Are the women who run birth blogs morally culpable for the deaths that result from their misinformation?

ethical and unethical words in wood type

There is a group of women out there who proudly and unapologetically kill and injure babies.

They are birth bloggers and they are a plague on babies who want nothing more than to live and to live uninjured by preventable birth injuries. The babies’ biggest enemy is the dozens of stupid, self important women with no obstetric education or training who dispense medical advice about childbirth.

Don’t get me wrong; they don’t mean for babies to die. But if they do, they are just unavoidable collateral damage of their favorite hobby: pretending to be experts in childbirth without any actual expert qualifications.

People like Ricki Lake and Ina May Gaskin are basically drenched in blood. One is a talk show host and the other a lay person who let her own baby die. They have lots to say about what is right with homebirth, and wrong with hospital birth, but neither of them actually has a clue. They present themselves as authority figures, but authority figures who don’t deign to take responsibility for the death and injury they leave in their wake.

Ina May is a cult leader, and probably believes every piece of nonsense that comes out of her mouth. Ricki Lake, on the other hand, knows that she isn’t a medical professional, yet she is happy to make money giving what amounts to medical advice. No matter how insulated she is from reality, Lake has got to know by this point that babies have died because their mothers watched her movies. Does it bother her? Does she lose sleep at night over those dead and injured babies? Could she care less about what happens after she takes her money and her kudos and goes home?

There seems to be an endless parade of birth clowns, who think the fact that they gave birth vaginally, or took a 16 hour doula course, or got certified as a “childbirth” educator, makes them an authority on childbirth. Everyone from the self proclaimed “public health scholar” Gina Crosley-Corcoran (I wonder what her professors would think about her “scholar” status), to uber conspiracist Jennifer Margulis (everything causes autism!!!), to the doula behind My OB Said What??!! actually have the temerity to believe that, despite an utter lack of professional qualifications, their blitherings about childbirth are wisdom to be shared with the unwary.

Consider Rebecca Dekker, blogger at Evidence Based Birth. What are her qualifications for analyzing the childbirth literature and holding forth on her conclusions? She’s a cardiac nurse.

Would you take cardiology advice from your labor and delivery nurse? You’d be a fool if you did. You’d be just as big a fool as the women who take childbirth advice from a cardiac nurse, although not as big a fool as a cardiac nurse who thinks she is qualified to analyze the obstetric literature and share her insights with the wider world.

Dekker, like all birth bloggers, is aware that her knowledge is terribly deficient. That’s why she quickly bans anyone who uses scientific evidence to contradict her. Birth bloggers are apparently “strong mamas” when it comes to vaginal birth, but pitifully fragile flowers when it comes to scientific criticism, so sensitive that they must magically make the criticism disappear.

Dekker’s latest adventure is to produce a YouTube video disagreeing with the new ACOG position paper on waterbirth. What qualifications does Dekker have to disagree with the American Academy of Pediatrics Committee on the Fetus and Newborn? Does she have any neonatology training? Don’t be silly. She doesn’t need any actual training or experience in either obstetrics or neonatology to value her personal opinion above the experts in those disciplines.

Dekker waterbirth

So here’s what I want to ask Dekker:

If you make your little video and a baby dies as a result of his mother watching it, do you plan to take any responsibility for that baby’s death?

Or do you think that baby’s death has nothing to do with you?

Or, more likely, do simple fail to think at all about the outcomes that result when you share your “expertise”? I’m betting on this one.

Dekker, like most birth bloggers, is so full of herself, with outsize belief in her ability to “analyze” the obstetric literature, despite absolutely no qualifications to do so and no professional experience to draw upon, that she actually thinks she is doing a service for mothers. The reality is that she is morally culpable for spreading misinformation. She is also morally culpable for any deaths and disasters that result, whether she thinks about them or not.

Real medical professionals consider very, very carefully how they advise both patients and people who read their writings. You won’t find real medical professionals counseling people on areas outside their expertise. You won’t find them pretending that their expertise somehow magically extends beyond their actual education and training.

But then birth bloggers are not professionals. They are clowns and they would be funny except for the sad fact that babies die as a result … and birth bloggers simply go on their merry way spewing misinformation with nary a thought for the death left in their wake.

  • justcuriousasitis
    • Medwife

      Super rapid delivery. Sometimes forced to catch gloveless. :P

  • expat

    It looks like TFB is highlighting a doula giving terrible medical advice. By becoming critical of the worst actors in NCB, she could influence a lot of people. Evidence shows that people are more likely to be convinced of something by someone they see as a peer. http://greatminuseight.wordpress.com/2014/04/14/21-doulas-and-donts-my-cautionary-tale/

    • R T

      What a scary delivery! I can’t believe they waited 48 hours after her waters broke with Strep B to go to the hospital! I can’t wrap my head around taking medical advice from a doula. I went through DONA training myself and would never act like this doula. It’s just insane.

      I did notice a factual error in the piece though. Homebirth with a CNM with OB oversight is legal in Kentucky. Only lay midwives and CPMs are illegal in Kentucky. It’s difficult to find a CNM with a true backup doctor, but they do exist in Kentucky!

      • Bombshellrisa

        Well, you don’t say! CPMs are illegal in Kentucky? Then I wouldn’t want to be this midwife, a CPM and co owner of Puget Sound Birth Center: “At 25, I apprenticed under experienced rural midwives in Kentucky. There, learning from these wise women, experts in normal birth, I developed my philosophy of birth: babies know how to get in and they know how to get out. My role is to monitor the wellbeing of you and your baby while providing support and encouragement. In the security and love of this space, you and your baby can do what your bodies know how to do.

        I have personally been on the receiving end of this type of family-centered care. My three children, Jonah, Shahala, and Julian, were all born at home. The experience of their births reinforced my understanding of the needs of pregnant women who choose to have their babies out of the hospital. The empowerment of my own experience frames my commitment to the midwifery model of care.” So there you have it-she trained with illegal midwives and she lets her personal experience cloud her professional judgement.

    • Susan

      Wow that’s a powerful story. I have seen almost every aspect of that story happen as a RN, and even before when I was a Bradley instructor I saw homebirth midwives teaching women how to fudge about the time of ROM… which I had enough sense to be appalled by and led me to have a homebirth with CNMs instead ( if they had not been available I would have gone to the hospital ). Regulars here know that was a long time ago. That story is powerfully told and she really captures something. It shouldn’t be the mother’s job to know the doula’s limits. She is blaming herself too, and I am not sure that it’s fair, because is it really that clear to someone who has no experience in this to know the limits of every profession…

      • Susan

        I just read the Feminist Breeder facebook comment and there are so many that defend the doula and are saying it’s the hospital’s fault! Yikes! And the part where the doula tells the mom to sue the OB when she doesn’t carry malpractice just makes me sick. I am so sick of the GDM isn’t real, GBS isn’t real, there would be no shoulder dystocias if only everyone had a natural birth and knew the Gaskin maneuver. That one is especially enfuriating, as the very first homebirth death I ever heard of was at a homebirth, with midwives I had met, who had actually hosted a video showing Ina May and the Gaskin Maneuver. It’s so creepy cult like when you see a story like that and the first response isn’t being appalled at what the doula said and did and encouraged. There is mom blaming on the page too… ” she didn’t trust her instincts” . Lots of the comments are the right comments but there are far too many that make my skin crawl.

  • Stephanie

    This is actually a very interesting question. You run into a thicket of First Amendment issues but the state of North Carolina has sued a blogger for giving out paleo diet advice without being a registered dietician. Similarly, states license medical professionals of all levels and varieties and could conceivably argue the same with homebirth blogs. I’m actually generally opposed to North Carolina’s approach here, which I think it is an infringement. However I think the stakes are higher in terms of homebirth outcomes and public risk versus giving up carbs and the state could conceivably better make it’s argument against birth blogs. http://www.forbes.com/sites/michaelellsberg/2012/07/10/american_dietetic_association_2/

    • sdsures

      How does this translate into Canadian, or UK bloggers, I wonder? Or Australian, I wonder (Lisa Barrett, cough cough)?

      • birthbuddy

        Australian consumer law prohibits misleading and deceptive conduct.
        If someone is being paid for their services and lies about what they are delivering, they are breaking the law.
        I believe this ‘misleading and deceptive conduct’ concept was used to force the local anti-vaccine crazies to change the name of their organisation.

        • sdsures

          How did/does Lisa Barrett attract new customers, then? (It’s a pity that the new name for the AVN has the word “skeptics” in it, as it makes it seem as they are aligned with us science-minded skeptics.)

          • birthbuddy

            Lisa pretends that she is neither in business or engaged in midwifery, by calling herself anything other than a midwife.
            If she is still delivering (killing) babies, it is just a matter of time before she is nailed.
            Unfortunately the new law, prohibiting unregistered practise of midwifery, currently only applies in South Australia, so she could theoretically still utilise her
            s(kills) in other states.
            The Australian College of midwives has a lot to answer for.

          • sdsures

            I vote this up, because it’s a good and thorough answer, but I’m disgusted by what Lisa is allowed to get away with. :( Does that make sense?

      • Sue

        Lisa Barrett has inspired legislative change by her own efforts.

        From
        ”UNREGISTERED midwives who take the lead in delivering babies can now be fined up to $30,000 or imprisoned for 12 months under new laws.

        The laws have been passed in the Upper House despite concerns that they will drive homebirthing further underground and that there was a lack of consultation.

        Government drafted the changes following the coronial inquest into the death of three newborns in South Australia.

        Controversial homebirthing advocate Lisa Barrett, who was at the centre of the inquest, had previously voluntarily deregistered as a midwife.

        The legislation covers the three stages of labour: the onset of contractions, the birth and the delivery of the placenta. It would also be illegal for nurses to lead these stages of a birth. No fine will be applied to the woman giving birth.”
        (Source: adelaidenow)

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

          Woohoo! That’s fantatic, I hope we see some similar legislation in the USA! 12 months is brief for a serial killer like LB, but is it enforceable in quacks who get lucky and don’t have a personal death toll?

    • random guest

      Moral culpability is different than legal culpability, though. It’s 100% possible for an act to be legal, and even something that CANNOT and MUST NOT be made illegal, while still being immoral.

      Certainly, they have a free-speech right to say what they do. That doesn’t absolve them of moral culpability for the ill effects of their free speech.

      • The Bofa on the Sofa

        Exactly. When I read the title, it was pretty obvious that, of course they are morally responsible. You encourage people do risky things, and you hold some responsibility for the outcome. Think of it this way: they would gladly accept the credit for someone who followed their advice and had a GOOD outcome, wouldn’t they? Of course.

        The real question, as random guest points out, is the extent of LEGAL culpability. Practicing medicine without a license? That’s a more complicated question.

    • Certified Hamster Midwife

      That wasn’t what’s at stake there, though–I thought the real problem was that this person was charging people money for diet “coaching” without being a registered dietician. What he was doing was more akin to if TFB were charging people to be their personal VBAC coach over Skype.

  • expat

    What I remember about Dekker is a post on induction for macrosomia which really twisted the literature and towed the ncb line of: ultrasound is so inaccurate, you shouldn’t believe your doctor when she reccommends induction. She employed a totally innaccurate statistic comparing mortality from cesareans to mortality from dystocia and she really played down the risks of shoulder dystocia. It bugged me because it looked like something I might’ve read and believed if I couldn’t identify the agenda behind it.

  • guest

    This has been on my mind a lot lately. In a mom’s Facebook discussion group in my town, one woman recently asked what people thought of the injection of Vitamin K at birth (the question had come on her doula’s worksheet, and she hadn’t considered it before.) It was followed by advice that was all over the map. There was plenty of the “just let the cord stop pulsing before you cut – nature left to itself doesn’t screw up.” And plenty of “I’ve seen women say yes and no to Vitamin K – both choices are completely valid.” (That was from a midwife). And I am going insane, and wondering what happens if this woman swings their way and her child ends up horribly brain damaged? Will anyone think back to the advice they gave on that post and think – Wow, I really need to go to that mom’s house and help her take care of her child and get out my wallet and help her pay for therapy and maybe give up my job to be a full time care aid for that child? What about all the people who told Kylee Young’s family how great raw milk was? Are any of them dropping by her house to babysit, or going to her therapy sessions to help her learn to walk and talk again? Or even changing the advice they give people now? For so much of this stuff you would have to track it back and back and back to find the original crazy source tha planted the original crazy seed that said “raw milk is great!” or “vitamin K is evil.” I’m sorry this is so long, but I guess what I’m saying is that the whole freaking chain is responsible, but the individual links probably won’t even remember their role in passing the craziness along.

    • Sue

      Well-put, guest. And yet, they are highly critical of the judgement of the very health care professionals who ARE held to account for their advice.

      Big girls (and boys) take responsibility for what they say.

    • Siri

      I just googled Kylee Young, poor little chick! How horrible and unnecessary. The comments after the Food Safety article are great, though; I especially liked Anj F asking if they put Koolaid in the raw milk! The raw milk enthusiasts don’t get much of a look-in, and rightly so. Quackadoodles.

    • The Computer Ate My Nym

      “…nature left to itself doesn’t screw up.”

      Said no one ever who understood anything about nature. Nature has been screwing up since the first bacteria produced a toxic waste product that eventually killed most of them off. That waste product was known as “oxygen” and new life forms that could tolerate it developed, but it sure didn’t work out well for the early anaerobes. We shouldn’t expect nature to favor us and make sure it all comes out right for us any more than it did those early bacteria.

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

        Well said! I almost snorted my coffee trying not to wake my husband laughing!

  • anion

    They don’t care, because their need to be “right,” and to prove they’re smarter and better than those dumbo doctors with their fancy degrees, and to get attention and adoration on the internet, is far greater than their actual desire to help people. Pregnant women and babies are just plastic toy people, not “real,” so they feel free to tell them whatever they want and then slam them for “not doing their research,” or shrug them off with “some babies aren’t meant to live.” Because it’s not about women or babies, it’s about them finding a niche where they can garner the accolades they feel they deserve but don’t get in real life.

    Only a psycho (or some sort of eugenicist) would act like the death of a baby is no biggie, man, shit happens.

  • Amy

    We all see the same GP in my family, and she’s wonderful. Reading this, I couldn’t help but contrast the careful and humble way she practices. When she doesn’t know something, she refers out to an expert. She doesn’t pretend to know everything. And she’s a practicing MD who keeps up on the literature!

    Any one of us could become a “certified” doula in a matter of weeks. Tell the certifying agency you’ve read the books they say to, pay a fee and you’re good to go.

  • https://dreahlouis.blogspot.com/ Dreah Louis

    “viral”
    Oh lord.
    The morgue will make big business

    • Trixie

      Dreah, I just read on your blog about your testimony before your state legislature. Good for you. It takes a lot of courage to do what your doing.

  • Hannah

    I personally feel they should be held responsible, especially when giving advice on these Facebook pages.

    I had a baby scare today, I had been feeling hiccups for four hours straight and then…nothing all of a sudden. No movement at all. I called my OB and she immediately had me come in to her offices to take a look. It turned out to be fine but my OB thoroughly looked at my fluid levels, the state of my placenta and the placement of the cord. She had one, ONE, patient with a similar complaint that turned out to be a stillbirth in her residency and she used that experience to be extremely cautious about frantic, extended hiccups going forward. EBB, BWF and Jan Tritten would no doubt say she was making me fear my body and profit out of that fear and the fact that our baby is fine proves that..

    These women aren’t qualified to even broach these subjects. Worse than that, they don’t use failures or unusual situations to inform their decisions going forward, they just say ‘it sucks when babies die sometimes’ and go on their merry way. It’s got to stop.

    • Mishimoo

      Exactly! That is something I have noticed about good medical professionals – there is always someone, often many people, who stick in their memory as a lesson, even if it wasn’t their fault that the patient was sick/injured. They’re portrayed as cold-heated moneygrubbers, yet they care more about good outcomes than the touchy-feely laypeople.

      • Hannah

        My OB literally breathed a sigh of relief the second she saw our baby’s heartbeat flash up on the screen, and then did it again when she confirmed everything looked good and the heart rate was perfect.

        I felt like such a moron. She told me ‘better safe than sorry’. Yeah, she’s only in it for the moneys *eyeroll*

        • Mishimoo

          I’m so glad that bub is okay, by the way. That would have been terrifying.

          I also totally get the feeling like a moron for freaking out over something that turns to be nothing. As she said, better safe than sorry.

          • Haelmoon

            I always prefer to have a patient come in and be reassured that everything is ok than have them sit at home and worry. I do think that moms are excellent at monitoring their babies, so when something seem off, it is time to use a back up form of assessment. I too sigh a breath of relief everytime the heart comes up on a woman who has come in with decreased fetal movement.

          • Medwife

            I emphasize a mother’s perception of normality of fetal movement over “kick counts”. I think it matters more.

          • AmyP

            I’d have gone CRAZY if I’d done kick counts.

            Most of the time, my perfectly healthy babies weren’t doing much at all.

        • Bombshellrisa

          You should not feel like a moron! What my doctor said was “if you are concerned, I am concerned”. It was reassuring!

        • The Computer Ate My Nym

          I’ve always felt that the ideal patient is just ever so slightly a hypochondriac: I’d much rather see someone come in with occasional worry over nothing than have someone ignore a crisis because they’re afraid it will be nothing and they’ll look silly. You did the right thing!

        • Amy M

          I had one of those episodes too, when I was pregnant. I was 25wks, and suddenly wasn’t feeling any movement, so I went in, and turned out my boys were kicking each other instead of me, so I wasn’t feeling them. They were fine. I felt a little silly, but they didn’t seem to mind and basically also told me “better safe than sorry.”

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

        Well, of course. I sometimes say that I have had the good fortune to see, at least once, just about the entire range of obstetric catastrophes. Usually, that takes a moment to sink in — “good” fortune? Yes, because it has made me [1] aware of what can happen, and [2] be on the lookout for the preliminary signs and how to properly react.

        Isn’t that the whole point of experience–to learn from it?

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

      I’m so glad you and your baby are ok! I think one thing “trust birth” robs mothers of is legitimate reassurance. Most moms worry about their baking babies. A. Lot. Sometimes for “silly” reasons, sometimes for really good ones. Calling the evil, money grabbing OB doesn’t lessen a mother’s agency, it increases it. There are tests that can quite accurately show if some worries are unfounded. And if they turn out to be real problems and not just worrying, often there is something mom can really do to at least improve baby’s odds. Instead of “you can do it, trust birth mama,” you can get a real care plan, or a least have “the other shoe drop” or ANYTHING beyond a drawing of a fetus to hold over your belly, some affirmations and some kale.

  • Dr Kitty

    A few years ago on an obstetric placement I learnt how to insert IUCDs. It isn’t hard to do.
    But I don’t insert them in GP.

    I don’t feel confident I could do as many as I would need to in order to keep my skills up, and I’m not happy about managing possible complications in GP.

    Because I know that what I want to do, what my patients want me to do and what I can safely do are not necessarily the same thing.

    It horrifies me that bloggers can be so blasé about giving advice, when they bear no responsibility for the outcome .

    • Renee Martin

      That is WHY they are so blasé- they will bear no responsibility at all, and may not even be aware of the harm and deaths.

    • Siri

      You’re just morbidly conscientious, Dr Kitty. If you’ve had a skill at ANY point in your life, you will ALWAYS have that skill, and be qualified to employ it in any manner whatsoever. Inserting IUCDs on a pay-per-insertion basis, perhaps in a screened-off corner of your local supermarket? Check. YouTube videos teaching self-insertion? Check. You’ve just got to learn to be more creative. Homebirth midwives don’t worry about keeping their skills up to date, so why should a clever lady like yourself have to?!

      ;-b

  • Adelaide GP

    I don’t think the HB bloggers even understand what “evidence” means, yet alone have the ability to apply valid critiques to the disciplines of obstetrics/neonatology. Although I would not presume to be a public health “scholar” (!), I did learn in the public health masters program about the hierarchy of research evidence , with level one ( the strongest) evidence derived from systematic reviews of level 2 studies, level 2 randomised controlled ( preferably double blinded) studies, level 3 case control/cohort etc , level 5 evidence is the Weakest and this is EXPERT opinion in the actual field in question. A lay person/ doula bloggers opinion would therefore have to be at least level 100 “evidence”. They bandy around the word “evidence” but have no clue as to what it even means, yet alone what the evidence actually shows. As Dr Amy says, it would be laughable if it weren’t for the fact that babies were dying as a direct result of bloggers posing as experts with no legitimacy to do so, and peddling dangerous misinformation.

    • Amy M

      From what I can tell, to them, evidence means “what they can see or have seen with their own eyes.” You are right, they don’t understand evidence in the scientific sense of the word. They are using it in the religious sense, or maybe the forensic sense—there is no evidence that god exists, yet no evidence that god doesn’t exist, so belief in the existence of god is based on faith. However, since these people have seen an HBA3C, or most waterbirths turn out fine, clearly that is “evidence”—something tangible–to show that it can happen safely. They don’t even need to take it on faith, there are more living homebirth babies than dead ones (and they don’t understand rate vs. absolute numbers either). I think it is really that simple.

      • Jessica S.

        Amy, I should have scrolled down before I posted my response – I said the same thing about experience! :)

      • Adelaide GP

        Agree completely Amy. It’s somewhat curious though when bloggers ( like TFB for example) accuse obstetricians of not following “evidence” based practise. She often writes condescending titles like “finally the science catches up” and links to some lame daily mail article or YouTube video or something. Surely when they are throwing the word around, they do think they are talking about science , not faith. ( even though in reality their “evidence” is faith or anecdotes at best) . A very strange double standard indeed.

    • Sue

      I have just been to an Evidence Review course, which I attend annually. Each year we cover twenty to thirty topics relevant to my specialty, reviewing about thirty relevant papers that contribute to the evidence on that topic. We don’t just note the abstracts – we review the study methodology, data analysis and limitations, and discuss whether the findings are valid, whether they support the conclusions, and whether practice should change. We do this with an international group of participants, so we can discuss approaches across continents and learn from each other. I come home with a 300-page summary of those topics, covering hundreds of research papers, and share the main messages with colleagues at home.

      I wonder what Dekker does to keep up with the obstetrics literature.

      • Adelaide GP

        Probably attends a Google conference :) . That sounds interesting Sue. That degree of analysis must add such rich layers of understanding to ones practice and hopefully assist with common management dilemmas. Isn’t it such a contrast that seasoned professionals spend so much time to continue to strive to “do things better” and yet these internet bloggers think they know everything because they “just know” . Such hubris has no relationship to reality at all!

    • Jessica S.

      Yeah, I think “evidence” really means “personal experience”.

      • sdsures

        This discussion reminds me of a video conversation between Richard Dawkins and a creationist named Wendy Wright. She keeps saying over and over, “Show me the evidence!” (i.e. of evolution), but doesn’t listen to a word Dawkins says. If you want over an hour of amusement or eyerolling, it’s on Youtube. You could make a drinking game out of how many times she says that.

  • Captain Obvious

    I would like to perform more VBAC and vaginal breech deliveries. What doctor wouldnt want to become proficient in all aspects of desired care. But after I go over informed consent with risk, advantages, non-guarantees, alternatives, and outcomes if you do nothing, most patients look at me and decline these procedures. Alternatives are safer in their minds and degree of consequences when they do occur can be huge.
    Is Dekker ready to answer for every morbidity and mortality that occurs? Even delays getting moms out of the tub that result in resuscitations or HIE? Lacerations from unsupportive perineums when patients in transition cannot help but push hard because the pain is so great? So many wrong issues with her motives.

    • http://whatifsandfears.blogspot.com/2012/12/the-business-of-being-misled.html Doula Dani

      Purely anecdotal…. but the worst tears I’ve seen as a doula have been the “hands off” deliveries. A dear friend – and home birth midwife – had very, very bad 4th degree laceration with her water birth…. tore through her urethra. I don’t know what her recovery was like exactly other than that it was quite difficult.

      I know some believe it should be very hands off, that the midwife/OB is there to “catch” not “deliver,” but I think that for those OBs/midwives that “deliver” it takes great skill. I’ve seen some amazing OBs and CNMs deliver like it’s an art, helping vocally guide the mom with direction, helping physically guide the baby, to help delivery be as controlled as possible to prevent tears.

      I understand the draw of laboring in water…. I, myself, found it very helpful/relaxing…. but I really do not understand the idea of humans being born into water. And after seeing water births, I don’t understand it even more. Having to pass off the baby, get out of the tub afterwards, lay down (on the floor, on a towel, soaking wet) to have the midwife check for tears, etc…… after seeing water births, it lost some of its appeal to me. Granted, I used to romanticize everything about home birth…. the mess, the inconvenience, etc…. it was all glorious and beautiful to me at the time!

      • fiftyfifty1

        Even Ina May recommends not letting the baby “explode from the puss”.

        • wookie130

          Every time someone references these sexually exploitative comments Ina made, I literally feel queasy.

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

            Me too. It’s disturbing in a way it’s hard to put words to. There’s something really uncomfortably off about it. The only parallel I can think of is a pedophile who uses “teen slang” in order to make potential victims feel more at ease.

          • Susan

            I read that last night and I felt sick. I had just watched/listened to the interview with the person who felt betrayed by Ina May and then Ina May spinning herself as never presenting birth the way she obviously does… that combined with the “explode from the” just after that really set my cult feelers into overdrive. She’s just dangerous, she really is because watching that interview is seductive, and she’s not honest ( at all ) about her past or taking real responsibility for anything. She’s comes off honest and compassionate and it scares me, because objectively, she’s lying, and even I was like “she seems so sincere”… very scary.

          • AmyP

            Yeah–who wants their health care provider talking like that?

            I once fired a pediatrician largely because he talked about the possibility of my BEAUTIFUL two-day old baby girl “farting like a truck driver.”

          • Gene

            But that’s actually true. The farts that babies produce can be quite impressive.

          • AmyP

            I was a sensitive new mommy at the time, and I was just horrified that anybody would use that kind of language to describe my precious little rosebud.

            I’m tougher now, but I think I’d still fire a pediatrician that used that kind of language with a patient’s mother. It’s just not very professional. When I told the story to my mom, she asked, “Had he been drinking?”

          • anion

            I’m still offended by the woman who came up to us in a bookstore and talked about my baby daughter’s “thunder thighs.” And that was eleven years ago.

            She tried to tell us it was all about how much she loved babies’ chubby little thighs, but I thought it was just rude. (We didn’t say anything, but I imagine our smiles looked awfully fake.) Thunder thighs, really?

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

            I’m offended too. Thunder thighs does NOT sound the same as cute little chubby baby legs!

          • anion

            My older daughter’s baptism was done during a special Easter ceremony, during which the lights in the church were turned off and there was a long moment of silence (it was supposed to be for meditation or the Holy Spirit to enter the room of something, I don’t recall exactly).

            My daughter chose the middle of that long moment of silence to give a little grunt and fart loudly.

            I’ve never been a person who laughs at body humor, really, but I laughed so hard I was crying–along with everyone else in the room. Even the priest was having a hard time keeping a straight face.

        • sdsures

          Ewww!

      • Siri

        I can testify to that; I had an extended episiotomy with my first, an epis with my second, a 2nd degree tear with my 3rd, and intact perineum with my 4th and 5th thanks to the excellent support and guidance of my midwives. The difference to my recovery was phenomenal! And I had been told my scar tissue would mean I’d always need an epis.

        My ladybits may not be factory fresh, or look quite the same as before I had children, but by Golly they work well, and I wouldn’t swap them :-).

        So yeah, I’m not an advocate for hands-off; I think it’s a cop-out.

    • Sue

      Meanwhile, if Dekker is a cardiac nurse, would she be happy managing all the patients presenting with chest pain at home? On her own?

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

        Probably keeps a defibrillator in a cupboard somewhere, ever living in hope :-)

        • Adelaide GP

          And a fridge full of clot busting drugs! It’s ridiculous isn’t it, when the same “logic” is applied to other medical specialties. Practising at home clearly doesn’t work at all. . Why should obstetrics be any different. I think pregnancy/ labour IS indeed a medical condition requiring the full medical approach. Why settle for less.

          • The Bofa on the Sofa

            Why should obstetrics be any different

            Because pregnancy is not a disease. Trust birth!!!!!

            That’s the answer you will hear, btw

    • Siri

      That’s a really good point; who wouldn’t like to do lots of ‘interesting’ deliveries, all other things being equal? There’s a huge amount of satisfaction in conducting successful deliveries of twins, breeches etc, plus it’s great to know you can do those in real life, not just the drills and skills lab. But given the full picture, most women opt for what they feel is the safest route, and rightly so; they are not there to furnish us with a thrilling or useful experience, but to choose wisely on their babies’ behalf. Homebirth midwives seem often to think that women owe them an interesting delivery with a high kudos factor, and will be biassed in the advice they give as a result.

  • Manabanana

    Thank you for calling out Rebecca Dekker. I had a faint hope that she would be unafraid to examine the scientific evidence surrounding home birth midwifery and home birth, but she has only demonstrated otherwise.

    Also, she has deleted my comments and questions on her blog and Facebook page – particularly when my questions reveal evidence not supported by her personal beliefs.

    She has also responded to my queries by telling me I don’t have a PhD like she does, effectively patting me on the head like a little girl and telling me her statistical analysis is beyond my meager intellectual capacity.

    So, yeah, I don’t have much respect for her. Professionally or personally.

  • expat

    I liked this so much, I had to share it.

  • 3loveme

    I like to refer to the internet medical information seekers as patients of the dangerous Dr. Google. He/she tells you what you want to read. It’s out there, just keep hunting. “HBAC? Sure, Sally did it, you can too!!”

  • Jocelyn

    I can’t get over the irony of seeing something called “Evidence Based Birth” straight up ask, “What can we do to get people to ignore evidence?”

    And yes, these woman are definitely responsible for the babies who die due to their misinformation.

    • Captain Obvious

      Evidence does show many women will do fine. But when things don’t go fine, the evidence shows the consequences can be catastrophic. Dekker is the glass half full, most parents are the glass half empty.

      • Captain Obvious

        Oh yeah, and when the evidence is based on CNM equivalent trained midwives in other countries or in the hospital, all of a sudden it extrapolates to doulas at home.

        • The Bofa on the Sofa

          “The evidence shows that international midwives can have just as good outcomes for homebirth as hospital with women in low-risk pregnancies with demonstrated success in vaginal birth. Therefore, HBACs for twins with a CPM!!!!!”

  • Monica

    Oh Dr. Amy, you got it wrong, Gina Crosley-Corcoran does not give out medical advice! She says so right on her FB page, you know right after promoting her v-bac workshop.

    • sdsures

      Did we ever discover exactly what her “VBAC workshop” entails? Or is that behind a paywall?

  • S2A2

    I hate to be THAT person, but typo in the title…

    • Amy Tuteur, MD

      Uggghhh! Thanks!

  • MLE

    Is she currently a cardiac nurse??? She should be fired!

    • Manabanana

      I think she’s currently a nursing instructor.

      • Manabanana

        Oh, and a home birth mom.

        That’s why she’s an “expert.”

        Her PhD in nursing makes her unbiased.

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

        Ah, “those who can, do; those who can’t, teach.”

        I personally think an academic degree in nursing, NOT backed by extensive clinical experience, is worthless, and the higher the degree, the greater the chance its holder has never done any bedside nursing she could avoid, preferring to either do “research” or “teach”. PhDs in nursing, in my experience, don’t like to get their fingers dirty.

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

      Well, she probably knows as much about obstetrics as I do about cardiology. The last med-surg patient I took care of was in 1965 and things have moved on a bit since then. That’s not to say I haven’t had the occasional patient who is pregnant or in labor who has a history of cardiac problems, but in a case like that I am working in tandem with at least one doctor and usually a specialist or two as well.

  • LovleAnjel

    Seriously, health care providers should know better than to even begin to advise outside of their specialty.

    I remember going in for my 2-week postnatal OB visit, and I had to bring the kid with me. My OB asked how she was, and I said she was fine and if anything seemed off I would be sure to take her to the doctor right away. My OB replied, “Well, don’t bring her here, we don’t know anything about them after they come out!”

    • Isilzha

      Most real HCPs understand that. These doulas, midwives, mommy bloggers aren’t real HCPs.

    • Elaine

      I switched my kids from a family practice doc to a pediatrician, and was talking to the ped about how I was glad to have a doctor who specialized in children. A little later he said something like “Yeah, I don’t know anything about adults.”

      I think it’s insecurity and undereducation that leads people to be willing to overstep their specialty. If you’re secure in what you know then it’s easier to be able to admit what you don’t know, which is also a valuable skill.

      • Jocelyn

        It’s the whole Dunning-Kruger effect – “the inability of the unskilled to recognize their ineptitude.”

        • Elaine

          That too. I think the tendency to take *some* knowledge of a field and use it to overreach is a little bit different though. I notice a difference on MDC between the people who clearly don’t know enough about science in general to understand how badly they are bungling it, versus those who do have a scientific background in one discipline and use it to assume they can easily reach conclusions about a different discipline. Both are irritating but in different ways.

    • Hannah

      Yeah. My OB has been on to me since week 24 about making sure we have pediatric care chosen before birth. She knows about pregnancy and birth, not babies, and she recognises that.

    • OBPI Mama

      A far cry from homebirth midwives who do baby check ups upto 6 weeks old and dispense their knowledge about babies until toddlerhood (from vaxing… or rather NOT, to circumcision, they’ll clip tongue ties, etc)…

      • Aki Hinata

        No way in hell would I let a lay MW near my kid, much less to clip a tongue tie!

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

        Any advice I give a mother about her children after they are 10 days old is based on my experience as the mother of three, not as a midwife, and I always say so.

  • moto_librarian

    I have said it before, and I will say it again. The natural childbirth community is indeed morally culpable for the deaths and injuries that result from home birth. Again and again, we see high risk situations painted as “variations of normal,” and the chorus of bloggers and their followers telling women to “trust birth” and disregard the advice of their “fearmongering” OBs and “midwives.” A lot of women get very lucky and manage to deliver at home despite being in high risk situations, and the only difference between them and women who have bad outcomes is exactly that: luck. I also assert that there would be far fewer shenanigans going on at home if there weren’t so many birth junkies masquerading as professionals cheering on these risky decisions.

    I am a feminist, and for the record, I don’t give a horse’s hind end how you choose to give birth. What I will not stand for is the willful dissemination of inaccurate information under the banner of feminist choice. Women have brains. We are doctors, scientists, and educators. We do not need to be patted on the head and told not to trouble ourselves with statistics and facts. We do not need to rely on “other ways of knowing” when we have access to evidence that demonstrates what the proper course of action is when a pregnancy becomes complicated. We are fortunate enough to live in a developed nation where we can be monitored during labor, and have access to c-sections and other interventions that keep our children from being born still or disabled due to oxygen deprivation. We have medications and a safe blood supply to keep us from dying of hemorrhages (still the leading cause of death for women who live in the developing world). The ignorance and arrogance of the NCB movement is disgusting to me. If you are part of it, realize that when a baby like Gavin Michael dies of a Third World cause, you do indeed bear some responsibility for his death.

    • Ennis Demeter

      Sub-trained home-birth midwives are the back alley abortionists of obstetrics. Advocating for choice should never been advocating for substandard healthcare.

  • Renee Martin

    Lets start a list of all the other blogger that KILL, shall we?

    #1 is BWF- Birth Without Fear

    Two reasons- she is exceedingly popular and very influential. It is her unapologetic, hubris filled, ignorant, promotion of the most insane and dangerous of stunt births. Twin HB? Check. Post dates? Check? HBAMC? Don’t be silly, those are just a variation of normal! She puts up these gorgeous pics of births when they go well, but has featured ONE HB death. And that was only after Liz P bravely, patiently, spent 6 months working on her to acknowledge these deaths.

    More importantly- I hold her 50% responsible for the death of Shahzhad Sheik (the other 50% belong to the MW). Why do I consider her as culpable as the actual killer? Because it was HER and her readers that egged Margarita on, who got her to drop her OB, and hire a lay MW in the first place. Without BWF, there would have been no HB; Darby Partner and Laura Tanner would not have been there to hold her hostage at home, killing her baby and devastating her life. BWFs blog and FB group were integral in this disaster.

    Who else has blood on their hands?

    • yugaya

      Jan Tritten for the murder by internet of Gavin Michael. Also, Donna the person who admins the Midwifery Today facebook page is guilty of making sure that not a single question directed at Midwifery Today and Jan Tritten about how and who allowed this medical emergency situation to be crowdsourced in real time has been answered.

      Jan Tritten and Midwifery Today are responsible for ignorantly and recklessly posting on behalf of the lay incompetent midwife in real time, an act which enabled flocks of other equally daft lay midwife birth expert morons to suggest a wide range of trust birth/try stevia idiocies that resulted in the lay midwife doing nothing and Gavin Michael dying because of that. .

      They never even apologised to the family, even though it has been confirmed that mother was indeed directly manipulated by her lay midwife with the help of the content that was posted on the Midwifery Today facebook page – Christy Collins the CPM killer states clearly in the email to the parents that she had read to the mother the replies.

      • Trixie

        Jan Tritten seems to be really into gardening. I hereby suggest that she quit midwifery and dedicate herself to crowd sourcing what I’m sure are her frequent horticultural disasters. Heck, she can even bury them deep in the compost pile, twice.

        • Dr Kitty

          Gardening leave. I like it.

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

            I’ve got a better one. Ever notice how “smoking breaks” are regarded as being perfectly all right, and always take at least 15 minutes while the smoker goes to the appointed place and lights up [and invariably visits the loo as well before returning to work].

            I don’t smoke. But I knit and/or crochet the equivalent of a 3-pack a day habit. Do I get a knitting break ever? Ha! In spite of the fact that I am truly addicted; more than an hour without a few rows has me snapping at co-workers and fidgeting.

            It’s all a bit moot now that I’m retired, and I can knit to my heart’s content if I blind myself to the state of my house. But there were times when I thought I’d picket the institution I worked for or maybe go to the International Court of Justice in the Hague for Knitters’ Rights.

          • madwife

            I second that!
            I’m a bit of a twitter addict.. can i also suggest 2 hourly y
            Twitter breaks? ? :)

        • Amazed

          I second that.

          Where do I sign?

        • KarenJJ

          Trust plants. If she treats her garden the way she treats her patients I wonder what her views are on pruning, fertiliser, composting, using supports for young plants, weeding, thinning seedlings and other common gardening interventions.

          watered my geraniums today and am waiting for the cascade of interventions – next thing I know they’ll be expecting some fertiliser…

          • Trixie

            One guess: biodynamics

          • Mishimoo

            That would not surprise me in the slightest. Did you also have the “Wtf am I reading?” reaction to the descriptions for the biodynamic preparations?

          • Trixie

            Sorry I didn’t respond to your comment earlier. I was out preparing my female cow horns for burial by the light of the moon on the solstice.

          • Mishimoo

            I do hope that they were from lactating female cows!

          • Sue

            Make sure you use the homeopathic stuff, Karen.

      • expat

        Science and Sensibility

    • Manabanana

      Improving Birth.org

    • Manabanana

      ICAN

    • Manabanana

      Birthing Instincts with “Dr. Stu”

    • Manabanana

      Bring Birth Home

    • Manabanana

      Stand and Deliver