now she can tell me what she wants, even if I can’t or won’t give it to her.

          Honestly, if I was told I could eliminate a 1% chance of death or serious injury for kid one, and I would have a 100% chance of losing future fertility, I’d make the trade without a second thought.

          • Jessica S.
            March 12, 2014 at 10:50 pm #

            I don’t have anything to add, but I just had to say I loved your response! 😀

  13. expat
    March 12, 2014 at 2:53 pm #

    How is it possible that TFB’s traffic jumped from 1000 per month for the last 4 months up to 25000 pe4 month in the last month? Did she do something noteworthy recently or buy hits? I remember her facebook follower number exploding in a similar fashion about a year ago (up to 25000 likes). It looked like purchased likes, since nothing particularly special was going on.

    • expat
      March 12, 2014 at 3:01 pm #

      The story I’m thinking of is here:

    • JennG
      March 12, 2014 at 9:21 pm #

      She had a viral post, looks like. The shape of her traffic just shows building virality is not the same as building audience, it’s actually a spike I would love to show around work because the descent is as same as the rise.

      • expat
        March 13, 2014 at 8:26 am #

        I was scanning her facebook page and noticing that links to her blog got a maximum of 9 likes, uncontroversial mom comments got 200 likes on average, and controversial birth comments got the most likes (up to 650). I’m guessing that the 25000 spike was inreaction to her insensitive facebook post which pissed off autistic people. Otherwise, it looks like 200 peope folow her because they find her sympathetic, 600 follow her due to birth activism, but only a handfull (less than 50?) actually read her pay-to-view blog.

  14. wookie130
    March 12, 2014 at 1:28 pm #

    I don’t care of my c-section was necessary or not (but it actually WAS, as I had placenta previa), I loved it. I’d do it again, and plan to this August, hopefully with a healthy boy this time.

  15. Ellen Mary
    March 12, 2014 at 12:34 pm #

    I couldn’t tell you if my own Cesarean was necessary & IDK even if my OB/CNM team really could. It was necessary at the point that we did it. But there were many little decisions leading up to it that maybe could have gone differently? Certainly only someone with clinical knowledge & access to my records could weigh in.

  16. LibrarianSarah
    March 12, 2014 at 12:23 pm #

    I’m sorry but I kind of wish that a condition of the law suit settlement would have been that Gina could never refer to herself as a “Public Health Scholar” or any derivative of that phrase without getting a PhD first.

    • sleuther
      March 12, 2014 at 2:26 pm #

      In fairness, Gina _is_ a PhD… Pretty huge Dope.

      • LibrarianSarah
        March 12, 2014 at 2:27 pm #


        I would have also accepted “Pretty huge Douche”

        • Dr Kitty
          March 12, 2014 at 2:35 pm #

          Bad for vaginal health, unnecessary and OBs recommend against using them.

          Seeing some eerie parallels here…

          • LibrarianSarah
            March 12, 2014 at 2:48 pm #

            It’s also a “feminist approved insult” according to the most prestigous source for information on feminism, childbirth, breastfeeding, pubic health, c sections, vbac, hbac, autism, and every other subject in the know universe.

          • Mer
            March 12, 2014 at 5:34 pm #

            Ha! Pubic health, such an appropriate typo!

          • yugaya
            March 13, 2014 at 3:55 pm #

            She is just an oversized schoolyard bully who happens to be a woman and a mother on the side.

  17. Name
    March 12, 2014 at 12:22 pm #

    I was bullied about my unnecessarean. Not funny at the timeubut funny now.

  18. sleuther
    March 12, 2014 at 11:34 am #

    Also, as to GCC’s statement “it’s incrediby difficult for me to overhear…” OH GOD, STOP RIGHT THERE. I’m sooooo sorry you had to overhear that. Maybe stop listening in on other people’s conversations to judge them and get on with the business of updating your very-successful blog.

    For someone so obsessed with everyone-but-her needing to check their privilege, she sure is entitled. I just watched “Twelve Years a Slave” and the main character’s struggles were nothing compared to what Gina goes through in line for a latté at Starbucks.

    • The Bofa on the Sofa
      March 12, 2014 at 12:22 pm #

      For someone so obsessed with everyone-but-her needing to check their privilege, she sure is entitled. I just watched “Twelve Years a Slave” and the main character’s struggles were nothing compared to what Gina goes through in line for a latté at Starbucks.

      Just want to note that sleuther is my new favorite poster.

    • Sue
      March 15, 2014 at 3:55 am #

      I reacted to that ”incredibly difficult for me to hear” too. It was incredibly difficult for me to read!!

  19. sleuther
    March 12, 2014 at 11:27 am #

    Great post. Another thing that upsets me about the Monday-morning quarterbacking that NCB advocates so readily engage in: Sometimes it’s really not possible to tell whether a C/S was necssary. It’s done as a precaution because the doctor is concerned and makes a professional judgment that a C/S is the safest way to proceed, and Mom agrees.

    In the type of situation I had with my older daughter (failure to progress even with an induction, 40w6d), you really don’t know if the C/S was absolutely necessary, in hindsight. (And in my case, you don’t really care.) Could I have birthed vaginally with a good outcome? Maybe. Was I prepared to take that risk? No. I wanted the baby out. My OB had seen a lot of similar scenarios, and she made the call and offered me a C/S, and I said, “Yes please.”

    A big part of the reason why modern obstetrics is so successful is that we don’t have to wait until it’s a totally frantic drop-everything EMERGENCY to get the baby out. We can act to prevent said emergency. Which is really, really a very good thing.

    • The Bofa on the Sofa
      March 12, 2014 at 11:34 am #

      Great post, because I agree with everything you’ve said (you know a post is great when you to copy something to quote below but then stop because you want to copy the next line instead, and the next line instead, etc through the whole thing).

      You make many points that I make a lot:
      Our first was breech, which means there was something like a 5% chance that something terrible would have happened. It also means that there is 95% chance that he would have been ok. So yeah, it is very likely that the c-section was not necessary. However, that is not a chance we were anywhere near willing to take. Not even close. So while our CS was likely unnecessary, we don’t care, the risk was too high.

      And your last paragraph is great: the whole goal of interventions is to prevent an emergency. If you reach the stage of emergency, you have waited too long.

      • sleuther
        March 12, 2014 at 11:43 am #

        Thanks! Yeah, the NCB’ers like to talk about the “cascade of interventions” and (they do have a point in some sense, because some interventions _do_ lead to further interventions.) However, they’re going into that whole argumentative space with the assumption that an epidural or C/S = Worst Thing Ever, which is false, and they also massively underemphasize the (very real) risks of the _actual_ Worst Things Ever (baby/mom is injured or dies). So, while there are some isolated truths in the NCB arguments (i.e., pitocin increases the probability of further interventions), their whole logical structure is flawed — more warped and convoluted than an M.C. Escher drawing. They’re missing the forest for the trees in a big, big way.

        My older daughter was breech for the longest time (and I had a C/S scheduled) – then she flipped on her own! I had a big fear of birthing vaginally, so I asked my OB if I could still do the C/S. She very kindly persuaded me to TRY going vaginal (ended up C/S for failure to progress, detailed above.) So much for the myth of the evil OB who just wants to pencil in C-sections so she can get to her golf game!

        • The Bofa on the Sofa
          March 12, 2014 at 12:23 pm #

          Did you try that argument with her?

          “You know, if we schedule a c-section for this day, you can still get to your golf game….”

          • sleuther
            March 12, 2014 at 12:28 pm #

            Ha! I didn’t! She was very understanding of all of my many neuroses.

            When she turned up the pitocin during my induction as a last-ditch attempt to go vaginal, she said, “We’ll get you your epidural if you get to 3 cm.” I didn’t catch the “if” at the time, but my mom did. At that point my OB already knew that I probably wasn’t going to dilate.

        • Jessica S.
          March 12, 2014 at 2:53 pm #

          All very good points!

          I wonder about this: “So, while there are some isolated truths in the NCB arguments (i.e., pitocin increases the probability of further interventions)”

          and whether it’s often the case that women who need their labor augmented in the first place (i.e. – they don’t go into it “naturally”) are already more likely to need* a c-section than women whose labor starts/progresses without aid.

          *I was going to say “at a higher risk for” instead of “more likely to need” but I just can’t stand that terminology – why should it be termed “risk” as if the procedure itself is a failure? We certainly don’t say “women whose labor progresses without the need for augmentation may be at a higher risk to deliver vaginally”. That sounds ridiculous but it’s saying the same thing, at least in Normalland.

    • FormerPhysicist
      March 12, 2014 at 1:19 pm #

      Exactly. “My OB had seen a lot of similar scenarios, and she made the call and offered me a C/S, and I said, “Yes please.””

      I tell mine in a funny way where my OB offered me another hour or two to keep laboring, and then definitely c/s if I didn’t progress, or c/s then – and I threw the decision back at him. But I’m SO glad we didn’t get anywhere near emergent c/s. No running down the hall to the O/R. Just, “yea, let’s go as soon as the O/R is ready.”

  20. expat
    March 12, 2014 at 8:05 am #

    Ages ago, I made a few comments on her “going without pain meds is like running a marathon” post and , lo and behold, I find that I can’t even “like” a comment on this more recent thread (banned). Jesse made some good comments.

  21. Vera
    March 12, 2014 at 6:13 am #

    A colleague was prattling on about the numbers of women who were “too posh to push”, but when I questioned her if she knew anyone who had a c-section for that reason, she couldn’t think of a single person other than what was ‘reported’ in the gossip mags. So where did this idea of too posh to push come from? Is it another media beatup? When I was a kid (and was deluded enough to want to be a midwife so I could play with babies all day), c-sections were thought of as being a ‘there but for the grace of god’ thing that families were thankful the mother and baby came through alive. I’m pretty sure my plunkett book even says something similar.

    And as someone with a MPH (Hons), get bent with your scholar bullkaka Gina. Stop making us look like pretentious twits!

    • Melissa
      March 12, 2014 at 6:29 am #

      I know of two women who have had elective c-sections for scheduling reasons. In both cases they weren’t too posh to push, but too busy to leave things up to nature to decide when the baby would come. I’m sure that many people would think that this isn’t a good enough reason, but they both were in favor of it. One of the women had 5 older children and wanted to be able to plan childcare for them while she was in the hospital without needing to do things once labor started. That seems perfectly reasonable. The other is the main breadwinner in her family and wanted to be able to start back to work (she telecommuted) as soon as possible and being able to control when the birth happened allowed her to do that.

      Again, I’m sure that many women would find these to be unacceptable c-sections but both cases allowed the women involved to have piece of mind and less anxiety before and after their birth. NCBers are always saying that we need to keep Mom’s from being stressed out. For some women the control that comes with a purely elective c-section is what gives them freedom from stress.

      • Vera
        March 12, 2014 at 7:05 am #

        Doesn’t sound like they were too posh to push to me, sounds like they made the best decision for them and their families. Too posh to push implies to me that they could have a NCB but thinks it’s below their station in life – which is just preposterous. I think too much emphasis has been placed on what others might think, like how adolescents with their not-yet-fully-formed prefrontal cortex think everyone is looking at them (but really everyone else is too busy thinking about themselves to think about you!). In fact, the whole NCB and one right way to parent thing reminds me a lot about adolescents and their behaviour patterns.

        • The Bofa on the Sofa
          March 12, 2014 at 9:49 am #

          Conversation I had with a friend:
          Me: “The other night, I dreamed I was a Spice Girl.”
          HIm: “Which one?”
          Me: “Well, Posh, of course.”

          • Dr Kitty
            March 12, 2014 at 12:29 pm #

            Of course La Beckham had all four of her babies by CS and she gets to go home from her very successful fashion house to the gorgeous David Beckham.

            Guessing she spends zero time regretting missing out on an empowering NCB, and much time doing better things.

    • March 12, 2014 at 4:59 pm #

      My mother has a little bit of ‘too posh to push’ judgment. When I first fell pregnant and was frantically looking for an OBGYN (hello, wedding night baby!) she was like ‘make sure they don’t have a high rate of c-sections’. I was like, I want whoever has a low rate of dead baby. Kthxbai. She is absolutely not NCB-pushy but the ‘interventions are bad/c-sections are bad/epidurals make labour harder/ultrasounds all the time are bad’ dogma is so pervasive. I have just had to ignore her when she expressed concern about the above.

      In the end, my OB is not a ‘cutter’. She won’t do a c-section if she doesn’t have to, but if it is necessary, then it is necessary.

  22. Lost
    March 12, 2014 at 5:35 am #

    An unnecessary C-section: one performed on a person who isn’t pregnant.

    • March 12, 2014 at 11:06 am #

      So, the c – section in Prometheus was unnecessary. Got it.

      (Why does my phone change that to Promethazine? Wtf autocorrect! )

  23. Megs
    March 12, 2014 at 5:11 am #

    Can someone please explain to me why TFB is going on about C-Sections being far riskier than vaginal birth. What does she mean? I understand emergency C’s are more likely to result in neonatal or maternal mortality because of the nature of ’emergency’ but say a scheduled c section. Is there a study to back her up? I was under the impression that C-section was fairly safe. (lay person asking, looking to be educated on this topic).

    • Stacy21629
      March 12, 2014 at 6:12 am #

      In very simple terms, a vaginal birth is “safer” for mom – slightly lower risk of death, no surgical complications, no risks of uterine damage affecting future pregnancies and labors.
      BUT a C-section birth is “safer” for baby. Labor and delivery are very dangerous for baby – so a surgical incision and speedy removal to the outside world is safer than hours and hours of contractions and a tricky negotiation through the pelvis.
      So it’s a trade-off, as all things are. BUT maternal mortality has ALWAYS been MUCH lower than fetal mortality, so even the very slight increase in maternal mortality from C-sections is trumped (in my opinion) by the much greater reduction in fetal mortality via C-section.

      This is what TFB and others like her can’t take into consideration – in her mind a C-section is all about her – the greater risk to mom, the scar, the pain, the affect on her future pregnancies/labors. She can’t get past her own nose to the life of her child, which is much safer delivered via C-section if she has a difficult labor or other complications that make vaginal birth more risky. Once again, it’s all about mom, and nothing about the baby.

      • AllieFoyle
        March 12, 2014 at 7:30 am #

        And when you count outcomes for vb that have historically been ignored in the risk assessment (perineal injury, urinary/rectal injuries, incontinence, sexual dysfunction, prolapse, need for future surgeries, psychological trauma contributing to PPD, etc.) the risk comparison becomes murky.

        • OttawaAlison
          March 12, 2014 at 7:47 am #

          Not to mention that a number of csection deaths happen after a disastrous tol. Those most certainly are in the csection mortality numbers.

          • OttawaAlison
            March 12, 2014 at 7:48 am #

            But I’m a vaginal birth hater according to Gina.

          • March 12, 2014 at 11:08 am #

            I’m a Gina hater according to my vagina. And brain.

          • yugaya
            March 12, 2014 at 5:10 pm #

            Gina is her vagina. End of story.

        • Sue
          March 15, 2014 at 4:07 am #

          While there is some maternal morbidity ( and a tiny mortality) for mothers having cesarean surgery, almost all of the complications are short-lived, especially in a controlled situation with regional anaesthesia. While there are some wound complications, a cesarean would can hurt less than a vaginal tear, and isnt’ painful to sit on or pee around.

          Even the small risk of nicking the bladder is no big deal – older people have their bladders intentionally spiked by suprapubic catheters when their urethra is blocked, and they heal right up.

          There are risks of excessive bleeding from any route of childbirth – it;s a very vascular area!

      • Megs
        March 12, 2014 at 8:14 am #

        Thanks for clearing that up. And what about someone rattling on about no improved fetal outcomes with c sections in the post about ACOG and the 4 fold increased risk of death? Ugh these people make my brain ache.

      • Danielle
        March 12, 2014 at 11:10 am #

        This is a helpful distinction to make, because it highlights the trade-offs involved. It also raises a very interesting cultural question that relates directly to personal medical decision-making: If i am only going to have one or two pregnancies, is it worth trading the risk of complications to me, the mom, in exchange for an easy delivery for the baby?

        If one is planning to bear multiple children, it makes sense to avoid needless incisions – especially if some of those deliveries are going to be vaginal. But we are entering a world where there are more and more young professional couples who are planning just 1-3 pregnancies and who are economically and psychologically willing to invest a lot in those children. When weighing medical decisions, I could see this fact being a game-changer. No doubt some will read this as an indication that millennials are “self-centered” (by which people mean: marrying but delaying having kids until their done educating themselves and testing their marital relationship for a period before adding children to the family). But read another way, it’s actually a story about how invested millennials are in planning for and investing in the children they eventually have.

        • Jessica S.
          March 12, 2014 at 4:15 pm #

          I think it’s pretty common that the more develop/educated, etc. the citizenry is in a country, the lower their birth rate is. Like you said, there are people who might see that as a self-absorbed society but I see it as one that is intentional. 🙂

          • Danielle
            March 12, 2014 at 4:40 pm #

            When you aren’t have children, people worry that you might be self-centered.

            Then you do have children, and then people become worried that you are a “helicopter parent” who over-controls and over-invests in one’s children.

            Both criticisms, generally directed at the same people at different ages, perhaps call out some foibles of the “intentional society.” (Great term btw, I am going to steal it!) But actually what people are expressing is anxiety about a social change that has many positives—or, if you want to be darker in interpreting it, people are responding to a hard reality: attempting to guarantee success for one’s progeny in an increasingly stratified information-based economy is expensive.

            Love it or hate it, it does make me wonder–if I know my second pregnancy will most likely be the last, do I care so much about a c/s that time around? Last time, the cost of my vaginal delivery was a hard first day for baby 1. If I’m already planning to squander hundreds of thousands of educational dollars and most of my free time into him and baby 2, and I don’t meed my uterus to accommodate several more pregnancies, what’s a little cut? Slighly increased risk to me, but that’s not actually a deterrent to me when it comes to the wellbeing of the baby. If I were having several kids and already knew I’d lose a few to disease and war, I might think differently: but that is not my context.

          • Jessica S.
            March 12, 2014 at 5:00 pm #

            Great observations! Very insightful. 🙂

          • rh1985
            March 12, 2014 at 6:22 pm #

            I think the risks don’t really start to go up significantly until after the 3rd CS. I was going to have an elective c-section for my first child last month, knowing that I wanted either no more children or at most, one more child but not for several years. It turned into an emergency CS for medical reasons so in the end, I would have had one anyway. But I’m not upset, and I’m not really worried about the risk of complications if I do decide to have a second child a few years from now. If I wanted several children, I probably would not have chosen an elective CS, but given the circumstances, I think I still would have agreed to the medically indicated CS instead of trying to insist on an induction (which I was not at all favorable for so it probably would have been a CS after a failed induction).

        • Guest
          March 12, 2014 at 6:18 pm #

          My nephew is a millennial – he’s too young (13) to be finishing his education!

    • NursingRN
      March 12, 2014 at 5:04 pm #

      Because it is a surgery. It’s a major surgery. Whether one feels it’s warranted or not. That doesn’t mean women don’t die in vaginal births- we’ve sent women to the ICU after they insisted on birthing “naturally” after it was confirmed they had placenta accreta (the placenta grows and embeds into the uterine wall- hard core) which is an emergency- and the stubborn, Ricki Lake brainwashed mom made it into a catastrophe. But the reason they say a section is more dangerous is because it’s not exactly MORE dangerous, but it carries a few more risks.

      • Mer
        March 12, 2014 at 5:42 pm #

        The reason it’s riskier is because the common risks for any surgery apply, correct? As well as the childbirth risks that occur regardless of method of delivery? At least that’s why I always thought it was a little more “dangerous”.

    • Young CC Prof
      March 12, 2014 at 6:08 pm #

      It’s actually a hard question to answer. Serious complications or death in the mother are more common after a c-section, but it’s tough to sort out how much of that is caused by the surgery versus the reason the surgery had to be done. If there’s placenta accreta, or if the mother comes into the hospital already near death from HELLP, complications are a heck of a lot more common. But then, in either of those cases, without the c-section, death is guaranteed.

      Now, researchers have tried to look at the outcomes of, for example, pre-labor c-sections performed for breech babies in healthy mothers, but the rate of mortality and serious morbidity in cases like that is low enough that it’s almost impossible to find enough data to properly measure it! (If there’s a 1 in 10,000 risk of something happening, you’d need a sample size of several hundred thousand to measure that.) Still, if a risk is small enough that it’s hard to detect, that’s good news.

      tl;dr: Probably a little more dangerous, not much more dangerous.

  24. gtrslingrmama
    March 12, 2014 at 3:47 am #

    True story… Was having lunch one day with my 3 month old and I spotted another young mom with a baby about my daughter’s age. I walked over to say hi (this is in a small town) and we just started talking about babies/motherhood etc. Out of nowhere an older woman eating at an adjacent table tells this mom “Oh I can tell you had a vaginal birth bc of the shape of your baby’s forehead.”. The mom said “Actually I had a c/s bc she was breech”. This other woman roles her eyes dramatically and says “ugh God I swear every baby is a c/s nowadays. They will just cut you up for any reason!”. To which I said “well my baby was a c/s too and I also needed one bc she would not come out.”. This fucking bitch says to us “Well you didn’t experience giving birth. When I had my babies I gave birth at home with a midwife with no paid meds.”. To which I replied “Congratulations! Guess what? We don’t care. I loved my c/s and I will be having another one for my next child and you can go pound sand!”. Needless to say the other mom and I totally hit it off and that lady came off looking like an idiot. The end 🙂

    • Danielle
      March 12, 2014 at 11:19 am #

      That is full of win.

    • Elizabeth A
      March 12, 2014 at 11:22 am #

      Sometimes I overhear a conversation in a coffee shop that makes me want to go over and make friends. It would be creepy, but I want to.

      This is one of those conversations. (Right up there next to the all-time winner “This is why our mothers don’t review our research projects. ‘This is an interesting question, but have you considered having children?'”)

    • Jessica S.
      March 12, 2014 at 4:28 pm #

      What a bitch! Oh, the things I would’ve loved to say, although you said it perfectly.

      “Thank you so much for being so thoughtful about our vaginas!” (Spoken loudly for maximum effect)

      Or, without the sarcasm “So how long have you had this fixation on the vaginas of perfect strangers?”

      Or the most obvious “Considering you guessed wrong about this babies mode of delivery, do you think it’s reasonable to continue speaking as if you’re an authoritative voice on childbirth?”

      Finally “Go away.”

  25. GraceEnough
    March 12, 2014 at 3:21 am #

    Dr Amy,
    Thank you for this.
    I was 19 when I had my son. While in labor I was given a dose of pain meds through the IV. I reacted badly, and became very confused and was not asked for my consent before my emergency c section. The day we were discharged I went to a breastfeeding support group, and I fell HARD for the woo. Now I’m not saying all support groups are this way, but the one I went to was so deep in woo they thought disposable diapers were a form of child neglect. I, being 19 and scared of making mistakes with my son, believed what they said. I believed that if I stopped nursing my son would get sick. I believed that so much that I hid having post partum psychosis for nearly a year. I thought my baby was possessed by a demon who wanted me to kill the baby. I lived in absolute terror that at anytime the demon would win and I would kill my son. Most of all though, I believed that my C-section was unnecessary. I believed that if only I had been smart enough to choose home birth the midwife would have protected me from my awful “birth rape”. I struggled with my “failure” for years. When I was pregnant with my daughter 3 years later I wanted a homebirth but my husband refused. I went to a different OB and expressed my fear of another unneeded operation. This OB got the records from my first birth, and we went over them together.

    And you know what? My C section WAS necessary. When I was pushing his head got wedged in my pelvis and his heart rate dropped very low. He was born blue and limp. I didn’t understand at the time because of the reaction I had to the meds. My doctor did not operate so she could go home for dinner. She saved my son from brain damage or death. She didn’t consider my birth experience at all. And I’m so very grateful.

    I look at my son now, and I don’t give a darn how he was born. He’s a healthy 12 year old boy. He plays the bagpipe and excells in school and rides his bike and speaks two languages. He refuses to eat squishy foods and loves his mama. To think that I could have ruined everything he is, and everything he has the potential to be in order to get the birth I wanted makes me sick to my stomach.

    Years ago it would have been helpful to have someone sit me down and say look, your baby is fine. He’s healthy and growing. That is enough. The birth matters very little.

    You’re doing a powerful thing here. So thank you.

    • GraceEnough
      March 12, 2014 at 3:38 am #

      Please excuse me if there are mistakes as English is not my first language.

      • Karen in SC
        March 12, 2014 at 8:49 am #

        No, it was perfect! Thank you for sharing.

      • Sue
        March 15, 2014 at 4:15 am #

        GraceEnough – it was wonderful to read your story – thank you for sharing it! We need this sort of perspective to remind us that, while this discussion may not convert the zealots, it can offer comfort to those who are perceptive enough to accept reality. Your child has an awesome mother!

    • moto_librarian
      March 12, 2014 at 9:50 am #

      I want to give you a big hug! I am so sorry for what happened to you. Thank you for sharing your story. It may well help someone else.

    • Zornorph
      March 12, 2014 at 9:59 am #

      While those women were convincing you that you had experienced ‘birth rape’, they were instead themselves guilty of ‘mind rape’. I’m glad that you were able to get out from under all that woo.

      • GraceEnough
        March 12, 2014 at 12:40 pm #

        Yes. They made sure I knew what a terrible thing had been forced on me. Everything was blamed on that C section. Oh, your son is 9 months and isn’t walking? My homebirth baby was tap dancing straight from the womb. Can’t your 2 year old dress himself while reading the newspaper? My homebirth baby crowned while reciting his favorate sonnet and knitting himself a hat.

        • Zornorph
          March 12, 2014 at 12:44 pm #

          Whenever people make any sort of comment to me comparing my baby to theirs (in terms of ‘milestones’ or something of that nature) I just say dryly ‘My baby can beat up your baby.’ I find they really don’t know how to respond to such a thing.

          • GraceEnough
            March 12, 2014 at 12:54 pm #

            Ha! I love it!

          • auntbea
            March 12, 2014 at 8:50 pm #

            My baby is 90 th percentile in both height and weight. She doesn’t need to beat anyone up. She can just sit on them.

          • Zornorph
            March 12, 2014 at 9:04 pm #

            So is mine! I suggest a cage match.

          • Mishimoo
            March 12, 2014 at 9:23 pm #

            Mine is lanky (75th for height) and thin (25th for weight) despite eating hearty meals. I guess breastfeeding on demand ISN’T as magical as people claim.
            Also, trying to find a formula to supplement with that he likes is really frustrating.

    • Coraline
      March 12, 2014 at 10:15 am #

      Thank you so much for sharing this!

    • March 12, 2014 at 11:11 am #

      That made me tear up. I’m sorry you had to go through PP alone and so very young!

    • Danielle
      March 12, 2014 at 11:32 am #

      Thanks for sharing this. Your story is really touching, and I think it points out the consequences of the natural birth ideology that its adherents often do not recognize. They want to think they are elevating women’s experiences (rejecting the power of the “male” OB, rejecting the “violence” of being cut, seeking to preserve control, and getting women to ‘trust the female body’). But that movement also works very hard to question the validity of women’s experiences that don’t conform, and to shame or make victims of those who did not have a “natural birth.” That’s harmful, especially because birth can be such a powerful or overwhelming event. The narratives people are encourage to construct really matter.

      I’m really glad that you were able to get closure later on by seeing the medical records so that you could see what happened, and why. I know that would have meant a lot to me.

      • GraceEnough
        March 12, 2014 at 1:12 pm #

        I don’t think any of them understand how damaging it can be. The women I delt with were not intentionally horrible. They honestly thought they were helping me by pointing out all the things I did wrong leading up to the birth. Maybe they were as mentally ill as I was at the time. The culture has gotten so much bigger since then though. And it prays on emotonally vunerable women.

        It was very validating to see the records. It restored my faith in doctors. When I told my homebirth friends about it they refused to acknowledge that my c section was needed. Someone actually told me that a baby born not breathing isn’t always an emergency, and neither is being blue and floppy. “some babies just have trouble settling into their bodies, they’ll breathe when they’re ready”.

        • The Bofa on the Sofa
          March 12, 2014 at 2:43 pm #

          The women I delt with were not intentionally horrible.

          My second grade teacher probably was not intentionally horrible, but that didn’t make her physical or emotional abuse any less abusive.

          She probably thought she was helping me by mocking me in front of all the class.

          I don’t give a shit. Monsters are monsters, regardless of whether they intend to be.

          (she is the one person who, if there is a hell, I hope she is in it)

          • March 12, 2014 at 5:08 pm #

            My second grade teacher was a twat, too. Actually, he was a monster. I am sorry you had to go through that, too.

          • The Bofa on the Sofa
            March 12, 2014 at 8:19 pm #

            Mine was a big fat nun.

          • Mishimoo
            March 12, 2014 at 8:42 pm #

            Mine was my mother, who sounds very similar to your nun.

          • The Bofa on the Sofa
            March 12, 2014 at 9:14 pm #

            Did she have a big ass nun ring that she turned around so the stone was on the inside and use it to slap the back of your head when your letters went above or below the lines in penmanship, too?

          • Mishimoo
            March 12, 2014 at 9:37 pm #

            No, I simply got sent to the bathroom to wait for her to calm down enough so that she wouldn’t hurt me too badly. Then a lecture on how my handwriting was deteriorating which was followed by bruises from a coathanger.

          • The Bofa on the Sofa
            March 12, 2014 at 10:14 pm #

            Coathanger. Nice.

          • Mishimoo
            March 12, 2014 at 10:17 pm #

            Better than it could be, I guess.

          • auntbea
            March 12, 2014 at 9:45 pm #

            What. The. Fuck. Was that not illegal?

          • The Bofa on the Sofa
            March 12, 2014 at 10:14 pm #

            Well, if anyone knew about it. But, you know, bullies….they have a way of keeping it not all that well known…

        • Danielle
          March 12, 2014 at 3:49 pm #

          “Someone actually told me that a baby born not breathing isn’t always an emergency, and neither is being blue and floppy. ‘some babies just have trouble settling into their bodies, they’ll breathe when they’re ready’.”

          My baby boy was also born “blue and floppy” and “had trouble settling into his body.” It bugs me that people are just writing that off as though it is not a big deal. Sure, some babies will breath in a minute or so. And you know what? Some babies aren’t going to stop breathing properly unless someone stops “waiting for them to breathe when they are ready” and helps them to start breathing.

          Frankly, seeing my baby born unresponsive, meaning that he already hadn’t been getting proper oxygen for a time, and waiting those long seconds/minutes to hear him cry was not “nothing.” He was having a rough time and couldn’t breathe. And it was sad and scary for me to realize that he was in distress.

          He was also just fine, thanks to a great medical team that cleared my sons lungs, then monitored his breathing closely for several hours. Our story is happy & just another typical and probably forgettable case in a long week for the medical staff at my hospital. But that’s not because “nothing happened.” It’s because a whole team of people were there to leap to our aid, and they had the expertise to make sure he was going to be OK.

          I know I’m ranting here, but when a baby is danger or even just suffering when they don’t need to be, it’s not time for cute euphemisms like “settling into one’s body.”

        • Jessica S.
          March 12, 2014 at 4:36 pm #

          “Someone actually told me that a baby born not breathing isn’t always an emergency, and neither is being blue and floppy. ‘some babies just have trouble settling into their bodies, they’ll breathe when they’re ready’.”

          Can we all agree that, from here forward, the appropriate response to such nonsense is: “IN WHAT WORLD?”

          Your story is touching. I’m sorry your PPP was so severe and that you suffered it alone. I’m glad you can talk about it and that your children are holy and healthy, it sounds. Blessings!

        • Carolyn the Red
          March 12, 2014 at 5:25 pm #

          Not breathing, blue and floppy isn’t an emergency.

          OK, just can’t make that sound at all reasonable. How long do you wait for them to be ready? Do they think the placenta is SCUBA?

          • GraceEnough
            March 13, 2014 at 2:11 am #

            I believe the thought was that if the cord hasn’t been cut the baby is getting enough oxygen through that? Or something along those lines.

        • Young CC Prof
          March 13, 2014 at 3:31 am #

          They will indeed breathe when ready, usually after the neonatal resuscitation team gets their lungs going.

          I’ve also heard the NCB idea that a baby who’s “calm” at birth is a good sign. This is actually just as dumb, but less obviously so. While there are some newborns who are breathing fine but don’t scream much, generally the screaming is a key sign of health and actually helps the lungs get going and open all the way.

    • March 12, 2014 at 12:52 pm #

      That does sound fucking awful though, having surgery when you are really confused about what is happening. I’m sorry that happened to you!

  26. theadequatemother
    March 12, 2014 at 1:52 am #

    When GCC starts tap tap tapping the delete button the discussion gets pretty hard to follow. I want to have a cup of coffee with Jessie Stavis. I wad almost, but not quite, lost at the point where Cartesian observers entered the discussion.

    • Anj Fabian
      March 12, 2014 at 6:22 am #

      Medicine is a reflection of the people who practice. If white male OBs are delivering babies, then everything they do is a reflection of the priorities of white males.

      If you point out that OBs are no longer dominantly white males, they will shift the discussion to well the OBs were HISTORICALLY white males and so that influence still dominates.

      If you point out that the actual practice of obstetrics has changed quite a bit over the last century, based on evidence and changing patient demographics – I don’t know what TFB et al will say.

      • Sue
        March 15, 2014 at 4:20 am #

        Let’s see.. within only a few decades, lots of women in OB, out with the twilight sleep, stirrups, routine episiotomies, better regional anesthesia, better surgical techniques, better-trained nurse midwives, more availability of lactation consultants, low molecular weight heparin for clots……….science just keeps on improving.

        If GCC is so much against scientific advancement, why doesn;t she hold a discussion group in the village square instead of a blog on the internet?

  27. Zornorph
    March 12, 2014 at 12:44 am #

    I find the focus on ‘birth stories’ might be a part of all this. I really didn’t get it, but I asked somebody if they might be a female equivalent of war stories. I guess having a C-section is ‘cheating’ in some people’s minds.
    I can think of only one person who had a genuine reason to be against C-sections. Macbeth.

    • Anj Fabian
      March 12, 2014 at 6:26 am #

      I bought into the medical patriarchal dogma twice – and all I have to show for it is two healthy children.

      I don’t have my VB medal or my unmedicated birth badge, so I can’t be part of the pseudo feminist sisterhood. I’m bereft!

      • Mer
        March 12, 2014 at 1:55 pm #

        You can have one of mine, I have two but I don’t need them, didn’t even want them. Wanted to be fully medicated all times but the first time there was no anesthesiologist and the third time I went too fast. I’m still mad about it!

    • Young CC Prof
      March 12, 2014 at 9:45 am #

      You know, I actually have made Macbeth cracks about my early c-section son, since he was indeed untimely ripped. Just remember, would-be usurping regicides, there are plenty of strapping young folks out there just like him!

      • The Computer Ate My Nym
        March 12, 2014 at 10:31 am #

        Hmm…I can’t really say my kiddo was untimely ripped. More like timely or possibly past timely ripped. Think she’s still qualified to kill murderous usurpers?

        • Young CC Prof
          March 12, 2014 at 10:35 am #

          Probably, yes.

        • Amazed
          March 12, 2014 at 4:11 pm #

          Ask the three witches. Oops, I meant, go to the hospital and grab three medwives to ask this important question.

      • An Actual Attorney
        March 12, 2014 at 3:49 pm #

        Last fall, when my son was about 2.5, he found a leafy branch that had fallen from a tree during a storm, or possibly trimming. He insisted on carrying it around in front of him for blocks. It was the only time I’ve ever been tempted to tell everyone I passed he was born by CS. Then I decided no one else was likely to be as amused as I was.

  28. AL
    March 12, 2014 at 12:41 am #

    I couldn’t even get through that thread. Honestly, why does she care so much?????? Why is it incredibly difficult for her to listen to someone telling their story? When will people stop reading her drivel?
    Scholar part…HILARIOUS. HA HA HA. Scholar. I’m still snorting.

    • yugaya
      March 12, 2014 at 2:41 am #

      XXI century and a ‘feminist’ ‘scholar’ who is still stuck prescribing what other women should do and do not do with their nether parts. Patriarchal much?

  29. Maria
    March 12, 2014 at 12:35 am #

    When we figured out my baby was breech (tushie was wedged pretty firmly in my pelvis) I started to read some of the c-section threads on my birth board just to get an idea of what to expect. It never failed that if someone posted a question like “I am having a c-section and want to hear from people who have also had one with advice for how to deal with healing or what to expect in the OR,” inevitably someone would drop in and say “Why are you having a c-section?” The implication being that if you know ahead of time that you are having a c-section, you better be ready to justify your reasons why. Seemed so odd to me.

  30. Bomb
    March 12, 2014 at 12:29 am #

    “Nothing so needs reforming as other people’s habits. Fanatics will never learn that, though it be written in letters of gold across the sky.” -Mark Twain

  31. Gretta
    March 12, 2014 at 12:24 am #

    I had a doctor tell me that she would not have treated me like a previous doctor did. It really messed me up like this post said, I started questioning myself, my judgement, my ability to use medical advice to make sound decisions, my doctor’s integrity, etc…. It made making healthcare decisions much more nerve-wracking and difficult.

    • Elaine
      March 12, 2014 at 2:38 pm #

      I think that would depend on how you felt about the previous experience. If you were content with it, it doesn’t seem to serve any purpose for the doctor to say it shouldn’t have happened that way. But if a patient comes in questioning the treatment they received previously, I think under those circumstances it would be okay for the doctor to say that they disagree with the previous doctor’s actions (if in fact they do).

  32. don'tgiveacrap
    March 11, 2014 at 11:44 pm #

    I am sick of the drama over it all. I don’t care how your baby came out, and why would you care so much how mine did? I really don’t see how this is even enough of an issue to justify a blog post, or even to justify my comment to your blog post.
    And yes, I birthed one naturally, no meds, no nothing. Oh yeah, it hurt, but recovery was a cinch.
    I had a CS, possibly preventable, but the DR didn’t want to try to turn my breech baby until week 38. By then baby was too big and tightly compacted to move an inch. The nurse that attended me had more wits then the DR and said she pretty much only saw success when the baby was turned before week 37. Labor was a breeze and mostly non-existent, but recovery was awful and I was shaking so badly that I was surprised they gave me my baby to hold soon afterward.
    I then had two VBACs. No way I was having another CS if I could avoid it! A couple of doctors in my practice were supportive and optimistic about it but one of the DRs that I admired the most tried to use scare tactics to convince me otherwise.
    So, chill out with your one-sided propaganda too! Next up, please post an article titled, “10 Ways Your OB Manipulates You”. And no, I am not a home-birth proponent, I just don’t like your essays or arguments.

    • Haelmoon
      March 12, 2014 at 12:09 am #

      ECV can be before after 37 weeks and be successful. Yes the rate goes down, but it does not go away. I have successfully turned babies who were “surprise” breeches at 41 weeks, but also have failed to flip babies at 36 weeks. Gestational age and size is not all that matters. There is the issue of fluid (just the right amount – too little and the baby won’t move, too much and I can’t grasp the baby), the location of the placenta (harder to grasp the baby if it is anterior, sometimes it sits in the way of how I am trying to turn the baby), position of the baby (footling is easiest, than complete, than frank – imaging trying to do a sommersault in pike position), maternal size (harder in bigger moms) and moms muscles and pain tolerance. Like most things in maternity care there are many factors involved, not just one.

      The problem in maternity is that people only want good news and happy thoughts. But that is not the reality of obstetrics. Bad things and happen, and to have informed choice, you need to know what the risk of those bad things happening are. We can’t have a VBAC discussion without talking about emergency c-section, rupture and fetal harm. Its not scare tactics, it the reality of VBACs. When confronted with probabilities, patients often assume it wont happen to them, but in a busy OB practice, we will see it happen. I want to warn every mom ahead of time so that they know what they are getting into. I fully support VBAC, but there is a risk and you have to be willing to accept that risk, but also accept my expertise that if I think that risk is increasing, perhaps it is time to plan for a c-section.

      Yes it is your baby and your body, but they outcome, particularly a poor outcome can hurt everyone who looked after you. I was involved in a case of a uterine rupture (good long term outcomes for mom and baby, excellent nursing team, but scary at the time). We lost two nurses after that event because of stress – they transferred and never came back. We have to care for all women – we see the disasters to it is not a “scare tactic” but a real risk.

      • March 12, 2014 at 2:58 am #

        When I was young in my professional life, and the world was young, too, as Kipling might have said, ECV was regarded as a medieval procedure best left to parts of the world where a C/S was impossible. And the rationale, besides the risks of the procedure itself* was that if a baby turned easily, it turned itself back easily, too. And if it was difficult to turn, the risk of abruptio was just too great. Far, far better to have a C/S.

        *This was before ultrasound, which meant the operator was “working blind”.

        • OBPI Mama
          March 12, 2014 at 7:24 am #

          I am thankful my doctor tried an ECV on my son. I didn’t want the recovery of a c-section because I had a special needs 14 month old at home to care for as well. It didn’t work, but I’m glad he tried (this is also why I wanted a trial of labor with my 2nd baby vs. automatic c/s for previous shoulder dystocia… so glad it didn’t work out though!). Recovery from my c-sections have not been a breeze and it takes a lot of work from me (6 weeks worth of freezer meals, housekeeping help, etc) because I had 4 babies in 4 years (the last 3 being c-sections). The ECV was done with an ultrasound on the baby the whole time. And the plan was that if the baby had turned, they would induce right away. It made sense and because they were monitoring the baby the whole time, was it still risky to have done?

          • March 13, 2014 at 12:48 am #

            What I read from what you’ve written is how important it is to be flexible and also to weigh risks and benefits. What the NCBers don’t understand is that there ISN’T a “one size that fits all”. Your situation and that of someone else can be completely different. Obstetrics is much more like a buffet than a “plat du jour”. The art of medicine is matching the treatment to the patient.

            I had 3 C/Ss in the space of 3 1/2 years, and bounced back from the surgery almost immediately, but that doesn’t mean that everyone does, so I never assume that all women have easy surgeries. But then, I don’t assume that because some women have traumatic vaginal deliveries, all will.

            There is some risk of dislodging the placenta with ECV even with ultrasound, and many doctors do it in the OR for that reason. It just so happened that two of my daughter’s friends, who also had breech presentations, had failed ECVs which required immediate surgery — my daughter opted for elective C/S for her breech a couple of weeks before her friends gave birth. [how odd is that, 3 friends, all primips, all breechs?] and told me later she was glad she did. Different strokes, etc.

      • Coraline
        March 12, 2014 at 12:29 pm #

        Thank you for this response!

      • Jessica S.
        March 12, 2014 at 4:50 pm #

        Great, measured response!

    • Renee
      March 12, 2014 at 2:27 am #

      Then don’t let the door hit ya on the way out…..

    • yugaya
      March 12, 2014 at 2:50 am #

      “10 Ways Your OB Manipulates You”

      I hope that given the amount of their decent formal education at least it will be more of a mental challenge to read than “10 Ways How Your Let’s Crowdsource What to Do In a Life and Death Situation Idiot Lay Midwife Brainwashes You Into Believing That She Knows More About Life And Death Situations Than Doctors Do”.

    • Coraline
      March 12, 2014 at 1:27 pm #

      If you don’t really care, then why do you feel the need to explain your own birth experiences and choices? Obviously this issue deserves a blog post, because you’ve fallen into the trap yourself. If you hang out with the NCBers, you likely always feel that you need to give an explanation to defend your c-section: “My baby was breech! My doctor did an ECV too late!” No one should have to defend their c/s before anyone else, no matter the reason it was done, and it’s EXTREMELY presumptuous and conceited for TFB to make women feel like they need to, which is exactly what she did with her Facebook post.

    • Jessica S.
      March 12, 2014 at 4:46 pm #


  33. Michelle
    March 11, 2014 at 10:20 pm #

    When my best friend was pregnant with her first (before I disavowed myself of the woo), her OB suggested she consider a c-section because her baby was measuring large and she had a small pelvis. I wasn’t asked and didn’t offer advice, but inwardly I judged that OB and considered her part of the problem. My friend ended up having a somewhat traumatic vacuum-assisted vaginal birth and was not able to hold her son for 30 minutes or so after he was born (he was and is fine). That was a real turning point for me – I realized that her OB knew what she was talking about and I was glad I had the good sense to keep my “medical advice” to myself!

    • Haelmoon
      March 12, 2014 at 12:14 am #

      I once had a patient who had a late second trimester stillbirth , with a really difficult delivery of the fetus. I recommended in the next pregnancy she have an elective c-section, given the baby was going to be bigger. I had documented all over her chart that I recommended a c-section, and strongly advised avoidance of an assisted vaginal delivery. In between pregnancies, she entered deep into the woo. The patient ended up having a vacuum delivery (she refused a c-section after a prolonged second stage), had a fourth degree tear and severe shoulder dystocia. The baby has Erbs palsy, and it will be long term. For the next pregnancy, she wants a c-section.

      Yes, you can make a too big baby.

      • Anj Fabian
        March 12, 2014 at 6:29 am #

        You did your due diligence.

        I wish mother and child did not have to experience that.

      • OBPI Mama
        March 12, 2014 at 7:33 am #

        Erb’s Palsy can be life long… my son’s Brachial Plexus Specialists purposefully don’t use the word recover. If movement comes back, it is “gained”. Recovery implies 100% can happen and it may never happen. It’s like false hope or something. My son also has a more severe OBPI.
        And I had 3 c-sections after his homebirth. Loved getting to experience having healthy newborns! Not having to go to therapies, surgeries, the feelings of unknown,etc. It felt like I finally got to have a “typical” baby experience! The word best used to describe my 2nd son’s babyhood: joy-filled.

        I am glad she is going to have a c/s next time!

  34. Squillo
    March 11, 2014 at 10:20 pm #

    How is it that Gina Crosley-Corcoran manages to make even other women’s births about her?

  35. no longer drinking the koolaid
    March 11, 2014 at 9:15 pm #

    Wish I had a nickle for everytime I heard a midwife cite the reason a woman didn’t get her vaginal birth/VBAC was because she didn’t want it bad enough.

    • The Bofa on the Sofa
      March 11, 2014 at 10:11 pm #

      I can tell you that, in our case, no, my wife most definitely “didn’t want it bad enough.”

      With our first, who was breech, we never even bother trying to turn him. She didn’t want it bad enough to even attempt it.

      And with our second, she didn’t want it bad enough to go to the hosptial an hour from home where a VBACS could be done.

      So no, she “didn’t want it bad enough.” But here’s my question: so the fuck what? Why does it matter whether she wanted to do it bad enough? She had no interest in “her” vaginal birth. She didn’t care that she wasn’t having a vaginal birth, so why should anyone else?

      • no longer drinking the koolaid
        March 11, 2014 at 10:25 pm #

        The phrase is usually used by midwives to absolve themselves from a birth that became a transfer, or a C/S. It is also a way of blaming mothers, rather than the midwife accepting responsibility for her own ignorance and not understanding the woman’s limits, especially the limits of her pelvis or her baby

        There are times when midwives use the phrase in explaining why they needed to transfer a patient, as in the emotional manipulation detailed in an earlier blog post. “If she had just listened to me, she could have had that baby at home.” All the while risking an arm fracture patting herself on the back.

        As you are a regular poster, I am sure you know these things, but point taken; why is it anyone’s business other than the woman giving birth.

        • Bomb
          March 11, 2014 at 11:43 pm #

          My midwife said I wasn’t “cut out for homebirth” when we chose to make a life saving transfer against her wishes. At the time I thought it was insulting and mean. Now I consider being cast out of their brain dead ranks a blessing and a compliment.

          • The Bofa on the Sofa
            March 12, 2014 at 9:59 am #

            Yep, that was the point of my post.

            My midwife said I wasn’t “cut out for homebirth”

            or you

            didn’t want it bad enough.

            Response: you say that as if it’s a bad thing. EVEN IF IT IS TRUE, so what? So what if I’m not “cut out for homebirth”? Or “don’t want [a vaginal birth] bad enough”?

            What’s wrong with that?

          • Sue
            March 15, 2014 at 4:26 am #

            Not cut out for homebirth, but cut out for prioritising your baby’s welfare? I know which I’d prefer as a parent.

      • Jessica S.
        March 11, 2014 at 10:35 pm #

        Yes!! I kept telling that to the doctors each time they checked me when my son was born. I would say “I’m willing to follow the route you suggest but again, I’m not adverse to a c-section. Really. So don’t be shy.” I plan on telling them the same when we discuss whether or not a repeat is in order. Although this time, it’s going to be more like “what time should I be here to scoop this kid out?”.

    • Renee
      March 12, 2014 at 2:30 am #

      This is so funny. I had a VBAC pretty much by accident. I did not even want one, and I spent the entire pregnancy planning to avoid one.
      But alas, ended up with a painless, 14 min, 4 push labor and delivery. I had slept through the rest of the labor I guess.

  36. yugaya
    March 11, 2014 at 8:30 pm #

    Ugh. Now I wish I had had me some c-sections just to be able to shove them all up her so heroically proven you-know-which-organ.

    Anyone wanna trade a pelvis tested in battle conditions more times than hers for a scar or two?

  37. March 11, 2014 at 8:29 pm #

    As an internet scholar, I can tell that Gina’s post is unnecessary. Prove me wrong, TFB.

    • rh1985
      March 11, 2014 at 9:14 pm #

      Can I be an internet scholar too? I have a degree from Google University!

      • Bombshellrisa
        March 11, 2014 at 10:32 pm #

        Wonder if I qualify to be a Pinterest Scholar?

        • rh1985
          March 11, 2014 at 11:39 pm #

          If you’ve pinned at least 81 pictures, I think you qualify!

          • Bombshellrisa
            March 12, 2014 at 1:25 am #

            81! If you participate in 80+ of something you must be an expert. Looking over my Pinterest boards, I must be a Certified Professional interior designer, chef, botanist and event planner.

          • rh1985
            March 12, 2014 at 12:22 pm #

            Well, if it works for CPMs, no reason why it can’t work for the rest of us!

        • March 12, 2014 at 5:25 pm #

          In my fantasy life, someone would pay me lots of money to organise Pinterest boards and create Polyvore moodboards. Dream job.

          • Bombshellrisa
            March 12, 2014 at 6:09 pm #

            You know, if someone pays someone to sit and knit in the corner “holding the space”, then I am sure someone would pay you to do your dream job-since you would actually be doing something besides holding the space

      • AllieFoyle
        March 12, 2014 at 7:25 am #

        I’m going to start calling everyone who has had any education at all a scholar. It just adds that extra bit of gravitas.

        My daughter, a third grade scholar with specializations in math facts and Harry Potter, is having a spirited debate with my son, the nursery school scholar, about the conflict between personal liberties and private ownership. My labrador retriever, an obedience scholar with an interest in civil disobedience, is taking advantage of this opportunity to simultaneously meet his nutritional needs and make an important political statement about the status of domestic animals in an anthropocentric environment.

        So much better than “My kids are squabbling over toys while the dog steals their breakfasts.”

    • Sue
      March 15, 2014 at 4:27 am #

      LOL. I’m a social media scholar.

  38. quark
    March 11, 2014 at 8:04 pm #

    I’ve been told my induction was unnecessary. The thing is, no one knows that, even my OB. She flat told me she recommended an induction because there were a few slightly concerning things on the BPP I had done several days past the due date. There was no clear urgent sign of fetal distress, but she felt it was time to move things along to be safe. She told me “No one knows what will happen if we don’t induce. The odds are pretty good that you’d go into labor in a few more days and your baby would be fine without the induction. But in some cases, this can be an early trouble sign.” So I had an induction (and an uncomplicated delivery and healthy baby). I might very well have had an “unnecessary” induction in the sense that my son might have been fine without it. But the only way to find out would have been to skip the induction and see what happened, and I was not willing to take that risk.

    • Young CC Prof
      March 11, 2014 at 11:11 pm #

      I had a slightly early delivery under similar circumstances: No clear signs of trouble, but some yellow flags. My son was born fine. At the time, I thought I’d never know whether it was really necessary or not, but was still glad I had agreed to do what the perinatologist said rather than gamble on waiting. Weeks later, I learned that the placenta had been examined and my son really had just about run out of time entirely.

      • Sullivan ThePoop
        March 11, 2014 at 11:18 pm #

        I never had anyone question whether or not my son’s early induction was necessary until recently. Even when I explain to them that my placenta had failed and I was leaking amniotic fluid down my leg they look at me suspiciously. Would anyone think that was a wait and see kind of situation?

        • Young CC Prof
          March 12, 2014 at 9:51 am #

          Oh, certain midwives on Facebook.

  39. fiftyfifty1
    March 11, 2014 at 7:44 pm #

    I had an unnecessary C-section. It went great and I loved it. I would never chose to birth vaginally again.

  40. March 11, 2014 at 7:41 pm #

    Not to mention it ISN’T ANYONE’S business, least of all a washed up self important narcissistic pontificating bitch like Gina’s.

  41. Mel
    March 11, 2014 at 7:12 pm #

    Every time I hear / read someone blabbering on about unnecessary C-sections, I think about the second time I watched my husband deliver a calf. I asked if it was possible to intervene too soon in a delivery – like the feet and head were in the right position, but the labor just kinda stalled. He said “As long as you are being safe (ie – not applying dangerous amounts of force OR yanking on a calf that is in a position that won’t come out), you’re not gonna do any permanent damage and may well save the calf or dam’s life.

    That stuck with me.

    It seems like NCBer’s first willfully ignore some basic rules of physics in medicine – let’s deliver footling breeches at home! Double points for twins! – then have to resort to petty scare tactics to justify the risk. (I’ve heard of a lot of reasons for difficulties in parenting. I’ve NEVER heard from a reputable professional that a family dynamic was totally screwed up by a C-section.)

    • guest
      March 11, 2014 at 7:23 pm #

      “basic rules of physics in medicine” are simply an attempt by the medical profession to usurp control over the normal process of birth!
      but a direct quote

    • deafgimp
      March 12, 2014 at 12:25 am #

      Every time you deliver a calf, you decalfinate the mother!

  42. Kate
    March 11, 2014 at 6:43 pm #

    Will never forget the “friend” that didn’t think I “tried hard enough” to deliver my baby. I ended up with a C-section after 2 hours of pushing him against my pelvis so that when they finally delivered him, there was a wound on his head from his head hitting with every contraction. She also was brazen enough to tell me that there was no way a woman could possibly bond with a baby born via c-section like a baby she pushed through the birth canal herself. As if I’m less of a mother. Oh yeah, she had a c-section for a breech birth but then had 3 successful VBAC’s at home. Every time the midwives showed up at her house for another birth, I just prayed that everything would go ok. Keep up the good fight Amy!

    • quark
      March 11, 2014 at 8:07 pm #

      It’s very sad that she would say that about bonding considering her own history. Does she realize that she is clearly implying that she didn’t bond with her first child as much as the three younger siblings? Does she say that kind of thing in front of the children? How sad, and I wish she would seek family therapy to help repair her relationship with the first child rather than projecting her apparent issues onto others.

      • Comrade X
        March 11, 2014 at 8:08 pm #

        Yes, I believe she does realize what she is implying. In fact, I think at some points she has come right out and said it.

      • Kate
        March 11, 2014 at 9:24 pm #

        You know, when she said those things to me I was so dumbstruck that someone would actually say that aloud to me (I believe my baby was about 3 months old at the time) that I had nothing so say in return (and I also wasn’t as vocal with my opinions as I am at my older, wiser age). But interestingly, she used to always talk about the strong bond she had with that particular daughter. What a hypocrite! It’s been 14 years and I have never forgotten this. I had wonderful recoveries with both my C-sections and never, ever was remorseful or felt “cheated” out of my birth experience.

  43. Jessica S.
    March 11, 2014 at 6:19 pm #

    It seems to me that this obsession over how a baby is delivered is often a matter of control. Women who get all worked up, such as TFB, over “unnecessary c-sections” must be terrified of losing that control, of being able to push the baby out “on their own”. (Using quotes b/c it’s highly arrogant to think it shouldn’t be a team effort, with appropriately trained professionals.) My view? WHO THE F#%* CARES? The way I see it, I lost autonomy with my person the moment I got pregnant (9 months of this other life system affecting mine – I love my child and child-on-the-way, but I detest pregnancy!) so I could not care less how this creature is expelled from me, just that it IS in a timely let’s-not-drag-this-out manner. I’m not hanging my womanhood on how my children arrived, just as certainly as I’m not hanging my personhood on my children in GENERAL.

    But that’s just me.

    • Bombshellrisa
      March 11, 2014 at 7:45 pm #

      I think you are onto something there. BTW, I was not enchanted with being pregnant and not obsessive about giving birth either. I just want the good part: a baby to kiss and hug and dress up in three different outfits a day : ) thankfully I didn’t have any illusions about controlling anything because I had no control over anything once labor hit. The most control I had was choosing what juice I could sip and what was on the tv while I pushed.

      • Jessica S.
        March 11, 2014 at 10:38 pm #

        I’m laughing at the three outfits a day comment: 1) that was/is totally me and 2) little did I know that often times the three outfits per day were necessary. I still am amazed at how a 2 month old manages to get poop in the foot of his sleeper pjs!! Nevermind the spit up. Ugh. 🙂

        • Sullivan ThePoop
          March 11, 2014 at 11:09 pm #

          Three outfits a day is nothing for my 17 month old nephews. One of them has copious amounts of drool and is a very messy eater and the other likes to make the milk come out of his cup onto himself.

    • OBPI Mama
      March 12, 2014 at 7:40 am #

      I was one who wanted control of my body (I never even drank because I was scared I’d get tipsy and didn’t like the thought of not being in 100% control of my person). The thought of an epidural and not being able to move my legs terrified me. But you know what I found out… even during a homebirth, you are not in control! Your body does whatever the heck it’s gonna do and, at least for me, I didn’t have any feeling of control during my homebirth. It was insane and gave me the most out of control feeling I have ever had. My c-sections felt much more controlled and much more peaceful to me.

    • prolifefeminist
      March 12, 2014 at 8:12 pm #

      Here’s the thing. I DID care about how I had my babies. I wanted the moment I first met them face to face to be as pleasant and non-scary as possible. I wanted to be treated with respect. But, as much as those things mattered to me, getting through childbirth healthy, with a live, healthy baby in my arms afterwards was infinitely more important than the experience itself. It’s a luxury that I can even afford to think about such things; in many parts of the world, women are too worried about dying in childbirth or losing their babies to care about whether the lights were dimmed, they had a doula, or even if the doctor was nice. The experience itself matters but it is secondary to safety (or at least it should be to any sane person).

      I know I’m not saying anything new here, but I think it’s important for the on-the-fence readers of this blog to hear that yes, the birth experience matters to many of us, but it does not and never will trump the safety of mother and child.

      • Jessica S.
        March 12, 2014 at 10:16 pm #

        Yes, you’re right. And admittedly, my stance is not quite as “in your face” when it’s not in response to nonsense such as TFB. It’s important to feel comfortable and safe, and not just “I’m in a hospital safe”.

  44. rh1985
    March 11, 2014 at 6:18 pm #

    I don’t really care if there is some remote possibility my c-section could have been avoided. I wasn’t invested in giving birth a certain way (other than having healthy me, healthy baby, and pain management!) and there were enough good reasons to do an immediate c-section (already 39 weeks, pre-eclampsia bad enough my doctor would have recommended delivery even at 32 weeks, completely unfavorable for induction with no dilation and very high up baby).

    • KarenJJ
      March 11, 2014 at 7:25 pm #

      I was invested heavily into an unmedicated vaginal childbirth but:

      1. It turned out that my ability to handle risk for my unborn child was very very low. The slightest bit of meconium and I wanted her out.

      2. All that stuff about being calm and relaxed and focussing on the positive even during something that felt scary that I learnt from the hypnobirthing course was equally helpful during the c-section.

      3. The midwife that ran the hypnobirthing course was woo-y and very pro Ina May Gaskin, but had the sense and ethics to point out that the medical professionals know what they are doing and to trust them (my biggest issue with medical care at the time).

  45. Comrade X
    March 11, 2014 at 6:03 pm #

    The thing is, nobody in their right mind behaves that way when it comes to ANY OTHER medical situation. If you have your appendix out, your facebook page is not going to be bombarded by half-a-dozen nosy bumblefucks questioning whether you really needed your appendix out, demanding to know whether it was taken out conventionally or laproscopically, second-guessing the surgeon’s decision when you tell them, grilling you about what anaesthetic you got for the procedure and then implying that you might be less than spiritually whole because you are living appendix-free and not tearfully apologizing for it. Anyone who behaved that way when it came to appendicitis would be viewed as a crazy person, and a weirdly inappropriate and creepy one at that.

    • AlisonCummins
      March 11, 2014 at 6:07 pm #

      They do, actually. Especially for cancer. Don’t get toxic chemotherapy! Do a cleansing diet instead! Fewer people have direct experience with cancer than with childbirth so fewer people will feel expert enough to weigh in, and talking about pregnancy and babies is much more fun than talking about cancer, illness and death, so there’s usually less of it, but it still happens.

      • Comrade X
        March 11, 2014 at 6:17 pm #

        There are woomeisters who will spread the guano about cancer, vaccines, childbirth, fluoride, chemtrails and alien abduction complete with anal probing, sure. But those will usually be people who have marked themselves out more-or-less deliberately as fairly idiosyncratic compared to the other children in class. The childbirth woo seems to have seeped down into much more mainstream territory – people who would never think to pry into your asthma or acne or allergic rhinitis or preferences in lavatory paper will feel perfectly entitled to lecture you on the Deeper Meaning of What You Did With Your Vadge That One Time. It’s very strange.

        • Young CC Prof
          March 11, 2014 at 7:05 pm #

          Definitely. The NCB crap seems to enjoy a much broader audience than most other natural health crap.

          • yugaya
            March 11, 2014 at 7:19 pm #

            They all speak the same language though.

          • Sullivan ThePoop
            March 11, 2014 at 11:27 pm #

            I find it odd how it seems to rope some doctors in to some aspects of it. Although so do some other forms of who like chiropractics.

        • auntbea
          March 11, 2014 at 8:02 pm #

          A homebirthing friend of mine just posted a pro-vax meme on her FB page, with the note, “If you can’t trust your doctor, why use modern medicine at all?”

          How can that level of cognitive dissonance not be painful?

          • Jessica S.
            March 11, 2014 at 8:22 pm #

            *palm to forehead* Although, I guess I’ll take a pro-vaxer anyway they come.

      • Anj Fabian
        March 11, 2014 at 6:35 pm #

        I watched someone try to push “natural treatments” instead of chemo for cancer.

        This was a nature friendly page and even then, people pushed back because too many people have had loved ones with cancer. You can convince people to “make your own flu shots!” but when it comes to cancer, most people aren’t willing to risk death on a whim.

        • AlisonCummins
          March 11, 2014 at 6:40 pm #

          But people do try to bring their woo, even if it isn’t often well-received.

        • Stacy21629
          March 11, 2014 at 6:44 pm #

          Case Example #1 – Steve Jobs.
          Jobs was diagnosed with a very “treatable” pancreatitc cancer. Treatable with standard, modern medicine, chemotherapy, etc. He tried diet and exercise and other woo treatments. Ask him how that turned out.
          I know a woo-supporting family doctor that gives out homemade formula recipes…

          • Lisa from NY
            March 12, 2014 at 1:01 am #

            Thanks for the info.

        • Monica
          March 11, 2014 at 10:20 pm #

          “make your own flu shots!”

          OMG, that’s a thing? o.O Hah, and I just watched an episode of Doc Martin where someone self-administered Botox… *droopyfacepalm*

          • Bombshellrisa
            March 11, 2014 at 10:38 pm #

            It’s the “natural flu shot” crap-lemon juice, garlic, ginger, pineapple juice and honey for six nights in a row or something like that. I have a friend who posts about it-along with warnings about soy formula (it exposes babies to estrogen 70x the amount in a birth control pill!), fluoride (it ruins your gut flora!) and all kinds of detox recipes and believes in “oil pulling” with sesame oil (you swish sesame oil in your mouth and then hold,it in for a few minutes. Takes the “toxins” out of your system)

          • Sullivan ThePoop
            March 11, 2014 at 11:26 pm #

            Oil pulling is ridiculous. I like the idea of making money off grounding mats though. You would have to be a complete idiot to buy one of those.

          • R T
            March 12, 2014 at 2:59 am #

            I do oil pulling to clean my teeth and it works great! I’ve never had a cavity in my life and I don’t think it’s my genes because everybody else in my family has tons of fillings. I don’t think it cleanses my body of toxins though, lol! It just makes my teeth really clean!

          • Sullivan ThePoop
            March 12, 2014 at 8:26 am #

            You are using it in the traditional sense though. Not to cure everything on earth. Oh, and I never had a cavity until I had a small surface on at 39 and none since. That is without oil pulling.

          • Trixie
            March 12, 2014 at 9:03 am #

            You do it in place of brushing? With fluoride toothpaste?

          • R T
            March 13, 2014 at 4:58 am #

            Yes, for the most part! I brush with toothpaste about every other day. It depends on what I eat. Every time I get a new dentist they panick and do a bunch of X-rays when I describe my oral hygiene routine. Then they tell come in and say I have no cavities and have great teeth and gums! I don’t know if I just got lucky in the tooth enamel department or if the oil pulling works? I’m not planning on changing things up though! I’m almost 34 years old!

          • Trixie
            March 13, 2014 at 9:08 am #

            I think you just got lucky.

          • Box of Salt
            March 12, 2014 at 1:04 pm #

            Steve Novella at Science Based Medicine agrees with Sullivan the Poop:

          • R T
            March 13, 2014 at 2:54 am #

            Yep, he agrees it has some benefit for oral hygiene, but not much else. My teeth are really white and no cavities at all. I started doing it as a child because I preferred it to brushing with baking soda like the rest of my family did! I do brush my teeth about three times a week, but I don’t floss or use mouthwash. I think most people don’t have great oral hygiene, they don’t floss enough or brush long enough. Oil pulling really makes you take a lot of time cleaning your teeth. I agree its just the motion of doing it that cleans your teeth, not something magical in the coconut oil I use. I like to do it while I watch TV at night!

          • Karenjj
            March 12, 2014 at 3:02 am #

            I use grounding mats all the time. With a wrist strap as well. To protect components from static electricity. I must be uber-healthy.

      • Sullivan ThePoop
        March 11, 2014 at 11:13 pm #

        Yes, the cancer woo is extreme. There are always some testimonials about people who “cured” their cancer with something or other. When you look at the facts they either had a lumpectomy (the actual treatment) and no chemotherapy (an adjuvant to the lumpectomy) or they are not really cancer free and just have a very indolent tumor that would have been the same with no treatment at all.

        Then I also wonder why people are surprised that chemotherapy is toxic. I mean, we are trying to kill human cells, right?

      • Lisa from NY
        March 12, 2014 at 12:56 am #

        I have a neighbor who died of doing the detox diet instead of chemo. The cancer spread and it was too late for chemo. No one could talk sense into her.

        She can’t blog about it because she is dead.

        • Bombshellrisa
          March 12, 2014 at 1:42 am #

          Exactly. My husband’s mother did “The Greek cancer cure” for her Hodgkin’s lymphoma. She was pregnant at the time and wanted only “natural” remedies. She died when my husband was two. I wish people could see what the woo really means in terms of “someone not making it”. It means following the questionable and unproven treatments and leaving your two and four year old behind. It means your four year old growing up and still remembering every minute of the night your mom collapsed and having the ambulance come and your father crying in the corner. It means your two year old wishing he could have known his mother, had her see his first day of school, high school graduation, wedding. Her grand babies would have loved her. Victims of the woo cancer treatments get the same treatment from the woo community as Ina May and the midwives give babies that they murder: the line about “not meant to live” and then something about at least they had treatment on “their own terms”. Makes me sick.

        • R T
          March 12, 2014 at 3:08 am #

          My great aunt thought God would cure her breast cancer. When he didn’t and she was on death’s door, she panicked and got medical care. She bankrupted my wonderful great grandfather, with her last second medical treatments, draining his hard earned and healthy retirement savings. Then she quickly died and he was left destitute. It was heartbreaking! He would have died for his children, but he should never have had to live out the end of his life like that. They found her cancer very early. She would have lived and he wouldn’t have had to spend the end of his life broke and broken hearted, living with my grand mother.

      • schnitzelbank
        March 12, 2014 at 2:50 am #

        Yes, a friend of the family worked her breast cancer with coffee enemas and those magnet bracelets. She’s dead now.

    • March 11, 2014 at 7:44 pm #

      Thank you for the term “bumblefucks,” I will be using it. 🙂

  46. AllieFoyle
    March 11, 2014 at 5:56 pm #

    Comments like that also contain the implication that a c-section is a fate worse than death, or at least, worse than vaginal birth. It reinforces the perception that c-sections are negative and to be avoided at all costs, which in turn probably sets women up to fear them. If you’re newly pregnant and your baby-related reading is full of sentiments of sadness and regret about c-sections that’s naturally going to color your perceptions. The truth is, of course, that many women have very positive c-section experiences while not all women who have vaginal births do. Personally, it makes me feel sad and regretful when other women spread guilt, lies, and judgement about other women’s personal experiences.

    • Stacy21629
      March 11, 2014 at 5:58 pm #

      This, +1,000,000
      See my comment below to Dr. Kitty. Many women have a great C-section experience but we never hear about it. The only thing that’s passed along are the horror stories that only serve to reinforce the stereotype.

      • Rochester mama
        March 11, 2014 at 6:06 pm #

        Or women that do have good CS experiences are framed as not woman enough to go through birth (and maybe just shouldn’t have kids). Or other such BS.

    • Mac Sherbert
      March 11, 2014 at 8:36 pm #

      Yes. I got so irritated at the I’m sorry line when I told people I had a c-section. My standard response is now “Sorry? So you would have rather we died?” Tends to end the discussion.

  47. Monica
    March 11, 2014 at 5:54 pm #

    My first run in with the founder of my states ICAN chapter was exactly this. For over a year she constantly invited me to come to meetings despite my insistence that I didn’t need to because I was fine with my very necessary c-section. Then she spent the rest of the time sharing articles about how breech is just a variation of normal and how I could have delivered my baby vaginally. I repeatedly told her I absolutely could not because aside from the fact that the hospital wouldn’t allow it, my doctor wasn’t trained or experienced in it, and due to the position of my son it likely would have killed him. But yes this possible non high school graduate who herself hadn’t figured out how to avoid those darn unnecessary c-sections, thus you know making her one of the few women who actually had to have c-sections was so sure that my c-section was completely unnecessary and that if I had just found another provider I could have delivered vaginally. Never mind that no doctor would have accepted a 3rd trimester transfer patient who had more than one reason why she was high risk. Nope, she didn’t want to hear that because boy did she know way more than my doctor did. She even knew so much that she then later had to come around and question my treatment when I got pregnant again. Grrr, I really can’t stand that know it all attitude. Unless you are my doctor, then mind your business.

    • Stacy21629
      March 11, 2014 at 5:57 pm #

      “who herself hadn’t figured out how to avoid those darn unnecessary c-sections”
      That would be a good response to these C-section second guessers – “so , how would YOU have avoided MY C-section?” Put them on the spot, make it personal and refuse to change the subject. The only way these folks’ arguments “work” is that they are never forced to stare one woman in the face and discuss this. They talk in generalities about a 30% C-section rate or type on their blog but never talk one-on-one to another mother about HER C-section and what they would have done in all their great medical knowledge to prevent it.

      • theadequatemother
        March 11, 2014 at 10:03 pm #

        Don’t you think they’d give you some drivel about staying home as long as possible, eating, doing the NCB hokey pokey and avoiding the epidural and fighting with the OB about when their tee time is? Plus lots of positive affirmations. And appropriately scented candles…for example vanilla is ok but honeysuckle causes instructive labour.

        • Anaesthetist
          March 12, 2014 at 6:57 am #

          Instructive labour? What do you learn from that?

          love it

          • theadequatemother
            March 12, 2014 at 10:12 am #

            You learn that autocorrect is funnier than you are….:)

    • Lisa from NY
      March 12, 2014 at 1:07 am #

      I adore your phrase “know it all attitude” along with “Unless you are my doctor, then mind your own business.”

      I am going to quote you in real life.

  48. Zoey
    March 11, 2014 at 5:45 pm #

    I suspect that my first CS for a non-progressive induction (that was absolutely necessary) that lasted 3 agonizing days with little to no progress was not strictly “necessary.” Baby wasn’t in distress, I was being monitored, but literally nothing was happening and, after my epidural failed I was so out of my mind with pain that when my OB offered me a CS I jumped at the chance.

    I felt so guilty afterwards for months, and got very defensive about my CS to people that asked, like I had to make up a harrowing story to “justify” my need for the CS. I felt like, if only I could have endured the pain for X more hours, then maybe I could have had a normal birth. I’m long past feeling that way now, but I get so angry when other women try to play Monday morning quarterback with someone else’s birth experience. Who knows if my CS was necessary? Who cares? I don’t, so I don’t know why anyone else should either.

  49. March 11, 2014 at 5:40 pm #

    Funny how there’s much noise about the csections that did not have to happen, but not a whole lot with regards to the csections that should have happened but did not – leaving damaged mothers or babies in their wake. Even the maternal request cesarean is not an “unneccesarian”…

    • fiftyfifty1
      March 11, 2014 at 7:48 pm #

      “Even the maternal request cesarean is not an “unneccesarian”…”

      Although mine was. My c-section didn’t “have to be”. I’ve made a number of good decisions in my life that were purely optional. I’ve looked at the pros and cons and made my choices. I did the same with C-section for my second baby and it worked out great for me.

      • Comrade X
        March 11, 2014 at 7:57 pm #

        Indeed. Something does not have to be necessary to be permissible. A couple of days ago I took an unnecessary ibuprofen because I had a headache – I would not have died without it, and the headache would probably have gone away on its own eventually. I wouldn’t die if I didn’t take my antihistamines in the summer either. I’d have a miserable time, but I’d live. So not really necessary. If you don’t moralize those choices, why moralize caesareans?

        • fiftyfifty1
          March 11, 2014 at 9:09 pm #

          “Something does not have to be necessary to be permissible.”

          How much we feel obligated to justify our choices as necessary is a measure of the social pressure to choose the other (approved) option. An even stronger example of this is sexual orientation. The mainstream societal conversation is still “I was born this way” as if it were a birth defect. When it becomes less stigmatized I guess it will be something more like “I choose to have sex with the people I’m attracted to, duh”.

  50. Karen in SC
    March 11, 2014 at 5:39 pm #

    Better to have an unnecessary c-section, then a necessary one that is performed too late. No one has a crystal ball to determine which babies can still be born safely via vagina when something happens to increase the risk of problems.

    • Stacy21629
      March 11, 2014 at 5:59 pm #

      I agree completely – I’d rather have a potentially “unnecessary” C-section and a healthy baby than a crash section and higher complications and risk. No thank you.

      • AllieFoyle
        March 11, 2014 at 6:04 pm #

        Yes, they all seem to want women and doctors to go to the point of actual emergency before going to c-section, but they don’t seem to grasp that not everyone values vaginal birth so much they’re willing to walk that line. Why would anyone?

        • Amazed
          March 11, 2014 at 6:43 pm #

          And when it goes to the point of actual emergency and it doesn’t work (look at the 44 week story on the link I gave in the last post of Dr Amy’s), it’s, like, well, even the emergency c-section didn’t work. This baby was clearly not meant to be.

          I also suggested coining out a new phrase: post-emergency c-section.

  51. Dr Kitty
    March 11, 2014 at 5:37 pm #

    I actually no longer care whether the CS was necessary, I just know that it was preferable to the alternative.
    My OB offered me a choice and I chose a planned pre labour CS.

    As someone who is 5′ tall with spina bifida occulta, a neuropathic bladder, sacralised lumbar vertebrae, metal work in my back and pelvis, a baby that wasn’t engaged in my pelvis at term and swinging merrily between OP, OT and OA, a baby measuring at what my OB felt was the upper limit of what I could safely deliver…and with a due date near a major holiday that tends to be celebrated by full scale rioting, no-one can convince me I made the wrong choice.
    No one.

    I have zero interest in a VBAC in future.
    Why would I? I had a lovely calm, controlled, painless CS, an easy recovery and a perfect baby.

    Why would I risk that just to be able to say I pushed a baby out of my vagina, risking their life and my health, future fertility and continence in the process?

    My CS was necessary to me, my OB agreed. GCC can take her judgement and go for a long walk…because I don’t want or need to hear it.

    • Stacy21629
      March 11, 2014 at 5:54 pm #

      ” I had a lovely calm, controlled, painless CS, an easy recovery and a perfect baby.”
      This is exactly what more mothers need to hear about. Folks like the student CNM posting several threads back describe all C-sections as this gaping, gory, painful, rip-you-open-tear-the-baby-out surgery. If they are done at an appropriate point (pre-labor or prior to an emergent situation intrapartum) and appropriate analgesia is used they are not the blood and guts horror that NCB people paint them to be.

      • R T
        March 12, 2014 at 2:54 am #

        I agree! My csection was wonderful! I mean I got to nurse my baby in the OR! The not great part was when the Duramorph didn’t work. I was clawing the walls in recovery screaming in pain for 7 hours until my OB showed up and thought to call in a pharmacy consult and get me on a pain pump. The doctors and nurses in recovery were aholes and I strongly dislike them all! My actual csection was really calm, intimate and beautiful and duramorph works perfectly for most of the population!

    • Jessica S.
      March 11, 2014 at 6:38 pm #

      Can I ask, what’s a neuropathic bladder? 🙂

      • Stacy21629
        March 11, 2014 at 6:59 pm #

        One’s ability to urinate (open the sphincters, contract the bladder muscles) are controlled by various nerves exiting from the lower spinal cord. Neurological damage to those nerves or the spinal cord can decrease or eliminate the ability for the bladder to function appropriately..meaning a decreased ability or even inability to urinate on your own. Passing a catheter into the bladder becomes necessary to empty the urine.

        • Jessica S.
          March 11, 2014 at 8:17 pm #

          Thank you! I have a very hard time (nearly impossible, so I don’t even try) going pee in public restrooms, no matter how hard I try or how urgent it is. But this is not the same thing as above – I’m not trying to relate the two. My problem is psychological, I’ve always assumed. Something I’d really like to get over someday, I just need to get the gumption to figure out how, I guess!

          • Sullivan ThePoop
            March 11, 2014 at 11:21 pm #

            I can go pee in public restrooms, but not the other and I have unfortunately passed that habit on to my daughters.

          • Jessica S.
            March 12, 2014 at 1:47 pm #

            Yes, it seems to be something I’ve “inherited”, too. Interesting, but unfortunate for sure! 🙁

        • Dr Kitty
          March 12, 2014 at 12:44 pm #

          Luckily I can pee, but I have to consciously remind myself, I don’t really feel like I have to go.
          I have a big, floppy bladder that holds a lot more urine than it should, and doesn’t send signals it needs to be emptied.

          It is quite possible that labour could send me into urinary retention, cause physical damage to my bladder from the presenting part, or lead to pelvic floor damage. All of which could permanently affect my ability to manage without catheters. Unfortunately exactly how likely that is is impossible to quantify, we just know it could happen.

          At no point was a CS pushed on me, it was always clear that because my daughter and I were healthy if I wanted a TOL we could do it…

          But when it came down to

          • Dr Kitty
            March 12, 2014 at 12:53 pm #

            But when it came down to the day I had to decide, a TOL just didn’t seem like it was worth the risk.

            My OB looked very relieved, so I know he thought I’d made the right choice, but it was a choice.

            I don’t care if GCC or other random NCB people think I should have tried to labour and see how it played out.
            To me, that was a risky option within insufficient pay-off to justify taking the risk.

            Someone else in that situation may choose differently, that would be fine, and I’d wish her a safe, quick and easy delivery. I don’t need a do-over, or a healing VBAC.

            I think I dodged a bullet…I might have dodged it before the gun was fired, but that beats hoping you can didge after the trigger gets pulled.

  52. moto_librarian
    March 11, 2014 at 5:28 pm #

    I am going to post my reply to Gina here, because she banned me from commenting long ago for the simple offense of disagreeing with her.

    Gina, quit calling yourself a feminist. You aren’t one. If you were, you would support a woman’s decision to have a primary elective c-section if that was what she concluded was best for her after reviewing the (actual) risks and benefits of the procedure.Feminism is about supporting a range of choices, which seems to be something that the NCB cultists have forgotten. Degrading women for having repeat c-sections with no actual knowledge of their medical or personal histories is actually quite paternalistic, and I daresay, misogynistic.

    I guess that you got lucky and didn’t suffer any long-term damage from giving birth to such large babies (or if you have, you don’t have any symptoms of it yet), but pelvic floor damage is at best unpleasant, and at worst, horrifying. I required some time in pelvic floor rehab after the birth of my second child, who weighed in at a whopping 6 lbs., 15 oz. (his older brother was even smaller at 6 lbs., 4 oz.). Having little babies wasn’t enough to spare me from second degree tears both times (and yes, my perineum was supported by my midwife), nor did it prevent the cervical laceration during my first unmedicated labor and delivery. That complication, which included a massive pph, left me so shaken that we almost didn’t have another baby. If it weren’t for epidural anesthesia, I probably wouldn’t have opted to get pregnant again, and I seriously considered an elective c-section. Your Monday-morning quarterbacking is both ill-informed and cruel, and I wish that you would think about supporting other women rather than abusing them because they didn’t give birth in your prescribed manner.

    I would also say that calling yourself a “maternal child health scholar” is at best a stretch since you have given no evidence that you have actually graduated with a MPH. You might want to consider the fact that most academics take a rather dim view of such pomposity.

    • AllieFoyle
      March 11, 2014 at 6:13 pm #

      It makes no sense to me… She’s weirdly distressed about people who had c-sections, but it’s not about the actual people or anything that happened to them–not their physical health or emotional distress, not some problem with the baby, not any anguish or regret they might have–it’s just the fact that they had a medical procedure that she doesn’t like. Bizarre. And even more bizarre, she doesn’t care about women like you who have genuinely suffered physically and mentally. It’s all good in her book. Actual human suffering is less distressing to her than some random stranger having a medical procedure that she dislikes, even when the people themselves are perfectly healthy and happy about it.

      • March 12, 2014 at 12:42 am #

        Not to mention considering “stretching out your vag” is a vain and silly concern.

    • jwell
      March 11, 2014 at 7:03 pm #

      Ah, so motto, do you consider yourself a feminist? Do YOU support a woman’s choice to have a homebirth? If that is what she concludes is best for her reviewing the (actual) risks and benefits of the procedure? So feminism is about supporting a range of choices? You mean like homebirth and UC? Or just a range of medicalized choices that take place in the hospital? Are you choices for you: well, you can choose a cesarean or you can choose an vaginal birth with an epidural! That’s what I support because I am for CHOICE.

      Do you do monday morning quarterbacking when women choose homebirth? Are you cruel or is that word only for women who don’t support the choices you personally have decided are the “right” ones?

      “I wish that you would think about supporting other women rather than abusing them because they didn’t give birth in your prescribed manner.”

      Have all of you people ever thought of taking your own advice? Hypocrites.

      • Amazed
        March 11, 2014 at 7:12 pm #

        Sure we support the informed choice to homebirth. Why not? I find it a stupid choice but I am entitled to my opinion, nothing more. Not every choice is mechanically admirable just because it’s someone’s choice.

        You won’t see us criticizing the informed choice. Now, my dear unhypocritical jwell, would you tell us what you think the actual risks and benefits of homebirth are? Benefits other than being calmer, loved and having the curtains be of your liking?

        • jwell
          March 11, 2014 at 8:04 pm #

          Let’s play, “Can you find the Sanctimommy!”

          “Sure we support the informed choice to homebirth. Why not? I find it a stupid choice but I am entitled to my opinion, ”

          “Sure we support elective cesareans and elective inductions. I find them stupid choices, but I am entitled to my opinion.”

          “would you tell us what you think the actual risks and benefits of homebirth are? Benefits other than being calmer, loved and having the curtains be of your liking?”

          “would you tell us what you think the actual risks and benefits of elective c-sections are? Benefits other than being easy to schedule, not stretching out your vagina and other vain and superficial needs?”

          “The only thing that saved her was the fact that she was not entrenched in woo enough to homebirth.”

          “The only thing that saved her was the fact that she was not sheep enough to be induced just because her doctor told her to”

          “dumb enough to homebirth”.

          “dumb enough to schedule a c-section because a ultrasound said the baby was too big.”

          Did you find the sanctimommy?

          • jwell
            March 11, 2014 at 8:05 pm #

            *hint: that’s a trick question

          • Amazed
            March 11, 2014 at 8:14 pm #

            Oh, you mean you can ask trick questions? Amazing, given the gibberish you posted. Given the fact that you support the so called scholar GCC, I am not surprised.

            Answer my not supposedly trick question. Up until now, we saw you cannot make a difference between having an opinion and giving it when it isn’t needed or wanted and that you value your curtains more than your child’s safety (elective c-sections are proven to be safer for the child) and stupid little things like preserving sex function and pelvic damages that are – gasp! – quite common in vaginal births as well.

            Answer the question, jwell. What are the benefits of homebirths other than the ones I listed.

          • jwell
            March 11, 2014 at 8:30 pm #

            Neonatal mortality rates for repeat c-sections are 1/1000 and 1.7/1000 for elective c-sections without medical need indicated. That’s higher than the neonatal mortality rate for low risk homebirth, btw.

            So, riddle me this brainiac, who is putting their baby’s life in greater danger: a low risk women who homebirths or some of the women who follow this blog and choose elective c sections because Dr. Amy has terrified them about pelvic prolapse?

          • MJ
            March 11, 2014 at 8:34 pm #

            Can you please provide a citation for those figures? We all try to do that here so that readers can go off and check the numbers for themselves.

          • Jessica S.
            March 11, 2014 at 8:40 pm #

            Exactly. I’d like to know precisely how they define “without medical need indicated”. That would basically isolate it to first time pregnancies, right?

          • perpetual lurker
            March 11, 2014 at 9:10 pm #

            I found this paper that sites 0.01-0.17% as the range for neonatal mortality for c-section for “no indicated risk”
            However, the citation for the higher number comes from a paper in Birth (NCB promoting journal) from none other than our friend Marian Macdorman, which Amy previously critiqued on SBM. According to her (unfortunately could not access the article) among the problems with the study is that birth certificate data (oh irony of ironies for Macdorman) was used which is not reliable in documenting complications, so “no indicated risk” may not be accurate.

            That’s just what I found. Maybe jwell has another paper to cite?

          • Amazed
            March 11, 2014 at 9:30 pm #

            Right. That’s what she meant. Birth and Marian Macdorman (I already lost the tracks of this one’s controversial statements).

          • Amazed
            March 11, 2014 at 8:39 pm #

            “In epidemiologic models, cesarean delivery on maternal request by 40 weeks of gestation would reduce fetal mortality because planned vaginal delivery could occur at up to 42 weeks of gestation”

            “Potential short-term maternal benefits of planned cesarean delivery compared with a planned vaginal delivery included a decreased risk of postpartum hemorrhage and transfusion, fewer surgical complications, and a decrease in urinary incontinence during the first year after delivery”

            The citations are from ACOG, not Dr Amy. You can find them here.


            Now, where can we find the citations for the figures you posted?

            Are we supposed to be impressed that you bumped a higher risk birth (after a previous c-section) and a low risk birth together as if they were comparable?

          • jwell
            March 11, 2014 at 8:58 pm #

            I thought C-sections were safe? Now they are higher risk? Ahhh. Good to know. Maybe there is something to be said for trying to avoid an unnecessary one and not just sign up right away because the ‘ultraound shows you are carrying an 8 pound baby’.

          • MJ
            March 11, 2014 at 9:09 pm #

            I’ll ask again, as politely as I did last time – can you please cite your sources for your figures on neonatal mortality and CDMR?

          • Amazed
            March 11, 2014 at 9:09 pm #

            Click on the link, jwell, and read what ACOG has to say.

            I am totally fine with a woman trying to avoid a c-section she deems unnecessary. Just as long as when it turns out to have been very necessary, she doesn’t scream, “But no one told me that my baby could die/get brain-damaged.” And sue, of course. There was a hospital that got sued because the homebirth transfer mom didn’t want to let the doctors near her but when the baby turned out to be brain-damaged, she changed her tune. Now, she became a poor victim of a delay in the very necessary c-section.

          • Sullivan ThePoop
            March 11, 2014 at 9:22 pm #

            Wow! Maybe you should leave this conversation to the adults. Or not because I cannot stop laughing at you.

          • MJ
            March 11, 2014 at 9:33 pm #

            Thank you. I’ll leave it to others who are more familiar with the work to critique this study if they wish. How do you explain the more recent findings by RANZCOG that CDMR reduced the neonatal mortality rate by up to ten times, over vaginal delivery?
            “Approximately 1.4 in 1000 can be expected to have an antenatal, intrapartum or neonatal death after 39 weeks gestation, increasing to 4.6/1000- at 41 weeks gestation. This is an unacceptable risk for many women and health professionals.
            Perinatal mortality from elective CS has been quoted at 10 times lower than that from vaginal birth.
            Ranzcog –

          • moto_librarian
            March 11, 2014 at 9:05 pm #

            Perhaps you should look up the difference between neonatal and perinatal mortality rates, brainiac. Here’s a hint for you: one is a measure of pediatric care, the other is a measure of obstetric care. Best to be sure that you’re using the correct one when telling us how much more dangerous an elective c-section is vs. vaginal delivery.

            Perhaps you should also note that the increased risks of c-section are to the mother, not the baby.

          • jwell
            March 11, 2014 at 9:18 pm #

            LOL. They are BOTH a measure of obstetric care. You are thinking of infant mortality. LOL. Brainiac.

          • Sullivan ThePoop
            March 11, 2014 at 9:29 pm #

            Early neonatal deaths are associated with obstetric care, but late neonatal deaths are not.

          • moto_librarian
            March 11, 2014 at 9:46 pm #

            As Sullivan the Poop explained below, only early neonatal mortality is associated with obstetrics. Perinatal mortality is more precise. I should have clarified that, and I can admit that I was wrong.

            Now, would you care to retract any of your statements?

          • yugaya
            March 12, 2014 at 3:22 am #

            Also take note that there probably are many women who are weird like I am who will willingly choose something with even significantly increased risks to the mother that decreases the risks to their baby as an acceptable risk for them in child birth. It is all about choices that each woman makes based on what her own priorities are.

          • The Computer Ate My Nym
            March 12, 2014 at 10:56 am #

            According to the CDC Wonder web site, neonatal mortality rates for all c-sections age GA 38-42 weeks (any c-section being done earlier or later being by its nature not truly elective) and 2500+ grams weight (again, any smaller not being elective/no indication) is 0.79 overall, ranging from 0.73 for 39 weeks to 0.95 for 42. In no case was the rate as high as 1.7 per 1000. And that includes high risk births. So there’s just no way that “elective c-section” results in a neonatal mortality of 1.7/1000.

          • moto_librarian
            March 11, 2014 at 8:33 pm #

            Oh jwell, where shall we begin? When the supposed “professionals” of the home birth midwifery profession (MANA, Melissa Cheyney, Jan Tritten, Ina May, etc.) constantly assert that “home birth is safer than hospital birth,” people tend to accept that at face value. The fact that lay midwives have invented credentials for themselves (the CPM and DEM) lend an air of authority to their statements. In other words, they pretend to be evidence-based even when their own data proves that they are lying. So no, I do not always assume that people who home birth are stupid. And when those families pay the ultimate price (like The family of Gavin Michael did), I feel horrible sorrow for them and incandescent anger towards the lay midwives who are so incompetent that they fail to detect or act on an emergency situation.

            It is not a matter of opinion that lay midwives and lay people are not as educated as medical professionals. They are also ignorant of basic history and what childbirth is still like in the developing world. But yes, let’s pretend that those of us advocating for true evidence-based care are the sanctimommies.

          • Sullivan ThePoop
            March 11, 2014 at 9:20 pm #

            Yes, it is you.

          • yugaya
            March 11, 2014 at 9:23 pm #

            First of all, if you want to pull something like that make sure that you have objectively leveled even the connotations that go with each set of statements associated with the things you are trying to parallel.

            Benefits of homebirth according to you:

            “being calmer, being loved, having curtains”

            -that’s plus, plus, I would say neutral save for there was that dude who was really much more into curtains than the actual birth, so based on that it is plus too.

            Benefits of c-section according to you :

            “being easy to schedule, not stretching vagina, other vain and superficial needs”

            -that is plus, plus and minus at face value, but the implications from that third one turn the connotation of both previous statements into minuses too ( “and other vain and superficial needs” ie the previous two benefits were also vain and superficial thus totally in the minus )

            So you have just by saying it like that proven that you are not able to look at these two things impartially – c-section is ALL negative to you and has no positive benefits. And homebirth has is ALL positive when curtains of choice are included.

            Lemme know how it goes and whether the accusation that equal sanctimommying has occurred in discussing homebirth vs c-setion is true, but only after you are able to scrap from somewhere at least TWO truly positive and ONE neutral to positive things to say about a c-section.

      • Mel
        March 11, 2014 at 7:16 pm #

        I would say that most of the scorn on this board is reserved for unqualified birth scholars who encourage women to birth at home without being honest about the real possible outcomes.

        After all, we have regular commentators who did give birth at home. Some of their births ended well. Others ended tragically with actual dead babies and actual severe injuries.

      • BeatlesFan
        March 11, 2014 at 7:18 pm #

        There are plenty of mothers here who have had vaginal births, unmedicated births, and yes, homebirths. If you read enough, you’ll find most commenters here do support womens’ choice to homebirth; assuming she is low-risk, fully informed with accurate information regarding the risks, and has an experienced, trained midwife who isn’t a complete dolt.

      • moto_librarian
        March 11, 2014 at 8:01 pm #

        I have said this before, but I will say it again for your benefit. I don’t care where a woman chooses to give birth. If she is fully informed of the potential risks, she can go squat in a forest for all I care. What no one has a right to is to expect a medical professional to condone risky behavior. I cannot go to a hospital with appendicitis and demand that the doctors treat me with herbs when an appendectomy is the standard of care. I can refuse the procedure, provided that I am capable of informed refusal but a doctor is not obligated to provide substandard care. Thus, if a woman is high risk (e.g., twins, HBAC, breech, etc.), she has no right to expect an ethical medical professional to preside over her home birth.

        Why are people like you so keen on airing an air of legitimacy to idiots masquerading as medical professionals? Is it feminist to hold home birth hobbyists to a lower standard than real midwives, I.e. CNMs? Are women too fragile and weak to go through a rigorous educational and clinical training process? Are women not capable of rational thought, and must instead rely on “other ways of knowing.” I could go on, but I suspect you are just a typical parachuting troll who will conclude that I am “mean” rather than taking a hard look at what feminism really should be. Maybe you’ll prove me wrong, but that’s probably just magical thinking on my part.

      • fiftyfifty1
        March 11, 2014 at 9:36 pm #

        I think that homebirths should continue to be legal as they always have been. It would be a bad policy to make something illegal that can sometimes happen very quickly and unexpectedly. Likewise with UCs, especially since what little evidence we have (Oregon stats) shows that planning a UC may be no more dangerous than planning an attended homebirth.

        The only thing I think we should make illegal is the CPM credential. I would not support a fake, grossly-undertrained, home abortion provider either. I’m pro-choice, not pro-quack.

      • Guestll
        March 12, 2014 at 2:24 am #

        I don’t give a rat’s about how you or anyone else gives birth. What I have a problem with are lies and sub-standard care for women and their babies.

        Sub-standard care arises from a sub-par “credential” not accepted in any other developed country. It needs to be abolished. It is unacceptable — no oversight, no accountability, no standards. Are there problems in the health care system, to encompass obstetrics? Sure are. Guess what — LESS QUALIFIED CARE IS NOT THE ANSWER.

        Along with abolishing the CPM, the lies need to stop.

        “Breech is a variation of normal”
        “Homebirth is as safe or safer than hospital birth”
        “Eating your placenta will stop a PPH”
        “Babies aren’t library books, they know when to be born”
        “The pain of childbirth is a different kind of pain”
        “Brewer Diet will prevent/cure pre-e”
        “The hospital is only 5 minutes away”

        And the list goes on. All of these things are lies. None of them are true. Stop saying them. Tell women the truth, that breech is a malpresentation, that going beyond 41 weeks gestation significantly increases the risk of mortality/morbidity to the baby, that the pain of childbirth follows the same neural pathways as any other kind of pain, including heart attacks, kidney stones, and slamming your finger in the car door. Tell women that the Brewer Diet is useless and there’s no evidence it works, and that the hospital may be 5 minutes away but really, it isn’t, and it doesn’t mean jack shit when your baby or your body’s in trouble.

        When you stop the lies, when you start telling the truth, I will not care any longer. Because it’s a woman’s choice — homebirth, UC, unicorn as midwife, it’s HER body, her choice.
        But when you do start telling the truth, you’ll lose. You won’t lose the religious hardliners or the militant off-the-gridders, but you’ll lose a huge segment of the prospective and current American homebirth population — affluent, health conscious, wanting to make the right choices for their families, do the right thing. You’ll lose, because they are not stupid, and it’s why you have to lie to them in the first place.

        One more tip for you — I respect your right to choice. I respect that right for all women. But it doesn’t mean I respect the choice itself.

      • R T
        March 12, 2014 at 2:41 am #

        I do! I support home birth with full disclosure! I also support UC if that is really what a woman wants. My mother had all of her children at home unassisted as did all of her friends. I was in attendance at many of these births and it was a great experience for me. More of my friends have had home births than hospital births and I considered a home birth before my pregnancy went horribly bad. Most everyone I know had a wonderful experience having their children at home, but one of my friends lost her first child during a home birth to shoulder dystocia. She had her second child by csection. Many of our friends went on to have home births after our friend’s baby died. I accepted their choice to do so because they fully realized the risks and were still willing to do it. I personally would very much like to have a VBAC if I ever have another child. I know many women would not be comfortable taking even the slight increase of risk with a VBAC. I understand acceptable risk is different for everyone.

        What I don’t support is the CPM credential. I don’t support unsafe midwives who put their clients in danger and risk the lives of women and infants for their own ego. I don’t support the cultish manipulation of women by many lay midwives and hardcore natural birth advocates. I 100% support a woman’s choices concerning her own body, be that, UC, home birth with a competent care provider, drug free birth in the hospital, birth with an epidural in the hospital or an elective csection. I just don’t support the right of a lay midwife to practice unsafely and lie to families and never face any consequences for their actions. Women have the right to choices, but they also have the right to know the real facts so they can actually make the right choice for them.

  53. Guesteleh
    March 11, 2014 at 5:28 pm #

    maternal child health scholar

    I literally choked on my waffle (not a euphemism).

    • The Computer Ate My Nym
      March 12, 2014 at 10:39 am #

      not a euphemism

      That’s good because all the things I could imagine it being a euphemism for are pretty disturbing.

  54. The Computer Ate My Nym
    March 11, 2014 at 5:18 pm #

    How do you tell if a c-section was unnecessary? Um…Ask her? Review the medical record? Have an expert review the medical record? All of the above? Another critical question might be why, unless you’re the woman involved or her doctor or maybe her attorney, you need to know whether another woman’s c-section was unnecessary.

  55. Lisa Murakami
    March 11, 2014 at 5:15 pm #

    Okay now this does make me curious about your rate of c-sections being lower than others’… is it because you were more skilled with and comfortable performing operative vaginal births? Or do you think there really are OBs who are too quick to section? Curious!

    • Elizabeth A
      March 11, 2014 at 5:40 pm #

      Not that this answers your specific question, but pretty much any doctor can say what Dr. Amy suggests, “my c-section rate is lower than many other OB’s rates.” “Many” is a vague term. There are “many” OBs who specialize in high risk conditions – maybe only a tiny percentage of OBs overall, but way too many to count on your fingers. There are “many” OBs who are very open to MRCS. Those doctors will do more c-sections then most, and are available for the making of pointless comparisons.

      Which, please note, Dr. Amy says she declined to make. Most patients asking qbout c/s rates are best serve d by a discussion of the factors leading to c/s, and the assurance that their OBs will exercise their best medical judgment.

      • Lisa Murakami
        March 11, 2014 at 7:15 pm #

        I don’t disagree with that at all. But I am still curious about the question I asked.

        • Amazed
          March 11, 2014 at 7:16 pm #

          Dr Amy has mentioned that her c-section rate was about 16 percent.

          • Lisa Murakami
            March 11, 2014 at 7:19 pm #

            So it actually is lower then. And my question is to what she would attribute that – better able to do operative vaginal births, or does she actually think that there are other OBs who are in fact too “quick” to section?

          • Amy Tuteur, MD
            March 11, 2014 at 7:50 pm #

            It wasn’t because of forceps because I never used them, and I rarely used the vacuum. People who know me only through the blog would be shocked, but I gave everyone lots of time, sat by the fetal monitor if necessary to be sure that the baby was okay, and tried pushing with a lower amount of medication in the epidural or stopped the epidural altogether if a patient couldn’t push effectively (but only if she agreed). I did no social inductions, either. It’s not that I hesitated to perform a C-section if I thought it was necessary; it’s just that usually the baby simply came out.

            One of my mentors used to say that only moths are attracted to light, not babies, so I used to have low lighting (but not so low that I couldn’t see) for the birth and always encouraged the mother to reach down after the shoulders delivered and lift the baby out. I was privileged to attend hundreds of joyful births and I know that the ambiance, the interventions, and the medication have no impact on the joy.

            Even though most of the time everything was okay, I never forgot for even one moment that childbirth can turn into a life threatening disaster from one moment to the next. I never trusted birth. It’s not trustworthy. I respected it.

          • Jessica S.
            March 11, 2014 at 8:34 pm #

            If you haven’t done so in the past, you should write a post with this info in it – I think it would probably surprise a lot of people, and personally, I find it endearing. I like hearing stories like this from doctors. Not that I’m saying you’re meeeeen! 😉

          • Trixie
            March 11, 2014 at 8:56 pm #

            I agree with Jessica S, this is really a wonderful anecdote and worthy of its own post. I’m sure most NCBers think you were slicing and dicing all day long.

          • yugaya
            March 12, 2014 at 4:18 am #

            “Even though most of the time everything was okay, I never forgot for even one moment that childbirth can turn into a life threatening disaster from one moment to the next. I never trusted birth. It’s not
            trustworthy. I respected it.”

            This reminds me of a documentary I watched where a group of elder women from Transylvania were telling a story of a surprise breech homebirth that happened to them. The one telling the story was a traditional lay midwife and baby and mom just barely made it alive through it.

            The thing that strikes me the most was the way this birth story was told – neither the midwife, nor the mother or these other women who were present had anything but sheer horror and terror to share about how it went down. These women live their lives as organic as it gets, and they know well how nature can during childbirth kill in seconds. That real traditional lay midwife probably delivered hundreds of babies and still she had audible fear of the unexpected complications of birth that happened decades ago.

            Not one of them used words like fearless, empowering, ‘beautiful surprise breech home birth’ or implied that birth itself is in any way to be trusted.

          • Siri
            March 12, 2014 at 5:39 am #

            That’s beautifully written, and doesn’t shock me at all; it’s what I have always assumed about you, Dr Amy. I wish we’d had more obstetricians like you at my hospital when I used to be a midwife! Working with you would have been a pleasure and a privilege.

          • Playing Possum
            March 11, 2014 at 8:06 pm #

            Unless you are talking about rogue doctors who very quickly get picked up due to the scrutiny of data gathering at all hospitals, you can’t say any doctor is too ‘quick’. Because the constellation of factors (and it’s often many small ones rather than a single, nice, easily assessable factor) that guides their intervention is based on prevention of injury. You can’t assess the necessity of an intervention after the fact because you don’t know what would have happened. You can only predict an outcome. You can’t criticize a single intervention if it was done in the context of an evidence based prediction of a possible bad outcome.

          • Lisa Murakami
            March 11, 2014 at 9:17 pm #

            I see what you’re saying, but what about this. My #1 was huge, 99th/100th percentile head, forceps delivery. I had heard many times about being induced early or scheduling c-sections for big babies, and at my postpartum checkup my OB straight said we would induce me at 39 weeks the next time around. I then switched OBs (I was curious if I would get the same advice, but more than that I had an OB when mine was out who was also into urology and her vaginal exams with me didn’t hurt because she understood my interstitial cystitis). My new OB seemed surprised that I was assuming I’d be induced early… at first I was actually kind of mad because she didn’t explain the science to me at ALL and instead she said (because I also mentioned wanting to make sure my mom could fly out to watch my son) that I “really needed to find a good babysitter.” I had no idea what to make of that – was she annoyed that I brought my son to my checkups (he was 1 and a handful at that age, super easy now at 3.5), or did she think I “must be going crazy” just because I stay home with my kids??? I was so confused. I then looked into it myself, used my husband (an oncologist, then a resident)’s passwords, and as best as I can ascertain, the ACOG says not to induce on suspicion of macrosomia because it doesn’t reduce the rate of c-section due to our difficulty predicting it. It turned out my #2 was 3 lbs lighter and I did go into labor on my own, and she flew out after 5 pushes. So OB #2 seems to have had the better answer. I still wonder about OB #1 and about people who are sectioned because their baby seems big… if that even really happens… I also never did get a straight answer from my own OB as to whether a 39 week induction would really increase my chance of a c-section considering I’d already had a vaginal birth. It also seems like, if the c-section rate stays the same, why not schedule the induction anyway if it’s more convenient to the patient’s schedule. I guess maybe both positions were, in fact, valid, if that’s the case… but as a patient I’m left really wishing it was better explained to me. A babysitter would have cost hundreds of dollars for overnights and transitioning to a sibling, I wouldn’t want to leave my son with a stranger.

          • Playing Possum
            March 12, 2014 at 12:45 am #

            So you had a less than ideal experience based around a decision or recommendation you think (in retrospect) was too cautious?

            You see an ob because you want someone who is skilled, educated, etc in a very narrow area of science. You don’t have that specific skill set, right? So you delegate the decision making to an expert. But that expert, while skilled, doesn’t have a time machine or crystal ball. A lot of the science is fuzzy. So experts have to be cautious because of the (low) risk of a (catastrophic) event. For them, it’s preferable to the (medium) risk of an (annoying, tolerable) event. The event could be death or permanent disability, and there isn’t a lot worse than the catastrophe of an intrapartum death, except maybe one where both mother and baby die.

          • Lisa Murakami
            March 12, 2014 at 8:51 am #

            Yup, that is exactly what I tell so many other people myself. I think the answer here though isn’t just that mothers should accept their OB’s words and decisions without questioning, just because it’s an area (like law) in which we have to trust our expert. I think the answer is for doctors to take the time to explain their thoughts to the patient.

            I have to believe that most mothers would never want even the smallest risk to their baby just to increase their chance of a c-section. But if all the doctor says is “I feel we should do X now” or “I like to do X in this situation,” that’s not enough these days. This isn’t just an issue in obstetrics, either; patients aren’t willing to just blindly trust anymore and the paternalistic model is increasingly obsolete. My friend had that exact situation – the doctor saying those things – while the nurses objected and fought for more time for her, saying things to the OB like she “IS making progress!” etc. The doctor relented and she had a vaginal birth… in her mind, only because of the nurses. Hearing her story, all I could really say was that the OB probably considered risk factors unknown to the nurses… but you can see why we can’t just expect women to trust their OBs blindly. That plan will only fuel the NCB and HB movements, because their proponents are more than happy to “explain” to women everything their doctor did not, 90% of their explanations being garbage.

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