Natural childbirth industry shocked; pretending vaginal birth has no risks increases women’s suffering

Woman with distressed expression holding a baby

Who knew?

It turns out that vaginal birth has risks and the suffering doesn’t end when the baby is delivered.

Among the typical symptoms women face in the first week after childbirth: heavy bleeding, abdominal cramping, constipation, hemorrhoids, chills, night sweats, difficulty going to the bathroom, engorged breasts, back pain, headaches. And it goes on: pain in the perineum (the diamond shaped sling of muscles in the pelvis), incision pain (if the woman has had a C-section), pain and difficulty walking (after an episiotomy or tear), depression, anxiety, and exhaustion.

The pain can last for weeks:

They demonize the one procedure that can protect the pelvic floor and recommend the one that is most likely to destroy it.

About half of women who give birth are still in pain weeks later. More than 40 percent of women who delivered vaginally reported perineal pain, and nearly 60 percent who had C-sections experienced incision pain within two months of childbirth … Nearly 80 percent of mothers surveyed said pain interfered with their daily activities. One in three reported urinary or bowel problems.

Why is this happening? It’s doctors’ fault!

OB-GYNs and midwives who deliver babies don’t often find postpartum problems like nerve damage and incontinence because they aren’t looking for them. As Kari Bø, pelvic floor expert at the Norwegian School of Sports Science, explains, “Gynecologists, urologists and colorectal surgeons concentrate on their areas of interest and tend to ignore the pelvic floor common to them all.”

Rather than focusing on the “three holes in the pelvis,” practitioners owe it to women to see the “whole pelvis.” Since they don’t, pelvic pain or dysfunction often goes overlooked. Nearly a quarter of women have a pelvic floor disorder. The prevalence increases with each child a woman has.

And that is pure unadulterated bullshit!

A substantial portion of gynecologic practice involves dealing with the consequences of childbirth injuries including uterine prolapse, cystocele, rectocele, urinary incontinence, fecal incontinence and fistula. Indeed there is an entire sub-specialty, urogynecology, that is devoted to nothing else.

What is a urogynecologist?

Urogynecologists are physicians who complete medical school and a residency in Obstetrics and Gynecology or Urology. These physicians are specialists with additional years of fellowship training and certification in Female Pelvic Medicine and Reconstructive Surgery. The training provides expertise in the evaluation, diagnosis, and treatment of conditions that affect the muscles and connective tissue of the female pelvic organs…

What do they treat?

Urinary incontinence: Loss of bladder control …
Interstitial cystitis and bladder pain syndromes: Discomfort related to the bladder and/or urethra
Pelvic organ prolapse: Dropping of the pelvic organs (bladder, bowel, retum, uterus, vagina)
Fecal incontinence/Accidental bowel leakage: Loss of bowel control
Urogynecologic fistula: Abnormal hole between the bladder and the vagina (vesicovaginal), the urethra and the vagina (urethrovaginal), or the rectum and the vagina (rectovaginal) …

Yarrow’s insistence that doctors don’t know anything has become something of a cottage industry for her.

The day after this nonsensical piece claiming that doctors are ignorant of pelvic floor injuries she had a different piece in The Washington Post entitled Why do we understand so little about breast-feeding?. The subtitle of the piece is “Despite the emphasis on breast-feeding, the medical establishment can offer little help to nursing moms.” That’s not true, either.

It is Yarrow who is ignorant, not doctors and her ignorance reflects the know-nothingism of the natural childbirth industry. It’s an industry based on the premise that if it is natural, it must be good. And now it is shocked to discover that natural can be very bad indeed.

Doctors have known this for millennia. Consider the episiotomy. It is anathema within the natural childbirth industry, which utterly ignores its purpose. The episiotomy was designed to protect the pelvic floor. It turns out that it didn’t work the way it was intended (it made the most serious perineal injuries more likely not less) but it reflects both the fact that obstetricians understood that childbirth led to serious pelvic floor disorders and the hope that they could be prevented.

We do know a way to mitigate pelvic floor disorders; a C-section protects the pelvic floor from the ravages of childbirth, but C-sections are anathema, too. How dare a woman have the choice of an elective C-section to protect her pelvic floor?

What’s the biggest risk factor for pelvic disorders? Obstetric forceps. That’s not surprising when you consider that it is the baby’s head that causes pelvic damage; the bigger the head, the greater the damage. Forceps, basically giant metal salad tongs, effective increase the diameter of the baby’s head while simultaneously increasing the forces on the pelvic tissues by adding the doctor’s pulling force.

Yes, a C-section is major abdominal surgery, but it is generally easy and can be accomplished in 30 minutes or less. In contrast, I’ve seen massive vaginal injuries that were caused by forceps that required multiple hours and hundreds of stitches to close. That’s one of the reasons why I never used forceps.

In the absurd moral panic around C-sections, natural childbirth advocates have promoted forceps deliveries as a way to avoid C-sections. They demonize the one procedure that can protect the pelvic floor and, in its place, recommend the one procedure that is most likely to destroy it. Does that make any sense at all?

Vaginal birth has serious risks and can lead to significant, debilitating, lifelong injuries. Doctors have always known this and tried to prevent it. Now the natural childbirth industry is shocked to discover that fact and instead of taking responsibility for their dangerous beliefs they’ve done what they always do. They reflexively blame doctors, the very people who were warning them of the risks all along.

  • keepitreal

    I know someone who insisted that she was going with a midwife and it was going to be in the hospital, so she had all her bases covered. She did her stunt-birth and her baby was born limp and pulseless and fortunately revived. A c-section could have prevented this. I don’t EVER want to hear another ‘natural’ freak extol the virtues and benefits of ‘natural’ vaginal birth. It can be deadly. A birth that gets a baby here safely is the ‘best’ birth.

  • BeatriceC

    This is rather timely and relevant. I think I might go. This is the group of doctors I’m trying to get an appointment with for a second opinion. I am really glad that this sort of thing is finally being talked about. That probably has something to do with why my doctors, after years of ignoring it, are suddenly interested in treating my pelvic floor issues where they haven’t really seemed all that interested in the past. Or maybe it’s because since it’s being talked about I got more demanding. But however it happened, I’m glad that these sorts of things exist.

  • mabelcruet

    A bit OT, but Dara O’Briain, a Irish comedian (and physicist) does a great routine about antenatal classes and midwives. His wife is a doctor, a surgeon I think. Great routine on antenatal classes, episiotomies, homeopathy etc.

    • Empress of the Iguana People

      that’s hysterical

    • BeatriceC

      I think you’ve linked this before, but it was just as funny this time around.

      • mabelcruet

        I love Dara O’Briain-like most of the best comics he’s very intelligent and is at his best in stand up. I saw him on his last tour and swear I pulled a muscle laughing so much. As well as comedy, he fronts programmes about maths (math for you American types!) and physics and astronomy. Bit of an odd mix!

        • Roadstergal

          I love him. He has a physics degree, and geeks out to a degree that pleases me greatly. I loved his bit about playing Metal Gear Solid, and I ADORED his bit about the “Neutrinos are evolving” quote from that terrible disaster movie whose name I can’t recall…

  • fiftyfifty1


    The writer makes the argument that nurse-ins actually reduce breastfeeding rates by making women afraid that being harassed for breastfeeding in public is a common occurrence, when in reality it is rare.

    • crazy mama, PhD

      I see her point, especially with more generic “let’s rally in front of City Hall to support breastfeeding” events like the one in the photographs. I’m (largely) OK with people protesting in specific cases where someone has been harassed for nursing.

    • Cat

      Personally I was hideously self-conscious about breastfeeding in front of other people, but I was never particularly worried about harassment or criticism – I just didn’t want anyone to see me engaged in a wrestling match with a furious, unsatisfied baby (and I especially didn’t want any of our well-meaning local earth mothers to start offering me patronising tips or, heaven forbid, invite me to “boob group”). I used to spend baby groups in a state of panic in case my daughter started to get hungry and I’d have to demonstrate my ineptitude as a functioning pair of tits in front of the whole group. I suspect that half the first-time mothers at my postnatal yoga group (where breastfeeding was very much encouraged) felt the same. I remember one particular mum looking like she wanted the ground to swallow her up as she tried to wrestle an angry, kickboxing baby into staying on the boob. I wonder if the idealisation of breastfeeding as easy, convenient and The Best Experience of a Woman’s Life actually makes many first-time mothers more reluctant to feed in public, because they’re ashamed to let the world see that they’re really finding it awkward, messy and sometimes painful? It wasn’t until much later that I started to talk about breastfeeding with other first-time mums, and the consensus was “oh my god, I thought I was the only one and my body was uniquely rubbish!”

      • maidmarian555

        I used to find it much easier to go and find somewhere quiet to feed my son. I was certainly never shamed by anyone for breastfeeding in public but as he started to get a bit bigger, if we were in a busy environment, any noise and he’d unlatch himself to have a good look round. As much as I’d love to be one of those people who are happy to put their boobs on display, I was most definitely not cool with the whole of Starbucks being able to see my nipples. I guess one of the things with nurse-ins and such is it puts pressure on you to not feel the feelings you might be feeling about being exposed in that way. As a society we teach girls to cover up from when they’re small and yet, all of a sudden, you’re supposed to be able to undo all the conditioning you’ve been getting your whole life and just let go of it. It’s good that some women can, but I think it’s also important to say to new mothers that it’s also ok if *you* find it difficult. It’s ok if it makes *you* feel a bit uncomfortable. Conversely I’ve also never experience shaming or any weirdness for bottle feeding in public either. Obviously shaming does happen and it’s hideous for those that go through it, I’m not really sure how common it is generally.

        • Merrie

          I’ve breastfed 3 kids and never had anyone say boo to me about feeding in public. And I’ve been pretty unapologetic about feeding wherever I happen to be. But as my babies have gotten older, it is harder to feed them in public because they are very distractible. My now 7 month old is combo fed (other two were EBF) and it’s kind of nice for him to be able to get a bottle at church or a friends house so that I don’t have to try to wrestle him into eating or find some non-distracting place to hide myself away.

          • maidmarian555

            I switched my daughter from combo feeding to EFF at around 4 months because it was almost impossible to get her to concentrate long enough to latch to my boob at home, upstairs in the bedroom with nobody else around. It’d take ages to get her latched on, a mouse would fart four miles away, she’d unlatch to look round and then start yelling because my nipple wouldn’t stay in her mouth while she moved her head about. Feeding in public was impossible. Even now she has a bottle, it’s still not easy to get her to focus, she’s just not that bothered about food if she thinks she might be missing out on something more interesting.

          • Merrie

            “a mouse would fart four miles away”

            Hahaha, love it!

          • rox123

            “..and then start yelling because my nipple wouldn’t stay in her mouth while she moved her head about”
            Oh God, my little man will stretch while latched on the boob, feel that something is restricting the movement of his head while tilting it backwards and then tilt his head even more, pulling my boob. And he just won’t let go!

          • maidmarian555

            Ouch! That does not sound like a fun time! My daughter was doing full 180s at speed so I’m glad she let go. It was pretty frustrating but not horribly painful.

      • AnnaPDE

        I have talked to exactly one other stranger mum while breastfeeding. Her 5mo-looking kid seemed to be super distracted and repeatedly popping off the nipple while she was trying to feed him in a wobbly camping chair close to the sprint finish line at a Little Athletics meet, so I told her about my go-to “no distractions, semi-comfy seat and some shade” BF spot in the shed.
        And even for that I felt horrible about approaching her, and seeing how she was clearly thinking “oh no, someone commenting on my BF!”. I hope the improved location made up for it.

    • ukay

      Yep. I am still to meet the droves of medical staff pushing formula and the old men in 5 piece suits on their crusade against breastfeeding. It is a largely fictional enemy lactivists are fighting.

    • Empress of the Iguana People

      I certainly was never harrassed for breastfeeding in public by anyone disapproving of it. I got harrassed a few times by people wanting to congratulate me for bf’ing. Ugh. Go away.

      • Empress of the Iguana People

        Although sotto vocce comments generally go by me. One of the few benefits of hearing impairment. 🙂
        The other being I never heard boybard’s bone snap dispite being a foot from my face.

      • Gæst

        Yes, I got stopped and quizzed on whether or not I was breastfeeding, and that was so annoying.

        • Empress of the Iguana People

          And gushing about how wonderful it was that I was breastfeeding while feeding the spawn. Go away, creepy stranger

          • ukay

            Creeping up on women and making uninvited comments on their breasts is usually considered harassment. But I guess it is always okay to comment on mothers…

    • Tigger_the_Wing

      I only had one incident where someone commented on my feeding method (in 1984); I was in the supermarket, after I’d switched my third to EFF, and had come to a complete halt so that I could hold the bottle. I was finding it impossible to steer a heavy shopping trolley one-handed. A woman approached me and said “That’s the wonderful thing about bottles, isn’t it? Being able to feed them anywhere?”

      Considering that I’d EBF the first two, and the third for several weeks, and not once had to stop what I was doing in order to feed them (they went in the baby carrier for feeds, leaving both my hands free) and never, ever had anyone comment about their feeding, I was most put out – but too surprised to think of a retort.

      Years later, I happily fed twins in public, again attracting no comment.

      But the shaming does go on; just because it was never directed at me doesn’t mean I didn’t witness it. When my second was re-admitted to hospital, there was one other very young baby on the children’s ward. Rather than be stuck in our rooms alone whilst feeding, we two nursing mothers would spend time in the other’s room (neither baby was thought to have anything infectious). There was one occasion when a nurse came bustling into the room, demanding that the curtains were drawn whilst the other mother was breastfeeding – she totally ignored me, also breastfeeding. I can only assume that it was because the other woman was well-endowed, and I barely had enough to fill a training bra.

    • Lady M

      See, i *have* been harassed, but its a running joke amongst my friends and family that I seem to attract people who just want to shout at me for no reason. I apparently have *that* sort of face-i’ve also been harassed in public because my middle has epic resting “b” face and i was yelled at because “why is your baby so angry”. (She wasn’t. She was literally sitting in the cart and surveying her domain)

      On the other side of that, my response wasn’t to call all my lactating friends and schedule a nurse in, it was merely to tell the the harasser basically to go sit on a cactus and to leave me the hell alone and if they didn’t like me feeding my kid, they could just simply not look. And if they continued, I had the state laws saved as a link on my phone, i’d pull them up, and smugly respond “leave. Me. Alone. Now”

      (for what its worth, I support all forms of infant feeding, breast, combo, formula- fed is best and I will cut in and defend a mom if i see a formula shamer, because i’m basically perpetually salty and new moms don’t need to be yelled at for no good reason)

      • MaineJen

        As a career introvert, I have trouble imagining a scenario in which I’d “yell” at someone in public. Unless they are actively causing harm, I tend to mind my own business. Honestly, the level of entitlement and self-satisfaction it must take to actively insert your nose into someone else’s business is mind boggling. :/

      • guest

        I formula fed and was never yelled at by a stranger. I’ve actually never been yelled at by a stranger in public – except for customers when I worked retail. I must have a face that discourages that kind of thing (yay me!) I would totally defend a mother if I saw someone harassing her for feeding her baby, no matter how she was doing that.

      • Gæst

        The only time I was yelled at it was because I was in a crowded farmer’s market and when I saw an opening in the passing foot traffic I quickly maneuvered into it – because no one EVER stops to let a stroller in here. The man who ended up behind me followed me for a block yelling at me about what a bad mother I was to be so bad mannered in front of my children. As if yelling at a mother trying to get two kids through a crowd isn’t bad mannered!

      • Roadstergal

        I have never fed a baby in public via breast or bottle, and I’ve had all kinds of shite yelled at me. 😀 I thought it was the whole ‘being a woman’ thing…

    • Mishimoo

      I accidentally made an elderly couple storm out of McDonalds by breastfeeding my middle kiddo in public, but it was more funny than upsetting.

    • SF Mom & Psychologist

      I was yelled at by a stranger on the street for allowing my baby to have a pacifier. This stranger was so “worried” it would prevent the baby from learning how to talk! She should see him now at age 9… I literally can’t get him to stop talking.

      • Who?

        The single most irritating common trait people who don’t mind their own business share? They never offer anything practical-fold a load of washing, run up a meal…

        That kind of interference we could all get on board with from time to time.

  • Empress of the Iguana People

    Okay, so this is a half formed thought, but I wonder if there’s a bit of the same impulse of those crazier manhood ordeals various groups do in the natural childbirth crowd. Show how -manly- you are because of how much pain you can stand? Or whatever.

    • The Bofa on the Sofa

      I’ve said this before. It’s the embodiment of an Arnold or Sly Stallone movie. You know how Rocky gets the shit kicked out of him for 10 rounds and then goes on a tear in the last minute to win by knockout? He’s such a hero because he can endure all that pain to win in the end.

      Arnold gets a dart shot through his hand, but that doesn’t slow him down.

      They are heroes for doing it.

      Same thing.

      • BeatriceC

        Well then you have shit in the real world like Kerri Strug’s second vault at the 1996 Olympics. This idea runs deep through our collective conscious.

  • BeatriceC

    I’m going back and forth between various doctors and my insurance company regarding fixing my pelvic floor. In the last six months I’ve seen the gyno-oncologist (everything turned out to be benign and easily treated) who then referred me to a urogynocologist, and now I get to see a second one because apparently not being able to walk fast without leaking urine isn’t enough medical justification to approve surgery to fix incontinence issues that in the last year has worsened from “just” stress incontinence to flat out incontinence. But I’m a woman, so it’s “normal”, and it’s okay that I need to wear big incontinence pads every single day and resort to a diaper if I get a cold (because the pads just aren’t enough if I sneeze or cough) at the ripe old age of 42. Women’s health care in the US sucks monkey balls.

    • Empress of the Iguana People

      I got some of that, too. Yes, women have more trouble as they get older, but I had none at all until 7 months pregnant the first time, and I have ever since. 🙁

      • BeatriceC

        My biggest complaint is that my insurance company is dicking around with approving surgery because it’s “normal”. Just because it’s “normal”, doesn’t mean it should be, dickwads. If men were suffering urinary incontinence as regularly as women do, for this common a cause, you bet your ass they’d be 1. finding a way to prevent it to begin with and 2. fixing it as fast as humanly possible when it did happen.

        • Who?

          Normal is not always acceptable.

          Someone should put that on a tshirt.

          Hope you get a resolution soon-it seems like people are talking about this a lot more over the last couple of months.

          • BeatriceC

            Thanks. I’m so excited for the prospect of surgery.

            Over Christmas I had the incident that basically broke me. MrC’s daughters and their spouses were here (with one visiting from the other side of the country) and we were playing the game Quelf. It’s a really funny game and there’s lots of laughing. Well, it was my turn, and I got a card that made me do something ridiculous and I was laughing so hard I completely lost control of my bladder and even though I was wearing a big bulky pad, the pressure from the laughter made me flood everywhere. I ran upstairs in tears and was so mortified I couldn’t come down for a long time. And these are with people I know and like and respect, and know beyond a shadow of a doubt weren’t judging me at all, but still. I still cry thinking about it. I just want it fixed. I want to have normal function. I don’t want to have to say “no, I can’t play this fun game because it will lead to embarrassing things.” And I shouldn’t have to live my life this way. But hey, since it’s a women’s issue and it’s “normal”, it’s not medically necessary.

            Oh, and all of this could have been avoided if a nurse didn’t ignore the EFM strip and alerted the doctor to a potential brewing problem either before the anesthesiologist went home for the day or in early enough to call her back in when she went home for the day (on call, but not on the premises) to do a c-section. Instead my OB had to resort to extraordinary measures that involved forceps and hands and dislocating the baby’s shoulder, which did lifelong damage to both me and the baby.

            But hey, he came out of my magic vagina, so it’s all good, right?

            (Sorry, I’m a little salty tonight.)

          • Who?

            I’m so sorry.

            I hope your insurance company can be convinced to cover your surgery is soon, and that it is uneventful and successful.

          • BeatriceC

            Thanks. My regular gyn said the the first urogyn has faxed all the paperwork to the second urogyn, but they hadn’t gotten it yet as of Friday. I’ll follow up again on Monday. The second urogyn is with UCSD, which is in general a good hospital, in spite of being “baby friendly”, so I have high hopes.

          • No way should you have to go through this when it can be fixed!

    • maidmarian555

      That’s outrageous! It’s not ‘normal’, it’s common. There’s a massive difference. I’m so sorry you’re going through this.

  • Casual Verbosity

    OT: I just want to encourage vaccine conscious people to consider getting serology done to check your immunity levels. I had to do this recently in order to work in the public health system during my masters placements, and I came back with low levels of rubella antibodies, and absolutely nothing for Hepatitis B. Despite having had the entire course of Hep B vaccinations in high school (not that long ago), I have absolutely zero immunity to it. The doctor was convinced I must have missed it, but I had the documentation to show I had received it (as well as a vivid memory of almost passing out because we got called out of P.E. on a 35 celsius day to get our first dose). So even if you have had all of your age-appropriate vaccinations, it’s a good idea to check your immunity levels, because we tend to just assume that we’re protected when we may not be.

    • Resident

      Approximately 15% of the population is non-responsive to the hep B vaccine. I have a relative who has gotten the full course 3x as well as several boosters and does not make antibodies in response. All vaccines have non-responders or people that aren’t able to get the vaccine for medical reasons and all these people (as well as the anti-vaxers) rely on herd immunity.

      • Casual Verbosity

        I’ve had a bit of a look into it and it seems like the chance of it taking after a second course is at most 50%. My doctor didn’t mention that at all. The problem for me is that if I’m a non-responder then I can’t really pursue my desired career in maternal mental health because you have to have evidence of both having received the vaccinations and having sufficient antibody levels. So if this next course doesn’t work I’ll be barred from working in the public health system because of my immune system. I’m trying not to think about that at the moment, but it’s sort of heartbreaking.

        • fiftyfifty1

          You will not be barred. As a primary care doc I have walked patients through this rodeo many times. When the titre says “non-immune” we re-vaccinate. Then either the school just accepts that the person has been re-vaccinated or RARELY requires them to try titres again. If the titres are then positive, you are done. If they are negative, then I write a doctor’s letter and you are done. Whichever way it ends you will be done and fully good to go. I promise.

    • fiftyfifty1

      Actually, the official recommendation is that the general public NOT get serology checked. Members of the general public should just make sure they have received all the recommended shots.

      There are multiple reasons for this recommendation, but the most important one is that titres often do not accurately reflect a person’s actual immunity. Titre numbers naturally fade over time until they become undetectable, but the person is still fully immune.

      • Casual Verbosity

        I can understand that. What about if you were having a new baby in the family or you come into contact with immunosuppressed people? It’s all well and good to keep your vaccinations up to date but if they don’t work for you, wouldn’t you still be putting those vulnerable people at risk?
        I have seen some preliminary research suggesting that Hep B nonresponders who come into contact with the virus can demonstrate some immunity to it, so that’s promising. My issue is that if I want to work in the public health system I have to demonstrate adequate immunity, so I could be barred from my desired career in maternal mental health because my immune system doesn’t respond properly.

        • fiftyfifty1

          Don’t worry. You will in no way be barred. You do not need to actually demonstrate immunity. Your master’s program requires titres because it is covering its butt. It is not legally required. But they don’t want to get sued if one of their students, or one of their student’s patients, gets sick. And students can easily lie and say they are up to date on their shots when they aren’t (submit fake dates) so your school just takes the simple way out and has everybody do titres, and get re-vaccinated for the “non-immunes.” Then they call it good. Sure it wastes a ton of $ on the testing, and another ton of $ on the unneeded re-vaccination but it’s a no-brainer way for them.

          And in terms of putting babies or immunosuppressed people at risk, remember that the fact that you have a negative titre is not, in itself, harmful to them. To be actually dangerous to them, there would still need to occur many other things: 1) the “non-immune” titre test would have to actually be true and not just a false alarm titre fade 2) there would have to be a breakdown in herd immunity in your area large enough to allow a a vaccine-preventable illness to start a mini-epidemic 3)you would have to come in contact with one of the sick people 4) you would have to get sick yourself 5) you would have to go to work anyway, even though you felt sick 6) you would have to contact the vulnerable person.

          • Casual Verbosity

            I hope that’s the case but I’m not certain it is. This form comes from NSW Health, not from our university. I received the same form when I was offered an administrative role in a public dental hospital (but never ended up going through the process because I took a job in a private clinic). We also have to get a doctor to sign off that they have sighted the records of vaccination as well as the immunity levels. I will definitely investigate further to see what my options are. The form seems quite strict so I just assumed it was a “no immunity, no job” scenario. Hopefully there’s some flexibility.

            My other question was more in regards to things like chicken pox and MMR. But it’s good to see the required events laid out like that.

      • safe and secure

        I’m glad I had my titers checked and received MMR booster shots. The titers show I’m immune now. I’m trying to get pregnant, so it’s nice to have the peace of mind of knowing I can’t get rubella.

        • fiftyfifty1

          Yep. As part of primary care/maternity care, for women of reproductive age, a 1 time rubella titre is the standard recommendation. It is likely overkill, but in this case the benefits outweigh the cost, especially because so many young women may have trouble finding their shot records.

  • Ozlsn

    Is there a link to the original quoted article that I am missing? And who is Yarrow?

  • AnotherOor

    My OB (half-heartedly) tried to convince me against my MRCS. After he realized I was not going to let it go, he conceded that his colleague, a urogynecologist, had c sections for all of her pregnancies due to what she’d seen in her line of work.

  • momofone

    I’ve only had a c-section, no vaginal births. I heard horror stories about how awful and agonizing my recovery would be, and how I wouldn’t be able to enjoy my baby during my maternity leave because I’d be incapacitated. I ended up needing a c-section, and though we’re not having any more babies, I would never consider giving birth another way. My recovery was smooth and uneventful, and by two weeks out I was back to normal as far as activities. I was tired, but no more so than any other parent of a two-week-old. I was also warned that breastfeeding would probably not work if I had a c-section (or if my baby ever had formula, or a pacifier, or a caregiver whose uterus he did not grow inside), and that was not the case either. Interestingly, I never heard such dire warnings about giving birth vaginally; I was only met with concerns that my OB would want to “overmedicalize” my son’s birth. I love medicalization. Medicalization saved my life many years before pregnancy, and my son’s life. If we decided to do it again, I’d start my first OB visit with a request for c-section and extra medicalization. 🙂

    • Cartman36

      I have only had C-sections as well and am about to have my third via repeat c-section. My friend just had a VBAC. She said that she actually found the C-section recovery easier and that felt deceived by her childbirth class because they minimized the pain she would experience (she did it natural) and minimized the time it would take to recover.

    • FormerPhysicist

      I’ve had three c-sections. The one that was pre-labor was nice and easy. Recovery was okay, not super easy.
      You know what makes recovery difficult? Toddlers. When you can’t nap when the baby naps, it makes recovery harder. Or feel harder. At least for me.

      • Sarah

        Oh yes!

      • PeggySue

        Yes, and that is true whether birth is vaginal or C-section! Toddlers are pure energy, doggone it!

    • Mel

      My C-section recovery was straightforward. I had some lower abdominal muscle pain especially when I turned over in bed at night for less than a week. I found the surgical glue over the incision to be kind of annoying as it started to peel off in pointy chunks.

      Um…yeah. That’s about it.

    • BeatriceC

      I’ve had both. I am still dealing with the negative effects of my one close to term vaginal birth, even though that child isn’t actually a child any more. He’ll be 19 in a couple months. My c-sections, on the other hand, are done, over with, never to be heard from again. Also, recovery in the immediate postpartum period was easier for the csections as well.

      • Empress of the Iguana People

        With toddler(s) in the the house!

    • NinjaMama

      Same. People told me how horrible it would be. After a really hard pregnancy, I felt awesome, frankly.

  • Heidi

    Ugh, I started reading her linked article on breastfeeding and backed right out when she claimed drugs for low supply are under-prescribed. No, they aren’t! They are dangerous, and I’m of the opinion they should never be prescribed unless the mother really understands the great risks they pose and the doctor doesn’t feel anything, like postpartum depression or societal pressure to breastfeed, is clouding the decision to take them.

    • The Bofa on the Sofa

      I started reading her linked article on breastfeeding and backed right out when she claimed drugs for low supply are under-prescribed.


      Is that an admission that low supply is under-recognized?

      • Krista

        If someone requires prescription drugs to make breastfeeding possible, then how in the heck is that natural? That baby would have died in nature (without substitutes such as formula). Why would that intervention be preferable to the formula intervention? For me, I would consider it worse due to the side effects of the drugs. Other people may make a different choice of course.

  • anh

    My csection was cake to recover from compared to my daughter’s vaginal birth. I’m done having babies but I’d never deliver vaginally again.

    I would argue that there isn’t a lot that medical professionals know about lactation. For that reason it’s rare that IBCLCs are actually useful

    • Heidi

      I’d argue, too, is that where we put all our limited funds towards either? We have a perfectly acceptable substitute for breast milk and we know all those “benefits” Yarrow mentioned are either overstated or don’t exist (I noticed she didn’t include any citations). It feels like there’s an assumption that if we do figure out the cause of every single case of under-supply, we’d automatically have a drug that would have no serious side effects, wouldn’t get into the milk supply and would take care of the problem. I doubt that would be the case.

      • Ms. Sweaterfan

        I love how so many articles with something to say about breast feeding start out like “we all know the many benefits of breast milk” and then don’t even try to provide any citations to support their claims. I guess they think that “common knowledge” doesn’t need to be supported, but any high school English teacher could disabuse them of that notion.

        • Charybdis

          Wikipedia is not a valid source. Neither is KellyMom or Milk Meg.

          I would also like to see their research papers, complete with proper citations on this stuff.

          • Empress of the Iguana People

            I had a prof who rather proudly admitted that he and some friends edited several history pages on Wikipedia to include some ridiculous, omnipresent fictional man. I think it took a couple weeks to be removed.

          • BeatriceC

            On a more minor scale, one of my deceased uncles has a Wiki page and once or twice a year I read through it and change shit that’s been randomly added but is totally wrong.

  • AndreaRealMPH

    Urogynecology is a great specialty! In my area, it seems like a lot of urogynecologists are osteopaths. I wonder if a lot of lack of knowledge about urogyn is because people may not be looking up or networking with DOs?

    • Emilie Bishop

      Are they woo-y? The only uro I’ve seen was an MD and did robotic surgery, but she also shared office space with a naturopathic sexual health practice. She flat-out told me my pelvic pain was caused by my “anxious personality,” even after an endo diagnosis confirmed by several doctors. Her go-to solution for everything was vaginal Valium, even though I had unexplained bleeding that coincided with my pain. When I left her office I was crying and shaking. I wonder what about this discipline leads people to other paths than a traditional MD.

      • AndreaRealMPH

        Yikes! Weird an MD would share office space with the woo-fairies. With urogyn, I’d look to see where they did post-residency fellowships, whether they were a DO or MD. The competitive 2 and 3 year fellowships strongly stress serious scholarship and practice.

      • PeggySue

        That’s awful. Simply awful.

      • AndreaRealMPH

        One thing that popped out to me as encouraging is at the bigger public schools like Michigan State, students in DO programs are just as eligible as MD students to jointly enter a Master of Public Health, an MS in clinical lab research, or a hard sciences PhD with the proper references and application materials. That doesn’t happen in naturopathy, acupuncture, or chiropractic.

      • Empliau

        I hope your insurance will allow you to see another urogynecologist. Dr. Jen Gunter has a recent blog post how vaginal Valium is crap. You deserve a doctor who takes your pain seriously.

        • AndreaRealMPH

          Something sounds so….icky….about Valium in the vag…

      • BeatriceC

        Oh, hell. That’s awful. Can you see a different doctor? My insurance is being stupid as well, so I feel your frustration here, but they’ve at least approved a second opinion for me, so at least there’s that.

      • FormerPhysicist

        Wow, awful. The urogynecologist my mother saw was not woo-y at all. (My mom had surgery this past summer.)