How many dead babies is one VBAC worth?

Doubtful Woman Holding Question Mark

How many babies would you be willing to kill to get your magical, “healing” VBAC?

I would have thought that one dead baby would be enough for even the most ardent VBAC activist to recognize the selfishness and folly of sacrificing a human life in exchange for an experience. Apparently not.

This week I’ve heard about not one, but TWO separate cases of women losing a baby as a direct result of attempting a VBAC and then attempting or planning to attempt ANOTHER VBAC!

1. The first case involves a woman I’ve written about before in a piece aptly titled Why don’t homebirth advocates learn from their mistakes? This woman didn’t learn from her first mistaken attempt at HBAC, which ended with a cord prolapse, emergency transfer, live baby born vaginally, and postpartum hemorrhage. She didn’t learn from her second planned HBAC attempt when her daughter died in utero apparently from undiagnosed IUGR. But if at first you don’t succeed in achieving your magical healing VBAC (apparently the cord prolapse vaginal birth didn’t count), risk, risk again.

This time she decided to go with a hospital and real medical professionals, she achieved her magical healing VBAC and the only thing she lost was her uterus and a lot of blood.

What truly amazing is that woman appears to think that one cord prolapse and emergency transfer + one dead baby + one hysterectomy + 3 units of blood was a reasonable price to pay for having the birth of her dreams.


2. In the second case, a woman lost her daughter Coraline at an attempted HBA4C. The story as horrifying as it is typical.

The consult with the obstetrician:

[I] did have a consult with a high risk OBGYN that works with [my midwife]… At the end of the appt, he said that overall, he sees no reason why I can’t do a vbac other than the fact that I have had 4 sections which puts me at VERY high risk!!

The obstetrician’s advice is ignored in an effort to achieve “the one thing in my life that has always meant the most to me.” Really? REALLY? That’s what has always meant the most to you? More than your baby’s life and your own?

The other complications, which in this case included prolonged rupture of membranes and prolonged latent phase:

My water broke & contractions picked up. A doula locally offered to come out & labor with me & dh & so she did Wednesday (11/20/13 10 PM) night. Through the night and the next day my contractions were close together, sometimes 2min apart & sometimes 5-7 min apart. My MW came around 3am … Later that morning, she checked me and I was about 5 1/2cm… I did not progress for the rest of the day…

Her midwife WENT HOME because she “was just so exhausted & had kids that needed to be tended to.”

It finally occurred to the mother at 3 AM on 11/22 that she ought to go to the hospital:

…DH checked the heartbeat w/the doppler that the MW had left for us & her hb was perfect. Same place & 148 bpm, which was average for Coraline the entire pregnancy.

But when they got to the hospital, Coraline was dead.

Her mother underwent a 5th C-section, this time for a dead baby:

… When the doc opened me up, my whole uterus, baby’s sac & baby was covered in infection … [I] never had any fever or other signs or symptoms that anything was wrong. NOTHING!!! Coraline weighed 11lb 2oz., 22 inches long.

Who could have seen that coming after only 30+ hours of ruptured membranes?!!

Did Coraline’s mother learn anything from this completely preventable disaster? No, not a blessed thing, although her husband appears to have learned something.

Earlier this year Coraline’s mother was posting to the VBAC group that encouraged the HBAC that ended in her daughter’s death:

…I’m going for a pre-pregnancy consult sometime in the near future to see what they say as I will be a vba5c if I can get accepted. I would do hba5c, but hubby won’t go for it.

At least he thinks that one dead baby is enough. Too bad Coraline’s mother doesn’t feel the same.

268 Responses to “How many dead babies is one VBAC worth?”

  1. Mrs P
    July 7, 2015 at 9:30 am #

    What a load of crap. You failed to balance this with the healthy babies who die from respiratory distress following elective caesarean section? VBAC is deemed the safer option in absence of other risk factors. I suggest you do your homework before you write any more dangerous drivel that gives a wholly inaccurate picture of VBAC versus caesarean. I can only guess that you have never had children yourself, or if you have, that you have been medicalised beyond belief and been stripped of any choice or control in your birth experience. I’m very sad to read such utter nonsence.

    • Megan
      July 7, 2015 at 10:09 am #

      “I suggest you do your homework before you write any more dangerous drivel that gives a wholly inaccurate picture of VBAC versus caesarean. I can only guess that you have never had children yourself, or if you have, that you have been medicalised beyond belief and been stripped of any choice or control in your birth experience.”

      You might want to check out the author’s bio in the top right corner before you comment.

      • PrimaryCareDoc
        July 7, 2015 at 1:52 pm #

        I love it when someone parachutes in and tells Dr. Amy to do her homework before they’ve done any of their own.

    • Cobalt
      July 7, 2015 at 10:35 am #

      Please, please, please show any credible source for the death rate (from ANY cause) of healthy babies from non-medically indicated cesareans.

      • momofone
        July 7, 2015 at 1:49 pm #

        My c-section was elective, but medically indicated. I think the term for non-medically indicated is maternal request? Someone please correct me if I’ve got it backwards!

        • Cobalt
          July 7, 2015 at 4:09 pm #

          I think you’re right. Elective just means you get some choice of when (could be chosen hours to months in advance, for any reason, including avoiding potential negative outcome), as opposed to emergency (ASAP to RTFN, typically actively treating current or imminent negative outcome).

          I singled out non-medically indicated to try to help Mrs. P define their response. Medically indicated (elective or emergency) treatment is, by definition, going to give better results overall than refusing it, or it wouldn’t BE medically indicated.

          And these harpies really are trying to bully the maternal requesters anyway.

    • Amy Tuteur, MD
      July 7, 2015 at 1:29 pm #

      That’s because healthy term babies don’t die from respiratory distress after elective C-section.

  2. Guest
    December 20, 2014 at 5:39 pm #

    An update (sort of) on case #1:

    A quote from the mother, who is a doula and supposedly educated on issues of pregnancy and birth: “Keene said she had no idea that babies could die right before they were born, and this is one way to bring awareness to such a tragic event.” A person who works in this field had no idea that stillbirths occur??

    Congrats to her and her family, though. It seems she had a lovely hospital birth (scheduled induction, pit, etc) and a healthy daughter this summer.

  3. English teacher
    September 10, 2014 at 2:51 pm #

    I’d like to add my support to Anon’s call to retitle this article. It is not about VBAC, but rather about HBAC and the mothers who were determined to VBAC no matter what the consequences or their medical history. Perhaps something like “How many dead babies is an HBAC worth?” would fit the content of the article. Not all VBAC mothers should be painted with the same brush as these mothers.

  4. Anon
    August 29, 2014 at 10:07 am #

    You have seriously conflated two very different terms here, one that is a real, scientifically supported option (VBAC) and one that, while it unfortunately happens, is not (HBAC). Obviously you know the difference, and I can only guess that you chose the title you did in order to bait people and get more reads. That’s a bit juvenile, but not uncommon online.
    Anyway, I have no issue with you criticizing HBAC, but I think you should reword this article and its title to accurately reflect what you are criticizing. If, on the other hand, you have a problem with VBAC, you should criticize it on scientific grounds. For any other readers who don’t know why this inaccuracy is so misleading, and the difference so important for anyone who purports to care about science, medicine, and evidence, read this from the American College of Obstetricians and Gynecologists:

  5. August 18, 2014 at 10:32 pm #

    Its hard when you are made to feel bad from other moms because you had a c-section and you didn’t attempt a home birth. I knew a mother who rubbed her home births in people’s faces and made people feel bad for going to a “hospital” to have a baby. I’ve had two c-sections and without modern medicine my babies probably wouldn’t be here! Its a shame when moms put this kind of pressure on other moms.

    • The Bofa, Being of the Sofa
      August 19, 2014 at 12:17 pm #

      Its a shame when moms put this kind of pressure on other moms.

      Very true. Shame on THEM, not you.

      Don’t let them get to you, Heather. You know what you did was the right thing to do, and no pretentious snob can change that.

      Ultimately, if I can, I try to shun people like that. They need to learn that they are not appreciated. If enough people ignore them, they MIGHT figure out why. Then again, the problem is that they end up being too full of themselves to notice that no one likes it.

  6. Stacy48918
    August 18, 2014 at 2:25 pm #

    Now this post hits even closer to home…

    At church yesterday I learned that our pianist who was planning a VBAC went into labor last Thursday. Her uterus ruptured. They initially did not think the baby would survive. She was cooled and flown to a higher level NICU. She’s now off the ventilator but it appears that if she survives she will be profoundly handicapped. Mom was 39 +4. Mom’s not a rabid ICAN type. Just a regular woman that wanted a VBAC because that’s just what you’re supposed to do. You have a C-section, you’re supposed to want to try for a VBAC. Even if this is going to be your last baby (it was for them).

    Our whole church was looking forward to welcoming this beautiful baby. Now we may be planning a funeral with a tiny coffin. At best, we will have to see her grow up, not the child she should have been. I’m not “anti-VBAC”…but if this woman had had a RCS at 39 weeks, she would be home right now with her healthy baby.

    I am so heartbroken for this mother and her family.

    • moto_librarian
      August 18, 2014 at 4:30 pm #

      I am so, so sorry.

  7. wookie130
    August 17, 2014 at 5:57 pm #

    Kind of OT, yet kind of not OT at the same time…

    I delivered our son yesterday morning at 10:56 a.m. via planned c-section…he’s a little dinker at 6 lbs. 9 oz.! I was in early labor when I arrived. While my OB was stitching me back up, she told me that my uterus was “paper thin”, and that she told me that I was on the verge of rupturing. She strongly suggested that we not become pregnant again in the future, which is fine for us, as we’ve known all along that baby Oscar was our last child. So, had I gone for that VBAC, I could be dead today. Thank goodness for c-sections.

    • araikwao
      August 17, 2014 at 6:13 pm #

      Congratulations on baby Oscar’s safe arrival!! Wishing you a quick recovery and happy times with your newborn 🙂

    • Box of Salt
      August 17, 2014 at 7:02 pm #

      Congratulations to your whole family, wookie130!

    • Young CC Prof
      August 17, 2014 at 7:22 pm #

      Congratulations! So glad to hear it!

    • Amazed
      August 18, 2014 at 7:44 pm #


  8. Stacy48918
    August 16, 2014 at 9:14 pm #

    So the first lady “Reannan Keene” – if you hover over her name in one of the comments regarding her partial hysterectomy it lists her as a “psychic and medium”. Obviously her psychic powers failed her a bit in planning for this birth…

  9. GiddyUpGo123
    August 16, 2014 at 2:56 pm #

    I had a history of tearing with babies number 1 and 2, so my OB recommended an elective c-section for baby number 3. Fortunately, no one had ever suggested to me that a c-section would ruin my life and the life of my unbonded gut-bacteria-deprived baby so I was like, “Hell, yes.” Shame on me for putting my desire to avoid having to wear adult diapers for the rest of my life ahead of a potentially magical, beautiful birth experience.

    I actually would love to hear an NCBer opinion on elective c-sections for the purposes of avoiding a lifetime of incontinence. Do they really feel like losing the ability to hold your poop is a perfectly acceptable sacrifice to make in exchange for protecting your baby from the horrors of a c-section? I mean, I’m sure that they do think that, but gawd …

    • Young CC Prof
      August 16, 2014 at 5:36 pm #

      Tearing must be caused by Doing It Wrong. Birth could never be so cruel in nature, duh. *Sarcasm, yes.*

      • RNMomma
        August 16, 2014 at 9:26 pm #

        Ha! Yeah, I was terrified of witnessing a birth during my OB rotation in nursing school because of what I had seen as a vet tech. The deliveries themselves weren’t bad, it was that one mare who needed to have a good 4-5 inch tear stitched up (the equivalent of a 3rd, almost 4th degree tear). I was horrified. Nature is most certainly not kind.

        • Cobalt
          August 17, 2014 at 6:53 am #

          I saw a mare who had delivered through a Caslick’s that hadn’t been opened. They just let it rip. Great mental image to take into labor with you.

          • Stacy48918
            August 17, 2014 at 6:55 am #

            Yea. I don’t miss large animal work AT. ALL. What are forceps compared to a calf jack?

            I’ll keep my dogs and cats in a happy hospital with a sterile OR, thank you very much.

          • Durango
            August 17, 2014 at 9:15 am #

            “Calf jack”??? Oh my…

          • Stacy48918
            August 17, 2014 at 9:26 am #

            Here ya go…


          • Durango
            August 17, 2014 at 9:35 am #

            Holy cow! 😉

            And all gloveless, to boot.

          • Elizabeth A
            August 19, 2014 at 12:41 pm #

            New personal rule – Do Not Click On Large Animal Vet Links.

            I’m sure those people are using best practices and doing their best for the animal. I still need smelling salts.

          • Mel
            August 19, 2014 at 11:58 am #

            Worst one I’ve seen so far was a big, roomy dam who had a pair of still-born twin bulls who both presented backwards with all of their legs pointing towards the dam’s head and fully extended. (Imagine calves in the pike position with the tail presenting.)

            Thankfully, the vet could give the cow an epidural so she wasn’t in as much pain as she would have been otherwise.

            The vet had to perform two fetotomies – which wasn’t so very bad in and of itself – but the dam’s had vaginal tears AND either broke her pelvis or tore nerves. We had to euthanize her a few days later.

            I stayed away from the barn for a week or so after that. It was too much for me….

          • Karen in SC
            August 19, 2014 at 12:25 pm #

            Very sad story.

            Now who says “Trust Birth”?

          • Mel
            August 20, 2014 at 9:44 am #

            I never have – I heard the stories of our births growing up – but two years on a dairy farm have given me no additional reasons to trust birth.

    • Amy
      August 21, 2014 at 4:13 pm #

      4th degree tear here! I also am in the same boat as you! I’ve had to throw undies away at work and the grocery store and go commando because of accidents. I feel your pain. A c-section would have made a huge difference in the quality of my life.

  10. Leah
    August 16, 2014 at 11:38 am #

    I’m confused. Is vbac a risk factor for prolapse? And isn’t this a criticism of hbac, not vbac?

    • Karen in SC
      August 16, 2014 at 1:19 pm #

      It’s a criticism of a desire so strong to have a VBAC that women who aren’t good candidates still can’t give up the idea. So they turn to an even riskier homebirth.

      • Leah
        August 16, 2014 at 11:43 pm #

        ah, ok. but that still means that this is about hbac, no?

        • MLE
          August 17, 2014 at 1:06 am #

          No, she was ensuring she achieved a VBAC by birthing at home. The purpose if the HBAC was solely to achieve VBAC, and nothing more. If she had not been determined to VBAC at all costs, the location of her labor would not have been significant.

        • Stacy48918
          August 17, 2014 at 1:36 am #

          No. See this post:

          This woman was dead set on a VBA3C. She did want to attempt it in a hospital – but without routine monitoring, without cervical checks, without an epidural. In short, she wanted to make it about as risky as possible…just short of staying home. She wanted to FORCE the doctors to comply with the way she envisioned birth should be, despite it being much more dangerous.

          This is where many of the complaints about not being “allowed” a VBAC (VBA2C, etc) come from. Even if these women are going to deliver in a hospital, they have an idealized and dangerous view of how birth should be that leads them to eschew routine monitoring and diagnostics for the sole reason that they believe they will hinder their attempt at a VBAC. Because it is the VBAC that is the goal.

  11. Stacy48918
    August 16, 2014 at 9:15 am #

    Even achieving your VBAC doesn’t mean everything will be rosy. This was posted just yesterday (very timely) on a birth board I lurk at. Mother got her all natural VBAC…plus massive tearing, repair under general anesthesia and a transfusion. Shoulda just had the RCS…

    “I went completely natural and Laurel arrived 5
    (long) hours later. Thank god for my doula – labor was really hard.
    She presented in a compound position (arm and elbow up by her head) and tore me so badly that I required general anesthesia for stitches. I
    tore in the vagina (very unusual) all the way from the top (near the
    cervix) and along the entire length of it. My doc said it’s the worst
    tear she’s seen. Plus two other tears to the labia, though none to the
    perineum, strangely enough. I lost a lot of blood and required a blood
    transfusion and a ct scan to make sure there was no other internal
    damage because the bleeding was so bad. It was really scary. But
    thankfully, everything was good and things calmed down after that first

    My own SIL said after her forceps/episiotomy VBAC she wished she’d just had the RCS. She had no idea that such trauma was possible or that it could be WORSE to recover from than a scheduled pre-labor RCS.

    • Cobalt
      August 17, 2014 at 6:54 am #


      • Stacy48918
        August 17, 2014 at 6:59 am #

        I KNOW! So she got her natural VBAC…but still ended up with general anesthesia, an ICU stay, separated from her baby and likely delayed breastfeeding. A scheduled C-section would have been so much easier!

        She’s since posted again and said that her recovery this time has still been easier than her C-section, though I don’t buy it. Even if it is, I’d love to hear how she’s doing 6 months, 10 years from now. How’s her pelvic support? How’s her marital life? She may be in Depends at 40 and have negatively impacted her sex life for the rest of her life just to have a VBAC. Not a good trade in my opinion. 🙁

        • Cobalt
          August 17, 2014 at 7:08 am #

          If I need stitches, I’d rather have them on the front than underneath! Time and scar tissue add up.

          • Daleth
            March 25, 2015 at 1:57 pm #

            Seriously. I said almost exactly that when I was fighting for my c-section.

        • moto_librarian
          August 18, 2014 at 9:06 am #

          She is in for a long recovery, and I don’t envy her a bit. I can’t even imagine how badly her tears must have been to require repair under general.

    • Opal
      March 25, 2015 at 12:02 pm #

      Correct me if I’m wrong, but how are these tears related to VBAC? The fact that she had a previous c-section doesn’t make her more likely to tear in this way, does it? Following the logic of the commenters here, it seems everyone should just have a baby via c-section to avoid tears. There’s no way this woman could have anticipated these injuries. Isn’t any laboring woman susceptible to them?

      • Cobalt
        March 25, 2015 at 12:18 pm #

        Tears are a risk of any vaginal delivery. That it was a VBAC means the patient can compare it to a cesarean, and had easy access to a cesarean if she wanted one. And yes, everyone SHOULD have the option, but that ability to choose is far from universal.

      • Daleth
        March 25, 2015 at 1:55 pm #

        Any woman planning a vaginal birth can and should anticipate that she could have tearing. A few minutes on PubMed or google should suffice to show that the risk of severe tearing (3rd or 4th degree) is on the order of 8%-10%, and if you spend more time researching it in valid sources (e.g. PubMed), you’ll also find that the risk of tearing goes up exponentially in any of the following situations:

        – Operative birth (vacuum delivery ups the risk by as much as 6 times, forceps by as much as 20 times),

        – Malposition (whether it requires operative birth or not),

        – Age (all our tissues become less resilient as we age, so the 35-38-41-etc.-year-old mother is more likely to have bad tearing than the 25-28-31-etc.-year-old mother), and

        – Lack of previous uncomplicated (no or minimal tearing) vaginal birth (if you’ve had such a birth before your risk of tearing is lower–your ladyparts are proven, as it were).

        The first two factors are unpredictable (except that you sometimes know in advance when the baby is malpositioned), but the second two are not. If you have those risk factors, you know it.

        I haven’t seen research but I would imagine that fetal macrosomia/big babies are also a risk factor for tearing, and again, that’s a risk factor you can get some indication of before going into labor.

  12. araikwao
    August 16, 2014 at 6:44 am #

    Wait, how does FDIU from IUGR = death due to VBAC?

    • Karen in SC
      August 16, 2014 at 9:03 am #

      I think because she was eschewing OB care in the hope of having a VBAC.

      • araikwao
        August 16, 2014 at 4:26 pm #

        Yeah, that’s the best I could some up with but it seems a little indirect to me.

        • Stacy48918
          August 16, 2014 at 9:41 pm #

          It seems a very direct connection to me. High risk mothers think their OBs are just playing the “dead baby” card by running various tests or declining to attend their VBAC so they go without testing or to a homebirth midwife. For those women the VBAC itself is the goal, so any testing that might possibly reveal an issue that would risk them out of their VBAC is their enemy. They want the VBAC so badly they are willing to go into it completely blind of a major complication and end up with a dead baby, just as long as the baby comes out of their vagina.

          • araikwao
            August 16, 2014 at 11:41 pm #

            I think the death was attributable to ideology rather than to VBAC per se, as VBAC can be done in an environment that minimises risk, and in many circumstances it’s not an irresponsible choice. Obviously not the case with this woman, but I don’t think it is accurate to say this baby’s death was directly caused by VBAC when it was never attempted due to his/her early demise.

          • Stacy48918
            August 17, 2014 at 2:02 am #

            It wasn’t an early demise. She was post-dates – 41 weeks. Her goal was a VBAC so I imagine she was trying to wait things out because “babies aren’t library books”, rather than be induced or schedule a RCS at 39/40 weeks…and her baby died in utero.

            This in addition to the apparent inadequate monitoring to know that her baby had IUGR.

          • araikwao
            August 17, 2014 at 5:15 am #

            Although I didn’t realise what gestation she was, I meant more a figurative “early”, in that the baby had died before birth. Again, due to the apparently unshakeable ideology, rather than actually attempting a VBAC.
            (It always interests me that the odds of successful VBAC drop after 40 weeks, yet still they wait – does the NCB hierarchy go like this: spontaneous VBAC > induced VBAC > spontaneous labour ending in RCS??)

          • Stacy48918
            August 17, 2014 at 5:38 am #

            I think it’s probably related to the recent study showing that induction at term (rather than post-dates) results in a decrease in C-sections. Placenta is healthier – baby is less likely to be in distress. Baby is smaller – less likely to be stuck/malpositioned. I would imagine those same reasons apply to term/post-date VBAC attempts as well.

            I think your hierarchy is spot on. Even the recent “hospital is trying to force me to have a C-section” lady Jennifer Goodall – she ended up needing another C-section but was still celebrating the fact that she labored at home unmonitored first until realizing she wasn’t progressing and THEN went in for her C-section. The MAN still won but at least she went into labor on her own. Post-dates as well.

          • Eszter
            September 29, 2014 at 2:12 pm #

            I was not high risk and my OB did play the “dead baby card”, trying to pressure me into having a RCS.
            I did not let myself be pressured and had my VBAC with no problems at 41w3d in a hospital with CFM. I purposefully went to a different hospital, not the one my OB worked at and ended up with a VBAC expert doc delivering my baby.

          • Daleth
            March 25, 2015 at 2:03 pm #

            Funny how they forget that there is no “dead baby card” to play unless there actually is an increased risk of your baby dying.

            It’s really chilling that they use such flippant language to describe a potential tragedy.

    • Leah
      August 16, 2014 at 11:39 am #

      I don’t understand that either. I also don’t understand how prolapse relates to VBAC.

      • fiftyfifty1
        August 16, 2014 at 1:56 pm #

        Cord prolapse happens during labor. It doesn’t happen with a scheduled repeat CS. It’s one of the risks that you take on (well actually that your baby takes on) when you choose to try for a vaginal birth rather than a CS. This risk is largely mitigated if you deliver in a hospital with continuous monitoring. If you choose to deliver at home and a cord prolapse occurs, your baby is very unlikely to survive. She really dodged a bullet.

        • Leah
          August 16, 2014 at 5:59 pm #

          but how does it relate to vbac?

          • fiftyfifty1
            August 16, 2014 at 9:36 pm #

            A pregnant woman with a history of a CS has only 2 choices about how the baby will be delivered: scheduled repeat CS or TOLAC. There are risks specific to planned CS and there are risks specific to TOLAC. Cord prolapse is not a risk of CS but is a risk of TOLAC.

          • Leah
            August 16, 2014 at 11:40 pm #

            But it’s a risk of any labor, right? I just don’t see how it related to the vbac issue. It’s a risk of vaginal delivery. I’ve got that. It’s not the “direct result of attempting a vbac” it’s just the result of attempting a vaginal birth. It just sounds like a critique of vaginal birth risks, but not vbac particularly.

          • Stacy48918
            August 17, 2014 at 1:41 am #

            And I doubt that anyone HERE would disagree with that very rational assessment of the risks of vaginal birth. But that’s the problem. The ICAN types don’t view vaginal birth that way. Vaginal birth is the way things are “supposed to be”. “Birth is as safe as life gets”. “Your body knows how to birth”.

            ICAN is VERY quick to spout the “increased risks of C-sections”, but where on their website is a corresponding list of risks of TOLAC and VBAC, to include the common things (tears, etc) and uncommon things (massive hemorrhage, prolapsed cord, etc)? I highly doubt it’s there because to them the C-section risks are ALWAYS worse, so why bother warning women about the risks of vaginal birth?

          • Montserrat Blanco
            August 17, 2014 at 4:20 am #

            Yes it is BUT if you labor at a hospital with EFM the problem will be picked up in seconds and you will have a C-section in minutes, saving the baby. If you choose to labor at home and your midwife is not even there you are going to have a dead baby.

          • Stacy48918
            August 17, 2014 at 4:38 am #

            EXACTLY. Even for those women that are planning to attempt their TOLAC/VBAC in a hospital many of them are told and are also planning to “labor at home as long as possible” hoping to show up fully dilated so that the OB will have to allow them to push. What they aren’t counting on is that there is no monitoring of their baby that entire time and he or she could be in real distress and they not know it. Again, being willing to sacrifice knowing your baby is OK, all for the goal of having the VBAC.

          • fiftyfifty1
            August 17, 2014 at 8:54 am #

            I can’t say it better than Stacy48918 said it.
            Groups like ICAN intentionally discount the inherent risks of TOLAC. The only one that they talk about is rupture, because rupture is the only one that they see as different from “regular” vaginal birth. They say “cord prolapses happen during regular vaginal births, so we can’t call them a risk of VBAC per se, so therefore they are not a risk of VBAC”. Likewise with tears, likewise with shoulder dystocia, GBS sepsis, abruption, late stillbirth etc. But you better believe they NEVER fail to list each and every possible risk of C-section. And they also never talk about how a mid-labor emergency CS is more dangerous than a planned pre-labor CS. This is especially egregious because a woman attempting a TOLAC is at higher risk of ending up with an emergency CS than a woman with no hx of CS.

            So in the end, they end up with a pros and cons list that has Rupture as the only risk of TOLAC, and about a million risks on the side of scheduled CS (even though many of those supposed CS risks are actually risks of emergency CS not planned pre-labor CS). Then they tell women that since TOLAC is obviously the safer option on that they can and should labor at home without monitoring as long as they can, or even HBAC.

            And I’m not even getting into individualized risk factors of specific women. You have to take into account why the woman needed the CS the first time. If the reason was baby distress, this puts her at higher risk of a distressed baby the second time due to tendency for making suboptimal placentas and/or cords. She is also at higher risk of late term stillbirth for the same reason. If it was for failure to progress she is at higher risk of shoulder dystocia the second time (mismatch pelvis size/baby size). Even cord prolapse which is what got us started on this in the first place! Cord prolapse is an especial risk for women with poorly shaped pelvises. Baby cannot descend easily and therefore doesn’t come down and fully “plug” the outlet with his or her head, but instead leaves a gap that a cord can sneak into.

          • Eszter
            September 29, 2014 at 2:08 pm #

            What about the inherent risks of c-sections?

          • Daleth
            March 25, 2015 at 2:02 pm #

            The inherent risks of c-sections are almost nil when it comes to babies. For full-term babies literally the only additional statistically significant risk is the chance that they might get accidentally nicked with the scalpel. I’ll run that risk any day rather than the risk of permanent brain damage due to hypoxia.

          • fiftyfifty1
            August 17, 2014 at 9:16 am #

            “But it’s a risk of any labor, right? I just don’t see how it related to the vbac issue. It’s a risk of vaginal delivery. I’ve got that. It’s not the “direct result of attempting a vbac” it’s just the result of attempting a vaginal birth.”

            Your logic is the same as that of people who claim that it is safer to drive across the country on vacation rather than fly. Because “dying in a car crash is not a direct result of driving to *my vacation destination*, it’s just the result of driving in general”. Since it’s just the risk of driving in general it can be discounted, whereas now AIRPLANE TRAVEL, that’s not a normal everyday risk, that’s an ADDITIONAL risk!

            But in the end, if you chose to drive to your vacation rather than fly, you and your passengers do have a higher risk of death. And if you do die in a car crash, it really was due to choosing to drive to your holiday destination rather than fly there.

          • Leah
            August 17, 2014 at 9:40 pm #

            I really don’t see how the vacation analogy relates. I understand that there are unique risks of vaginal delivery that are avoided by RCS. It still seems to me that this was problematic because it was an OOH birth, not because it was a vbac. I understanding that you’re saying it was because of vbac that she was driven to OOH birth. I don’t think we know much about this person’s qualifications for vbac, but if she was a “good” candidate but was not “allowed” TOLAC because of hospital policy (or other reason) it seems to me that the burden is also on the system (as well as her own decision to birth OOH) for pushing a woman into a situation where she made an unsafe decision to birth OOH to be able to make a major decision about her own body. I also understand that providers shouldn’t be pushed into situations where they are not comfortable providing care that they feel is unsafe. However, there are two hospitals where I live. Neither of them “allow” vbacs even though all of the local OBs are willing to attend vbacs. Some of them used to teach vbac classes, explaining the importance of cefm, etc.. but they no longer do since they are officially not allowed. Now they have women staying home and walking in the door ready to push, women flocking to OOH birth, and women signing refusal to consent to CS without even knowing what they’re signing. It doesn’t seem to me that that serves mothers, babies, or the providers who would like to care for the patients. It seems to me that the system is driving them to make riskier choices than they otherwise would. I do understand the point that ICAN (and the likes) do not accurately represent the risks of vbac and that many women are not making a truly informed choice when they decide to vbac. Is there really no room in the system to allow women to choose vbac (even if it has risks that RCS does not) but facilitate it happening in a place that it can be attempted *more* safely than OOH? That’s not a rhetorical question, or one that I have decided on an answer, it’s just something I’ve been thinking about since the local changes have happened and I’ve seen the frustration in providers and patients alike.

          • fiftyfifty1
            August 17, 2014 at 10:07 pm #

            So if the individual docs are willing why aren’t the hospitals in your area willing? That’s the piece of info that’s missing here. Usually it’s one of 3 things:
            1. The hospitals don’t meet adequate safe staffing standards of care. This means an OB, OR staff and anesthesia in house for the entire duration of the labor.
            2. The insurance companies are refusing to cover VBACs. As Young CC Prof has pointed out before, insurance companies are remarkably free of ideologic bias. If something statistically is safe enough that their company is not likely to experience a net loss by insuring it over time, they will insure it. But the opposite is also true.
            3. The individual hospitals have recently stopped supporting it because of a high profile VBAC disaster.

            We could fix #1 by having more governmental control in hospital planning. For instance they could order one of the hospitals to close its maternity ward so that the other hospital could have high enough volumes to afford keeping the needed staff in house 24/7.

            We could fix #2 through tort reform.

            We could fix #3 by deciding as a society that we are willing to sacrifice a certain number of babies so that women can get the VBACs they want. That brings us right back to Dr. Tuteur’s question: How many dead babies is one VBAC worth? Or probably more accurately, how many VBACs does it take to make up for 1 dead baby?

          • Leah
            August 17, 2014 at 10:24 pm #

            One hospital has never allowed them. One had a high profile disaster with a positive outcome. It was a catestrophic uterine rupture that both mom and baby survived because of vbac procedures in place.

          • fiftyfifty1
            August 18, 2014 at 8:43 am #

            A near miss looks very different from the outside as opposed to the inside. From the outside it’s All’s Well That Ends Well. From the inside, where you watch the whole thing unfold in real time like a real life horror film and the outcome has yet to be determined but YOU are responsible for the outcome, and that outcome is the life of a baby and a young mother with another child at home…. It looks and feels real real different.

          • Leah
            August 18, 2014 at 10:57 am #

            Sure, that’s true. I do have a somewhat “inside” perspective, although I wasn’t directly involved with the patient. It was the insurance that decided to drop vbacs. And I still don’t think it serves the mothers or providers who want vbacs, and it will be the babies who pay the price. If the goal is really healthy babies and moms, this is most definitely not going to help.

          • Stacy48918
            August 18, 2014 at 3:07 pm #

            “it will be the babies who pay the price”
            In what way? My church pianist suffered a uterine rupture last Thursday trying for a VBAC in a hospital. In what way would a VBAC ban mandating a RCS at 39 weeks have hurt her baby? Other than she’d be home and healthy right now?

          • Eszter
            September 29, 2014 at 2:07 pm #

            A VBAC ban would have hurt thousands of other women who would have been denied choice and a chance at a TOLAC.

          • fiftyfifty1
            August 18, 2014 at 6:32 pm #

            I find it interesting (and telling) that when a hospital decides it can no longer offer VBACs, that so many people flock around the hospital trying to shame it for supposedly making babies “pay the price” when their mothers choose HBAC. Interesting that they don’t flock around HBAC mothers guilt-tripping them or send peticions to ICAN protesting that their vaginal at any cost message is risking lives.

            The reason is that deep in their hearts they know that the medical establishment really is the only responsible group, really is the group that *actually* has a goal of healthy babies and moms.

          • Stacy48918
            August 16, 2014 at 9:38 pm #

            Because the ICAN types promote VBAC, almost as a virture. That’s it – VBACs for everyone. Doesn’t matter why you had a C-section before or how your current pregnancy is going the answer is always “VBAC”.

            There is minimal to no discussion of the risks involved with that choice. C-sections are demonized and VBAC is glorified. Sure, you might go to the hospital and have a relatively easy 8 hour labor, vaginal delivery, no tears, home tomorrow. Or, you could tear top to bottom, need surgical repair under general anesthesia and transfusions. Or you might have a prolapsed cord and a dead baby. Or any other complication that is a risk of VBAC but not RCS.

            Women are not being told of the risks of VBAC in groups like ICAN. They are just being told that their prior C-section was likely unnecessary and they need to have a VBAC. Their VBAC could turn out to be worse than any C-section.

          • Eszter
            September 29, 2014 at 2:04 pm #

            Anybody with half a brain knows that VBACs are not for everyone, however there are two sides to the coin. Some OBs seems to think VBACs are for no-one, but conveniently forget to tell you and use bait-and-switch.

          • Opal
            March 25, 2015 at 12:12 pm #

            I’m honestly asking: how are the risks of vaginal birth listed in the comment above uniquely related to VBAC? Aren’t they just related to vaginal birth, period, regardless of OB history?

          • Cobalt
            March 25, 2015 at 12:33 pm #

            Yes, but some risks are greater in VBAC, most notably uterine rupture. VBAC is not the same risk profile as a woman without a history of cesarean or with multiple cesareans. It also matters somewhat why the primary cesarean occurred.

        • Eszter
          September 29, 2014 at 2:01 pm #

          So with the same logic, first time mothers should have an elective c/s at 39 weeks, because otherwise they expose their babies and themselves to certain risks, like cord prolapse, etc? What about the risks associated with c/s? What about someone who wants 3 or more kids? There is NO risk-free birthing option, ever.

    • Stacy48918
      August 17, 2014 at 2:17 am #

      Forgetting the IUGR momentarily…

      The mother was 41 weeks. I would wager that mom was planning on waiting as long as legally allowable before an induction or C-section would be necessary so she could have her VBAC. And in the process her baby died in utero. An induction at 39/40 weeks or a RCS would have resulted in a live baby, but that wasn’t her goal. A VBAC was. So she waited. And her baby died.

      When your goal is a VBAC, you will push to wait as long as possible, including going post-dates to 41/42 weeks. Except that increases the risk of stillbirth.

      Post-dates. Prolonged ROM. No GBS testing. No GD testing. No NSTs. No US. Macrosomic babies. Multiple C-sections. No in-labor monitoring. I don’t oppose all VBACs but there is a line one crosses where decisions are made purely to try and achieve a VBAC even though it directly increases the risk of death for the baby. That is where VBAC = death of baby. They were willing to take tremendous risk just to achieve the VBAC.

      • araikwao
        August 17, 2014 at 5:21 am #

        I think this is my point – it was the ‘VBAC at all costs” mentality that caused the death rather than her actually *having* a vaginal birth after a previous caesarean.

        • Stacy48918
          August 17, 2014 at 5:34 am #

          In some respects though it doesn’t have to be as extreme as “VBAC at all costs”. How many moms/midwives believe that baby “isn’t a library book” and want to wait until 42 weeks before inducing? Post-dates just adds one more element of risk to a VBAC – any VBAC, not just the extreme ICAN types.

          • Cobalt
            August 17, 2014 at 7:01 am #

            My pregnancy board has a lot of these types. They keep posting how awful it is that someone would dare to be induced for anything less than an immediate life threatening emergency. Because otherwise “where’s the magic?”.

          • The Bofa, Being of the Sofa
            August 17, 2014 at 8:54 am #

            Holy smokes, if there IS a “life threatening emergency” who wants to piss around with induction? Go straight to c-section and get the baby out!

        • fiftyfifty1
          August 17, 2014 at 9:08 am #

          “Mentalities” don’t cause deaths. Concrete physical factors do. In the case of the late term IUGR stillbirth baby, the death was caused by placental insuffficiency. This was 100% avoidable with standard OB care and a scheduled repeat CS. It was 100% UNavoidable with VBAC.

          Keep in mind that if a placenta is so poor that it produced a tiny baby and then couldn’t even meet the metabolic needs of this tiny baby during a non-labor situation, it absolutely could not have supported this baby through the increased demands of labor and delivery. This baby was not coming out the vagina alive.

          • araikwao
            August 19, 2014 at 10:50 pm #

            I think this is getting unnecessarily pernickety. Mentalities may not cause deaths, but the actions – or lack thereof – taken as a result of them most certainly do. This blog is full of stories where “trust birth!” has led MWs to do nothing (or do weird, implausible stuff), and mothers and babies have died as a result. In the event of proper antenatal care for this mother, perhaps there would have been an opportunity to weigh up the risks and benefits of either mode of delivery before disaster struck. Unfortunately we will never know.

      • Eszter
        September 29, 2014 at 1:57 pm #

        “legally allowable”? Meaning at some point a pregnant woman should be legally forced to have a c-section or an induction??? What about bodily integrity? What about patients’ rights?

  13. Box of Salt
    August 16, 2014 at 4:02 am #

    I read the title to this post and I was hoping it was all hypothetical.

  14. Junebug
    August 16, 2014 at 12:20 am #

    Happened to just find these two brilliant hbac princesses in some random threads from 2011 on a blog:

    “We had our first home birth last year after 4 c-sections. Before we decided to have a vba4c, we took time to educate ourselves, took a vbac class, and then found a midwife who was willing to help us. Most importantly, we prayed for the vbac and felt total peace about it. It turned out amazing! It was a 2 hour labor, so the midwife didn’t make it in time and my awesome husband had the honor of delivering our daughter. It was peaceful. It wasn’t an emergency. It just happened. We knew God was there leading us through it all and we rested in that.

    If any one was ever considering doing a vbac, especially at home, I would recommend taking a vbac class first. We know several doulas that hold these classes. Also, know your legal rights. A good place to start with that is
    Lastly & most importantly, PRAY! Go with what Jesus is telling you.

    We are 17 weeks pregnant with our seventh child. We are excitingly planning a second home vbac after 4 c-sections. We humbly give all the Glory To GOD!

    October 31, 2011 at 11:16 AM Add Reply
    Rightthinker said… 7
    I love homebirths! After 5 hospital births, including a c-section for a transverse baby, and a “forced” unnecessary repeat c-section due to a VBAC ban at the hospital, I had our 6th baby at home.

    It was a few hours of labor when I delivered 10 lb 9 oz Oliver James at just shy of 42 weeks.

    I am pregnant again, and unfortunately, the new midwife licensing law has made it illegal in the state of Idaho for a midwife to attend my birth. I am likely going to utilize a CNM in neighboring WA to attend my birth, God willing.

    The only other choices are driving an hour away for a VBA2C hospital birth at a VBAC supportive hospital in WA as I did with our 5th, or unassisted. A c-section is out of the question, since it is not necessary for me.

    Love the blog and the post..I’m a new follower.

    God Bless!”

    • Junebug
      August 16, 2014 at 12:23 am #

      One midwife no show for hba4c and one post dates 10.5# baby after 2c but er mah gawd it all worked out so homebirth is aaaaammmmaaaazzzziiinnngg! We are totally clueless at how utterly dangerous that was! Warm fuzzy blessings! Educate urselfs!

      These midwives are a damn menace to society.

    • Anj Fabian
      August 16, 2014 at 10:47 am #

      Doulas giving VBAC classes? Oh, yeah. Doulas totally know everything there is to know about VBACs – like how to profit from them, or rather from the idea of a VBAC.

      • The Bofa, Being of the Sofa
        August 16, 2014 at 10:56 am #

        Oh but doulas don’t give medical advice, don’t you know?

        • Anj Fabian
          August 16, 2014 at 11:02 am #

          They are helping women to have the birth of their dreams! Birth is different. It’s natural. Birth is not a disease!

          (I think I’m missing a few memes. Help me out folks!)

          • D/
            August 16, 2014 at 1:26 pm #

            Not exactly memes, but here are a few recent verbatim one-liners from a professional group:

            ‘Women birth babies in jungles and rice fields and are fine.’

            ‘You really dont need anything to birth except trust, your vagina and maybe some towels.’

            ‘Anyone can learn to resuscitate a baby …at least long enough to buy time for an ambulance to arrive.’

          • Anj Fabian
            August 16, 2014 at 1:57 pm #

            I can mock the first two but the last one is so ignorant and misguided that I can only groan and shake my head.

            Can you assess the baby?
            Can you suction it correctly?
            Do you have the equipment to do the most basic NNR?

            I can’t do any of that. The best I could do would be to follow the dispatcher’s instructions.

          • Young CC Prof
            August 16, 2014 at 5:52 pm #

            Sure, anyone can learn to resuscitate a baby. Start with nursing school, and then pursue an appropriate specialization. In a few years, you’ll know exactly what to do. And why you never want to do it in a living room.

          • D/
            August 16, 2014 at 6:15 pm #

            Sometimes though you can be a quick study and just jump to that key lesson before you even have a remote clue what to do.

            My first week as a graduate nurse (probably 4th or 5th delivery I observed) was an unannounced gastrochisis requiring resuscitation!
            ^^”Why I’d NEVER want to do it in a living room!”^^

        • D/
          August 16, 2014 at 1:42 pm #

          No medical advice, but some really do seem to know a lot though.
          A few recent “What I know” doula quotes:

          “No one, really no one, makes a completely informed decision. There is always more we can learn, always more to know. We do the best we can with what we have at the time. There is a threshold for information, we learn as much as we can and operate with that knowledge. I think it’s important that we as birth workers and as mothers learn to acknowledge and listen to our intuition as well. That’s how we know we need more information or how we become ok deciding with what we know.”

          “I know that birth is safe and things going wrong fall into three categories:
          1) nothing that can’t be handled easily with either a car ride to the hospital or something hubby or myself can do.
          2) something caused by staff intervention (like in a hospital)
          3) something that nobody could have prevented or fixed no matter where you were.”

          “Seeing births as a doula…I know how big of a difference a midwife can make in life and death. I will have a midwife at my hba3c.”

          • jenny
            August 16, 2014 at 9:08 pm #

            The author of quote two “I know that birth is safe” is actually, literally, stupid.

          • D/
            August 16, 2014 at 10:38 pm #

            You are being too kind about what she actually is … Her stupidity will in all likelihood play a part in some future *avoidable* tragedy that she will accept no responsibility for.

            I am so very sorry for the loss of your daughter.

    • InvisibleDragon
      August 16, 2014 at 3:39 pm #

      “A c-section is out of the question, since it is not necessary for me.”

      The two parts of that sentence don’t seem to go together. Or is that just me…? If it’s “out of the question” why would it follow that it’s “not necessary”?

      I have a headache…

  15. guest
    August 15, 2014 at 7:27 pm #

    As Forrest Gump would say, “Stupid is as stupid does”…

  16. jenny
    August 15, 2014 at 7:07 pm #

    A few weeks after my daughter died (d/t an unplanned OOH birth with complications), I had a conversation with a very natural birth oriented acquaintance where I said, “Well… I guess I could be recovering from a c/s and she could still be dead, and maybe that would be worse than this.” I was struggling to find some way to understand what had happened, how my beautiful child could have died, how this could have happened when everyone I knew believed that birth was safe and natural and “not an emergency.” Now I know that any intervention that could have improved her outcome in any way would have been worth it, even if it ultimately failed.

    I know I’m supposed to accept other people’s feelings and interpretations of their own experiences, but all I can think is how lucky we are to live in a time and place where there are c-sections and safer ways of giving birth. After my daughter died, there was still a next time for things to be different. My next child had a chance to be born in a place where he could have the best shot at life. I grieve for all the women around the world who have to suffer losing a child and knowing that there is not next time things can be different, because next time they will be in the same resource poor position they are in now, or next time their child will have a problem science cannot solve.

    • MLE
      August 15, 2014 at 8:18 pm #

      I always think about the mothers and fathers in pretty much any time before recent history, and how families could lose multiple babies or children to childbirth or disease as a routine matter. How did they carry on? It’s mind boggling to me, and even more so that some seem to want to return to that time.

      • Smoochagator
        August 16, 2014 at 9:10 am #

        I think at that time the idea that “some babies aren’t meant to live” was essential to just coping. You were grateful for the children that did live and hardened yourself to the grief. Otherwise how could mothers and fathers go on?

    • Junebug
      August 15, 2014 at 8:42 pm #

      I’m so sorry for your loss.

    • Smoochagator
      August 15, 2014 at 8:55 pm #

      That’s a really good way to put it. You had a chance for a “do over” of sorts – not that your daughter could EVER be replaced, but rather you had a chance to give birth in a place & manner that would give your next child every chance at life. But a mother in a developing country who doesn’t have access to lifesaving medical technology doesn’t have that chance. Her next pregnancy could end even worse – with her death as well as the child’s.

      And I am very, very sorry for your loss.

    • Lynn
      August 15, 2014 at 11:36 pm #

      I am so sorry for the loss of your precious child.

  17. Ellen Mary
    August 15, 2014 at 6:35 pm #

    Yk what makes Cesareans awesome? Live babies. I can’t think of anything less desirable from a NCB POV than a Cesarean on a baby that is not even going to ever be ‘earth side’. That is the most awesome thing about planned CNM/OB Births: the overwhelming majority of their Cesareans produce babies that are alive.

    • CanDoc
      August 15, 2014 at 8:15 pm #

      Oh man, I am TOTALLY stealing this line to use in clinical practice: “You know what make Cesareans awesome? Live babies.” Love it.

      • Elizabeth A
        August 15, 2014 at 8:30 pm #

        The OB who delivered my daughter came within a hair of actually saying that. He wound up settling on “we can do a lot more for her out than in.”

    • Kesiana
      August 17, 2014 at 4:35 am #

      YES. The idea of any sort of MAJOR ABDOMINAL SURGERY shouldn’t be taken lightly, but when lives are undeniably on the line, all bets should be OFF.

  18. Cody
    August 15, 2014 at 6:27 pm #

    I’m assuming this was with a lay-midwife. This is slightly off topic, but I’m wondering, in a circumstance like this; how much prenatal care is it assumed that this woman has had? Can a direct entry midwife, or whatever they’re called refer you for an ultrasound or blood work etc? How does that work? Also, is the midwife libel for just f-ing off when her patient needed her? You don’t just leave a woman who is 5 1/2 cm.

    • Bombshellrisa
      August 15, 2014 at 7:37 pm #

      As long as they are recognized as a healthcare provider in their state, they can usually order ultrasounds and blood work.

      • Young CC Prof
        August 15, 2014 at 8:07 pm #

        Even if they aren’t, they may have informal “referral” channels of some kind, like a CNM to sign the bloodwork form or a friendly ultrasound clinic.

        • Cody
          August 15, 2014 at 11:25 pm #

          But this is a problem. If there is no legal and appropriate way for them to conduct appropriate prenatal care, then this should be a big red flag. I’m not sure why people would choose a care provider that can’t offer anything better than the care a woman would have received in 1649. If a person is choosing illegal services to bring a child into the world, when there are other options, one has to wonder about his or her mental state and whether he or she if fit to care for children without at least some intervention from child protective services.

          • Busbus
            August 16, 2014 at 12:10 am #

            When I was pregnant and planning a homebirth, I had back-up care from an OB who knew my midwife and had me sign a contract that he wasn’t responsible for the outcome of my birth or some such thing. I have heard of other women who went to an OB practice for ultrasounds etc. without telling them that they were going to deliver at home (or not until the very end). I believe such setups are not uncommon among people who want a homebirth but also want prenatal care with blood work and ultrasounds.

          • Cody
            August 16, 2014 at 3:04 am #

            But that’s irresponsible. How can a woman expect a health care provider to give appropriate advice if she is withholding information? If the only option for having a HB is to lie or miss out on appropriate prenatal care, then it is not a good option. I think it speaks volumes about the type of people who decide to go to these extremes just to have a homebirth. I think they feel like they are freedom fighters or something, and it’s not even really about the birth experience like they say it is.

          • The Bofa, Being of the Sofa
            August 16, 2014 at 10:37 am #

            I think the way to think of it is that they act like it is a game of some sort, and they are trying to “win.”

      • Trixie
        August 15, 2014 at 9:31 pm #

        In the state this happened in, lay midwives are alegal.

        • Bombshellrisa
          August 15, 2014 at 9:49 pm #

          Oh, got it. Then ultrasounds and blood work are part of the “cascade of intervention”. The parents were probably prepaid for the birth too.

      • PrimaryCareDoc
        August 16, 2014 at 8:07 am #

        Right, but you have to know how to interpret the data. Any idiot can order a lab test or an ultrasound. It’s what you do with the results that matters. Christy Collins is a case in point. She was able to order a BPP, but had no idea what to do with the results, leading to a baby’s death.

        • Amazed
          August 16, 2014 at 9:14 am #

          I am still interested to know how her back up OB story turned out. Was there such a doctor, after all?

          • PrimaryCareDoc
            August 16, 2014 at 10:31 am #

            I doubt that there was a true backup, in the sense of a doctor being informed of what was going on.

            BTW, Collins’ “homesweetbirth” website is now defunct. I hope this means that she is now well and truly out of business.

          • Amazed
            August 17, 2014 at 8:37 am #

            I hope so!

    • Ash
      August 16, 2014 at 11:59 am #

      Not sure about “alegal” or “illegal” midwives, but it appears CPMs can apply for a NPI (National Provider Identifier) in their state. I think the category is “Midwife”

  19. Julie Ann
    August 15, 2014 at 5:02 pm #

    If the HR that DH heard was the mother’s, it is then a life threatening condition for the mother as well. Increased HR comes before increased body Temp c any infection including amnioitis. I wonder how long her heart was racing before they went to hospital. So you have 2 patients in a very dangerous situation. As a L&D nurse I would have summoned the OB long ago. Any CNM or nurse would have.

    • Young CC Prof
      August 15, 2014 at 5:15 pm #

      Well, the surgeon did say there was infection “all over” the baby and uterus, so I imagine she was very sick or getting there.

    • Anj Fabian
      August 15, 2014 at 7:26 pm #

      I’ve seen multiple stories of HB transfers where women came into the hospital for nothing more serious than “maternal exhaustion” (according to the MW) and the way they were treated made it obvious they were in terrible shape. Severe dehydration is very common, skyrocketing blood pressure is another one. Signs of infection also have figured in.

      What is surprising is that none of the women seem to have realized how ill they were. Yes, they were in pain and exhausted but they appear to think that how they felt was due to labor, not their body physically failing.

      I can’t decide if they were out of it due to their physical condition or suspected that something was amiss and their midwife wouldn’t confirm it. It’s one reason that I don’t ever trust a midwife’s assurance that everything is “fine” unless I am given hard data.

      • Junebug
        August 15, 2014 at 8:49 pm #

        My midwife had ditched me and left me at home laboring at 5cm. I couldn’t take the pain, vomiting, or fear anymore and went to the hospital (after much drama between the midwife and I, who returned when my husband told her we were transferring). I was insanely dehydrated, going through 3 bags in no time at all, and my baby’s HR was in the 30/40s.

        No monitoring because I was alone, no way to know things were going so wrong. Thankfully after blowing up my uterus with fluid (can’t remember the tech term), hydrating me, and getting me medicated her HR shot back up.

        If every OR wasn’t busy with a c section and I had my own Dr and not just the guy on call, I probably would have gotten an emergency section. I wouldn’t have begrudged that decision one bit. Thankfully the measures they took to stabilize us while waiting for someone who could perform the surgery actually solved all of our problems and one was no longer needed.

        • Junebug
          August 15, 2014 at 8:54 pm #

          To add, if I trusted birth and/or had the buddy buddy relationship many have with their midwives my daughter would be dead. The only reason she is alive is because I remained skeptical of births inherent safety.

          In retrospect I’m kind of glad my midwife wasn’t slightly less shitty, and that I didn’t have her and a doula there to egg me on and tell me everything was cool.

        • Sarah
          August 17, 2014 at 8:33 am #

          I still can’t get over your midwife ditching you- jaw dropping

      • Smoochagator
        August 15, 2014 at 8:58 pm #

        This is interesting, considering how opposed NCBers are to IVs, insisting that mother’s better off eating and drinking for sustenance. But as Junebug noted below, sometimes mom can’t keep anything down, or just can’t be bothered to sip Gatorade between intense contractions. So that evil IV might actually be a life-saving “intervention.”

        • RNMomma
          August 15, 2014 at 9:17 pm #

          That’s the thing… I think a lot of it is that they can’t be bothered and it isn’t insisted on. I was nauseous, but forced myself to eat some fruit and take constant sips of water and juice because I could tell I was getting dehydrate. My midwife wasn’t the one making me do it. I was.

      • RNMomma
        August 15, 2014 at 9:13 pm #

        I find it surprising as well. As a health professional, it’s hard for me to understand that not everyone can differentiate between labor pain and “something’s wrong.” I was fully aware of my dehydration when I was in labor.

        • Dr Kitty
          August 16, 2014 at 4:32 pm #

          Or there is sheer bloody mindedness and endorphins.

          Intellectually, I knew that after I hadn’t kept anything down for more than 72 hrs with hyperemesis that I was dehydrated and needed to go to hospital. But I felt *fine* and would have driven myself there if my GP hadn’t insisted otherwise.

          Likewise, I was at home going “well, I appear to have rebound and guarding and right iliac fossa tenderness and a temp of 39C…maybe it’s appendicitis. I should get a taxi to A&E, but surely I’d be feeling worse than this” and not actually feeling that unwell.
          I had a heart rate of 140 and a systolic BP of 80 in triage, which gets you ALL the drugs and a surgical consult.

          The major sign that I am very unwell appears to be a stubborn denial that anything is wrong with me.

      • Sarah
        August 16, 2014 at 1:19 am #

        I just read a news article about a new mum who put her tiredness down to being a new mum- unfortunately she had undiagnosed type I diabetes and died. I think there’s a real culture of being stoic around childbirth and pregnancy that doesn’t do us any favours

        • Karen in SC
          August 16, 2014 at 8:02 am #

          That is exactly what happened to me. I was so tired, I could barely do anything. I even had trouble snapping my son’s onesies and writing with a pen. I thought it was normal for being a new mom. Around six months later, a friend visited me from out of town and told me I looked like death. That scared me so I made an appointment with my primary doctor.

          Turned out I was severely hypothyroid, which can happen after pregnancy, but mine was so low she felt it was permanent. In fact, she told me I was a few weeks from a coma and possible death.

          • Sarah
            August 17, 2014 at 8:32 am #

            That’s terrifying! Glad you were picked up but I guess it just illustrates that women expect to feel crappy after having a child so follow up post birth is so important

      • rh1985
        August 21, 2014 at 3:16 am #

        I was not in labor but I had pre-eclampsia and had no idea how sick I was. I had the same symptoms I had for most of my pregnancy just worse. I went in to the hospital because I assumed I felt so awful due to dehydration (I threw up almost everything I tried to eat) and my OB had said I could get an IV for hydration if I went in. I was completely shocked to be told how sick I was. My daughter was born by CS about an hour after the diagnosis.

  20. ngozi
    August 15, 2014 at 4:38 pm #

    I can totally see a patient in a hospital laboring, and everyone goes home because they have children to see about, or a fish fry to attend, or “Dancing With The Stars” is about to come on…yeah right.
    If an OB had left like this midwife did, the natural birth community would be up in arms. Why is it acceptable for this midwife? The natural birth community goes up in arms even if they think an OB is hurrying things along, much less leave all together!!

    • Ash
      August 15, 2014 at 4:40 pm #

      I have seen linked FB threads recommending that a midwife go home during a stalled labor so the pregnant woman can relax and have her “space”

      • D/
        August 15, 2014 at 6:12 pm #

        Saw a fb thread just now on suggestions for furthering your education on pregnancy, birth, etc. that included on a short list of references along with this gem,

        “I heard if you read for an hour every day for 7 years, you can call yourself an expert. There is SO MUCH on line you couldn’t possibly run out of information!”

        … Who knows, depending on the timing your midwife could leave to give you your “space” but come back as an “expert”.

        • Young CC Prof
          August 15, 2014 at 7:17 pm #

          You can study an hour a day for 7 years, or you can ask a doctor who studied or practiced at least 12 hours a day for 7 years. It’s a dilemma.

          • D/
            August 15, 2014 at 8:07 pm #

            You *are* just being funny, aren’t you? … There is really THAT MUCH information on the internet?!

          • AgentOrange5
            August 17, 2014 at 5:29 am #

            of course there is that much information on the internet (nevermind the quality of that information….)

          • Amazed
            August 17, 2014 at 8:39 am #

            No but you cannot become educated with just one reading. You have to read, reread, rinse and repeat only to memorize what you’re talking about. Not even understand it.

          • D/
            August 17, 2014 at 6:45 pm #

            You have inspired me! Without a need for understanding, I can become an expert in something in no time … I read fast and memorization comes pretty easy for me.

            So today I decided to become an Ebola expert. Picked that specialty out of the air after noticing a post by an *actual_nurse_practitioner* on my fb feed: “Living Young versus Ebola”. After soaking my big toe in the idea of warding off Ebola with cinnamon bark, oregano and other EOs I decided Ebola “treatment” may not be my calling after all.

            I did manage to become Ebola (social media panic management) expert though. Read the protocol here three times, memorized it and will move on to my next speciality tomorrow!


    • The Bofa, Being of the Sofa
      August 15, 2014 at 5:05 pm #

      Dancing with the Stars is over. Now they should go home to watch So You Think You Can Dance. Valerie is awesome. I could watch her all day. I have such a big crush on her…

    • Elizabeth A
      August 15, 2014 at 8:34 pm #

      If an OB left like this midwife did, the *hospital* would be up in arms! The NCB community would have to stand in line to be outraged, behind at least six separate, equally outraged factions of the medical community, all of whom would have extremely specific and insulting things to say at great length and high volume.

    • August 16, 2014 at 2:53 am #

      At one time in my career I could have admitted private patients to the hospital where I worked as a staff midwife, and delivered them in a special “birthing suite”. The reason I chose not to do this was because I had three children at home and could not guarantee child care for them at any hour of day and night for extended periods. It was a no-brainer: either I’d be derelict in my duty to my patient, or my children, and both are unacceptable.

  21. Are you nuts
    August 15, 2014 at 3:44 pm #

    This really blows my mind. Most of the time when you talk to a mom who has lost a child, she is SCARED TO DEATH of the thing that ended her child’s life. Car wreck – scared of driving. Drowning – won’t set foot in a swimming pool. They may be able to overcome these fears because they have to in order to get on with their lives. WTF is with these women who will jump back in with both feet to the very thing that killed a previous child. Especially when, unlike driving or swimming, they are VERY likely to get the same result (a dead baby) as they did before.

    • jenny
      August 15, 2014 at 7:54 pm #

      Denial is a very powerful (and sometimes maladaptive) coping mechanism.

      These women are very unlucky and their babies even moreso. We all do things that aren’t entirely safe all of the time and many people make ill-advised choices out of ideology, but only some people pay the price.

    • Junebug
      August 15, 2014 at 8:59 pm #

      It is because driving a car or swimming usually isn’t the cornerstone of their personal identity like natural birth and vbacs become to these lunatics.

  22. Medwife
    August 15, 2014 at 3:31 pm #

    The midwife went home and left a Doppler with the parents. Really. Really? REALLY?!! Oh yeah, no sign of infection except for prolonged ROM+a completely stalled labor at 5-6cm. FFS.

    • Amazed
      August 15, 2014 at 4:54 pm #

      You’re just jealous. How often have you had the delightful chance to leave hospital during a VBAC labour you’re solely responsible for overseeing to take care of your kids? That would be right, 0 times, amirite?

      Don’t you feel you should have become a real midwife like the one in the story and collect charges for caring of your own kids?

      • Medwife
        August 15, 2014 at 5:17 pm #

        “You know, mrs smith (I mean Diane, we are bosom buddies after all), the nurses and I have been here almost 12 hours, your labor isn’t going anywhere real fast, and I need to feed my kid, get some laundry done, you know how it is. You’ll be on the monitor. If the bottom squiggles are too close together or the top squiggle goes over 160 or under 110, give me a call. Toodles!”

        • Amazed
          August 15, 2014 at 5:18 pm #

          No, no, you have nurses to cover for you. Not the same situation at all.

          • Medwife
            August 15, 2014 at 5:21 pm #

            Oh no, they’re leaving too. We all need a break.

  23. Julie Ann
    August 15, 2014 at 3:07 pm #

    148 is a perfectly normal FHR, however, it is HB variability that’s important. I wonder that the HR was always “the same” as husband implied. I think it’s unconscionable that the MW left c such a high risk Mom. Of course I don’t even believe in HBAV. I am a retired L&D RN.My children were born at home c lay MWs who would have advised the hospital for this Mom. Hospitals have changed since I delivered. We had no rooming in, we were actually discouraged from breastfeeding. Would I deliver at home today? No. I realize now that if something went wrong I would never recover. ://

    • The Bofa, Being of the Sofa
      August 15, 2014 at 5:07 pm #

      Yes, variability is an important factor, but I don’t buy for a second that the baby’s heartbeat was really 148. I don’t think they ever measured the baby’s heartbeat.

      • Medwife
        August 15, 2014 at 5:19 pm #

        It could have been the woman’s heartbeat doubled by the Doppler. They do that, either double a hb that’s very slow or halve one that’s very fast. Gotta confirm with your ears. The same thing can happen with cEFM.

        • August 16, 2014 at 3:00 am #

          Just take the maternal pulse at the same time as one listens to the Doppler. I once had a case where the maternal pulse was160 and the FH was 80.

          • Medwife
            August 16, 2014 at 10:20 am #


    • the wingless one
      August 16, 2014 at 12:00 am #

      From 1:30pm (when my NST started) to 5:49pm (when my son was born via c/s) my son’s HR hovered right at 150, his strip was an almost perfectly straight line. I never would have known this was a bad thing though, but luckily the highly trained MFM, OB and nurses supervising my care did.

  24. jenny
    August 15, 2014 at 2:41 pm #

    It’s despicable that the midwife left them to essentially provide for themselves the care she should have been providing.

  25. The Computer Ate My Nym
    August 15, 2014 at 2:34 pm #

    Some questions about the second case:
    1. Did DH have any idea at all how to use a doppler? I have some doubts about the reliability of the number he got.
    2. Did anyone ever check the patient’s temperature? How does she know that she didn’t have a fever? (I apparently didn’t even notice when I was in labor and had a very high fever. My partner told me later that he heard someone mention a temp of 104 or 105, but I didn’t feel it.)
    3. Baby over 11#: undiagnosed gestational diabetes?

  26. Renee
    August 15, 2014 at 2:16 pm #

    Was Coraline post dates too?

  27. Renee
    August 15, 2014 at 2:07 pm #

    he sees no reason why I can’t do a vbac other than the fact that I have had 4 sections which puts me at VERY high risk!

    I can hear in my mind just how this might have come out. “Yeah, if it wasn’t for the OTHER 4 CS that make you super high risk, you could totally have a VBAC. Just forget about the 4 !” It may have been in the tired, lightly sarcastic tone I would use with someone that refused to listen. Or, it could have been in a tone of, well, I am sorry this meant a lot to you! “:Well, if it hadn’t been for the 4CS, you could have VBAC’d” Which is more likely.

    But she heard only what she wanted to hear.

    • The Bofa, Being of the Sofa
      August 15, 2014 at 2:18 pm #

      “Aside from that, Mrs. Lincoln, how did you like the play?”

      • The Computer Ate My Nym
        August 15, 2014 at 2:30 pm #

        And Ms Lincoln replies, “Apart from that, the play was quite good! That actor Wilkes is quite talented, isn’t he? I think I’d like to see him in another play in the future.” As an aside, I’ve heard it said that Lincoln was a jerk to his wife and she might be well justified in thinking something like that.

        • MaineJen
          August 15, 2014 at 2:58 pm #

          But but but…Daniel Day Lewis!

        • AgentOrange5
          August 17, 2014 at 5:34 am #

          From what I’ve read Lincoln’s wife had a lot of psychiatric problems that probably both of them were ill-equipped to handle. She was pretty verbally abusive to him, & she left him at one point for a couple of years & moved back with her parents.

          • Stacy48918
            August 17, 2014 at 5:44 am #

            I think if 3 out of my 4 children died…I’d have some psychiatric problems too. 🙁

          • AgentOrange5
            August 17, 2014 at 5:57 am #

            good point!

    • yugaya
      August 15, 2014 at 4:34 pm #

      I read the other day a comment on one of NCB pages (improvingbirth?) that said sth like… “if I take the high number and believe them that there is a 4% risk of rupture that means that 96% of the repeat c-sections are unnecessary”.

      I think she applied that same (lack of) logic to what she was told and came up with conclusion that her HBA4C was not unsafe at all.

      • The Bofa, Being of the Sofa
        August 15, 2014 at 5:12 pm #

        Well, if by unnecessary you mean that they can be delivered successfully, then, yeah, but jeez, that’s a silly standard to apply. A 1 in 25 risk of a serious problem is orders of magnitude higher than anything that anyone reasonable would accept. Jeez, the risk of dying when trying to climb Mount Everest is only 1 in 50.

        For pete’s sake, the risk of dying in Russian Roullete is only 1/6 (with a six shooter). Avoiding that is mostly unnecessary.

        No one in their right mind accepts a 1/25 risk of a disastrous outcome.

        • yugaya
          August 15, 2014 at 6:04 pm #

          I don’t know what they mean by unnecessary, I truly don’t understand how in hindsight a potential risk of 4% avoided can ever lead to “gee see, the doctors lied, there was no risk at all of uterine rupture because look, I did not have one when I VBACed!!!”.

      • rh1985
        August 21, 2014 at 3:19 am #

        Not to mention most sane people would rather have an unnecessary CS than roll the dice and be the one that ended up with a dead or permanently damaged baby and/or loss of fertility.

  28. Mac Sherbert
    August 15, 2014 at 2:05 pm #

    Did anyone else notice the weight of baby Caroline? 11lbs. 2oz!! Anyone else thinking undiagnosed GD on top of everything else. Personally, I can’t imagine wanting to have VB after having one that big. My last was over 9lbs. and I’m so glad my VBAC never happened.

    I’m so sorry for the loss of this precious baby. I wish the Mom would get some counseling and realize that the healing she feels she needs is not going to come from a VB.

    • Renee
      August 15, 2014 at 2:13 pm #

      But think of how many warrior mama points she would have gotten for a 2 day SROM, HBAC with a 11lb baby! WOW.

      She could be out there saying “You can do it mama! I defied MY MFM, and had a HBAC, that lasted days after SROM, and birthed a 11lb baby! Don’t let the man keep you down! Get a HB MW!”

      Too bad the baby died, ruining her moms chances at winning the HBAC crown. I guess she will try again later! After all, what can be more glorious than trusting birth to have a HBA5C rainbow baby!

      (I sure hope she is speaking from grief, and not really thinking of trying this.)

      • Jules
        August 15, 2014 at 4:18 pm #

        My fourth child was 11 lbs 4 oz and had shoulder dystocia, and since it took longer for him to come out than anticipated, by the time I was fully dilated, my anesthesia had worn off and it was too late to get more. Luckily, I had a *fantastic* OB who was able to get my son out quickly without injury to him *or* me. When the perinatalogist I saw for #5 (I was 42 when I got pregnant) advised a C-section, given the fact that we may not be so lucky this time around, since shoulder dystocia can end badly, I took him *very* seriously and scheduled a C-section to be performed at 39 weeks. My daughter was 10 lbs, 11 oz. I had no desire to press my luck and risk my baby’s life. I can’t wrap my head around the fact that these women are willing to do that in order to have a ‘healing’ or ‘natural’ birth when the odds are clearly not in their favor.

        • Bombshellrisa
          August 15, 2014 at 6:20 pm #

          The difference is that you want a baby at the end of the day. Those women want bragging rights.

      • yugaya
        August 15, 2014 at 6:15 pm #

        “2 day SROM, HBAC with a 11lb baby! WOW.”

        What a perfect title for a birth story post on a homebirth forum! I’m not kidding, I found out that people actually do that in RL the hard way when I visited motherinsanity . com:

        “Homebirth, shoulder dystocia, 11lbs 12oz, 42+6 weeks, 7 hr labor – Wonderful!!!”

        • Amazed
          August 15, 2014 at 6:28 pm #

          I can’t believe it! I really thought you were kidding. Silly me.

          • yugaya
            August 15, 2014 at 6:39 pm #

            Just be careful if you go there to read, exclamation marks are contagious!!! :)))

        • Guest
          August 15, 2014 at 7:14 pm #

          She seriously sent her kids away for THREE WEEKS!?!?!?!

        • Mishimoo
          August 15, 2014 at 7:50 pm #

          I’ve read that one before! Oh goodness, my heart was in my throat for almost the whole thing.

          Except for the bit about transition – was kind of ‘meh’ about the description of the emotional stuff because it comes across as unrealistic. (Hitting transition for me, all 3 times, was “Argh I hate vomiting so much! Baby is nearly here though, so yay!!”)

          • Smoochagator
            August 15, 2014 at 9:07 pm #


    • Bombshellrisa
      August 15, 2014 at 3:09 pm #

      I wonder if she simply has large babies and that is why she had four previous c-sections. It’s always interesting listening to the women who give birth to large babies at home. If this mother was egged on at all, it was probably by a homebirth mother who told her “all my babies were large, those doctors just wanted to have you deliver by c-section because they didn’t want to get sued, you will be FINE at home and so will your baby”.

      • August 16, 2014 at 8:48 am #

        Part of the VBAC problem is definitely that not all women ARE VBAC candidates. The assumption, by the lay public, is all too often that there is no real reason to avoid a TOLAC/VBAC in any and all cases, except for hospital cowardice and the evil and lazy doctor.

        Generally, but not always, subsequent babies are a little bigger than the previous one — the average is about 200 gm.

        GDM can be diagnosed during any pregnancy. Many women are amazed, after several completely uncomplicated pregnancies, to develop it, which is why GDM testing in EACH pregnancy is so important.

        And, while macrosomia is the most common effect of GDM, the opposite can be true as well, with IUGR resulting from an incompetent placenta.

    • yugaya
      August 15, 2014 at 4:41 pm #

      I see a lot of GD test avoiding and ignoring on NCB boards. The problem is that pretending that something is not an issue or a risk factor does not prevent the complications. Magic unicorn thinking does not work, does not prevent shit and ultimately you may end up with a dead baby because you believed that magic unicorn thining was enough.

  29. Renee
    August 15, 2014 at 1:59 pm #

    And I am sure this mom still gave her glowing reports, further misleading other moms into hiring her. We need the MW name so it can be out there online somewhere that she WENT HOME, during a very dangerous time, and is responsible for a death.

    Bad enough she left during a VBAC, but after labor stalled? OMG, that is so bad even a total layperson like myself knows this is an ominous sign.

    These HB MWs are the WORST kind of amateurs, because they think they know it all, say they are experts, but are steeped in the worst type of ignorance. I am pretty sure any regular reader here, with zero experience, could do 100x better than even the most beloved HB MW. At least we would recognize the basics! I am surprised that mom did not rupture.

    At least the other mom went to the hospital. She would be DEAD had she stayed home. I wonder if she realizes this, and if she does, is she telling anyone else about it? Or is she still claiming HBACs are wonderful?

  30. PrimaryCareDoc
    August 15, 2014 at 1:55 pm #

    Is there a link to the second story?

    • attitude devant
      August 15, 2014 at 2:06 pm #

      Something tells me it’s a private FB group. Cue the trolls complaining that their privacy was violated.

  31. MaineJen
    August 15, 2014 at 1:51 pm #

    The midwife left because she was tired…and she left the couple with a piece of equipment they didn’t know how to use properly (because why would they?). Come to think of it, who is to say that the midwife even knew how to use the doppler properly? Who is to say the couple knew how to count heart tones properly? (148 bpm is pretty rapid, speaking as a lay person) No one can say these things for sure, because nothing was documented, because the one person who was supposed to be “with woman” was nowhere to be found, once the shit really started to go down.

    I’m sure both of these women have been thoroughly “debriefed” on their experiences by the midwives in question; I think that would go a long way toward explaining their willingness to try the whole thing again.

    • Renee
      August 15, 2014 at 2:01 pm #

      She was TIRED and had to tend to her KIDS, so she left an HBAC with a STALLED LABOR alone all night?
      She should be jailed so she doesn’t harm others.

      • Smoochagator
        August 15, 2014 at 4:07 pm #

        Yeeeeeah… except that she won’t.

      • Amazed
        August 15, 2014 at 5:05 pm #

        The more I read, the more I realize why I’ll never be a rich woman. Since I was a child, I’ve been watching my mom gulp one cup of coffee after another to fight exhaustion so she could actually teach the students she was paid to teach. And I’ve heard the refrain, Amazed, you go to the other room now and don’t come here until we’re done. Oh, and take care to keep your baby brother entertained, so often that I can sing it half-asleep.

        Bad family values.

        Moto, Bofa, everyone with little kids around, Hear Me Roar. It’s too late for me but it might not be too late for your children. Take care of teaching them the right course.

  32. Smoochagator
    August 15, 2014 at 1:24 pm #

    I can understand, I think, being deeply disappointed to have never been able to have a vaginal birth. Not that the children born by c-section are any less valuable or loved, but that the mom might be very sad to never have expereienced birth – perhaps as a mother who loves and treasures her adoptive children might still feel sad that she never experienced pregnancy and childbirth. BUT. I am not sure I understand a woman choosing to jeopardize her life AND the life of her unborn child AND potentially leaving her other children motherless and her husband a widower. In that case, I feel that the desire for the long-sought-after “birth experience” has become pathological.

    • Montserrat Blanco
      August 15, 2014 at 3:24 pm #

      I am pregnant right now. I have been eating well, exercising as much as I can, taking prenatal vitamins, going to my OB appointments, doing all the GD tests and blood tests my OB recommended, not drinking any alcohol, etc,etc, etc. And I will continue doing that for the months left. I will deliver at the hospital with the best neonatal unit in the whole country just in case (and I am having a low risk normal pregnancy so far). The hospital has OB and anesthesia 24 h in house. I hope I will have an uneventful and easy vaginal delivery but if ANYTHING goes wrong I want a C-section and I know I will not mourn my vaginal delivery for a second. I have been wishing this baby for years now, I love this baby since the moment I knew I had conceived, I have been nurturing and taking care of him for months. It is far more important for me that my baby survives the delivery and is healthy than wether he was born vaginally or not. The day my baby will be born will be ONE day. I am sure it will be special and important but I care much more about the years that we hopefully have ahead to enjoy together than to one day in particular. And I care much more about his health than about my “experience”.

      I can’t understand how there is people that thinks so different. After carrying a baby I can’t get my mind around it.

      • Smoochagator
        August 15, 2014 at 4:07 pm #

        Totally – the health of the mom & baby (and many mothers would rank their own health well below the baby’s, though the rest of the family would likely argue that they’re of equal importance) are much more important than the experience. Is the experience important? Yes. Are some women legitimately disappointed and/or traumatized by their birth experiences? Yes. But ultimately, you can deal with disappointment and trauma. Dealing with a dead child, however, is not something I’d wish on anyone.

        • The Bofa, Being of the Sofa
          August 15, 2014 at 5:24 pm #

          Yes. Are some women legitimately disappointed and/or traumatized by
          their birth experiences? Yes. But ultimately, you can deal with
          disappointment and trauma.

          While “trauma” is a different ballgame, if you can’t deal with disappointment when things don’t go the way you hoped, then don’t become a parent.

          • Smoochagator
            August 15, 2014 at 8:52 pm #

            Very true. And it seems that the confusion between “trauma” and “disappointment” crops up quite a bit in discussions about NCB.

          • Box of Salt
            August 16, 2014 at 3:04 am #

            Bofa “if you can’t deal with disappointment when things don’t go the way you hoped, then don’t become a parent.”


            If you can’t deal with disappointment when things don’t go the way you hoped, GROW UP! Stop pretending you are more mature than a toddler.

            It’s not parenthood you need to figure out how to deal with – it’s reality in general.

        • jenny
          August 15, 2014 at 7:59 pm #

          Yep. It’s possible to heal from trauma. A dead mom or baby cannot recover from being dead.

        • Montserrat Blanco
          August 16, 2014 at 2:52 am #

          I rank my own health below my child’s. After all, the worst that could happen to me is less of what could happen to my baby. C-section scar infection vs neonatal sepsis??? No brainer. Loosing my uterus vs brain function loss??? No brainer. Massive bleeding at a hospital with a well stocked blood bank vs Rh issues???? You are kidding… That is why I chose the hospital with the best neonatal unit and not the one that I liked the most in case of maternal health problems (I must admit the one I am delivering in is extremely safe for mothers too, the difference is slim). When faced with the choice I decided in the blink of an eye.

      • The Bofa, Being of the Sofa
        August 15, 2014 at 5:23 pm #

        I can’t understand how there is people that thinks so different. After carrying a baby I can’t get my mind around it.

        Yep, I have said the same thing my self (this quote, not the rest). Before I got kicked off the monthly groups at WhatToExpect, I interacted with a lot of expectant moms, and every single one was exactly this way. I can honestly say, I have never encountered anyone outside of those who drop in here who have this attitude in any way shape or form. Expectant moms that I have encountered have all been, if anything, overly paranoid. When my wife was pregnant, I always panicked when she would go to the bathroom during the night, fearing she would come back and tell me something bad would happen. If we thought there was anything we could do or not do to make things better, we did it.

        After spending that nearly 9 months worried about every little thing, like whether it’s safe to eat bleu cheese salad dressing, you think for a second that we would do anything to compromise the safety of our babies? I can’t imagine why anyone would.

        • Smoochagator
          August 15, 2014 at 9:17 pm #

          The thing is that when you’re part of the NCB echo chamber, you get it into your head that these risks really aren’t *that* bad. You’re exposed to so many lies and so much misinformation that you may not “get” that you’re endangering your child’s life and your own. At least that’s how it was for me during my first pregnancy. I am still stunned by my absolute arrogance regarding the GBS screening. I bought into the idea that a very small risk = no risk at all. Thankfully, I didn’t have to pay for my stupidity. But what if I had been GBS+ and my child had died? Hopefully I would have learned my lesson. But maybe not.

          • The Bofa, Being of the Sofa
            August 16, 2014 at 10:49 am #

            The thing is that when you’re part of the NCB echo chamber, you get it
            into your head that these risks really aren’t *that* bad.

            Yeah, that is clearly the case. See the claim that birth is “as safe as life gets.” If you actually think that, then you really don’t know anything about the risks we face in life, which are far and away no where near the risk of childbirth.

            If you don’t have the perspective, 1 in a 1000 sounds like a small risk. However, there is almost no endeavor that anyone does where we accept a 1 in a 1000 chance of death, or anywhere close, and certainly nothing we do routinely. Not to beat a dead horse, but the risk of death if you drive drunk is 2 in a million, and that is considered unacceptable.

            Yes, we are willing to accept the risks of childbirth, because the benefit is so large. However, that doesn’t make it safer, it just makes it worth it.

        • Montserrat Blanco
          August 17, 2014 at 4:32 am #

          Sometimes it is difficult not to be a complete neurotic…

        • moto_librarian
          August 18, 2014 at 9:17 am #

          I really thought that I was going to love being pregnant. And while there were some amazing things about it – mainly feeling my sons kicking and squirming – most of it wasn’t all that great. I worried about everything. Had SPD and 5 months of severe morning sickness with my second. I wanted to have CHILDREN. The birth “experience” was an obstacle that had to be surmounted to have our sons.

      • araikwao
        August 16, 2014 at 6:33 am #


        • Montserrat Blanco
          August 17, 2014 at 4:30 am #

          Thank you very much.

      • Dr Kitty
        August 16, 2014 at 4:41 pm #

        Wonderful news, I hope you have an easy delivery and a settled baby!

        • Montserrat Blanco
          August 17, 2014 at 4:29 am #

          Thank you. I hope that too…

    • guest
      August 15, 2014 at 4:15 pm #

      Definitely this. It is okay to have expectations of a particular “birth experience.” However, the health of both the mother and the baby should far outweigh those expectations. When I didn’t get my natural unmedicated birth, I was disappointed that things didn’t go like I wanted, but that was far outweighed by the joy of a healthy baby, and I have absolutely no regrets. The horrible stories like the ones in Dr. Amy’s article are the ones in which the mothers had misplaced priorities.

    • August 16, 2014 at 8:53 am #

      It seems to me that an adoptive mother does “give birth” in the first minutes she holds the adopted baby for the first time. For anyone who wants a child so badly that she and her partner have endured the endless waiting, possible anguish at disappointments and the struggle, it must be a totally magical moment. So the kid didn’t exit her vagina, so what?

      • The Bofa, Being of the Sofa
        August 16, 2014 at 10:41 am #

        So the kid didn’t exit her vagina, so what?

        Yeah, but as soon as you admit that, then you have to concede that the same thing can happen with c-sections, and if your premise is that c-sections are evil, that’s a big problem.

  33. The Bofa, Being of the Sofa
    August 15, 2014 at 1:04 pm #

    he sees no reason why I can’t do a vbac other than the fact that I have had 4 sections

    Yeah, other than that, I’m good to go…

    • MaineJen
      August 15, 2014 at 1:54 pm #

      But other than that, Mrs. Lincoln, how did you enjoy the play?

    • Beth
      August 15, 2014 at 3:40 pm #

      yeah, that sentence was basically like saying
      “he saw no reason why I couldn’t go back into my house, other than the fact that it was on fire.”
      “he saw no reason I should be afraid for my life, other than the fact that I was exposed to ebola.”

  34. Trixie
    August 15, 2014 at 1:03 pm #

    How much do you want to bet the midwife bailed when she realized things were going south? I’m sure she had been paid in advance.

    • Renee
      August 15, 2014 at 2:18 pm #

      No, most are not heartless, they are dangerous, fatally, negligent and ignorant. She had NO IDEA, she probably thought she could nap, come back, and deliver a perfect baby. I am sure she has left moms lots of times, and come back no problem.
      This is why HB MWs are dangerous quacks, among a million other reasons.

      • Trixie
        August 15, 2014 at 9:24 pm #

        I disagree. There are plenty who are ignorant and mean well, and some who are actively evil. This behavior falls in the latter category. It’s Lisa Barrett style.

  35. mostlyclueless
    August 15, 2014 at 1:02 pm #

    Is the criticism here HBAC or VBAC? I am really hoping to do a VBAC myself and personally would like not to be lumped in with these loonies.

    • Trixie
      August 15, 2014 at 1:04 pm #

      Lots of people have had VBACs here, including me. A VBAC in a hospital under the care and advice of real medical providers is not what we are talking about.

    • Young CC Prof
      August 15, 2014 at 1:12 pm #

      If a real medical professional says you’re a decent candidate, and you do it in the hospital, that’s a great choice.

      If multiple doctors say “No, not for you” and then you go do it at home, that’s breathtakingly dangerous and irresponsible.

    • folara
      August 15, 2014 at 1:13 pm #

      mostlyclueless, the criticism here is people who refuse to listen to qualified healthcare providers such as OBs and CNMs and insist on taking advice from the Internet and unqualified lay midwives and doulas. On its face, TOLAC (and VBAC) are reasonable options. Here is ACOG’s official practice bulletin on TOLAC:–%20Obstetrics/pb115.pdf?dmc=1&ts

      TOLAC is not recommended for high-risk women (>2 previous C-sections or history of other complications) and TOLAC should only be attempted at a hospital that has the capacity to perform emergency deliveries. There is always a real risk that TOLAC will lead to RCS instead of VBAC.

    • Renee
      August 15, 2014 at 1:44 pm #

      Are you willing to go for a VBAC even if its very dangerous, even if there are complications, even if you lost another baby having a VBAC?
      Than we are not talking about you. , or anyone that is not like that.

    • Therese
      August 15, 2014 at 10:44 pm #

      Yeah, I do wonder, in the first case, did this woman do anything wrong the third time around? She had a VBAC in the hospital, even induced so she wouldn’t go past her due date. Are the issues she had in the her two previous pregnancies reasons not to VBAC?

  36. The Bofa, Being of the Sofa
    August 15, 2014 at 12:50 pm #

    DH checked the heartbeat w/the doppler that the MW had left for us & her hb was perfect. Same place & 148 bpm, which was average for Coraline the entire pregnancy.

    I’m guessing that’s not fetal heart tones they were hearing there.

    • Trixie
      August 15, 2014 at 1:05 pm #

      I had the exact same thought. I bet the midwife ran when the fetal heart rate started to go bad.

      • The Bofa, Being of the Sofa
        August 15, 2014 at 1:09 pm #

        I think it’s an issue of different perspectives.

        See the sequence “the heart rate was perfect at 148; we went to the hospital and she was dead; they did a c-section and there was infection all over”

        What’s the lesson? Some might see the lesson being that things can go very bad, very quickly. On the whole, I don’t think that is a bad lesson to learn, if you actually learn it. However, my take is more, “you can’t trust amateurs playing with doppler stethoscopes”

        • August 15, 2014 at 1:49 pm #

          This is entirely true, and it is the reason I don’t like handheld dopplers in the hands of amateurs or instead of EFM. 148 sounds like a great FHR, but with a doppler one cannot know whether there is beat to beat variability, and often one cannot listen throughout a contraction and so doesn’t register decels, but only hears the FHR after it has recovered.

          • Ash
            August 15, 2014 at 1:51 pm #

            Also the father was listening…why hire a midwife if you’re going to have to do your own monitoring?

          • jenny
            August 15, 2014 at 2:29 pm #

            What do you think of listening with a doppler during contractions after a period of EFM has shown category 1 tracings?

          • August 16, 2014 at 9:01 am #

            You aren’t going to have EFM at home.

            To be honest, I’ve had one situation where the FH was lost in a ten minute period. I was working at a rural hospital which only had one functioning monitor, not usually a problem, because we did not do all that much obstetrics, but one day, by evil chance, we had two women in labor, one high risk, the other not. So we switched the monitor back and forth between the two women. Patient A’s FHR was fine, so I disconnected her and attached Patient B. Also fine. 10 minutes later, switched back. Patient A did not have an FHR.
            Dr. was in attendance; also tried in vain. Baby was delivered by emergency C/S, dead. No obvious cause of death. Patient A was the low risk patient.

            Not an experience I ever want to repeat, believe me.

          • jenny
            August 22, 2014 at 3:37 pm #

            I responded to fiftyfifty1 as to why I asked this question. That’s really terrible. I’m sorry for that woman. This is why the intermittent monitoring gave me a funny feeling after my son was born. He was fine, but I wondered … what if he hadn’t been?

          • fiftyfifty1
            August 16, 2014 at 9:21 am #

            Better than being unmonitored, but why would you chose this rather than a tracing?

          • jenny
            August 22, 2014 at 3:32 pm #

            Well, that’s what I was wondering. This is what was the midwife did during my last hospital delivery. I had been monitored with a tracing for 40 minutes in triage, then got up and walked for an hour because I was only 3cm. When I returned, I was monitored an additional 20 minutes, found to be 5cm and admitted. Then the nurse and midwife remained with me in the delivery room for the following hour until delivery. They told me because I had a good tracing I could be monitored intermittently in the delivery room. I wasn’t really able to have a conversation at that point so I was like, “Ok.”

            She listened every 15 minutes, and she noted when it would accelerate as he moved and she said that was good. She also would listen through the contractions. I cannot remember if she listened during pushing because I was, er, indisposed at that point.

            I wondered if this was really comparable to the tracing or not.

          • Medwife
            August 16, 2014 at 10:28 am #

            I would be ok with this in the hospital, if AWHONN guidelines were strictly followed as to frequency and lengths of auscultation. The demands of nursing care including charting just do not allow for it. And I can’t do it because I have the care of every patient on the unit. It’s not practical unless you’re providing concierge care.

    • Renee
      August 15, 2014 at 1:50 pm #

      They simply do not understand that until there is a terminal bradycardia (IIRC), they cannot hear the signs of distress on a doppler. By the time they hear a low heart rate, its pretty much too late if they are at home. This is why they always say “everything was perfect”, until the baby drops out (or is cut out) dead.

      If you cannot see the problems, all looks rosy.

    • Anj Fabian
      August 15, 2014 at 7:06 pm #

      FHR should slow as the baby grows, yes? The same FHR all pregnancy long sounds wrong.

      • The Bofa, Being of the Sofa
        August 16, 2014 at 8:13 am #

        I still am not convinced they didn’t have the doppler set in “demo” mode.

    • fiftyfifty1
      August 16, 2014 at 9:32 am #

      Yep, could have been baby, could have been mom. My heart rate before my epidural sat in the 130s-140s. That was form pain alone. Add to that a uterine infection…It could have been anything in the hands of these amateurs.

      Homebirth is a form of cosplay: I get to play The Midwife!! Well then I’m The BirthGoddess! Jennifer, you’ll play The Doula–take off your skirt and blouse and get into the tub. …what about me? what’s left for me?! Ha ha! You’re stuck playing the baby. Sucks to be you!

  37. auntbea
    August 15, 2014 at 12:46 pm #

    I feel anyone who is not learning when faced with such a profound lesson is struggling with bigger demons that we can imagine.

  38. sleuther
    August 15, 2014 at 12:44 pm #

    Unbelievable that someone would go in this direction and even more unbelievable that VBAC advocates would encourage her.

    • Renee
      August 15, 2014 at 1:52 pm #

      Nope- not one bit unbelievable that VBAC/HBAC advocates encourage this. They routinely encourage this stuff everyday.

      • Karen in SC
        August 15, 2014 at 2:12 pm #

        And delete any dissenting posts, even those with links to scientific studies, so no one hears the other perspective.

  39. August 15, 2014 at 12:41 pm #

    It is heartbreaking – simply heartbreaking. These are not easy things to live through and with. Why are we (as a society, as women) at a place where having a vaginal birth is an achievement? How did we get to the point where science is shunned? How is it that doctors are having such a hard time communicating with their patients, and that patients are having such a hard time avoiding the most tragic of outcomes? There needs to be a shift – the relationships are no longer functional, they have been undermined in so many ways.

    • EmbraceYourInnerCrone
      August 15, 2014 at 1:53 pm #

      I don’t get how things have changed so much in mere decades. The women in my family considered NOT dying in childbirth and not losing any kids an achievement-lets review great-grandmother dead at 20 along with her second child, grandmother homebirthed 7 of her 8 kids, lost one to Rh factor issues, other grandmother lost her third child and only daughter at birth, full term stillbirth. My mother full placenta previa, transverse lie, and when they did the Emergent C-section they found her uterus was rupturing. Stat hysterectomy as they could not stop the bleeding. extra bonus points as my dad is Rh+ and mom is Rh-(yay for Rhogam!) Thank you modern medicine and OBs I still have a mom, shes 85 and my baby brother got to keep all his brain cells. My sister had a nuchal cord with her third kid – he’s fine as they caught it in time..again Yay modern obstetrics…

    • Amazed
      August 15, 2014 at 5:11 pm #

      I don’t find it heartbreaking at all. Having a child die in earthquake is heartbreaking. Holding a child’s hand as they’re dying in hospital because despite the great advancements in medicine there are still limits is heartbreaking.

      Stomping your foot on the floor and subjecting your current baby to the exact same danger that killed the last one is not heartbreaking. It’s maddening. These “mothers” can go *expletive, expletive*.

      • The Bofa, Being of the Sofa
        August 15, 2014 at 5:30 pm #

        I always remember that the number of people who think the Apollo moon landings were hoaxed is about 5 times higher than the number who homebirth. And as you note, only a small number of homebirthers would do something so silly, so in the end, we are talking a very, very extreme position. Like, we are talking past the looney end of the chemtrails crowd, that’s how out there this is.

        At some point, you have to admit that there are those that can never be reached.

        • Amazed
          August 15, 2014 at 5:40 pm #

          “At some point, you have to admit that there are those that can never be reached.”

          Exactly! And the fact that they cannot be reached says more about their nature than it does about the doctor/patient relationship as a whole. I feel for the poor sods who happen to be on the doctor side of the relationship with these loons.

          When all is said and done, the vast majority of mothers can mutter about too many interventions but at the end, they pick their little bags and go to the hospital. Why? Because they don’t want to be the one that happened to be the statistics. Because they prefer safety. Because they are afraid. A good thing, fear.

          A little OT: A few days ago, a friend of mine who recently had a RCS got some problems. My mom, of course, was immediately sure it had something to do with the CS (turned out she was right). Of course, she then said something about too many CSs. A few hours later, we were in the street and had to enter the first shop we saw VERY fast. When my mom left the bathroom, she said, “Well, at least now she has a lesser chance to encounter troubles such as THIS one!”

        • Therese
          August 15, 2014 at 10:47 pm #

          Hmmm, doesn’t seem like a good comparison because only women in their childbearing years can homebirth but anyone of any sex or age could disbelieve in the moon landings.

          • Therese
            August 15, 2014 at 10:49 pm #

            And you only have a limited number of times to homebirth. So if you homebirth in 2014, you’re unlikely to homebirth again in 2015. So you don’t get counted for 2015 homebirth statistics. Where the moon landing conspiracy theorists could be counted every time they take these statistics.

          • Young CC Prof
            August 15, 2014 at 11:13 pm #

            Perhaps a better count is relative to total births. There are about 60,000 home births with midwives recorded annually in the USA, though the number is rising. There are about 4 million births each year. That works out to 1.5%. Then again, home birth mothers tend to have more children (plenty of grand multips in that pool) so 1.5% may be overcounting.

          • The Bofa, Being of the Sofa
            August 16, 2014 at 8:14 am #

            That’s why you base it on percentages.

            Homebirth % refers only to women in their childbearing years, too.

  40. PrimaryCareDoc
    August 15, 2014 at 12:38 pm #


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