Science journalist Tara Haelle throws a tantrum

Child Screaming and Throwing a Fit Isolated on White

After more than a decade blogging about natural childbirth, breastfeeding and anti-vaccine advocacy, I’ve become pretty inured to the vitriol directed my way.

I understand threatening the livelihoods of the birth industry and the breastfeeding industry isn’t going to win friends, and I appreciate that cognitive dissonance is hard for women who have staked their self-esteem on imagining that their adherence to the ideology of natural parenting marks them as superior mothers. I’m not blogging to make friends; I’m blogging to reassure women that mothering is about much more than the function of a woman’s reproductive organs.

Had I wanted to publicly make a fool of her, I couldn’t have done a better job than she just did herself.

Every now and then, though, I am surprised by the vociferous response of a critic. That’s the case with Tara Haelle’s tantrum.

This is what Haelle posted on a Facebook page in response to my recent piece about MANA’s acknowledgement of their hideous death rates:

IMG_2158

Oooh boy. Tuteur is not a credible source. She is a nasty woman whose tone actually DOES represent some aspect of her beliefs, even if it’s not as overstated as the tone comes across. Yes, she had a LOT of editing to get rid of the tone in her book, as she did in a NYT editorial. She’s a hateful, nasty woman with one of the worst cases of confirmation bias I’ve ever seen.

In short, she *is* against all home birth in the U.S., period. She looks askance at home birth in other countries, though she’ll deny that. She exploits women’s stories without permission and has illegally run an online medical advice service. The circumstances concerning her not having a license to practice anymore are uncertain and not necessarily nefarious, but she hasn’t had a license to practice in over 15 years and hasn’t practiced at all in over 25. She likely practiced for under 5 years and definitely under 10, and her belief in the evidence stalled when her practice did. She intentionally misreads certain studies and refuses to accept new data that comes out.

She believes that all doulas are suspect and that doula care does nothing to improve outcomes among women. She trusts very few midwives, regardless of where they work. She also believes that the C section rate is not too high (despite ALL evidence and expertise to contrary). She has personally attacked me and MANY MANY others, including my coauthor (in a particularly vicious way where she went after my coauthor’s kid) and Dr. Neel Shah, a Harvard OBGYN who teaches there and has been working assiduously to reduce C section rates safely.

Tuteur offers pretty much NOTHING to the discussion of home birth or birthing in general, she’s a nasty woman whose death I will not grieve, I have zero respect for her, and I have reduced respect for anyone who spreads her work after they learn who she really is and what she really does. And all of that is me with restraint.”

“And I’m almost certain all of that will get back to her because she has plenty of minions and flying monkey spies who look specifically for this kind of thing from me and others so they can screenshot it and send it to her, and I know this post is public. So this will be one more thing she gets to bitch about with me to her audience of sycophants. I don’t waste any more oxygen on her, which is why she’s blocked on all social media channels, as are several of her minions.

What precipitated this outburst of immaturity? As far as I can tell, it’s because I have publicly disagreed with Haelle on several issues and Haelle simply cannot abide that. She has a problem, and it’s one that afflicts all too many health journalists: she doesn’t have enough science knowledge to argue with me, so she’s reduced to ad hominem attacks.

Haelle is hardly alone in practicing health journalism by calling upon experts to interpret the scientific research for her. Most of the time that works quite well since often the science is settled. It doesn’t work at all for the subjects of childbirth and breastfeeding because there is a wide gulf between the science and the “conventional wisdom” espoused by the birth and breastfeeding industries.

Haelle offers the conventional wisdom in her writing and in the area of vaccines, for example, that is good enough. It’s basically useless, however, in addressing what I write about since the thrust of my writing is a paradigm shift: childbirth and breastfeeding, far from being perfect because they are natural, are inherently flawed precisely because they are natural.

Childbirth is inherently dangerous and any philosophical argument or public health campaign that doesn’t take that into account is likely to be deadly. Breastfeeding has a significant failure rate and any philosophical argument or public health campaign that doesn’t take that into account is likely to be deadly.

I also offer a philosophical argument of my own: most of what passes for natural childbirth and breastfeeding advocacy is deeply retrograde and fundamentally sexist. It’s a not so subtle way of reducing women to their reproductive organs and relegating them back to the home. It’s not a coincidence that natural parenting always represents more work for mothers.

Haelle is miffed because I have publicly disagreed with her and rebutted some of her empirical claims. She’s frustrated because she doesn’t know enough science to argue with me and is reduced to name dropping (e.g. Neel Shah who is apparently still smarting because he wrote an opinion piece about homebirth in the New England Journal of Medicine and I pointed out that he had no idea that there were two different types of midwives in the US).

It’s ironic that Haelle produced this wall of text in response to my piece about the latest MANA data. It makes her criticism look particularly foolish because it lacks substance of any kind. Haelle doesn’t bother to address the data in the my piece. I doubt she even read the piece before she commented.

In the few public arguments I’ve had with her, she hasn’t rebutted a single statistic that I’ve presented. Generally, she has stalked off when I rebutted her claims with empirical evidence.

She thoroughly misrepresents my positions such as my views on the C-section rate. I have repeatedly stated that the C-section rate is almost certainly too high, with the important caveat that while we know that many C-sections are unnecessary, we don’t know which specific C-sections are unnecessary in advance.

She wouldn’t grieve my death? That’s the statement of a petulant child, not an adult, and certainly not an adult who claims to be practicing journalism.

Grow up, Tara. Stop obsessing about your feelings and start addressing facts. If you can’t stand when it is pointed out that you are wrong, do more research and make sure you’re right. And thanks — had I wanted to publicly make a fool of you, I couldn’t have done a better job than you just did yourself.

  • Anj Fabian

    For Kathy:

    Sessions is rolling up his sleeves and going to work.

    Investigate alleged corruption and abuse of power in law enforcement? Naw. No need for that. Local law enforcement needs our support! Why spend resources picking on a few bad apples?

    This sounds exactly like home birth apologists. Investigate negligent, incompetent and dangerous lay midwives? No need for that! We should be helping women have safer home births by providing unconditional support instead!

    What could possibly go wrong?

    • MaineJen

      When will this nightmare end…

      • LibrarianSarah

        3 Years, 9 months, 3 days, 4 hours, 45 minutes and 26 seconds.

  • As the author of the other comments, the ones you whited out, I still support what Tara wrote 100% and respect her greatly. She is spot-on in her analysis of you, Amy. The burn may hurt, but it also could help you realize how you really only speak to an echo chamber.

    • Amazed

      As a normal person who finds a double increase in death something that should be avoided and would never wish death upon another person for the great sin of pointing out someone’s mistakes, I say fuck you to both you and the other clown you respect so greatly. You’re deluding yourself if you think your bullshit can “burn” someone like Dr Amy. She’s had much higher bars to clear.

      • Nice! Typical classy SOB fanatic

        • yugaya

          Namecalling is a thing with Tara fangirls. What a surprise.

          Also: “As the author of the other comments, the ones you whited out”

          Huh?

          • Karen in SC

            Her name is whited out, not the comments

          • yugaya

            Wait, someone showed up to copyright comments in which they express full agreement with wishing death on another human being?

          • Amazed

            Looks like it. As I said, queen of class teaching ME class for cussing her out as a heartless moron and monster.

        • Amazed

          I am heartbroken that the Queen of Class hasn’t stated she wouldn’t grieve my death already and you stated your great respect for her.

          Let’s make it clear: Queen of Class wishes death upon another person – great respect. You and Queen of Class get cussed at and called out as clowns – lack of class.

          Your priorities are as messed up as what passes for your heart and head.

          • She did not wish death upon anyone. She said she would not mourn SOB’s death. Huge difference. You flying monkeys need to retreat and chill the eff down.

          • Amazed

            No difference at all. The very fact that she – and you – think of death to bring in the conversation shows how your rotten minds work. Death is a proper punishment for disagreeing with you.

            As I said, fuck you.

            Oh but don’t take that to mean “delete all your posts before fucking off”. That’s what a similarly math-challenged official in a midwifery school did when she finally grasped that her grasp of percents was nonexistent. Just like yours.

          • yugaya

            We’ve talked about this before how the Dunnung-Kruger crowd likes to pretend that we are all five year olds when it comes to language use, and how there are no complex, adult, implied meanings to the words that we say.

            Nice informal indicator of overall reading comprehension levels attained in Tara Haelle Science Mommy Blogger/Writer Fanclub. :)))

          • You all are very angry people

          • yugaya

            U R ALL MEEEEEN.

            Meh.

          • No, saying people are mean is a put down. Y’all are angry. That’s a fact.

          • yugaya

            “That’s a fact.”

            You forgot all caps and at least a dozen exclamation marks – it ain’t a fact unless you type it like that.

            Word.

          • No, the all caps would be more something your group would do. I am calm. I don’t yell or get angry. No all caps necessary.

          • yugaya

            “your group”???

            You do know this is disqus comments section right?

          • Empress of the Iguana People

            It -would- be pretty simple to look and see how many of our “group” regularly use all caps

          • kilda

            babies dying when they didn’t need to does tend to make me a bit angry. speaking just for myself.

          • Amazed

            Speaking for me as well.

          • MaineJen

            I have to agree…unqualified practitioners failing to recognize when a higher level of care is needed, resulting in the needless death of an infant, makes me a bit ragey too.

          • Empress of the Iguana People

            Nah, I’m depressed, but grateful for my OB for making sure the unexpected pre-eclampsia didn’t kill me or my kid.

          • If you had had pre-e with a midwife in my town, in WA, she would have outed you to an OB upon that diagnosis.

          • Empress of the Iguana People

            I was 4 hours into labor. The drive was uncomfortable enough in the first hour.

          • yugaya

            “f you had had pre-e with a midwife in my town, in WA, she would have outed you to an OB upon that diagnosis.”

            Probably not. https://fortress.wa.gov/doh/providercredentialsearch/PDF/353281818.pdf

          • Nick Sanders

            That’s nice, I guess.

          • Would she have been able to make that diagnosis? Would she have required all the tests? Because an awful lot of midwives don’t.

          • Amazed

            And if she had had pre-e with a midwife in Oregon, she might have died, her baby would have likely died or at least been severely damaged, Tara Haelle would have said, “That’s the very, very slight increase in preventable death/brain damage”, and you would have screeched how slight the increase was and called us (Empress included, provided that she survived her ordeal and had the mental capacity to realize that she had lost her baby) a bunch of very angry people.

            Such charmers you are.

          • Linden

            Innumeracy enrages me, I admit

          • Sarah

            We’re pretty good at dealing with tone policing here, you know.

          • maidmarian555

            You do understand that in this situation that *you’re* the flying monkey don’t you?

        • The Bofa on the Sofa

          I guess that is easier than addressing the point…

    • Ken S., As Seen On Watch Lists
    • Who?

      I missed the bit where Dr T got burnt.

      Tara made a fool of herself-not a big task, granted, but she aced it.

      • SOB would not have written this blog post if she had not felt personally burnt by Tara. It’s a passive aggressive attack.

        • Who?

          Tara’s article was one long personal assault. What psychological driver informed her decision to write that?

        • Nick Sanders

          You might want to look up the definition of “passive-aggressive”.

          • pas·sive-ag·gres·sive
            adjective
            of or denoting a type of behavior or personality characterized by indirect resistance to the demands of others and an avoidance of direct confrontation, as in procrastinating, pouting, or misplacing important materials.

            The avoidance of direct confrontation is key to my use of the term.

          • Nick Sanders

            I’m unclear on how a blog post calling a person out by name is “indirect”.

          • A direct response would have been made on the original PUBLIC Facebook post from which SOB C&Pd this screenshot.

          • yugaya

            Tara Haelle has most of her critics blocked on social media. In fact, I believe there is a blog about when she blocked dr Tuteur on Twitter…:)))

          • Gee, I wonder why? (sarcasm)

          • Amazed

            Care to retract your claim that Dr Amy should have responded on the original PUBLIC facebook post, now that you know your deity has made it impossible?

          • yugaya

            Oh that’s easy – so that idiots can make complete fools of themselves by running around the internet demanding that people she has blocked on social media respond to her directly on social media. :))))

          • maidmarian555

            Erm, Haelle wrote on that very post you’re complaining about that she has Dr T blocked on all social media. So no, she wouldn’t have been able to respond directly to a comment. Do you actually read anything properly?

          • The comment is MINE. SOB got a screenshot so she could see what Tara wrote. The post is public, my comment is the one Tara responded on. SOB could have posted on the public thread that she cannot see Tara’s comment but she read it and this is what she thinks. But, no, she posts a whinefest on her blog. This is the definition of passive-aggressive.

          • Amazed

            Let’s make it clear. Tara bitch gets someone blocked and then bitches about them knowing that they can’t see her post (the very definition of a passive-agressive coward). Then you have the nerve to dictate how the blocked person should have reacted as not to hurt Tara bitch’s goddessness without having the post to go by but only your bitch self’s reply to guide her. You both comment on someone’s possible death (what sick minds can think of such a thing in a context of someone disagreeing with them!) and how you won’t grieve it. Then, you come here and cry passive-agressive, showing your lack of empathy for preventable deaths other than Dr Amy’s and demonstrating that the people who let you graduate from elementary school suck.

            You’re a scum, Kathy.

          • maidmarian555

            Jesus Christ. Yes, she would have been able to see your original comment. But she wouldn’t have been able to see or respond to any comments Haelle made. Haelle would not have been able to see or respond to Dr T’s comments. You’d have had a really frikking weird thread full of people not responding properly to each other. Wouldn’t have made much of a debate (although it’s pretty clear from Haelle’s comment she wasn’t looking for debate- it was just an extensive ad-hominem). Also, if you’re going to go around publicly wishing death upon people, you shouldn’t be surprised when they’re not enormously thrilled about it and respond in a public way.

          • yugaya

            You are the definition of internet stupid.

          • you remind me a lot of antivaxers.

          • yugaya

            There’s a perfectly viable explanation – Kathy sucks at reading comprehension just as much as she sucks at math.

          • Mike

            Do you not know what the words “direct confrontation” mean?

    • Sarah

      You supporting what Tara wrote is not persuasive evidence that it isn’t shite…

    • John

      This is missing the most important part, the meat of the reply is not addressed. Whether or not the reply was made in this place doesn’t answer why the analysis is spot on. It’s almost a red herring. Kathy, why do you see it as a spot-on analysis?

      • Because I agree with Tara. She was responding to my comment about SOB, which was somewhat similar, albeit less harsh.

        • yugaya

          LOL.

          Q: Why do you consider it a spot-on analysis?
          A: ‘Cuz it validates how I feel.

          :)))

    • moto_librarian

      Oh, this is hilarious. I love when some butt-hurt NCBer parachutes in and claims that this is an echo chamber. If it really were that, why are your comments still here? Bless your heart.

    • Mike

      Kathy, the fact that I am responding here proves that you are wrong. She does not speak to an echo chamber. She advocates for the safest options for children and you rabid lunatics hate her for telling the truth.

    • Vulcan Has No Moon

      All I saw was a temper tantrum because someone proved her “science” was “science fiction”.

  • Gæst

    Huh. I’ve found Haelle to be level-headed and, I thought, anti-woo before. But that is quite the rant.

  • mostlyclueless

    What’s the back story here? Why does Tara H hate Dr. Amy so much? I thought she was not particularly woo woo?

    • yugaya

      Tara writes crap articles and her book is choke full of woo. She employs this type of ranting against everyone who confronts her about the fact that she writes crap articles and that her book is choke full of woo.

      • Tara writes scientific articles full of facts.

        • yugaya

          Bwahahahaha. Because you say so?

          Remember that time when she described doubled death rate in homebirths in Oregon study as “slight increase”, in an article that was so full of bs that she ended up excusing how shitty it was on the grounds of having a deadline and being stuck with student loans? You know, the same article for which she did not even figure out when mandatory reporting of all planned OOH births in Oregon started, or that full datasets were publicly available? The same one in which she placed a quote about VBAC bans despite the “fact” that it discusses a study that excluded all VBAC outcomes?

          Like I said, lazy journalism. Her articles are full of bs and only laced with enough facts and citations to fool the gullible into believing she knows what she is talking about.

          • I see her, in that article, stating

            “Before considering characteristics of the moms, such as their age, race/ethnicity, income, existing pregnancy complications and underlying health conditions, the raw numbers for a baby’s death during birth (perinatal death) were 3.9 per 1,000 for planned out-of-hospital births and 1.8 per 1,000 for planned hospital births. After adjusting for mothers’ medical conditions and other characteristics, women who planned out-of-hospital births had more than double the odds of having their baby die during birth—but the absolute risk of death was still very, very low: 1.5 more babies per 1,000 died during planned out-of-hospital births than during planned hospital births.”

            Looks clear to me. She was reviewing that study, not reviewing all the data in the world.

          • yugaya

            Looks clear to you what? That a doubled risk is only a “slight increase” ? Ook.

          • Yes, “1.5 more babies per 1,000” is a slight increase.

          • yugaya

            That would be 1.5 DEAD babies. Accurately represented like this: https://uploads.disquscdn.com/images/01a1cf343ea5e2fe3f37af40aa5d8724a9370efef9d22669077cf2e2b22d120f.jpg

            As
            a supposedly unbiased and experienced science journalist she made the choice to frame the analysis of numbers with
            certain semantic ornaments. Against the new Oregon medicaid regulation
            firmly saying that all VBAC is too high risk for homebirth, she picked this
            quote to be included in the article” The evidence doesn’t yet tell us
            who the “ideal” out-of-hospital birth candidate is, nor the categories
            of pregnant women who should never have an out-of-hospital birth,
            Caughey said” . It is far, far from objective analysis to throw such bs quote in there without at least informing her readers that the Oregon
            health authorities looked at that same data and came with opposite
            conclusions when they clearly defined categories of women In Oregon who should
            never have OOH birth. But hey, at the time when the article was published, according to her own admission, she wasn’t really aware that Oregon had homebirth risking out criteria at all.

            Apparently some “just moms” manage to have more facts at their disposal than Tara Haelle the science mommy tantrum throwing primadona does when she writes her articles. 😛

          • Maybe, instead of advocating we ban all homebirth, we should look at how and why problems happen and how to make homebirth safer? Why does that never occur to you SOB fanatics?

          • Amazed

            Ah I can see someone has been listening to Tara Haelle faithfully, instead of actually finding out what we advocate here. Hint: no one, Dr Amy included, advocates for banning all homebirths. Surprised? Good Tara didn’t tell you this?

            Did good Tara tell you how we suggest we ban all homebirth? Did she fill your head with how we suggest we imprison all women who didn’t make it to the hospital in time? Of course, you didn’t check that either, right? Since you respect her so greatly.

          • The Bofa on the Sofa

            How do you even “ban home birth” in the first place?

          • fiftyfifty1

            Yeah, banning home birth would be impossible. Precipitous deliveries happen. Besides, women (like all competent adults) have a right to refuse medical care for their bodies. If you don’t want to go to the hospital, you don’t have to, whether it’s for a kidney stone, or for a birth or for whatnot.

            What is possible is what other developed countries have all done: make it illegal for lay people to call themselves professionals and practice medicine without a license.

            It’s never been about “freedom to birth at home”. Women are, and always have been, free to do this. Heck, they can even invite whomever they want to be there with them. If you want to invite a woman who loves attending births, and has attended a bunch of them previously, have at it! But that woman can’t claim she is a medical professional. And she can’t take your money in exchange for her services.

          • Amazed

            I don’t know. Ask Tara Haelle or her faithful lapdog. Personally, I see no way.

          • yugaya

            “Maybe, instead of advocating we ban all homebirth”
            And who is advocating that here?

            “we should look at how and why problems happen and how to make homebirth safer”
            *We* have done that – that’s how *we* knew all that stuff and data about Oregon homebirth that Tara Haelle didn’t know even existed.

          • fiftyfifty1

            “we should look at how and why problems happen and how to make homebirth safer?”

            Actually, we know already. Look at studies like the Birthplace study from England. This is how to make homebirth safer:
            1. Require all homebirths to be attended by not 1 but 2 university trained midwives. (Here in the United States the equivalent is hiring 2 CNMs. CPMs are illegal in England).
            2. Mother must be delivering baby #2,3,or 4. First time mothers are too risky. Likewise, grand multips (baby #5 and above) are risked out.
            3. You must live within 15 minutes of the hospital under any traffic conditions.
            4. You must do ALL prenatal testing (blood, urine, diabetes, ultrasounds etc)
            5. If you have EVER had ANY medical problem in this or ANY OTHER pregnancy or birth you are risked out. Therefore no twins, VBACs, gestational diabetes, anemia, history of preemies etc.
            6. Absolutely no post-dates. Postdates pregnancies must agree to be induced and delivered in the hospital.
            7. The local hospital must be faxed, in advance, a copy of your medical records including all tests and labs.
            8. You must accept transfer at the first sign of trouble, as determined by your CNMs.

            These are common sense guidelines that can be followed here in the US just as they can be in the UK. We have discussed them in detail here on the SOB. If this is what you are advocating for the direction homebirth should go in the US, you will find a lot of supporters here on the forum.

          • Why doesn’t SOB focus on those positive recommendations instead of demonizing everyone who does anything differently? Do you all really think that you can kill more flies with vinegar than honey? Homebirthers are a lot like antivaxers in that you will do nothing but alienate them and further entrench them in their dogma if you all out attack their beliefs. If you want to facilitate change, you either change the laws and/or you gently work on changing people’s views. SOB’s negativity does absolutely nothing to change the mind of home birthers.

            For years, SOB has, instead, infiltrated private accounts, forums, and websites to cut and paste comments from others for mockery and derision. This comment from Tara is a perfect example. Tara commented on MY COMMENT on a personal friend’s FB page. It was a public post. Being a complete and total coward, SOB did not bother to engage us on the post but instead cut out the comment (whiting out my name) and writing a temper tantrum blog post about it. She could have an ally in Tara, as another person who writes about science. (You can deride her all you want but the fact of the matter is that, unlike SOB, Tara actually makes a living out of writing for Forbes, NPR, Scientific American, Slate, Politico, HealthDay, Everyday Health, and Consumer Reports as well as for her own blog. And she is an author. Why alienate someone who could be a strong ally for her? Because SOB alienates anyone who questions her, period.

            Tara’s comment about SOB is spot-on and exactly why SOB will never facilitate change for the better with homebirthers. She hates them and they revile her. She contributes nothing of value to homebirth conversations other than to her own echo chamber. How do I know all of this? Because I spent years in the homebirth community. Before you bust your gut, my homebirth was exactly like what you write, above, about the UK protocol. And, yes, I live in the USA. My midwife has never lost a mother nor a baby in 30+ years practicing. Why doesn’t SOB talk about people like my midwife? Why doesn’t she lobby for positive change? Why does she do NOTHING but harass people and then post hateful comment on her blog?

            It’s a shame because homebirth in the USA does need to be restyled to be safer for everyone. But, it is never going to come from SOB. The homebirth community long ago realized she hates them and now they hate her. Tara is right.

          • myrewyn

            But focusing on these positive recommendations is exactly what Dr Amy does. I’m currently killing time in late pregnancy by catching up on the archives here and she is very consistent in driving these points home. Her style comes off as abrasive to some but if you really read what she’s saying, she’s very consistent about wanting to make homebirth SAFER for those who want to choose it, and risking out a larger number of women for whom it just is not a good idea.

          • yugaya

            “…infiltrated private accounts… This comment from Tara is a perfect example. Tara commented on MY COMMENT on a personal friend’s FB page. IT WAS A PUBLIC POST.”

            I can’t. Are you really that stupid?

          • Amazed

            AND this entitled. Everyone should cater to Kathy and Tara’s self-esteem.

          • fiftyfifty1

            ” If you want to facilitate change, you either change the laws and/or you gently work on changing people’s views.”

            Exactly! Those are the 2 options. It’s funny that you mention vaxing, because there are good studies comparing those 2 potential tactics with the anti-vax community. Turns out that option #2 (gently working on changing people’s views) doesn’t produce results at all. The only thing that has ever been shown to work with anti-vaxers is option #1 (changing the laws, for example getting rid of religious and personal conviction exceptions). This is why Dr. Tuteur does what she does. She exposes the fact that homebirth with CPMs has a hideous death rate. She gives real life examples of what happens at these births to show the unbelievable level of incompetance. The end goal of this is to legally abolish CPMs. Why should American women have to give birth under fake midwife care that would be illegal in England, Canada, the Netherlands and every single other developed country?

          • yugaya

            Tara Haelle got a major slap in the face earlier last year from AAP regarding her entire “you need to be gentle to antivaxxers” stance when they made it clear that their official position is that pediatricians are more than welcome to refuse to cater to antivaxxers. It’s too funny that her fangirl is selling us that same proven useless approach as the way to accomplish homebirth reform in USA.

          • FallsAngel

            What is a “CPM”? I get that “M” means midwife, but I can’t find any definition that gives me a clue about the other two.

          • Nick Sanders

            “Certified Professional”

          • FallsAngel

            Thanks. Here in CO they’re called “Direct-Entry Midwives” or “Registered Midwives”.

          • fiftyfifty1

            Yes, what they are called can vary from place to place, but all of them are what was previously known as “lay midwives”. They got together and awarded themselves this “credential” of CPM, basically as a marketing ploy. Some of them have apprenticed under other lay midwives, or done correspondence courses sold by other lay midwives. There are even a few in-person courses at places like Bastyr. In all cases, there is very little if any real medical training. None of them are allowed to practice anywhere else in the developed world. The lay midwives in Canada tried to do something similar, but the government realized that they were not trained sufficiently to practice safely and banned them.

          • FallsAngel

            Good for Canada! I remember here in CO, back in the 1980s, the legislature wanted to put the midwives under the board of nursing, and that really caused a firestorm in the nursing community, and rightly so. In 1993, they got their own board.

          • yugaya

            Deadly as hell over there – last time they disclosed perinatal mortality rates they were what 16 per 1000?

          • And how many laws has she succeeded in changing? None. Because she speaks to an echo chamber and doesn’t really care about women. She doesn’t actually do anything to make birth safer. This blog does nothing.

          • fiftyfifty1

            “And how many laws has she succeeded in changing?”

            Well, let’s take Oregon. MANA special interest advocacy had pulled the wool over the eyes of Oregon officials for years. But Dr. Tuteur kept calling out Melissa Cheney publicly year after year. The Oregon legislature finally took the issue seriously, demanded accurate tracking data, commissioned an independent analysis of that data (Judith Rooks). And now there are risk-out criteria in Oregon, where there weren’t before. How’s that?

          • Yes, Judith did that. Not SOB. Judith Rooks.

          • fiftyfifty1

            Judith Rooks was contracted as the neutral party, but she was not who started the movement to look into the death rates. Dr. Tuteur, in contrast, had been calling publicly for the release of the death rates for years.

          • Nick Sanders

            Yeah but did Dr. Tuteur personally pen the legislation, cast all tje aye votes, and then sign it into law? Didn’t think so! Therefore she played no part in it. /s

          • Amazed

            Judith Rooks also did her best to spin the stats ih homebirth favour but even so, the conclusions she arrived at were terrible.

          • Amazed

            Well, she speaks to the echo chamber of obstetricians since she was actually invited to give a talk about homebirth to the ACOG annual meeting in 2013. They are an echo chamber, don’t you know? They’re very much against homebirth. Of course, that’s because they’re the ones left to pick up the slack when women are rushed there with complications after trusting the Tara Haelles’ of the world sage words that the icrease in preventable deaths is so very slight.

            Did Queen of Class tell you about this? I guess not. Or she might not have been bothered to dig this info. After all, she’s just a mom.

          • Meredith

            Then why the heck are you here? You speak in these absolutes about how this is an echo chamber, about how Dr. Tuteur cares nothing about women (the hubris of making such a statement about any human being!), and you say your goals are to make homebirth safer. If you believe all these statements, I don’t see how defending the ad hominem attacks of another person accomplishes what you say you want to accomplish (i.e. what the OP was about). It is incredibly off-putting to hear someone relish the idea of someone else’s death, no matter what you think of their tone or not. You complain about Dr. Tuteur’s tone without any recognition of your own. It doesn’t help your case.

          • I am defending the conversation between my friend and I that SOB posted here and turned into a blog post. That is me, in the whited out section of the screenshot. Tara was responding to me.

          • Meredith

            I know you are defending that, which is why I am dumbfounded. I would imagine extraordinary embarrassment would be a more appropriate response than prolonged defensiveness (try reading that exchange from the perspective of someone not intimately involved in it…spoiler alert, it doesn’t read well). Frankly, I have no horse in this race. But your defense of Tara has made it sure I will avoid her books. I suppose if your goal was to dissuade readers on the fence, your goal was not accomplished.

          • Box of Salt

            Kathy “Tara was responding to me.”

            Newsflash: It was public.

            And Ms Haelle’s response was unprofessional.

            If Ms Haelle wanted to vent to you about Dr Amy in private, she should have done so in private. She chose to do it in public.

          • Amazed

            At the end, it always boils down to this, right? You start making claims about things you have no idea about, spitting in the face of babies’ preventable deaths, pretending interest and wish to make homebirth safer when it’s all about your image and your desire for you and Tara not to be perceived as the bitches your public words revealed you to be.

            You’ll make an excellent CPM, Kathy. And no, Dr Amy would not, under ANY circumstances, recommend that a woman leaves her life and her baby’s life in your incompetent CPM hands, in or out of a hospital.

          • fiftyfifty1

            “she speaks to an echo chamber”…”This blog does nothing.”

            And yet, for some reason, you are here arguing as if your life (or maybe just livelihood?) depended on it. Strange.

          • Azuran

            There is more than one way to create change and help. Obviously you haven’t been here long if you think this blog does nothing, as there have been many comments from people who have thanked her for educating them on the real implications of homebirth and helping them make their own educated choice on various things regarding pregnancy/birth/breastfeeding etc.
            Beside, the American government is a shit fest and trying to pass any sensible law is basically a miracle. She most likely has done much more reaching out directly to the people as she would have trying to make angry old white dudes care about mothers and babies.

          • Liz

            This blog has been an enormous help to my peace-of-mind following two scheduled c-sections and two failures to breastfeed (the first low supply and an undiagnosed tongue tie, the second over supply and a refluxing baby, and both cases anatomical issues making any latch extremely painful). The first time I doubted the evidence of my own eyes that my baby was screaming and feeding constantly because he was hungry, and it hurt so much for reasons other than I was doing it wrong (hearing that still makes me feel stabby). The second time with the benefit of this blog I didn’t beat myself up about turning to formula when pumping became impractical alongside caring for a high-maintenance infant and a busy toddler. It also took over a month of dedicated hard work to stop my milk, so all that panic about supplementing affecting supply for me was nonsense. Nothing I did the first time improved my supply, just like nothing I did the second time caused my cup to runneth over, so-to-speak.

            So anyway, I’m immensely grateful to Dr Amy, and commenters, for all the voices of reason. I didn’t know about gas-lighting before, but I recognise it now and it makes me so mad that I fell for it.

          • This blog does nothing, she says, to a very large group of women who have A) learned a lot, B) been supported through many births and heartbreaks, and C) been galvanized to look at BFHI and the homebirth laws in their states and contact their legislators about them. But no, clearly, absolutely nothing of value happens here. *rollseyes*

          • Amazed

            Why doesn’t Tara Haelle focus on those positive recommendations instead of lying that everything is great just as it is? Why don’t you make any demands of her to shut her lying trap but make demands of the one who speaks the truth? Or are the recommendations positive and the risk real when you get to rant about Dr Amy but when it’s about Tara, everything gets as peachy as Her Serene Highness claims it is?

          • Amazed

            It’s interesting how homebirth has a “community” but Dr Amy has an echo chamber. Do you realize what you’re saying, Kathy? You’ve just confirmed our claims that homebirth is a cult. You won’t meet a “c-section community”, “a “hospital community”, whatever. Instead, you’ve just admitted about the existence of a community whose members get bound by the way they give birth and bark in chorus about evil Dr Amy. I am not surprised you, personally, had a homebirth.

            But it’s us in the echo chamber. All righty.

          • Heidi_storage

            Whoops, didn’t see your excellent list before I posted.

          • Linden

            A statement easily refuted by spending more than 10mins actually reading Dr T’s articles: “the SOB wants to ban all homebirth”

          • I’ve read this blog for years. I’ve never seen her support homebirth in any way.

          • yugaya

            “I have never seen her support any” = “wants to ban all”.

            I’m sure that’s a legitimate claim in your fanclub. :))))

          • Linden

            I don’t support smoking, I’m happy with placing restrictions to minimise harm to others, yet I do not want to ban smoking. I don’t eat meat, I welcome regulations for the welfare of animals, but would not want or expect to see eating meat banned.

            Dr T has explicitly said that she doesn’t want to see homebirth banned. What she would like banned is unqualified ignoramuses lying to women, endangering them and their babies. Let women be attended by qualified people who encourage them to get the prenatal care to keep their babies safe, and who realistically inform them of the risks they take.

          • Amazed

            You’ve read this blog for years and you still don’t know that Dr Amy is against CPMs in any shape? Instead, you claim they’re the only one she trusts.

            We have this established now: you’re as memory challenged as you’re math challenged.

          • Nick Sanders

            How to make homebirth safer: teams of specialist doctors within walking distance prepped and ready to go 24/7 and a bunch of expensive medical equipment only hospitals can afford.

          • So you’re want to control a women’s choice? You’re as bad as prolifers

          • Nick Sanders

            Because I prioritize birth success over birth location?

          • Until you start to understand why women want to birth at home, you’ll never make any progress in this battle.

          • Amy Tuteur, MD

            I understand; they’re ignorant of the risks.

          • Wow, how many years have you been lurking in homebirth forums and chat rooms and you still think they are completely ignorant of the risks? Really? It’s astounding that you have spent what, ten years doing this, and that is the conclusion you’ve come to. Therein lies the reason you will never succeed in this journey.

          • yugaya

            You keep saying that. And yet, ACOG has delivered a no fucks given for feefeelz policy on homebirth. Oregon has not only mandated all reporting of outcomes, it has created a risking out criteria that has closed most of the killer midwives and their practices in Cheyney’s own backyard.

            A lot has changed in the ten years since dr Tuteur started exposing American homebirth killers and risks.

          • fiftyfifty1

            ” Until you start to understand why women want to birth at home, you’ll never make any progress in this battle.”

            Oh, I understand. I was raised in a homebirthing (and antivaxxing) subculture, so I have seen close up the cult-like reasons and justifications. The demand doesn’t arise spontaneously. It’s *created*. And it’s not hospitals and doctors driving women away. It’s the screwed up cult of NCB that ranks and tears down women based on how “natural” they are, while at the same time doing what you do—lying to them about the risks.

          • I have not stated any risks, so how could I be lying?

          • fiftyfifty1

            “I have not stated any risks, so how could I be lying?”

            My goodness, yet another lie. Do you think we can’t read? Your own deceitful comment about the risk of homebirth is right above:

            “Yes, “1.5 more babies per 1,000″ is a slight increase.”

          • Box of Salt

            Kathy “I have not stated any risks, so how could I be lying”

            How do you not understand that this is not to your credit, and actually drives the point home your critics are making?

            You don’t want to state the risks.

          • Merrie

            In addition to the “natural is better”, some of it is this fear of doctors and hospitals and “unnecessary interventions” that is also, to some extent, created by the NCB movement. Some people go that route because they personally had an unpleasant experience with a provider, but I bet that a lot do because they’ve heard about unpleasant experiences had by others and they want to avoid that themselves. They don’t understand the risks of birthing at home and think it’s just as safe or almost as safe. I used to be pretty in the woo myself and toyed with the idea of a CPM homebirth, and it was really the worry about doctors and hospitals that was getting me, and this worry was founded on scare stories told by NCB types. Ultimately the science denying got to me and we went with a CNM in the hospital instead. I still know a lot of homebirthers and cringe when I hear someone is planning one. I’ve heard a couple of personal stories that sound like “near misses”.

            I have had 2 kids and am pregnant with my 3rd. Only one time in all the obstetric care I’ve received was I ever treated anything less than perfectly nicely. Some providers have crappy bedside manner and I know that there is room for improvement in how providers communicate with patients, but that’s a reason to work on improving communication between real providers and their patients, not a reason to chuck it all and birth at home with some underqualified yahoo.

          • Nick Sanders

            Well, I asked why, but you refused to tell me.

          • myrewyn

            I have to keep reminding myself that although we see a lot of them here, women who want to have a home birth are still a tiny, tiny fraction of the population. For me, giving birth away from the comfort of a hospital with quick access to surgery, would be terrifying. I was sort of musing yesterday over what makes some people so afraid of doctors and hospitals and I wonder if a little of it is early exposure leading to doctors feeling comforting rather than distant and frightening. I have doctors in my family, and two of my early besties had doctor fathers (an OBGYN and a Cardiologist). My first “job” was as a candy striper at one of our biggest local hospitals and I thought seriously about a career in medicine myself.

          • MaineJen

            Well Nick…if you have to ask, you can never understand. Just like if you don’t *believe* in clairvoyance, the reading won’t work for you.

          • The Bofa on the Sofa

            It’s a woman thing. Men like Nick can’t understand.

          • MaineJen

            We women have other ways of knowing!

            (Although, wouldn’t it be cool if we really did? I would love to be able to echolocate…)

          • kilda

            according to smithsonian magazine it is possible:

            http://www.smithsonianmag.com/science-nature/how-human-echolocation-allows-people-to-see-without-using-their-eyes-1916013/

            maybe it can be your new hobby. 🙂

          • MaineJen

            Oh my god! That video of the guy on the bike. Really cool 🙂

          • fiftyfifty1

            “You’re as bad as prolifers”

            You know who are really as bad as prolifers? The CPMs. They created a fake credential and intentionally gave it a similar name to the CNM in order to trick the gullible. It’s like the anti-choice “crisis pregnancy clinics” that spring up right across the street from abortion clinics and adopt a name only one word different. Pathetic.

          • Heidi_storage

            Um, no. We want to make sure that this choice is informed. And even those of us who are dead against home birth want this choice to be made safer. This cannot happen without serious reform of the home birth midwife community.

          • Azuran

            It’s about safe medical practice.
            Let’s say you have dental problems. You have the right to go see an actual medical professional about it, you can also refuse to see a medical professional and just live with it, or you can also tie your own teeth to a door and slam it if you want to because it’s your own damn body. But random nobodies with barely a high school diploma are not allowed to call themselves ‘dental expert’ and pretend to practice dentistry.

          • Amazed

            Aren’t you ashamed, Kathy? Just a little? You just proved you have no idea what Dr Amy advocates. Hell, you proved you have no idea what CPM MEANS! And you come here bellowing to commenters about choice? When you have no idea what an INFORMED choice in this situation is?

            Rush and kiss Tara’s behind some more. She might love ignorants like you. Here, we aren’t this insecure. SOB.com isn’t the place for you.

          • moto_librarian

            Fuck off, Kathy. I for one am sick to death of excusing charlatans under the banner of feminist choice. I’m not interested in banning home birth (or even unassisted birth, for that matter), but I am disgusted by the number of people who think that it’s fine to lie by omission about home birth. The mantra of NCBers has always been “informed consent” when bashing hospitals, the c-section rate, etc. But whenever someone points out the hideous death rate (and the largely unknown morbidities) of home birth, suddenly it’s a different story. Women are intelligent, autonomous beings. If you don’t think that women deserve to know the very real risks of home birth, you are part of the problem. In fact, complaining that women will often make a different choice when presented with the actual risks and benefits is paternalistic bullshit. It’s also interesting that you would bring prolife into this. I assume you get up in arms about the outright lies and obfuscations of crisis pregnancy centers. Why aren’t the lies espoused by home birth midwives just as odious to you?

          • Heidi_storage

            When has Dr. Tuteur advocated banning homebirth? Providing accurate mortality comparisons and advocating for proper attendant training/risking out and transfer criteria are not calling for a ban on home births.

          • She has stated many times that only CPMS should be allowed to deliver and only in hospitals.

          • Empress of the Iguana People

            CNMs. They had a nursing degree. Hell, they have to have more than a high school degree.

          • myrewyn

            That’s not what I’ve seen. She wants midwives to have CNM credentials (not CPM), to carry liability insurance, and to risk out certain women/pregnancies.

          • Heidi_storage

            You mean CNMs? She certainly does think that only CNMs (or OBs) should deliver babies, but I have never seen her advocate for criminalizing home birth. Given her insistence on patient autonomy, I would be astounded if she did take such a position. However, she would like patients to realize that home birth is more dangerous than hospital birth.

          • fiftyfifty1

            “She has stated many times that only CPMS should be allowed to deliver and only in hospitals.”

            Wow. Looks like you don’t know the difference between CNMs and CPMs. You’ve been totally hoodwinked, just like the CPMs intended. CPMs are just the same lay midwives of old who banded together and created for themselves a fake credential intentionally similar-sounding to CNM, to trick the gullible. Like you.

          • Has anyone here advocated banning homebirths? I know Dr. Tuteur doesn’t advocate that, and I don’t advocate that, and I’m pretty sure the vast majority of commenters don’t advocate a ban. Homebirth is a stupid decision, and it will always be a stupid decision, but people are allowed to make stupid decisions.

            What we advocate is banning CPMs, who claim to be medical practitioners but aren’t. What we advocate is strict rules around homebirth, such that if someone wants one within the medical establishment, she meets stringent low-risk criteria. She can still go UC if she really wants, but she would know that she’s flying solo for that.

            But for you to know that, you’d have to have actually read what goes on here, and maybe read Dr. Tuteur’s words for comprehension instead of for confirmation bias.

          • swbarnes2

            The way to make homebirth safer is to have fewer homebirths. The recent data provided by MANA shows ever more support for this. Breech? No homebirth for you. Twins? No homebirth for you. VBAC? No homebirth for you. GD? No homebirth for you. Evidence of pre-eclampsia? No homebirth for you. Any other serious medical condition on top of the pregnancy? No homebirth for you.

            If all those homebirths had not happened, the stats on homebirth would be better than they are.

            And if you are really, sincerely serious about making homebirth safe (not safer than hospital birth, of course, just safer than homebirth is now), no homebirths for primips. Every single first time mother who wants a professional licensed attendant needs to be in a hospital. Homebirthing midwives claim that hospitals are so ghastly that they drive women away? Well, if virtually no women giving birth in hospitals are pleased with their care, if virtually no mothers are grateful for life-saving care that no homebirthing midwife could have possibly given them, then midwives should have no problem securing tons of clients from the pool of mothers who had hospital deliveries for baby #1.

          • MaineJen

            We know how to make homebirth safer: ban CPMs and institute actual standards of practice and risking out criteria. Why is there so much pushback against these measures?

          • myrewyn

            Ugh, makes you want to beat your head on your keyboard. Dr Tuteur has the patience of a saint to keep at it.

            The disconnect between what this blog and its supporters are saying and what the HB community hears is staggering. We say, “we respect women’s choices on birthplace but want to improve the safety of ALL births and make sure everyone makes a decision based on all the available information” and they hear “we want to take women’s choices away by banning all homebirth”. I seriously don’t get it.

          • Dr Kitty

            We know what problems happen and how to make homebirth safer.

            The problems that happen are:
            Foetal distress during labour is not recognised until it is too late.
            TOLACs rupture.
            Breeches suffer head entrapment.
            Shoulder dystocias occur in women with LGA or post dates babies and their babies are disabled or die.
            Women labour for days with ruptured membranes and they and their babies end up septic.
            GBS isn’t managed appropriately during labour and babies get GBS sepsis.
            Second twins die due to placental detachment before delivery.
            Hidden abruptions aren’t recognised and babies die.
            Women push for too long and their pelvic floors are irrepably damaged while their babies are deprived of oxygen.
            Dysfunctional labours are allowed to continue for days and babies die from hypoxia.
            Women suffer PPH and bleed out.
            Pre-eclampsia is unrecognised or managed ineffectively (Brewer diet) leading to IUGR, foetal distress, abruptions, eclampsia and HELLP.
            Postdates babies die when their placenta craps out because no-one is checking to see if they are ok.

            Many of these things happen because CPMs ignore best practice for intrapartum and antenatal monitoring, or don’t have sufficient education to recognise problems when they arise, or actively prevent women accessing appropriate care when it is clear things are going wrong.
            For many of the examples I am thinking of specific babies – Magnus, Aquila, Vylette, Gavin, Shazad and more.

            How you prevent this happening is having nationally agreed guidelines on risk criteria for homebirth and ensuring that only appropriately trained, insured practitioners attend deliveries, and that said practictioners keep accurate contemporaneous notes which are immediately available to other professionals in the event of a hospital transfer.

            Women choose homebirth because:
            they genuinely believe it is a safer, more gentle way of bringing their child into the world
            they have deep seated phobias and anxieties about hospitals, needles and surgery
            they distrust doctors and don’t believe that HCPs have their best interests at heart
            they believe that only at home can they have a truly natural, spiritual experience
            they know all the risks and seek to birth at home as an act of deliberate transgression against societal norms (stuntbirth)
            they have certain religious views (Quiverful, Amish etc) which make homebirth a more acceptable option.

            Downplaying the risks, feeding into a fear of intervention and validating feelings of mistrust of “the system” and telling them that CPMs are adequately trained with appropriate professional standards and oversight does absolutely nothing to help these women make truly informed decisions about their healthcare.

          • Heidi_storage

            Ah. So car seats reduce childhood fatalities “slightly”; ie, by 71% in infants, even less in older children. (After all, fewer than 2/100,000 children die in car crashes.) Clearly, it’s safe to drive without putting children in car seats.

          • Wow. Math is hard for you, huh. 1.5 per 1000 is lot smaller than 71%

          • fiftyfifty1

            “Wow. Math is hard for you, huh. 1.5 per 1000 is lot smaller than 71%”

            The 1.5 per 1000 is how many EXTRA babies die in homebirth. It’s actually more than a 100% increase over the baseline rate in the hospital. And that’s just the ones who die in labor. Another 0.6 per 1,000 homebirth babies die in the neonatal period.Which is ~3x as die for mothers who choose the hospital.

          • So, why not make it safer instead demonizing it?

          • Box of Salt

            Why doesn’t MANA? They’re the organization for the folks who want to be employed to do it. Why don’t they take responsibility for setting and enforcing actual safety standards?

          • yugaya

            Who is “demonizing homebirth” here? Giving women access to full information instead of downplaying the risks via shitty deadline/money driven articles is called demonizing homebirth where you live?

          • Amazed

            Why doesn’t Tara want to make it safer, instead of glossing over the deaths? Why don’t YOU?

          • fiftyfifty1

            “So, why not make it safer instead demonizing it?”

            That’s what I’m working to do. And how to do it is clear. It involves 1) Abolishing CPMs 2) Risking-out women who are not good candidates to deliver at home.

            So the question is why aren’t you doing this?

          • yugaya

            And why has the tantrumish author failed to mention such simple yet extremely important facts in her supposedly science-literate and objective “in depth” article on Oregon study?

            Because she is 1) lazy journalist who did not know/care to know about Oregon regulation or risking out criteria much when she wrote it and 2) because the article she wrote is nowhere near objective.

          • And what are you doing to facilitate those changes? SOB does exactly nothing except chat online.

          • Linden

            She gives women the facts they need to make their own decisions. And that is what puts you in a tizzy.

          • fiftyfifty1

            “SOB does exactly nothing except chat online.”

            Nothing except chat on line?! How about publishing a book about it with a major publishing house, speaking at the national ACOG meeting, multiple articles in national magazines, radio appearances?

            “And what are you doing to facilitate those changes?”

            Educating my patients about the real risks. Teaching the medical students, residents, and mid-level students that I precept about the real risks. Phoning and writing my state legislators. Recruiting my OB colleagues to serve on the state board overseeing direct entry midwifery practice. Educating people like yourself one-on-one here on the SOB.

          • Box of Salt

            “And what are you doing to facilitate those changes?”

            Back at you, Kathy.

          • Amazed

            And Tara Haelle lies about in supposedly scientific articles. Still, you kiss her ass and relish talking about Dr Amy’s possible death.

            What’s wrong with you?

          • The Bofa on the Sofa

            Actually, Dr Tuteur has spoken recently at an acog meeting about the risks of home birth.

            So you are exactly wrong.

            If you are referring to commentators, we have obs, other doctors , nurses and even midwives who educate their clients about the risks.

            Double wrong.

            We even have occasional visitors who are active within the acnm trying to affect change.

            So to sum up: you are full of shit

          • Nick Sanders

            Why not make drunk driving safer instead of demonizing it?

          • Homebirth is not like drunk driving

          • Nick Sanders

            Why not?

          • Empress of the Iguana People

            being drunk is more fun?

          • Linden

            You can say that again.
            I can say that I threw up more times during my one time in labour than I ever did due to alcohol.
            Maude bless whatever they gave me to stop that. I was surprised they got a cannula in. I felt dessicated.

          • The Bofa on the Sofa

            True. Drunk driving is a he’ll of a lot safer

          • moto_librarian

            Probably because the homebirth lobby is against it. These are people who think it’s just fine and dandy to deliver multiples and breeches at home, after all. They consistently oppose regulations that would restrict their practice to what they claim it is: low-risk birth.

          • Amazed

            I wouldn’t cast stones in your place, Kathy dear. Where were you when the lesson that percents can only be compared to percents was taught? 1.5 per 1000 isn’t a percent, it’s the EXTRA DEATHS THAT NEEDED NOT HAPPEN! The INCREASE is far more than 100 percent.

          • It’s 0.15%. And what was that 0.15% about? Why did it happen? What were the circumstances? Can homebirth be made safer? Can we look at details of the homebirth experience and make it safer for all? Why don’t you all focus on that?

          • maidmarian555

            Why don’t you ask MANA how *they* can make homebirth safer? Why aren’t you angry at the very industry that is causing these additional deaths? Why aren’t you furious with American legislators that continue to allow unqualified, uninsured practitioners to attend homebirths who face no legal or professional consequences when things go wrong? There are people who are making money out of these unconscionably dangerous practices and yet, for some reason, you’re angry with people like Dr T who are merely pointing this out. Homebirth where I live in the UK is much, much safer than it is in the USA. Largely because it’s illegal to have people who have no clue what they’re doing calling themselves midwives. Lobbying for legislative change just for a ban on CPMs and making it so there are consequences for pretending to be a midwife (like being thrown in jail) would improve your homebirth death rate. This isn’t rocket science- there is much in the way of existing best-practice evidence in other parts of the world. You’re pissed at the wrong people here.

          • Amazed

            Because her goddess is angry at Dr Amy, not MANA, and like a good little follower Kathy follows the line. Be it wishing death on someone else or saying, “What’s a few dead babies?”, she’s here, barking enthusiastically under her mistress’ tree.

          • Amazed

            Once again, who was the fool who let you graduate elementary school? We’re talking about percents. Percents of the RIGHT THING! Which you don’t get! Rush back to your Goddess of Classy and beg her to teach you how to compare percents or perhaps teach you how to look at the right thing to take percents from.

            Oh wait, she’s as dumb as you. She’s just a mom.

            Get lost, monster.

          • Amazed

            God! It isn’t 0,15% at all. Linden spelled it clearly for you. How do you function at everyday level if you STILL can’t grasp it? How do you tie your shoes?

          • Charybdis

            She wears slip-ons or wears the ones that fasten with Velcro.

          • Nick Sanders

            Learn the difference between absolute and relative percentages, please.

          • Abby

            Homebirth could be made safer if the people attending the homebirth had proper obstetric training, and actually recognised when things were not progressing normally, but it will never be as safe as being in a hospital with an operating theatre for an emergency c section. The horrible tragedies of baby deaths that are reported here in the U.K. are almost always found to result from a delayed caesarean or a denied caesarean due to either pressure on staff to reduce the caesarean rate or a culture of ‘vaginal birth at any cost’ amongst the midwives.
            I think women are treated poorly in hospitals here by rationing and denying epidural pain relief and understaffing especially of postnatal wards but homebirth doesn’t solve this. If anything it makes things worse as 2 midwives are pulled off labour ward to attend the homebirth of 1 woman. In a socialised health service it makes no sense to spread precious resources like this ( we have properly trained nhs midwives -like nurses)
            I don’t get the harking back to the good old days when the midwife was a local wise woman, and loads of women and babies died – have you read any fairy stories? There are lots of stepmothers for a reason!!

          • maidmarian555

            When I had my son last year, the midwife looking after those of us that were in for induction was pulled off to go and attend a homebirth. This resulted in me not actually having my induction properly started until 11pm that night (I’d got there at 2pm) and set off a chain of events that made my personal experience a pretty shitty one. 4 women had a break in their care so that 1 woman could have her baby at home.

          • Amazed

            Sounds a lot like the bragging of a homebirther at motheringdotcom that if she transfers in labour, she gets to bump another c-section that was planned in advance as they wait to see if she’d need one.

          • maidmarian555

            They certainly are a charming bunch. I am unsurprised at their total lack of empathy when it comes to the consequences of their choices for other women who may end up with breaks in care like I had, or a delayed planned section. Seeing as a number of them don’t really seem to be that bothered about the risks to their own babies, it’s logical they wouldn’t care about people they aren’t related to.

          • Amazed

            A charming bunch, indeed! I am horrified that YOUR bunch was left without appropriate care for this long. 9 hours of delay is huge! If something had happened to you or another mom, would the equipment have jumped to your rescue on its own?

            I know, I know we say that too often, it’s equipment that makes the difference but we don’t mean it like this! What’s next, robotic equipment for hospital sheeple so Her Homebirthing Highness can enjoy bonding with all midwives at the labour ward in the Chamber of Serenity?

          • maidmarian555

            Oh I had some random nurses come round and monitor baby and my ongoing contractions. I was repeatedly told I was in labour and was going to have my waters broken but not until after the next shift came on. It’s just that nobody did a VE (original midwife did one at about 3pm and told me I would have another at 5pm). By the time the next shift remembered to do that and worked out despite my ongoing contractions, literally nothing was happening and I hadn’t dilated at all by myself it was really late. Rather than leave it til the next day, the midwife on duty decided it would be a great idea to give me a pessary for induction at 11pm. Then gave me a paracetamol and said I should get some sleep. Whilst contracting 2 in 10. She also neglected to tell me she’d given me the 24hr and not the 12hr pessary. And blamed the original midwife for everything. I am currently 14wks with #2 and am (hopefully) going to be able to have an elective section this time. If I get my way and then get bumped on the day for another homebirther I will be pretty pissed.

          • Amazed

            So, the normal routine of the ward was disrupted because Her Homebirthing Highness needed handholding and womanly support all for herself, resulting in at least one mother receiving less than optimal care. Well, well, if they pant and rant about homebirth so excitedly, why won’t they make a drill of how not to give other women short shrift in their rush to attend the homebirthers? As I see it, your safety and indeed, comfort was compromised so a homebirther can get her way.

            Not OK.

          • maidmarian555

            Pretty much. And it is an important part of the conversation too I think. Homebirth is pretty safe here. But we have a midwife shortage and there are real consequences for other mothers when they get pulled off labour wards, where they may be caring for a number of women, and sent to a home where two of them will be looking after just one. I don’t know if that’s really the best use of the resources we have.

          • Dr Kitty

            I have pointed this out before.
            To be ethical, something must be just.
            To be just it must do the most good to the most people.
            Having two midwives attend a homebirth and leave a labour ward dangerously understaffed is not just, and therefore cannot be ethical…even if it might be nice for the homebirthing lady.

            In a single payer, NHS system the care you get is determined by need, not want.

            Homebirth is “cheaper”, but as the situation stands at present it is both a false economy and an inequitable and unsafe workforce distribution.

          • Dr Kitty

            motheringdotcom!
            Where the true woony tunes hang out and everyone had to tiptoe around the feelings of stormbride, one of the least pleasant people I have ever come across online, but who has some sort of magical status there as a warrior goddess.

            Anyone who thinks this is an echo chamber posting medical advice by unqualified laypeople should try posting “My CNM has risked me out and the OB recommends a C-section- what should I do?” or “My paediatrician told me to supplement with formula-what should I do?” on MDC and see what happens.

            The MDC parenting boards had way too many “How to avoid CPS taking your kids away for neglect, just because they are functionally illiterate, have never seen a dentist or doctor, eat only a raw vegan diet and we have no electricity or running water in our woodland cottage” posts.

          • MaineJen

            …and yet somehow, they have internet?

          • Dr Kitty

            I’m exaggerating for comic effect, but really, not by a lot.
            MDC is a rabbit hole. You think you’ve seen the most ridiculous NCB post possible, and then it just spirals.

          • Amazed

            And dangerous. There was this woman who wanted to work as a nanny but without the vaccination required. She got encouraged to tell potential employers that she had all the necessary shots – meaning no shots because to her, they were all unnecessary. But that was not to be mentioned, of course.

          • Dr Kitty

            Oh the UP/UC woman who diagnosed herself as pregnant with triplets and wouldn’t contemplate the possibility it might be hydatitiform mole, polyhydramnios, GDM or, in fact, any of the many more likely causes of measuring large for dates than spontaneously conceived triplets.

            Spoiler alert- it wasn’t triplets.

          • myrewyn

            You don’t say!

          • MaineJen

            Oh my god. That’s worse than Babycenter.

          • Dr Kitty

            If you ever have an hour or two to spare, and you think your blood pressure can handle it, check out the MDC forums.
            If you ever worry, for example, that you might me in an echo chamber and should seek some alternative viewpoints.

            From an actual, real post, currently in the Pregnancy and Birth sub-forum on Unassisted Childbirth:

            “In my heart, I knew that this [UC] is what I wanted all along, but I had too many fears about bleeding to death or my baby suffocating. After reading many books and articles, it’s become clear that that is so unlikely that I may as well not worry about it”.

            From an actual, real post currently in the Child and Teen Health sub-forum:
            “My dd will be 15 next summer and is considering a trip to India for 2.5 weeks. She is unvaccinated and a very healthy girl. Of course the group she is traveling with requires proof of vaccination. I need to educate myself in what diseases we will be up against, how to attain exemptions, and how to boost her immune system for travel. I encourage any suggestions and thoughts on the issue!”

            Seriously, everything might be a Poe.

          • Empress of the Iguana People

            ugh.

          • Heidi_storage

            Are…are you serious? We’re talking a 71% reduction in the proportion of fatalities occurring in unrestrained infants–WHICH IS LESS THAN 2/100,000 INFANTS.

          • Nick Sanders

            That is entirely dependent on what it’s 71% of.

          • Amazed

            You’re a monster, Kathy. Just like Tara.The burn may hurt, but it also could help you realize how you really are a heartless moron. The risk isn’t slight, no matter what the other moron tells you.

          • I’m neither nor a monster but thanks for being classy!

          • Amazed

            The moron and monster being offended. You’re so sweet. Am I now to proceed how you advocate letting 1.5 baby in 1000 die a preventable death and claim you’re a horrible woman whose death I will not grieve? That’s what your guru Tara Haelle does, after all. Queen of class, she is and you are.

          • Amazed

            Wait! A double increase is slight?

            No wonder you’re so awed by Haelle’s bullshit. You don’t even know that even if the NUMBER 1.5 looks low to your uneducated mind, the INCREASE is gigantic? Wow.

          • ACOG says about 35,000 homebirths occur yearly, with 25% of those being unplanned and/or unattended. So, 26,000 planned homebirths, with 1.5 per 1000 neonatal deaths. That is 39 deaths. So, how and why did those 39 babies die? What can we do to help homebirth be safer so that we can get that number closer to zero?

            From Tara’s article “the difference in absolute risk of neonatal death between the two settings was, again, still very low, just 0.6 deaths per 1,000 deliveries. Put another way, if 10,000 women planned a hospital birth and 10,000 women planned an out-of-hospital birth, six additional newborns would die in the second group.”

            So, how can you prevent those 6 deaths? Demonizing homebirth isn’t working, is it ? Y’all are just making enemies. Trust me when I tell you that you all are doing nothing whatsoever to change homebirth practices. The homebirth community is just digging in deeper to make sure birth freedom doesn’t go away.

            You want to make things better? Be a positive change.

          • Who?

            Didn’t take long for you to go to the homebirth hobbyist chestnut:

            ‘What’s a few dead babies.’

            Not the words of someone I’d trust on any topic, thanks all the same.

          • yugaya

            “That is 39 deaths”
            Nope.

            Oregon study excluded all the deadliest homebirths. The actual death toll is much higher. See Rooks report and full data from Oregon, the only state in USA that has mandatory reporting on all outcomes if you want to entertain us all with your calculations. 2013: Rate of term fetal+early neonatal deaths for planned hospital birth was 1 in 618 ( 1, 61 per 1000). Rate for planned OOH birth was 1 in 206 ( 4.85 per 1000). Planned OOH in Oregon was 3x more deadly in 2013 for a lower risk cohort of women whose *perception* was that homebirth is safer. Extrapolated to total of homebirths in USA, that is a lot bigger pile of dead babies on a population level than “just six more dead babies”. Not to mention that even those six deaths you miscalculated are all excess death toll in lowest risk cohort possible.

            (Do I need to feed the lapdog data too like I fed it to its master , or can the lapdog manage to find it on its own?)

          • Karen in SC

            Remember when the CEO of GM was called to testify before Congress about a defect that caused 13 deaths over a DECADE? And GM probably paid out millions? Homebirth attendants don’t even give a refund when the baby dies at their hands! And they say things like “at least the mother had a lovely homebirth”, “some babies aren’t meant to live” or “you should have done your research” etc.

          • Amazed

            I don’t trust you. I never trust bitches who wish for someone’s death for the sin of disagreeing with them. I just make it a principle.

            However, I trust the mothers who come here with blazing guns to defend homebirth and then end up horrified at realizing the risk they put their homebirthed babies into. I trust mothers like Ellen Mary who heartily disliked Dr Amy’s tone (and many of us here) but listened to the message and went to the hospital, just in case, and was profoundly grateful that her unexpected complication was managed professionally and she ended up with a healthy baby.

            I never trust people who prioritize their fee-fees over their child’s wellbeing. That includes both anti-vaxxers and homebirthing monsters who won’t listen out of ego.

          • MaineJen

            So…what’s a few more babies born to women with no risk factors who would definitely have survived if born in a hospital, but instead died for no good reason?

            Right? Isn’t that what you’re saying?

          • Lemongrass

            Kathy, that is an over 100% increase and roughly the death rate of measles. You don’t think that is a big deal?

          • Roadstergal

            I’m now thinking she might be an anti-vaxxer, and considers measles NBD. :p Her profound innumeracy is very anti-vax-amenable.

          • Lemongrass

            No, she is not an anti-vaxxer. That much I know for sure!

          • Roadstergal

            Oh, good. Anti-vaxxers make me soooo mad.

          • FallsAngel

            OK, I’ve said my piece on here about Tara Haelle and what I think of her numbers, but I’ll not tolerate someone talking about Kathy that way. Kathy is very pro-vax, as you can see by searching her posts.

          • Roadstergal

            I apologize for suggesting such a possibly existed.

          • Amazed

            She also said the risk was “still very, very low.” Dumb asshole didn’t know the number one rule at reviewing something that you have no idea about – ask an expert. Any obstetrician in a first world country would have told her that the absolute risk of death was monstrously high.

          • 1.5 per 1000 is very low.

          • fiftyfifty1

            Out of curiosity, where would you personally draw the line between “very low”, “low”, “high”, “very high” etc?

          • Who?

            So you’d happily sit in a room for a day with 1999 other people knowing three of you would be carried out dead at the end?

            Or is it just others who get no say, ie babies, who you’re happy to have run that risk?

          • I ‘d rather find positive ways to make homebirth safer than facilitate an all out war with homebirthers.

          • Who?

            So that’s a yes then.

            Nice.

            The things that make homebirth safer are simple and finite-fiftyfiftyone outlines them below.

            I’m copying them here to save you the trouble of looking down the thread. They are not a secret, nor are they difficult or controversial.

            What they are though is the end of homebirth hobbyists, some of whom make a living out of the homebirth movement.

            How many of these do you support?

            fiftyfiftyone wrote:
            Actually, we know already. Look at studies like the Birthplace study from England. This is how to make homebirth safer:
            1.
            Require all homebirths to be attended by not 1 but 2 university trained
            midwives. (Here in the United States the equivalent is hiring 2 CNMs.
            CPMs are illegal in England).
            2. Mother must be delivering baby
            #2,3,or 4. First time mothers are too risky. Likewise, grand multips
            (baby #5 and above) are risked out.
            3. You must live within 15 minutes of the hospital under any traffic conditions.
            4. You must do ALL prenatal testing (blood, urine, diabetes, ultrasounds etc)
            5.
            If you have EVER had ANY medical problem in this or ANY OTHER pregnancy
            or birth you are risked out. Therefore no twins, VBACs, gestational
            diabetes, anemia, history of preemies etc.
            6. Absolutely no post-dates. Postdates pregnancies must agree to be induced and delivered in the hospital.
            7. The local hospital must be faxed, in advance, a copy of your medical records including all tests and labs.
            8. You must accept transfer at the first sign of trouble, as determined by your CNMs.

          • Azuran

            You think that CPM and Mana are going to sit idly by while someone else uses ‘positive ways’ to make their job illegal?
            And what is a positive way in your mind?
            Dr.Amy is using science and statistics to show that homebirth in the USA isn’t safe. You think that’s a negative way of trying to make it safer?

          • Amazed

            You’d rather wish death on someone for disagreeing with your goddess of ignorant bullshit. It doesn’t matter that she’s sweeping unneeded deaths under the carpet.

          • yugaya

            Let us know when you find those unicorn fart ways, will ya?

          • Nick Sanders

            Why? What end does homebirth serve? What makes it worth enhancing instead of replacing?

          • Herein lies the reason you all exist in an echo chamber. If you have to ask the question, you’ll never respect the answer.

          • Nick Sanders

            What I’m hearing is “there is no answer, just do it because I said so!”.

          • fiftyfifty1

            ” just do it because I said so!”.”

            Exactly. That is what is behind the demand for homebirth. NCB advocates create the demand for homebirth themselves. They tell women they have failed themselves and their babies if they don’t measure up to their screwed up “100% natural” ranking system, and they turn women against conventional medical care. In my opinion, it has a lot of features in common with cults. And I say that as someone whose experience with homebirth culture (and anti-vaxxing culture) goes back nearly 40 years to the 1970s.

          • Empress of the Iguana People

            I don’t exist in an echo chamber. The other alto in my choir is a CNM who works in a birthing center. Still think it’s better to go to the hospital, just in case.

          • myrewyn

            I don’t exist in an echo chamber, either. I live in the center of the wooniverse and I have friends who have home births, a friend currently in school to become a CPM, and a friend about to give birth in a free standing birth center with a CNM. I am able to form my own opinions while at the same time respecting their choices.

          • MaineJen

            So if you deign to ask questions about the accepted party line, you’re out of the club?

            What is the date of middle school graduation this year?

          • Heidi_storage

            So do you support the banning of CPM/LPN/other unqualified biryh attendants? Do you support strict risking-out and transfer criteria? Because if you do, you are at “all out war” with homebirthers, who are hostile to these safety measures; and if you do not, I’d like to know what safety measure you do support.

            Dr. Tuteur has written about how homebirth can be much, much safer than it is in the United States. These safety measures are, however, predicated on the (correct) idea that birth is inherently risky, which is an idea utterly rejected by nearly all homebirth attendants.

          • I believe the model we have in WA state is good. We have licensed midwives who have education and training and malpractice insurance requirements and only do out of hospital births with low risk women.

          • Azuran

            What kind of education and training do they have? Are they exclusively CNM or another kind of poorly educated CPM?
            I expect that you know that basically every other first world country requires years of university level training to be a midwife. That’s what real education looks like. Anything less than this is not ‘good’ and will result in preventable death of babies.

          • Heidi_storage

            Doesn’t look like they limit licensure to CNMs, and Bastyr is a naturopathic school. Could you point me to the requirement that midwives carry malpractice insurance?

            Also, what sort of mortality statistics do you have for home births in Washington State?

          • Linden

            You’re kidding, right? Right?

          • Linden

            Since you appear to be math-challenged, I will put it in simpler terms. Our local hospital delivers about 7000 babies a year. How would you feel about this hospital if some guy walked in off the streets and shot ten of the babies? Unspeakable tragedy, right? Not a small loss at all. Grieving parents, newspapers demanding answers, the PM and party leaders standing up in parliament expressing their condolences (i live in the UK).

            Now imagine if, the year after, the gunman came in and shot 10 more babies. And the chief administrator of the hospital gave a press conference about how awesome the hospital facilities are, and how 10 babies isn’t that big a deal. He’d be out of that job as fast as someone could make a phone call.

            In this scenario, you, Haelle and MANA are that hospital administrator. And that is why you’re being called a heartless monster, Kathy. Do you get it now? People with more empathy and a better grasp of maths just don’t need this spelled out for them.

          • MaineJen

            Wow. That’s a horrible sentiment.

          • Abby

            No it isn’t, 1.5 per 1000 is really high. The hospital I had my child in had 4000 births per year, i.e. a small unit, if they lost 6 full term low risk babies per year they would be investigated and shut down!

          • Dr Kitty

            With 26000 homebirths planned every year in the USA that means 39 babies who don’t have to die will die annually in the USA.

            20 kids died in Sandy Hook.
            So 2 Sandy Hooks a year worth of extra dead babies dying preventable deaths.
            And if Homebirth becomes more popular in the USA, the death toll will just keep rising.

            I wouldn’t go and see my favourite band at 1500 seat theatre if I knew one person from the audience was going to be shot at random.

            I certainly wouldn’t take my kids anywhere there was a 1 in 250 chance they wouldn’t make it out alive (which is basically what 3.9 in 1000 is).

          • Empress of the Iguana People

            Well, that’s not callous or anything. We aren’t talking about the number of people who get permanent disability from shoulder distocia, we’re talking about the number of people who *die* who would have *lived* if they’d been at the hospital.

          • Amazed

            1.5 per 1000 is just about one dead student in my high school. Pretty sure my mom wouldn’t have enrolled me there if those were the odds. Mind you, the school ranked among the top ones in our city and it was a fight to get accepted – and let’s not mention the PRICE of lessons I needed to get in! Mom would have happily fucked the expenses they made if she knew 1 of us would die. It would have been hard for me to get all the advantages this school brought me if I had been, you know, dead.

          • Roadstergal

            How does that compare to the risks of driving drunk? Or un-seatbelted?

          • No, no it is not. There are approximately 4 million births in the US every year. That means 6,000 dead babies every year. By not being stupid, we can save 3,000 babies a year. Still think that’s not worth it?

          • MaineJen

            …do you think those odds sound good? “only” 1.5 more dead babies per 1000! 😮

        • Amazed

          Hahaha. You’re really fun.

          What? You mean you were serious?

  • crazy grad mama

    Ugh, can’t say I’m surprised. I started following her on Twitter a while back because her reporting on breastfeeding research was surprisingly decent, but it became more and more apparent that she has a very dogmatic C-SECTIONS = BAD approach to birth. And she was disingenuous about it—she’d tell me she thought one thing, and then turn around and tell other people something different. The tipping point for me was she and her book co-author threw a fit about an article suggesting that women be told the risks of vaginal birth.

  • yugaya

    I thought she was having another projecting rant about me on her fb wall. Turns out she resorts to namecalling every time someone hurtz her lazy journalist feelingz. :)))

  • Eater of Worlds

    This isn’t in response to this post, but I wanted to ask. In light of the information about the BFHI causing injuries and deaths, do you think that anything will change? Apparently the Dept of Health and Human Services said that they are supporting the BFHI and are pushing for all hospitals to do that, way back when it was first set up. Has there been any response from them regarding the failure of the BFHI? It would be awful if they continued to push for it when it’s been proven to be so bad in the form it is in.

    • Anj Fabian

      BFHI is a net loss for hospitals that do it. Hospitals have to pay for the privilege.

      Unless federal dollars are contingent on hospitals achieving BFHI status, hospitals can and will refuse to do it.

      • myrewyn

        wait, what? I thought they were doing it because they got some sort of kick back although I always wondered who was funding that.

        • The Bofa on the Sofa

          I just assumed it was marketing? I mean, why go to that hospital when ours is “baby friendly” and they aren’t? Who wants to be known as not baby friendly?

          • kilda

            That’s what I assume too. Baby friendly just sounds warm and friendly and like a good thing, as if the alternative is “Come give birth at our hospital! We hate babies!”

  • On the caesarean issue, there are likely even a number of “unnecessary” ones, that are necessary because we respect women and they have the right to provide informed consent with respect to a medical decision. The line between “necessary” and “unnecessary” isn’t as black and white as many would like.

    • Dr Kitty

      I am currently having some issues with a local hospital’s miscarriage management.
      Women are *supposed* to be offered their choice between expectant, medical and surgical management.
      However, it is NHS midwives running the pregnancy assessment unit, and it seems to be that advising women of their options goes something like “of course you’ll want to go home and let nature take its course with your family around you and some privacy,, and if that is too slow or you bleed too heavily you can have some misoprostol and then hopefully you can avoid surgery!”

      Which I discovered after a patient collapsed, bleeding heavily, in our toilets. She came to collect a prescription for painkillers after being sent home by EPAU. She hadn’t been told surgical management was something she could request, nor that it was the least painful, quickest recovery, with the lowest risk of blood transfusion and that if she wanted pathology she would have to collect tissue and store it in her home fridge…

      So, I’m in the process of drafting a letter to the OBGyn department requesting the written information materials used to help women make a decision about the best option for them. Which will be fun, because I don’t think it is being used.

      I have a feeling someone is patting themself on the back for all the unnecessary D&Cs they have saved women from…

      • That is awful. I had a dear friend of mine almost die from letting “nature take its course” during a miscarriage. Women deserve to know their options and make informed choices and any care provider who believes otherwise has no business being a care provider. Best of luck.

        • LaMont

          Well, in Iowa now, women who miscarry after 20 weeks are legally *required* to let nature take its course. The GOP is seriously just going to ban miscarriages at this rate.

          • myrewyn

            That is maddening.

          • Technically, losing a fetus after 20 weeks is a stillbirth, not a miscarriage. The fetus is large enough that the cervix has to dilate, otherwise it cannot be expelled, so labor must be induced (not always easy) or a hysterotomy (mini-C/S) be done. If left in situ, it can rot and cause septicemia or hemorrhage and, in extreme situations, hysterectomy may be rquired, or it can even be fatal.

          • Dr Kitty

            However, the SAFEST way of managing a second trimester loss is D&X or D&E, where under general anaesthetic the cervix is dilated enough to allow passage of instruments and the foetus is removed surgically, often in pieces.

            Which I believe is what Iowa has specifically outlawed, under the guide of banning “dismemberment abortions”- correct me if I’m wrong.

            Some women prefer to labour and deliver after a second trimester loss, but some women do not, and for example, if someone has had multiple C-Sections and loses a baby at 22 weeks, the surgical D&E procedure would be MUCH safer than inducing labour on a scarred uterus and an unripe cervix.

            Leaving such a woman with only a choice between hysterotomy with all the risks of abdominal surgery and a higher chance of uterine rupture in subsequent pregnancy, and induction of labour with risk of uterine rupture in order to deliver an intact but dead foetus would be considered negligent malpractice to most sensible doctors when there is a much safer, not technically difficult procedure available.

          • Empress of the Iguana People

            Apparantly, my sister’s stillborn co-trips were starting to decompose. How she, 3rd born and bigger than me at birth, survived is beyond me

          • mabelcruet

            In utero, decomposition only occurs if there is bacterial infection, and if there is no intra amniotic infection, a fetus who dies goes through a process of maceration instead. The tissues start to soften and then lose fluid. If the fetus is retained for more than a few weeks (which can happen in multiple births) then the fetus becomes a ‘fetus papyraceous’, a paper baby, they get very dry and completely flattened. Their placenta also shrivels up and stops growing so all of this gives the surviving twin or trip space to grow. It only really works if the twins or trips are non identical and don’t share a placenta. If you’re monochorionic (identical twins sharing a placenta), if one twin dies the other one is at far higher risk, but if the placentas are dichorionic then it’s a bit safer.

          • Empress of the Iguana People

            Thank you for the information.
            Sadly, Mom’s stories weren’t always accurate, rather the reverse, so i wasn’t sure there even were triplets until fairly recently when I heard from Grandma. Grandma was there and although she didn’t see the trips’ bodies, she did see them get taken away under a sheet. My brother’s co-trips were miscarried girls, and the twins she gave up are a boy and a girl, too, so fraternal seems very likely.

          • mabelcruet

            It wasn’t so long ago that mothers were advised not to see their baby if he was stillborn or miscarried, so wrapping them up and taking them out of the room immediately is sadly the last memory a lot of wome have of their baby.

          • Melissa Wickersham

            That is completely stupid and evil for the Iowa GOP to even consider passing such horrible laws.

      • FormerPhysicist

        That’s awful. I went to my local hospital during a miscarriage when I was passing huge clots and was asked if I wanted to go home and wait. Um, no. I came in because it was going wrong. I don’t want to go home and wait for it to go wrong again, I want the D&C and to be done with worry.

      • In situations like this, probably the last person who should decide how her miscarriage is to be managed is the woman herself — or a midwife. There are so many factors to be assessed that, really, only an obstetrician should be involved. While the current thinking is that a D&C is no longer routine, it’s not always easy to know if the products of conception have been completely expelled and severe hemorrhage can result. A miscarriage is potentially life-threatening and a lay person is in no position to decide.

        • EmbraceYourInnerCrone

          When i miscarried the first time I was in so much pain and had been to the OB the week before complaining of pain in my side, that combined with a BP of 60/40 made the ER doc think I might have an ectopic pregnancy. They did an echo and luckily it was just “just” a regular miscarriage. But as you say, I was in no shape to be the one who decided if I should just go home and “wait it out”. I think my husband might have had words for anyone who suggested that…

          • EmbraceYourInnerCrone

            The second time the fetus died but was not expelled. I wanted a D/C that time as soon as possible.

      • Inmara

        Do you have some resource about comparable risks for natural management and D&C? Just stumbled upon an article in local website where midwife is touting the benefits of natural management and claims that it doesn’t have more risks than D&C. Would love to rebutt as many women haven’t even thought to seek information about this.

        • Dr Kitty

          Expectant management carries a 1% risk of infection requiring antibiotics and a 2% risk of haemorrhage severe enough to require blood transfusion.

          The risk of infection with surgical management is higher (2-3%), the risk of heavy bleeding is lower (0.5%), although there is the risk of uterine perforation and anaesthetic (which are minimised using modern suction techniques and anaesthetic agents).

          Expectant management also carries the rare risk of products becoming stuck in the os with cervical shock and collapse as possible complications. This tissue needs to be manually removed with forceps during an examination which is usually painful and distressing.

          Expectant management also carries the risk that an emergency D&C may be required as part of the treatment of heavy bleeding, infection or retained products that fail to pass in a reasonable timeframe (usually 3 weeks).

          Not everyone wants to spend days to weeks bleeding and cramping, with repeat scans and blood tests required to check that everything has passed.

          Here is a fairly good leaflet on miscarriage management options:

          http://www.miscarriageassociation.org.uk/wp/wp-content/leaflets/Management-of-miscarriage.pdf

          It is a very personal choice, there is no “right” answer, and there definitely shouldn’t be an institutional expectation that a patient “ought” to choose one particular option over another.

          • MI Dawn

            I *hate* expectant management, though I had some patients who preferred it. Of course, then there was the Catholic hospital (my then-employer) who wanted to use expectant management on me when I was diagnosed with an ectopic pregnancy because “they couldn’t treat me until there was no heartbeat” or I had a tubal rupture. Every day I bless the chief of OB who over-rode the U/S tech and said there was no heartbeat, that what she was seeing was simply tissue movement.

          • Roadstergal

            Ugh, Catholic hospitals scare the shite out of me.

          • Azuran

            Seriously, I can’t even understand how those are even allowed to practice like they do.
            People here lose their shit whenever a Jehovah’s witness dies after refusing a blood transfusion in a normal hospital and it’s on the news for a week.
            Heads would roll left and right if a woman were to die because a catholic doctor or hospital refused her proper treatment for an ectopic pregnancy because of religion.

          • mabelcruet

            I’ve had an obstetrician tell me that there is no such thing as a lethal fetal abnormality or abnormalities incompatible with life and therefore termination of pregnancy on these grounds should be banned. His argument was that a baby with anecephaly (no brain) could be born with signs of life and even if the heart beat for just a few moments, that’s enough. So let’s force all women to go full term putting their health and possibly life at risk because of that few seconds of existence. I’m all for choice-if a woman wants to continue, then that’s fine and we can provide the care she needs, but if there is no chance of survival, we need to support those choices too, and consider the mothers life and health first.

          • Juana

            WTF? Enough for what? What is that supposed to achieve, other than torturing everyone involved?
            So if a fetal abnormality has a intrauterine death rate of less than 100% (just almost 100%), that’s no reason for a termination because one of very many of those babies could take a breath and _then_ die?

          • Melissa Wickersham

            That obstetrician has a Horrible, awful religious belief system. Did he think that the soul resides in the heart rather than in the brain? What a stupid belief system to think that an anencephalic baby even has a soul. Anencephalic infants do not have souls. The reason is that no soul or spirit would desire to inhabit a vertebrate body that lacks a brain as a result of a lethal defect. It would be inconvenient for any soul to do so.

          • Dr Kitty

            It amazes me the hoops people jump through mentally.

            What is the moral difference between ending an ectopic pregnancy that we know is not viable and has a high risk of tubal rupture, haemorrhage and death BEFORE the tube ruptures, and waiting until the tube ruptures and a theroetical risk of death becomes an actual one, and why would G-d care either way?

            I would assume any benevolent deity would want me to save who can be saved with the least amount of risk and trauma to them in the process, because, presumably, a compassionate deity would understand the motivation came from a place of good intention.

          • Merrie

            The only thing I can work out is that they think that God can perform a miracle and move the tubal pregnancy to a more suitable location, but only if they don’t “play God” by terminating it. These are the same people who believe they’re “playing God” by using birth control but that periodic abstinence is okay because it’s still sex, just at less fertile times, but God can cause fertility then if He really wants to. Me, I figure that God can also get around a pesky thing like an IUD or a pack of birth control pills if He really wants to.

      • mabelcruet

        Expectant management really worries me for another reason-we looked at all the products of conception from first trimester losses (all spontaneous losses, usually diagnosed on early scans <10 weeks) histologically in our hospital, and the rate of hydatidiform molar pregnancy is far higher than the text books say (we reported 44 in a year out of 1200 miscarriages-mostly partial moles but a few complete moles in there too, and these were all confirmed by referral to the regional trophoblastic disease centre). This is because traditionally early miscarriages may not have been looked at histologically so the historical incidence is inaccurate, but also the diagnostic histological features of molar pregnancy have changed significantly over the years because they are coming to us earlier and earlier, and less experienced pathologists may not be picking these up. More early moles are picked up histologically rather than clinically because these pregnancies are being picked up as early pregnancy failure on scanning, and we're not having to wait until a mum presents mid-trimester being too big for dates. There is a recognised intra-and interobserver variability in diagnosing moles, but we were a team of 2 doing all of them so we got very experienced and had a very high degree of correlation (of the 46 we sent to the regional centre that we had diagnosed as molar locally, we had 44 confirmed, and the other 2 needed lots of genetics before they were eventually happy to rule out mole).

        So moles are more common than we think, and we know moles lead to persistent gestational trophoblastic disease. But if women are being discouraged from having surgical management of early loss, that risks the tissue ending up being lost and unavailable for histology, so how are we going to diagnose it then? We already under-diagnose and undertreat, its going to get worse.

        • Roadstergal

          That sounds like something you could publish?

          • mabelcruet

            We presented it at a local audit meeting and the obstetricians were not particularly concerned. We took over reporting the cases from a much larger group of general pathologists, and the incidence rate started climbing quite quickly. Every case we diagnosed was confirmed by the trophoblast referral centre, so we were reasonably confident that we were correct, but we still used to get phone calls from people saying ‘are you sure? We seem to be getting a lot of moles recently…’. As part of our normal protocol, the lab results were copied to the patients general practitioner-most women with early miscarriages wouldnt generally be reviewed by an obstetrician automatically, the GP would deal with it. So I used to get GPs phoning asking about cases sometimes and what they needed to do-basically the woman just has to send pots of pee to the trophoblast unit. In the UK there are three trophoblast units-they all are reporting the same thing, moles are underdiagnosed, particularly partial moles. Luckily they aren’t too dangerous in the long run.

        • Dr Kitty

          Choriocarcinoma scares the beejezus out of me.
          I know it has a good cure rate, but that is no consolation to the women who die from it due to late diagnosis and missed treatment opportunities.

      • TheArtistFormerlyKnownAsYoya

        I wasn’t told of any of these options, or even offered pain management in a Canadian hospital.

  • Dr Kitty

    Haelle claims the you can’t be trusted to look at the evidence because you went to medical school a long time ago, but she can, because she went to journalism school?

    The difference between a Scientist or doctor who writes for public consumption (like Dr Amy, and Ben Goldacre) and a journalist who writes health stories is just…

    When I found out what homebirth in the US entailed, I was horrified. I think it is perfectly acceptable to be against homebirth as practised by CPMs in the USA, and the CDC Wonder data, MANA Stats etc do nothing to change my opinion. I’ve read the Birthplace study- it doesn’t say what most people think ti says, and it only pretends to because of how the data was sliced and diced.

    Now, do I think that a woman has a right to refuse interventions and demand to deliver at home- yes I do, and Dr Amy has said that too, over and over again.
    Is homebirth with a CPM an objectively better choice that giving birth in a hospital, if the stated goal of childbirth is to have a healthy baby? No, it isn’t.
    Should it be encouraged?
    If you care about reducing neonatal mortality and morbidity more than you care about reducing CS rates, no it should not.

    Women should be able to exercise autonomy by choosing to deliver at home and not have to put their lives in the hands of quacks and birth hobbyists.
    Supporting the birth hobbyists and quacks as legitimate birth attendants doesn’t improve care for women.
    Tort reform, followed by insurance reform, removing barriers to CNMS and MDs attending home deliveries would help.

    I do not see why this is anything other than common sense and at all controversial.

    • yugaya

      When we smacked her lazy ass down for writing poor to godawfully bad piece on Oregon study she threw a tantrum along the lines of how the piece was so shitty because she didn’t have time do dig up the data we presented to her because she has student loans.

      Go figure.

      • Dr Kitty

        Exactly.
        She’s a non scientist writing for non scientists, so she doesn’t see the need to search for and cite supporting evidence or read full studies herself.

        How much science journalism today is just regurgitating the press release of a new study from a drug company without critical examination of the evidence?

        Or, G-d help us, the “awareness” raising articles that go
        “Special Snowflake Syndrome often misdiagnosed by doctors says Special snowflake syndrome society.
        Many doctors admit that they don’t consider special snowflake syndrome, which affects 1 in 70 million people, when considering the differential diagnosis of common symptom X.
        More funding is urgently needed to educate medics on this condition says Special Snowflake Society, especially since horribly expensive drug Y has just come on the market and has been shown to improve outcomes in 10% of Special Snowflake patients”.

        In case you don’t know, “awareness raising” is usually the first step in a concerted push by Big Pharma to bring a new treatment into mainstream prescribing practice.

        If your job is *literally* to understand the data back to front so that you can present it to laypeople in an unbiased way there is no excuse for that nonsense.

        • yugaya

          “If your job is *literally* to understand the data back to front so that you can present it to laypeople in an unbiased way there is no excuse for that nonsense.” Neither is there any excuse for her deliberate misrepresenting of the data and disseminating it to others with an aura of *expert* while speaking out of her arse and privilege. Case and point: bedsharing. She went as far as to claim publicly that head of AAP Safe Sleep Task Force endorsed her book chapter on bedsharing. We called her out on this lie, and she …well, she had a full meltdown similar to one she is having right now about dr Tuteur. One of her ad hominems was that we were ” just moms”. Says the person who peddles shit for oversized leaflets. :))) https://www.facebook.com/liz.ditz/posts/10154513036671535

          • Dr Kitty

            You’re “just moms” who appear to have done research and are able to follow up citations and sources effectively to rebut a false statement.

            So you’re already better journalists than her, presumably because, what with all the momming, you have lots of spare time to devote to fact checking the work of a complete stranger for free, time that a real journalist working for actual money clearly doesn’t have.

            Or maybe because you’re smart women who recognise BS when you see it, and being moms, you’ve got multi-tasking and working for free for little thanks down to a fine art already!

          • Gæst

            I love the comment in that post from someone who “assures” us that “most” cosleeping parents are doing so “out of necessity,” because otherwise they and their children would not sleep at all. Now, I’m sure that’s a thing that happens, but the horrifying/amusing part is that she thinks she knows that “most” parents do it for the same reason she does based on her own anecdotal observations. I mean, *my* anecdotal observations of internet threads indicates that most parents bed share because it’s convenient and they think it’s safe. One of us has to be wrong.

          • fiftyfifty1

            Tangential to your comment:

            As a physician, I am interested in the phenomenon of babies who “just can’t sleep at all” unless they are sleeping in bed with mom. I find that my breastfeeding patients report this frequently, while my formula feeding patients almost never do. I do not know the reason, but I have some theories:

            1. The breastfed babies who have trouble sleeping might actually be hungry. Their moms are producing only marginal milk amounts in total or have small storage capacities. The babies who sleep well (either breast or formula fed) perhaps are able to do so because they are fed boluses sufficient to last them.

            2. Co-sleeping along with breastfeeding is pushed by Natural Parenting philosophy. Mothers know that doctors warn against co-sleeping, but if they adhere to Natural Parenting philosophy, they will want to want to do it anyway, and “baby just can’t sleep in a crib” is a way to justify the choice.

          • FallsAngel

            1. May be true in early days, but eventually breast feeding either works or it doesn’t.

            2. Possibly

          • fiftyfifty1

            “1. May be true in early days, but eventually breast feeding either works or it doesn’t.”

            I would disagree. There are women who continue to breastfeed despite borderline production and/or small storage capacity. Their babies are able to grow well enough, but if and only if they feed frequently. In the first few weeks it is normal that babies feed frequently and don’t sleep through the night. I am theorizing that the babies who continue this pattern past the first ~8 weeks may be doing so not because they are poor sleepers, but rather because they are never entirely full.

          • guest

            My second child was a horrible sleeper and wanted to be attached to me 24 hours a day. I indulged this during the day while I was awake. At night, I worked through different solutions to get her to sleep on her own, with the help of her pediatrician. It would definitely have been easier to put her in bed with me, but I didn’t feel comfortable with that risk. Ultimately, a combination of my husband and I splitting up the night shift and having her sleep in a bassinet then crib right next to the bed where I could put my hand on her back at night worked for us. At 18 months, I spent a few weeks going back and for to her crib multiple times a night when we moved her to her own room. Most people thought I was crazy to invest all this time in her sleep. I was told to let her cry it out (which we did) or put her in bed with me. But I am a huge nut about sleep, mine and my kids. It is in my opinion the 3rd most important thing in life, next to air and food. So it was extremely important to me that my children could sleep on their own.

        • FallsAngel

          I do agree with what you wrote, but I don’t think that’s what Tara Haelle does, at least from her stuff that I’ve read.

          I’m not crazy about Ms. Haelle, though I think she did a good job on the DTaP-Baboon study. I’m also not a big fan of the SOB comment board, as I find it anti-vaginal delivery and anti-breastfeeding to the extreme, but I do like the vaccine posts. So maybe I’m a good one to respond.

          Any birth method that doubles the rate of intrapartum fetal death is too risky, IMO, even if the effective rate is still low.

          I also think saying “I won’t grieve her death” is ghoulish.

    • mabelcruet

      It would be illegal for a CPM to deliver babies in the UK-its a criminal offence to attend a delivery and act as a midwife if you don’t have a proper professional qualification as determined by the Nursing and Midwifery Council. The only exception is if you are in training (and supervised by a properly registered person), or if its an emergency, so paramedics and taxi-drivers are covered. Hopefully we won’t get CPM wannabe midwives here.

      • Steph858

        I hope you’re right, but I suspect wannabe midwives will just find loopholes. “Yes, Officer, it was an unforeseen emergency. I was having a coffee evening with my good friend when she suddenly went into labour. I was so busy attending to her that I didn’t have a single spare minute to call an ambulance.” “I wasn’t acting as a midwife, Your Honour; I had been hired by Ms. Doe to work as a Mother’s Helper for the evening when she unexpectedly went into labour.”

    • But, Amy doesn’t care about reducing neonatal mortality. She only cares about alienating everyone who is pro homebirth in any way at all by calling them names and reducing their experiences to ad hominem attacks. Amy lumps all homebirthers in USA into one pot, even though laws and licensing vary by state. I agree with you that “Women should be able to exercise autonomy by choosing to deliver at home and not have to put their lives in the hands of quacks and birth hobbyists.” And Tara would agree with that statement. But that is most definitely NOT Amy’s position at all. Amy is 100% anti all homebirth of any kind.

      • yugaya

        “Amy”? You two are on first name basis?

        ” Amy lumps all homebirthers in USA into one pot, even though laws and licensing vary by state”.

        No, that’s what YOU did with your pitiful attempt at math in order to downplay the risks of homebirth. Dr Tuteur has over the years provided extensive, in-depth analysis of risks of homebirth across various states/countries, for all types of unqualified and qualified birth attendants and with varying levels of regulation.

        “Amy is 100% anti all homebirth of any kind.”
        Citation needed, because unlike your exchanges with Tara where orgasming at her every word is all you need to display, this blog and its regulars have higher standards for debating in place.

        • I was referring to her as SOB until others started using “Amy.”

          • yugaya

            Regulars here refer to her like decent people will – dr Tuteur or dr Amy. Because you know, she IS a medical doctor. Not a “just mom” blogger turned deadline chasing crappy journalist.

            Try again Kathy.

          • She is not a practicing doctor. I will just go back to calling her SOB.

          • yugaya

            “You really like to argue about stupid shit, don’t you?”

            You really can’t stop with ad hominems, can you?

          • The Bofa on the Sofa

            Not practicing doesn’t mean she should not be called doctor. That is a privilege that comes with the degree. It has nothing to do with practice or even licensure.

            You do what you want, but that’s the way it is.

          • Azuran

            OB stands for obstetrician you know, so you are still basically addressing her as a doctor.

          • I don’t even think she has a license anymore.

          • moto_librarian

            All you have to do is read her bio at the top of the page. She’s retired. Nothing nefarious about that.

          • You really like to argue about stupid shit, don’t you? I mean, seriously, someone calls her Amy, I respond with Amy, and you attack that? Good grief.

          • Melissa Wickersham

            I would call Dr. Tuteur “Doc Amy” or “Doc”as an affectionate nickname. 😉

          • PrimaryCareDoc

            You know, I’m a physician. Dr. Tuteur is my professional colleague (and you don’t lose the title “Doctor” upon retirement). I still won’t call her by her first name. It’s disrespectful. I’d expect she would also not address me by my first name.

            Seriously. What kind of manners were you raised with?

          • Amy Tuteur, MD

            It’s okay. I don’t mind when people call me Amy.

          • PrimaryCareDoc

            You’re a kinder person than me. Especially given Kathy’s stupid reason for not using the title of “Dr.”

          • The Bofa on the Sofa

            How about Amy-Amy-bo-Bamy-banana-nana-nonana-fee-fi-fo-Famy?

          • Empress of the Iguana People

            She’s saving Nana for the glorious day one of her kids makes her a grandma

      • Meredith

        I’ve followed this blog for a while, but don’t usually comment. I agree that the tone of the blog is harsh (although it doesn’t bother me because the argumentation has been good). But the cognitive dissonance of condemning the tone of this blog while defending the personal attacks of a journalist are confusing and inconsistent. I also don’t understand your conflicting lines of argument in this comment section. On one hand you say Dr. Tuteur misrepresents the statistics, but you haven’t actually proven that point. Indeed, others have helped explain them. On the other hand, you agree homebirth is inherently less safe than a hospital birth, but then complain that Dr. Tuteur’s tone is at fault for not convincing enough people of how to fix it (as if that was her personal responsibility). You also claim to have some inner knowledge by saying “Amy doesn’t care about reducing neonatal mortality.” This is a rather odd and extraordinarily cruel thing to say. How would you even know that? It’s as if you are arguing “Yes, homebirth is less safe, but shame on you for hurting our feelings about it.” Can you not see how this sounds callous when talking about the actual lives of human beings? Because it does. Extremely so. And I haven’t even been aware of the other arguments behind the scenes, so I’m basing this 100% on your line of reasoning. Yes, homebirth needs to be made safer, but wouldn’t this be the responsibility of those advocating for home birth. You are simultaneously arguing Dr. Tuteur is irrelevant AND arguing that she should somehow fix homebirth. This leaves the average reader totally confused.

        • My questions about how she could fix homebirth and make it safer are mostly rhetorical. I don’t think SOB wants to fix it. She just wants to ban it.

          I don’t believe I stated she misrepresents the stats. I believe I wrote that that she doesn’t fully explore that statistics or how they vary by state and by type of licensure. I believe there are ways to legally allow homebirth, but regulate it, so that it can be a choice for low risk women. That never seems to come up on this blog. My state, WA, licenses lay midwives and they are legally only allowed to work with low risk women. This is a win-win situation. I believe this should be the model.

          http://www.doh.wa.gov/Portals/1/Documents/Pubs/679150.pdf

          • fiftyfifty1

            “My questions about how she could fix homebirth and make it safer are mostly rhetorical.”

            Exactly! Because YOU don’t actually want to fix it. You know darn well that MANA and CPMs have no desire to limit their scope or require that their members get actual medical training.

          • yugaya

            ” I believe I wrote that that she doesn’t fully explore that statistics or how they vary by state and by type of licensure.” Too funny. That’s exactly what Haelle failed so miserably to do in her piece on homebirth.

          • I would like to see all 50 states have legislation like we have in WA state.

          • fiftyfifty1

            I would like to see all 50 states abolish CPMs and other lay midwives. Homebirth should be attended by qualified midwives (CNMs) only. Women deserve the same level of competency that women in all other developed nations get.

          • yugaya

            “My state, WA, licenses lay midwives and they are legally only allowed to work with low risk women.”

            And with that, your ignorance goes from mildly entertaining to insulting: https://www.healthgrades.com/media/english/pdf/sanctions/HGPYC5506F3793944C5BA10082012.pdf

          • Her license was suspended and she continued to practice. That is as problematic as people practicing medicine without a license. Has nothing whatsoever to do with the discussion.

          • yugaya

            ” they are legally only allowed to work with low risk women”

            Yeah. they ALL only take on low risk clients. You are attempting to gaslight people who know a lot more than you do with the fact that there is regulation in place that no one respects and that doesn’t get them suspended unless someone dies. To make matters worse, in WA state, it usually takes more than one completely horrid, out of scope death to get the wheels rolling.

            “Has nothing whatsoever to do with the discussion.”

            Oh here’s another one – HBAC of twins. Low risk only right? https://fortress.wa.gov/doh/providercredentialsearch/PDF/1569036472.pdf

          • Box of Salt

            Kathy “Her license was suspended and she continued to practice. . . . Has nothing
            whatsoever to do with the discussion.”

            It *is* part of the discussion.

            And it will be as long as your compatriots tolerate the problem.

          • Amy Tuteur, MD

            My license was never suspended. That’s libel.

          • Box of Salt

            Dr Amy, Kathy is referring to the midwife from yugaya’s link, not you.

            Disqus makes replies viewed later confusing.

          • Melissa Wickersham

            Yup. I wish that Disqus had a better, more easy to view comment system.

          • myrewyn

            Dr Amy has said repeatedly that she does not want to ban homebirth. You are either not reading or you are having a comprehension problem.

          • Box of Salt

            Kathy,
            this is what I don’t get.

            Homebirth advocates like you come to this site and complain about Dr Amy’s harsh tone and “why isn’t she doing anything to make homebirth safer?”

            Why is that Dr Amy’s responsibility?

            Why isn’t it yours?

            You’re the one who want it. Make it work better.

          • Meredith

            If this is your goal, your rhetoric does not reflect this. And if this is your goal, how does publicly supporting hateful language help accomplish this? These questions are mostly rhetorical. It’s hard to claim the moral high ground when you’ve abdicated decency.

          • I think it is not decent to take a screen shot of a conversation and write a blog post about it. Very childish. SOB could have addressed my comment directly and alluded to Tara’s. That would been mature.

          • Box of Salt

            Kathy, “That would been mature”?

            Tara Haelle is supposed to be a science journalist. The comment she posted on your page should have been voiced in private. Instead she chose, like a middle schooler, to write it out on a public forum.

            I lost a lot of respect for Ms. Haelle upon reading “whose death I will not grieve.” It’s unprofessional, and it bothers me.

            Kathy: deal with it.

            And, hey, since you are Facebook buddies, pass that on to Ms. Haelle.

            We are women. We need to do better.

          • Corblimeybot not logged in

            I was mostly okay with Tara, despite her shifty viewpoints and occasional terrible arguments. I thought she meant well, at least. But I will never give her another moment of my time after this particular tantrum, and especially not after she longed for the death of a real human being – which Dr Teuter is, you know. Not that you show empathy for the lives of human beings, since you think preventably-dead babies are NBD.

          • fiftyfifty1

            ” My state, WA, licenses lay midwives and they are legally only allowed to work with low risk women. This is a win-win situation. I believe this should be the model.”

            Why do you believe this should be the model? No other developed country thinks so. None of them give lay midwives licenses or allow them to practice medicine. The midwives you think are so great are banned in every other developed country including Canada, the UK and the Netherlands. Lay people delivering babies is a lose-lose situation, even for low risk women. Their death rates are hideous.

          • swbarnes2

            Oregon has had stats for many years, they have been discussed here before. They are not pretty. They do not at all suggest that home birth is safe. Quite the opposite. After a few years of collecting gruesome stats, Oregon midwives stopped collecting them.

            Lay midwives? “Licensed” midwives are a joke. Not a single other civilized country would allow those illiterates to be midwives. CNMs do meet international standards, and because of their experience and training, only a small percentage of fringe practitioners choose to do homebirths.

            But you are so sure you know better than they do, right? Some people value their vanity over the very lives of other people.

            Where is your safety data showing that the state’s ill-conceived blessing is magically making lay midwives able to save babies in emergencies where midwives in other states can’t?

      • Amazed

        Since you are someone who actually wishes death on Dr Amy or at least won’t care if she pops up dead tomorrow, you are the last person qualified to come here and argue about people caring about deaths or not.

        Your Tara won’t agree wth the statement you claim since she did her best to paint the difference as so very insignificant. And you’re incredibly hypocritical for insisting that Dr Amu should fix the faults of the homebirth system. They’re so small that Queen of Class should get a pass for lying about them but so great that Dr Amy is terrible for doing it the wrong way, amirite?

        • I have never wished death on anyone.

          • Amazed

            You cheered the sick mind who came up with Dr Amy’s possible death. But I guess it’s too much to expect of you and Queen of Class to understand that normal people don’t think of such things without any reason. Tara stopped herself before she actually said she wishes for Dr Amy’s death but her sentiment was clear, as well as yours.

            And I notice you still don’t address the hypocrisy part. So, homebirth has deadly flaws when you can blame Dr Tuteur for not fixing it but just some small glitches when Tara Haelle says so?

    • Having read Dr Goldacre’s work and Tara’s, I would put them in the same camp.

  • Sheven

    Good to know that Donald Trump’s “nasty woman” insult has spread to science writers.

    As for the descriptors “nasty” and “hateful,” Tara, have you ever heard the phrase, “You become what you hate”?

    • Empress of the Iguana People

      Some day I shall become coffee?? Brr.

      • Sheven

        Are you bitter? Is there a big debate about whether or not it’s better to put sugar in you?

        • Roadstergal

          “I like my men like I like my coffee – weak, bitter, and tasteless.”

          • Dr Kitty

            I like my men like I like my coffee- in a cup with a spoon.

            Covered in bees.

          • Dr Kitty

            Sorry, this is an Eddie Izzard joke, I haven’t lost my mind.

          • SporkParade

            This is well-timed since I saw Eddie Izzard in Tel Aviv last Thursday. 🙂

  • Sarah

    Why on earth would she feel the need to trouble everyone with her grieving plans when you die? As if that has anything to do with your legitimacy or otherwise.

  • Heidi

    Well, I can’t say I’m surprised she made the mention that she wouldn’t grieve Dr. Amy’s death. I mean, seems like staunch homebirth advocates (not those who are lied to and duped and unfortunately many times end up victims) who shout from the rooftops that homebirth is just as safe as hospital birth despite evidence showing otherwise take death pretty lightly. You know, “some babies aren’t meant to live.”

  • myrewyn

    I love it. Don’t take medical advice from Dr Amy because her license has lapsed! Instead take medical advice from people with no medical training at all!

    Also, can we pick whether we want to be a minion or a flying monkey? I’d like to be a flying monkey, please.

    • The Bofa on the Sofa

      My patronus is a flying monkey, in fact…

    • Kerlyssa

      that’s always been one of the odder lines of attack, imo. i mean, would i go to dr amy if, god forbid, i was having a baby? of course not. i’d go to a currently practicing physician. if we were marooned on a desert island, would i pick dr amy or a random writer with no medical training? no brainer.

      • Empress of the Iguana People

        Hell, I’d prefer my husband’s ophthamologist over a random writer. At least she studied anatomy, even if she hasn’t studied it in a decade or so.

    • StephanieJR

      I think we’ve been called a brigade of losers, before. I quite like that one.

    • Empress of the Iguana People

      WHEN will they learn?! I am the Empress of the Iguana People, your reptilian overlords’ overlord! I am no one’s minion!!
      Of course you may be a flying monkey, myrewyn!

      • myrewyn

        How dare they not refer to you by your rightful title??

        • Empress of the Iguana People

          Quite!

    • Allie

      I want to be a minion. I like bananas and I look good in coveralls : )

  • critter8875

    It seems to me that pre-establishing a C-section number or percent for a doctor or hospital would be similar to a dentist pre-establishing a rate for extractions, root canals, crowns.

    • Lemongrass

      And the “right” number of c-sections would almost certainly not only differ between countries, but between states and towns since conditions like obesity (and in turn diabetes) increase the risk of complications and different areas have different obesity statistics. I just don’t get this obsession with wanting one precise “ideal” c-section number to apply across the board – that is likely never going to happen.

      • Azuran

        I really don’t get their obsession with this ideal rate. I might be wrong, but I can’t think of any other medical procedure where people are arguing that the should be an optimal rate that should be reached.
        Seems to me that you should treat every patient depending on their needs, if you think a specific patient needs a specific procedure, then you do it. You don’t refuse it because you’ve done ‘too many’ that week.
        Of course everyone should aim to reduce unnecessary interventions. But you can’t achieve that safely only by claiming you should only do a certain number of intervention…

        • Eater of Worlds

          It’s because the WHO stated it and since it’s lower than what happens in practice, they think what happens in practice is awful. I think it’s stupid that the WHO still states that 10-15% (it’s actually 19%) rate is ideal for reducing mortality, because people skip that bit or don’t understand that it only means that rate is ideal for preventing death. It doesn’t include the rate that is necessary to prevent brain damage or other complications, which the WHO admits increases the rate.

          • AnnaPDE

            Oh, well, that’s just the little luxuries for posh people, a working brain and a physically mostly healthy kid and an intact pelvic floor, why would you want to promote those at all? The WHO has a great track record of viewing women as stupid life support systems for babies.

      • Eater of Worlds

        Another thing they mention is how many issues the US has compared to say, a country like the Netherlands. S, ome of these things are like preterm birth. One thing they don’t consider is that the US has a much more varied population than some place like the Netherlands. For instance, we have a much higher black population, and that population is known to have more preterm births. So that can raise the c-section rate and they don’t even consider that when comparing the data.

        I also get annoyed that people rag on the rates of c-sections, when there’s no control over them if they are due to issues like obesity and lack of prenatal care. Those are issues that have to be fixed in other ways, reducing the number of c-sections those populations have isn’t going to fix anything.

    • KeeperOfTheBooks

      Exactly. It’s idiotic.
      As I’ve posted here before, one of the best local hospitals to have a natural birth or VBAC is also the one with a near-50% CS rate. Why? Because it’s the regional hospital you get transferred to when the shit hits the fan, medically, for a pregnant mom or preemie baby. Sure, you could say “nearly 50% of women who go there have C-sections!”, and you’d technically be right. But when you’re talking about moms with some really awful medical conditions, or 24-week preemies with spinal bifida, CSs are generally and indisputably the right call. And while a hospital further out in the boonies may well have a lower CS rate, it’s partly because they’re transferring their really sick moms and babies to this major hospital, not because they’re All About Teh Natcheralz. If you go in there and you and baby are well and you want your VBAC or natural birth, you’ll likely get it, and with the promise of absolutely top-of-the-line care if something does go wrong, to boot.

      • BeatriceC

        That pretty much describes the hospital where I delivered my younger two. Even with MK, at 32 weeks, they were trying to encourage me to deliver vaginally, but I was dead set against it and my actual doctor backed me up (even coming in on his day off because the on-call doc was being a dick about it). And, of course, with YK, I was one of those women who were there because the shit had hit the fan. I was already in perinatal ICU when delivery was the only choice to save my life at 24 weeks. I wouldn’t have wanted to be anywhere else, to be honest, regardless of what type of birth I wanted. They were awesome.

        • Amy M

          Yep. I don’t even know the Csection rate of the hospital where I had my boys, but it’s the largest teaching hospital in the area (and in a big city too), and has a Level 3 NICU. Based on those facts, I’m going to guess it is pretty high. I didn’t even think to look up those stats though, because I understood that the hospital’s stats have nothing to do with my individual situation. It doesn’t matter how many Csections take place there, it only mattered that I had access to one, in case I needed it (and access to a doctor who wouldn’t have hesitated to perform it).

          • Empress of the Iguana People

            i delivered my first down the hall from Rainbow Babies in Cleveland. I was developing pre-eclampsia and they were still not pressuring me about pain relief and had a slight assumption that i’d rather gowith vaginal birth.

  • Lemongrass

    Wow…that is an epic tantrum. What does she mean by “…has illegally run an online medical advice service.” ?

    • Amy Tuteur, MD

      She’s probably referring to my old website Ask Dr. Amy. There was nothing illegal about it.

      • Lemongrass

        At what point does this sort of stuff become defamatory? Accusations of breaking the law and “viciously” attacking children shouldn’t be made lightly in my opinion.

    • MI Dawn

      I suspect the fact that she posts about medical issues and recommends people with questions *ASK THEIR DOCTORS* those questions is an online medical advice service in Tara’s eyes. She’s OK with vaccines, though.