New natural childbirth motto: Safety Third!

Safety first on blackboard

The natural childbirth movement has unveiled a new motto:

Safety Third!

No, not really, but they might as well have made it their motto.

Yesterday I wrote about midwife Hannah Dahlen and her various cold blooded statements about perinatal death, especially:

To hear many midwives and natural childbirth advocates tell it, the first and most important priority is the mother’s birth experience.

When health professionals, and in particular obstetricians, talk about safety in relation to homebirth, they usually are referring to perinatal mortality. While the birth of a live baby is of course a priority, perinatal mortality is in fact a very limited view of safety.

A reader, Houston Mom, jokingly described Dahlen’s approach as “Safety Third!” and the more I thought about it, the more apt it seemed as a motto for the entire natural childbirth movement.

Experience First!

To hear many midwives and natural childbirth advocates tell it, the first and most important priority is the mother’s birth experience.

As Caroline Bledsoe and Rachel Scherrer note in The Dialectics of Disruption: Paradoxes of Nature and Professionalism in Contemporary American Childbearing:

… As childbearing became safer and more benign visions of nature arose, undesired outcomes of birth for women came to consist of a bad experience and psychological damage from missed bonding opportunities. Today, with safety taken for granted, the new goal has become in some sense the process itself: the experience of childbirth… (my emphasis)

Specifically:

If nature is defined as whatever obstetricians do not do, then the degree to which a birth can be called natural is inversely proportional to the degree to which an obstetrician appears to play a role. The answer to why obstetricians are described with such antipathy thus lies not in the substance of what obstetricians do that is unnatural … but in the fact that obstetricians represent a woman’s loss of control over the birth event…

Many midwives and natural childbirth advocates certainly believe this to be so. Dahlen is shockingly explicit about this belief:

Women have told us there is something worse than death – there is being alive but dead inside. There is being so traumatised by pressurised interventions in their birth plan that … their own mental health is affected.

Worse than death??!!

Ask any woman whose baby has actually died and you will find that there are vanishingly few women who believe that there is something worse than the death of their babies. Dahlen’s claim doesn’t reflect reality, merely the central conceit of those in the natural childbirth industry.

Providers’ Experience Second!

The providers’ experience is dramatically more important in the midwifery/natural childbirth paradigm than in obstetrics. Even a brief look at the midwifery literature confirms the central role of the midwife’s experience. Several years ago I did an informal analysis of the papers in various midwifery and obstetric journals. I found that anywhere from 20%-50% of papers in midwifery journals are concerned specifically with the midwife’s experience, whereas only 0%-8% of papers in obstetric journals mention the obstetrician’s experience.

For many midwives, process is deemed more important than outcome and the ideal process is one that affords the midwife maximum scope for practice and profit. Natural childbirth has come to be defined as “anything a midwife can do” regardless of whether it happens in nature or not.

A rather bizarre confirmation of the centrality of the provider experience among natural childbirth advocates is the existence of counterfeit midwives who have awarded themselves the designation “certified professional midwife” or CPM. These women are laypeople whose only education requirement is a high school diploma, and they fail to meet the minimum international standards for midwives. Not only are these counterfeit midwives allowed to practice in nearly half of all US states, the organizations that certify and represent them have NO safety standards of any kind. Safety is simply not a priority for CPMs.

The other confirmation of the centrality of the “provider” experience is the importance of the payor experience. The British National Health Service is desperately promoting homebirth despite the fact that it is not safe for a substantial proportion of women and despite the fact that 95+% of women have absolutely no interest in delivering far from medical expertise or pain relief. No matter. The ability of the payor to save money (even if those savings are subsequently dwarfed by massive monetary payouts for injured and dead babies) is considered more important than what women actually want or what is safest for babies.

Safety Third!

These factors relegate safety to third position in the hierarchy of natural childbirth values.

Partly it’s because natural childbirth advocates are profoundly ignorant of the medical and historical realities of childbirth. Childbirth is and has always been, in every time place and culture, a leading cause of death of young women and THE leading cause of death of babies. Childbirth in industrialized countries in 2015 appears safe, but only because of the liberal use of obstetric interventions. Without them, childbirth is inherently dangerous.

Mostly, though, it is because many midwives and natural childbirth advocates actually believe that both the maternal experience and the provider experience is more important than whether a baby lives or dies. Not surprisingly, in cultures like UK midwifery where this ugly philosophy is allowed free rein, there are a never ending series of scandals involving preventable perinatal and maternal deaths followed by midwives’ attempts to cover them up.

Modern obstetrics is not perfect. No one knows that better than an obstetrician like me. But at least obstetricians have their priorities in order. Safety of mother and baby comes first. Period. That’s why female obstetricians choose liberal use of obstetric interventions for themselves and their babies. That’s what is safest.

The truth is that safety ought to come first. That doesn’t mean that the mother’s experience is irrelevant; just that it is not as important as her safety and the safety of her baby unless she explicitly claims that her experience is more important to her than whether the baby lives or dies. The providers’ experience ought to be irrelevant. The preferences of midwives ought to be no more important in the provision of childbirth care than the preferences of neurosurgeons in the provision of brain surgery. Making midwives’ experiences equal to or more important than safety is, in my view, grossly unethical.

Ultimately, it is up to individual women to decide what is important to them. If you prioritize safety (and the vast majority of women do), then safety takes precedence. Before choosing providers, you should understand for many midwives though it’s “Safety Third.”

  • The Computer Ate My Nym

    I’m not sure safety is third. I think statistics are third: No more than 15% c-sections, no matter how high risk the woman who would be the 15%+1st one. No inductions before 39 weeks, no matter how distressed the fetus. Low epidural rates, no matter how many women are denied pain control as a result. And so on. Which is odd given that they’re also all about “individualized care” and how the evil doctors in hospitals will treat you like a number.

    • Azuran

      Try no induction before 44+ week and the baby is dead.
      Babies know when to be born and if they die before, they just weren’t meant to live.

    • demodocus

      Yesterday I took my boy for his flu shot and the nurse administering it remembered me from the OB’s office. 2 years since I last was there. Must totally have been a number. *eyeroll*

      • Amy M

        My OB tells me every time I go for my annual check up that she’s sorry I’m not planning to have more children because she misses me. It’s been almost 7 years. Who knows, maybe she says that to everyone, but it still comes across as friendly.

  • Margo

    Load of cods wallop ……so much that is written here is interesting valuable stuff…and then you blow it by making statements like “safety third”…it makes me really cross.

    • Daleth

      Why does it make you cross? I see from your other comment that you “don’t know of one single midwife who would think, ‘safety third.'” But I don’t think Dr. T is saying that midwives literally, consciously think that. What she’s saying is that their actions and stated priorities result in safety taking a back seat to the mothers’ and the midwives’ “birth experience.” So they actually are putting safety third, even if they don’t think of it that way.

      • Who?

        And the midwives sit comfortably with that choice-when a leader in that community says:

        ‘While the birth of a live baby is of course a priority, perinatal mortality is in fact a very limited view of safety.’

        they are making it abundantly clear that safety for the baby is not the primary goal. And the more they say that, the better as far as I’m concerned, because it is at least a true reflection of their values, which will be of interest to someone considering purchasing their services.

  • Margo

    I do not know of one single midwife who would think “safety third” …..what a load do cods wallop.

    • Who?

      But they do say that perinatal mortality is a limited view of safety.

      I would have thought being dead-or seriously injured-is the opposite of being safe.

      • SporkParade

        Well, it is a limited view of safety. There’s also maternal mortality and morbidity. That’s the only reason we don’t automatically due scheduled C-section at 39 weeks for every birth. ;P

    • moto_librarian

      Until midwives begin recording their mortality and morbidity statistics and reporting them in a transparent fashion, I will remain unconvinced that they place any meaningful value on safety.

    • Stacy48918

      I can agree with that. They don’t talk about safety at all. Not in any meaningful, evidence-based way.

  • JJ

    This is so right on. I just had my first hospital birth (of my 4th child) 2 days ago and yes it was a less peaceful experience but since I knew it was the safest it was the way to go. I even got induced and chose an epidural. (I know, the horrors!) It went really well!

    Honestly, I did not like that I was hooked up to a lot of things or the busyness of the hospital. I chose safety first, I could not have been cared for better by the nurses and doctors, and I came home the next day with a healthy baby so I am thrilled. I also like that I had maximum care available to my child and I. I loved that I could choose strong pain relievers instead of only tylenol or homeopathy for the after pains, for example. Anything we needed/wanted was available instead of just herbs and positive thinking. I also liked having evidence-based care instead of woo. For example, I told my doctor I really did not want to go way overdue because the baby seemed big and I was worn out from pregnancy. She assessed that I would be a good canidate for induction and scheduled me. She did not tell me that I “could not grow a baby too big” or that babies should “choose their birthday”. I did not have to resort to the limited midwife options of castor oil and blue cohosh. Good thing I was induced because she was 9 lbs 6 oz!

    Anyway, my experience was great because I knew we were in the safest place possible and now I am cuddling my baby at home which was the whole point of getting pregnant anyway. I cannot imagine knowing the truth that homebirth was less safe and risking our very lives for any experience/bragging rights.

    • lilin

      Congratulations! You are one tough lady! I’m glad everyone’s safe, healthy, and happy.

    • Bombshellrisa

      Such wonderful news! Congrats on your baby and I am so pleased to hear that you both are doing well.

    • Mishimoo

      Congratulations!! So glad to hear things went well and that you’re both home again safely.

    • Amazed

      Congratulations and welcome to the newest addition!

    • fiftyfifty1

      Congrats!

    • Megan

      Congrats!

    • Sue

      Conograts and welcome to little baby JJ!

    • demodocus

      Congrats on the not so little newborn! 😉 Glad everything went reasonably well

    • Monkey Professor for a Head

      Congratulations!

    • Who?

      Congratulations! May sleep be in your immediate future.

    • araikwao

      Congratulations!!! So glad all is well

  • demodocus

    OT: my pregnancy test was positive. My insurance-lab did the wrong test, so the outside fertility clinic isn’t positive that it’s not a chemical pregnancy, but the woman I spoke with seemed to think my fortnight of nausea was a good sign
    Now if only the warmest grandparent response wasn’t “I’m happy if you’re happy”

    • Who?

      So pleased for you, all crossed everything goes well!

    • Mishimoo

      So happy for you! Hope everything goes well and you have an incredibly boring pregnancy. Sorry about the grandparent response!

    • Monkey Professor for a Head

      Congratulations, that’s brilliant news!

    • Megan

      Congratulations!!! I’m very excited for you. Sorry the geandparent response was lukewarm. Will a quantitative hcg test be done to confirm or is that what you had done?

      • demodocus

        Thank you. It’s what should have been done and wasn’t, if I understand correctly, so there’s still the chance that it’s a chemical pregnancy.

        • Megan

          Well, let’s hope that’s not the case. As someone who had repeated chemical pregnancies before a successful pregnancy, I know how horrible the emotional roller coaster is. I hope they will do a quantitative test for you to put your mind at ease. Please do keep us posted!

          • demodocus

            Provider was working on it when the fertility clinic called. I should get the answer tomorrow. Thanks! and I’m sorry about your chemical ones; they must have been hard on you

          • Megan

            Honestly, for as much as the chemical pregnancies sucked they did clue me in to my uncontrolled PCOS, which was then treated. Shortly after I got pregnant with my first daughter and now I am pregnant again and so far having a very smooth pregnancy. In some ways, my chemicals were a blessing in disguise because they got me the treatment I needed. Anyway, I hope you get your answer today. I’ll be thinking about you.

          • araikwao

            I hope we can be happy with you soon!

    • Hilary

      Congratulations and good luck! When I told my grandpa I was pregnant, he said “Congratulations, I guess.” 😉

      • demodocus

        My gramma would be excited, but her dementia’s pretty bad now. Gram always acquired extra kids/grandkids somehow

    • Amazed

      Congrats! That’s great!

    • Sullivan ThePoop

      Older people are funny to us. When my daughter was born my grandmother swooned over her and how beautiful she was and how newborns are seldom that beautiful. Then when I brought my son home she said, “Well, He is just as cute as he can be.”
      Then, we are probably funny to the next generation

      • demodocus

        MIL will probably show more excitement if there’s another girl in the family, that’s for sure. Soo many guys lol

    • The Computer Ate My Nym

      Congratulations! Crossing my fingers for this being more than a chemical pregnancy and for a healthy pregnancy with a healthy baby and mom at the end of it.

  • And informed consent last. The denial of a woman’s right to make a medical decision with informed consent that impacts herself and her child is appalling. The NCB community actively seeks to deny informed consent because of the discounting of adverse outcomes in homebirth settings. Further, I fear that due to lack of adequate training (in the US at least) – many midwives are not adequately equipped to provide the information women need. The numbers of women choosing homebirth would plummet if they were aware of the risk of severe outcomes at home (brain injury and death) relative to birth in a hospital setting. The numbers of women choosing vaginal delivery would also likely plummet if issues of pelvic organ prolapse, and severe obstetric tears were discussed. Too many avoid surgery at birth, only to need surgery later to correct the damage done from birth.

    • Roadstergal

      Wasn’t a UK OB quoted in an article that Dr Amy posted recently, saying that she didn’t give informed consent about the risks of VB to her OB patients, because then too many would make the ‘wrong’ choice and request a C-section?

      • Daleth

        Yep. And I believe that OB recently lost a multi-million pound lawsuit because her approach resulted in a perfectly healthy child becoming seriously handicapped as a result of birth trauma.

    • Anna

      For some reason they think the c-section is most traumatic of all, even worse than forceps delivery. Ugh. I was fine in a week after my surgical birth, whereas one relative of mine suffered a very bad tear and, yes, had to return to the hospital to fix it. She is very small, baby big, classical situation. Don’t know what her doctor was thinking about, no big deal perhaps, well, at least her baby was fine.

      • Joy

        I had forceps. I was fine after 10 days, but given the future implications, I would rather have had a c-section.

  • Stacy48918

    Very, very true. When my ex and I were arguing about homebirth vs. hospital birth he came right out and said it. His priorities were (1) homebirth, (2) vaginal birth, and he stopped there. I guess the baby and I were third?

    Other homebirthers I’ve known in person were the same way. They’ll go on and on about different aspects of the experience. They never really seem to get around to safety, not in terms that really matter anyway (life and death). They’re concerned about “false” ideas of safety (epidurals, interventions and C-sections) but can’t see the truth at all. And the ones making money off it, the midwives, encourage it. Sickening.

    • moto_librarian

      I’m so glad that you finally got away from him.

    • LizzieSt

      Wow. That is awful!

      My husband had a brief romantic delusion that I should give birth in our bathtub. Happily, once I showed him the homebirth death rates, he dropped the idea like a hot potato. He’s a romantic, but not an idiot.

  • Cartman36

    One of the commenters yesterday made a comparison to aviation and I think it is especially fitting here as well. Can you imagine if a commercial airline was more concerned with passenger and crew experience than safety? One of my recent flights was delayed recently for over 5 hours waiting to receive a part and then for maintenance to install said part, rerun ground checks, etc. I was annoyed at the delay but I recognize the airline was more concerned with the flight safety than getting me to my destination on schedule.

    • The Computer Ate My Nym

      I agree. Though to continue the analogy, it would make sense for the airline engineers and/or executives to sit down together and say things like, “Delays for mechanical failures are annoying the passengers. Is there any way we can reduce the number of times passengers have to wait for mechanical problems to be fixed without compromising safety?” and then maybe brainstorm things like more frequent scheduled maintenance, discussion with the airplane manufacturers about how to improve reliability of particularly failure prone parts, etc.

      Similarly, it might be reasonable for OBs to say, “Emergency interventions are frightening, increase recovery time, and introduce a small risk to patients. How can we reduce the need for emergency c-sections, episiotomies, etc?” and then maybe think about clinical trials to see if, for example, ultrasounds assessing position, shoulders, and head size at the start of labor could identify babies at high risk of shoulder dystocia who might be better served by a semi-urgent c-section rather than waiting for the dystocia to occur or something similar.

      OTOH, the CPM approach of “maintenance delays annoy passengers so let’s stop doing pre-flight checks” is clearly only going to result in more crashes.

  • Sarah

    I hear very little from Hannah about women who are traumatised following denial of intervention in their births. I’m certainly not going to say it’s worse than being dead. Pretty sure it isn’t. It’s not fun, though. Hannah, if you’re reading this, where are your articles about those of us who still suffer because the epidurals we needed were withheld?

    • SarahSD

      NCB ideology cuts both ways.

    • And those who desired caesareans but were denied. Birth trauma is not solely the domain of those denied their “natural” experience…it is also the domain of those who got one when they did not desire it, or who lived with the aftermath of putting the process ahead of the outcome.

      • SporkParade

        Then there’s also the unacknowledged birth trauma of those who, due to time and place, simply didn’t have access to interventions. I know women who vaginally delivered breech babies and twins without any interventions, including pain relief, after going into labor naturally. It pisses me off that NCB zealots feel free to demean these women and their experiences by pointing to these births as “better.”

    • JJ

      So true. After having an epidural with this baby I am so upset that I did not have one with my first. It was so painful but I did not get one because of NCB LIES about their safety. All the needless suffering for what?

    • Sue

      Interestingly, you hear very little from Hannah other than her articles – she never engages in the comments on TC.

  • LizzieSt

    Although working as a Maternity/NICU social worker was very traumatic at times, and I still have unpleasant flashbacks about it, I am forever grateful for the experience. Why? Because it vaccinated me against all of the natural childbirth / natural parenting rhetoric that is currently infecting many of my contemporaries (over-educated 30-somethings). The evidence appears on Facebook every day: Someone I knew from high school is still terribly disappointed about her C-Section, even though it resulted in an adorable, healthy baby, because she believed her child’s birth was not “natural” and that she missed out on “critical early-bonding moments.” And then there was another former high school friend who posted a bit of nonsense from an Australian mommy site about how sleep training is equivalent to child abuse. It’s everywhere! And without my professional experience, I might have fallen for it, too.

    But now I never will. Now my only birth plan is this: “Mother and baby both survive birth. Also please do anything you can to avoid brain damage. Thank you, OBs, CNMs, and nurses, for all that you do.”

    • OttawaAlison

      The bonding hysteria has gotten worse over the last decade too. Back when I was pregnant with my eldest in 2005/2006, the bonding was supposed to come from breastfeeding (weirdly enough I’m well bonded to her even though she was mainly formula fed and I had a csection with her). Now it is supposed to come from immediate skin to skin (something I didn’t do) because I needed to be looked after, I couldn’t look after my baby right away)… I’m just giving this the whole side-eye.
      As mentioned below, I lose my second daughter, and the amount of love I feel for her even without being able to hold while she was alive and raise her is immense.

      • LizzieSt

        I am very sorry for your loss. I remember each and every one of my infant-loss parents, mothers and fathers both, very clearly, and I always will.

        • OttawaAlison

          I know it’s hard for the staff to see as well. I’m planning on sending a basket to the nurses and obgyns at the labour and delivery unit on my daughter’s first birthday.

          • LizzieSt

            That’s a beautiful idea! I’m sure they will love the gesture.

      • SporkParade

        I was just in a Facebook conversation where a pregnant woman was freaking out that she had “done something wrong” and risked her ability to breastfeed because she didn’t insist on skin-to-skin instead of letting the nursery do all the post-birth tests on her first kid. Even though she had no problems breastfeeding. And liked having several hours to recovery from a difficult labor. It’s really gotten crazy. Sorry to hear about your daughter.

    • Mel

      Your HS friend is partially right: Her kid’s birth wasn’t natural. In nature, the baby would have died and there would have been a very high chance of her dying.

      Your HS friend is partially wong: She didn’t miss out on “critical early-bonding moments” because she is not a sheep. If she was a sheep who missed the bonding window, she would literally refuse to acknowledge her baby’s existence and kick / headbutt the baby when it tried to nurse. Since she hasn’t left the baby at the hospital or in the middle of a mall, or wherever, I’m wiling to bet she’s bonded to the kiddlet and the kiddlet has bonded to her.

      I’m thouroughly over the whole nature/bonding crap.

      • LizzieSt

        I have seen mothers spend weeks in intensive care after birth because something went frightfully wrong during labor. They bonded to their babies just as well as any other mother I have seen.

        • Montserrat Blanco

          Yes, somehow I bonded very well with my baby even thought I did not even see him for more that 24 hours nor could I hold him for more than 48 hours after his birth. He recognized me very well too.

    • Sue

      Insight is so valuable.

  • Mel

    I only disagree about one point: I don’t think NCB deserves to get safety third.

    Let’s be honest: Safety isn’t on the radar.

    Home birthing is first and foremost about feelings. Feeling safe from anxiety, feeling safe from uncertainy and feeling safe from judgement seem to be high on the minds of most HB moms. HB midwifes – well, I don’t know what’s going on there, but I suspect it’s a feeling of power, a feeling of competence and a feeling of control.

    When you combine those two sets of feelings with minmal education in human reproductive health, you get a system so dysfunctional that no one utters concerns about an unattended child-birth after 3 cesarians.

    • demodocus

      Ironic, since radar is in every ship and airport for safety reasons.

    • SporkParade

      For people who are obsessed about birth without fear, these folks sure are afraid of an awful lot.

  • SarahSD

    I fear that there continues to be cognitive dissonance for most
    NCB-aligned expectant parents, who want to believe the nice story that
    natural is safer and better and that interventions are the cause of all
    problems and the real source of risk. This story lets them feel
    justified in prioritizing the birth experience over all else, because
    they are convinced that to prioritize birth/birthing parent’s experience
    is not in contradiction with prioritizing the baby’s safety. No-one
    wants to feel like they are being totally selfish. It also gives them a
    false feeling of control over a scary situation. This is exactly why it
    is so important to keep pushing the real safety data and reveal the
    flaws in the NCB rhetoric.

    I am glad that it is becoming harder for the NCB industry to continue pulling the wool over expectant parents’ eyes by convincing them that homebirth/natural birth is “as safe or safer” than hospital birth. Given the overwhelming evidence that shows otherwise, they are forced to backtrack and reveal their core priorities, which are embarrassing.

    • LeighW

      I never understood the “homebirth is safe” mentality.

      Anything is safe as long as nothing goes wrong.
      Anything is safe enough as long as everything goes according to plan.
      But nature doesn’t give a sh*t about plans.

  • demodocus

    Do they not read history books? In any pre-WWI biography there are references to loosing newborns and young wives all over the place.

    • OttawaAlison

      I have a history degree and that made me suspicious of the woo… It just didn’t make sense.

      • demodocus

        Mine’s only a bachelor’s in history, but yeah, me too.

        • OttawaAlison

          Same here!

          • Amazed

            You’re just brainwashed by your education. History professors are also in the pocket of the Big Pharma.

          • OttawaAlison

            Hmmm, maybe that’s why my syllabus was sponsored by Merck 😉

          • Empliau

            Would Merck like to brainwash some literature students? I could use the money ;).

          • araikwao

            I’m almost finished my medical degree, and not one cheque!!

    • LizzieSt

      I once asked a natural-birth advocate this. Her reply: “Oh, but those mothers and babies died of infections, because doctors and nurses didn’t wash their hands back then. Now everything is so clean and sanitary, so you see there is no danger at all!”

      And then my reply: “But so many other things can go wrong. Shoulder dystocia. Hemorrhaging. Pre-eclampsia!”

      NCB reply: “Yeah, yeah, sure you would say that, you work in a hospital! Those things almost never really happen.”

      Me: “…………………………………” (Because how do you keep arguing with someone like this?)

      This is very similar to the anti-vaccination argument: “We don’t have polio or smallpox anymore because now we have clean water and food and improved sanitation. Vaccines had nothing to do with it!”

      A complete, willful denial of reality. That’s what it is.

      • Mel

        Well, yes -and no.

        Pre-WWII, a lot of women were polished off by infections. Yes, many of those were caused by poor hygiene prior to ~1900, but prior to -1950 most of the deaths were due to the absence of antibiotics. If you are birthing at home, you still have a small risk of contracting an infection. You also have a much higher risk of postponing treatment because no one is monitoring you and/or your baby.

        The absolute probability of a shoulder dystocia is very low. Statistically speaking, the chances that any woman will have one is pretty negligiable. It’s not a great way to make a decision, though, because if you are that woman who has a shoulder dystocia the risks of catatrophic injuries to the baby are very high and your rate of maternal morbidity climbs.

        Hemorrahage and pre-ecclampsia are not rare. PPH runs at just under 4% and pre-e runs between 3-6%. Considering PPH can kill in minutes and pre-e can become ecclampsia – which kills the mom, just in a more slowly and agonizing way, I would be very afraid of either – or both – if birthing at home.

        Plus, my mom developed the rare post-natal pre-ecclampsia. My twin and I were born around 9am. A nurse took Mom’s BP in the evening and found it was at >200/>100. Whenever I read about women leaving birth centers within hours of birth, I wonder how many of those women understand the risks of late PPH or late-onset ecclampsia.

        • Liz Leyden

          I was hospitalized with pre-eclampsia 10 days after delivery. I was a first-time Mom with a lot going on (twins, open-heart surgery for my daughter, a temporary move, a job interview 7 days post-partum). My b/p was in the 170s when I called the OB attending, and got as high as the 190s.

          Knowing what I know now, it’s terrifying. Most pre-clampsia deaths occur postpartum, The only signs were a headache and swollen legs. I only got help because my sister in law suggested I might have cellulitis.

          • FormerPhysicist

            Uh me, too. Just the after delivery pre-E. It’s rare? To be fair, I had pre-E, or on the edge of it right before delivery too. But also about 12 days after. Went to my OB for post-partum checkup. Go directly to hospital, do not pass go.

          • Shawna Mathieu

            Yipe. I basically had subclinical postpartum pre-eclampsia – I was about one point off on the 24hr urine test. I thought the swelling was just normal post-delivery stuff. It wasn’t until I went to see a doctor for a routine checkup that I found out my blood pressure had skyrocketed.

        • Sue

          We also know that the major causes of intra-partum death today are the same as what they always were: obstructed labour or bleeding. Not infection.

        • Linden

          My BP was under 110/70 for the entirety o my pregnancy. Systolic climbed to at least 180 after the birth. I don’t know if that counts, as it came back down again after some hours.

      • Sue

        Sure. Just like “it’s not vaccination that got rid of polio – it was sanitation and nutrition”
        but, but

        – Polio now gone in India, still areas of poor nutrition/sanitation;
        – HiB now gone since 1980’s – no change in sanitation or nutrition.

        Sigh.

    • AirPlant

      I have had internet strangers tell me that those references are just to add drama to the story and not at all a reflection of reality. It hurts my brain.

      • demodocus

        Do they also believe the government is vaccinating and/or poisoning us through airplane contrails?

        • Amy

          Surely you mean CHEMtrails!

          • demodocus

            Natch

        • Amy

          Also don’t forget fluoride!

  • OttawaAlison

    I can’t reply to any of this without my blood pressure rising and me swearing a million times.
    I’m a loss-mom who lost a baby at 37 weeks in utero (I chose conventional medical care, unfortunately science isn’t there yet to have been able to prevent my daughter’s death). Grieving a baby is the hardest thing I have ever done. It is an enduring pain and loss. I’m only 10 months out, and I am dealing and coping with the pain most of the time, but the reality is it is just under the surface.
    My epidural, csection and formula feeding my eldest have nothing on what I am dealing with now (btw – I see nothing wrong with epidurals, csections and formula feeding).
    What upsets me with the trust birth crowd is that the majority of them aren’t living the reality of being a loss mom so they can recommend whatever the hell they want. When a baby dies, they can just spout platitudes because they do not understand the hell that is losing a full-term baby that under different circumstances should have lived (my daughter appeared normal, I suspect my placenta crapped out – hopefully science will prevent deaths like hers in the next decade).

    • SarahSD

      I am so sorry. Their ignorance is beyond infuriating.

    • Megan

      I am so, so sorry that you had to experience that. I have not lost a child myself but I have helped with the care of a mom with a story very similar to yours. That doesn’t mean I claim to understand how you feel, of course, but I do know that caring for that mother affected me deeply. Thank you for sharing your story and your much-needed perspective.

    • LizzieSt

      I am very sorry for your loss. And you’re absolutely right: Most of the people who crow about the superiority of “natural birth” have never been through what you have been through.

    • Daleth

      I’m so sorry.

    • moto_librarian

      Losses like yours are what make me keep speaking out against the lunacy of the NCB movement.

    • KeeperOfTheBooks

      I am so very, very sorry for your loss.

    • Anna

      I am so sorry. It is heartbreaking. I can imagine how you look at these discussions about birth experience under an entirely different angle now.

    • OttawaAlison

      Ironically? While I stepped into the woo a bit a little while after I had my eldest daughter (which required a shitload of cognitive dissonance), by the time I was pregnant with my second I was very much like “just give me a csection. All I want is a healthy baby). I had met loss moms, I was no longer under the illusion that it “will all work out in the end”. Then my baby died, it was absolutely my worst nightmare and I don’t want to forget, the pain reminds me how much I loved her, but I still wish dealing with this was easier. It’s not, it’s like losing a limb.

      • Sue

        Thanks for telling us about that, Alison. So sorry for your suffering.

  • Erin

    I am one of those unfortunate women who experienced the trauma of a stillbirth. Mine was not preventable (34 weeks complete placental abruption r/t atypical acute presentation of preeclampsia) and I went into HELLP syndrome shortly after I came into the hospital. I had no warning and I had no idea what was going on (all the bleeding was contained behind the placenta and promptly clotted off. I never saw a drop of blood to clue me in). The hospital (where I actually worked as an L&D nurse) saved my life, though it was too late for my baby. I was considered a textbook low risk patient until I got struck by the proverbial lightning. So, it baffles and offends me when women place their experience on a pedestal over the safety of their baby. All this “trust birth” and it’s “natural” and “we’re made to do this!” You can’t look me in the face and tell me, after what I’ve been through, the process is as important as the outcome. I don’t care how little risk they think there is. I’ve been handed my dead baby. It’s a horror no mother should ever have to experience if it can be avoided. Not. Even. Once. To suggest otherwise is, quite frankly, spitting in the face of women like me.

    • demodocus

      Mom was low risk too when she lost her first at 8 months along. She’d occasionally speak of her, but very rarely. I suspect it hurt too much.

      • demodocus

        She also never shared her emotions when she went into labor with her 2nd (me) at 7 months along. At least not to us kids

      • OttawaAlison

        It is a horrendous pain. Unfortunately for about 100 years women have been discouraged from talking about it, only recently has it come back into view that women do have stillbirths. I also had a huge sense of shame when I lost my daughter. I have overcome that though and speak to people about it. I want to honour the baby girl I lost.

        • Amy M

          I’m so sorry. You shouldn’t feel ashamed, and it sucks that culture set you up for that. It wasn’t your fault.

        • Roadstergal

          I’m so sorry for your loss. You so clearly loved her, and honor her by expressing that.

        • Sue

          Alison – you are honouring her by your story here. Thank you for the insight you bring.

      • Roadstergal

        After my mom died, my dad told me about a pregnancy she lost between my oldest sister and my brother. He wasn’t able to give too many details, because he simply fell apart just mentioning it. Over 20 years and three healthy babies later, it still seemed like a fresh wound.

      • Sue

        My M-I-L – now in her 90’s, occasionally talks of the pain of loss of her first stillbirth. In those days, the baby was whisked away and the young woman was told to “get on with it.” Clearly that strategy didn’t work – the women just buried the hurt deep inside.

        • KarenJJ

          My friend is one of 3 siblings, but spoke to me once about a fourth that died at birth. The family still say a prayer together at Christmas about the baby.

    • OttawaAlison

      I’m so sorry, I am a loss mom too… It is a hell I wouldn’t wish on anyone 🙁

      • Erin

        It is unimaginable pain. Words can’t adequately express it. I am sorry you went through it as well. I wish I was the only one, but sadly, there are enough women out there like us. Sadder still, are the loss-moms who never should have been so.

    • prolifefeminist

      Erin, I am so, so sorry that you lost your sweet baby. What a horrible shock it must’ve been, especially without any sign that anything was amiss. I’m glad you survived but I’m so sorry for your loss.

      Why more people don’t realize how risky pregnancy and childbirth really are is a complete mystery to me. I nearly lost my son to a partial abruption (post-MVA at term). I didn’t have any bleeding either (the only sign was a continuous, mild cramp, and later on fetal heartbeat irregularities – and of course the hx of a MVA). I was already in the hospital being monitored and a crash c-section saved his life. I remember thinking as I was rushed into surgery that I would give ANYTHING in the world to save him. How could anything put a “birth experience” before their baby’s life? It’s completely insane.

      • Inmara

        So fortunate that you and baby were lucky and saved by contemporary medicine!
        When talking with moms in our postpartum room I realized that I’m only one who has a clue about most possible pregnancy and childbirth complications and necessity of particular interventions. Other moms just deliberately didn’t want to know – some because they trusted health care providers, some because of belief that “negative thoughts may attract negative outcomes” (yeah, that much of woo). With all due respect to my gynecologist, having appointment once a month is not enough to catch early signs of many problems so I wanted to know what could go wrong and what signs should I be looking for.

      • Erin

        I am so happy your outcome was positive! Yes, to loss-moms and mom’s of scary near-loss, the worship of experience over outcome makes no sense. To the point where it does cause angry for me and my dear husband, who wanted to be a father more than anything. We’ve talked about the insanity of natural and homebirth woo and he said it best. “It’s like shards of glass in my head.”

    • Megan

      I’m so sorry you went through that. You’re right; the NCB crowd really doesn’t get it.

    • Daleth

      I’m so sorry!

    • Roadstergal

      I’m so sorry for your loss. 🙁

    • moto_librarian

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

    • Inmara

      So sorry for your loss.

    • The Bofa on the Sofa

      Erin – your story highlights just how insensitive this whole idea is. What message do statements like “Trust birth” and “Your baby knows when to be born” send to parents who have lost babies like you, or my sister, who’s first was stillborn at 41 weeks? Did he not know when to be born? I guess not.

      It’s just like the very clear message that adoptive parents can’t bond with their kids because they didn’t have them naturally or breastfeed. Could you be any more insulting? I’m sure they could…

      • Anj Fabian

        Their response to those complications is:

        “Those things do happen, regrettably. But they are very rare, so you don’t need to worry about them..”

        If it’s something common like PPH or shoulder dystocia, then they switch to:
        “Midwives are trained and know exactly how to deal with those situations!”.

        • D/

          And if (or rather when) the worst comes to pass their necessary attitude may move more along the lines of this behind the scenes shop talk on professional responsibility that I ran across a while back:

          “The hospital doors is an intervention. While working as a doula birth was horrifying and I had to keep reminding myself birth is safe and reflect where it unraveled. Your midwife can’t save you or your baby. Babies do die. Moms do die. No matter where you birth YOU and only YOU have to take responsibility for yourself, your baby, and your birth. No one can save you. You are not guaranteed a life. In fact you are guaranteed more to loose your baby in hospital, than out.”

          I’ve actually come across a number of these type of discussions in home birth professional forums, and while my on-line tone interpretation may not always be spot on, more than a few of them have come across as a seethingly angry, “YOU, and only YOU, are responsible for your own and your baby’s life (and death), period” delivered through bared teeth.

      • Roadstergal

        Or crudely eugenic?Could you be any more insulting?”

        Or crudely eugenic?

      • Erin

        They cling to their rhetoric in the face of stories like mine. It’s like sticking fingers in their ears and going, “Lalalala!” Accepting the truth is too uncomfortable for them.

    • I am so sorry for your loss.

    • Anna

      I am so sorry. People want to pretend such things don’t happen because they are scared. They burry their heads in the sand.

  • Mariana Baca

    To hear them talk, I think they actually put provider’s experience first, and mother’s experience second. Otherwise, they wouldn’t deny/delay transfer when a mother decides to get pain relief or feels something isn’t right.

    • sdsures

      That would explain stories where the midwife never actually shows up.

    • MaineJen

      Not only is their experience put first, but they actually expect the laboring woman’s family to feed them, right? (From some of the stories I’ve read)

      • Bombshellrisa

        That is true. The “birth crew buffet” is pretty real around here. Moms knock themselves out providing snacks for the birth photographer, doula and midwives as well as the student midwives and any family and friends who are going to be there.
        Most midwives will make sure there is a place for them to nap too.

  • Gene

    Having taken care of many neurologically devastated kids, I can assure you that some families believe there are things worse than death.

    It is only when things become so safe that we never hear about the bad that safety drops in rank.

  • moto_librarian

    I am particularly angry today. A family that I know IRL chose to have their third baby at home, despite having positive experiences with hospital-based CNMs with their older children. The baby had a shoulder dystocia, and was transferred 15 minutes after delivery. He was already having seizures, and spent three days under cooling therapy, plus a week in the NICU. They are just now beginning to wean him off of anti-seizure meds. He seems fine, but only time will tell. I wish that I had asked the mom if she was sure that she wanted to have her baby at home, but I was sure that she wouldn’t want to hear it. Given that we know that MANA doesn’t track morbidities like this, I find myself wondering how many other families out there are suffering because of the outright lies told by people like Hannah Dahlen.

    • prolifefeminist

      Probably a lot of families out there are suffering thanks to people like Dahlen and the whole crew at MANA who can’t be bothered to properly track the long term outcomes of the birth practices that they’re pushing on American women.

      • moto_librarian

        Next time I see her, I am going to try to find a way to tell her that if she needs some support, there are groups that can help. I would guess that she’s in that awful position where all of her NCB friends don’t want to hear about the trauma of her home birth, yet she feels certain she’ll be judged by mainstream people. I feel awful that this happened to her, and I hate that I didn’t speak up. I don’t know her very well, and I just couldn’t summon the courage to say anything.

    • prolifefeminist

      And that really sucks about your friend’s baby, moto. Poor little guy. :.( I hope he doesn’t suffer any more long term.

    • Megan

      I’m sorry to hear about your friend and her son. I really hope the little guy is OK.

    • SporkParade

      I’m not sure you really could have convinced the otherwise. I Facebook-know someone waiting to have a homebirth despite having had a rapid first labor and a family history of precipitous second labors (both her mother and sister gave birth within 2 hours of the first contraction). Her biggest concern is remaining close enough to home that she doesn’t end up giving birth in the car.

  • Anna

    Immature, self-obsessed and narrow minded people. To not want to live because of a not-so-nice birth experience is about as absurd as killing oneself because one got few likes on Facebook.

    • mythsayer

      I think they have this thought that since only women give birth it should be this super powerful/empowering event… I don’t base my worth on being able to pop children out, though. Why the hell would I want to be in extreme pain if I don’t need to be? I never thought a vaginal birth sounded like a good idea. I literally had no desire to have one. But these women seem to think that if they don’t show the female power through childbirth, they are nothing. They literally seem to base their self worth on this one experience. It’s just stupid IMO. Just get the baby out safely.

      I mean, don’t get me wrong, I hate having bad experiences with doctors. And i certainly don’t want to be traumatized during any surgery by a mean Doctor. But a lot of times, I feel like they bring it on themselves with ludicrous demands. Doctors must roll their eyes at these five page birth plans. Flexibility will likely net you the best experience possible. And if you have a bad one, get a different provider next time.

      Me, I just requested a CS, which was awesome because I was able to pick the date and have a lot more control over everything.

      • Erin

        A lot of these women are just looking for something to grasp on to, something so make them feel special and important. Some kind of validation that they are a superior class of woman and mother. (I don’t mean women who choose unmedicated birth, necessarily…just the ones who put this absurd amount of emphasis on the “experience” even to the detriment of their child.)

        • The Bofa on the Sofa

          I always think of that quote from Cheers when Lilith was pregnant and went all “earth goddess”…something like

          “A spider gives birth a thousand times over, but you don’t see it making an ass of itself in front of its husband’s friends”

          And Carla comes running out of the office yelling, “I don’t know what they did with the birth goo!”

          • Roadstergal

            The stray cat wandering around the house we bought gave a fully natural our-home birth right under the eaves shortly after we moved in. We caught her, fixed her, and released her. She still hangs around our front yard a lot – the back is now the property of the dogs – and never brags about her drug-free UC delivery.