Happy New Year and thanks to my readers for another banner year!
The Skeptical OB had 1.5 million visits this year and 2.9 million page views for an increase of 67% over 2012.
According to WordPress, in 2013, there were 292 new posts, growing the total archive of this blog to 1,215 posts.
The busiest day of the year was June 12th with 27,412 views. The most popular post that day was Would you hire this midwife?.
These are the posts that got the most views in 2013 were:
- Vaginal weight lifting 5 comments December 2008
- Vaginal tears 353 comments February 2012
- Would you hire this midwife? 292 comments June 2013
- Baby dies because mother refused newborn vitamin K shot 401 comments January 2013
- Lawsuit 792 comments January 2013
A special thank you to the 5 most active commentors:
- The Bofa on the Sofa 1726 comments
- KarenJJ 1349 comments
- Bombshellrisa 1277 comments
- Dr Kitty 1164 comments
- auntbea 1014 comments
The most commented on post in 2013 was The narcissism of lactivism with 1103 comments.
As I said last year, I would put The Skeptical OB up against any blog on the Web as having the most articulate, the most intelligent and the most compelling commentors of all.
Thank you also to the many, many people who wrote to me privately, sharing their experiences, questioning my views and offering interesting links. I am especially honored that several professional homebirth advocates have been in private communication, despite the fact that I have criticized them in print and they have criticized me. Even though we disagree, sometimes quite profoundly, they trust that they can seek my opinion about medical issues or aspects of homebirth practice that unsettle them.
I know that many homebirth advocates dismiss what I write without even reading it. To those people I say: you (perhaps especially you) are welcomed to this site with open arms. I am grateful to have the opportunity to inform you about the real risks of homebirth. It’s up to every woman to make her own decision where to give birth, and this blog offers information that you cannot get anywhere else outside the scientific literature.
The blog is not perfect. It is a one person effort, from the writing to the coding, and sometimes that shows. There is no editor and I am terrible at proof reading my own work. I occasionally make math mistakes. I try to correct any mistakes as soon as they are pointed out to me and the mistakes are never an attempt to mislead. I am trying to present the most accurate, most detailed and most up to date information on homebirth and other areas where parenting intersects with pseudoscience, and I fervently hope that I am usually successful in that effort. To the extent that I am not, it is not for lack of trying.
Thank you again to all my readers. Happy New Year!
Sincerely,
Amy
Thank you for a fantastic, thought-provoking blog. Thank you for being a can’t-ignore voice for childbirth safety and mothering sanity.
Happy New Year, and very best wishes for 2014! Thank you for a huge amount of enjoyment, your posts never fail to educate, provoke, entertain and stimulate. I look forward to many more decades of the SOB!
Happy New Year Dr. Amy – thank you for your efforts in this area, they are much needed and much appreciated.
This blog has become an almost daily read for me this year as I struggle my way through the woodom that I’ve been a part of promoting for 30 years. It is a painful experience. Cognitive dissonance is never easy. Thank you to those who take the time to comment on issues. I haven’t posted in reply but that may change. When I started reading it was out of morbid curiosity, but now I am starting to see things a bit differently. Wonder where I will end up? It’s a bit scary!
Happy New Year, Dr. Amy! Also, Happy New Year to everyone who comments and lurks here! 🙂
Happy New a Year!
Let’s hope 2014 brings less HB disaster and more people being brought to account for past misdeeds.
While I obviously enjoy the discussion here, if I had to pinpoint ONE piece of information in this blog that I think is probably the most important, it would the distinction between the CNM and CPM. Coming in naive, I had no clue that there were two different types of midwives in the US.
I think this is one of the most interesting, intelligent blogs around.
Not exactly sure how I found this blog – probably a stray comment on the WTE site. I find it really interesting and it appeals to my political activist side. It really is an enjoyable read and I find myself checking it daily – something I would have never expected to find myself doing!
I remember very well how I found SOB: through a complaint about Dr Amy’s comments on an anti-vax website! And here, I found my rational/activist community. The one thing I have to thank anti-vaxers for!
This all sounds very familiar. Every time I saw a reference to Dr. Amy somewhere on the birth-related internet sites (even Babycenter, which I suppose is fairly mainstream), everyone would get their knickers in a knot about how “horrible” and “mean” and “wrong” she was. Finally curiosity got the best of me. I started reading…and just never stopped. I could see from the start why some people would find her abrasive but her blog posts never bothered me and I loved the wealth of information here.
How I found this blog: Someone on Babycenter had linked to Dr Amy’s “Ten things you shouldn’t say to Dr Amy” post, which I then read and thought was hilarious. I rarely visit Babycenter any more (except for laughs…), but I find myself checking this blog every day. I’m not bothered by the ‘tone’ of the posts…if she’s passionate and unforgiving, well, these are serious subjects about which we should all feel strongly. Especially as a mother now, I’m very interested in the health of moms and babies. I personally know two women who would not have their children today if they had tried to deliver at home. (In one of the cases, my friend’s baby needed resuscitation after delivery and underwent the ‘cooling’ therapy which is the subject of today’s post. She is now a normal healthy 4 year old)
I stumbled across it a while ago thanks to another blog (which has since become private), and wasn’t really interested. When I was pregnant with our last baby, I was wandering all over the ‘net to combat anxiety about various things with statistics and found this site again. It helped me so much, and helped my best friend to not feel guilty about having a hospital birth.
Thank you Dr. Amy and everyone who posts here in the comments! This is the only blog I’ve ever read where I actually read the comment section. There is so much interesting information, commentary, stories and respectful give and take shared here. I’m so glad to have found this site, especially as I slowly approach giving birth to my second child in this new year.
Best wishes to everyone here in 2014!
Thanks Dr Amy for giving us a place to learn about the reality of home birth and NCB. I started coming here again because working in Seattle really makes one think all is lost when it comes to pregnancy and childbirth. Your posts about VBAC really helped one of my IRL friends make an informed decision about where to give birth and how. She is now very happy with the RCS she chose instead of feeling bad for not having a home birth.
Thank you Dr. Amy! I look forward to my (almost) daily dose of interesting reading.
Thank You Dr. Amy for respecting your readers enough to expose us to the truth.
Thank YOU Dr. Amy for your tireless efforts!
Not to mention another achievement of 2013:
Publicly funded homebirth in Australia: a review of maternal and neonatal outcomes over 6 years
Susan Ieraci and Amy B Tuteur
Med J Aust 2013; 199 (11): 742.
Oooh!Going to look that up. Nice work, both of you!
Oh wait, I remember that (ridiculous) article. Hadn’t seen your comment, Sue. I wish there had been scorn heaped upon it from many sources..
It took a long time for the letter to be published – so it came out long after the original article. Did come out with another rational letter, though. Every bit helps.
Happy New Year, Dr Amy and my fellow commenters and readers!!
I am glad I found this blog. It rescued me from the guilt of “disadvantaging” my son by not “trying hard enough” to breastfeed my son. (The Fearless Formula Feeder blog also helped me out in this immensely as well.) I had allowed myself to get a little brainwashed by the woo infested NCB crowd AFTER my induction and breastfeeding “failure”. All it managed to do was drive me into guilt and shame over my parenting “failures” thus far. It was a breath of fresh air to read the Skeptical Ob and the Fearless Formula Feeder blogs. They helped to pull me out of the quagmire of guilt and self doubt.
I won’t be breastfeeding my baby due next month (eek! I can say next month now!) for medical & personal reasons and I am happy to have found sane websites like this one and the FFF – I felt so alone since everyone on the due date clubs, etc is soooo dedicated to wanting to breastfeed.
I just wanted to let you know how brave you are for sticking to formula feeding. There is so much (unfair) pressure for new mums to breastfeed regardless of medical and personal reasons, and I really admire you for doing something that is right for you instead of martyring yourself to please others.
Thanks! I’m happy to have doctors who don’t guilt trip about it either. I haven’t gotten one negative word about it from a medical professional, but there is so much nasty crap said about formula feeding online. 🙁
I am so glad that your doctors are supporting you, that is awesome!
There is, and it really bugs me in so many ways.
Eek! Another month!! Exciting and terrifying-I think you and I are due the same time (Valentines Day).
The support I have gotten about not breast feeding (aside from here) has been from women like my mom and her friends-who breast fed while being SAHMs 30 years ago. They have all told me that while they enjoyed that time with their children, there were plenty of other wonderful moments they have had since with their kids, ithe bond doesn’t come down to breast feeding or not.
Happy New Year to you, Dr. Amy and a giant thanks to yourself for this blog. You’ve helped untold numbers with your words, either by educating those of us here so we may help others in our own lives or through providing information to people who are seeking it. You’ve saved lives and that’s something that should be celebrated.
Happy New Year, all. I love the discussions on this board and look forward to more!
Dr Amy: Thank you so much for maintaining this blog and presenting the other side of the story. I was having a hard time swallowing some of the home birth people’s rhetoric (how could home birth possibly be as safe as hospital birth?) but until I found your site I had been unable to find any contradictory information. So, thanks.
Happy New Year Dr Amy!
I`ve been reading your blog for the past 2 years and I credit you with saving both my daughters life and my sanity.
Thank you for keeping me away from a midwife-led vaginal breech birth of a baby that turned out to be almost nine and a half pounds.
Thank you for being the only blog on the web brave enough for calling the NCB movement out on this bullshit that a vaginal birth is morally superior to a cesarean. You are right: a woman`s virtue is NOT in her vagina.
Thank you for putting the rabid lactivism and BFHI insanity in their proper place. For saying out loud that breastmilk may be a bit better than formula, but not so much better that women should torture themselves over it. You saved me from postpartum depression when it turned out I couldn`t breastfeed.
Thank you for taking the REAL feminist stance that women should be free to choose whatever way of birthing and infant feeding they feel is best for them, not just the NCB/lactivist approved choice.
Keep up the good work in 2014, you ARE making a difference!
Agreed about the BFHI insanity – the hospital I am delivering at wants to become “baby friendly” and still has the well baby nursery, but it’s like they try to hide that they have it which I think is nuts! By this I mean it’s not publicly mentioned ANYWHERE – not on the website, the pamphlets they hand out, etc, they all make it sound like everyone rooms in. It definitely exists, I had to go to L&D at midnight (for what turned out to be nothing, by the way, but I’m glad to have overly cautious doctors!) and saw the sign for it and there were two or three babies in there with the nurses. I think it’s sad they have to pretend it doesn’t exist in order to “promote” rooming in for the BF status.
I’m going to have to comment more in 2014!
Vaginal weight lifting….so many views, so few comments. I can only imagine the viewers who have stumbled their ways onto that post….
so many views, so few comments
To misquote Molly Ivins: Sometimes you read the net and it’s like you open your refrigerator and found Fidel Castro inside smoking a cigar: Just hard to know what to say.
Thank you for providing a much needed viewpoint. You help a lot of people.
Happy New Year.
I know I don’t comment very often, but I do spend a lot of time reading. I think what are doing is very useful, even to those of us practicing outside of the US. I practice in a part of Canada that is heavily infested in the woo – not infrequently patients actually bring up BOBB or Gloria Lemay in discussion about standard obstetrical procedures and guidelines.
Your sight has provided me significant insight into where these women are coming from, and has allowed me to talk to them in away that addresses the NCB lies that are stuck in their heads. It is still frustrating that a simple consult discussion VBAC some times takes longer than my high risk patients with multiple fetal anomalies or complex medical disease. However, I think I have become more effective in addressing their concerns, and the next step is to approach this at a community level. I have been inspired to start group VBAC counseling, in part to have a mix of patients talking together, to get them out of their echo chamber (I have instructed my assistant to book two GP and two midwife patients/couples per session), so their will hear concerns outside of the NCB crowd, not just from me. I hope it works well, because we still have near misses due to this ideology – two cases of HELLP (severe!!) due to refusal of induction after the diagnosis of pre-eclampsia, leading to emergency c-sections under general anaesethesia (due to low platelets). That is just in the last two months. The main reason for refusal of induction was a desire to “avoid intervention”. Both women accused me of trying to “ruin their experience”, when their decisions and refusal of treatment led to a much worse experience, for all involved!!
Again, thank you for the insight into the NCB world!!
” The main reason for refusal of induction was a desire to “avoid intervention”.”
The woo used to be only “If you are healthy, avoid interventions because that’s your best bet for staying on a normal healthy course and avoiding problems”. Now apparently it is “If you avoid interventions it will fix and heal problems you already have”. That’s a whole new level of woo. Holy buckets this craziness is dangerous! Where will it end?
The Pacific northwest is truly a different world I have discovered. I want to know when did labour become an process to be enjoyed instead of a process to get through to get the prize – a healthy baby!! The woo drives me up the wall. However, it is actually having harmful consequences – we have had more PPH’s this year. One of the main contributors was prolonged second stage – often more than 6 hours, because of a refusal to consent to treatment (oxytocin augment, vacuum or forceps or c-section). We have an unfortunate record for ICU admissions this year, but the woo in our community is excited because our c-section rate is down 3% (nothing intentional to lower that, just part of patient variation and an inclusion of home births as vaginal births in our community so the c-section rate now is a community stat instead of a hospital stat. We have an unusually high homebirth rate.) We are treating the consequences of the woo, but I think we are failing to address this at a community level. They are so anti-physician by the time the meet us we are at a disadvantage to provide appropriate care. I think this needs to be addressed.
Ha! I was assuming you were in B.C. And I am intensely curious about this, because the integration of trained midwives in the system is lauded by so many people. Yet I personally know two Vancouverites whose official, registered midwife arrived at their homes at the last possible moment before delivery. (Both first time moms, not speedy labors.) Both of them described some frantic maneuvering that sounded as though the midwife was trying to resolve a stuck shoulder. And there were so many other Vancouverites that I know who have preached the gospel of Gloria LeMay, include her posts on their facebook feeds (recent example – don’t tell people your child isn’t vaccinated, tell them that he has a natural immune system). I’m blathering here, but I guess what I’m wondering is whether the integration of midwives into the system really is helpful and really does fight the woo? Or does it just amp up a feeling of overall homebirth safety in every kind of midwifery?
I’m sorry to interrupt but I can’t resist. “A natural immune system”!?!?! Really now? Every one has a “natural” immune system if you consider something we’re meant (as humans) to be born with as natural (i.e. not induced by exogenous effects of teratogens or such).
Oh, sure it needs exposures and time to begin to ramp up it’s capabilities, but the basis is there at birth. It is natural for us to have it. Although of course it may not ever work optimally in the case of various disorders of the immune system.
But I think I’d sprain my eyes from rolling too hard if someone told me their kid had a natural immune system.
I suppose if you’ve had a bone marrow transplant, or if you have a deficiency and rely on some sort of injections to maintain your immune system, that’s not a natural immune system. Everyone else, however? All natural! (Whether it works well or no.)
Yes, a bone marrow transplant is a good example. I was thinking along the lines of how very multi-faceted the immune system is. Even if one or two+ aspects of it are not present or working correctly the vast majority of humans do still have a component of their immune system that is “natural”.
Being entirely without an immune system is exceedingly rare although being with an immune system that is combined “natural” AND supplemented with pharmacotherapies to enhance or maintain some function of it is not (especially if you consider those who have been vaccinated to belong to this category, which I’m sure is Lemay’s thought).
It’s just another poor example of the NCB crowd’s idealism that natural = good/better/best when that is so far from the case if you actually look at reality. Natural can mean so many different things depending on context and plenty of harmful and deadly things are in fact natural.
I had a natural appendix. Didn’t work out too well for me. Ditto for my natural wisdom teeth, and don’t even get me started on my (diabetic) sister’s natural pancreas. If only there were a vaccine to prevent diabetes…
I thought that Type 1 was sometimes secondary to chickenpox? In which case there is a vaccine to prevent some diabetes.
Type 1 is technically an autoimmune condition…so I guess it’s *possible*. Source?
Mayo Clinic says maybe mumps, doesn’t mention chickenpox:
http://www.mayoclinic.org/diseases-conditions/type-1-diabetes/basics/risk-factors/con-20019573
So maybe there is a some protection in the MMR.
While a bone marrow transplant wipes out the existing immunity, the immunity you develop afterward is just as natural as before, and obtained in the exact same way: through exposure to antigens.
It’s completely natural.
Well then so is plastic. Made out of dead dinosaurs and all. Contains atoms etc.
That doesn’t follow.
In what respect is the immune system after a bone marrow transplant not natural?
Assuming “not natural” means “made by people” then plastic clearly is, because we do the manufacturing, and, to the extent it compares to natural plastics (polymers, at least), that process has no comparison. Meanwhile, a bone marrow transplant patient’s immune system is made the exact same way that everyone else’s immune system is made, by development of antibodies by the body upon exposure to antigens.
There is really nothing in nature that resembles plastics, and those that are closest are not made like plastic. The same is not true for the immune system that develops in a bone marrow transplant patient.
What about the kids who have had gene therapy for SCID? Their immune systems could reasonably be said to be unnatural.
Even if laws are in place, if enforcement is seen to be lacking, you can expect disregard for the laws. Think of the difference between posted speed limits alone or roads with lots of cops, traffic cameras and radar, etc. Human nature is such that if you think you can get away with something, you’ll probably try. If the cat’s away, the mice will play!
Even in a system with highly-trained midwives who are integrated into the establishment, unless everyone is legally required to maintain registers, do frequent refresher courses, and KNOW that they will be subject to supervision and if found to be non-compliant with regulations will be deprived of the opportunity to practice, even some of the most “highly trained” will try to get around the letter of any laws on the books. And that means the establishment of active enforcers and THAT means $$ [as well as, unfortunately, usually a proliferation of bureaucracy]
From what I read, Canada has a system with good intentions, but it is a vast country, and I don’t know how it plays out on the ground — I expect some areas are very good, and others let midwives do pretty much what they want without any supervision.
Oh it sure is a different world Haelmoon. There are days in the NICU when I just want to bang my head against the wall…
When you adress this concern at a community level, I wonder if showing the increased stats for ICU admissions and nicu admissions as a consequence might help? Those of us who go to high risk docs embrace the medical technology and the knowledge of our docs because we know it is in our best interest.
Looking forward to your next blog post, Haelmoon 🙂 I’ve tried unsuccessfully to comment on it before – I’ve really enjoyed reading there.
Thank you for all your work, Dr. Amy!
You are the only doctor who debunks NCB propaganda. You are saving lives!
P.S. You always include the BEST pictures! Meant to praise you for that, as no doubt that takes up time and effort too! Thanks!
Wow, those are some impressive numbers, Dr. Amy-your dedication and desire to improve the safety of childbirth comes through loud and clear! You are inspirational, and I wish you (and your loved ones) all the best for the coming year!
Thanks too to the faithful commenters that educate and make me go ‘hmmmm’ on a daily basis! The main points are Dr. Amy’s, but the meat and potatoes are not only found in her posts…there’s always lots to ‘chew on’ when reading the comments too! Let’s keep the information coming, there are lives at stake!
Thank you, Dr. Amy! I don’t like when you’re “mean”, but I LOVE your blog, because you say the things that need to be said.
I love it when she’s “mean.” I know it can rub some the wrong way, but I’m kinda mean myself, so I appreciate the manner in which she presents her arguments.
The “mean” broke through my PPD when I first found this site years ago. I don’t think nicey nice would have gotten through to me at that time. I think too much passive aggressive nicey nice Seattle culture has allowed woo to get as far as it has out here.
Whenever the “mean” comments come up, I think of the following quotes: “Well behaved women rarely make history” — Laurel Thatcher Ulrich, and “Bitches get stuff done!” — Tina Fey.
Happy new year to Dr. Amy and all the lovely, amazing, thoughtful commenters on this blog! Keep up all the important work!
Hmm…I feel a little bit like I have just been outed as having no life….
Oh no, you could be much, much worse of a dork–just look at Bofa.
ROFL
But Bofa DOES have a life (of sorts) – he is the king of pop culture! (and a valued member of the SOB community!)
Makes me think that I need to watch more TV.
Yeah, but if you did a breakdown of my comments, it would be mostly
1) “The goal of intervention is to prevent emergencies, not solve them”
2) Something about Pablo’s Scenario or First Law of Internet Discussion (I don’t talk much, if at all, here about Pablo’s Wager
3) Random pop culture reference
It’s easy to post a lot when you post the same thing over and over. As Steve Martin says, “Development of new material: .0001%. I’ve got it all shown up in a pie graph, here. And over here, I have a ‘rubber chicken’ graph”
I am wondering, how many total comments were posted this last year? 292 posts, let’s say an average of 500 comments per post, would be maybe 150 000 comments? That means that I am only slightly more than 1% of all the comments. When you view it that way, it doesn’t seem like such a big deal.
Dork.
Dear old Bofa. I’m relieved someone out-dorked me.
I aspire to joining the top 5 commenters list for 2014. I have two months of maternity leave left, and my son is sleeping 4 hours between feeds. Lots of time to become as awesome as the top 5!
I think I’m only up there because I post in a different time zone to most of you, and just have to reply to things when I see them (even if it is a day after the rest of you).
Maybe that’s it 🙂 I miss out on the main conversation while it’s happening and spend my time on Skepticalob filling in the gaps or arguing with a few late night trolls while everyone else is asleep.
As someone who does not know what it’s like to have a baby who sleeps like that, long may it last!! It sounds amazing… 🙂
Happy new year, Dr. Amy!
Also, I’m more than a little sad that Vaginal Knitting didn’t make the top 5.
Never stop or give up what you’re doing Amy. You are the best. I want to follow in your footsteps and stop the new Tradition entering the Jewish homes, of birthing like our foremothers from long ago. Nothing wrong with hospital settings. Especially when its a mitzvah to ‘choose life’.
I hope they also have the tradition of begging not to die in labor, as many prayerbooks from the 19th century that I’ve seen have truly heart-rending pleas from women terrified of their impending ordeal, and possible death.
After childbirth, it is customary for a woman to “bench gomel” or make a special prayer of thanksgiving for having survived.
Yeah, our foremothers had a great time before modern medicine!
I would be interested in a link to those prayers, if you have them.
I don’t know if there are any online, although I’ll try to see if there are. Feldheim Publishers puts out a small book called “Aneni: Special Prayers for Special Occasions” which has a few for pregnant and delivering women, but they are considerably tamer than those I’ve seen in old prayerbooks [which are usually in Yiddish, occasionally in Hebrew]. I don’t own any such books myself, alas.
Happy New Year to you also Dr. Amy!
Happy New Year! Though I more often lurk than post, I’m very glad you keep putting this information out there.
Happy New Year, Dr. Amy!
I don’t comment often but do read daily – this blog has taught me so much about critical thinking, feminism, science, and respect. Keep up the great work!
Thank you Dr. Amy for doing this and for providing an awesome resource that I can use to help educate other women about some very important women’s health issues.
Happy New Year, Dr. Amy! I can’t thank you enough for this blog – it’s what pulled me away from NCB and another HB attempt, and likely saved my son’s life (and quite possibly my own). Keep shouting it from the rooftops – you’re making a HUGE difference.