Is this pitiful response the best homebirth midwives could offer?

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I’ve been waiting eagerly to see how CPMs (certified professional midwives) would respond to my piece in The New York Times Sunday Review Why is American Home Birth So Dangerous?

I made several points in the piece:

  • Homebirth is relatively safe in Canada and other countries.
  • The US homebirth death rate is 3-7X higher than comparable risk hospital birth.
  • Most US homebirths are attended by CPMs a second, poorly educated, poorly trained class of midwives that do not meet international midwifery standards.
  • If we want to ensure safe homebirth we should start by abolishing the CPM credential.

Abolishing the CPM and requiring all midwives to meet international standards is the first step to making US homebirth safe.

The Midwives Alliance of North America (MANA), the organization that represents homebirth midwives has responded … sort of.

They wrote a lot of words, they raised a lot of irrelevant points and they did not address the central issue, the fact that CPMs don’t meet international midwifery standards.

MANA President Marinah Valenzuela Farrell wrote Women Are Choosing Home Birth: The Infant-Maternal Health Care System in the US Owes Them a Safe Option.

Yes, and a safe option would mean abolishing the CPM and requiring ALL midwives to meet international standards.

Ms. Farrell is a case in point. As far as I can determine [please correct me if I am wrong], she has no formal midwifery training of any kind, no midwifery school, no midwifery degree, no hospital training, nothing.

How does Ms. Farrell address my four points in her response. She can’t, so she doesn’t even bother.

1. How does Farrell address the disparity in homebirth outcomes between the US and other countries that have relatively safe homebirth?

She ignores it.

2. How does Farrell address the statistics and citations in my piece demonstrating the higher death rates at US homebirth?

She doesn’t.

Critics of home birth cite flawed birth certificate studies and highlight relative instead of absolute risk. The State of Oregon has recently made an important leap forward by creating a birth certificate that captures the intended place of birth as well as provider type.

That’s EXACTLY the birth certificate data used to compile the statistics that I quote from Oregon show that planned homebirth with a licensed CPM has a death rate 800% higher than comparable risk hospital birth.

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The data was compiled by Judith Rooks, CNM MPH, a noted homebirth advocate. Rooks’ testimony before the Oregon Legislature is damning:

Many women have been told that OOH births are as safe or safer than births in hospitals…

But out-of-hospital births are not as safe as births in hospitals in Oregon, where many of them are attended by birth attendants who have not completed an educational curriculum designed to provide all the knowledge, skills and judgment needed by midwives who practice in any setting.

3. How does Farrell address the fact that CPMs don’t meet international standards for midwifery education and training and would not be considered midwives in Canada, the UK, the Netherlands, Australia or any other industrialized country?

She ignores this critical fact.

Farrell writes:

Families deserve the support of a provider that meets international standards.

But she neglects to mention that CPMs don’t meet those standards.

Judith Rooks, in a 2013 interview, asked pointed questions about the CPM:

The lingering questions then become why are the minimum standards so low, especially in comparison to counterparts around the world? Why is it acceptable for midwives to aim for the cheapest, quickest route instead of striving to be their best? Why are the “certifying” bodies (ie NARM/MANA) keeping the bar so low…as in only requiring a high school diploma as of 2012 instead of requiring a college level education to deliver our babies?

Why, indeed?

The answer is that there is a group of laypeople, Marinah Valenzuela Farrell among them, who can’t be bothered (or don’t have the academic ability) to get a real midwifery degree, so they practice without one … and the results are deadly.

I do agree with Valenzuela Farrell on one point, though.

The US healthcare system should do everything possible to ensure that American women who choose homebirth have access to the same level of safety as Canadian, Dutch, British and Australian women who choose homebirth.

That’s why we must abolish the CPM and require all midwives to meet international education and training standards.

It will put women like Marinah Valenzuela Farrell out of business and that can only be a good thing for American babies and mothers.

  • Breaking Rank

    Ok, I read the article, I am a US Licensed Midwife. It is a credential that is given by a few Staes that requires a Three Year Degree. I won’t go into the details. But its not a CPM nor Lay Midwife, which in my State is Illegal. That being said, I find NO ISSUE WITH DR AMY’S ARTICLE! And I have found plenty issues with much in the past. However… much needs to change in the United States before Home birth Midwifery becomes a truly safe alternative and on Par with the European Model of care we so like to Tout in our little circles.
    The problem begins when we take our rules and regulations and decide we know better and practice outside the law. This is rampant. And this is in a State where we are Licensed AND Regulated!!! There is little to no oversight. If we are perfectly honest with ourselves and the public we will begin to say what we have witnessed and experienced. In my training I experienced or heard
    the following;, use of Cytotec given to women in labor without their knowledge ( informed consent? Ha!) Dangerous in a hospital setting and Russian Roulette in an out of hospital environment. Use of Kiwi ( Again outside the law). Pitocin administered as a tincture,tea, sub q injection ( Again given to unsuspecting mothers without informed consent, telling them its a tea or a tincture or a little homeopathic shot) or I have come to know recently IV administration to augment labor, this can and does KILL BABIES…. ( AGAIN AGAINST THE LAW!!!!!! THESE ARE IN OUR POSSESSION ONLY TO ADMINISTER POST-PARTUM).
    Women taken into care that are obviously flying “under the radar” such as women that have had custody of prior children taken from them. Women who are or have recently been drug addicted. and the list goes on and on.I trained in various settings under multiple midwives and locations. I have spoken to student midwives and graduate midwives that verify this same experience. This is not an exception. If Midwifery is going to go forward and become safer, then a serious conversation is going to have to take place within the Ranks. Because the reality is that while there are some midwives( these are a shockingly small number, but boy do I have an ENORMOUS RESPECT FOR THEM) that are practicing within the law, and within their capabilities, there are a shockingly high number that are not. I have lost most of the respect that I held for this profession. I came into this with a passion that was founded and based on what I saw and still view as a high amount of unnecessary intervention in labor, and wanted to offer an alternative. Too much coercion ( see; I do disagree with Dr. Amy) and not enough respect for the process of labor and the laboring mother. Thats where I came from. But what I have witnessed and heard about among our ranks is even more offensive than anything I ever witnessed in any hospital setting. And I witnessed much that I found upsetting and disturbing. But I am sad to say that I have found no less among the Home Birth Midwifery community. I find this even more of a violation, I say this because these women come to us with a complete trust that we will care for them in a natural and holistic manner. That we will be honest with them. WHERE IS THE HONESTY WHEN YOU SLIP THEM CYTOTEC/ OR PIT? Where is the care when they go beyond their 24 hr mark, and you have a failure to progress, and you should transport but you don’t, inspite of clear signs that you have a mother that is showing maternal exhaustion, and therefore all the immediate post part complications that ride shotgun with that. Or even keeping women in care whose lab values are not inside the Guidelines and the complications that could come from that? I imagine that a large reason that our European Counterparts have such great outcomes is the fact that they transfer/transport care appropriately. They abide by the law. Perhaps if we begin to do so, and we stop transporting train wrecks, we can one day garner the respect that our European Counterparts have earned.
    But as long as we continue to deny these facts, as long as we continue to discuss all the wrongdoing that goes on around us , all the “rogue midwives” while we do nothing about it, nothing will change. We have a real problem here, and its not “them’ it’s “Us”.

  • Breaking Rank

    OH BOY AM I EVER GOING TO BREAK RANK! Hopefully I can post anonymously… cause they will surely hunt me down.

  • Meaghan

    I appreciate that you make a distinction between home birth attended by regulated Registered Midwives in Canada and those attended by CPMs. Many Canadian studies have found that homebirths attended by Canadian RMs in low-risk pregnancies actually have the same rates of morbidity and mortality as births in hospital. However, I would like to point out that Canadian Registered Midwives are provincially regulated and not federally or internationally regulated.

  • Amazed

    Clearly not. The pitiful whiner by the name of Rita Laubert Ledbetter is currently thumping herself in the chest on Navelgazing Midwife’s page that she’s a person with strong feeling of justice so she wouldn’t condemn all CPMs because many of them do much good. Give them another chance, she’s pleading. That sounds better.

    Of course, this chance has to come at the expense of mother and babies but that doesn’t worry Rita’s just heart. Why should it? After all, she happily lies that Dr Amy has no influence in ACOG. I guess she was busy wiping the tears of a good and great CPM who was hurt by her profession being called imcompetent, so she had no time to follow Dr Amy’s speech at the ACOG’s annual conference.

    The Ritas of the world are an even bigger disgrace than the Gma Gardners. (Remember her? She came here to brag that she was a Midwife with a huge amount of knowledge. Clearly, it did not cover spelling meconium right.) They know that CPMs hurt mothers and babies but they’re ready to let this go on until CPMs get their act together and actually become qualified. How many more years is she ready to give them? They’ve already had more than thirty!

  • Mab

    Looking at the CDC Wonder stats for 2007-2013, I could not find any evidence to substantiate the assertion that planned home birth is unsafe–unless an MD is in attendance. The numbers all indicate–or suggest, when the cohort is too small for statistics–that CNM’s in or out of hospital are the safest bet, followed (and sometimes surpassed) by non-CNM midwives. MDs have horrific stats in out of hospital births, probably because their training is intended for hospitals. Most compelling: the numbers clearly indicate that an unplanned birth–I.e., no or late prenatal care–, in or out of hospital, carries the highest risk. Prenatal care seems to be the most important factor in reducing infant mortality.

    • Amazed

      Really? Would you show us how you reached this very interesting conclusion? It’s definitely NOT what any numbers show.

      Prenatal care and INFANT mortality? Do you even know what infant mortality mean?

      Anyway, your post was very informative. Thanks for illustrating how non-CNM midwives delude women gullible or uneducated enough to take them to their word. Thanks you.

    • Montserrat Blanco

      Well, I did look at the CDC database and found out something very different. What would be a good sample size for out of hospital birth according to you? What method have you used to get that number? The p-value is one sided or two sided? I am guessing for your message that it must be two sided since you assume that out of hospital birth might be safer than hospital birth. I am very interested in your answer.

    • swbarnes2

      What limits are you putting on the data set? Are you limiting to deaths in the first month? Only babies at least 37 weeks? Only babies at least 2500 grams?

    • Charybdis

      What is your thinking behind your statement of ” unplanned birth–I.e.no or late prenatal care”? And how can giving birth in a hospital, planned or not, carry the highest risk? Please explain these outlandish claims; we’re all agog.

    • The Computer Ate My Nym

      What parameters are you using? Are you including infant mortality (28 days to one year)? Infant mortality, as opposed to neonatal, is more indicative of pediatric than obstetric care.

      Using the parameters maternal age 20-44, at least 37 weeks GA, at least 1500 grams, mortality in days 0-27, “all” on every other category (in other words, eliminating ONLY premature birth, low birth weight, maternal extremes of age, and infant death), I get higher mortality for all OOH birth, the lowest being CNM attended at 0.90 per 1000. This might sound pretty close to the MD in hospital number of 0.79 per 1000, but remember, a lot of risk factors are NOT eliminated by these criteria, including maternal race, martial status,and education, any obstetric or fetal complications, poor prenatal care (which you correctly point out is a serious risk for poor outcome), or any other factors.

      A more restrictive analysis, limiting to married non-hispanic white women who had at least some prenatal care, with infants at least 2000 grams, at least 39 weeks GA, where the cause of death was not congential anomalies, showed an in hospital mortality of 0.23 per 1000 with MD and 0.17 with CNM and out of hospital of 0.87 with other midwife. CNM was not calculated by the program but would be 0.49 per 1000 if it were.

      Please let me know if you have any difficulty following what I did or suggestions about how I might make a better comparison.

    • Daleth

      Um, infant mortality? That is totally irrelevant, for reasons the other posters mentioned. Start your analysis over and look at neonatal mortality (0-28 days).

    • AA
    • Squillo

      If you’re just using the numbers with no exclusion paramenters, you’re getting numbers that are highly skewed against in-hospital births, where the vast majority of black babies, babies with no prenatal care, preemies <37 weeks, lethal congenital anomalies are born. Hospitals also receive emergency transfers from both planned and unplanned OOH birth.

      To try to match the population in MANA's study of planned homebirth, I ran the Wonder numbers using the following criteria:

      *Attended by MD/DO/CNM/Other midwife (to eliminate unplanned homebirth)
      *Gestation 37 weeks and up (according to the MANAStats survey, only 2.5% of their clients' babies showed "clinical signs" of prematurity; so one may extrapolate that the vast majority of ill premature babies are born in-hospital)
      *Singleton and twins (again, MANAStats reports no higher-order multiples intended for birth OOH)
      *Vaginal and c/s
      *All ages
      *All races (although the vast majority of MANAStats mothers were white)
      *All education levels
      *All marital statuses
      *All birth orders
      *Death from <1 hour to 28 days of life (early and late neonatal mortality; beyond that, obstetrical/midwifery care is not usually a factor)
      *Excluding deaths from congenital anomalies (the majority of these are born in-hospital; moreover, none of those born in-hospital would have had better outcomes at home)
      *Excluding deaths from congenital anomalies, "special causes" (terrorism), and external causes (vehicle accidents, poisonings)
      *Excluding mothers with no pre-natal care (again, these are overwhelmingly cared for in hospital; unlike hospital clinicians, homebirth midwives aren't required to–and don't-attend births for people who come in off the street)

      Here's what I got:

      IN HOSPITAL
      MD: .33
      DO: .36
      CNM: .20
      Other midwife: suppressed (6/16,891, or .36)

      OOH
      MD: suppressed (4/7268, or .55)
      DO: suppressed (1/1531, or .65)
      CNM: .46
      Other midwife: .93

  • moto_librarian

    I thought that some of you might be interested in Faith Gibson’s attempt to discredit Dr. Amy’s op-ed. It’s incredibly pathetic.
    http://faithgibson.org/mcdg-amy-tuteur-question-why-people-think-american-home-birth-dangerous-may2-2016/

    • Angie Young-Le

      I think if they are going to keep referencing other countries to promote US home birth and its “safety” then perhaps they should increase their standards to that of those countries. Also, using stats about maternal deaths from 1916 to 1925 to “prove” how dangerous hospital birth is today seems completely ludicrous and irrelevant. So what they used to use chloroform? It’s awful, but they haven’t done that in years. Where is the recent information concerning CURRENT medical practices? You know stuff that isn’t from 50-100 years ago. And what does any of that have to do with Dr. Amy? Thanks for the history lesson Mrs. Gibson. Do you really think women are that stupid?

      It really is pathetic.

      • moto_librarian

        I knew when she started out by referring to Dr. Amy as “Miss” Tuteur and saying that she fantasized about tying the good doc to a chair and forcing her to watch 48 hours of SpongeBob that we weren’t going to be treated to insightful analysis. Her obsession with birth from the early to mid-20th century was just bizarre. Apparently, she couldn’t find anything more recent to critique.

        • Angie Young-Le

          my point exactly 🙂

        • demodocus

          Mr. Tuteur would be quite surprised if Dr. Amy was a “miss” *snort*

    • mabelcruet

      Sorry, I gave up after the first paragraph. The use of ‘loose’ when they meant ‘lose’ is one of those little things that really annoys me-I’m irrational in that way.

  • An Actual Attorney

    OT. Alabama is taking steps to stop prosecuting women for use of prescription drugs during pregnancy. Yep, in the name of protecting the fetus, women were convicted for decisions actively made by doctors. https://www.propublica.org/article/alabama-lawmakers-limit-drug-prosecutions-in-pregnancy

    • demodocus

      lovely. because people always abuse medications.

    • OttawaAlison

      So in theory since I was taking Cymbalta when I was pregnant and had a stillbirth, I could have been charged for my daughter’s death?

      • An Actual Attorney

        Yes. That seems to be the case.

    • guest

      Christ. Because clearly not taking my asthma medication would be healthy for a fetus.

      • sdsures

        Oxygen is so important in those formative years.

  • ConsciousWOMBAN

    The medicalization of birth is what is the problem. You have no faith that a woman’s body can do what it was built to do. I pity you poor old women who were indoctrinated by “men” (the pathetic white people who run our country) to think that you can’t have a baby without medical intervention. You do know that hospitals and the medical industry were created for just that, to be an industry, that way they can make money form it. That is why is it called practicing medicine, not health or wellness. So “Doctor” Amy, you should go take some more Prozac or whatever you people dope up on and stop oppressing women just because you don’t have enough courage to be a real one!

    • Green Fish

      I stared at your post for a while trying to decide whether it is a parody…

      Anyway: The medicalization of births saves life. Giving birth at home with an unqualified CPM kills babies (mostly) and mothers (rarely).
      That’s what it boils down to.

      Could hospitals do more to have a better atmosphere and could they try to treat their patients better? Yes, sure.
      Could CPMs please stop offering sub-par services that kill people? Sounds like a good idea.

      • lilin

        Me too! It has to be a joke, right? No one could make their movement look that nasty and stupid without meaning to do it.

      • AirPlant

        Like a part of me is just like “Alright guys, fess up. Who got drunk last night. We aren’t mad, just disappointed”

    • Who?

      All fine. You live that way if you want. Would you have the courage of your convictions, to let yourself die in childbirth with a fully stocked hospital down the road. I doubt it.

      I’ll take high quality medical care.

      My body, my choice.

    • Sarah

      Your face is the problem. Closely followed by your inability to understand evolution and your MH stigmatising. And your oppression of me, a woman, by whining about my preferred (medicalised) birth model.

    • The Computer Ate My Nym

      Speaking of pitiful responses…

      Women’s bodies were not “built to do this”. We evolved to give birth to live young with large heads. It “works”, that is, produces one or more living children and a living mother, most of the time. Here’s the problem: I’m not interested in it working most of the time. I want it to work ALL the time. No more dead women, no more dead babies! You, apparently, want more death. Because there is no other reason to discourage women from receiving proper medical care.

      PS The majority of ob/gyns are women. Idiot.

    • RMY

      Last I heard, the argument wasn’t that medical intervention is always needed at every birth, but that it sometimes is and it can be catastrophic if there is too much of a delay in receiving it — so it is best to birth where any needed medical intervention can be given in a timely manner. Additionally, a point that is often made here is that we don’t currently have the technology to know who will or won’t need medical intervention during birth, so it is best to err on the side of caution when deciding where to give birth.

    • momofone

      You lost me at “WOMBAN.”

      • Linden

        Yes, the internalized sexism is incredible.

      • Bombshellrisa

        Maybe they meant “wombat” but misspelled it. In which case, yes, it is might indeed be a problem to medicalize the birth of wombats. As for attachment parenting in wombats, their young leave their back pouches at 6-7 months and are weaned by 15 months.

        • guest

          BAN WOMS!

          • sdsures

            That was my initial interpretation.

      • Angie Young-Le

        I saw her comment last night right after she posted it…. I was going to say something to her about her abusive post but saw the name “WOMBAN” and decided that it was wasting my energy to try… came back today to witness the firing squad take aim at her. lol

    • demodocus

      My mother’s the same age as Dr Amy, and like Dr Amy, she had most of her kids au natural. Only, in mom’s case it was 5 pregnancies and 6 babies. I don’t blame her for getting a c-section with the twins when *I* was 20. If you think less of her for that, you might need to reevaluate a few things.
      Oh, and bonus points for the ableism. So nice when people mock others for difficulties beyond their control.
      i truly hope you’re a Poe, but we’ve had too many say the same crap in all seriousness

    • demodocus

      Also, several of us are either currently pregnant or had a child in the last year, so unless you’re 15, you shouldn’t be considering us old.

    • The Bofa on the Sofa

      ) to think that you can’t have a baby without medical intervention.

      My sister’s oldest child was stillborn at 41 weeks. If she had been induced or had a c-section at 40 weeks, her son would still be alive.

      Lack of medical intervention led to the death of her son. It’s that simple.

      Care to tell her that she can have a baby without medical intervention?

      Her three other children were born by c-section at <40 weeks.

      • Anna

        Going post-dates is more dangerous than people think. Sorry for your sister’s loss.

      • Angie Young-Le

        I was born in hospital blue and not breathing for several minutes… medical intervention saved my life. But I guess these pro-NCB people think it would be better if people such as myself died because OB’s are evil. It’s so completely ridiculous. I’m sorry for the loss of your nephew.

    • Juana

      The thing is: everyone of the commenters here knows that you CAN have a baby without medical intervention. It’s just not exactly a failsafe process – neither for the woman nor for the baby.
      As is, actually, any bodily process.
      Some people can’t metabolize glucose efficiently enough to survive without intervention (type 1 diabetics). The pancreas is obviously not failsafe. I could find examples for any organ and biological process of your choice – some more and some less compatible with life, but none of these is failsafe. Pray tell: Why should a woman’s womb be?

    • Amy Tuteur, MD

      A real woman?

      What does it take to be a real woman?

      Unmedicated vaginal birth? Did that.
      Breastfeed 4 children until they weaned themselves? Did that.
      Attachment parenting? Did that.

      Of course I added a Harvard degree in biochemistry, an MD, caringg for thousands of women and delivering thousands of babies to that.

      What are your “real woman” credentials?

    • Anna

      The crucial point is that doctors and hospitals though sometimes imperfectly (what you refer to as medicalization) do their utmost to ensure that every mom and every baby walk out of the hopsital alive and as sane as possible, while homebirth midwifes just leave it to God. They don’t care about anything but their doctrine and making money from it.

    • yentavegan

      I have one name for you, the name of a mother/infant who trusted and had faith with every fiber of her being what her body was built to do. Read the true story of Vylette Moon.

    • Charybdis

      How about YOU stop oppressing women by insisting that birth is always safe and somehow the epitome of health and wellness. You and your ilk don’t ever look at the flip side of your self-appointed crusade do you? The constant, never-ending litany of “you were built for giving birth”, “midwives give better care than OB’s”, “trust your body and trust birth”, etc, ad nauseaum is getting pretty damn old.

      Yes, it is possible to have a baby without medical intervention. Women have been doing it since forever, and some continue to do so because they have no choice. But when there is a problem, there may not be time to get to the expert medical assistance needed to resolve the situation with the least amount of damage to both baby and mother. Hospital birth is not like it was back in the 60’s. The rooms are larger, they have a lot of the things needed by women who choose to forgo medical pain management (large showers, jacuzzi tubs, adjustable lighting, birthing balls, bars, etc). Fetal monitoring is also improving, letting women move around as they wish, either with a wireless monitor or possibly intermittent monitoring (10-15 minutes consecutively out of every hour or some other schedule), you can labor and push in whatever position you wish, up to a point. Some positions might be necessary for instrumental delivery, or for the doc to see what is going on. So hospital birth is not cold, clinical and impersonal any more.

      CPM’s are dangerous, poorly educated about birth, and value process over results. They lie (fluid was clear when it was meconium filled), refuse to listen to the mother when she requests a transfer to the hospital, will delay calling EMT’s, and a whole host of other shady practices because THEY (the CPM’s) want all women to give birth at home, naturally , with no medication and minimal assistance/intervention. They are the ones giving midwifery a bad name and reputation. I’m suprised that the CNM’s aren’t raising holy hell about the CPM’s corrupting and devaluing the title of midwife.

      I would NEVER, EVER want a midwife to attend any birth of mine. I don’t care if they are CNM’s in a hospital setting, because the NCB at all costs woo is starting to creep into their numbers. I don’t care if it is supposedly “better” to have a midwife, although I’m not sure exactly *how* it is better. I do not want to give birth at home. Ever.

      And maybe you can answer this question: why is it, that after 40 weeks of pregnancy and indoctrination into the NCB woo, women who have violently opposed giving birth in a hospital with doctors, nurses and CNM’s, suddenly cave when there is a problem and go to the hospital and expect the staff there to deliver a dead baby, a brain damaged, hypoxic baby, or stop the mother from bleeding to death because of a PPH? I mean, if you subscribe to the theory that “your body is built to do this, you cannot grow a baby too large for you to deliver, and pregnancy and birth is not a medical issue”, then you should be ready, willing and able to deal with the consequences of that heartfelt philosophy, whatever they are (dead baby, dead mother, dead mother AND baby, damaged baby, damaged mother, perinatal mortality of any type,etc).

      Because that’s the way it’s always been for women and childbirth.

    • moto_librarian

      I so love when other women are so insecure that they have to resort to ad hominem attacks. Dr. Tuteur is indeed a doctor. It is insulting and rude to put the quotation marks around her title, and it only makes you look like a child. I could also do without the usual maligning of mental illness.

      I guess if you really think that women are so weak and stupid that the majority of us choose to have our births in the hospital is simply because we have been indoctrinated by white men, there’s not much I can say to you.

      • The Computer Ate My Nym

        It’s not clear that the poster is a woman. On the internet no one knows you’re a…

        • moto_librarian

          That’s true.

    • OttawaAlison

      Irony is that you were indoctrinated indirectly by men that you should fulfill your female destiny by using your womb to push out kids.

    • lilin

      Are you deliberately trying to embody the self-righteousness, gender-essentialism, and basic stupidity of the natural birth movement? I honestly can’t tell if this is a parody or not.

      Also, “a woman’s body was made to give birth”. Really? Who made it to give birth?

    • Nick Sanders

      Sweet merciful…

      Please tell me you are a Poe.

      • OttawaAlison

        that’s what I’m thinking/hoping!

      • The Computer Ate My Nym

        By the very nature of Poes…no, I can’t tell you that for sure.

    • rosewater1

      OK. So if you break your leg you won’t go to a hospital so they can make money off of you? Or is it just pregnant women who are so oppressed?

      If you are a Poe…not a bad effort.

      If you are serious….you are just the latest boring pathetic troll who slings insults when they stumble on this blog.

      Don’t let the door hit you where the good Lord split you on your way out.

    • Heidi_storage

      Ha, ha, ha! Excellent parody, right down to the “womban” handle! Not terribly subtle, but well done.

    • Squillo

      Can women who have not had babies, with or without medical intervention, use women’s rest rooms in North Carolina? Just wondering…

      • Roadstergal

        If they induce lactation.

    • DelphiniumFalcon

      No, I don’t trust that a woman’s body was built to give birth. Otherwise I wouldn’t be here.

      I have five potential siblings that were miscarried in the space of four years. One I know would have been a little brother. That’s how late he was lost. I have one younger sister that my mother’s body kept trying to deliver from five months on. She’s only here because -doctors- medicalized my mother’s pregnancy and stopped early labor. My mother refused the “some babies aren’t meant to live.” Shed already lived that five times over and found it more heart breaking every time no matter how early the loss. She wasn’t going to lose my sister too.

      Should she have passively let herself die when her gallbladder backed up and caused her liver to abcess and take my sister with her in late pregnancy?

      It took half a million dollars in fertility treatments and five years to get me here safely then another half a million dollars and four years with five miscarriages in that time to get my sister here. My mother would be the first to say her body hasn’t got a damn clue how to safely make babies in the first place never mind that she almost died in childbirth both times. Labor just plain stopped out of the blue when trying to birth me.

      You’re going to tell a woman who desperately wanted to be a mother but her body betrayed her in almost every way possible that maybe she just wasn’t supposed to have children then? What gives you the right to decide that for her? Adoption didn’t work out either. After three tries where everything was set and then for various reasons the mother decided to keep the baby at the last minute my parents couldn’t do it anymore. My mother has veins so scarred from fertility treatments and surgery for endometriosis and exploratory laparoscopies that phlebotomists practically want to run and hide when they see her come in for tests.

      Her body wouldn’t allow her to have children naturally so she told nature to take a back seat because she wasn’t taking a no until all options were exhausted. So get off your high horse. My mother is a real woman and real mother. I know how much she and my dad wanted my sister and I. They fought tooth and nail for us and my mom let her body be cut open, scraped out, given hormones and other medications, ruined her veins, and endured so much stress to her body she went gray before leaving her twenties. Just for my sister and I. Could.you endure the same trials?

      • demodocus

        Hell, I’m pretty sure Mom had a nearly ideal body for pregnancy and bfing. She still miscarried half her multiples and her first child was stillborn when she was about 19 and not yet fat.

    • I know, personally, at least 3 women who wouldn’t have survived childbirth without medical intervention. One had a massive infection that she only survived because immediately after the baby was born, she was started on heavy-duty IV antibiotics; it was still very close, and if she’d waited even a few hours, she’d probably be dead. Another hemorrhaged after birth- her traumatized husband still goes pale when recounting watching through the OR glass as a nurse lifted her uterus out of her body and massaged it to make it stop bleeding. He was terrified that he would become a new father, single father, and widower all in one day. Yet another had such severe hyperemesis gravidarum that she was hospitalized, on IV fluids and nutrition, for about five months of her pregnancy.

      People’s bodies fail them all the time; we get heart disease, cancer, and various other internally-mediated ailments. Why would the human body be better at pregnancy or birth than it is at breathing or making its heart beat (which we fail at on a regular basis)?

      Some people can have babies without medical intervention. A lot of people can’t. What do you think they should do, bury their babies in tiny graves like they used to? That’s … harsh.

      • guest

        I have one word for our new troll: Eclampsia.

        • sdsures

          What’s the difference between eclampsia and pre-eclampsia?

          • Liz Leyden

            Eclampsia involves seizures.

          • sdsures

            Anything else?

          • EmbraceYourInnerCrone

            https://en.wikipedia.org/wiki/Eclampsia
            This has some good info (I realize it’s just Wikipedia though) My sister in law developed pre-eclampsia that became eclampsia in her first pregnancy. She was19. Her kidneys then started to shut down. Followed by a crash section and a preemie. baby is grown and has her own kids. My sister in law unfortunately had a second high risk pregnancy 7 years after her first, and when she was 42 she died of a stroke…

          • EmbraceYourInnerCrone

            From the article:
            “Hypertensive disorders of pregnancy are one of the most common causes of death in pregnancy.[9] They resulted in 29,000 deaths in 2013 – down from 37,000 deaths in 1990.[10] Around one percent of women with eclampsia die.[1] The word eclampsia is from the Greek term for lightning. The first known description of the condition was by Hippocrates in the 5th century BCE.[11]”

            But women were “built” to give birth…Yeah right..

          • sdsures

            I’m so sorry.

          • Amazed

            Well, obviously, eclampsia is pre-eclampsia progressed too far. At the time, my grandmother was taken with pre-eclampsia to the town hospital (from her village, no less) and she was unconscious when she arrived. She started seizing in front of the other expectant mothers. She was hospitalized for 40 days after giving birth and at leaving, the doctor happily told her that she was the great exception – a fully eclamptic mother who left without any major health complaints and with an intact baby. They had had an eclamptic mother five years earlier and neither she nor the baby had made it.

            Eclampsia is basically pre-eclampsia made worse.

          • sdsures

            Thank you for the explanation. Because my husband and I don’t have kids yet, there are many issues surrounding having kids that we just don’t know enough about yet simply because we’re not going to be encountering them yet. (We both have chronic illnesses and pain, so naturally, we’re more on top of terminology and research issues there). We want to be much healthier, as possible, before we TTC.

      • Daleth

        People’s bodies fail them all the time; we get heart disease, cancer, and various other internally-mediated ailments. Why would the human body be better at pregnancy or birth than it is at breathing or making its heart beat (which we fail at on a regular basis)?

        THAT THAT THAT! Exactly that!

        It’s because of my own experience with infertility and the fact several people close to me have had massive health problems (friends dead of cancer much too young, severely handicapped family member etc.) that I could not even really parse the question–which was asked when I mentioned my scheduled c-section–“Don’t you trust your body?”

        I was like, dude, I can’t even “trust my body” to never get a cold or laryngitis–what makes you think I should trust it not to have any problems during the much longer, more complicated and more physically taxing processes of pregnancy and birth?

        It’s funny though: one of the women who asked “don’t you trust your body” had actually gone through an emergency appendectomy just a couple of years earlier due to severe appendicitis. Not sure why she still “trusted her body.”

    • Tiffany Aching

      Wow ! Apparently you get to decide who are “real women” based on whether they agree with you or not ! That is so feminist of you. Are you Donald Trump ?

    • Amazed

      Hey, are women who are housebound due to fistulas or severe fecal incontinence after labouring and delivering (not necessarily a live or healthy) baby “real” women? They did it right, after all, it just backfired on them.

      Just curious.

    • Deborah

      Brooke’s womb twin?

      • demodocus

        On the internet, no one knows you’re a placenta?

    • LibrarianSarah

      Personally I rely on Zolaf and Buspar and I have no shame about it. Ablest bigots like yourself are the ones who should be ashamed. You wrap yourself in all this woo and false progressiveness and think that you are radical but really you are just as bigoted as Donald Trump and his supporters. Just instead of feeling superior to the poor and people of color, you think you are better than the sick and the disabled.

      Keep rubbing that talisman honey. Hopefully, that organic food will keep you from joining our ranks.

    • guest

      Why is a woman’s body built to give birth, but a doctor’s body is not built to make birth safer? If anyone is “building” us, they gave us all our abilities.

    • sdsures

      I don’t know what your parents said or did to you to make you act this way, but you need professional help.

    • Petticoat Philosopher

      This reads like a post written by an anti-feminist troll intending to make feminists look bad by hitting on every stereotype you can fit into one paragraph (a lot, as it turns out). But, sadly, I think it is real.

  • Marie Gregg

    Yes, please. Let’s get rid of CPMs. The one with whom I’ve had contact (very minimal) is directly responsible in my eyes for a friend’s daughter living with brain damage. Sure, she can walk and talk, but she’ll never catch up to her peers. This fills me with a rage I can’t express. (I know the parents near responsibility, but trust me, they’ve beat themselves up enough. Nobody else needs to). Get rid of CPMs. Make practicing without a license illegal.

    • Why are they allowed to practice medicine without a license when it’s against the law in any other situation?

      • Bombshellrisa

        The free ebook “From Calling to Courtroom” (written by a midwife for midwives) explains that one. http://www.fromcallingtocourtroom.net

        • Holy shit, I know one of the authors! She’s a friend of my college mentor and they’re working on a book together. Dang. I’m going to hate read this later.

          • Bombshellrisa

            It’s an interesting read for sure. It helps people understand the reasoning and motives behind a lot of what happens and also why there is such a fight about things like licensure, scope of practice being spelled out and oversight.

          • sdsures

            Let me know how it goes!

      • Therese

        CPM cert counts as a license in many states.

        • I looked that up after I commented. How terrible! I don’t see why the government allows quacks to put people’s lives at risk like that.

        • Marie Gregg

          That’s a sad, sick joke.

      • Marie Gregg

        Precisely.

  • A CPM in training responded to me when I shared your article. She thinks a bachelors in biology with “equivalent experience” is just as good as a CNM. Then she questioned your license. I pointed out to her that she has no license, never passed boards or graduated from medical school…so she stopped responding.

    • Sue

      Not knowing what you don’t know – that’s a very dangerous characteristc in a health care provider.

      All the medical reference checks I am asked to complete ask whether the person “readily seeks advice when appropriate”. Insight is essential. CPMs don’t appear to have it. Or, those who do leave the job or get proper training.

  • BeatriceC

    OT: Update on middle kid.

    They admitted him to the main hospital last night/early this morning. They’re doing a whole slew of tests. He won’t be released until he gains at least five pounds, so we might be here a while. They have him on IV anti-nausea meds and those are helping, but eating is still excruciating for him. The radiologist attending still hasn’t read the CT scan, but the initial read is clear for anything obvious except for a slightly enlarged spleen. The doctor said that while it’s enlarged, it’s not enough to cause his symptoms. They repeated the blood work from Monday and got similar results. They’ve added a whole crap load of other tests. They might do a colonoscopy and upper/lower GI tomorrow. At this point nothing is off the table (except appendicitis). Now it’s a waiting game.

    • Roadstergal

      Wow, what a trial for you guys. I’m so sorry. 🙁

    • Megan

      Good luck. We’ll be thinking of you guys. I hope they find answers for you soon!!

    • Spamamander

      So many thoughts extended for you and your family.

    • Sean Jungian

      Ach, I’m so sorry. I don’t pray but I am hoping everything goes well and middle kid is feeling MUCH better ASAP.

    • Valerie

      Thanks for the update. I hope they figure out the problem quickly and the solution is easy, painless, and permanent. If my experience with dieting is any indication, 5 lbs will go back on pretty quickly.

    • Amy M

      Oh good luck, I am hoping your son gets well soon.

    • PeggySue

      Thanks for taking the time to update. More good thoughts your way. I hope they get to the bottom of this soon.

    • KeeperOfTheBooks

      Thanks for keeping us in the loop; I hope they find out what’s going on, and soon!
      In the meantime, don’t forget to take care of yourself. Caregivers need care, too, and when you’re as stressed as you must be over all this, it’s especially important to make sure you’re eating, drinking plenty of water, and getting some sleep.

    • The Computer Ate My Nym

      Hope middle kid at least feels better overnight and that you find a treatable problem soon!

    • Amazed

      Good luck, Beatrice! I hope it all gets sorted out in a treatable way any hour now.

    • Nick Sanders

      I’m sorry I haven’t offered support as others have, I really don’t know what to say. I do hope he comes through this alright and no worse for wear.

    • DelphiniumFalcon

      Keep us posted but don’t kill yourself keeping us updated. We’re just as worried about you as we are him so take care of yourself too!

    • Mrs.Katt the Cat

      Glad he is getting the help he needs- Hope they find something out soon and get him feeling better.

    • AnnaPDE

      All fingers and toes crossed that it’s something simple and he gets better soon.
      Given you’re mentioning enlarged spleen: Have they checked for a weird presentation of mono or CMV? My sister had a huge scare when she was 19 with horrible liver results, constant fatigue and nausea, and doctors mentioning stuff like liver cancer, plus an enlarged spleen, but a bunch of doctors and a hospital didn’t manage to diagnose it. Finally her blood was tested by the local uni’s virology lab (coincidentally, she was trying to postpone her upcoming exam with the prof there and he got curious) who found boring old mono. So this sounds kinda familiar…

      • Sean Jungian

        I was hospitalized when I was 14 for the same thing, although they thought it was Reye’s Syndrome for a while. Turned out to be mono. Copious vomiting, no pain with eating, just couldn’t eat at all. I think I lost 25 lbs in a week, IIRC.

        • Sue

          INfectious Mononucleosis (glandular feveer) sounds possible – especially with slightly enlarged spleen – though it;s likely they tested for it. Best wishes to Beatrice and familyf or a swift recovery.

          • AnnaPDE

            I would have expected that to be a standard test too, but with my sister it took 2 weeks and a virology prof to consider it. :-/ So just throwing it out there together with lots of hugs and good wishes.

    • LibrarianSarah

      I’m not good at being comforting so here is a gif of a puppy looking inquisitive.

      http://i.imgur.com/Orfwjiu.gifv

      • Kelly

        Those ears are so dang cute.

      • demodocus

        my kid has been talking to the doggie for 5 minutes now

      • sdsures

        Oh my, YMMD! Head tilts always melt me.

    • BeatriceC

      Replying to myself here. CT scan was finally read by the attending radiologist. There’s a mass of some sort in his small intestine. They’re doing some sort of MRI in a few hours. I forget exactly what she called it, but he’s getting contrast dye both by drinking it and by IV, and then the MRI to get more information on what it is. There probably won’t be results until tomorrow.

      • Thinking of you and middle kid. I don’t have any advice–just hopeful thoughts and virtual hugs.

      • Amy Tuteur, MD

        Thinking of you and your son. It sounds like you are in very good hands.

        • BeatriceC

          Thank you. I’m actually really happy with the care at this hospital. I actually moved to this city specifically for the Ortho department here, for the care of the other two boys who have a fairly rare, genetic bone condition. This boy escaped that genetic pitfall and has been healthy as a horse since roughly toddlerhood (he was a preemie, so had some issues at the beginning). I have not been disappointed in my choice. This experience confirms things. They really have been excellent. They should be coming to get him for the MRI in just a few minutes. I can’t recall the exact name of the test, but it’s when they have the patient drink some sort of contrast liquid as well as the normal contrast via IV. It’s a teaching hospital, so there will be a read by the resident radiologist overnight, but the final read won’t happen until the attending comes in tomorrow morning.

          • Megan

            Hugs. Thinking of you. Glad you are getting good care during a tough time.

          • The Computer Ate My Nym

            Hugs to you and middle kid. It sounds like a diagnosis is approaching, at least. I’m so glad that he’s in a good hospital!

      • Amazed

        You’re getting soime clarity now. Thinking of you.

      • Bombshellrisa

        Thinking of you and your son *hugs*

      • momofone

        Hoping for answers and for rest tonight for you both.

      • Gatita

        I just caught up on this. I’m so, so sorry your son and family are going through this. Hoping you all get some answers and relief soon.

      • Sarah

        Hopefully you both get some sleep. Fingers crossed.

      • KeeperOfTheBooks

        At a bare minimum, at least it sounds like you should get some sort of answers soon, which has to be at least slightly better than worst-case-scenario what-ifs?
        Let us know how it goes; there are so many of us here thinking of you and your DS!

      • Charybdis

        Ahh….the barium. I have less than fond memories of that stuff. With the upper GI, the nice tech told me I would have to drink a “little cup” of barium while they watched on the fluoroscope, then they would move/tilt the table some to watch it move about. The “little cup” was more like a 50 gallon drum with a straw stuck in the top. Vaguely strawberry flavored and like drinking liquid chalk. The first few gulps were okay, but then the taste (or lack thereof) and thicker, chalky texture registered with my brain, who then stopped letting me swallow easily. Then the table tilting/moving started. Yeah. Not fun.

        The lower GI (barium enema), oddly enough was preferable to the upper GI. You don’t taste the barium at all, although the actual insertion/application of the enema nozzle is a bit embarrassing. Especially when you are in college, in pretty good shape and you have a *really, really hot* male tech who is doing your procedure. Then, the draining of the barium is fun, as is the uncomfortable, butt clenching waddle to the bathroom afterwards. Because they drain the barium, tell you to hop off the table and go to the bathroom that’s like 6 feet away (looks like a damn football field), poop out as much barium as you can, then come back in so they can take some more images to see how effectively you have eliminated the barium. More fun times, with the *really, really hot* male tech just on the other side of the thin door and wall who can HEAR all the “bathroom noises” you are making while ejecting the barium.

        The flexible sigmoidoscopy is a treat as well, as they will inflate your colon with air (carbon dioxide, I think) so they can get a good look at the landscape. That is SO MUCH FUN afterwards, because of the gas.

        That being said, I really hope they find out what the issue is and that it is completely fixable (remove blockage surgically) or that it can be treated/managed with diet and/or medication, or some combination of those. When I go pick up my son at school, I’ll pop into the church and light a candle for both of you. Hang in there, we’re thinking of you and pulling for your son.

        • Roadstergal

          Barium? I hardly knew ’em!

          • Charybdis

            That’s right up there with “Rectum?? Damn near killed’em!”

    • Montserrat Blanco

      I really hope it is something not serious and he gets well soon.

    • Squillo

      I hope you get some answers soon, and that the news is good.

    • Tiffany Aching

      Thinking of you. Hugs.

    • Deborah

      In my thoughts x

  • Nick Sanders

    OT: Is anyone else having trouble loading the front page?

    • BeatriceC

      The splash at the top hasn’t been loading, but the links down the page a bit have been fine.

    • Sean Jungian

      I’ve been having the same issue as @disqus_2SLSRqtokm:disqus. I’m using Google Chrome.

      • Roadstergal

        Same issue on IE.

        • Megan

          Same on Safari.

          • prudentplanner

            and firefox, since this morning.

          • BeatriceC

            I’m on Safari as well, both phone and laptop. (I went home last night to get essential items like clothes, toiletries and computers.)

    • KeeperOfTheBooks

      The images associated with the posts aren’t loading for me on the main page.

      • Nick Sanders

        Same here.

    • The Bofa on the Sofa

      Yes. It doesn’t load. Chrome or firefox or phone

    • Amy Tuteur, MD

      WordPress is having a problem with images. I don’t know why but I do know that it’s happening on other websites, too.

  • Megan

    OT: More evidence that mode of birth and infant feeding doesn’t affect long term gut microbiome.

    https://www.buzzfeed.com/tomchivers/the-friendly-bacteria-in-your-gut-isnt-as-set-at-birth-as-we?utm_term=.sk2QJGgBYW#.oa5b4MKPqV

    • Sue

      Yep. It’s known that the infant gut biome is a moving feast, so to speak, until the child is fully established on solids.

  • AA

    “Dr” Amy, I strongly disagree with your shortsighted rejection of clients’ rights. As a Certified Professional Dentist ®, we support clients’ rights to opt out of the rigid, intervention based dental system. Did you know that excessive intervention on normal teeth results in clients being forced to have dental procedures on their backs? With bright lights shining in their faces? With a cold disposable bib on their torsos?

    We support the right for clients to get dental work while walking to open up the oral cavity. We encourage clients to drool on their shirts instead of on a sterile and un homelike dental bib. Studies have shown that normal dentistry is best done by candlelight in a waterbath.

    Isn’t it sad that CPDs have to go under the radar right now? Many CPDs have extensive training in listening trusting teeth. I myself took a correspondence course that required such rigorous study as being able to name 10 medications. Ten, I tell you!

    Oh, I forgot, I dropped out of that course and learned from a blacksmith instead.

    We believe in normal teeth, not fear. Each CPD must make their own standards about what is “normal.” We also don’t believe in standards for standards. We believe crowdsourcing is the new standards. Our facebook group consists of over 100 members, if you ever have a question, you can just post and get a response!

    We stand with our midwifery colleagues to support self-licensure.
    Signed,
    The founding member of the Certified Professional Dentist Organization since 2016,
    Registered Tooth Encapsulator,
    Licensed Oil Pulling Doula,
    Normal Gum Educator

    • Zornorph

      I have only one question about your dentistry.

      “Is it safe?”

      • AA

        As MANA said, monopolies (aka Not Us) prevent this safe licensure choice for mothers and babies. If you want to find the problem, look at Big Dentistry.

        • Roadstergal

          I hate Big Dentistry. These so-called Dentists just want to yank your tooth out so they can get to the golf course, rather than letting it come out naturally.

          • DelphiniumFalcon

            You know that they’re just sadists who want to drill and only became dentists so they can indulge in their psychopathy!

            I saw it on TV on what I’m sure was a documentary!
            https://youtu.be/bOtMizMQ6oM

      • Sean Jungian

        BAAAHAHAHAHA!

    • Sean Jungian

      I have to admit, I kind of fell for this until I got to the “dental work while walking to open up the oral cavity” lol well played!

    • Roadstergal

      *applause*

    • Azuran

      You forgot to mention the boobs in your face while they do the cleaning. That’s dentist rape!!!!

      • sdsures

        I always wondered if I should report that. LOL

    • sdsures

      I grew up on a farm with an honest-to-God blacksmith’s shop on the grounds. Anvil and horse shoes included. So of course I’m getting a lot of nice mental images from my childhood, spliced with Natural Dentistry. YMMD!

  • Zornorph

    I like how one of the goals of MANA is ‘smooth transfers’ which really means passing on their failures and escaping liability for them.

  • Megan

    Their response was a whole lotta nothing. I feel like one of the peanuts characters in class listening to their teacher, “Waa waa wa waa…”
    https://m.youtube.com/watch?v=ss2hULhXf04

    • Zornorph

      The sound of Miss Othmar ‘speaking’ used to piss my Dad off so much, he’d make us turn the TV down if she went on too long.

  • Linda Rosa

    In her op-ed piece, Dr. Tuteur wrote that it is up to the states to “abolish” CPM practice. In recent months, this is what activists like myself have tried to convince Colorado legislators to do, alas, without success.

    HB-1360, the “Direct-Entry Midwife” practice bill, is now on the desk of Gov. Hickenlooper, and we would ask you to email him, urging him not to sign the bill.

    Here is the governor’s email address:

    Governor.hickenlooper@state.co.us

    Colorado’s 64 lay midwives have a high perinatal mortality rate (18.3 deaths/1000 in 2015). This bill will allow them to start suturing and continue doing VBACs in the home. (These midwives lied to senators that they had never experienced a uterine rupture.)

    Colorado probably has violated constitutional law in exempting only the lay midwives from carrying liability insurance and any formal education. This makes it nearly impossible for Colorado’s 304 Certified Nurse Midwives — who must have a master’s degree and insurance — from competing with them in the home birth market. This situation limits the public’s ability to access safer home birth attendants.

    • 18.3/1000?? The overall US rate is 15-20/10,000! That’s 10x the death rate!
      I know this is lots and lots of exclamation points, but holy shit. That’s ridiculous. Why aren’t those women in jail?

      • The Bofa on the Sofa

        I will not that the 18/1000 statistic is used to bury the result.

        If they said 1.8%, what would anything think?

        • A lot of people still don’t wrap their heads around 1.8%. I prefer “almost 2 in 100” or even “almost 1 in 50”. That brings it home a lot better.

          • The Bofa on the Sofa

            I think there is a good line of demarkation above and below 1%.

            Notice that 2% is the death rate for people trying to climb Mount Everest.

    • MaineJen

      …suturing? Suturing???? With no medical training. I wouldn’t trust these women to deliver kittens.

      • sdsures

        Oh, come on, we’ve all sewn on buttons in our day. What could go wrong?

  • Daleth

    Typo: there’s a second “is” in the title that’s not needed.

    Farrell’s/MANA’s response is pathetic indeed!

    • Amy Tuteur, MD

      Ugh! Thanks.

  • Squillo

    Yet another shining example of the CPM motto: “Meh, good enough.”

  • AirPlant

    Seriously, this is just basic consumer protection. Like I have a lot of lovely artistic and detail oriented people in my life, but I choose to go to a certified cosmetologist to get my hair done. Last time I checked the worse case outcome for a salon visit was scalp fungus which is gross, but will not kill you or your child.
    .
    Even peak woosters will admit that death is a possible outcome of childbirth. Shouldn’t they have at least equal training with my hairdresser?

    • swbarnes2

      A cosmetologist likely at least knows “Get blood on something? 10 minutes in 10% bleach”. I’m not sure homebirthing midwives even know that.

      • KeeperOfTheBooks

        Right. I once had a cosmetologist as a roommate; she’d bring her shop towels (ie, the ones used on customers’ hair) home to get washed. Those suckers went straight from a trash bag (disposable) to the washing machine on the “sanitize” cycle. With bleach. Twice. She was *not* interested in screwing around with even the possibility of passing along fungi/viruses/bacteria/a louse egg, thankyouverymuch.