An existential question for homebirth advocates

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More integral to homebirth than a birth pool, delayed cord clamping or a doula is the relentless boasting about it during and afterward.

So I have an existential question for homebirth advocates:

If you give birth in a forest, and there’s no one around to tweet it, video it, live blog it or create birth announcements that proclaim it happened outside the hospital, is it still a homebirth anyway?

80 Responses to “An existential question for homebirth advocates”

  1. joanjettrn
    June 4, 2014 at 10:21 pm #

    ha ha: My niece who has von willebrands had a home birth of baby # 3. She tried to have a homebirth last month with baby #4. Her lay midwife (cause you know that no CNM is going to touch her with a ten foot pole) let her push at home with a hand hanging out of her vagina.

    • moto_librarian
      June 5, 2014 at 3:35 pm #

      Jesus. That is terrifying! Is the baby all right?

  2. Sue
    June 4, 2014 at 5:30 am #

    If you give birth in a forest, and there’s no one around to hear you scream, does it still count as ”unmedicated”?

  3. Mac Sherbert
    June 3, 2014 at 1:29 pm #

    Nope it’s a forest birth and the mom needs to hope there’s not a grizzly bear around to see it. Extra points for using a beaver pond as a birth pool!

    • Amy M
      June 3, 2014 at 1:45 pm #

      Then both mom and baby can go home with giardia! Fun!

    • Young CC Prof
      June 3, 2014 at 1:47 pm #

      I bet beavers make great midwives. They can bring some raw fish up for a refreshing post-birth meal.

      • Trixie
        June 3, 2014 at 1:51 pm #

        At least a beaver won’t prevent you from dialing 911.

        • Amy M
          June 3, 2014 at 1:56 pm #

          I don’t know, they can really dam up a creek, who knows what kind of traffic that might create for the ambulance boat trying to get that woman’s sorry ass to the hospital when she is bleeding out. Or requesting a rabies shot.

      • Zornorph
        June 3, 2014 at 2:46 pm #

        That would be a ‘beaver’ birth in more ways than one!

    • anion
      June 3, 2014 at 3:45 pm #

      They’ll bite the cord in two and use it as a handy-dandy log-puller.

      • MaineJen
        June 3, 2014 at 3:49 pm #

        Increases efficiency by 66%

        • anion
          June 3, 2014 at 3:51 pm #

          *is delighted*

          *loves Lady & the Tramp*

          • Amy M
            June 3, 2014 at 3:55 pm #

            Thank you! I was trying to remember where I heard that line.

          • MaineJen
            June 3, 2014 at 3:58 pm #

            One of my favorite parts of that movie is when the excited husband is all “Doctor! Doctor, it’s a boy!” And the doctor, trudging out of the house into the rain clearly exhausted, says “Yes…yes, I know.”

  4. Trixie
    June 3, 2014 at 1:02 pm #

    I’m not sure if this story has been discussed here before, but a Utah DEM was just charged with manslaughter for a death that resulted from her delivering preemie twins at a birth center.

    • The Bofa, Being of the Sofa
      June 3, 2014 at 1:02 pm #

      See yesterday’s post.

      • Trixie
        June 3, 2014 at 1:48 pm #

        Thanks, missed it over there.

  5. Carolina
    June 3, 2014 at 12:34 pm #

    OT post suggestion: could you do a post explaining the testing protocol for GD and explaining why we don’t use jelly beans, finger stick tests, etc.? I’m seeing more and more if the anti-GD testing stuff pop up:
    You’ll see she links to a few woo blogs for her “alternatives” It would be nice to have a resource explaining why those alternatives aren’t used and why it’s important to test everyone for GD.

    • PrimaryCareDoc
      June 3, 2014 at 12:45 pm #

      Make sure you read all the comments.

      • Carolina
        June 3, 2014 at 5:01 pm #

        I did read the comments. It’s hard to refer people to anonymous blog comments to refute woo. I like it when Dr. Amy explains the reasons behind the protocols and practices. I thought her piece on fetal monitoring was excellent.

        • Jessica S.
          June 4, 2014 at 11:04 am #

          Dr. Amy may have posted on this in the past, did you do a search? Also, in the comment section Primary Care Doc referenced, there are some links provided here and there that I found useful. (In fact, you may find a few of them in response to my own questions – I had to do a 3-hr GD test that same week, I learned a lot from the comment section. I agree, it’s difficult to use comments as sources, but a good portion of the commenters are doctors and nurses themselves. Hope that helps a little, I know a singular post would be easier. 🙂

  6. Pilo
    June 3, 2014 at 12:22 pm #

    A good friend of mine had an unmedicated first birth, not by choice. She had a very fast labor for a primip, and lived a considerable distance from the hospital. By the time she arrived, baby was crowning. Now she likes to joke about all the people who congratulated her on the faux achievement of natural childbirth. There are many aspects of her life that are impressive and worthy of congratulations–but she says an unmedicated childbirth wasn’t an accomplishment, it was just what happened–like appendicitis or having vision good enough to not require corrective lenses. She plans to be induced for baby #2 so she doesn’t have to be in a car during labor again.

    • Helen
      June 3, 2014 at 1:37 pm #

      I can completely identify with this. With my first I had a “I’ll see how it goes and get drugs if I want them” attitude. Hurt like hell but she was crowning on arrival at the hospital so no drugs. With the second I was at 8cm on arrival. I had heard that the second baby flies out at the pushing stage so figured “this will be quick, no time for drugs”. She had a nuchal arm, 1 hour pushing, hurt like hell. In the theoretical world in which I have a third, I will probably request an induction so the drugs can be in place in time.
      I have a PhD, I have run a marathon. Two things I am proud of because I had to work hard (in different ways) to achieve them. Unmedicated labour just happened.

      • Jessica S.
        June 4, 2014 at 11:10 am #

        Great points. And may I add, whether this is noteworthy to you or not, the examples you gave as achievements of which you’re proud are solely your own and not focused on your children or anyone else? Not that our children aren’t worth celebrating, but I don’t want my greatest achievements to be defendant on anyone else. (I like to point out how it’s altogether possible that any great things my children go on to do might be in *spite* of my parental guidance. Ha! I’m certainly no exemplary mother.)

        • Helen
          June 4, 2014 at 11:20 am #

          I totally agree. The things I am most proud of are things I have done entirely myself. I struggle a bit when I hear people say that their children are their greatest achievements. Like you say, however wonderful my children are, is this because of me or in spite of me? I don’t really feel I can take credit. Don’t get me wrong, I love them and I take huge joy in hearing and seeing them say and do funny/clever etc things, I feel privileged to be able to witness that and to spend time with them. But is it my achievement? I don’t think so. And the way they were born definitely isn’t an achievement 🙂

          • The Bofa, Being of the Sofa
            June 4, 2014 at 11:22 am #

            I totally credit my children’s cuteness to their mother.

          • Jessica S.
            June 4, 2014 at 11:39 am #

            Precisely how I feel! It wasn’t until I stumbled upon women who discussed feelings like this that I felt like I might actually be ok as a parent. (We were at the “so, should we start having kids?” point in our marriage) Up until that discovery, all I seemed to read about raising kids was the popular Attachment Parenting (the Dr. Sears-marketed variety, not the valid psychology field of attachment theory or parenting styles that include aspects of AP that work for their family specifically) and that totally turned me off to the concept of having kids.

    • Amy M
      June 3, 2014 at 1:51 pm #

      Yeah, I’ve gotten unwarranted credit for having a vaginal birth of twins. Not really an achievement—it just happened to work out that way, nothing I did affected that outcome. I could have had a Csection if I’d have said the word–either way, I’d have ended up with two healthy babies. I’m way more interested in being a good parent to them, than how they were born. And as for achievements, to me that means things I’ve gained through hard work and effort: my college degree, my current position at my job, my happy marriage, etc.

    • Beth S
      June 5, 2014 at 1:26 pm #

      Yeah I got all kinds of congrats for my totally unplanned and unwanted homebirth with my daughter, until the community found out I was in an ambulance parked out in front of my house because the baby just came out too darned fast. Funny a few years later all I got was grief because of my medicated, planned C-section with neurologist, pediatrician, MFM, OBGYN and anesthesiologist on hand.

  7. Bomb
    June 3, 2014 at 12:10 pm #

    All of my homebirth friends announce their kids first birthday as something like this “One year ago today little XYZ was born at home, and hasn’t had a drop of formula touch their lips since!

    Every single one…including the ones I know for a fact gave formula.

    It seems so unhinged to me.

    • FormerPhysicist
      June 3, 2014 at 12:33 pm #

      Very. If you feel the need to lie about it, something is wrong.

      • June 3, 2014 at 12:51 pm #

        There – that’s indicative of how stigmatized formula has become. It’s such a shame as it really isn’t something that should be considered a failure of any sort.

    • MLE
      June 3, 2014 at 12:50 pm #

      I considered it a success story when my kid turned 1 and hadn’t had any illegal substances yet. Only 17 to go!!

    • The Bofa, Being of the Sofa
      June 3, 2014 at 12:56 pm #

      Are these people’s lives so empty that this is what they have to boast about?

    • Amy M
      June 3, 2014 at 1:53 pm #

      Huh. Well mine are almost 5.5yrs, I have no idea how much formula passed their lips, but had to be gallons. I’m happy we haven’t been the in ED yet, but that’s not really an achievement either…more like luck with two active boys. It’s only a matter of time, really.

      • Mishimoo
        June 3, 2014 at 7:16 pm #

        Nearly ended up there today due to a curious little boy. Thank goodness for the health advice line and poison centre. I caught the youngest playing with a lid that had had about 5mL of Ant Rid in it, because the dogs had knocked it down (damn counter surfers). I cleaned him up before realising that it was mostly on the floor. Made the calls just in case, and found out that he’d need to drink most of a bottle of Ant Rid to have an effect. I don’t even care that the lady on the Poison Line had a patronising tone, I just care that he’s okay.

        • Amy M
          June 4, 2014 at 10:44 am #

          Glad he’s ok! I’m running a pool (in my head) as to which injury will land one/both of my boys in the ED first: head injury, broken bone, stitches. I suppose it could be a combination of some or all of those. They aren’t so likely to poison themselves anymore, but they sure bash their heads a lot.

          • Mishimoo
            June 4, 2014 at 7:16 pm #

            Thanks! None of our munchkins have had stitches (yet) which is a miracle to me because my siblings and I were incredibly accidentprone. Oh goodness yes, the head injuries – I am tempted at times to put helmets on them while they’re running around.

          • The Bofa, Being of the Sofa
            June 4, 2014 at 7:31 pm #

            Fortunately, stitches aren’t needed for skinned knees or my guys would be stitched up all the time.

            My younger guy would have stitches all over his face.

          • moto_librarian
            June 5, 2014 at 3:38 pm #

            I always figured that my older son would be the first to need stitches, but his baby brother beat him to it. He decided to scale one of the kitchen chairs, and fell and hit his nose on the corner of the table. He got stitches, but fortunately, no broken facial bones. He was two months shy of his second birthday.

      • Jessica S.
        June 4, 2014 at 11:23 am #

        That reminds me of something that happen this weekend. My son, 3.5, punched his finger in a drawer at my in-laws’ house and was bleeding. I don’t think he’s ever really bled before – plenty of bruises and bumps – so he couldn’t put words to what was wrong. He kept telling us he wanted to go home and he thought he was going to start “gagging” (his term for throwing up). We finally noticed he was rubbing his thumb on his shirt and saw the blood stains (Nana to the rescue; she got the stains out in no time flat) and all was well after a rinse and a bandaid. My sister-in-law, mom to three boys, said “if that’s the first time he’s ever bled, he needs to get out more often!” Ha! Comes with the territory of having parents who aren’t outdoors-y people, I guess. 🙂

    • Zornorph
      June 3, 2014 at 2:40 pm #

      I would want to show up at their LO’s birthday party with a squirt gun filled with formula and shoot it at the baby’s mouth.

    • Bomb
      June 3, 2014 at 3:10 pm #

      On a related note, today is my first DD’s fourth birthday. Every year I send an email to my OB with a picture thanking him for saving her life after we transferred from home. Homebirth is definitely on my mind every year today, but not in the way the advocates would want.

      • Karen in SC
        June 3, 2014 at 4:19 pm #

        For the longest time, I sent pictures to my RE with a thank you note as well.

      • RN who has seen too much
        June 3, 2014 at 11:11 pm #

        I love this! I bet this seriously makes his year.

    • Mac Sherbert
      June 3, 2014 at 4:13 pm #

      Basically they are celebrating their own experience/achievements and not the child’s life. My friends usually says things like “I can’t believe it’s been one year since our little princess was born. She has given us so much joy! She is XYZ.” or “One year ago God blessed us with little Johnny. He is so much fun and loves life!”

      • An Actual Attorney
        June 3, 2014 at 6:46 pm #

        I think my reaction at one year was “Holy Shit — we made it!!” Which I suppose is celebrating myself, but it was just for surviving.

        • Mac Sherbert
          June 3, 2014 at 8:55 pm #

          Celebrating, but not patting yourself on the back for your wonderful parenting choices. You weren’t trying to make a I’m better than you statement.

        • Jessica S.
          June 4, 2014 at 11:15 am #

          Exactly! I’ll be amazed if I make it to my son’s 4th bday without committing myself to a psych ward. 🙂 My great achievement of any given day is often how I didn’t stoop to his level and throw a reciprocal tantrum. Hehe…

    • Jessica S.
      June 4, 2014 at 11:11 am #

      I’d be so tempted to call the “evil” formula feeders out, in a total passive aggressive way. 😉 But I’m petty like that. Ha!

  8. Amy M
    June 3, 2014 at 11:15 am #

    Of course it is Dr. Amy…even if there is no way to use the internet, or even snail mail to announce the home birth, there is still word of mouth at the local birth circle, and of course telephones. Anyone and everyone this mother comes across may be subject to hearing her birth story, even at dinner. Even if she couldn’t tell anyone for some reason BUT it was a healing birth because of some prior birth trauma (like her previous baby was hatted by hospital staff), it would still count, because she was made whole by passing a baby through her vagina.

    • June 3, 2014 at 11:33 am #

      This reminds me of an old Jewish joke about the Jew who plays golf on Yom Kippur. after the angels point this sacrilege to God, He agrees that this guy ought to be taught a lesson, and the next stroke the golfer makes is a hole-in-one. The angels tell God that, so far from being a punishment, this is something all golfers dream of. God says,”And precisely who is he going to tell?”

  9. anh
    June 3, 2014 at 11:08 am #

    I may go to hell for this comment but….this post makes me think about a conversation a friend and I were having about how upper class white women brag about making their birth experiences closer and closer to those of women suffering in the developing world. We imagine a conversation like this:

    “I gave birth in a hospital with no medications and left 12 hours later!”
    “Oh? well I gave birth in a birth center in the middle of the forest”
    “that’s nothing, I did it at home with a community midwife I met at my church! No education but she has Other ways of knowing!”
    “ha! I gave birth at home surrounded by no one but my husband, my 22 month old, and our pet yak! We live in the middle of the Alaskan tundra and have no heat or water!”
    “ummm….I gave birth at 13 in a filthy hut while my village was looted by warlords. I had to keep from screaming so they wouldn’t find me. the midwife was the same woman who circumsized me with a shard of clay just 2 years prior”

    • lawyer jane
      June 3, 2014 at 11:26 am #

      Remember the documentary Babies, that followed families in Namibia, Mongolia, Japan, and San Francisco? The SF mom was all proud that she had a home birth and wanted the Namibian mom to know that they were really sisters. But the Namibian mom made clear in interviews that she had agreed to the documentary because the money and assistance of the filmmakers allowed her to get her kids actual medical care, and seems like she would have preferred to give birth in a hospital.

      • MaineJen
        June 3, 2014 at 11:55 am #

        Wait, didn’t they show the San Francisco baby in a hospital, all hooked up to monitors, at the beginning of the film? If that was a home birth, I guess “something” must have gone wrong…

        • Young CC Prof
          June 3, 2014 at 12:06 pm #

          Even if the baby is full-term, with no congenital defects, and birth goes off without a hitch resulting in a 9 Apgar, there are a number of potentially serious things that can go wrong in the first few hours to days. Reason #3 that home birth is dumb.

      • Susan
        June 3, 2014 at 12:11 pm #

        I remember that really well. I loved that movie. It seemed too that they purposefully hid that it was a SF home birth. I think you can link to the interviews with the moms and that’s where the SF mom says what happened. If I remember correctly the baby was admitted after the birth. I also recall she didn’t seem to think that the baby really needed to be admitted? And yes, the irony that all the Namibia mom wanted was to get the opportunity to have hospital care….

        • Young CC Prof
          June 3, 2014 at 1:18 pm #

          The baby went home totally fine just a few days later! The hospital stay was obviously unnecessary!

          • 06Emma06
            June 3, 2014 at 2:41 pm #

            I am not sure how you can say that just because the baby went home a few days later, the stay was unnecessary. Perhaps the child had jaundice, and infection or some other issue that was quickly treated by the hospital staff.
            I have not seen the movie that is being discussed so perhaps I am way off base.

          • Zornorph
            June 3, 2014 at 2:43 pm #

            Fairly sure that was sarcasm.

          • Young CC Prof
            June 3, 2014 at 3:59 pm #

            Sorry, sarcasm. Yes, newborn issues that respond quickly to treatment are extremely common.

          • Jessica S.
            June 4, 2014 at 11:31 am #

            Yeah, that’s basically what she’s saying. 😉

        • MaineJen
          June 3, 2014 at 2:58 pm #

          Do we know what really happened? Because it looked like that baby was being monitored pretty closely. I always did wonder what that was all about…I guess I just assumed she was born prematurely or something. It’s a good movie. I hope they do “Toddlers” next 🙂

          • Young CC Prof
            June 3, 2014 at 9:38 pm #

            Based on the mother’s description in the article above, it sounds like she was born at home and then had transient tachypnea of the newborn.

      • Mariana Baca
        June 3, 2014 at 12:12 pm #

        I liked the movie a lot, but I always felt very disconnected from the SF couple, like they were a bit alien. The Japanese couple was super high tech and the others were super rural, but I don’t know, the SF couple had a different parenting vibe, a sense of unreality. Maybe all it is is that they want a “culture” to fit into and don’t have one except for the NCB manufactured one. It might just be my own biases, though.

        • Susan
          June 3, 2014 at 12:38 pm #

          I agree on the SF family. I figured that because it’s the culture I am a part of I might sense off where I probably wouldn’t sense someone who was similarly a little different in one of the other cultures.

        • The Bofa, Being of the Sofa
          June 3, 2014 at 12:38 pm #

          I liked the movie a lot, but I always felt very disconnected from the SF couple, like they were a bit alien.

          Mainstream parents don’t make it into documentary movies.

        • lawyer jane
          June 3, 2014 at 1:48 pm #

          Ok, I’ve watched Babies a million times because my toddler loves it. I also thought the SF couple was strangely subdued and that the documentary did very little to show how beautiful that part of the world is! What I think happened is two things: 1) the family and baby are just legitimately totally laid back and subdued people. 2) the dad is actually one of the filmographers for the documentary, so I think that may have altered some of the way they were filmed and edited, consciously or unconsciously.

    • June 3, 2014 at 11:28 am #

      This reminds me of my first birth. Picture this, if you will: 48 hours after my C/S, I was lying with my legs on the raised head of my bed to reduce my severe pedal edema*, when a new patient was transferred from L&D, accompanied by a huge family. She was a true super-JAP, constantly moaning about how she’d had to suffer A WHOLE HALF HOUR of contractions before the anesthesiologist had agreed to give her an epidural, and in spite of it she had actually had to PUSH the baby out at the end–birth was truly awful, she would never go through THAT again!

      After commiserating with her at length, one of her friend or relatives, who probably felt she ought to be polite, even tho’ I was obviously a fruitcake to be lying the wrong way round on the bed, asked me if I’d had a difficult labor. It gave me considerable satisfaction to reply that I’d had 48 hours of strong contractions (epidural didn’t work) before my C/S.

      *Foot swelling went down very fast — but IHad to keep running to the loo at 10 minute intervals, not too easy to do so soon after the op.

      • Young CC Prof
        June 3, 2014 at 12:07 pm #

        *Blink.* Getting up from THAT position with a fresh incision sounds… difficult.

        • June 3, 2014 at 2:53 pm #

          Less difficult than it might be. As with lying down when heavily pregnant, first roll onto one’s side [pillow on incision helps], swing the legs off the side of the bed, and then lever oneself upwards. I always recommend to patients who are going to have C/Ss to bring a length of strong rope, tied in a loop and which can be tied to the bed’s head or foot, in order to get into a sitting position more easily. Israeli hospital beds, even today, are often not electric, or you need to be already sitting to raise the head of the bed.

          I only had to do this maneuver once. Within a couple of hours my legs, which had looked as if I was afflicted with elephantiasis [over the entire labor period I had gotten huge amounts of IV fluid], were back to normal.

      • yentavegan
        June 3, 2014 at 9:33 pm #

        Side note, JAP is a slur and yes, I feel a bit stung by its use.

        • June 4, 2014 at 2:26 am #

          As I have a daughter who is a World Champion in that field, I regard it as a mere descriptive phrase, sorry if it offends you. To be completely accurate, she was a JIP. Her shenanigans were the talk of the maternity ward for quite a while. [If you live in Jerusalem, you undoubtedly are acquainted with her family’s business, but I won’t say more]

          In any case, this lady really, really was an extreme example, and rather than give you a long description which would essentially say the same thing, I used JAP as shorthand. Disqus comments don’t lend themselves to prolixity.

          • June 5, 2014 at 12:43 am #

            JAP? JIP?

          • June 5, 2014 at 1:35 am #

            Jewish American Princess; Jewish Israeli Princess.

          • June 5, 2014 at 1:56 am #

            Ah, okay. Thanks!

    • Siri
      June 3, 2014 at 1:20 pm #

      …and my pregnancy was due to being raped by different warlords nine months before.

      • Young CC Prof
        June 3, 2014 at 1:38 pm #


        Yeah, people talking about the terrible violence of modern society have no idea how common that sort of thing was back in the day.

        • Dr Kitty
          June 3, 2014 at 3:08 pm #

          Or, actually right now in DRC, Northern Uganda, Syria…

    • Carrie Looney
      June 5, 2014 at 3:53 pm #

      An updated version of Monty Python’s Four Yorkshiremen is called for…

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