Why is Dr. Neel Shah giving legitimacy to midwives with blood on their hands?


The adulation must be truly head turning.

I can’t otherwise explain why Neel Shah, MD, who ought to be completely cognizant of both the scientific literature and the history of people he supports, is giving legitimacy to midwives with blood on their hands and self-serving nonsense in their heads.

Advocates of “normal” birth have been waiting for years for a respected obstetrician to legitimize their deadly ideology and Dr. Shah is making their dreams come true without a thought for the many mothers and babies who have suffered at their hands.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Dr. Shah is making their dreams come true without a thought for the many mothers and babies who have suffered at their hands.[/pullquote]

First we learn that Dr. Shah is taking part in the for profit venture Birthpedia a website that features advocates of pseudoscience and poor practice, including Ina May Gaskin, Michel Odent, Brad Bootstaylor, Barbara Harper and a chiropractor, among others.

Dr Gena Bofshever has an infectous personality to go along with her thorough chiropractic skills to help women who want to get pregnant by making the organs in their body easier to talk with their brain. (my emphasis)

Dr. Shah wasn’t merely one of the contributors; he featured prominently in their promotional materials:

“Imagine having a Harvard OBGYN answer your specific question/concern for only $8 a month. We are changing how providers and patients intake information about birth where any pregnant woman can get answers by qualified professionals” – Co-Founder Justine Tullier

After I wrote on my Facebook page about Dr. Shah’s association with quackery, the Birthpedia information on Dr. Shah and the other contributors disappeared from the internet. Hopefully Dr. Shah was unaware that he was associating with quacks and charlatans and reconsidered his involvement.

Several days ago, Dr. Shah tweeted his excitement at a forthcoming meeting of Sheena Byrom, a leader in UK midwifery.

Byrom is the poster child for moral depravity in the face of preventable infant deaths. She has the unmitigated gall to defend the unethical behavior of midwives in privileging process over outcome by arguing that it is more important to preserve “normal birth” than human life.

Despite dozens of preventable perinatal and maternal deaths at the hands of UK midwives, despite the fact that liability payments now account for fully 20% of UK midwifery spending, despite multiple investigations detailing poor midwifery practice and strenuous attempts to hide it by midwives lying to investigators and regulators bodies, Byrom insists on Normal birth – a moral and ethical imperative:

Yes, there needs to be learning from incidents, and development where needed. But blaming one professional group, or a particular type of birth, does little to improve any situation.

Actually, insisting that a professional group take responsibility for their own deadly mistakes does A LOT to improve any situation.

But that’s not the worst of Bryom’s behavior. She has become well known for publicly tormenting a father who lost his son in the Morecambe Bay midwifery scandal.

Now comes news that Dr. Shah is headlining Normal Birth 2018.


Of course Dr. Shah may have no idea what he’s getting into. It wouldn’t be the first time.

He certainly had no idea about homebirth when he wrote about it in the New England Journal of Medicine, A NICE Delivery — The Cross-Atlantic Divide over Treatment Intensity in Childbirth, and for a companion piece Are hospitals the safest place for healthy women to have babies? An obstetrician thinks twice on The Conversation.

Dr. Shah appeared entirely unaware of the two most important issues in American homebirth.

1. In contrast to the UK where there is only one type of midwife, highly educated and highly trained, in the US there are two types of midwives: certified nurse midwives (CNM), the best educated, best trained midwives in the world, and a second, inferior class of midwife, certified professional midwives (CPM), who lack the education and training of midwives in every other industrialized country.

2. There is a large and growing body of research that demonstrates that home birth with an American home birth midwife has a death rate 3-9 times higher than comparable risk hospital birth.

Dr. Shah is one of the plenary speakers at Normal Birth 2018. Others include Melissa Cheyney, anthropology professor and homebirth midwife and Soo Down, midwifery professor and promoter of goofy, quack midwifery theory.

Does Dr. Shah know that Melissa Cheyney has single-handedly done more to hide the growing toll of tiny bodies of babies who succumb to American homebirth than anyone else? She has lied, denied, decried and defied efforts to inform the public of the hideous death toll at homebirth.

Does he care that Cheyney, in her role as the Chair of the Oregon Board of Direct Entry Midwifery, steadfastly REFUSED to release the homebirth mortality rates in her possession for fear that regulatory authorities might wish to investigate the death rate and discipline the midwives involved in the deaths. In the face of that refusal state of Oregon subsequently hired Judith Rooks, CNM, MPH, a known supporter of homebirth, to calculate the Oregon homebirth death rate in 2012. Rooks found that the death rate at the hands of LICENSED homebirth midwives was 800% higher than comparable risk hospital birth.

Is Dr. Shah aware of Soo Downe’s midwifery “philosophy”? Downe, like many quacks, won’t accept the existing scientific evidence and invokes quantum mechanics, a concept she knows nothing about, to rationalize her refusal to accept copious evidence on the dangers of promoting “normal” birth.

The implication of the new subatomic physics was that certainty was replaced by probability, or the notion of tendencies rather than absolutes: ‘we can never predict an atomic event with certainty; we can only predict the likelihood of its happening’… This directly contradicts the mechanistic model we explored above, and it implies that a subject such as normal birth needs to be looked at as a whole rather than its parts…”

Prof. Downe has managed a stupidity trifecta: she used the wrong theory, from the wrong field, wrongly interpreted to reach the ideologically predetermined result.

Dr. Shah, these women are not your friends. More importantly, they are not the friends of babies and mothers, too many of whom have died at their hands or as a result of their beliefs.

Do you really want to legimitize midwives with blood on their hands?

63 Responses to “Why is Dr. Neel Shah giving legitimacy to midwives with blood on their hands?”

  1. Steph858
    April 23, 2018 at 6:27 pm #

    An article explains why some reputable doctors/scientists descend into quackery: https://sciencebasedmedicine.org/how-do-scientists-become-cranks-and-doctors-quacks/ In particular, there is this quote:

    “Where one transitions from ‘scientist’ to ‘kook’ is the inability to say ‘I was wrong’ and move forward. In the 1980s, Peter Duesberg could have been right! No one knew what was causing this scary-ass world-wide epidemic. Yeah, it might have been HIV-1, but in the US it could have been a side-effect of some recreational drug, only surfacing when use was wide-spread and intense enough. Duesberg could have been right!”

    Is it possible that Dr. Shah got on board with the ‘Interventions in childbirth should be minimised’ line back when such a position was semi-defensible, and is now too far down this road to admit that he took a wrong turn?

    I’m also torn regarding #NormalBirth18. Should we reiterate that (mother + baby) (alive + healthy) = normal birth? Or should we start tweeting home/midwife-led birth horror stories with that hashtag sarcastically appended?

    • fiftyfifty1
      April 23, 2018 at 8:14 pm #

      Interesting. Peter Duesberg’s AIDS denialism is responsible for the death of one of my family members. I wasn’t aware what a previously well-respected scientist he was. Very sad. Very maddening.

      • Eater of Worlds
        April 27, 2018 at 2:02 am #

        Remember Linus Pauling, only person to have 2 Nobel prizes that weren’t shared? He turned quack, is reponsible for the belief that lots of Vit C will kill a cold and tons of Vit C will kill cancer


        • Empress of the Iguana People
          April 27, 2018 at 9:09 am #

          I love Linus’ chem work but oy, the vitamin c stuff. Sigh. Isaac Newton was the same way

    • momofone
      April 21, 2018 at 3:46 pm #

      But he smiled! And she felt warm and hopeful! That’s healing, right?

    • namaste
      April 21, 2018 at 5:53 pm #

      How in God’s name do you evn GET saliva from a rabid dog without ending up being exposed yourself?

  2. Abi
    April 20, 2018 at 5:35 am #

    This develpment has been confusing the hell out of me, too. I had reached the conclusion that there must be vast sums of money involved, because I can’t otherwise fathom why a harvard educated doctor would want to be associated with this stuff.

  3. LaMont
    April 19, 2018 at 5:34 pm #

    OTish: Is anyone else feeling ambivalent re: all the Tammy Duckworth news? I mean, it is reasonable to allow newborns into places where they won’t be disruptive (and good lord, given how low-urgency most things in the SENATE are, the Senate has to qualify), but the rhetoric out there is equating “going to work in a newborn-unfriendly place” with “not feeding your newborn”. Seriously? I know women who cherish being able to get away, and whose family members enjoy getting to be a part of raising the baby! Basically, yes, breastfeeding women (just like pregnant women) should get more support from stuffy, needlessly rigid workplaces. But no, I don’t like how this will inevitably come back to be used against working women, who will be expected to bring their newborns in to work (FOR A YEAR) and thus be regarded as toxically “feminine” and held back for it.

    • Casual Verbosity
      April 19, 2018 at 6:30 pm #

      In Australia we had a similar situation a few years ago with a member of the senate. I found myself unable to get on board with the celebration of this moment, because it was basically presented as “See! Even if you’re a member of parliament, you have no excuse not to breastfeed!” Rather than a win for acceptance and accommodation of new mothers, it felt like yet another impossible standard for women to live up to.

      • Cartman36
        April 20, 2018 at 11:49 am #

        I agree. She is a senator but if she worked at McDonalds we wouldn’t be praising her for showing up with her baby in a sling.

        • EmbraceYourInnerCrone
          April 20, 2018 at 12:15 pm #

          I kind of feel the same way. If you want to breastfeed or combo feed, that’s your choice, and there should be rooms set aside where you can pump ( the Senate should also be wheelchair accessible!)

          But I am not sure a baby belongs on the floor of the Senate or any other work place. I work in a lab. In the building there are lots of offices and “cube farm” areas. But we are not supposed to have kids in the building because it’s a safety hazard. It’s also distracting.

          • sdsures
            April 20, 2018 at 12:33 pm #

            The Senate isn’t wheelchair-accessible?!

          • EmbraceYourInnerCrone
            April 20, 2018 at 1:55 pm #

            Parts of it are not,one Senator suggested Sen. Duckworth vote from the door of the Senate cloakroom when she was breastfeeding her baby… slight problem, Sen Duckworth can’t get to it in her wheelchair:

            “Yes, you can vote from the doorway of the cloakroom, but how is she going to get to the cloakroom when it’s not wheelchair accessible?” Klobuchar asked.”


          • EmbraceYourInnerCrone
            April 20, 2018 at 1:58 pm #

            The fact that some Americans with Disabilities accessibility laws exempted Congress is not new:


          • sdsures
            April 23, 2018 at 6:35 pm #


          • sdsures
            April 20, 2018 at 12:33 pm #

            Adult politicians, these days, are more of a safety concern for the country and Senate than children.

    • The Bofa on the Sofa
      April 19, 2018 at 6:45 pm #

      Tammy’s tweet about it was funny, though. She was picking out clothes and was wondering if a duckling onesie was consistent with Senate rules.

      That’s awesome.

      (Duckworth, duckings, get it?)

    • Amy Tuteur, MD
      April 19, 2018 at 8:01 pm #

      I am. I fear it sends several disturbing messages:

      1. There’s no need for maternity leave; just bring the baby to work.
      2. Women can’t be trusted to pay full attention to their jobs because a baby will be occupying their attention.
      3. Breastfeeding mothers are more deserving of accommodation than bottle feeding mothers.

      If you wouldn’t trust your neurosurgeon to operate while breastfeeding, why should you trust your Congresswoman to legislate while breastfeeding.

      It doesn’t seem like progress to me.

      • Merrie
        April 20, 2018 at 1:54 pm #

        “If you wouldn’t trust your neurosurgeon to operate while breastfeeding, why should you trust your Congresswoman to legislate while breastfeeding.”

        ‘Cause she is thinking and talking but not doing micro-precision manual work? I would trust a neurosurgeon to be able to explain something while breastfeeding, just not to actually perform surgery. Her brain is working just fine and that’s the part of her body that is engaged in her work in the Senate.

        • AnnaPDE
          April 21, 2018 at 8:25 pm #

          Thank you. That neurosurgeon comparison is so wrong, it undermines the valid points.
          Also, most of the work of a congressperson for which they should be alert and not distracted is the stuff other than voting, such as negotiations about what exactly will be voted on. And that can be done remotely when it fits the schedule, or better yet by a proxy, or a temporary replacement.

        • Sarah
          April 22, 2018 at 1:07 pm #

          Agreed. If you’re worried about this being used as a stick to beat non-breastfeeding women with, as an argument against paid maternity leave etc, that’s valid. It’s a sufficiently reasonable point in itself not to require obviously flawed brain surgeon analogies.

          • Tigger_the_Wing
            April 26, 2018 at 5:54 am #

            Yes, that analogy is pretty terrible. I was breastfeeding twins when I went back to work – yet not once did I have to work and feed at the same time. I scheduled my appointments around their feeds, so that they would be fully-fed, clean and changed and fast asleep whilst I was driving. Never caused a problem and, indeed, I had customers come back specifically to see how the twins were growing.

            Mothers still have our brains after giving birth, and can adjust our behaviour according to circumstance – had either of the twins been as demanding as my first, I wouldn’t have gone back to work until they were weaned, because it wouldn’t have been fair on them. Also, for my first, I gave up what might have been a good career in medical research because it was incompatible with taking care of a baby and I didn’t want to do either job badly.

      • Box of Salt
        April 22, 2018 at 10:17 pm #

        I am hoping it’s a sign of change for the better.

        Maybe I’m naive. Maybe I’m looking at it with rose-colored glasses.

        Maybe all of those messages Dr T worries about are true.

        But the only way the playing field levels is if everyone takes child raising seriously, without relegating it to a sphere of “other.”

        And I am hoping this is a step in that direction, and that someday it won’t matter whether you are man or woman, you’ll be able to reproduce *and* contribute your skills – whatever they may be – to society at the same time, just as men have been able to do all along.

        • Who?
          April 23, 2018 at 4:06 am #

          To see her, learn what she has done, and survived, and gone on to do, surely taking a new baby to work for a couple of hours won’t make the top 10, when the book is written.

          The someday you hope for is currently unimaginable, though I agree it makes a lot of sense, for all kinds of reasons.

    • swbarnes2
      April 19, 2018 at 10:06 pm #

      Child care is work. Real work. It should be treated as such, not acting like it’s something’s that’s easy to slip in while doing a real job.

    • Who?
      April 20, 2018 at 12:18 am #

      I wrote and then deleted a long-ish response to this earllier, as I couldn’t find the right note to hit. The rest of you have now done it for me: looking after a child is work, let’s not double up and pretend anyone can simultaneously do both well, at least not enough of the time to make doubling up a sensible idea.

      Here in Oz the Senator would have got a ‘pair’ for the vote-that is, she could have let them know she wasn’t coming, and someone on the other side would have matched her absence, so that the overall result wasn’t affected by her non-attendance.

      She could have chosen to leave the baby with a responsible adult for a couple of hours, if she wanted to be on the floor. Given the vote I get why she wanted to be there.

      Just because you can do something doesn’t make it a good idea.

    • Zornorph
      April 20, 2018 at 1:24 am #

      Okay, I had my doubts but I’m a dude so wasn’t going to open my mouth for fear of mansplaining something. Honestly, it seems more like a political stunt to raise her profile than anything else.

    • Merrie
      April 20, 2018 at 1:52 pm #

      I think the issue is more that she doesn’t get any way to proxy vote and so if she can’t come in, she just can’t vote at all and her constituents lose out on representation. If she doesn’t feel it’s in her and her child’s best interests to be separated at this time but she also doesn’t feel that stepping out of her job is a good option for her, she’s stuck. At least she’s being offered a way to combine both. And I think there was also some sort of provision for her being able to pass the baby off to a staffer. But I totally get wanting to find a way to nurse the baby (getting pumping and bottle feeding to work at 10 days old sounds like an entirely different level of hassle she may not be ready for) and continue to participate in her very important work. The real issue is that there’s no way for her to do her job remotely. For those of us who get a maternity leave and have someone else cover our job duties, it’s less of an issue.

      • AnnaPDE
        April 21, 2018 at 8:18 pm #

        This. She can’t just ask someone fo the job for her while she’s physically away. That’s very different from most normal jobs.
        And she’s not back in for full time work or anything, it’s a single vote she had to turn up for – a small, simple and pretty symbolic part of her job, and at the same time one she cannot delegate.

    • fiftyfifty1
      April 20, 2018 at 5:17 pm #

      I feel ambivalent too. The problem is, no matter what Senator Duckworth does, she is potentially screwed. I just hope that what she has chosen will lead to her being screwed less.

      Having more women in government is a good thing. We especially need more young women in government. Because if you don’t start until you are older, that limits how high you rise. And young women have babies-that’s a fact. And they should be able to have babies, just like men have babies, and not have their careers penalized for it. And their constituents shouldn’t be penalized either. Their senator should be allowed to vote when able. This is different than a Senator being sick. A sick Senator in the hospital may be incapacitated, but breastfeeding doesn’t incapacitate you from voting.

      Yes, there is a danger that this will cause women to be taken less seriously. But if we make being in Congress totally inflexible to reproductive-age women, then we will continue to end up with mostly men. In years past, women had to make the calculus of “My family or my career?” They shouldn’t have to do that anymore. And voters shouldn’t have to make the calculus of “I like [young female candidate] better, but if she has a baby, she will be out for weeks, so I’ll vote for the guy.”

      I don’t really buy the idea that a Senator can’t combine her job and the occasional 10 minutes of breastfeeding. It’s not the same as being a neurosurgeon or working at McDonald’s. They just did an expose in my state of what lawmakers do while on the floor. It’s a lot of downtime activities including games, making bets, sleeping, sending social texts. It’s a lot like a Jr. High classroom it turns out. If the dudes can kill time sending sexually harassing texts, I suppose Senator Duckworth can find the time to latch on a newborn.

      Do I like that it potentially sends messages about breastfeeding moms vs. bottle feeding moms? Not at all. But Sen. Duckworth didn’t invent those societal messages. Women from her class overwhelmingly breastfeed. To say that she should have to formula feed to not derail her career is going to keep young women away. Women are harshly judged for not breastfeeding especially for very young newborns. If she chose formula, a few voters might think it signals she is more “serious”, but a larger number would judge her as cold-hearted, unnatural, even abusive for giving her child an “unhealthy” start. This is why we need to keep getting the message out that formula is not actually second best.

      And I don’t think this is the same as the candidates who breastfeed in their political adds. That is just a publicity stunt. But with Sen Duckworth, I see a woman asking for a reasonable request: the ability to do her job with reasonable accommodations.

      • Who?
        April 20, 2018 at 7:13 pm #

        I don’t know her political circumstances, but is the choice to make the arrangements she has likely to win, or lose, her a single voter?

        A voter who takes the view that they will vote for a man rather than for a woman who might get pregnant, then they are not seriously considering the woman in the first place.

        Like the song says, haters gonna hate, regardless of what she does.

        On balance, I’d prefer she left the baby with a responsible carer, who could give the baby any food required, while she did her work. Why? Because the Senator has a job worth taking seriously, and because the baby deserves looking after. I’d like to think that’s what I would do in her shoes.

        • fiftyfifty1
          April 20, 2018 at 8:45 pm #

          ” is the choice to make the arrangements she has likely to win, or lose, her a single voter?”

          I think her choices could win or lose her a lot of votes actually. For example she could take her maternity leave, but if she did so this could be used against her. An opponent could claim she was MIA for 6+ weeks. Or if she returned to work when the baby was 10 days old (as she has) but leaves her baby at home with a nanny, an opponent could claim she didn’t have her priorities in line. For example I can imagine a Republican female opponent highlighting how she stayed home with her own babies, how she understands that motherhood is the most important job blah blah blah. My female Republican friends on Facebook are constantly posting saying like that. They are fine with women in the workplace, even in government, but women must be very careful not to come off as ambitious “career women.”

          • Who?
            April 20, 2018 at 9:26 pm #

            Are they votes she would lose, though, or votes she could never get in the first place? If she hadn’t come in, wouldn’t the same women be saying she
            shouldn’t have taken the job if she couldn’t be available?

            Given Senator Duckworth’s history, her position as an ambitious career woman might already be out of the bag.

            Trying to please everyone is a fool’s errand. Maybe she felt she had no choice-for whatever reason-on the day, and decided to put a positive spin on it because heaven forbid anyone in public life asks the general public to just mind their own business.

  4. namaste
    April 19, 2018 at 2:41 pm #

    It’s sad that these clowns can’t get it through their heads that there are women out there (Dare I say, the vast majority) who view pregnancy and birth as a means to an end, and not some sort of bizarre method of self-actualization. They don’t get that for sane, rational human beings, the goal is to have a baby, not a “Birth experience.” Further, they don’t seem to get that for the vast majority of the world’s women, their “Birth experience” sucks. They have to look forward to, at best, hours of excruciating pain with squat that they can do about it, and at worst, the not insignificant chance of ending up dead. I’m pretty sure that if women in the developing world ever see these NCB blogs they will laugh until they are rolling on the floor, pick themselves up, and call out the authors for the privileged, spoiled, entitled shits that they are.

    • Merrie
      April 19, 2018 at 4:40 pm #

      I mean, I did want to have birth be as pleasant as possible, but obviously not at the expense of getting a healthy baby out of the deal.

    • Kim
      April 20, 2018 at 4:56 am #

      Birth experience doesn’t suck, though. All things being equal, no woman wants to have a 30-hour labour at the end of which her baby is dragged out of her by forceps, and she is left with permanent injuries. No woman wants to give birth by emergency caesarean section under general anaesthetic. That doesn’t make them spoilt or entitled shits.

      • MI Dawn
        April 20, 2018 at 7:21 am #

        True. But most normal women don’t give a flying flip about HOW the baby was born as long as the baby is alive and healthy and mom is alive and healthy. Permanent injuries suck, but I don’t know any normal woman who would prefer a dead baby over being injured herself. Emergency c-section sucks. But if the outcome is a living baby and living mom, then that’s what is most important for most normal people.
        Yes, I would have preferred a less painful birth experience and fewer drugs. However, since I had severe pre-eclampsia, induction and mag sulfate kept me alive. And yes, baby was born small but nursed well and is now a healthy adult.

        • Kim
          April 20, 2018 at 8:33 am #

          “But if the outcome is a living baby and living mom, then that’s what is most important for most normal people.” It might be the most important thing, but it’s not the only important thing. In my volunteer work, I come across a lot of women who have been both physically damaged by their birth experience and severely traumatised. These are not trivial things, and their feelings of trauma should not be dismissed with an airy wave of “all that matters is a healthy baby”. They should not be told that they are spoilt or entitled (and are these words ever applied to men?) for wanting a properly functioning bladder and bowel, or the ability to have a normal sex life, or not to suffer debilitating flashbacks every time they walk past a hospital or see a medical professional.

          • namaste
            April 20, 2018 at 10:33 am #

            The thing is, sometimes in life you have to do things you don’t want to do. Sometimes you have to sacrifice satisfaction with an experience to prevent a really bad outcome. Childbirth is dangerous. It can and does kill. Noone WANTS to have her child dragged out by foreceps or give birth via emergency c section under general anesthesia. Sometimes, though, thatis what they NEED in order to preserve the life and health of the mother and child. As for the physical complications, noone is saying that it is ideal, or even desirable. It is, however, largely correctable. Surgery and physical therapy can restore function, to varying degrees. As for tye mental health complications, I am a psychotherapist by trade, and I actually specialize with trauma. Again, PTSD is not an ideal or even desirable outcome. It is very treatable. There are a whole host of interventions to treat it and even to make it asymptomatic. Nobody on this blog will argue that these are not serious problems. We will argue that they can be worked with. You cannot work with death.

          • Kim
            April 20, 2018 at 11:08 am #

            Well, of course sometimes women need their baby to be born by emergency c-section or by forceps. (Sometimes they don’t, of course – sometimes it’s a case of poor medical judgement that leads to that kind of delivery.) My point is not that those interventions aren’t lifesaving, but that describing a woman as “spoilt” or “entitled” because she doesn’t want to be physically damaged or emotionally traumatised is just plain misogynistic. It’s the flip side of the argument that says some women are “too posh to push”: on the one hand, women are berated for having a highly medicalised birth, on the other for having the temerity to want their birth to be as natural as possible. But it always seems to be about how terrible women are, how they have the temerity to think they should be allowed to exercise choice, or to be treated with dignity and kindness in birth. Everyone, it seems, hates women – even women.

          • The Bofa on the Sofa
            April 20, 2018 at 12:36 pm #

            Sometimes they don’t, of course – sometimes it’s a case of poor medical judgement that leads to that kind of delivery.

            Do you have any examples of a c-section that you can show was unnecessary?

          • Who?
            April 20, 2018 at 7:31 pm #

            It is spoilt and entitled to think that you can choose a 100% good birth experience. It’s fantasyland.

            Let’s assume we’re talking about adults here. They choose their care provider. They have one who tells them scary stories, and one who tells them lovely stories. It’s up to them to decide who to believe, and who to go with. That’s a choice they can make.

            They can’t choose how their blood pressure, or placenta, or whatever else will be. They can’t choose how big their baby will be. Getting angry at the care provider telling them the scary stories won’t make any of that right.

            It’s deluded and often arrogant to think you can choose safety and niceness by wishing it so. If we could, there would be no cancer, or car accidents, or smeared nail polish. Unicorns would roam freely.

          • AnnaPDE
            April 21, 2018 at 8:46 pm #

            You’re confusing outcome with process here though.
            Not being injured by the birth – neither mum nor baby – is an outcome.
            Having the “experience” you’re planning is process.

            Unfortunately the kind of process that you talk about, the one that promises the “most natural” experience is highly uncertain, not actually under the mother’s control despite all efforts, and is more likely to end in an undesirable outcome than a more medicalised approach. The bad outcomes you mentioned are all a result of taking the “let’s just allow nature to progress as it sees fit” approach far enough to necessitate a life saving intervention without regards to anything less urgent than “someone is dying”, instead of letting go of the “experience” early enough to intervene when it’s still about comfort and preventing survivable complications.

          • Lilly Starnes
            April 25, 2018 at 1:45 pm #

            The problem isn’t the physical injuries. I could take my vagina being ripped up to have a healthy baby. The problems are the dismissive attitudes of medical staff and society at large. The lack of care for women after birth, and the ideas that women are just spoiled if they want to be able to hold their pee. Why don’t American women get PT after birth like UK women? Etc. I’ve been in trauma therapy for three years now and I’m no where near calling it “very treatable.” Everyday I’m just barely hanging on to life and I honestly wish my mother had just aborted me so I don’t have to live with this. There is nothing I can do to get rid of the memories, and the reality of the world I live in. I can retrain my body, but that doesn’t change the fact that we live in a society of misogynists, rapists, and rape apologists. A society where the government or other entities can come take you at any moment and disappear you (happened to my family so please don’t pretend this isn’t real.) A world where we exploit humans and animals alike for pointless profits. How do you treat that?

          • Lilly Starnes
            April 25, 2018 at 1:14 pm #

            I can’t believe this needs to be said. Spoilt for wanting to be able hold your pee and have sex without pain for the rest of your life. Spoilt for not wanting MORE trauma. The dismissiveness is really what makes the trauma worse. I’m never going to give birth becauseI don’t trust medical professionals not to dismiss me during birth. I would be a high risk pregnancy and not willing to do a homebirth. I never want that powerlessness over my body again, after experiencing sustained sex abuse. After being molested by a police officer as a child, you can imagine how little respect for authority I have. I feel so bad for female survivors and victims of sex abuse who do desperately want to have kids. I felt kind of “meh” about it anyway, and then I stared work in welfare, and that ended my dreams of being a mother. The ones who do want a baby so badly are risking making their trauma so much worse. The way women are treated as if birth ain’t no thang, just take a Tylenol and be happy about your healthy baby, is disgusting. I read a story on Reddit where the lady’s uterus was inverted and fell out, the doctor shoved her uterus back in with his bare hands. *The hospital gave her no aftercare instructions, did not warn her about infection, and dismissed her when she came back with a fever*

            This is the world we live in

      • Who?
        April 20, 2018 at 7:50 am #

        Thing is, the birth experience just might suck. People (mothers and/or babies) used to, pretty reliably, wind up dead or injured as a result of a birth. Still do, in parts of the world not served by modern medicine.

        It is entitled and privileged and spoiled to assume that a birth experience will go well because of ‘research’ or diet, or exercise, or positive affirmations or whatever woo du jour. While I am usually all for people taking the road of their choice to hell, I have a problem with them dragging innocent bystanders along, in this case, an unborn child whose survival and good health they claim to have a great interest in.

        The issue here is that the woo is being pushed by someone who should, on paper at least, know perfectly well what a potential shit show birth can be.

      • AnnaPDE
        April 20, 2018 at 8:32 am #

        But the solution to the “how to not end up with a 30-hour labour and permanent injuries” or “how to avoid an emergency CS” questions is not to try to give birth as “naturally” as possible in the sense of avoiding medical assistance, pain relief or a timely decision for a not-yet-emergency section, but the opposite.

        And except in a few exceptional cases, the typical birth experience does suck. Even when it isn’t abnormally long and doesn’t result in serious permanent damage. I don’t see why we’d need to pretend that the very painful physical process of pushing a baby out, or the less painful process of having surgery is a wonderful experience. The wonderful thing is having the baby afterwards.

        • Abi
          April 20, 2018 at 11:45 am #

          Completely agree – it reminds me of all the BS I remember hearing at uni about how we should ’embrace’ our periods because they are not a disease.

          Well OK fine, but I’m still going to hate and dread mine while using whatever tools I have at my disposal to prevent them – because they make me feel like shit in one way or another for almost half of every month. Anyone who thinks this is somehow unfeminist needs to take a long hard look at themself.

          • Kristi Berry Pedler
            April 20, 2018 at 5:03 pm #

            I tell many patients, my job boils down to “periods are overrated.” Hence hormonal manipulation, ablations, tvh.

          • Tigger_the_Wing
            April 26, 2018 at 5:43 am #

            The best part of having a total hysterectomy in my thirties was getting rid of the pre-cancerous ovarian tumours; I wouldn’t die from ovarian cancer like my aunt and great-aunt. But coming a close second was the fact that the surgeon removed the endometriosis at the same time; not only no more periods, but no more monthly agony! My quality of life skyrocketed after the surgery. Who bloody cares about natural? Pain-free is where it’s at!

    • Zeldacat
      April 20, 2018 at 10:38 am #

      A co-worker of mine had her second on Monday by a repeat csection. Everybody is fine. The baby’s adorable. She’s have had to go to a city three hours away to try a vbac but didn’t feel like going to all that effort. She’s definitely not in the crunchy set.

  5. mabelcruet
    April 19, 2018 at 2:24 pm #

    Why is Dr. Neel Shah giving legitimacy to midwives with blood on their hands?

    Because he wants to be loved. He probably has mother issues. Or maybe its Stockholm syndrome.

    And whilst the UK may have highly trained degree educated midwives, unfortunately we still have our share of whackjobs.

  6. Christine O'Hare
    April 19, 2018 at 1:16 pm #

    I have to say calling your conference “Normal Birth” is ridiculous and offensive on so many levels. “Normal” should be a healthy mom and baby. But as Dr. Amy has noted they value process over outcome.
    Frankly, I would consider my C-section a lot more normal than my cousin’s vaginal birth that resulted in 200 stitches for her.

    • mabelcruet
      April 19, 2018 at 2:25 pm #

      200??? I dread to think of how badly she must have been injured-your poor cousin.

    • The Kids Aren't AltRight
      April 20, 2018 at 9:51 am #

      I recently took a birth class which was a great class in my totally inexperienced opinion. But in the book we were given there was this whole chapter that was like “remember birth is normal” that the nurse instructing the class just sort of read, and I had no idea the purpose of the thread or what it was about. I wonder if it was something to appease some sort of birth activists or professional pressure or something.

      • The Bofa on the Sofa
        April 20, 2018 at 12:38 pm #

        But in the book we were given there was this whole chapter that was like “remember birth is normal”

        So is flying through a windshield in a car crash. Nonetheless, I am still going to wear my seatbelt to prevent it.

        Or I could just say, “So is dying. Perfectly normal. So normal, in fact, that everyone does it eventually.” Not sure I see the virtue in that.

        • The Kids Aren't AltRight
          April 20, 2018 at 5:27 pm #

          I know. It was weird and irrelevant, but the rest of the class talked about risks and why C-sections are performed and what could go wrong and when to call a doctor. It seemed just sort of awkwardly shunted into the class.

  7. fiftyfifty1
    April 19, 2018 at 12:10 pm #

    I think you are too kind. Why should we believe that Dr. Shah doesn’t realize what he is doing? He has 4 years of undergrad, 4 years of medical school and 4 years of specialty OB/GYN training. This should be his area of expertise. He is not some poor clueless mom choosing a homebirth, hoodwinked by a quack.

    • Amy Tuteur, MD
      April 19, 2018 at 12:26 pm #

      Why do I think he doesn’t realize what he is doing? Because he demonstrated in his commentary on homebirth in NEJM that he had no idea what he was talking about. Moreover, when he found out about the charlatans he was associating with at Birthpedia, the association seems to have disappeared.

      • Mdstudentwithkids
        April 19, 2018 at 1:35 pm #

        But if we assume he intentionally dissolved the association, and likely knows about yours or others’ criticisms regarding his beliefs but continues to be a vocal supporter of the community, it does not sound unlikely that he is intentionally remaining ignorant.

        • fiftyfifty1
          April 19, 2018 at 1:45 pm #

          Exactly. At this point, any ignorance would have to be willful. And if he was just innocently unaware of the 2 types of midwives in America, as you claim he was, he could and should have issued a correction or statement qualifying his NEJM piece.

    • Empress of the Iguana People
      April 19, 2018 at 2:20 pm #

      Honestly, I’m also pretty skeptical that he doesn’t know full well what he’s fallen into. Doctors are supposed to have more common sense than your average 3 month old puppy.

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