Does the University of Illinois Hospital know about its midwives’ Facebook page?

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Hmm. I wonder if the folks at the University of Illinois Hospital know that their midwives maintain their own Facebook page? Based on what’s on it, I suspect they don’t.

Here’s a screencap of a new post about me:

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Here are the best quotes.

First comes the obligatory misrepresentation of my views:

It has come to our attention that there is this person who goes by the name of “Dr Amy, The Skeptical OB”. What she spews on her page is a lot of negativity and hatred towards the normal birth process. In her opinion, why in the world would anyone want an unmedicated birth? …

Then the ostentatious sadness for me:

I feel sorry for Dr. Amy and her former patients that she pushed her biases on. She will never truly know and never get it.

Of course, no post advocating unmedicated childbirth would be complete without a “non-judgmental” jab at the “anxious and fearful” women who want an epidural.

Midwives believe we should “Listen To Women” and we do. If you want a natural, unmedicated birth, “we will do everything in our power to help you achieve that”. If you are very anxious and fearful of labor and want a labor epidural, “we will do everything in our power to help you achieve that”. (You may be surprised to find out that our epidural rate is 69.6%.) …

The obligatory accusations without any attempt to actually rebut what I write:

The last thing we want is for you to experience PTSD from your birth memories.

So Dr. Amy, you are no better than the homebirth midwives you complain about. You are on the far, far right of the birth spectrum of those on the left that you ridicule. As Certified Nurse Midwives, we are everything in between.

And the coup de grace of any obnoxious natural parenting post:

Peace.

Anyone who knows me knows that I value any opportunity to publicly debate the claims of natural childbirth advocates. So, U of I Hospital Midwives, do you have any specific claims of mine that you are capable of rebutting?

Let me guess, you don’t want to debate because you’d be eviscerated; you’d rather whine on Facebook. I wonder if the administration of the hospital and the Department of Obstetrics will be proud … or just embarrassed. I’m going to guess they’ll be embarrassed.

  • Ash

    The FB page is still up, unmodified. The UIC Media Relations team are idiots for letting this page remain (especially when some SkOb did forward complaints to Patient Relations)

    • moto_librarian

      Well, well, well…The page was down for a period of at least a week (right after I posted the complaint to UI Hospital). I’ll be keeping an eye on it from now on, and I won’t hesitate to report them again.

  • Ducky7

    Wow, so unprofessional. It’s too easy to see things in binary black-white. Even so, I find very little of what Amy writes to be incompatible with the viewpoint of a CNM. I guess you have to get past the bluster, and people are better at making snap judgments rather than actually reading…

  • melindasue22

    Totally OT but if you had a patient that was 36w2d with protein in urine headaches and bp hitting 150s/90s for four weeks would you induce? A FB acquaintance is going through this now. She is constantly at the hospital and getting blood checks and NSTs and works full time. But quess how long they want her to wait…… 39 weeks of course. If that was me I’d tell them to shove it and induce me at 37 weeks.

    • Karen in SC

      Can she get a second opinion? Or she could call the head of OB at the hospital and say “I’m not comfortable with the risks of waiting until 39 weeks with high blood pressure etc.” Since she is going to the hospital all the time she could stop by the office.

      • melindasue22

        I will kindly make the suggestion.

        • Karen in SC

          Keep us posted!

          • melindasue22

            Will do. I sent her a message but maybe it was too stalkerish LOL. It looks like she read it but didn’t reply. We casually met in college and have just been on friends on FB since but seeing her message was just concerning me and I couldn’t let it go. I think all is well and BP must be down again since she hasn’t posted anything similar since then. Hopefully it stays that way.

    • Are you nuts

      Well I’m not a doctor but I am 37 weeks pregnant and had BP in the 140/75 range at 35 weeks. Luckily, it turned out to be a fluke as it has been low since then (BP checked twice/week) and my urine protein levels are low, but the doctor said she would induce me at 37 weeks if my blood pressure continued to be high, and/or there was too much protein in my urine. Isn’t that the standard ACOG recommendation?

      • Kate

        That’s what my OB told me the recommendation was. My son was born on the 7th…I was induced at 37+1 after having high blood pressure readings and some protein in my urine, and I wound up developing pre-eclampsia in labor that I am still on some pretty strong meds for.

    • Liz Leyden

      She needs a second opinion, and possibly a stat C-section. I delivered at 35w 2d and developed post-partum pre-eclampsia 10 days later. My bp was in the 170s by the time I was diagnosed.

    • Phascogale

      How much protein in the urine? What sort of headaches – does she usually get them – migraines? What are her bloods like ie LFT’s, uric acid? What were her blood pressures like before these? Were they 140/90? It will be about looking at the big picture. It may not be pre eclampsia at all. There may be kidney issues, it may be essential hypertension which may or may not be related to the pregnancy. Is she unwell? She is still working! Lots of thing to look at before insisting on an induction.

      • melindasue22

        Thanks. I guess that is what I was looking for. Wondering if the would be a good reason for her doctor to feel monitoring was the best approach. I am normally trusting of a doctor’s approach but seeing the 39 weeks made me wonder. There are always many things to consider.

  • LibrarianSarah

    I didn’t realize that childbirth was a left/right issue. So because I comment on this site and agree with Dr. Amy on a lot of issues I am on the “far far right?” Okay then. Better check out what Rush is saying so I can parrot it to all my friends and relatives (please kill me now).

    • MaineJen

      Jesus, I hope not. Let me check…nope, still a bleeding heart. *Phew*

      • LovleAnjel

        I just tried to hug a tree. I didn’t blow up!

    • staceyjw

      Home birth/NCB advocates in the USA are a group that includes both the far left and the far right. The most hardcore of the NCBers seem to be the furthest out in their political ideology too. Where I live its the far far left, think extreme hippies, but in the last town, it was the far far right, think Quiverfull/Chrisitian patriarchy.
      When those polarized groups agree on something, there will be trouble. You see this with anti vaxx and CAM as well.

      Those pushing for regulations and safety come from all sides, though I am curious how many libertarians there are, as they are heavily anti regulation. No matter, politics is irrelevant here. I am a liberal-pinko-socialist-atheist, but it is not important to my opinions of birth.

      • Young CC Prof

        I sincerely hope that preventable perinatal deaths due to incompetent care is something people of all political persuasions agree is bad, though they might reasonably disagree on the best ways to stop it.

        • The Bofa, Being of the Sofa

          I sincerely hope that preventable perinatal deaths due to incompetent care is something people of all political persuasions agree is bad

          But in a libertarian POV, that is just the cost of doing business with appropriate freedom.

          Which is why I can’t stand the libertarian POV.

  • The Computer Ate My Nym

    Clicked on the link to their facebook page and all I can say is, “My, they’re anxious for business, aren’t they?”

  • renee

    Hope someone sent this on to the head of OB over there. The page is full of whack a doodle shit and condescension for anyone but NCBers. It ought to be stopped, I cannot imagine if this is OK with the hospital. I would email screen caps to all the people in charge over there.

    If I didn’t know a few excellent CNMs, and know that some great ones are still in school (like a friend who is brilliant, and will be awesome!), I would write off all of MWery. I know I am THRILLED I never have to go to any MW and I feel bad for those stuck with them without choices. Yuck. No, thanks.

    Yeah, yeah, I know, they aren’t all like that. But the ones that are awesome are also the ones not enamored with the “midwifery model” that is so focused on NCB. They are like OBs with different schooling. I am sure the NCBers love their MWs, and that is fine, but I just can’t see any need for one when you can have an OB. The focus on PIAN, I mean, NCB, is just so inappropriate, anti woman, and downright gross. These MWs show this attitude in spades!!!

    • auntbea

      The page was down, but is now back up. Post about Amy is gone, but everything else is still up. Not sure whether they have already been in negotiation with the powers that be, or whether they have self-censored in hopes of avoiding being shut down.

      • staceyjw

        We should write every few days until they quit spreading their BS.

        • auntbea

          Someone on a FB thread pointed out that this unit is the university’s cash cow. They are bringing in crunchy maternity patients who might otherwise go to birth centers or whatnot, so they have an incentive not to censor them too much.

          • The Bofa, Being of the Sofa

            Someone on a FB thread pointed out that this unit is the university’s cash cow.

            “The Business of Being Born,” right?

          • Elizabeth A

            But almost everything they said in that movie was wrong.

          • The Bofa, Being of the Sofa

            Yeah, because they didn’t say things like, “Birth Centers staffed by midwives are good ways to get money from those patients that we scare away from hospitals with the other crap we say in this movie.”

          • Elizabeth A

            L&D units are typically considered a marketing tool for hospitals, but they aren’t cash cows by a long shot. They’re valuable because they bring in business down the road, but they cost a bomb. Between liability insurance, and negotiated rates with insurance companies, plenty of hospitals have gotten out of OB because it’s too expensive.

      • Guest

        I am not seeing the post Reality Cheque linked to downthread, promoting their ideals with biased risks and benefits. Maybe I am just missing it or maybe they realized the error in their bias?

        • auntbea

          Still there.

          • Guest

            Of course it is. I see it now. Thanks.

    • moto_librarian

      I messaged the University of Illinois Hospital’s main FB page and suggested they take a look at what their midwives were communicating. Most universities have strict policies regarding social media, and I would be stunned if U of I found this to be acceptable.

  • Anj Fabian

    Off topic, but this surfaced recently. Homebirth from 2002, possible GBS sepsis.
    http://thinkingmomsrevolution.com/when-intuition-fails/

    This sounds familiar – but I don’t know if it’s been covered before. It does sound very familiar – the baby died of a Strep A infection contracted in utero. The mother concludes nothing could have been done….

    • Young CC Prof

      Yes, because the real mistake was made long before the baby died. Her vaunted maternal instincts told her something was wrong, her provider squashed them.

    • PrimaryCareDoc

      Ah, the thinking mom’s revolution.

      A misnomer if there ever was one.

    • Ash

      Definitely has been covered before–I recognize certain phrases of that article in a past post.

    • yugaya

      Would prenatal care with an OB have given this baby a chance and would the signs of the infection have been picked up had she gone to the hospital to have it checked instead of calling her midwife who believes antibiotics are overused? The ‘incident’ she describes happened two days before her due date, for five days after that the baby was ravaged by infection, she was strep B positive to begin with – would an induction not have been the safest option?

      • Young CC Prof

        If a woman at term, strep B positive, calls her OB and says, “I think maybe my water broke,” the OB will tell her to get checked promptly. And if the water is leaking even a little, induction + antibiotics = baby is fine.

        The mother’s critical error was in choosing a provider who chose to be hands-off to the point of defying all reasonable guidelines.

      • Maria

        I noticed a picture of a water birth. I wonder if she actually labored and/or birthed in the water would that have exacerbated Strep A.

  • lilin

    “If you are very anxious and fearful of labor and want a labor epidural, “we will do everything in our power to help you achieve that”.

    Wow. What’s amazing is, they don’t even hear it. The condescension is so ground down deep in the bone that they don’t know how to think without it. They just feel so sorry for those lesser people.

    I don’t generally follow Lena Dunham – she’s a different generation, but she has one quote that I actually wrote down because it applies so often: “It’s way cooler when people do things out of pure, blind spite than out of faux altruism.”

    • Sue

      ”But if you are empowered and rational, and not scared of needles, we will do everything in our power to help you become scared.”

      There, fixed.

      • lilin

        Yeah. Couple that with, “Did you know that choosing an epidural during birth reveals a deep lack of character?”

    • MaineJen

      And did you catch that jab at the maternal-choice cesarean moms? “Yes, there are actually doctors who will do that!” Oh, I’m so SURE that a mom who walked in wanting a MRCS would be fully supported. Yup.

  • WordSpinner

    So correct me if I’m wrong, but I get the sense that OBGyns are the only health professionals that deal with women’s reproductive health during all stages off life. Yes, they deal with childbirth, but they also diagnose a teenager’s painful periods, do pap smears, deal with uterine prolapse, and perform hymenotomies for women with imperforate or rigid hymens. My gynecologist had to fit in a post-surgery consult with me in between births.

    There are other healthcare workers (CNMs, gynecological RNs and PAs) but I get the sense that they aren’t involved in all that OBs are–it seems like for other healthcare workers, childbirth and normal vagina maintenance are two separate specialties.

    I wonder if this gives OBs a different sense of the importance of childbirth, since that isn’t all they do? Or maybe they have a better sense of some of the future risks of vaginal childbirth. And maybe why a lot of CNMs seem to place premier importance on vaginal birth, since that is the only thing they can be in charge of?

    • Therese

      Nope, CNMs do gynecology too.

    • Guest

      CNMs do provide care across the lifespan and many of us spend much more time treating dysmenorrhea, family planning, infertility, abnormal pap smears, urinary incontinence, menopause management and osteoperosis, as general Well Woman care and health promotion than we do antenatal care or attending births.

      My guess is there are some CNMs particularly drawn just to the obstetrics. For me, providing antenatal and intrapartum care is just one short period of the lifespan. Good outcomes trump the misplaced value of vaginal births.

      • WordSpinner

        Did not know that. I’ll edit.

    • Guest

      There was no need to edit, it’s a common question. Aside from the obvious lack of training and education of CPMs, CNMs provide care for so much more than the childbearing process. Perhaps that is what enables CNMs to view women in their entirety and not just for their reproductive potential. Surprise, surprise, women are so much more than the biologic functions of our vaginas or breasts.

  • guest

    I’m sorry. This is so off topic. But I just came across this article and it sounded so very familiar (C-section) but about a different topic (feeding solids). What is up with the WHO? http://www.theguardian.com/lifeandstyle/2011/Jan/14/six-months-breastfeeding-babies-scientists

    • guest

      Erg. I can’t seem to link. Google Guardian, Mary Fewtrell, Hazel Blears, six months exclusive breastfeeding.

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

      This is one of those issues which seem to have gone full circle since my first days as a new graduate RN in L&D. Back then, it was advised to begin introducing solids at between 3-4 months. Then “only breast for 6 months” became the mantra [however, I soon learned that, where my children were concerned, they wanted "real food" much earlier than that, which seems to be the same conclusion the article comes to]. At least a couple of years ago I remember reading an article written in the UK that supplementation with solids beginning at the 4th month was recommended, so this “latest change” has been around for a while.

      • KarenJJ

        In Australia the recommendation was to introduce solids at around the 4-6 months depending on the kid’s interest and ability to sit up. My eldest especially was very, very interested in food at four months so she started at the early end and even grabbed the spoon off me and shoved it in her mouth – she was that keen to get started.

        Interestingly I’ve come across some very strident “nothing but milk until 6 months” which appears to me to go hand in hand with lactivism. Apparently a little baby’s gut can’t handle real food until 6 months. I don’t know why they seem so fixated on that, since kids are shoving all sorts of things in their mouths before that age and surely in paleo times that would have been taken as a sign to starting handing them some food to try.

        • Young CC Prof

          And then there are the folks who attempt to do nothing but milk until well PAST 6 months, which is absolutely not nutritionally correct. Those babies are at risk of iron deficiency and, in some cases, calorie deficiency.

          • Trixie

            Zinc deficiency too, I think.

        • Ash

          There’s a lot of info out there, which makes things tough. Some statements by the AAP say introduce solids “around the first 6 months of life” and some say “breastfeed exclusively until 6 months of age and then introduce solid foods”

    • RKD314

      What is up with the WHO is that they have to make recommendations that are valid for the whole planet. And a great number of people on this planet live in situations where yes, exclusive breastfeeding until the longest possible time you can get away with doing that (~6 months) is a good idea. If you are very poor, and/or you live in a place where food preparation conditions are unsanitary, then these are good recommendations. By getting more babies living in those conditions to breastfeed until 6 months, you may ensure that they get the food they need and that it’s not contaminated. What is completely unreasonable, but seems to happen all the time, is for people to take recommendations that are general enough to apply to the whole world, and apply them to developed countries that don’t share the same concerns. I can start my daughter on solids at 4-6 months, I don’t have to worry that by doing so I am introducing a less-clean food source with little benefit, nor do I have to worry that I am limiting the amount of non-milk food that I give her (but at the same time decreasing her supply of milk) because I can’t afford to buy enough food. In the same vein, it really bothers me when lactivists cite possible contamination as one of the “risks” of formula feeding, as dictated by the WHO. The WHO is not talking about people in developed countries when they make that statement, and formula feeding in places with clean water is not risky! Sometimes national organizations like the CDC make different recommendations than the WHO, and I think that it makes sense to listen to the recommendations for your own country.

  • Dr Kitty

    OT
    Meanwhile, in Ireland
    http://www.bbc.co.uk/news/world-europe-28823433

    There is something Orwellian about the HSE simultaneously claiming that someone is not at substantial risk of suicide, and therefore cannot legally access an abortion in Ireland, yet is at risk of dying from self imposed starvation and therefore requires force feeding and hydration against her will…

    • Dr Kitty

      Oh it just gets better and better, apparently the “expert panel” agreed she WAS suicidal, but her request was still refused…and the “compromise” was a CS at 25weeks.
      http://www.bbc.co.uk/news/world-europe-28825766

      Ireland…sort it out, because the “Irish Solution to an Irish Problem” isn’t working.

      • Siri

        How utterly disgusting. Poor young woman; poor little 25-weeker. When will these people emerge from the Dark Ages?!

      • lawyer jane

        This is like the parable of dividing the baby in half. … What sense does it make to go such lengths to deny an abortion, then bring about the birth of a potentially catastrophically disabled person? They already deprived the mother of her freedom, so why not wait until 30 weeks? I don’t understand their mentality. It seems to lack all consistency.

        • Ash

          Does the panel who decided when to deliver consist of physicians, I wonder?

  • Stacy48918

    Gotta love how they keep running tallies telling the world how many women had successful vaginal births. I’d hate to be the one woman that ends up with a C-section. Publicly shamed on Facebook. Even posting how many cm dilated a currently laboring TOLAC mother is.

    • Trixie

      What!?! Screen shot that.

    • PrimaryCareDoc

      Plus they identify women who are their patients. Even if they consented to that (which somehow I doubt) it’s incredibly unethical.

    • lilin

      Oh, man. They name names? That’s disgusting. And potentially hugely illegal.

      • Liz Leyden

        Have they heard of HIPAA?

  • AgentOrange5

    Wow. Good thing you screen captured it appears that post has been removed. Still their website is filled with enough anti-modernization stuff that it is hard to believe it is associated with a major teaching hospital. Honestly, it would make me scared to use a midwife these days, certainly not from that group. I don’t know if I was just fortunate, or if CNM’s have changed over the last 15 years. I went to a CNM/MD combo practice for my 4 births (picked because it was the closest that my insurance covered, I knew *nothing* about giving birth with my first & hadn’t exactly planned the pregnancy.) I had 4 very happy births & 4 healthy babies, 1 with the midwife, 1 started with the midwife who ended up calling in the MD due to complications (still turned out vaginal), & 2 with the MD. 2 with epidurals, 2 without. Absolutely no difference in bonding with my children. I was never told any of this “woo” stuff that is on the UofI page. My practitioners were straight-forward about my options, for stuff such as for pain relief, (epidural, Lamaze class, bouncing ball, they let me know they did not do water births…) with no bias encouraging any choice over another. For medical choices, such as during my 2nd labor when the midwife felt the MD should be called, she explained that she thought the medically best option was calling the MD (and explained why and what the options the MD would present), she also let me know that the baby was not at an immediate risk (but could become so) and that if I wanted to continue labor with her I could. THIS is how women should be treated, and I am sad to realize that so many women are not treated this way during labor. This belittling of women either way (oh women can’t take much pain, so of course you want an epidural or oh, I see you are an anxious & nervous women, you can have an epidural if you aren’t strong enough to birth the natural way)–it makes me sick. And that stupid Ida May Gaskin quote that is on the UofI site, “don’t think of it as pain, think of it as an interesting sensation”…..the only thing “interesting” about the pain, was that I knew it meant I was close to meeting the newest member of my family, and for me, that was the SOLE purpose of childbirth. I have plenty of other ways to “empower” myself, “show my strength”, or whatever the lastest woo thinks I should be doing. Birth to me, was like getting to a concert I was really looking forward to, I really didn’t care how I got there (as long as I got there safely.) The end result was the goal, not the journey, and I just can’t understand women who think otherwise.

  • realitycheque

    Ughhhhh, this post: https://www.facebook.com/permalink.php?story_fbid=10152564286513545&id=48540578544

    “You want an unmedicated labor? Great! We’ll help you achieve that.
    You want pain medications or an epidural? Great! But first we are going
    to explain the risks and benefits with those interventions. NOTHING we
    do is without risk! Every single thing your provider does to you has a
    potential risk associated with it to you and your baby, so ask
    questions! And then if you still want that epidural, we’ll get it for
    you.”

    In other words, “If you want an epidural, we’ll give you a guilt inducing lecture, fill you with fear about a ‘cascade of interventions’ and then, if you STILL want one we’ll reluctantly arrange for it”.

    Also:

    “You want a repeat cesarean section? We will first have a discussion about the risks and benefits of a Trial of Labor After Cesarean (TOLAC) which is mainly
    uterine rupture and then the risks benefits of repeat cesarean. Did you
    know that ALL pregnant women are at risk of uterine rupture? Not just
    those with a scar on their uterus. The risk is 0.012%. The risk of
    rupture with one previous low transverse cesarean section (LTCS) is
    0.87% and with two prior LTCS it’s 1.76%. While there is definitely an
    increase between no prior c/s and 1-2 prior c/s, we are in agreement
    with ACOG that women should be offered a trial of labor.

    The risks
    associated with cesarean section is risk if hemorrhage requiring blood
    transfusion, risk of trauma to internal organs requiring repair and risk
    of infection requiring antibiotics. Ultimately, it is your choice and
    after informed consent, we will support that decision!”

    Biased much? Don’t even get me started on the link they shared in the post.

    • Melissa

      Do you think that if you want an unmedicated labor they’ll explain the recent study that pain management may reduce PPD? Yes, everything has risks, including “natural” childbirth. They aren’t being informative by just telling half the information.

      • guest

        Also, pain in labor can cause increased levels of maternal cortisol, with negative effects on the fetus.. wonder if they educate their patients about that?

    • Stacy48918

      That’s really disgusting.

    • KarenJJ

      Well I’m glad that they are explaining the risks of TOLAC and the main risk being a risk of rupture. The thing is for the second time around, one of the considerations I had was whether I might be successful at a VBAC or whether I’d go through the labour + emergency c-section scenario which I dreaded even more than a c-section on its own. I can’t be alone in that consideration because I know hardly any mums that went for a VBAC – and that’s not because we don’t have the option for VBAC where I live.

      So for someone with a history of failure to progress (in fact failure to engage even after my waters broke at home), unproven pelvis, baby with large head circumference and mum with chronic anaemia and underlying immune system condition, I felt the odds of a successful labour leading to a straightforward vaginal birth where around the region of didley-squat.

      To be honest I didn’t even consider the issue of rupture and if I had all it did was added yet another check mark against TOLAC.

      • Young CC Prof

        Exactly. As I see it, a woman can’t make a rational choice about TOLAC vs scheduled RCS without knowing three numbers:

        1) Probability of serious complications with RCS (for her, right now, including future fertility questions)

        2) Probability that TOLAC results in rupture or another serious complication (for her, right now)

        3) Probability of success with TOLAC (for her, right now.)

        If the probability of success is low, opting for RCS makes a lot of sense just to avoid the long labor.

        • fiftyfifty1

          “for her, right now”

          These are the all-important words. Not on average for the population. Not the hospital’s average. Not the doctor’s or the midwife’s average. Not the running tally on the ICAN website, not the individual result that the ICAN leader got last week. Not what your results would have been if you had gone into labor last week, or if you had tested just under the borderline rather than just over the borderline on your GDM test. No, YOUR numbers, NOW.

    • Dr Kitty

      So, nothing about the risks of instrumental delivery, perineal tears, pelvic organ prolapse, future continence issues or future sexual dysfunction on the VBAC side…just rupture.
      Nice.

    • PrimaryCareDoc

      That was…impressive. “Want a repeat section? We’ll do our damnedest to scare you out of it. We’ll make sure that you know how risky that is. Want a VBAC? Awesome choice, mama! Go for it!”

      • PrimaryCareDoc

        Oh, and good to know that they don’t “force epidurals.” I know that most doctors throw themselves over the patient, hold them down, and shove a catheter in the back while the patient is screaming, “No, no!”

    • RNMomma

      What about the risks of the provider not doing anything to you? Because, you know, sometimes babies or moms die if the practitioner does nothing.

      I’m really tired of people, especially medical “professionals,” talking about interventions like they are bad.

      • yugaya

        Estimated maternal death rate in childbirth without any interventions? 1000 -1500 dead mothers per 100,000 births.

        Current maternal death rate in the USA which is considered too high? 28 dead mothers per 100,000 births.

        Trust birth? Thanx but no thanx.

    • Laura

      Wow. My CNM was the one who encouraged me to have an epidural after I was making no progress without pain meds.

  • MS

    I have never heard a single argument in favor of midwives, in any setting, that is remotely attractive or appealing. The midwife model of care, and the ideologies that infect seemingly most midwives, instills absolutely no confidence in me, and I am glad I get to avoid it. After reading this, I count my lucky stars for my OB and cesarean (both of which gave me a healthy baby, despite a crappy pregnancy).

    Oh, and if you want an endorphin rush, hit the gym. Have an orgasm. Eat a fantastic meal. Go skydiving. But please, don’t put that responsibility on your child and external factors you can’t control. Have a baby because you want a child, NOT because you want an endorphin rush. These women are pathetic, and the University of Illinois should be embarrassed.

  • Junebug

    To run a marathon you have to train, practice, endure, all in addition to being gifted with reliable biology.

    All you need to have a natural birth is reliable biology. That isn’t an accomplishment any more than having straight teeth or perfect eyesight.

    Anyone capable of surviving a natural birth will successfully have one when deprived of any other option. It is the expected outcome of pregnancy.

    • Ob in OZ

      Don’t forget to complete the marathon, you have to avoid injury.

      • Junebug

        That’s the reliable biology part. Which is a luck of the draw.

    • Sue

      (and btw, people die during marathon runs)

  • Forgetful Guest

    I wouldn’t want to give birth in a place where I’ll be labelled anxious and fearful for requesting an epidural, even if they’ll kindly “help me achieve that” (anyway, shouldn’t an epidural just be a simple request rather than something requiring help to achieve?)…

    Yet they still accuse Dr Amy of being the biased one? Logic fail.

    • melindasue22

      The exact same thought came to my mind. Or say I chose no epidural, why assume I chose that because it is “empowering.”

  • guest

    Wow.. beyond belief.. most women I’ve worked with in L&D who want an epidural are not “anxious and fearful” they are IN PAIN and want RELIEF…. how demeaning to the women they supposedly “serve”…

    • MLE

      Exactly. I was in more of a suppressed rage state, pre epidural. I would not describe my emotions as fearful, other than I would be filling someone with fear had I been denied my pain relief.

      • guest

        I can definitely understand that, and have seen that many times in L&D.. there is absolutely NO EXCUSE whatsoever for a woman to be coached, coerced, manipulated or discouraged to get pain relief if she desires it! And, believe me, I’ve been filled with rage myself when caring for a woman with a doula who tries to talk my patient out of an epidural!

        • MLE

          I bet! What nerve!

          • guest

            Unfortunately, many doulas interfere and undermine us in L&D.. so disrespectful to us, but most importantly to the laboring woman..

        • lawyer jane

          guest, are you an L&D nurse? The ONLY truly supportive person in my labor was the L&D nurse who helped me get my epidural. She was the only one who acknowledged how much it hurt. Everyone else, it was like some weird mind game about how much pain I could endure.

          • guest

            Yes, L&D nurse for 13 years.. I’m so glad you had a good labor nurse.. we really do try to advocate for our patients… thank you for acknowledging that! I know I cannot stand to see a laboring woman in pain when she doesn’t have to be.. what a shame to hear that others were not as supportive of you.. I am very lucky to work with doctors and midwives who are very supportive of pain relief..

  • Captain Obvious

    I don’t see any midwife names proudly listed at the end of that statement. And I think the link is now down. Wah wah wah

  • no longer drinking the koolaid

    That is so completely unprofessional that I am at a loss for words.

    • Guest

      I wish I were speechless. Instead, I am just so livid there are a million things I want to shout but am exhibiting every bit of willpower not to do so.

      I am just so curious to know whether this represents the majority or minority of CNMs in this practice. I’d also like to know just which topics Dr. Amy has discussed that they take issue with. Dr. Amy’s tone may make some uncomfortable, but nothing she covers is truly outside an established standard of care.

      Really UIC MW’s, Dr. Amy is no better than HB CPM’s, just at the other end of a spectrum? That’s interesting. As I understand it, she’s the one who has remained steadfast in her commitment to ensure babies don’t die preventable deaths and mothers aren’t subjected to the vitriol meant to demean their value or safety. This is nowhere in similarity to CPM’s and could not be further on the spectrum.

      • MLE

        Yes, I would love to know what they found objectionable to the point where they could not restrain themselves. I also loved the supporter(s) complaining about the subsequent minion attack. Well golly gee, sorry no one sat on their hands after an unexpected broadside.

        • Melissa

          The objectionable thing was probably when potential clients were coming in saying “I read on Dr. Amy’s blog that there isn’t any health benefits to avoiding pain relief. Why are you so focused on making sure I don’t get them if it doesn’t matter?”

          Dr. Amy has never said that every woman should be given an epidural by force. She’s just said that the rhetoric about the dangers of pain relief are not scientifically proven and that, in fact, pain relief may prevent problems.

          They seem really sad that reality has an anti-NCB agenda.

          • MLE

            I really, really hope that’s what started this!

      • Stacy48918

        Funny that they create this imaginary spectrum of Dr. Amy on one side and homebirth CPMs on the other and them/CNMs somewhere in the middle…then feature a talk by Ina May herself. Wackos.

    • Sue

      Are there codes of conduct for on-line behaviour for licensed/registered health care providers? I suspect there would be – they now exist in many jurisdictions, with registered providers being held to account for their on-line comments.

  • PrimaryCareDoc

    It would have been better if they had closed with “Namaste”.

    • Trixie

      I agree. They whiffed at the last second.

    • Junebug

      I was thinking the same thing.

  • Dr Kitty

    Apparently neither ACNM or these midwives are aware that elective primary CS is not the same as CDMR, having just read the ACNM position statement.

    • Young CC Prof

      How many people here had a medically necessary elective primary CS? You’d think medical professionals would know and use the correct definition of elective, but nope.

      • Dr Kitty

        I know, right?

        Guess what, if you have placenta praevia, quadruplets or a baby requiring an EXIT procedure, you will be coded as an elective primary CS.

        My own CS is coded as “Maternal Spina Bifida, Maternal Request”, and it was a planned, pre labour CS on a primip- I.e. Primary elective CS. Because of my medical history, I requested a CS, with the full support of my OB.

        This scenario is MUCH, MUCH more likely than a pure CDMR because someone looked at their options and decided on a CS in the absence of tokophobia or another psychiatric issue (which are legitimate medical reasons too).

        I didn’t want to risk my hard won continence and my child’s brain cells just to see if, despite all evidence to the contrary, I could have a vaginal birth. How DARE ACNM or this group of midwives decide for me that I should have tried labour, hoped for the best and had an emergency CS when it all went pear shaped?

        • fiftyfifty1

          How dare they? They dare because NCB philosophy tells them not only that they CAN object to your choice, but that they SHOULD. That a vaginal birth is a good in and of itself.

          This is a fundamental difference in the foundational philosophies of Midwifery vs. Obstetrics. Midwifery at its core believes that Vaginal is Best. Sure with certain exceptions maybe, but fundamentally that vaginal is best. OB, in contrast, runs off the idea that What is Best is Best. Most of the time, for most women, this will probably be a vaginal birth. But when it’s not, or when there are signs it might not be, CS becomes Best, not some second-rate disappointment.

          • Dr Kitty

            I agree.

            It is one thing to see a rising CS rate and recognise the contributing factors (more multiples, more DM, older mothers, higher BMI, pre-existing maternal medical conditions, better antenatal diagnosis, smaller families desired, medico-legal factors, safer CS).

            It is another to dismiss all of those factors and suggest that women should ignore them, with everyone having a TOL and CS only being done in labour only once it is clear to everyone that it is really necessary, which, as far as I can see, is what the ACNM position statement on elective CS amounts to.

            In other words, I’m not sure that the correct response to

          • Dr Kitty

            Response to… A rising CS rate is to make everyone but the obviously high risk attempt a vaginal birth whether they want to or not!

          • fiftyfifty1

            It’s instructive to compare ACNM’s and ACOG’s position statements on CDMR. As you note above, for starters, ACNM can’t even get the term right. Then their position statement goes on to be completely one sided:

            -They unilaterally decide that vaginal birth is “the optimal mode of birth for women and their babies”.
            -They say they support a woman’s right to “accurate, balanced and complete information” about their choice, but then in the next breath go on to imply that CDMRs are being “unduly influenced by factors such as liability, convenience or economics” completely ignoring the true risks and benefits that women tell us that actually matter to them when they are weighing their options.
            -Then they go on to call for more research.. into the downsides of the choice.

            The ACOG’s position, in contrast, is even-handed, while at the same time being VERY cautious and conservative:
            -Their position is that a trial of labor is the best for most women, and therefore should be recommended to most women, but that there ARE risks and benefits to both choices that must be weighed VERY carefully.
            -OBs are urged to see each woman who is contemplating CDMR as an individual and “consider her specific risk factors, such as age, body mass index, accuracy of estimated gestational age, reproductive plans, personal values, and cultural context” as well as attempt to understand any “critical life experiences” that may underlie her request.

            -If a woman does still chose a CDMR, the AGOC gives practical guidelines to help minimize risks to mothers and babies.
            -ACOG then goes on to call for more research into a variety of factors including short term risks and benefits, long term risks and benefits, best methods of promoting good doctor/patient communication surrounding this request and economic factors.

            tl;dr:

            Midwives: “Those women asking for elective CS are wrong. Their motivations are wrong. Vaginal is optimal, so Just Say NO. We should be looking for more proof that elective CS is bad.

            OBs: “We need to be very careful to help women accurately weigh the pros and cons in their individual circumstances. If a woman chooses a CDMR, we need to make it as safe as possible. Let’s do more research and be open minded about what it shows.

            I know which way I would want my provider to approach me and my concerns. I want to be treated like a grown up.

  • Tala

    These midwives unconditionally support mothers in their birth choices… as long as those choices are:

    - vaginal
    - without pain relief
    - breastfeeding

    Ask for anything else and be prepared for their scorn, or even to have your choices overruled.

    Usually natural birth nutters hide under the guise of feminism and enabling womens freedom to choose. At least these ones simply admit that they are there to enforce an ideological agenda on their patients. You have to hand it to them: they are less hypocritical than your average NCB fundamentalist.

  • deafgimp

    And barf, they are supporting an Ina May Gaskin TEDx talk. It’s like these women are idiots or something.

    • Stacy48918

      I commented in response to this. It’s been deleted and I’ve been blocked. These women really stand by what they believe in. Cowards.

  • deafgimp

    Oh, and to contact the Dept of Ob and Gyn, straight off their website

    Department of Obstetrics & Gynecology
    820 S. Wood Street, M/C 808, Chicago, IL 60612

    P 312.996.7006
    F 312.996.4238

    E uic.obgyn.dept@gmail.com

    • Trixie

      Did anyone post this to that hospital’s main FB page?

      • Trixie

        Looks like you can’t post to the hospital’s page. I messaged them this link though.

      • moto_librarian

        I messaged them about it too.

    • Stacy48918

      I plan to email tonight. Probably call next week as well. If people don’t stand up to this nonsense it will continue to be promoted.

  • deafgimp

    Look at this quote they put on their site. Yeah, midwifery is proven the most deathly maternity care model in the world (I don’t include hospital based woo-free CNMs in that).

    Alanis Morisette gave birth with a midwife and doula. She describes it as “A transcendental experience. I just went to this whole other world.” Midwifery care honors and nurtures your inner rock star as a new mother. FAM raises money for organizations that increase access to midwives in the US. Shouldn’t more than 10% of American women be given access to the most proven maternity care model in the world?

    • Stacy48918

      They deleted my comment in response to this as well. I was asking if they would advertise a celebrity homebirth death as widely as an Alanis Morisette or Gisele homebirth. Doubt it.

      • Liz Leyden

        Deborah Allen, the unlicensed midwife who did Gisele Bundchen’s birth in 2010, lost a non-celebrity birth a year earlier. Water broke, midwife waited 3 days to send the patient to the hospital (going home in the meantime), baby ended up dead of strep infection. Because Massachusetts does not regulate non-nurse midwives, Allen could not be censured.

        “Deborah Allen declined to be interviewed for this article. Her lawyer, Stephen Lyons, was unwilling to go into the details of the case, the play by play of what happened,
        though he did say that Allen had informed Holloman about Group B strep. He explained, too, that lay midwives provide a different model of care than doctors or even certified professional midwives and that Holloman knew exactly what she was signing up for, including the risks. He said if Holloman wanted lab tests, she shouldn’t have been seeing a lay midwife. “There was nothing that would have indicated to the mother or anyone in attendance that there was anything wrong,” he says. “Sometimes these things aren’t anyone’s fault.” He said Allen has delivered more than 800 babies in her career. She continues to do so. Last year, she attended the home-birth delivery of Tom Brady and Gisele Bundchen’s baby.”

        “After Holloman and Beetz’s baby died, Allen agreed to undergo a peer review by several local certified professional midwives. Had she been a CPM herself, a peer review would have been the first phase of the process that could have ended in stripping her of her credentials. In Allen’s case, since she isn’t a CPM, the process was nonbinding. The review found numerous failures in the care Allen provided, including not getting Holloman’s informed consent, especially with regards to risks associated with extending a pregnancy that far past her due date or about Group B strep testing. They also found she “demonstrated negligence and the inability to practice safely” by not monitoring Holloman’s temperature or, once her water had broken, getting her blood tested for signs of infection.”

        “A better-trained midwife would never have allowed what happened to transpire,” Holloman says. She and Beetz wanted their case to be investigated by an entity that could, if appropriate, sanction Allen and prevent her from delivering more babies. Holloman went to the police, the district attorney, the attorney general, the Department of Public Health, the Board of Nursing, and the Board of Medicine. “No one could do anything. They told us she’s neither fish nor fowl in the eyes of the law,” Holloman says. Last year, she and Beetz filed a lawsuit in Superior Court against Allen alleging negligence. “We didn’t want to sue
        anyone,” Holloman says. “This is the last house on the left for us.”

        http://www.boston.com/community/moms/articles/2011/07/10/one_womans_home_birth_battle/?page=full

        • Stacy48918

          Wow, I’ve read that before. Didn’t realize it was Gisele’s midwife.

        • Melissa

          “He said if Holloman wanted lab tests, she shouldn’t have been seeing a lay midwife.”

          That’s chilling.

          • Happy Sheep

            Especially considering that she was most likely counseling the mother on the dangers or unnecessariness of testing and how if she just put garlic up her vagina GBS isn’t a problem.

        • Smoochagator

          Terrible.

  • Amazed

    Hey, Dr A., are you going to let the administration know? They are dangerous because they do have the authority of the hospital behind them to lend credence to their practices.

    • Ash

      I sent a message. Didn’t take a screencap of the entire thread, though. Oops. But there’s enough bizarre stuff on that FB page. Clearly they are not abiding by whatever social media guidelines are published at UI. Do a comparison to the University of Illinois Hospital & Health Sciences System FB and you’ll see a big difference!

  • MLE

    There is a difference between the words of a private individual and those representing an institution or professional organization. HR 101 ladies.

    • Young CC Prof

      Precisely. If I write an article or opinion piece, and post it under my own name, and somewhere way down the page, mention that I work at My CC, it’s pretty obviously my own opinion. (If it were headline-worthy controversial, I might avoid even that.)

      If I make a webpage and put my employer’s name right on top of it, I am clearly speaking FOR my employer, and you really better get permission for something like that. (In fact, my employer’s marketing department has some pretty specific policies in that area.)

      • MLE

        I would be shit canned immediately, even if it were a weather report!

  • lola

    So it’s “your birth” and “your memories” until you want something other than an unmedicated vaginal birth or a caesarean. Politicians can’t tell you what to do with your body, but midwives can. Alrighty then. I cannot believe that they don’t understand that if you’re supportive of women’s choices in pregnancy and childbirth, you have to be supportive of ALL safe choices, not just the ones you yourself would make.

    • MLE

      ZOMG some doctors do c sections on a first time mom…on purpose!!! We on the other hand will help you cope with the labor pain by giving you a bwankie if you are scared. (Misspelling intentional.)

  • Trixie

    Oh look! There’s a private Facebook group! Wonder what kind of HIPAA violations go on there? I bet hospital administration would love to know. https://m.facebook.com/groups/574531582667674

  • Clara

    Danielle Yeager, the mother of Gavin Michael posted a comment asking them about their views on homebirth midwifery. Not only did they ignore her, they deleted her. I respectfully commented that I found that very sad. They deleted AND banned me. Meanwhile they kept saying that they did not delete any comments but that a facebook algorhythm had made somme comments disappear. It is just pathetic.

    On a different note, I am now very afraid. If this is the amount of ideological indoctrination on the L&D floor of a large university hospital, there really are no safe places left to give birth.

    • Trixie

      Looks like they’ve deleted the post.

      • Karen in SC

        Of course they did. And I hope there are repercussions for all the members.

        • yugaya

          Yes.

    • Guesteleh

      Shocking. I shouldn’t be shocked anymore but the deleting and lying takes my breath away. The definition of Orwellian. And to do that to a loss mother! Fucking heartless.

    • guest

      That’s the damn truth.. they’re an embarrassment to all nurses, and especially to the majority of excellent CNM’s out there… I hope they all lose their jobs..

  • lovleanjel

    They’ll do anything to help you achieve a natural birth…including refusing to admit you until it is too late to get an epidural.

    • Guest

      Let me get this straight. UIC Midwives will get you an epidural if you are ‘anxious or fearful’ of labor? What if you just want an epidural for some damned good pain management? I’d like whomever is representing the UIC Midwives in that post to explain what happened to the empowering part of Midwifery. When was it decided personal values or idealizations determine how we, as Midwives, provide care. I am just so, so disappointed.

      • KarenJJ

        LOL I’d have had an epidural as soon as I got that first positive pregnancy test if the only indication for getting an epidural was being pregnant and being anxious and fearful of labour. I’m sure painful contractions must also weigh in there somehow.

  • fiftyfifty1

    ” our fantastic stats, low cesarean section rate and high VBAC rate are our armor. Whatever she has to say, can’t beat that.”

    No duh! No OB can ever have the same low CS rate and high VBAC success rate of a hospital based CNM. Because when you, as a CNM, run into a high-risk case that you can’t handle, you send them on to the person who can–the OB. To brag in this way is as ridiculous as me, a family physician, bragging that my patients have lower rates of heart attacks than any cardiologist I know. Well of course! A cardiologist’s patient panel consists largely of people with known coronary artery disease. My patient panel? A large percentage of nice healthy young people.

    Give me a break CNMs!

    • Young CC Prof

      And, strangely enough, the OBs who work with groups of CNMs (often themselves very NCB-friendly) have extremely high CS rates. Why could that be? Oh, right, because they’re getting all the CS patients from 4 or 5 practitioners.

      • fiftyfifty1

        So true. And any provider can manipulate his or her outcome stats by passing the buck. During training, I did an additional OB elective at a very busy OB hospital. There was one OB who had markedly lower CS rates than the rest of his partners. I was on overnight with him early in my rotation. He bragged to me about his low rate and gave me an earful about how he believed CS rates in the US were “too high”. But it rapidly became clear how he got his low numbers-he basically refused to do a section unless a baby was in distress. He would let women with obviously obstructed labors just sit there stuck for hours on end until his shift ended in the morning. The next OB would start his or her shift with a lot of cleaning up to do–always 1 or 2 exhausted women who should have been sectioned hours earlier. It wasn’t good for babies or for mothers, and frankly it wasn’t safe. If an OB is tied up in the OR getting rid of the “back log” then they aren’t as available to be there for an emergency. Luckily this sort of bullshit is rare among OBs. This guy was a total jackass and the hospital bought him out for an early retirement in the end I believe.

        tl;dr: Don’t chose a provider based on their CS rate.

        • Guest

          Couldn’t agree more. I have a certain OB in mind who had a 75% CS rate last month, while I had a 0% CS rate (I/CNM will NEVER have greater than a 0% CS rate according to how stats are compiled.) He cursed me all month for ruining his stats by scheduling a RCS and Primary Maternal Request CS, then pulling him in for a PCS Arrest of Descent and a Vaccum Assisted Vaginal Delivery. Left his stats awful. Meanwhile, he sat patiently by as I attended 16 vaginal births, including a VBAC, VBA2C and two sets of twins. Yeah, statistics are a bitch. Any provider worth his or her salt reflects on statistics, but never lets statistics guide their practice.

        • Smoochagator

          With my second child I had very few OB options because I had recently changed my insurance provider. I chose a practice that delivered at my preferred hospital and had a very low CS rate (about 15%). Then I found out that a coworker had gone through the drama and expense to transfer at 30+ weeks from that OB’s care to a practice that was out of our insurance network. When I asked her why she transferred she explained that a friend of hers in L&D at the hospital said the doc was known at the hospital as being very bad at Csections and several of her patients had required a second surgery for repair. Her low CS rate either caused her poor surgery skills or she avoided CS because of her poor skills – either way, I didn’t want to deliver with her! Luckily my preferred practice started accepting my insurance when I was about 16 weeks along so I was able to transfer care. Whew!

  • fiftyfifty1

    This is yet another example of why I no longer recommend CNM care to my pregnant patients. These are CNMs at a mainstream hospital, and yet they are infected with ideology. And so unprofessional. So immature and shallow in their thinking.

    • CrownedMedwife

      You’ve mentioned this before and I’ve responded in the past. As a professional, I respect your decision not to refer to CNMs. It certainly seems UIC’s Midwifery page only serves to reinforce that decision and I cannot disagree with that. The content and links on that page are abhorrent to me and I say that as a CNM.

      There are a handful of FP’s and Peds I will not refer patients to for various reasons, including, but not limited to promoting antivaccine, antiformula or providing care outside their defined scope of privileges (ie antenatal care to T incision or multiple gestations) without prearrangement backup and emergency care. This does not preclude me from referring to the majority of other FP and Peds who practice according to establish guidelines or within the context of safety.

      On a personal note, I do provide gynecologic and obstetrical care to the daughters, sisters and wives of orthopods, anesthesiologists, ED’s and yes, ob/gyn’s. The professional relationship I have with these providers is what motivates their referrals to my practice, not my title.

      There WILL be women who specifically seek midwifery care, whether you refer them or not. Knowing the practice style/safety of a specific CNM in your locale whom you felt comfortable with referring to could help prevent those women from seeking care with a CNM swept up by the woo.

      It’s obvious from the post on UIC MW page, as well as the appalling links provided from scanning a years worth of posts, that the woo infestation is not limited to OOH CNMs. Really disappointing, as it seems my efforts to educate every new patient of childbearing age on the differences in CNM vs CPM qualifications and outcomes has been in vain. Just when I thought I could protect each young woman from falling prey to the woo, the woo was there all along.

      • KarenJJ

        It’s as thought they are infected before you start teaching them and are being coached to “game the system” and that what you are teaching is “not real midwifery” and to just get the certificate and move out and do “real midwifery” like what Ina May Gaskin does. That said there’s a lot of woo midwives teaching in Australian universities too (eg Hannah Dahlen and another on the Sunshine coast who’s name escapes me). Perhaps the critical mass has meant that midwifery as a profession has moved a jump towards the nutty side.

        • Guest

          I remember noticing a portion of the younger and less experienced students having a tendency towards the woo during midwifery school. Chalked it up to the naivete and lack of real life experience, but was sure to share enough real life experiences that they weren’t as surprised when they entered the real world. In fact, they should have been darn right scared of how not to trust birth and romanticize it in every situation by the time I was done with story time.

      • fiftyfifty1

        CrownedMedwife, I would love to be able refer to CNMs again and I know many CNMs who are great and whom I trust. But the situation is different than referring to a primary care provider. If you know that a certain primary care provider is bad, you can tell your friend to avoid that one. But if one of the CNMs in a group is an NCB nut, you can hardly say “If you show up in labor and find out that Nutty Midwife is on, cross your legs and go home and come back when her shift is over”.
        When your business model includes an on-call pool (as all the CNM groups around here do) then one bad apple really does spoil the bunch.

        • CrownedMedwife

          There aren’t many CNMs in my area and those that are are very mainstream, not being swept into birth ideology. Being isolated from CNMs that practice outside mainstream, I sometimes forget what a gamble of ideals it could be in a group practice. I wholeheartedly agree that if referring to a practice runs the risk of a NCB nut, one cannot in good conscience do so.

          I suppose I can relate in terms of doulas. Many doulas around here; some are great, others more like hobbyists and a few are just downright dangerous. If a patient insists she would like referrals for a doula, there are some I can refer to and others I cannot, as I know who their backups are.

          As far as UIC MW, that post still has me outraged. I don’t know how deep it runs. However, I do wonder what prompted the poster to address Dr. Amy specifically in a post that does nothing to serve or promote Women’s Health.

          • Young CC Prof

            Yeah, saying, “I can recommend these people” is totally professional. “Stay away from these” is not so professional, no matter how true it may be.

          • The Bofa, Being of the Sofa

            Does that apply to chiropractors and accupuncturists, too?

            Because, you know, “not all chiropractors are bad”

          • Young CC Prof

            Well, all acupuncturists are quacks. Chiros, one can identify the bad ones without naming them: If they sell supplements, or claim to treat things other than back, joint or muscle pain, run away. A doctor can hence herd patients away from a quacky chiropractor in the neighborhood without being so rude as to name him.

          • The Bofa, Being of the Sofa

            Well, all acupuncturists are quacks.

            So you agree that saying “stay away from these” is perfectly acceptable in certain circumstances.

            Chiros, one can identify the bad ones without naming them:

            Actually, it’s a lot easier to point out the good ones.

            See also CPMs. There may be some good ones, but there are so many bad ones that it is better to just say, “Avoid them.” You don’t think that is warranted with CNMs. fifty501 thinks it is. In the end, it’s not a question of whether there is a line or not, only where you draw it.

          • Young CC Prof

            Actually, I’m saying that if there is a problem with quacky CNMs in the neighborhood, a doctor can more easily get away with saying, “I’d prefer you to see an obstetrician, try this one or this one” than “These particular midwives are crummy.”

            This is especially true if, as fiftyfify said, the smart science based midwives and the not-so-good ones are all in the same practice.

          • fiftyfifty1

            “as fiftyfify said, the smart science based midwives and the not-so-good ones are all in the same practice.”

            Yet to be frank, I do hold “the good ones” responsible for the actions of the bad ones. In the case of the CNM group at my hospital, the ones who I had believed to be smart and science based knowingly hired Midwife Wise Woman who is a dangerous quack. They must have known. She practiced in a neighboring state and I googled her name and her old webpage from her birthing center business came right up. They CHOSE this woman. It’s not like there is a shortage of CNMs to chose from around here. Then there is the ACNM. The leadership seems infected with ideology. They are in bed with CPMs and turn a blind eye to the deaths. Do I have respect for the probably majority (maybe majority?) of responsible CNMs like CrownedMedwife? Sure. But too bad! I still won’t recommend CNMs seeing what I see now. My patients come first. When patients ask me I tell them a version of the truth. I say that the CNM groups I know are all in states of flux and that while they might have a good experience, they might not and for that reason I can’t recommend them. But that I know the local OB group and I have a lot of respect for it and that they are all great clinicians and nice people and that they are the group I chose for my own daughter.

          • Guest

            I’m going to have to commend your professionalism in the way you handle not referring to the CNM practice with Wise Woman CNM. When I have patients inquire as to Homebirth and HB Midwives, I have to admit I seek clarification of their motivations. Then I pull out the ACOG position statement on HB. But I won’t refer to the few HB CNMs, because I just can’t bring myself to do it. I do make a point to differentiate between CNM and CPM (illegal in my state, but still practice underground or come across state lines).

            I’ve mentioned before, I practice in an area with very few CNMs and we’re mainstream. If we didn’t hold each other accountable, the medical community here would. I am grateful for the very supportive medical community here and there’s no way in hell they’d tolerate the likes of Wise Woman either.

            As for ACNM, their latest Moment of Truth campaign clearly demonstrates their solidarity in a joint effort with the likes of MANA. None of us can expect that to change any time soon and is just another reason I (and many others) have distanced myself from them.

            So yes, CNMs need to hold one another accountable. By not referring to Wise Woman practice, you’re holding CNMs accountable too. If CNMs and MDs don’t hold CNMs accountable, no one will.

          • Dr Kitty

            Disparaging another professional can count as professional misconduct or bringing the profession into disrepute here- which are sanctionable offences.
            I use “I’m afraid I don’t know enough about their practice to have formed an opinion I could share…whereas I have previously worked with Dr X who I would be happy to recommend” as a response.

          • Trixie

            Or if they do the type of neck adjustments that cause a stroke….

          • Karen in SC

            May have the VBAC post; it would have been nice had they specified anything.

          • The Bofa, Being of the Sofa

            May have the VBAC post; it would have been nice had they specified anything

            Of course, if they mention something specific, all they do is open up the chance to have it refuted. If you make vague accusations, you can always dismiss any counter with, “Oh, we aren’t talking about that one”

          • Guest

            Maybe it was the VBAC post. But then again, if all they could take away from that post was a concern with Dr. Amy’s tone and not the outcomes, they really are missing the big picture.

      • DiomedesV

        Honestly, as a nonmedical professional, it looks to me like the primary value of midwives is their cost-effectiveness. They have less training so they’re paid less. Since most births will be straightforward, it seems like a good strategy to have many or most women seen initially by a midwife. Of course, that cost-effectiveness will vary with the tendencies toward litigation over negative outcomes in any given community. I would be surprised if CNMs grew markedly more common in the US for that reason, even with the increase in federal control over healthcare delivery that I think is inevitable.

        Just like I think NPs have a place in healthcare delivery, I see a place for midwives. But I don’t see NPs claiming that they have “special ways of knowing” and any sort of special calling or culture that makes them uniquely qualified, yet that sort of prioritizing of culture and subjective knowledge seems commonplace in midwifery.

        As a scientist, I would always tend to steer clear of any profession that has a culture like that. Not only is it bogus, it seems to largely serve the purpose of deflecting attention away from the fact that midwives have, by design, less training than OBs.

        • Young CC Prof

          Most of the CNMs I’ve run into have been in community care, working at Planned Parenthood, in my college’s health office as an undergrad, etc. They seemed to be pretty practical about, well, just about anything they might be called upon to handle.

  • Ash

    There’s no way the hospital administration knows about this page or it would cease to exist. Sheer idiocy to make an unofficial work FB page, especially in healthcare.

    Nice photos in the gallery saying that a physician is not an “expert” at “natural delivery” and that pain is just an “interesting sensation” (courtesy of Gaskin).

    The “ICAN Checklist” advising women to “Avoid medical intervention whenever possible.” include cEFM.

    • Young CC Prof

      The ICAN Checklist also advises women to dodge induction as long as possible, which not only increases term stillbirth and other adverse outcomes, but also increases the probability of CS.

  • Roadstergal

    “There are some docs that really do that!” Yes, and there are some women who really want that!

    “If you are very anxious and fearful of labor and want a labor epidural” – Nice. What a bunch of judgmental harpies they come across as.