Rebecca Dekker’s “Evidence Based Birth”: you can put lipstick on a pig, but it’s still a pig.

Evidence based birth

One of the favorite memes of advocates is that natural childbirth is “evidence based,” while obstetricians ignore scientific evidence. Childbirth blog, websites and message boards slap “evidence based” over whatever nonsense they dream up, and figure that the gullible public will look no further.

A good rule of thumb for anyone researching childbirth is this: if a natural childbirth website calls itself “evidence based,” it almost certainly purveying pseudoscience dressed up as science. The website of cardiology nurse Rebecca Dekker, Evidence Based Birth is a prime example. As the saying goes, you can put lipstick on a pig, but it’s still a pig, and in the world of childbirth, “Evidence Based Birth” is a big fat pig covered with lots of lipstick.*

How can you tell the difference between science and pseudoscience dressed up as science? This image from I fucking love science lays out the general principles.

IFLS photo

The primary difference between science and pseudoscience is a willingness to change based on new evidence. Pseudoscience, in contrast, starts with a conclusion and defends it regardless of the evidence.

Rebecca Dekker starts with the premise that the tenets of natural childbirth are true and looks for evidence that confirms those tenets. She ignores evidence that does not support natural childbirth, and is not above deliberately misleading readers by posing one question, but answering another.

Her recent piece on waterbirth, Evidence on the Safety of Water Birth, is a classic in this genre. Dekker starts with the premise that waterbirth is safe and cherry picks evidence to support that claim while ignoring or inappropriately dismissing evidence that shows the opposite.

What is waterbirth? It is the practice of giving birth a plastic pool of water that is inevitably fecally contaminated. It is the equivalent of giving birth in a toilet, and has similar risks, including the risk that the baby will breathe in or swallow the fecally contaminated water.

The American Academy of Pediatrics’ Committee on Fetus and Newborn in conjunction with the American College of Obstetricians and Gynecologists has recently updated its position on waterbirth. Nothing has changed since the previous edition published in 2005, except in the intervening years more cases of perinatal death and injury have been reported.

Some of the reported concerns include higher risk of maternal and neonatal infections, particularly with ruptured membranes; difficulties in neonatal thermoregulation; umbilical cord avulsion and umbilical cord rupture while the newborn infant is lifted or maneuvered through and from the underwater pool at delivery, which leads to serious hemorrhage and shock; respiratory distress and hyponatremia that results from tub-water aspiration (drowning or near drowning); and seizures and perinatal asphyxia. (my emphasis)

But, hey, that’s just the way that the American Academy of Pediatrics’ Committee on Fetus and Newborn and the American College of Obstetricians and Gynecologists assess the scientific literature. Cardiology nurse Rebecca Dekker thinks she knows better.

Her piece contains lots and lots and lots of words, but her conclusion is pretty simple. The evidence that currently exists is less than the highest quality evidence.

Duh!

The AAP and ACOG are well aware of that. They are invoking the precautionary principle. What’s the precautionary principle?

According to Wikipedia:

The precautionary principle … states that if an action or policy has a suspected risk of causing harm to the public or to the environment, in the absence of scientific consensus that the action or policy is not harmful, the burden of proof that it is not harmful falls on those taking an action.

In other words, in the absence of high quality evidence that waterbirth is safe, it should not be standard care. AND it is up to the proponents of waterbirth to provide that high quality evidence before waterbirth can be recommended.

But Dekker completely ignores the precautionary principle in her conclusion.

According to Dekker:

Based on the data that we have, waterbirth is a reasonable option for low-risk women during childbirth, provided that they understand the potential benefits and risks. If women have a strong desire for waterbirth, and there are experienced care providers who are comfortable in attending waterbirths, then at this time there is no evidence to deny women this option of pain relief.

Simply put, the AAP and ACOG believes (in conjunction with Dekker) that there is no high quality evidence to support waterbirth, and a growing body of lower quality evidence that waterbirth kills babies who breathe in the fecally contaminated water or swallow it during birth. Dekker starts with the conclusion that waterbirth must be safe, dismisses the existing evidence on the deaths that resulted from waterbirth, and asserts that it must be considered safe until it is definitely proven to be deadly. Dekker’s claim about the safety of waterbirth isn’t evidence based; it’s her opinion.

The same thing goes for nearly everything on her site. That is presumably why Dekker isn’t spending any time speaking in any venue where she could educate pediatricians or obstetricians about their purported errors in evidence interpretation. She knows she’d be laughed off the stage. She isn’t writing for physicians or scientists, either, because they would eviscerate her claims in short order. She writes for lay people who aren’t capable of assessing the validity of her claims and, in many cases are merely looking for justification to ignore the advice of pediatricians and obstetricians.

A more accurate moniker for her website would be “Rebecca Dekker’s Opinion on Birth,” but who is going to take that seriously? Instead, she calls it “Evidence Based Birth.” Dekker can put lipstick on a pig of a website, but it’s still a pig.

 

 

*Dekker basically admits this in her website disclaimer:

The information presented here does not substitute for a healthcare provider-patient relationship nor does it constitute medical advice of any kind… The opinions expressed in this blog are strictly the author’s personal opinions … The information on this blog may be changed without notice and is not guaranteed to be complete, correct, timely, current, or up-to-date…(my emphasis)

  • Jane

    Hi
    What I don’t understand is why you have to be so inflammatory and rude. Is being pleasant whilst debunking what others say not reasonable?
    I doubt you spend energy on this log and on your entire career in order to be hurtful harmful or misdirected so shouldn’t we believe the same of others? – Ms Dekker in this case.
    I’ve read heaps of her stuff and it seems reasonable and definitely suits my world view more than your opinions do, however I am genuinely interested in what you have to say as you seem very learned and experienced.
    It is hard though for me not to get put off when you are obtuse and rude to others and their views.
    Does it have to be so black and white so them and us all the time?
    Thanks Amy
    Jane

    • Stacy48918

      As long as your yardstick for information is what “suits my world view”, there can’t really be any real discussion. Science is about facts, “verifiable evidence”, as Ms. Dekker posted herself. Not about one’s “world view”. That would be in the Pseudoscience column in Ms. Dekker’s chart.

      Have you messaged Ms. Dekker as well, asking why she recommends women pursue more dangerous methods of childbirth, actively discouraged by ACOG? Have you messaged other NCB leaders, admonishing them for being equally black and white in their depictions of OBs and hospitals?

      If you’re worried about Dr. Amy being “meen”, should you not be equally worried about Ms. Dekker being truthful? Apparently not. Because she fits your “world view”.

      Preventable baby deaths are not “pleasant”. So sometimes the discussion of those that contribute to those deaths gets a bit unpleasant as well. But as you said, it’s not really the tone. It’s the “world view”.

      This blog discusses many of the same topics as Dr. Amy, but is “nicer” if that’s what you’re really looking for: http://whatifsandfears.blogspot.com/

      • Jane

        Thanks 🙂

  • Sue

    DOes this woman treat Cardiology in the same way – ie pick and choose the bits she likes? I don’t think any coronary care unit would employ her on that basis, so she has to be an amateur in someone else’s specialty. Nice work.

  • RNMomma

    OT: I need a little help. Finally got an in to talk with my neighbor about her birth plans. She was planning a home birth but has GD and was risked out to a hospital. She’s very angry because all other tests are in the clear and her home glucose checks are within range. I think her baby is on the smaller side but I’m not sure how small. Anyway, she asked me to help her with a birth plan for the hospital but I have no idea what common practices are in major hospitals… Anyone have a suggestion for reasonable non woo sites that help with natural hospital birth planning?

    • moto_librarian

      Is she seeing an OB or a CNM? It might ease her mind a bit to go on a tour of the hospital where she plans to deliver. My CNMs also had a brief instruction sheet about how to write up your birth plan. Included in it was a list of things that were not done routinely, including shaving, enemas, I.V.s (but a heplock was recommended), and episiotomies. It also asked about preferences regarding pain management, asked about things that could contribute to relaxation (like the lighting level), and also asked you to identify who would go with you should a c-section be necessary. I’ll try to find the paper and scan it for you – it might help to ease her mind.

      • RNMomma

        I was just thinking about a tour. She is with a CNM but I’m not sure if she is staying with her or transferring to an OB. If you find the list, that would be great. I’m going to try and call one of the local hospitals about it as well.

    • Ash

      has she attended any hospital childbirth classes? some of them cover that.

      • RNMomma

        I doubt she would go to one… I messaged her asking if she would be interested in a tour and I still have yet to hear back.

        • Daleth

          Gosh, she really should go. Maybe if you emphasize the benefits of the place of birth being familiar to her before she’s actually in labor there…? It’s just got to be more emotionally comfortable if you have some sense of the lay of the land in advance.

          • Sara

            Definitely! As I said above, I had a great hospital experience recently. With my first I planned a homebirth (with an incompetent CPM, of course) and ended up in the hospital anyway b/c midwife didn’t believe I was in labor. At the hospital I knew absolutely no one and had the CPM trying to scare me over the phone saying things like “you’re in a hospital, they’re just gonna section you”– very unnerving. It’s much better to plan a hospital birth and get familiar with staff and procedure beforehand, which is exactly what I did this time around.

    • Bombshellrisa

      How far along is she? Many OB and CNM practices hand out a template to be completed by 34 or 35 weeks and then the doctor goes it over it with you at the 36 week visit.
      http://www.swedish.org/services/pregnancy-and-childbirth/pregnancy/trimester-checklists/how-to-write-a-birth-plan
      This is also has a link to the template my doctor gave me

      • RNMomma

        33 weeks. Thanks!

    • Sara

      I just had a hospital birth with a medically indicated induction. It would be best if she went for a tour at the hospital, met some of the nurses, and ask directly about their policies. I got most of the info I needed just from talking to my CNM and visiting L&D a few times.

      • Sara

        i should add that when I was admitted, I had to answer so many questions that it basically would have been a birth plan outline, and THEN they asked if I had a written birth plan. Things like skin-to-skin for 2 hours after birth (if possible) were standard practice.

        • RNMomma

          That’s awesome! I called the word of mouth best “natural birth supportive” hospital today and got info on tours. They told me they even do more natural deliveries in a month than some other local hospitals do all year. I had no idea!

        • Medwife

          I just love when people come in with a birth plan all ready to fight for their choices, and I go down the list, “standard practice, standard practice, hasn’t been done for 50 yrs so don’t worry about it, standard practice, here’s why this one doesn’t even make sense”. Totally shocks them. A Bradley instructor around here gets ’em all prepped for battle.

    • Sadlady

      I only had 2 special requests for a home-like birth. Since I did not have the money to store cord blood for later, I decided to keep that goodness with my baby and delay cutting the cord after the it stops pumping, for 5 minutes, as long as the placenta wasn’t delivered. I figured a delivered placenta is basically dead meat. No point in delaying too too long (for me) also to delay that eye goo for 10 minutes after they were born because baby can see 8-10 inches and I wanted baby to see my face, not be all blurred from eye goo. This is a good option if you are RH negative otherwise it does protect baby. Also I wanted no epidural but said it would be OK if I ask 3 times. Because maybe Im just being emotional the first 2 times LOL. haha. Hope that helps. Also my baby was one ounce too big for their diabetes care/check cut off (9.1 lbs) so I had them cut the cord shorter and change the weight to 8.15. That will only work for about an ounce LOL. I wasn’t going to be separated from my baby for just an ounce or 2!

    • sdsures
      • RNMomma

        What an amazing read! I’m glad you shared.

        As a side note, she ended up having a section after a failed induction for HELLP syndrome and babes needed to spend some time in the NICU for hypoglycemia. It was a disaster for her, but she’s in a much better place about it all now a few months later.

        • sdsures

          That’s good.

  • expat

    She deleted my valid criticisms of her article on macrosomic babies. I really read that one closely and she misrepresented so much.

  • Jenny_from_da_Bloc

    Did anyone else notice that all the pictures in Rebecca’s article were black and white except the pictures without the baby? Could that be because most of them were probably that awful blue/purple/grey color?

    • Beth S

      That’s what I think, if they can cover up the deaths due to homebirth they can sure as hell cover up the blue babies.

      • Jenny_from_da_Bloc

        I bet most of them were not pink and should have had low apgars., but we all know that they love to inflate the scores to try and legitimize home birth and water birth. Nothing like being born into a fecal contaminated pool of tepid water to build baby’s immune system and gut flora!

        • araikwao

          Colour isn’t a reliable indicator of oxygen saturation, that’s why a monitor is used in hospital (evil, I know). Blue/purple doesn’t necessarily = poor neurological outcome or inadequate care, although of course timing is important, and these photos don’t tell us that.
          Am just playing devil’s advocate here as it’s as important for “us” to be accurate when pointing out flaws in the NCB devotees’ arguments.

          • deborah

            No, blue really does mean low sats. REALLY low sats. That’s why a monitor is used: because there’s a large range of sats while you are still pink, and some of those sats are no good either.

          • araikwao

            I went for an abbreviated answer because it’s something that has come up before, sorry it was misleading. I guess my point was supposed to be that a baby that comes out blue/purple isn’t necessarily a disaster in the presence of appropriate resus and monitoring. Normal sats in the first minute are only 65-70 or so (IIRC, I can check my notes), as there is the stress of being born plus the transition from fetal to neonatal circulation. The normal range gets higher quickly, but just because a baby is blue/purple at a moment in time captured by a photo doesn’t definitely mean something has gone wrong. (Although I would never be prioritising skin-to-skin over appropriate resus and monitoring)

          • ihateslugs

            Agree that being blue at birth can be quite normal and is actually very common. As you mentioned, the baby is transitioning from fetal to neonatal circulation, and depending on their pulmonary pressures and cardiac function, there is a definite range in oxygen saturation immediately following birth. Cyanosis, or a blue/purple discoloration visible to the eye, is typically seen when saturations fall to the mid-80s, which would not be unexpected in a neonate at the time of delivery. There is a reason that APGARS are not first assessed until one minute, as typically central (not necessarily peripheral) cyanosis has resolved. Furthermore, remember that color is just one aspect of the neonatal assessment. Poor neurologic outcomes are generally associated with an infant who remains compromised for a longer duration, (prolonged cerebral hypoxia).

            That said, a blue baby should receive immediate attention (at minimum, suctioning, warmth, stimulation), and snapping pictures should be delayed until the babe is stable. And, I’ve said this before, a white baby always scares me…

          • Young CC Prof

            That’s the real problem as I see it. Not that these babies sometimes pop out blue, but that when they do, no one seems to think that helping them is particularly urgent. (Or, when they do try to fix it, they sometimes do it horribly wrong.)

          • ihateslugs

            Exactly! It’s like they leave a struggling baby on the mother’s chest, just waiting for it to improve. Most times, the baby usually gets it together, and all is well. But not always…

            And honestly, many of the early resuscitation steps can be done on the mother. You can often suction, warm, dry, and stimulate right there…but I guess those are considered “interventions,” huh? Oh, and I’m thinking about the mother being on land. I don’t know that you could really do much resuscitation with mother in a birthing tub and the cord still attached. What a nightmare to think about having to move a mother out of the tub without too much traction on the cord, then cut, then finally get to the baby.

            I almost said that I’m surprised more babies don’t die from water birth, and then I stopped myself. I think the truth is that they DO, only their death is not appropriately attributed to their water immersion. My first night on call in the NICU as a resident, I remember my attending talking to an EMS crew who had called to see if they should even bring a baby with no heartbeat following a water birth in to the hospital. She advised that they should, even just for autopsy

          • ihateslugs

            Oops! Story continued: Apparently, the parents opted not to, and the midwife termed this a stillbirth, though the paramedics indicated the initial 911 call had referenced a heartbeat. I don’t believe there was ever any further investigation.

            Fast forward one year, on call another night, and we were transferred an infant in respiratory distress following a home water birth. The baby went into full respiratory failure, ended up on ECMO, and after developing IVH (bleeding in the brain, not uncommon for a neonate on ECMO), support was withdrawn. Cause of death was listed as IVH and parents elected against an autopsy.

            The point of these stories is that unless one knew of these babies and the full details of their birth, they will never show up in statistics or data about water births. How many more similar stories are out there?

          • The Bofa, Being of the Sofa

            It’s just another version of the “Studies show that blue babies usually turn out just fine”

            Which is true, of course. In a hospital, with proper care.

            Therefore, the obvious conclusion is that you don’t need to do anything about it if it happens at home.

          • Jenny_from_da_Bloc

            Exactly, no urgency when the situation obviously warrants some attention. Most of the time they transition well, but that baby in the video, not so much

          • araikwao

            Ditto on the white baby – I’ve mentioned this before, but didn’t go there this time out of laziness (typing from phone too tedious!) And yes, I agree with all that you’re saying. I don’t want to use the baby’s colour unfairly to presume poor/inadequate care (although that may wel be the case). Innocent until proven guilty – isn’t that an American thing? 😉

          • Jenny_from_da_Bloc

            I guess what I meant to say is a baby that stays blue for an extended period after birth.

          • Jenny_from_da_Bloc

            I’m a respiratory therapist and blue does mean low o2 sat and we use the monitors to determine the range. It doesn’t necessarily mean impaired neuro function but the longer the baby is blue the more likely the baby will have some sort of brain damage. A pink baby can have a low or not good o2 sat, but a blue baby most likely always does

        • Beth S

          The Anti-vaxxers love to say Sanitation is the reason a lot of VPDs went on a downturn between when the vaccines were available and the outbreaks of today. Okay so why is it okay to give birth and expose not only yourself but your child to the types of diseases the waters of a birth tub are likely to contain. Hell I’ve seen pictures of some of these women pulling their kids into the water and exposing their whole family to the disease.
          While color might not be a reliable indicator, it is one possible indication. Plus I’ve got the mummy baby seared into my brain.

          • Jenny_from_da_Bloc

            Color is a good indicator though not 100% reliable, that’s why babies who are born that color generally get warmed up and checked out. Sitting in a dirty pool wrapped in a wet towel is not going to help. Its deplorable

    • Trixie

      That or the birth tub water was full of poop.

      • Amy M

        Or blood.

  • Beth S

    Personally, and this is my own opinion, blogs like EBB do more to harm the population that even blogs like TFB. By framing everything she writes as “evidence based” Rebecca gives her posts a legitimacy that they don’t deserve. People will read her blog, say hey this is a nurse and she’s behind this dangerous practice or that dangerous practice, and think that her opinions are fact based instead of the NCB fallacy they actually are.
    Pregnancy and motherhood are already one of the most vulnerable times in a woman’s life, and by calling her blog evidence based Rebecca invalidates even the disclaimer she puts on her own site. Or at least she does to me.

    • Jessica S.

      I totally agree with you. You have to have some idea of what’s wrong with the NCB logic (as an ideology) to catch on to what’s wrong with her opinions. And Dr. Amy is right: they are very much just that – opinions.

      ETA – the big red flag to me was reading her “why I started doing this” story. It’s the typical “everything seemed so wrong and not how birth should be” trope. Which really means “it didn’t live up to my expectation. Wah!! *stomp stomp*”. 🙂 This is why I try to empty my mind of expectations in relation to big events.

      • Young CC Prof

        Yes. Her article sounds good! It’s well written, it cites and summarizes a number of sources, provides what sounds like nuanced critique, recognizes some potential confounders, overall she knows what she’s doing.

        She’s just not telling the whole story.

      • Beth S

        I’ve always said my birth plans consisted of two or three things depending on the birth for the first two it was healthy baby and healthy me. For my last it was healthy baby, healthy me and no repeat post natal seizures.
        She’s a cardiologic nurse yet she never thought to go up to the maternity floor of a hospital to find out the way things should be before she gave birth. I know if I were a nurse and had hospital privileges I would have been all over the birthing wing asking questions, finding out the facts. I mean with my first I asked both of my nurse aunts, on a pediatric nurse, the other a public health nurse, tons of questions every time I saw them.
        I was lucky both my aunts really did go with the evidence at the time and gave me great advice, but I worry about women who don’t have the resources I had, especially the ones in third world countries that are forced to play test subject to homebirth midwives.

        • Michelle

          Yes, I think that correct – it was up to her to investigate and learn for herself. The only proviso I have there is that going to maternity isn’t the way to do that, they have enough to do without rubberneckers from other departments turning up, patient education being a whole other thing entirely. It was however up to her to utilise her training (which in my country does cover obstetrics and paeds, unsure about the US) and/or search out reliable courses and other information sources if she wanted to learn more.

  • The Bofa, Being of the Sofa

    Another row I’d add to the science/pseudoscience table is that in science, we clearly define what something means before we start, and therefore what will constitute verification or not. Pseudoscience leaves things completely open-ended such that any observation can be twisted into being affirmative.

    Alternatively, in trying to counter science, pseudoscience will use a strawman version of the topic (and then fail to actually even address that)

    • Cobalt

      Or a straw horse

      • Trixie

        Nice contradictotry

      • Beth S

        OT but I see the word straw horse and I automatically correct it in my mind to saw horse and wonder why a building tool is being talked about on a scientific blog.

      • The Bofa, Being of the Sofa

        In the words of the late, great John Pinette, “Nay! Nay!”

  • guest

    Well, I’ve seen her article on Vitamin K do a good job convincing a few people to get the K shot. So there’s that.

    • Beth S

      I’m glad she’s advocating for the K shot because to me people refusing the shot is almost criminally irresponsible, however by advocating for dangerous birthing practices she’s cancelling out what good she could do for the community at large.

      • Guest

        Can someone please explain why the CDC felt it was worthy to link to EBB on the CDC Fact Sheet on Vitamin K? The requisite information is concisely provided by the links to actual professional organizations. I cannot understand the purpose of providing Dekker’s link, but I DO see the danger in linking inquisitive parents there. I wonder how many people who follow the link will read the actual disclaimer Dekker provides which explicitly states the information to be an opinion piece and how many others that will assume CDC condones her ‘opinions’ on other topics. I find it frightening and disturbing the CDC chose to include that link among AAP, ACOG, AAFP, AWHONN and HealthyChildren.org

        • Beth S

          I think they link to EBB because Rebecca Dekker also did an interview about the vitamin K shot with Lamaze international. So they link to her site because the interview is there too.

          • Guest

            But WHY? The content is provided by the other links, professional organizations.

          • Beth S

            Maybe the CDC thought that if it were on a blog that advocates above all else NCB philosophy that mothers who are drawn into the belief system will read it and think twice about not getting the K shot.
            I know a lot of NCBers who won’t read any of the professional organization sites, but will read a site like EBB which advocates for their particular lifestyle so in promoting that interview they’re getting the information out to people who wouldn’t read on the other sites.

          • Guest

            I understand that and see it in my own practice as well, but at what risk if it appears CDC then condone’s EBB as a valid source and the remainder of its content? It is an opinion piece, disclaimer explicitly says so but this is lost on the reader if CDC links it.

          • guest

            Dear other guest, I can’t tell you why. But I can tell you that in my crunchier-than-thou social media mamas group in my crunchier than thou city, those other links fall on deaf ears. But her article seems to turn people around toward Vitamin K. Maybe there’s a crunchy dog whistle involved – I don’t know. Maybe the title “evidence-based” automatically makes people feel more smugly correct. But her vitamin K piece gets much better reception than other vitamin K stuff that I post, and you’re right – it’s exactly what other organizations tell you. It’s exactly what Dr. Amy tells you . But this is the one that works.

          • Guest

            Yes, I am playing devil’s advocate here. I find it very frustrating though that the CDC is referencing her site. I spend a lot of time with my expectant mothers discussing the use of internet for ‘research’. I’ve heard some providers tell patients never to use the internet, which seems awful paternalistic in the day and age of internet access. However, I use precious office time during appointments discussing what websites are good resources, including the CDC. Additionally, I discuss my valid concerns about using birth blogs to gain information, as well as attempt to help them decipher whether a blog is an echo chamber. I’s much easier to do so then, than having to start a new discussion at 36 weeks about the evils of medically indicated induction, the woes of Vitamin K or the tragedy of a CS while having to discredit sources such as VBACfacts and EBB. As far as I am concerned, CDC just did a disservice to expectant parents.

          • Jessica S.

            That’s really cool that you take the time to explain responsible internet research.

        • Jessica S.

          That’s very disturbing.

    • moto_librarian

      She only came around on that after all of the hideous reports coming out about babies with brain bleeds because their parents refused the shot. If people like her didn’t go out and scare the shit out of parents with misinformation, this never would have happened.

  • Arwen

    Nature doesn’t care if someone “understands the risks.” Nature similarly doesn’t care if a provider is experienced or “comfortable” with providing water birth.

    Babies don’t know if their mothers “understand the risks,” nor do they have the capacity of caring. Similarly, babies don’t have the capacity to know or care if the care provider is “comfortable” with how their mothers are giving birth.
    This seems to follow the pattern of wishful thinking that permeates the NCB and lactivist lines of thinking. That babies somehow know when and how to be born better than people with ample training, or even laypeople with proper respect for the capriciousness of nature (how many moms with preeclampsia need to push their doctors to take them seriously? I sure did! But I have a VERY healthy respect for the fact that nature isn’t some benevolent goddess.).

    Or that babies are always on board with breastfeeding, such that if a mom isn’t breastfeeding, it’s because she’s too stupid/uneducated/lazy/uncaring to do so. The thinking seems to be that if you just don’t talk about food allergies, lip ties, sensory disorders, poor oral-motor development, etc., then these things won’t affect a baby’s ability to breastfeed. Or if you simply don’t talk about life- or breast-threatening mastitis, moms who hate nursing because they can’t stand the sensation (maybe they have sensory issues too, or it’s triggering PTSD from their rape or childhood abuse), moms who need sleep or to take medications because they have auto-immune disease, etc., then these things won’t exist.

    Really it seems to boil down to the attitude that women aren’t capable of handling tough decisions, risks, bad news, or…any information, really, that might affect their plans. How does Dekker define a woman who is informed of the risks of water birth? Someone who has read what research is out there and told in detail how a baby can die by inhaling essentially used toilet water? Or that anyone who tells a woman that water birth is dangerous is “playing the dead baby card?”

    I feel that any woman who wants a water birth should be required to visit a birth suite with a dirty birthing pool before it’s been cleaned and invited to stick her face in there. Or even her hand. And then she should be asked why in the hell she’s willing to let her fragile newborn touch it, nevermind breathe it.

    • Daleth

      I hate the phrase “playing the dead baby card.” If the doctor/nurse/midwife has a “dead baby card” to play at all, it’s because the thing you’re talking about carries a risk of the baby dying. Would people really prefer that the doctor/nurse/midwife NOT mention that?!

      • Beth S

        It bothers the crap out of me too. There’s no such thing as the dead baby card because in the end to have truly informed consent you have to mention that your child can in fact die because of the choice you are making.
        Informed consent is one of the cornerstones of our medical system, and without truly informed consent how can a person make a choice that’s best for them.

      • Kupo

        Sure, let’s play cards. Here’s the hand you might be dealt: a healthy term baby, a baby disabled by shoulder dystocia, a baby dead because the placenta wore out, a dead baby because the oxygen cord got compressed, a dead baby because of meconium aspiration, a dead baby because we don’t know why and we’d like to examine the placenta to understand.

      • DiomedesV

        The problem with the phrase “playing the dead baby card” is that it 1) assumes an adversarial relationship with medical staff, 2) implies that staff and patients are involved in a mere game, as if they had just sat down to a game of poker, 3) implies that winning said game is of great importance, and 4) assumes that what is most at stake is the woman’s control and autonomy, and that the baby’s wellbeing is never really in doubt.

        I don’t see how staff can really get through to women who think in those terms.

        • Beth S

          I hate the fact that it seems like they’re playing games with a baby’s life. Sure there’s a lot to be said for control and autonomy, but to me I always assumed that the end goal to pregnancy was a healthy mother and healthy baby. Before I started reading here I was woefully ignorant of the mothers who valued their birth experience over and above the baby’s life.
          Plus it pisses me off when the NCB community uses it on loss mothers who are trying to warn others and make sure their story is heard. These women are not playing the dead baby card, these women are trying to warn people that they never thought this could happen to them, but it did. They are not playing cards, they’re living with the pain and hurt.

        • Arwen

          Yes. Hence my use of the word “indoctrination.” How do you reason with the indoctrinated, when the indoctrination isn’t based on reason in the first place?

          • Beth S

            I don’t think you can reason with the indoctrinated. They think their beliefs are based on reason so when someone comes out with a well researched opinion that goes against that indoctrination they’re part of the conspiracy. It’s eerily similar to the methods used by Jim Jones and other cults.

      • Arwen

        I think there is a real fear that telling a woman about a risk makes the bad thing you’re talking about happen. I don’t even think we do this in sports. Lives don’t depend on people winning trophies, but athletes practice game plans that cover lots of different scenarios–winning by a lot, winning by a little, tied, losing by a little, losing by a lot. But somehow it’s okay to foist the notion on women that they can control bad outcomes simply with the power of their minds? A positive attitude can make some difference in your life, but it can’t stop preeclampsia.

  • Guesteleh
    • Young CC Prof

      That actually makes a disturbing amount of sense, that constant exposure to pathogens prevents them from eating enough or absorbing nutrients.

      • Beth S

        I rag on people who mention sanitation as a reason VPDs have gone into decline because I’m a strong vaccination advocate, however I will say poor sanitation has it’s own consequences when it comes to the health and welfare of a population.

        • Young CC Prof

          Sanitation doesn’t wipe out measles or flu. It sure as hell wipes out cholera, most forms of dysentery, many parasitic infections, and all sorts of other fun stuff.

          Clean water changes everything.

          • Alcharisi

            Wow, it’s almost as if there’s no such thing as a panacea, and sanitation and vaccines are both important! But that would be too complicated for some of *that* crowd.

          • Beth S

            Oh I agree totally. Since water systems in the United States became centralized and clean Cholera has been all but wiped out. In 2010 there were 23 cases of Cholera in the United States, 22 of those cases were from people who’d gone to Hispanola where there was an epidemic at the time and 1 of those cases caught it in Haiti.
            Clean water is the reason that using formula in the developed world is a reasonable and safe option for most of the developed world, while in a lot of countries in say Africa should only be used as the form of feeding of last resort. Also in all honesty if they do use it in Africa they should use the premixed ready to feed bottles.
            Sorry for going on a rant there, I support a couple of clean water initiatives and it’s something I can ramble on and on about. I’m also a huge vaccine advocate and want to prove the two aren’t mutually exclusive.

  • Look at this water birth. Baby is born around shortly after 1:00 but doesn’t come out of the water until 1:35, due to a nuchal cord…. then no crying/breathing afterwards for how long?? Midwife asks for mom to hand over the baby and get out of the tub but mom says “no!” WTF? Not sure how long this baby isn’t breathing b/c the video cuts out. Oh…. and that is the DOULA in the water with her. So much wrong here…..

    https://www.youtube.com/watch?v=rH1d9YluJSQ

    • PrimaryCareDoc

      Ew. The doula got into the water with her? Into the biohazard water? That is disgusting.

      • Beth S

        Good God that’s gross! I can barely deal with vomit, ask me to get into the biohazard water, I’d probably end up yakking all over you.

    • Guesteleh

      Just reading your description of that video freaked me out. Terrible.

    • auntbea

      So… that’s the doula and not mom’s partner? Because I am pretty sure she keeps kissing mom’s shoulder. Also, why is she wearing one glove? What is the possible purpose of that?

      • It says in the comments that it’s the doula. I’m pretty sure the husband/boyfriend is holding the underwater camera.

      • Guest

        What’s the purpose of two gloves over one glove? Unless they’re bovine gloves, I cant see a purpose in protecting mother, baby or birth attendant with contaminants freely flowing between the three. Just another way they try to give the impression they know what they’re doing, despite no rationale for the action.

      • Guestll

        Michael Jackson fan?

      • Lucy Eades

        HI! THAT IS MY VIDEO. LET ME SET YOU STRAIGHT NOT SO SMARTY PANTS!!! The baby was breathing immediately. Babies don’t always cry and just because they aren’t it doesn’t mean they aren’t breathing!! My MW asked me to hand baby over so they could monitor her breathing beneath the placenta. The MW who was counting her reps (a different MW) is training and this was like her 3rd or 4th birth so my MW wanted to count herself. There is no reason why I can not hold the baby. We all know this. Secondly, the footage cut away for nudity reasons. That’s it. She never said get out of the tub. Thank you though. The doula was in the water to ensure I got my waterbirth bc my husband didn’t want to get in. Nothing wrong with either. This was the plan from the get go before labor started.

        Maybe if you had your facts straight you wouldn’t be sitting here speculating stories that aren’t even true. Don’t assume, you just look like an ASS!

    • fiftyfifty1

      “So much wrong here…..”

      And it begins with the title, clearly placed there to brag about going past her due date.

      • Lucy Eades

        Clearly there to state the facts. Not to brag.

        HI! THAT IS MY VIDEO. LET ME SET YOU STRAIGHT NOT SO SMARTY PANTS!!! The baby was breathing immediately. Babies don’t always cry and just because they aren’t it doesn’t mean they aren’t breathing!! My MW asked me to hand baby over so they could monitor her breathing beneath the placenta. The MW who was counting her reps (a different MW) is training and this was like her 3rd or 4th birth so my MW wanted to count herself. There is no reason why I can not hold the baby. We all know this. Secondly, the footage cut away for nudity reasons. That’s it. She never said get out of the tub. Thank you though. The doula was in the water to ensure I got my waterbirth bc my husband didn’t want to get in. Nothing wrong with either. This was the plan from the get go before labor started.

        Maybe if you had your facts straight you wouldn’t be sitting here speculating stories that aren’t even true. Don’t assume, you just look like an ASS!

    • Captain Obvious

      Uh, the doula could have been replaced by a water proof chair. The doula takes her own hand out of the tub water and wipes her own nose and mouth several times. Ugh.
      On the other hand, I would like to get that under water camera for my up coming trip to Maui.

      • Durango

        Oh my god that is so disgusting.

      • Carrie Looney

        Are you going to visit Molokini? The biodiversity in fauna when diving around Hawaii is just awesome, IMO. I love the reefs, and the manta ray night dive we did was simply amazing.

        Yes, I’m just trying to distract myself from the vid. The sight of blue babies coming out of contaminated water does not make my day – I don’t even want to click on it.

        • Lucy Eades

          My bluest baby of all was born in a hospital. GASP! That said Dr caused my only PPM too! Double GASP!

          • Bombshellrisa

            Lucy, nobody here is going to claim that babies cannot be born blue in a hospital. We will argue that the setting allows closer proximity to professionals who can quickly respond with equipment, meds and effective techniques.

          • Bombshellrisa

            I would like to add that a midwife carrying oxygen isn’t enough. A midwife, a doula and an apprentice midwife are not enough hands

          • Lucy Eades

            & what are CPMs or CNMS? are they not professionals who can quickly respond with equipment, meds & effective techniques? Aside from a csection what does an OB/GYN have on a CPM or a CNM? They both carry drugs (prescribed by OBs to use at their discretion)

          • Bombshellrisa

            The equipment and techniques come from the other members of the team too, the ones that can be paged and respond to situations. A midwife can carry oxygen, a mask and has another midwife there is something goes wrong, sometimes they have an ambu bag, sometimes not. In a hospital setting there are oxygen saturation monitors, warming beds, professionals who can can start an IV and intubate the baby. Two minutes in resus time is a very long time.

          • MLE

            Since CPMs only need a HS diploma, they shouldn’t be carrying any drugs. There is a vast difference between CPM and CNM and drugs only scratch the surface.

          • Stacy48918

            The fact that you are unaware of the breadth and depth of ways in which an OB differs from a CNM, much less a CPM, demonstrates your complete ignorance of all things related to birth.

            A CPM in Spokane called 911 last Friday for a blue, apneic baby with no heartbeat (in other words an Apgar of ZERO) because leaving the cord attached, knowing/starting neonatal CPR/NRP was insufficient. What does the hospital and OBs have on homebirth and CPMs? LIFE. That’s all.

          • Life Tip

            Big bowl of nope.

      • Lucy Eades

        We had a water proof chair and it could NOT have been replaced because it would have punctured the tub.

        • different guest

          So, you actually considered the risk of the waterproof chair getting a puncture? Risk assessment is very important.

    • Kazia

      The mother also has a history of postpartum hemorrhage, and also has a blood clotting disorder. What a *great* candidate for home birth! /sarcasm

      • Jenny_from_da_Bloc

        According to NCBs and Rebecca’s article you can’t bleed out during a water birth! Duh don’t ya know!

        • Young CC Prof

          Except when you do, and no one notices because all the blood is just in the tub…

          • Jenny_from_da_Bloc

            Yup my point exactly, how would anyone know she was bleeding out since the water would dilute the amount of blood. The better question being what kind of midwife takes on a patient for a home birth with a clotting disorder? But of.course if the mother bleeds out it was because she wasn’t meant to live! *sarcasm*

          • Young CC Prof

            And what kind of mother with a clotting disorder goes “all-natural” and post-dates? I have RAGE on behalf of every woman doing Lovenox and praying to eke one more week out of a clotted-up placenta so the baby might survive.

          • Jenny_from_da_Bloc

            She probably wanted a healing birth lol, cause bleeding out and stillbirths are healing especially if they are vaginal *sarcasm* ugh

          • Lucy Eades

            HI! THAT IS MY VIDEO. LET ME SET YOU STRAIGHT NOT SO SMARTY PANTS!!! The baby was breathing immediately. Babies don’t always cry and just because they aren’t it doesn’t mean they aren’t breathing!! My MW asked me to hand baby over so they could monitor her breathing beneath the placenta. The MW who was counting her reps (a different MW) is training and this was like her 3rd or 4th birth so my MW wanted to count herself. There is no reason why I can not hold the baby. We all know this. Secondly, the footage cut away for nudity reasons. That’s it. She never said get out of the tub. Thank you though. The doula was in the water to ensure I got my waterbirth bc my husband didn’t want to get in. Nothing wrong with either. This was the plan from the get go before labor started.

            Maybe if you had your facts straight you wouldn’t be sitting here speculating stories that aren’t even true. Don’t assume, you just look like an ASS!

            I took a baby aspirin a day as a PREVENTATIVE for a POSSIBLE blood clotting disorder.

          • Jenny_from_da_Bloc

            Lmao a baby aspirin?!

          • Bombshellrisa

            Well, if you are a CPM and you can’t prescribe anything, baby aspirin is your anticoagulant of choice (along with fish oil and cinnamon. Don’t argue the cinnamon makes you stop bleeding point with me, my CPM preceptors assured me that cinnamon thins the blood!)

          • Lucy Eades

            An ob/gyn and an anticardiolipin iGM specialist prescribed it. Thank you though. Ignorance!

          • Bombshellrisa

            Not ignorance, Lucy. I don’t doubt that OBs do prescribe baby aspirin. What I doubt is that with a suspected condition that requires baby aspirin that someone would be considered low risk and a good candidate for homebirth

          • Mishimoo

            Well, it must be the correct one to take. It’s right on the label and everything.

          • Jenny_from_da_Bloc

            81mg of baby aspirin should do the trick! I mean duh it says baby on the bottle and a doctor didn’t prescribe it so it must be safe and effective

          • auntbea

            It’s especially good for someone with a history of hemorrhage.

          • Stacy48918

            No kidding. And when I’m worried about bleeding to death an anti-thrombotic is EXACTLY what I want to take. Basic phys/pharm fail.

          • Lucy Eades

            A Dr DID prescribe it as did a anticardiolipin iGM specialist. Who all agreed home birth was perfectly safe. Oh & a CNM & my CPM agreed as well.

          • Jenny_from_da_Bloc

            You are a disgrace go troll a message board where people agree with everything you say and powder you behind too! Nobody will ever agree with you here because science trumps pseudoscience every time.

          • Stacy48918

            I thought you said it was an ASSUMED clotting disorder. You saw all those specialists and no one bothered to actually check your clotting ability? Yea

          • Lucy Eades

            Yes, a baby aspirin as prescribed by a CNM & an OB/GYN.

          • Stacy48918

            Lucy, aren’t you THRILLED? You posted your video for all the world to see and now we have! Isn’t that what you wanted? @ @

          • Lucy Eades

            It is! It’s exactly what I wanted. =)

          • Lucy Eades

            HI! THAT IS MY VIDEO. LET ME SET YOU STRAIGHT NOT SO SMARTY PANTS!!! The baby was breathing immediately. Babies don’t always cry and just because they aren’t it doesn’t mean they aren’t breathing!! My MW asked me to hand baby over so they could monitor her breathing beneath the placenta. The MW who was counting her reps (a different MW) is training and this was like her 3rd or 4th birth so my MW wanted to count herself. There is no reason why I can not hold the baby. We all know this. Secondly, the footage cut away for nudity reasons. That’s it. She never said get out of the tub. Thank you though. The doula was in the water to ensure I got my waterbirth bc my husband didn’t want to get in. Nothing wrong with either. This was the plan from the get go before labor started.

            Maybe if you had your facts straight you wouldn’t be sitting here speculating stories that aren’t even true. Don’t assume, you just look like an ASS!

          • Jenny_from_da_Bloc

            Your rant proves you are just as crazy as your video makes you seem and you chose the wrong person to debate respiratory function with. Your baby was under water for over 20 seconds probably inhaling feces, water and whatever other bacterial or viral contaminants that were floating in that cesspool with your doula contaminating the pool as well. I might be an idiot, but I’m smart enough to know that it is dangerous to give birth in a tepid pool of bacteria. Sorry you are offended by the observations I made by your own video. If you wanted your birth to be private than you shouldn’t put it on YouTube.

        • KarenJJ

          Exactly – that’s why people don’t die from blood loss during shark attacks.

          True, evidence based, story – see all the research on saline used to treat blood loss in emergencies.

          • araikwao

            Of course they don’t – shark bites are natural!

          • Jenny_from_da_Bloc

            Lol!

        • araikwao

          Oh good grief, I don’t think I can read this article… So they haven’t heard of Caroline Lovell?

      • Lucy Eades

        HI! THAT IS MY VIDEO. LET ME SET YOU STRAIGHT NOT SO SMARTY PANTS!!! The baby was breathing immediately. Babies don’t always cry and just because they aren’t it doesn’t mean they aren’t breathing!! My MW asked me to hand baby over so they could monitor her breathing beneath the placenta. The MW who was counting her reps (a different MW) is training and this was like her 3rd or 4th birth so my MW wanted to count herself. There is no reason why I can not hold the baby. We all know this. Secondly, the footage cut away for nudity reasons. That’s it. She never said get out of the tub. Thank you though. The doula was in the water to ensure I got my waterbirth bc my husband didn’t want to get in. Nothing wrong with either. This was the plan from the get go before labor started.

        The PPH you referenced was caused by the Dr who yanked my placenta out. The blood clotting disorder is SPECULATED, has yet to be confirmed. It was such a low risk that we only took a baby aspirin a day as a PREVENTATIVE.

        The ignorance. You sound like you know me or our situation, you obviously don’t.

    • Trixie

      WTF WTF WTF

    • antigone23

      I know it’s only seconds but it feels like that baby took forever to make a sound and was so quiet. Freaking scary. Both my babies were screaming from the second I felt them leaving my body.

      • Young CC Prof

        The horrible water-birth pictures and videos are endless. There should be a tumblr for “low-Apgar water babies.”

        Except no one wants to see that, that’s freaking horrible.

        • Lucy Eades

          Her APGAR scores were great!

          HI! THAT IS MY VIDEO. LET ME SET YOU STRAIGHT NOT SO SMARTY PANTS!!! The baby was breathing immediately. Babies don’t always cry and just because they aren’t it doesn’t mean they aren’t breathing!! My MW asked me to hand baby over so they could monitor her breathing beneath the placenta. The MW who was counting her reps (a different MW) is training and this was like her 3rd or 4th birth so my MW wanted to count herself. There is no reason why I can not hold the baby. We all know this. Secondly, the footage cut away for nudity reasons. That’s it. She never said get out of the tub. Thank you though. The doula was in the water to ensure I got my waterbirth bc my husband didn’t want to get in. Nothing wrong with either. This was the plan from the get go before labor started.

          • Stacy48918

            Of course her Apgars were great. Your midwife doesn’t know how to properly assign them (and shouldn’t be the one to do it anyway). Reference – Amos Grunebaum, March 2014 (might be May, definitely earlier this year)

      • Lucy Eades

        HI! THAT IS MY VIDEO. LET ME SET YOU STRAIGH NOT SO SMARTY PANTS!!! The baby was breathing immediately. Babies don’t always cry and just because they aren’t it doesn’t mean they aren’t breathing!! My MW asked me to hand baby over so they could monitor her breathing beneath the placenta. The MW who was counting her reps (a different MW) is training and this was like her 3rd or 4th birth so my MW wanted to count herself. There is no reason why I can not hold the baby. We all know this. Secondly, the footage cut away for nudity reasons. That’s it. She never said get out of the tub. Thank you though. The doula was in the water to ensure I got my waterbirth bc my husband didn’t want to get in. Nothing wrong with either. This was the plan from the get go before labor started.

        Babies don’t always cry. Most water birth babies or natural birthed babies in general don’t. A lot don’t make any sounds. Doesn’t mean they aren’t breathing. The ignorance in these post is insane!

    • Jenny_from_da_Bloc

      Wow, this video is horrifying and disturbing! That poor baby was underwater forever, probably inhaling water and whatever those chunks floating around, and the mother denies the baby medical assistance because she is selfish and just plain stupid. At least she got her home birth no.matter the risk to her baby….

      • Lucy Eades

        HI! THAT IS MY VIDEO. LET ME SET YOU STRAIGH NOT SO SMARTY PANTS!!! The baby was breathing immediately. Babies don’t always cry and just because they aren’t it doesn’t mean they aren’t breathing!! My MW asked me to hand baby over so they could monitor her breathing beneath the placenta. The MW who was counting her reps (a different MW) is training and this was like her 3rd or 4th birth so my MW wanted to count herself. There is no reason why I can not hold the baby. We all know this. Secondly, the footage cut away for nudity reasons. That’s it. She never said get out of the tub. Thank you though. The doula was in the water to ensure I got my waterbirth bc my husband didn’t want to get in. Nothing wrong with either. This was the plan from the get go before labor started.

        The baby wasn’t under the water that long. It’s very normal time frame. We unwrapped the cord and allowed baby to unwind on her own. She can’t inhale water while submerged. She has yet to take her first breath and can’t till she hits oxygen. Her lungs won’t expand until then. Do some research! Geez. In the meantime don’t be some judgmental especially when involving a topic you clearly lack knowing about.

        • guest

          Have you ever seen babies do practice breathing in utero? How is this any different?? Of course they can inhale underwater! Geez….

          • Lucy Eades

            Their lungs haven’t expanded. Its different than breathing oxygen. I’m seriously talking to an idiot.

          • guest

            You are the idiot. Of course she can inhale water while submerged- that’s what babies do in utero.

          • different guest

            Exactly- this is how the lungs develop in the first place in utero.

          • Haelmoon

            Lucy, I am sorry to correct you, but fetuses develop their lungs by filling them fluid. That is how all of the future air pockets are developed. If in the uterus a fetus does not have fluid to do this, it is a lethal condition called Potter’s syndrome or sequence. I would be very careful about making up physiological “facts” because it shows your ignorance of basic fetal physiology. Some us us have dedicated out lives to caring for women and their children. With the advent of the internet the amount of useless and incorrect information being provided to moms is horrendous, and you are contributing to it. I am very glad that you and you baby are well. But you are wrong, newborn babies can breath in water, it has being going on the entire time they are in the uterus. Why would it suddenly change at birth? Worse, if a fetus is stress or short of oxygen at birth, they will display a gasping reflex and be even more likely to swallow the water from the pool, which is not likely sterile like amniotic fluid.
            I have had to tell women that their babies’ lungs won’t expand due to a lack of amniotic fluid. It’s a pathological condition called pulmonary hypoplasia. These babies die. You do not know what you are taking about. Check out

          • Haelmoon

            Sorry, on an iPad, cut myself off.

            Check out http://www.potterssyndrome.org to see babies whose lungs didn’t expand in fluid. They all died.

          • Dr Kitty

            Nope.
            I understand that you are repeating what you have been told, but you are incorrect.
            The “idiots” here aren’t the ones who have taken university courses in foetal development and physiology…

            Lucy, you’re the one who needs to educate yourself and do some research. Like maybe from a foetal physiology and anatomy textbook rather than from natural childbirth websites.

          • The Bofa, Being of the Sofa

            Pablo’s First Law of Internet discussion hammers again.

          • different guest

            How long before she comes back to teach us all about the diving reflex?

          • Jenny_from_da_Bloc

            I was just thinking the same thing. I’m in my den digging up my neonatal respiratory textbooks right now just to clarify and cite some real information on fetal and neonatal pulmonary function just to prove how deadly wrong she is

          • Mishimoo

            Every time someone mentions the dive reflex, I want to send them to the mining town I spent my teen years in. Over there, the socially acceptable method of getting rid of unwanted newborn kittens/puppies is to slip them into a bucket of warm water soon after birth, because it doesn’t trigger their dive reflex. They breathe in the water like they would in-utero, and die with a minimum of fuss.

            It still horrifies me several years later.

          • Lucy Eades

            They aren’t inhaling oxygen, their lungs aren’t expanding. The ignorance!

          • guest

            As others have said – that’s not going to keep water out of the lungs, regardless of whether they’re expanding or not (which- what the what? where did you come up with that? please provide a link that proves that). Why do you think babies sometimes cough up amniotic fluid?

        • Jenny_from_da_Bloc

          And btw I’m a respiratory therapist and the baby will try to breathe the second they are born whether to are under water or on land. That bullshit in your last sentence is wrong and I don’t need to do research because I spent 4 years almost exclusively studying the pulmonary and cardiovascular organ systems and how they function in adults, children and infants. But don’t worry I will always be in the NICU treating the babies that did breathe in their mothers feces and blood during their so called safe water births and develop life threatening pneumonia and strep infections, because it happens all the time.

          • Lucy Eades

            I’m sure you are….haha 😉

          • Mishimoo

            Because seriously ill neonates are just so funny?

          • Mishimoo

            I know you probably can’t tell us, but the cayenne pepper solution bub that you mentioned is still on my mind. Did they pull through okay?

          • Jenny_from_da_Bloc

            Yes, she was in the hospital for a while and was able to go home with her grandmother a couple weeks ago.

          • Mishimoo

            Oh good! I’m so happy that she survived. Hope her brain function was preserved, and that she has a long and happy life.

        • anion

          You do know babies have died from inhaling the water in waterbirths?

          And good lord, “research.” I sat in a hospital and watched via ultrasound as my baby practiced breathing in utero. They’re not mummies in there; they expand their lungs and swallow and open their mouths and eyes. What in the world sort of “research” have you been doing that says the opposite?

        • different guest

          Why are you deleting all the comments Lucy? Don’t you like the answers? When are you going to tell us about the diving reflex?

    • lawyer jane

      It also looks like she kept that baby wrapped in a wet blanket in the tub for a long time. That can’t be good for temp regulation! A mother of three with a history of PPH and a clotting disorder who insists on a home waterbirth probably can’t be reasoned with — her assessments of risks and benefits is FAR different from any readers here; or she has a completely different frame of reference (e.g., God will decide, so it doesn’t matter where I birth.)

      • Lucy Eades

        HI! THAT IS MY VIDEO. LET ME SET YOU STRAIGH NOT SO SMARTY PANTS!!! The baby was breathing immediately. Babies don’t always cry and just because they aren’t it doesn’t mean they aren’t breathing!! My MW asked me to hand baby over so they could monitor her breathing beneath the placenta. The MW who was counting her reps (a different MW) is training and this was like her 3rd or 4th birth so my MW wanted to count herself. There is no reason why I can not hold the baby. We all know this. Secondly, the footage cut away for nudity reasons. That’s it. She never said get out of the tub. Thank you though. The doula was in the water to ensure I got my waterbirth bc my husband didn’t want to get in. Nothing wrong with either. This was the plan from the get go before labor started.

        My history of PPH was caused by the Dr I used my first time around. It was preventable but my Dr yanked on my placenta, blah blah blah. It wasn’t a normal series of events that caused my PPH with my 1st. Thank you though. Babies temp was taken and was against me. It’s all very normal actions and was monitored. Skin to Skin is the best!

        • Bombshellrisa

          I assume you are talking about active third stage management with cord traction when you say the doctor “yanked your placenta”. Cord traction reduces the incidence of postpartum hemorrhage http://www.sciencedirect.com/science/article/pii/S0002937897702667

          • Mishimoo

            I had cord traction with my second, it was mildly uncomfortable but hey, it works.

          • Bombshellrisa

            I had cord traction with my second too!

          • Mishimoo

            Did you also have a crappy placenta? Mine was crunchy (had calcifications), apparently. My little sister wanted to know what it felt like, so one of the CNMs asked my permission and then gave her some gloves and explained what they were looking/feeling for.

          • Bombshellrisa

            They didn’t say-but I am wondering. I know I didn’t with my first, but no cord traction then either.

          • Mishimoo

            Same! My uterus was also pretty tired after the second – I had augmentation, as well as fundal massage + IM pitocin, so there’s that too. Didn’t need cord traction with the third, but did have augmentation, IM pitocin and fundal massage due to a tired uterus, manual anterior lip reduction, and mild shoulder dystocia. No PPH, but considering my low iron and B12, I was just lucky.

          • Lucy Eades

            No it doesn’t and here’s one of SEVERAL studies that says just that: In high-resource settings, the practice of controlled cord traction for the management of placenta expulsion is not associated with a decreased incidence of postpartum hemorrhage, according to the results of a study conducted in France.1 – See more at: http://www.obgyn.net/articles/does-controlled-cord-traction-reduce-postpartum-blood-loss#sthash.zVVqtU97.dpuf

        • Stacy48918

          Wait, wait, wait. Holy contradiction Batman.

          So the OB caused your PPH? Yet you consulted a CPM, CNM, OB, and some kind of anticardiolipin IgM specialist? And took aspirin?

          So which is it? If your PPH is solely the fault of your OB, why did you bother with all the rest? Either your OB caused it or you don’t trust your body to know how to birth a baby without you bleeding out and you see specialists.

    • Sara

      Dad says “she’s starting to look nice and pink now” at about 11 minutes. Then at 14:40 minutes mom says “Is that what was wrong, you needed to burp?” It seems like everyone is recognizing a problem but no one is responding to it… at all. This is scary.

      • Lucy Eades

        HI! THAT IS MY VIDEO. LET ME SET YOU STRAIGH NOT SO SMARTY PANTS!!! The baby was breathing immediately. Babies don’t always cry and just because they aren’t it doesn’t mean they aren’t breathing!! My MW asked me to hand baby over so they could monitor her breathing beneath the placenta. The MW who was counting her reps (a different MW) is training and this was like her 3rd or 4th birth so my MW wanted to count herself. There is no reason why I can not hold the baby. We all know this. Secondly, the footage cut away for nudity reasons. That’s it. She never said get out of the tub. Thank you though. The doula was in the water to ensure I got my waterbirth bc my husband didn’t want to get in. Nothing wrong with either. This was the plan from the get go before labor started.

        There wasn’t a problem like how you are trying to manipulate it out to be. She was squirming and needed to burp. Babies get pinker as time passes. We had discussed prior to birth how quickly my babies drop and come out and sometimes in that process they get bruised. So there was talk about whether this one would too or what. As she got pinker we realized she wasn’t bruised like how her older sister was during the first 24 hours. I had kept checking my self and I couldn’t feel her head till the very end.

    • Lucy Eades

      HI! THAT IS MY VIDEO. LET ME SET YOU STRAIGHT NOT SO SMARTY PANTS!!!

      The baby was breathing immediately. Babies don’t always cry and just because they aren’t it doesn’t mean they aren’t breathing!! My MW asked me to hand baby over so they could monitor her breathing beneath the placenta. The MW who was counting her reps (a different MW) is training and this was like her 3rd or 4th birth so my MW wanted to count herself. There is no reason why I can not hold the baby. We all know this. Secondly, the footage cut away for nudity reasons. That’s it. She never said get out of the tub. Thank you though. The doula was in the water to ensure I got my waterbirth bc my husband didn’t want to get in. Nothing wrong with either. This was the plan from the get go before labor started.

      • Bombshellrisa

        How would having someone in the tub ensure you a water birth?

        • Mishimoo

          Well, they hold you there until you’re done… /snark

          • Bombshellrisa

            Guess everyone got wise to the taking away cell phones and blocking cars in tricks.

        • Lucy Eades

          Because of my baby’s position the squatting position was what was most comfortable and getting her to come down & out. I’m also accustomed to a birthing chair (they are amazing) and I couldn’t find a comfortable position that would mimic that. We talked about putting a water proof chair in except the birth pool I was using is inflated and the chair risked the possibility of puncturing the pool floor. The pool is rather large and can be difficult depending on the circumstances, when someone is trying to reach your lower back or support you & we already knew this having used this style of pool before. Prior to labor starting we talked about having physical support in the pool except my husband didn’t want to get in & my doula & I were comfortable with her getting in if needed. When it was needed she got in. She squatted and mimicked the same position of the chair so I had the ability to feel like I was on the chair that I had previously used out of the water. Soon as I found that position it was almost instantly that baby came down and started pushing her way through. That’s why most women find comfort in sitting on the toilet during labor and/or the pushing phase. It’s a very beneficial position in or out of the water.

      • Mishimoo

        Thank you for proving a point by spamming this thread. You see, dissenting opinions on this site are not deleted. They’re left to stand up to argument from others instead of being censored in order to maintain readers’ ignorance, as is frequently done on NCB sites.

        • Lucy Eades

          I didn’t spam, I replied back. Y’all are debating & speculating about things that aren’t even true. Productive though. Yes I am a homebirther. I love midwives. blah blah blah but I don’t condemn those who chose otherwise. I think that every mom should be where she feels safe whether that’s an ob/hospital birth, MW/hospital birth, MW/birth center birth or MW home birth. I think a lot of these commenters are bitter and immature for whatever the reason.

          • Mishimoo

            So, copy/pasting the same chunk of text at the top of most of your replies isn’t spamming? Huh, how about that.

          • Lucy Eades

            They are with trained healthcare professionals. One of which wouldn’t take on a client that is considered too risky.

            I added to the text when needed.

          • Mishimoo

            Stick around, read more of the site, have a look at the #NotBuriedTwice campaign and then see how you feel about these ‘trained healthcare professionals’.

          • Bombshellrisa

            I still don’t understand why you would need trained healthcare professionals if birth is not a medical event.

          • Lucy Eades

            At what point did I state its not a medical event?

          • Bombshellrisa

            Why would you chose home if it was a medical event?
            My clients always stated that they were fine with homebirth because birth wasn’t a medical event. If it became a medical event, they could call 911 or go to the hospital which was only ever a few minutes away.

          • Stacy48918

            “wouldn’t take on a client that is considered too risky”
            And yet if you truly had PPH with a previous birth, they absolutely took on a risky birth – yours. Or maybe they just don’t know that PPH is still a leading cause of maternal death and having had it once means you’re likely to do so again.

            So your midwives either DO accept risky clients, or they are uneducated. Which is it?

          • MaineJen

            You pasted the same paragraph 11 times. I think that counts as spamming.

  • There were so many unknowns in the MANA data it wouldn’t shock me if there were deaths in that data set due to water birth. So many home birth loss moms opt out of autopsies.

  • Deena Chamlee
  • Anna T

    If the woman’s nether regions are immersed in water while the baby is being born, how can she receive any assistance from the midwife/doctor during the actual delivery? In case it’s needed, you know. How can a midwife look and see if all is going well? Does she put on a mask and dive into the birthing pool? Because if not… how is it different from unassisted birth?

    • Amy M

      The mother would have to get out of the water…which, I imagine, could be quite a project.

      • Anna T

        I think so too, and actually this bothers me even more than the bacteria in water. If a midwife can’t help with the delivery, what is the point of her being there at all?

        • Young CC Prof

          For one of the ladies on my birth club, her job was to hit the alarm when the baby developed shoulder dystocia in the tub. Saved the baby’s life that way, but it could have ended a whole lot less stressfully had there been no tub.

        • Amy M

          I’ve seen some pics and a video or two, where the midwife was reaching into the water, to assist the delivery of the baby, but yeah, aside from that, she wouldn’t be able to do much unless the mother got out. In a hospital water birth, there is a lot of monitoring, AND a lot of staff around, so getting the mother out quickly, as soon as there is a problem detected or suspected, is probably less of an issue than at home.

          • Anna T

            I understand the role a water can play to ease labor pain, I really do. I spent most of my labors in the shower and it was bliss, but… the thing is, I am not a whale (though by the end of a pregnancy I might look like one), and the delivery itself is such a crucial part of labor. Correct me if I’m wrong, but it seems this is precisely when so many things can go wrong very quickly: baby stuck, shoulder dystocia, compressed cord, fetal distress… I want my midwife there. And by “there” I don’t mean just standing beside me, but actively looking to see how I’m doing, if I’m pushing too furiously (a problem with me) for instance, and she also did some maneuver to ease the baby’s shoulders out (it was not dystocia, but she still did something). How can it all be done in water? For that matter, how can EFM be done in water? Can the equipment be waterproof?

          • Amazed

            If you imagined that you were the whale you thought you looked like, it would have become true. You would have had a whale’s wisdom on how to give birth while staying in touch with water, so no midwife and certainly NO EFM would have been needed. It’s all in your mind!

          • Amy M

            I’m not arguing with you—I think hospitals are fine with women laboring in water, pool if available, or shower, but like you say, actually giving birth in the water is whole different story.

        • Therese

          Well, she still can help, it would just delay things a bit. I’ve heard water birth stories where the baby gets stuck…they always get mom out of the tub eventually.

  • attitude devant

    Critiquing these folk is like shooting fish in a barrel. Thanks for another great piece.

  • Trixie

    This graphic was especially hilarious.

  • Beth S

    So this website pushes water births and other dangerous birthing practices, yet still claims that they use evidence based science for their conclusions?
    This website just proves what Dr. Amy has been saying all along, the NCB diehards are indeed wrapped up in cult groupthink. If the “science” matches their conclusions they celebrate it, however if you go against the grain and question you’re ostracized from the group. In other words you’re meeen and trying to harsh the mother’s mellow and want all women strapped to a bed for a C-section.

  • Jessica S.

    I discovered EBB by way of a Wikipedia citation – scary, I know. I was looking up info on macrosomia and the article had (sadly, still has) that contemptuous undertone when discussing suspected LGA babies and c-sections. I thought some of the claims sounded fishy, and when I followed their sources, I found myself on the EBB site. I can’t recall which other articles I discovered that use her site as a resource, but it was disheartening to see her legitimizing that way. Here’s the passage where EBB (5) is used as a reference:

    “It’s important to note that LGA and macrosomia cannot be diagnosed until after birth, as it is impossible to accurately estimate the size and weight of a child in the womb.[5] Babies that are large for gestational age throughout the pregnancy may be suspected because of an ultrasound, but fetal weight estimations in pregnancy are quite imprecise.[5] For non-diabetic women, ultrasounds and care providers are equally inaccurate at predicting whether or not a baby will be big. If an ultrasound or a care provider predicts a big baby, they will be wrong half the time.[5]
    Although big babies are only born to 1 out of 10 women, the 2013 Listening to Mothers Survey[6] found that 1 out of 3 American women were told that their babies were too big. In the end, the average birth weight of these suspected “big babies” was only 7 pounds 13 ounces (3,500 g).[6] In the end, care provider concerns about a suspected big baby were the 4th most common reason for an induction (16% of all inductions), and the 5th most common reason for a C-section (9% of all C-sections). Unfortunately, this treatment is not based on current best evidence.[5]”

    Now, I’m not saying this is out and out incorrect, but the Wikipedia article barely addresses the risks associated with birthing a large baby, but instead addresses why doctors are wrong at least half the time, leading to the dreaded unesscaesarean. Bottom line, I hardly feel that EBB should be used as a Wikipedia reference, but maybe I’m wrong.

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

    • The Bofa, Being of the Sofa

      Of course, it’s completely deceptive.

      Doctors know darn well that there are uncertainties associated with size estimates. Moreover, they also know the extent of the uncertainty. Yes, the estimates will be high half the time. But high how high is the question?

      If the weight is still within a half a pound, it really doesn’t change anything. The baby is still relatively large.

      And they are just as likely to be exceptionally low.

      • Amy M

        Also, it leads people away from thinking about the times the doctors might have MISSED a large baby, at least until the birth is going sideways and emergency C section is in order, or the woman gets torn from here to Tuesday. Pretty sure that’s why the doctors are going to err on the side of caution and recommend inducing before baby gets TOO large (even if its just a suspicion) or even just a C section, depending on the situation.

        I guess they still equate induction with Csection, because it is seen as almost as bad. Which is one of the stupidest things ever.

        • Young CC Prof

          But inductions cause c-sections. (except they don’t.)

      • Jessica S.

        People who criticize fetal weight estimates seem to forget that the actual margin of error – like, the percentage – doesn’t change, it just tends to look more drastic when delivery time comes, b/c you’re dealing with a larger number to begin with.

        I wondered something the other day about estimating fetal weight. I’ve had three US since mid-May (around 30wks), spaced out enough to track growth. I don’t know anything about obstetrical sonography, but I got to thinking about women who have the stories of being told they needed a CS b/c of a suspected large baby only to have a very average sized baby (within the margin of error, usually, but let’s say the estimated weight wasn’t high enough to allow for an overestimation to still snag a large for gestational age baby). I wonder in some of those cases if the suspicion was based on one ultrasound at the end, with no recent scans to rule out an obvious anomaly. I don’t know if that makes sense. Basically, I’m curious if the estimates of fetal weight are usually closer to actual birth weight when they have enough to chart a pattern, so to speak, as opposed to one single scan done around or after the due date, the last scan being the level 2 at 18-20 wks or something. It’s probably not worth pondering, but in my scenario, I suspect they will be pretty accurate, since they can see a stable and symmetrical growth. (My guess is 12 pounds. We’ll know for sure this Thursday!)

        • Young CC Prof

          I had growth scans at 32, 34 and 36 weeks, and his birth weight at 37 was just a couple ounces bigger than his last scan a week before. He probably didn’t grow much that last week, so I’d say my scan was dead-on accurate.

          But, there were three scans. Specifically looking for size. By an ultrasound technician followed by the MFM picking up the wand to have a look for himself. Operator error or “fluke” was pretty much ruled out.

          Also, as I understand it, the weight isn’t the most important thing when it comes to delivery. What matters is the head circumference and the abdominal circumference, and those should be more reliable. (I may be wrong about this, I’m just speculating.)

          • KarenJJ

            My average weight babies had head circumferences at the 90th percentile. No wonder they never engaged…

          • Cobalt

            Yeah, not weight, but diameter of the bony bits. My lightest baby was my longest and hardest delivery because of his enormous head. Looked like a backwards unicorn at birth.

          • Jessica S.

            You’re right, the AC and HC are important, esp the AC when looking at macrosomia. Of course, that’s if I understood a lot of the technical info I found when researching this. It was difficult (thanks to sites like EBB) to find accurate info on macrosomia. There’s the typical sites like Mayo and whatever that are okay, but sometimes their info can be lacking. Not incorrect, just shallow. If that makes sense.

        • Amy M

          I had a lot of scans, because the OB was on the watch for TTTS, so the growth of my twins was tracked pretty well, as a result. As I mentioned above, they estimated their weights pretty close (off by 1/2 lb for one), a few days before they were born.

          Good luck with your (giant) baby! My two together weighed 9.5lbs. (But my husband and I are pretty shrimpy people.)

    • Captain Obvious

      Sorry for posting this again.
      “Your body won’t produce a baby that is too big for you to deliver”

      From Evidence based Birth…
      ” If diabetic women were offered an elective C-section for every baby that is suspected of weighing more than 8 pounds 13 ounces, it would take 489 unnecessary surgeries to prevent one case of permanent nerve damage. This would cost $930,000 per injury avoided. If diabetic women had an elective C-section when their babies were suspected of being 9 pounds 15 ounces or greater, it would take 443 unnecessary surgeries to prevent one case of permanent nerve injury, at a cost of $880,000 per injury avoided.”

      But as you can see, it only takes one lawsuit to justify the cost of all those preventative cesareans. $33,351,934 reasons why a doctor might consider offering an elective cesarean. These are only one year’s OBG Management Medical Verdict worthy cases. There are more that are just not published, this is not just a rare event parents and babies have do worry about.

      1) WHEN SHOULDER DYSTOCIA WAS ENCOUNTERED
      VERDICT A $5.5 million Iowa verdict was returned.

      2) ERB’S PALSY AFTER SHOULDER DYSTOCIA
      VERDICT A $1.34 million New Jersey verdict was returned.

      3) FORCEPS DELIVERY INJURES MOTHER’S PELVIC FLOOR
      VERDICT A $1,716,469 Illinois verdict was returned, which included $484,000 to the patient’s husband for loss of consortium.

      4) LARGE BABY WITH CERVICAL SPINE INJURY
      VERDICT A confidential Texas settlement was reached.

      5) DID OB’S ERRORS CAUSE THIS CHILD’S INJURIES?
      VERDICT A $1,314,600 Iowa verdict was returned.

      6) 12 LB, 7 OZ BABY, BRACHIAL PLEXUS INJURY
      VERDICT A $1,174,365 Ohio verdict was returned.

      7) EXCESSIVE TRACTION BLAMED FOR NERVE INJURY
      VERDICT An Illinois defense verdict was returned.

      8) BRACHIAL PLEXUS INJURY AFTER SHOULDER DYSTOCIA
      VERDICT A $72,500 Texas settlement was reached.

      9) ZAVANELLI MANEUVER; BRACHIAL PLEXUS INJURY
      VERDICT A Georgia defense verdict was returned.

      10) Pelvic injury from the McRoberts maneuver?
      VERDICT A $5.5 million New York verdict was returned.

      11) 1. Severe birth asphyxia: cerebral palsy and seizures
      Verdict: The insurance company ultimately paid $10.15 million.

      12) 4. Shoulder dystocia, uterine tachysystole complicate vaginal delivery
      VERDICT A $3.55 million Idaho verdict was returned.

      13) CHILD’S ARM PARALYZED DESPITE MOTHER’S EXPRESSED CONCERN
      VERDICT A $1.6 million Ohio verdict was returned against the ObGyn group.

      14) MIDWIFE “PULLED TOO HARD”; CHILD INJURED
      VERDICT A $950,000 North Carolina verdict was returned.

      • Amy M

        If you shared this evidence with Ms. Dekker, would she just delete it?

      • PrimaryCareDoc

        Excellent work. Even without looking at the lawsuits- the medical costs of an Erb’s palsy- possible surgeries, braces, therapy- along with the lost productivity from a parent who might need to leave the workforce or cutback to care for a child along with the lifetime disability of the child…$930,000 is a bargain.

        • Daleth

          Not to mention, permanent nerve damage is only one of the many things that could go wrong in a VB and be prevented by a CS. I’d be interested to know what the numbers are–how many CS would be needed to prevent one case of ANY of these problems, and the cost–if you included not just nerve damage but also hypoxia, death, etc.

          • Jessica S.

            I’d like to know that, too. Not to mention the damage to mom’s precious parts. That’s pretty important in my book! 🙂

          • Daleth

            Mine too! When I googled “fourth-degree tear” I was like omg, c-section, stat!

      • Jessica S.

        This is good information. There are really risks with big babies, bigger risks than the manufactured “risks” of CS the NCB crowd crows about. A scheduled CS is far less risky than waiting around for a baby to get stuck and THEN have to go to a CS. I wonder if that’s why these anti-CS folks are so worked up over the “risks”: b/c they are surrounded by and will themselves tend to be women who will push (figuratively and literally!) to the very last second before conceding defeat, even though they’ve been passing the “road closed ahead” “bridge out ahead” “stop here or you will all die” signs for hours. So yeah, when you have a baby stuck in the birth canal or similar nightmare, and your body is all worked over from hours of labor, the risks are WAY higher.

        This is why we listen to the trained professionals. Seriously.

        • Captain Obvious

          How many times do I read crunchy blogs tell women that all you have to do is bring in ACOG criteria that states ACOG doesn’t recommend delivery for big babies. Or women saying ACOG doesn’t care about big babies unless they are over 12 pounds. Where do they get that? ACOG clearly states that delivery may be considered for diabetic woman with babies over 4500g (9.92 pounds) or for non-diabetic women with babies over 5000g (11.02 pounds). And expert opinion suggests to watch out for AC > HC babies over 4000g (8.82 pounds).

          • Jessica S.

            Exactly! Which is why the OB was relieved and quite secure in our decision to do a RCS with this big girl. She said the risks for a VBAC were too numerous with a baby estimating 10lbs at 37wks, and she very clearly stated that was even WITH the consideration that the US was an overestimation. Those NCB fanatics stop reading once they’ve found the partial wording that works for them.

    • Anj Fabian

      I would ask Ms. Dekker what the correlation between confirmed (not suspected) macrosomia and birth injury from shoulder dystocia.

      It turns out that when it comes to injury from shoulder dystocia, macrosomia has a higher correlation compared to SD without macrosomia. So a big baby won’t always have SD, but when it does, it is far more likely to be injured by it.

    • Rabbit

      And I swear it is verboten to mention on those sites that the margin of error goes both ways. The day before my oldest son was born, the doctor estimated his weight by ultrasound at 8 – 8 1/2 pounds. He was 9 pounds 14 ounces. A few days before my second was born, the estimate by ultrasound was 8 pounds. He was 9 pounds, 5 ounces. But if I dare mention that anecdote on a pregnancy board, I’m scare mongering.

      • Beth S

        Yeah they told me my baby girl was going to be a 7 pounder which was good for me because my last two had been barely five pounds, she turned out to be a healthy and husky 9 pounds.

        • Jessica S.

          That is a good size, for sure! Was that a trip, having a newborn that was four pounds heavier than the others? I’d be worried of break them! 🙂

          • Beth S

            It’s a trip that’s for sure. With my eldest daughter I was a little afraid I would break her before she could go with her parents, with my middle daughter I would panic every time she would lose an ounce especially considering she was so small premie clothes were too big on her. I remember when I found out I was having another girl, I was so excited to be able to repurpose all the clothes ODD used to wear, only to realize the baby is too big for those clothes already.

          • Jessica S.

            Yeah, I intentionally avoided the newborn sizes, b/c my son was 10lb 10oz at birth. But considering they estimated this little girl (she’s being ousted this Thursday!) at 10lbs two weeks ago (my back can testify to this!), I’m starting to look at some of the 3 month stuff with a little chuckle. I just don’t know what to expect! 🙂 My son simply looked like he was already a month old. I guess she’ll be similar! What a trip.

      • Jessica S.

        Ugh, I hope that they overestimated the size of our little girl, joining us via RCS this Thursday – two weeks ago, the estimate was 10 pounds. Seriously. At 37 weeks. (My official due date is this Saturday.) But I’ve had three growth check US since the beginning of my third trimester, and together they show a steady, symmetrical growth – I’m guessing it’s probably pretty accurate. The big question is just how much she’ll have gained between 6/30 and this Thursday!

      • MS

        When my daughter was estimated to be an alarming 2lbs at 31 weeks, my friend’s criminally-idiotic “Bradley Birth” instructor “assured” me that ultrasounds are routinely inaccurate by 2lbs (her advice was unsolicited and very unwelcome, I might add). She completely missed that the estimate could be wrong in both directions, so by her thoroughly unscientific guesstimate, my daughter could have weighed nothing. At 33 weeks she was estimated to weigh 2lbs 1oz, but her birth weight, two days later, was 2lbs 7oz. (She now weighs over 18lbs, so she’s got the growing and gaining weight thing down!)

        Mistrusting ultrasounds like that is the hallmark of an idiot, IMHO. My parents lost a child to birth defects, and while an u/s wouldn’t have saved him, it would have prevented them from being stunned by it at his birth. Trust me, they expressed how amazing ultrasounds are every time I had one. It saved my daughters life.

        Plus, u/s do more than estimate weight. My perinatalogist could measure the blood pressure through the umbilical cord (if I’m not mistaken, some details are a bit fuzzy now). You would *think* that a cardiology nurse would know how to appreciate the power of imaging technology like that. Huh. Guess not.

        • Young CC Prof

          At the 20-week anatomy scan, babies usually weigh one pound. Assuming a 2-pound margin of error, this would mean many 20-week fetuses do not exist and ultrasound technicians cannot reliably distinguish between mid pregnancy and no pregnancy.

          • MS

            YES! Thank you! The logical gymnastics you have to do to believe some of this crap is mind boggling. My SIL is a radiologist and had her own high-risk pregnancy, so on top of a team of very good doctors, I had her, and immediately knew that woman was full of it. Granted, the ultrasound at my OB’s regular office was not as accurate or as capable as at the perinatologist’s, but trust me, everyone was taking everything very seriously. Except for the BB instructor. She thought I should transfer my care to a midwife (again, unsolicited advice).

            Dismissing monitoring and imaging technology is the equivalent of stuffing your fingers in your ears and humming. If you refuse to detect a problem, it will not exist.

            And I know you had your own IUGR pregnancy, and I hope everything is well with you and yours.

          • Amy M

            What did she say after your baby was born?

          • Amazed

            She would have lived at home, too!

            Amiright?

          • Jessica S.

            Probably cricket noises. 🙂

          • Young CC Prof

            My mini-man is great. Kind of large now, actually, 70th percentile height, and extremely active.

          • Jessica S.

            That’s another good point, that it depends where you’re getting the US, too. Mine were always done by specialists, not my doctor.

          • Amy M

            I think I heard/read somewhere that size estimates on u/s are most accurate between 7 and 20-something weeks (some point in the 3rd trimester), after which you start getting the 1-2lb margin of error. Common sense says that it can’t be off by 2lbs at mid-pregnancy, when the baby weighs only about 2lbs anyway.

            Even with my twins, at 35wk and change, they estimated one spot on, and the other 1/2 lb off (he was smaller than they thought). Twins are especially difficult because its hard to tell whose leg you are looking at, and so on, by the end. Maybe the u/s tech was very skilled. Maybe they were basing their estimates on the measurements PLUS their knowledge of the average size of 35wk twins, and my size.

            You know what’s true? There’s only been what, 4 babies born (recorded anyway) that were over 14lbs? Some insanely low number. And if your baby is getting into the 14lb range? Someone is going to notice that it is large.

          • Jessica S.

            I think that after 20 wks, there is a greater variation between individual fetuses. Up until that point, I think they follow a more predictable growth in comparison to all fetuses, if that makes sense.

            The actual poundage over/under gets larger as the baby gets larger, so while it may appear “less accurate”, it isn’t necessarily, in the sense that the percent they may be off doesn’t change. (This is all knowledge I’ve picked up from my conversations with my doctors and the US techs, plus stuff I’ve read online, etc – it’s not actual expertise – so it’s not worth much!) I guess in a way, that is less accurate, though! Ha!

            But I suspect if you have a few US later in the third trimester, you can get a better sense of a growth pattern, as opposed to one at the very end with the only nearest comparison at 18-20wks or something. Again, I’m no expert so that may be wrong.

          • D.D.

            Shroedinger baby: the act of measuring the baby with an ultrasound determines it existence.
            Because Quantum.
            Duh.

      • KT

        Somewhat OT but related to this thread: is there any way to get an even remotely good weight estimate without an ultrasound? My OB doesn’t do ultrasounds in third trimester standard, but I’m carrying huge this time around (could easily, I realize, be just a function of the way the baby is positioned and my short pelvis) and am curious since weight will impact my chances of a successful VBAC and therefore might change my decision on when to schedule my back-up c-section.

        • Jessica S.

          The US with my son were almost dead on. We had one about a week before he arrived (via CS due to stalled labor) and it was a little under a pound less than his birth weight. I imagine they’ll be just as accurate with this one, I’ll have to report back on Thursday! 😉

          If done correctly, by skilled technicians, they’re accurate with 20% +/-. So the actual amount that they’re off will be larger at the end, simply b/c the baby is large. It depends on the estimate, I guess. If it’s a large estimate any way you slice it, like the not-so little one I’m carrying (EFW was 10 lbs at 37 wks, consistent growth with earlier third trimester scans), then even a 20% overestimate could account for a 10 lb baby at birth. (*sigh* I really thought I did better this time, not gaining as much weight. And I don’t even have gest. diabetes! But I guess some people just make big babies!)

        • Jessica S.

          A follow-up note – I realize you were probably looking for a more expert answer than I gave. Hopefully someone else could weight in.

          Have you asked her if you can get one, even if it’s not going to change her decision, it might change yours. I think that’s a very valid reason for a third trimester growth check, to determine whether you want to try for a VBAC. It was never a question with my doctor or the OBs at the hospital whether they’d want an US to consult – esp since my first was big, too. I’m having a RCS, my chances were under 50% even without factoring in her weight.

  • Sullivan ThePoop

    That last bit is just the quack miranda warning

  • Captain Obvious

    Some of the benefits of waterbirth, less episiotomy, epidural use, vacuum use, forceps use, etc, could equally be attributed to birthing in a car on the way to the hospital. With no increase risk for cord avulsing or drowning. So is delivering in a car better than waterbirth? It’s just my opinion.

    • lilin

      Support Car Birth!

      • An Actual Attorney

        A great-aunt gave birth in a cab about 70 years ago. I recall her saying for years she didn’t tell her son, because she was afraid he would think she didn’t care enough to make it to the hospital. When she died, he found that she had kept the cancelled check that they had given to the cabbie to buy new seats.

        • Smoochagator

          That’s sweet, that they kept the check, like a memento. And that she was worried her son would feel upset about how he was born, as if she did it on purpose… because women totes want to give birth in public places with strangers in attendance!

      • Young CC Prof

        Taxi drivers not lay midwives!

        • anion

          Taxi drivers would probably be better in some cases, because at least they wouldn’t sit there knitting and insisting everyone should “trust birth” while the baby dies.

          • Young CC Prof

            There are so many reasons taxi drivers are better than lay midwives, let’s see how many I can remember.

            1) They know how to get to the hospital, and their vehicles are reliable.

            2) They cost less.

            3) As per Gruenbaum, they are apparently just as good at delivering babies.

            4) They really don’t want to deliver the baby, and will drive fast to avoid it.

          • AmyP

            5) They’ll take you to the closest hospital.

          • stenvenywrites

            Even more important, when you tell them to take you to a hospital, they freaking DO it, and don’t argue with you about whether that’s really what you want.

      • Beth S

        Support Ambulance birth! Instead of midwives go with EMTs who maybe deliver one or two babies their entire careers. And when they need an extra hand haul in the stepfather of the woman giving birth just to add that little extra bit of trauma!

        • lilin

          Ambulance birth is part of the Medical Pharmaceutical Industry! It corrupts the experience of childbirth and takes away an empowered woman’s ability to make decisions by pushing for a cascade of interventions.

          Reject Big Pharma! Stay natural! Labor the way women have labored for thousands of years! Trust Car Birth, not ambulance birth!

      • Liz Leyden

        My husband doesn’t drive. When I was pregnant, I had to prepare for the possibility of talking my husband and a cabbie through assisting in delivery. Fortunately, that didn’t happen, but the cabbie who drove us to the hospital after my water broke was very nervous.