When my husband and I were first married, we didn’t have much money, and, therefore, didn’t have a lot of choices in housing. Our apartment, while conveniently located, had certain problems including a cockroach infestation. Every morning when we turned on the light in the windowless kitchen, dozens of cockroaches would scurry out of the light back into the darkness.
I hadn’t thought about that daily occurrence in many years until it recently came to me that birth bloggers are like cockroaches. They, too, gather in the darkness and scurry away when the light of science is shined upon them. That’s because they KNOW that they cannot defend their claims against actual scientific evidence.
Unlike cockroaches, however, birth bloggers can turn off the light when they are exposed. How?
1. The natural habitat of the birth blogger is her own blog, where she decides how much light, if any, is shed on actual scientific evidence.
2. Birth bloggers almost never stray outside their blogs because they will be crushed in the light of scientific evidence. Hence, they never attend mainstream conferences, they never speak at medical conferences, are never invited to sit on expert panels, are never invited to testify in malpractice cases, and are not considered “experts” by anyone but themselves.
3. Birth bloggers invite visitors to their natural habitats, but protect themselves from the light of scientific evidence by deleting and banning any commentors who dare to question them or to present evidence that they chose to ignore.
4. Birth bloggers thrive in the darkness of ignorance and gullibility of their readers. Anyone with actual scientific knowledge would laugh at them.
5. Birth bloggers, like cockroaches have highly evolved defense mechanisms. Birth bloggers are evidence-resistant. They start from a conclusion and work back to cherry pick evidence to support it, while ignoring the larger body of evidence that debunks their conclusions.
6. Birth bloggers find support in numbers. They proliferate like cockroaches and no sooner is one crushed by the weight of scientific evidence, then another repeats the same lies that the first couldn’t rebut.
When we shined the light of science on the hideous rupture rate in Jen Kamel’s VBACFacts group, she ruthlessly purged the group, leaving her followers in the dark about the truth. When we shine the light of science on Rebecca Dekker’s assertion that her claims are “evidence based,” she deletes them and bans commentors, leaving her followers in the dark about the truth. The Lamaze blog Science and Sensibility routinely vets comments to be sure that their followers are left in the dark about real scientific evidence. Indeed, there is not a birth blogger that I am aware of who doesn’t routinely ban and delete when presented with scientific evidence.
Why are these birth bloggers afraid of the light? Because, like cockroaches, they know they will be easily crushed when people can see them for who they are: lay people who promote and profit from pseudoscientific nonsense.
How can women protect themselves from the infestation of birth bloggers? It’s pretty simple.
Never trust the information you get from a birth website that heavily moderates, deletes and bans. It means that, just like cockroaches, they are hiding in the dark. They wouldn’t need to heavily moderate, delete and ban if what they are write were true.
HI SkepticalOB,
I’d really appreciate your professional opinion on this website – Evidence Based Birth – in particular on this link about water births. I read from the AAP that from the reviewed evidence delivery in water may have risks and should only be permitted in a clinical trial setting until more is known about it. In this blog she (im assuming it’s a she) is criticizing the standard of evidence because most is from low quality case reports. Is she right? What do you think?
http://evidencebasedbirth.com/waterbirth/
http://www.skepticalob.com/2014/07/rebecca-dekkers-evidence-based-birth-you-can-put-lipstick-on-a-pig-but-its-still-a-pig.html
Thanks 😉
Off topic, but related to the blog topic as a whole, apparently, pain in surgery was once thought critical to survival Parallels to the modern NCB movement?
Possibly because the people who did manage to lose consciousness often were dying?
Or because the pain stimulated endogenous adrenaline, which helped compensate for blood loss.
Probably. You’d think the lower amount of thrashing about and blood loss that would be associated with anesthesia would counter that, but maybe you can’t give someone enough morphine to keep them still during surgery without depressing their respirations as well. I’m so glad I live in a time when this is not a relevant question.
Another thing I hadn’t known before reading the article: I’d thought pre-anesthesia surgery was all chopping off gangrenous legs. No, they were doing cholecystectomies and mastectomies. And getting at least some survivors!
Now I’m picturing a gigantic termite mound.
So why does the CDC have EBB on their recommended links? Jealous much?
http://www.cdc.gov/ncbddd/vitamink/links.html
Having one blog post recommended does not mean they recommend your whole blog.
Oh so the CDC is the standard of success now?
Come back when you have an intelligent counter argument to ANY of the actual INFORMATION on this blog.
Evidence for the Vitamin K Shot in Newborns; March 18, 2014 by Rebecca Dekker, PhD, RN, APRN of Evidence Based Birth®; In Evidence Based Birth: A blog written by Rebecca Dekker that provides unbiased, evidence-based information on pregnancy and childbirth.
“Unbiased”?
Because they figured that woo-sucked mothers might decide to actually follow evidence-based care if they get their ego stroked by thinking “Hey! I understand that! I know better than doctors and I choose to follow this information because I am super informed, not because evil medicine recommends it!” And Rebecca Dekker excels in ego stroking. Pity that her way of presenting information sucks in general.
Note that the CDC links to her post on vitamin K, not on water birth. Shockingly, being right on one thing does not guarantee that someone will be right about everything.
Where is that link to EBB about waterbirth from the CDC?
So EBB agrees with Dr Amy and the medical community on ONE issue at least. That’s a good start.
This is obviously going to come as a tremendous shock to you, but this is not about my ego. It might be about YOUR ego and Rebicca Dekker’s ego, but I’m more interested in whether babies live or die, not seeing my name in print.
Unfortunately I feel like the cockroaches are winning. In both cases. NCB woo is taken as a given in groups of educated middle class white women. It is widely believed that most c-sections are unnecessary, that doctors and hospitals are just plain wrong and you should refuse to capitulate to their warnings on what is necessary for the health of your child and should lie about things like your water breaking. And if you don’t give in and your baby doesn’t die, it’s seen as proof that they’re wrong. Not understanding that “increased risk” does not mean “your baby will probably die” and doctors would rather do unnecessary c-sections sometimes than have unnecessary deaths and injuries. It’s just so frustrating being the only person trying to talk some sense into people who are normally intelligent. The NCB movement has just won for some reason.
This is going to be very dependent on local environment. For example, I don’t of a single person who believes any of this. I don’t see it being “widely believed” in any shape or form.
Homebirth is still very fringe. Heck, about 5 times as many people believe the moon landings were faked (6% of the population) than go for homebirth. I realized the anti-c-section sentiment is more common, but still it is not the majority view or anything. The majority of women are perfectly content with their c-sections and trust their doctors.
Oh, the “you should lie” part is probably a fringe belief, but too many unnecessary c-sections is totally mainstream, reinforced by continuous mainstream news articles.
I was shocked when my highly regarded hospital based CNM midwife suggested lying about a high BP measurement … the fact that she did so suggested that a big percentage of her clientele (all highly educated professionals) would have thought that was ok.
As a student I shadowed a prominent, respected home birth CNM through some prenatal visits. She was taking the bp of a woman who had developed gestational HTN in her last pregnancy. She made a point of selecting an incorrectly sized cuff, too large for the patient, to give her the best chance at a normal bp reading.
I think it’s mainstream to lie.
Now that is just disgusting. And leaves the door open for avoidable MATERNAL death, which draws a whole lot more negative attention than perinatal death.
A homebirth CNM is not at all mainstream, though.
Oh my – what?!?! Did she tell the woman that she’d fudged the test and the results were likely inaccurate now?
The patient appreciated it because she was convinced she had white coat HTN and this would correct for it. Crappy.
Yes, homebirth is fringe, although I know a few people who have had one, and a few more who want to have one next time.
But I feel like, from my experience talking to women I know, a lot of the NCB dogma has become mainstream among a certain subset of women — women who are educated, middle class, and white. These views spread through specious internet “research” (often birth bloggers and sensationalistic articles), and word of mouth. Such views include:
1. An unmedicated vaginal birth is the ideal outcome.
2. Most inductions and c-sections are unnecessary, and are done for the convenience of the doctor. C-sections should only be done in emergencies.
3. Hospital and doctor rules and regulations regarding induction at 41+ weeks, continuous fetal monitoring, no waterbirth, no eating, baby must be born within 24 hours of water breaking, heplock/IV, etc. are unnecessary and wrong and should be worked around if at all possible because they will prevent you from achieving an unmedicated vaginal birth.
I live in a large city, although it is more conservative and not known for being crunchy. I’m in two different SAHM groups and have talked with dozens of women about childbirth in my time as a SAHM. Not because I’m a birth junkie but because it just seems to come up a lot in conversation since it’s a shared experience and there’s always someone around who is pregnant or who has just had a baby. And from the least crunchy to the most crunchy person I know, most of them espouse the viewpoints above and there seems to be an overall sense of distrust of OB/Gyns. It’s not 100%–there are a few who have had c-sections and were happy with it, and had no interest in VBAC, and one person I know who rejected the NCB viewpoint after her son almost died due to a low-intervention CNM. But yes, the NCB viewpoint does seem to be the majority to me. Before I actually had my first kid I believed a lot of it, although I did not remotely consider homebirth.
And I don’t know anyone who regrets their c-section nor has any qualms about being induced.
I do! Me! And a sample size of one may not be statistically valid but my reality is pretty valid to me.
The biggest problem in my opinion is that all this banning and deleting is not visible to the average reader. I had no idea this was going on until I started to read here. In the meantime, one of my own posts was deleted on a message board o used to frequent a lot when I was pregnant with my first (the NUCB forum on babycenter). Even though at that point I had heard of this going on, I was shocked! But again, no one who doesn’t follow these debates in detail would have noticed anything.
Anyone have an idea how to change that?
OT: The Push to Understand the Placenta
http://www.nytimes.com/2014/07/15/health/the-push-to-understand-the-placenta.html
I loved this article! It was learning about the placenta that really made me understand how incredibly complex birth is! The mother’s body has to shut down a whole organ that’s taking 20% of her blood in a matter of minutes! A really amazing feat. I was sad that I didn’t get to get a better look at mine.
I really like examining the placenta postpartum, and that’s just the superficial obvious stuff. It’s an incredible organ.
Am I a bad person if I’ve been thinking this ever since I started reading your blog?
If you’re a bad person than I’m also on the fast train to hell because I was thinking the same thing.
No, it just means you are very smart!
There’s an old saying that when the world ends there will be cockroaches and Cher I think birth bloggers should be added to the list.
I just don’t understand why people who are claiming to be skeptical aren’t skeptical of the claims made on these blogs. They take everything at face value and don’t do much research beyond Google University. Now granted I do use Google when searching for information, but I always look at the source of that information before I take it for granted.
Because they don’t understand skepticism.
This is similar to the “well-meaning” discussion the other day. Claiming to be skeptical is similarly a meaningless concept. Who DOESN’T think they are skeptical of nonsense and a critical thinker? Does anyone actually say, “Oh, I just believe anything that sounds good to me willy-nilly?” Of course not. They all couch it in “I’m a very skeptical person, and I’ve done my research!” They are “skeptical” of mainstream medical claims, but swallow up the biggest nonsense just because it’s contrary, and therefore they can call themselves a skeptical person.
Everybody’s skeptical of something. A normally credulous person might be skeptical about her co-worker’s seventeenth promise to stick to the deadline this time, or her three year old claiming that his stuffed bear was the one who spilled the juice. Some people call themselves skeptics when they are in fact denialists.
The process of really being a skeptic, however, is more complicated. You have to learn to take just about everything you hear and ask, “How do we know that? Does it agree with other things I know? Can I find a source or some evidence for that claim?”
Everyone gets fooled sometimes. Everyone.
What? My daughter’s bear spills juice all the time.
Lay person and birth blogger here….. 🙂
It is a pity that so many followers/readers of certain sites like VBAC Facts and EBB aren’t aware that comments are deleted/moderated. I didn’t realize that sort of thing until it started happening to me. Jen Kamel was deleting like crazy last week after she deleted her community group. Even people from her group were getting deleted. Someone made a comment and said something like “what link was just deleted? I saw it earlier but it’s gone now.” And then Jen deleted and banned that person for simply asking!!! It was a former community member. I don’t think she or her admins slept for days. Comments and links that called her out were deleted within a few minutes.
Totally OT; but does anybody have any good info or advice about cholestatis and gestational diabetes? I was diagnosed with both today which seems unbelievable to me. I’m not over weight at all and eat very well. I just don’t get it and my OB seemed a little unconcerned and I was so shocked I couldn’t think of any questions to ask.
I don’t think GD has as much to do with weight as type 2. I know in my diet class we had women of all sizes in the group. It’s more of how your body is handling processing the sugars with the pregnancy, it can strain the pancreas, that’s what they told us. We had to watch our carb intake, even healthy eating can give you too many carbs, so you have to figure out what works for you. Did your OB say anything about going to a Dietician?
No she didn’t she gave me an info packet and said I needed to get some.more blood work tomorrow and I have another appt this week. She seemed unconcerned, I’m more worried about the cholestatis tho to be honest
Jenny – see my message above.
Yeah, makes sense. I think a lot of people make the mistake of thinking being fat leads to diabetes, when it’s more likely that having diabetes leads to being fat. But since GD only occurs during pregnancy, there wouldn’t be enough time for the condition to necessarily cause you to gain huge amounts of weight.
Therese – it is actually obesity that causes insulin resistance, but, as you say, GD is a different beast. Being both obese and pregnant increases the risk.
Good luck. I was diagnosed a week ago with GD and none of it makes sense. I’m average weight as well and have gained a normal amount of pregnancy weight. I know two other people who had it – one weighs about 125 pounds and the other weighs about 300 pounds. I think as long as you manage it well (either with diet & exercise or some people have to have insulin), it’s of little to no consequence to the baby. My OB acted like it’s more of a hassle than anything. I cried for a solid day when I found out but now I’m down to an every other day meltdown… ha! Do find a dietician who can set you on the right path.
I’m 5’9″ and weigh 150, I’ve only gained 16 lbs in 28wks. I just don’t understand how this could be happening. It explains the fatigue and itching but none of it makes sense. I’m trying to find a dietician now, ugh! I’m not upset, just perplexed
I got cholestasis for my first pregnancy, I was within normal weight range for my height and only gained 11kgs total for the pregnancy. As far as I can tell, there are no reasons for ICP, so please don’t think it was anything you did. My OB said there was nothing I could change about my diet or lifestyle to fix it. I can’t help with the GD though cos I never had that.
There is a good page based out of the UK – ICP support. They also have a Facebook page, and there is a US based one called OC support I think.
I’m at 15 weeks with my second, and praying that the ICP doesn’t come back. That itch was horrendous! Good luck!
Progesterone – the pregnancy hormone – is an insulin antagonist. Simply being pregnant and having progesterone in your system means that your body may not recognize your own insulin as it should.
Obviously there are some patient populations that are more prone to getting GD, but it ultimately comes down to a hormonal thing. Every pregnant woman is at risk simply by being pregnant.
Don’t blame yourself or your diet too much. 🙂
I’m sorry your dealing with GD it is a pain in the butt as is cholestasis – it’s important to remember that while weight increases risk, there are still those of normal/underweight who suffer. Ironically all of the suffers of GD I’ve known personally have been normal weight or trim…
I had non-pregnancy cholestasis when i was 18 – the itching was intense!
I had GD for 2 out of 4 pregnancies. Overweight is just a risk factor, but they are finding it has a lot to do with a particular hormone (placental lactogen, I think) that is actually good for your pregnancy. Kind of like having a ton of progesterone and hcg is good but leaves you puking and sleeping through the first trimester.
I was extremely careful with my carb loading and testing during those pregnancies and those babies were 6.5 and 7 pounds, no complications. It is not an automatic macrosamic baby, with management and a bit of luck, GD is more of a hassle than anything else.
I never found any really good resources for management other than the one doc at the practice where I had my first GD baby. The internet just says don’t be fat and see your doctor/nutritionist.
Thanks for your encouragement! You’re right, there is a total lack of information out there, and combined with a healthy amount of guilt, anxiety and pregnancy hormones it’s an ugly combination!
I had GD….even though I started off slim pre-pregnancy (117 pounds), had HG and lost 10 pounds in the first trimester. By the end of the pregnancy I’d only weighed 130. Baby was 5.9 pounds. 2weeks after giving birth I was 110pounds. So I don’t think GD has anything to do with weight.
Thanks (!) to my GD, I gained a net total of 12 pounds my last pregnancy, 9 pounds of which was baby. By 6 weeks postpartum, without any particular effort on my part, I was about 20 pounds lighter than when I started the pregnancy–I’m pretty sure the weight loss occurred mainly during the pregnancy. OB never seemed worried, though. It was plenty WEIRD to lose three pounds between 2 OB apts.
I’m a BIG girl, so I had lots of surplus to share with baby. In my previous pregnancies, I’d gained around 40 or 50 pounds.
The first day I found out I had GD (before I had the stuff to do blood tests at home), I ate celery, a boiled egg, sugar free jello, and a bunch of similar no-carb stuff, and got SO sick.
By the next day, I was observing a much more moderate low-carb diet and felt much better (although I often felt half-starved for the rest of the pregnancy).
In my experience the 2 friends I know who had GD were both on the low end of the weight scale.
Jenny – insulin sensitivity gradually decreases as normal pregnancy advances, requiring greater secretion of insulin. This is hormonally-driven. Women with GD are unable to increase insulin secretion enough to cope with the greater demand. Sometimes this can be a pre-existing issue with pancreatic beta cells that only manifests when there is resistance (and therefore need to pump out more insulin). In the absence of obesity (as is your case), this is often not an issue post-partum, as the need for the extra insulin reduces. This is in contrast with obesity-related type 2 diabetes, where the obesity causes insulin resistance and need to pump out more insulin. If obesity and pregnancy co-incide, there is clearly a greater chance of getting GD.
Pregnancy intra-hepatic cholestasis is also hormonally-induced. The precise cause is not known, but there is a genetic component, and it is relatively common. It is called “intra-hepatic” to distinguish from the standard cause of cholestasis (which means blockage of bile flow) because it occurs in the absence of gall-stones (which are ”extra-hepatic” – outside the liver – in the gall bladder and biliary ducts).
If your OB seems unconcerned it is probably because she/he has seen many cases before, and seen them resolve after delivery. If you don’t have symptoms, then this is what is called a test-based diagnosis. It is worth watching your blood sugars, though, in case they get high enough to need treatment. Best wishes!
Jenny, I had in risk factors in my first pregnancy and had GD. I was able to control it with diet and didn’t require any insulin. I didn’t have it with my subsequent two pregnancies.
Some things that worked for me in managing it included:
– avoiding carbs – particularly bad for my blood sugar were breakfast cereal and fruit juice
– as my pregnancy progressed (about the last 10 weeks) I found I had to be even more controlled about my carb intake
– in the last few weeks I actually had to modify my portion size to keep the sugars under control
– a 20-30min walk after meals helped a great deal with my sugars
– a dietician/nutritionist is an excellent help
This is some information from the hospital where I had my babies https://www.thewomens.org.au/health-information/pregnancy-and-birth/pregnancy-problems/pregnancy-problems-in-later-pregnancy/gestational-diabetes/
I remember how upsetting it was to first find out that everything wasn’t going as planned with my pregnancy. But in retrospect it wasn’t that bad.
Disqus is playing up and didn’t let me finish by saying that my blood sugars immediately returned to normal within an hour or so of my son being born – and his sugars were normal from birth too.
Best of luck.
Here’s what worked for me with gestational diabetes:
http://xantippesblog.blogspot.com/2012/09/gestational-diabetes.html
I could barely move, so it all had to be done on diet.
Nuts are great–I never went anywhere without a bag with either crackers and some nuts or sesame seeds.
The formula that worked for me was–when eating, always have a little bit of carbohydrates and a protein/fat food. Never just protein/fat, never just carbohydrates. A “normal” serving of carbs is probably too big.
I believe I remember hearing that in the morning one often needs to be particularly cautious about carbs. I found, though, that I was able to have a small serving of no-sugar-added ice cream with nuts at bedtime or a couple servings of sugar free pudding with nuts at bedtime with no trouble.
Salads are great.
Everybody is different, though.
This may seem OT…CNMs regardless of our shortcomings are my family. So we must change for the betterment of everyone, including the masses who cry “me too” to each other.
OT: Now that I know how many SOB fans are also Weird Al fans, I give this to you.
[youtube http://www.youtube.com/watch?v=8Gv0H-vPoDc&w=560&h=315%5D
LOL I must admit I love the sense of humor….
If someone has to learn of this from here, they are no true fan! Thanks for posting it though; it cannot be reposted too much!
He forgot “between you and I”
Yes, I know your teachers beat you over the head with “you and I” when you said “me and you” as the subject of the sentence, but as the object, it is ME
“between you and ME”
I’m talking to you Eric Carmen and Jessica Simpson!
But I liked his less vs fewer
I got this for my mom for Christmas last year: http://shop.newseum.org/a530/just-between-you-me-dessert-plate.html
It was painful for me to get purged from VBAC Facts AND the other VBAC support group on FB. I had to remind myself that *actually* it does not impact my ability to actually TOLAC or VBAC and may actually improve my outcome to not be in a group that bans & purges anyone who does not toe an idealogical line. I think why I got purged was that I dared to say that intentionally *combining* HBAC with a short inter pregnancy interval might be a recipe for disaster. The mother I said that to asked me what my source was on that, I posted a study whose sample size was about 1000, showing a double rate of rupture for intervals under 9 months. She linked to VBAC Facts and said any sample size under 5000 was invalid. I pointed out that she didn’t have a study with a sample size of 5000 showing a not double rate of rupture, so . . .
She couldn’t purge me from the group we had the discussion in, so I suspect she went behind the scenes and got me purged from the VBAC groups.
In any case, it was inspiring and possibly beneficial for me to read all the success stories in my newsfeed, so I am sad about the purge, but purging women who want to talk logically about studies does not bode well for the women who want to seek unbiased info from that group.
Whether 1000 (or 5000) is a large enough sample is something that depends on the characteristics of the sample itself. There are conditions when you will need 200,000 and conditions under which 100 would be sufficient. To accurately predict the winner of a typical American presidential election, for example, you need a sample of only 1600 voters.
Was this before you started participating in the Fed Up group on Facebook? Because that alone could have been enough to get you purged.
That’s another thing that pseudoscience fans sometimes do: methodolatry. Just because we don’t have a large placebo controlled RTC, that doesn’t mean “your guess is as good as mine.”
There are degrees of evidence, no study is perfect. Evaluating multiple pieces of imperfect evidence to draw the most accurate possible conclusion is a very difficult task requiring a mastery of statistics, critical thinking and the basic science involved. Most amateurs haven’t got the faintest idea how to draw straight with crooked lines.
“Methodolatry” – I like that! It’s a real feature of the anti-scientists, be they ant-vax, radical-NCB or from wacky alt med modalities (or all of the above). I’ve seen it manifest in two opposing directions.
First is the criticism of any mainstream scientific finding they don’t like, because it isn’t from a RCT. (Even though RCT can only be used for interventions, not for population studies etc).
Then, they quote any nonsense as ”evidence-based” or ”peer reviewed” because some obscure journal has published it. (Usually a case report that says ”I saw someone once and gave them (x) and they got better”.
Reading, for example, the Chiropractic literature, I have realised that even the best-intentioned, rational chiros don’t realise how poor in quality their body of research generally is, with a few exceptions.
I feel for you, but I actually agree that you might be better off avoiding groups that are so biased, they consider a vaginal birth to be more important than a live, healthy baby. And, I think you know that there is VERY LITTLE that you can personally do to have a successful VBAC. So much is beyond your control, and lies in the realm of chance. Should you end up requiring a repeat section, you are not a failure. You’ll hear that message over and over here: your success as a mother is not dependent on the manner in which your child enters this world. Period.
I agree with your last statement but I disagree with there being very little you can do to influence your birth. First, I can achieve a ‘normal’ BMI in the next year, that has been shown to improve VBAC outcomes & it improves all outcomes. Also, I can wait 9 months to TTC or even longer, as is my goal. If a woman does not do that, it is an automatic repeat C according to ACOG. How long I wait to TTC is almost entirely in my control. Next I can choose a practice & facility with high VBAC success rates as well as good overall outcomes as well as immediate OB & Anesthesia to help ensure the best outcome if my VBAC turns into a CBAC. Women have a lot of control over their birth outcome in terms of choosing a practice, choosing a facility, choosing a TOLAC or RCS, etc.
And of course none of this will influence my success as a mother but it can influence my medical outcome. Heck, even being aware of Accreta and insisting on elevated screening for that ahead of delivery would potentially improve my outcome if that condition presents. If there was truly very little a mother could do to influence her outcome, this blog would not exist. After all the mother is the one who chooses to seek hospital based care, chooses to go to prenatal appointments, chooses to follow medical advice, etc. I don’t agree with a mantra of powerlessness. Of course chance plays a role, but so does choice.
I think it’s great that you’re being so actively involved in your progress. However (and this is a big thing), take care not to see a repeat c-section (if it happens) as a failure on your part or on the part of anyone else you’re chatting with on line. Yes, you can do all those things, but a certain amount is just dumb luck. You tried your darnedest the first time (I believe you had a weird cord issue?) and your c/s wasn’t a failure then, and it won’t be a failure if a c/s happens next time. I’m sure you know that, but it bears saying.
Just one example: http://www.ncbi.nlm.nih.gov/pubmed/24215856
The study shows a very modest effect for weight loss which was barely statistically significant. But it you want to lose weight and are able to do it, good for you. The only thing I would caution is not to believe too much in something like this which is so small in effect and then place blame on yourself if it doesn’t work out for you.
I absolutely agree in taking what practical measures you can to ensure a healthy pregnancy and set you up for better odds of a successful VBAC, such as the steps you have suggested above. However, I feel you have to understand that many times, despite a mother’s diligence and effort to maximize her odds, she may still end up with a repeat section. And my point is that she is is not a failure. Yes, there are variables within your control, but there are a lot that are not. And the guilt and sadness that can accompany a “failed VBAC” can be so destructive.
I’ll only comment on the point that there is no such thing as an automatic c-section. Yes, if you deliver vaginally with a complete placenta previa your baby will most likely die and you will be risking your own life as well, but you cannot have surgery if you do not consent to it. It is that simple. Sure, if you’re become unconscious from blood loss I hope someone will consent on your behalf, and there are exceptions if you are incapable of consent, but you get the point.
To the subject at hand. An attempted vaginal delivery after a recent c-section does increase the risk of uterine rupture, but it is still roughly 1% or less. So it is comparable to the risk of oxytocin use with one prior c-section, or spontaneous labor with 2 prior c-sections. As an Obstetrician, if I am capable of responding and treating the sequelae of uterine rupture 0.5% of the time (spontaneous labor with one prior c-section), then responding 1% of the time is no big deal. So the bottom line is not my ability to treat you if it does occure, but your willingness take the risk, and live with the consequences.
More women need to hear this message. Our worth as women and worth as mothers is not measured in the manner through which we give birth to our children. That measure, like image, is superficial. I had a successful VBAC, but the divide between the crap I read in woo-infested sites and the very little my own OBs shared meant that I entered the labor and delivery room very skeptical of anything my OB said to me. All’s well that ends well and even though I told myself I’d be okay with a c-section, it would have been mildly disappointing.
I was once heavily steeped in the woo, and this was in an era before the internet.. The VBAC /NCB’s believe that negative thoughts can have a physical impact on how your uterus behaves. And just like it would be nearly impossible to reach an orgasm while being scrutinized by nay sayers and outside influences, your uterus is just as easily distracted. So if you want the birth of your dreams you need to envelope yourself by loving positive warm engaging people.
Birth is not science..it is life
Although I can spout their philosophy I know it is bullsh*t.
And once again, I’ll plug our new VBAC and Birth After Cesarean Facebook group. Our admins include a couple of VBAC moms, an RCS mom, a former homebirth midwife, and a wise and experienced mom 🙂 Everyone is welcome. https://www.facebook.com/groups/289408731231663/?fref=ts
But how are readers to KNOW when their moderators are deleting? Unless you follow a community closely, you have no idea how much is being erased and changed. I get deleted all the time over on ICAN, and other community members don’t seem to know why my posts disappear.
I suppose the real answer is to look for the dissenters. Are there any? Real dissenters, not people arguing over trivial matters. If there’s a post about a controversial matter and 200 comments all assenting, you’re looking at an echo chamber. If you’ve got even 3 dissenting comments that are engaged with, you’ve got discussion.
I would say look for gaps in the conversation that make no sense. If the group or owner is deleting nine times out of ten they will forget the comments that make no sense within the context of the conversation. I also tend to stay away from groups that are an echo chamber because it usually means that no dissenters need apply.
The other thing would be to encourage someone to post something dissenting and see if it gets deleted? There must be a few tricks that people can try to “test” a page and check that people are discussing ALL the issues – and not just those that agree with a moderator’s point of view. Some sort of “echo chamber test” – I mean fair enough for emotional support etc that people don’t want people trolling and stirring up trouble for shits and giggles, but when you are making medical decisions based on a website’s content (especially when it is undermining your doctor’s advice) I think it is a fair call to test their knowledge and test their ability to examine the counterpoints to their knowledge.
The only echo they want to hear is that of their own voice. It’s a form of narcissism.
It’s kind of a variation of normal, I think (pun intended). We do want to surround ourselves with people and voices that re-affirm our beliefs, because we can avoid cognitive dissonance that way – it’s more comfortable. I just wonder why some of the people take it to the extreme with all the deleting and banning. It seems a bit childish, not to mention dangerous for the women who are taking the advice of the NCB faithful.
It’s the reach that is so worrisome. It looks so reasonable to the average first time mom, and never gets refuted. Doctors and hospitals are going along with the woo now, too.