Unassisted birth advocate Meg Heket has a revelation

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Will wonders never cease?

Homebirth advocates are scrambling to address the hideous death rate at homebirth.

First Midwives’ Alliance of North America executive Melissa Cheyney, CPM acknowledged that MANA’s own data shows that home VBAC (HBAC) has an appalling death rate, far higher than she expected. Of course, she has known about this for 5 years and only got around to mentioning it now.

This information was acknowledged by Jen Kamel of VBACFacts, and by the Lamaze blog Science and Sensibility. Henci Goer, in her inimitable style, clarified in the comments that it’s only a few dead babies.

I would add, too, that the increased likelihood of vaginal birth at home should weigh into the equation in this population. Women with no prior vaginal birth may be at slightly increased risk of perinatal loss with planned HBAC compared with women planning hospital VBAC, but they also may be much more likely to birth vaginally, thereby avoiding the serious and life-threatening risks of accumulating cesareans for the mother, baby, and any future pregnancies.

See the advantages of letting your baby die at homebirth?

To support group members without honestly counseling them about the risk of death does not absolve Heket and Rodley of responsibility for dead babies.

Now unassisted birth advocate Meg Heket has had a revelation. Heket, you may recall, is the sister of Janet Fraser (My dead baby was not as traumatic as my birth rape). She is also a co-administrator with Ruth Rodley of a number of homebirth and unassisted birth groups. No doubt you remember Ruth. She’s the one who, in the wake of 7 homebirth deaths in 1 week, referred to the death of a baby as “a little hickup.”

Stung by the response to her heartless comment, Ruth subsequently offered this:

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I would like to publicly apologise to all the ladies from groups helped admin who lost their babies. I am very sorry for your loss and I’m sorry if what I did or said contributed to this. You have lost someone precious to you and I am sorry.

In the month since those 7 deaths, there were 5 additional homebirth deaths as well as a case of baby who suffered brain damage at homebirth. Even Meg Heket is shaken up.

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Please, PLEASE, please, PLEASE contact CARE PROVIDERS  when concerning medical issues arise. We cannot assure you that everything is okay…

… we cannot tell you that you are ok because we’re only people on facebook.

Who could have thought that Meg was giving medical advice when she posted this comment and similar comments?

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So say it with me now “when I go to the dr tomorrow I will NOT NOT NOT have any VEs”

Don’t get me wrong; I’m thrilled that Heket and Rodley are now offering disclaimers. But they should not think that washes off the copious amount of blood that is already on their hands. Many babies have died already, not merely from their medical advice, which they dole out at the drop of the hat; they’ve died from their “encouragement” as well. Most importantly, babies have died because Heket and Rodley have steadfastly refused to acknowledge that unassisted birth and home VBAC are deadly stunts with appalling death rates.

If we are to take seriously their pious, self-serving claims that they don’t want to bear responsibility for the endless stream of homebirth deaths that occurs in their groups, they must publicly acknowledge that they cannot support anyone who doesn’t understand that unassisted birth and home VBAC unequivocally and dramatically raise the risk of perinatal death.

Unassisted birth and home VBAC are stunts on the order of bungee jumping off a cliff. If an adult is informed of the death rate of cliff bungee jumping and wants to do so anyway, he or she has made an informed decision. If a woman is informed of the high death rate of unassisted birth and home VBAC and wants to undertake one anyway, she has made an informed (though often selfish and heartless) decision. But to “support” and “encourage” these stunts without honestly counseling women about the risk of death does not absolve Heket and Rodley of responsibility for the deaths that result.

Heket and Rodley are not alone, of course. There is an ever growing pile of tiny dead bodies and people like Melissa Cheyney and Henci Goer (not to mention Ricki Lake and Ina May Gaskin) bear responsbility for those deaths. They are drenched in blood and no amount of disclaimers will change that.

  • Catherine St-Cyr
  • Amy Tuteur, MD

    “No more lies” is not likely to be Meg Heket unless she is currently vacationing in South America.

    • yugaya

      Proxy servers are no big deal for someone like her who is using multiple web accounts and platforms dr. Tuteur. The language usage patterns are a dead match.

      • attitude devant

        “language usage patterns” is a nice way of saying that Meg often mangles English a bit, and not in the way you’d expect a native Spanish speaker to do.

        • yugaya

          Yeah the liar posting under *no more lies* is a native speaker of English language. Plus a few other characteristically MEG HEKET online idiolect traits that are the same. Plus the timing of those comments popping up on this blog post. Plus the level of birth psychopathy on display. It’s her.

          Fuck off Meg Heket because people on this blog know exactly what you told Isaac’s mother. It’s time for you to borrow some empathy and shut up out of respect for that mom’s life of pain you *enabled* her to experience.

          • Amazed

            What? Another dead baby? Please tell me that I missed something and I’m wrong.

          • attitude devant

            Yep, Meg and her group have egged on another mom, and the baby paid the price.

          • Amazed

            My god! I was so hoping that it was me losing count.
            Do you have a link?

          • yugaya

            It is posted in public Fed Up group.

          • yugaya

            Another perfect, healthy post term baby is dead after mom got her info on the risks of 42+ weeks from Meg Heket directly. She was pulling no stops and even posted in other groups to convince this mom.

            His name was Isaac. The one before him was baby Penelope. The baby boy before that was Garlen. All post term, all moms *supported* by Meg Heket.

      • Trixie

        The language usage really does match Meg.

        • guest

          Very interesting.

    • attitude devant

      Sure sounds like Meg, she’s been going on and on about possible brain injury to her child at c/s.

    • attitude devant

      The other reason it’s likely Meg is the timing of her posting as ‘no more lies:’ she’s defending her point of view after this latest death, the death of Isaac.

  • sdsures

    Your friendly spellchecker:

    “Henci Goer, in her initimable style, clarified in the comments that it’s only a few dead babies.”

    It’s “inimitable”.

    I do stuff all the time like hitting the key next to the one I want on the keyboard even though I have teeny fingers! 🙂

  • Amazed

    Guys, please help me out here. Is this Joy the same Joy Jones of the Brewer diet that never fails? I think they were the same person but I am not sure.

    • yugaya

      Nope, not her. It’s this one: http://www.mothering.com/forum/gtsearch.php?cx=partner-pub-7865546952023728%3A8370985649&cof=FORID%3A11&ie=UTF-8&q=joycnm&sa=Search&siteurl=www.mothering.com%2Fforum%2F20-homebirth%2F1338114-back-up-plan-home-birth.html&ref=www.google.hu&ss=5342j9662304j9

      Here’s a sample: “This belief that all babies should be born healthy and alive or else someone is to blame or to pay seems wrong to me. I believe there are some birth emergencies that if occurring at home or birth center might be worse for baby or mom. But, on the converse, there are more things done in hospitals that are worse for mom & baby. Parents have to pick the risks they can live with.”

      • Amazed

        Thanks!

      • CrownedMedwife

        “…more things done in hospitals that are worse for mom & baby”? What? Worse than preventable morbidities and mortalities? How can she rationalize this? What warped sense does that take from a person? So frightening.

        • Megan

          That’s all very easy to say until it’s your baby who dies.

          • CrownedMedwife

            When I became a CNM, I began a delivery log of births I had attended. To conceptualize the number of births attended, I envisioned a comparative size kindergarten classroom, then many classrooms, then an entire elementary school full of happy healthy children with giggles, puzzles and books. Then one day I had to log a stillbirth and my vision became that of a classroom full of eager little children with a single empty desk. It’s a heartbreaking vision. Since then there are many more classrooms and several more elementary schools I can envision, but I can still tell you exactly how many empty desks there are, their names, their parents’ grief and their circumstances. I could never, ever, live with myself if in any way or circumstance those empty desks could have been prevented by surveillance, intervention or location. It takes the ultimate of warped mentality to excuse a death for the sake of a homebirth. The words of Joy CNM represent a vile belief under the guise of homebirth over hospital birth.

        • Squillo

          And there are more things not done at homebirth that would be better for mom and baby.

          I’d rather run the risk of having an unnecessary intervention than of not having a necessary one.

    • Bombshellrisa

      She is the one who believes in tearing unless severe fetal distress. She says episiotomies make tearing more severe.

      • sdsures

        What the…?

  • Amy

    What is WRONG with Henci Goer? Yes, your baby has a higher risk of dying but YOU have a lower risk of having a c-section! WTF?

    • No more lies

      Except that cs increases the mother’s risk of death at least 3 times and you’d leave your other children motherless.
      If the choice was between increasing risk of death and increasing risk of intervention that is perfectly safe and risk free… EVERYONE would choose the intervention over the increased risk of a death baby…

      In fact most of us, now natural birth advicates AGREED to one or more c-sections even when we had a bad feeling about it (that we were being lied to about needing one)
      With all the risks of cs (including our own death) we agreed because the thought “what if he is right and I need this to save my baby” was enough to makes us agree.. That possibility of them telling the truth was enough to risk ourselves.

      Dont believe me? Talk with my friend that almost bleed to death during/after her cs. Was it needed? No. Her official doctor didn’t answer the phone and other doctor play dirty to get her to agree. Even her official doctor is pissed with her for agreing to the cs.
      Or talk to me. The ONLY moment in which my babies were in danger… was DURING the c-sections. My last baby could’ve died and I’m still unsure if he is brain damaged…

      • Amy

        You want to look at the numbers on that? What is the mother’s risk of death at a c-section relative to the baby’s risk of death at a home birth, for example? How many mother’s die each year as the result of a c-section, and how many babies die or are seriously injured as the result of a LACK of intervention? Do you know the answers to those questions?

        I’ll be honest, I don’t, but I’m willing to put my money that the natural-at-all-costs side comes out looking a lot worse. If you have evidence proving otherwise, I’d love to see it.

        I had two c-sections myself. And I was where you’re at right now in demonizing c-sections and lionizing natural birth. I read the ICAN mailing list several times a day. I saw how every issue was met with suggestions to “just have a home birth” and reminders that “the doctors work for YOU, mama!” I read the birth story of the mother whose baby was stillborn at home but “at least she got her VBAC.” I saw woman after woman on the ICAN list and MDC planning subsequent pregnancies primarily so they could have a natural birth to “heal” from their c-sections. Talk about a terrible reason to bring another child into the world; what if that baby ends up needing to be delivered surgically as well?

        And now my kids are 8 and 10. You know what helped me “recover” from the “trauma” of having surgical births? Distancing myself from people like you! And realizing that outside of super-crunchy circles where women dress their kids in pro-homebirth, pro-breastfeeding tee shirts, it’s impossible to tell how a child was born or what they ate as babies.

        So no, I’m sorry, but without actual evidence, I don’t believe you. I do believe you were upset at your own birth experience, but that doesn’t translate to a mother’s slightly increased risk from a cesarean coming anywhere near the baby’s hugely increased risk from a home birth.

  • Anna

    Just yesterday saw another woman bragging about unassisted homebirth on Facebook with pictures and comments encouraging other women to do likewise. Can’t possibly express how much that sort of thing bothers me. And the smugness that always goes with it. They can’t praise their birth experience without bringing down someone else’s. They truly believe that “not all babies are meant to live” and it breaks my heart because I remember the women in the maternity hospital who truly fought for their babies like real warriors overcoming all sorts of difficulties one can imagine with babies in the NICU for weeks and the ladies themseleves barely walking after extra-crush c-sections but coming up to those units and bringing their breast milk several times a day. All this went on in silence and you probably won’t see a post on Facebook about it, but to me they are the heroes not the woman who was cold-hearted enought to risk her baby’s life but lucky enough to not to have to acually deal with it, laying there with a smug smile on her face and being taken pictures of.

    • JJ

      I am having a hospital birth any day now. I think I will brag about it on facebook. Complete with #safestchoice #medicalizedandalive #birthattendedbyasurgeon

      • Kelly

        I have always wanted to do that. I hope you do.

      • Who?

        Hope it is all entirely incident-free.

        Enjoy the baby!

      • Megan

        Please do! And I hope everything goes smoothly for you! Congratulations!

    • Catherine St-Cyr

      Heard a story recently about a woman undergoing a crash c-section for a baby in severe distress and the f-ing anesthesia resident didn’t want to put her to sleep until his supervisor got there (“because protocol”). The mother said to the ob, “please save him. I will hold very still”. They got the baby out with rapidly administered local anesthesia to the abdomen (i.e. skin freezing). Now THAT mom is the real deal hero. Talk about courage!!!

      • Anna

        Oh, Gosh! That’s a real act of self-sacrifice and something worthy of praise and deepest respect. Very sorry for what she had to go through though((( Ugh, how shallow of some to care about birth experience i. e. candles, music, aromatherapy, birthing pool, all that shit, when such things actually happen for real.

  • Rosalind Dalefield

    Wait, so they are saying kill one baby so you can have the next one vaginally??

    • Hilary

      Yes. Because your hypothetical future babies – assuming you are able to get pregnant again and carry to term again and that there are no other problems with those pregnancies necessitating c-sections – will be safer if you risk the life of this present, non-hypothetical baby. Makes perfect sense … if you’re looking at statistics instead of actual human lives.

      • Sarah

        It makes sense if you’re unfortunate enough to be living somewhere you’re unlikely to have access to obstetric care in future pregnancies. Especially if future pregnancies are likely to be numerous. If you have access to Facebook, this is unlikely to be you.

        • Cobalt

          There was a case someone here was discussing quite a while back that fit that criteria. An African woman temporarily in the US was pregnant with triplets and was very motivated to avoid a cesarean (even at risk to one of the babies) because of her access to care once she returned home. Everything worked out fine, but someone in that position has a lot more to worry about with future risk than someone who can walk into just about any hospital and get a timely, safe cesarean whether or not she can pay for it.

          • Sarah

            I can quite see why a woman in that position would prioritise an unscarred uterus over the survival of a baby.

          • Daleth

            Yes, in that position ONLY. Because that position is, either risk losing a baby now, or risk leaving all your children motherless in the relatively near future. (I doubt uterine rupture is particularly survivable for women in third-world countries.)

          • Sarah

            Presumably the woman would also be highly likely to lose the child being born at the time of the future rupture too. Additionally, motherless children in poor societies don’t have very good outcomes as a cohort.

          • No more lies

            NO one would. Such an ignorant comment!
            In fact most of us have a scarred uterus BECAUSE we thought we were protecting our babies.
            At what cost?
            My friend nearly bleed to death in a very unneeded cs (confirmed by her doctor. Not the one that lied to her to agree) last month.
            My babies were harmed DURING my unneeded c-sections.
            My last baby could’ve died and I still have to rule out brain damage.
            Confirmed by the two doctors that saw the cs video.
            My baby was born perfect (last one) great muscle tone, etc.
            The interventions and negligence caused the damage. He had symptoms for several weeks.
            The worst part? I HATE c-sections, yet I was haply about that one because kt was “truly necessary”… until I had the guts to see the video several weeks after that.

          • Sarah

            No one would? Bollocks. There are women in resource poor countries who do just that every day. If you know you’re going to have several more births that will almost certainly be unassisted, you simply can’t risk a scarred uterus. That is a call that some women are forced to make. If you don’t understand this, you’re the one that’s ignorant.

            Also, fuck your anti section shit. You can hate your own, you don’t get to make that call about mine. I am sorry for your troubles (whilst simultaneously reserving the right to take your account of them with a large pinch of salt). They don’t mean you get an opinion on the way I or my youngest child came into the world.

          • no more lies

            I never said anything about your c- section.
            All of my friends had c-sections.
            What I meant is that even thou I hate c-sections I agreed to them for the supposed safety of my baby.
            My interest were not above my baby nor I had the mentality of going “natural at all cost”.
            If you understood anything more than than I apologize. perhaps is the language barrier.

          • guest

            When you imply that doctors are coercing women into c-sections who don’t need them and damaging babies in doing so, you are saying things about other people’s c-sections, not just your own. You had a bad experience, but you have no data on c-sections IN GENERAL. You can’t generalize from your own experience.

          • yugaya

            You literally cheered these babies until death. You Meg Heket. No one
            else. You personally. May the horrible tragic way how this baby died and how
            those other post term babies you killed died be how you are punished
            once you are in hell – here is a pathologist description :

            “”
            When I do an autopsy on a stillbirth I always take a section of stomach
            to look at microscopically. I can physically see the pus in the
            stomach, clusters of neutrophils, white blood cells that have collected
            in the fluid and that the baby has subsequently swallowed. I can
            physically see the pus in the lungs where the baby has aspirated pus
            cells, because babies practice breathing in utero , and so suck all this
            pus into their lungs. And you know what? The pus is mixed with squames,
            skin cells that the baby has shed, and in its last desperate frantic
            panic it starts to gasp and draws these deep into its lungs.

            These
            babies are literally swimming in a bag full of pus, in a giant
            bacterial laden boil. They are swimming in it, swallowing it, breathing
            it, and I see the end result. And you know what else? It makes me
            despair that there are midwives out there who write this off as normal.
            Membranes ruptured for 5 days? Not a problem….

            And
            when the baby is born dead, not sleeping, and covered in meconium, and
            he stinks of bacterial poisons, and I see the pus, I want whoever
            delivered that baby in front of me, so that they can see this is not a
            game. This is not a game of ‘ooh, doctors are horrible, they just want
            to cut you, so let’s pretend there’s nothing wrong’.”

          • Sarah

            You said you hated sections. That includes the one I had and the one I came into the world via, but apology accepted.

            I’m not sure why you’re talking about your interests here, though- I can’t see how this pertains to you? There are women who need to prioritise retaining an unscarred uterus over the life of the baby currently being delivered, because they’re likely to have future deliveries in an environment where a rupture would kill both them and the baby then being delivered. In such environments, leaving children motherless also tends to reduce their chances at health, education, even survival sometimes. So it’s a decision they have to make. If you’re not one of those women, great. I don’t think anybody said you were? And if you were, nobody living in the developed world has any business judging you.

          • Karen in SC

            Post that video so we can make sure it doesn’t happen to other babies.

          • yugaya

            Fuck off Meg Heket. This was you in the group you own to baby Garlen’s mom THREE DAYS after her membranes had ruptured. She had extremely high risk medical history and was over 43 weeks. A day later her son Garlen was born dead. You hoorayed his mom into going against medical advice all the way to his grave.

            We all know what you did and what you do. You are a psychopath and baby Isac is third post term baby you have killed in less than a year with your *support*

          • demodocus

            My sister is the only one among my friends who’s had a c-section. After laboring 24 hours and not getting anywhere, they recommended a c.s. Turned out she had ovarian cancer all over her uterus and the baby’s umbilical cord. She had a hysterectomy 6 weeks later and chemo for months. Her c-section barely registers on her personal list of things-that-sucked, much less than things she hates.

          • Stephanie Rotherham

            Oh my god, that sounds like such an awful thing; I’m so sorry your sister and your family went through that. How are they doing now?

          • demodocus

            Nephew is just fine and nearing double digits. Sib had a relapse a few years ago, but has been upgraded to stage III and is holding steady and working full time
            .

          • areawomanpdx

            If that were my position, I’d have the three babies via cesarean and have my tubes tied. I can see the argument, but I’d still prioritize actual babies over hypothetical ones.

          • Sarah

            I’d want to know more about the care available in the event of complications from tube tying, such as ectopic pregnancy, before making that call.

          • Cobalt

            If tubal ligation is accessible (and at Catholic hospitals it is frequently not), that would be a solution.

            I have no idea where she delivered, or what her future fertility was worth to her personally and culturally.

    • JJ

      My brain can’t make it work either. I came up with the summary of: the baby died but came out of your vagina so it’s ok.

    • EllenL

      Yep.
      Call me unreasonable, but I’d like ALL of my babies to live.

      • No more lies

        Me too.. and both of my babies were harmed DURING the cs that werent needed in the first place!
        The ONLY moment in which they were in danger was during rhe cs.
        My last baby could’ve died and I still need to rule out brain damage.
        Confirmed by other MD and my former pediatrician.
        They both saw the video and agreed that they were born great and the intervention caused the damage.

        • guest

          Both of MY babies WEREN’T harmed during the cs, so that’s PROOF that c-sections are great!!!!!!

          Data or it’s meaningless, bro. Anecdotes mean nothing.

        • yugaya

          Fuck off Meg Heket. How about your own sister showing us the video of how she killed her own daughter? You know, the baby that she later LIED was stillborn?

    • Megan

      The logic is so twisted. I mean, I feared the complications of multiple CSections when I had to decide to have my primary CSection but I sure as hell wasn’t going to let my baby die over those fears!

  • Who?

    The background noise you are hearing is me being sick into my own scorn-thanks Bernard Black.

    How dare they. This is the start of the full blown history re-write: we never said don’t go to the doctor; when we said don’t go to the doctor we meant don’t let the doctor boss you; when we meant don’t let the doctor boss you we were trying to convey the message to take doctor’s advice if the doctor said the baby was at risk.

    These women are an utter disgrace.

    Dr T congratulations for being so adamant and persistent in bringing all this into daylight, lives are probably already being saved as a result.

  • Thea

    Call me cynical but I suspect this was prompted by contact with someone from the legal profession. They plan to continue promoting deadly nonsense. It is like a warning label on cigarettes.

  • JellyCat

    They need to be held accountable. The disclaimers are not enough.

    • yugaya

      It’s a huge improvement. Heket is probably washing her mouth with soap right now to cleanse the taste of being forced to ever let the words “seek medical care” escape her.

      • No more lies

        In a homebirth that ended up in cs she did seek medical care as it was needed.
        She has never advised anyone against medical care WHEN ITS NEEDED and if you are unsure she advises you to seek care anyway to rule out possible complications.

        She believes in seeking medical care herself and she advises the same thing to others.
        It has been like that in the 2 years I know her.

        The argument of her offering medical care by asking a woman to deny vaginal exams is pointless.
        First give us SOME evidence that a vaginal exam is safe and helpful and we can talk about that.
        The risk of infection and premature rupture of membanes due to vaginal exams were never mentioned to me.
        So when a baby suffers an infection CAUSED by an intervention.. at the hospital. Who’s fault is that?
        If a doctor ask me to swallow poison excuse me for asking for evidence of safety and a good reason to do it.
        The extreme of thinking doctors are perfect and know it all is much more dangerous and lead to many more deaths than homebirths…
        Latrogenia. Thirth cause of death in USA.
        Compare that to homebirth and we’ll talk about that.
        15000 people MONTHLY killed.

        • yugaya

          Fuck off to you Meg Heket.

          Another post term baby whose mother you coerced with your lies has died.

          Baby Garlen, baby Penelope, baby Isac now.

          All perfect, full term babies whose deaths are on YOU.
          The only questions is how many babies has she *supported* to death so far? Meg Heket’s been doing this for over a decade. We are talking HUNDREDS of preventable losses probably.

          Compare that to anything you want in order to attempt to give yourself an alibi. Won’t work. Meg Heket has blood of too many babies on her hands to ever be washed off by flimsy moving of the goalposts.

        • Enough already Heket

          Oh seriously fuck off!! I’ve witnessed babies dying in your group! Women egged on until it’s too late to save their children! These mothers and babies are innocent and just need support! Proper support not the bullshit you give them!

        • Trixie

          Interesting that you came here to comment on this post about your disgusting behavior, knowing that a baby named Isaac, whose mother you goaded into attempting a UBAC, just passed away of a completely preventable death. Now you and your admins are busy deleting her comments and threads and probably pretending she never even existed. You got your thrills, now on to the next one.

        • Krystle Dolbow

          Excuse me but I just seen Meg cheer on a post dates woman to ubac and encouraged her not to go back to her doctor’s and claimed she doesn’t need a doctor when she was on the fence about it, which ultimately led to the baby’s death. That poor mom was a victim to Megs bullshit. Meg has so much blood on her hands and with the tons of proof for it, you aren’t fooling anyone.

    • CrownedMedwife

      Agreed. A disclaimer at this point is useless. Their damage is done. Their nonsensical medical advice has already spread through their tropes and is echoed in the words of their followers and members. The self-proclamations of those who believe their words represent their superiority in ‘having done their research’ litter their echo chambers in chorus; avoid SVE’s, they’re useless; treating GBS will ruin your child’s microbiome, US’s are notoriously inaccurate, they’re just trying to find an excuse to cut you; 42 weeks is still term, ask ACOG and just don’t show up for the appointment; vaccines cause autisms and the flu can be prevented with essential oils.

      All. All of these and more countlessly repeated in groups under the guise of support. Yeah, a disclaimer is useless and a pathetic attempt to absolve themselves of the accountability.

      • Karen in SC

        Yikes!

  • Roadstergal

    “increased likelihood of vaginal birth at home”

    I still can’t get over this. I likely never will. That increased likelihood is _entirely_ due to not seeing warning signs that would make one choose a CS over VB rather than roll the dice. You can have exactly the same likelihood at the hospital, if you’re willing to know that things are potentially going south and stick to your guns nonetheless. These women are screaming out to be lied to. Please, never tell me of anything that might be going wrong, because my conscience might step in. I don’t want to roll the dice _intentionally_.

    • MLE

      Just like there’s an increased likelihood that you’ll leave by the front door in a house with no back door.

      • Roadstergal

        Well, you can get some contractors to come in and put in a back door if needed. But if the house is on fire and the front door is jammed, there might not be time for them to make a back door…

    • yugaya

      Remember that part of that statistic that shows “increased likelihood of vaginal birth at home” are the two women whose babies were delivered vaginally after uterine rupture only because it was too late to even attempt to save them with a CS. Both of these babies died, which does not prevent MANA to hypocritically claim these were not “confirmed uterine ruptures” only because no CS during which they were visually diagnosed was performed at all.
      And MANA did that deliberately, so that the truth can get twisted and hidden like this when their shitty paper is shared around: “There were two confirmed uterine ruptures. The women were transferred to
      a hospital, had a cesarean, and both mother and baby went home three
      days later.” http://www.vbac.com/2015/09/update-on-the-safety-of-home-birth-after-a-cesarean-hbac/

      Truth: the two uterine ruptures that were confirmed via CS were picked up in the hospital, after women were transferred for unrelated causes. Immediate CS during which ruptures were confirmed visually and babies were saved was only possible because they were IN THE HOSPITAL.

      4 uterine ruptures out of 1227 HBACs. Two uterine ruptures that were diagnosed at home by MANA midwives resulted in both babies dying. Two uterine ruptures that were diagnosed after transfer by qualified medical care providers resulted in both babies surviving.

      • manabanana

        I’m confused about suspected, but not confirmed, uterine ruptures. Why would surgical intervention NOT be indicated in a case where a large internal organ with a significant blood supply ruptured? I mean, do uteri just heal themselves after rupture? I think not.

        It doesn’t make sense.

        Clearly, something VERY BAD happened (abruption?) but the whole idea that midwives would suggest that a rupture occurred, but nothing was done to confirm or repair this injury doesn’t make sense.

        • joycnm

          A uterine “rupture” can be 1/2 inch in length or half the entire width of the uterus in length. Of course, 1/2 inch wouldn’t be fatal, but is still included in VBAC research as being a ruptured uterus. This just happened to a patient of mine who was transferred from home to the hospital for a complication of labor. (I’m a home birth midwife). She had a small uterine rupture, a “window” they call it during the birth in the hospital. It went undiagnosed (even though I asked the nurse and doctor why her abdomen was enlarging after the birth!) This window wasn’t diagnosed until 2 days later when, after discharge from the hospital, I took her back to the hospital (The OB’s refused to see her) and she was admitted from the ER, got a CAT scan, and was diagnosed with a “suspected” uterine rupture that had healed over in the 2 days. It happens.

          • fiftyfifty1

            Your attitude comes across as so oppositional. I would love to hear the Obs’ side of the story. “Refused to see her”. Snort.

          • joycnm

            Yes, it does sound oppositional, I apologize. Actually I like the OBs that help my patients when they need more advanced care than I can provide; they’re actually great OB’s. The opposition I have is to the hospital policies that don’t include the “caring” in healthcare. When I was a hospital L&D nurse 16 years ago, this patient would’ve been readmitted to the labor floor, cared for by the OB and the appropriate specialist(s) would come to the floor to see her while she was not separated from her 2-day old newborn. Not today. Hospital policy is that if it is not an OB problem, no OB has to be involved. Oh, and you can snort all you want. The direct reply I received when I told (the one OB I do not get along with who was on call that day) “(Patient’s name) is having signs and symptoms of a paralytic ileus, can I bring her back in?” He barely looked at me and says, “ER” “Excuse me?”, I say, “ER” he repeats. “She needs to be seen in the ER.”

          • Gene

            She does need to be seen in the ER. That is not something managed in an office. And initial work ups are done in the ER. How can you not know that?

          • joycnm

            Gene, I don’t know how old you are, but in the olden days (25 years ago) when I worked the labor floor, these patients were taken care of on the labor floor, not the ER, for the reasons I stated in my rather lengthy diatribe which you evidently didn’t have time to read. Nowhere did I say this patient needed to be seen in an office on a Sunday of all things. Yes, I see patients in their homes on a Sunday if there is an emergent problem. Never did I think an OB would do that, or in his office, but just possibly on the labor floor where he was anyhow, with no labor patients to care for. THIS is the state of hospital birth in America. Pass the patient on to someone else (a surgeon) who knows nothing about caring for a woman 2 days postpartum or who even wonders what her 2-day old breastfeeding newborn is doing without Mom.

          • Daleth

            I can’t believe you’re complaining about an OB telling you that a postpartum patient who develops ileus symptoms on a Sunday should go to the ER. He’s sending her to the only place that a person who is not currently hospitalized can get the necessary workup on a Sunday, and he’s “passing the patient on to someone else” who knows how to diagnose and manage an ileus.

            If your patient broke her arm on a Sunday two days postpartum, the OB would give the same advice. And you would still complain, I suppose, because you seem to think that understanding pregnant women is more important for taking care of a recently pregnant woman’s broken arm than understanding broken arms is?!

          • Megan

            I was surprised she was complaining about it too until I read her posting history…

          • joycnm

            OB’s are surgeons and completely able to care for an ileus. 25 years ago they were fairly common on an L&D floor, perhaps how they cared for C-section patients or how they did C-sections. OB’s, obviously don’t do orthopedic surgery. You have to give them some credit as surgeons–diagnosing and treating an ileus isn’t that complicated.

          • Who?

            Perhaps if your patient hadn’t been discharged-that is, was on the ward when the problem arose, which in the ordinary course she would have been-she would have continued to be cared for on that ward.

            She came back to hospital with a condition that needed attention, and she got attention. Which is fantastic. Why not focus on that rather than on it not being done quite in the way that you preferred. If she was sick having a new baby around to look after isn’t going to help her get better.

            Sounds to me like a way for you to remind your clients to be dissatisified with mainstream care so they’ll keep coming to you, and to wrap that self interest up in a pretty bow and calling it ‘caring’.

          • Megan

            “Sounds to me like a way for you to remind your clients to be dissatisified with mainstream care so they’ll keep coming to you, and to wrap that self interest up in a pretty bow and calling it ‘caring’.”

            Exactly. Thank you.

          • Megan

            But until they get worked up, you do not know that they in fact even have an ileus. There are more diagnoses in the differential. On a Sunday, the only place to get a workup in a timely fashion and get a correct diagnosis is THE EMERGENCY ROOM!

          • fiftyfifty1

            Actually on ANY day of the week, the only place to get a workup in a timely fashion and get a correct diagnosis for this sort of severe abdominal pain with a broad and potentially serious differential is the emergency room.

          • Megan

            That’s usually true. I’ve direct admitted a patient on a weekday from my office quite a few times, but that’s only because I work for a residency and I literally can have a patient in the hospital getting their testing done and being evaluated by a resident and the inpatient attending within an hour. That’s not always fast enough though, and I have also sent patients from the office to the ER via ambulance when faster care was needed.

          • fiftyfifty1

            “diagnosing and treating an ileus isn’t that complicated.”

            No, diagnosing and treating a *simple* ileus isn’t that complicated. What IS complicated is differentiating an uncomplicated ileus from all sorts of other potentially fatal causes of abdominal pain and bloating. And to do that, it takes things like STAT labs, STAT CT imaging, timely administration of fluids. Things that you won’t be able to get on a L&D floor.

            Have you no idea how a modern hospital works? Unstable patients with no clear diagnosis should not be direct admitted to the hospital. Especially not to the L&D ward which is a ward that specializes in, as its name hints, LABOR & DELIVERY. Send your patient to the ER you idiot.

          • Kq

            Oh be fair. How can someone attending births right now, where babies and mothers can die, know ANYTHING about hospital admissions and how medical / hospital care works currently? So unfair! Her 16-25 years out of date info is TOTALLY good enough!

            /snark

            This woman should be charged with criminal negligence and practicing medicine without a licence – because if her CNM/RN was current she’d know the BASICS.

          • Who?

            And for those playing homebirth bingo-my card is always to hand-we got an accusation of meanness (Gene, nice work) very early on.

          • PrimaryCareDoc

            Except when it isn’t an ileus, you fool.

          • Bombshellrisa

            Seems a little basic to know how a patient is admitted to a hospital.

          • joycnm

            How would one that hasn’t worked in a hospital in 16 years know this basic knowledge?

          • Kq

            Seriously? You attend births yet don’t know how hospital admissions work currently?

            That is f**king terrifying.

          • fiftyfifty1

            “You attend births yet don’t know how hospital admissions work currently? That is f**king terrifying.”

            Oh it’s worse than that. Scroll back over her old Discus comments. You’ll find one where she pooh-poohs a grandmother concerned about her daughter’s homebirth plans by reassuring her that EMTALA ensures that all her daughter would need to do would be go to the ER and she will be treated immediately.

            Turns out she hasn’t worked in (or with) a hospital in 16 years and admits she doesn’t know the first thing about their procedures. And doesn’t know the first thing about EMTALA either.

          • Kq

            Oh, I saw. Nauseating.

          • Box of Salt

            joycnm “How would one that hasn’t worked in a hospital in 16 years know this basic knowledge?”

            Why is someone who hasn’t worked in a hospital in 16 years providing medical care to patients within the US?

          • Bombshellrisa

            Wouldn’t that be basic for someone who may have to transfer patients from a home to hospital setting? Most CNMs also do healthcare as NPs, it’s not a strange concept to know how their patients would get admitted to a hospital. Even the non nurse, strictly home birth midwives I know understand how a hospital admission via an ER works.

          • Megan

            I really don’t understand the problem. Going to the ER for evaluation on a Sunday is the correct procedure, whether it fits in with your ideas of the “good old days” or not.

          • fiftyfifty1

            ” but in the olden days (25 years ago) ”

            So you freely admit you are practicing way outdated medicine. OK.

          • joycnm

            Oh no, I practice with the “new” evidence based protocols, I just do it in a caring way of giving health care. Yes, driving to a patients home to give them a postpartum check up is very old fashioned and “out of date”, but my horse and buggy driving patients do appreciate it.

          • Box of Salt

            Maybe this is a dumb quesiton, joycnm, but your statement “but my horse and buggy driving patients do appreciate it” tongue-in-cheek or does this actually describe your patient population?

          • Box of Salt

            joycnm, I have scrolled up and found the answer to my question.

          • yugaya

            What a hypocrite but that is so typical of homebirth midwives. Of course she is exploiting the vulnerable minority groups while openly being a bigoted arse about their cultural and lifestyle choices.

          • Megan

            Yes, rather than educate that population about the known risks of homebirth and letting them make a truly informed choice, she’ll take advantage of them. Then she’ll lie and say it’s because of how much she “cares” about them. If she truly cared, she’d be making sure they understood that even MANA’s own data show homebirth to be more dangerous to babies. But I’m sure that’s not part of the spiel.

          • fiftyfifty1

            ” I practice with the “new” evidence based protocols,”

            Oh sure you do. VBAC at home.Totally all about following the guidelines.

          • Megan

            So it sounds like your problem is really with the current model of healthcare in America. Fine. What does that have to do with this particular OB you’re so mad at?

          • fiftyfifty1

            “Yes, driving to a patients home to give them a postpartum check up is very old fashioned and “out of date”, but my horse and buggy driving patients do appreciate it.”

            Your hero complex isn’t fooling anyone here.

          • Daleth

            Whatever protocols you may use in your practice–and by the way, HBAC is not part of any “evidence based protocol,” quite the contrary, so you’re wrong there–you clearly are not up to date on how actual medicine (by MD’s) is practiced these days.

            And if you think the OB did something wrong by directing your patient to the ER when actually the ER was absolutely the right call, it sure makes it clear you don’t know much about hospitals… which makes me wonder whether you even have a transfer agreement in place for your patients. Let me guess–no?

          • Daleth

            driving to a patients home to give them a postpartum check up is very old fashioned and “out of date”, but my horse and buggy driving patients do appreciate it

            Do they appreciate it when you misdiagnose them because when they describe symptoms that could be something serious, you just tell them what you think it is and start treating them for that, rather than suggesting that they go to the ER?

          • Gene

            Oh sweetie… The L&D floor, even their triage area has been, for at least the last twenty years I’ve been doing this, only for women WHO ARE PREGNANT. It is not a post partum work up area for patients coming in off the street. And of course, when you see a woman who is having complications 2-3 days after birth, where exactly do YOU think she will get a real medical work up started? She may end up on the post partum floor of the hospital, but the ED is where she goes first. Where we know nothing about birthin babies, post partum complications, breastfeeding problems, etc. I mean, I usually stand at the doors, wringing my hands and say, “Lawdy, Lawdy, you had a baby? What end do they come out of? And let me give that baby some coffee to drink, since it looks sleepy”.

          • joycnm

            Well, Gene, if you’ve been a hospital nurse on an L&D floor for the past 20 years that explains your attitude. I would be mean and condescending to complete strangers too if I still had that job. Fortunately I like taking care of patients at the bedside and since nurses in the hospital can no longer do that I absolutely love my work–approximately 90% is patient interactions that do not involve paper–charting, EFM, computers. I absolutely hated my job as an L&D nurse searching for the perfect hospital over the 10 years, that gave good and caring service to women and babies. I’m still looking. Unfortunately those hospitals are all located out of the United States.

          • Gene

            1. Not a nurse (though I borrow their stethoscopes on occasion)
            2. Don’t work on L&D.
            3. Take excellent and caring bedside care of pregnant and postpartum women regularly.

            Sorry you hated your job. Maybe it was your lack of medical education (see comment above regarding ileus) that made your job such a trial.

          • PrimaryCareDoc

            You’re a moron. Here’s a clue for you- we don’t practice medicine the way we did 25 years ago…because more people died that way. HTH.

          • Daleth

            Of course she needed to be seen in the ER. They can’t readmit her to the hospital just because she has symptoms that might be an ileus–they have to do a workup, including an x-ray, to figure out if she has an ileus. The fastest way to get that workup is to go to the ER.

            If she does have an ileus, then she might be readmitted (but probably not unless it’s severe/advanced), or she might be given self-care instructions (liquid diet, appointment next week, come back in if symptoms get worse) and sent home.

            And if she did get readmitted, it wouldn’t be to L&D because OB’s and L&D nurses are not the best care providers for an ileus–you want internists with oversight from gastroenterologists.

            So REALLY? This is your complaint? They wouldn’t readmit your patient to the hospital just because a midwife that she might have an ileus? OF COURSE they wouldn’t!

          • joycnm

            As an ob nurse 25-30 years ago we cared for women with an ileus fairly regularly on the ob floor. OB’s are surgeons, they should be able to care for a woman with a simple ileus (in fact it wasn’t an ileus, it was hypoactive gastrointestinal tract due to the blood pooling in her abdomen against her intestines.) Yes, things have changed since I was a nurse. Nurses no longer are “patient advocates” which was a great source of pride in the old days. They are now keepers of the chart for the lawyers, assistants to the doctors to keep them on track, and chief chef and bottle washer (an old term meaning anything else no one else wants to do). No, I’m still happy with my bedside nurse midwifery with a community that still appreciates the old health”care”.

          • Gene

            Umm, by definition, ANY slowing or cessation of intestinal propulsion is an ileus. Are you sure you are even in the medical field?

          • Megan

            In our hospital, it’s possible that a mom only a few days postpartum would end up back on the maternity ward for care of an ileus, but to presume that you can know for sure that’s what your patient even has without her being worked up first is silly. There are other things on the differential and she would need to be worked up before being admitted and placed on the appropriate floor/unit, (indeed, your patient did not even have an ileus but rather, a uterine rupture that wasn’t known until she had her workup in the ER). I still don’t see why you are so upset with this OB for following current protocols for appropriate patient care.

          • Daleth

            JoyCNM, do you genuinely not even understand the difference between treating a diagnosed ileus and diagnosing symptoms (that may or may not be an ileus) in the first place?

            Of course L&D nurses can care for an inpatient who has been diagnosed with an ileus. It’s not that hard to treat a simple ileus in any part of the hospital because basically all you do is put the patient on a liquid diet, wait, and run more tests if things get worse.

            But can an L&D nurse diagnose one? No, of course not. And can an OB diagnose one? Maybe, but that would be irresponsible when you can simply send the patient to the ER and get all the tests done there ASAP and evaluated by a gastroenterologist.

          • Medwife

            Your third paragraph, OMG YES. When I have a pt on L&D who we are suspicious of having an ileus, I hope and pray for a hospitalist to deign to be involved with her care. They’re better off in med-surg with L&D support PRN, at least at my facility.

          • fiftyfifty1

            “”She needs to be seen in the ER.”

            Yep, just as a thought. You are so oppositional that you can’t see the medical facts right under your own nose. The OB isn’t refusing to see her, he is saying she needs to go through the ER. You know, the place where people with serious symptoms should go to have potentially life threatening problems ruled in or out when time is of the essence. You know, the place they go when you are worried they might have an acute abdomen or ischemic bowel. Because only somebody with blinders on would stop their differential at ileus.

          • Gene

            I get calls all day long from docs sending in their patients to the ED. It’s usually a brief history and request for evaluation. And “call me when s/he gets there” or “after eval”, etc. And plenty (assuming they have privileges at my hospital) of “I’ll be there shortly”. It’s what we do!

          • Catherine St-Cyr
          • CrownedMedwife

            Oh, Joy. The martyrdom in your comments is astounding. In an attempt to translate your agenda into reality.

            As a Labor & Delivery RN, you hopped from locale to locale. Instead of an initiative to institute improvements in obstetric care, you lamented its shortcomings. Your solution to a system that did not share your agenda was to escape into homebirth midwifery with a blatant disdain for the nursing profession misplaced as their failure to conform to your agenda.

            Once within the homebirth culture, you treaded further and further into the abyss of NCB as you learned to excuse high-risk care of breeches, multiples and VBACs as simple variations as normal. You allowed the vulnerability and beliefs of a culture to become your platform for your savior complex and rationalized your behavior at the expense of their well-being.

            Rather than demonstrate your professionalism by securing a collaborative obstetrician, you used the default of a system you abhorred as the safety net. Despite your obvious disgust and contempt for their processes, you had the audacity to expect an open reception upon transfer and consultation. It isn’t a far stretch to assume they were all too aware of your lack of standards of practice. They’ve been on the receiving end of your transfers, ready to assume the unknown and unable to decline a willingness to participate in the risk you had already undertaken.

            The on-call obstetricians don’t have a say in how you practice, they don’t have warning of what you’ll bring to their doorsteps. Some may respond with open reception, grateful to have the opportunity to intervene before the outcome is grave, willing to overlook your risk-taking if that encourages you to transfer in sooner. Others may no longer be able to express themselves well in your presence, are fed up with the risks you take under the guise of normalcy or a NCB agenda. There is no doubt they ensure the transfers are provided with the highest level of care and resources, all within the system you despise and tried to escape.

            As an assumption, you transferred care of a high-risk mother for a ‘labor complication’ and per the professionalism and integrity of the hospital system, she was afforded care. A complication occurred, presumptively from a TOLAC or grandmultipara given the eventual outcome of a presumed uterine rupture and the unlikelihood of a rupture in an unscarred uterus. Regardless, this mother went home apparently healthy with a newborn, because of their care, in spite of your contempt of it.

            Days later, you call the on-call obstetrician involved with the care of your patient by default with an acute abdomen. Did you expect a social conversation, at attempt to afford a differential diagnosis or a discussion of management? It was an acute abdomen, direct her to the hospital. That presentation did not require any further participation on his behalf, he provided the direction you as an advanced practice nurse should have known. He may have been involved by default at the onset of transfer, but surely you cannot be surprised at his lack of further discussion and unwillingness to provide anything further than a simple response to get her to an ER.

            You assumed the acute abdomen was a result of an ileus, that simple diagnosis you have seen OB RNs care for many times before. Really, what is the incidence of a nonsurgical postpartum ileus. You deflected the seriousness of the situation, most likely brought upon by the risk-taking you did with your NCB agenda, with complaints of the system in place for evaluation and treatment. An acute abdomen, a possible surgical emergency, and you are most concerned about whether she is admitted to OB or a general floor? It is not your decision to make and just because it was done that way 25 years ago, doesn’t mean it is the most appropriate plan. In your view, you could not accept the standards and procedures over your ten years of nursing experience, but admission to OB for a nonobstetric indication must be correct because it fits your agenda? We did a lot of things in the past, practices change and as a provider on the fringe of healthcare, it is not your words that dictates the best course. You chose to practice outside of the evidence, you chose not to collaborate within a system, you do not choose how it functions.

            In all of this, I have sympathy for the on-call provider for having to become involved by default, the hospital system you expect to have at your beckon call despite your obvious disdain for its practices, the woman and her community that have been manipulated into a warped sense of trust in a provider who invokes their inherent risk in their vulnerabilities. You, I have no sympathy for, despite your pleas and heroic/savior complex. You are what is wrong with midwifery. I will stop short of excusing your behavior as representative of our profession by saying we’re not all like that. As long as you exist in practice like that, you bring disgrace on this profession.

          • moto_librarian

            STANDING OVATION!!!

          • Catherine St-Cyr
          • PrimaryCareDoc

            Oh my god, if I could like this a million times, I would.

          • Catherine St-Cyr
          • Who?

            Thank you that’s just it.

            This is my million times like.

          • Catherine St-Cyr
          • Catherine St-Cyr
          • PrimaryCareDoc

            And he was right. You told him she has a paralytic ileus. That’s not an OB problem. What the fuck was he supposed to recommend?

          • Dr Kitty

            I’m late to the party, but Joy, your expectations are seriously unrealistic.

            You tell an OB that his patient has reduced bowel sounds, abdominal pain, no bowel movements and you want him to say “send her straight to the ward for liquid diet and TLC for her obvious paralytic ileus”. NOPE.

            If I have a postpartum lady with probable RPOC or a obvious wound infection, who is haemodynically stable, I’d expect the obstetricians to see her on the ward based on nothing other than my phone call. Everything else goes through the ER.

            And I’ll give you an example of why.
            I had a lady who phoned complaining of chest pain and SOB six days after a CS- most likely a pulmonary embolism, so I advised ER via ambulance. You know what it turned out to be? A perforated duodenal ulcer. Which was demonstrated by investigations, and she was appropriately admitted by the surgeons.

            Sending that patient to the OB ward for anti-coagulation based on the most likely diagnosis would have killed her.

            You send sick people to the ER, for stabilisation and investigation.
            Once they are stable and diagnosis is made THEN you can decide which specialty will admit them, if they still need admission.
            That HASN’T changed in 16 years.
            Samuel Shem was writing about “buffing and turfing” before I was born.
            Did this somehow pass you by?

          • Cobalt

            I had emergency surgery at one week postpartum, I was admitted through the ER. Good thing, too, as it was not an OB issue and I needed a full evaluation to figure it out.

          • The Bofa on the Sofa

            Did this somehow pass you by?

            Joy is the current poster child for Pablo’s First Law of Internet Discussion.

            I did like when she tried to tell Gene all about how patients are (were) handled. Because, you know, Gene doesn’t know any of that stuff.

          • Catherine St-Cyr
          • Daleth

            He barely looked at me and says, “ER” “Excuse me?”, I say, “ER” he repeats. “She needs to be seen in the ER.”

            But… she did. That’s where you go when you’re not currently a hospital inpatient and you have symptoms of a potentially dangerous or even fatal health condition. You go to the ER.

            What were you expecting him to say? An OB can’t admit a patient, even one who was an inpatient until 2 days ago, without first confirming that she has a problem requiring readmission. And he can’t confirm that in his office. To diagnose an ileus, you need an x-ray, and the fastest place to get that when you’re an outpatient is the ER.

            I’m just genuinely confused here. What were you expecting him to do instead?

          • Fallow

            Her posting history on Disqus is way on the looney side. This isn’t someone who’s going to engage in a discussion based on evidence. “Oppositional” is a kind word for her typical mode of discourse.

          • yugaya

            ” The only way to find out the (homebirth) “statistics” is to ask this midwife; they are not published.”

            Yes they are Joy, so stop lying to your clients.

          • Catherine St-Cyr
          • Catherine St-Cyr
          • Who?

            Might have been more like-‘That sounds serious, probably best to go straight to the hospital where they can assess and action as appropriate. They’ll call if they need me.’

          • Catherine St-Cyr
          • Catherine St-Cyr
          • Sarah

            I imagine it will still be included in the stats because it is, in fact, a rupture. Personally I operate from the position that the only good uterine rupture is no uterine rupture, but that’s just me.

          • yugaya

            “but is still included in VBAC research as being a ruptured uterus”

            No. Uterine rupture and uterine dehiscence (window) are classified in studies and reports separately even when outcomes are reported together. Like this: “Results. Eleven uterine ruptures and 10 dehiscences occurred during this period.” http://www.medscape.com/viewarticle/432436

            Criteria from MANA study makes no mention of any such grouping, and it is clearly stated that “probable uterine rupture” in their study = not confirmed visually during CS.

          • Catherine St-Cyr
          • Who?

            Was your patient discharged from hospital or did she discharge herself against medical advice?

          • joycnm

            She was discharged from the hospital the “normal” way. She is a Mennonite lady (like Amish) who would rather recuperate at home and the hospitals around here are mostly amenable to allowing early discharge for this community.

          • Who?

            So not ‘normal’ then-your word not mine-in fact early, at the patient’s request.

          • Catherine St-Cyr
        • Ash

          MANA stats did have some missing data points–like an unknown cause of neonatal death, or unknown outcome after transfer to the hospital. So if on a MANAstats data worksheet, the MW reported that the client transferred to the hospital because of suspected rupture, it’s possible for the rest of the data to be missing.

          Remember–MANA stat is self reported, there’s no checking of the original source. There are some events that trigger the MANA coordinating center to call the MW in question, but there’s no requirement that the individual MW sent MANA actual redacted records, or make good faith attempts to actually get the data.

        • yugaya

          These were uterine ruptures as diagnosed by everything else except “visual confirmation during CS” -because it was too late to perform a CS to save the babies. That does not mean that there was no surgical repair afterwards. The fact that MANA singled out that exact visual confirmation during CS criteria to be able to differentiate between a confirmed and a probable UR is because they are deliberately trying to hide the real number and rate of UR at home and how deadly they are. Look at how VBAC. com followed the intended party line in its digest version that I quoted:

          “There were two confirmed uterine ruptures. The women were transferred to a hospital, had a cesarean, and both mother and baby went home three days later.”

          The intention was to fool an average reader that less ruptures occurred, and that outcomes were good. The two “probable” uterine ruptures and two dead babies are hidden from the view. Buried twice.

        • Catherine St-Cyr
      • Roadstergal

        Thanks for all of the background information. I didn’t realize how bad it was. 😮

      • Catherine St-Cyr
    • lilin

      Ignorance means being able to post on your facebook wall, “My baby probably still would have died if we went to the hospital,” instead of “I killed my kid.”

    • Chi

      Some of them aren’t though. Some of them have been lied to right from the outset and because they trust their midwife (because the midwife is more personal, more willing to stroke their ego, unlike those cold cold doctors), when the midwife lies to them during labor and says everything is ok, how are they supposed to know any better.

      The whole reason we have primary care providers during pregnancy and labor is because in general, us lay-people DON’T know any better. With my first I DIDN’T know what things they were looking for in my urine samples and what they meant. But I expected my care provider to know and to let me know if there was a problem so we could take care of it quickly.

      The biggest problem with these lay midwives is that they are lying to the families under their care to try and make themselves look competent, right up to the point where it’s clearly more than they can handle and THAT’S when they pass the buck. Because at that point they can shrug, wash their hands and say, “Clearly they weren’t meant to be saved” when, if they had just pushed aside their damn ego for a moment, and gotten help earlier, they may have been.

      So I totally agree with Dr Amy. Women need to KNOW the REAL, 100% true fact that VBAC and even homebirth in general is FAR FAR more risky than hospital birth.

      If they choose to go ahead with it then, well, that’s when the dice get rolled.

      • demodocus

        Also, doctors seem a lot less cold if you can get them giggling like schoolgirls by telling bad jokes 😉

    • Are you nuts

      Yes you are far more likely to have a vaginal birth at home. Because I have yet to hear of a home c-section. What a dumb statement.

    • MaineJen

      Of course, because you *can’t* have anything other than a vaginal birth at home. Whether you and the baby both come out alive…or not.

    • Megan

      Yup. The flipside to this decreased likelihood of CSection for homebirthers is the increased risk of death or injury to your baby. But they never mention that part…

      • No more lies

        Do you mention the increased risks of death for both mom and baby when interventions are overlyused?
        How about you read the insert of pitocin (not fda aproved for elective induction btw) and read the part in which says that it can cause DEATH or brain damage to the baby.. post partum hemorrhage to the mom, etc)
        Or 3x risk of death for elective c-section moms?
        Or how LIFE long wellbeing could be compromised in babies birth by cs?
        My babies were injured at the hospital. I’ve never had a homebirth. My last one could’ve died!
        My friend almost die last month during her UNNEEDED c-section.

        Yeah.. keep thinking that hospitals are safe.. .even Margsen Wagner from WORLD HEALTH ORGANIZATION used tk say “if you are low risk GET THE HELL AWAY FROM A HOSPITAL

        • Nick Sanders

          Why are you doing so much gravedigging?

          • Karen in SC

            These “injuries” are never specified.

          • yugaya

            Nick because it’s Meg Heket posting under a fake name.She has made a hobby out of creating baby graves where there should have been none.

        • yugaya

          Fuck off Meg Heket. No one needs better proof for what a deadly psychopath you are other than a fact that less than 24 hours after the latest death announcement of a baby whose mother you lied and mislead into going against medical advice was made – you are here, posting under a pseudonym, defending yourself and trying to justify the deaths you are personally culpable for by “babies die in hospitals too”.

        • Poogles

          “it can cause DEATH or brain damage to the baby.. post partum hemorrhage to the mom”

          You know what else does that? Birth.

        • Poogles

          “Or 3x risk of death for elective c-section moms?”

          Citation needed.

          Of course, The Birth Trauma Assocation in the UK found that an elective c-section is actually the safest mode of birth for mothers:

          http://www.telegraph.co.uk/news/uknews/1584671/Women-choosing-caesarean-have-low-death-rate.html

  • Karen in SC

    Excellent post!

  • N

    “Now unassisted birth advocate Meg Heket has had a revelation. Heket, you may recall, is the sister of Janet Fraser (My dead baby was not as traumatic as my stillbirth).” as my stillbirth: Should it not be hospital birth or birth rape or whatever it was?

    • Amy Tuteur, MD

      Right. Fixed it.