The lost art of driving drunk


Imagine if I wrote the following:

I cannot sufficiently describe the profound sadness and disappointment I feel upon hearing that the State of California has banned drunk driving. I wanted to write to you to express my thoughts on the matter. It is my sincere hope that you will reflect seriously on my comments, as the consequences of this decision are grave and impactful far beyond the catchment area of your state.

You’d think I was nuts, right? Drunk driving has a terrible death toll and results in tremendous human suffering. Moreover, the person who chooses to drive drunk might not be the person who bears the burden of the injuries and death. Innocent bystanders are often the victims.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Breech vaginal birth has a HIGHER death rate than drunk driving.[/pullquote]

The words above were not written about drunk driving. They were written about breech vaginal birth, a practice that has a HIGHER death rate than drunk driving. I paraphrased a public letter posted by Dr. Emiliano Chavira, of Dr. Chavira is objecting to the decision by Glendale Adventist Medical Center banning elective breech vaginal birth. is planning a demonstration in front of the hospital next Wednesday to protest this change in policy.

But drunk driving doesn’t kill that many people. And driving drunk after partying is a long standing tradition.

Continuing the paraphrase:

To begin with, a brief word about drunk driving. This used to be a standard procedure in which all young people (and many older people) routinely indulged. As is also true with sober driving, drunk driving was on occasion, fraught and serious injury or death occurred. A landmark study shows that in 2014 drunk driving accounted for only 4/1000 US deaths each year. Moreover, the majority of auto accident deaths (over two thirds!) involve no drunkenness. Nonetheless, officials in many states banned drunk driving. To this day, the option of drunk driving is denied to all individuals.

But 4/1000 deaths each year is more than enough to justify banning drunk driving. Are we supposed to believe that the HIGHER death toll of breech vaginal birth is trivial?

Dr. Chavira emphasizes that this is an issue of personal autonomy:

[ACOG has] expressed in explicit language that in honor of the ethical principle of patient autonomy, the mother is the ultimate decision maker in the setting of childbirth. They have stated explicitly that competent individuals have the right to accept higher degrees of personal risk. They have also stated that decisionally competent individuals have the right to refuse recommended care, even when needed to maintain life…

But we don’t accept that reasoning when it comes to drunk driving. Why? Because others may be harmed. In the case of vaginal breech birth everyone participating faces the potential harm that comes from losing a baby to a preventable cause. They and the hospital face legal liability. Moreover, society faces the harm that comes from the massive expense of raising a brain injured child.

But medical autonomy is extremely precious, so I have a proposal for how we can preserve women’s autonomy to choose breech birth while simultaneously protecting others.

The obstetricians that choose to offer elective breech vaginal birth should agree to a rider attached to their malpractice insurance. Malpractice insurers set rates by calculating potential financial exposure. That’s why obstetricians have much higher malpractice rates than internists. The insurer could therefore calculate the additional financial exposure posed by breech vaginal birth, divide by the number of obstetricians offering the procedure and charge those doctors more.

Wait, what? That would cost Dr. Chavira and like minded obstetricians hundreds of thousands of dollars? Correct! And that’s where organizations like come in. Instead of holding rallies and threatening hospitals that refuse to participate in unsafe care, they could indemnify those same hospitals, giving them the financial freedom to accede to’s demands.

It’s a win-win!

Wait, what? Dr. Chavira and don’t want to pay. They want hospitals to pay to insure procedures that are unsafe? They want all obstetricians to pay more for malpractice insurance even though most obstetricians think breech vaginal births are unsafe and would not perform them? That doesn’t seem fair, does it?

I believe deeply in women’s medical autonomy. Women most certainly have the right to refuse medical treatment, even life saving treatment. That’s a negative right; the right to be left alone. But they DON’T have the positive right to demand unsafe treatment.

Don’t want a C-section for a breech baby? Fine, don’t come to the hospital for a breech vaginal birth or transfer to the hospital when the baby’s head gets stuck at a homebirth. Doctors and hospitals also have rights; they aren’t required to provide unsafe care.

Freedom comes with responsibility.

Freedom does not mean that you are free to drive drunk and vaginal breech birth is MORE dangerous than drunk driving.

Those who demand the freedom for breech vaginal birth have a responsibility to pay for it. Let’s see them put their money where their mouths are.

94 Responses to “The lost art of driving drunk”

    September 6, 2016 at 4:03 am #

    I haven’t heard a more stupid argument recently than this one. Pffff. Next they’ll be arguing whether its good to be in the backseat with a drunk foetus behind the wheel. 😛

  2. Laura J
    September 2, 2016 at 12:51 pm #

    I did not have the opportunity to have my kids naturally. Had a great pregnancy, but on week 38 got an infection that had no symptoms. Placenta sprang a leak, caused a huge infection. Sepsis was the scariest moment of my life. Thank God the drs were on top of this and I thought why would women choose to have homebirths? Time and life was the essence. Our second baby, now 6 months old was also C-section because I never wanted that drama again. We also do not drink in our household. We have seen what alcohol does in our families. Banning drink driving might work but we see people who don’t care and drive anyways. Does that mean being intoxicated with drugs now?

  3. LadyKatie16
    September 2, 2016 at 11:17 am #

    I feel like I agree with a lot of what dr. Amy says but it doesn’t always look that black and white in real life. Here it is so often set up as caring elective c-section moms vs. risky happy nut jobs.
    In real life mothers can often find themselves more conservative than their providers and left unsure what that means. My baby has VCI and my doctor is planning AROM at 39 weeks followed by induction. My friends say “c-section better safe than sorry” but I’m not even being offered that, even though it does make sense to me. Am I a risky hippy? I think a C-section does sound better but wouldn’t taking advice of my friends over my ob be against the spirit of this blog?
    I imagine this is the same way women might feel in settings where Vbac is basically automatic and vaginal breech is allowed. I delivered my second son in such a hospital (medical school) in Europe. Are those moms risky nuts? Following medical advice sometime means taking on more risk than the mother wants. I don’t think that truth is always admitted by anti-ncbers. Mainstream OBs aren’t all the prophets of caution we imagine.
    I really want to thank Dr. Amy for running this blog. As far as I know it is the only place, literally, lay people can go to find NCB myths debunked. I really think it can save lives.

    -worried about my baby

    • MB
      September 2, 2016 at 11:29 am #

      I’m not a doctor. I just did a cursory search of VCI on the webz, and I can see why you’re nervous. I would definitely ask your doctor to justify his/her recommendations and provide you with a detailed list of all the risks involved in having both a vaginal delivery, as well as the risks of a c-section, and don’t be afraid to get a second or third opinion if that is an option for you. Informed consent means understanding your risks. I’d also ask how many of these types of births the doctor has performed in the past and what the outcomes for baby and mother were. That’s just me though.

      I wish you and your baby the safest delivery possible. Good luck.

      • LadyKatie16
        September 2, 2016 at 7:03 pm #

        Thanks to all above for the advice and kind wishes. I am going to push the doc further on why no c/s. It’s hard to find good info for standard of care for VCI…but I need to learn as much as I can to advocate for the baby!

    • Heidi
      September 2, 2016 at 11:47 am #

      I don’t think it would be “against the spirit” of the blog to ask your OB questions about why he’s suggesting AROM at 39 weeks followed by induction, and like @disqus_nUmFiOUJJD:disqus said, go for a second (and third and fourth, if need be) opinion if you don’t feel right about it. It was a doctor that was delivering breech babies vaginally after all.

    • BeatriceC
      September 2, 2016 at 11:57 am #

      It’s perfectly reasonable to ask questions. One of the reasons your doctor is there is to provide information. Asking her why an induction and vaginal birth is preferred to a c-section isn’t out of line. You’re simply seeking out information.

  4. MB
    September 2, 2016 at 9:51 am #

    Sheesh. Just saw my neighb yesterday; she’s about 7 1/2 mos pregnant. She had a c-section w/ her first. She just told me yesterday baby is frank breech. She DESPERATELY wants a VBAC. I have declined comment, but she is hopeful that her doctor can turn the baby (which is apparently what he did with the first, but no matter, that one still ended in a c-section).

    I respect her rights. This is a decision that she gets to make with the doctor, but I have to express this to just get it out of my system, because I will not discuss this matter with her. Like I said, whatever it is, it’s her decision.

    But I think she’s nuts.

  5. Barzini
    September 2, 2016 at 8:59 am #

    I really appreciated this paragraph from the article:

    “I believe deeply in women’s medical autonomy. Women most certainly have the right to refuse medical treatment, even life saving treatment. That’s a negative right; the right to be left alone.”

    I’ll remember that the next time someone tries to inject me with a substance which has been to sometimes cause life changing harm

    • Megan
      September 2, 2016 at 9:04 am #

      Like heroin?

      • Barzini
        September 2, 2016 at 9:16 am #

        Yeah I guess, although at least that would be fun for a bit

    • MI Dawn
      September 2, 2016 at 10:39 am #

      Funny, I don’t know of anything that doesn’t have a risk of life-changing harm. Even water. Even air.

      Sure, some injections can harm. But can you give any examples of harm (barring illegal drug use) that is greater than the help the injection gives?

      • Barzini
        September 2, 2016 at 11:08 am #

        I’m inclined to agree that the risk of the vaccine is lower than the risk of the disease, but I still don’t fancy injecting myself with aluminium – it’s just not the way I roll

        If we could find a way to remove things like aluminium from vaccines (like we have partly done for mercury) I’d feel better about the whole thing

        • MI Dawn
          September 2, 2016 at 12:16 pm #

          Do you understand WHY the small amount of aluminum salts (not the same as elemental AL) are in some vaccines? And you get a lot more AL just from the food you eat daily (and yes, it’s absorbed, just like a vaccine) than from any vaccine. AL allows fewer antigens to be used in the vaccine yet it will still be effective.

          Thimerosol isn’t in any vaccine except a few multi-dose flu vials. And you can always ask for a single dose vial. All it does is prevent bacterial growth. If thimerosol was dangerous, than most of my generation would be autistic since it was slapped on every open wound we had from infancy (umbilical cord) onwards.

          • Barzini
            September 2, 2016 at 12:23 pm #

            You should contact the researchers looking into a possible link between aluminium and alzheimers and the writers of the many articles on Pubmed – they are obviously wasting their time and need your advice and expertise

            To be on the safe side I’m not going to inject myself with a proven neurotoxin

          • MI Dawn
            September 2, 2016 at 12:24 pm #

            Then I assume you have stopped eating food, also.

          • Barzini
            September 2, 2016 at 12:35 pm #

            And cyanide is found in apple pips

            I’m not going to start injecting cyanide into my baby’s body nevertheless

          • Sanveann
            September 8, 2016 at 11:58 am #

            No one is saying we’re going to forceably inject every child with vaccines. They’re just saying you may not be able to avail yourself of certain public services (such as schooling) if you won’t vaccinate

          • Laura J
            September 2, 2016 at 12:58 pm #

            I happened to stumble on that new study last week.

          • Roadstergal
            September 2, 2016 at 4:03 pm #

            Care to cite any papers other than the ones that have been debunked in the other thread?

            We’re down to a YouTube video and someone’s personal webpage as your sources, as far as I can tell.

        • Charybdis
          September 2, 2016 at 1:16 pm #

          Ethyl mercury and methyl mercury are not the same thing…..

          • Barzini
            September 2, 2016 at 1:57 pm #

            I wouldn’t want to inject either into my body

  6. guest
    September 1, 2016 at 10:46 pm #

    OT: We lost a student at work this week. I can’t give any specific details because of privacy obligations, but it involved illness and there was nothing anyone could have done. Just…there’s enough stuff waiting out there to kill us without inviting more opportunity through dangerous NCB and anti-vax practices.

    • MI Dawn
      September 2, 2016 at 10:18 am #

      So sorry to read this! Mother Nature isn’t kind.

    • demodocus
      September 2, 2016 at 11:11 am #

      always tough. We lost 2 classmates to accidents when i was a kid.

  7. CanDoc
    September 1, 2016 at 4:04 pm #

    Hmm… I have mixed feelings about this. The Term Breech Trial has been heavily criticized for incentivizing breech births even without adequate fetal assessment and with accoucheurs inadequately skilled in the procedure. Although I myself do not/cannot offer vaginal breech delivery (not enough experience or confidence), I recognize that in many cases it may be a safe option with an experienced team (OB/anesthesia/paeds) ready to provide experienced care. The more measured and relevant European PREMODA trial ( suggests that, much like VBAC, it is reasonable for many women to consider vaginal breech delivery with informed consent.
    I recognize that this doesn’t mandate every hospital to support or safety offer VBACs or vaginal breech deliveries, but I think it is foolishly polarizing to demonize women who consider vaginal breech delivery as being selfish or seeing birth as performance art. Women have many reasons for wanting a vaginal delivery, from easier recovery to help look after other children at home, to avoiding the potential risks of a surgery. They are not necessarily being reckless, and I’m concerned that the tone of some of these comments is just as nasty and narrow-minded as the asinine comments we see from the NCB zealots we dislike.

    • Cody
      September 1, 2016 at 8:20 pm #

      Slightly OT: Is there any way of knowing how many Canadian OB/Gyns are actually doing vaginal breech deliveries?

    • MB
      September 2, 2016 at 10:17 am #

      Sorry, my experience with forced vaginal birth is that it was barbaric, horrific, and dangerous.

      “Birth Experience”? If you want an “experience”, please, go to Burning Man, but leave your precious baby out of it.

      • AA
        September 2, 2016 at 10:55 am #

        I don’t see how CanDoc was saying that women who have a breech baby should be forced into a trial of labor.

  8. Gatita
    September 1, 2016 at 1:18 pm #

    The headline alone literally made me guffaw.

  9. Sean Jungian
    September 1, 2016 at 12:52 pm #

    I work in a place where this article would not be considered satire – I hear my rural, alcoholic, mechanic co-workers regularly complain about not being able to drive drunk anymore. REGULARLY.

  10. PrimaryCareDoc
    September 1, 2016 at 12:10 pm #

    All this complaining about the “right” to have a breech birth…what about the rights of doctors to not be forced to be a part of your performance art/stunt birth?

  11. MI Dawn
    September 1, 2016 at 12:03 pm #

    Me: OK, you want a vaginal breech birth.

    First, if you’re a primip, I won’t do it. At all. I refuse to put you, your baby, and me in that kind of risky situation.

    So, now, you’ve had (at least) one term delivery of a XX lb baby, so a pelvis proven to that weight. The risks of a vaginal breech are tears and lacerations for the mom due to the speed of the aftercoming head’s birth, head entrapment leading to oxygen deprevation for the baby which may lead to brain damage or death, cord compression leading to oxygen deprevation, etc, etc.

    For me to do this birth, you have to sign the agreement that you understand all the risks, give up your right to sue if anything goes wrong, and pay an extra $100,000 for the birth to cover my malpractice costs for offering this.

    Think I’d still get takers?

    • Irène Delse
      September 1, 2016 at 4:30 pm #

      “The risks of a vaginal breech are tears and lacerations for the mom due to the speed of the aftercoming head’s birth, head entrapment leading to oxygen deprevation for the baby which may lead to brain damage or death, cord compression leading to oxygen deprevation, etc, etc.”

      Ouch. The risks to the baby in a vaginal breech birth are well known, even if the NCBers downplay that. But I bet the added risks to the mom is simply not on the radar for a lot of women.

      • Spamamander
        September 1, 2016 at 4:41 pm #

        I just looked at the size of said parts… a bottom and curve of back vs a skull that is designed to be molded through the birth canal. Bottom coming first through my vagina? Nope.

  12. AA
    September 1, 2016 at 11:37 am #

    “The literature also does not address the issue of the impact of cesarean
    delivery on breastfeeding, bonding and attachment, and the
    psychological well-being of the mother.” Really, Dr. Chavira?

    • Sean Jungian
      September 1, 2016 at 11:52 am #

      Face-palming lion avatar INDEED. Sheesh.

      • namaste863
        September 1, 2016 at 11:55 am #

        Can I just say that your avitar kicks ass?

        • Sean Jungian
          September 1, 2016 at 12:10 pm #

          lol aww thank you!

    • namaste863
      September 1, 2016 at 12:09 pm #

      My guess is that there isn’t a negative impact, because most women living in the sane world want a healthy baby and don’t really give a rat’s ass how that is accomplished.

    • CanDoc
      September 1, 2016 at 4:48 pm #

      I am always perplexed by highly-educated specialists who wind up off the end of the spectrum of normal practice. How does this happen? I do not know.

  13. AA
    September 1, 2016 at 11:36 am #

    re: Term Breech Trial results for Details of stillbirths and neonatal deaths (excluding lethal anomalies). I have uploaded an Excel spreadsheet from the fulltext of the Lancet article if anyone wants to take a look.

    • Karen in SC
      September 1, 2016 at 11:48 am #

      and here are some anedotes. Quite chilling.

      • AA
        September 1, 2016 at 11:56 am #

        Dr. Chavira attended Dr Fischbein’s “Teach the Breech” conference in Amsterdam. Some attendees were CPMs/lay midwives. Dr Chavira should keep in mind that for the Term Breech Trial, they were all planned hospital births, and they had more specific inclusion/exclusion criteria than what CPMs may be doing (not even including the hospital part, of course).

        • Karen in SC
          September 1, 2016 at 3:53 pm #

          CPMs can go to Amsterdam for conferences since they charge cash and it’s all profit. Supplies are purchased by the mother.

  14. Anonymous
    September 1, 2016 at 11:35 am #

    I like this bit:

    “[ACOG has] expressed in explicit language that in honor of the ethical
    principle of patient autonomy, the mother is the ultimate decision maker
    in the setting of childbirth. They have stated explicitly that
    competent individuals have the right to accept higher degrees of
    personal risk. They have also stated that decisionally competent
    individuals have the right to refuse recommended care, even when needed
    to maintain life…”

    Uhhh….no. I got news for any wannabe birth warriors out there. You may think your baby is a prop in your performance, but the hospital does not. That is a person, and they are obliged to save that person’s life, despite your insane, desperate, and asinine claims that you “don’t want an intervention.” We had a guy come in one time that was trying to treat a terrible second degree burn on his daughter with mayonnaise. He screamed bloody murder that we were trampling all over his rights as a parent because he didn’t want his daughter to get any shots. Just because you are in a group that believes something is right doesn’t make it so.

    • The Bofa on the Sofa
      September 1, 2016 at 11:52 am #

      Why did he bring her to the hospital if he didn’t want you to treat her?

      • Charybdis
        September 1, 2016 at 12:36 pm #

        Same reason rabid home birth people flee to the nearest ER when things go sideways. His mayo treatment wasn’t working, so he thought he would see what the docs said about it.

        • Gatita
          September 1, 2016 at 1:24 pm #

          Can you imagine how much pain that poor kid was in? Jesus Christ, that’s criminal, maybe literally.

        • Roadstergal
          September 1, 2016 at 4:54 pm #

          “But it’s called the Mayo Clinic!!”

          • Sean Jungian
            September 1, 2016 at 5:03 pm #

            That deserves a rim-shot lol

          • guest
            September 1, 2016 at 10:50 pm #

            Thank you for making me LOL.

          • Sue
            September 2, 2016 at 2:19 am #


            Roadstergal wins the thread!

        • The Bofa on the Sofa
          September 1, 2016 at 5:34 pm #

          He already knew it wasn’t working, so he didn’t need the doctors to tell him that. He brought him to the doctor, but wouldn’t let the doctor treat the kid?

          I just don’t get it.

    • MI Dawn
      September 1, 2016 at 1:28 pm #

      Ah, the old butter/fat/mayo on a burn. I remember those days…fortunately, my parents weren’t of that mindset.

  15. Brooke
    September 1, 2016 at 11:33 am #

    Giving birth is more dangerous than not giving birth. Everyone should just get sterilized.

    • anh
      September 1, 2016 at 11:38 am #

      You really sound profoundly silly and uneducated. Why are you so defiantly opposed to informed consent? Don’t women deserve that? Why do you gain by controlling their choices? If a woman gives birth to a breech child without understanding the increased risk, she cannot give informed consent. It’s simple. What aren’t you understanding?

      • The Bofa on the Sofa
        September 1, 2016 at 11:52 am #

        You really sound profoundly silly and uneducated.

        anh, meet Brooke.

    • Megan
      September 1, 2016 at 11:42 am #

      So if we can’t eliminate risk altogether, we should just throw up our hands and not try to even reduce risk? What a strange world you live in…

      • corblimeybot
        September 1, 2016 at 12:01 pm #

        Brooke don’t think too good. If a obstetric protocol can’t reduce risk to absolute zero, that protocol should be totally abandoned! What good is it if it’s not perfect?

        • Sue
          September 2, 2016 at 2:22 am #

          Just like in anti-vax land, where less than 100% is the same as zero%.

    • namaste863
      September 1, 2016 at 11:45 am #

      Oh, for God’s sake. Nobody here is saying we should all be sterilized. What we ARE saying is yes, giving birth is risky, and thank (Insert preffered deity here) that we now have the knowledge, technology, and equipment to produce a healthy outcome by managing those risks. Most of the time, anyway. Weare saying that childbirth can, has, and does go sideways on a fairly regular basis, but that we’ve learned how to cope with those situations and send everyone home alive and neurologically in tact anyway. Further, we are saying that this would NOT be the case if childbirth was left to its own devices. Risk is a continuum, not an either/or. Grow up.

    • Montserrat Blanco
      September 1, 2016 at 11:46 am #

      Driving is more dangerous than walking, so we should stop driving altogether.

      • Roadstergal
        September 1, 2016 at 11:50 am #

        Exactly. Since driving is more dangerous than walking, we shouldn’t try to control the risks of driving to an acceptable level with mandated safety equipment on the cars, licensing standards (shitty though they may be in the US), and restrictions around driving under the influence of drugs, alcohol, or the need to text. We should just ban driving altogether. Welcome to Brooke-world!

    • The Bofa on the Sofa
      September 1, 2016 at 11:51 am #

      I’ve done my part. Your turn.

    • Dr Kitty
      September 1, 2016 at 11:52 am #


      Do you think that only doctors who are willing to attend vaginal breech birth should pay for insurance, or should all obstetricians (and by extension, all of their patients) pay for it?

      Women have a right to autonomy, and doctors may certainly choose to support their decision if they wish.

      In a non-single payer health system, do those doctors and women have a right to make everyone else pay for their choices though?

      • Dr Kitty
        September 1, 2016 at 12:32 pm #

        In a single payer system like the UK where vaginal breech, twins, homebirth, VBAMC are all legal and supported, the NHS is paying almost £700 PER BIRTH in malpractice insurance.

        £700 is more than 50% of the entire cost of a normal vaginal birth in a hospital, and more than 30% of the cost of an elective CS.

        Can you explain why, in the USA, a physician offering a risky procedure should have their practice subsidised by physician with safer practices, and if so, why this should only be the case for obstetricians and not for all doctors?

        Real talk here- every baby disabled by head entrapment during breech delivery who requires lifelong care will cost tens of millions of dollars to care for.

        Should the parents who choose breech delivery have to pay more and the premiums of only doctors offering breech go up, or should everyone have to pay more so that vaginal breech can remain affordable for the few who want it?

        I want to hear your take on this.

    • Azuran
      September 1, 2016 at 11:55 am #

      Driving is more dangerous than not driving. Let’s not do the intelligent things and constantly develop new technology like seat belts and better car to reduce the risk of accidents and the severity of the injuries when an accident occur. Let’s just stop driving altogether.
      Man, you really are a stupid person.

    • corblimeybot
      September 1, 2016 at 11:55 am #

      You dropped your rancid turd in the punchbowl again. But will you continue to prove yourself so cowardly, that you won’t come back and address people’s reactions to your fetid poopoo? History says you’re most likely to drop the turd and run away.

    • Gatita
      September 1, 2016 at 1:23 pm #

      Brooke is a walking Dunning-Kruger effect.

    • Sarah
      September 1, 2016 at 3:42 pm #

      One or both of your parents should’ve, some time before your conception.

    • Charybdis
      September 1, 2016 at 9:29 pm #

      You first.

    • guest
      September 1, 2016 at 10:52 pm #

      Not so. A zero birth rate is incredibly risky to the economy, and total economic collapse is damaging to biological health, eventually.

  16. namaste863
    September 1, 2016 at 11:14 am #

    I don’t understand it. If I do something ridiculously stupid and it kills me, I can accept that. I’ve reaped what I’ve sewn, so submit my story to the Darwin Awards and have a good laugh. If I do something ridiculously stupid and it kills someone else…….That’s a different story. I don’t think I could look at myself in the mirror. I don’t get how these wackadoodles can play Russian Rulette with someone elses life, especially the lives of their own children. How do they sleep at night?

    • Megan
      September 1, 2016 at 1:07 pm #

      I seriously don’t get it either. There is nothing more precious to me in this world than my children. I would have happily taken on the risks of a CS for even the tiniest risk reduction for them. Happily.

      • Fleur
        September 1, 2016 at 4:16 pm #

        Me too – I went for an elective c-section because I had a post-dates baby who was showing up big on a late growth scan, a history of really bad vaginal birth outcomes on my mum’s side, a midwife whom I didn’t trust as far as I could throw her, and a local hospital with a word-of-mouth reputation for letting babies die unnecessarily. I’ve got a pretty angry looking scar, but there are worse places to have scars (both literally and metaphorically).

        I think, to be fair, a lot of women who opt for high-risk births do so because they’ve been brainwashed with the message that it’s the safest option and that they’re protecting their babies by insisting on a home birth of breech twins whilst suffering from gestational diabetes etc etc. I can only assume that the rest make their decisions based on some kind of combination of magical thinking and the “just world” fallacy.

        • Megan
          September 2, 2016 at 9:03 am #

          Well, that and there are also a subset of women who might consider a vaginal delivery because they plan a large family and don’t want multiple CS, which has its own set of risks. Personally, I still wouldn’t do it, but I understand that’s just my prioritizing of risk and others may be different.

          • MB
            September 2, 2016 at 10:32 am #

            So true, but I was thinking about this the other day – where does our greater responsibility lie? To babies that don’t yet exist? Or the one that does?

            ACOG states in its blurb on maternal request c-section that the risks of c-section, “…emphasizes the need to consider the woman’s total number of planned or expected pregnancies if cesarean delivery on maternal request is discussed during her first pregnancy, with the realization that many pregnancies are unplanned.”

            But no one ever mentions that there are so many pregnancies nowadays which are planned, and never come to fruition. Where are the stats on that, I wonder?

          • Megan
            September 2, 2016 at 10:57 am #

            For me, having had two prior miscarriages, I would always place more weight on a current pregnancy than a future hypothetical one because for me, they are more hypothetical than if I were a twenty-something with no fertility issues. I feel very fortunate I have the two children I have. But every woman will weigh risks and benefits based on her situation and history. And every doc will weigh their comfort level of doing a vaginal breech delivery based on experience and risks.

          • MB
            September 2, 2016 at 11:14 am #

            Totally agree. Every person has to weigh these risks. I do find it just tad prescriptive, maybe a little paternalistic, though – the little jab “with the realization that many pregnancies are unplanned.” Lol. O rly? Many? How many?

            Listen, it’s a legit concern. You may unintentionally get pregnant and risk increases your when you start talking about having to perform another c-section. I just think it’s a little, I don’t know, weighted against maternal request c-section, when you warn women that “many” pregnancies are unplanned, without also warning them that “many” planned pregnancies also never happen.

            I mean, infertility/miscarriage factors hugely in these decisions, but does ACOG talk about that, I wonder? They certainly don’t in their recommendations on maternal request c-section.

          • MB
            September 2, 2016 at 11:52 am #

            Lol. I am noticing now my rant is a little OT, but still. When I was reading that on ACOG’s website like 3 days ago, I was sort of burning to talk about it.

          • MI Dawn
            September 2, 2016 at 12:24 pm #

            Uh…2 of my 4 pregnancies (only 2 pregnancies to term, though – the other 2 were miscarriages/ectopic. I happened to be one of those people who got pregnant at the drop of a hat, or missed birth control pill/tubal ligation failure.) A coworker RN found out she was pregnant again at her 6 week PP checkup – WITH exclusive breastfeeding… another friend discovered it wasn’t perimenopause that made her periods stop…

            And that’s only a few examples. TBH, I think more pregnancies are unplanned (not unwanted, just unplanned) than planned.

          • Fleur
            September 3, 2016 at 4:55 pm #

            Oh, I quite agree – I actually typed out part of a comment to that effect elsewhere on this thread, and then deleted it because I was worried I was rambling on! I certainly wouldn’t jump to judge a woman who was dead set on a large family for not wanting to start with a c-section. Or, come to think of it, a single mum with a toddler and limited support who’s panic-stricken about whether she will cope after surgery. I know a fellow single mum who, alarmingly, pushed herself to start driving again two weeks after an emergency c-section because she had no support network and would otherwise have been totally stranded, so I know how desperate people can get.

            What worries me is that, in my personal experience, the majority of women with a “vaginal birth or bust” attitude aren’t necessarily planning a big family, nor are they birth warrior ideologues – they’ve just received an exaggeratedly negative picture of what c-section recovery is like from people with an agenda, and they’re scared. I mean, it’s surgery and it’s not pleasant or something to be taken lightly, but I was on my feet the next day and basically ok apart from the odd twinge after the first week. Some women will have a worse recovery, but a lot will recover even faster than I did (the staff on the ward made it quite clear that I was their post-op recovery dunce of the month!). Yet a lot of women who’ve never had a c-section seem to believe that you’ll be totally bedridden for a fortnight, unable to lift your own baby for weeks, and unable to breastfeed. If I’m honest, that’s what I believed myself until I was given a briefing pack by the hospital two days before the op. Meanwhile, there’s a deafening cultural silence around the possible negative consequences of pregnancy and natural childbirth (despite the fact that every third advert on British tv at primetime seems to be trying to sell urinary incontinence products to women of childbearing age). I worry about whether there can be true informed consent to high-risk natural birth when women get told all the cons of c-sections, loudly and repeatedly throughout pregnancy, and few of the possible cons of vaginal birth.

            (Looks as though I’ve ended up rambling after all – apologies!)

    • Gatita
      September 1, 2016 at 3:30 pm #

      This reminds me of a comment thread I read about Chris McCandless, the person profiled in Into the Wild. I was freaked out by how much some people romanticize him. His story is actually deeply sad: grew up in an abusive home and went out into the Alaskan bush with no preparation or proper equipment despite being warned repeatedly by locals to turn back. Died in a horribly lonely and painful way, despite being a half mile walk from a tram that would’ve taken him back across the river and toward help.

      Now his life was his own and if he wanted to risk it in that way it was his choice to make. But the people who have written about him and romanticized his life are now encouraging other young people to make the journey and the Alaskan authorities are pulling their hair out because now they have to rescue people each year. That’s where things get really screwed up.

      • Sean Jungian
        September 1, 2016 at 3:53 pm #

        And the way I read his story (waaay back when I read it, before the film) his own romanticizing of the “self-made man live off the land” lifestyle is what led him there in the first place. I don’t know if I felt sad, exactly, over his story – his hubris in that endeavor was a mile wide, after all – but it definitely is not an uplifting tale.

        • Gatita
          September 1, 2016 at 3:56 pm #

          I didn’t feel sad until his sister wrote her memoir about her shitty father and mother and I realized that McCandless was probably a damaged person in many ways.

        • September 1, 2016 at 5:25 pm #

          When I read the story, I was amazed that John Krakauer, who I generally find to be a fairly responsible journalist, spent a lot of time arguing that McCandless’ choice to store legumes in plastic bags which caused molds to grow which poisoned him to the point he could not self-evacuate was a completely unforeseeable tragedy.


          If you want to run in the woods with the big boys, you need to know how to store foods safely. Plants do not die instantly when collected. They will continue to undergo cellular respiration and put off water vapor for days or weeks. That’s why even today you buy large quantities of beans or peas either frozen, canned or DRIED. Setting up a basic sun-drying system wouldn’t have been so hard and would have prevented him from dying of that .

          But that would have required actually listening to any of the 4 or 5 helpful strangers who tried to make sure he was correctly and safely equipped before he tramped off into the woods and he wouldn’t do that.

          • Sean Jungian
            September 1, 2016 at 5:34 pm #

            I don’t recall that part specifically, I though Krakauer argued that McCandless was significantly weakened by possibly eating toxic wild potato seeds. That weakness snowballed since he was on the very outer edge of starvation.

            It’s entirely possible I am mis-remembering, it was many years ago when I read the book.

            In any event, how ever his final days and hours played out, there can be no question that he was a misguided young man who ignored useful advice in favor of his own romanticized narrative. He set out on these journeys with nothing much more than a 10-lb bag of rice. which always told me he felt it was his will versus nature, and that he did not believe nature could trump his will.

          • September 2, 2016 at 3:11 pm #

            So, Krakauer had two theories. His first theory was that McCandleless misidentified a toxic legume for a safe legume. The problem with that is that McCandleless actually had a very good botanical guide for the area and it was pretty unlikely that he would collect the seeds safely for several months then suddenly screw up.

            Second theory was based on pictures of how McCandleless stored the seeds in plastic bags.

            I have very little pity for Chris and a great deal of pity for the people he “befriended” then left behind to deal with his passing.

          • Liz Leyden
            September 8, 2016 at 1:48 am #

            Krakauer wrote a New Yorker piece in 2015 that finally explained McCandless’ death. Turns out wild potato seeds are toxic afer all.

      • meglo91
        September 2, 2016 at 8:43 am #

        I lived in AK for five years and, let me tell you, actual Alaskans hate the Chris McCandless story. They see him as a twit who underestimated the harshness of the Alaskan wilderness and died as a result. With just a bit more planning and forethought, he would have survived. He was a jackass who romanticized nature instead of respecting it.
        The parallel, of course, is that the home birthers and free birthers and water birthers and vaginal breech birthers also romanticize nature instead of respecting it. Respect means minimizing your risks and planning for the worst case scenario (which is why we drove around the state with emergency water, blankets, food, and a generator — which he had to use at least twice!) Respect does not mean expecting everything to be OK because you’re honoring nature. Nature, as I and the other Alaskans know, will kill your happy ass.

      • MI Dawn
        September 2, 2016 at 10:29 am #

        A better story was Ralph Edwards (Crusoe of Lonesome Lake). I read that one as a girl. He knew what he was getting into.

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