UK midwives foolishly continue their bullying on Twitter

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You might think these women would have more important things to worry about like the hideous death rates at their hands at Morecambe Bay (where 16 babies and 3 mothers died over a 9 year period) to the newly revealed horror at Royal Oldham/ North Manchester General Hospitals (where an appalling 7 babies and 3 mothers died in just 8 months!). But that would mean taking time from praising themselves and each other for the purportedly “evidence based” care.

Instead, they are making fools of themselves on Twitter (again!) by trying to bully anyone who dares question their clinical judgment.

It started innocently enough when a British obstetrician tweeted me a link to this “empowering” story of an HBA3C attended by a British midwife.

I responded:

It’s like someone winning Russian Roulette and boasting that they were so smart to play.

Tweet 4-6-14 1

That’s when the midwifery bullies swept in.

Remember the cruel behavior of those mean girls from middle school and high school who appointed themselves arbiters of the social universe? It was never enough for them to exclude the girls they didn’t like. Nope, they set out to punish anyone who wouldn’t fall under their sway. The classic mean girl line? “You can’t be friends with me if you’re friends with her.”

Their hypocrisy is mind blowing, exceeded only by their stupidity in conducting their bullying in a public forum. What is wrong with these women?

Sheena Byrom, who has publicly treated a loss parent viciously, and who was not being addressed by the obstetrician, is “so shocked that you engage this way on Twitter.”

Pot, meet kettle!

And Milli Hill*, who wouldn’t know an obstetric fact if she fell over it, whines that it is “highly unprofessional,” and, as is apparently routine for UK natural childbirth bullies, sends the tweet to The Royal College of Obstetricians and Gynecologists. She also inanely links to a quote from MacBeth about the three witches, explaining that the combination of the obstetrician, the patient advocate and myself in one Tweet is just like them.

Tweet 4-6-15 2

The thread twists and turns and branches off and I won’t bore you with the detaisl, but this is perhaps my favorite part:

Tweet 4-6-15 3

The obstetrician tries to discuss the wisdom of a homebirth after 3 C-sections, but Milli Hill insists:

YOU should explain why you are tweeting with Amy Tutuer [sic]

There follows an flurry of midwives and natural childbirth advocates retweeting and favoriting each other’s tweets as if that might make them true.

The sad reality is that an obstetrician wants to discuss patient safety; the midwives and natural childbirth advocates want to bully anyone who tries to discuss patient safety. It is indicative of the UK natural childbirth culture and midwives, doulas and celebrity natural childbirth advocates who are out of control, specifically:

1. Patient safety appears to be irrelevant
2. Clinical guidelines are irrelevant
3. An obsession with “normal” birth regardless of the dangers
4. An inability to behave professionally online
5. A culture of bullying that spends more time on threatening dissenters than investigating (or even acknowledging) the deaths at their hands
6. A sense of invulnerability, as if they can say what they want, threaten whom they want, ignore what they want, and get away with it that extends from the highest to the lowest and, indeed, the bullying tactics are sanctioned by the highest and copied by the lowest.

Keep it up ladies, you’re doing a fabulous job at discrediting yourselves, far better than I could discredit you on my own!

 

*Addendum: Hill is deeply concerned that people might get the impression from this piece that she is a UK midwife when she is merely a celebrity midwifery apologist. Hopefully, this clears up any confusion.

  • yentavegan

    Hypothesis: 1. The Female reproductive organs are manifestations of an All Knowing All Loving All Caring Righteous God/dess 2. Like all Deities She requires absolute Fealty. 3. She occasionally and with regularity requires sacrifice 4. Medical Science and Doctors are Non-believers who are hostile and abhorrent. 5. The God/dess loves the process of labour and birth but her powers begin and end there.

  • Sue

    And this, even more scary because she is junior:

    • Mattie

      Yeh, she’s a student…it’s definitely concerning that the view is so ingrained in new students, her twitter makes for interesting reading.

      • Sue

        And “beginner’s intuition”? Is that not an oxymoron?

        (couldn’t resist adding the apostrophe)

        • Mattie

          it’s definitely a something moron lol I think she means her judgement isn’t clouded by all that ‘knowledge and safety and risk management’ that gets in the way of a nice normal birth. Ick

  • Really? My mind boggles – if they could just shift their focus, just a little bit – to understanding that it isn’t “who delivers the baby” that matters, its that the baby is born and both mom and baby go on to the much bigger drama that is being a parent for the next however many years with as few complications from the transition to parenthood as is reasonably feasible. (ie. no brachial plexus injuries, no birth asphyxia, no extensive tearing, no incontinance, no hemmorhage, no lasting birth trauma/PTSD). Leave the middle-school politics in middle-school…advance the care of women and babies.

  • araikwao

    OT: the friend I was worried about, who was having her 4th baby at home (after an 11lb HB last time) has had her 11lb 2oz baby safely in the hospital. After labouring at home for 24ish hrs, her water broke, and the MWs told her they were to busy to attend, so she would need to go to the hospital.
    I don’t know any more details, but I am curious about a 30+ hour labour for a fourth baby..but most of all glad that they are safe

    • Guest

      The midwives were TOO BUSY???

      • The Bofa on the Sofa

        Don’t you know? “Midwives” means “with women…unless you are busy.”

        • KarenJJ

          Wow. Thank heavens they don’t play golf, hey?

      • Mattie

        There’s usually 2 community midwives on-call for home births, if they are already attending one then they can’t go to another, women are then told to go to hospital to ensure they have care during labour and birth. At least where I was this was explained during the homebirth assessment, sort of sucks though as women don’t have their choice respected, but in cases where hospital birth would be better it’s good I guess =/

        • Wren

          Actually, that makes sense. It beats leaving women unattended during labour and birth.

          • Mattie

            Definitely, the difficulty arises if the woman refuses point blank to go to the hospital, it’s fortunately unusual because usually at the time (when labour is in progress) women just want to feel safe and for their baby to be monitored. However if it does it often means other CMWs have to attend the homebirth, which leaves other women who need postnatal or antenatal checks without a midwife to do them

      • araikwao

        Yup, this was an Australian public hospital homebirth programme. And even they don’t show up sometimes, apparently :p

    • Mishimoo

      I am so glad that they are safe!!

      (I’d guess at an OP bub because of the length of time despite being a multip.)

  • Dr Kitty

    So an obstetrician links, without comment, to a description of an extremely high risk home birth, bringing it to the attention of two campaigners for safer childbirth and increased professionalism in midwifery.

    The obstetrician makes no disparaging comments to said campaigners about the contents of the piece.
    The obstetrician makes no disparaging comments about the professionals in the piece.
    In fact, the obstetrician doesn’t do anything, as far as I can see, except say “here, you might find this interesting”.
    I’m afraid that falls far, far below any reasonable definition of unprofessional behaviour.

    It is perfectly professional to state that it is your professional opinion that another practitioner is taking on cases which are too high risk to be safely managed at home, BTW. Especially when RCOG guidelines support that very position!

    As far as I am aware, there is no GMC/NMC/RCOG sponsored fatwa against speaking with Dr Tuteur, regardless of what Milli Hill might wish.

    • Mattie

      IMO any registered midwives involved in the kind of bullying faced by James Titcombe or the unprofessional comments and clear lack of remorse shown via social networking have far more to fear from the NMC finding out than the OBs do from RCOG, shame most of them are retired =/

    • Mariana Baca

      Don’t you know it is “unprofessional” to simply associate with Dr. Tuteur? Sigh.

  • Watch it, Dr. A.

    Next thing you know, they’re gonna throw your clothes in the toilet during gym and totally prank order like a million pizzas to your house.

  • Lana Muniz

    OT: Please sign the petition at change.org to make homebirth safer. We want to use these signatures to show state legislators the priorities of women who want homebirth to be safer. My latest blog post at babyMed explains why I support the petition:

    http://www.babymed.com/blogs/lana-muniz/sign-petition-protect-women-and-babies-make-home-birth-safer

  • Kerlyssa

    detaisl=details?

    These people have no shame about their actions.

  • Medwife

    These people have no sense (not to mention respect for human life and the gravity of their professions). If they had two brain cells to rub together amongst their group, they’d take a nice long twitter vacation. And come back as professionals.

  • Amy M

    How about “..and Milli Hill, who wouldn’t know an obstetric fact, if she gave birth to it in a kiddie pool while singing kumbaya….”

    That bit where she wants to know why the other OB is talking to Dr. Amy is just mindblowing, in its unprofessionalism and immaturity.

  • demodocus’ spouse

    If anyone has the right to “play the victim card” it would be Mr. Titcombe. Bah, what a jerk that Milli Hill person is.

    • Mac Sherbert

      An actual victim playing the victim. Can’t have that.

      • KarenJJ

        That struck me as particularly callous. Who’s behaving unprofessionally?

  • Bugsy

    OT: I found this blog comparing parenting in the U.S. & Norway this morning, and it contains the reference below to not treating strep B. It seems odd to me; can anyone shed any light on it?

    http://joannagoddard.blogspot.ca/2013/07/10-surprising-things-about-parenting-in_15.html

    “On birth: I applied to give birth at the “no drugs” unit at the hospital. (Mostly because when you apply to the regular unit, there is a possibility you could be turned away if the hospital is full and sent to another hospital you may not be familiar with.) When they say no drugs, they mean no drugs. No exceptions. You can’t even get antibiotics if you’re positive for Group B strep. Women who’ve had a baby in the U.S. know about Strep B; every pregnant woman is tested for it, and if you test positive, you get antibiotics when you deliver so you can’t pass it to the baby and make the baby sick. Here, it’s not even mentioned. When I asked about it at the hospital the nurse just said, “We don’t worry about that.” At first I was appalled, but I’ve learned that in socialized medicine, they take calculated risks, and as my husband says, it usually works.”

    • Ash

      The concept of a “no drugs unit” is just plain idiotic. In what other hospital unit is there a “no drugs” rule? What exactly is the purpose of a hospital then if they cannot treat?

    • Mac Sherbert

      I also believe they do not routinely test mother for Strep B in the UK. I think the author summed it nicely. It’s a calculated risk they are willing to take to save money.

      • Mattie

        you’re right they don’t, although there is a group campaigning to change that http://gbss.org.uk/what-is-gbs/testing-for-gbs/ecm-test-where-how/ they also do a lot of campaigning encouraging women to request testing/pay for private testing if their NHS Trust do not offer it. so it’s moving in the right direction although you can imagine the response from some of the wooiest midwives.

      • Mishimoo

        They didn’t do it here in Australia either, but I’m not sure if that’s changed since I had my last. We also don’t test every pregnant person for Toxoplasma gondii, my GP is appalled by that and orders it for every pregnant person in her care even though it’s outside of the standard battery of antenatal testing.

        • Dr Jay

          It’s changed. :). We routinely swab for GBS at 36 weeks or so and treat if you are positive, were positive in a previous pregnancy, or if your status is unknown.

          • Mishimoo

            Awesome!!

    • Medwife

      Have they really done the math, I wonder? Cost of GBS swabs and treatment of positives vs cost of NICU for GBS disease babies?

  • Amy Tuteur, MD
    • Daleth

      Wow. That is HUGE.

    • Elizabeth A

      That is amazing. How can we support that woman and help her be heard?

    • Ash

      I wonder if there would be a real cost savings (to the insurance companies/Medicaid) to allow a home health nurse to evaluate mom&baby in between the period of discharge and the first peds/family medicine visit. The RN could do vital signs on mom and baby, ask the parents about baby’s elimination and eating.

      I don’t see this actually happening as I don’t think insurance companies would ever get around to it, despite that 1 admission is very expensive compared to a few home health nurse visits.

      • fiftyfifty1

        Such a thing wouldn’t even be necessary if we went back to the way things were done in the past (and are still done in many cultures): routinely supplement baby whenever it seems hungry before milk has come in. This is how all my patients from east and west Africa and Latin America do it. They put baby to breast, feed both sides, and then offer baby a little formula to see if it is still hungry. Breastfeeding rates go on to be very high in these populations, and we don’t get re-admits for dehydration or jaundice. What is the downside to this approach, beyond hysterical theoretical concerns about “gut purity” ? The upsides are very clear.

        • Ash

          I’m a cynic that the tide will turn towards supplementation when baby is hungry in the next, oh, 10 years. The media perception is already too strong. Widely circulating pictures like these are not helpful either

          http://www.sophiebrigstocke.com/wp-content/uploads/2014/12/Size-and-volume-of-a-newborns-stomach.png

          Boston Medical Center is an academic medical center, and their documented policy is here

          http://www.flbreastfeeding.org/HTMLobj-2124/BFHI_BMC.pdf

          These policies simply do not allow for your absolutely reasonable suggestions, sadly.

          Check out 6.3 too

          http://www.azdhs.gov/phs/bnp/gobreastmilk/documents/AzBSBS_MHPG_Sample%20Policies.pdf

          • Kelly

            Plus, all babies are different. My second child was very hungry all the time. She was drinking three ounces at time every two to three hours at a week old. The lactation consultant told me it was too much. She was drinking 36 oz a day starting at two months. My first child was the opposite. You give the baby what it needs in order to be healthy.

          • Mel

            *blinks*

            If that graphic is true, a newborn baby’s stomach increases in volume by 1100% in the first week. I know human babies show all sorts of weird allometric growth patterns, but that seems a bit absurd.

            Also, I’m pretty sure the ‘apricot’ is actually a Clementine orange. (Not terribly important, but the shape and position of the stem isn’t right for an apricot. Well, and the fact that apricots are fuzzy, not shiny.)

          • fiftyfifty1

            That graphic is not true. Or rather it is very misleading. Stomachs are made to stretch. If a stomach has nothing in it (e.g. a day 1 newborn who is being breastfed), and you look at its size with ultrasound, it will be small. That doesn’t mean that that is all the bigger it can get.
            A day #1 newborn’s stomachs can easily stretch to hold 2 ounces. Go to any newborn nursery and see how much the formula-fed infants take. They happily suck down about 2 ounces and then fall asleep.

          • KarenJJ

            That makes much more sense and why I’m very cynical about that graphic. Talk about misinformation for new mums. I believed I “knew” something about infant milk intake except right in front of my eyes my baby was drinking a truckload of milk by comparison. Factor in the “formula fed babies lead to obesity” I can see where parents might start under feeding. Mums need real information about this stuff. Not made up crap.

          • The Bofa on the Sofa

            I remember when my oldest niece was born, by c-section, at about 8 pm at night. We got to the hospital about 9 pm, and by that point, she had already drunk 1 oz of water from a bottle.

            Regardless of whether giving her water at birth was a good idea or not. that means 1 oz (30 cc) within 1 hr of being born. So much for the stomach volume being 7-8 oz on day 1 and 22 – 27 oz on day 3.

          • fiftyfifty1

            Yeah, it’s total bullshit. It makes me so mad because this is what is being told to moms to get them to ignore their infants’ hunger signals–“Oh, it can’t hold more than a marble anyway”. And you will hear this from hospital-employed lactation consultants. Either the are lying on purpose or are total idiots who have never fed a baby with a bottle. Either way, that ain’t good.

          • CharlotteB

            Ok so I’ve wondered about something the last couple of days. Everybody told me some weight loss is normal right after birth. But is that true for exclusively formula-fed babies? Do they lose weight too?

          • Amy M

            Well, technically, I tried to breast-feed in the hospital, but I had no milk yet the whole time we were there, and my [small, pre-term] twins needed something, so they were formula fed via SNS. They lost weight anyway—not more than 10%, since they were being fed. Part of the issue with my boys was because they were pre-term, they were more inclined to sleep than eat, and we had to actively wake them up and remind them to eat for the first 2 weeks. Maybe a baby that will actually cry from hunger and eat enough formula to be satisfied won’t lose so much weight.

          • Liz Leyden

            My formula-fed twins were born at 35 weeks. Instead of waking my son up to feed, I let him wake up when he was hungry and let him eat until he fell asleep. He woke up about every 3 hours, and didn’t lose weight. He’s now a long, skinny (21st percentile for weight), very active 1-year-old.

          • fiftyfifty1

            On average they lose only about 3.5% of initial weight, and gain it back rapidly. It is almost unheard of for a formula-fed baby to lose the 10% weight loss that is considered the cut-off for trouble.

          • NoLongerCrunching

            I have no input about the evidence for that picture, but if a baby is not getting those amounts, it should be pretty easy to figure it out by weighing the baby before and after feeds. I am not sure why this practice is not more widespread when there is a question about baby’s intake.

        • Mac Sherbert

          Yep. First baby I was all no formula, but finally gave in because the baby was clearly hungry. BF for 6 weeks, it was a terrible beginning! 2nd baby supplemented from the beginning. BF for 18 months.

      • Mac Sherbert

        Like an extra visit in between the 2-3 days out of hospital visit and the 1 month well baby check?

        • Ash

          That’s right, or possibly at Day 1, especially for first time moms. The home health nurse should also ensure that the family has a copy of the discharge instructions. If the family no longer has the dischrage instructions, they should be provided with a new copy. The home health nurse should also ensure the family understands the instructions, as not everyone has a high degree of health literacy.

          • Mac Sherbert

            Sounds like overkill to me. Maybe some mom’s need it, but having a nurse show up at my door the next day would have bothered me. I had C-sections stayed in the hospital for 3-4 days anyway. I just wanted to be left alone.

          • moto_librarian

            Both of my sons were seen at two weeks as well. I didn’t realize that it wasn’t standard.

          • Elizabeth A

            I had post-partum home nurses with both of my babies (once because I bled a ton, once because she was premature and they wanted weight checks). In both cases, they were really clear about what they were scheduling.

            One of those nurses was fantastic. The other was wretched.

            I’ve never been able to understand why they aren’t more openhanded with discharge instructions.

          • Amy M

            The insurance covered post-partum home nurses to visit us 2x/week for the first 2 or 3 wk and then 1x/week for another 4 or so, but it was because I had pre-term babies. IIRC, they weighed them, asked about how they were eating, and recorded that they were gaining weight normally. That was in addition to seeing the pediatrician 2 days after leaving the hospital, and the pediatrician asked us to come back a couple days later, I think,for a jaundice check, but they were improved on the recheck.

      • theadequatemother

        So with bith of. Kids there was a community postpartum RN who was also a lactation consultant that did just that. She called within 24 hrs of discharge and came by to check me and the baby, weigh it…and then she would come back daily until you didn’t need her anymore and also check up by phone. My GP wanted to see us at one week of age and then at one month. And then 2 mo to start the vaccination process. It was awesome.

      • Julia

        Seattle and King County in WA offered the option of having a public health RN come to your house at 2 days after discharge so that you didn’t have to go the Pediatrician until 1-2 weeks. They did a weight and bili check and checked mom’s vitals too. It was great and free to families. That went away about 4 years ago due to budget issues.

    • Somewhereinthemiddle

      Based on the information presented, that seems like a very viable theory. Very much looking forward to additional research and info that can (hopefully) prevent more cases of autism. How amazing would it be if the answer to slowing the rates of autism is to simply FEED YOUR DAMN BABY.

      • Anj Fabian

        While I think that would be great, if it isn’t true this is just another using autism as a scary disease bogeyman.

        I am heartily sick of that tactic.

        • Kelly

          Yes, but she is calling to get a study done to prove it. She is not saying it is this, but that she sees a pattern and would like to see if she is right.

          • Anj Fabian

            A proper study.

            That would take about six years assuming the child attends a public school that screens all students for developmental delays.

        • Mac Sherbert

          I agree. It seems every other week someone knows the cause of Autism. I will say that at least this woman makes sense and isn’t telling parents to do crazy things.

          • Medwife

            Makes me headkeyboard. I am raising my son probably much like me and my sibs were raised, and there is no autism anywhere on either side. My son has been given the school district version of an ASD diagnosis. There’s autism and OCD on my husband’s side- from before autism was a diagnosis. GENETICS GENETICS GENETICS.

          • Amy M

            I think most studies on the issue are leaning towards a heavy genetics factor, with AS disorders. However, isn’t it also true that neurological damage that could occur before, during or shortly after birth, could lead to symptoms that are very much like AS symptoms? For example, I know a woman whose twins were born at 33wks. At least one of them has been diagnosed with autism (not sure about the other), but it is believed to be linked to the prematurity in that case, which would be an environmental factor. I guess that might be a different disorder, than someone genetically predisposed to autism and born full term, but it looks the same and with our current diagnostic criteria, technology and methods of treatment, we can’t make the distinction.

          • Mel

            We were typing at the same time, but I suspect science will find that the genetic variation across humans creates a continuum of susceptibility to autism.

            At one extreme, some genotype(s) create biochemical cascades or developmental problems that lead to autism regardless of environment. (For example, a relative, B, has high-functioning autism without any known environmental causes.)

            At the opposite extreme, some genotypes(s) create a brain nearly immune to ASD-type injuries in all environments. (Think of soldiers who get closed head injuries with few or no permanent side effects.)

            In the middle, a mixture occurs. B’s brother, M, was born with a bubbly, friendly personality and was a flirt. At age two, he fell from a fence he had scaled and hit his head on a rock that was on cement. According to the family, M has never been the same. In fact, he seems to have developed ASD-like symptoms extremely similar to B.

          • Amy M

            Sure. Another way to look at it is—what kind of neurological damage? If the damage is from an external source (head injury, prematurity-related, etc), we might be able to find a lesion via MRI, but we can’t really know how that will affect a given person’s abilities. The brain can compensate for damage to some degree, but there’s a point of no return. The location of M’s brain damage, and what that part of the brain was responsible for could account for the differences in his outcomes from the fall, vs. some other kid whose head was turned the other way and didn’t damage the same part of the brain, or sustained less damage/brain was able to compensate.

          • Maya Markova

            Two (to be precise, 18-24 months) is the textbook age when a toddler (typically a boy) with apparently normal early development can undergo a period of regression, then resume his development, but already in the autism spectrum. I’ve observed this first-hand, loss of the cute first words (“mama”, “tata”), loss of eye contact and everything. When speech returns, the first word is usually something like “train”.
            Of course it is possible that in M’s case, the head trauma had been the cause, but I rather think it has been a precipitating factor.

          • Medwife

            “Autism spectrum disorder” is such a seriously huge spectrum, it seems likely to me (caveat, I’m not a neuroscientist!) that it could, and eventually might be, split into different disorders with similar symptoms but different etiologies. As someone whose kid seems clearly to have inherited it, I’m biased towards digging into the genetics aspect. Probably a blind spot of mine.

            Twins with one autistic and one NT- they should be in a twin study!

          • Mel

            My husband’s family clearly has a genetic predisposition to ASD. They also seem to have a more-severe than expected reaction to head injuries.

            With the caveat that I am a teacher/plant biologist, these two facts lead me to believe that there is some combination of genetic/environmental gradient of responses to insults/injuries to the brain that lead to autism.

            Some genetic types may be highly predisposed or have biochemistry that leads inexorably to autism. Other genetic types may be nearly immune. My husband’s family seems to be a mix of genetic susceptibility (too high of a number of high function ASD adults for random chance alone) w/o known head injuries and a really, really high chance of developing ASD after a childhood head injury.

          • I am firmly of the opinion that ultimately the cause[s] of autism [and even more the “autism spectrum” which is a grab-bag phrase, IMO] will be shown to be multi-factorial, with a genetic factor among others.

            It’s all rather like trying to pin “cancer” on a single cause, when it is increasingly obvious that different cancers have different bases. There isn’t any “one size fits all” any more than we are all clones of one another.

          • Mac Sherbert

            When I taught special education the more experience teachers always said “When you meet parents it will all make more sense.” Of course, that wasn’t always true, but it was true a lot. All the teachers I worked with were convinced Autism is genetic.

        • Roadstergal

          An alternate possibility to explain the same data might be that ASD babies have more difficulty with latching/feeding and are more likely to end up jaundiced?

          Either way, Just Feed The Baby does apply.

          • Somewhereinthemiddle

            Yes, that’s the biggest part that jumped out at me that could account for the numbers she is presenting. Correlation does not equal causation and all that jazz.

          • Squillo

            That wouldn’t surprise me, given the sensory issues many people with ASD have. My autistic kid had latch issues, then bf like a champ once we’d worked them out, but for years he would only eat “beige” pureed food.

        • LibrarianSarah

          Yeah I was bottle fed from birth and still autistic as hell so I doubt lack of food as a baby is the cause. Can we find a new boogieman please? Pretty please?

          How bout we just blame me for autism. I came into your kids room/family bed one night and sprinkled my autism dust on them because I am a bad person and love giving people autism. So it’s all my fault you can vaccinate, feed, etc. your kids now. Just avoid me, the autism fairy.

          • Daleth

            She’s not saying it’s THE cause. She’s saying it’s A cause. Not all cases of diabetes are caused by the same thing either.

        • The Bofa on the Sofa

          If it is true that jaundiced babies are 36 times more likely to be diagnosed autistic, that is a serious correlation and is absolutely worth investigating.

          Most important, I think, is her point that the guidelines about not giving formula are based on studies that show the effect on breastfeeding success, but no one has examined the effect on health. Whether it causes autism or not, jaundice is not something desirable.

        • Somewhereinthemiddle

          Well yeah, there is that.

          • Siri

            Vaccination?

          • Somewhereinthemiddle

            You mean implicating vaccines as a (bogus) cause of autism?

          • Siri

            Yep.

    • Bugsy

      Wow. At the very least, it’s a hypothesis that’s worth exploring more.

      I would also be curious whether gestational diabetes would play into it, particularly from the hypoglycemia angle.

    • namaste863

      The tit nazis have gone completely overboard. No news there, but what IS news is that the WHO is now recommending that HIV positive women bf for a year, and ebf for the first six months. Seriously, I got it straight from their website. Look it up. Thank God the CDC is a little more sane.

      • Mel

        The rationale is that in developing countries the risk of death from infant diarrheal illnesses from contaminated water is much, much higher than the risk of an infant contracting HIV from breast milk from a mom on anti-viral medication.
        It’s a heart-breaking commentary on safe water availability in developing countries – and an issue that I’d rather all the energy directed at bothering moms be redirected for.

      • Medwife

        Wait WHAT?! They are recommending solids and breastfeeding from 6-12mos now?? That’s unreal! Do they mean for women who are on antiretroviral therapy?

    • Mattie

      So this is the NHS advice to parents on neonatal jaundice, just wondered what your thoughts are?

      http://www.nhs.uk/conditions/Jaundice-newborn/Pages/Introduction.aspx

      Midwives usually see women postnatally on day 1, 3 and 5 (unless more frequent visits are needed) babies are weighed on day 5, and if they have lost 10% or more of their birthweight they are referred to the hospital, the majority of babies I saw had some degree of jaundice, but I think I only saw 2 babies who had to be referred to hospital (for either weight loss or jaundice). Obviously statistically that means nothing, but wondering if the UK just aren’t ‘doing enough’ or if it’s not as big of a problem =/ obviously starving babies is awful, and we’d ask about wet and dirty nappies as an indicator of sufficient milk intake as well as general baby postnatal checks

      • Dr Kitty

        Community midwives do heel pricks, so there is an assessment of bili levels, and no midwife seeing a Day 1 jaundiced infant should be doing anything other than sending that baby to hospital.

        My kiddo was a delightful shade of banana yellow by day 5, but we knew her bili levels and weight, and the safety netting advice I got from the midwives (decreased feeding, jitters, decreased urine output, drowsiness, jaundice not improving in 48hrs) was excellent.

        I do think that prolonged and late onset jaundice aren’t picked up well or adequately investigated by midwives and health visitors and few seem to believe in repeating bili levels if the baby seems well otherwise, which I personally think is a mistake.

        Like most GPs I dread that one day I’ll see a baby at their 8 week vaccination appointment and they’ll be jaundiced, with everyone having gaily ignored it for weeks on end.

        • Siri

          I refer babies per the prolonged jaundice protocol fairly regularly, but find community midwives rather blasee about it. Lots of jaundiced babies are discharged around day ten.

        • Mattie

          Yeh definitely, I don’t think I ever saw any jaundiced babies on day 1, but was told that jaundice appearing that early was not the ‘normal’ neonatal jaundice and baby needed to be checked at hospital. Do they check bilirubin levels in the newborn screening, I thought it was just CF and the metabolic disorders? I can imagine that fear and I would hope that something like that wouldn’t get missed but you never know sadly.

  • Votre

    In the UK it all comes down to saving money for their national health care system. Since homebirth is seen as a cost-cutting measure with acceptable levels of collateral loss (i.e. dead babies and mothers), it will continue to be promoted at the highest levels.

    Whenever something doesn’t seem to make sense, just “follow the money.”

    • MWguest

      I think we will start seeing more of this attitude in the states as CPMs peddle themselves as ‘cost-effective’ maternity care providers, reimbursed at a fraction of the rate that physicians charge.

    • Mattie

      But homebirth isn’t cheaper if the NHS ends up having to pay out for birth injuries/deaths…also paying 2 midwives to attend the birth, not to mention the added cost of transfer and then the potential cost of hospital delivery anyway. It’s really just enough people perpetuating the myth that it is just as safe, cheaper, better which has led to it being accepted and encouraged.

  • fiftyfifty1

    I went to the original link (the one describing the HBA3C) and I really am shocked. UK midwives claim that they only support low risk homebirths. When asked about the high risk homebirths actually occurring in the UK, they claim that those homebirths are something they do not agree with but that they are literally forced (by UK autonomy law) to attend them if a woman refuses to go to the hospital despite doing all they can to convince her. This link shows what a lie that is! They are using this birth story on their website to promote their business!!!

    • Mattie

      Makes me so angry 🙁 this is not right, not at all!

    • Ash

      You are right–the UK even has published guidelines for an antenatal risk assessment. It’s specifically stated that a woman with past history of uterine incision should be referred to Maternity Team Care. Rogue MWs who advocate homebirth TOLAC after 3 sections are NOT following guidelines . It’s also more shocking because Sheena Byron is a leader of UK midwifery. A disgrace to the profession.

      • Mac Sherbert

        That was my first thought when I read this! I can’t believe they are bragging about attending births that fall outside of the guidelines. I really thought they were better than the crazy CPMs in the US taking on high risk cases.

        • Ash

          CPMs in the US often have no published definition of “low risk” so they can use that (asinine) argument. UK midwives have no such excuse.

      • Mattie

        Yeh and I do believe that as Sheena is retired there’s nothing that the NMC can do, and no way to make her accountable for the crap she spouts…so gross.

    • Liz Leyden

      Do you have the link to the HBA3C?

      • Amy M

        I went to the site, there is an HBA3C around mid-March under the “stories” tab and another one, a few below that. Also, one woman who got risked out of homebirth by the NHS, (it appeared to be for a large baby), but these midwives said “no problem!” and she had an 11 pounder at home. I guess everything was fine, but clearly the NHS suggested the hospital for a reason!

        • Mattie

          So, this made me remember a local (to me) story of a woman who had a homebirth of a 12lb baby with an independent midwife (works outside of the NHS, but is fully trained and regulated the same way all midwives are, the only difference is no liability insurance although that is changing). It’s an interesting blog, even though long, because she gives the rationale for her decisions which you often miss with midwives, I dunno, it’s obviously not ideal but it went well and IMO her clinical decisions were appropriate (but she is very in to woo) http://kentmidwiferypractice.blogspot.co.uk/2008/11/sharons-story-normal-birth-of-12lb-baby.html

    • Hannah

      Independent midwives tend to be more cavalier, although in theory they have the same training.

  • Mattie

    You know what, I take back everything I ever said about it being a ‘few bad apples’ this goes way too deep. Recently a facebook page for student midwife dot net posted a link to an opinion piece by Sheena Byrom which IMO was horrifically problematic. I posted comments detailing why I thought it was problematic, as well as how concerned I was that a page/website created to encourage and support student midwives could back something like that considering the events at Morecambe Bay. The responses I got were argumentative, ignored every point I made and when cornered just point blank refused to answer as that would be unprofessional. I just don’t know what anyone can do to change it 🙁 I thank you for making this blog though, and for helping to get the message out, if I hadn’t found it I’d probably still be worshipping people like Sheena and that is just dangerous…poor Mr Titcombe, he really doesn’t deserve to be treated this way.

    • moto_librarian

      Don’t be too hard on yourself! It’s really disappointing to discover just how corrupted midwifery has become by woo, particularly when you know midwives who do practice within scope.

      • Mattie

        Thank you, yeh it was just upsetting because I have seen people work so hard and to then end up working in an environment like this, it’s sickening.

    • The Bofa on the Sofa

      Yeah, Mattie, welcome to that realization.

      The concept of “a few bad apples” is that it is way too often used as an apologetic, and a reason to avoid addressing the issue. However, the question is, how many bad apples are there really? And how many are too many?

      Midwifery goes way beyond “a few bad apples.” With midwifery, the defense is not “there are a few bad apples,” but more of the “not everyone is like that.” And any profession that has to be defended with “not everyone is bad” has a serious problem, either real or perceived. See also: chiropractors.

      The only way that these professions can be fixed is if the “good” ones take a stand. I know you’ve claimed that the NCM (I think that’s the group) has been working against the attitudes of those in the RCM, but it’s clearly failing. They need to make the bad ones the rare bad apple, instead of trying to find the good one in a festering mess.

      Of course, keep in mind that calling them “bad apples” doesn’t really help, because, as the ripening process works, one bad apple DOES ruin the rest. Therefore, “bad apples” does not mean that they are rare and therefore don’t need to be worried about. The whole point of the bad apple analogy is that ONE bad apple DOES ruin the batch, and therefore you need to get rid of it, and you can’t ignore it.

      • Mattie

        That is so true, gah I want to just write a long letter to the NMC, I do agree that they definitely need to do so much more. I think the education needs to be addressed, as well as changing the guidelines so there’s no potential for ‘interpretation’.

    • Shannon

      This is Byrom’s daughter. https://twitter.com/acbmidwife

      The apple doesn’t fall far from the tree

  • heatherdalgety

    They just get worse & worse . Telling Mr Titcombe not to play the victim card !
    You honestly couldn’t make this stuff up !

    • The Bofa on the Sofa

      Telling Mr Titcombe not to play the victim card !

      This was the one that struck me.

    • Votre

      Yes Mr. Titcomb. If you’re going to continue to try and muddy up the issue with facts, there’s no point in continuing this discussion!

      • Mattie

        all those darn facts, they’re just not natural enough

    • Mel

      Sheena Byron et al. must not understand what unprofessional behavior is. Tweeting articles and talking with other professionals is professional behavior.

      Telling a father whose son died “not to play the victim card” is so far outside of professional behavior that I image this could/should lead to sanctions for any licensed midwives involved in this continuing terrible behavior.

      James Titcombe is my hero.

      • moto_librarian

        I called Sheena on the carpet on Twitter about the things that she tweeted about James Titcombe. I quoted her own words. Her response? She claimed I was quoting her out of context (I wasn’t) and that I was harassing her. She has now blocked me.

    • luckymama75

      Oh that really stuck in my craw too! He didn’t even mention his precious son and he got a horrible comment like that. What a total bully…and bitch.