I am disappointed and very, very frustrated.

Scientific journals continue to publish more and more junk. Do the editors read what they publish? Do they think about whether it is true? Or do they simply print it, send out a press release and wait for attention?

The latest piece of junk published in a reputable scientific journal is Publicly funded homebirth in Australia: a review of maternal and neonatal outcomes over 6 years, just published in the Medical Journal of Australia.

I reviewed the findings when they were first presented at a medical conference in April (Australian midwives boast about terrible homebirth death rate):

During the 5 years of the study, there were 1807 women who intended, at the start of labor, to give birth at home. 83% had a homebirth, 52% in water (I have no idea why they mention this except to check women’s performances against the midwifery ideal.) The transfer rate was 17%. The C-section rate was 5.4% and the neonatal death rate was 2.2/1000. That’s more than 5X the rate of 0.4/1000 found in a 2009 report on birth in South Australia.In addition, 2 babies suffered hypoxic ischemic encephalopathy (brain damage due to lack of oxygen).

And that probably undercounts the deaths and complications because reporting was voluntary and only 9 of 13 program directors responded. Nonetheless, the authors conclude:

This study provides the first national evaluation of a significant proportion of women choosing publicly funded homebirth in Australia; however, the sample size does not have sufficient power to draw a conclusion about safety. More research is warranted into the safety of alternative places of birth within Australia.

Actually, the study is not underpowered to detect an extremely high death rate.

What is statistical power?

In plain English, statistical power is the likelihood that a study will detect an effect when there is an effect there to be detected. If statistical power is high, the probability of making a Type II error, or concluding there is no effect when, in fact, there is one, goes down.

Statistical power is affected chiefly by the size of the effect and the size of the sample used to detect it. Bigger effects are easier to detect than smaller effects, while large samples offer greater test sensitivity than small samples.

In most studies we find very small differences between the two groups under investigation. Therefore, we need a lot of individuals in each group in order to be sure that the difference we have found is real, and not the result of chance.

In contrast, if we find a very large difference, we don’t need a lot of individuals in each group in order to be sure that the result is real. A 400% increase in the death rate is an extremely large difference.

The authors never bothered to conduct a statistical analysis of any kind, which means that they literally have no idea whether any of their claims are valid. They simply announced that they could make no determination of safety, but nonetheless boasted about excellent outcomes. You can’t have it both ways. Either the study has too few individuals to draw ANY conclusions, in which case the entire paper is meaningless, or the study contains enough individuals to provide a meaningful result.

Caroline Homer, one of the authors of the study, and Hannah Dahlen, a spokesperson for the Australian College of Midwives, take to the lay press to boast about the results of the study (Study of low risk women reveals good news on the home birth front):

Hannah Dahlen, Professor of Midwifery at University of Western Sydney, said the findings we “very reassuring” and showed a very low perinatal mortality rate, comparable with birth centres.

That is an utter falsehood.

The study shows a VERY HIGH neonatal mortality rate, 400% higher than comparable risk hospital birth.

Which raises the question: Is Dahlen deliberately trying to trick readers, since a neonatal mortality rate of 2.2/1000 is 5X higher than comparable risk hospital birth? Or are she and the authors of the study so ignorant of childbirth safety statistics that they don’t realize that the homebirth death rate 400% higher than comparable risk hospital birth?

And what about the MJA?

Why did they publish such a misleading paper? Why didn’t they insist on a discussion of the very high death rate? Why did they allow the authors to declare that the study is underpowered to determine safety when they authors did no statistical calculations of any kind? If the study is underpowered, why did they bother to publish it?

The publication of this study is disappointing and very, very frustrating. The very best we can say about this paper is that it is utterly misleading.

As I said above, I don’t know if Hannah Dahlen and Australian midwives are trying to trick the Australian public into believing that homebirth is safe when it clearly is not, or whether they are so ignorant of basic science, statistics, and mortality data that they don’t realize that have shown that homebirth is dangerous.

It doesn’t really matter. Boasting about a hideous death rate is both bizarre and unacceptable.

Dutch midwife Ank de Jonge is at it again, slicing and dicing data in yet another unsuccessful attempt to show that homebirth is safe.

She thought that she had succeeded in  Perinatal mortality and morbidity in a nationwide cohort of 529 688 low-risk planned home and hospital births (2009)  which appeared to show that homebirth with a midwife in the Netherlands is as safe as hospital birth with a midwife. Unfortunately for her, the subsequent study, Perinatal mortality and severe morbidity in low and high risk term pregnancies in the Netherlands: prospective cohort study, was a stunning indictment of Dutch midwives, demonstrating that Dutch midwives caring for low risk women (home and hospital) had a higher mortality rate than Dutch obstetricians.

Two months ago, de Jonge in a paper in the journal Midwifery Perinatal mortality rate in the Netherlands compared to other European countries: A secondary analysis of Euro-PERISTAT data that attempted to absolve Dutch midwives, but actually CONFIRMED their poor mortality statistics .

de Jonge continues to slice and dice the Dutch homebirth data is an effort to somehow prove that homebirth is safe, when the data suggests that it is not. Her latest effort is Severe adverse maternal outcomes among low risk women with planned home versus hospital births in the Netherlands: nationwide cohort study. She and her colleagues found:

Overall, 92 333 (62.9%) women had a planned home birth and 54 419 (37.1%) a planned hospital birth. The rate of severe acute maternal morbidity among planned primary care births was 2.0 per 1000 births. For nulliparous women the rate for planned home versus planned hospital birth was 2.3 versus 3.1 per 1000 births (adjusted odds ratio 0.77, 95% confidence interval 0.56 to 1.06), relative risk reduction 25.7% (95% confidence interval −0.1% to 53.5%), the rate of postpartum haemorrhage was 43.1 versus 43.3 (0.92, 0.85 to 1.00 and 0.5%, −6.8% to 7.9%), and the rate of manual removal of placenta was 29.0 versus 29.8 (0.91, 0.83 to 1.00 and 2.8%, −6.1% to 11.8%). For parous women the rate of severe acute maternal morbidity for planned home versus planned hospital birth was 1.0 versus 2.3 per 1000 births (0.43, 0.29 to 0.63 and 58.3%, 33.2% to 87.5%), the rate of postpartum haemorrhage was 19.6 versus 37.6 (0.50, 0.46 to 0.55 and 47.9%, 41.2% to 54.7%), and the rate of manual removal of placenta was 8.5 versus 19.6 (0.41, 0.36 to 0.47 and 56.9%, 47.9% to 66.3%).

Conclusions: Low risk women in primary care at the onset of labour with planned home birth had lower rates of severe acute maternal morbidity, postpartum haemorrhage, and manual removal of placenta than those with planned hospital birth. For parous women these differences were statistically significant. Absolute risks were small in both groups. There was no evidence that planned home birth among low risk women leads to an increased risk of severe adverse maternal outcomes in a maternity care system with well trained midwives and a good referral and transportation system.

There’s just one teensy, weensy problem. de Jonge left out the mortality rates. Severe maternal morbidity is an appropriate measure of safely ONLY when death rate is zero or nearly zero. If the death rate is not zero, that MUST be taken into account in assessing safety.

To understand the problem, it helps to look at a graphical representation. The image below compares the incidence of severe maternal morbidity in two groups.

It’s easy to see that there were a greater number of serious complications in the second group than in the first. It is tempting to conclude that the place of birth for the first group is safer than the place of birth for the second group.

Look what happens, though, when we add the number of women who died in each group.

Now it’s easy to see that the place of birth of the first group is far more dangerous than that of the second group. Notice that the rate of serious SURVIVABLE maternal complications is unchanged. But the dead women had complications, too, and they can’t be excluded simply because they died. If 6 women have serious complications in the first group and 3 die, compared to 5 women in the second group who suffer serious complications, and one dies, we CANNOT conclude that the group that had more survivors is the safer group.

de Jonge has shown us the equivalent of the first image, but it’s meaningless unless she shows us the equivalent of the second image. In other words, the MOST important piece of information, the information we MUST have in order to draw conclusions about safety is missing from the new paper and its absence is both inexplicable and impossible to justify. de Jonge does not explain what she did with the maternal deaths. It appears that she excluded them altogether.

If so, de Jonge compared the number of women who SURVIVED severe complications at homebirth to the number of women who SURVIVED severe complications at hospital birth. She didn’t compare the number of women who EXPERIENCED severe complications in each place. And she didn’t compare how many women DIED at each place. Without that information, de Jonge is not entitled to conclude anything.

This paper doesn’t show that homebirth is safe. In the absence of mortality data, this paper is meaningless.

For years I’ve puzzled over the appeal of Ina May Gaskin.

She’s obviously a complete fraud. She babbles nonsense and makes up “statistics” that she refuses to publish in scientific journals. She has no education or training in midwifery. She has blood on her hands; homebirth kills babies, and indeed she let one of her own children die. She is a cult member who accepts her own husband as a “prophet.”

In writing yesterday’s post about the fact that she proudly transgresses personal boundaries, the final piece fell into place for me. Ina May Gaskin is the high priestess of her own cult, and her loyal followers, for their own reasons, pretend that she is leading them to the promised land.

What are the characteristics of a cult? According to the Group Psychological Abuse Scale, characteristics include:

• The group advocates or implies that breaking the law is okay if it serves the interests of the group.
• The group discourages members from displaying negative emotions.
• Members feel they are part of a special elite.
• The group teaches that persons who are critical of the group are [evil].
• The group teaches special exercises … to push doubts or negative thoughts out of consciousness.
• Medical attention is discouraged, even though there may be a medical problem.

What are the characteristics of cult leaders? According to Lalich and Langone, characteristics include:

• The group displays excessively zealous and unquestioning commitment to its leader and … regards his belief system, ideology, and practices as the Truth …
• Questioning, doubt, and dissent are discouraged …
• The leader is not accountable to any authorities …
• The leadership induces feelings of shame and/or guilt in order to influence and/or control members. Often, this is done through peer pressure …

It’s hardly surprising that Gaskin, the wife of a cult leader, has created her own cult in the area of action that he allows her. How do the characteristics of cults apply to homebirth in the US?

• Homebirth advocates and homebirth midwives routinely break the law and encourage others to do so.
• Homebirth advocates characterize dissent as “negativity.”
• Homebirth advocates believe that they are more “educated” than others.
• Homebirth advocates are vicious to those who question their beliefs. They reserve special contempt for women who have lost babies at homebirth.
• Homebirth advocates attribute poor outcomes (from C-section to disability to death) to the “negative thoughts” of women who “didn’t trust” birth.
• Medical attention is strongly discouraged, even though there may be a medical problem. Indeed medical problems are elided altogether by calling them “variations of normal.”

Does Gaskin exhibit the characteristics of a cult leader?

• Homebirth advocates display zealous and unquestioning commitment to Gaskin, even though she has no education and training, let one of her own children die, and transgresses sexual boundaries.
• No one questions Gaskin’s claims about homebirth even when they are obviously nonsensical. No one demands that Gaskin provide proof for her claims of purported excellent outcomes at The Farm.
• Gaskin is not accountable to any authorities. Indeed she set herself up as THE authority, going so far as to join with others in creating a fake “credential” to fool non-cult members.
• Homebirth advocates, including Gaskin, wield shame and guilt as cudgels to discipline members. Often, this is done through peer pressure.

Gaskin freely admits that she fondles women during labor:

It helps the mother to relax around her puss if you massage her there using a liberal amount of baby oil to lubricate the skin. Sometimes touching her very gently on or around her button (clitoris) will enable her to relax even more. I keep both hands there and busy all the time while crowning … doing whatever seems most necessary.

And:

Sometimes I see that a husband is afraid to touch his wife’s tits because of the midwife’s presence, so I touch them, get in there and squeeze them, talk about how nice they are, and make him welcome.

There is no possible medical or scientific justification for fondling women’s breasts and genitals without express permission. PERIOD. Unless Gaskin has her patients sign advanced consent for “tit squeezing” and clitoral stimulation, she has committed a sexual violation. What’s worse, she violates victims when they are most vulnerable, in pain and unable to advocate for themselves.

That’s the final piece that brought everything into focus.

It’s long past time to recognize this woman for what she is, a cult leaders whose empirical claims have no basis in fact, whose recommendations have caused countless preventable neonatal deaths, and who uses shame and guilt to discipline her followers.

Ina May Gaskin has condemned herself with her own words. Her followers have known about this reprehensible behavior for years and have excused or ignored it as is typical in a cult. This woman is not worthy of anyone’s admiration. She is worthy of condemnation in the strongest possible terms.

Abuse is abuse, even when it is committed by one woman on another, even when it is done under the guise of medical “care,” and even when the perpetrator is widely beloved by other members of the cult. There is no possible justification for this behavior.

Would you hire this midwife?

Don’t let the head suddenly explode from the mother’s puss. Coach the mother about how much and how hard to push. Support the mother’s taint with your hand during rushes. It helps the mother to relax around her puss if you massage her there using a liberal amount of baby oil to lubricate the skin. Sometimes touching her very gently on or around her button (clitoris) will enable her to relax even more. I keep both hands there and busy all the time while crowning … doing whatever seems most necessary.

And:

Sometimes I see that a husband is afraid to touch his wife’s tits because of the midwife’s presence, so I touch them, get in there and squeeze them, talk about how nice they are, and make him welcome.

And:

I might want to have a cunt one day and a twat the next. On the third day I might decide that pussy is my favorite word.

Would you hire this midwife?

Her quotes make her sound immature, foul mouthed, and sexually inappropriate.

Plenty of women have hired her. Her name is …

Ina May Gaskin.

The quotes come from Spiritual Midwifery, 3rd and 4th Editions

Natural childbirth has nothing to do with childbirth in nature. Not only does it fail to replicate birth in nature, it adds on practices that have never been seen in nature and then pretends they are “natural.”

Here are 5 of the goofiest unnatural things that Western, white, well off advocates do while cluelessly preening to each other that they are imitating primitive people.

1. Waterbirth

No primates, let alone humans, give birth in water. Zip, zero, nada. It’s pretty obvious why: childbirth in water is UNNATURAL and puts offspring at risk for drowning. To the extent that infants are “designed”, they are “designed” to be born into air and take their first breathe of air in relatively short order. Animals and pre-industrialized humans make great effort to ensure that their offspring survive. They don’t include stunts as part of birth, because they find no benefit in impressing their peers.

2. Eating the placenta

You have to be the most gullible rube on the planet to be or use the services of a “placenta encapsulation specialist.” Human beings in nature do not eat the placenta, and they certainly don’t freeze-dry it first.

Indeed, the anthropological literature dates the first sighting to an indigenous group of California homebirth advocates (I kid you not). In Consuming the inedible: neglected dimensions of food choice, MacClancy and colleagues report:

In association with the natural childbirh movement from the 1960’s placentophagia was taken up in some ‘Western’ societies, especially in California, on the basis that it was ‘natural’, as ‘all’ mammalian species eat the placenta. The problem with this is that not all mammals are regularly placentophagous and our closest primate relatives also are not placentophagous… [M]odern placentophagia is based on an inaccurate idea of making the human birthing process more ‘natural’.

3. Lotus birth

I can’t decide who are the bigger fools. Those who eat their placenta or those who leave it attached to the baby to rot off.

To my knowledge, there is not a single higher order animal that leaves the placenta attached to the baby for more than minutes. Lotus birth has nothing to do with childbirth in nature. It was made up by a wacky woman trying to outdo her wacky peers. Amazingly, gullible natural childbirth advocates have adopted it, too.

4. Unassisted childbirth

Unassisted childbirth rarely if ever occurs among human societies. There is a good reason for that. Assistance in childbirth raises the chances that both mother and baby will survive what is universally accepted to be an inherently dangerous situation. Unassisted childbirth is yet another fabrication from whole cloth that childbirth advocates try to pass off as “natural” when it is nothing more than a stunt practiced by the clueless in order to impress their clueless peers.

5. Tandem nursing

Although widely beloved by lactivists, to my knowledge there are no higher order animals that practice tandem nursing. Breastmilk is reserved for the youngest child and the older child is invariably weaned. It is not clear whether that’s because allowing an older child to continue to nurse robs the baby of valuable food and nutrients, but it simply doesn’t happen in nature.

If none of the above 5 are natural, how did they come to be included in natural childbirth?

Easy. Natural childbirth has nothing to do with childbirth in nature. From its “father,” Grantly Dick-Read, to its current exponents, natural childbirth was made up to serve the interests and aims of its fabricators. Once you start lying about the inherent dangerousness of childbirth and lying that women are “designed” to give birth perfectly, it is a short step to making up never before seen practices and advertising them as natural.

The current fetish for unmedicated childbirth while refusing life saving interventions, complete with birth photographer, live tweeting and a video on YouTube, is about as natural as hunting rabbits with a bazooka while wearing camo. It is not only unnatural, it doesn’t even mimic what really happens in nature.

Why aren’t breastfeeding advocates satisfied with the real, albeit small, benefits of breastfeeding? Why do they repeatedly publish pathetically poorly done studies that make irresponsible claims about the benefits of breastfeeding?

I don’t know the answers, but I’m becoming ever more disgusted with their insupportable attempts and the willingness of scientific journals to publish the crappy papers that result. Not one, but two, new papers on the benefits of breastfeeding are making headlines this week and both suffer from flaws that would doom a middle school science fair project.

The first paper is Breastfeeding and early white matter development: A cross-sectional study by Deoni, et al. published in the journal NeuroImage. The purported “findings” have been published by sanctimommies everywhere under titles such as Breastfed Babies Are Smarter But That Doesn’t Mean Formula-Fed Babies Are Dumb. There’s just one teensy, weensy problem. The authors didn’t show anything of the kind. Indeed, as far as I can determine, they didn’t show anything at all.

To understand why the their study is fatally flawed, imagine for a moment that I did a study comparing two groups of children to determine if breastfeeding increases children’s height. Imagine further that I found the children from Group A, which contains a high proportion of exclusively breastfed infants, turn out to be several inches taller at age 5 than the children from Group B, who never received breastmilk. I’ve included a sophisticated graphical representation below.

Would I be entitled to conclude that breastfeeding made the children in group A taller than the formula fed children in group B?

It might appear that way at first, but as students of statistics know, you must compare like with like. Are the mothers in group A the same as the mothers in group B? I’ve added more data to the sophisticated graphic representation.

Now we see that the mothers in group A are actually taller than the mothers in group B. We therefore CANNOT conclude that breastfeeding increased the height of the children. The more likely explanation is that the children in group A are taller than the children in group B because of genetic inheritance.

Deoni and al. committed that very mistake. They compared two group of children on a proxy measure of intelligence without ever comparing the intelligence of their mothers. The authors actually acknowledge:

While maternal IQ was not specifically measured, the combination of education and SES [socio-economic status] was believed to provide an adequate alternative.

But the education and socio-economic status of the mothers in group A was known to be higher than in group B. Hence any observed differences between breastfed and formula fed babies is most likely due to genetics and social advantages, NOT to breastfeeding.

That’s only the most egregious deficiency of the study. There are many more. The authors didn’t actually look at the intelligence of the children in the two groups; they looked at white matter development in the brain and implied that it is correlated with intelligence. There’s no proof that the two are correlated. Indeed there is no proof that white matter development is in any way related to intelligence let alone correlated with it.

So, in the end, the authors found nothing at all. The study is junk.

The second study, Cost Analysis of Maternal Disease Associated With Suboptimal Breastfeeding, is, amazingly, even more irresponsible than the first. Bartick et al. breathlessly conclude, with absolutely no basis in fact:

… [W]e estimate that current breastfeeding rates result in 4,981 excess cases of breast cancer, 53,847 cases of hypertension, and 13,946 cases of myocardial infarction compared with a cohort of 1.88 million U.S. women who optimally breastfed. Using a 3% discount rate, suboptimal breastfeeding incurs a total of $17.4 billion in cost to society resulting from premature death $733.7 million in direct costs, and $126.1 million indirect morbidity costs.

There is just one ginormous problem. There is NO EVIDENCE AT ALL that breastfeeding prevents maternal high blood pressure or maternal heart attacks. That means that out of nearly 73,000 purported lives saved, fully 93% are simply made up.

If there’s one thing we know about breastfeeding, it’s that women who breastfeed differ in important ways from women who don’t. Women who breastfeed tend to be wealthier, better educated, and thinner, among other things. There are studies that have investigated an association between breastfeeding and maternal cardiovascular health, and they’ve found that any observed differences disappear when the comparison groups are corrected for economic status, educational attainment and weight.

Bartick et al. acknowledge the tenuousness of their claim with this caveat:

If observed associations between breastfeeding duration and maternal health are causal …

There’s absolutely no reason to believe that breastfeeding affects maternal cardiac health and no mechanism has been proposed, let alone established. The idea that breastfeeding has a protective effect against the diseases of old age in affluent societies is absurd on its face. For most of human existence, women didn’t survive long enough to develop high blood pressure or have heart attacks.

This isn’t the first time that Bartick has published her own wishful thinking as if it were science. In The Burden of Suboptimal Breastfeeding in the United States: A Pediatric Cost Analysis published in 2010, Bartick used highly fanciful methods to  “estimate” that the US could save 900 infant lives and $13 billion if 90% of US women breastfed. The numbers are grossly misleading since not even a single US infant death (let alone 900 per year) has ever been attributed to not breastfeeding and since the purported savings are primarily the “lost wages” of the 900 dead infants.

Who is Dr. Bartick? She’s an internist and fervent campaigner to ban formula gift bags in hospitals, an idea that is punitive (particularly to women of color and those of lower socio-economic status) and has never been shown to have any impact on breastfeeding rates. Dr. Bartick appeared in the comments section of this blog and revealed herself to be a bit of a crank, bemoaning the way that babies are mistreated in the first hour after birth:

Instead, babies [are] routinely whisked off and traumatized during that hour with baths, shots, eye ointments.

Baths, shots and eye ointment are traumatic? I suppose if you believe that, without any evidence of any kind, it’s not hard to believe that breastfeeding prevents the diseases of old age in affluent societies.

Both papers are emblematic of current breastfeeding “research,” which substitutes wishful thinking for scientific evidence.

If you told me that breastfeeding reduces the chance of infants developing malaria, I would find that plausible, since malaria has posed a serious threat to babies for thousands of years and anything that protect against it would be highly beneficial. That’s why the fact that breastfeeding is somewhat protective against infant diarrhea is hardly surprising since diarrhea is a killer in primitive societies. But the claims that breastfeeding addresses the obsessions of contemporary privileged societies (such as the emphasis on infant “intelligence” and diseases of old age) are extraordinary claims. Why would breastfeeding prevent diseases that rarely occurred until the last century? How can we possibly believe that breastfeeding increases intelligence when we have lived through several generations of virtually exclusive bottle feeding with no apparent change in brain power, technical innovation or academic achievements?

Extraordinary claims require extraordinary evidence. Instead we are treated to poorly done studies making bizarre claims based on wishful thinking. What’s next? I’ve got it: breastfeeding prevents global warming!  That’s gonna really make a splash.

Is there any limit to the narcissism and stupidity of these women?

1. Planning an unassisted childbirth (UC):

I believe that I can birth this baby unassisted, safely and happily. I have been trying to convince my DH, but he told me he will never be on board. Planning to birth while he sleeps or is at work. I’m sad that he can’t support me, but I know what this baby needs.

2. The baby is struggling to breathe and the mother is expressing colostrum into her mouth “just so she’d get a taste since we wouldn’t be able to breastfeed any time soon.” If the mother were struggling to breathe would she find it helpful for someone to squirt liquid into her mouth?

Her baby was transferred by helicopter to a NICU (without her) and this is what the mother is thinking:

On the way home from the birthing center, I kept saying, “I did it. I gave birth! Naturally!”

3. After an uncomplicated vaginal birth induced in the hospital at nearly 43 weeks:

… Although I had a mostly natural unmedicated vaginal birth with the most natural birth friendly doctor in the state, it still wasn’t the birth I had planned or wanted for my daughter. To this day, I feel guilty that Dinah didn’t get to choose her own birthday. I’m afraid I may have let her down by having her birth induced.

4. A homebirth midwife wails about the “horrors of midwifery licensing“:

… There are time limits on how long you can labor, or how long you can push, or on the size of your baby. If she ignores any of these rules and regulations, she is (again) subject to disciplinary action. But more importantly, if she ignores the rules (and many do)…then what happens to the “licensing equals safety” argument? How is she a “safe midwife” if there is blatant disregard for the rules that have been deemed to make birth “safe”?

You can’t make this stuff up!

Those of you who follow Hurt by Homebirth will be familiar with the story of Sam’s brain injury and his mother’s near death.

Sam’s mother Tina experienced a life-threatening abruption at home and transferred to the hospital. According to Sam’s father Frank:

…The doctors decided to prep for the emergency c-section, as this was being done Tina had the opportunity to push and push she did just before they were going to begin moving her to the O.R. Samuel was born vaginally @ 4:00 AM. Blue and not breathing the nurses began working on him, massaging “bagging” him for his breathing. I never did hear him cry…

After the birth Tina’s blood would not clot, another term I heard was “DIC”, which has to do with the inability of the blood to clot. 4:30 AM the decision was made to take Tina to the OR- losing a lot of blood- possible hysterectomy. Called to lab for blood, none available. Tina lay bleeding on the operating table for the next 1 ½ to 2 hours, basically bleeding to death…

OK, so about 7:00am the doctors come out and tell me that Tina’s hemoglobin has risen to 6 – still dangerously low but rising … – Tina still alive. There is hope, doctors decided against hysterectomy after a lot of consult with other doctors at other hospitals. If in fact they had opened her up she would have bled out on the table. GOD granted the doctors and nurses the wisdom to not operate.

Tina made a complete recovery. Sam was not so fortunate.

According to his aunt Candice:

Sam began to seize early morning, May 19th. The NICU doctors told me that the baby was being transported to Memorial Hermann, downtown Houston Medical Center for an EEG and further evaluation.

To summarize my nephew’s status, the EEG, (electroencephalogram) taken within 24 hours revealed that his entire brain had been affected by the lack of oxygen due to the loss of blood that he had sustained. A MRI was completed and read one week after admission and clearly delineated that there was global brain damage which confirmed the results from the EEG.

We celebrated when his pupils constricted (even though they were sluggish), when exposed to light via an ophthalmoscope because that meant he was not brain dead. There was a response. We were happy to hear that the sedation medication, Phenobarbital and Ativan, were maintained at adequate levels in order to keep the brain from seizing. It was critical to have the brain rest so it could recover and heal to whatever extent he was capable of. We were so glad to have him taken off the respiratory equipment (CPAP) days after the incident because given time, he was able to take deep enough breaths to satisfy his blood oxygen levels. He could breathe on his own!

In conclusion, my nephew has been diagnosed with severe encephalopathy due to a hypoxic ischemic event or HIE.

Sam’s parents brought charges against the midwife in the Texas Board of Midwifery. The Board acknowledged that she had failed to immediately transfer Sam’s mother despite evidence of abruption. The punishment? Six months probated suspension.

Sam’s family, including two older sisters, took him home and loved him … and got lots of love in return.

I received an email from Tina the day before yesterday:

We lost Sam during his sleep 4/26/2013 due to aspiration.

The autopsy ruled that it was directly related to his labor/birth injuries.

We had a celebration of Sam’s life on 5/18/2013……..what would have been his 3rd birthday. Our family is heartbroken yet due to our Christian faith, we do rejoice for Sam. He is now free of all limitations……..fully restored as God had originally intended.

Sam never talked, sat up, crawled, stood, walked, used arms/hands purposefully. He was completely dependent on us for his care. He was orally fed but it was always a challenge and he never had enough caloric intake so most of his nutrition was by PediaSure/Boost…….Sam was still on a bottle.

He was our sweet, precious little boy. He seemed very aware and interested in his surroundings………..had a twinkle in his eyes and a huge smile…………wonderful laugh/giggle. He knew all of his family and those involved in his daily care/weekly therapy.

Tina shared Sam’s obituary:

Samuel Frank Comstive 2, of Richmond, TX ran through the gates of Heaven into the awaiting arms of Jesus Christ during the wee morning hours of Friday, 4/26/2013.

Sam was born to Frank and Tina Comstive on May 18, 2010. He was welcomed into the family by his big sisters, Rose and Lily. Caring for a child with special needs was the hardest challenge our family had ever endured yet there was much joy and reward. Sam impacted so many lives in such a short period of time although due to his disabilities, never spoke a word. Sam brought together a group of ladies that have formed a support group for families of children with special needs….The Special Mom’s Group.

Sam loved people and they were all drawn to him. Sam had a smile that could brighten the darkest room and a light in his eyes that reflected the love of Jesus. Sam’s last day on this earth was spent with people that loved him the most. He was greeted in the morning by his Daddy and played with…”daddy-style”. Sam was smiling from ear to ear and giggling as they played. He then spent a few hours at the Fort Bend Shriners circus where he was the only person in the crowd to receive a clown nose from one of the clowns. Sam continued to enjoy the rest of the day surrounded by loved ones.

The autopsy report concluded that Sam’s passing was directly related to the injuries he sustained during labor/birth. Sam aspirated during his sleep. Aspiration was one of the many threats to Sam’s health due to his injuries. It appears that Sam never awoke. What a blessing!!! To spend the day with the ones you love, close your eyes and walk into the arms of your Heavenly Father…the one that loves us most.

Sam had a purpose. (Romans 8:28) Sam fulfilled his purpose and God took him home in order to spare him any further hardships due to his disabilities. Our family is positive that Sam was greeted with the words, “Well done, good and faithful servant”. Our family is heartbroken yet we find comfort in knowing that Sam’s body has been fully restored as God had originally intended. Sam can now walk, run, dance, talk, sing, etc. Glory to God!

Left behind to treasure our time with Sam are his parents-Frank and Tina Comstive and sisters-Rose and Lily … paternal grandmother,.. paternal grandfather,.. maternal grandfather,.. and caregiver Adriana .. and her son Angel… Sam was also loved by his extended family members. One of many to greet Sam at Heaven’s gates was his maternal grandmother…

We will have a celebration of Sam’s life on what would have been his 3rd birthday, May 18. We will have birthday cake!… One of the best blessings in our life is Adriana … “Ms. A” has helped us love Sam for the past 2.5 years. She loved Sam as her own and he loved her. She is forever part of our family…

Rest in peace, sweet Sam.

One of the central conceits of natural childbirth advocacy is that it involves taking control of your birth. The reality is precisely the opposite; natural childbirth involves ceding total control to others who have devised an arbitrary standard to which you must adhere.

Claiming that natural childbirth gives women control over their own bodies is like claiming that being a runway model gives women control over their own bodies. If you want to be a high fashion model, you must maintain a certain weight, be of a certain height, and have facial features that meet someone else’s definition of attractive. Similarly, being a natural childbirth advocates requires that you make every feature of your baby’s birth conform to a pre-approved script, regardless of whether that is right for you or your baby.

Consider:

• Want to determine your use of pain relief based on your preferences?Impossible. Your preferences, your experience and your needs are irrelevant. You must avoid pain relief of any kind because natural childbirth is about pleasing the arbiters of birth, not about pleasing yourself.
• Want to control the way that you give birth by choosing a C-section?Impossible. There is one and only one approved mode of giving birth and that is unmedicated vaginal delivery.
• Want to give birth on a day that’s convenient for you?Impossible. Induction is forbidden, especially for social reasons.
• Want to reduce the risks of birth to your baby?Too bad. The particulars of your baby’s circumstances are irrelevant. Breech? Only a vaginal birth counts. Postdates? Only a vaginal birth counts. Twins? Only a vaginal birth counts.
• Want to take joy and pride in your baby’s birth regardless of how it took place?You’re out of luck. How YOU feel about the birth is meaningless. All that matters is how the arbiters of natural childbirth feel about the birth.

It’s no wonder then that natural childbirth sets women up for disappointment with perfectly wonderful births, in the exact same way as trying to look like a high fashion model sets women up for disappointment in their bodies.

So the question pregnant women need to ask themselves is this: Do you want to be free to control your own birth, tailoring it to your needs and desires and your baby’s safety? Or do you want to cede control over your birth to others who don’t have your interests at heart and plan to hold you to an arbitrary standard that fulfills their needs and ignores yours?

Andrea on Baby Center, planning a twin homebirth, asked What would the world be like if we had no hospitals? and then proceeded to answer her own question with multiple comments claiming that hospitals are unnecessary.

She was shocked, shocked to discover that some women found her comments arrogant and ignorant.

She replied:

I mean, I know now that people now rely on such places like hospitals but what did people do before hospitals? Herb doctors, cleansing, or whatever was needed for the person to be back on trap. Maybe doctors did house visits. The post said what would the world be like without hospitals it was not meant to be disrespectful but for some reason there will always be that one person that you can count on to take a subject out of context.

And:

Who said that herbal cleanses don’t help against strokes and heart attacks.. There is an herb for every issue on earth. The herbs were here before technology. Sorry. No technology needed. Time is of essence though. In a timely manner most issues can be resolved by herbs, diet, and exercise.
Thats my story and Im sticking to it. Be mad if you want ladies. Thanks for giving the post relevance and commenting anyway.

The clincher, just in case you hadn’t gotten the point.

P.S.
You can’t have a natural unmedicated childbirth at the hospital.
That’s vinegar and water status it just doesnt mix.
Bye ladies

Andrea has learned a very hard lesson and her daughter is fighting for her life.

I did have my twins. Akilah …. and Aminah … on 05/24/2013 @ home. I wrote a recent post about What would the world be like without hospitals. I had to eat my words this last week because my second baby had prolapse cord and has been in the hospital since birth fighting for her life. Both babies were born great weights Baby Akilah first baby was 6lbs even and Baby Aminah was born 5lbs 9oz at birth. My midwife didn’t show up on time to deliver my babies so my natural unmediated childbirth was a disaster, it was pretty much an unassisted child birth and that is so dangerous with twins. So to all the women who commented on my previous post, I have to admit I was wrong about hospitals. We defintely need them. Without hospitals my daughter would be dead.

Kudos to Andrea for having the courage to acknowledge her mistake. I have two questions for her if she’d care to answer:

Your daughter is paying a terrible price for your new-found knowledge. What, if anything, could have changed your mind before this disaster occurred? What would you tell other women contemplating homebirth who believe that hospitals are unnecessary?