Let’s review: Twelve things you shouldn’t say to Dr. Amy … unless you want to appear very foolish

This piece has received more comments than any other I have written, 1000+ and counting. It first appeared 2 years ago, but rarely a week goes by without someone asserting one or more of the following in the comments sections. Clearly, some people need a review.

It seems like every day a new visitor parachutes in to this blog and attempts to “educate” me. Inevitably, the visitor finds that almost everything she says is false. Indeed, almost everything she thinks she “knows” is false. So to spare these visitors embarrassment, and to reach those who are attempting to “educate” me on other blogs, I have compiled the following list. Here’s what you should not say to me, and why you should not say it.

1. The US does very poorly on infant mortality.

Infant mortality is the WRONG statistic. It is a measure of pediatric care. That’s because infant mortality is deaths from birth to one year of age. It includes accidents, sudden infant death syndrome, and childhood diseases.

The correct statistic for measuring obstetric care (according to the World Health Organization) is perinatal mortality. Perinatal mortality is death from 28 weeks of pregnancy to 28 days of life. Therefore it includes late stillbirths and deaths during labor.

The US has one of the lowest rates of perinatal mortality in the world.

2. The Netherlands, which places the greatest reliance on midwives, has low mortality rates.

No, the Netherlands has, and has had for some years, one of the HIGHEST perinatal mortality rate in Western Europe. It also has a high and rising rate of maternal mortality. The Dutch government is deeply concerned about these high mortality rates and a variety of studies are underway to investigate.

A study published in the BMJ is early November 2010 revealed and astounding finding. The perinatal mortality rate for low risk women cared for by midwives is higher than the perinatal mortality rate for high risk women care for by obstetricians!

3. Obstetricians are surgeons.

I never understand how anyone has the nerve to say this to me. I AM an obstetrician. No one knows better than I what obstetricians are or are not. I went to college. I went to medical school. I spent four years in obstetric training. I delivered thousands of babies. I have cared for thousands of gyn patients. That some doula who is a high school graduate thinks that she can possibly know more than I about the nature of obstetricians defies belief.

Obstetricians do surgery as part of their practice. That does not make them surgeons. If it did, ophthalmologists and dermatologists would be surgeons too, since they do surgery as a routine part of caring for their patients. Is anyone seriously suggesting that you cannot go to an ophthalmologist for an eye exam because he or she will recommend unnecessary surgery?

4. Homebirth is safe.

No, all the existing scientific evidence and all national statistics indicate that homebirth triples the rate of neonatal death. Even studies that claim to show that homebirth is as safe as hospital birth, like the Johnson and Daviss BMJ 2005 study, ACTUALLY show that homebirth with a CPM has triple the rate of neonatal mortality of comparable risk women who delivered in the hospital in the same year.

The Midwives Alliance of North America (MANA) is well aware that homebirth is dangerous. That’s why they are hiding their own mortality rates. They spent almost a decade collecting information on more than 18,000 CPM attended homebirths, announcing at intervals that they would use the data to show that homebirth is safe. So why haven’t any of us seen it?

The data is publicly available, but ONLY to those who can prove they will use the data for the “advancement” of midwifery. MANA is quite up front about the fact that they will not let anyone else know what they have learned. Obviously, if homebirth had been anywhere near as safe as hospital birth, they would be trumpeting it from the mountain top. It does not take a rocket scientist to suspect that their data shows that homebirth dramatically increases the risk of neonatal death.

5. Homebirth midwives are experts in normal birth.

This one always makes me laugh. Experts in normal birth? That’s like a meteorologist who claims to be an expert in good weather.

I guess they’re trying to make a virtue of necessity. Homebirth midwives know virtually nothing about the prevention, diagnosis and management of pregnancy complications. That’s a problem when you consider that the only reason you need a birth attendant is to prevent, diagnose and manage complications. You don’t need any expertise to catch the baby and make sure it doesn’t hit the floor. Ask any taxi drive; he’ll tell you.

6. Childbirth is safe.

No, childbirth is INHERENTLY dangerous. In every time, place and culture, it is one of the leading causes of death of young women. And the day of birth is the most dangerous day in the entire 18 years of childhood.

Why does childbirth seem so safe? Because of modern obstetrics. Modern obstetrics has lowered the neonatal mortality rate 90% and the maternal mortality rate 99% over the past 100 years. What has the contribution of midwifery been to lowering those mortality rates? Zero? They’ve invented nothing, discovered nothing and tested nothing that has had any impact on perinatal or maternal mortality.

7. Childbirth used to be dangerous but that is only because sanitation was poor and women were poorly nourished.

No, the great advances of sanitation occurred in the 1800’s and the early years of the 1900’s. Not surprisingly, this had a big impact on deaths from infectious causes. However, rates of perinatal and maternal mortality did not begin to drop appreciably since the late 1930’s and the discovery of antibiotics. In the intervening years, easier access to C-sections, epidural anesthesia, newer and better antibiotics, blood banking, and neonatology led to dramatically lower mortality rates.

8. C-section increases the risk of maternal and neonatal death.

No, women who die in pregnancy are most commonly women with serious pre-existing medical illness (heart disease, kidney disease) or serious pregnancy complications (pre-eclampsia). C-sections are often done in an effort to save the lives of these women. Sometimes it is not enough. The C-section is what is known as a “confounding factor.” Both the C-section and the death can be traced back to the mother’s health status; the C-section did not cause the death.

MacDorman and colleagues have attempted to show that C-sections for “no indicated risk” increase the neonatal death rate. Their papers have been roundly criticized because they used birth certificates, not hospital record. Unrelated investigations of birth certificates have shown that, while they are highly reliable for data like weight and Apgar scores, they are highly unreliable for risk factors. Indeed, unrelated studies have shown that up to 50% of women who have serious medical illnesses like heart disease, have those risk factors missing from the birth certificate.

9. Induction harms babies.

No, induction lowers perinatal mortality. The yearly CDC data on births shows that as the induction rate has risen, the rate of late stillbirth has dropped by 29% and the neonatal death rate has not increased.

10. If childbirth were dangerous, we wouldn’t be here.

This represents a profound lack of knowledge about evolution as well as a profound lack of knowledge about childbirth. Evolution does not lead to perfection. Evolution is the result of the survival of the fittest, not the survival of everyone. Human reproduction, like all animal reproduction, has a massive amount of wastage. Every woman was born with millions of ova that will never be used. Every man produces billions of sperm that will never fertilize an ovum. Even when a pregnancy is established, the miscarriage rate is 20%. That’s right. One in five pregnancies dies and is expelled and yet we are still here. Human reproduction is perfectly compatible with a natural neonatal death rate of approximately 7% and a natural maternal death rate of approximately 1%.

11. US maternal mortality is rising.

Despite a rather histrionic political report from Amnesty International making that claim, US maternal mortality is not rising and has even dropped in both of the past two years. Why does it look like it has risen? Because the standard death certificate has been revised twice in the past two decades in order to more accurately capture maternal deaths. The new death certificate has revealed maternal deaths which otherwise would not have been counted. It is not clear that maternal deaths have increased; it’s merely that reporting of those deaths has improved.

12. Women are designed to give birth.

Women are not “designed”: they have evolved and evolution involves trade offs. Babies with big heads tend to be more neurologically mature, so having a big neonatal head has evolutionary advantages. A small maternal pelvis makes it easier for a woman to walk and run, providing her with an evolutionary advantage. Those two advantages are often incompatible. The woman with a small pelvis may have been able to survive by outrunning wild animals, but when it came time to give birth, she was more likely to die because that small pelvis could not accommodate a large neonatal head.


The above statements have two things in common. First, they are wrong. Second, they are passed back and forth between natural childbirth advocates who “teach” each other they are true. That’s why it is impossible to become “educated” by reading natural childbirth books and websites. Most of their information is flat out false, and they are entirely insulated from scientific evidence. Natural childbirth advocates make up their “facts” as they go along. They don’t read the scientific literature. They don’t interact with science professionals. Indeed, professional natural childbirth advocates take special care to never appear in any venue whether they might be questioned by doctors or scientists. They know they’d be laughed out of the room. That’s okay with them as long as there is a large pool of gullible women out there who will believe them and buy their products.

It is important that those who are parachuting in to “educate” me understand that they literally have no idea what they are talking about. Most of what they think they “know” is factually false. And they demonstrate that every time they write one or more of those twelve statements.

700 Responses to “Let’s review: Twelve things you shouldn’t say to Dr. Amy … unless you want to appear very foolish”

  1. Flamelily
    August 2, 2019 at 3:37 pm #

    I just wanted to say a huge thank you to Dr Tuteur for this blog as it completely sealed the deal for me when I was wavering in my decision on having a home birth. It made me realize that if the science was so clear and that if hospital birth had been proven to be truly the safest for both mother and baby, then there would be no need for the extreme level of fear mongering and vitriol found here. In the end I chose to have home birth and decided to just accept that it was impossible for me to eliminate the inherent risks associated with childbirth. All I could do was trade one set of risks for another. But my goal was more than just to have a live birth and I truly believe that to prioritize the health of my baby above that of my own would be a terrible disservice to my baby. My goal was to give me baby the best possible chance for health in all its forms: physical, emotional and psychological.

    • AnnaPDE
      August 2, 2019 at 7:08 pm #

      This is like saying, “If it were really proven how dangerous drunk driving is, they wouldn’t have to run all those campaigns to discourage people from it.”
      Well done completely misunderstanding the concept of risk, and I’m glad you survived.

      • The Bofa on the Sofa
        August 2, 2019 at 8:18 pm #

        Fuck, they go so far as to make it illegal! Why would they have to make it illegal if it were obviously more dangerous than sober driving?

    • momofone
      August 2, 2019 at 8:30 pm #

      “Not finding what I wanted to find here made me realize that, though I absolutely do not understand ‘the science,’ I am much more comfortable pretending I do and putting my baby at increased risk than I am actually trying to understand the science.”

    • Zizi
      August 6, 2019 at 6:10 am #

      I’m glad your home birth went well. But I’m confused by this sentence “But my goal was more than just to have a live birth and I truly believe that to prioritize the health of my baby above that of my own would be a terrible disservice to my baby.“ How?

      Also: “My goal was to give me baby the best possible chance for health in all its forms: physical, emotional and psychological.” I know this is anecdotal evidence, but I was born in a hospital (turns out I probably would have died otherwise) and I turned out okay psychologically.

    • MaineJen
      August 6, 2019 at 8:50 am #

      “My goal was more than just to have a live birth…”
      You don’t have to say any more than that. We understand! Your goal was bragging rights, and now you have them. Congratulations on your simple good luck. Wishing you the same good luck in the future.

  2. Kirstin1476
    August 22, 2018 at 11:07 am #

    https://uploads.disquscdn.com/images/cd6a4319094f73e4f0d97f1e5a848875f04595b8c9874898c6d0fd60e01a7e79.jpg Why Did Donald Trump Get Fired When He Was a Carpenter? He wouldn’t take down any walls.

  3. Heather Hardy
    March 22, 2018 at 1:52 pm #

    I just found this web page….and I love you already Dr. Amy! Over the last couple of days, I stumbled into a debate about mid-wives vs. hospital births…and I was completely surprised by the militancy of the pro-mid-wife advocates when I dared to express some skepticism over the stats and studies they were quoting that “proved” homebirths were as safe. I’m not a mother, so this topic does not directly impact me and I admittedly did not know much about it. But my extended family is currently reeling from the death of my 31-year-old cousin from AFE. Plus, I have a niece who coded after delivery and needed immediate care (she is a healthy 8-year-old today). And I can think of several other people I know who had an unexpected emergency arise related to their delivery. All of these examples I just mentioned were “low risk” pregnancies. So I kept making the argument, yesterday, that it is better to ALREADY be at the hospital if one of these emergencies arises. I heard a lot about empowerment, and “childbirth is natural”, and “women are designed for it”….and on and on…all from women…and it struck me as just an embarrassing form of feminism that they seemed so antagonistic against hard science, MDs, and others with genuine expertise.
    The information you’ve provided on the webpage confirmed that my instincts were right. And I’ll promote this webpage any chance I get.

  4. 1personvoice
    September 7, 2017 at 4:37 pm #

    This is one of my favorite posts! Some clear educated rebuttal to the constant misinformation being spread by the hippy mamas movement who forgot that it’s not the 1970s anymore. Thank you Dr. Amy.

  5. Adrienne Courtemanche
    December 13, 2016 at 5:39 pm #

    you are a scary woman haha, you are one of the poeple that make people scared of crazed, over controlling doctors who seem to talk out of their bottom with no proof they are right just “because”. Definetly worth the laugh thanks!

    • Beatrix S.L
      March 5, 2017 at 4:21 pm #

      You sound uneducated and desperate.

    • 1personvoice
      September 7, 2017 at 4:27 pm #

      and you’re a psycho troll who talks out of her bottom, with nothing worthwhile to say either, just because lol!

  6. painedumonde
    August 25, 2016 at 11:14 am #

    Thank you for your work here. Perusing some of the comments, I’ve noticed that they request citations. While I’m in your camp, it wouldn’t be hard to place one or two PDF’s or links for each point. That would quell the quacking.

    Bonne chance !

  7. mandy jones
    August 18, 2016 at 9:17 pm #

    Forsake Are we ever going to evolved a pelvis that outsize these big-headed babies?

  8. Todd Duffield
    April 4, 2016 at 1:52 pm #

    The credibility of the information you present on your blog is diminished by the quack ads claiming: ‘Local Mom Lost 27 lbs in 4 Weeks – Doctors are surprised by this natural product that is helping women lose weight quickly without changing their diet or exercise routine’.

    • demodocus
      April 24, 2016 at 3:14 pm #

      She doesn’t pay enough to have a blog free of ads. I’ve got shop PBS on the sidebar because I was recently looking at their site, and lots of utter nonsense at the top and bottom of the comments.

  9. November 25, 2015 at 10:04 pm #

    Citations needed, please.

  10. Jenflex
    November 10, 2015 at 9:43 pm #

    I find this very interesting. Obviously you know this field cold, and you do a great job articulating the rational, scientific issues. And I appreciate the way you explain them. If I were giving birth today instead of 16 years ago, I would think differently about a hospital birth than I did at the time.

    My question, or issue, or whatever you want to call it, has to do with the fact that, even knowing that I would probably THINK differently, I don’t know that I would FEEL differently. I am not alone in feeling intimidated, frightened, and depersonalized in a hospital environment. That emotional state isn’t particularly conducive to labor and birthing.

    I am a marketer, so my livelihood is rooted in the reality that, however we may aspire to being rational, human beings are emotional, irrational animals. It seems to me that if hospitals could feel as safe as they are statistically, that might do more than trying to fight emotion with rationality

    • Madtowngirl
      August 5, 2016 at 1:09 pm #

      I know you posted this forever ago, but I just saw it – hospitals do seem to be recognizing this as a problem. I gave birth last year, and they hospital had gone to extensive lengths to make the birthing suite have a “homey” feel. Unless you are in the pushing stage, they don’t make you stay in the bed (assuming no epidural or other issue that prevents you from walking). You can be in any position you wish in the bed while you’re delivering. You can labor in a tub. You can have anyone you want in the room with you. You have a TV, mp3 player, even a mirror that comes down from the ceiling if you’d like to see. I have other problems with that hospital, but I have to give them credit for trying to make it a less depersonalized, less intimidating environment. And this has been true in every recovery suite I’ve visited in the past 5 years.

    • Dana Werpny
      January 11, 2021 at 9:55 pm #

      I planned a hospital birth with epidural. I knew that in order to be eligible for the epidural that I would need to feel contractions for hours and dilate for as long as possible first. So I dove in to researching unmedicated pain relief options. That’s when I became away of the natural birth movement. To be honest, all the aniti-hospital rhetoric scared me! I wanted an epidural before I even got pregnant but then was faced with all the toxic negativity surrounding epidurals which was confusing and disheartening. I remember thinking that I would fight the doctors if they tried to force me to get the epidural too early or if they were mean to me or insisted on a c-section. I was pleasantly surprised that every one of the hospital staff were lovely. I arrived in active labor at 3cm dilated and after they admitted me, they let me labour uninterrupted! They only asked me if I wanted an epidural once after I got admitted (which I was always planning on – so yes!) but didn’t force it at all. It was 100% my choice! I was able to labor unmedicated for hours and they were so patient with me. They allowed me to have my husband AND doula with me. I didn’t even get my epidural until 5 hours later. Then they provided me with a peanut ball to open my pelvis to ensure a successful vaginal delivery and even let me eat food when my doula requested it for me! They checked on me to make sure I felt comfortable and happy. Never once did anyone make me feel like I needed to rush my labour. When it came time to push, they encouraged me to stop pressing the epidural button so that I can feel the pushing part. I did and I felt the contractions but no pain! It was incredible! I pushed with every contraction and I felt every inch of my baby come out of me. (That head whoa!) Once the head and shoulders were out I was able to reach down a pull my own baby out! My beautiful daughter! I did skin-to-skin immediately and they have a policy to do delayed cord clamping. My doula helped me breastfeed right away so no issues there. I have a picture of me pulling my baby out with the doctor, a nurse and my husband smiling from ear to ear. The doctor could have easily pulled her out but he stood back and gave me the beautiful experience of birthing my own baby. I loved my hospital experience. Don’t be afraid to share with your OB about your birth wishes. They aren’t evil like I read about. A good OB will care about you and your baby and ensure that you both come out of it safely and happy. Please don’t vilify hospitals. I had a magical hospital birth. I will maybe try to labour and deliver unmedicated next time to see if I can go further with it but more out of a newfound selfish desire to experience the pain (which I’ve already forgotten), not because I didn’t like the epidural. Honestly, I frikin’ loved the epidural and I will never hesitate if I want it again! Why is no one talking about empowering epidural births???

  11. Michelle Davidson
    September 2, 2015 at 7:48 pm #

    I have to disagree with basically eveyrthing you say here.
    You seem to find skewed data. The US IS one of the lowest in 24 hour infant death rates. Inductions DO increase neonatal death and we women
    were DESIGNED by God Almighty to bear children.
    Babies heads may get bigger, but that has nothing to do with evolution (otherwise pelvises should also grow to compensate- survival of the fittest and all that stupid stuff), but the hormones that women are getting in their diets.

    I REALLY pray women do not find this blog of yours intelligent because it is as biased as it gets.
    Home birth is as safe as hospitals for LOW RISK mothers.
    Birth is not a search for a problem, it is a natural process- like nursing, or do you also prefer formula so you can monitor what is in it?

    Wow. I can’t believe I just wasted time commenting here LOL.
    You ma’dam is why and how Obama has milked us Americans out of our healthcare system dollars, penny by penny, pitocin by pitocin.

    • Young CC Prof
      September 2, 2015 at 8:43 pm #

      That’s a Lamarkian view of evolution. Pelvises would not automatically get bigger just because babies’ heads do, instead, women with small pelvises die in childbirth and only those with large pelvises survive. However, nature is imperfect and keeps producing women with small pelvises. Natural selection doesn’t make perfect systems, it makes systems that work well enough often enough to perpetuate the species.

      Please provide one example (within the last 10 years in the USA) of a baby who died as a result of induction of labor who most likely would have survived without it. I can name several who died because they weren’t induced.

      • November 25, 2015 at 10:07 pm #

        Isn’t Ina May working on a birth quilt to commemorate women who died from Cytotek inductions?

        • Young CC Prof
          November 26, 2015 at 4:04 pm #

          Ina May’s quilt commemorates all women who died in childbirth or from pregnancy-related causes. I am not aware of any women who died due to Cytotek.

          Cytotek is a drug that helps open the cervix. It can be used to induce labor and it generally works quite well. It should not be used in a woman with a history of cesarean or other surgery on the uterus, and of course it should never be given to a pregnant woman who does NOT want to deliver the baby within the next few days.

          • Michelle K. Hogan
            April 24, 2016 at 2:14 pm #

            Actually – Cytotec is a drug that was developed for stomach ulcers and it just happens to work as an induction method. It has not been approved by the FDA for the induction of labor.

          • Young CC Prof
            April 24, 2016 at 2:57 pm #

            That is correct. Because the drug is very inexpensive, the manufacturer has not petitioned the FDA to add an indication for induction of labor to the label. The FDA would only do that if the manufacturer asked, and it would cost a considerable amount of money.

            Many many drugs are used “off label.” In some cases, a drug’s best use is discovered only after approval. Bottom line, there’s a ton of evidence that it works.

          • Zen
            April 24, 2016 at 3:20 pm #

            And my eyes would roll so hard they’d get stuck in the back of my head if a doctor put a patient on Cytotec for gastroprotection unless some major contraindication existed to the several classes of meds that have far fewer side effects and are generally much better for this indication. Don’t get too hung up on FDA labeling. In pediatrics and critical care medicine, drug therapy is often not under FDA labeled use. That doesn’t make it bad pharmacotherapy.

    • guest
      January 11, 2016 at 10:20 pm #


    • Cynthia Burke
      April 30, 2016 at 4:31 pm #

      I was present at the HOMEBIRTHS (in my apartment in Midtown Manhattan with mid wives in attendance) of my three granddaughters (a half dozen hospitals nearby if needed). I myself had two children in a Manhattan hospital, the first high forceps after a lot of pitocin and having been induced because the OB/GYN didn’t think I’d make it through his weekend. If I had it to do over again I would NEVER ever have a baby in a hospital for more reasons than space here allows to write. The difference in the experience was monumental. No drugs or machines needed.

      • Dana M
        January 11, 2021 at 10:07 pm #

        Hi, I’m sorry you had a bad hospital experience. Hospitals are aware of these issues and respect women’s wishes for the type of birth they desire and intervene when it is medically necessary to do so (similar to when a midwife might transfer a birthing mother to a hospital). The policies have changed dramatically in years passed. And some women actually want pain relief during labour so a hospital is a necessity in that situation. Natural birth ideology tends to scare women out of the pain relief that they have a right to. It really can be a comfortable and beautiful childbirth experience to deliver a baby with pain relief. My only wish is that an anaesthesiologist could attend a home birth if the home is preferred – now that would be epic!

    • 1personvoice
      September 7, 2017 at 4:32 pm #

      Are you a doctor? What kind of research have you produced and what degrees do you have to show that your disagreement is an actual fact and not just a layman opinion?

  12. Anaisl
    August 15, 2015 at 3:43 am #

    I am looking for figures: perinatal deaths, infant mortality rates for each country. It’s a good article but would be even better if the statements were accompanied by the figures and links to the studies/sources (maybe in a list at the end so it doesn’t stop the flow of reading?) Thanks for this anyway.

  13. jenn
    August 3, 2015 at 12:09 pm #

    What is a “normal” birth? In my limited experience having babies– 2 babies, both delivered safely by an experienced ob who saved my life during #2– there is no such thing as a “normal” birth. Every woman experiences this differently.

  14. lmaw03
    July 17, 2015 at 2:16 pm #

    haha this makes me laugh!

  15. Alison Mercer
    July 1, 2015 at 12:42 pm #

    see this is why i like dr amy, then i read her outdated circumcision post. but she is only human after all. since having a baby and being in groups i notice some of these home birthers it is absurd the shit they get on with, they seem to believe that homebirth is more natural(this more natural thing wtf is up with that? and waterbirths how does that tie in with the more natural? unless u are a dolphin.? . and this fear of epidurals and this c sections are bad garbage. drives me batty. if someone has to have a c section and it saves lives , is that not a wonderful thing to be celebrated? seriously. i have seen mothers who feel guilty because they could not go “natural” , i don’t understand why it meanS something to people. you have your baby and you get to survive and be healthy so that is good right there , right? a vaginal birth , great but saving lives by c section, i honestly think it should be celebrated as backlash against these fear mongering liars , i did no know child birth was such a competition and yet the competitors insist their risky way is right.

  16. Christy Renee' Younce Rach
    April 7, 2015 at 11:27 pm #

    The truth has been spoken!!!

  17. exileandcunning
    March 16, 2015 at 5:49 pm #

    Thank you for giving me permission to ignore the homebirthers! I am not pregnant or even trying yet, but many of my friends have had children at home [many VERY painful, long births w/ no anesthetic that sounded awful!], obsessed with breastfeeding, etc. I am a recovered heroin addict (IV use for 11 years, clean 2 years). My health is superb — I never got any diseases, cycling and healthy eating have kept me at a healthy weight, and a middle-class upbringing goes a long way even after being a heroin addict (I still have all my teeth, lol). That said, I am terrified of pain during childbirth, especially because I have PTSD due to sex work/abuse … that “area” of my body is very anxiety-provoking and pain there triggers bad memories. I am also nervous about getting injured in some way and being forced to take opiates for pain, and becoming addicted again. As far as I know, an epidural is not a narcotic, and a C-section might be safer for me… my mother had two, I am very tiny and small-boned, etc.

    I am also terrified of breast-feeding because my nipples are very sensitive and painful and I have bad memories associated with them, also because of sexual work/abuse in my past. And though I am about to graduate from college, finally, my fiance and I are barely above the poverty line and both have idealistic, low-paying jobs that won’t allow one of us to stay home, so formula-feeding will probably be a necessity.

    I have thought about this stuff for years but accepted I would just have to “deal with the consequences” of having a hospital birth, epidural, formula-feeding, etc etc. It’s a huge relief to learn that I won’t be sacrificing the health and safety of the (hypothetical) baby that I hope to have some day. I still plan to attempt breastfeeding, but I’m going to stop feeling guilty over planning a hospital birth with as much help as I need. Thank you!

    • Roadstergal
      March 16, 2015 at 6:53 pm #

      It sounds like the ‘consequences’ will be preserving your mental health by using the tools the modern era can offer.

      Theadequatemother is an anesthesiologist who has done some very helpful posts on the safety and efficacy of epidural anesthetic.

      • exileandcunning
        March 24, 2015 at 1:03 pm #

        Thanks! I don’t even know why I’m worrying about this since I’m not even pregnant, but my friends who have had children all have such crazy standards of how they dealt with the birth, breastfeeding, etc.

        • Dr Kitty
          March 24, 2015 at 1:51 pm #

          Have honest discussions with your health care providers about what YOUR goals are.

          There is, just BTW plenty of evidence that opiate pain relief, when used appropriately for acute severe pain and followed up closely, does NOT causes relapse for the vast majority of people.

          It is unacceptable to inadequately treat the acute severe pain of a recovering addict simply because of their addiction history.


      • exileandcunning
        March 25, 2015 at 12:19 pm #

        I checked out that blog… very interesting post about the connection between painful birth experience and PTSD… and how inadequate pain management can cause trauma to the mother (separate from post-partum depression… my PTSD symptoms are not depression, they are anxiety, phobias, memory loss, panic attacks, etc).

        There were even a few studies, including how women who have dealt with sex abuse have more trouble dealing with the pain. I guess it makes sense that other women would have this same issue, but I never really thought about it. I’m glad it’s being acknowledged. One thing she said that really made sense was that physical pain is known to cause PTSD, and it doesn’t make it okay that someone hands you a baby at the end of your painful labor… the pain can still be traumatic.

        Definitely gave me a lot to think about. I hope to get pregnant within the next year or two so I want to be ready. Thanks for the tip!

        • Utstroh
          April 14, 2015 at 10:28 pm #

          Don’t freak yourself out. Don’t overlook it. My wife didn’t have easy births but she did them natural and without meds. She says the pain is worth it, you forget it real quick, not that it’s the worst you’ve ever felt but just how bad it was.

          • Ruthless M
            September 2, 2015 at 5:28 pm #

            The pain is worth it. WTF… shut up. Seriously, shut up. Take all the facking meds you can.

        • Daleth
          May 6, 2015 at 10:32 am #

          Another site I would recommend, since you’re planning to formula feed, is FearlessFormulaFeeder.com. I ended up formula feeding after planning to breastfeed, but that site is helpful either way.

    • Ash
      March 24, 2015 at 1:21 pm #

      C-section, vaginal birth, breastfeeding, formula feeding…none of these things are bad. You are not a bad person or a bad mother if you go one way or the other. Do what’s right for your individual circumstance.

    • Utstroh
      April 14, 2015 at 10:34 pm #

      Sorry saw this after my other reply. My wife couldn’t make enough milk so we had to supplement. She felt a little guilty but we found options other than corporate formula. Read the side of a formula can. Research the ingredients. If you’re ok with that then I am too. Good luck making your baby it’s amazingly not the best part of parenthood.

    • Michelle Davidson
      September 2, 2015 at 7:52 pm #

      The first thing I would do, is get to the bottom of the fear you are talking about. There is no reason you need a home-birth, but do your own research on all the risks and benefits and find a provider that you feel comfortable with.
      There are books for trauma survivors as well. A doctor will not likely listen to all these needs, so you may need extra help to overcome.
      Birth should not be led with fear 🙂

    • Esther
      June 15, 2016 at 5:33 pm #

      Don’t listen to anyone who naysays your choices. You should be able to choose how you deliver your baby. Books and counseling can only help so much, some mental scars never completely heal and you have a right to bring (and nurture) a baby into this world in whatever way you deem will not trigger anything you don’t want it to. Anything that takes away from you enjoying your baby is not worth it, take it from someone who had awful experiences breastfeeding and basically didn’t even like her daughter until she was weaned at 13 mos. Whatever “health benefits” derived from my milk is not worth constantly fighting with a baby whose personality just didn’t gel with me during 90% of the feeds, when I was ready to give up and give her a bottle, she wouldn’t take one..so I was trapped doing something that created more stress than it solved, knowing that she had no other way to eat.

      Get an epidural or opt for an elective c-section. Women have choices about whether they stay pregnant when it is unplanned, why shouldn’t they have choices about how to bring their planned baby into the world?

  18. Imogen
    March 12, 2015 at 5:55 pm #

    Oh, how I wish I had known about your blog back when I was 40+4, being induced due to high maternal age and SUA and generally jumping out of my skin. In the world of pregnancy and birth it is rare to find information on the interwebs that are based in science and reality! Thank you 🙂

  19. Kathleen
    February 6, 2015 at 11:20 am #

    I am so glad that I stumbled onto your blog. I am beginning the process of trying to get pregnant, and am trying to learn everything I can, but I am a little intimidated. I’m generally an earthy crunchy granola type of person, but I’m also a really, really big fan of SCIENCE. I know there’s a lot of bad advice out there in the earthy crunchy granola community. I’ve already found a lot of info here that’s settled some questions I’ve had. I’m going to order your book!

    • fiftyfifty1
      March 12, 2015 at 7:06 pm #

      ” I’m generally an earthy crunchy granola type of person, but I’m also a really, really big fan of SCIENCE.”

      Be both! Earthy, crunchy, granola is a lovely choice to make. Breastfeed your kids (if you want to and it works out), dress them recycled cotton kids clothes, bury the placenta in your backyard, literally eat delicious granola…do all these things and have an OB or “medwife” (science-based CNM) and give birth in the hospital. If luck has it, you may have a very crunchy birth as well. And if it doesn’t, science will be right there to help you and your baby, and you will have a precious living baby to take home to show the wonders of nature to. You two can stand under white pines and listen to owls hoot and make homemade applesauce together.

      • Daleth
        March 25, 2015 at 1:06 pm #

        “And if it doesn’t, science will be right there to help you and your baby, and you will have a precious living baby to take home to show the wonders of nature to. You two can stand under white pines and listen to owls hoot and make homemade applesauce together.”

        Beautiful! Perfect!

        Or you can use a home-birth “lay midwife”/CPM and bury your baby under a white pine.

    • The Computer Ate My Nym
      March 13, 2015 at 12:46 pm #

      Nothing about being a crunchy granola type that’s incompatible with being a science type person! I’m a crunchy sort myself, but I like my crunch to be evidence based. So I’m all into whole grains and bicycling, but not so much into home birth and paleo diet.

  20. spijim
    February 5, 2015 at 3:21 am #

    I wound up here because a friend posted a link to one of your anti-vax posts and I stayed for the ranting. Reading this was both humorous and enlightening. Not because I’ve ever quibbled much with what is written on these pages but because of the tone deafness of it all.

    I work in a profession (not medicine) in which a lot of average folks consider themselves experts. It can be a pain and, at times, has made me question if i’m in the right field. On the other hand, my profession (collectively) has also made a lot of mistakes in the not-so-distant past but especially in the distant past. The difference I think is that in my profession most people are quite honest about those mistakes while displaying a sense of humility at the same time. And most professionals, when confronted by skeptics, will take the time to explain that, while we’re not perfect now, how and why things are different, how we’ve changed the way we educate new people in the profession, how they get to be accredited and maintain it, and the ways and means in which we continue to improve our profession.

    Medicine isn’t humble and it’s almost always condescending. I don’t need to run through a painfully long list of medical and pharma horrors that got chucked into the “oops” pile. Everyone knows them. Drug recalls still happen routinely. Hospital deaths from “accidents” are giving cancer deaths a run for their money. It’s one thing to not apologize for them. It’s something else entirely to pretend that your profession has never been responsible for some horrible, collective mistakes. It would suggest that you’re not willing to accept that you might be making mistakes now.

    Giving off an air of infallibility in what is a fallible profession comes across as dishonest to a lot of people. If you don’t get that then maybe you are tone deaf and maybe that’s why you’ll never really understand why so many people are skeptical of the medical profession or the pharmaceutical industry. And that’s really a shame because those of us in the non-medical world could gain a lot from an open and progressive medical profession that doesn’t talk down to people or call them idiots because they don’t understand what it is you do.

    There’s a difference between people who won’t listen and people who stop listening. Figure it out.

    • Poogles
      March 12, 2015 at 6:36 pm #

      “Giving off an air of infallibility in what is a fallible profession
      comes across as dishonest to a lot of people. If you don’t get that then
      maybe you are tone deaf and maybe that’s why you’ll never really
      understand why so many people are skeptical of the medical profession or
      the pharmaceutical industry”

      I honestly don’t feel that Dr. Amy has ever felt that the profession of medicine is infallible. In fact, she had a blog about how the profession of medicine can do better in regards to how patients are treated, which has, unfortunately, since been abandoned due to low traffic/reader engagement:


      • spijim
        March 12, 2015 at 9:09 pm #

        You don’t see the irony in that, though? That one would right a blog like that but then drop it and take up such a condescending tone in one like this? That a blog aimed at docs treating their patients with a little more respect and having a little more humility gets dropped for lack of interest?

        • Who?
          March 12, 2015 at 9:40 pm #

          Sometimes correct can sound condescending if the ears doing the listening are tuned to a different channel, and particularly if the speaker is saying something the listener doesn’t want to hear, and backing it up with reality the listener is either ignorant of, or would prefer to not acknowledge for reasons of their own. I’ve certainly experienced this in my area of professional expertise as I’m sure you have too.

          ‘Nice’ blogs don’t get traffic, controversial ones do. Dr T’s tone is not always sweet, but then she is often talking about challenging and infuriating topics, for example avoidable deaths at home birth.

          • spijim
            March 13, 2015 at 1:47 am #

            You’re right. I’ve experienced heaps of it in my profession. But no, being correct only sounds condescending when you’re trying to intimate that , not only are you correct, but also that the listener is too stupid to understand why you’re correct.

            If you suspect that the listener is tuned to a different channel it’s your job as a professional to tune that person into the right channel. Scorn and ridicule don’t make that happen. If you don’t have the patience to change the channel for someone and you can’t even tell them what the frequency is then you’re probably in the wrong line of work – or at the very least you should be seeking out the area of your profession that’s a little less “front line.”

            The world is already sorely lacking in civility. It’s not something to overlook because it gets attention – it’s part of the problem.

          • Who?
            March 13, 2015 at 2:02 am #

            Sure-but what if the listener is stuck? If someone comes to a lawyer and insists the lawyer facilitates something illegal or unethical, despite the lawyer using everything in his or her arsenal to explain, it is the lawyer’s obligation to sack the client.

            We can talk until we’re blue in the face, communicate openly etc but if they are on short wave and I’m posting on the web (or the other way around if you’d prefer) no amount of using the right words is going to get the message across.

            So someone who ‘knows’ they don’t want a section and is prepared to not have one has a perfect right not to. It isn’t bullying or condescending to explain why that choice is dangerous. If they ignore that advice, and the outcome is other than optimal, how can the doctor be responsible for that?

          • spijim
            March 13, 2015 at 3:07 am #

            A lawyer can say “I can’t do that and I wouldn’t want to do it because it’s unethical. If I got caught I could be disbarred” or “it’s illegal and we could both go to jail.” That’s really the end of the conversation. If someone doesn’t understand it you can point them to the code. If they still want to argue you have a door you can show them.

            A doctor might have a more difficult time dealing with an obtuse patient in the throes of labor and that is certainly an unenviable position for the doctor (and the mother) and no, it isn’t bullying to explain that the baby (and/or the mom) is in jeopardy and the reasons why. As a doctor you might get tired of explaining it but each one of your patients is probably hearing it for the first time. Then again there’s also a long lead up to labor and delivery. 40 weeks +/- with maybe 30 of those weeks where you’re becoming familiar with your patient. There’s plenty of time to hash that stuff out.

            I was in a car accident once. I wasn’t hurt but I still had to sign a waiver telling the ambulance driver that I was refusing care. If a patient doesn’t want to listen/refuses care then it’s not on the doctor.

          • The Computer Ate My Nym
            March 13, 2015 at 10:44 am #

            A lawyer can say “I can’t do that and I wouldn’t want to do it because
            it’s unethical. If I got caught I could be disbarred” or “it’s illegal
            and we could both go to jail.” That’s really the end of the

            Yep, nothing condescending here, not at all. Just end the conversation. No need to explain to the client why you think that what they’re asking is unethical, no need to consider their interests in the matter, no need to suggest a legal and ethical alternative. Just point them to the code if they object. No, you don’t need to bother to explain the code in layperson’s terms or answer their questions. Just point them at it. That’s enough. No need to refer them to a lawyer who will be more helpful either. Just show them the door and if the end result is that they’re convicted of a crime that they didn’t commit or held financially responsible for something that they didn’t do, hey, not your problem. You showed them the code and if they were too dumb to understand, that’s their fault. VERY non-condescending and empowering position you’re taking there. Yep. Definitely.

          • The Computer Ate My Nym
            March 13, 2015 at 12:11 pm #

            Also, I don’t think a lawyer can actually do this. In some circumstances when there’s an established lawyer/client relationship, I think it needs a court order for the lawyer to be able to drop the client.

          • Montserrat Blanco
            March 13, 2015 at 11:46 am #

            Actually you can’t do that if you are a doctor.

            You need to take care of the patient. Period. If she is in labor you need to take care of her. If the requests she makes are stupid, put her baby in danger, put her own life in danger, whatever you still need to take care of her. If you fail to do so you will be guilty of denying medical attention to a laboring woman… Bad place to be…

            You might be able to make her change providers if you have very important disagreements before labor, but once she turns up in labor… No way, you need to provide care and you can never ever do anything without the woman’s consent.

          • Who?
            March 13, 2015 at 6:22 pm #

            This is true, and why lawyers on the whole have an easier time, because overwhelmingly often, no one is going to die.

          • fiftyfifty1
            March 13, 2015 at 8:18 am #

            “The world is already sorely lacking in civility.”

            Oh give me a break Mr. Tone Troll. Your past Discus comments are available for all to read.

          • The Computer Ate My Nym
            March 13, 2015 at 10:46 am #

            There it is again. The reference to your mysterious but perfectly ethical profession that has learned from its mistakes in the past and now never condescends or maltreats people. So curious about what it might be and why you’re unwilling to say.

          • Amy Tuteur, MD
            March 13, 2015 at 11:21 am #

            He appears to be a real estate agent.

          • The Computer Ate My Nym
            March 13, 2015 at 11:31 am #

            Oooh, real estate! Definitely an area where the practitioners have learned from the past and now are 100% ethical. Certainly no real estate agent has ever, say, participated in discrimination or worsened segregation by sending clients to different locations based on their race. Definitely not recently. No history of encouraging people to make financial commitments that they can’t meet either. And clearly no real estate agent has EVER misled a client about how easy it will be to pay off a loan or a “balloon payment”.

            Seriously? The profession that he is claiming is full of remorse for past misdeeds and humility and is entirely accessable to the lay public is REAL ESTATE?

          • The Computer Ate My Nym
            March 13, 2015 at 11:55 am #

            Seriously, though, you’re not spoofing me, are you Dr. Amy? Real estate is the profession that is “quite honest about those mistakes while displaying a sense of humility”? Wow. Unless something is very different from the way I think it is, that doesn’t deserve mockery, it practically demands mockery.

          • Amy Tuteur, MD
            March 13, 2015 at 1:06 pm #

            The email address associated with the Disqus account belongs to a real estate agent.

          • The Computer Ate My Nym
            March 13, 2015 at 12:31 pm #

            Though “naturopath” would have been even funnier.

          • PrimaryCareDoc
            March 13, 2015 at 12:34 pm #

            This made my Friday afternoon.

          • MaineJen
            March 13, 2015 at 1:14 pm #

            OMG. This is the best thing I’ve heard all day.

          • Who?
            March 13, 2015 at 6:20 pm #

            Oh now that is very harsh Dr T.

          • Meesh525
            May 12, 2015 at 12:21 pm #

            I would guess it is because they are lying about it. If not, tell everyone. It’s not a f’ing State secret. I call Bullsh*t on everything they say.

    • fiftyfifty1
      March 12, 2015 at 7:11 pm #

      I am curious now, what profession are you in?

      • spijim
        March 12, 2015 at 9:14 pm #

        It could be law, engineering, finance, environmental science . . . it doesn’t matter. The point isn’t that my profession is better than anyone else’s but rather that any of those professions are well regulated, provide services that everyone needs and they all have completely different relationships with their clients. Medicine doesn’t need to be as paternalistic/authoritarian/condescending as it is to get its job done.

        • fiftyfifty1
          March 12, 2015 at 10:00 pm #

          Still curious. And it does matter. You make a lot of claims about how your profession has done a big turn-around, and is now all about humility. Then you say your field “could be” finance. Or law. Do you really believe people in finance are now trusted and respected? Or lawyers?

          But even if public perception in your unnamed field is actually good now, we still need more specifics. How did this change in attitude and education happen? How does your field deal with charlatans? Does it call them out, as Dr. Tuteur does, or does it play nice so as not to alienate clients? Or maybe your field doesn’t have charlatans, the way the healthcare field does?

          ETA: it better not be architecture, cause that would be a laugh!

          • spijim
            March 13, 2015 at 1:25 am #

            This isn’t a blog about my profession and it’s not a blog post about my profession. The subject here is about healthcare and I’m not the one here suggesting that John Q. Average is too stupid to understand what I do. My comment was a response to a long rant of a post about how people should just shut up, take their medicine, and not ask questions because Dr. always knows best.

            Your defensive inquiries only serve to further my point. No, people shouldn’t trust lawyers or bankers. It’s more than acceptable to ask a lot of questions and second guess them. Professional people shouldn’t automatically be trusted because they’ve studied something longer than you have and they certainly shouldn’t be trusted when they’re calling you a know-nothing idiot.

          • Who?
            March 13, 2015 at 2:02 am #

            Not sure anyone suggested John Q Average (whoever he is) is too stupid to understand anything-though experience indicates he may over-estimate the value of his amateur skill and knowledge in areas of the professional expertise of others.

            Asking questions is great-challenging is great. Not being open to the answers or advice of the expert is where the problem arises.

            Must have missed where patients are called know-nothing idiots, though I think some birth hobbyists probably deserve that handle.

          • spijim
            March 13, 2015 at 2:50 am #

            If you can’t pick up on the scorn, ridicule, and hyperbole dripping off of this page then you’re part of the problem. Like I said in my first post, I don’t have much of an issue with what Dr. Amy is saying but rather with how she’s saying it and it’s part of a much larger problem. I’m not a doctor but I’m well educated enough, with a enough of a background in statistics to be able to comfortably read something like a CDC report and I can see that, while on the right side of the issue, some of the numbers she’s using are exaggerated. If you’re right then just be honest. What’s the point in saying that something is 3x as likely when it’s really only 2x as likely? What’s the point in saying that vaccines are completely safe when in actuality some kids do have horrible reactions and die – the point is that they save millions of lives. When people find out you’re lying – or exaggerating – they wonder what else you’re being less than truthful about and that’s how this whole anti-vax mess got legs in the first place.

            You don’t get people to “see the light” by treating them like idiots (even if they really are). You get them to see the light through straightforward explanation of the facts, by dealing with skeletons in your own closet in a head-on, truthful fashion, and by giving them the time and space to think it through.

            There are raving lunatics out there who you will never convert. I’m not suggesting to waste your time on the lunatics – your efforts should be spent on inoculating those “great unwashed” against the proselytizing of the lunatics.

          • fiftyfifty1
            March 13, 2015 at 8:15 am #

            Where does she say something is 3x as likely when it is only 2x as likely? Where does she say vaccines are completely safe? She recently had a post where she specifically states their risks.

            “You get them to see the light through straightforward explanation of the facts”
            -Actually this tactic has failed miserably with vaccines.

            “I don’t have much of an issue with what Dr. Amy is saying but rather with how she’s saying it”

            -See, it comes down to this, you are a tone troll.

          • spijim
            March 13, 2015 at 4:21 pm #

            “homebirth with a CPM has triple the rate of neonatal mortality of comparable risk women who delivered in the hospital in the same year.”

            It’s isn’t triple. It’s double. If you can’t agree on facts it’s hard to convince people why you’re right.

            Preaching to the choir and echo chambers like this one where you all +1 each other don’t count as a tactic of “getting the message out in a productive and honest way.” If you watch the news or read print journalism about the vaccine issue it’s rarely ever about what the actual risks are, the likelihood of death or permanent injury, how vaccines work, or a careful explanation of why they’re not dangerous. Even if the message is reaching 50% of people who already have their kids on a regular vax schedule it’s not penetrating the echo chambers of the anti-vaxers and it’s not giving the pro-vaxers the information they need to counter the claims of their friends and acquaintances who might be anti-vax.

            But yeah, if that’s tone trolling then by all means, stop replying.

          • The Computer Ate My Nym
            March 13, 2015 at 4:29 pm #

            It’s isn’t triple. It’s double

            Where is the reference that says it’s double? The assertion that the risk is triple baseline is documented in numerous places on this blog with references to published data and raw data that is publically available. Please back up your assertion if you’d like to be taken seriously.

          • Who?
            March 13, 2015 at 4:58 pm #

            I think you are wasting your time with this one.

            And let’s pretend it is double, just to be friendly-are the scales suddenly going to drop from home birth hobbyists’ eyes? No.

          • The Computer Ate My Nym
            March 13, 2015 at 5:05 pm #

            Well, yes, but it’s amusing to watch spijim trying to pick up the goal posts and run with them, all the while decrying our “intellectual dishonesty.” I fear my sense of humor is rather low.

          • spijim
            March 13, 2015 at 5:14 pm #

            I didn’t call anyone intellectually dishonest – that was an insult lobbed at me. You can put the goalposts wherever you’d like. It’s 4-on-1 and you’ve yet to address anything other than trying to figure out a way to attack me personally.

          • yugaya
            March 13, 2015 at 6:13 pm #

            No it was not an insult “lobbed at you”, it’s the official definition of what you used to argue your point.

          • spijim
            March 13, 2015 at 5:11 pm #

            No. They aren’t but at least you can have an honest conversation about what needs to change and why – unless you’re goal is just to be sanctimonious.

          • spijim
            March 13, 2015 at 5:10 pm #

            0.09 vs. 0.2 is not triple. Even if you take the 95% confidence interval numbers they used it’s still not triple.


          • The Computer Ate My Nym
            March 13, 2015 at 5:54 pm #

            Not bad. It’s a real, peer reviewed study with usable data. But there are some limitations. First, it is an old study. Things have changed since the 1980s, when some of the studies included in the meta-analysis were performed, making hospital birth safer, but making no change in home birth risk. Second, the data included demonstrate that the home and hospital birth cohorts are not equal risk. For example, there was a considerably higher rate of premature birth in the hospital group. This is entirely appropriate–if home birth is ever safe that time is not in premature labor–but does bias survival in favor of the home birth group. Finally, there were more infants with congenital anomalies in the hospital birth group. If you look at non-anomalous births only the neonatal mortality was 0.15% for home birth, 0.04% for hospital. In other words, a relative risk of 2.87 or nearly 3x.

          • The Computer Ate My Nym
            March 13, 2015 at 6:19 pm #

            Alternately, you could consider a more modern reference: http://www.ncbi.nlm.nih.gov/pubmed/24662716

            This study found a relative risk of 3.87, closer to 4 than 3 so I suppose you could accuse Dr. Tuteur of underreporting the risk, but it’s certainly nowhere close to RR of 2.

          • Box of Salt
            March 13, 2015 at 6:40 pm #

            “When people find out you’re lying – or exaggerating – they wonder what else you’re being less than truthful about and that’s how this whole anti-vax mess got legs in the first place.”

            No, it’s not. And if it were true, why are the anti-vax folks still clinging like barnacles to Andrew Wakefield whose paper was retracted and license to practice medicine revoked?

            “You get them to see the light through straightforward explanation of the facts, by dealing with skeletons in your own closet in a head-on, truthful fashion, and by giving them the time and space to think it through.”

            We did that for over a decade with the anti-vax folks. What did that get us? A measles outbreak that has spread all over North America.

          • fiftyfifty1
            March 13, 2015 at 8:04 am #

            Ah, you’re not here to get in a productive conversation. You’re here to tone troll. Got it.

          • spijim
            March 13, 2015 at 4:04 pm #

            If by “tone troll” you mean “asking people to look at the glass house they live in and see how they might be part of the problem” then sure, that’s exactly what I’m doing. I’ve already touched on a few pretty serious topics. You’ve had ample time to address them . . . unless of course you’re just here to be defensive, change the subject, and pretend that the problem is just ‘people who don’t want to listen.’

            You want a productive conversation that might get down to the roots of the problem? Why so many people are skeptical of pharma and the doctors who push their products? Let’s talk about $4 *billion* in disclosed payouts to doctors last year (data releases that pharma fought vigorously) and $100s of millions more in undisclosed “gifts.” Average Jane may not have spent a few years in medical school but she does know what corruption looks like.

          • Daleth
            March 25, 2015 at 1:17 pm #

            Let us pretend that “big pharma” did give $4 billion to doctors last year, plus hundreds of millions in undisclosed gifts. Do the math: there are almost 1 million doctors in the US. That means “big pharma” gave each of them a WHOPPING $4000, plus a few hundred bucks in “undisclosed gifts.” Let’s call it $4500 a year.

            The average American doctor earns $189,000/year, and many earn dramatically more. As a lawyer, I’ve seen hospital employment contracts with perfectly ordinary, non-famous surgeons with base salaries–BASE salaries–of well over $500,000 a year, and I knew a cardiologist who was making over $800,000.

            You really think people earning that kind of money are going to sell their integrity and their professional competence for a measly $4500?

          • The Computer Ate My Nym
            March 25, 2015 at 1:35 pm #

            I’m also curious about what is included in “gifts”? $4500 isn’t a lot of money in terms of salary, but it buys a heck of a lot of pens and lunches, which is pretty much all I ever got from drug companies even before the petty gifts were declared tainted and stopped. Do the gifts include things like samples or discount cards to give to patients to decrease their copays? It could be argued that these types of gifts are wrong–they certainly can influence prescribing practice–but they’re hardly trips to the Bahamas or free cars or whatever else people imagine when they hear “drug company gifts to doctors”.

        • yugaya
          March 13, 2015 at 8:24 am #

          You brought your profession into this conversation and argued that it is of certain/higher moral quality than medical profession. Denying others the possibility to evaluate the morality of that profession in comparison to the medical one on their own equals “because I say so” argumentation and being deliberately vague and persistently denying other participants access to the same information that you have. Such speaker attitude is far more offensive than tone trolling and makes “productive conversation” virtually impossible. You’ve applied so many faulty debate tactics in your comments here that, if this were a conversation that was mediated, you’d probably be asked to step away from it on the grounds of intellectual dishonesty.

          • spijim
            March 13, 2015 at 4:29 pm #

            It’s only intellectual dishonesty if my anecdote is what’s on trial here. This is a blog post about why people shouldn’t question doctors. What I’ve said makes you uncomfortable so you want to change the subject – so you can be intellectually dishonest with some tu quoque fallacies. There are plenty of problems here to address. If you want to be dismissive and pretend that the all of the problems are because “they won’t listen to me!” that’s your prerogative.

          • yugaya
            March 13, 2015 at 4:30 pm #

            IOW, it’s only intellectual dishonesty if you say so. Got it.

            Here’s a helpful definition applicable to the rest of the world though: http://en.wikipedia.org/wiki/Intellectual_honesty

            Intellectual honesty: “Relevant facts and information are not purposefully omitted even when such things may contradict one’s hypothesis.”

            Intellectual dishonesty is the opposite of that, and you do amount to a good example.

          • spijim
            March 13, 2015 at 4:54 pm #

            But it is if you say so? Got it.

            hypothesis: “a supposition or proposed explanation made on the basis of limited evidence as a starting point for further investigation.”

            What I do for a living isn’t relevant to my hypothesis.

            But $4 billion last year from pharma to docs? No one? Really? But please come back with more ad homs.

          • The Computer Ate My Nym
            March 13, 2015 at 4:58 pm #

            You may wish to Google the Sunshine Act.

          • Who?
            March 13, 2015 at 4:59 pm #

            And that’s the disguise beginning to fall off…the glint we just saw wah tinfoil.

          • spijim
            March 13, 2015 at 5:29 pm #

            And there the guise completely fell away. Thanks for proving my point. Don’t address any issues. Just insult people.

          • spijim
            March 13, 2015 at 5:46 pm #

            The Sunshine Act – the one we’re just starting to see data from? the one that the AMA is still lobbying to chip away at?

          • yugaya
            March 13, 2015 at 5:12 pm #

            “But it is if you say so?”

            No, and that’s why I backed up my hypothesis that you are being intellectually dishonest here by arguing clearly what in your comments is the said problem ( deliberate omitting relevant information, remaining vague after being prompted for clarification) and cited the definition.

            If that’s ad hominem, I’m in the wrong profession.

          • spijim
            March 13, 2015 at 5:23 pm #

            Calling someone intellectually dishonest rather than addressing the issue is an ad hominem. Trying to change the subject so that you can call me a hypocrite is ad hominem tu quoque.

            My hypothesis is that a lot of people have stopped listening to the medical profession because there have been too many mistakes (and a considerable amount of corruption) and not enough forthrightness about those mistakes and that lack of forthrightness comes from a place of authority and a sense of infallibility. Using an inconsequential anecdote to make that point doesn’t suddenly make my hypothesis about my anecdote.

            But keeping talking about me.

          • yugaya
            March 13, 2015 at 5:37 pm #

            The issue is that you are here presenting false arguments. You are insisting on this blog being unable to take part in a productive conversation, while at the same time making sure that no one here can even attempt to debate your hypothesis about the lack of morality in medical profession on equal grounds.

            When such issues arise in communication they ought to be dealt with before the conversation continues.

            So keep on avoiding, I most’ certainly won’t indulge your further one-sided conversational points until you do the debate-wise decent thing and address the problems in ” …as compared to what exactly” argumentation.

          • spijim
            March 13, 2015 at 5:45 pm #

            It’s not about morality in the medical profession vs. other professions. It’s not even about morality. Its about the medical profession and its relationship with its clients and how it acknowledges and deals with mistakes.

            If you’re point here is to say, “we’re not perfect but we’re better than xyz” and not, “we’re not perfect but here’s how we’re trying to fix it.” then you’ll never get it.

          • The Computer Ate My Nym
            March 13, 2015 at 6:06 pm #

            Yes, and just how has the real estate business attempted to fix its racism and tendency to sell people houses they can’t afford, ruining their credit and leaving them homeless?

          • yugaya
            March 13, 2015 at 6:07 pm #

            You stated that medical profession is not only dishonest about its past mistakes, but that medical professionals “pretend that (their) profession has never been responsible for some horrible, collective mistakes.” As opposed to your still undisclosed profession.

            That’s not talking about “the medical profession and its relationship with its clients and how it acknowledges and deals with mistakes”, that’s medical profession in general being called amoral when directly compared to your profession (?).

            No one can argue with such a statement in a clear and responsible manner other than calling it out as a fake arguent.

          • Daleth
            March 25, 2015 at 1:09 pm #

            In what universe did “pharma” give doctors $4 billion last year?

          • spijim
            March 25, 2015 at 1:26 pm #

            I misspoke. It wasn’t $4 billion “last year”. The data is from last year. ~$4 billion over 4 years so far but data on the money is still coming in so it’ll likely wind up higher than $1 billion per year.

          • Daleth
            March 25, 2015 at 2:34 pm #

            Ah. So, not ~$4000/year per doctor, but more like !$1000/year per doctor.

            Seriously? You think that would sway a person earning $200k-$600k a year? They could make a $1000 rounding error when balancing their checkbook and not even notice it.

          • The Computer Ate My Nym
            March 25, 2015 at 3:05 pm #

            And at $1000/year I’m still not getting my fair share…

            Actually, if the gifts aren’t given anything like equally but are given to specific “thought leaders”, there could be a major problem. Suppose that, for example, there are several new drugs available for treatment of a certain disease. All of them have their risks and benefits but none of them is clearly best in every situation. Drug company A that makes drug X gives presents to the people who write the guidelines for treating this disease and suddenly drug X is the one that gets a mention in the guidelines. This sort of thing could be a problem and might explain certain oddities in the latest guidelines for treating VTE, for example. So I’m not ready to dismiss the possibility that there is a problem and I’m certainly not ready to turn the medical industry loose to play without regulation*, but I’m also not buying spijim’s implicit claim of a vast conspiracy.

            *We’ve seen where that leads with the naturopathic industry: it’s effectively unregulated and full of dubious claims, poor labelling of product, and overall bad behavior.

          • The Computer Ate My Nym
            March 13, 2015 at 4:33 pm #

            This is a blog post about why people shouldn’t question doctors.

            It’s hard to imagine how an intellectually honest person who can read English fluently could read this blog and come to the conclusion that it advocates that patients don’t ask doctors questions. But perhaps you came on this post and have read no others. If so, I’d encourage you to keep reading. Dr. Tuteur does not advocate not asking questions. She advocates not refusing to listen to the answers.

        • The Computer Ate My Nym
          March 13, 2015 at 10:21 am #

          Law is well regulated and lawyers never condescend to their clients? In what universe is this? And engineers? Well, there’s a reason that they don’t let engineers talk to the clients directly…Conversely, while the occasional person is foolish enough to think that they know better than lawyers and try to represent themselves in court or other legal situations, few people are foolish enough to believe that they know better than engineers and that they should be able to build their own airplanes free from the restrictions of conventional avionics.

          • spijim
            March 13, 2015 at 4:43 pm #

            I never said that lawyers can’t be condescending. I know full well they can be and they don’t have a very good public reputation – which is my entire point. But the law is, well, law. It’s rather well codified and we have a large, well established hierarchy of tribunals for dealing with cases where there’s a big disagreement over outcomes. Attorneys don’t make those laws. It’s their job to know what they are and help their clients navigate them.

          • The Computer Ate My Nym
            March 13, 2015 at 5:01 pm #

            Well, you said your profession was “quite honest about those mistakes while displaying a sense of humility” and then said that, while you refused to divulge your profession, “It could be law, engineering, finance, environmental science”, which is at least an implicit defense of the law as a profession. Along with engineers, environmental scientists, etc. It is quite disengenuous to claim that you weren’t implying that these professions are in some way better than medicine.

          • spijim
            March 13, 2015 at 5:28 pm #

            You’re taking two different posts, made weeks apart, out of context. I’m not claiming that those professions are better – I’m saying that they they also have to deal with the know-it-all public but have quite different relationships with their clients (at least publicly)

          • The Computer Ate My Nym
            March 13, 2015 at 5:43 pm #

            Oh? How are the relations different? And do you not stand by your statement that your profession has dealt with its mistakes honestly and with humility or by your statement that your profession could be law, engineering, etc?

    • demodocus' spouse
      March 12, 2015 at 11:21 pm #

      I’m a teacher. Everybody *knows* how to teach, since they have all been students. Just park kids in front of a textbook, right? I’ve felt more condescended to by politicians and parents than any medical doctor. ‘Though there was that one dentist…

      • spijim
        March 13, 2015 at 2:24 am #

        I can only imagine the BS you’ve had to endure as a teacher. I know a lot of them so I hear about it often. But I’m fairly confident that you deal with those issues in a more professional way than Dr. Amy.

        To be clear, for the most part I’ve had great experiences with my own doctors. My kids’ first ped. was ridiculously condescending but by the time it got to the point where I’d had enough and really wanted to switch we were moving anyway. Our new ped. is phenomenal.

        The problem isn’t anyone’s personal experiences with their family doctor. It’s how the profession deals with issues of public health. The whole anti-vax thing should’ve been nipped in the bud 10 years ago but instead the “professionals” rolled their eyes, made snide comments, and ignored the problem it until it was out of control. When the actual professional thing to do would’ve been to address it head on with facts and the truth and persevere until that battle had been won.

        • demodocus' spouse
          March 13, 2015 at 3:18 pm #

          The difference is, Dr. Amy isn’t seeing patients here. Perhaps she cultivated a different persona in person. Perhaps she’s a different person now, years since she last saw a patient. And honestly, I don’t see the condescension you’re talking about here.

      • yugaya
        March 13, 2015 at 9:18 am #

        “Everybody *knows* how to teach, since they have all been students.”

        Even worse if you teach English as a foreign language because everyone either speaks English *perfectly* or can become fully proficient by watching TV.

      • The Rita
        August 26, 2016 at 12:20 pm #

        I know this is a year old but maybe you will see my reply. I have been snubbed because I don’t want to homeschool my kids because “How did you graduate high school if you’re afraid to teach your children up until high school?” Or “well you taught your kids their alphabet and how to eat at the table surely you can teach them through elementary school” it really diminishes the work teachers go through to become teachers. I don’t want to homeschool but homeschoolers think they are above me because their kids will be smarter, more well rounded, finish college at 15, and because they can homeschool and I can’t. I can see where homeschooling might work if you have a lot of free time and money and no chronic health issues and can drive all over. But if you’re like me and have two chronic health issues and can’t drive and can’t afford to take the kids to every museum, amusement park etc…homeschooling won’t work. But people in the homeschooling community will make you think you’re less than them because you can’t teach your kids so you must be an idiot.
        Also I have two kids who need ieps. How the hell do I, a neuro typical adult with no formal education on dealing with special needs children in an educational setting, homeschool these kids? I don’t.

        • demodocus
          August 26, 2016 at 12:46 pm #

          Some can do it, i suppose, but all the teachers i know, whether they left to be a SAHP or not, send their kids to school.
          (i shortened my name, btw, because the old one was annoying me)

        • Heidi
          August 26, 2016 at 1:32 pm #

          I am a SAHP and I am not attempting homeschooling! I didn’t go to school to learn to teach. I think I know the material through at least 9th grade (although, I may even be too confident there), but I do not know how to teach or really help someone understand material. Seems like there is a lot to know – how to do lesson plans, how much homework to give, how to test the child’s knowledge of the material, how to really help them if they are struggling with a subject and the list goes on and on. I love my child, but I’m looking forward to 180 days a year that involve 6 or 7 hours of time when I can focus on something but my child, whether it be me time, time to catch up on laundry, do a hobby, read a book, whatever.

        • Charybdis
          August 26, 2016 at 2:03 pm #

          Depends on if they are your friends or not, or if you want to maintain some sort of social contact with them. It’s none of their business how you educate your kids. You could offer any one of these for a reason you aren’t homeschooling your kids and see what happens.

          1. “I only managed to complete a 6th grade education myself, so I don’t feel comfortable teaching them.”

          2. “I have my own life, interests and activities outside my kids’ lives. Homeschooling is not one of those.”

          3. ” I am supporting the local economy by providing a job for a qualified, certified teacher.”

          4. “They need to work on their social skills and school is just the ticket.”

          5. “I don’t feel the need to micromanage my children’s lives.”

          6. “I am secure in the knowledge that I love my children and they love me. Sending them to school will not change that.”

          7. “I don’t want to homeschool. Period.”

          8. “I am not the only person qualified to teach my children and interact with them.”

          9. “It’s not a contest to see who can sacrifice the most of themselves and their time for their kids.”

          10. “They need to develop a sense of independence and achievement and school is the best place for that to happen.”

          11. “They want to go to school and who am I to limiit their experiences by denying them?”

          12. “They need specialized instruction and professionals are the best ones to provide it.”

          Or something like that. I tend to lean towards the sarcastic, so these retorts may not be everybody’s cup of tea. But it does relay the message that it is none of their concern.

          Because it is not their decision to make and homeschooling is not for everyone.

    • The Computer Ate My Nym
      March 13, 2015 at 10:36 am #

      I work in a profession (not medicine) in which a lot of average folks
      consider themselves experts. It can be a pain and, at times, has made me
      question if i’m in the right field. On the other hand, my profession
      (collectively) has also made a lot of mistakes in the not-so-distant
      past but especially in the distant past. The difference I think is that
      in my profession most people are quite honest about those mistakes while
      displaying a sense of humility at the same time.

      I am seriously curious about your profession because I honestly can not think of a single profession that this description fits. Law? Well, hardly. The keystone of law is precedent and that means relying on past decisions, even if they were mistakes. Engineering? Well, hardly. Engineers admit that they have, collectively, made mistakes in the past, but the history of engineering from the engineers point of view is “we’re superior to past engineers because we’ve learned from them.” Building on past mistakes, yes, but not with deep humility and soul searching. Finance? No. Just no. Environmental science? Well, more than the others, but I don’t see a lot of humility about past mistakes in environmental science.

      Actually, I’d say that the description fits medicine better than any other field. What other field has the equivalent of institutional review boards and root cause analysis committees looking over its collective shoulder at all times simply because it acknowledges past abuses and a desire to never repeat those abuses? What other profession has people with no qualifications who are promoting something known to be useless and/or dangerous presenting themselves as members of that profession (homeopaths, naturopaths, CPMs, etc)?

      It’s not about the patients’ intelligence. I’m willing to believe that the majority of my patients are smarter than me. It’s about their education. It takes time to learn medicine. It takes even more time to learn the specifics of a given field within medicine. I wouldn’t trust my evaluation of, say, an infectious disease problem over that of an ID expert and that’s a field mine is fairly close to. Even learning the vocabulary takes time. “Why not present it without all the jargon?” you might ask. Well, we try. But we often end up sounding like we’re discussing the up goer five. It just isn’t easy.

  21. Sara
    January 13, 2015 at 9:45 am #

    Amy, I found your tone hard to tolerate throughout, though I wished totake your criticisms into respectful consideration. But here, at least, I have a sense of what drives you. Do you evaluate HB with, say, a CNM with 30 years of training, as equally risky as one with a CPM? Any high stakes process attended by someone underqualified to be there could have dire consequences. From my family ‘s birth experiences, I would hazard to include some hospital residents in this category as well.


    With heart,

    • PrimaryCareDoc
      January 13, 2015 at 10:01 am #

      If you stick around a read for a while, you’ll see that Amy has a great deal of respect for CNMs.

      Certainly there are inexperienced hospital residents. That’s why there are always attending physicians overseeing their work.

    • The Bofa on the Sofa
      January 13, 2015 at 10:56 am #

      Everyone has to be evaluated from an individual perspective, and there are absolutely great CNMs out there.

      HOWEVER, I will say that I don’t share as much enthusiasm for CNMs on the whole as many others around here. I fear that the CNM profession is getting sucked into a deep hole of quackdom, and is taking on too much of that CPM-like attitude. In particular, I have been very critical of the ACNM in their unwillingness to take a stand against the unqualified pretenders trying to enter the profession, to the level where they are collaborating with them. If the governing body of the profession doesn’t stand up for standards, I fear about the direction of the membership.

      That being said, they aren’t as bad as CPMs, who can you count on being unqualified (if they were qualified, they’d go get the CNM instead of their list of excuses why they won’t). But even with CNMs, you have to be more careful these days, because it’s very easy for them to run rogue. As PCD notes, you won’t get this with an experienced resident, who has to answer to the attending (and the hospital and the medical community).

  22. Jenny alderden
    January 10, 2015 at 9:59 pm #

    My son was delivered by cesarean birth after a post-dates induction. my birth experience was satisfying and joyful, and most importantly SAFE. Birth is just one day, people- it’s not a contest, and it’s definitely not risking a child’s entire future.

    • Jenny alderden
      January 10, 2015 at 10:13 pm #

      Not *worth risking

    • Ruthless M
      September 2, 2015 at 5:32 pm #

      Exactly. There is no medal at the end of your life for vaginal birth. No award, nothing.

  23. NotaFan
    December 17, 2014 at 1:51 pm #

    “Women are not designed”. Thanks for revealing the reason your posts don’t resonate with me. I guess in your world, extremely complicated, highly functioning, autonomous machines just pop out of the ether. If evolution is truly what you believe, why do you bother trying to save the lives of people you’ve called “idiots”? Wouldn’t it just be better to let them and their progeny die?

    • Amy Tuteur, MD
      December 17, 2014 at 2:04 pm #

      No, they don’t pop out of the ether, they evolve from single cell organisms. The beauty of science is that it’s true whether you believe it or not.

      • VeritasLiberat
        December 17, 2014 at 2:46 pm #

        What I don’t get is why the “women are designed” proponents assume that the implementation of the design is always going to be perfect. According to most religion I know about, nothing on this earth is perfect. Perfection is an attribute of God alone. Those who do not want to believe in evolution do not have to, but it is inconsistent for religious persons to believe that any aspect of the human body whatsoever is perfect, even if it was designed without any evolution at work. Why would human bodies be perfect if human souls are so clearly NOT? (The very imperfection of the human body is why human beings, having been taught compassion, then went on to invent medicine so that they could relieve the sufferings of others.)

        • KeeperOfTheBooks
          March 12, 2015 at 10:22 pm #

          Just had to toss this in there. Even those of us who do believe in the Judeo-Christian view of God mostly accept the idea that due to original sin, our bodies malfunction, get sick, die, and so on. Why in the world is it logical to think that childbirth is the sole exception to this, that it will always go perfectly smoothly If We Just Believe?

          • SporkParade
            March 13, 2015 at 12:54 am #

            Jews don’t believe in original sin. We just believe that humanity fundamentally screwed up the universe. Also, there is no such thing as a “Judeo-Christian” view of God since Judaism’s and Christianity’s concepts of God are fundamentally opposed to one another. Sorry for the rant, but the phrase “Judeo-Christian” gets under my nose because it is usually used to mean, “I want to lend an air of authority to whatever the Christian position is, so I’m going to [erroneously] assume that Judaism is just Christianity minus Jesus.”

          • yugaya
            March 13, 2015 at 9:11 am #

            There is also a rather big chunk of Christianity that does not subscribe to that version of “original sin” at all: http://theorthodoxchurch.info/blog/ocrc/2009/06/original-sin/

          • KeeperOfTheBooks
            March 13, 2015 at 12:25 pm #

            Huh, interesting. I suppose in retrospect that makes sense–IIRC, albeit belatedly, it was Augustine who really developed the whole idea of original sin, at least by that name.
            Do you mind, though, if I ask a genuine but probably stupid-sounding question? How would you differentiate between “humanity fundamentally screwed up the universe” and original sin? I suppose I see original sin as being both collective (we all carry it and suffer its affects) and personal (pre-baptism, I had it on my soul), while “humanity fundamentally screwed up the universe” is more…distant, somehow? Or am I getting it wrong? I’d really love to understand your perspective better, if you don’t mind clarifying. 🙂
            One last question: is it understood in Jewish tradition that this fundamental screwing-up means that the world needs a savior, a Messiah? I’ve always understood that to be the case, which leads in my tradition to believing in Jesus as the fulfillment of that idea, but is that accurate?

          • SporkParade
            March 15, 2015 at 5:54 am #

            Ooh, let me think a little bit about that. It’s complicated because, when it comes to eschatology and Judaism, we have fewer “beliefs” and more “widely accepted theories.”
            I guess something to keep in mind is that Judaism is a very tribal religion and focused on “the nation” whereas Christianity is a more universal religion with a focus on the individual, including when it comes to sin and repentance. So there’s no real concept of the individual needing to be purified of original sin. There was, however, a crazy, crazy ritual on Yom Kippur where the High Priest would atone for the entire nation of Israel, and if a red string turned white, it was a sign everyone was forgiven and there were wild celebrations [which is why (fun fact) the Torah reading for the afternoon of Yom Kippur is all about forbidden sexual relations].
            The Messiah has two roles in Judaism: he is both a Davidic king who will restore the Temple and bring the Jewish people back to perfect religious observance, and he will also fix what went wrong in Genesis by resurrecting the dead and bringing about the Day of Judgment. But there’s no eternal damnation, just ceasing to exist if you did really, really bad things. And after that, there’s a big party with meat and fish, which is how you know this is a Jewish eschatology. 🙂

    • Box of Salt
      December 17, 2014 at 2:46 pm #

      NotaFan: your question “Wouldn’t it just be better to let them and their progeny die?” is not about evolution.

      Your question is about eugenics.

    • Poogles
      March 12, 2015 at 6:38 pm #

      “extremely complicated, highly functioning, autonomous machines just pop out of the ether” =/= evolution. Try again.

    • The Computer Ate My Nym
      March 13, 2015 at 12:38 pm #

      1. That’s not even slightly how evolution works. It took millions of years for eukaryotic cells to form. Nothing popped out of the ether.
      2. If you don’t believe in evolution, do you refuse to use any drug besides penicillin when you have a bacterial infection? The others are designed–really–to combat evolutionarily produced resistance.
      3. That’s not how evolution works either. Evolution isn’t working towards a goal, be that smarter humans or anything else.

  24. AgainstMedicalRape
    November 23, 2014 at 11:00 pm #

    I find it incredible that you have “delivered thousands of babies.”

    You are truly amazing!

    I thought the record belonged to Vassilyev, who gave birth to 69 children in her lifetime.

    Oh wait, never mind. It is just that you use terminology that gives *yourself* total credit for delivering these babies. Your patients are passive women who did not contribute to the delivery of their own babies that came out of their own bodies, and you please feel free to take all the credit for them.

    Yeah to feminism!

    • birthbuddy
      November 24, 2014 at 3:41 am #

      “Your interpretation of “delivery” is probably just as distorted as your interpretation of “rape.”

      • AgainstMedicalRape
        November 24, 2014 at 10:25 am #

        The use of the word “delivery” by the author is condescending toward female patients. This jargon was constructed by the mostly male minds that invented OBGYN, and was intended to place women in a passive position, while declaring conquest and power over their own basic bodily processes. For the author to boast that she “delivered 1000s of babies” is not only a physiologically impossible fable, but also illustrates to us that she is hellbent on prolonging such misogynistic terminology, and does not view her own patients as contributors to the delivery process.

        For her to promote herself as someone who is trying to empower female patients is hypocritical.

        I am open to any discussion regarding the logic behind my interpretation of “rape”. Simply telling me that my logic is “distorted” and “funny” [in your other post] is not convincing me to challenge my viewpoints.

        • Anj Fabian
          November 24, 2014 at 10:47 am #

          If the use of “delivery” is the hill you choose to die on, go for it. I’m not going to save you from yourself.

        • Bombshellrisa
          November 24, 2014 at 11:25 am #

          What word would you like substituted for delivery? And remember it will have to also be on a sign with “labor” (as in the Labor and whatever word you now wish to have used unit) so make sure it’s one the general public can recognize.

        • Empliau
          November 24, 2014 at 11:34 am #

          Nonsense. Check the King James Version of the Bible – there women are always being delivered of children. You may think the translators were misogynistic, but it certainly predates modern OB-GYN.

          • Bombshellrisa
            November 24, 2014 at 11:54 am #

            And delivered of children by MIDWIVES!

          • AgainstMedicalRape
            November 24, 2014 at 1:06 pm #

            Thank you for the information; I did not mean that nobody had ever used such misogynistic terms before OBGYN (predating feminism too!). To clarify, these terms are used pervasively in OBGYN to enforce the stereotype that female patients are passive and need to be “rescued” by having their babies delivered for them.

          • Amy Tuteur, MD
            November 24, 2014 at 1:10 pm #

            Or maybe the outrage against words is manufactured to divert attention from the fact that the philosophy of natural childbirth is what actually harms women and babies.

        • AlisonCummins
          November 24, 2014 at 12:44 pm #

          I understand completely — I’ve never liked that language myself. “Attended the births of thousands of babies” is too passive though. It works for unassisted vaginal deliveries but not for operative vaginal or c-section deliveries. “Delivered” is conventional, well-understood and works in the absence of better language. If you have better language I’d love it.

          As Empliau points out, it’s short for “delivered of.” Women are extremely passive in that construction which highlights the dangerousness and hardship of pregnancy. The pregnancy is a burden and a threat, and birth is something that happens to her that relieves her of that burden. There is no birth attendant implied, it’s god or fate. If she survives pregnancy and giving birth it’s a huge relief to everyone.

          • AgainstMedicalRape
            November 24, 2014 at 1:12 pm #

            Thanks AlisonCummins.

            I do not believe “attended the births” is too passive for a doctor to say. Given that most births do not require any medical intervention whatsoever, doctors should only “attend” or at most “monitor”/”assist” the births most of the time. To say that she “delivered” 1000s of births is just outrageous for a modern educated doctor to say, especially as we are no longer living in pre-feminist biblical times :o)

          • AlisonCummins
            November 24, 2014 at 1:21 pm #

            As I said, “attended” is not suitable because it excludes operative vaginal or c-section births. These births do exist. What word includes obstetric care during birth that is not determined post-hoc by the ultimate mode of exit?

          • AgainstMedicalRape
            November 24, 2014 at 3:00 pm #

            A word such as “supported” or “assisted” would probably be the most
            all-inclusive and respectful to patients. However, I do not think we need an all-inclusive term – because every case is different. Most cases should just be “attended” because most cases do not require any intervention.

            The most dreadful use of an all-inclusive term is “delivered” because it gives absolutely no credit to patients, despite excluding the vast majority of births that should have just been “attended”.

          • AlisonCummins
            November 24, 2014 at 3:40 pm #

            If it’s such a dreadful word it should be easy to come up with a better one, and yet you can’t.

            You have no idea what “should have” happened at any given birth. You only know what did. Even if you had a unique, magical ability to see into multiple futures and identify and choose the best one, that’s irrelevant when the rest of us are talking about the actual things that happen.

          • AgainstMedicalRape
            November 24, 2014 at 10:15 pm #

            I believe I listed better words that demonstrate participation of the patient.

          • Samantha06
            November 24, 2014 at 11:23 pm #

            So, when my colleagues and I ask about a mother we took care of the day before, we always say, “what time did Mrs Smith deliver her baby?” We don’t say, “What time did Dr Jones deliver Mrs. Smith”.. you’re really clutching at straws here..

        • birthbuddy
          December 14, 2014 at 4:08 pm #

          Just as I said, a distorted reply.

        • yugaya
          December 14, 2014 at 6:07 pm #

          In my primary language, and two dozen other similar languages that I can attest for there is no “delivery” as synonym for birth, so the effects of this linguistic medical conspiracy that” was constructed by the mostly male minds that invented OBGYN” are apparently limited to English speakers only and maybe to languages where this meaning was later loaned into. Oh and one of those nasty people who “invented” one of the major worldwide interventions that brought down childbirth mortality was from my part of the world and to the best of my knowledge never learned any English at all.

          Linguistic trivia: verb “to give birth” in my language can be both reflexive and transitive. When used as transitive verb the OB, the midwife, the cab driver or whoever is the birth attendant is the agent, and the woman giving birth is the patient.

          There, my mother tongue semantics just trumped your cheap insinuations.

          • SporkParade
            December 15, 2014 at 4:34 am #

            In the language of the country I gave birth in, there are two different active verbs with the same root. One means “to give birth” and one means “to cause to give birth” i.e. to deliver. Also, the woman giving birth is “the birther,” a midwife is “the person causing giving birth” and an obstetrician is “a women’s doctor of causing-giving-birth-ness.” Root-pattern morphology is fun!

          • yugaya
            December 15, 2014 at 7:46 am #

            Great! More linguistic evidence that the conspiracy OP is insisting on, the supposed deliberate framing of women out of control over the birth as event and their lack of agency in this process is

            a) way older and more widespread than the modern Western obstetrics

            b) the same grammatical conclusion that different languages came up with and found present and important enough to mark it.

            That’s probably because the birth is exactly as dr. Amy describes it – a wild animal whose unpredictable nature is to be respected, and a deadly beast that only fools will believe they can jump into its cage and control it without proper safety gear.

          • Young CC Prof
            December 15, 2014 at 9:22 am #

            Nearly all human societies have the practice of assisting women as they give birth, and many anthropologists believe that the death rate in truly unassisted childbirth is too high for the human race to survive without it.

          • VeritasLiberat
            December 17, 2014 at 2:57 pm #

            Yes. The woman labors, and the attendant delivers (that is, he or she is waiting down there as the baby is coming out, to make sure it gets all the way out without strangling on its own umbilical cord or getting its shoulders stuck or falling on the ground), I guess in the case of an UC you deliver yourself. (But I don’t know about anyone else, but when I was pregnant I found it almost impossible to bend over far enough to get a really good look at my yoni-ish regions. It was like trying to touch my elbow with my tongue. Another advantage of a delivery attendant, who can move to get a better view.)

          • yugaya
            December 15, 2014 at 12:40 pm #

            In Hungarian language the word for OB literally translates as “the birther”. Shock! Horror! :)))

          • The Bofa on the Sofa
            December 15, 2014 at 12:56 pm #

            Do you know Hungarian? I’ve always wondered, what does that Hungarian woman who gets hung in the musical Chicago says in The Cell Block Tango (aside from, “Uh-uh. Not guilty!” in response to Roxy’s question, “Yeah, but did you do it?”)

          • yugaya
            December 15, 2014 at 2:18 pm #

            Uh if I remember correctly her husband was killed by her and lover, and she was protesting her innocence in the what-am-I-doing here-I had-nothing-to-do-with-it-I-swear kind of way. I have to watch it again and pay more attention. 🙂

          • The Bofa on the Sofa
            December 15, 2014 at 2:42 pm #

            Well, that’s kind of the whole premise of the song (they all killed their husbands, but they all deserved it so the women were all not guilty), but I wondered on the circumstances. Like the one who’s husband ran into her knife – he ran into her knife 10 times.

            And some guys just can’t hold their arsenic.

          • Guesteleh
            December 15, 2014 at 3:02 pm #

            From IMDB: I don’t know why Uncle Sam says I did it. I tried to explain at the police station but they didn’t understand.”

            The original, in Hungarian: “Mit keresek én itt? Azt mondják, a híres lakóm lefogta a férjem, én meg lecsaptam a fejét.

          • Guesteleh
            December 15, 2014 at 3:04 pm #

            Oh, and this too, per someone on Yahoo Answers (so you know, shady source but seems legit): “What am I doing here? They say my famous tenant held down my husband and I chopped his head off. But it’s not true. I am innocent.”

          • yugaya
            December 15, 2014 at 4:02 pm #

            The tenant “got” the husband, so meaning held him down also works.If you need anything translated from Hungarian there are a couple of great online learning communities which are pretty active and have tons of native speakers willing to help on board.

          • yugaya
            December 15, 2014 at 3:26 pm #

            The original translates as “What am I doing here? They said that (my) famous tenant killed my husband, and that I cut his head off.”

            It is not specified whose head she supposedly cut off, so the whole thing sounds even more confusing. :)))

        • HipsLikeCinderella
          February 3, 2015 at 7:37 am #

          As a woman who was in an abusive relationship for over two years and was repeatedly raped during that time. I can say with confidence that what you are calling rape is NOT equal or similar to what survivors like myself have gone through. I’m not saying that what you went through wasn’t tramatic. However, for you to use the word rape as a way of getting attention, making headlines, or as a way to promote your home birth agenda is truly offensive.

    • Stacy48918
      November 24, 2014 at 5:51 am #

      Are you kidding??? It’s possible to be 100% passive in my child’s delivery??? If there’s an option to just lay back on a bed and have someone else do all the work, SIGN ME UP BABY! Does Dr. Amy provide this service? Can you refer me to someone you know that does? Sounds GREAT!

      • sdsures
        December 17, 2014 at 7:10 pm #

        C-section under general anaesthestia?

    • HipsLikeCinderella
      February 3, 2015 at 7:42 am #

      Jeez I don’t usually like the c-word but for some odd reason it’s the only word that comes to mind when I read your posts….

  25. April
    August 27, 2014 at 5:17 pm #

    So let’s say we have a completely low-risk woman, hospital minutes away, not anemic, no pre-eclampsia, full-term, healthy, measuring perfect..etc TRULY LOW-RISK planning a homebirth with a CNM. CNM’s are equipped to deal with a bleed (pitocin + cytotec if needed) and also fully equipped to deal with a resuscitation (O2, equipment, assistant with them, etc.) and this CNM is also capable of recognizing when things have escalated, monitoring HR, vitals, etc…what would keep you from considering a homebirth? The CNM I work for has been delivering for 30 years at home/birth center and hasn’t lost a mom or babe. We transfer at the first sign of a problem (haven’t really had to do that much and I’ve yet to do an emergent transfer with her) and risk out anyone that shows signs beforehand. What is wrong with homebirth in this scenario?

    • Amy Tuteur, MD
      August 27, 2014 at 5:35 pm #

      According to the Malloy study, homebirth with a CNM has double the risk of death of hospital birth with a CNM.

    • FredFuchs
      September 10, 2014 at 7:04 pm #

      So you won’t trust an OBGYN with the entire birth process, but if something goes wrong, you’re running there begging for their help?
      That’s a bit hypocritical and idiotic.

    • October 7, 2014 at 12:43 pm #

      That’s a bit like saying that you have two cars outside your house, one a brand new Volvo and the other a junker with dodgy brakes that you dearly love despite it being unreliable and unsafe; you’re only going to the corner store, so why would you not take the junker?

    • Bombshellrisa
      November 24, 2014 at 11:26 am #

      So transferring at the first sign would mean any complication would count against the hospital, not the midwife.

    • yugaya
      December 14, 2014 at 6:31 pm #

      “Hospital minutes away = crash c-section in no less than half an hour, if you are lucky and if you have taken your transfer up a notch.

      Grow up.

    • MaineJen
      December 14, 2014 at 8:05 pm #

      The desire for (effective) pain relief would keep me from considering a home birth.

    • Daleth
      March 25, 2015 at 1:37 pm #

      What would keep me from considering a home birth with the ultra-qualified CNM you describe is two things:

      (1) In a dire emergency she cannot get me into an operating room and get my baby out in anything less than 45-60 minutes. In a hospital there could potentially be as little as 5 minutes between decision and incision, and more typically 10-30 minutes. Remember, there are no epidurals in home births so in addition to the transport and evaluation/explanation at the hospital–they can’t operate before they even know what’s going on–they also need to call the anesthesiologist, have him/her evaluate the situation and get me appropriately anesthesized. If I were delivering in the hospital they would already know what was going on, which would save at least 15-20 minutes by eliminating both the transportation and the evaluation/explanation parts of the process, and I would probably already have an epidural so all they would have to do to operate is up the dose a notch.

      (2) What if we both need help? What if the baby needs resuscitation AND I am hemorrhaging? In a home birth there are two patients (mom and baby) but only the one CNM. In a hospital birth the two patients each have their own doctor (OB [or CNM] and, if needed, neonatologist or pediatrician) and nurse and/or other assistants (e.g. residents), plus a whole team ready to run in and perform whatever emergency procedures may be needed at a moment’s notice.

      Oh, and (3), pitocin and cytotec may not be enough to stop a hemorrhage. In my case I went into hypovolemic shock and needed IV fluids, and some women need immediate transfusions too (I barely managed not to need that). Does your hypothetical ultra-qualified CNM put in heplocks at home births? If not, then even if she DID carry and know how to use IV fluids, she still might not be able to save mom.

  26. SG
    August 25, 2014 at 7:27 pm #

    I do have some honest questions: What do you make of iatrogenic prematurity (I don’t mean when it is medically indicated; I mean the relatively small percentage that is thought to be without clear medical indication)? Do you think it’s a good trade off for the lower perinatal mortality rate associated with medically-indicated iatrogenic preterm births? How is a mother to decide, or should she, as to whether her caregiver might be in that small percentage of OBs or MWs if she is still unsure about the reason for her induction before term?

    • Daleth
      March 25, 2015 at 1:39 pm #

      Did I misunderstand, or are you seriously suggesting that being born 3-4 weeks early could possibly NOT be “a good trade off for [a] LOWER PERINATAL MORTALITY RATE”? Is there any mother on this earth who would NOT rather have her kid be born slightly early than have her kid be born dead?

  27. Lynn Ratcliffe
    July 22, 2014 at 6:51 pm #

    https://www.npeu.ox.ac.uk/birthplace/results Very different results in the UK where midwives are recognised as professional equals

    • Young CC Prof
      July 22, 2014 at 7:59 pm #

      1) UK birthplace study applies in the UK, it cannot be used as evidence towards the safety of home birth in the USA, where the safety measures are all missing or inconsistent.

      2) UK outcomes overall (home or hospital) are not as good as US hospital outcomes. In particular, stillbirth rates are substantially higher in the UK.

      • potkettleblack
        November 13, 2014 at 6:56 pm #

        What is the source of your evidence in no 2 (citing stillbirth rates substantially higher in the UK than the USA)?

        • Young CC Prof
          November 13, 2014 at 11:25 pm #


          According to this document from the World Health organization, the stillbirth rate in the UK is 5 per 1000, versus 4 per 1000 in the USA. More recently, UK public health authorities have expressed concern about stillbirths, including preventable term or near-term losses.

          • potkettleblack
            November 13, 2014 at 11:57 pm #

            Ta for your quick reply. WRT the stillbirth rate, the UK O of Nat Stats are quoting the UK stillbirth rate falling from 5.2 (2011) to 4.9 (2012) to 4.7 (2013) so would like clarification if you have a diff source (RCOG or NHS?) as am researching this for a paper. SB rates had a blip 10 or so years ago and I lived and worked there til 2010….but I’m not aware of an increase recently. Standard induction has usually been 40+10 in the UK after an offered sweep as you prob know and I’m comparing the two practices. Thanks for further info.

          • Young CC Prof
            November 14, 2014 at 12:09 am #

            I don’t believe there’s been an actual increase in UK stillbirths recently, just more attention paid to the problem.

            For the most recent US data in detail, look here:

            Be careful, as some definitions of stillbirth start at 20 weeks and some at 28. In 2012, the US stillbirth rate was 3 per 1000 if you use the 28-week cutoff and 6 per 1000 if you use the 20-week definition.

          • potkettleblack
            November 14, 2014 at 12:53 am #

            Thks. Will make sure I compare apples to apples.

          • potkettleblack
            November 14, 2014 at 1:14 am #

            fyi and just to be diff, I’ve just read the small print to learn the UK (ONStats) is defining SB as 24wks+.. Have just been reading up on Poulter/Sands. Athough Poulter is not my fav politician at least he’s highlighting SB. Will leave you alone now.

    • Stacy48918
      July 24, 2014 at 9:00 pm #

      Really? Midwives are equal to OBs in the UK? So they do C-sections?

      • Lynn Ratcliffe
        July 25, 2014 at 5:58 am #

        in the same way the anaethetists are professional equals; they don’t do caesareans either!
        Uk midwives are educated to degree level, and they are the lead professional for all pregnant women. IF a woman needs extra care because she or her baby have complications they THE MIDWIFE referrs the woman to the obstetrician. The woman can of course decline & remain under midwife-led care if she chooses.

        • Stacy48918
          July 25, 2014 at 7:28 pm #

          Except of course that anesthesiologists are DOCTORS, just like OBs and NEITHER would overstep into the medical area of the other because OBs are not trained in anesthesiology and vice versa.

          • Lynn Ratcliffe
            July 26, 2014 at 5:15 am #

            Like I said, Midwives in the UK are the lead professional & refer on if a woman needs extra help. I’m not going to engage in this ridiculous argument anymore.They are regarded by UK obstetricians as professional equals. It is a very different system in the UK.

          • Birthbuddy
            November 14, 2014 at 3:36 am #

            Stacy, you have upset Lynn and she is not going to play anymore.
            Sorry Lynn, the only way midwives can be the equivalent of an OB is to undergo specialist training.

          • Dr Kitty
            November 14, 2014 at 4:35 am #

            Not true for all of the UK Lynn.
            In Northern Ireland, obstetric care is either Consultant led (for high risk women, or at maternal request), midwifery led (for low risk women, and usually as caseload service) or shared care (GP and midwifery, again for low risk women).
            Each women, regardless of how her care is provided, has a Consultant obstetrician assigned who is the lead clinician.

            As not all midwifery provision is caseload, it is currently impossible to have an assigned MW as lead, because women may not see the same midwife. We have a MW clinic in our practice on a weekly basis- we used to have a regular midwife, now we have a different MW almost every week.

            I do a lot of shared care provision, and while I respect my midwifery colleagues, when it comes to medical decisions, they will defer to me, just as I will defer to them about usual midwifery practice or protocols.

            Currently I’m the one providing continuity of care to most of our obstetric patients, and, as a GP, they can come and see me as often as they like, not just the fixed routine antenatal appointment schedule. Midwives don’t offer extra appointments unless there is a risk factor- my doctor and phone are open even if someone just wants to chat.

            Most of our patients, whether low or high risk, will still come to see a GP.

            I have never met someone who has refused consultant led care, and several who have demanded it after horrible previous experiences with midwives!

          • Dr Kitty
            December 14, 2014 at 7:01 pm #

            That’s a UK wide statement of how midwives would like services to be provided by 2020.

            Is it how services are being provided in Northern Ireland now?

            Is it how services are likely to be provided by 2020?

            There are fewer than 50 planned home births in Belfast every year (I’m being generous, it is probably in single figures).
            The birth centres without obstetric and anaesthetic cover at the Mater, Downe and Lagan Valley hospitals are all working at less than predicted capacity while the Consultant and midwifery led units at the Ulster and The Royal between them are delivering about 10,000 babies a year.

            Women are voting with their feet.
            They are being offered home deliveries and midwife led units 20 minutes from the nearest hospital.
            And they are not choosing them.

          • Daleth
            March 25, 2015 at 1:44 pm #

            Find me an OB anywhere who considers midwives to be “professional equals,” and then I will see if I can find a lawyer anywhere who considers paralegals to be “professional equals.”

            It’s a near-perfect analogy. Lawyers consider paralegals professionals, respect them and rely on them for a lot of basic-level work, and recognize that there are many simple things that paralegals are perfectly qualified to do. Preparing the paperwork for a real estate closing, for instance. Doing a title search. You know–routine, low-risk stuff.

            Does that make them “professional equals” of lawyers? Compare the years of education and the paychecks of paralegals vs. lawyers, and there’s your answer.

    • October 7, 2014 at 12:56 pm #

      They are not professional equals, that’s a bit of a silly claim to make. You would not claim that a nurse practitioner, an analogous role, is professionally equal to a doctor. That doesn’t make nurse practitioners useless, unvalued or dangerous, just not as equals. It’s not a point of shame.

      However, we did have a trial scheme where the community midwife travelled into hospital with the mother and performed the delivery, in the hospital with all the paraphernalia (and backup) readily to hand in case it went wrong. That genuinely was a good thing in my view: familiar face plus backup care in depth if it was needed. This was of course stopped – I don’t know why for sure but was told it was down to costs, which I guess has truthiness.

      Even then, there were those who you felt comfortable with and those you did not. We were lucky: ours was excellent, and clearly kept well up to date on the literature.

      There’s also an elephant in the room. A lot of midwives (though less so in the UK) spread folk myths and there are even records of them promoting dangerous nonsense such as anti-vaccine activism. There are many records of midwives promoting homeopathy, reiki and other ludicrous fantasies. Not all midwifery bodies are robust in their response to this.

      Aside: I like midwives; our midwife, Ruth Moynes, later moved to Haverfordwest in Wales, and delivered my sister’s fourth (who was named Ruth after her).

  28. sameguest
    June 30, 2014 at 5:04 am #

    Is it time to update the MANA statement (Number 4), now that they have published their disastrous results?

    • yugaya
      December 14, 2014 at 6:38 pm #

      They are yet to acknowledge their own results and issue a statement saying that according to their own numbers, homebirth in US is nowhere nearly as safe or safer than hospital birth.

  29. Steph
    June 26, 2014 at 4:01 pm #

    This is amazing. Thank you Dr. Amy. You might not get any thanks from the angry mob, but you’ll have fewer deaths on your conscience than they; and that alone makes me glad people like you who are brave enough to speak out exist.

  30. Sue
    May 18, 2014 at 5:45 am #

    So what of your ‘false’ beliefs, no doubt, that ‘every woman must have active management of third stage’ or she will bleed to death? Or that it was ‘research evidence’ that suggested that baby’s were removed from mothers at birth and kept away from mothers with no adverse effects? Many aspects of medical management claim to be evidence based, yet the evidence seems to evolve…

    • Stacy21629
      May 18, 2014 at 5:59 am #

      “So what of your ‘false’ beliefs, no doubt”
      Do you have any documentation, whatsoever, that Dr. Amy holds these “beliefs”? Or are you just making stuff up so you can ignore what she says?

  31. Lisa
    May 3, 2014 at 9:10 am #

    Just spent probably an excessive amount of time looking for the outcome of Carolyn Gall AAHCC’s pregnancy.


    Based on the comment at the end of this article it seems that she was diagnosed with pre-eclampsia at some stage and voluntarily went to a hospital to give birth. No mention of anything going wrong (other than a general sense that it wasn’t enjoyable) so can hopefully assume both mother and baby are doing okay.

    • Karen in SC
      May 4, 2014 at 11:23 am #

      She’s the 50 year that was freebirthing with only her husband in attendance? I have wondered what happened. Thank you for updating.

  32. deb
    April 12, 2014 at 8:21 am #

    I had two wonderful uneventful home births. I understood the normalcy of birth and took care of myself and had a positive outlook. Since I w o r ked in maternity and saw first hand the reasons for most complications (drs and their interference mostly) I was very confident. It was wonderful!!!

    • Trixie
      April 12, 2014 at 8:34 am #

      So, people who have life-threatening complications in childbirth — it’s their fault for not having a positive enough outlook?

    • fiftyfifty1
      April 12, 2014 at 8:42 am #

      If home birth works so well, why is the death rate for babies 4 times that of hospital birth?

    • MLE
      April 12, 2014 at 9:26 am #

      Alternative title: “Mom discovers one weird trick to wonderful home birth.”

      • Squillo
        April 12, 2014 at 11:46 am #

        “I’ll take post hoc ergo propter hoc fallacy for fifty, Alex.”

        • Something From Nothing
          May 2, 2014 at 10:53 am #

          I LOVE saying post hoc ergo propter hoc!

    • Young CC Prof
      April 12, 2014 at 11:01 am #

      Congratulations! You are one of the 90% of healthy moms who delivered without a major complication!

      Good thing you weren’t in the other 10% of equally healthy moms who have random problems that will seriously damage or kill themselves or the baby without major interventions.

    • Captain Obvious
      April 12, 2014 at 1:08 pm #

      And a higher rate of Homebirth moms say “I understood the normalcy of birth and took care of myself and had a positive outlook”, and had a bad outcome than hospital birth moms. Having a Homebirth doesn’t guarantee you a bad outcome, you just have a higher rate of having a bad outcome. I don’t like to gamble.

    • Mer
      April 12, 2014 at 1:09 pm #

      I’ve worked in maternity and seen major complications as well. I also had very healthy pregnancies, 3 of them in fact and normal deliveries all except that last one. It was lovely, I took care of myself and had a positive outlook, waited for labor to start naturally and had absolutely no pain relief meds, in fact I used hypnobabies! And guess what, my 10 lb (we expected a big baby as his older brothers were each over 9 lbs) baby got stuck with a shoulder dystocia AND a freaking Nuchal cord. With the intervention of my midwife, OB and the nursing team they got him out in 2 minutes, even with that speed he still had an apgar of 4 at 1 minute and needed O2 and assessment by pediatrician and needed to be observed for 48 hours to make sure he continued to be alright. On top of all that, the poor little guy had low blood sugar, but thanks to my decision to supplement him early it was never a problem. On the bright side, thanks to my midwife and OBs management, including IV pitocin, I only lost 450 ml of blood.

      So yes birth is totally normal, as normal as the complications that I’ve witnessed and experienced. I don’t even spend that much time caring for pregnant women much less helping with labor and delivery and I’ve still seen some hair raising complications,

    • Something From Nothing
      May 2, 2014 at 10:51 am #

      So deb, are you implying that if we understand the normalcy of birth (whatever that means) and we take care of ourselves and think positively, there will be no complications and no mothers and babies need die?

    • ngozi
      May 2, 2014 at 11:11 am #

      Was my gestational diabetes, lousy pregnancy history, elevated maternal age, 4 miscarriages all caused by doctors and their interference? Those are complications, and you say complications are caused by doctors.

      • ngozi
        May 2, 2014 at 11:11 am #

        Could all of those things been cured with positive thinking?

    • Amazed
      May 2, 2014 at 11:16 am #

      Says the cleaning woman?

      You are clearly neither an OB, nor a CNM, or a L&D nurse, otherwise you would have said so. Sorry, Debbie dear, but your fellow maternity care worker who boasted about her experience that supposedly made her a competent midwife and was later revealed to be a cleaning woman already gave us an idea of just how competent you “maternity workers” are.

  33. Lisa
    March 10, 2014 at 2:08 am #

    You should be shot in the fucking face for the way you write these articles. not only are you the rudest and most vicious woman i have ever come across, but in most of these, you’re a downright cunt. Who the hell are you to tell a woman that she is “uneducated” for making an informed decision to have a CPM deliver her child?? IT’S HER CHOICE NOT YOURS!! and frankly, it’s not your place to discourage a woman, only to priovide the facts. Which you have done.. but in a completely unneccesary and rude manner! I would rather have a baby in the middle of a forest completely alone in the middle of no where before I would even consider letting you (or someone like you) touch me or deliver my child. and follow the money??? I am following it right to the hospitals where OB’s main focus is to get women in and out to fill the beds and keep the dollars flowing. Go to hell you fucking bitch

    • March 10, 2014 at 2:32 am #

      Dear me. Language.
      You really are pathetic, my dear. Please do go have your baby wherever you choose. And good luck to you, and your baby.
      Foul language is often used as a refuge when you don’t have any justification for your viewpoint — and you know it. Reasoned argument may convince; vulgarity never does.

    • March 10, 2014 at 3:37 am #

      I upvoted this because it made me laugh, and because she used apostrophes properly.
      Good for you Lisa, getting on the internet.

    • Trixie
      March 10, 2014 at 7:56 am #

      Thanks, Lisa, for the new insights you brought to the discussion. Stay klassy!

    • Jessica S.
      April 12, 2014 at 11:59 am #

      Lisa concedes that Dr. Amy has provided women with the facts to make an informed decision. But Dr. Amy didn’t do it THE RIGHT WAY!!! She was MEEN!! Lisa offers an example of how one SHOULD conduct themselves in such discussions: she doesn’t like how Dr. Amy is RUDE, so she suggests that Dr. Amy “go to hell you fucking bitch” and offers that the doctor is a “downright cunt” [Lisa demonstrates her proficiency in anatomy – it is, in fact, right down there.]; she takes issue with Dr. Amy’s viciousness, so she recommends being “shot in the fucking face”.

      Unlike Dr. Amy, who seeks to advocate the safest place to deliver babies (i.e. in an fully equipped and competently staffed facility), Lisa clearly CARES about the well-being of women and babies, demonstrating this by declaring she’d “rather have a baby in the middle of a forest completely alone in the middle of nowhere” before she’d even consider letting Dr. Amy or someone like her – by implication, a trained professional – care for Lisa or deliver her child. What a model of selflessness and concern for others! Certainly not a dogmatic obsession with ideology. (BTW – are some forests not in the middle of nowhere? Perhaps one located directly behind a hospital?)

      Thank you, Lisa, for showing us how not to discuss things on the internet and how one supports the health and well-being of human beings. We can all learn something from you.

      • fiftyfifty1
        April 12, 2014 at 12:30 pm #

        “(BTW – are some forests not in the middle of nowhere? Perhaps one located directly behind a hospital?)”

        I just returned from vacation in a small town where the forest, although not literally DIRECTLY behind the hospital, does start only about 200 meters away. I would strongly suggest that Lisa avoid this sort of forest if she truly is looking to deliver “in the middle of nowhere” and avoid the possibility of even being touched by “someone like” Dr. Amy, because the hospital, although not staffed by any OB, does have emergency c-section capabilities due to an FP with c-section training and a general surgeon who share coverage duties.

      • Monique Davis
        April 25, 2014 at 2:51 am #

        I have tears rolling down my face from trying not to wake my husband up with my out of control laughter, thanks!

    • Melissa
      April 12, 2014 at 12:33 pm #

      If it isn’t Dr.Amy’s place to discourage women from homebirth, does that mean it is also not the place of NCBers to discourage women from hospital birth? Should these sites just be lists of statistics (which I think we’d be fine with if the NCB side also had the same position of not encouraging or discouraging anything, only giving facts, because the facts are on the hospital birth side).

      Also, I don’t particularly care if my doctor/nurse/professional is a nice person. I want them to be good at their profession. This seems to be a major disconnect between NCB and the real world. I hire a professional because of their expertise at a profession, not because I want to be bff with them. I don’t give two craps if my doctor is rude on the internet (another issue if they are rude to me as a patient, but that is very different).

      Finally, I always love the idea that OBs are inducing labors, having c-sections, and generally being evil in the pursuit of money for the hospitals. Think about it logically. If turning over hospital beds was the sole criteria wouldn’t hospitals push natural child birth since it leads to shorter stays than c-sections? If it was about increasing medical bills wouldn’t they be banning c-sections so they could get more money for their NICU? It also misunderstands the supply and demand of a hospital setting. It isn’t like they clear out one patient so another one can come in. The patients are coming in (or not) no matter the bed availability. It isn’t like they are telling laboring women to come back next week when they are open.

      • McPierogiPazza
        December 14, 2014 at 2:55 pm #

        I had to have a biopsy of tissue right at the edge of my clitoris, and my touchy-feely (in the verbal sense) nurse practitioner fussed so much beforehand about how bad she felt for me that I was really scared. It ended up being no big deal, just a little soreness. I dumped her. My general physician at that time was perfect. Compassionate but respectful and professional, even calling me Ms. [last name], which I found I liked since it wasn’t like I was calling her “Mary.” I want a doctor, not a buddy. I also had a colleague who didn’t like the emotion (nerves, really) of a doctor during her difficult labor and delivery. She was relieved when an old male doctor came in and gave her respectful but calm professional care, the very thing some women assume older men can’t do.

    • Susan
      April 12, 2014 at 1:33 pm #

      These foul mouthed tirades always make me wonder about what sort of rage lurks beneath some of these alternative health sorts… ( and lack of self awareness )….

      • Something From Nothing
        May 2, 2014 at 10:57 am #

        Yeah, but you are referring to someone who would risk their babies life and their own by delivering in an isolated forest rather than with a Harvard trained obstetrician. There’s no sense in that.

    • ngozi
      May 2, 2014 at 11:18 am #

      I don’t think Dr. Amy or other doctors like her are going to cry in their beer (kool-aid, milk, or whatever they like) because they lose a patient like you.

    • Steph
      June 26, 2014 at 4:05 pm #

      ‘You should be shot in the fucking face for the way you write these articles…you are the rudest and most vicious woman i have ever come across’

      I can only assume you’re trying to take her title with an opening statement like that. Jeez.

    • FredFuchs
      September 10, 2014 at 7:08 pm #

      Hey there slut. You’re the one coming off as a rude cunt, not Dr. Amy. You are uneducated, and trust me, opinions like yours don’t bother OBGYN’s one bit. Go give birth in the middle of a forest, and if it comes out dead, just kick some dirt over it and tell yourself you did the best you could. Stupid neo hippies. You’re the ones who should drop dead. Society does not need nor do we want you around. Cunt. See I can call you a cunt too.

  34. Jjacmac
    February 23, 2014 at 9:59 pm #

    I am not sure why I’m wasting time writing here but alas,
    I have had both a hospital birth and a home birth and for myself in my humble opinion the home birth was the least invasive, most comfortable and best option out of the two. After the induction of my first child and the unceremonious grabbing and handling of my perfectly healthy child I was left with a fourth degree tear.
    My home birth on the other hand left only a first degree , and it was the most relaxing experience.

    I’m sorry you disagree with home births but I don’t think invoking fear in others is a good idea. To each their own!

    • March 10, 2014 at 2:34 am #

      Did you stop to consider that your pleasant, relaxing homebirth was due more to the fact that this was not your first child than because it was at home? Second, third, and fourth births are very often easier than first ones. Labor is shorter, muscles and tissues have been stretched, second stage is shorter.

      • Jjbmac
        March 10, 2014 at 11:48 pm #

        Either way..to each their own. Instilling fears in what should be a mothers choice is not the way to go

        • ngozi
          May 2, 2014 at 11:30 am #

          Instilling fear or stating facts?

        • Steph
          June 26, 2014 at 4:35 pm #

          But that’s the thing. It isn’t just a mother’s choice any more. There’s another human being in the equation. A mother should do what is best for her baby. And that should surely be giving it the best chance at survival.
          Would I prefer comfort and relaxation surrounded by whale music, dimmed lights and scented candles? Of course. Are bright lights, medics swarming, and the scent of antiseptic anywhere near as soothing? No. But would I consider the latter a small price to pay for a healthy baby with the greatest chance at safe delivery, and thus put my own comfort aside? Yes, absolutely.

        • McPierogiPazza
          December 14, 2014 at 3:06 pm #

          It’s instilling fear if someone is inaccurately paints a picture of danger. Just providing data on birth safety is giving women information for making good decisions.

          • birthbuddy
            December 14, 2014 at 4:05 pm #

            You mean actual scientific data on birth safety, right?

          • Box of Salt
            December 14, 2014 at 4:33 pm #

            McPierogiPazza “It’s instilling fear if someone is inaccurately paints a picture of danger.”

            I absolutely agree. That’s why some of the folks who comment here object when homebirth supporters’ describe the hospital experience with practices from last century.

          • Box of Salt
            December 14, 2014 at 4:35 pm #

            ^oops. Forgot to edit out the apostrophe (misuse of which is one of my own peeves).

    • Trixie
      March 10, 2014 at 7:54 am #

      Yeah, you were wasting your time.

    • ngozi
      May 2, 2014 at 11:29 am #

      I think a homebirth that goes well IS more comfortable and happy than a hospital birth. But if a true emergency comes up, comfortable and happy kind of go out the window. I am glad your homebirth went well, but you can’t always know when an emergency is going to happen. Most emergencies cannot be handled at home.

    • McPierogiPazza
      December 14, 2014 at 3:04 pm #

      I would think that the best doctors encourage a mix of the two styles. There is a lousy history to how women were treated in hospital births for a long time. We had a feminist backlash against the old ways for good reasons. Finding the best mix of making women comfortable, not being invasive unless necessary, etc., while keeping mother and baby safe seems reasonable to me.

      • Samantha06
        December 14, 2014 at 3:57 pm #

        “Finding the best mix of making women comfortable, not being invasive unless necessary, etc., while keeping mother and baby safe seems reasonable to me.”

        AKA hospital birth and modern obstetrical care. “Not being invasive unless necessary” is standard rhetoric for home birth supporters.

        • McPierogiPazza
          December 15, 2014 at 2:03 am #

          Again, with old practices having been so lousy for mothers, we arrived at a backlash for good reasons, and there is still a wide range in quality of care and options, so dismissing my comment so readily is unhelpful. With disagreement over US c-section rates alone, this isn’t a simple issue.

          • Samantha06
            December 15, 2014 at 11:26 am #

            I am stating facts. Would you be more specific about what constitutes a wide range of quality care and options? How do doctors “encourage a mix of both styles”? What would you consider an unnecessary intervention? And who is disagreeing over C/Section rates and why? Please elaborate. Thanks.

      • Guesteleh
        December 14, 2014 at 5:26 pm #

        Do you know the history of twilight sleep in childbirth? In the early 20th century feminists campaigned for the right to be unconscious during labor, even arguing that it allowed them to “enjoy the birth that earlier, more ‘natural’ women had enjoyed…” It’s just interesting that both the initial move to anesthesia during labor and then the turn away from it have been framed as feminist choices.


  35. MM
    January 31, 2014 at 10:49 am #

    Oh you’re an OB? That’s funny, I thought your license lapsed over a decade ago… And “skeptical” you are not. More like hateful extremist with an agenda. Let’s change the blog name to “Former obstetrician who hates midwives.”

    • March 10, 2014 at 2:37 am #

      Yes, Dr. Tuteur is still an MD, hate to tell you. Not maintaining active registration does not wipe her brain clean of 8 years of med school, an internship, 4 years of residency, and a number of years of practice, as well as keeping up with recent developments in medicine. Nor does it mean she no longer has the degree she worked for.

      Grow up, or at least, become educated yourself.

  36. LookingForTruth
    January 25, 2014 at 5:05 pm #

    I have a question about infant mortality, or rather first-day mortality. According to a chart on page 55 of Save the Children’s 14th State of the World’s Mothers report (www.savethechildren.org.uk/sites/default/files/images/State_of_World_Mothers_2013.pdf), US has the highest first day death rate in the industrialized world. Wouldn’t it contradict your first point?

    • Young CC Prof
      January 25, 2014 at 5:15 pm #

      Two reasons for that:

      1) The US has a higher rate of premature birth, perhaps for genetic reasons, perhaps partly due to poverty, but unfortunately the world’s current obstetrical technology can’t do much to prevent prematurity. The US is very good at saving those preemies, week for week our survival rates are near the top, but there are so many of them, and sometimes they slip away despite everything we can do.

      2) Reporting differences. In the USA, a baby who draws breath counts as a birth (and possibly a death.) In other countries, a baby born severely premature or with dire birth defects who breathes only for a very short time might be counted as a stillbirth instead of a live birth and a death.

      • LookingForTruth
        January 25, 2014 at 5:26 pm #

        Just trying to play devil’s advocate here, but homebirth advocates could use this statistic, and then they would be right to say that US does very poorly on first-day mortality. I realize that first-day mortality is not the same as perinatal mortality (28 days of pregnancy+28 days of life), but if we are looking at deaths during the first 24 hours after birth, we aren’t doing that well. I wonder if there is a statistic of premature birth in the US versus other industrialized countries.

        • Young CC Prof
          January 25, 2014 at 5:35 pm #

          Read this: http://www.cdc.gov/nchs/data/databriefs/db23.htm

          It’s an article by the CDC analyzing exactly why the US fares more poorly on certain measures than Europe. The one key fact it doesn’t mention is that the increased prematurity mostly occurs among African-Americans–and there’s some evidence that it’s actually genetic!

          It’s a subtle and complicated question. People who don’t understand statistics can pick whatever they want to misuse, but you seem to want the real answers.

          • LookingForTruth
            January 25, 2014 at 5:48 pm #

            I do want real answers, not for me though, because I am done having babies. I have friends, who are avid homebirth advocates and some who are undecided. The topic of homebirth often comes up in conversation, and I want to be armed with real information when it does.

          • Young CC Prof
            January 25, 2014 at 6:32 pm #

            Here’s another talking point for you: Break out infant or neonatal mortality by state. If a lot of your friends like home birth, you almost certainly live in a state with fantastic outcomes. (And no, it’s not because people home birth. Even in Oregon, home births are a tiny percent of the total.)

        • Box of Salt
          January 25, 2014 at 5:40 pm #

          Here are two links from the WHO:
          The second one is a 126-page report from 2012 which I did not download.

        • Captain Obvious
          April 12, 2014 at 1:04 pm #

          Many countries use 28 weeks as the cut off between miscarriage and stillborn as well. Have a baby at 27 weeks and it dies in America equals perinatal death, in other countries it is a miscarriage.

  37. Brett Longworth
    January 16, 2014 at 12:16 pm #

    Is there data to support “epidural anesthesia… led to dramatically lower mortality rates” in #7? My wife will make the final decision, but this would help. I haven’t found anything convincing on benefits of anesthesia beyond pain relief (which is a big one). There are some relatively minor drawbacks, which together put epidurals into category 3 below.

    I am a scientific-minded soon-to-be father who’s trying to make sense of all the data on birth to come up with a best-practices evidence based birth plan. It’s tough to do this when every source has bias. Even the WHO best practices are sometimes not supported by data! The <15% C-section recommendation comes to mind here.

    My order of reasoning for thinking about things goes like this: 1) Choose things that have clear evidence supporting them. 2) If evidence does not clearly support either option, use logic to choose. 3) If 1 or 2 don't provide a clear choice, pick the option that involves less intervention. Good prenatal care is an obvious (and not contentious) example for #1. Choosing hospital birth because of easy access to emergency measures is my example for #2. Yes, the data on homebirth are fairly convincing, but this logic solves any question about data ambiguity. Delayed cord clamping and avoiding unnecessary ultrasounds are an example for #3.

    • Amy Tuteur, MD
      January 16, 2014 at 12:25 pm #

      Epidural anesthesia dramatically lowered mortality rates because prior to its advent, the only alternative for surgery was general anesthesia, and the only alternative for pain relief was systemic medication like twilight sleep.

      The WHO withdrew their C-section rate recommendation in 2009, acknowledging that there had never been any data to support it.

      When it comes to scientific evidence, obstetricians are the ones who research it and apply it. Midwifery claims that obstetric practice is not based on science are usually bald faced lies. For example, there is NO scientific evidence that delayed cord clamping benefits terms infants.

      • Brett Longworth
        January 16, 2014 at 5:26 pm #

        Amy, thanks for your answer and for the blog.

        I haven’t come across the data showing this, but twilight sleep and/or general anesthesia was clearly a terrible idea. It raises an interesting point though. At the time, this was considered to be the best practice for birth, but was later shown not to be so. While medicine is far better and more evidence based today, it seems reasonable that certain common practices today could later be shown to be detrimental to maternal or fetal health. To me it seems that avoiding procedures that have not been well studied and shown to have clear benefits would be the wisest course of action. The key then seems to establish whether things are beneficial, detrimental, or neither using the best available data.

        An easy example seems to be cord clamping. There’s no evidence of benefit or detriment, so what’s the harm in delaying for a minute? Assuming mother and baby are in no distress, of course. A similar case would be prophylactic erythromycin. If the mother has tested negative for bacteria that typically cause ophthalmia neonatorum, and the condition is treatable with good neonatal care, why use antibiotics if they’re not needed?

        I’m not trying to be confrontational, just trying to see whether this approach makes sense.

        • AlisonCummins
          January 16, 2014 at 5:47 pm #

          Brett, in general your wife’s OB should be able to explain her reasoning for various decisions. You aren’t going to be able to cram eight years of training into eight months of internet research, so you can be releived that the OB has done it so you don’t have to. These are *exactly* the kinds of questions that clinical practice is all about and the OB will address them if you ask.

          There are a lot of things that OBs just don’t care about that much in most cases. Cord clamping is one of them. If you want to wait a minute the OB will be fine with that unless there’s a problem of some kind.


        • Box of Salt
          January 16, 2014 at 6:09 pm #

          Brett Longworth, please forgive me for butting in, but since you did start out saying “My wife will make the final decision, but …”

          My suggestion is you let your wife make the decision when the time comes. It’s not going to be your pain – let your wife figure out for herself what she can tolerate.

          No “buts.”

          (Yes, tongue in cheek; no less true because of that)

        • Young CC Prof
          January 16, 2014 at 7:36 pm #

          “While medicine is far better and more evidence based today, it seems reasonable that certain common practices today could later be shown to be detrimental to maternal or fetal health.”

          Good point. It’s extremely difficult to show that something is really safe. However, one CAN say that scientists have looked pretty hard for evidence of harm and failed to find any. And yes, sometimes it does happen that initial trials showed something to be reasonably safe and harm shows up later, but in that case, the harm it tends to be minor, indirect or rare.

          Twilight sleep was implemented without a lot of research, and during the 1960s and 70s, obstetricians were able to demonstrate that it led to more breathing problems in newborns. Before epidural anesthesia was brought into general use, researchers carefully looked for evidence of poor newborn outcomes.

          So, twilight sedation for normal labor is out. General anesthesia is still used occasionally, but only for dire-emergency cesarian births where either an epidural is not available, it’s contraindicated in the mother, or there isn’t time to administer one. (This is one reason why it can be safer to have an epidural in labor: if things go wrong in a hurry, you can get into surgery faster, without the risks of being knocked out.)

          As for delayed cord clamping, the benefits are small, but most OBs have no problem doing it. The only reason NOT to delay cord clamping is the rare case when a baby is born blue or otherwise in need of immediate medical attention and resuscitation. In that case, the cord must be cut immediately so the baby can be carried over to the work table.

    • Maria
      January 16, 2014 at 6:19 pm #

      Hi Brett, I just wanted to steer you to a blog you might appreciate. The Adequate Mother is written by an anesthesiologist and she does a great series of posts on epidurals (with links to sources you can read on your own). http://theadequatemother.wordpress.com/epidurals/

      I found her info well balanced and a refreshing change from the drama found on so many other discussions of choices afforded to women/families during labor and birth.

  38. Christa - OB nurse
    December 30, 2013 at 11:41 pm #

    You are awesome!

  39. Hollie
    December 27, 2013 at 9:23 am #

    Gosh, you don’t do anything in moderation do you? Like the medical care you provide by the looks of it. You focus on the illest of the ill of women, the most extreme of maternal decisions which happen rather infrequently, and you seem to not really reason anything.

    I wouldn’t hazard at you being very good in a debate about childbirth, if simply for the fact that you seem to think that those with thoughts and feelings about childbirth fall into two distinct categories: “Earth-mothers” who refuse all and any maternity care and rely 100% on how they “feel”, and those who believe that any semblance of normality in childbirth is unsafe, unreliable and totally undesirable.

    I’ve actually considered that this blog is some deliberate, ironic reaction to the above Earth-mother type. You’re so morbidly focused on the wonders of intervention that it surely has to be a joke.

    I know you also probably think I’m one of the Earth-mother types. As opposed to a truly flexible, knowledgeable, balanced practitioner.

  40. Natural and Informed
    December 26, 2013 at 6:49 pm #

    It makes me angry when homebirth centers fill the heads of well meaning Moms who only want what’s best for their baby, with false surety and then to see the faces of those Moms, disillusioned and in painful shock as they walk into the NICU to see their precious baby because the “Home Birth” went tragically wrong. Now looking at the Physicians and hospital staff with imploring eyes instead of distain.

  41. slinky jets
    December 2, 2013 at 2:16 pm #

    i feel sorry for you dr amy. why are you so angry? it’s ok for people to have a different perspective and i think that’s what this comes down to. i am an advocate of homebirth but more of an advocate of informed decision-making and being comfortable with one’s choice. reading your articles and replies to posted comments i can’t help but feel you’re missing out and it’s sad to see someone so well-educated have such a stilted view. the best part of learning is understanding that we can never stop learning unless we choose to. it seems as though you’ve chosen to. i’m certainly not trying to educate you, only open your mind. when i first started reading your stuff i got a little angry, but the more i read, the more i just feel sorry you.

    • moto_librarian
      December 2, 2013 at 2:22 pm #

      If you are truly interested in engaging with Dr. Amy and the other commenters, why don’t you try commenting on a current post?

    • Amy Tuteur, MD
      December 2, 2013 at 2:31 pm #

      Why am I angry? Because innocent infants die preventable deaths when their mothers are so gullible they believe the crap broadcast by homebirth advocates. Why aren’t you angry about these deaths?

      I notice you can’t manage to rebut a single factual assertion in this piece, but I’m not surprised. No other homebirth advocate can, either.

  42. Harper
    November 30, 2013 at 10:42 am #

    It’s appalling that you are spouting this information in such a vitriolic way. Instead of uselessly trying to force your hand, why don’t you advocate for making safer options to those who are seeking home birth and/or midwifery? It reminds me very much of the anti-abortion debate. People who want to take away safe, legal abortions are creating a market for highly dangerous procedures. As far as I can tell, that’s exactly what you are trying to do to home birth. You can not convince the world that your way is the right way, because every person is different. What you can do is facilitate safety with your knowledge and expertise. When things like this are made illegal, they are made dangerous.

    • Young CC Prof
      November 30, 2013 at 10:53 am #

      Dr. Tuteur has never ONCE said that home birth should be illegal, not in this post or anywhere else, and most posters here believe that outlawing home birth is not a practical solution. Instead, women should be made aware of the real risks of home birth.

      The only thing that should be illegal is for people with minimal training and no malpractice insurance calling themselves midwives and charging money to assist with planned home birth. It would be far better if women who were determined to home birth sought care from certified nurse-midwives who had a good relationship with the nearest hospital, instead of grannies who have an adversarial relationship with local hospitals, the way so many do now.

  43. Bethany
    November 26, 2013 at 9:54 pm #

    I know you wrote this over a year ago, but I just want to stand up and applause. This subject is something I feel strongly about, not only as a supporter of science and women’s healthcare, but also because a friendship was ruined over it.

    One of my best friends became pregnant (she didn’t know that women’s actual time of ovulation can vary from the 2 weeks before menstruation model), and though she was always a crunchy type, she reached entirely new levels of ridiculous. All she ever talked about was how hospital births and OBs are terrible, homebirth is best, vaccination hurts babies, all scientific studies are bought out by Big Pharma etc. I was studying Biology, and scientific thinking is important to me. Reasoning with her accomplished nothing. She ended up with a healthy daughter thankfully, though she ended up giving birth alone without any support since her midwife did not get there in time.

    It enrages me that she put her daughter at risk over this unscientific BS. She isn’t taking her daughter for well-baby visits, she had Group B strep yet still had a homebirth, she and her boyfriend do bedsharing

  44. TC
    November 13, 2013 at 7:56 pm #

    Ultimately at the heart of each issue you raise, the message is, I am uncomfortable with others challenging my training in patriarchal western medicine. I am insecure with my role as mother as a career choice and in order to prove to myself and others that I am in fact contributing(intellectually, because that is what I value most) I will work against what I perceive as a threat to my title, MD. And by the way, if it wasn’t already obvious, I really would like you to remember that I have a comma after my name with an MD following it. God forbid; I have little to no identity without it.

    That being said, Amy, this blog would be much more tolerable, perhaps even readable if you came to this conversation with humility and a willingness to learn from another–even a labor assistant/Doula.
    Furthermore, it is silly to state that labor assistants have ‘just’ high school educations.
    Many labor assistants have Masters level educations and beyond. This blog only polarizes the conversation even more than it already is polarized.

    • Captain Obvious
      November 13, 2013 at 8:07 pm #

      Well I hope if these Masters level educated labor assistants are assisting as a part time gig. I would hate to pay for that level of education and only get paid at the level of a doula.

    • Young CC Prof
      November 13, 2013 at 8:08 pm #

      TC says: I am uncomfortable with others challenging my preconceived notions. I cannot accept the idea that not all sources of knowledge are equal, and that training, experience and the scientific method allow others to speak with authority that exceeds mine, derived from armchair speculation and casual reading.

    • The Bofa on the Sofa
      November 13, 2013 at 8:21 pm #

      Yeah, I guess whining is easier than actually addressing the content.

    • Amy Tuteur, MD
      November 13, 2013 at 8:41 pm #

      In other words, you can’t rebut my factual statements so you’ll attack me personally. Welcome to the club of homebirth advocates who cover their own ignorance with ad hominems! You have plenty of company.

      • ngozi
        May 2, 2014 at 11:41 am #

        Ok, so now the complaint is that you use MD behind your name?? And OMG you do it with a COMMA! Shame on you!!

  45. ophelia
    November 9, 2013 at 9:30 am #

    I understand the Netherlands may have a higher neonatal fatality rate than other Eu countries, but how does it compare to the US? Everything I can find shows their rate is lower than the US (by 2 deaths per 100,000) despite 1/3 of the women doing homebirths…. I seriously can’t find anything that says otherwise.

    And having childbirth be a “leading cause of death” doesn’t mean childbirth is inherently dangerous. The risk of death for women of child bearing age overall is very very low, period. There has to be *something* that is going to be “the leading cause of death” at ANY age & in any group and that does not mean that thing is “inherently” fraught with danger. Car accidents are the leading cause of death in children from 1-14 yrs old last I knew….I don’t see my car as a death trap though every time I take the kids to the park. I feel extremely confident that when we get into the car we will arrive safely & most people think the same thing if they are honest. We all know accidents can happen, yet we have the good common sense to realize that it probably won’t, otherwise we’d all be stuck at home paralyzed with fear to load the kids up & go. So yes, some children will die in car accidents while the majority will actually make it to adulthood without ever having been in a car accident at all. I do find it troubling to see someone who is educated fear monger over a medically normal event. Pregnancy & birth are not an illness…they are a normal thing that all mammals undergo. If we are experiencing a high rate of complication that creates an unsafe situation then we would be best off to address the overall health of our population rather than to assume that interventions at the end of pregnancy are the best course of action.

    • Becky05
      November 9, 2013 at 9:40 am #

      The Netherlands has a slightly higher perinatal mortality rate than the US. Perinatal mortality looks at stillbirths and neonatal deaths, both.

      The WHO estimates that childbirth has a natural (ie, without any medical intervention at all) maternal mortality rate of 1 -1.5%. The natural perinatal mortality rate is even higher. This certainly counts as inherently dangerous in my book. And many mammals also have high rates of wastage in reproduction; childbirth is dangerous for many species of animals.

    • Becky05
      November 9, 2013 at 9:42 am #

      Also, I think most people ARE well aware of the dangers of driving or riding in cars, and work to mitigate those dangers. They wear seat belts and use child restraints for their children. They look at safety records of the vehicles they purchase. We require those who drive to have demonstrated a certain proficiency with driving and to be licensed to drive, we require all drivers to have insurance to cover liability in the case that a collision requires despite the steps taken to mitigate the risk. Various agencies from local governments to insurance companies support additional defensive driving education to further limit the risk of driving. We teach pedestrians to constantly look out for vehicles, etc.

      Dr. Amy isn’t saying, “Be terrified of and anxious about childbirth!” because that isn’t going to help anyone. She is saying, “Childbirth has inherent risks and it is only through awareness of those risks that we can work to reduce risk.”

    • Young CC Prof
      November 9, 2013 at 9:51 am #

      I love that you are asking the right questions. Let me keep giving you clear answers.

      First of all, your last sentence was brilliant: “If we are experiencing a high rate of complication that creates an unsafe situation then we would be best off to address the overall health of our population rather than to assume that interventions at the end of pregnancy are the best course of action.” A large number of pregnancy complications are related to pre-existing health problems or lack of prenatal care, which in turn is related to poverty and lack of access to care.

      However, the US is really not doing that badly overall. As Becky said, the relevant number is not neonatal deaths, but perinatal deaths. Listen carefully: Just like I told you about maternal mortality, our infant mortality numbers suffer from a reporting problem. You see, in the US, a baby who is born horribly premature or with hopeless birth defects and breathes only a very short time is more likely to be classes as a newborn death. In Europe, that baby might be listed as a stillbirth. The perinatal death rate controls for this reporting error, and in fact, if you look up the numbers, the USA and most of western Europe have similar perinatal death rates, but in Europe, more babies are “shifted” from neonatal deaths to stillbirths.

      This WHO report has all the relevant data: http://whqlibdoc.who.int/publications/2006/9241563206_eng.pdf

      As you can see, the Netherlands have a perinatal mortality rate of 8 babies per thousand, while ours is 7. (Sweden is one of the best in the world, at 5 per thousand. Why are they better than us? Probably because their poverty rate is so low.) Like you said, if we want to lower our rate further, we need to address poverty and poor health throughout the lifespan.

    • Paloma
      December 16, 2013 at 2:51 pm #

      To compare the mortality rates of two countries there are many factors to take into account. I haven’t compared the mortality rates for the Nederlands and the US, but I have compared them each to my own country (Spain). In both cases, Spain has the lowest. It is no coincidence that homebirth here almost never happens, both because mothers have their childs life as a priority and also because, like in most european countries, healthcare is free, unlike the US. This might not seem important, but when not everyone has healthcare coverage mortality raises, just because not having access to a doctor when needed is obviously a cause of death.
      Birth is dangerous, there are many things that are more dangerous, as you pointed out cars are too, which is why there are traffic laws to prevent accidents, and seat belts. Hospitals are the seatbelt for a birth. You expect everything to develop with no complications, but if something were to happen, you have trained and prepared professionals to deal with it. This doesn’t mean it is impossible to die in a hospital, but does make it a lot less likely.

  46. ElizabethJ
    October 14, 2013 at 10:52 am #

    The strident tone of this piece unnecessarily masks its intelligent content and retards productive conversation rather than furthers it. If you want to keep preaching to the converted, then the tone of this blog is perfect. If you actually want to change minds and perhaps save lives, consider treating your adversaries with a modicum of respect.

    • JT
      October 28, 2013 at 12:13 am #

      Honestly ElizabethJ, I don’t think Amy wants to do anything other than scare and undermine. The bitterness woven through her blog is sad. You are correct in saying that a modicum of respect would be good – problem is it doesn’t appear Amy has any respect for her fellow women. More’s the pity.

      • theNormalDistribution
        October 28, 2013 at 1:01 am #

        Respect… I don’t think that word means what you think it means.

      • October 28, 2013 at 3:33 am #

        I thought respect included respecting your audience as mature human beings who could read information and process it. Silly me, I guess it means coddling people and hiding (highly appropriate) anger at people who would be so foolish as to write off the unnecessary deaths of both infants and adults.

        Oh wells, learn something new about vocabulary every day, I guess.

      • Eddie Sparks
        October 28, 2013 at 6:01 am #

        I haven’t read everything that Dr Amy has written, but I have just read the above article twice. Could you please quote the specific passages that you thought were disrespectful to women, because I am not seeing it.

      • ngozi
        May 2, 2014 at 11:43 am #

        Do you hold the NCB websites to such standards? They can be pretty mean too.

  47. Ellie San Martin
    October 14, 2013 at 1:15 am #

    How do inductions affect mothers? Are there any posts considering the birthing mother as a human being rather than a potential dangerous environment for the baby?

  48. blinkered27
    October 6, 2013 at 11:46 am #

    one other thought – If we surgically removed all the breasts of women over 50, we’d have far less women die of breast cancer.

  49. blinkered27
    October 6, 2013 at 11:19 am #

    ‘the only reason you need a birth attendant is to prevent, diagnose and manage complications’

    you really think that? So the huge percentage of women who don’t have complications during childbirth don’t benefit from having a birth attendant present? Of course medical intervention is necessary for some women. Of course it saves lives. Of course obstetricians do an amazing job. But I don’t want a unnecessary interventions any more than I want my bladder catheterised if I can still pee naturally.

    There are different kinds of birth attendants who have different roles to play in making birth a safe and positive experience. There is no need to hold one profession in higher esteem than another. Yes, it’s annoying when other people try to tell you that you’re a surgeon because they think they know more about what they do than you do. It’s equally annoying to tell a different kind of birth attendant that what they do doesn’t matter, just because it’s different from what you do. Let’s try listening to obstetricians about why obstetrics is important, and midwives about why midwifery is important, and nurses and doulas and mothers and electricians and gardeners. Perhaps then we might stop offending everybody under the sun and accept that we are all doing different jobs and don’t actually need to compete with each other.

    • Captain Obvious
      October 6, 2013 at 11:37 am #

      That would be nice, except too many bad outcomes come from the Homebirth midwives. There is nothing wrong with CNM. You do understand the difference Dr Amy is pointing out between well trained CNM and self appointed birth junkies like DEM and CPM.

      • Susan
        October 6, 2013 at 11:42 am #

        Aye Aye Captain. Dr.Amy has always spoke highly of CNMs calling them “real midwives”. It’s so important to note in Europe that CPMs would not qualify as midwives at all.

        • blinkered27
          October 6, 2013 at 11:49 am #

          thank you for pointing that out. I don’t know as much about the american system and would agree that birth attendants need adequate training or they do more harm than good! Contentious question is how much training is ‘adequate’.

          • DaisyGrrl
            October 6, 2013 at 12:13 pm #

            At least one four-year university degree plus practicum. The US is the only developed country that accepts less than that.

  50. Carrie
    October 4, 2013 at 1:40 pm #

    Regarding #11, if maternity mortality is indeed rising (and, like you said, this is not clear), I wonder if it would have more to do with the rise in other things like obesity, diabetes, heart disease, etc., along with the fact that there are more “older” (and therefore higher risk) mothers in recent years. I don’t know why that would have anything to do with obstetrical care per se, and certainly not why home births would be the answer to this alleged problem!

    Dr. Amy, I don’t always agree with what you say or how you say it, but I must thank you for this information. Some “natural birth” circles are very loud, very forceful, and very bullying. While home birth would never have been an option for me, I WAS sympathetic towards it, and your information has helped bring me to a more sane state of mind about it.

  51. eribra
    September 25, 2013 at 3:49 pm #

    I don’t even remember how I was directed here but I really, really enjoy your blogs Dr. Amy. Great statistics, no nonsense truth. Glad I found you!

  52. Rachael
    September 24, 2013 at 5:30 pm #

    Doctors like you are the exact reason I have a midwife! Birth is over medicalized by doctors need to control situations rather than trusting a mom to know her own body.

    • Amy Tuteur, MD
      September 24, 2013 at 5:38 pm #

      Ptients like you are the exact reason why midwives have patients even though they are not as knowledgeable, skilled or effective at saving lives. They’ve managed to convince you that “medicalizing” birth is a problem (although it has lowered the neonatal mortality rate 90% and the maternal mortality rate 99% in the past 100 years) and they’ve managed to convince the gullible that “trusting” has any impact on anything.

    • September 24, 2013 at 6:21 pm #

      Fuck no I don’t trust my own body! Excuse my language, but my body tries to cause me to want to self-hysterectomize (yes I know that’s not a word) myself every few months with incapacitating menstrual cramps combined with severe nausea if I don’t have hormonal birth control. It has tried to kill me by failing to fight off infections a few times. My mom has had two very easy births and one “sunny-side up” one where she got an epidural because she wasn’t progressing due to the pain. Can you imagine how horrible that one would have been without being in the hospital?

    • Karen in SC
      September 24, 2013 at 6:30 pm #

      I had two unmedicated births in a hospital, and there was no “knowing” about it! The pain was mind-numbing and I was barely aware of anything outside of the pain. I had special doula-led prep classes too, and had a doula to help.

      Second birth was a week late, mec aspiration, blue baby, so thankfully I was in the hospital and happy for the medicalizing that helped him. How come I didn’t “know” that in advance???

    • Mishimoo
      September 24, 2013 at 7:16 pm #

      Knowing my own body is why I chose to deliver in a hospital. Trusting that I know my own body, coupled with the readouts from CFM, meant that I received the interventions that we needed and I had requested. I had midwives, they do practice in hospitals too.

  53. Red
    September 17, 2013 at 2:42 pm #

    Hi Dr. Amy, I just “parachuted in” to “educate” you on the fact that you seem to have a huge chip on your shoulder. Did you go to medical school just to prove how much better you were than everyone else? Maybe cut the caffeine.

    • Dr Kitty
      September 17, 2013 at 2:49 pm #

      Did you not go to medical school because you just weren’t smart enough and realised it was better not to apply, or because you were this rude and obnoxious in the entrance interview and they decided not to let you in?

      • Red
        September 17, 2013 at 6:18 pm #

        I’m certain I am smart enough for medical school, but that’s never been one of my interests. I do, however, have several degrees in Internet trolling. The efficacy of my technique is evidenced by your replies. Thanks!

        • I don't have a creative name
          September 19, 2013 at 8:31 am #

          Efficacy being troll-speak for “I have nothing of real substance to contribute to any conversation, so I’ll pretend to feel smugly satisfied that I got people to answer my inane attempts at insult.”

          • Red
            September 30, 2013 at 9:58 pm #

            Sure, if that works for you.

    • Amy Tuteur, MD
      September 17, 2013 at 2:57 pm #

      I went to medical school because the practice of medicine is fascinating, intellectually challenging and offers countless opportunities help others.

      I didn’t go to feel superior to anyone else. When it comes to sanctimonious self-aggrandizement, I couldn’t possibly compete with NCB and homebirth advocates who like to pretend that how they give birth is an achievement.

    • ngozi
      September 17, 2013 at 2:59 pm #

      That was immature, to say the least.

  54. Dizzle
    September 11, 2013 at 10:05 am #

    I would never purport to say that c-sections are unnecessary; but is it true that the rate of c-sections to vaginal births has/continues to increase? What is responsible for the increase? Should we be concerned?

    • Sullivan ThePoop
      September 11, 2013 at 10:32 am #

      The increase is because other instrumental deliveries have decreased. C-sections have a more reliable safety rate than other instrumental deliveries.

  55. AlwaysAsking
    August 30, 2013 at 9:02 pm #

    Why does everything have to be one way or the other? Where is the balance? I am currently pregnant with twins, I see my regular OB, a Maternal Fetal Medince OB, and a chiropractor. I love them all. They all have their place and their abilities. Plus, yes, I have a doula, because I want to do this without any drugs or interventions, and yes I need someone to remind my I am capable when it hurts like hell. But I will still deliver in the Operating Room at a hospital, because I understand there are risks, and some are not worth taking.

    • Young CC Prof
      August 30, 2013 at 9:38 pm #

      And there’s your balance, and that’s fine for you. You are doing what makes you comfortable while keeping you and the babies safe. No one here objects to you planning a natural birth, in a hospital with emergency help right on hand if necessary. (Of course, there are a few mothers who have known risk factors that make safe natural birth impossible, like placenta previa, but that presumably doesn’t apply to you.)

      Dr. Amy’s beef (and mine) is with people who would charge you money to deliver those twins at home and try to tell you this is totally safe and nothing could possibly go wrong. Or people who would try to shame you if you wind up needing interventions.

    • Tim
      August 30, 2013 at 10:05 pm #

      There is such a thing as legitimate, responsible chiropractors who admit and practice to the limit of what their training can provide (eg; the same kind of relief and treatment a physical therapist could provide) – there is also a whole lot of quacks who tell people that having proper spinal alignment can make them not be/get sick. Nobody here has a problem with the former I’d wager. The latter.. well..

    • Ainsley Nicholson
      September 1, 2013 at 12:26 am #

      You seem to have found a good balance. I had my twins in the hospital with a doula, just like you are planning to. I wanted to avoid pain meds if I could, despite being induced, and my labor was quick enough that it’s a good thing I didn’t want pain meds, cause there wasn’t time for them anyway! (I did have some dark moments during transition….) So it can be done!
      I am curious why you pose the question about balance in response to this particular blog post, which addresses the hyperbole surrounding certain of the NCB movement’s claims. What is not immediately obvious to visitors of this blog is that the “Natural Childbirth” being promoted by the NCB movement is very differant from what you or I might think of as “Natural”. To me, “natural childbirth” always meant maximizing my chances of having an uncomplicated vaginal delivery- I choose to go without pain meds and hired a doula in hopes that doing so would help acheive that goal. The NCB movement, on the other hand, seems to be anti-science and anti-medicine simply for the sake of being anti-science and anti-medicine. How do you find a balance with that?

  56. carolyn Gall AAHCC
    August 28, 2013 at 8:58 am #

    You know it occurred to me that this is like talking politics here. Like the Republicans vs. the Democrats. You have your reasons for your belief’s I have mine. Each side is convinced they are right. We could argue all day long. The fact remains that I have the right and the freedom to birth at home. No one can take that right away from me. Sorry if you don’t like my choices. I have spent a great deal of time reading information on the subject and I am comfortable with my choice. It’s pretty common for people who are using statistics to present them in a favorable way. Or a way that promotes their side. Heck, politicians do it every day. Like I said. I will come back here after my birth and let you know how it went. I have faith in my body to birth my baby without any medical interventions. If you continue to disagree with me then I will have to post links to all the information I found online that supports my choice.

    • ngozi
      August 28, 2013 at 9:13 am #

      I don’t think that anyone is kicking your right to have a homebirth. This is America (I assume you live in America, if you don’t, I apologize for jumping to conclusions). But people who support homebirths and natural births have sites that bash hospital births with or without medical interventions. I don’t agree with everything Dr. Amy says, but she has a RIGHT to say it. If people have a right to present the problems that can arise from having a hospital birth, then why can other present the problems–the very real problems–that can arise from having a homebirth. A birth performed anywhere under any conditions still has its risks, no matter how small. What is wrong with discussing the opposing viewpoints?

      • Carolyn Gall AAHCC
        August 28, 2013 at 9:16 am #

        Good. Normal dialogue. Sane discussions. Now we are getting somewhere.

        • ngozi
          August 28, 2013 at 10:29 am #

          I’m being called sane! Write me a reference letter!

    • Durango
      August 28, 2013 at 9:23 am #

      All the links you’re thinking of posting that “support your choice” have already been posted to the blog by others in the past and have been thoroughly deconstructed by those who actually can unpack and interpret statistics. You have nothing new to offer. How do I know? Because all you homebirth advocates spout the exact same thing every time and somehow think that you have this special knowledge.

      It’s fascinating to me, actually, that you all come here spouting your NCB-talking points, completely unaware that that is what they are. It’s as if you all have a form letter to fill in for commenting here, so similar are your posts, complete with meaningless letters after your names.

      • Carolyn Gall AAHCC
        August 28, 2013 at 9:30 am #

        The letters after my name are for The American Academy of Husband Coached Childbirth. I take exception to your saying they are meaningless. It means a lot to me to be able to teach natural childbirth to couples who seek training. You are insulting me. I have credentials to teach.. not medical credentials. I don’t practice medicine.

        • Amy Tuteur, MD
          August 28, 2013 at 9:39 am #

          Your credentials are about as meaningful as a degree in astrology.

          By the way, “husband coached childbirth” is completely unnatural. There is no evidence in all of recorded human history that male partners were ever involved in childbirth, and there are no mammals that I know of in which male partners are involved with childbirth.

          • ngozi
            August 28, 2013 at 10:33 am #

            I can go for husband coached childbirth a lot better than I can homebirths. But that is because of personal experience, not anything scientific.

          • a Homebirther
            August 28, 2013 at 12:15 pm #

            Dr. Tuteur, Your credentials are as meaningless to me as a token in a box of Cracker Jax. You aren’t even a practicing OB Dr. You hate women, you don’t even think we can birth our own babies without surgeons and hospitals and drugs up the wazoo. You are a complete quack and everyone in the community knows it. Why don’t you give it a break and go back to your home where you can bake pies and be a good homemaker. Since you seem to live in the 1950’s era. Thank God you don’t practice Obstetrics anymore. Think of all the babies and mamas saved because you aren’t in any hospital drugging them up and cutting them up!

          • The Bofa on the Sofa
            August 28, 2013 at 12:29 pm #


          • ngozi
            August 28, 2013 at 12:38 pm #

            Have you talked to any of her former patients? Not to defend her (she can probably do a better job of that than me), but why doesn’t she have the right to present an opposing viewpoint?

          • Amy Tuteur, MD
            August 28, 2013 at 12:54 pm #

            Carolyn, stick to your original screen name.

          • The Bofa on the Sofa
            August 28, 2013 at 12:54 pm #

            Sock puppetry: #1 sign you’ve lost it.

          • homebirthers rule
            August 28, 2013 at 3:49 pm #

            No. I’m sure half of these responders are you in disguise

          • Amy Tuteur, MD
            August 28, 2013 at 4:12 pm #

            Carolyn, this is your second warning. Next time you’ll be banned.

          • Homebirthrocks
            August 28, 2013 at 4:40 pm #

            Ah ha! I finally got to the old hag. She’s going to kick me off of here because she doesn’t like my user name! LOL! When half these people are most likely her with various names as disguise! What a joke you are. I bet this doesn’t even get posted because I was *banned* from here. Bye idiots. Bye quack Dr. Nice knowin ya

          • Karen in SC
            August 28, 2013 at 4:41 pm #

            But but but how will you be able to come back and trumpet your homebirth success?

          • Poogles
            August 28, 2013 at 6:16 pm #

            “She’s going to kick me off of here because she doesn’t like my user name! ”

            Or because sock-puppetry is generally frowned upon by bloggers and most decide not to allow it to run rampant in their comments. It’s disruptive, misleading and confusing.

          • LibrarianSarah
            August 28, 2013 at 6:49 pm #

            Is it just me or did Carolyn’s entire tone change with the change of the username, even after she was called out on being a sockpuppet. Creepy…

          • Bombshellrisa
            August 28, 2013 at 7:07 pm #

            She probably realized that a simple google of her name brings up her website and on that she links to a newspaper article about herself, one that gives personal info. She probably thinks we are going to ruin her homebirth by showing and protesting on the lawn. Then again, she thinks that we are all Dr Amy so that would be only one person protesting on the lawn

          • LibrarianSarah
            August 28, 2013 at 7:50 pm #

            I hope that is what it is but it is still as creepy as hell to see someone go from “I am here to have a discussion and have a right to my opinions” to “You are all stupid old hags fu fu fu!!!!1”

            Usually we get one or the other seeing both in one person is pretty un-nerving. Her using different “handles” between the two persona’s gives it a shade of “Hollywood Multiple Personality Disorder” that adds to the creep factor.

            Or maybe it’s me. Today has been a rough day and I am exhausted.

          • Bombshellrisa
            August 28, 2013 at 7:56 pm #

            It’s not just you. There is something running rampant today, some strange vibe everywhere.

          • LibrarianSarah
            August 28, 2013 at 7:58 pm #

            I’ve had “Don’t fear the Reaper” stuck in my head all day as well. If I believed in omen’s I’d be scared right now.

          • The Bofa on the Sofa
            August 29, 2013 at 10:02 am #

            I hope that is what it is but it is still as creepy as hell to see someone go from “I am here to have a discussion and have a right to my opinions” to “You are all stupid old hags fu fu fu!!!!1”

            She may have came in pretending to wanting to “have a discussion” etc, but it was pretty transparent. She may as well have given up pretending, because she wasn’t fooling anyone.

            I don’t think it really is multiple personalities. Her true self was pretty apparent from the beginning.

          • Squillo
            August 29, 2013 at 10:40 am #

            I suspect that’s true. She wanted it both ways: Carolyn Gall AA-whatever is the name under which she does business, so she probably thought arguing “rationally” with Amy would be good for her image–or at least, wouldn’t hurt it.

            When she ended up embarrassing herself under her business name, she resorted to the predictable tactic of sock-puppetry, not understanding that she’d be called out. So now it’s doubly embarrassing. Like Kim Mosny. (Hey, wasn’t she going to sue Amy for butthurt in the first degree or something?)

          • LibrarianSarah
            August 29, 2013 at 11:05 am #

            I don’t really think she has Multiple Personality Disorder (we’re talking about a condition so rare that thereis a debate among medical professionals on whether or not it exists here.) I wouldn’t have said anything if I did. I think less than 1% of the people coming here to have a “conversation” actually want to have a civil conversation but most don’t drop the pretense so quickly. It might have been less jarring if I read it in “real time” but alas I had too much shit to do yesterday.

          • anion
            September 21, 2013 at 10:16 pm #

            Creating sockpuppets is excellent practice for all the obfuscation of facts she’ll be doing when one of her oh-so-safe homebirths goes wrong and the police ask her what happened.

          • An Actual Attorney
            August 28, 2013 at 8:25 pm #

            If we’re all Dr. Amy, does that mean she needs to break it to her husband that she’s really a lesbian, or do I have to tell my wife I’m really a doctor?

          • Durango
            August 29, 2013 at 8:59 am #

            And, like all the NCB nutters before her, she flounces.

          • Captain Obvious
            October 7, 2013 at 8:00 am #

            No, you didn’t “get” Dr Amy, and your adolescent posts are still here demonstrating what an idiot you are. You must have been the smartest one in your class with comments like those, 😛

          • Karen in SC
            August 28, 2013 at 4:39 pm #

            That’s a good one. These commenters are so varied, multi national, blog owners themselves in some cases. There’s a few FB pages where we hang out, real pictures, real babies, real families. No commenter is Dr. Amy in disguise.

          • Amazed
            August 28, 2013 at 7:12 pm #

            Hey, I am! I am Dr Amy Number Seven!

            Who might you be?

          • An Actual Attorney
            August 28, 2013 at 8:28 pm #

            But are you Seven of Nine?

            My geekery amuses me.

          • Amazed
            August 29, 2013 at 9:41 am #

            Well, I’ll admit that… I am not sure who I am. You need to ask Carolyn.

            But don’t tell.

          • Squillo
            August 29, 2013 at 10:20 am #

            I’m Brian, and so’s my wife. Or maybe I’m Bonnie Offit. Is it Tuesday?

          • Jackie
            August 28, 2013 at 1:09 pm #

            Didnt dr. Amy have 2 unmedicated births? Just pointing out how truly ignorant you are. And age is a risk factor.

            This is a serious though, did you get pregnant naturally at 50?

          • carolyn Gall AAHCC
            August 28, 2013 at 3:46 pm #

            Yes I did.

          • Captain Obvious
            October 7, 2013 at 7:56 am #

            Just have to link this here.


          • potkettleblack
            November 13, 2014 at 9:20 pm #

            There are no non-human mammals that I know of that have birth attendants of any kind – male or otherwise at their births. Using the logic above, that would make OBs, MWs, etc unnatural at births. Most every other mammal eats their placenta. Is it unnatural that we don’t eat ours?

        • attitude devant
          August 28, 2013 at 9:41 am #

          Made-up credentials to teach a totally made-up brand of NCB indoctrination. Nobody recognizes your stupid acronym because in the real world it IS meaningless.

          • The Bofa on the Sofa
            August 28, 2013 at 10:03 am #

            It’s not just that nobody recognizes the acronym, or that it is meaningless in the real world, it’s that the crap that she is spouting is clearly wrong to the extent of being dangerous (a 50 yo is a high risk patient, and denying that is dangerous).

            Her spouting her supposed credentials has made it a lot of fun to mock her, sure, but the reason she is treated like a fool is not because of her credentials, but because of what she says.

            The same happens with Jay Gordon, who signs everything MD, FAAP. Now those are absolutely legitimate credentials. Doesn’t stop him from being a fool. It’s not the supposed credentials that matter here (there are a lot of highly credentialed people here in lots of areas), you are judged on what you say.

          • Carolyn Gall AAHCC
            August 28, 2013 at 12:10 pm #

            see below

        • Captain Obvious
          October 7, 2013 at 7:53 am #

          If you trust birth, then why do you have to teach the husbands? Can you use your “letters” and get a job with them in any other country? Will the UK or Canada hire you?

      • August 28, 2013 at 1:14 pm #

        I’ve found the same from religious apologists, actually. They come in waving various arguments about as if these are new and special arguments, and the people who are regulars on the boards sigh and prepare to debunk Pascal’s Wager for the eleventy-millionth time.

    • Lizzie Dee
      August 28, 2013 at 1:18 pm #

      Do other people have to like your choices? You make them, you live with the consequences of them, what difference does it make what other people think of them?

      If you choose to paint every room in your house a particularly virulent purple, people may wonder about your choice, but are not really going to care much. If, on the other hand, you try to argue that purple is absolutely the best, the only choice, and that people who paint their homes purple have a much better quality of life and are ever so, ever so admirable then that might be provocative. Most people don’t choose purple. Most people don’t choose the extra risk of homebirth.

    • Karen in SC
      August 28, 2013 at 4:36 pm #

      Yes, it is your choice and it seems you have taken care to minimize risks, although the risk is not zero. Lisa from NY, a regular commenter, has a 50 yr old neighbor that had a homebirth last spring. Almost bled to death, transferred to the hospital and spent some days in the ICU. A close call and who knows what aftereffects to mother?

      I hope you and your baby have healthy birth, wherever it happens.

    • Some Lady
      September 8, 2013 at 8:23 pm #

      Some of these are not about “beliefs” though. You can not “believe” home birth is safer if the scientific peer reviewed studies prove the opposite. You cannot claim that induction harms babies if the scientific peer reviewed journals prove the opposite. A person presented with facts cannot say, “Well, you have your belief’s [sic] and I have mine.” It’s not like politics. And even in politics, especially in politics, the cognitive dissonance is appalling.

    • Captain Obvious
      October 7, 2013 at 7:49 am #

      No, what your analogy should be is a parent talking to their 10 year old child. You won’t believe the evidence and you want to come back and prove to us that you can birth at home without complications. Yep, no politics analogy there, just a parent and a child.

  57. Carolyn Gall AAHCC
    August 27, 2013 at 11:13 am #

    Obviously you are mocking me. Well, at least I know where to find you if I need cherry picked data and fear mongering. And a heavy dose of guilt. BTW, I am 50 years old too. Does that make me.. shudder… a high risk home birther?

    • The Bofa on the Sofa
      August 27, 2013 at 11:20 am #

      You are high risk anywhere.

      Wake up, Carolyn. On-line discussion is a game. Your baby is real life. Stop playing around and take it seriously.

      • Carolyn Gall AAHCC
        August 27, 2013 at 11:21 am #

        I have had nothing but sarcasm since I started this discussion. If you were really concerned you would be more serious with me. I am always researching information online and came across your website. How can I take you seriously with your comments?

        • Amy Tuteur, MD
          August 27, 2013 at 11:27 am #

          I’ll be serious with you.

          You have no idea what you are talking about. You are willing to risk your baby’s life for bragging rights. You are a fool.

          Is that serious enough?

          • Carolyn Gall AAHCC
            August 27, 2013 at 11:51 am #

            Dr. Tuteur. I am so sorry that I came to your discussion board only to be mocked and tossed around like a toy doll. I have been patient in trying to have a real dialogue with you but it is not possible. I have heard rumors of you and now I have come across your page. I am sorry I did. You don’t respect woman. You are creating fear in woman and you are dangerous. I am not looking for bragging rights by having a home birth. In fact, I haven’t told anyone about it. It’s just that I don’t like the interventions in the hospital. Yes. I believe in natural childbirth. Yes. I believe that woman were designed to give birth. No. I am not taking risks by having a homebirth. I noticed everyone shut up when I told them who was going to attend. She has an excellent track record and has not lost a baby in her career. Have a good day.

          • Box of Salt
            August 27, 2013 at 11:56 am #

            Good luck Carolyn. I didn’t “shut up when I told them who was going to attend.” I’m simply not impressed with your midwife’s 1000 births as you are, but you aren’t listening anyway.

            You clearly think that risk does not apply to you.

            Again, good luck!

          • Amy Tuteur, MD
            August 27, 2013 at 11:59 am #

            Oh, please, Carolyn, you’re not trying to have a dialogue with anyone. You are boasting about what you think you know (which merely confirms your ignorance) and proudly proclaiming that you plan on defying medical advice, the truth be damned.

            Of course you were mocked. You sound like a fool. Too bad your baby may have to pay the price for your arrogant ignorance.

          • Carolyn Gall AAHCC
            August 27, 2013 at 12:02 pm #

            Dr. Amy, You are boasting of your knowledge too. Cherry picked statistics. I see you as a woman hater and fear mongerer. You sound like a complete quack. How can anyone take you seriously? I certainly don’t. Good bye

          • The Bofa on the Sofa
            August 27, 2013 at 12:05 pm #

            You want to have a discussion of the statistics? I’m sure Dr Amy will gladly have that discussion with you. I’d love to watch. I’m sure I will learn something.

            However, I have to say, “I don’t believe in your statistics” doesn’t help me learn much.

          • Carolyn Gall AAHCC
            August 27, 2013 at 12:07 pm #

            “I don’t believe in cherry picked statistics that have no merit” I have my own statistics that I have researched thoroughly. Thankyou

          • The Bofa on the Sofa
            August 27, 2013 at 12:10 pm #

            So do I. And my Sooper Secret Statistics contradict yours.

            You really are a fool, that’s for sure. And you talk about not taking Dr Amy seriously?

          • Amazed
            August 27, 2013 at 12:14 pm #

            Your own statistics? That you can actually discuss using your non-existing credentials? Forgive me for being skeptic. Your ability to compare apples to apples leaves me somewhat unconvinced.

            I wish you all the best. I hope you don’t get on the wrong side of ‘consumer should research her midwife’.

          • Kalacirya
            August 27, 2013 at 12:32 pm #

            What are your statistics, Carolyn?

            I have another honest question. I am a statistician. What do you think I do with myself? What do you believe I am trained to do? Can you tell me what you think my training entails?

            People like you are so flippant with the term statistics, and it makes me think that you fail to understand the depth and complexity of the field. That you think that you can perform your own analysis without any education on the subject (real education, taught from actual mathematicians), or that you can evaluate what makes a “good” statistical inference or a “bad” one.

          • The Bofa on the Sofa
            August 27, 2013 at 12:39 pm #

            People like you are so flippant with the term statistics, and it makes me think that you fail to understand the depth and complexity of the field.

            Kal – I am not a statistician, but I have presented a paper at the JSM. Do I gets my bona fides?

          • Kalacirya
            August 27, 2013 at 12:45 pm #

            LOL, I’m sure you’re fine.

            I just get bothered when clearly very ignorant people use the term like it doesn’t have anything behind it. As if the extent of the issue mean, median, and mode, or just tallying up numbers and doing some division.

            There are guys at my gym that think just because they’re fitness enthusiasts and they like to exercise, that they’re equivalent to physical trainers. And sometimes I’ll get a comment from one of them, that goes directly against what my actual physical trainer told me to do. But the lunkheads don’t seem to realize that the man actually went to school to do what he does. I could train for this man twice a week for a year and I still wouldn’t be able to design my own workouts half as effectively. I try not to be flippant about what other people have spent hundreds and thousands of hours to do.

            But I’m somehow doubting that it took hundreds of hours for Carolyn to become a Husband Coached Childbirth “expert”.

          • AAHCC Certified Awesome
            August 27, 2013 at 1:10 pm #

            You have to write a few book reports, breastfeed a baby, have a drug and intervention free birth, and attend a 3 day workshop. (and pay the AAHCC of course)

            Then you get to say outlandish shit to pregnant women and their partners for a few hundred bucks a pop, such as

            “Ultrasounds are RADIATION. That could be dangerous for your baby – we just don’t know! Do you really want that risk??? Would you expose your baby to URANIUM?”

            “The chances of having something like phenylketonuria
            are like 1 in 50,000 – do you really want your baby to have to suffer through BLOODY HEEL STICKS at the hospital for that state screening?”
            “If they have to deliver with forceps your baby might get CP.”
            “If you show the nurses and OB your ‘certified childbirth coach’ card, they will respect what you have to say a lot more during the birth!”
            “You can pay me another 500$ and I’ll be your doula”
            “Feel free to take this class again for 300$ with your next pregnancy because you really need a refresher”
            “Nobody really needs vitamin k shots, do you really want your baby TRAUMATIZED by needles?”
            “We just don’t know whether or not vaccines can cause autism – better safe than sorry!”
            Yes, the benefits of AAHCC certification are endless and wonderful. You too can masquerade as a medical expert once a week after you’re done teaching fifth graders american history.

          • Certified Hamster Midwife
            August 28, 2013 at 5:14 am #

            So, I take it you didn’t like your Bradley method class.

          • AAHCC Awesome
            August 28, 2013 at 10:08 am #

            That’s putting it mildly 🙂

          • I don't have a creative name
            August 27, 2013 at 11:53 pm #

            You’ll never get an answer to this. She doesn’t understand actual statistics. However, she did make a snotty comment that she would come back and let me know that she and the baby are fine after the birth. I hope she does.

          • Kalacirya
            August 27, 2013 at 11:54 pm #

            I just can’t imagine which midwife would tell a 50 year old woman that she is low risk. I hope that Carolyn is actually a Poe.

          • The Bofa on the Sofa
            August 28, 2013 at 9:54 am #

            It’s like someone drives drunk, and doesn’t have any problems, and writes MADD a letter boasting about.

            Who would be impressed?

          • ngozi
            August 28, 2013 at 9:27 am #

            She is accepting the statistics she likes, and ignoring the ones she does not. It is the same thing people do with the Bible.

          • The Bofa on the Sofa
            August 27, 2013 at 12:03 pm #

            You commented on a post that said, “12 things not to say unless you want to look foolish,” you basically say exactly that, and then you whine that you get treated like a fool?

          • Carolyn Gall AAHCC
            August 27, 2013 at 12:06 pm #

            Well, I guess I am going to take my toys and leave. I don’t need this abuse and bashing anymore. Didn’t know this was a discussion group to mock fun at mothers? Sorry. My mistake

          • The Bofa on the Sofa
            August 27, 2013 at 12:37 pm #

            We don’t mock mothers. Shoot, most of the people here are mothers themselves.

            We have no qualms about mocking fools, but then again, we don’t do that unless you have actually established yourself as one.

            Say something that we can take serious, and we will do it.

          • ngozi
            August 28, 2013 at 9:26 am #

            I am about to have my 6th baby in December. I mock and piss off everyone, but heck, I have been doing that since preschool.

          • Amazed
            August 27, 2013 at 12:41 pm #

            So being a mother automatically gets you out of being a fool? Nice. Because it’s fools we mock here, not mothers. Not specifically, at least. We don’t give exemptions to fools who happen to be mothers.

          • The Bofa on the Sofa
            August 27, 2013 at 12:43 pm #

            Besides, nothing we are mocking her for is mother related. When it comes to her pregnancy and childbirth, it has gotten serious, but she is mostly being mocked for her nonsense about being a childbirth instructor and being educamated and her own statistics. These things are all irrespective of being a mother.

          • Amazed
            August 27, 2013 at 12:52 pm #

            She knows it, Bofa. But she draws upon the ‘we mothers should support each other and we should accept each other’s choices’ mentality that’s prevalent among her circles. After all, it’s so cruel when people attack a mother. A. Mother. It isn’t half as cruel when people attack a fool for demonstrating that she’s a fool.

          • ngozi
            August 28, 2013 at 9:24 am #

            Ok you couldn’t read a few titles of the articles and know what was going on?

          • Kalacirya
            August 27, 2013 at 12:28 pm #

            I think a woman who is pregnant at 50 should have a healthy dose of fear about the realities surrounding her pregnancy and childbirth. And that reality includes a high level of inherent risk.

          • Jocelyn
            August 28, 2013 at 12:41 am #

            Humans are designed to eat. Doesn’t stop people from choking on food.

            Human bodies are not perfect, and we cannot always predict when something is going to go wrong.

          • ngozi
            August 28, 2013 at 9:24 am #

            You do know that you can avoid a good many interventions in the hospital by saying one of my favorite words…”no.” A lot of hospitals don’t force unnessary interventions on a patient, but when they offer them and the patient says yes, or nothing at all, then that is what the patient gets.

        • The Bofa on the Sofa
          August 27, 2013 at 11:35 am #

          Because I distinguish between the game of on-line vs real life. You want a serious discussion, then let’s get serious. Unfortunately, nothing you have said so far can be taken seriously.

          Come you, you actually asked me if I had heard of the “American Academy of Husband-Coached Childbirth.” Of course not. My response is, literally, “You can’t be serious?”

          • Carolyn Gall AAHCC
            August 27, 2013 at 11:37 am #

            It’s been around for 40 years. It is in California and it is the company I work for and promote the practice of Natural Childbirth. I am serious. Go look it up http://www.bradleybirth.com

          • The Bofa on the Sofa
            August 27, 2013 at 11:39 am #

            The American Astrological Society has been around even longer.

            Still a bunch of loons.

          • ngozi
            August 28, 2013 at 9:21 am #

            I’d be more willing to go for husband coached childbirth as long as it is happening in a hospital.

          • Carolyn Gall AAHCC
            August 28, 2013 at 9:25 am #

            Almost all of my students have hospital births. And that is their choice. I have had 2 couples choose home births and in both cases they had great experiences. One couple actually had 2 home births and have 2 sons.

          • ngozi
            August 28, 2013 at 10:41 am #

            I don’t mean to say that just because someone chooses a homebirth that they are just automatically going to die. I am aware that many homebirths turn out great. What makes me nervous is the chance that something could go wrong (and that chance is probably small) and the mother and baby would not make it to the hospital in time.
            As I have said before, a lot of hospitals don’t force interventions on patients unless it is a life or death situation. Patients for the most part can say no. Satisfying births can happen in hospitals.

    • I don't have a creative name
      August 27, 2013 at 5:04 pm #

      Please, please do not do this.

      This baby needs access to immediate high level care at birth, as your risk of complications is much higher than someone 20 years younger. What other risk factors do you have?

      Why is your desire for “no interventions” so much more important to you than being in an environment where your baby can receive immediate life saving care if you have a complication? I ask this honestly. Women were designed to give birth, and heads were designed to grow hair. But neither of those processes always works correctly 100% of the time, and the older you get, the less likely they are to work correctly.

      • Carolyn Gall AAHCC
        August 27, 2013 at 5:25 pm #

        I don’t have a creative name. I don’t know why I am bothering to respond but here goes. Being fifty is not a risk factor. It’s a risk factor because Dr.’s say it is but their is no evidence to support that notion. Especially since you have to factor in other things. I don’t have gestational diabetes, high blood pressure or any other previous risks or complications in my obstetrical history, All my previous pregnancies were intervention free (for the most part) and vaginal deliveries. I have a proven pelvis, As the pregnancy continues I will have testing done for things like GBS. I follow the Brewer diet and exercise almost daily. The odds of something going fatally wrong at my home birth are 2%. I think those odds are pretty low and I am comfortable with that. That’s all that you need to know. Nothing more.
        Post Note: Also, I said “my research” in a previous post. I meant the research that I have conducted. Not my own research. Don’t try to second guess me. Don’t try to talk me out of doing something that I feel comfortable doing. You can rest now, you must be tired . Have a good day

        • I don't have a creative name
          August 27, 2013 at 5:39 pm #

          So you want to come to a blog that is with odds with what you are planning to do, announce your plans, then order people not to argue about it. Got it.

          Last comment from me. If a civic organization in your community came to your house selling tickets for $5 for a new car, and every two out of 100 people would win, you would think those are pretty good odds; much better than the average lottery. Be honest- you would think there was a good enough chance that you’d probably buy a ticket. Yet those same odds – 2 out of 100 -apply to the death of your baby from preventable homebirth issues, and you think the risk is really low.

          All I can do at this point is shake my head. There are no catastrophic complications that will be prevented by exercise or any diet. Be healthy, great – but it won’t increase the amount of power you have over this process, which is really very little.

          I truly do wish you the best, and I hope that neither you nor your baby has to pay a terrible price for your foolishness.

          • Carolyn Gall AAHCC
            August 27, 2013 at 5:59 pm #

            Well how about I write back after the birth and tell you all about it? Being healthy and low risk puts me in another category. I have more choices. If I was considered high risk (if that should be the case) then I would opt for the hospital birth. Still good odds. Still good enough for me and my baby. Especially since I have a trained Midwife in attendance. Your the one who is the fool. Now go ahead and take a break. You must be tired trying to run my life for me..

          • I don't have a creative name
            August 27, 2013 at 11:32 pm #

            So you come to a blog that is at odds with your beliefs, argue, and then when people argue back, they are trying to “run your life”. Got it.

            Just FYI, words alone are not enough to claim that someone is trying to run your life, whether you like the words or not.

          • The Bofa on the Sofa
            August 28, 2013 at 12:54 pm #

            Of course. She came her to educate us. She is an AAHCC certified instructor, you know, and so therefore, that makes her an expert in childbirth.

          • ngozi
            August 28, 2013 at 9:19 am #

            There is a risk that there are complications that can happen while giving birth that no one could have known about before hand, no matter what age you are, what diet you eat, or how well you handled birth in the past. Some serious complications come up all of the sudden and you won’t have time to go to the hospital before it is too late.
            The risk of this happening is low, but is still a risk. I hope you can write back after the birth and tell us a happy story.

          • Carolyn Gall AAHCC
            August 27, 2013 at 6:00 pm #

            No I would not buy a lottery ticket if my odds were 2 chances out of 100.

          • Amazed
            August 27, 2013 at 6:21 pm #

            Of course it’s good enough for a NCB crank.

            You’re welcome to take risks with your life and your baby life/quality of life. I shudder at the thought of those mothers who can believe your nonsense and try it but alas, there’s no law prohibiting fools from procreating and searching the services of quacks.

          • Tim
            August 27, 2013 at 10:58 pm #

            “Posting links to Dr Mercola’s website” needs to be added to the list of ways to look foolish. That guy is the king of internet “natural” crackpots.

          • The Bofa on the Sofa
            August 28, 2013 at 9:51 am #

            Joe Mercola? Seriously?

            Major, major crank in pretty much everything he does.


          • tim
            August 28, 2013 at 10:06 am #

            There is two kinds of DO’s – ones who practice medicine and don’t say bullshit like “unlike ALLOPATHS, osteopaths treat the ‘whole patient’ with a holistic approach” , and ones who are chiropractors with prescription rights. Guess which “Dr.” Mercola is (oooh, i used their favorite tactic against them!)

          • The Bofa on the Sofa
            August 28, 2013 at 10:20 am #

            Mercola’s picture is in the dictionary under the term “crank magnetism.” If there is some crank position in medicine, Mercola espouses it.

            That’s why it makes me laugh. I had never heard Mercola’s name mentioned in a homebirth discussion before, but it doesn’t surprise me in the least. I know of him very well from other areas. Major crank.

          • tim
            August 28, 2013 at 10:24 am #

            Like I said, he’s a chiropractor with prescription rights. 🙂 Total crackpot in every way

        • ngozi
          August 28, 2013 at 9:14 am #

          I think I am going to faint…

  58. Carolyn Gall AAHCC
    August 27, 2013 at 11:03 am #

    I am a Bradley TM Method Affiliated Instructor. The AAHCC stands for the Academy. American Academy of Husband-Coached Childbirth. I’m sure you have heard of it?

    • The Bofa on the Sofa
      August 27, 2013 at 11:04 am #

      You’re funny.

    • The Bofa on the Sofa
      August 27, 2013 at 11:07 am #

      I’m a PCM – a Pablo Certified Midwife. I’m sure you’ve heard of it?

      I’m also the Pablo Volleyball Rankings Originator (PVRO), and a member in goodstanding of the Anti-Acronym Society (AAS). I also have a Master’s Degree…in SCIENCE! from Dr. Science. I have the diploma to prove it.

      • Carolyn Gall AAHCC
        August 27, 2013 at 11:11 am #

        Sounds good. I hope that you have a rewarding career with all your credentials.

        • The Bofa on the Sofa
          August 27, 2013 at 11:11 am #

          Back at ya.

  59. Carolyn Gall AAHCC
    August 27, 2013 at 10:59 am #

    Sorry. it posted without finishing… Those incidents of homebirth deaths sound dreadful. Like MD’s there are also incompetent midwives. They do exsist unfortunately. My pregnancy is low risk and I am receiving prenatal care through a regular practice in addition to seeing my midwife. I am very confident in her training and expertise. She has delivered over 1,000 babies. I have been privy to some of her most recent home births through communication and I am very impressed with her knowledge.

    • Poogles
      August 27, 2013 at 3:49 pm #

      “My pregnancy is low risk ”

      You’re FIFTY, your pregnancy is NOT low risk, no matter how strongly you might want to believe it is.

  60. Carolyn Gall AAHCC
    August 27, 2013 at 10:55 am #

    Also, I think that once we license and regulate midwives in this country incidents that took place (Huffington Post