Class on How to Bring Episiotomy Back!

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To understand why I created this class, let’s go back to March 2006 when ACOG released Practice Bulletin 71 restricting the use of episiotomies.

But I don’t like it. I’ve been waiting years for ACOG to retract it so I could cut women to my heart’s content, but apparently that’s not going to happen.

 

So here’s the bad news. The ACOG Bulletin on Episiotomy is not going away anytime soon.

 

But who cares about scientific evidence? My opinion is more important than anything the scientific evidence shows.

 

What is the good news?

 

I designed the “Bring Episiotomy Back, Baby!” class to help you prevent or reverse bans on episiotomies.

So if episiotomy has been restricted in your local hospital, or administrators are talking about suspending it, or if you were about to start a episiotomy program and it’s been put on hold because of the statement, then this class is for you.

Class Button

Wait! What?

It is wrong to hold a class designed to promote a practice proven to be dangerous and discouraged by ACOG??!!

Are you sure? Because that’s what Rebecca Dekker of “Evidence Based” Birth is doing.

See: Class on How to Bring Waterbirth Back!

You remember Evidence Based Birth? I wrote about it not long ago, Rebecca Dekker’s “Evidence Based Birth”: you can put lipstick on a pig, but it’s still a pig.

Evidence based birth

Dekker wrote to ACOG explaining why she thinks they are wrong about waterbirth, and was shocked, shocked to learn that they believe scientific evidence is more reliable than Dekker’s personal opinion.

So Dekker is only going to charge you $49 for a class (“valued at $79”! By whom? By no one, but it sounds so cool to say that!) to explain why it’s okay to ignore scientific evidence in favor of her personal opinion as a cardiology nurse.

The “Bring Waterbirth Back, Baby!” course gives you the tools, tricks, and tips to help you bring waterbirth back to the hospital in your community. We will start by talking about how change occurs in hospitals, and talk about why it is so important that you form a team to tackle this issue.

But wait! There’s more!

When you download the Waterbirth Ban Toolkit (included in the class), you will receive:

PowerPoint file you can use to critique the Opinion Statement
Change.org petition language for you to use
Printable petition to gather handwritten signatures
Sample press release about bringing waterbirth back to your community
One-page handout of “talking points” about waterbirth
Two-page handout on tips for dealing with the media
Sample letter to hospital administrators from a mother
Printer-friendly PDF of the Evidence Based Birth blog article on waterbirth (42 pages)
Evidence Based Birth Annotated Bibliography of all the research ever conducted on waterbirth (80+ pages)
Formal letter that you can give to hospital administrators about the flaws in the ACOG/AAP Opinion Statement

Who is teaching this class?

This class was designed and organized by Rebecca Dekker, PhD, RN, APRN, a nurse researcher and the founder of Evidence Based Birth. In 2014, Rebecca spent four months conducting a systematic review of the literature on waterbirth, which she published at Evidence Based Birth.

FOUR WHOLE MONTHS! OMG! OMG! The woman is a wonder!!! Obstetricians have to spend literally YEARS to master the practice of obstetrics, and Dekker, a CARDIOLOGY NURSE, did it only four months.

Can Dekker (WHO SPENT FOUR MONTHS CONDUCTING A SYSTEMATIC REVIEW OF THE LITERATURE ON WATERBIRTH!!!!!!) guarantee that we will be able to reverse waterbirth bans by taking this class?

There are no guarantees. To be totally honest and up front with you—there are many barriers to waterbirth, and by simply taking this class we cannot and do not promise that you will be able to reverse waterbirth bans in your community.

However, this class is the first time all of the knowledge, skills, and tools to fight waterbirth bans have been gathered into one online resource.

So your efforts to overcome waterbirth bans will be made exponentially stronger by what you learn here and through access to materials that will make your fight both more productive and more strategic.

Exponentially stronger!!

Bad news, Rebecca, zero to the 5th power is still zero.

But wait! There’s more!

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And that’s not all, folks:

To celebrate the launch of this new class, I am doing a GIVEAWAY for a free waterbirth t-shirt from the soon-to-be-launched Evidence Based Birth online store.

To enter the giveaway, simply click here to visit the giveaway site and drop your email in the box below before Monday, October 6th at 9 PM Eastern Time.

Once you enter, you will be emailed details on how you can get your name entered in the giveaway up to three more times by sharing the link to the contest.

Believe me, you are going to LOVE this waterbirth t-shirt. I am planning on releasing it by November, so you will receive your prize then once the t-shirts are printed. The t-shirt design is top-secret, so I can’t show it to you right now, but I promise you– you are going to gasp and say, “AAAH! I LOVE THIS SHIRT!!”

And yes, there will be lots of options for you to choose from– V-neck, unisex, plus-size, or maternity style. And we will ship it to you for free, too!

That’s right folks. One lucky winner will get a FREE T-shirt!

No doubt this is a great deal in the fantasy land that Rebecca Dekker (WHO SPENT FOUR MONTHS CONDUCTING A SYSTEMATIC REVIEW OF THE LITERATURE ON WATERBIRTH!!!!!!) inhabits. But in the real world, the whole thing is just a way to enrich Rebecca Dekker.

I have a better offer.

For the low, low price of nothing I will give you important knowledge about waterbirth (valued at $3 million dollars!) and unlike Rebecca Dekker, cardiology nurse, I’ve spend the last 30 YEARS reading the obstetric literature.

Here it is:

Water birth is unnatural. No primate gives birth in water.

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

The American Academy of Pediatrics’ Committee on Fetus and Newborn in conjunction with the American College of Obstetricians and Gynecologists reports:

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

Rebecca Dekker can’t fleece the gullible make a profit on giving away her worthless opinion for free. so she charges for it.

Let me end by offering my heartfelt thanks to Dekker (WHO SPENT FOUR MONTHS CONDUCTING A SYSTEMATIC REVIEW OF THE LITERATURE ON WATERBIRTH!!!!!!)

Thank you for making my job of debunking the nonsense of the natural childbirth industry so easy. Reading and responding to your website is like shooting fish in a barrel. The amount of crap you spew forth in an effort to profit from the gullibility of your followers is truly impressive. If I wanted to make money by hoodwinking the foolish, I would absolutely use you as my role model!

In the meantime, I’ll keep debunking your self-referential, self-indulgent, self-enriching idiocy for free.

  • AgainstMedicalRape

    “I’ve been waiting years for ACOG to retract it so I could cut women to my heart’s content”… I am not going to take advise from someone with such a rapist mentality. You do realize that contributed to your desire to enter your objective male-developed “science” of OBGYN right, Dr. Twat-er?

    • KarenJJ

      Dr Amy, you left off the “Satire” warning… Apparently this article needed it after all.

      • AgainstMedicalRape

        If a person is interested in spending a proportion of their lives cutting vagina, penetrating vagina, all when recipients do not desire it, then there is some conscious or subconscious ulterior, primitive reason behind it. These exams do leave women feeling raped and violated, and it is because they involve unwanted penetration of sexual organs, which is part of the definition behind rape. While an OBGYN has diverted their rapist desires and behaviors into a field that arguably has benefited and saved a very small fraction of the people it hurts, they are no better than traditional rapists in the way they make many women feel and their deep desires to sexually assault women.

        Believing that OBGYNs do not have psychopathic tendencies to contribute to
        this field is wishful, naive, and faith-based
        thinking. Rape is never funny. Violence against women is never funny. This holds true whether there are satire warnings to excuse any obvious signs of rape culture promotion that follow.

        • birthbuddy

          You, on the other hand, are quite funny.

        • Stacy48918

          Speak for yourself! I absolutely desired having someone stick their hands in my vagina when I was in labor!

          If you don’t like it, stay at home. When your baby is dying inside you, cut it out on your kitchen table. Stay away from those evil OBs. That’ll teach ’em.

          • SporkParade

            Me, too! In fact, my initial reaction to this post was, “But I liked my episiotomy!” Of course, it was plainly audible from the heart beat on the fetal monitor that my baby would be in very, very deep trouble if he wasn’t cut out of me one way or the other soon, so . . .

          • AllyPolwarth

            That’s really disgusting. There are a whole range of other ways to make your point. What I am getting is that women who don’t like the OB care they get only have the option to have their baby at home? And then when a tragedy happens it’s their own fault right? Unless they join the ani homebirh movement as a result probably? You people on here are so often bullies that your point fails to have an impact. Its little wonder that your movement isn’t garnering support where it needs it the most – the childbearing population.

          • SporkParade

            No, they have the option of switching care providers unless they are part of an underserved community (hint: they usually aren’t). Heck, I switched prenatal care providers twice during pregnancy. Also, no one here is criticizing homebirth loss mothers. We’re criticizing the people who convinced them they’d be safer at home.

        • SporkParade

          Yes, let’s allow women and babies to die because saving them involves getting up close and personal with their reproductive organs! Clearly anyone who wants to save women and babies is a rapist. {}

        • AgainstMedicalRape

          I notice that women who have given hospital birth often deny their own feelings of violation, and slump into some sort of Stockholm Syndrome, where they defend their own violators. These women become visibly upset and distraught when someone like me comments that she finds OBGYN to be abusive toward women, which makes me believe that deep inside they agree with me, and are unwilling to tear down those walls they build up as a self-defense mechanism to cope with going through such abuse. So instead, they try to tear down comments that threaten their chance of prolonging their denial that they have felt abused themselves.

          Just posting a simple comment garners so much information that confirms to me that hospital birth will be my decision one day:

          – “Clearly anyone who wants to save women and babies is a rapist.”

          This is denying that there are avenues of birth that do not involve rape (unwanted penetration of sexual organs). I do not believe anyone who wants to save women and babies is a rapist. I just believe anyone who wants to save women and babies via rape has a rapist mentality, and they have directed it all to a field that allows them to carry out their desires without legal punishment. I do not believe women need to be “saved” and “rescued” by this male-invented industry, and I find it a very outdated damsel-in-distress type of thinking.

          – ” I absolutely desired having someone stick their hands in my vagina when I was in labor!” and “But I liked my episiotomy!”

          Whether or not you are using sarcasm, making these statements is only a bandaid for your feelings of violation regarding what happened to you. This is a demonstration of Stockholm Syndrome, because instead of realizing and admitting that you were mistreated, you forgive your own abusers by shoving it under the rug with bitter and unhelpful sarcasm.

          – “When your baby is dying inside you, cut it out on your kitchen table.”

          This is simply a threatening and vile toned comment, and intended to arouse some sort of fear inside me of my own capability to make my own decisions about my own body.

          • Samantha06

            Good grief. Only someone who has never really experienced hardship and has the ability to snub their nose at the excellent medical care we have at our disposal in this country would be this ungrateful, arrogant and just plain crazy. If you want to reject our health care, please, do it. Just don’t run to the hospital to be rescued when you or your baby are dying at the hands of an incompetent midwife. We have our hands full taking care of people who are actually interested in living and being cared for. We just don’t have time to fight with combative people who are really not interested in our services. Since you are convinced that women in labor are “raped” in the hospital, best for your sake to stay away, don’t you think?

          • Dr Kitty

            I’m sorry you went through whatever it was you went through that made you believe any of what you have just written is true.

            I think you’re delusional, with fixed, false beliefs which are not amenable to logic or reason.

            You’ve even set up an explanation, which you believe to be coherent, wherein women who disagree with you are only proving your theories to be more true.

            There is something wrong with you.
            Please get help.

          • AlisonCummins

            The way you have constructed your argument makes it unfalsifiable.

            “Women experience hospital care as a violation” — accurate report of their subjective feelings.

            “Women experience hospital care as helpful” — Stockholm Syndrome.

            Assuming that there is at least one woman alive who authentically desired help and received what she wanted, how do you distinguish her from the all the others who experience Stockholm Syndrome?

          • AgainstMedicalRape

            I would suspect that women who declare their hospital care was helpful only then to describe their experiences in violent terms like “stick their hands in my vagina” are not being sincere about their feelings. I also feel this may be the case when these same women threaten other women who are choosing alternative routes (homebirth) with dramatic descriptions of what will become of their dead babies, in a projected apparent attempt to justify that what their own abusers did to them was necessary.

          • Samantha06

            “descriptions of what will become of their dead babies”

            That’s a telling statement. Why do you think other women supposedly “threaten” other women about their decision to homebirth? Have you ever considered maybe a mother who lost a baby in a homebirth disaster might want to share her story to help others? And what’s wrong with that? If anyone would find it threatening, it would be home birth advocates who stand to lose money.

            “I would suspect that women who declare their hospital care was helpful only then to describe their experiences in violent terms like “stick their hands in my vagina” are not being sincere about their feelings.”
            So, what would you do if you were in a situation where your baby was dying and in order to save it’s life, something “drastic” like forceps, vacuum, or a doctor had to “stick their hands in my vagina” to get your baby out? No, that is not a pleasant experience. However, women are not stupid. They are smart enough to know that drastic situations sometimes require drastic interventions and they know better than to feel “violated” when their baby’s life is at stake. Your statement insinuates that women are delicate little flowers who are not in touch with their feelings and just can’t face the fact that they’ve been supposedly violated and abused by their Obstetricians or hospital care. In fact, the opposite is true and overwhelmingly, women are very satisfied with their care.

          • Something From Nothing

            Such a convenient term for you to use. Medical rape. This language is designed to shock and to provoke an emotional reaction. I spent 13 years in post secondary education, I have spent countless sleepless night, shed countless tears of joy and of sorrow, and missed many moments with my own loved ones, all for the purpose of ensuring women have safe, supportive obstetrical and gynaecological care. Patients are always active participants in their care. This profession takes a tremendous amount of personal sacrifice, and to read your comment infuriates and insults me to the core. To imply that women who experience hospital birth experience Stockholm syndrome is deeply insulting. And inaccurate.
            And women do need to be saved and rescued. A quick look at maternal mortality stats will tell you that, if you have half a brain. And it isn’t a damsel in distress male thing, either, since ONLY women have babies. They are not in distress because they are women, and the patriarchy says so, it’s because reproduction is dangerous for women. You arguments are brainless, dangerous and anti-feminist.

        • Something From Nothing

          What an absolutely horrible thing to say… I’m rarely shocked by anyone’s comments on this site, but your hateful vitriol has stopped me in my tracks this morning. How could you possibly say such hateful things? Are urologists rapists who can’t wait to humiliate and penetrate men anally? There’s something wrong with you.

      • Young CC Prof

        There’s always one. No matter how obvious it looks, there’s always someone.

    • Trixie

      Apparently someone has surgically removed your sarcasm detector.

      • AgainstMedicalRape

        Unlike many followers of this blog, I do not get unnecessary surgeries.

        • birthbuddy

          I think there is a lot that you don’t get.

        • Trixie

          I’m a sarcasm intactivist.

        • Sarah

          I get c-sections all the time, when I’m not even pregnant.

    • An Actual Attorney

      Whoosh. That was the sound of the point going right over your head.

    • Those of you who think you know about rape are annoying to those of us who do.

  • Samantha06

    I saw this a while back. It’s embarrassing that she is an RN promoting this garbage. The fact that she is a cardiac nurse with NO obstetrical experience using her RN to masquerade as someone “knowledgeable” about obstetrics is arrogant and grossly unethical. (Her disclaimer is an entire page long, hint, hint..)Then she markets it like a used car salesman, even worse. Imagine her as an Obstetrical RN marketing to convince unsuspecting cardiac patients to stop taking those silly cardiac drugs and buy her recommended supplement designed to reduce arterial plaque. It’s actually unsafe and might result in a few deaths, but what do those stupid cardiac patients know anyway? They just need to ignore those pesky cardiologists and the “real” evidence-based recommendations! After all, an RN is an RN and everyone knows they are well-educated and knowledgeable in “all things medical anyway.” Ugh!

  • CanDoc

    This needed to be said. Thank you.

  • ForgetfulGuest

    I’m torn between “this is such a scam” and “anyone who’s stupid enough to give money to that woman deserves to be scammed”! …

  • Like x 1000.

  • Guest

    Like x 1000.

    • Hey! That was me who posted that, not a guest. Oh well. I’ll try again.

      • Bugsy

        It shows up as you on my computer, both of the comments.

        I ran into the same problem last week…Discus!

        • Haha! Now I just look like a creeper with no patience. Which, really I am, so that’s fair! : )

          • Amazed

            Congratulations! I wish you a very textbook pregnancy.

          • SporkParade

            And a textbook labor, as well!

          • Ha! Yes, I’m starting to journal my birthplan tonight. (Kidding!)

          • Bombshellrisa

            Make sure to get it notarized : )

          • Oh you know I will!

          • Thank you!!! So far, so good! I’m textbook feeling like crap. : )

        • I’ll delete the other one since I can’t delete the “Guest” comment! Thanks for calming my fried early pregnancy feeling like crap nerves.

          • Bugsy

            Lol. Congrats on the pregnancy!

          • Thank you so much!!!

          • Mishimoo

            Congratulations on the pregnancy! Hope it’s terribly boring.

          • Thank you, thank you! (And, yes, me too!)

          • Conga-rats on your pregnancy! May it be easy & dull.

  • Bugsy

    Not entirely related…our NCB friend’s husband just posted on his Facebook page that he needs to focus his energies on preparing for his second child’s birth, due any day now. (What the heck?)

    Not to be rude, but what the heck type of preparation does he need to do? His own education is 100% Dr. Google, never mind that the extent of my husband’s involvement with L&D (aside from cutting the cord and yelling “push” occasionally) was waking up when I was fully dilated…

    • Bombshellrisa

      There are people who use their hot tubs or jacuzzi tubs for home birth.

      • Bugsy

        Wow.

        • Bombshellrisa

          They don’t want to rent a tub. Let me tell you that it’s really hard to use the fishnet scoops in those cases. I don’t know how often it’s done, I have seen it only five times (hot tub, outdoors). Soaking tubs with jets are more common.

          • Dr Kitty

            I have never been terribly keen on hot tubs and jacuzzis since a colleague who works in Genito-urinary medicine told me of the outbreak of trichomonas that was traced to an improperly maintained jacuzzi at a very up market and famous spa.

            There were a lot of cases of TV in adamantly monogamous women before someone thought that it might be a shared spa rather than cheating husbands…so “outbreak” was definitely the operative word.

            So… Turns out you can get an STD from a jacuzzi.

            Just the place to give birth!

          • toni

            oh.my.god.

            what about non-chlorinated swimming pools?

          • Trixie

            So how do you properly sanitize a jacuzzi?

          • Samantha06

            A hospital I worked at several years ago used them for labor (NOT delivery). They used a mixture of powdered dishwasher detergent and bleach and ran it through the jets for 20 minutes. It worked very well. The dishwasher detergent “scrubbed” the pipes and jets, and the bleach disinfected it. They did “before and after” cultures of the jets and the after-cleaning cultures were negative.

      • expat

        That reminds me of the time that I, my mother and my sisters got utis from using the hot tub in the back yard.

        • Trixie

          Grossss

    • staceyjw

      Water birth is when you push and the baby comes out into the water. Not good.
      LABORING in water is fine, you just get out when its time to push. Use of hot baths, jacuzzis and showers is very common and every hospital I have had a baby in had private jacuzzi tubs.

      You do not want the water too hot, for to long, it can raise moms temp and hurt mom and baby.

      You definitely never want water hot enough to kill bacteria, as that is boiling temp! OW! Women aren’t lobsters to be cooked, LOL.

      • Roadstergal

        “Women aren’t lobsters to be cooked”
        That wasn’t what world-famous obstetrician Dr Zoidberg told me…

      • Bugsy

        Thanks for the explanation – much appreciated!

  • Guesteleh

    My inner 13-year-old appreciated you writing Evidence-Based Birth on the lipstick pig’s underwear. *cue Beavis and Butthead laugh*

    • NoMorePigDoctors

      Yes, I could not help but notice the uncanny resemblance between the lipstick-wearing cartoon pig and the lipstick-wearing doctor’s profile picture in this blog!

  • Zoey

    Oh boy, another reason in my already really long list of reasons why I can’t stand Evidence Based Birth.

    Although I’m forced to give grudging credit to her blog post on Vitamin K for newborns, which has convinced a few of the NCB prone parents I know to actually agree to get the shot. But I suppose even a broken clock is wrong twice a day…

  • Kq

    OT: cracked.com has an article that may interest readers here. Check out #1!
    5 Trivial Things With Armies Of Crazy Advocates: http://www.cracked.com/blog/5-trivial-things-with-armies-crazy-advocates/

    • Guest

      LOL! I enjoyed that he stuck the breastfeeding debate in there with the debates about text editors and gaming consoles.

    • Roadstergal

      Hey, Oxford commas are way more important than breastfeeding! 😀

      Or, because I’m punchy today, Oxford commas are way more important than important parenting decisions, breastfeeding and skin-to-skin. Or was that: Oxford commas are way more important than important parenting decisions, breastfeeding, and skin-to-skin?

      • Young CC Prof

        My language geek is falling all over this one.

      • Smoochagator

        I love you.

  • Trixie

    Lamaze is offering online VBAC classes for $29.95. If there’s any silver lining, it’s that they might be stealing market share from Jen Kamel. http://elearn.lamaze.org/courses/vbac-informed-and-ready

  • Bombshellrisa

    I can’t help thinking about what it would be like wear a water birth t shirt to the grocery store. Would people see it and picture me naked in a tub of poopy, bloody water, clutching a barely crying purple-gray newborn to my chest while I chant “I did it! I had a water birth!”? It’s like those “born at home” onesies. If my ten month old wore one to accompany me grocery shopping, would people blame his need to turn around in the shopping cart or his checkout stand time to go home shriek on his being born at home?

    • Bugsy

      LOL!

  • expat

    Bring waterbirth back? As if it is some ancient technique lost to time? It is my understanding that waterbirth is a hippie trend which has never had more trendy practitioners than it has today. Soon, they will be saying, “”water birth? So 2010s.”

    • KeeperOfTheBooks

      Quite.
      I admit that if I were to give birth vaginally, the idea of giving birth in water is *very* appealing. I mean, warm Jacuzzi=nice way of getting some pain relief and relaxation during a painful (to put it mildly) and stressful time.
      Right up to the point that the baby inhales my feces. Somehow, that’s just not as warm and fuzzy a feeling.
      Eh, well, that first post-birth shower is still pretty awesome.

  • The Computer Ate My Nym

    a systematic review of the literature on waterbirth, which she published at Evidence Based Birth.

    If I were going to spend 4 months reviewing a subject and writing a review paper or, even better, a meta-analysis on it, I’d want to publish it some place peer reviewed. She “published” in EBB instead because…

    • Pillabi

      Because she doesn’t trust Big Science!

  • attitude devant

    Dekker is a terrific example of how NCB is an industry. Her monetizing this pathetic ‘research’ is jaw-droppingly avaricious.

    • I hope she writes more articles like her Vitamin K and GBS posts….. but sadly, she’ll never be able to approach certain home birth topics in an unbiased way.

    • Sue

      Is she sponsored by Big Tub?

      • Who?

        More like big tinfoil. Conspiracies everywhere…

      • attitude devant

        Or Calgon…

        • The Bofa on the Sofa

          Oh, that’s so they can claim that it is based on Ancient Chinese methods…

          “Ancient Chinese secrets, hmmmm?”

          #PCMCredit

  • Pillabi

    Nobody finds the “Sample letter to hospital administrators FROM A MOTHER” a little… suspect? Like… you only have to change the mother’s name and there you are, fake letter ready without even having to make it up!

    • attitude devant

      Pillabi, I know you are in Italy, but this is how people do this kind of campaign in the US. Awful, isn’t it? During our election season people will send letters to their newspapers for publication, but the letters have been written by campaign staff in Washington. The local person just puts her name on it and sends it off. Free campaigning.

      • Pillabi

        I’m not going to pretend such things don’t happen here… I’m not from, say, Germany… or Switzerland…we are talking of Italy!! 😉 …But still, reading it so bald faced left me astonished. We are better at hypocrisy 😉

        • attitude devant

          Don’t sell Italy short. I never met an Italian without an opinion that she would vigorously state and defend. Americans are very anti-intellectual. We don’t have the history of public debating (in print, in cafes) that Europe has. Most Americans are actually more comfortable putting their names to something someone else wrote.

          • Pillabi

            Thank you for your trust. Unfortunately if you try to debate something with NCB advocates here, it’s exactly the same story as I understand it to happen in the USA: they retort with dogma, they quote supposed “evidence” without having read anything of the kind, they attack you personally and in the end ban you and delete your comments, if the discussion is taking place in the web. Otherwise they simply don’t talk to you anymore.
            There is a difference, actually: here information tends to arrive late. Of course they don’t bother reading sources in English, so it takes at least some months before articles are translated and published here. Last month I had to argue with a midwife here who was oh so happy to announce that the MANA study finally demonstrated the safety of homebirth!! Now I’m waiting for them to get subtitles for the nice video “I’m a midwife” so they can show it to their expectant public. Like they have just done with Microbirth. Holy shit.

          • attitude devant

            I hope I don’t offend you, but since women can’t easily get epidurals in Italian hospitals with low-risk births, I’m not sure how they’re selling birth at home. After all, Italy has the best maternal mortality rates in the world. Hard to improve on success…

          • Bombshellrisa

            Do you think they are pushing home birth or a “be ok with the pain” agenda? I didn’t know home birth was even a thing in Italy

          • Pillabi

            It’s becoming a thing. It started with “be ok with the pain” (please don’t think this has something to do with the Bible or the Pope, because actually Catholic Church was fine with no pain in labour already fifty or more years ago) and it’s continuing with “too much medicalization, we need to get back to Mother Nature!” stuff. Epidural access varies a lot from region to region and from hospital to hospital. It’s easier to get in the North (my H makes 1500 births/year and offers epidural 24/7, with no charge for the patient), but it also depends on how “wooish” the hospital is. To make an example, one of the biggest H in the North, near Milan, with a big and advanced birth unit, doesn’t offer epidural except in case of induction with pitocin or of certain clinical conditions, such as high blood pressure (I’m not a doctor nor a nurse, so please forgive if I make mistakes in the jargon). There are people fighting for the right of getting free epidurals everywhere, and at the same time the NCB movement is growing. @Attitude Devant: you don’t offend me in the least! Our outcomes are so good that a pregnant woman can easily be persuaded to take safety for granted and to believe that horrible things happening in hospitals (episiotomies, C-secs… or simply a nasty nurse met occasionally in the aisle) might better be avoided by giving birht in the comfort of her own house…

          • Bombshellrisa

            Oh, I didn’t think it was because of the church, I think that when there is a lack of access to epidurals, a whole “be ok with the pain” movement is started.

          • Pillabi

            I didn’t think you were suggesting it (the church thing), it was just something I wanted to make clear. 😉

            Edited to add: lack of access to epidurals imo is more a consequence of the “be ok with the pain” movement, than its cause.

          • Bombshellrisa

            Of course! (I love love love Italy, hubby and I went there for our honeymoon. We started in Venice and then ended up in Rome. There are some things we miss even all these years later, like those cool breakfast cookies and real panini at an Autogrille)

          • Pillabi

            and what about all those spaghetti, pizzas and mandolino players?!?! 😀 😀 😀 … just joking. thank you for your words.

          • Roadstergal

            The first breakfast we had in Italy – the morning news featured the Pope and news about Ferrari’s F1 team. We figured it was all we had to keep up to speed on? 🙂

            (We were there to see Rossi at the Misano GP.)

          • Pillabi

            Sorry for answering so late, I had missed your comment. When I finally saw it, it took me quite long to understand the phrase “to keep up to speed on”… Is that commonly used? I hadn’t ever heard it.
            End of American English class. 😉

            (How was the GP??)

          • staceyjw

            I heard that the CS rate is really high because moms would rather a CS with anesthesia than birth without an epidural. SOunds like a smart thing, IMO. That is the choice I would make if I could.
            I cannot imagine that CS on demand would be big, if you cannot get an dpi though, but ???
            Is this a rumor or true?

          • Pillabi

            @staceyjw Your comment had disappeared somewhere in the last days, I see it only now!
            CS rate is again something that varies deeply on a geographical base. Some regions in the South are over 60%!!, others in the North around 25%. Here you find a table with CS rate pro region (2011): http://ingenere.it/articoli/troppi-parti-cesarei-italia-il-triplo-del-resto-deuropa .In the last years recommendations for reduction of CS rates have been more or less implemented in hospital practice, so I am fairly sure that more recent data would look slightly better, but now I haven’t time to do more research 😉
            What are the causes? I’m not an expert and my personal experience is of a H with (as already said) epidural 24/7 and a quite low CS rate, where I had two VBACs, so it is difficult for me to understand what happens elsewhere. Lack of epidural access could be an explanation, I’d say it’s more than a rumor, but this is only my opinion. CS rates are higher in private than in public birth centers, and CS on demand is tipically performed in private birth centers, more difficult to obtain in the public, where the decision is more or less up to the medical staff; these are other points to take into account. This is the information I gathered on the subject from my personal experience and a little reading, but I’m far from being able to make an exaustive analysis. Sorry 🙂

  • Bugsy

    Great post!

  • guest

    you definitely got my attention with that title!

  • Anonymous

    80 pages of bibliography on all the waterbirth research? That’s it? Can someone venture to guess the number of pages the bibliography would be for cesareans?

  • Amazed

    OT: Anyone has a screenshot on Danielle Yeager’s page? There was this wonderful, kind-hearted woman, Miranda G-something, who feels obliged to counter anything this loss mom writes with hospital birth stories. The last one was a gem: Miranda G. personally saw an obstetrician bullying a mother into unnecessarian because you see, he had a personal appointment in an hour. Then, unfortunately, I went to another page and when I returned, this tragic story had disappeared, along with the replies I hadn’t read yet!

    I’d really like to know how this tragedy unfolded. Maybe the surgeon left with the mom still open so he could meet his appointment?

    • attitude devant

      I could cheerfully strangle that Miranda G. She actually said to Danielle “The feelings of the mother are irrelevant.” Seriously.

      • Amazed

        Really? Wasn’t she a diehard fan of Improving Birth which is all about the feelings of the mother when it came to – oh the horror! – ruining her BIRTH PLAN?

        • attitude devant

          Well, you know Danielle has such a forthright manner with these people. She just said that if the mother consented to the c/s, the mother must have thought it was a good idea too, and then Miranda replied that it didn’t matter what the mother thought. Danielle is so brave—I would have been phoning my Cousin Vinny (and I do have one) in New Jersey to see if he could fix Miranda up a bit.

    • moto_librarian

      I wish I had capped it since Miranda pulled a dirty delete.

      • Amazed

        Hold it against her. Next time she shows up, remind her of that occasion and ask how you can be sure she won’t pull a dirty delete again. Make sure everyone over there knows they don’t have a genuine person to meet them in the middle. She isn’t worthy of having a real discussion with.

    • Amy M

      What is this, facebook?

      • Amazed

        Yes. She posts as In Light of Gavin Michael. I remember Miranda G, from a while ago over there. Quite obnoxious, this one. Tried to convince people that Improving Birth was to save babies like Gavin. Yeah, I bet it is.

        • Bombshellrisa

          How did Miranda G come to see an OB bullying a patient? I can’t believe a doctor would tell a patient they had an appointment in an hour as a way to hurry things along. I have seen an OB who wasn’t on call come running into a room because she wanted to be there to deliver the baby and when asked “Don’t you have something to get to?” (The patient asking) replied “yes, but since baby wants to be born right now, I will still get there!”. There is an OB who always wants to be called if her patient comes in to deliver, she wants to be there if at all possible. That is especially reassuring for first time moms.

          • Amazed

            I find it interesting that the bullying doctor was a man. They all just happen to be men, despite the fact that so many OBs are women nowadays.

          • CandiB

            I wish I had screen shots but she made herself look more like an ass than ever!
            Danielle amazes me with her patience.
            Miranda ended up deleting everything after another poster pointed out she knew where she was doing her internship at and that’s not how it’s like there. All of the sudden all the replies were gone.

          • Amazed

            Really? More like an ass than when she was scolding Danielle for diminishing the pain of “Kelly” with the barbarian episiotomy Improving Birth used for their propaganda?

            Colour me impressed. Colour me black with a shade of bluish with being impressed (I am quite fair-skinned).

          • CandiB

            She said she is on an intern rotation and mom was dilated to a 9 but the doctor had a meeting in an hour so her bullied/pressured her into a c-section. Supposedly all the nurses said it was common.
            When I asked her a question she then came out and said it was 10 am and his meeting was at noon.

          • LovleAnjel

            Maybe things are different in hospitals, but I take any and all possible excuses to skip meetings.

          • Cobalt

            How possible is it for a doctor to tell an almost fully dilated mom that the doctor has to leave L&D at a certain time, and offer her a cesarean as an alternative to delivering vaginally with an on-call doctor the woman’s never met?

            It sounds plausible to me that some women would prefer the choice of provider, especially if it’s a doctor they really like and trust, over the choice of delivery method.

          • Liz Leyden

            Some docs are that unprofessional. When I was in college, the doc at health Services, who was there for 2 hours a day, refused to see a friend who hobbled in with a suspected broken ankle because she had an “important personal appointment.”

          • fiftyfifty1

            Did your college health service have an X-ray machine? Most don’t. If that’s the case, and a broken ankle was suspected, then it makes sense to send the patient immediately to the place where an x-ray can be done and the ankle can be taken care of. Why stay after hours, wasting everybody’s time and money doing an exam that can’t tell anyone anything they need to know? Off to urgent care with you!

    • Trixie

      I know someone who screencapped it.

      • Amazed

        Great! Are they inclined to post the caps somewhere we can reach them? Just for further reference. And, I’ll admit it, to my guilty pleasure since I have no doubt people had called her bluff. I’d like to know the OB who tells a nursing student (is she one, BTW?) that they are going to mislead a patient and double cut the time needed for a c-section just so they can meet an appointment.

        • Trixie

          It came out later that she was lying about being a nursing student.

          • Amazed

            So what is she? Do we know? Besides being a liar and a birth junkie, you know.

          • Anj Fabian

            She was doing a lactation consultant internship.

            So she claimed.

          • Bombshellrisa

            Is she already a nurse then? I don’t understand why a LC would be in a delivery room.

          • Amazed

            To bear witness at the chauvinistic OB’s malpractice, of course!

            I am fascinated with the nurses who have no problem badmouthing an OB to a LC intern.

          • attitude devant

            Of COURSE she was lying.

    • CandiB

      This is the only screen shot I was able to get before she deleted

      • Amazed

        OMFG! Please tell me that it wasn’t Danielle she was addressing? Pretty please?

        • CandiB

          No, thankfully

          • moto_librarian

            I’m not sure that she wasn’t addressing Danielle. She deleted the comment just as I was finishing up an epic reply.

          • Amazed

            That seals it. If she appears again, treat her like bitches like her deserve to be treated – with contempt.

          • Guesteleh

            How about reporting her to her program? They would not be smiling on these shenanigans.

          • moto_librarian

            In my reply that never posted, I advised her to educate herself about HIPAA.

          • Bombshellrisa

            It sounds like she WAS talking about Danielle, even if she wasn’t directly talking to her, why else word it like that. And she is only a student? She is going to be the newbie nobody wants to hire. She had so much to learn and it sounds like she is tuning out everything that doesn’t fit into her agenda

        • violinwidow

          No, she was talking to me because I questioned her story.

      • Young CC Prof

        In order for a former victim of quackery to become a voice against quackery, first one must come out alive and healthy enough to fight. Then, one must make an incredible journey, emotionally. In many cases, it involves breaking with friends or even family, accepting that one’s own judgement was disastrously wrong, and reexamining one’s entire intellectual framework.

        And finally, for those few who go all the way through and have the strength and will to fight, this GARBAGE gets thrown at them.

        And people wonder why no one complains about the bad actors?

        • Trixie

          Danielle is truly a hero.

  • Ash

    OT: in your area, do you have to specifically request a CNM to care for you rather than a physician (hospital/clinic based practice, not birth center;/home)? Around here, it appears that you’d have to specifically call the midwifery clinic and set up care with a CNM. Default otherwise is OBGYN and OBGYN Residency CLinic

    • Amy M

      I’m in MA, and my insurance at the time said I could choose a CNM or an OB. I had a complicated pregnancy, so I went with OB. I made sure to pick one that worked out of the big teaching hospital that had a Level 3 NICU.

      • Jocelyn

        I’ve been in CA and UT, and it was same with me for both places. Insurance said I could choose either CNM or OB; I just had to pick one and set up an appointment.

        • Ash

          Right, insurance here covers both CNM and OB, but the only women seeing CNMs are those who are specifically interested in midwife care. This seems to be in contrast to some other “medwives” in the USA that alternate appointments between OB and CNM.

    • Elaine

      In Ohio. There are a couple of practices in my area with CNMs (and OBs as well) that do deliveries. You would have to specifically choose one of these practices and tell them you want to be under the care of the CNMs. Otherwise everywhere else you would see an OB, and you could also be a patient at one of these practices and see the OB(s). My friend wanted to deliver with a CNM, but after she developed GD and hypertension, she had to see the OB at the same practice instead and deliver with him.

  • moto_librarian

    I wish that Dekker would give up this pretense that she is an advocate for evidence-based care. Waterbirth has very real risks and the only possible benefit is a reduction in pain for the mother. Given that there are plenty of other options for pain relief that do not place the baby at risk, water birth is indefensible based on evidence.

    I think it’s brilliant that you compared her campaign to bring back waterbirth with a campaign to bring back routine episiotomies. I had a good giggle over this one.

    • Amy M

      I agree, but I think laboring in the water is considered safe, barring complications, if the woman gets out to actually give birth. I wonder how many people are truly dead set on the baby actually being born into the water vs. wanting warm water during labor for whatever pain relief it can offer. Is the difference between water labor and water birth understood by the people Dekker is trying to reach?

      • moto_librarian

        Using water for pain relief during labor is fairly standard at a lot of hospitals. Granted, not all have tubs, but most at least have showers. Dekker is reacting to the news that some hospitals are banning actual water birth in response to the evidence that it can harm or kill babies. I think this is understood by Dekker’s audience.

        • Amy M

          Thanks–I know I once had a discussion with a friend about water birth, and she wasn’t distinguishing between laboring in the tub, and giving birth in the tub, which is why I mentioned it.

      • Cobalt

        Why choose pain relief that means you have to get up and walk away from it once you finish dilating? The last thing I want to do at 10 cm is get up and walk!

        • Medwife

          It actually felt right to me. I started feeling pushy and suddenly was like, Get me out of this tub! Maybe because that was the plan and I did want my air-breathing offspring to be born into air.

      • Sue

        If she’s only talking about pain relief before the baby is actually being born, then nobody is advising against that. So, she’s either wrong, or she’s…well…wrong

  • Young CC Prof

    Next I think you should offer a class on the proper medical uses of laudanum. Let’s bring back all the classics.

    • Amy M

      How about ether?

      • Young CC Prof

        The surgical anesthetic, or the astrophysics theory? Either would work.

      • Roadstergal

        Bring back twilight sleep!

        Ugh, I wish I could laugh about all this. My UK friend was rhapsodizing the other day about her friend’s recent midwife-encouraged and supported ‘healing’ HBAC waterbirth, and is planning a midwife-attended ‘healing’ HBAC waterbirth for her second. It seems like there’s so much official preaching of NCB dogma over there, and it just makes me so depressed.

        And to the comments above and below, yes, it’s all about giving birth in the water, not laboring there and then coming out.

        • Liz Leyden

          I had twilight sleep during a colonoscopy 5 years ago. It wasn’t bad.

      • theadequatemother

        If we brought back ether we couldn’t have celebratory cigars.

        Ka-BOOM!

    • KarenJJ

      Biting on sticks?

    • Mishimoo

      Chloral hydrate for ‘nerves’ (Post-partum depression and/or PTSD)
      Yes, I’ve been rereading Kerry Greenwood novels.

      • Sue

        Chloral + alcohol = Micky Finn – still in use when I was starting inner-city medicine…um…a while ago

  • TsuDhoNimh

    “Water birth is unnatural. No primate gives birth in water.”

    Even seals haul out onto the beach.

    Sea otters deliver on the water, but they manage to curl around so the kit emerges into the air onto the mother’s belly. She’s a floating birth platform.

  • Ash

    Hold on, where are my Fiskars scissors! Gonna watch a Powerpoint webinar online and then cut a woman’s perineum as part of my apprenticeship!

    Actually, screw the apprenticeship. I was reading on the Aspiring Midwives forum that since it’s too hard to find an apprenticeship and my potential clients are in an “alegal” state, I really don’t need that.

  • Mom of 2

    Hmmm….can you teach a class on how to get rid of waterbirth in hospitals? I’m a nurse, I have no power to say no when the woo-ey CNM’s I work with are doing waterbirths (to be fair, they don’t actively push it with their pts, but they do it if the pts ask. They also used hospital funds to purchase the stand alone tub they use. I can think of a bajillion ways that money could have been better spent.)

    • Ash

      I haven’t heard of any USA hospitals that have actual clinical trials for waterbirth, but some do have a registry. That could be useful in identifying adverse outcomes.

      • Mom of 2

        We only do 1-2 a month, so it would take a long time to get a meaningful sample size. I wish it was tracked nationwide so we could really know the outcomes. I assume that if we ever have a bad waterbirth outcome, my hospital will stop, and I’m guessing the same is true for most hospitals.

        • Ash

          Gotta convince a physician there to be an investigator and get a grant for a national registry 😉

        • attitude devant

          The problem is that to do this right you’d have to follow the neonates. Just a registry wouldn’t help unless you had stats on the newborns for a few weeks after. And there is some concern that perineal injuries to the moms are greater, so you’d need some subjective assessment of that. It’s not easy. What’s more, given that the governing bodies of pediatricians and OBs are firmly negative, it would be hard to get an IRB to sign off on this. Really the only way to do this right would be to have a real trial with real informed consent. As a parent I for one would not be willing to accept the risks in a trial setting or elsewhere

          • Ash

            I know of one hospital that already has a registry. They do have a local IRB. I don’t know what their consent form looks like but at least 1 hospital has done it.

            Actually, they probably may not require a consent form, because it’s retrospective chart review so they may have a waiver of consent from the IRB.

          • Mom of 2

            Great, so it can’t really be studied. So people like Dekker will continue to say it’s not proven to be dangerous.

          • Roadstergal

            “As a parent I for one would not be willing to accept the risks in a trial setting or elsewhere”

            No, but there are women who are willing to have a waterbirth in light of the known possible complications. If women really want a waterbirth and are willing to read the IC and sign it – I can definitely see a trial happening. But I think the only way to make it happen is for hospitals to actually follow the guidelines and not offer waterbirth outside of a clinical trial. If you can get one without having to sign extra forms and be tracked, you’re going to default to the easier path, and everyone will be denied useful hard data.

          • Elaine

            I delivered both my kids with CNMs and that practice did waterbirth as well, ick. They suspended doing them when the new ACOG recommendation came out, to much hullaballoo from moms who chose their practice specifically in order to waterbirth. They say they want to get an experimental protocol in place so they can start doing them again. I don’t doubt they’ll be able to find interested patients. Bleh.

    • Amy M

      Are the babies actually delivered in the water? Or do the moms just like to labor in the tub?

      • Mom of 2

        There are some that just labor in the tub, which I’m fine with, but they do deliveries in the tub as well. There are also a fair amount who start out planning to birth in the tub, but end up back in bed before delivery for various reasons. What I don’t understand is why our physicians are okay with it, since they back up the midwives. The docs won’t actually do water deliveries themselves.

    • araikwao

      Ugh. The hospital I did my ob/gyn rotation at just started doing water births this year. The MW showing us around the unit was all huffy that it had taken them this long to offer ut (b/c everyone else was doing it ages ago). Sadly, I think it will take a lot of adverse events before it gets called into question. And given that the numbers are small, that will take awhile..
      ETA: sorry, I see you have already mentioned these things below!