Don’t listen to Dr. Amy … because she hasn’t practiced in years


Natural childbirth and homebirth advocates have serious problems with basic logic and that is often highlighted in their criticisms of me. Notice that I refer to criticism of me, not criticisms of my claims or analyses. That’s because NCB and homebirth advocates know that they cannot rebut my empirical claims; most of them have never even read the scientific literature that I present and discuss and most of them have problems with basic arithmetic, let alone statistics.

My personal favorite, because it is so nonsensical, is “don’t listen to Dr. Amy because she hasn’t practiced in years.”

It reminds me of that old joke about the patient facing surgery:

“Doctor, doctor, will I be able to play the violin after the operation?”
“Yes, of course…”
“Great! I never could before!”

We laugh because we recognize that if he couldn’t play the violin before, he won’t be able to play the violin after regardless of whether or not he has surgery.

Similarly, if obstetricians, pediatricians and neonatologists have not revised their view that homebirth increases the risk of perinatal death, homebirth is still unsafe, regardless of whether or not I have been in practice.

The reality is that I represent the mainstream of contemporary medical practice. The overwhelming majority of obstetricians, pediatricians and neonatologists agreed with me 20 years ago and they agree with me today: homebirth increases the risk of perinatal death.

After all, what has changed in the interim?

American homebirth midwives still don’t meet the educational and training standards of all other midwives in the first world.

There is still no evidence that American homebirth midwives are safe practitioners.

The statistics that have been generated in the past decade confirm that homebirth increases the risk of perinatal death.

The only thing that has changed in the interim is that more babies have died preventable deaths because their mothers, lacking basic knowledge of obstetrics, science and statistics, have trouble thinking logically about the dangers of homebirth.

147 Responses to “Don’t listen to Dr. Amy … because she hasn’t practiced in years”

  1. Rebecca
    February 22, 2013 at 3:07 pm #

    Even stranger is when they question Dr. Amy’s knowledge based on her use of an email address.

  2. February 22, 2013 at 4:57 am #

    Many of the NCB community are very backwoodsy type Evangelicals. There is a huge movement in being old fashioned, amish and Country. The prefer Folksy ideas to science. The really sad thing is, Babies are dying unnecessarily.

  3. Me
    February 21, 2013 at 2:53 am #

    The only thing that irks me is that because you’re not board certified, or indeed licensed to practice, is that you have no evidence that you have stayed up to date with the state of the science, as measured by your peers. _As measured by your peers._ You take all the credibility of the label “obgyn” with none of the responsibility.

  4. Whatever name I used last time
    February 20, 2013 at 6:05 pm #

    But you know what, I bet they would listen to a NCB midwife who hasn’t practiced in years… and if someone pulled them up on that, they’d probably argue that the female anatomy and physiology of birth doesn’t change, or something along those lines.

    (I’m sure they’d find some twisted logic to explain why that argument couldn’t apply to Dr Amy.)

    It’s not like you hand back your knowledge when you stop practicing, or we would never listen to retired teachers, politicians, judges, scientists, doctors, astronauts… in fact we should probably just round them all up and stick them in a nursing home!?

  5. GoodDaySunshine
    February 20, 2013 at 11:44 am #

    Aww, you wrote one about me. I feel so touched.

  6. Marguerita
    February 20, 2013 at 12:12 am #

    OT but funny:

    That’s the kind of STAHM working mom I want to be when I grow up 🙂

    • KarenJJ
      February 20, 2013 at 3:57 am #

      If only if it was that easy…

      Working together meant my child thumped on my laptop with me (Don’t touch the key board! Don’t flick your sippy cup at it and get milk all over it!!!)

      Nap time did not equal work time. I maybe got 20 minutes out of my daughter who was a terrible cat napper and dropped the day sleep completely at 18 months…

      The only way around it for me was to hire a sitter, wave ‘bye bye’ at the front door and run around the side gate to the side entrance to my home office and start working. It also meant I couldn’t do phone calls and any correspondence happened via email.

      Thankfully I’m now in the local office and the kids are mostly at daycare/kindy on the days that I work. I can usually manage to check my emails while they watch TV but that’s it. Anything serious has to wait for one of my days in the office, or after they’ve gone to bed at night…

  7. I don't have a creative name
    February 19, 2013 at 7:23 pm #

    Can I just say that disqus sucks. There is someone spouting lovely eugenics on the 2/16 thread, and every time I look at the discussion, I see different posts. Sometimes my own aren’t there, but I see some from Lizzie D and Dr. Kitty. Then I look later and that’s reversed. Sometimes I don’t see Alan’s posts at all. What the fudge, man.

    • Josephine
      February 19, 2013 at 7:25 pm #

      Yeah, I’m not a fan myself. It’s hard for me to go back and find comment threads that I was looking at previously despite the different things I try, and I’m constantly getting “new comments” buttons popping up which lead me to nothing.

    • Calla
      February 19, 2013 at 7:59 pm #

      I always go to the top and sort it by oldest so that I can read everything in the order which is was posted. It’s annoying but that’s disqus.

      • I don't have a creative name
        February 19, 2013 at 8:17 pm #

        Hmmm… I have it default to newest… I’ll try oldest and see if that helps.

        • I don't have a creative name
          February 20, 2013 at 10:54 am #

          Actually, that DID help, then I was able to ctrl+f to look for “Alan” and find the lovely sentiments that homebirth is good because it saves money and if more babies die that’s okay because IT SAVES MONEY.

          And all his children were born in the hospital. Sigh.

        • TiffanyEpiphany
          February 20, 2013 at 11:07 am #

          I have my defaulted to newest, too…but I have to always click “newest” (even though the checkmark is already next to it) for the newest posts to actually come up at the top.

          Thanks for the top about searching; I didn’t know you could do that.

    • Lena
      February 19, 2013 at 8:56 pm #

      Another issue–and I don’t know if it’s new or I’m only just noticing–the wrong name sometimes appears on a comment. There was one yesterday that had the adequate mother talking about when she was into the woo and considering a water birth. I thought I was losing my mind. The issue was fixed a few hours later.

      • theadequatemother
        February 20, 2013 at 8:51 am #

        Ah…if only there was a waterproof epidural catheter and dressing…..:)

    • Aunti Po Dean
      February 20, 2013 at 3:22 am #

      thats cos Dr Amy is deleting them dontchano? 🙂

      • TiffanyEpiphany
        February 20, 2013 at 11:09 am #

        um, actually, she doesn’t delete anything…only the quacks out there (e.g., those moderating the homebirth sites) dare to delete anything that doesn’t jive with what they say. Haven’t you been paying attention?

        • KarenJJ
          February 21, 2013 at 8:09 am #

          The antipodean Aunti Po Dean has been posting a while and I suspect she’s being sarcastic.

          • TiffanyEpiphany
            February 28, 2013 at 2:14 am #

            KarenJJ, what a fool I am. Thank you for point this out. See my apology to Aunti Po Dean. (I have trouble reading sarcasm, how embarrassing.)

        • TiffanyEpiphany
          February 28, 2013 at 2:11 am #

          holy cow, I really can’t read sarcasm. So sorry, Aunti Po Dean, truly sorry. This is what I do when I can’t sleep: read, write, and think…this blog has been a great new treasure trove for my troubled nights. I am slowly getting to know the personalities of the “regulars” (and the idiots), and I am very sorry that I was being an idiot here. I was (and still am) new at this; please forgive me. Heck, I didn’t know how to find out if people responded to me until a few days ago, hence the late reply and apology to you. (and see how I’m replying to myself here? jeez…still learning)

      • TiffanyEpiphany
        February 28, 2013 at 2:12 am #

        Holy cow, I really can’t read sarcasm. So sorry, Aunti Po Dean, truly
        sorry. This is what I do when I can’t sleep: read, write, and
        think…this blog has been a great new treasure trove for my troubled
        nights. I am slowly getting to know the personalities of the “regulars”
        (and the idiots), and I am very sorry that I was being an idiot here. I
        was (and still am) new at this; please forgive me. Heck, I didn’t know
        how to find out if people responded to me until a few days ago, hence
        the late reply and apology to you.

  8. stenvenywrites
    February 19, 2013 at 5:26 pm #

    The guy who inspected my house hasn’t been a licensed contractor for the last 10 years. But when he told me that having my attic joists supported by a single brick was bad architectural practice, somehow, I believed him. Clearly I am a victim of the patriarchy.

    • Josephine
      February 19, 2013 at 7:26 pm #

      Your inspector wanted to make his tee time, so he played the structurally unsound card to scare you and just get it over with.

      • stenvenywrites
        February 19, 2013 at 9:09 pm #

        I know, I just should have trusted The Brick. Now, woe is me, in order to recover from the horrific trauma, I have to unassisted-build myself another house. I’m thinking straw, or maybe twigs.

        • February 19, 2013 at 10:07 pm #


        • KarenJJ
          February 20, 2013 at 4:04 am #

          Don’t listen to those structural engineers and licensed building contractors. They’ll play the big bad wolf card.

  9. Lindsay Beyerstein
    February 19, 2013 at 4:45 pm #

    Coming from the reflexively anti-medical elements of the home birth crowd, the complaint that Dr. Amy’s not a practicing OB reminds me of another old joke: This food is terrible, and in such small portions!

  10. Ash
    February 19, 2013 at 4:29 pm #

    I just don’t understand why American home birth midwives DON’T need a formal degree and qualifications (and subsequently registration to the state board) to practise as a “midwife”. Can anyone explain why? Is it a loophole in the law?

    Personally, I like midwives. I delivered both children with one (in a hospital), and I plan to become one. I think they have their place in low risk pregnancies and hospital deliveries, so your not tying up a skilled OB on a normal birth.

    But here it requires to get a degree in nursing, and usually a masters in midwifery, and then registration as a nurse/midwife before I could ever practise.

    Are American home birth midwives essentially someone off the street who has observed a midwife for a while?

    • Bombshellrisa
      February 19, 2013 at 4:32 pm #

      You are so right, midwives that are well trained DO have a place!
      Not every state recognizes home birth midwives, the CPM credential was invented by Ina May Gaskin. Some places (Oregon for example) you don’t have to be certified at all, you can call yourself a midwife and start caring for pregnant women right away.

    • The Bofa on the Sofa
      February 19, 2013 at 4:41 pm #

      In the old days, I used to have the initials “PCM” after my user name, which was a Pablo Certified Midwife. It was a midwife certification that I made up myself, and granted to myself. I figured, it’s no less legitimate than a CPM…

      • Certified Hamster Midwife
        February 19, 2013 at 5:39 pm #

        And then there’s me.

        • Bombshellrisa
          February 19, 2013 at 6:11 pm #

          If you have observed a hamster birth or in anyway feel connected to that magical mystical dance the baby hamsters and their mother share, you should use that title : ) Maybe I should add “Apostate Midwife” to my name ((see discussion thread between myself and Alan))

          • auntbea
            February 19, 2013 at 7:18 pm #

            Eating your young is just a variation of normal.

          • Certified Hamster Midwife
            February 20, 2013 at 6:43 am #

            Extreme placenta-eating!

          • KarenJJ
            February 21, 2013 at 8:15 am #

            OMG, I was thinking the same thing – that maybe they started with the placenta and just kept going. Oopsy..

          • Petanque
            February 20, 2013 at 12:33 am #

            That’s “HamsterMotherBaby” – they really are one single unit, you know.

          • Bombshellrisa
            February 20, 2013 at 3:45 am #

            Sorry, I stand corrected…but I refuse to believe that they don’t have some mystical magical oxytocin dance.

        • The Bofa on the Sofa
          February 19, 2013 at 6:36 pm #

          PCM’s are not qualified to deliver hamsters.

          • fiftyfifty1
            February 19, 2013 at 9:36 pm #

            That’s CATCH hamsters not DELIVER hamsters you patriarcal jerk!

          • The Bofa on the Sofa
            February 20, 2013 at 7:22 am #

            Oh, we CATCH hamsters all the time, but that is because we throw them at each other.

          • KarenJJ
            February 21, 2013 at 8:14 am #

            Anyone for a game of tennis?

      • February 19, 2013 at 11:53 pm #

        YOU are VB Pablo PCM?!! Oh my gosh, I have been meaning to write on here and ask what happened to you b/c I hadn’t seen you around but I kept forgetting! I didn’t know you switched names…. awww, good, you were the first person to talk to me on SOB and you gave me some good encouragement…. Thank you, Bofa. I’ll never forget my first SOB interaction lol 🙂

    • Bombshellrisa
      February 19, 2013 at 4:42 pm #

      IT also depends on what you call yourself. Using the title “lay midwife” or “traditional birth attendant” means that you don’t have to be registered with the state you are practicing in, you just aren’t allowed to advertise the same way someone who as an LM or CPM can.

    • Alenushka
      February 19, 2013 at 4:46 pm #

      Look up CNM

    • Calla
      February 19, 2013 at 7:56 pm #

      I’m not sure why it’s allowed either. CNMs generally have a bachelor’s in nursing and a master’s or doctorate in midwifery. I don’t know why that isn’t the minimum standard required. But some states do allow those of lesser education to do home births legally. They each have their own requirements for who is able to do this.

    • Lena
      February 19, 2013 at 9:01 pm #

      I blame it on the libertarians. And I’m only kind of joking about that. There’s a huge “stick it to the man” attitude in many parts of the country. There are people who bitch about food safety regulations, so that should tell you something. The existence of lay midwives is an extension of that.

      • Guest
        February 20, 2013 at 8:33 am #

        Several of the most extreme crunch mothers I know, ones who do unassisted birth etc are libertarians. They believe in total self-reliance.

      • Renee Martin
        February 20, 2013 at 4:05 pm #

        Yes, they are libertarians, except for their demands for Mediciad payment. They forget their belief in “self reliance” and “small government” when it comes to using Mediciad funds for birth, or SNAP for food.

    • KarenJJ
      February 19, 2013 at 9:21 pm #

      I didn’t understand this part either. Where I live midwives are trained at universities and registered before they practice. I assumed all the American midwives were the same. So when I was pregnant and reading and getting recommendations for things like the ‘Spinning Babies’ website and also for Ina May Gaskin’s book ‘Spiritural Midwifery’, I assumed that they were the same and that their knowledge also came from a background of university or even the older hospital-based training and from many years of practise as such.

      Instead they make up crap and hang up the term midwife to lend legitimacy to a movement that has its roots in religion and women’s suffering or from a hippy anti-establishment movement (from what I can tell). They’re alt-med practicioners, not medical providers, and some of them seem to have some serious boundary issues when it comes to caring for mothers and babies.

      I’m grateful to not have this where I live and I hope to see legal changes in the wake of Lisa Barrett’s incompetency that prevent us from seeing these types of alt-med wackos.

    • Renee Martin
      February 20, 2013 at 3:48 pm #

      It’s *only* because they are organized and loud, and pushing for something few people know, or care, about.

      For example: there was a town hall here in Eugene, where people could talk to their legislatures about upcoming healthcare changes. 50 HB MWs and supporters showed up to demand they are included, and paid by the state! They were numerous, loud, and they always write tons of letters and show up to every event.

      Other events where you meet your lawmakers show why the MWs win- the things the population is focused on are big things that effect us all, like healthcare, education, economy, law enforcement. The only people who care about HB and HB MWs are HBers and HB MWs, so when they show up and make demands, no one cared enough to oppose them. The legislature would rather do nothing, or do the minimum to make them happy, than bother fighting against them- a fight no one else cared about.

      Until this time last year, they never had any opposition. *None*. The first counter protest to their demands *ever* was this time last year. We are planning another counter protest this month, but we are so few. There will be 30-50 of them to 10 of us (if all goes well!) The average person doesn’t care; even when they are appalled to learn of the deaths, they just don’t care enough to show up to do anything about it. It’s just not their issue. Those that do care often have other things to do. Unlike a group of HB MWs and their SAHM followers, the opposition has other things in their life than pushing against HB and NCB. Basically, It’s a small group of busy people, vs a larger number of singleminded zealots that spend their days steeped in HB/NCB.

      There is a small group of loss moms, healthcare activists, and healthcare providers that have seen the damage done by HB MWs, working on change. (Thankfully, there are fewer loss moms than happy HB moms, even though it makes our job harder.) We will be relentless, but we are outnumbered and fighting in a state notorious for woo, and hatred for rules and regulation. It’s slow going.

      • Karen in SC
        February 20, 2013 at 3:52 pm #

        Renee, good luck on your protest. Please share more here and on the Fed Up FB pages.

      • Renee Martin
        February 20, 2013 at 4:02 pm #

        Yes, in most parts of the US, all it takes to be a MW is following another MW around, maybe taking a short test (CPM). The CPM was invented to these so called direct entry MWs could demand Medicaid funding (half of all births are paid via Mediciad.), without having to go to college or anything strenuous.

        In some states (OR, MI, notoriously) ANYONE can call themselves a MW and be one. If I woke up tomorrow and decided I felt like being a MW, I could say I was one, throw up a website, and get patients- no education, no rules, no insurance needed.

        A few states require CNMs, which is smart, but they are few, and CPMs are pushing to be allowed there too.

        It’s a pretty scary situation for moms that want OOH birth, as the patchwork rules (or lack thereof) make it nearly impossible to know the skill level and background of who you are hiring.

    • areawomanpdx
      February 20, 2013 at 11:15 pm #

      Yes. Here in Oregon, my four year old daughter could hang out a shingle and deliver babies. No training, certification or oversight required. Just the innate wisdom of a child and a deep faith in birth.

      • KarenJJ
        February 21, 2013 at 8:11 am #

        if she knows how to ring the emergency number and give the address she might be doing better than some of those midwives too. Scary thought.

  11. GiddyUpGo123
    February 19, 2013 at 2:40 pm #

    My favorite is when home birth advocates put “doctor” in quotes as if the fact that Dr. Amy disagrees with them means that she didn’t actually go to medical school.

    • Bombshellrisa
      February 19, 2013 at 3:54 pm #

      How many of them actually understand what it is to earn a doctorate in anything? When I was a teenager, working as a nurses aide in a nursing home, I was taught that anyone who had earned the title doctor was still to be addressed as that until they corrected us and asked we call them something else.

      • Certified Hamster Midwife
        February 21, 2013 at 4:18 am #

        Well, there’s Rixa Freeze, PhD.

  12. Aurora Borealis
    February 19, 2013 at 2:39 pm #

    “mothers…lacking basic knowledge of obstetrics, science and statistics, have trouble thinking logically about the dangers of homebirth.”

    I don’t think that obstetrics, science and statistics are a prerequisite to think “logically”. What’s missing is a little pragmatism whether held back by circumstance, lack of acknowledgment of personal issues or an unfortunate inherent trust in the person who told the most comforting story. Examples of trust abuse abound, and not just in the homebirth community.

    The point is that certain ideologies target people at a vulnerable point in their lives. NHBs target pregnant women. It’s a common practice that the first thing you do with vulnerable people is to tell them how powerful they are. How enticing!

  13. Bombshellrisa
    February 19, 2013 at 2:09 pm #

    Valerie Sasson, co-owner of Puget Sound Birth Center on the local NPR station talking about alternatives to hospital birth

    Here is a comment from one of her admirers on the birth center Facebook page

    ” I wish that they would have had more than 20 minutes! The emphasis of the conversation seemed to be on the experience of birth – I would have loved to have heard more about the health benefits to mother and baby of physiological birth, as supported by the midwifery model of care. It was great hearing this topic on our local NPR! Hopefully it will bring more awareness to maternity care and birth options in Washington State!” “Benefits of physiological birth”? Oh please. If Valerie (who trains other CPMs at the birth center and teaching at Bastyr University) could speak to the benefits of anything but the services she provides I might actually tune into that conversation.

    • Karen in SC
      February 19, 2013 at 2:25 pm #

      I hate the term “physiological birth”!! I’m pretty sure that in the hospital the mother’s body is still involved… Call it like it is – out of hospital birth for instance.

      • Bombshellrisa
        February 19, 2013 at 3:03 pm #

        I hate that term too. I also hate that they talk about “alternatives” to hospital birth. Either you give birth there or you don’t. Technically, delivering at the local shopping mall or the parking lot of the hospital is an “out of hospital birth”.

  14. Bombshellrisa
    February 19, 2013 at 2:02 pm #

    OT: Can you imagine if someone did this with the tag line “Help Fund Me, I want to become an OB”?

    • Awesomemom
      February 19, 2013 at 3:53 pm #

      I would be more inclined to help someone who wanted to become an ob since the cost can be overwhelming. All this person needs to do is save up a bit of extra money for a little while. I can’t help but wonder if she went to a less well known workshop if she would end up not having to pay as much. That book wish list is also a bit silly. I had a number of those books and got them pretty cheaply at a used book store.

      • Bombshellrisa
        February 19, 2013 at 3:57 pm #

        I would fund an OB any day over someone who wants to study at Bastyr. But you don’t see people asking for medical school money.
        I think you are right, there are other places to train, but this is the most well known one. Then she can say that she attended the Penny Simkin school of Allied Health professions. Although I don’t think that Penny is teaching there anymore, she is teaching at the Seattle Center for Birth.

    • Captain Obvious
      February 19, 2013 at 8:31 pm #

      This Sara Vichorek has no job? No savings? She wants Internet friends to put her through school? How does anyone know she isn’t going to just take the money and goto Jamaica? I should start a fund me site.

  15. Yammy
    February 19, 2013 at 1:34 pm #

    This argument is also ridiculous because even if Dr. Amy were still practicing, they would still find a way to attack her as opposed to discussing the facts. These are the folks who prefer the delete button over the reply button after all.

  16. Rochester mama
    February 19, 2013 at 1:18 pm #

    I am in Rochester MN and gave birth at Mayo last July, I labored in the water but I got out to give birth. I was on a monitor in the tub. They don’t let you deliver in the water. After I started pushing my son’s heart rate started dipping below their threshold and the CNM midwife had the OB and Peds team in there in what seemed like seconds and I had a quick vacuum assisted delivery. The tub helped tremendously with pain, mainly because I could squat with the water helping support my weight. Mayo Clinic throughout their practice takes the care and comfort of their patients very seriously and that means offering both cutting edge medicine and caring for the whole person. I would never give birth at home but I think the only way to stop the attraction to home birth is for hospitals to highlight the support of VBACs, non medicated labor etc… I felt good trying the natural route because I knew Mayo supported that as long as it is safe and would tell me the moment it wasn’t. I have had care at other places where I truly do feel shift changes and convenience of the staff would have influenced the advice I was given.

    • Karen in SC
      February 19, 2013 at 2:32 pm #

      Sounds like you had a great experience. Unfortunately, like other corporations, hospitals are trying to do more with less, so changes like birthing tubs may only be feasible when there is a positive effect on the bottom line. Hospitals that don’t support VBAC may not have 24/7 anesthesia coverage – heck the hospital “birthing center” in my city doesn’t have that. An anesthesiologist is called in when and if a laboring woman arrives late at night. I have no idea how they would do a crash section – maybe send in ambulance to bigger hospital across town.

      • Charlotte
        February 19, 2013 at 4:43 pm #

        In my area, there are two hospitals that compete fiercely for birthing women and their insurance dollars. They do things like install hardwood floors, labor tubs, and have a gourmet food menu to try and attract more women, so in some ways, improving their birth centers does improve their bottom line. I personally think making women feel as comfortable and happy as possible during their birth as long as it is safe. Even though having a safe birth is the #1 priority, wanting a comfortable hospital stay isn’t an unreasonable request if it doesn’t interfere with safety.

        • fiftyfifty1
          February 19, 2013 at 9:50 pm #

          I personally am turned off by the “cater to the ladies” trend in American hospitals. Or I should say American hospitals that are located in wealthy areas. My health system currently is remodeling an already perfectly nice birthing wing to better compete with the 3 other local hospitals nearby. Women getting mammograms go to an area remodeled to look like a spa and they change into fancy warmed spa gowns for the 2 minutes that it takes to do the mammogram. And then we have the millions of totally uninsured…..

          • Dr Kitty
            February 20, 2013 at 5:37 am #

            *cough* USA has biggest percentage of GDP spent on health in the world, and you’re not exactly getting much bang for your buck, so to speak. Your worried well are over treated, over investigated and over medicated, and your sick poor aren’t investigated, medicated or treated enough *cough*

          • The Bofa on the Sofa
            February 20, 2013 at 7:23 am #

            Oh yeah? And what is YOUR great health care system doing for your cough?

          • theadequatemother
            February 20, 2013 at 8:59 am #

            In canada the cost of administering the universal health insurance plan is 2% or less. In the US, depending on the insurance carrier, the overhead costs vary between 15-20%, averaging something like 18%. That’s a lot of wasted money going to things like denying claims, investigating claims, getting pre-approvals etc.

      • Therese
        February 19, 2013 at 7:54 pm #

        They would call in an OB and anesthesiologist for a crash section. As long as they can start the c-section within 30 minutes it meets ACOG’s standards.

    • Renee Martin
      February 20, 2013 at 4:18 pm #

      I disagree.
      Where I live, every hospital has most of the things HB and NCBers cry for (MWs, labor tubs in every room, birth balls/squat bars, nurses that work with unmedicated labors, wireless and waterproof monitoring, etc.) Some even have all of those, plus: Vag breech, VBAMC, water birth, free doulas, etc.
      It does little to nothing to reduce the numbers of HBers, but it does give NCB more importance than it deserves. IMO, while it’s great to offer these things, focusing on them (and these hospitals do) does a huge disservice to the 90% of moms that want pain relief and aren’t into NCB! The rest of us don’t want to be told to “try to walk” or “try the tub” when we ask for an epidural.

      There are some places have an excellent balance, but from my own experiences, it seems like when they bring in a lot of NCB practices, it often shifts their entire way of relating to patients in a negative (to the majority) way. Maternity care is a hot commodity, and NCBers are loud and demanding. In the rush to serve the vocal minority, it’s vital not to ignore the majority.

  17. TheOtherAlice
    February 19, 2013 at 12:54 pm #

    It’s pretty hilarious that a movement built on people who haven’t studied medicine, nursing or midwifery, don’t read and analyse scientific publications on a meaningful level or use facts and data to make their arguments use ‘her expertise is out of date’ as an argument.

    I mean, for god’s sakes, at least Dr Amy actually reads the damn papers! I’m sure if the evidence had shifted in the last 10 or 20 years, she would be willing to acknowledge that and change her views…because they’re based on FACT.

    • Bombshellrisa
      February 19, 2013 at 1:10 pm #

      They don’t want to read the papers because they could never understand the papers! All they want to do is catch BAYBEES! I can’t imagine those people reading through medical journals to keep up on anything. My grandmother was 91 when she died, and even though she had retired from nursing years before, was still reading nursing and medical journals, watched the UWTV channel and kept up with ground rounds and all the other presentations given and was interested in changing practices. Contrast that with Ina May and Penny Simkin, who only want to relive their births over and over and talk about “how women used to give birth”.
      OT: This is who they prefer to listen to.

      • Lisa from NY
        February 19, 2013 at 2:40 pm #

        I love the “Holy Sh!t Scary” story. Healthy baby with 98th percentile head born via C. What a tragedy.

        • Bombshellrisa
          February 19, 2013 at 3:07 pm #

          This one, where the poor father was calling 911 because the woman decided that she was going to have a homebirth instead of going to the hospital to deliver with the midwife is complete with a bluish looking baby. She read the “Gentle Birth” book by Sarah Buckley.

          • Guest
            February 19, 2013 at 5:07 pm #

            Good lord.

          • Sullivan ThePoop
            February 19, 2013 at 10:45 pm #

            I love how she is trying to insinuate that there are hormones present after an unmedicated birth that are not there after a medicated birth.

        • Jessica
          February 19, 2013 at 4:16 pm #

          A little Googling and I found the story of her second baby’s birth:

          • February 19, 2013 at 4:46 pm #

            ” My bad knee is starting to give under the stress of squatting. I’m in
            too much other pain to tell anyone and it goes unchecked. Later I find
            out I re-tore an old sports injury that night and I would require
            surgery 3 months later.”

            Sounds magical..

          • Renee Martin
            February 20, 2013 at 3:22 pm #

            So much birth pain that she missed that she retore an old knee injury? How much pain does it take to make you not be able to mention your knee is ripping internally. Holy shit, that sounds awful. and the opposite of empowering.
            (good job on the alternative positioning. Wonder if they even knew of her old injury, or if they thought it was normal too?)

          • Klarastan
            February 19, 2013 at 5:02 pm #

            I feel so terrible for these women who have been convinced that the only value they have – as mothers, as women – comes from nothing babies through their vaginas. You gave birth! To a gorgeous baby! You are strong and amazing! I hate that the NCB community has done that.

          • Lisa from NY
            February 19, 2013 at 7:55 pm #

            Thanks for the link.

            “I’m so sorry Christina, it feels so clear to me now, your pelvis feels wide on top but more narrow at the back, I really don’t think she will pass under the bone in this posterior position. I can feel that you are pushing strong, that the baby is hitting the bone, she might be chin up in addition to posterior, and your pelvis does not seem to be average shape.”

            So much for body making baby that you can’t push out.

    • auntbea
      February 19, 2013 at 1:49 pm #

      Because people want the prestige of being experts in something without having to do any work, or experience any intellectual struggle, or possibly even fail in the endeavor. Why do you think that they choose to become “experts” in something that the majority of the time turns out okay whether the expert is there or not — so, in the other words, which has a high success rate irrespective of one’s actual level of effort or skill?

  18. c
    February 19, 2013 at 12:44 pm #

    “mothers, lacking basic knowledge of obstetrics, science and statistics, have trouble thinking logically about the dangers of homebirth”

    ALL mothers, except those who are OBs have a lack of knowledge of obstetrics (and probably science and statistics too). That’s a given. That’s why we turn to experts. We read things on the Mayo Clinic website saying water birth is safe. We watch BOBB with doctors saying that you won’t bond with your baby if you have a c-section. We don’t get a degree in medicine, no. But we do try to seek out other points of view.

    The problem? The lies! The fact that even OBs are softly endorsing home birth because they don’t want to say, “ARE YOU OUT OF YOUR MIND?” (my OB didn’t say this to me, anyway). The hospitals and birthing centers that offer water births as a safe alternative to epidurals. The NCB literature that says the MAIN problem is that women don’t believe in their bodies. We have to believe. Believe. So when presented with conflicting evidence to those beliefs, we have to ignore them, to maintain the belief or we won’t get the natural birth we want. That’s a strong incentive.

    Why do we want it? Because we do think, wrongly, that birth is safe, because modern medicine has made if feel that way. It does feel like there’s almost no chance of something going wrong. And because needles and surgery and hospitals are scary and suck. And if home birth is JUST AS SAFE, if not SAFER, then don’t we deserve to have the peace delivery of our dreams? What exactly is the problem here?

    THANKFULLY Dr. Amy is doing the good work of dispelling that myth. I was just told on FB by a family member that I could cure my pre-eclampsia by juicing and soaking in epsom salts and taking some dubious herbs. I CAN HAVE A NATURAL BIRTH TOO! IF ONLY I IGNORE MY CREEPING BP! Obviously, I don’t believe in my body because I’ll likely be induced or have a c-section next week.

    It’s a business model that shames women to sell them products and services that do absolutely nothing at best, and harm/maim/kill them at worse. We can’t blame the women for not having the science background to get to the bottom of this, until we fully blame the OBs who don’t take a stand, the NCBers who flat out lie, and everyone who is making money off this trend (including, birthing centers — even the hospital adjacent ones, the home birth advocates and writers).

    • theNormalDistribution
      February 19, 2013 at 1:13 pm #

      I have to take issue with your first sentence. C’mon!

      • suchende
        February 19, 2013 at 2:28 pm #

        It’s like an LSAT problem: obstetricians have training in science, statistics and obstetrics. All mothers who aren’t obstetricians don’t have training in science, statistics and obstetrics. Find the flaw in the reasoning.

    • February 19, 2013 at 1:58 pm #

      I’m surprised the nurse from Mayo didn’t get in some kind of trouble for endorsing a practice on the hospital’s website that even the hospital itself doesn’t allow. Gee I wonder why the hospital itself won’t allow a woman to deliver in water…..maybe it has something to do with the practice being usafe and posing a huge liability! I hope Dr. Amy will write a post about real doctors and nurses who go down the woo rabit hole. Obvthrouly untrained midwives are the bigger problem but, it really worries me that some medical professionals are lending them credibility either by actually agreeing with what they say or saying nothing to opose it.

      • Elle
        February 19, 2013 at 2:17 pm #

        Yes Clarissa – the teacher at my (hospital) birth class recommended Ina May’s books, told us we could look for pressure points on our ankles to help deal with pain (though I can’t say for sure that it doesn’t work because I didn’t try), and told us to “trust the process!” And other things that I can’t remember… very NCB-esque. I’m pretty sure she was a hospital employee. I thought it was cool at the time but not so much now.

        • Bombshellrisa
          February 19, 2013 at 2:21 pm #

          Sounds like what was happening in AllieP’s class. It’s just wrong to present just one side of birth that way-especially with any recommendation to read something written by Ina May.

          • Dr Kitty
            February 19, 2013 at 4:14 pm #

            Reminding me of a MW who mentioned to me that she was offering women acupressure and a senior GP overhearing and making a comment about witchcraft and sorcery being funded by the NHS…and why didn’t she just give the poor woman eye of newt and deliver the baby in a ditch and have done with it! *
            The MW did not take it well.

            *actual awesome Macbeth reference in there.

          • E151
            February 19, 2013 at 9:50 pm #

            That WAS a really awesome Macbeth reference.

          • Karen in SC
            February 19, 2013 at 11:16 pm #

            wasn’t Macbeth the one who was ripped from his mother’s womb, thus either fulfilling (or screwing up) the witches’ prophecy?

            PS. I’m a chemistry teacher not an english teacher

          • Klain
            February 19, 2013 at 11:38 pm #

            No, it was MacDuff.

          • Amazed
            February 20, 2013 at 5:49 am #

            I simply love the line “not from a woman born but from my mother’s womb untimely ripped” (sorry, I do know it by heart in my own language but in English… ). C’mon, ladies and gentlemen, all of you who were not born but C-sectioned… how dare you celebrate your birthdays?!…

          • February 20, 2013 at 7:29 am #

            Interesting that this play is one of Shakespeare’s (frequent) meditations on what is natural and unnatural. Not much comfort for NCB that it is the unnaturally born Macduff that embodies all the positive virtues. The question of Lady Macbeth’s attitude to natural and her status as a mother is also a bit obscure – making it clear that her ambition and drive to power is at odds with a more maternal image of her giving suck to a babe she would willingly sacrifice. As for “of woman born/borne – perhaps we should not confuse so readily the word related to birth and the word derived from bear – to bring forth. Both Anglo Saxon, but in those days the superiority of vaginal was as opposed to being dead, not as opposed to being inferior.

          • Amazed
            February 20, 2013 at 8:55 am #

            Oh yes, I know this – vaginally born/dead thing. I have no idea why this play always comes to mind when someone talks about C-section as an inferior way of bringing a baby into the world. Someone told me that women who were C-sectioned “had surgery from a baby”.

            OT, a few days ago I spotted a fabulous piece of journalism in a site I frequent. I don’t have the time to translate it but it was along the lines of “a new Canadian study shows that babies born unnaturally are in greater danger of diabetes, heart disease, obesity and so on”. Of course, few people take this part of the site seriously. We’re there to connect on the forum. But anyway, it’s annoying that they write such things and label them “news”. There are pregnant women there who don’t have the time or education to make the distinction between fact and propaganda. They deserve better than being subtly brainwashed.

          • The Computer Ate My Nym
            February 20, 2013 at 8:36 am #

            I always did think that one was pretty weak as a fulfillment of the prophecy. Though it should be pointed out that at the time that meant that MacDuff’s mother died giving birth to him or maybe had already died and so he was born of a corpse not a woman. Or maybe the point is that however nonsensical the idea that someone born by c-section wasn’t really born is, MacBeth bought it and therefore doomed himself.

          • Dr Kitty
            February 20, 2013 at 6:42 am #

            “Finger of birth-strangled babe, ditch delivered by a drab” is one of the ingredients in the Witches’ Cauldron, along, of course with eye of newt. Just in case I completely lost anyone.

        • February 19, 2013 at 11:57 pm #

          Maybe there needs to be better oversight of these hospital birth
          classes. I work for a financial services company and I’m pretty sure they wouldn’t like it if I ran class using their name and started giving out unsound financial advice. When I get pregnant, I’m going to politely decline any invitations to a birth class. No offense to the good childbirth educators out there but, I’ve heard enough stories like this to be nervous. I really don’t want to pay someone to end up give me a lecture on the evils of epidurals, c-sections formula etc…. as we’ve all seen there is plenty of that available for free via the web. Ironically, it seems the midwives might be right about one thing—some hospital employees aren’t practicing evidence based medicine 🙁

          • KarenJj
            February 20, 2013 at 4:16 am #

            The best tip I got from the midwife at the hospital based education class was how to circumvent the paid parking meters by using the staff paid boom gate instead. Insider knowledge that really helped me enjoy my hospital stay that little bit more.

      • auntbea
        February 19, 2013 at 2:39 pm #

        I delivered at Yale New Haven and information provided by the affiliated women’s center was uh-may-zing. And not in a good way. They sign you up for this weekly email when you register at YNHH, and it’s all about avoiding c-sections and epidurals — not only totally unsupported by evidence but also completely out of synch with the actual policies of the OBs and the hospital (they won’t even let their own CNM’s do delivery there.) I have no idea if the doctors know this going out or if they just got overridden.

  19. E151
    February 19, 2013 at 12:26 pm #

    “Don’t listen to Dr. Amy’s opinion on obstetrics, she’s not a practicing doctor.” Oh. So you’re saying one should be a practicing, trained doctor to be an expert in obstetrics?

    Plus, isn’t this the movement that claims to honor feminism and motherhood? Does Dr. Tuteur really surrender 20 years of education and training and professional identity just because she chose to retire to raise her children?

    • suchende
      February 19, 2013 at 2:31 pm #

      Plus, best I can tell, she now devotes a significant amount of time staying current on the literature. I don’t think many OBs with active practices can say they spend as much time staying current as Dr. A does.

      • Certified Hamster Midwife
        February 19, 2013 at 5:35 pm #

        I’m sure none have time to read homebirth sites on the internet in addition to keeping up on the literature. (Some people would say that as an insult, but I mean it as the opposite.)

        • Lisa from NY
          February 19, 2013 at 7:41 pm #

          But they will invent their own literature anyway, as Dr. Amy said, distorting statistics to prove their point.

          • Certified Hamster Midwife
            February 20, 2013 at 6:42 am #

            By “none,” I meant OBs in full-time practice.

  20. Mrs. W
    February 19, 2013 at 11:53 am #

    It’s not the mother’s lack of knowledge of obstetrics, science and statistics that is the problem –it is their care providers who have deprived the mothers of informed consent because of their lack of knowledge of obstetrics, science and statistics. Patients are not expected to be experts – but they must still be able to make decisions for themselves by being able to trust the information given to them by those who are claiming to be experts.

    • Guest
      February 19, 2013 at 12:47 pm #

      Yes, I so agree with this. Just yesterday a local CNM who does homebirths and hospital births posted a bad ultrasound study that seemed to indicate US were not safe. A bunch of her patients anxiously posted, asking her what they should do? She responded that personally, she never got an US during any of her 6 pregnancies, but it was up to the families to decide based on the evidence. Well, she had just presented to them some supposed evidence indicating the dangers of US. WTF are these families to think? They aren’t educated in birth and US, they are trusting her as their care provider, she has a CNM/RN after her name, and said she doesn’t believe in them basically. I can’t blame the families.

      • Captain Obvious
        February 19, 2013 at 1:28 pm #

        Report her to the hospital she delivers at. Screen capture the FB pages and forward them to the chief of OB, MFM department, and performance improvement committee. I am sure she will have some explaining to do.

        • I don't have a creative name
          February 19, 2013 at 2:27 pm #

          Yes, please do report her! This passive way of encouraging families to turn down very basic care could have devastating consquences.

        • Lisa from NY
          February 19, 2013 at 2:51 pm #

          What happened to the consent form post for vaginal birth? I wanted to comment that this should be an advertisement for birth control.

        • Guest
          February 19, 2013 at 5:12 pm #

          I will. In my experience in my region, the CNMs who do homebirth (there are several) are just as dangerous in their beliefs and advice as the CPMs. I think many CNMs in the United States who do homebirths are ideological twins of the DEMs, with all the woo and risk that entails.

          • Renee Martin
            February 20, 2013 at 3:25 pm #

            I often think that when it comes to OOH birth, the HCPs beliefs are more important a factor in tragedy than just about anything else. No matter how well trained you are, if you are headlong into NCB and use it as a guide to practice, you *will* be more dangerous than someone with a basic understanding of the risks of birth.

  21. BCMom
    February 19, 2013 at 11:18 am #

    I would also add that the potential problems and complications facing pregnant women have not changed in the last twenty, one hundred, or even five hundred years. Dr. Amy’s insight gained from experience delivering babies while she was practicing doesn’t go away.

    • The Computer Ate My Nym
      February 19, 2013 at 11:38 am #

      Obstetric practice has changed in the past few decades, but, as you said, not that much. The basics are much the same, certainly for spontaneous vaginal deliveries. In any case, Dr. Tuteur clearly keeps up with the literature and probably does CME work periodically.

  22. auntbea
    February 19, 2013 at 10:49 am #

    You know who else isn’t a practicing OB anymore? Dr. Biter.

    • LukesCook
      February 19, 2013 at 1:43 pm #

      And who was never an OB? Dr Odent.

      • Captain Obvious
        February 19, 2013 at 2:04 pm #

        Nor Mardsen Wagner.

      • Bombshellrisa
        February 19, 2013 at 2:09 pm #

        “And who was never an OB” Ina May and Penny Simkin-although Penny Simkin was a physical therapist.

      • KarenJJ
        February 19, 2013 at 9:14 pm #

        Nor Dr Sarah Buckley.

  23. Lena
    February 19, 2013 at 10:23 am #

    And if you were still practicing, you’d be an know-nothing OB who can’t possibly understand “normal” birth because you’re only around for the last five minutes of labor, unless you’re running late for your golf game then you’d just do a c-section, AMIRITE?

  24. One Hopes
    February 19, 2013 at 10:05 am #

    I would love to be able to counter Dr. Amy’s detractors with something substantive. Too often, I hear something like, “Amy Tuteur never practiced obstetrics or gynecology after her residency was finished.” Although I assume this isn’t true (like the untrue rumors that she never had a vaginal delivery and never nursed a baby), I sure would like to be able to say, “Actually, Dr. Tuteur practiced as an OBGYN in X city for Y years from 19– to 20–. You are misinformed.” Anybody have that kind of ammunition for me? Dr. Amy maybe?

    • Lisa from NY
      February 19, 2013 at 10:44 am #

      It’s irrelevant, though. It doesn’t take a meteorologist to say that swimming alone in the ocean at high tide is stupid. Likewise, you don’t need a brain surgeon to say that jumping out of an aircraft without a parachute might break your skull.

      • nohika
        February 19, 2013 at 10:54 am #

        Ignore the neurosurgeons! They’re just in it to make bank! Your head will naturally cushion your skull and you will be fine!

        • OR_Guest
          February 19, 2013 at 12:11 pm #

          Trust gravity. It’s natural!

    • The Computer Ate My Nym
      February 19, 2013 at 11:35 am #

      Well, her bio states that she was a clinical instructor at Harvard, which implies that she practiced there after residency.

      But no matter how long Dr. Tuteur has been out of practice, she almost certainly has more experience than the average DEM/CPM. I nearly qualify for being a DEM based on number of deliveries seen and my only experience in OB was as a not particularly interested medical student. Dr. Tuteur may not be up on the subtle points of which drug is currently first line for stopping premature contractions in the setting of chronic hypertension without signs of pre-eclampsia in the presence of a factor V leiden heterozygote*, but she’s far more knowledgable than a DEM about normal delivery.

      *Total made up babble about what might be a complicated decision in OB, but probably isn’t. As I said, I only did obstetrics in medical school.

    • Karen in SC
      February 19, 2013 at 11:44 am #

      One Hopes, have you read the lawsuit filing? I believe Dr. Amy’s bona fides are listed in that. Hey, it may even be fun to link to that document when rebutting…

      • Karen in SC
        February 19, 2013 at 11:45 am #

        Of course a better rebuttal would be “so you listen to someone who NEVER even had medical school and an OB residency?”

      • One Hopes
        February 19, 2013 at 5:50 pm #

        I am an attorney. I just read the Complaint with interest, and I think she has a strong case against TFB. However, the Complaint merely states that she “stopped practicing in 1995.” It does not say where she practiced or in what capacity.

        I disagree that her length and location of practice is irrelevant. She stands on her authority as someone who was educated and trained to be an OB/GYN and indeed as someone who has written a book on the topic. At any rate, even if it IS irrelevant (just like it’s irrelevant whether she ever breastfed or gave birth vaginally), if there is one less excuse for critics to dismiss her, I am all for that.

        • suchende
          February 19, 2013 at 6:40 pm #

          Another attorney! I’m done with my JD but haven’t taken the bar yet. The thing I find most baffling about NCB is how many attorneys are sucked into the woo. So much for learning to think critically like a lawyer.

          • One Hopes
            February 19, 2013 at 8:56 pm #

            Good luck with the bar exam! It is a beast but if you do barbri and work the program, you’ll live through it, pass, and have it behind you.

            Many attorneys are sucked in. Luckily I never was, but it’s easy to see how somebody could be. The woo is full of flattery and ego-stroking – you’re too smart to fall for the mainstream, you have secret knowledge, etc.

          • suchende
            February 19, 2013 at 9:01 pm #

            Thanks. I am taking it in a fairly low pass rate state :-/ Not really excited to start prep.

            I saw BOBB and was pretty concerned by the issues it raised, but the first thing I did was start looking for critical analyses of it. Which I would expect any attorney to do, but I guess that’s not necessarily true.

          • quadrophenic
            February 20, 2013 at 12:27 am #

            May I ask what state? I’m in California. I found bar bri adequate but really it’s more about learning how to write for the graders (in CA) than learning the law. I forgot half the contracts and community property stuff I needed to know and had a fairly startling earthquake mid day 1 of the exam and still got through just fine.

          • suchende
            February 20, 2013 at 1:27 am #

            Delaware. We don’t really have normal BarBri but I guess my firm has some hand-me-down prep materials that are supposed to be clutch haha

          • fiftyfifty1
            February 19, 2013 at 9:59 pm #

            ” It is a beast but if you do barbri and work the program, you’ll live through it,”

            I recommend raspberry leaf and affirmations instead.

          • Frequent Guest
            February 20, 2013 at 8:54 am #

            “Trust BarBri”.

          • quadrophenic
            February 20, 2013 at 12:23 am #

            An attorney here… I did do a NUCB in the hospital, took a Bradley class, but stopped short of buying into woo. I’ve always been firmly anti alt medicine. And as a defense attorney I have zero respect for chiropractors. I seriously went into NCB thinking it was just a pain management strategy, I didn’t realize it was a lifestyle.

            Good luck with the bar! Looking back it was kind of fun, and marked the end of my “student” life. After I passed I had to face real life and stuff, which sucks.

          • suchende
            February 20, 2013 at 1:28 am #

            I worked before law school, and took off time before college, so for me the stops and starts of student life have been pretty fluid… but I think this really is the last exam for me!

          • Lisa from NY
            February 20, 2013 at 8:33 am #

            I disagree. I have seen people with back pain helped by chiropractors.

          • quadrophenic
            February 20, 2013 at 10:24 am #

            Not to get too off topic – I do think some get relief but they would get relief from PT or massage therapy which are more legitimate disciplines. The whole history of chiropractic care is sketchy, even if they do some things that are helpful it isn’t enough to redeem from the rest of the BS beliefs (although some chiros aren’t nearly as bad). A couple of months of chiro is fine, but beyond that you need to see someone else if you still have pain.

          • The Bofa on the Sofa
            February 20, 2013 at 10:43 am #

            As I asked the recent chiropractor here, what does it say about your profession when your defense is “not all of us are quacks”?

            Of course, reading between the lines, I am not sure she should have included herself among those chiros that weren’t quacks.

          • Frequent Guest
            February 20, 2013 at 8:53 am #

            And another attorney here. I also had an unmedicated hospital birth, but only because I am terrified of needles and the epidural sounded worse than labor pains. Also, my husband is a third-year medical student, and (along with Dr. Amy) serves as a pretty good reality-check to keep me out of the woo! 😉

            P.S. suchende, good luck with the bar!

    • Guest
      February 19, 2013 at 12:51 pm #

      The irony is that they will trust a CPM with only a high school degree and training in 40 births as an apprentice.

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