Actually homebirth DID cause your daughter’s struggles

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Psychological defense mechanisms are strategies that protect people from emotional distress:

[They are] brought into play by the unconscious mind to manipulate, deny, or distort reality in order to defend against feelings of anxiety and unacceptable impulses and to maintain one’s self [image].

Denial is one of the most primitive and most powerful defense mechanisms:

Homebirth advocates insist they are taking responsibility for their baby’s health … right up until the baby is harmed by their choice.

Refusal to accept external reality because it is too threatening; … resolution of emotional conflict and reduction of anxiety by refusing to perceive or consciously acknowledge the more unpleasant aspects of external reality.

Denial is one way that women whose children have been harmed at homebirth try to avoid responsibility for the harm that resulted from their decision. For example:

Enlight108

I want everyone to realize something…because I was asked again today if I still agree with home birth. Let me make this clear…what happened with M would have happened in the hospital too!! Group B strep can go undetected and then when baby tries to breathe, they just can’t. It had NOTHING to do with birthing her at home! And arguing with me that she would have had better and quicker care in the hospital is bogus too. My midwife immediately began exactly what doctors would have done (minus cutting the cord as that is what was literally keeping M alive!). Doctors would have done neonatal resuscitation and oxygen first as well. Then moved on to ventilator. THIS WAS DONE!! Homebirth does not mean we birth in a cave with no emergency supplies. So stop asking me if I still agree with homebirth!
I AM 100% STILL IN SUPPORT OF HOMEBIRTHS AND I WILL ALWAYS RECOMMEND THEM TO WOMEN.
Again, homebirth did NOT cause M’s struggles…a horrible horrible infection did that.

I wrote about this mother and baby a few weeks ago, Another baby grievously harmed by homebirth; another mother desperately pretending it’s not her fault.

She was in denial then and she’s still in denial now.

This would likely not have happened in the hospital for a variety of reasons, but the most important one is this: we now test women for group B strep bacteria at the end of pregnancy and elaminate it before it can infect a baby by giving antibiotics in labor. The results have been remarkable:

The incidence of invasive early-onset GBS disease decreased by more than 80% from 1.8 cases/1000 live births in the early 1990s to 0.26 cases/1000 live births in 2010; from 1994 to 2010 we estimate that over 70,000 cases of EOGBS invasive disease were prevented in the United States.

Why didn’t M’s mother know she was colonized by group B strep and her baby was a risk of a brain threatening, life threatening infection? Because she declined the group B strep test at the end of pregnancy and therefore was not treated with antibiotics during labor.

But that’s not the only serious complication that Baby M suffered as a result of her mother’s choice to put her life at risk at homebirth.

She was deprived of oxygen during labor.
She inhaled meconium.
She needed an expert resuscitation with intubation.
She was unexpectedly breech.

Each factor ratcheted up the risk. Each factor was unknown or ignored at home and would have been treated very differently in the hospital.

The breech position would almost certainly have been diagnosed before labor and the mother offered an elective C-section; had she taken it, the baby would not have suffered a severe insult to her brain.

The oxygen deprivation during labor would almost certainly been diagnosed during labor by the use of electronic fetal monitoring. EFM has a very low false negative rate; it almost never misses actual fetal distress. Doctors would have recommended an emergency C-section and the baby would not have suffered a brain injury.

The meconium would have been taken into account in a diagnosis of fetal distress. Had the mother consented to an emergency C-section, the baby might not have inhaled meconium or would not have inhaled as much.

The baby would have received an expert resuscitation, intubation and immediate treatement with antibiotics to minimize any injury in progress.

What about the mother’s claim that it was delayed cord cutting that kept baby M alive? That’s nonsense. The problem was that baby M was not getting enough oxygen in utero. That’s why there was meconium; that’s why the baby inhaled it; that’s why the baby was born not breathing; the brain injury was already in progress. The idea that delayed cord clamping was lifesaving is foolish; it wasn’t providing enough brain preserving oxygen before the baby was born, it certainly wasn’t providing any more after the baby was born.

Homebirth advocates often insist that by choosing homebirth they are taking responsibility for their baby’s health … right up until the baby is harmed by their choice. Women who choose homebirth do so because they believe that routine hospital interventions are almost never needed. Yet when a baby is born injured because she did need those routine interventions but was deliberately deprived of them, many homebirth mothers retreat into denial. All of a sudden nothing is their responsibility; everything supposedly would have happened exactly the same way in the hospital.

Denial, as powerful as it is, rarely lasts forever. There will almost certainly come a time when the mother will have to reckon with what she did: she made a choice that profoundly harmed her baby and both she and her baby will wake up to that horrible reality every day for the rest of their lives.

Think homebirth is safe? Think again.

  • sapphiremind

    I did a guest post on this blog a while back on why being “trained in NRP” is vastly different than regularly providing NRP in a hospital with a full staff. In order to perform NRP well, ideally you should have at least 4 people: 1. Head of bed/airway, 2. HR/compressions, 3. IV access/med administration 4. Someone to pull up meds, run for supplies, watch monitors and time while people are doing interventions, document what is happening, etc. Not to mention all the equipment – HR/sat monitors (so you can see if your compressions are effective, see the baby’s response in real time) epinephrine, ETT tubes, blended oxygen, umbilical lines, saline for boluses, d10 to prevent hypoglycemia, light to transilluminate for pneumothorax (or have ready xray), and emergency blood if needed, and opiates for pain control if you have to decompress a pneumo or do something painful. PGE if the issue is the heart. Nitric Oxide if the baby has pulmonary hypertension.

    As someone who does run head of bed, it’s even better when I can get the baby intubated, have someone else take over on bagging and then step back to look at the baby’s whole picture and make sure everything is being taken care of. I’m not even happy with all hospital’s performance of NRP – when you aren’t doing it often, you make mistakes and lose sight of what you should be doing.

    These are the moms that are the absolute worst “I did something wrong and refuse to learn from it!” I had a homebirth mom come in – baby had group B meningitis. (Group B prefers brain tissue, the bastard) and she kept repeating “but that’s so rare”. I explained to her that it is rare these days because we treat for it in labor and then treat high risk infants immediately. Before we did that, it was disturbingly common with an incredibly high mortality. The point wasn’t to make her feel guilty (and I said it in a better way) but to explain why this wasn’t some random freak occurrence and that it can be prevented, and that she was misled (by her own research or midwife) because the only reason it is rare is because we treat them.

    It would be like having a 28 week baby at home with no support or resuscitation and it dying and then citing the statistics that more than 85% of babies at that gestation survive. Yes, they do, when given proper care. But you’re pretending like it is 1900, where 95% of those babies *died*. grrrr.

    • MaineJen

      That’s what kills me. Some of these homebirth enthusiasts act like they really do want to go back to 1900, with its terrible mortality for both moms and babies! No, thank you.

      • rosewater1

        Just imagine how some of those midwives must have felt. They would watch a woman and/or her baby die and have no idea how to save her-or even what was wrong.

        Imagine the woman laboring for days and knowing she was dying. Little to no pain relief.

        That’s what they want?

    • Empress of the Iguana People

      I suspect my grandmother may’ve been a preemie. Anyway, she was born tiny and I gather they weren’t really expecting her to survive the winter. The Depression had just started, too, although i doubt it was having much effect yet on her rural home region.

  • “I AM 100% STILL IN SUPPORT OF HOMEBIRTHS AND I WILL ALWAYS RECOMMEND THEM TO WOMEN.”

    After making a series of TERRIBLE decisions, she is doubling down?!?
    -.-
    My heart goes out to the poor baby who didn’t have a say in any of this.

    This lady reminds me of Heather Dexter.

  • Hi Dr. Amy, I have been away for a while. Glad to see you are still telling the whole truth as you know it, whether others care to listen or not.

    After coming across your website when I was pregnant with my second about four years ago (I now have three!), I was able to more fully embrace the experience (am I allowed to call it that?) of a hospital birth–viewing it as a moral advancement in women’s and babies’ lives instead of an anti-faith thing (I am familiar with certain church cultures that esteem absolute faith in God or whoever even in the face of evidence that suggests the all-in faith (i.e., arrogant ignorance) posture poses a real risk to a child’s health and well-being).

    Thank you for helping your readers and passer-bys acquire a more enlightened way of approaching childbirth and breastfeeding.

  • maidmarian555

    OT: Accidentally fell down the rabbit hole with the Hadley Freeman Twitter thread re:c-sections again today. In this exchange, the delightful Amy Brown appears to be suggesting that we should give women having c-sections a lower dose of epidural to help prevent issues with breastfeeding. I think if you’ve got to a point in your lactivism where you would even consider suggesting that someone having fucking abdominal surgery have less anaesthetic because breastfeeding then you seriously need to have a long, hard look at yourself and your priorities. And then volunteer yourself for abdominal surgery with less epidural and see how much fun it is before you start telling other women they should be doing it.

    https://uploads.disquscdn.com/images/6cff7f6a10d07c91771f6150b14fb988862690b66ae116e459faa9a57657fa17.png

    • Azuran

      wtf, does she think pain is important for breastfeeding?

      • maidmarian555

        Anything to avoid supplementing with formula for that first week! Including, it would appear, effective pain relief. During surgery.

        In fairness, the idea of having a c-section without enough epidural to make it so you’re not in agonising pain would probably put more of us off having elective sections. Which I suppose would be considered a win by these lunatics.

        • Kq

          I spent most of my c section very loudly stating “I AM STILL EXPERIENCING PAIN IN MY UPPER LEFT QUADRANT.” at some point they knocked me out, or upped the dosage until I can’t remember it. I do remember them teasing me because I had zero interest in seeing the baby. I was still yelling about my upper left quadrant…

      • Sheven

        Unfortunately, yes. This is perhaps the most consistent thing in all do-gooder wellness movements for the last hundred years. You never seem to be able to get “well” from relaxing, eating food you enjoy, and making hardships as easy for yourself as possible. The “best” thing is always the most painful and difficult thing under the circumstances.

    • Montserrat Blanco

      I have had two abdominal surgeries. First, a CS with an epidural. Second, a 7-hour surgery with general anesthesia. I loved the second surgery. Being awake while my belly is open is not exactly my thing.

      • mabelcruet

        I had laparoscopic gall bladder surgery. I had 4 tiny incisions that didn’t need sutures, just strips, and one slightly longer incision about 3 cm in my umbilicus that needed 2 sutures. Immediately post-op I was given pain relief-a lovely big shot of diamorphine (medical heroin!). It was wonderful-completely pain free immediately. I’ve never had a baby, but section incisions are what? 15 cm long? So how come a few teeny incisions gets me heroin, and a whacking great hole gets you ‘pain is good for you, so suffer, bitch’ ?

        • Dr Kitty

          Yup.
          I got heroic doses of morphine pre-op with an emergency laparoscopic ovarian cystectomy/appendicectomy and OxyContin and Oxynorm to take home, without even having to ask. It’s a surgery where you are supposed to be fit to return to work in 2-3weeks.

          I had to pitch a fit to get more than paracetamol and diclofenac to take home 48 hrs after a C-Section- a surgery where you’re usually advised not to work for 6weeks.

          • mabelcruet

            I got tramadol to take home and didn’t get on with it as it gave me hallucinations (and didn’t really relieve pain) but my GP very happily gave me OxyContin. She said I had to avoid driving on it, but seeing as though I was advised not to drive until I felt able to do an emergency stop that was no problem. I couldn’t imagine dealing with a huge incision and not being given decent pain relief-turning over in bed for the first couple days was really painful, even with the little incisions I had.

        • Mariana

          I don’t get that ether…

          But my husband got better pain meds when he had his wisdowm tooth removed then I did with either csections… I was sent home with Tylenol. I’m lucky it was just enough

          • Roadstergal

            For a ~12cm incision surgery, I got an Iceman, generic Vicodin, and PT. And rest. With all of that, I bet a C-section would be a WAY better experience.

        • Mel

          When I had my C-section with Spawn, I got some decent pain relief. The anesthesiologist topped me off with a long-acting pain relief drug that was apparently good for 24 hours after birth. I was given acetaminophen every 4 or 6 hours and had an oral narcotic that worked well on demand.

          The Special Care OB staff and the NICU staff were all about encouraging adequate pain relief in new moms.

          I didn’t find the recovery from the C-section very difficult, but I was very preterm and didn’t have an infant to care for which allowed me to sleep for 4-5 hours at a time. I would have slept more, but my BP was still disturbingly high at times so nurses had to take my BP frequently and sometimes give me IV meds.

    • MaineJen

      “Still sufficient” my a$$. Give me all the anesthetic necessary. End of story. This woman is nuts.

    • mabelcruet

      Save your sanity and stop reading! I’ve got completely sick and tired of the absolute drivel some of the midwife ‘leaders’ post, full of juvenile sappy memes a 16 year old girl who believes in unicorns would post, not so called professionals. Let’s all hold hands and sing Kumbaya and think pink and sparkly princess thoughts….

      • maidmarian555

        I think most 16 yr old girls would have better reading comprehension. There are women on that thread saying that they had no issues with their c-section births but they are sick and tired of being told they ‘failed’ by midwives. They all then jump in to tell them how sorry they are about their c-sections. I can’t look at it any more, even when this is pointed out to them, they just hunker down and insist they don’t want to ‘argue’. I imagine that if Hell exists, that’s what it is. Trying to have the same conversation over and over again, with the person you’re talking to completely refusing to acknowledge any of the the words that you’re actually saying. None of them should be allowed anywhere near vulnerable women or babies. Let alone be considered “experts” or “leaders” in women’s health.

        • mabelcruet

          You should be nesting or whatever nearly-ready-for-birth women do at this stage, not getting riled up reading crap on Twitter from uni-neuronal idiots! Think of your blood pressure!

          • maidmarian555

            Ha! Yes, I think Twitter might have to get added to the list of sites I am Not Allowed to visit for the next month or so.

    • Mariana

      Yeah… that is a great idea… not! I found it very weird on my second csection that I could feel the doctors pull my son out, despite feeling no pain. I can’t even imagine what it would be like with less epidural….

    • Mac Sherbert

      Yes, because a traumatic birth experience and terrible pain would be conducive to great breastfeeding and bonding. Head to desk.

      • Martha G

        That’s literally what she was advocating. What’s the expression, positive stress or some nonsense? You couldn’t make it up!

        • The Bofa on the Sofa

          Why is stress positive for breastfeeding? Because that’s what they have in the current situation.

          Of course, if it were peaceful, relaxing time, then that would be a great situation for breastfeeding.

          Every time is the perfect time for breastfeeding, you know?

          • Roadstergal

            Homebirth is better for breastfeeding because it’s quiet and the lights are low and you can have your own music and no invasive, prodding doctors. Such a relaxing, quiet, low-stress atmosphere is very conducive to breastfeeding.

            Limited pain relief is better for breastfeeding because positive stress has beneficial effects on mum’s focus and alertness that are very conducive to breastfeeding.

            It’s a good thing I’m not cynical, because I might believe they’re just lumping Stuff Midwives Can Do into the Conducive To Breastfeeding bucket, regardless of internal consistency. (Let alone actual evidence.)

        • Mac Sherbert

          I guess if she ever has to have a c-section maybe she should volunteer for that little experiment. Aside, from that I don’t imagine a doctor wants to operate on someone in pain. The doctors I know are not real big on causing their patients pain. That’s why I like them!

          • Martha G

            How much of this do we think is good old fashioned sadism? I’ve known people with those tendencies who have found harmless outlets for their feelings, and the parallels between their characters can be quite striking .

    • yentavegan

      Speaking from experience, my two c/sections under the recommended dosage of epidural medication had no impact on my ability to breastfeed. Amy Brown sounds like an agenda driven ideologue. And a dangerous one at that,

      • AnnaPDE

        Also what exactly do they think the mechanism is supposed to be? Trouble latching — i.e. the when the baby doesn’t manage to put their mouth around mum’s nipple in a way that they can suck milk out — has literally nothing to do with the mother’s spine, abdomen and legs. If they were talking with milk coming in later or some other mother-related problem, I could at least see a hint of a point, but like this it’s just the height of idiocy.

      • maidmarian555

        She’s dreadful. And is sadly regularly asked her opinion in the press as she’s a ‘breastfeeding expert’ apparently. My milk took 5/6 days to come in after my c-section but we did supplement. I also struggle to believe that the delay was only caused by the epidural (I really don’t understand how the two things are linked if I’m honest). I was awake for several days before my son was born and ate maybe two sandwiches in the hospital the entire time I was there (I couldn’t face their revolting food). That combination of exhaustion and not eating for the best part of a week seems to me to be a much more likely culprit- I mean your body needs energy to produce milk and I didn’t have any! Supplementing meant my son didn’t starve so it wasn’t an issue (although I did so against the recommendation of HCPs who all said I shouldn’t give him bottles because nipple confusion etc etc). We continued combo feeding but I could have easily gone on to EBF had I wanted to. I find even the suggestion that we should be looking at messing about with anaesthetic during surgery, as opposed to supplementing babies with formula for a couple of days really alarming. It’s completely unnecessary.

        • Dr Kitty

          What exactly is the mechanism by which a spinal anaesthetic (which lasts for 4hrs, and is what I, like most women, had for my elective CS) would affect latch or delay milk coming in?

          No really- what is the mechanism?

          The babies aren’t sleepy, the mum’s can move their arms, and I found that the fact my nipples were numb while the spinal was in effect actually meant their first feeds were painless and much more pleasant than the subsequent feeds over the next 6 weeks- because my babies have both latched like barracudas, and it takes a while for their mouth to grow big enough that my big, flat nipples don’t mind.

          My milk came in day 5 PP with both, but being a large breasted person who makes copious colostrum, the MWs both times told me it was already in by day 2.

          No.
          When my milk came in, it came IN.
          Lolo Ferrari had nothing on me.

          Give the baby formula if necessary and let mum sleep, eat and recover with adequate pain relief rather than making everyone miserable trying to hit an entirely artificial goal of “exclusive breast feeding”.

          Also, my mother helpfully reminded me that most of her patients in Zimbabwe in the 1970s didn’t feed their babies much colostrum, if the newborn was hungry before their milk came in they just handed the baby to a relative or friend who had an older baby, and the baby was nursed by them.

          People have always supplemented hungry newborns- whether with breast milk from another woman, animal milk, gruel or formula- it’s not a new practice.

          I’d personally rather my babies have safe formula than unscreened donor milk, and reputable milk banks need to feed preemies and sick babies, not healthy newborns.

          • maidmarian555

            Quite! It makes me sad that despite the fact we know how supplementation can be used very effectively and safely in that first week, there still seems to be an awful lot of time, money and effort being spent on dealing with a problem for which we already have a good solution. I wish they’d put their efforts towards researching why some women don’t produce any/very little milk at all, sometimes with absolutely no obvious reason. Surely finding answers to questions to which there are currently no clear answers would be a better use of available resources? The only reason I can see for them even thinking about messing about with anaesthetic during c-sections is to punish women who make decisions about birth that they don’t agree with. It’s barbaric and weird that it’s even being discussed.

  • Ozlsn

    There was a report on Australian TV last night titled “The Rise of Freebirthing” which was mostly about insurance changes due to come into effect in 2019 (current status is that private midwives must take out indemnity which covers them for births in hospitals or centres but not home births. As there are no insurance products at present that will cover that there is an insurance exemption currently in place for home births which requires that the attending midwives get a signed informed consent from the parties requesting the home birth;, eport relevent data to government bodies, and follow all relevent practice guidelines. This exemption expires in 2019.)

    Anyway. They interviewed a freebirther who said:

    NATALIE: The very small risk that was posed I felt that I was prepared to take and if there was a death of my baby or a death of me, then I was capable of grieving or if I was dead, my partner was capable of grieving. 

    *headdesk* It’s not often I scream at the TV over something other than sport or politics but that had me just exploding with rage. The level of sheer bloody ignorance, seriously. Was she ready for a child with an acquired brain injury? To have to renovate her house to provide wheelchair access? For her power bills to literally double overnight because oxygen condensers pull a lot of power? For continuous feeds and alarms going off at all hours of the damn night?

    Of course not. Because it couldn’t happen to her – and birth is totally natural and fluffy, right? SMDH. (Oh and she had a PPH but it was OK, she just had a little rest and got better.)

    • Roadstergal

      “Was she ready for a child with an acquired brain injury?”

      Was the _kid_ ready to have a preventable brain injury?

      • Ozlsn

        Oh like the child gets any choice in this! Which is also what is factoring in to what is making me so angry – you have a healthy term baby and you want to screw up their life from something preventable for what exactly?

      • Ozlsn

        Come to that was the partner ready for a spouse with an acquired brain injury? Were they ready to look after a newborn and an older child as well as a partner needing high level care as well? What were they ready and capable of grieving for, exactly? Morbidity is equally as important as mortality in this context.

    • Christy

      She must have had a charmed life so far, to have absolutely no idea of the unrelenting torment caused by the death of your baby. It’s not serene.

      • Ozlsn

        Basically. And it’s obvious she didn’t really believe anything could happen to her, or the baby, not truly. Otherwise her first pregnancy with the scary medical interventions post-PPH that gave her such a bad experience in hospital might have been A Clue or something.

        I just don’t get the magical thinking that goes “my first pregnancy I had this life-threatening experience that was really scary in hospital – I know what will fix that! Avoid the hospital!”

    • I work in insurance, though not health insurance. Insurers like to make money, but they also like to price their products at an affordable level. If no one is offering homebirth insurance, that’s because it’s not possible to do so at a reasonable price. In other words, it’s so risky insurance companies won’t offer a product at all. Do you know how rare that is? They cover cancer, FFS, and that can cost hundreds of thousands of dollars. They cover NICU stays of many months, which can cost well over $1 million dollars. And they won’t cover medical malpractice for homebirthing. Shouldn’t that tell people something about the risks involved?

      EDIT: Though I will note that malpractice and health insurance companies aren’t usually the same company, but still- they cover oncologists and OBGYNs and neurosurgeons for medical malpractice.

      • The Bofa on the Sofa

        Yeah, we’ve pointed that out many times.

        HB MWs whine about how expensive liability insurance would be, so that’s why they can’t do get it. To anyone paying attention, that is very telling. The risk is way too high.

        • Ozlsn

          I know. I suspect the solution will end up being the government subsidising part of the insurance cost for homebirth – there are some reasons why this could be a good thing, mostly to do with access to maternity care in remote areas although frankly if they are going to do that I would prefer they put the money into better access to medical care overall in remote (and rural) areas. Also I suspect if they subsidise then there will be a lot more oversight and reporting required in order to obtain the insurance. Naturally this will “force” some women to freebirth because you can’t prevent people from making spectacularly bad decisions.

          I would like someone in government to ask how many women are actually wanting this, whether there are ways to lower them by (for example) expanding hospital homebirth programs (which have strict inclusion and exclusion criteria), and what the costs are likely to be though before any hard decisions are made.

          Also colour me amused to discover yesterday that hiring two private midwives for your care and homebirth will cost $3500-4000 here – a private obstetrican costs about $8000, or you can go through the public system and pay basically zip (already paid through taxes). I suspect if midwives have to pay the same level of liability as obstetricians then the homebirth costs will rise to similar levels as private obstetricians.

  • Madtowngirl

    My water broke before my GBS results came back from the lab. The attending doctor had to contact the laboratory for the results, but we did antibiotics anyway – just in case. Oh noes, I might have had a bit of loose stool for “unnecessary” antibiotics. Way better than even taking the chance of infecting my pre-term newborn!

    P.S., she was breech, too. Gasp! We had a c-section! But hey, she’s alive and doesn’t have any lasting consequences from her birth!

    Just like your wedding day, the day of your child’s birth is a blip on the radar. A memorable day, perhaps, but ultimately nothing more than a one-time event. It’s not worth risking your baby’s health, or your health to put “natural” or “at home” on some sort of pedestal.

  • Rachel

    I find all this so hard to fathom. Modern interventions are so far from the enemy! I found out weeks ago that I have placenta previa, and the OB was sad telling me this. I said, so this means a C-section? He said most probably, if the placenta doesn’t move… I said, fine! The baby looks good? It’s my third (first two vaginal deliveries,) I am no fan of any pregnancy or birth (I like the end result I hate the process!) so bring it on! What would a woman do who had no screenings and then a home birth? Birth through the placenta?? Home birth and lack of monitoring is so foolish, I just don’t get these women!

    • MaineJen

      Placenta previa at a home birth? …They’d both probably die

    • EmbraceYourInnerCrone

      My brothers birth in 1966 was a C-section due to placenta previa (and transverse lie, because he started out a giant pain in the neck!) He is currently still wicked smart, funny and a a pain in the neck. Modern Obstetrics for the win! Fun fact, back then they did an X-ray to confirm his position, weird I know but they felt their concerns out-weighed the risks.

      • MaineJen

        That must have been a cool looking x ray, though 🙂

        • EmbraceYourInnerCrone

          Yeah, that’s what my dad said, it was pretty late in the pregnancy so I think they figured the chances of problems from it was minor. Only weird thing he had was SUPER long roots on all 4 wisdom teeth, which probably had nothing to do with it. He’s actually the healthiest of my siblings so far…and the only one born via C-section.

          • Azuran

            Well, to be fair, the risks from 1 x-ray on a term baby is pretty much nothing. Driving to the hospital to get the X-ray was probably hundreds of times more dangerous. We are extremely over careful with pregnant women.

          • Empliau

            My mom worked in the ER when she was pregnant with me, a long time ago, and she says there was little to no lead shielding for the staff. She says this may explain a lot …

          • Azuran

            Or course it’s different for a pregnant woman who works at a hospital and is therefore exposed for multiple x-rays during the whole pregnancy.

          • Eater of Worlds

            They routinely x-ray pregnant dogs at term to see how many babies there are. Not all vets have an ultrasound or are particularly skilled at using it, xrays are quicker and can give a more accurate count. There are no issues on the pups from that x-ray, and it’s always fun to count. Plus you can see if there’s an oversized pup likely to cause problems.

          • Azuran

            Indeed, but the amount of risk we accept for puppies is much higher than what we accept for humans, so it’s not really a good measure of safety.

    • sapphiremind

      Watch the first season of “The Knick” from showtime to see what happens to moms with previa before modern treatment. When they were finally successful at doing a c/section without killing both patients, you just felt this immense relief. And before that, they kept trying over and over, because they knew previa was a death sentence to mother and baby, and most wanted to risk trying to live or have their child survive than to just accept the death sentence.

  • MaineJen

    ~The baby was “unexpectedly” breach.~ Fixed that for you.

  • Mac Sherbert

    How often is the GBS test wrong? How often would a negative test would be wrong? Not that it really matters because it would seem to me that this poor baby suffered from more than just GBS.

    I had a c-section for a breech baby. That baby is alive healthy and intellectually brilliant. So, many say he’s going to do something one day. If I had not had the c-section there’s no doubt in my mind his big head would have gotten stuck and he could have (probably would have) ended up with brain damage. Everyday I look at him I know it was worth it even if I do feel the c-section caused some other problems. Even if he had been my only baby. It was still worth it. Please, mom’s don’t let the fantasy of a perfect birth affect your perfect child.

    • Anne

      I think the figure is 2% of those testing negative at 35-37 weeks are positive at delivery.

    • swbarnes2

      I think the test can yield false negatives and false positives, (or the GBS population can wax and wane, and be undetected at time of testing and reappear at birth) but using it as a guide to antibiotics treatment greatly decreased the incidence of sepsis, so it’s clearly protecting a lot of babies. So we can’t say for 100% certain that she would have tested positive, but it was pretty likely.

      And yeah, then there are all the other things that the hospital would have done differently.

    • Kerlyssa

      part of the calculation is how innocuous the treatment is, and how devastating untreated infection is. it’s low cost, usually completely non invasive (since ivs are generally placed for other reasons or as a precaution), and serious side effects are extremely rare. therefore, a pretty high false positive rate would be acceptable, but a high false neg would not.

  • Jessica

    I had GBS. I got IV antibiotics and my daughter didn’t get sick. I had meconium stained amniotic fluid during active labor. The doctors monitored fetal distress and I had a full NICU team standing by for delivery, who took my daughter (no delayed cord-clamping, they wanted to make sure her lungs were clear ASAP) immediately after delivery where they discovered (fortunately) that her lungs were clear. I confirmed she was well while being stitched up by my delivering physician for a deep muscle tear that caused a post-partum hemorrhage. Two days later my daughter and I went home perfectly well and she is now a thriving two year old. Had we tried to do this at home, the result could have been very different.

    • moto_librarian

      I was not GBS positive, but my second child also passed mec prior to delivery. The NICU team was there, and I will always be grateful that they were. As he was crowning, there was sudden distress. I heard the labor nurse ask if she needed to page the OB emergency team, and the CNM told me to push as hard as I could. Our son unrolled out of his cord, which was wrapped around his body twice. He needed deep suction, O2 via CPAP, and vigorous stimulation, but he was stable and in my arms within 20 minutes. I give zero fucks that we didn’t have skin-to-skin – I was simply glad to know that he was fine. Today, he is a bright, mischevious 5 year old who started kindergarten three weeks ago.

    • MaineJen

      I had GBS for my second kid, as well. I was more than happy to get the antibiotics, especially since my water has a tendency to break long, long before labor starts (annoying!). I only wish she had held off being born until they could get the second bag of abx in, but alas, she was in too much of a hurry, and we only had time for one bag. I was only in labor for 6 hours total before she was born. Whee!

  • The Bofa on the Sofa

    I said it before: this could have easily been my wife…if she had refused every intervention.

    But it wasn’t. She was tested for GBS. We knew the baby was breech. C-section went off without a hitch, and now we have a bouncing baby almost-9-year-old who has passed his hambone-all-the-time stage and moved on to the constantly-doing-handstands phase.

  • JDM

    Being Captain Obvious here for the sake of anyone who tunes in not thinking of this (which I’d imagine is only a very small number of readers here), there is no reason that a midwife couldn’t view their job as including such things as making sure their patients get a group B strep test. And etc. Maybe some do (I sure hope so), but the existence of case after case like the one described in this post shows a lot don’t. If those involved in a birth want a midwife involved, why not make part of the selection process finding one who doesn’t eschew modern medical advances (many not so modern at that).

    As Dr. Tuteur has so often pointed out, it’s the outcome rather than the process that’s the most critical thing. This is Captain Obvious signing off.

    • Banrion

      Can a midwife prescribe or administer antibiotics? I don’t think they can. Which is why they would never recommend testing for something they can’t treat.

      • The Bofa on the Sofa

        garlic!

        • Heidi_storage

          Thank you, Judy Slome Cohain.

        • Mad Hatter

          That is why I didn’t tell my mom I was GBS+. I knew she would ask about trying some ‘natural’ remedy like garlic. Or washing my vag with betadine.

      • MI Dawn

        Depends. A CNM can prescribe most medications, in the US. CPMs cannot prescribe because they aren’t licensed providers.

        • Daleth

          CPMs cannot prescribe because they aren’t licensed providers

          No, they can’t prescribe because they have no goddamn medical training. In most states CPMs are or at least can be licensed providers, i.e., licensed midwives. But they can’t work in hospitals or prescribe medicine because their education and training is totally inadequate; they’re not qualified for that.

      • JDM

        My dentists have suggested procedures that neither they or their practice does. Don’t see why anyone else couldn’t do it. Working as part of a partnership should be possible for midwives. It’s obvious (that word again) that some don’t want to.

        • Azuran

          Knowing and accepting the limit of your skills and knowing when you should refer a patient is what define real professionals.

        • Daleth

          Exactly. I used to see a dentist who didn’t do endodontics. When I needed a root canal, she referred me out. If she were following the practices of most homebirth midwives in the US, she would’ve probably told me my tooth abscess was a “variation of normal” that she could treat with affirmations and herbs.

    • The Bofa on the Sofa

      I don’t think our regular Captain Obvious would disagree, but she might object to you stealing her identity….

      • JDM

        Apologies to her then; I didn’t realize someone here was actually using that as an identity. I hope I danced without stepping on her toes, in that case. 🙂

    • Gæst

      My CNMs tested for it. I don’t know if they would have been okay with someone refusing it, but they didn’t make it sound like refusing was an option. GBS+ meant antibiotics in hospital – I didn’t even make it to the usual test because they caught a UTI (that I had no idea I had!) early in the pregnancy, and it was caused by GBS bacteria, so I was slated for antibiotics in labor from early on.

      • sapphiremind

        CNMs though are different from lay midwives. They are usually partnered with OBs and work in hospitals and have a master’s degree in nursing.

        • Gæst

          Yes, having worked with CNMs I know how they are different from CPMs and random people calling themselves midwives. JDM said simply “midwife” and suggested hoped that some do perform these tests, and I confirmed that some, in fact, do. A month ago.

  • anh

    Is she in the U.K.? My midwife says they don’t routinely test for it here and just monitor babies once they are born.

    I found this super disturbing and requested I receive abx in labour as a precaution.

    • moto_librarian

      She is stateside. I am extremely disturbed that the UK does not test for GBS status.

      • Dr Kitty

        The UK doesn’t do perineal swabs, but does routinely culture urine.
        Anyone with GBS+ve urine or a hx of known GBS colonisation or a baby with previous GBS infection gets antibiotics in labour.

      • She left Israel? Good.

  • Sheven

    Typo: “The idea that delayed cord clamping was lifesaving is fowlish”

    I do feel for the woman. She is taking two incredibly painful hits. She has to feel pain because her child was injured and she must feel pain because her own sense of self was destroyed. She can’t protect her kid anymore, but she can protect her sense of identity.

    • Empress of the Iguana People

      Well, chickens are fairly stupid so fowlish works for me 😉

  • Empress of the Iguana People

    I feel a little bad for that deluded woman but much worse for the poor baby. At least she survived and hopefully will lead a generally contented life.

    But good heavens, people, it’s not jumping out of the airplane that hurts you, it’s the landing. The hospital’s parachuet is much more effective than what’s available in homebirth.

  • kilda

    yes, GBS can go undetected in the hospital too – but it’s a lot less likely to, because they actually test for it. She says it like the GBS was just inadvertently missed in her case, like it was an error that could have happened in the hospital too. But that’s not what happened. It wasn’t “missed” – she refused the test.

    Of course, if she was in the hospital she probably would have refused the GBS testing there too. And the EFM that would have detected the baby’s distress. And the C section that would have been recommended when they found the baby was breech.

    So yeah, it probably would have happened in the hospital too, in this case, because this woman would have refused all the medical care that could have made it different.

    • Roadstergal

      Once the baby was born, though, couldn’t they have taken more immediate and useful care in the hospital? In labor, the women’s bodily autonomy is paramount, but once the baby is born, can’t they take care of it properly?

      • kilda

        yes, at that point the baby would have gotten faster more expert care in the hospital, but at that point most of the damage was probably done.

      • MI Dawn

        Yeah, meconium in amniotic fluid in the hospital will lead to immediate suctioning and so forth, to prevent inhalation if at all possible. Then, too, the baby would have been treated appropriately with antibiotics, especially with the episodes mom describes (including the one where they cancelled the ambulance…)

        • sapphiremind

          We don’t do immediate suctioning for meconium babies anymore – the meconium that causes the problems is deep in the lungs, and routine suctioning has not improved anything, and sometimes led to delayed initiation of ventilation and HR. The thought is that the kids who have the most issues, they’ve had meconium in there for a longer time, have been “breathing” it deep into their lungs and suctioning the trachea at that point isn’t helping. The kids who didn’t have long-standing meconium won’t have a chance to breathe it in deeply and then don’t need the trauma of intubation.

          But we would have coded the hell out of the baby and put it on antibiotics. It would have had a much better chance.

  • So what the mom is saying is that IF doctors ignored the breech, and IF they didn’t give her antibiotics, and IF they ignored meconium staining, and IF they didn’t intubate right away, THEN the outcome would have been the same? That’s a lot of ifs that never would have taken place in the actual real world in which we live.

    • MI Dawn

      And if she’d had all that happen in the hospital, she’d be suing the pants off every one of them. But midwives don’t have deep pockets.

  • Anj Fabian

    Still singing in the choir. Still singing hosannahs to home birth. Still shouting AMEN! when asked about her home birth.

    Still shitting on ethical responsible providers of real medical care.

    It’s the last part that always gets to me. I can sigh and watch her mired in her need to believe that it was nothing she did and nothing her trusted midwives did that caused her baby’s injuries.

    When she insists that it would have all happened the same way in the hospital, that trained, experienced professionals would have been helpless to do anything to change the outcome.

    BULLSHIT. Leave them out of your fantasy.

    • Mel

      There is no way that this baby was attached to a ventilator at home.

      There’s no way the baby was intubated at home – let alone intubated with a deep suction machine and ventilator waiting on hand.

      That’s completely made-up bullshit.

      They were also missing the crash cart and scads of well trained medical professionals who intubate, suction and care for critically ill infants every day.

      What pisses me off is that this mom KNOWS better. Her daughter was on a god-damned ventilator in the NICU for several weeks. She was attached to a ventilator and a humidity tower and there was a suction apparatus in the NICU – but there sure as hell was not one at her house.

      She may still be hoping for support from the NCB crowd – but damn -she’s making it hard to get support from former NICU parents and medical professionals.