Doula Dani’s letter to the VBACFacts Community

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This is a guest post from Doula Dani who asked me for an opportunity to explain some of the history that led up to the purge of the VBACFacts Community.

Hi, I’m Danielle Repp. Online I go by “Doula Dani.” Jen Kamel likes to refer to me as “Robin.”

I am sure you are wondering what is going on and what happened to your online community. You’ve been left in the dark. Unfortunately, this isn’t the first time that Jen Kamel has left you in the dark – this is just the first time that you know about it.

I’m not sure if you are aware of what happened a couple months ago when Jen Kamel took a completely private conversation between the two of us and shared it for all to see in a blog post, trying her hardest to make me look like a fool and to make herself look good. She was trying to prove a point: non-expert birth bloggers are dangerous.

Jen Kamel herself is a non-expert birth blogger.

What she did was cruel and vindictive and I have no idea why she did what she did.

To give some background… I was writing a piece about VBACs and HBACs for my blog. (linked below) At the end of the blog post, I was hosting a Q&A with an HBAC mom and wanted Jen Kamel to participate as well. Jen Kamel originally said yes, she would participate… but then backed out. I was really bummed when she backed out but had an HBAC-friendly home birth midwife be a part of the Q&A instead. It ended up working out better as the HBAC mom and the midwife knew eachother.

After the piece was finished, I had a VBAC-friendly OB/GYN and a statistics professor review my piece for accuracy. I had made some mistakes so I made the appropriate changes, they reviewed it again, I got the OK and I published it. I sent it to Jen Kamel afterwards for her to see the piece, since originally she was going to be a part of it.

She didn’t like it, to put it mildly. She was clearly upset with what I wrote and how I wrote it. I was upset and incredibly surprised – I had two experts review my piece! At the time, I had no idea what Jen Kamel’s experience/education/training consisted of. I made assumptions… I thought someone who runs a website called “VBAC Facts” would at least be some sort of research expert. I let her walk all over me. It was a humiliating conversation that left me very upset. At one point, because of her insistence, I took down the piece I wrote – a piece that I was very, very proud of. My credibility is important. I would never want to post something that didn’t represent the truth. I don’t have an agenda to promote or protect. I don’t make money from my blog or my stance or anything. All I care about is that women have the (real, truthful) information they need to make informed decisions. I did make some changes based on her suggestions but the truth was, she was never going to be satisfied. She didn’t like what I wrote and especially did not like the information I was sharing regarding HBAC mortality rates.

The conversation ended between Jen Kamel and I. I thought the drama was over with. Until weeks later, Jen Kamel posted a blog sharing our entire conversation!! Our private conversation. Not only did she share the conversation, but she added in little digs and afterthoughts… she tried as hard as she could to make me look horrible. It was so hurtful. She wanted everyone to see that she is the VBAC expert and no one else should be trusted with their VBAC information. I could not believe the low level she stooped to, to try and make me look horrible. (Dr. Tuteur wrote about the whole situation. Relevant links are at the bottom of this post.)

Why didn’t she critique the piece I wrote? Why didn’t she want anyone to read it? She wanted to leave you in the dark. People tried to share the piece on her Facebook page. It was deleted every time.

Just like many pro-home birth sites and Facebook pages, Jen Kamel wants to keep you in the dark. They want information to be shared only in ways that helps their agenda and/or that backs their personal choices. They delete and censor to keep their readers in the dark. You have no idea how often information is censored in the world of home birth. I am a former home birth advocate and I didn’t realize all the deleting and censoring until it happened to me. Being deleted was one of the first major red flags for me. I had experienced and read some troubling things about home birth by that point (of my first deletion) and my head was spinning with questions/concerns…. and then when I asked a question on a blog about one of my concerns, I was deleted…… and then banned. That’s when I really realized I something was very, very wrong. It wasn’t that the outspoken home birth advocates were unknowingly passing around false information…… it was that they were/are intentionally misleading.

It is really a shame. I was not expecting Jen Kamel to do what she did. I couldn’t believe it. Obviously, Jen Kamel and I don’t agree on certain matters. But when I went into it, I was excited that she said yes to participate. I thought she seemed reasonable. I thought she cared about true information over agenda. Clearly, I was wrong.

Now fast forward to all the current drama: someone in her group took screen shots and shared them with Dr. Amy Tuteur. Dr. Tuteur shared them here on her blog.

It’s ironic, isn’t it? Someone was clearly just following in Jen Kamel’s footsteps… sharing information that was private. No, it wasn’t me. And no, I didn’t tell anyone to do it. I can’t lie and say I don’t feel a little bit of justice here… Jen Kamel had someone do to her what she did to me.

What could Jen Kamel have done? She could have let her community know what happened and told them to be careful with what they share – it’s the internet, nothing is ever truly safe. Not even in a secret group.

What did she do instead? She deleted a large number of people from her group. She is only allowing certain people in. She shut out people who need support and looked to the VBAC Facts Community for it. I don’t understand it.

I’m writing this because I want you to see the full picture. I tried to respond to Jen Kamel when she wrote that horrible piece, I wrote a response on Facebook… but she deleted the whole thread shortly after I did respond. I have since been banned from her Facebook page.

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I don’t think Jen Kamel is a monster. I don’t think she’s a bad person at all. I think of all pro-home birth sites out there, she did a fairly good job of not getting too extreme. I think she made some snap decisions that she thought were in her best interest… decisions that haven’t been the best for her community and decisions that she likely regrets.

You can read Dr. Tuteur’s piece about the ordeal here.

You can read the piece I wrote about VBACs and HBACs here.

You can read my follow-up piece here, addressing HBAC data sample size.

If you are searching for a new VBAC group to join, a couple of the members from the VBAC Facts Community started a new support group on Facebook, VBAC and Birth After Cesarean Facts — Evidence Based Support.

Be well,
Doula Dani

  • Mittstamp

    This is slightly OT, but when I remember the first time I conceived (after 3 IVFs) I was living in an East Coast university town (Ivy League, no less), that was completely woo-infected and t seemed every lady hippie n town was a “midwife.” I even went so far as to attribute my “miracle” pregnancy to vitex, royal jelly, FertilAiid, raspberry leaf tea & yoga rather than the dedicated fertility specialists. Naturally, I wanted a homebirth, complete with kiddie pool like many of my DH’s female colleagues. And then I lost the pregnancy at 25 weeks.

    Fast-forward sixteen months…DH took a position at a school in Baltimore, and this time after just 2 IVFs, got pregnant again. (Yeah, still spent hundreds on the raspberry leaf tea & every other form of birth woo; I even still had my sub to Mothering magazine.)

    The day my dr. told me he would not consent to TOL under any circumstances, I was crushed for my idea of the “idealized” birth. Sobbing, I went to my DH’s office to tell him. Thank God, though, his department secretary, a wonderful woman & a grandma was there. She asked me what was wrong. Not caring at that point about TMI, I told her, using up both boxes of tissues on her desk.

    She looked at me like I was crazy, and at first I thought she was going to call either 911 or hubby & have them cart me to the mental ward. Instead she said, “After all you put yourself through to get pregnant (and lord knows IVFs, esp, in the days of intramuscular injections, were No Fun) why would you take even the slightest risk that something might happen? Because it does all the time, you know.” She’d grown up in some of Bawlmer’s tougher sections–she knew many women that gave birth at home, either because they had no choice, or because they wanted to conceal a baby from Social Services for fear their kids would be taken away if they had “another baby out of wedlock,” etc. She’d known women & babies who died–she’d SEEN some of them die. Homebirth for her was not some romantic ideal but in her mind, the worst form of stuntbirth.

    Had I been living back in Ivy town, I might have been tempted to find a midwife who would have convinced me that my condition was a “variation of normal” and that OF COURSE I could have a homebirth! Instead, I thought, “geez, I’ve been f**king stupid.” Never thought about it again, except to recall my dad’s saying, “How you see the show depends on where you sit.”

    That said, I wonder how many of these “homebirth mammas” who have to transfer and get “unnecessarians” keep getting knocked up in search of a “healing birth experience,” only to end up disappointed again, with more kids than they wanted/could handle/could afford, There but for the grace of God….

  • JustSomeGirl

    It’s a blessing in disguise. As Dr. A pointed out, she can no longer have an unlimited audience, but just her cherry picked victims.

  • Starling

    OT, but just saw this: http://www.rixarixa.blogspot.com/2014/04/update-on-breech-mama.html

    Brief recap–a woman in Pittsburgh with a breech baby goes down to Atlanta to deliver with a perinatologist who will consent to a trial of labor. By 24 hours after rupture of membranes, the child is losing variability in heartbeat, and a C-section is performed. The child’s Apgar scores are 3 and 8. She’s admitted to the NICU with suspected sepsis.

    Mom’s takeaway? She wants HBAC next time, because interventions!

    • Ash

      At some point, I don’t really understand how people can delude themselves.

    • Medwife

      Oh, that guy. He’s the dr biter of the southeast.

      • Trixie

        In a sex-with-patients way, or just a horribly risky-birth way?

        • Medwife

          Horrible risky-birth, much loved by crunchies. I don’t think Biter had sex with patients, though. That was his good buddy Stuart Fishbein.

          • Box of Salt

            Dr Biter gave up his suspended license after he allowed a baby to die at a homebirth, because the parents trusted him in spite of his lack of hospital privileges and failure to open his planned birth center: http://www.nbcsandiego.com/news/local/Doctor-Accused-of-Botching-Home-Birth-Surrenders-License-233560431.html

          • Medwife

            He’s still working on that project, by the way! I looked at his Facebook page. Bleh.

          • Trixie

            Oh, whoops. Sorry, I need a chart to keep this all straight.

          • The Bofa, Being of the Sofa

            It’s easy to mix them up. I mean, it just seems so right that the guy having sex with his patients SHOULD be called “Dr Biter”

            (in fact, for many years, I just assumed that “Dr Biter” was what folks called Fischbein; they seemed to be used so interchangeably)

          • Trixie

            Yeah, that was pretty much where I was coming from.

    • Kelly

      So she can’t trust her husband to make the right decisions but she can trust a doula? Also, does she realize that they saved her baby? She obviously does not get it. If the same thing happens next time, she will lose her baby and possibly make herself very sick.

    • Trixie

      What an idiot. That birth center in Pittsburgh is actually one of the good ones. They don’t take chances and risk out to UPMC in a heartbeat. Also lots of doctors at UPMC do VBACs.
      I predict next time she will drive across the state for a VBAC with Diane Goslin. I hope I’m wrong.

    • The Computer Ate My Nym

      A bit off topic, but does anyone else find the statue on Rixa’s page creepy? As far as I can tell, the woman is depicted as either not having arms or as having arms tightly bound to her body. Her legs also appear to be restricted. She literally is nothing but a walking incubator.

    • Who?

      It’s interesting isn’t it. She acknowledges throughout the story that they were fully informed and that they understood and agreed to everything in order to get a good outcome, but then says HBAC next time. It’s like that’s the price she has to pay to be okay-ish with the section and the NICU, despite acknowledging that all of it was necessary.

      Let’s hope she’s moved on by the time the next baby is on the way.

  • Susan
    • Guesteleh

      I saw it when someone posted it on FB saying what a great person he was. IDGI. Check this from the article:

      Today, the Farm has about 200 residents. Among its most successful
      business endeavors is the sale of personal nuclear-radiation-detection
      devices.

      • KarenJJ

        Tin foil hats?

        • Sue

          In a range of colours?

      • AgentOrange5

        Eh, who cares, nobody dies from buying a nuclear-radiation-detection device. Much more alarming is the lack of care they promote for pregnant women.

  • sdsures

    Shouldn’t a person assume that *anything* they post on the Internet is up for grabs? Email and blogging are part of the Internet. Why are they exempt?

    • auntbea

      Of course not. You have a reasonable expectation of privacy that your conversation won’t be overheard by an unknown third party, but repeating what someone said to you — or publishing what they wrote — is just tacky, not illegal. Otherwise we would all go to jail for gossip.

    • Medwife

      Email is actually not protected, legally (as I understand it). Some clever people worked it into a bill some years ago, exempting email from laws that protect physical mail.

      • Anj Fabian

        The postal service is under federal jurisdiction.

        The jurisdiction of electronic communications….I haven’t a clue.

      • sdsures

        This is a very interesting and important question!

        • Medwife

          It is! I totally went down a rabbit hole just starting to read about it. I think it’s deliberately hard to understand so law enforcement can access almost anything they want. Like the tax code for corporations.

    • Lost

      Back in the civilized hey day of the Internet (pre-Sept 1999), people were expected to display good netiquette, including respecting the intended privacy of emails. Of course as we know (gracias Edward Snowden) “anything posted via Internet” will be/is grabbed by NSA.
      So yeah, be paranoid. Be very paranoid.

      • Medwife

        It’s not paranoia if they’re actually out to get you ;)

    • LibrarianSarah

      Although this might have already been answered to death I feel like I should answer it as netiquette as weel as online privacy covered under standard 5 of “ACRL’s Information Literacy Standards for Higher Education.” In other words, I teach this stuff.

      Private message and personal emails should ideally remain between the two parties involved unless permission is granted or special cercumstances apply. Sometimes people break this rule as Jen did. However, it should be understood that the person who published a private email without permission in the wrong not the person just as someone who spread your private business all over town orally would be in the wrong.

      With social media things get blurry. On the Internet their are private areas and there are “private” areas. If you have a Facebook group with 3000+ members, it is not private. Your group might be invitation only but if you agree to everyone’s invitation it is not private. On the other hand, a private blog only shared with family members should be considered private. Listservs are sent out by email but they are not considered private because the are accessible to anyone who signs up for them.

      • LibrarianSarah

        All this should be considered ethical not legal with certain exceptions (if you publish the private emails between you and your boss that contain company secrets be prepared to be in a world of legal trouble). However, breaking ethics can hurt just as much as breaking laws.

        • The Bofa, Being of the Sofa

          From my perspective, I don’t give a rat’s shiney back end whether it is legal or not. It’s slimey, and that is the point.

          You can defend slimeball actions by saying, hey, it’s not illegal to do it. Which is true, but it doesn’t make it not slimeball.

          (a marginally related comment: I’ve seen this in discussions before. Me: Wow, you are an asshole. Other person: Oh yeah? If we meet in person, I will kick your ass! Me: probably true, but that probably won’t make me think you aren’t an asshole.)

          • LibrarianSarah

            I agree. I was just clarifying because… I teach this stuff. A lot of the rules are kind of fuzzy but this was obviously sleazy behavior. There can be an argument on whether or not posts on a “private” group with 3000+ people on should remain “private.” But an email conversation between 2 people? Jen you are sleazy!

          • Medwife

            Didn’t Dr Amy share her email exchange with the CPM responsible for Gavin Michael’s death? Don’t get me wrong, I’m glad she did. What that “midwife” did, and then tried to avoid responsibility for, was outrageous. But Amy did share a private email exchange. I think it’s a matter of the ends justifying the means.

          • LibrarianSarah

            From what I remember, Amy shared her email exchange with one of the family members and was given permission to repost. I don’t remember an email exchange with a midwife.

          • Box of Salt

            Dr Amy did post a Facebook exchange with the midwife. It’s in the archives here end of Feb/beginning of March, but I don’t have the time to dig it up right now.

          • The Bofa, Being of the Sofa

            Facebook exchange =/= email conversation, of course

          • Medwife

            Are we talking about PMs? I think that’s the same as email when it comes to privacy standards- not legally of course. If it was a comment on a page, that’s totally different.

          • Amy Tuteur, MD
          • Medwife

            So it was a public exchange that continued in private message. See, I don’t really care. I think if you’re PMing you just shouldn’t necessarily trust in confidentiality. I think Jen Kamel was out of line in how she trashed Dani’s piece. But the whole sharing private email exchange thing- meh. Amy does it, why is it so much worse when Jen Kamel does it?

          • Trixie

            That’s pretty much the only time Dr. Amy has shared a PM, and it included Collins making crazy threats about legal action and denying her involvement in Gavin’s death. I think she was ethically justified in sharing that.
            I don’t think Jen Kamel was ethically justified in sharing her correspondence with Dani, but, ultimately it worked against her anyway.

          • NoLongerCrunching

            I think Gavins mom posted it on her fb page In Light of Gavin Michael

          • yugaya

            That exchange was public and in the comments somewhere, I think it got deleted later.

  • yugaya

    Question about the numbers that JenVBAC”Facts” revealed here:

    “…Anecdotally, over the last year, I know of at least five moms who have lost their babies during UBAC…I lost count after that”

    Giving her the benefit of calculating the rate for the entire year and not period shorter than that, and since she states that there were definitely more than five babies who died ( and god knows how many because she “lost count”) – do these at least six dead babies not show exactly how much more dangerous HBAC is compared to VBAC in hospital? I’m assuming that all of those unassisted births had to happen outside of a hospital and since the information is from the groups she is a member of I am also assuming that the OOH location of birth was intentional, not accidental

  • Anna T

    Dani, I’m so sorry this happened to you. I had exactly the same thing happen to me not long ago – I emailed a blogger I disagreed with on certain points and presented my questions and concerns. She shared our private correspondence – without permission – on her blog, complete with a link to my blog. I was shocked and hurt and demanded that she take the piece down at once, which she fortunately did. But I really don’t know if there was anything I could have done if she had not. Apparently one has to be careful even while emailing, not only on FB.

    • MLE

      If the goal is to help women succeed at VBAC, you would never support HBAC!!

  • Ob in OZ

    Does anyone realize how few Obstetricians care about whether someone has a repeat c-section or tries a vaginal birth after c-section? If the hospital has the appropriate facilities and response time to an emergency (this should be any emergency, not just those with risks that make it more likely), then why would I care which way the patient chooses? An attempted vbac is basically another person in labor, and a small (about 0.5%) chance that she has an emergency c-s for uterine rupture as the cause, as opposed to any other emergency that I have to respond to in a more or less rapid manner. A repeat c-s is what it is- surgery has risks, but slightly safer for the baby. That is my take and counseling in a nutshell. SO explain why this is such a hugh issue?

    • Young CC Prof

      What? You mean obstetricians are totally cool with VBACs as long as they can be done with reasonable safety? You don’t lose points when they happen? The OB who did the first c-section doesn’t come after you with a baseball bat? Really?

      • Siri

        With a scalpel, YCCP. With a scalpel.

        • Guest

          Or a golf club.

    • wookie130

      I’m glad you posted this comment. The OB’s up in my office don’t give a rip either way, and you can completely tell upon visiting with them. When asked what I was thinking in terms of delivering this baby (after a primary c-section just months before…my children will be 17 months apart), I told them that I’d like a RCS. All my doctor said was, “You don’t want to try for a VBAC?” And I told her “no”, and she noted it on my chart, and that was that. No further inquiry, no reaction, etc. I gleaned from that brief exchange that my OB respected my choice, and had zero interest in swaying me either way…this particular practice is VBAC-friendly, and I have friends who have taken that route with these doctors, with no attempt at persuasion either way.

      • anion

        My OB mentioned VBAC several times during my second pregnancy; I know he would have liked to see me go for it. He was fine with me saying no, but I know he was a tad disappointed that he didn’t get to deliver my bab(ies) vaginally. (We had a pretty close relationship; he wasn’t annoying or pushy about it, he was just a sweetheart.)

    • MS

      Because it’s all your fault she had the uneccessarian in the first place you evil butcher!! Please know, I’m only joking.

      I have a thought, and I don’t know if it would hold up to scrutiny. I think groups like this can only survive by sowing the seeds if mistrust of doctors and the medical community in general. It might vary from encouraging you to be slightly skeptical, to the whackadoodles who think conventional medicine is downright dangerous and evil. If you could have these conversations with your doctor, why would you need the Facebook group? Why would you need to pay to go to workshop run by a layperson? You wouldn’t. That’s why groups like this need to claim to have “secret” or “difficult to find” knowledge. They are willing to share it with you, under the premise that your doctor is either uninformed or keeping this knowledge from you (because you secretly just want to perform a RCS!!!). It’s a constructed narrative that keeps groups like this in business. It might be particularly convincing for a patient who has trust issues. Just a thought, though.

      • The Bofa, Being of the Sofa

        I have a thought, and I don’t know if it would hold up to scrutiny. I
        think groups like this can only survive by sowing the seeds if mistrust
        of doctors and the medical community in general.

        Obviously.

        I mean, how else could you convince people that a complete lay person is the “expert” in VBACS, and that you shouldn’t listen to your OB?

        It’s Jenny McCarthy all over again.

        • MS

          I guess it is pretty obvious, huh? I’m just always surprised at how easily people throw around such serious accusations about doctors, and how easily some people believe it. It just boggles my mind.

          • Anj Fabian

            I was floored the first time I heard the claim that “Hospitals cover up deaths all the time!”.
            (That meme seems to originate in Australia.)

            Once I saw what else the person had to say, it was more of the same – don’t trust doctors, don’t trust hospitals, stick with the people you can trust. Those people were not part of the ‘system’. They were the alternative culture, the chiros, the NDs, the herbalists, the home birth midwives.

          • Mishimoo

            “Hospitals cover up deaths all the time!”.
            (That meme seems to originate in Australia.)

            The origin wouldn’t surprise me, I’ve heard it quite a bit from people who are into various forms of quackery. What I would like to know is: Why are anecdotes for natural medicine acceptable when hard evidence for mainstream medicine isn’t acceptable, by their standards?

          • Beth S

            The only death I’ve heard of where the death was directly caused by the hospital was a baby who was decapitated during birth because the hospital forgot to remove the circlage. However, the hospital didn’t try to cover it up and it was all over the news when it happened.
            That hospital also used that incident to change policy and start sending high risk pregnancies to a better equipped hospital downtown. The doctor voluntarily surrendered his medical license and quit practicing. The parents eventually forgave the doctor, and now all three are on a campaign to find a different method to help mother’s keep their pregnancies.
            That’s the kind of response I like to see to unnecessary accidental birth accidents. They didn’t try to silence the parents, didn’t deny their pain was all too real and all too terrible, and in the end everyone has tried to come together to find a better methodology.

          • Guesteleh

            That’s heartbreaking. I used to work for an organization that worked to reduce medical errors and mistakes on that level ruin the lives of not only the patients and their loved ones but the clinical staff as well. And while individual doctors, nurses and pharmacists get blamed, often the real problem is systemic–things like not using checklists or manufacturing doses of different medications in identical containers so it’s difficult to tell the difference, especially in the heat of the moment. The system could do a much better job in this area, but there are a lot of smart and energetic people tackling the problems, especially since Obamacare specifically ties Medicare payments to lowered error rates.

          • Mishimoo

            Oh, that’s horrible! I prefer that kind of response to it as well, because at least something is being done to prevent others from going through it.

            My cousin’s death was contributed to by a surgeon’s error, the hospital didn’t cover it up either. There were reviews and changes, so it will hopefully never happen again.

            My cousin had spina bifida and went in for a bowel re-section + to have a few gangrenous toes removed. The surgeon didn’t connect things properly, which meant that there was no outlet and her intestines just looped back into itself. It was found and fixed, but she had developed a VRE infection and passed away a few days later.

          • Smoochagator

            That was easily the worst thing I have read all day. Dear Jesus.

          • yugaya

            I entertained some thoughts on the subject of: if that claim were, true how many people would have to be in on a conspiracy of that magnitude to cover up healthy term babies were dying intrapartum in hospitals at the rate that they are dying in homebirth? Entire hospitals and people who work in them, their friends, families, facebook acquaintances, spouses and families, their hairdressers, not to mention the families of the victims…well, almost everyone is part of it except homebirth activists and homebirth supporters.

          • The Bofa, Being of the Sofa

            Boggles my mind as well how casually accusations of “conspiracy” get thrown around, like doctors are a bunch of idiots.

            While there are always exceptions, on the whole, the doctors were among the best of the class in high school, and pretty damn good in college, too (I know, I teach them).

            I just figure it is anti-elitism. The old, “Doctors think they’re so smart, but they don’t know everything.” Amazingly, it’s true. On the whole, doctors ARE smart, and they will be the first to tell you that they don’t know everything. The problem is the conclusion that, therefore, I know more than they do (conspiracy), or even I know that know just as much.

          • Box of Salt

            Bofa “I just figure it is anti-elitism.”
            After all, who wants admit that the geek they bullied during high school years later will be the same person who saves their lives?

          • Amy M

            Or is more successful

      • Forgetful Guest

        I think you are right on the money with that thought. That mistrust and disregard for facts is really all some groups have & are based on. Without it, a lot of their members would probably have nothing in common.

    • Forgetful Guest

      I guess there’s a small number of OBs out there who are thought to be discouraging towards VBAC. Some are also thought to have better VBAC “success rates” than others, though I don’t know how true that is. I suspect it has more to do with the hospitals they work at and the availability or lack of facilities (as you also point out) than a doctor’s personal stance on the issue. I don’t know if insurance plays a role for some? Obviously for some people the odd OB being less than enthusiastic is enough to start vilifying all OBs and turning it into something personal. Because you know, you OBs clearly just want to get that birth over with as quickly as possible so you can go play a few rounds of golf… *groan*

      The OB I had for my second child was exactly like you – he didn’t care how I gave birth, as long as I came out the other end healthy, had a healthy baby and none of the complications I suffered after my first birth. I chose a repeat c-section, but there was zero pressure either way.

      • Mac Sherbert

        I think the hospital may play the most important role in an OB’s willingness to do VBAC. My OB was perfectly fine with VBAC at the hospital where I delivered. However, she did make reference to not liking to do them at a previous (much smaller) hospital where she had worked.

    • Sue

      If I understand correctly, the only systematic opposition comes from small hospitals without the appropriate back-up. In Oz, VBAC is not likely to be permitted in the few small midwife-led units, is it?

      • Ob in OZ

        Most hospitals in Australia are midwife run. All are midwife led. Doctors are consulted when needed. Ok, this is an exaggeration, but close to the truth. There are many places that have no business offering tolac but do because of pressure from midwives more than patients, in my opinion

  • Anj Fabian

    Slightly OT

    PREMISE:
    Since VBACs are the result of labors that are (in theory) carefully monitored and far more restrictive than non VBAC labors, these births should be lower risk than other vaginal births and their complication rates should reflect this.

    The complications that should show a decreased incidence are shoulder dystocia (restricted first and second stages), PPH (avoid prolonged labor). There are probably other complications that should show similar decreases because of the process of risking out poor candidates and only allowing the best candidates to proceed with VBACs.

    Does anyone know if there are studies that compare VBAC versus non-VBAC vaginal births?

    • Karen in SC

      Interesting hypothesis! Any medical student need to do some research?

      • araikwao

        Already got something planned, thanks! But the problem I see with that is there are multiple RFs for PPH and SD, so it would take vast numbers to show any difference between groups.

        • Anj Fabian

          It takes vast numbers to show a reliable difference in rate between most complications.

          I’d love to see the rates of all complications in the benchmark demographic:
          multiparas with a history of ONLY uncomplicated vaginal deliveries.

    • Trixie

      You mean, lower risk for other risk factors besides rupture?

      • Anj Fabian

        Other than uterine rupture of course.

    • Ob in OZ

      topical
      red journal this month (RANZCOG journal)
      compared transfusion rates in repeat c-s vs vaginal birth and showed less likely for cs.

  • lilin

    In some ways (even though I still believe what I posted below) I feel quite bad for her. It’s always painful to make a public mistakes. It’s more so when you get personal pride from your work, and when you believe in your philosophy. The urge to self-protect is incredibly strong.

    • Box of salt

      “I feel quite bad for her.”

      I can’t feel bad for anyone who’s trying to make money from promoting misinformation.

      • Mishimoo

        I was yelled at on FB for saying something similar to a local prominent anti-vaxxer that claims her son died due to vaccines in order to promote her book and seminar sales.

        (According to doctors, it was probably a rare genetic disorder, but of course she knows better)

        • Box of salt

          OK, so how’d you end up in a FB discussion with Stephanie Messenger? Or did I pick the wrong anti-vax author?

          • Box of Salt

            Since I did name names, I’ll add a link to a Salon review of Messenger’s book. Be sure to read all the way through the last paragraph. Dahl’s daughter’s first name was Olivia.
            http://www.salon.com/2013/01/07/anti_vaccine_book_tells_kids_to_embrace_measles/

          • Amy M

            Wow, that’s ironic. I didn’t know Olivia Dahl died from measles.

          • Mishimoo

            You got the right one, congrats! She’s close friends with my best friend’s mum, we argue every so often when I get fed up with the misinformation in my feed.

          • Box of Salt

            Mishimoo: Wow. I don’t have regular contact with anyone that extreme in real life. I’m not sure whether to say I’m sorry you have to deal with her, or offer references – which you’ve probably already ready posted and she will ignore anyway.

          • Mishimoo

            Yeah, they tend to ignore it or answer with nonsensical posts that are difficult to interpret, but at least there is always a concise dissenting opinion on the anti-vax posts. Hopefully, it will get through to some people.

          • Box of Salt

            Mishimoo: in that case, I congratulate and thank you for providing the voice of reason.

          • Mishimoo

            Thanks, I try. :)

        • Beth S

          Don’t feel bad. I got told the other day to take my emotion out of the discussion about vaccinating after I posted an open letter about my father’s death and how it could have been prevented if people would just get their flu shot.

          • Mishimoo

            I’m so sorry :( It’s pretty unfair that emotion is only an acceptable weapon if you’re an antivaxxer.

            My husband has a lot of contact with the general public, so we always get our flu shot. He’s had his DTaP within the last 5 years, and is going to have his titres checked for measles immunity as we’ve had a few outbreaks.

    • anion

      That’s true, it is difficult. But the thing is, if you make a public mistake, the thing to do is them admit it publicly, apologize, and move on. It’s happened to me, more than once (because of the work I do, I have a public face and a public following; not a huge one, but one nonetheless, and sometimes even the best of us accidentally put our feet in our mouths).

      It’s uncomfortable and you feel like a dick, but I’ve learned that a quick, gracious apology & acknowledgment alleviates that quite a bit and enables you to feel that at least you saved some face in the situation.

      It’s hard for people to make fun of your dumb mistake if the next day you publicly said, “Man, yesterday I made a really dumb mistake, and I shouldn’t have said/done that. I really apologize, everyone–I try my best but sometimes I mess up,” thus showing grace, intelligence, and class. It’s amazing how the impression people have of you can change when you handle a bad situation in an appropriate and mature way, instead of flinging poo, screaming like a spoiled child, and running off in a huff to form a Much BETTER Club Without Those Doodyhead Meanies.

      • Susan

        well said and history is just so full of examples of that being the way to go and the disasters that happen with cover ups. Why is it so hard for us to own our behavior?

  • Susan

    Your post is great but one mystery remains unexplained… why does she refer to you as Robin?

    • http://whatifsandfears.blogspot.com/2014/04/mana-study-part-4-vaginal-birth-after.html Doula Dani

      She didn’t name me directly in her blog post because she didn’t want anyone to read the post I wrote. She wanted people to doubt all sources except her site, her information.

      • Zornorph

        I figured it was because she thinks Dr. Amy is really Batman and you are her sidekick.

  • Heidi

    Awesome, Doula Dani.
    I just posted to her group. Let’s see how long it takes until it’s deleted.

    • Stacy48918

      Love it!

    • CandiB

      Heidi, check your others folder on fb. I sent you a message :)

      • Heidi

        Okay, soon as I get to my laptop. I can’t seem to pull up other messages in the FB app on my iphone.

        • Amazed

          For now, you’ve managed not to get yourself banned. I wish I could say I could not believe the way she tried to mislead people about your post and deflect from the dangerous advice her admins were spreading.

          • Heidi

            Keep reading, she was caught in yet another lie. SMH

          • Amazed

            I did. Their defense is unbelievable. The mother didn’t want to hear about anything else to help her achieve her VBAC, so it was all fine and dandy to recommend an unassisted HVBAC. It defies reason.

            Ever heard of safety first, anyone?

          • Mac Sherbert

            I just don’t understand the notion of only telling people what they want to hear! The mom was only interested in VBAC so we told just what she wanted to hear.
            My kids really hate when I tell them they can’t do something because they could get hurt …. but then again they just want to.

          • Amazed

            Yeah. It’s like, after someone rejects all my proposals of what to do to make the ends meet, I decide that the only way to help them is to give them the address of my sweet old neighbour who lives alone, so they can rob her to pay their bills.

            Ridiculous.

            But hey, they don’t support any way of birth as superior to the others. If you don’t count VBACs, I mean.

          • The Bofa, Being of the Sofa

            Very Orwellian. All births are equal, but some are more equal than others.

            And 4 legs good, two legs baaaaaaaaaaaaaaad

          • Trixie

            Wow. I hope she is wearing flame retardant pantaloons.

  • MLE

    Rock on, Doula Dani. You have 100x more integrity and class, and she views you as a threat. Well done.

    • http://whatifsandfears.blogspot.com/2014/04/mana-study-part-4-vaginal-birth-after.html Doula Dani

      Thank you. I really appreciate that. I can’t think of a better compliment to receive than on ones integrity.

  • lilin

    What’s happening here is the result of her attacks, not anything that happened to her. She made some very aggressive moves – moves that would show that her credibility is better than anyone else’s. They did the opposite. They showed that she’s ignorant and an amateur. Now all she can do is minimize the damage.

    She’s beginning to realize that meanness and snark aren’t enough. Even if she educates herself well, she will not, for many years, have the experience and knowledge that she requires to have the kind of authority she wants. The only option left is to minimize the number of actual experts who can see her blog, and can show how little she understands. She wants to preen like she always has, but due to her own public mistakes, realizes she can’t do it in public anymore.

    • yugaya

      “She’s beginning to realize that meanness and snark aren’t enough.”

      Her “truths” disguised to look like facts are not enough to fool people anymore. The tide has started to turn, and this blog and people who have gathered around the issues of natural childbirth doctrine and dangers have really made an impact. Soon Jen, Jan Tritten and other bigmouth “experts on natural childbirth” will be quoted only for the lolz by reasonably sane people, what we see happening to Jenny McCarthy whenever issues of vaccines are discussed nowadays.

  • RebeccainCanada

    Thank you a Doula Dani. I read her attack post some time ago, filled with arrogance. She made it sound like she was *the ultimate* expert and I remember thinking “who is this lady?” And then realising she was just an opinionated lady with no expertise and obviously no couth. I couldn’t finish her article and never looked back. I’ve really enjoyed your blog though, so thank you! Very much admire your work.

  • Ellen Mary

    Two factual corrections: the group was ‘closed’ not ‘secret’. And taking screenshots of a private convo is so different than taking a screen shot of a post from the group admins to the whole membership discussing statistics. Just different.

    • Stacy48918

      ” the group was ‘closed’ not ‘secret’”
      Oh. That’s totally ok then.

      “And taking screenshots of a private convo is so different than taking a screen shot of a post from the group admins to the whole membership discussing statistics. Just different.”

      You’re exactly right. When that “private convo” involves an administrator of a group that is supposedly concerned with the “facts” and “safety” of VBACs RECOMMENDING that a mother pursue UNASSISTED HBAC it is even MORE important that the members of the group, the public and any new members be aware of the incredibly unsafe practices that these women believe in.

      You would rather that no one know that an admin from VBAC”Facts” promotes unassisted HBAC?

      • MLE

        I think Ellen Mary might be saying that revealing the private convo is worse.

        • Ellen Mary

          Yes, I am also saying that when a group admin posts something quasi scientific in a closed group, IMO that is essentially public.

          • Stacy48918

            I’m of the opinion that if I want to have a truly *personal* discussion with someone I will at least do it via email not a Facebook page.

            So you would rather that we DON’T know about the promotion of unassisted birth within the VBAC”Facts” admins?

          • anion

            Ellen Mary is agreeing with the rest of us, Stacy. She’s never said she thinks the truth about VBACFacts should be hidden, and she’s not defending them.

    • http://whatifsandfears.blogspot.com/2014/04/mana-study-part-4-vaginal-birth-after.html Doula Dani

      Yes I know the group wasn’t secret at the time. I was just saying that even in a secret group things aren’t 100% secret. It doesn’t matter how top secret a group may be, ya just never know who might hack into it.

      I agree. What Jen did was much worse. Our conversation took place via private messenger. It was just the two of us.

  • Captain Obvious

    I have even mentioned her site in the past for patients who are considering VBAC. I can explain the risks and benifits just fine, and I can explain “non-expert birth blogs” opinion just fine. Watching “Dr” Jen (I think I am using the infamous Dr in quotes correctly) act out on this fiasco gives me great pause to ever refer a patient back to her site. If I do, I will first have them look at Doula Dani’s and Dr Amy’s critique of “Dr” Jen Kamel’s horrible actions.
    I think VBACs are a great option, if you are a good candidate. Sometimes you don’t know who is a good candidate until term. Are they dilated? Are they contracting on their own? How big is their baby, compared to their CS delivery? I hate when VBAC at all cost bloggers say the doctor “bait and switch” their patients. At their first OB appt you can easily say someone is not a good candidate, but sometimes you have to wait til term to see if you are still a good candidate. Women develops GDM, have a big baby, or are closed at term and not contracting and they scream bait and switch and look for a new provider. Thanks to sites like “Dr” Kamel, we have to deal with this shit.
    Thank you Doula Dani, I refer more patients to your site now!

    • http://whatifsandfears.blogspot.com/2014/04/mana-study-part-4-vaginal-birth-after.html Doula Dani

      Thank you, Dr. Obvious! :)

    • Renee Martin

      Ugh, never send anyone to Jen or other NCB birth bloggers, they are zealots and liars. That Jen isn’t the worst is a sad thing indeed.

    • Young CC Prof

      “Bait and switch.” Yup. Sometimes they sound a bit like preschoolers.

      “But you promised! You’re breaking your promise.”

      “No, I said we would try, IF everything looked good when the time came.”

      • Danielle

        Yep. My pregnancy was textbook, and low risk.

        Then I went into labor.

  • yentavegan

    25 years ago I fell under the sway of the VBAC/ICAN movement. I took unnecessary risks to my life and my infant’s life all b/c I wanted/felt entitled to a healing vaginal birth. Knowing now what I have learned from reading this blog , I never would have been so cavalier with my labor/delivery.

  • Amanda

    She should rename her page VBACAttacks.

    Good job Dani, I think there will be justice for how she treated you.

  • anion

    Well, I think Jen Kamel is a bad person. Putting her own ideology above women’s lives? Behaving like a spoiled toddler when people point out an inaccuracy in her work? Withdrawing a space lots of women apparently counted on for support just because she’s butthurt somebody didn’t keep her nastiness secret? Yeah…that’s not a good person. Good people don’t do that.

    • yugaya

      Her schtick is to quote authority and then piggyback her own “expert” thoughts on top of it – latest example from the post where she explains the selfless objectivity quest (sic!) that is supposedly the reason why she removed her own “real” birth story from her website:

      “As
      ACOG says, two women can look at the same data and make difference
      decisions because there is no Right or Wrong answer, just what is right
      or wrong for a specific woman. What was right for me may not be right
      for someone else and as far as I am concerned, that is not a judgement
      against me or the other person. People make different choices. Not
      everyone likes anchovies.”

      Notice how she invoked ACOG (“two women can look at the same data and make difference
      decisions”) and then superimposed her own personal opinion over that (“because there is no Right or Wrong answer what is right
      or wrong for a specific woman”) which btw happens to be factually misleading – there may be “no right or wrong answer for a specific woman”, but there definitely is the answer what is safer or not for a specific woman and in general when it comes to VBAC vs HBAC debate.

      • anion

        I especially like the way that post manages to conflate “what’s right” with “choice[s],” thus implying that:

        A) What is right or wrong in a medical situation is *always* subjective, when it is not. If someone is having a heart attack, it is objectively wrong of the ER doctor to, say, offer them a backrub or tie a plastic bag over their head. It would be objectively wrong for an OB to, when faced with a woman in labor at term, start repeatedly slapping her abdomen as hard as possible No amount of feelings about choices will change that fact.

        B) All choices are equally valid.

        C) The only criteria important when making a decision is how the mother feels about it, not how effective or lifesaving or necessary it is, or how well the mother in question even understands what’s happening and what the consequences of her choices are.

        D) There is no such thing as facts or truth, there is only how the mother feels, and facts she does not like can be safely ignored just because she doesn’t feel like dealing with them or the reality of them.

        E) If her baby dies because of her choice, well, that doesn’t mean she made the wrong choice, because only she knows whether or not it was right.

        If someone offered this sort of nonsense in a discussion about anything else, they’d be laughed out of the room. Can you imagine? “Well, Your Honor, I know some people wouldn’t have opened fire over the heads of that crowd, but really, just because it was wrong for them doesn’t mean it was wrong for me. They can make their choices and I am free to make mine. I didn’t think anyone would really die–those anti-gun people make up so many statistics just to keep us buying locks for our doors and pepper gas and store-bought meat instead of hunting out own for free–because I know other people who’ve shot guns into the air and the most that happened is somebody got winged by a bullet and it barely hurt or anything. So clearly you can’t say I was wrong. This isn’t my fault, some people just aren’t meant to not get shot in the face.”

        Anyone else trying to justify their dangerous and irresponsible actions with such morally bankrupt, narcissistic bullshit would be rightfully called on it, but the NCBers just nod their heads and applaud the idea that anything that “feels right” to you is automatically right no matter who it hurts or kills.

  • CandiB

    Doula Dani, thank you for explaining this.
    The links are not working for me either

  • Trixie

    Great piece, Doula Dani!
    FYI, the links don’t seem to be live, for whatever reason.