Homebirth advocates are lamenting the court defeat of Aja Teehan. Teehan petitioned to Irish courts to force the health service (HSE) to PAY FOR a homebirth VBAC, against medical advice, attended by a non-HSE provider. Not surprisingly, she lost, in large part because her toddler level claims.
The arguments of homebirth advocates bear a remarkable similarity to toddler tantrums. Indeed, the language is the same.
Consider:
1. I want
Homebirth advocates, like toddlers, appears to believe that because they want something, they deserve to have it. It doesn’t matter that it isn’t safe. It doesn’t matter that others (the baby) may be hurt or die because of their choice; it doesn’t matter that other people (health professionals) must be forced to do things they don’t want; it doesn’t matter what it costs. They want it, and like toddlers, they appear to think that this is their most compelling argument.
2. Gimme
Homebirth advocates, like toddlers, appear to think that because they want something, everyone else has an obligation to provide it for them. Regulatory boards should violate their standards to admit uneducated, unqualified midwives; the most basic principles of safety should be ignored, and somebody else, be it an insurance company, the government or donors on crowd sourcing website. should pay for it.
3. Mine
In the world of homebirth advocates, everything is “mine.” My homebirth, my rights, my desires. No one else counts, not even the baby. Everyone else is just a prop in their little piece of performance art.
4. How do you know?
Homebirth advocates, like toddlers and even older children, have zero respect for the education and experience of those who are older, better educated and better trained. Like the second grader who asks for help with math homework and then whines that the parent is doing addition wrong, homebirth advocates insist that they know more about childbirth, medicine and science then people who have spent decades studying and practicing obstetrics. In exactly the same way as the second grader who needs help with his math homebirth believes that his mother doesn’t understand addition, homebirth advocates who transfer to the hospital in obstetric emergencies believe that doctors and nurses don’t understand childbirth. Such astounding naivete may be understandable in a second grader, but it truly defies comprehension in an adult.
5. You can’t make me!
The battle cry of toddlers and homebirth advocates everywhere.
That’s because defiance is the hallmark of homebirth advocates as well as of toddlers. It’s true that we can’t force women to give birth in hospitals or hire real midwives instead of birth junkie self-proclaimed midwives, nor should we be able to force women to do so. Nonetheless, choosing to risk your baby’s life because you enjoy defying authority isn’t any more mature than the toddler who lies thrashing on the floor, whining “you can’t make me.”
6. It’s not fair!
Homebirth advocates, like children of all ages, have acute appreciation for fairness BUT ONLY as it applies to them. They are constantly wailing about injustice without giving a moment’s consideration to their fairness to others. Homebirth advocates, like small children, insist that their “rights” are being violated as if there is a right to homebirth. They simply made it up; there is no right to homebirth, just as there is no right to stay up past your bedtime.
Ultimately, homebirth advocates are going to find it impossible to achieve their desires as long as they continue to resort to toddler-speak. “I want” a homebirth does not incur any obligation on the rest of us. “Gimme” does not mean we need to pay for it. Insisting that the birth is “mine” and ignoring the baby’s well being just makes most people think less of you. “How do you know?” and “You can’t make me!” are cries of the immature. And “It’s not fair!” begs the question of fair to whom; the baby? the health care providers? the government?
Fortunately for babies, I don’t foresee homebirth advocates improving their reasoning skills. In the books they read, and the echo chamber websites they frequent, toddler reasoning carries the day. They can’t seem to figure out that what works for toddlers isn’t going to work in the world of adults and professionals. And so they are left to wail, yet again, “it’s not fair!”
I have a whine. My third baby is by far my best and easiest nurser, but at 2 months I am strongly considering quitting. I don’t want to. I don’t have a problem with formula, and her dad give it to her a few times a week. I’m just lost about it. Feeling stupid for feeling bad, feeling bad for considering quitting, etc. too many feelings.
Currently taking cymbalta and abilify. P doc won’t add klonopin 2mg 3x day until I stop BF. So I’m nut balls crazy and need the anxiety meds but can’t decide what to do. Bf with the meds, quit bfing, not get the meds, etc.
Haalp! Oerwhelmed and emotional. Need advice.
If you were my sister I could give you advice and no matter what I’d say it would not jeopardize our relationship. But you don’t know who out in the cyber-world will respond to your plea for help.
If you were my sister I would advise you to ask your baby’s pediatrician before taking any medications while breastfeeding.
I was venting more than asking for help.
Quit BF. Your mental health and stability mean far more to baby than any breast milk.
Quit bf. And go over to Fearless Formula Feeder – Dr. Amy has the link on the Blogroll on the right.
I think your baby (and other children, and husband, and yourself, and everyone) needs you in good condition, which may mean you getting your meds. I think that after your doc doesn’t want you to breastfeed while taking klonopin, you’d better quit breastfeeding. I understand that you’ll miss breastfeeding. I am not sure the baby will miss it as much. For my babies, as long as they were hugged while fed, it apparently made little difference where they sucked from.
I would quit breastfeeding. I have been on antidepressants for severe depression/anxiety for 12 years now (stayed on them during pregnancy). You need to be healthy for your children, and if taking klonopin will do that, this needs to be your priority. Besides that, you have given your baby two solid months of breastmilk, and that’s fantastic.
Do you think your anxiety is making it hard to make this decision? Can you imagine what your feelings would be if you quit vs if you continued? Like which decision you would look back on with regret or with peace? There are plusses and minuses to each option, and also it’s not like you cant change your mind after a few days if you dont like how things are. Anyway, we all support you with whatever you decide.
If the inability to take necessary medication is DAMAGING TO YOUR HEALTH, then you need to take it (and, by extension, stop breastfeeding). The goal should be healthy mom, healthy baby. If mom is not healthy due to breastfeeding (and will become healthy by stopping), then PLEASE STOP.
Seriously, formula is not poison. And an unhealthy mom is not the best mom.
Everyone’s going to be happier and healthier in your family if you are happier and healthier. If you need the meds, take the meds.
It’s not a whine. After a scary, high-risk pregnancy, I made the decision to use formula and go back on my antidepressant (I switched to a “safer” one during pregnancy, but it really didn’t work for me.) I have no regrets. I feel guilty that I couldn’t to the best for my son, nutrition-wise, but I think it’s important that I feel good enough to get out of bed every morning.
I’m very sorry that you need to quit BFing to take care of your health. I know that I would feel a little sad if I had to quit BF as well, and it would have nothing to do with mommy guilt or hating FF (which I don’t, DS was FF). I just really enjoy BF, and would miss it, like I miss other things I cannot do anymore (like drink a glass of wine w dinner). It is OK to feel this way, though I think the overwhelming feelings will lessen once your anxiety has been tamed.
That said- If you need the meds, then you need to quit BF. I’m sorry, but your health is very critical. There is so much more to lose than BF! I had serious GAD and CBT really helped, and is worth looking into. It won’t replace the klonapin, but may help quite a bit.
Also, there are alternatives that can help ease the transition for you (since baby won’t mind). You don’t need the breast to get a good connection during feeding time! If you don’t mind the formula, and are just wanting the physical action, you can use an SNS for a few feeds in order to get that “at breast” feel. I have also seen moms FF just like BF- they hold babies in the same way, and position the bottle right under their boob so they get the same snuggles as BF.
I hope you are feeling better soon!
Thank you for the responses. I formula fed both of my other kids at one point or another, the middle one getting the ebil ebil corn syrup formulas due to complications from salmonella at 8 or 9 months. So I am no kind of ‘formula is poison’ person. I posted here because other than FFF, everywhere else on the Internet would be all BE A MARTYR TO BF!!!11
I think anxiety that needs to be treated is a factor in my little pre p doc appt (which is today) tantrum. I really want to just be able to take a med that is safe for breastfeeding, but I’m pretty sure e giant dose of klonopin doesn’t have an equal that is safer. I’m going to ask about Ativan since it has a short half life, and I could bottle feed part of the day and breastfeed at night.
Tank ou all for listening and being rational.
You could say this about anyone who wants anything. ????
Um….no.
‘In exactly the same way as the second grader who needs help with his math homebirth believes that’
I think it’s supposed to be math homework? 🙂
Otherwise fantastic article, as usual. People are special that way.
Thanks for pointing that out.
The last paragraph also starts with “Fortunately” which I think is a typo in that sentence as well. Why would it be fortunate HBers won’t change their tune?
Should I feel guilty for wanting to make my 13 year old read this part of the article? When I am asked for math help I never seem to do it ‘right’ (the way the teacher taught)…
You think that’s bad. I had to hire one of my students to tutor my daughter in biology because she kept saying what I was telling her was not the way her teacher taught her. I teach virology to grad students.
My husband’s father, on the other hand, was sure that the teacher was teaching my husband math the wrong way and would spank him for doing it the teacher’s way…
This is a few weeks old and I don’t know if someone already posted this, but had to share:
http://www.babble.com/baby/formula-fed-baby-enters-medical-school-satire/
Hey, Dr. Amy! Would you consider writing something about Emily Oster’s new Slate blog on pregnancy? She’s done one entry so far (http://www.slate.com/blogs/expecting_better/2013/08/19/bed_rest_during_pregnancy_doctor_s_orders_to_curb_premature_labor_but_there.html, and I find I violently disagree with her conclusions on this one subject, at least. She’s making a lot of hay out of a not very well done study on bed rest for pre-term contractions, and one “review” article in which a doctor was willing to make the sweeping pronouncement that bed rest wasn’t good for any pregnancy complication (which was news to me, after that whole adventure with the placenta previa).
Oster is an economist by training, and seems to mostly be reading the abstracts.
I’m waiting I’ve had chance to see the book, which comes out tomorrow.
I was underwhelmed by today’s post because I thought she missed the larger point. As she acknowledged, obstetricians KNOW that bedrest isn’t very effective, and they certainly don’t make money by prescribing bedrest, yet she fails to look at the fact that obstetricians are dealing with women who are desperate to save their children and are more likely to say that bedrest doesn’t hurt, not to say that it helps.
Haven’t read her blog but read this recently, which showed activity restriction did not reduce the rate of preterm birth in a symptomatic nulliparous women with a short cervix. Bedrest does have risks of VTE, decreased work income, deconditioning risks, and emotional ramifications. Bedrest hasn’t been the cure all it was once thought to be.
Grobman WA, Gilbert SA, Iams JD, et al: Activity restriction among women with a short cervix
Obstet Gynecol 2013(Jun);121(6):1181-6 [PMID 23812450]
Oster is attempting to argue that bed rest is useless for all pregnancy complications, not just cases of thinning cervix/preterm contractions.
Well to be thorough, there is pelvic rest, work leave, and non-work rest. It seems bedrest for plain ol’ preterm labor or for nulliparous women with short cervix (OB GYN June 2013) doesn’t help much. And you’re right that VTE risk, deconditioning, emotional ramifications, and financial burden does exist. But for placenta previa, vasa previa, PPROM, and incompetent cervix, pelvic rest helps. For hypertensive exacerbations or mild pre-eclampsia, non-work rest and/or work leave helps. Blood pressure and edema will improve.
That was my suspicion, more or less. There are conditions that bed rest is not useful for (or at least, not more useful then pelvic rest or work leave), and conditions it’s not.
I also wonder about how much practical difference there is between unsupervised bed rest at home, and following a doctor’s vague instructions to put your feet up as much as possible. I wonder if bed rest is sometimes prescribed to help women working manufacturing, food service, or retail access disability benefits when they have pregnancy complications that might not strictly require them to stay in bed, but would be helped by ceasing to work.
I was put on home bedrest—no work, stay off feet as much as possible, but I wasn’t restricted from a quick trip to the grocery store, I was allowed to take the dog to the end of the block–when my cervix started to shorten around 27-28wk with my twins. But, when PTL started in earnest at 30wk, I was put on hospital bedrest with tocolytics. I think I recall my OB saying something along the lines of those things weren’t proven to work, but didn’t hurt to try, and being in the hospital was the best for the obvious reasons that I was already there should labor be unable to be stopped.
My labor did stop (and start again at 32 wk, and stop again) and then they sent me home still on nifedipine, stable, 4 cm dilated, 34wk pregnant. I was good until 36wk, when I came back after SROM. I don’t know if it was the bedrest, the tocolytics, the combo or just luck. This was back in 2008/09 (Dec/Jan) and I’m not sure the OB would follow that protocol anymore. Also I don’t know if multiples makes a difference vs. a single, though it’s clear that multiples is high risk for PTL, and not uncommon for the mothers to end up on bedrest at some point during such a pregnancy.
Mother cited for neglect following stunt birth.
http://thestir.cafemom.com/pregnancy/159907/moms_extreme_home_birth_plan
I would imagine the issue was more about the heroin than the homebirth.
So much for no pain meds.
An excellent point. She should join my opiate-assisted childbirth advocacy organization.
She should have just gone to the hospital, you get the GOOD drugs in there! Much better than street heroin.
Yeah, I agreed with the comment someone made about this being more of an avoiding-prosecution-birth, rather than avoiding hospital intervention type of thing.
Dear potential home-birthing people,
As a teacher/dairy farmer with no children, I think I can say this important message without being accused of bias.
Let’s say you give birth at home and something goes badly wrong. Your baby is entrapped. You start bleeding profusely. Who does this affect? You, your baby, your significant other, your other children, your midwife? Yes, yes, of course.
But who else does it affect? How about the EMTs who rush to your house to find a semi-conscious bleeding woman with blue feet between her legs? The EMTs who work frantically to get a line started on your collapsed veins, attach you to oxygen, and help the midwife deliver you baby who is not breathing. The EMTs who start doing CPR frantically on the baby or you. The anesthesiologist who has to try and knock you out without knowing any sort of medical history or the last time you ate. The OB/GYN who has to stitch up your 4th degree vaginal tear or perform a Cesarean hysterectomy. The OB who has to call your time of death when the C/S hysterectomy was too late to stop your torrential bleeding. The nurse’s aids who have to mop up all the blood. The neonatologist who sees a baby who has no chance at survival but should be a healthy bouncing baby. The neonatologist who sees a baby whose brain is dead but body is still alive… for now. The nurses who try to comfort you in the aftermath of this horrible birth. The nurses who care for your child as it becomes clear the child is brain dead.
Medical professionals are people too. EMT’s, nurses, nurses’s aids, OB/GYN’s , anesthesiologists and neonatologists are all people who feel emotions in response to situations they encounter at work. Medicine brings great joys and great sorrows, but your situation was not the fault of medicine. And yet, although this situation was not caused by medicine, the medical professionals are going to have to deal with the aftermath of this situation.
You say home-birthing is about freedom. No one is free. We live surrounded by others. Your actions affect far more than you and your family.
The story you describe happens far too often. Having to call and ask the carpenters to remove the blood soaked flooring from a patient room is one of the worst memories I have of my career.
When people complain about lack of choice, what they’re often really complaining about is the lack of a perfect choice.
Not a perfect choice, a preferred choice. I see this all the time with people when they call us to pay their bill. They can pay their bill for free online, in person at a branch OR an authorized location (WALMART), through their own banks website, mail the payment in, direct debit, a free pay by phone option if they’re signed up, or a pay by phone option through an outside agency that charges $1.50.
But they can’t pay over the phone with me.
Time and time again people complain that we make it so hard to pay their bill and we aren’t giving them a choice.
Kinda unfair to compare home birth advocates to toddlers….toddlers are cute and sweet and can be expected to grow up someday.
Plus their tantrums are much shorter (even my intense older girl with medical issues managed to calm down within a couple of hours) and they never make it to court.
Mrs Teehan and her supporters need to get that this was like winning an insurance company’s competition for an African holiday, and then demanding the insurance company fund a white water rafting trip down the Zambezi.
Then the insurance company saying “nope, that’s a bit risky, how about an all expenses paid safari instead?”. You still get your African holiday (birth) for free, but the insurance company is entitled to decide that white water rafting (HBAC) is too risky, and a safari (VBAC in hospital) isn’t.
Your alternative is to have your white water rafting holiday at your own expense with no travel insurance (UC).
You forgot “inability to see greater picture”
Toddlers fixate on small details they perceive as important without fully understanding the greater picture. My toddler will get very excited about going to the park, then spazz when it’s time to put shoes on because it’s delaying going to the park. He doesn’t realize that shoes keep his feet safe from rough objects and that if he cooperates with shoes, we’ll get out the door and off to the park faster. This reminds me of some stories I’ve read of homebirth moms spazzing because their baby is in NICU and doctors are recommending formula supplementation. They say they just want their baby healthy & home, but balk at steps that will make that happen faster because they don’t want to do the bit they don’t like.
So when my last GD baby was born she had a severe case of hypoglycemia (18!) so naturally she was a little too out of it to latch on properly. The pediatrician suggested we try formula. “Okay” I said and popped it in her mouth. I didn’t think anything about it, I just enjoyed feeding her and watching her blood sugar go up (hubby was upset that I didn’t let him feed her since it was a bottle, whatever)
Afterward the pediatrician thanked us for being so open to feeding our baby some formula. Apparently most parents at this hospital insist on a NICU stay with an IV over a f****** bottle. I was SHOCKED! Our baby didn’t have a NICU stay,’perked up right away, and breastfed like a champ for 2 years. These lactivists are stark raving mad!
omg I can’t imagine giving a baby an IV over a bottle… I’ve had an IV when I hadn’t had anything to drink in 12 hours and it was agonizing!
Parents are told by staff LC that an expensive NICU stay with IV is better than formula. I hope the donor milk supply will reduce this nonsense, even though I think scarce donor milk should be for preemies and full terms with gut problems.
That is freakin’ ridiculous. I might be willing to make the argument that NICU admission makes breast feeding harder, and is traumatic for everyone involved.
The baby in my house who got an ounce of formula by bottle in the hospital got FAR more breast milk then the baby who spent time in the NICU. I really think a little formula applied as needed can facilitate a breast feeding relationship.
Head. hits. desk. I really, really, hope that is not true.
I’ve seen that one 🙁 maybe I wasn’t sure where the idea came from but I have seen the IV is better than formula choice.
During my mandatory baby friendly training the LC staff taught us IV is preferable to supplementation of any kind but especially formula. The NICU nurses in the room were dumbfounded and asked why the physiologic way (eating) was less preferable than expensive non physiologic treatment that goes on for days. No answer….
NICU nurses ain’t dumb. IVs are an infection risk, all babies need to learn to eat, and NICU care is obstructive to the breastfeeding relationship, causes real challenges in emotional bonding (while it lasts – I hasten to add that most parents bring their babies home and bond just fine), and imposes a physical separation between mother and infant that natural childbirth advocates and lactation consultants otherwise claim is a bad thing.
There are plenty of cases in which NICU care is lifesaving, and more in which it has great benefits, but this is not one of them.
Amen. We need the beds available for true emergencies.
I know, I think they are making things harder than they need to be.
Soooo….as the mother of a 16-month old who has discovered The Tantrum, can someone tell me how long this lasts (assuming she does not become a NCB advocate)? On an unrelated note, would anyone like a toddler?
Generally to three or four. Or sometimes 18. Or in the case of my BIL 37.
It stops eventually – my 6 year old has begun trying it again. I’ve found that remaining calm and letting her yell for a bit until she starts winding down, and then asking in a bored tone: “Are you done yet?” seems to reduce the frequency. Probably because we talk things through afterwards and she’s old enough to understand things once she’s calmed down.
I can’t take another toddler, but if I find a circus that does curbside pickup, I’ll let you know.
Do you think I have to pay a bulk-item fee for that?
Depending on the child, it can last until they are in their 20s. They improve once they become parents themselves. And no, having had three of my own, you can keep yours.
Sometimes, when I deal certain couples in prolonged fertility treatment, I think loaning them a toddler for a couple of weeks might make them think twice about that decision to do “anything!” to have a baby. Certainly, when The World Champion Picklepuss & Jewish Princess, a.k.a. The Curly Haired Monster, was a toddler, i found myself wondering if I could use her as a source of income, renting her to encourage the use of contraception [thought about “The Ransom of Red Chief” a great deal]
Ha, I am 12 weeks pregnant and the other day there were two siblings having a screaming argument at the department store and the mother refused to stop them. They weren’t even toddlers. Upper elementary age I think. Ugh. All I could do was hope that my kid doesn’t turn out like that and if they do I have the sense to remove them from the store…
I was already envisioning myself as the favourite aunt, spoiling a niece or nephew shamelessly before returning them to their owners. Then, we made the mistake of sitting in a cafe where children were allowed. In 3 minutes, exactly, my SIL said she wasn’t ready for children. 2 minutes later, my brother followed.
Turned out one of the kids had a birthday and the parents decided to save money by taking their guests to an ordinary cafe, to the detriment of all the other patrons. When my brother went to their table, they were quite pissed off. I didn’t care because oh joy! the yelling stopped.
Be careful. In three years, if I’ve learned one thing, it’s that every judgy thought I’ve ever had about another parent has come back to bite me in the ass.
Children who are close in age fight with each other. My two oldest were 20 months apart and were always fighting. I would never have let them do it in a store. I actually used to set up pillow fights and have them air their anger with each other. It helped some.
Children who are not so close in age fight with each other, too! My
brother and I, we are almost 5 years apart and my mother (an only child)
often came to end the war and was shocked, shocked that she wasn’t
needed or wanted. Leave them alone, my father (the youngest of 3) would
say but she wouldn’t believe it until she heard it from us.
Ah,
the fights for our only TV! He wanted this, and I wanted that, a fight
followed. Ten minutes later, a third thing would start and we would grow
quiet in front of the TV screen.
I have to say, though, that
having a fight in a store or in public was something neither of us ever
considered. I don’t know whether we tried and were firmly dissuaded, or
no one else did and so we didn’t know we could do it.
Love that story!! Just goes to show that children have always been the same and will always be the same.
My eldest one had some pretty full on tantrums. We ended up at a child psychologist office due to the frequency and duration of them – they were quite alarming (and she also had some health issues we needed help with). She could spend an hour lying down, screaming and twiddling at her hair (her method of calming herself as a baby). I couldn’t distract her from them and couldn’t calm her.
They stopped when she was around 3yo. The psychologist said that her tantrums were a little on the extreme end of things but still common enough. She’s always been an intense, independent and determined character. Her brother is much more easygoing and his tantrums are not nearly as full on (although he doesn’t mind the public variety) and I an sometimes wave a lotllipop at him to distract him.
Thankfully, mine’s tantrums just involve lying down and refusing to move until we pick up her limp, pitiful self and take her where she wants to go. We left her lying in a display at Ikea and walked away and she just didn’t care. My sister used to do exactly the same thing.
LIZ EARLE- perhaps you would like to continue telling me about your midwifery company over here where I’m more likely to see your response?
Are the NMC aware of the “high risk ” homebirths the midwives in your company are allegedly undertaking? Is your medical indemnity firm?
Do you want to reconsider anything you previously posted about the case mix (previous PPh, VBAC) and transfer rate (3%)?
Re posting, so she has the maximum chance to see it, and particularly apt because part of the HSE’s case was that the UK, which supports HB, doesn’t support HBAC.
WELL SAID! I am dealing with all that at home with a 14 months old at home. My 6-year old daughter already understood that “life is not fair” and “yes, Mommy and Daddy know more than me.” Reading homebirth advocates’ articles totally reminded me of my older one’s toddlerhood.
Just wait until adolescence, then you will recall toddlerhood with nostalgia as being “so easy”.
Oh lord – we’re starting that. I could pick her up and remove her when she was a toddler.
You forgot that in response to the slightest criticism is “SHUT UUUUUPPPPP!!! YOU’RE BEING MEEEEEEEEEEEENNNNNNN!!!!!
Haha! My 4yr olds have recently been using “It’s not fair!” just about every time something doesn’t go their way. I’ve started trying to explain why it doesn’t make sense most of the time, and they actually listened…not sure they got it, but they were paying attention at least. I tried to explain what “fair” means first of all, and finally concluded with the revelation that life isn’t actually fair.
I am sure that if any homebirth advocates read this post, they will believe it isn’t fair, and that Dr. Amy is being hateful and mean. Oh, and spewing vitriol, almost forgot about that.
Wait, are we talking about toddlers, or about Gina Crosley-Corcoran?
Po-TAY-to Po-TAH-to
This is why no one gives toddlers a delete button.
off topic. I suddenly found interesting information (measurement error and clustering) about a cluster randomised trial of a breastfeeding promotion intervention carried out in the Republic of Belarus
http://www.bmj.com/content/339/bmj.b2900 (about this trial from the words “Recent example”).