Did Aviva Romm just blame women who die in childbirth for their own deaths?

Blaming the victim

An alt-med shill’s work is never done.

She always has to be out there shilling her books and supplements to increase her income, as if she didn’t already make enough from practicing “functional” medicine.

One of Romm’s favorite tactics, in common with everyone who profits from the natural childbirth industry, is to demonize modern obstetrics. But this time she appears to have gone off the rails. She is so busy demonizing that she comes perilously close to demonizing women who die in childbirth.

Here’s what she posted on her Facebook page, attempting to boost sales for one of her books.

Aviva Romm 2-9-15

While the chance of dying in childbirth in the US is extremely low, the rate, according to the latest data from the CDC, continues to rise, not go down in recent years. This is attributed to increasing rates of chronic disease in pregnant women — and much of this is preventable by achieving a healthy weight prior to pregnancy, preventing gestational diabetes with a properly balanced diet that is not high glycemic and getting enough nutrients, especially vitamin D3. Some of this is also due to birthing practices in the hospital (not saying that home is without problems, but the maternal mortality rate is lower with planned home births to healthy moms with competent midwives).

So, Aviva, if only those lazy, fat pregnant women would stop stuffing their faces, they wouldn’t die in childbirth?

And since maternal mortality disproportionately affects Black women (who are 3 times more likely to die in pregnancy or childbirth than white women), they must be 3X more likely to be lazy, fat, and endlessly eating, right? It couldn’t possibly be racism or poverty?

That wasn’t what you meant to imply, Aviva, when you blamed women who die in childbirth for their own deaths, was it?

You only meant to mislead women about the role of nutrition in maternal death so you could make more money off your own books? That’s what it seems like to me.

Before we parse the absolute bullshit that you posted, let’s take a look at who dies in pregnancy and childbirth in the US. The data come from Pregnancy-Related Mortality in the United States, 2006–2010 published in the January 2015 issue of Obstetrics and Gynecology.

Maternal mortality by ethnicity 2006-2010

The highest rates of maternal mortality occur in women greater than age 40. Maternal deaths among African Americans dwarf those of other ethic groups.

Why do women die in pregnancy and childbirth?

Maternal mortality causes 1987-2010

You can see that whereas some causes of maternal death like hemorrhage and pre-eclampsia/eclampsia have diminished in importance, others have steadily increased including pre-existing cardiac disease and cardiomyopathy (pregnancy induced weakness of the heart muscle).

What do these have to do with nutrition?

Absolutely, positively NOTHING.

What do these have to do with vitamin D3?

Absolutely, positively NOTHING.

What has Aviva herself been doing to decrease maternal mortality?

Absolutely, positively NOTHING.

She practiced for years as a homebirth midwife, but now that she has real medical training, and could actually care for pregnant women properly, she refuses to take that responsibility.

Wait, let me amend that; she’s not doing nothing: she’s been exploiting the tragedy of maternal mortality to sell her books and promote her world view.

And lying.

Consider this gem:

[T]he maternal mortality rate is lower with planned home births to healthy moms with competent midwives

Not only is this a lie, but to my knowledge, there are no studies that are large enough and have enough statistical power to address that issue, since maternal mortality is measured per 100,000 women.

Ironically, I recently heard about yet another maternal death at homebirth that occurred in Arlington, Texas. A mother attempting a VBA2C delivered a lifeless baby and collapsed. The baby survived after being treated with cooling therapy for hypoxia (lack of oxygen), but the mother died despite heroic attempts by doctors to save her life. She left 4 children motherless. Add that to the 22 additional children left motherless when their mothers died at homebirth (She trusted birth … and it killed her. Now her children will pay the price.)

No doubt all these women were getting enough nutrients, but it didn’t make any difference.

The truth about maternal death is the US is this:

It’s not clear that it is rising, because better reporting has been responsible for at least part of the increase, but it isn’t falling. As the graph above demonstrates, the single biggest factor is the increased birth rate of women over 40. Those women are more likely to have chronic diseases, NOT because they didn’t eat right, but because chronic disease incidence increases with age. Moreover, although the number of pregnant women requiring intensive care is increasing, there are very few obstetric intensivists, very few obstetric intensive care units, and no rating system to facilitate transfer of critically ill mothers to hospitals that have the experts and equipment to treat them.

The bottom line is that the solution to maternal mortality is NOT better nutrition; it is NOT vitamin D3; it is NOT homebirth; and it is NOT buying Aviva Romm’s books. It is imperative that we increase our ability to identify critically ill pregnant women, transfer them to specialty obstetric units that have the personnel and equipment to manage their complex medical problems so we can apply MORE interventions to those complex medical problems, and identify best practices for managing complex medical conditions in pregnancy.

Stop blaming the victims, Aviva Romm; stop exploiting the tragedies of these women, particularly women of color, to shill your books; start doing something effective to address the problem, if indeed you care about it at all.

  • Frustrated

    I’m going to print this out and bring it to the Obesity in Pregnancy clinic at our High Risk hospital. Obviously their focus on diet and exercise as a means of improving outcomes is hugely misplaced. Also, going to bring it to our Endocrinology clinic – tell them to stop helping women with GDM get it under control through diet and exercise as a first approach. How deluded are we! Seriously – sometimes I think you just want to disagree with midwives. If another OB had written something like this, you would probably be lauding their efforts to improve maternal health, instead you are trying to make it seem like she is victim-blaming instead of promoting healthy lifestyles. This kind of post really compromises your credibility and integrity in my eyes.

  • lindy

    Forgive me if this came up further down in the comments, but it seems to me she’s also trying to blame gestational diabetes on a woman’s diet. Forget the placental hormones that increase the body’s insulin resistance, those will take care of themselves if you eat organic and stop munching all that cake!!

    It’s a bit of a sore spot for me because I had GD in my second pregnancy. Prior to becoming pregnant I was very fit with a great diet, then I was hit with 6+ months of vomiting, SPD, and finally GD which thankfully I was able to control with diet, but a very different diet from my usual. I guess according to Dr.Romm I should have continued to eat my normal diet and exercised through all that vomiting and pelvic pain while working every day and caring for a toddler….she can f off.

    • Cobalt

      I had it in two pregnancies, both at a healthy weight, diet, etc. For one of them I was working on a farm, so plenty of physical activity! It happens, there’s not really a sure way to prevent it.

    • Bugsy

      I had it in my one & only pregnancy, diagnosed at 28 weeks. Prior to getting pregnant, my BMI was 19.4, I ate well and exercised up to 2 hours daily. Exercise was my religion. Despite all this, I was a GD patient.

      My NCB friend also had GD in her first pregnancy; she became extreme anti-GMO, anti-toxin, all-organic after his birth. I’m guessing she had unmonitored GD for her second pregnancy (taking the au naturale route, of course): a nearly 9-lb kid came out of her 5’1″, 100-lb frame. If diet were the sole factor in GD, there’s no way she would have developed it based on her GMO-free, all-organic and whole/raw foods diet.

  • Dr Kitty

    OT: I’m still puking a lot, but I’m maintaining my weight and avoiding dehydration and ketosis, so I’m doing better this pregnancy than my first.

    We’ve had a scan, dates confirmed, one happy baby in there, with a plan for serial growth scans from 28 weeks, a date for CS at 39 weeks all being well, and an anaesthetic consult at 34 weeks.

    My OB said “we’ll have a chat at 34 weeks about the plan if you go into labour spontaneously”, I said “I doubt I’ll change my mind, no interest in VBAC thanks, I’ll be wanting a section” and he laughed and said “Well, it’ll be a QUICK chat then”.
    I’m feeling very positive about that!

    • Bombshellrisa

      Yay! So exciting!!!
      I didn’t get to comment/commiserate on your other thread–the only thing that helped a little when I was nauseated was the scent of green apple. Cake batter flavored ice cream helped too (but I couldn’t imagine eating it now).

  • KarenJJ

    It ties in with yesterday’s discussion of “what’s the harm?” of doing integrative medicine. Firstly, it diverts resources from the real issues that might cause serious problems (eg poverty, genetics, access issues), secondly it feeds into the moral superiority surrounding things like food, size, “healthy lifestyles” etc and thirdly it lines the pockets of unethical providers (alt-med providers might not ALL be unethical, but there’s no real way to discern the ethical from the unethical until you’ve handed over a significant amount of money).

    • Sue

      “Integtative medicine” essentially “integrates” science-based methods with the non-science-based. Why would you do that?

      • The Bofa on the Sofa

        It’s the Gambler’s Fallacy.

        Since green comes up on a roulette wheel every once in a while, you should bet on green about the same proportion of time.

        Doesn’t work that way.

        (actually it depends on the odds. Most roulette wheels are set up so that the return is pretty much the same for every bet. Doesn’t matter whether you are betting red/black, individual numbers, even/odds, 1-12, etc. Although there can be differences for 0 vs 0 and 00 wheels)

        • Young CC Prof

          Hey, conventional medicine MIGHT work, and alternative medicine MIGHT work, so it doesn’t matter which one I pick, right, both are valid choices!

          Nope. Conventional medicine is usually likely to work, and your doctor can actually tell you the approximate chance that it will work. If it doesn’t work, your doctor will make a note of that and try something else, at least until he runs out of tools.

          Alternative medicine is in most cases extremely unlikely to work. You will have a very hard time finding the odds. And if it doesn’t work, especially if it’s a labor-intensive treatment, the practitioner may well blame you for doin’ it wrong.

          • The Bofa on the Sofa

            “The fight does not always go to the strongest, nor the race to the swiftest…but that’s the way to bet.”

  • JJ

    How is food going to prevent you from hemorrhaging to death at home?

    “The medical model dose not know how to prevent disease.”

    In the alt-med world the only things that count as prevention are organic food, special water filter, all natural products, supplements, special exercises ect. I am guessing because vaccines and testing are not very DIY they don’t count..

    “It’s how I took care of myself when I was pregnant and will help fill in the gaps in your conventional or midwifery care.”

    This sentence bothers me because it is like she has some special knowledge that you can’t get from ANY provider. Her pregnancies probably went well because she is (seems to be) an upper middle class white women.

    • KarenJJ

      It’s funny because at one stage vitamins would have been the cutting edge of science and limes for scurvy would have been a medical intervention based on the knowledge of the day.

      • Sue

        Exactly, Karen. We wouldn’t even know what the individual nutrients or vitamins WERE it if wasn;t for medical science.

      • Roadstergal

        The use of Vitamin C-containing foods to cure scurvy was one of the first recorded clinical trials, under the guidance of a doctor (not blinded, but it was early days).

    • Samantha06

      Well, she was a midwife, so maybe she still has those “other ways of knowing”..

    • luckymama75

      That exact sentence bothered me too. Almost like, you’ll want to buy my book if you want to avoid dying or killing your baby because I know things that even modern science doesn’t.

  • Sue

    If this woman doesn’t actually know the causes of maternal mortality, WHY WOULD YOU BUY HER BOOK??

  • The Computer Ate My Nym

    I’m afraid my first reaction was “…could have been worse.” At least GD is a real thing and lifestyle changes can have a real effect on it (though nothing like Romm is claiming). When I read the title of the post I thought Romm was going to say that death in childbirth only occurred due to “tension” or “not trusting birth” or one of the other BS reasons NCB advocates give for women having pain in childbirth.

    • Young CC Prof

      I still have pretty big issues with the whole idea that the “perfect” diet will result in much better health than a reasonably good diet.

      • The Computer Ate My Nym

        I agree. One could argue that that little bit of reasonableness makes it more dangerous: less easy to spot the nonsense.

  • kate

    Shablammo!

  • Guest

    OT: could any doctors here explain to me why a glucose challenge test is needed to screen for gestational diabetes? A family member of mine sees CPMs and they just do a one time finger prick to screen for GD. Her last baby was pretty big and she’s worried this one will be bigger, and I’m wondering if she possibly had undiagnosed GD last time. Is it even possible that a one time finger prick could pick up on GD?

    Thanks!

    • Pregnant Guest

      Not a doctor, but i had GD w/my last pregnancy and was checking my sugars 6 times a day. MANY of my sticks were normal. I could have easily missed my GD w/a one time stick, but without a tightly controlled diet the rest of the numbers were totally wonky.

      • Guest

        That’s what I was thinking. I could understand if they made her do finger pricks for a few days that maybe that could show GD, but a one time finger prick doesn’t seem like it would be adequate.

        • Stacy48918

          Especially when some CPMs advise a high protein breakfast before the single fingerprick. They are deliberately trying to miss it so they won’t have to risk out.

          • Who?

            So much for being responsible hey?

          • Guest

            Exactly! I seriously hate talking to her after her appointments because I’m so frustrated by the “care” these CPMs provide.

        • Pregnant Guest

          Also, my GD got harder and harder to control as the pregnancy progressed. My understanding is that’s expected. So even a few days of finger pricks in the second trimester would be insufficient. I only failed the (2 hour) GCT by 2 points for 1 of the values. I was skeptical that I even had GD until my numbers started going all over the place a few weeks later.

    • Cobalt

      The glucose challenge measures how your body responds to glucose by delivering a set amount of glucose and waiting a set period of time. A single fingerstick, in the absence of strict control of glucose load and time, doesn’t give any useful data.

      Kind of like weighing yourself once during pregnancy. With no starting weight or other parameters, you have no idea if your weight gain is appropriate or not.

      Or glancing at your speedometer once to see if you’re speeding, without knowing what the speed limit is.

      • Amy M

        Also–I don’t remember, but is the glucose challenge done after a 12hr fast? Or do they just do a baseline before the glucola?

        Regardless, randomly checking glucose during the day will also not always give you the same number. If you are not GD, it should always be within a certain range, but on the higher side of that range after a meal. Diabetics (of any stripe) will show a blood glucose level beyond normal after fasting, when non-diabetics would be at the low end of the range.

        • fiftyfifty1

          Diabetics (of any stripe) will show a blood glucose level beyond normal after fasting.

          Typically, but not always. I have a number of DM2 patients who have fasting glucose levels in the normal range, and who go high only after eating.

          • Amy M

            Ok, diabetics often show a blood glucose level beyond normal after fasting. 🙂
            I work with a diabetic mouse strain, but don’t have so much experience with diabetic people.

          • Jennifer2

            Really? I always do fine on fasting glucose tests at my physicals, but I did when I had GD also. It was only my post-meal numbers that went high. Makes me worry that I could end up with type 2 DM or predicable yes/insulin resistance and not know about it.

          • Pregnant Guest

            I insisted on an A1C at my last physical for this reason; I did fine on the fasting glucose my providers recommended, but many of my fasting numbers were normal at the height of my GD. Don’t know if it was really necessary, but gave me peace of mind.

          • Medwife

            How were you diagnosed with GD?

          • In 1980, in Israel, it was the practice only to test for GDM if one’s FBS was high. Mine was normal. First child weighed 4.1 kilo, second weighed 4.2 kilo, and the third, an elective C/S at 39 weeks, was 4 kilo. I am obese, and now have type 2 diabetes. It is known that 50% of fat women with GDM who have babies over 4 kilos will go on to develop diabetes in later life. In retrospect, I am sure I had GDM.

            There are various testing program protocols. In Israel we now do a 50 gm glucose test one hour after ingestion at 24-28 weeks. If that is high, then a full, 4 hour 100 gm GTT to make a definitive diagnosis of GDM.

        • Cobalt

          Usually it’s at least 8 hours. There are versions with 12 hour or 2 hour plus baseline, depends on if they’re screening or testing.

        • Jessica

          As I recall, the one hour did not involve a fast, but the three hour did. My doctor did not give me instructions regarding my diet before either test (I’ve seen some women advised to eat a certain amount of carbohydrates in the days leading up to the tolerance test). I failed the one hour test, and because I am obese was pretty sure I would fail the three hour test (also, STRONG family history of type 2 diabetes). All of my readings on the three hour test were perfect.

          I had very low tolerance for carbs during my pregnancy – I craved meat and high protein foods, and breads and sweets often caused me to vomit. Very odd.

      • Guest

        Thanks! I knew it wasn’t adequate. Now only if I could convince her…

    • Montserrat Blanco

      If the result of the one time is really high you can diagnose it with only that. Let’s say it is 350 mg/dL, you are diabetic for sure. If it is normal, you have no idea.

      Even sometimes you need a glucose overload for normal diabetes, as it has been explained by other commenters.

  • attitude devant

    It is difficult to convey the depths of my disdain for Aviva Romm. Here she is, trading on her groovy street cred (former homebirth midwife!) to hawk books and oils, all the time claiming the authority of an Ivy-minted M.D. Well, here’s the key: absolutely everything hangs in her refusal to attend births any longer. See, once you have the medical degree, you WILL be held to a standard set by science in your personal practices, and she knows, down to her EO-scented toes, that the very stuff that she claims in her pregnancy book doesn’t work. That all she’s peddling is hope and false assurance, unicorns and rainbows. If she actually had to take care of pregnant women, she’d be called out by every single one of the agencies OBs have to certify with every year.

    And I’m sorry, but all these claims she makes? She’s LYING. She KNOWS better. And yet, here she is, hiding behind giving advice in a field where she doesn’t even practice…… She disgusts me.

    • Sue

      This woman’s website say that she is trained in internal medicine, but practices family medicine, “integrative” medicine, herbalism etc etc.

      Does she actually have training in any specialty?

      Funny that this ex-MW chose not to continue caring from pregnant women once she had further training…

      “Women’s herbal medicine” is obviously more lucrative, much lower risk and much better hours than obstetrics or midwifery!

      • Samantha06

        Since she became “educated” she’s realized she has no character or ethics and wouldn’t make it in the real world, so she sticks with what she’s comfortable with… quackery..

      • fiftyfifty1

        “Does she actually have training in any specialty?”
        Yes, she did a Family Medicine residency. She gives us family doctors a bad name. Yuck. Get out Aviva.

  • Mac

    They are trying to become legal again in my state. =The medical community is fighting this and so far they have been able to stop any legislation from passing.
    http://blog.al.com/wire/2014/01/two_north_alabama_lawmakers_pa.html

    And this is included in the bill! –“This bill would provide immunity from criminal prosecution to midwives and certain other health care providers that provide care related to physiological childbirth – that is, naturally-progressing vaginal childbirth, often at home without the care of a licensed medical doctor.”

    • Sullivan ThePoop

      I want to vote your post down because of the content.

    • Staceyjw

      Your state can have ugly rates like Oregon if they keep it up!

      You CAN make a difference. The HB MW crowd is used to gettig what they want, and the few places they haven’t, their only opposition is the medical community, not the public. So even a small number of people that care enough to spend a bit of time, can tip the scales in the right direction. Get your voice heard, enlist as many people as you can, and make sure to thank the politicos voting against it, and letthe mD groups know they have support.
      I hope they stay illegal.

    • The Computer Ate My Nym

      Wait, what? Does that mean that anyone claiming to be a caregiver for pregnant women is immune from being sued as long as they don’t do a c-section? That seems…poorly thought through.

    • Liz Leyden

      Would immunity from prosecution only apply to CPMs, or would it cover CNMs as well? Who are the “certain other health care providers?”

    • Roadstergal

      That sentence should be heavily publicized. “Midwives want to be able to get off scot-free if they kill or damage you or your baby.” Oh, but that word ‘natural’ just makes it all better, doesn’t it. I can’t believe nobody reads books about what pre-obstetric-care ‘natural’ childbirth was like anymore.

  • Bugsy

    Huh?

    I laugh at the thought that diet alone can stop gestational diabetes. I had GD, hardly because my diet was “high glycemic.” (FWIW, my one pregnancy craving was red, orange and yellow peppers.) My GMO-free friend ate ridiculously well, and still had GD. The same goes for a handful of other friends I know who had GD.

    I would, however, state that modern obstetric care helped all of us ensure that we had healthy outcomes in childbirth despite having GD. My full-term son was a whopping 6 lb, 8 oz at birth thanks to the treatment and care I received.

    • The Computer Ate My Nym

      I ate noodles, plums, and coffee cake during my pregnancy. And went into it overweight. No gestational diabetes. My HgbA1c has actually gone up as I’ve gotten thinner. Sigh.

      • Bugsy

        …and yet according to Ms. Romm, we’re both at fault somehow – me for my GD, and I’m sure you for your rising HgbA1c. Gotta love it.

        Hang in there with it. I’m predisposed for GD (hereditary), and blood sugar issues aren’t fun.

        • The Computer Ate My Nym

          Whereas my doctor, after I lost 30 pounds and was starting to act obsessive about my blood sugar gently told me, “I think we sometimes overestimate what we can do with lifestyle changes.” In other words, no, it’s not all your fault. Sometimes it really is just bad genes. Ms Romm, I presume, would advise more supplements sold by her friends and kale smoothies, I presume.

  • MLE

    Each copy should be sold with a giant foam hand on a stick to pat yourself on the back with.

  • Courtney84

    For the sake of refuting her claim that heavy women are who die, is there data available to graph deaths by BMI catergory?

  • mostlyclueless

    Don’t be ridiculous, Dr. Romm is really on to something here. Using your OWN LOGIC, we can see that all we need to do to decrease maternal mortality is to STOP WOMEN FROM TURNING 40. Is there an essential oil for that?

    • S

      There’s the Suzanne Somers method; i think it involves massive amounts of corticosteroids until your immune system is severely depressed (“bioavailable” steroids, don’t worry, it’s natural).

    • Mac

      I wish there was an essential oil that would stop me from turning 40! 🙂 🙂

      • Mom2Many

        Careful what you wish for…who knows what poison is out there posing as an EO! Nobody is double checking what crap they’re packaging up. Besides, turning 40 is not all bad! 🙂

        • momofone

          I just turned 45, and it beats the hell out of the alternative! 🙂

      • D/

        Turning forty traumatized me. I’d gotten expensive, salon hair products as treat to ease the pain of the day. Took a luxurious bath in the garden tub and started to read what wonders I should expect for my frazzled mane … except I couldn’t read *any* fine print on the bottle.

        Unfortunately, there is just not enough salon (or essential oil) magic in existence to counteract that moment of being forty, fat, naked, and realizing oh crap now I need bifocals too.

        • Samantha06

          Uh, wait until you turn 50…… sigh… although, I have to say, 40 was quite traumatic for me too… so 50 wasn’t too big of a deal..

          • Who?

            With you there. Forty is such a turning point-I didn’t realise it at the time, addled as I was by pregnancy and toddler-rearing, but for me 30 was the last really postitive zero birthday. I’m not too keen on feeling young and looking old though, and I do give myself a fright in the mirror sometimes.

            V sweetly my mother, who is in her mid-70’s, was more traumatised about having a 50 year old child than I was about being 50.

            And they are not kidding when they say you will see the benefits of wearing sunscreen, btw.

          • Samantha06

            Aw, that’s cute about your mom! I guess it would be a little disconcerting, having a child of 50!

            And that’s the truth for sure about the sun-screen! I worked with a girl who religiously used the tanning bed, including on her face, and went to the beach and baked.
            Her face looks leathery and VERY old! I’m 10 years older than her but my skin is much smoother and younger looking.

          • D/

            Yeah, being 50 really didn’t faze me … At least not until I started thinking about having a 30 year old kid, that is!

        • Who?

          I hear you re the greys-mine are just coming in-what the hell is with the frizz!?!?

        • fiftyfifty1

          You have a garden tub? Like an outdoor bathtub? Wow, that sounds divine!

          • D/

            No here “garden tub” is just realtor-speak for a oversized, deep tub. Mine’s stuck in the corner of my bathroom with not a garden in sight, but I do have a nice floral pattern wallpaper so there’s that I guess. Although as a child I did have the privilege of enjoying true summer-time garden tub baths and thought they were a divine thing! And they were since the alternative was a “bird bath” from a water basin.

            Probably not the garden tub scene you’re imagining though. Picture horse trough in the yard, parked by the manure mulched vegetable garden with the tobacco fields in the distance. And as likely as not with my pet chicken, “Peepy Chick” perched on the tub’s edge in between bouts of falling in and flapping about. Yep … absolutely divine 😉

        • Roadstergal

          I haz plan. I do triathlons, and your ‘race age’ is always your age as of the end of the year. So last year I was ’38’ (and had it written in a big font regularly on my leg) before I actually turned 38, so once the birthday hit, I felt prepared. Ditto this year – I’m ’39,’ but won’t actually be 39 until September. We’ll see how that works for 40 next year.

          I like the idea of a spa treatment, though. My husband now will know what to get me for the 40th. That and alcohol.

    • Young CC Prof

      I know many people who have celebrated their 39th birthday several times. Clearly we need to make the tradition more popular, especially among women who may have more children.

      • The Bofa on the Sofa

        I know many people who have celebrated their 39th birthday several times.

        This year, my wife is celebrating the 6th anniversary of her 39th birthday.

        • Young CC Prof

          See, then she can still have more kids safely!

          • The Bofa on the Sofa

            But I can’t, so she’ll have to find another guy to be the father if she wants to.

        • The Computer Ate My Nym

          My father recently celebrated the 41st anniversary of his 39th birthday.

      • Bugsy

        Heck, I’m still celebrating 25! This year will mark the 11th anniversary of my 25th.

  • Courtney84

    Ugh don’t we have this problem with the March of Dimes too? Wasn’t it the March of Dimes who recently issued a report lauding 10 states for their low preterm birth rate and chastizing states such as Mississippi for having very high pre term brith rates. Dr. Amy make graphs of the pre term birth rate and the % of the population that was African American and voila! it turned out that geography had nothing to do with pre term births, it was in fact about blackness. In all seriousness, why isn’t the MOD hard at work trying to figure out why it is African American women are so much more likely to have premies and trying to do something about it?

  • fiftyfifty1

    The cover of her book says it all: Self-satisfied white women navel gazing.

  • Mel

    I know the plural of anecdotes isn’t data, but I had plenty of previously healthy late-teenage (17-21) girls who developed some pretty nasty pregnancy complications in spite of being thin, well-nourished and eating a reasonably balanced diet. I doubt that vitamin D3 supplementation alone would have magically fixed any of the young ladies problems….although access to good nutrition from birth, uninterrupted access to health care, and being a few years older may have helped.

    • aurora

      Another anecdote for you: My mother is white, thin, ate very well as her mom cooked very healthy because her dad had very mild diabetes that they could keep under control with diet instead of insulin and she learned to cook the same way, and was physically fit by running and being on a softball team. She had a perfect pregnancy with me until she went into labor and her blood pressure just spiked and both of us nearly died. She was only 23 when she had me. So…care to comment on that, Aviva?

      • attitude devant

        That was me too. Couldn’t have been healthier before and during pregnancy…..until my blood pressure went through the roof.

        • demodocus’ spouse

          Nonsense, only fat ladies like me have high bp. (it isn’t, btw, except during labor) Must have been that icky hospital atmosphere making you anxious. Some essential oils and whale song would have helped. //sarcasm//

          • KarenJJ

            Dunno how I managed it, but I went through both pregnancies anaemic (quite severely at one stage) due to anemia of chronic disease and with high CRP levels and ESR (due to underlying untreated immune system issue) and managed to have very text book and uninteresting pregnancies with healthy a kid at the end of them… Must have been all that chocolate, or.. um.. kale, that I ate….

        • Liz Leyden

          I was morbidly obese when I got pregnant. My blood pressure was fine before and during delivery, but I was back in the hospital 10 days later with post-partum pre-eclampsia. I doubt a midwife could’ve prevented that.

    • Sullivan ThePoop

      Aren’t teenage girls at a higher risk for pre-e during pregnancy?

      • Mel

        If they are under 16 at time of conception, the rate of complications is high. (I’ve seen numbers similar to AMA women). Over 16, the complication rates drop off pretty quickly. They are young in terms of emotional maturity, but physiologically, they are adults and usually have quite uncomplicated pregnancies. (We averaged about 15 pregnancies a year and I taught for 8 years. Most girls had an easy of time of it, but a few had some nasty surprises. One “older” girl who was 20 had an emergency CS for pre-eclampsia that ramped up in a very short time in her 2nd trimester. Both her baby and my student survived, but only because she had access to good prenatal care – and no woo. Thankfully, my students were blessedly woo-free. They liked epidurals and OB-GYNs.)

        • Sullivan ThePoop

          I was just curious because I had my first at 18 and pre-e. The doctor told me teens are at higher risk for pre-e and I believed her.

  • Ellen Mary

    Wow. This post was really helpful, both to woman kind and personally. Thank you. <3

  • Amy M

    I also noticed she said that modern medicine isn’t preventive. So I guess she’s never heard about screening tests. I mean, why would she? If she screened her patients, she might actually find something (unrelated to nutrition)that she would have to prevent.

    • Kelly

      What about vaccinations? I guess modern medicine is actually just trying to give you something for them to treat. These people are stupid. Had a woman on my feed link to this lady and now I am wondering what other woo she buys into as well.

    • Amy Tuteur, MD

      The irony is that most of modern obstetrics IS preventive medicine. All the tests, procedures and most C-sections are done with the SPECIFIC OBJECTIVE of preventing infant and maternal injury and death.

      • Amy M

        I had a high-risk pregnancy with mono-di twins. My OB ordered a ton of u/s for us, to watch for TTTS. Using the u/s was a preventive measure (and not the only one she used) and I was grateful to be pregnant in a time where this technology was available. Of course, Ms. Romm and other people like her would say that “u/s has high risk of pre-term birth!”

        I’m pretty sure Ms. Romm knows that to say that would be pretty twisty, but many lay people wouldn’t know the difference and then avoid u/s because they fear pre-term birth. I know that TWINS has a high risk of pre-term birth and u/s are used frequently in twin pregnancies to detect possible problems, but that is the correlation between pre-term birth and u/s. I know that u/s do not cause pre-term birth.

        What I don’t totally understand is this: If Ms. Romm is opposed to preventive medicine (she seems to be, if she thinks that OBs interfere with all their tests), why does she blame modern medicine for supposedly failing to provide the preventive medicine? What would she suggest as preventive medicine? Eating right? Does she really think that’s the end all-be all? Or is that just a front to sell a book? If she is doing a book tour and makes the “no preventive medicine in modern medicine” claim, and someone points out vaccines, screening tests, and all the other tools doctors use in an attempt to prevent problems or at least catch them early, what does she even say to that?

    • Sue

      Vaccination, anyone?

  • lawyer jane

    Incredibly striking charts, thank you for putting that together. A 25 year old black woman’s risk of death in childbirth is greater than the risk to a 40+ white woman! Any “birth activist” who is obsessed only with VBACs and c-sections should be ashamed of herself.

    • Staceyjw

      The truth is these NCB zealots only care about black women if they can be used to further their cause. AA women really do get stepped on from every angle. I just don’t know why anyone acts surprised by their maternal deaths- they are both women and black, and often poor too, so they have multiple oppressions killing them.

      • Elaine

        Even when you control for socioeconomic factors, black women still have worse outcomes than white women with otherwise similar backgrounds.

    • The Bofa on the Sofa

      I’ll admit, I don’t like the second chart as much, because it is a breakdown of percentage. Therefore, if one term gets smaller, another has to get bigger. I’d prefer that chart in absolute terms.

    • Roadstergal

      Romm has the answer! All that Black women need to do is buy The Natural Pregnancy book, eat better, and avoid hospitals.

      Ugh, I felt gross just typing that.

  • Young CC Prof

    Here’s another thing she could do to reduce maternal mortality: Fight health disparities!

    If all women had access to basic health care continuously across the lifespan, including regular medications for things like asthma and diabetes, dental care, reliable contraception and prenatal care from the first trimester, we could easily bring down our maternal mortality rate to Western Europe’s average.

    But nope. She provides boutique care to the wealthy women who can afford it. Isn’t that… increasing health disparity?

  • Margaret

    “The medical model does not know how to prevent disease” is just insulting and ridiculous. So….during my yearly check up when my doctor ensures I’m maintaining a healthy weight, getting enough exercise, questions my alcohol consumption, my salt intake, asks if I smoke, that I have booked my yearly pap and mammogram, whether or not I’m stressed, checks to see if I have a copy of the Canada Food Guide he’s just blowing smoke out of his ears? I’m astounded she can spew this b.s. but more astoundingly, I can’t understand how others would believe it.

    • Amy

      She needs to fix her sentence: “The medical model does not exploit the prevention of disease for a profit the way the alterna-health model does.”

    • Nick Sanders

      Don’t forget hand washing, implement sterilization, and those nifty paper masks.

    • Melissa

      I remember when I was 17 and my doctor talked with me about the dangers of traffic accidents. He had similar talks with all his teenage patients because he’d lost more to accidental death than to disease, and he wanted to prevent it anyway he could. I don’t think that is rare. In my experience my doctors have always been interested in making sure that I’m eating right, getting enough sleep, exercising, etc.

      I sort of think that what she means by saying that the medical model does not know how to prevent disease is that they don’t offer false hope to their patients. The medical model doesn’t promise that you can prevent all illness by just eating right. They won’t promise that you won’t ever get cancer because you are taking the right supplements. And that is what the woo-followers want. They want to be told that if they do X, Y, Z then nothing bad can happen to them. In other words, they want to be lied to.

      • Samantha06

        You’re right about that. Woo followers absolutely do not want to hear the truth. The person who wins in their eyes is the one who tells them exactly what they want to hear.

        • The Bofa on the Sofa

          I have said this all the time. One of the common things of alternative practitioners is that they lie.

          The best example is Suzanne Sommers’s book about doctors who “cure” cancer. She said it herself in an interview. Doctors won’t talk about things like “cures.” However, the doctors in HER book all tell you that they will cure you.

          Of course, it’s all a bunch of lies, but hey, they will say it and those evil other doctors won’t.

          • Samantha06

            Yes, exactly. And they know that desperate people with resort to desperate measures. That’s what makes them that much more despicable. When the woo-believer learns the truth it’s even worse for them. They realize they’ve been completely conned, and their disease has likely worsened and may no longer be treatable. What a horrible thing to have to face.

  • fiftyfifty1

    Here’s something she could do that would reduce maternal deaths among mothers of all ages and races: strongly encourage all her patients and readers to get their yearly influenza shots. Influenza is especially dangerous and has a much higher mortality rate in pregnant women. But don’t just immunize the pregnant women. Immunize everybody to help with herd immunity too.

    • MegaMechaMeg

      But in my office people try to get the flu for the time off! It is like a free vacation! The flu shot is therefore useless.

      • Sullivan ThePoop

        Who would get the flu for time off? Maybe a sinus infection or a cold. Getting the flu on purpose is insane. Really, you might as well purposely fall down the steps for time off.

        • MegaMechaMeg

          (That was hella sarcasm. Nobody gets the flu on purpose because our sick time is kind of bullshit and our insurance does nothing)

          • Sullivan ThePoop

            Oh, I thought you were serious. My bad.

          • MegaMechaMeg

            The internet is hard 🙂

      • GiddyUpGo123

        Oh good lord. I am sitting here at home right now with two kids who have the flu (one is running a fever of 104) and I am having flu symptoms myself and wondering how I’m going to make it through the week. And we all got our shots, too. I can’t imagine *wanting* to have the flu.

        • GiddyUpGo123

          Haha and then I read the part below where you said it was sarcasm. I guess you duped me too, see what a fever does to your brain?

          • MegaMechaMeg

            I need to work on my deadpan I think. Or maybe just take a blowtorch to a world where people actually would believe that statement is legit.
            Feel Better quick and take care of your munchkins! Sick kids just about break your heart.

          • GiddyUpGo123

            Thank you! It’s funny we were just talking here the other day about fever reducers … my six year old (the one running the 104 temp) wouldn’t even get out of bed this morning until she had her ibuprofen, and then she spent most of the morning cheerfully making Valentines. I couldn’t bear to see her laying around so sick like that all day, thank goodness for fever reducers.

    • GiddyUpGo123

      I was mostly very satisfied with my OB care, which was from 2005 to 2010. But the one thing that I now know was utterly lacking was advice on immunization. It wasn’t until my fourth pregnancy, when swine flu was in the news and I read that it was killing pregnant women that it ever occurred to me to get a flu shot, because my doctor never mentioned it, and (I am ashamed to admit) it wasn’t something I ever did prior to that (I now get one every year). Also not mentioned was the pertussis vaccine–it took a TV commercial for it to dawn on me that I could get pertussis and give it to one of my unvaccinated babies. Of course they were all fully immunized by the time I made that realization, but even today I think back and I just can’t believe I was that ignorant, and I feel so lucky that I never got pertussis and that no one ever passed it to my babies in our very undervaccinated community.

      • just me

        I prefer my ob’s method–med asst shows up with flu shot at an appt (both my kids were born near the end of the year so I was in the 2/3 tri in early fall). Of course I had to fill out a consent but it was just assumed I’d get it. Convenient for me also. Same with tdap for my first pregnancy. Apparently it’s now given with each but that wasn’t the cas at the time of my 2nd pg.

        • Young CC Prof

          My OB didn’t carry vaccines, so I had to go to the pharmacy. Then the pharmacy gave me a hard time about TDAP, because I’d had a recent TDAP booster. My OB was PISSED when I explained to her why I hadn’t gotten it yet! (I ultimately did get it in time.)

          My husband, on the other hand, got his TDAP at work. Why? Because in my 4th month, he sliced up his hand on a hose clamp. (I had no idea hose clamps were a major occupational hazard) and the employee clinic gave him a tetanus booster while fixing it.

      • nomofear

        I believe tdap wasn’t officially recommended til 2013, if it makes you feel any better!

        • just me

          Well I know in 2010 there were WC outbreaks in Calif so it was recommended then for pg women and any adults who would be around the baby (since apparently the immunity from our childhood shots may have worn off). So we all got it in 2010 before my 1st was born. I had actually had it 5 years before that before going overseas but got it again anyway.

        • Bugsy

          Yep, you’re correct. My son was born in late 2012, and the recommendation came out just after he was born. (I got the booster the day after he was born, I think.)

      • Mac

        That’s interesting. I had babies in 2007 and 2012. I was advised during both pregnancies to get the tdap. Maybe it just depends on the area you live in. I believe there had been couple of outbreaks in my area around or before 2007.

    • Young CC Prof

      In 2009, at least 50 pregnant women died of flu. Most of them were basically healthy beforehand, other than being pregnant. This is really serious. I got the shot while pregnant, but I mostly got it for the baby. I didn’t really comprehend that I could wind up on a ventilator if I caught it.

      • Amy M

        I know I’ve told my flu story here–despite the flu shot, got a mild flu in 2010. But I have asthma and before I was recovered, since the asthma was in overdrive, I got another upper respiratory bug. I ended up with pneumonia, pleurisy, an ear infection (rendering me temporarily deaf in one ear) and a sinus infection simultaneously. I think that is the sickest I have been in my life and thank god I wasn’t pregnant. My boys weren’t quite 2, and one them got pneumonia too, (they also had that 2nd bug) and the other got away with only an ear infection. Damn right I get the flu shot every year, as does the rest of my family. (I already was doing that, but anything to help prevent that scenario again)

        • Cobalt

          My family got swine flu the year that went around. The youngest and I were laid out on the couch for the better part of a week, my husband and the older kids ran a fever for a few hours and were fine. I thought I was going to die and was too out of it to care. I’m a lot sterner about getting everyone the shot as soon as it’s available now.

          • momofone

            Ugh. We had swine flu, too, and it was awful. I totally relate to the “too out of it to care” part.

          • GiddyUpGo123

            My daughter got it too. She was 18 months old, and I was in my second trimester. There was no vaccine for it yet, so I was told to take Tamiflu (or something like that, don’t remember exactly what) as a preventative while she was sick.

          • Amy M

            Yeah, my husband and children got the swine flu–literally days before the vaccine was available. My husband got it first, luckily fairly mild. The pediatrician sent out a message saying the swine flu shot, which there had been a shortage, was in, so we got the babies done (they were about 10mos old at the time) and the next day, they were sick. Too late. Luckily they had it fairly mild too. I never found out for sure, but I do wonder if what I had that next year was H1N1.

      • Kelly

        That is so terrifying. These people claim that pregnancy is not a disease and by doing so do not acknowledge the real risks of being pregnant.

    • Deborah

      THEY WON’T DO IT!!! I have NEVER changed the mind of a flu shot refuser. What’s interesting is how many flu shot refusers AREN’T general anti-vaxxers — most of them are fine with the 28w TDAP, for example. It runs about 50-50 for my patient population. It’s very rare that someone is neutral about it: the people who want the flu shot will drive 50 miles to find it, and the refusers are just convinced it will make them ill. I’m afraid I don’t try as hard as I used to.

      • fiftyfifty1

        Don’t give up. I have had a number change their minds. In particular many grandparents will accept the flu shot for the first time.

        • GiddyUpGo123

          I used to just not bother with the flu shot, because in my 20s and early 30s I was that person everyone hated, who never missed a day of work because I never got sick. In fact I managed to almost entirely avoid colds for almost a decade. So flu shot wasn’t even on my radar and even after my babies were born I was sort of like, “Eh, it’s just the flu.” And then I read a horrible article about a little girl (4 years old) who was sent home from preschool with mild flu symptoms and then suddenly died overnight. That was all it took for me (see, the power of anecdote!) and now I am first in line for those flu shots. Of course, the damned things didn’t work for us this year so I’m still kind of freaking out a little on the inside, especially if my 5 year old gets it.

          I think you can probably sway people like me who just never really thought about the flu shot far more readily than those that have thought about it and are firmly against it.

          • Roadstergal

            Yes, that was me – the ‘I’m totally healthy and never get sick, so why bother?” in my 20s. Then I stopped and, well, _thought_ about it, about my friends who were all now planning families, about aging people I know, and I realized I was being an utter tit. I get it every year now. (So does my husband, without any urging aside from a reminder, bless.)

          • Medwife

            I lost a peer to H1N1 and granted, that was a horror show of a flu strain, but it really adds a little something to how I feel about the flu shot. That happened when I was in nursing school so I was already getting it, although I hadn’t had the flu since childhood.

      • GiddyUpGo123

        My husband is in the “can’t be bothered” crowd. It’s crazy because he believes very strongly in vaccinating his kids but when it comes to himself he just doesn’t seem to care, no matter how much I say “herd immunity” and point out that he’s being seriously hypocritical. Someone here once suggested just taking him to Target and announcing, OK flu shot time! Which I never should have mentioned to him, because now he finds reasons not to go to Target. I think it might be a general fear of needles thing more than the laziness he claims it is.

        • moto_librarian

          I pretty much told my husband he had to start getting his flu vaccine. I have severe asthma, and both of our kids had reactive airway as babies/toddlers. Most years, we make a family trip to the pediatrician’s office and get them together.

        • Dinolindor

          And for this reason I am so, so glad my husband’s company brings in a flu shot clinic each year. Otherwise he would never bother.

        • Poogles

          “I think it might be a general fear of needles thing more than the laziness he claims it is.”

          I have been trying to get my husband to get the flu shot the past couple years, and I’ve expressed the absolute necessity of getting his pertussis booster before we have a baby – he always vaguely sort of waves away the topic. This has perplexed me because he understands the impotance of vaccines and the concept of herd immunity. Your comment though has given me a bit of an ah-ha! moment.

          Several months ago we ended up in the ER because he had pulled a lower back/hip muscle and he was in agony (couldn’t bear to sit or stand, lying down gave minimal relief). When we finally got back to a room and the nurse came in with a shot dilaudid, he tried to refuse it because it was a shot! He was worried about that little needle even though he was in so much pain he could hardly think straight! I had to gently persuade him, hold his hand and get him to look directly into my eyes while he got the shot. Afterwards, of course, he was very very grateful he had gotten the shot.

        • Erica A.

          I have had problems getting my husband to get his shot in the past too. This year I am pregnant, so I told my husband that he had to get one, or he could kill me and the baby. I also reminded him of how mad he would be if he had to use up all his sick and vacation time on the flu. It worked!

          AND some of his co-workers got the flu, and he did not, so he was very happy about that.

          Of course, the truth is that neither of us seems susceptible to the flu, whether we get the shot or not, but it still seems like good insurance to me. (I have had the flu 1 year out of 35 and only have gotten the shot for about 5 of those years.)

      • SuperGDZ

        I think that people still conflate flu and colds, and don’t see having flu as being really sick. Also, if they have the shot and get a sniffle after they’ll scream “I GOT FLU FROM THE SHOT!”

        • demodocus’ spouse

          Sometimes its a grammar thing. I know the difference, but I tend to refer to all lesser illnesses as colds unless I’m trying to be specific. That said, I also never blame my immunizations.

        • Liz Leyden

          In 2000, I got the flu about 3 days after I got the flu shot. I was only sick for 36 hours, but it was a miserable 36 hours. I know the flu shot didn’t cause the flu, but I can see how someone would think it did.

  • RNMomma

    Is there a link anywhere to the Arlington, TX death? That’s right down the road from me.

  • Allie P

    Amniotic fluid embolism scares me more than any other pregnancy complication. I have nightmares about it.

    • Daleth

      Omg me too. I actually asked my doctors, and they complied, to please not exteriorize my womb when stitching it up post-c-section because I’d seen a study that linked that with a higher risk of embolism (amniotic fluid embolism and air embolism, if I recall correctly). It’s just so scary because it happens so fast and there’s basically nothing you can do.

      • Medwife

        Also increases nausea and vomiting (which makes sense) without improving outcomes.

    • SporkParade

      A woman in my area died just a week or two ago from AFE. Scary as hell.