Death at homebirth is becoming such a common phenomenon that I now have to write about homebirth deaths and disasters in groups. Here’s are the deaths and disasters I’ve learned about in the last week. They have a common theme: the insistence that everything is “normal” when it is not.

#1 When Intuition Fails (postpartum death):

Later that evening [of the day of birth], when he was nursing, I noticed that he was a little blue. I called to my husband and told him I wasn’t sure he was breathing. He whisked him up and tried to get him to wake up. I had enough time to get the midwife, and then 911, on the phone before he got him awake. He seemed okay, so we canceled the ambulance. Then Miriam told us that sometimes big babies get hypoglycemic after birth and pass out so to try and make sure he eats frequently. Well, he didn’t. After that first latch on, he showed no interest in nursing. We actually broke out the free case of formula that we’d been mocking when it arrived.

… The next morning, Miriam came over to check him and said that he seemed fine. But I couldn’t shake the feeling that he was working too hard to breathe. I’ve had asthma since I was 13, and I know what it’s like to have to use all your energy just to breathe. She said if I was still worried I should have him checked by his pediatrician. Only it was Sunday; the pediatrician’s office was closed, and the emergency number for the pediatrician was a cell phone that was out of range.

I called my cousin Jeanine, who is a lactation consultant, and asked for some advice. She gave me some tips that resulted in success later that evening. He nursed beautifully for about a half hour, one of the most beautiful interludes of my life, and I’ll always treasure it. The love in his eyes as he stared into mine was palpable. I could feel it melting the anxiety I’d been carrying for weeks. I thought he must be getting better, but I had resolved to take him into the doctor in the morning anyway.

Later that night, I got worried again and woke up my husband, and the two of us were watching him when he stopped breathing. It was obvious this time. My husband did CPR and I called 911. Police came quickly and took him down to the ambulance. We waited in the police car barefoot and in night-clothes as they worked on him. Finally, they drove us to the hospital and stashed us in the waiting room.

The baby died. The cause was overwhelming infection.

#2 Homebirth disaster, long term effects not yet known:

I trusted birth, my body, and my baby. However, when I was 40 wks along, my blood pressure rose. The consulting doctor wanted me to go to the hospital to be induced, but the MW convinced me there was no need, and induced me instead with homeopathic remedies.

The birth turned into three days and four sleepless nights (I was almost insane with sleep deprivation by the end) of torture and agony. I broke down several times but the MW kept telling me it would be even worse if I went to the hospital. DS was asynclitic, posterior, double-corded with the hand wedged near his face (not to mention weighing 10lbs), and b/c of the strange position, the MW insisted on doing constant internal exams, which were absolutely excruciating. (I guess I should mentioned that I was sexually abused as a child. It was like being violated over and over again.)

At the end, his heart rate decelerated rapidly and the MW screamed: “We have to get this baby out NOW!” I didn’t know what was happening, but DS was stuck with a severe shoulder dystocia. Everything was panic and pain. The MW and her assistants pulled me out of the birth tub and onto the bed, and tried all kinds of different positions, nothing worked, the paramedics were called, I couldn’t breathe, the MW told me I didn’t have time to take a breath, I gasped anyway, everyone was yelling at me, I just wanted to die so it would be all over. The MW had to reach in while I was pushing and dislodge DS’s shoulder, he was born grey, the oxygen tank wouldn’t work at first, but he was finally resuscitated just as the paramedics rushed into my bedroom. I know I am so lucky and I have so much compassion for mamas whose little ones did not make it.

#3 Brain damage after homebirth:

Sadie was born at home 2 days past her due date. Everything in my pregnancy and labor and delivery was normal…actually, so normal that my midwife told me I was clinically the perfect patient!! However, we found out later that I was Group B Strep (GBS) positive and didn’t know it. We have, after MUCH detective work, determined that the infection (which was found in my placenta and all the way through the umbilical cord) must have stressed Sadie out, causing her to pass meconium, which was aspirated and caused Hypoxic Ischemic Encephalopathy (HIE).

Within minutes of being born, paramedics came to my home and rushed Sadie off to the hospital, where they discovered some brain damaged and then transported her to Phoenix Children’s Hospital (PCH). PCH practices newborn brain cooling therapy and immediately got her on a cooling blanket…

The baby now has cerebral palsy.

What did the mother learn from this experience? Not a damned thing.

Here’s a comment she wrote on Baby Center:

I love that you touched on that it’s NOT just about having a healthy baby in the end. It is about having a good birth experience and getting what you wanted. You’ve carried that baby for months in your belly, you should enjoy giving birth!! People say to me all the time that the biggest concern for this baby is it being born healthy (ie. not like Sadie), but I have had to give up my homebirth dream. I hate that I have to give birth in a hospital just so everyone else is comfortable. I’m choosing not to fight them (mostly my husband) this time… but next time I’m staying home!!! I’m glad you’re mad and unsatisfied and I hope that next time you get exactly what you want!

#4 Homebirth death:

… Two lovely midwives came and sat with me in my living room, I had scented candles, soft music.. and having had a homebirth before was very confident that I was going to get through it just fine…

At about 5am they offered to examine me as things were going very slow and my labour didn’t seem to be progressing much. I was 3cms dilated, and Angel’s head was completely engaged, ready to come out beautifully once things got going a bit more. The midwives checked her heartbeat and told me ‘we have a happy baby’ ‘that’s perfectly fine’.

… At about 5.15am one of the midwives came to listen to angel’s heart and said that’s fine carry on.

… At about 5.45 she came again to check the heart beat. She told me to turn on my side as she couldn’t get the heartbeat. She then asked me to move again, saying there’s interference and that her silly monitor wasn’t working very well. She then asked me to get in a towel and come downstairs and lay on the sofa so they could check the heartbeat…

The midwife monitoring the heart beat kept glancing up at me and down again to keep listening. After a few minutes she found the heartbeat and I let out a sigh of relief, but she looked up at me and said ‘okay what we’re going to have to do is transfer you now, baby’s heartbeat in dropping a little’…

The paramedic didn’t even speak to me, they were told to just take us in straight away. The midwife carried on monitoring the heart beat. I knew that Angel’s heartbeat usually sounded like galloping horses. But now all I could hear was ‘thud ..thud ..thud’ it was terrifying and I felt numb and scared.

The trip took 5 minutes, staff were waiting at the hospital entrance…

We got to a room, and … they were all fixated on the monitering machine they’d just attached to my belly. The thuds sounded a bit faster, I sighed massive relief … The doctor quickly told me that ‘no this is not okay, her heartbeat is not okay’ … She told me she was going to break my waters and had the stick in me before I could even respond. ‘gush’
my waters had gone and there was blood everywhere. I would later be told that this meant it was a hidden placental abruption…

We raced through corridors again … [t]he midwife reappeared in theatre and held my hand…

While I was sleeping my first daughter, Angel Elizabeth was born, weighing 8lb14, she had no signs of life. Doctors worked on her for 11 minutes, before being able to bring back her heart beat. They estimated that she was essentially dead for around 20 minutes all in all…

Around 4 hours after her birth I was finally able to see her for the first time, they wheeled my bed down to intensive care and she was SO BEAUTIFUL, with her daddy’s nose, her cute chubby cheeks, but she was full of tubes which was to be expected. The nurse caring for her had obviously been crying.

[Angel] was transported to Addenbrooke’s for cooling treatment to prevent brain damage from the time she had no oxygen going to the brain…

To cut a long story short .. an MRI scan when she was a week old revealed extensive damage and not much activity. At 9 days old, we went to a hospice and took out the tubes and wires, she lay between me and her father, and did not try to breath.

I was hysterical, I picked her up for the first time, finally being able to hold her properly, being able to fully see her beautiful face for the first time. I’m crying as I write this.

We were left alone with her. I tried to resuscitate her, my partner softly told me to stop. I stripped off and laid her on my breast, I thought if she could feel and smell her mummy’s milk she would do something to try and wake up.

She didn’t respond.

I laid in bed with her on my chest, and spend some beautiful time with her, she did a gasping motion every so often and I told myself she was going to come back.

After 20 minutes she had gone.

The take home message from these stories:

Trusting birth is useless.

Intuition is worse than useless.

The hospital is never close enough.

Homebirth is not safe.

This piece is not satire.

I have complained several times that it is getting harder and harder to parody homebirth advocates and lactivists. No matter how outrageous the parody, there is a comparable example in real life.

Several days ago I wrote a satire entitled Natural childbirth is a risk factor for tyranny. I was satirizing the penchant of natural childbirth advocates to fabricate outrageous claims about the benefits about unmedicated birth (“Peace on earth begins with birth.”) Now I learn that a counselor for the Australian Breastfeeding Association (ABA), a government funded organization, was caught by a reporter insisting that baby formula is like AIDS.

That’s right. Lest you think someone is exaggerating, a major Australian newspaper sent the reporter (who is pregnant) to the class to confirm a complaint that an Australian Breastfeeding Association counselor was teaching utterly fabricated assertions.

Formula is a little bit like AIDS… Nobody actually dies from AIDS; what happens is AIDS destroys your immune system and then you just die of anything and that’s what happens with formula. It provides no antibodies.

Furthermore:

Every 30 seconds a baby dies from infections due to a lack of breastfeeding and the use of bottles, artificial milks and other risky products. Every 30 seconds.

And in case anyone failed to get the point:

“Of course, there’s the higher IQ and all of the diseases that you don’t get,” the breastfeeding counsellor said in her opening remarks.

“We used to talk about all those sorts of things, but we don’t talk about any of those any more.”

She added: “A couple of years ago I broke this leg, quite badly. Nobody said to me ‘we have this wonderful range of wooden legs now’ … they fixed the leg.”

Like wooden-leg salespeople, formula companies would try to promote benefits, attendees heard.

“That’s what formula is; it’s pure sales pitch. They don’t say ‘look, a baby dies from this product every 30 seconds’ … they forget about that bit.”

All this from one of the ABA’s most highly regarded counselors, mentioned by name in the most recent Annual Report, available here:

Desley Hubner, a counsellor with the West End Group, was the counsellor who took the highest number of calls on the National Breastfeeding Helpline …

She received the ABA’s highest honor in April:

The remarks got a swift response from Mamamia, a major Australian parenting website:

If you didn’t read yesterday’s papers, get ready to have your jaw hit the floor.

Yesterday the Australian Breastfeeding Association (ABA) were accused of using ‘scaremongering’ tactics following revelations one of their most popular counsellors told a class that, “Baby formula is a little bit like AIDS’ and that a baby dies ‘every 30 seconds” from formula feeding.

The author put her finger on the real problem:

Baby formula

… it is time to acknowledge that there is a fanatical, zealous undercurrent to the ABA that is disturbing. And it is undermining all the good they do.

Frightening vulnerable parents into breastfeeding by using blatant lies and propoganda [sic]; intimating that formula is akin to AIDS and that babies are dying every thirty seconds is nothing short of a disgrace…

What is without doubt is the fact the ABA counsellor in question is not alone. We know from past posts on Mamamia … that there are many more stories of ABA counsellors who are discrediting the name of the ABA and doing the organisation damage …

A spokeswoman for the ABA appeared on Australia’s Today Show this morning.

Fortunately, the ABA is denouncing the counselors claims, but the spokeswoman could not explain why a counselor would have made such outrageous statements or what the ABA plans to do to prevent others from making the same mistake.

This incident shines a harsh light on a phenomenon that I have described repeatedly: the propensity of natural childbirth advocates, homebirth advocates and lactivists to simply make things up.

It is unlikely that the ABA taught these claims to the counselor. There is no reputable organization or book that advances these claims. Moreover, these claims are ludicrous on their face and betray a woeful ignorance of immunology, AIDS and the benefits of breast milk. But in the world of homebirth, natural childbirth and breastfeeding advocacy, whether or not a claim is true is irrelevant. If it makes sense to an advocate (an extremely low standard), it is deemed to be true and it is proudly proclaimed to others.

Imagine that there was a simple, safe and highly effective treatment that prevents the spread of AIDS and other sexually transmitted diseases, not to mention cervical cancer and penile cancer.

Sounds too good to be true, right? But it is true. It’s not a medication, it’s not a vaccine, it’s … circumcision!

I’ve taken a lot of heat over the years for my stance on circumcision: that it is a matter of parental choice and that it has medical benefits. As far back as 2008, in discussing a just published paper on circumcision and HIV transmission, I pointed out:

The new study does not change what we already know: circumcision dramatically reduces the risk of transmitting HIV.

It was only a matter of time, therefore, before the American Academy of Pediatrics reversed its stance on circumcision to acknowledge the weight of the scientific evidence. The new recommendations were released on line today in advance of publication in the September issue of the journal Pediatrics:

Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks and that the procedure’s benefits justify access to this procedure for families who choose it. Specific benefits identified included prevention of urinary tract infections, penile cancer, and transmission of some sexually transmitted infections, including HIV. The American College of Obstetricians and Gynecologists has endorsed this statement.

Specifically:

Systematic evaluation of English-language peer-reviewed literature from 1995 through 2010 indicates that preventive health benefits of elective circumcision of male newborns outweigh the risks of the procedure. Benefits include significant reductions in the risk of urinary tract infection in the first year of life and, subsequently, in the risk of heterosexual acquisition of HIV and the transmission of other sexually transmitted infections.

Contrary to the claims of anti-circ activists:

The procedure is well tolerated when performed by trained professionals under sterile conditions with appropriate pain management. Complications are infrequent; most are minor, and severe complications are rare. Male circumcision performed during the newborn period has considerably lower complication rates than when performed later in life.

Infections disease experts and public health officials have been pushing for years to have the health benefits of circumcision acknowledged and widely publicized. The AAP has finally responded albeit somewhat tepidly:

Although health benefits are not great enough to recommend routine circumcision for all male newborns, the benefits of circumcision are sufficient to justify access to this procedure for families choosing it and to warrant third-party payment for circumcision of male newborns. It is important that clinicians routinely inform parents of the health benefits and risks of male newborn circumcision in an unbiased and accurate manner.

Anti-circ activists have been repeatedly thwarted in their efforts to ban circumcision.

The San Francisco initiative was struck off the ballot:

udge Loretta M. Giorgi ordered San Francisco’s director of elections to strike the measure from the city’s ballot because she said that it is “expressly preempted” by the California Business and Professions Code.

Under that statute, only the state is allowed to regulate medical procedures, and “the evidence presented is overwhelmingly persuasive that circumcision is a widely practiced medical procedure,” the ruling said.

After a brief hearing, Giorgi also found that the proposed ban would violate citizens’ right to the free exercise of religion, said Deputy City Atty. Mollie Lee, because it targets Muslims and Jews, whose faiths call for circumcising males.

And the recent decision by a German court was overturned:

In Europe, a government ethics committee in Germany last week overruled a court decision that removing a child’s foreskin was “grievous bodily harm” and therefore illegal. The country’s Professional Association of Pediatricians called the ethics committee ruling “a scandal.”

Does the change in the AAP’s stance mean that parents should circumicize their sons? That decision is best left to parents … but at least parents will now receive accurate information with which to make the decision.

In light of the fact that the Echo comment system is being discontinued in a few weeks, I’ve been forced to move the comments to a new system. I also took the opportunity to move to a new server, which allows more options in blog design.

The switch is imperfect. Although all the blog posts imported correctly, there are many, many problems with imported comments. I’ve been working for the past week on trying to fix the problems, but I’ve decided to bite the bullet and switch. I intend to continue working to recover as many of the 130,000+ comments that I can. They are not lost; I have them all. The problem is getting them to display correctly in the blog. In addition, sometimes the comments imported successfully and display correctly, but the comment count does not appear. Finally, any comments posted over the weekend were not imported and are missing.

I apologize in advance for these problems and for any problems you have in signing up for the new comment system. Many of you may already be signed up with Disqus and others will be able to sign in with Facebook and Twitter.

Please let me know about any problems you are having with commenting and I will do my best to fix them.

The folks at the Royal College of Obstetricians and Gynecologists should be profoundly ashamed of themselves. They have participated in the creation of new clinical guidance that is fundamentally unethical.

I’m referrering to Making sense of commissioning Maternity Services in England, produced in collaboration with the Royal College of Midwives and the National Childbirth Trust. It is fundamentally unethical because it focuses on process instead of outcome. It reads like a full employment plan for midwives and childbirth educators, since that is basically what it is.

The chief goal of any maternity service or any maternity provider is simple and straightforward. The chief goal is to deliver healthy babies to healthy mothers. PERIOD. Anything else is untterly inappopriate and smacks of self-interest, not concern with patients. Indeed, this document is an object lesson in the venality and self-absorption of contemporary advocates of natural childbirth. It is in their interest to increase their employment options, but increasing employment options for a particular group has no place in a document that purports to be about patient care.

To understand what I mean, try a thought experiment:

Imagine if a group of lawyers, paralegals and casket manufacturers called for replacing death row appeals with paralegal counseling on will preparation for the condemned man. And for good measure imagine that they recommended withholding legal services of many people who have been charged with murder entirely on the grounds that they are probably guilty anyway.

Sounds reprehensible, right? But it’s no different than the document in which the RCOG participated.

• Both promote saving money above improving outcomes.
• Both promote responses that are based on cost rather than on efficacy.
• Both promote replacing more highly trained professionals with extenders who cost less and are capable of less.
• Both take no account of the needs, wishes and outcomes of the receivers of services.
• Both are transparent attempts to line the pockets of the extenders and others who benefit when the patient loses services.
• Both are fundamentally unethical because they replace the best interests of recipients of services with the economic interests of government, extenders and providers of ancillary services.

It would be one thing if the British maternity system was a shining beacon of best outcomes. Then, perhaps, it might be reasonable to consider ways to provide the same outstanding outcomes with less money. That’s not the case in the UK. Mortality rates are average to high (London mortality rates in particular, are unacceptably high and rising) and multiple hospital systems are facing multiple massive lawsuits precipitated by deaths that occurred when midwives insisted on managing patients who should have been transferred to doctors.

The Hippocratic oath covers this type of situation:

Primum non nocere. First, do no harm.

The RCOG seems to have forgotten that Hippocrates was referring to the patients, not to the economic interests of midwives, childbirth educators, or the government.

Addendum: For more on this subject, check out Pauline Hull’s press release

On its website, Midwifery Today features a timeline entitled The History of Midwifery and Childbirth In America. The timeline extends from 1660 to the late 1990’s. It contains interesting tidbits of information about childbirth practices, interspersed with general historical events. It seems quite comprehensive with the exception of one curious omission. It barely mentions mortality statistcs.

To my mind, the history of childbirth is a continuing effort to master its inherent dangers. Childbirth is and has always been, in every time, place and culture, one of the leading causes of death of young women and the leading cause of death of newborns. Indeed, the primary purpose of a childbirth attendant is to increase the chance that the mother will live, at least, and hopefully the baby will live too.

The secondary purpose of a childbirth attendant is to comfort the mother as she endures the excruciating pain of labor. The history of childbirth has also been a continuing effort to master the pain of childbirth. That’s another curious omission from the Midwifery Timeline. It makes no mention of chloroform, general anesthesia or epidurals, arguably among the most important advances in the history of childbirth.

I suspect that the reason for these glaring omissions reflects the direct entry midwifery obsession with process. The outcome, whether or not the mother or baby lived, is virtually irrelevant.

Perhaps another reason why the timeline is silent on the issue of mortality statistics is that they illustrate the spectacular success of modern American obstetrics. For hundreds of years midwives presided over childbirth and had almost no impact on the appalling rates of maternal and neonatal mortality. It was only with the advent of modern obstetrics that the mortality rates began to fall.

I thought it might be interesting to look at the statistics that the Midwifery Today timeline left out. I took as the starting point the timeline itself. It faithfully chronicles the movement of birth from the home to the hospital starting in 1900. In every decade, it reports the ever increasing percentage of hospital births. Yet it is silent on massive declines in maternal and infant mortality that occurred simultaneously. For each point in the timeline where the percentage of hospital deliveries is mentioned, I looked up the corresponding maternal and neonatal mortality rates. The above graph is the result.

As the percentage of births in the hospital rose, the maternal and neonatal mortality plunged. The graph is a powerful way of demonstrating that the association is dramatic. During the 1900’s, for the first time in history, using the tools of modern obstetrics, the terrible inherent dangers of childbirth were mastered. Could we do even better? No doubt, and the search continues to make birth even safer than it is today. As Dr. Atul Gawande wrote in his New Yorker article (The Score, How childbirth went industrial), “Nothing else in medicine has saved lives on the scale that obstetrics has.” The graph makes that very clear indeed.

Infant and maternal mortality rates abstracted from CDC on Infant and Maternal Mortality in the United States: 1900-1999. Although neonatal mortality is a much better measure of obstetric practice, neonatal mortality figures were not collected in the earlier part of the century. Therefore, infant mortality statistics are used as a proxy, albeit imperfect.

Homebirth, and natural childbirth advocates insist that “Peace on Earth Begins With Birth.”

That’s not what my research shows. I’ve discovered an astounding fact about natural childbirth and attachment parenting: both are risk factors for tyranny, mass murder and a variety of other ills.

Consider:

Of history’s greatest tyrants, men such as Hitler, Torquemada, Henry VIII, Attila the Hun, etc., nearly all were born vaginally. The only potential exception is Julius Caesar, reputedly born by way of the eponymous Caesarean section.

Almost all of history’s greatest tyrants were breastfed … exclusively.

The long term effect of giving birth without pain medication is dreadful. 100% of the children born to women who gave birth before the advent of anesthesia in the mid-nineteenth century are now dead.

Vaginal birth is a risk factor for Communism: Marx, Engels, Lenin, and Stalin were all born vaginally.

Breastfeeding is a risk factor for plague. Nearly 100% of people who died of the Black Death were breastfed.

Attachment parenting played a major role in imperialist expansion in the US. Fully 100% of the invaders who displaced the Native American population of this continent were born vaginally. Moreover, fully 100% of the Native Americans who were unable to resist the advent of the invaders were breastfed.

Breastfeeding is a risk factor for violent behavior. Almost all Viking marauders were breastfed.

Nearly all slave-holding Americans, plantation owners and the entire Confederate army were born vaginally.

Not a single Crusader was born to a woman who had an epidural in labor.

Vaginal birth is a risk factor for anti-social behavior. Roman emperors Caligula and Nero, as well as Jack the Ripper and Lizzie Borden (who committed patricide AND matricide) were born vaginally.

Breastfeeding leads to transmission of disease. Typhoid Mary was breastfed.

Hospital birth promotes technological progress. Desk top computers, iPhones, Skype and Twitter did not exist until the proportion of US births occurring in hospitals rose above 90%.

What is the cause behind these incontrovertible facts?

First, we’ve known for centuries that deep seated prejudice is “imbibed with mother’s milk.” I’ve never heard of anyone imbibing hatred with Similac, so the obvious solution is to promote formula feeding.

Second, as Dr. Michel Odent has insisted, oxytocin is the love hormone and some women clearly don’t have enough love. The solution is oxytocin supplements. Fortunately, pitocin has the exact same chemical composition of oxytocin, so it seems clear that, to be on the safe side, all labors should be induced or augmented with pitocin.

Finally, epidurals ought to be mandatory in labor. The mothers of the greatest tyrants in history gave birth without pain relief and look what happened as a result.

It’s time to acknowledge that “Peace on Earth begins with Interventions in Birth!”

This piece is (obviously) satire.

Republican Rep. Todd Akin of Missouri reminds me of certain natural childbirth advocates.

When asked whether he opposes abortion in cases of rape, Akin declared:

If it’s a legitimate rape, the female body has ways to try to shut that whole thing down.

Akin ought to win an award for cramming the largest amount of ignorance into the fewest possible words.

I don’t know where he got the idea that women can turn off ovulation or prevent conception or prevent implantation or a fertilized egg, but I do know where he got the idea that not all rapes are “legitimate.” It comes from an old line of legal “reasoning” that claims that most women who are raped were “asking for it,” were tramps, or actually enjoyed it. Evidently, “legitimate” rape occurs only when a virgin (or a married woman who has only had sex with one partner, her husband) is assaulted by a stranger. Oh, and for most of American history the woman has to be white, and the man is preferably of a different race.

Fortunately, almost everyone recognizes that distinguishing “legitimate” rape from any other form of rape is morally abhorrent and downright outrageous.

Why does this remind me of certain natural childbirth advocates? Though not nearly as morally egregious, natural childbirth advocates have a bad habit of trying to distinguish “legitimate” births for all other births.

Consider this fairly representative comment thread from Mothering.com:

C section mamas – do you still say you “gave birth”?

… I want opinions from c section mamas on this because I was on yahoo and one lady was throwing a *bleep* fit at how some women who have had c sections will say that they “gave birth”. She was really irate because she doesn’t think that c section mamas have the right to say that they “gave birth” because they didn’t physically push the baby out of their vaginas.

The replies included:

Honestly, I don’t feel like I gave birth. I remember thinking it sounded so absurd after DD was born when someone would say to me “You need to take care of yourself too, you just gave birth!”… I’ve talked to other friends that have had c-sections and they feel the same way. There’s a baby there. And you were pregnant and the baby was inside you. But there is a huge disconnect in your brain about how the baby got here

And:

… I don’t say that I “gave birth”, but I say that I had a baby or that my babies were born.

And:

I dont say i gave birth, i say he was born, i dont feel i gave birth, I laboured, but i didnt birth him, the doctor with the scalpel did

In other words, according to certain natural childbirth advocates, only a vaginal birth is a “legitimate” birth.

Their “reasoning” is just as pathetically flawed as that of Rep. Akin. Tragically, there is no single “legitimate” way to be raped. Similarly, there is no single “legitimate” way to be give birth.

In both cases, those who choose to distinguish “legitimate” from other forms have an ulterior motive. In the case of Rep. Akin, his motive is to force his view of moral behavior on everyone else. In the case of natural childbirth advocates, it is to force their idiosyncratic view of birth on other women.

Hi, I’m Jen, lay nuclear physicist. I just returned from the gynecologist and I am so pissed off.

I went for a routine annual visit and exam and I am completely fed up with the way that gynecologists pathologize menstruation.

Here’s what happened:

As soon as I got into the exam room, the nurse asked me when was the first day of my last menstrual period. I couldn’t give her an exact date because I’ve only had my period 5 times in the last year (just a variation of normal).

After my pelvic exam (which was totally unnecessary since it turned out to be fine) the gynecologist started in with all sorts of scare tactics. Instead of accepting that periods are not library books — they’re not due on a certain day, he insists that I am at risk for something called polycystic ovarian syndrome (PCOS). That’s right; I’m supposed to believe that my body is defective!

This is the difference between the medical model of menstruation and the lay menstrual midwifery model. Menstrual midwives are trained in holistic care and they know that women are PERFECTLY DESIGNED to menstruate. Sure, I only get 4 or 5 periods a year, but my body is just as perfectly designed as the next woman. Women have been having periods without the help of gynecologists for thousands of years and we are still here.

And yes, I do have painful periods menstrual rushes, but I am not going to dull the joy of my body working perfectly just to get rid of the pain rushes. Even if my periods were painful, it would be pain with a purpose and if I had pain, I’d hire a menstrual doula to support me as I writhed in bed.

The doctor wants me to have blood drawn for hormone tests, but I refused. I know what would happen if the results came back abnormal; I’d have to have more blood tests and maybe even interventions into my menstrual cycle. Once you let gynecologists start the cascade of interventions, who knows where it will end? If I don’t let him do the test, then he can’t tell me my hormone levels are abnormal.

Even though I refused the testing, the gynecologist wouldn’t let it drop. You are not going to believe what he said next. He actually commented on the amount of body hair that I have. At first I thought I hadn’t heard him correctly. All I could think was: My GYN said WHAT??!!

And that’s not the worst of it. I know I am overweight, but he actually pointed it out and claimed that PCOS can lead to excessive weight gain.

Then he started in with the typical scare tactics claiming that women with PCOS are at greater risk for high blood pressure, diabetes, and endometrial cancer. But the worst was when he played the “no baby card.” If I don’t diagnose and treat PCOS, I might be unable to conceive and end up with no baby! He thinks he can scare me but I know better.

First of all, I could have periods every 28 days if I wanted to. All I have to do is practice menstrual affirmations (I will get my period; I am made for menstruation; My body is not broken.) and get a cranio-sacral adjustment. Oh, and I could eat more kale.

Second, I have a friend whose gynecologist told her that she might have PCOS, but when the blood tests came back, they were normal. He made her worry for nothing. I don’t want to go through that.

Third, my gynecologist, like all gynecologists, is in the pocket of Big Pharma. He just wants to prescribe some sort of medication like birth control pills to regulate my period. I bet he makes a thousand dollars every time he writes a prescription for the Pill.

Fourth, my gynecologist wants to regulate my period for his own convenience. It’s easier for him if I have regular periods and he doesn’t want to be bothered by my extremely heavy cycles, my persistent anemia and by the fact that I complained that I have been trying to conceive for three years without success.

Well, I’ll show him! I’ll get pregnant even though I have only 4 or 5 periods a year. Then I’ll be able to relax. Surely even gynecologists know that women are perfectly designed for pregnancy and no one has ever had a miscarriage.

This piece is satire.

Compare and contrast:

Mother #1

… So yes, I had preeclampsia and I needed to have my baby in the hospital just in case something went wrong.

This isn’t the part of my story that makes me angry.

The diagnosis does not make me angry.

Ok I am angry about my diagnosis, but that’s my placenta’s fault not the hospitals.

I am angry with the hospital because of the cookie cutter way in which they treated the diagnosis of preeclampsia.

Is all they saw was a woman showing signs of preeclampsia who was 38 weeks pregnant, full term in their eyes. And as far as they were concerned I needed to deliver that baby right then and there, not 2 days from then, not 12 hours from then, right then.

They could see no reason to compromise. No benefit to staying pregnant even a day longer…

They could not accept that I was not trying to put me or my baby at risk by refusing an immediate induction but that I needed ONE night to both change gears and accept what was happening mentally AND GET SOME FUCKING SLEEP so that I could come to the hospital refreshed and ready to have a baby, not so exhausted that I don’t know how I even found the energy to do what I did.

I had even signed all the leaving Against Medical Advice paperwork that they shoved in my face so I could not sue them should I start seizing in those 12 hours that I was away from the hospital. But they couldn’t let it go.

And the fuckers bullied me into that induction by calling me an hour after I left to tell me my bloodwork was changing. Had I not been so exhausted, had I not already been fighting them for 2 days, had I just been in a better place mentally I would have questions WHAT was changing and what it meant.

But I was tired of fighting and I gave in….

And that, my friends, is why I desperately tried to stay out of the hospital system while I was pregnant. Why I so desperately wanted a homebirth. Why I was so upset with the way the induction was handled.

Everyone says that once you have the baby it doesn’t matter how he came into the world because you got a healthy baby in the end.

I disagree.

Mother #2

… This pregnancy i switched from an ob practice to a midwife practice. 1st appt with them was everything i was looking for. But when i found out i had GD they act like they couldn’t let me vbac at all. One midwife the one i liked scheduled my c section for me without me and it’s on my due date. Another midwife said i can’t go past 39 weeks.

Then:

So im 36.5 weeks with GD. And my chances of vbac are slowly decreasing. Im currently on meds only at bedtime to controll my fasting numbers. They might not let me go past either 39 or 40 weeks i have to go into labor by then or its a rsc for me.

But at 39 weeks and 6 days:

My angel passed the day before i was suppose to get my c section… I was high risk with GD so im mad at the fact they didnt induce me earlier before she passed…

And, inevitably:

I’m devastated i know this could’ve been prevented.

So, natural childbirth advocates, what’s an obstetrician to do when confronted by a patient with risk factors for a serious complication? Please tell me because I and other obstetricians want to know.