Getting your information about C-sections from homebirth midwives is like getting your information about solar power from Big Oil

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More than 20 years ago, when my husband and I were seeking a new home for our expanding family, we were shown several beautiful plots of land. The houses were spacious, the plots of land were large and the entire area backed up onto conservation land. The builder who owned the land was offering three different house models, all very attractive.

We toured the development, but were not happy with the available models; none had a family room located off the kitchen and that was one of my few absolute requirements. My children were small and I wanted to be able to see them at all times, including when I was preparing meals. The fact that our 3 year old had recently cut the 5 year old’s hair with kindergarten scissors when I left them playing where I could not see them from the kitchen only strengthened my resolve on this point.

We tried to convince the builder to adapt an existing model to our requirement and were astounded when he told us that while we thought we wanted a family room off the kitchen, we didn’t really want one. Eventually the kids would get older and we would appreciate it when they weren’t in view. In other words, he couldn’t or wouldn’t built a house with the family room attached to the kitchen and it was therefore in his economic interest to convince us that we didn’t need one.

Not surprisingly, we sought out another builder with a different piece of land and ultimately got the house we wanted with a kitchen overlooking a sunken family room. For years I watched 4 children play by themselves, with each other and with friends in that room, and no one ever cut anyone else’s hair with kindergarten scissors ever again. And when the kids got older and we didn’t want them in view, we finished the basement.

I’m reminded of that episode whenever I see homebirth midwives discussing C-sections. Just like the builder who wouldn’t build the house we wanted tried to convince us that we really wanted what he was selling, homebirth midwives, who cannot perform C-sections, try to convince women that they don’t need C-sections, don’t want them, and will be sorry if they have them.

What never ceases to amaze me is that women seeking information on C-section from homebirth midwives fail to recognize the economic motivation behind midwives’ demonization of C-sections. It’s the intellectual equivalent of seeking information on solar power from Big Oil. Would you believe Big Oil if it tried to convince you that solar power was a bad idea? I doubt it. So why believe homebirth midwives when they tell you that C-sections are a bad idea?

135 Responses to “Getting your information about C-sections from homebirth midwives is like getting your information about solar power from Big Oil”

  1. Em may
    October 14, 2014 at 6:09 am #

    Or they also try and convince “successful” home birthing mums that they WOULD HAVE HAD A CS if they had birthed in hospital in order to shore up heir revenue for the next birth and perpetuate fear about unneccesarians. Seriously.

    I’ve had TWO hb friends declare that they would “definitely” have been given a CS if they had been in hospital. This, despite an uncomplicated home labor. Why?! Who the fuck knows, other than the midwife “told them so”.

    Never mid that you can’t actually have a CS without consent, but sure, whatever.

    Yet these two women also mock the people who would have “died without a CS” saying that’s bullshit and lies, and that they only has a CS cos of intervention anyway. So basically – if you don’t want one, you will be FORCED TO HAVE ONE, and if you will DIE without one, that’s just lies

  2. Sara
    October 13, 2014 at 5:42 pm #

    Our well pump just went out (we were without water all morning), and the well driller showed up to fix some of the parts and suggested we replace the tank. My husband mentioned that we were planning to run a line to connect to public water, now that we have that option. We would still use the well for the gardens and such.

    The guy got spittin’ mad. He warned us about the chlorine, the fluoride and the brain eating amoebas that persist in the public water despite the water having “as much chlorine as pool water.”

    That has nothing to do with how safe our well water is, or whether our pump will operate when the power is out. But of course, this guy drills wells for a living. The public water system *has* to be bad.

  3. KG
    October 12, 2014 at 11:16 pm #

    Home birth is clearly the work of the devil in the opinion of the participants of this blog. Can anyone support these opinions with valid data? This is a genuine question. Data I have read seems to support safety for women and risk for babies. Is this because of a single attendant or lack of NRP skill?
    I am an RN soon to be CNM. I am interested in understanding the actual risk involved in hb. The reality is it happens. Perhaps instead of bashing moms for choosing this option, we can explore what about it is unsafe.
    In addition, is anyone aware of any studies that differentiate hb attended by cpm’s vs CNM’s? One vs two attendants?

    • Stacy48918
      October 12, 2014 at 11:39 pm #

      There are TONs of studies. There is a link on the right side of the page: 2013 in review, Papers and studies.

      Here’s a few:
      Homebirth associated with increased risk of stillbirth, neonatal seizures and HIE: http://weill.cornell.edu/news/pr/2013/09/birth-setting-study-signals-significant-risks-in-planned-home-birth.html
      Homebirth increases risk of HIE and cooling therapy by 16.9 times: http://www.ajog.org/article/S0002-9378%2813%2901604-9/abstract
      Homebirth increases risk of Apgar of 0 (ZERO!) at 5 minutes!: http://www.ajog.org/article/S0002-9378%2813%2900641-8/abstract

      If you take the time to read more of the blog than one single post, perhaps you’d see that the entire purpose is to explore what about it is unsafe. Here’s an overview:

      1. Poorly educated attendants, primarily CPMs
      2. High risk patients (Amos Grunebaum did a great study early 2014 illustrating that homebirths frequently include high risk patients)
      3. Distance from the hospital – in a true emergency it doesn’t matter too much if you are a CPM or a CNM…you still can’t do a C-section, give a transfusion or perform adequate resuscitation.

      Homebirth is not “of the devil” but ill-trained “midwives” that kill babies through their negligence, hide the evidence of their death and still promote their actions as safe definitely are.

      “The reality is it happens”. Yes. But it shouldn’t. Many of the babies that die at homebirth would almost certainly have lived if they had been in a hospital. I’m not OK with promoting that practice. Are you?

      • KG
        October 13, 2014 at 11:48 pm #

        My point is I would like to truly explore the risks rather than demonize the practice. The tone of responders and this entire blog is… Confirmation bias. Retrospective studies based off of vital records are limited. The Cornell article cites a study that identifies increased risk r/to hb regardless of practitioner certification. Limited study is out there that identifies such risk.
        I would like to see more unbiased study that controls certification of practitioner as well as number of persons attending the birth. In addition, other variables including risk out factors should be identified. Of course it all has to be retrospective as we cannot submit women and their babies to known risks of untrained, solo attended hb’s. Is it reasonable to conclude that the practice of hb is unsafe, when I fact, it may be the practice of births untrained birth attendants is unsafe. This is far more likely to occur in out of hospital settings as MDs and CNMs are held to standardized training and boards.

        • Bombshellrisa
          October 14, 2014 at 12:09 am #

          Or maybe it’s the fact that there isn’t CEFM, a blood bank, an OR and a whole team of people to work on mom and baby. Having birth attendants who have no medical training but have read lots of warm fuzzy accounts of birth and are driven by ideology doesn’t help either.

        • guest
          October 14, 2014 at 1:26 am #

          I think it’s more than reasonable to conclude that HB is grossly unsafe. In an emergent situation, “5 minutes from the hospital” is simply not acceptable. A mom and/or baby could be dead by the time they arrive. As an RN you know how it goes in a code, and you have all the drugs and equipment at hand in the hospital. In a home birth,you sure won’t have your Neopuff with you, or a UVC set up and epi, all things that may be needed if that baby is born needing extensive resuscitation. And a woman with a severe PP hemorrhage can bleed out in a matter of minutes. These are always possibilities in every birth and every mother and baby deserve fully prepared attendants and a fully equipped environment. A CNM might fare better as she is educated, better trained and has superior skills, but that still doesn’t account for the precious time wasted just getting to the hospital, when lives are in the balance. And in my experience in OB, when something goes bad, it usually goes really bad, really fast.

        • AlisonCummins
          October 14, 2014 at 3:03 am #

          Ok, what you’re asking for is the UK birthplace study.

          Two trained midwives part of the hospital system, very rigorous exclusion criteria, high transfer rate: homebirth is a reasonable option for women who have had at least one child with no complications of a previous pregnancy and while riskier than hospital birth for first-time mothers, not insane.

          Note the very rigorous exclusion criteria — stricter than currently required by the UK health system.

          Note the high transfer rate — I think 38% for first-time mothers and 15% for women who have had at least one child and no complications of previous pregnancies?

          • AlisonCummins
            October 14, 2014 at 3:10 am #

            These criteria are difficult or impossible to meet in the US. That would require two hospital-affiliated CNMs with exceptionally conservative strict risk-out and transfer criteria. Because of the nature and structure of the US health system, insurance and social safety nets, insurers typically do not insure practitioners of homebirth against malpractice, which means that hospitals will not allow their staff to attend homebirths.

        • Young CC Prof
          October 14, 2014 at 9:10 am #

          Fine, go ahead and do it yourself. Go to the CDC Wonder database of infant mortality. Search for neonatal deaths of full term babies born in the hospital with a CNM versus born out of hospital with a CNM. (That’s gestational age at birth 37 weeks or more, age at death 28 days or less). Apples to apples.

        • guest
          October 14, 2014 at 10:45 am #

          what is your nursing specialty?

    • guest
      October 13, 2014 at 12:18 am #

      I’m curious. You say you are an RN soon to be CNM. Do you have L&D experience? I ask because the CNM’s I worked with in the US all had several years of L&D experience as a prerequisite for midwifery school. It seems to me that as an RN with L&D experience you would already understand why home birth is unsafe.

    • Bombshellrisa
      October 13, 2014 at 1:14 am #

      Nobody bashes loss mothers-many of them post here. The risk isn’t just single attendant of lack of NRP skill (although nobody can do an NRP at home no matter how skilled). CPMs have no standard of training and attend so few births that they are not able to spot problems before they turn into disasters.

    • Dr Kitty
      October 13, 2014 at 3:21 am #

      KG, maybe read this site. There is plenty of evidence about the risk of HB.
      Most of it is actually the issue with a delay in diagnosis of adverse events.
      Labours being allowed to continue for days without adequate monitoring, placental abruption being missed for hours, GBS sepsis only being picked up when the child is moribund, PPH only bring indentified as severe when the woman collapses, tears only being identified as serious when they fail to heal by secondary intention after two weeks, babies falling dead or almost dead into the hands of midwives “completely unexpectedly”.
      Then the delay in diagnosis is compounded by delay in accessing proper treatment. Usually because of the need for transfer, and then the need for a back to basics admission because the data shared by the MW is incomplete or unreliable. Occasionally the delay is worsened because their distrust of hospitals and Drs mean that the family and MW resist all efforts to treat them once they go in.

      HB is only acceptably safe with properly trained attendants, adequate medications, oxygen and equipment, strict adherence to risk-out guidelines and quick and straightforward transfers.

      There is plenty of evidence here. You’re capable of doing your own homework, so I’m not going to do it for you.

  4. Ash
    October 11, 2014 at 4:50 pm #

    Can anyone tell me which states gather “intended place of birth” on birth certificates?

  5. guest
    October 10, 2014 at 7:45 am #

    “Just like the builder who wouldn’t build the house we wanted tried to convince us that we really wanted what he was selling, Obstetricians, who cannot perform Midwifery-led/Home Births, try to convince women that they don’t need midwives/home-births, don’t want midwives/home-births and will be sorry if they have them………”

    • Amazed
      October 10, 2014 at 8:16 am #

      Yeah, obstetricians are so sorry that they routinely help women with not getting pregnant, so there would be less births for them. After all, this 1 percent of births is so very important to obstetricians. It isn’t as if it’s a tiny part of their routine job and their income. And it isn’t as if it’s the only source of job and income for homebirth midwives.

      Oh wait…

    • birthbuddy
      October 10, 2014 at 9:11 am #

      What do you mean, obstetricians can’t perform homebirths?
      Anyone can perform homebirths, no skill whatsoever is required.
      Everything is normal and nothing can go wrong, if it does it’s not your fault anyway.
      Anyone can do that.

    • Dr Kitty
      October 10, 2014 at 9:59 am #

      OBs certainly CAN attend HBs.
      They usually just don’t for very sound reasons relating to safety concerns and the fact that in the event of a disaster they are going to be on the hook financially.

      When the people with the most to lose don’t want to play, and the only ones still betting are the ones who have nothing to lose you really have to question if you want to play this game.

      If an OB attended a HB and it went pear shaped they could lose their business, licence to practice, and a lot of money.
      If a MW attends a HB disaster she might (might) get an angry review on Yelp.
      Not the same thing.

  6. AmyH
    October 10, 2014 at 12:08 am #

    http://www.usatoday.com/story/news/nation/2014/09/11/newser-c-section-death/15441741/

    Doesn’t look like all the details are available yet, but this just caught my eye. (Family claims mom died because hospital DIDN’T do C section.)

    • Sally RNC-NIC
      October 10, 2014 at 12:16 am #

      Egads. So many details missing. Will be interesting to see what comes of this. Not good at months, can only think in weeks…wonder what the exact gestation was, why they weren’t able to mag her, why they didn’t go for a section, and what the shit SHE died from. Geesh. Sad story for sure. Will be interested in hearing more when the details surface…thanks for sharing.

    • Poogles
      October 14, 2014 at 4:49 pm #

      Honestly, why the hell did they feel it necessary to link not 1 but 2 stories about “forced” C-sections at the end of this article??? Like, oh yeah, some women and babies die when they don’t get a timely CS, but ZOMG some women are forced (pressured) into the life-saving surgery!!

  7. Sally RNC-NIC
    October 9, 2014 at 10:57 pm #

    OT…but today, towards the end of shift in my amazing NICU, word began to spread we’d be getting a baby who had earlier been born at home. My response to my Charge Nurse was of course, “On purpose?” She didn’t know, the details were fuzzy. An hour later, I’m starting to get bouncy, wondering where in the world this baby was, and what the deal was.

    My sweet Charge Nurse came in and informed us the story had changed. MOM was in the ER, being evaluated for excessive bleeding, the BABY would not be admitted as he was doing ok. However. The Midwife had the baby….on a cold, rainy midwest evening, in our Level 1 Trauma ER, throwing a shit-fit that the baby couldn’t hang out with his mom. I will never cease to be amazed at the thought process of homebirth peeps. It’s the beginning of flu season, EV68 pretty much started here in Kansas City, and it’s an ER. Ew. Oh, and not to mention mom was clearly not ok…

    Meanwhile…up in Postpartum….mothers and babies cuddled together on a rainy Thursday night, and all was right with the world….

    And if I sound snarky, I don’t mean to. I’m sad for this mom. I’m sad someone convinced her to birth at home, I’m so sad she had to come to the hospital and be away from her baby. It breaks my heart, and I’m angry for her.

    • Bombshellrisa
      October 9, 2014 at 11:56 pm #

      Well, the midwife was trying to save that baby from having to wear a hat.
      But seriously, WTF-the mom is bleeding excessively, she probably doesn’t have the strength to be looking after a newborn, and the midwife is an idiot for not realizing what a germy place the ER can be. Isn’t that an argument the homebirthers throw out? That they don’t want to have their babies in those germ filled hospitals?

      • Sally RNC-NIC
        October 9, 2014 at 11:59 pm #

        Ding-ding-ding-ding-ding! Exactly. It makes ZERO sense.

        • Bombshellrisa
          October 10, 2014 at 12:46 am #

          Wow. I have no words. So mom gets taken to surgery, and midwife thinks that when mom gets out, that she will be able to just keep the baby in the room (or the bed) with her? It shouldn’t surprise me that the midwife has no idea how an admit works. It should also not surprise me that they feel like it’s perfectly acceptable to admit a healthy baby to the NICU because it’s convenient for them, never mind that there might be a baby who really does need that level of care.

          • Karen in SC
            October 10, 2014 at 8:30 am #

            I thought that sometimes a mother with a nursing baby can bring the baby to the hospital with her when a procedure is planned that keeps the mom there, but doesn’t affect breastmilk.

          • Dr Kitty
            October 10, 2014 at 9:52 am #

            Well, the problem is, if you don’t have a well baby nursery because of your rooming in policy and mum is actually not well enough herself to care for an infant, you just don’t have the staff or the setting to care for the baby.

            I know in the hospital I worked in that if someone had an endometriosis or mastits or wound infection and needed admitted for IV that the baby could certainly come too if they were nursing, but that rooming in was only an option of here was another family member prepared to stay and care for the baby. Otherwise it was put in the well baby nursery and just brought to mum for feeds.

            It isn’t fair to give a needed NICU bed to a well baby, nor to expect a very sick woman to care for a baby, nor to ask staff to care for an extra (small and cute, but fairly high needs) visitor without the appropriate space and resources to do it right.

          • Dr Kitty
            October 10, 2014 at 9:53 am #

            Damn spellcheck. Endometritis and mastitis.

          • Amazed
            October 13, 2014 at 7:04 am #

            The smaller the visitor, the higher the needs! After all, a toddler can point at his or her ears or tummy to show where they have an ochie.

            The lack of Well Baby is madness! I’d really, really want to know how they do it. How do they know which mothers won’t bleed so much that they’d spend their entire stay dazed and completely unable to care for a baby, for example?

            Maybe those hospitals have discovered the crystal ball? Pass over here guys. I’d really like to know which deals conducted at the Frankfurt Book Fair will lead to… well, bestselling of bestsellers.

          • Sally RNC-NIC
            October 11, 2014 at 12:05 am #

            I think that’s probably true for controlled situations. This mom was in bad shape, and had lost a great deal of blood. The baby was only a couple hours old. It would be great if we could stick the kiddo in the Well Baby nursery, but he would still have to be admitted – and unless something is wrong and they need to be in the NICU, babies born outside the hospital aren’t admitted. Never to Well Baby. There would have to be a Medical Record and Account # created, the baby would have to go into the HUGS system and a security band placed. A diagnosis would need to be given. We’re all baby crazy, and would love to help in a situation like this, but simply watching the baby would be a security and staffing nightmare, and a huge liability for the hospital. Yuck.

      • Sally RNC-NIC
        October 10, 2014 at 12:04 am #

        I mean, do they let you breastfeed in the PACU? What a hot mess…

  8. Guestll
    October 8, 2014 at 6:48 pm #

    “And when the kids got older and we didn’t want them in view, we finished the basement.” — Exactly how old do they have to be? Asking for a friend.

    • fiftyfifty1
      October 8, 2014 at 7:42 pm #

      just as soon as you don’t want them in view.

      • NoLongerCrunching
        October 9, 2014 at 9:00 am #

        For me, seeing my teens is a rare treat lol.

        • Amazed
          October 9, 2014 at 10:02 am #

          My mom claims that after I left to go to university, she’s seen more of me than the three years before combined.

    • Young CC Prof
      October 8, 2014 at 9:01 pm #

      Old enough not to engage in unplanned and unskilled barbering.

      • KarenJJ
        October 8, 2014 at 11:07 pm #

        I’m nudging 40 these days and still engage in unplanned and unskilled barbering…

        • Young CC Prof
          October 8, 2014 at 11:36 pm #

          Hmm, yes, there was this time in college, with a couple of people I knew, and a lot of alcohol…

          Luckily his hair grew out enough to look OK in just a couple of weeks.

        • The Computer Ate My Nym
          October 9, 2014 at 9:02 am #

          Well, ok, old enough to say, “you did it, you deal with it” when they engage in unskilled barbering. I’d say about 13 or so. Though really if the 11 year old decided to cut her hair, I’d probably just ask “are you sure?”

    • Gozi
      October 9, 2014 at 1:12 pm #

      I am approaching middle-age and my mom still wants me in her sight all the time.

    • Who?
      October 9, 2014 at 11:57 pm #

      Your ‘friend’ will know when it happens.

  9. Bombshellrisa
    October 8, 2014 at 5:35 pm #

    Totally OT but the part about the haircuts had me laughing-dd decided to give herself an asymmetrical do a few years back and was in the process of styling her friend’s hair the same when we found her. They were using craft scissors, the kind you get at a scrapbooking store.

    • Cobalt
      October 8, 2014 at 5:42 pm #

      One of mine removed a beautiful 8 inch long pigtail once, between her head and the hair tie. Ended up with a pixie cut and a bald spot, nothing else we could do with it.

      I cried, silly as that is. She loved it and has had short hair ever since.

      • KarenJJ
        October 8, 2014 at 10:51 pm #

        My girl ended up with a pixie cut too and it looked really cute. She’s now decided she wants long hair, which is a bit of a pain..

    • Who?
      October 8, 2014 at 6:09 pm #

      I remember being the four year old who did this-sitting up in bed-was I sick? My most vivid memory is the look on Mum’s face when she walked in and found me in the middle of cutting myself a fringe, which is to say, the four year old with no mirror interpretation of a fringe.

    • Mishimoo
      October 8, 2014 at 6:19 pm #

      My girls gave themselves fringes and bangs, and keep trimming them every so often ‘accidentally’ at school and while doing art at home. Luckily, they’re cute.

    • KarenJJ
      October 8, 2014 at 6:50 pm #

      My kids just waited until I was in the shower…

      • Amazed
        October 9, 2014 at 5:39 am #

        That was what brother and I did, although not about cleaning ourselves up. “Is she still in there?” “Yes.” “OK, I’m going.” “Mum? Still in there?” “What are the two of you doing? Whatever it is, DON’T!” *mom finishes shower earlier than expected and runs to see what’s going on*

        • KarenJJ
          October 9, 2014 at 8:48 am #

          My eldest was more devious and came in and told me about how her little brother had been cutting his hair., I dashed out and found him sitting in a chair with a pair of his sister’s craft scissors in his hand and a pile of his hair collected neatly in an empty box… It was not the work of a 2yo and later that day we got our confession from her that she’d been the one to do it.

          Our local hairdresser has fixed a few mistakes now – her haircut, her attempt at cutting her brother’s hair and my attempt at cutting her hair.

          • Amazed
            October 9, 2014 at 8:53 am #

            I cut off my own plaster from my foot when I was 18. It was one of the heavy things that wouldn’t let you walk OR wash them, I had been wearing it for 25 days and I. Was. Done. 25 days, the doctor said. Was I to blame that the 26 day was Sunday and they wouldn’t admit me?

            Funny thing is, my brother was the only one who thought that I might do so. Mom and Dad had left for the day and he asked, “What if she tries to take it off?” “Don’t be silly,” they said. “Of course she won’t.”

            I managed to send him to the nearest shop, grabbed a knife and scissors and set to work. When he returned 10 minutes later, the plaster was hanging on a few threads.

            I was 18 then.

    • staceyjw
      October 8, 2014 at 7:05 pm #

      My son cut a chunk out of the right side of his curly hair. So we fixed it by doing a faux-hawk. SO glad he cut it, the hawk is perfect on him.

      • Bombshellrisa
        October 8, 2014 at 7:08 pm #

        That sounds precious!

      • Elizabeth A
        October 9, 2014 at 11:37 am #

        This is *useless* without curly faux-hawk kid pictures.

        DS has had super short cuts and faux-hawks occasionally. They’re adorable.

    • Amazed
      October 8, 2014 at 8:36 pm #

      A friend’s daughter cut her ponytail off with a kitchen knife because “I couldn’t see!” and then hid it in the waste-paper basket under a bunch of papers.

      My brother shaved his entire eyebrow off.

      I don’t know how old he was but I once let him paint me – all visible me – with his crayons. We thought that this was what Mum painted her face with (to this day, the only kind of eyeshadow I can apply is a pencil one).

      • Amy M
        October 9, 2014 at 8:01 am #

        My sister was a menace with scissors. I don’t recall her cutting her own hair, though she might have, but she cut a lot of doll’s hair.

        • DaisyGrrl
          October 9, 2014 at 8:21 am #

          My sister cut her own eyelashes off once. She decided they were too long and gave them a trim. My mom was not impressed.

          • Amazed
            October 9, 2014 at 10:48 am #

            Maybe they were getting into her eyes? Much like my friend’s girl proclaimed that the ponytail stopped her from seeing.

          • DaisyGrrl
            October 9, 2014 at 12:10 pm #

            She did have long lashes (and was repeatedly told as much). But hey, at least mom found her before she had a chance to get to my brother’s equally long lashes.

  10. Stephanie
    October 8, 2014 at 2:15 pm #

    Full disclosure – My current career is with big oil.
    The interesting thing is, the companies I have worked with fully admit they are profit driven, not ideology driven and consider themselves energy, rather than oil companies. The available state when green energy becomes profitable, then they will switch gears. Most oil companies in my area have a solar, wind and biofuel porfolios within thier sustainability departments, waiting for the profitability to occur, and don’t care which energy they use as long as the profit is maximized.
    They don’t hide under the guise of being better for the environment, just cheaper and more available than the alternatives.

    • Staceyjw
      October 8, 2014 at 3:43 pm #

      I’m in solar.
      People don’t realize that oil companies often put big money into solar research, development and deployment. They have owned manufacturing capacity in the past, and are only waiting for it to be profitable for them to jump back. We have shared conference speakers, and often discuss energy issues together. I have found people in oil to be surprisingly frank.

      The idea that there is this big divide, where they are pit against each other, fighting to destroy each other, is not the reality. *There is so much demand for energy that all players are welcome, and needed.* The fights are more about who will get what subsidies, how this effects profitability and the cost per watt (solar is now cheap enough to be equal in many markets), and of course, the ecological nightmare that comes with our zealous appetite for power, in all forms (and what to do about it).

      • Sue
        October 8, 2014 at 11:19 pm #

        Any smart company which relies on a non-renewable resource would be reading the market and supply and preparing for the future. It only takes business sense, not even concern for the environment (though that would be a bonus).

    • Gretta
      October 8, 2014 at 8:45 pm #

      Yes, the idea of the “boogie man ” Big Oil is unrealistic and tiresome.

    • Sue
      October 8, 2014 at 11:17 pm #

      “Energy” rather than ”oil” is a good analogy for “OB” vs “HBMW”. An OB can offer the full range of products, tailored to need. A HBMW offers only one product, and has to convince you that you both want and need it.

  11. Gozi
    October 8, 2014 at 12:29 pm #

    The worst part of my C-section was when I became constipated and the nursing staff didn’t realize what was going on. They just kept feeding me pain pills that I told them wasn’t doing any good. I didn’t know that was the problem because no one had told me that could be the cause of my pain. It wasn’t until things corrected themselves that I really realized what was going on. The nursing staff had let me administer my own suppository and hadn’t checked the results. I told them the results (which could have fit into a teaspoon) and they said that I was fine.

  12. Zornorph
    October 8, 2014 at 11:37 am #

    I had an architect friend once who told me that sunken rooms are a good way to trip and hurt yourself.

    • The Bofa, Being of the Sofa
      October 8, 2014 at 12:09 pm #

      Was his name George Costanza?

      (appropos of nothing: Jason Alexander commented recently that it is ironic that his daughter is now dating an archetect)

      • 2boyz
        October 8, 2014 at 12:33 pm #

        Does he work for Vandelay industries? (Sorry, couldn’t resist)

        • The Bofa, Being of the Sofa
          October 8, 2014 at 12:44 pm #

          Kramerica.

          “Mr. Kramer says,’Hey, buddy'”

    • Anonymous
      October 8, 2014 at 12:44 pm #

      My house has a sunken dining room and in two years nobody has tripped once.

    • UsernameError
      October 8, 2014 at 3:45 pm #

      We have one sunken room, 4 half staircases and 2 spiral staircases (yeah, our floor plan is nutty), and so far no one has tripped. There is this interesting philosophy of “looking where you are going”. 😉

      • Mishimoo
        October 8, 2014 at 7:08 pm #

        The only time that I slipped on my grandparent’s spiral staircase was while I was looking. The problem was unthinkingly wearing socks on polished wood. 😉

    • LovleAnjel
      October 8, 2014 at 4:31 pm #

      I grew up with a sunken living room next to the dining room/kitchen. Never tripped, slipped or fell into it, and it had polished wooden steps.

    • AnotherAmy
      October 8, 2014 at 6:28 pm #

      We have a 2-step sunken living room that we moved into when our daughter was 15 months; she’s now seven. The only accidents we’ve had are hitting our toes on the ‘stupid strip,’ as we not-so-lovingly call it, connecting the carpeted stairs to the kitchen flooring.

    • Guestll
      October 8, 2014 at 6:50 pm #

      I grew up in a mid-century modern monstrosity with a “conversation pit” – a sunken family room — but that was what the architect called it.

  13. Montserrat Blanco
    October 8, 2014 at 11:22 am #

    I remember reading about C-sections on NCB sites. They said it was awful, you were unable to move for weeks, it was the worst experience ever.

    I would certainly not recommend a CS instead a walk at the park but it was not the worst experience in my life, recovery was far better than I had expected. I was walking the day after, walking alone two days after and exercising a little two weeks after. I admit that standing up hours after the surgery was painful but it was not the worst pain in my life and it lasted two minutes. In any case, a small price to pay for an undamaged son and an intact pelvic floor. The ladies I have seen after vaginal deliveries those days are still not able to walk properly weeks after and seating on cushions weeks after ( one of the moms is seating on a cushion three weeks after delivery).

    Scaremongering tactis… Very far away from reality.

    • EmbraceYourInnerCrone
      October 8, 2014 at 11:32 am #

      Yup, I was one of those ladies with the cushions. I had a really fast delivery( 6 1/2 hours from first pain to baby) and a big baby(just shy of 9 pounds) and I am 5 feet tall. I would have appreciated knowing that tears are common in this situation and healing from lots of stitches in your perinium may be JUST as painful as healing from them in your abdomen…Also the peeing a little every time I cough or sneeze is not fun either…

      • mythsayer
        October 8, 2014 at 11:47 am #

        See… that’s what I was SO scared of. I’ve had lots of surgeries, so I know what surgery recovery is like. And I once got a bad scratch “down there” and it hurt for days… a scratch (when I was 11 I fell on a set of RV stairs and ended up straddling the metal stair… that’s how I got scratched). So I really didn’t want to tear. To me, that sounded way worse than surgery. I got the surgery I wanted and was quite happy with it.

        • Amy M
          October 8, 2014 at 12:58 pm #

          Me too. I mean, I didn’t get my C section information from NCB websites, because I wasn’t looking at those, but the idea that the recovery from a Csection can be a nightmare is pretty mainstream. I might have opted for a Csection, and saved myself a nasty PPH, if I’d have known the recovery could have been ok. Though I imagine that a Csection recovery is easier when the surgery is pre-labor or at the very beginning of labor, than if labor has been going on a while before-hand, or there is some emergency.

          • mythsayer
            October 8, 2014 at 4:10 pm #

            Which was another reason I wanted an elective CS. I just had a feeling that I’d be in labor, totally miserable, and then end up with a version. That was the LAST thing I wanted.

          • FormerPhysicist
            October 9, 2014 at 11:51 am #

            My experience says that’s true. More labor, more complications = harder recovery. Also, toddlers at home = harder recovery.

        • Sara
          October 8, 2014 at 2:58 pm #

          Ouch! I had a similar injury when I (foolishly) tried walking around the aluminum edge of an above ground pool at the age of 10. So. much. pain. And I didn’t even tell anyone because I was too embarrassed.

          My last birth was even worse. I was also mostly incapacitated from pain the first few weeks. It wasn’t until around 6 weeks that I actually felt somewhat normal.

      • Gozi
        October 8, 2014 at 12:25 pm #

        I healed find from all of my vaginal deliveries, except from my first one. Even that one wasn’t a nightmare.
        But what surprised me more was how well I healed from my CS!! I had read a lot of the fear mongering websites and books, and I thought that I would be agonizing for weeks and months after a C-section. I was so surprised that I healed nicely. I only had one problem, and I mention it above, so I won’t repeat myself right here.

        • The Bofa, Being of the Sofa
          October 8, 2014 at 12:29 pm #

          I’ve told this story before: I was very worried about how my wife would recover from her c-section. Not because of any fear mongering websites, but because I knew what she went through after her laproscopic appendectomy. Considering that only included three tiny little cuts, I was really worried about how she would handle a big cut like a c-section.

          It wasn’t even close. Her recovery from her c-section was so much easier it isn’t even funny. And that is even considering that she had a lot of nausea afterward. Knowing that, she told the anesthesiologist about it on her second, and that ended up being even easier!

          • Gozi
            October 8, 2014 at 12:30 pm #

            I didn’t have the tiniest bit of nausea.

          • The Bofa, Being of the Sofa
            October 8, 2014 at 12:31 pm #

            It’s a common side effect of anesthesia, though.

          • KarenJJ
            October 8, 2014 at 6:58 pm #

            There’s something about laparoscopic surgery that doesn’t agree with me. My recoveries were much worse than from my c-section. I suspect it’s due to the gas stimulating my innate immune system (which is already over-stimulated due to an underlying condition). The first time I had laparoscpic surgery (even when it was just to take a look and they didn’t do anything) made me feel so sick a day later I couldn’t stop vomiting and ended up back in hospital on a drip.

            The second time I had laparoscopic surgery the underlying condition had been diagnosed but I’d forgotten to take my medication. Same thing started happening but I remembered to take my medication and felt fine again 15 minutes after I took it.

    • Dr Kitty
      October 8, 2014 at 12:41 pm #

      My CS recovery was easy.
      Less than 10 days of painkillers, driving at 3 weeks, no problems.

      But then I’m the sort of idiot who insists on standing at the finish line of a 10k to watch my husband finish it…48 hrs after getting my appendix out. So…YMMV

    • Anonymous
      October 8, 2014 at 12:50 pm #

      My wife had a CS after our second didn’t turn. Both my dad and I were there when it happened and it was simple and quick. She was up later and was able to see our son later that day. Now after a few years, you’d never know that she ever had a CS and is back to wearing midriff shirts.

    • DiomedesV
      October 8, 2014 at 2:43 pm #

      Mine was a straightforward recovery, too. I took whatever opioid medication they gave me in the hospital for 18 hours and then transitioned straight to regular old Tylenol alternating with ibuprofen.

      For me, the worst part was the fear that I would tear the stitches. I’d never had surgery before. But every doctor/nurse I mentioned this to seemed to think that was not only unlikely, but nearly impossible.

    • InvisibleDragon
      October 8, 2014 at 3:16 pm #

      I was up the next day after mine. It took me that long to get my brain to engage again after being under full anesthesia because they couldn’t place the whatever-it-was-called 30 years ago. I also had a raging head cold when I got to the hospital. I was a cushion lady too, except not to sit on; to keep my guts where they belonged while coughing and sneezing for a week. I’d still rather have a CS than a vaginal birth.

    • Liz Leyden
      October 8, 2014 at 3:21 pm #

      When I was pregnant, I signed up for the least-crunchy childbirth class I could find, largely for my husband’s benefit. It was taught by a French Canadian doula, and it was specifically for couples planning a hospital birth. She talked a lot about guided imagery and massage oils (she even passed around a “birthing balm” that smelled like my cat), but she included pain meds and c-sections in a very matter-of-fact way. It wasn’t fear-based, more “here’s what to expect if you end up having a C-section”

      I have pelvic floor issues, and I was worried that a vaginal delivery would leave me incontinent. The worst part of my C-section recovery was extreme itching from the morphine. I was walking the next day, and drove a week later. I couldn’t run for a few weeks (not distance running, short dashes across the street).

    • UsernameError
      October 8, 2014 at 3:49 pm #

      The scaremongering I read about c-sections totally affected me when it was time to have my gallbladder out. I was absolutely petrified. I had a much more complicated gallbladder surgery than the usual (long story). The whole thing was super easy, and I felt like the biggest fool/baby ever when it was over.

    • Sally RNC-NIC
      October 8, 2014 at 8:32 pm #

      I was pleasantly surprised with my recovery after an unexpected section. I remember seeing a flier somewhere a couple weeks later advertising for a “C-section Support Group”….and I remember thinking, “Seriously? Get over yourself.” Going into the birth of my daughter, I was pretty stubborn that I didn’t want to have a section. But two hours into pushing, my sweet OB told me I was doing great, the baby was great, she’d stay here all night with me….but I hadn’t progressed in about 45 minutes. And she wasn’t comfortable trying to assist with vacuum or forceps….and her hunch was right. Lucy came out with a whopping hematoma that I can’t even begin to think what a vacuum may have done to it. Anyway, I remember taking a deep breath, and just saying, “Take me back.” I delivered at the hospital where I work as a NICU nurse, so I had all my friends around me, which may have made the whole thing better. But, once the wheels were in motion, I didn’t care anymore. I just wanted my baby and myself to be ok. And we were fine, it was fine, I was up and at ’em fast, and besides the fondus checks (holy crap) it really wasn’t that bad. If we have another kiddo, I’ll probably elect for a scheduled section.

      • Montserrat Blanco
        October 9, 2014 at 11:14 am #

        If I ever want to have another child I will book a CS. Yes, I do no get why would you need a support group, I mean, there are no support groups for appendix removal…

        • Gozi
          October 9, 2014 at 1:09 pm #

          If people need a support group then I guess that it is good there is one. I just wish that there wasn’t this idea that a c-section automatically means glum and doom.

    • Amy M
      October 9, 2014 at 8:03 am #

      To be fair though, my sister had a pretty rough recovery from a Csection. She had labored for 20hrs first though. She didn’t have any particular complications, but she was in a lot of pain, and it took a few weeks until she was feeling 100% again.

      • Montserrat Blanco
        October 9, 2014 at 10:03 am #

        It is surgery and I understand that you can have bad luck and an awful recovery. The problem is that when you read NCB sites it looks like everybody gets an awful recovery, and that is simply not true.

        • The Bofa, Being of the Sofa
          October 9, 2014 at 10:21 am #

          The problem is that when you read NCB sites it looks like everybody gets an awful recovery,

          …because people who don’t have problems with recovery or the c-section in general don’t hang out at NCB sites…

          • Young CC Prof
            October 9, 2014 at 11:05 am #

            Actually, it’s a consistent source of bias on almost all health message boards: The people who recover quickly tend to stop visiting, so the only ones there are either acutely ill or the ones having prolonged problems with loads of complications.

          • Dr Kitty
            October 9, 2014 at 11:08 am #

            Or don’t want to be that obnoxious person saying “but I found it a breeze and would do it again tomorrow!”

            If you enjoyed your CS and had an easy recovery, your story is often not welcome on NCB boards (MDC really, really don’t want that kind of birth story, for example).

            You’re allowed to say how awesome your natural birth was, or how awful your CS was, but you cannot EVER say that your CS was great and your natural birth wasn’t all that it was made up to be,

            I think the tagline for NCB should be “upholding our preferred paradigm!”

    • The Computer Ate My Nym
      October 9, 2014 at 9:12 am #

      My biggest regret associated with my c-section is that I took too many pain killers afterwards and got badly constipated. I took them because I’d heard how terribly painful c-section recovery was and wanted to jump on the pain before it got out of control*…which it didn’t. If I’d switched to tylenol on POD #1 I could have saved myself some gastrointestinal distress and been just as well controlled with respect to pain.

      And I agree about c-sections: I wouldn’t recommend one for fun, but it was by no means awful pain, not even when they started cutting before the full anesthetic effect (it was only proprioception and motor that were still on line anyway). Labor, OTOH, that was simply awful. The only thing that made it NOT terrible torture was that the people around me were sympathetic and assisted me in getting relief from the pain. If they’d dismissed it or tried to give me pep talks about being a “warrior mommy” I don’t think I could have stood it.

      *Well, ok, when I had a PCA pump I also played with it a bit because I wanted to see if I could tell a real drug delivering push from a lock out push. I can’t. Also, they took the PCA away once they figured out what I was doing.

  14. Sara
    October 8, 2014 at 10:45 am #

    I love this succint analogy.

    I bought a book recently (before stumbling into this helpful forum) called “Natural Hospital Birth” by Cynthia Gabriel. It was all nice and encouraging until I developed complications and realized– wow, there’s nothing helpful at all about the usefulness of interventions when complications arise.

    It was all about how to avoid interventions when the doctor is making recommendations… all the way up until the point when it’s a true emergency and the “one more hour” stalling tactic is overridden by the health staff’s need to act to save your life.

    • Gozi
      October 8, 2014 at 12:39 pm #

      It may be my ignorance, but from what I have read I don’t see where the average doula could do more than a helpful, attentive family member. I mean, if the doula happens to be a nurse or something like that maybe so. I was once reading about the role of a doula in one of my crunchier birth books and I kept thinking “well, this is what my 62 year old (at the time), disabled, chronically ill mother did for me while I was in labor, and she didn’t charge me hundreds of dollars. She’s happy to be taken to IHOP.”

      • Young CC Prof
        October 8, 2014 at 1:11 pm #

        It kind of seems like doulas would be most useful for people who DON’T have family members who can or will do that stuff.

        • Sara
          October 8, 2014 at 1:24 pm #

          Yes, and maybe first time moms who really don’t know things about birth and don’t have family members who do… but *only* if the doula is honest, not totally self-interested, and actually has skills to help the mother communicate better with her medical caregivers.

        • Trixie
          October 8, 2014 at 1:26 pm #

          It can be very helpful to have a person doing that job who isn’t emotionally involved the way a family member could be.

        • Liz Leyden
          October 8, 2014 at 2:33 pm #

          I wish I’d had a doula when I had my babies, only because my husband couldn’t be there (I had to be life flighted, Hubby was on a bus). Going through a C-section surrounded by strangers was terrifying.

        • Lion
          October 8, 2014 at 2:47 pm #

          My husband was unwilling to offer emotional help during labour, and was quite nasty. I have no family nearby. Having a doula at our second birth was the best money I have ever spent. I’m sure the first would have felt far less traumatic with one there too.

          • araikwao
            October 9, 2014 at 6:19 am #

            That sounds terrible..I’m glad you had an ally the second time around

        • Cobalt
          October 8, 2014 at 5:37 pm #

          I’ve seen (or not seen because they were absent) some dads be really useless or negative in the delivery room. I’ve been the friend/family/informal doula for several births, just because I was the closest person to the mom who could be supportive, calm, and didn’t mind dumping the bedpan when she had to pee.

          • Dr Kitty
            October 9, 2014 at 4:49 am #

            I’ve seen- angry husbands, drunk husbands, stoned husband, fainting and vomiting squeamish husbands and, memorably, a partner who came straight from a rave having obviously taken Ecstasy and who kept trying to kiss the MW.
            Doulas would DEFINITELY have been a good idea for those ladies.

          • Gozi
            October 9, 2014 at 1:34 pm #

            In these cases I would have paid well for a doula, or just gone through it by myself (which I have done).

        • Elaine
          October 8, 2014 at 9:35 pm #

          A friend hired a doula because she and her husband were both iffy about relying on him to do the labor support role. He’s great otherwise but that just wasn’t his thing. I was content with my husband and didn’t feel the need for a doula, but the other advantage I can see is in a long, difficult labor (which mine weren’t), having someone to spell the family member.

      • LovleAnjel
        October 8, 2014 at 4:40 pm #

        Yeah, I had my husband there to change the DVDs and laugh at my contraction-induced farts. He was free.

      • madwife
        October 9, 2014 at 1:15 am #

        Exactly!
        I had my sister in law help me in labor. she fed me ice chips.
        she held my hand. she wiped my face… for free!

        she’d never been to a birth before. I just wanted a friend to be with me!

      • Therese
        October 9, 2014 at 2:22 am #

        Yeah, and how could a maid be anymore helpful than having a family member come over and clean for you or how could a childcare worker be anymore helpful than having Grandma babysit? Silly that these people expect to get paid for jobs that family are willing to do for free!

        • The Bofa, Being of the Sofa
          October 9, 2014 at 7:42 am #

          Silly that these people expect to get paid for jobs that family are willing to do for free!

          You’ve got family members willing to come over and clean your house for free?

          • Gozi
            October 9, 2014 at 11:46 am #

            Mine aren’t willing to come from 200 miles away to do it (clean). But if someone wants to pay for a doula, I am of course fine with it. I may should have explained that the book I was reading gave the impression that a person MUST have a hired doula.

          • Sara
            October 9, 2014 at 3:48 pm #

            I read a number of doula books, some of the ones on the DONA reading list. I still had trouble figuring out why I *really* needed a professional doula. They show some stats about decreased c-sections and epidurals, but how meaningful is that? I think it may only be true for first time moms anyway.

            I did glean some great advice from experienced doulas while getting ready for pregnancy (I was lurking in their forums). It was all stuff I could have learned from the nurse, but I wouldn’t have thought to ask.

        • Life Tip
          October 9, 2014 at 10:29 am #

          To be fair, many people wouldn’t consider holding someone’s hand during labor the same as cleaning or babysitting.

          My husband wasn’t really that helpful the first time (he was pretty freaked out), but I found the nurse to be more than sufficient. I can’t imagine paying someone to hold my hand, although I see that some women find it worth the money.

    • SporkParade
      October 9, 2014 at 9:22 am #

      I read that book, too! At least it didn’t paint hospital staff as the enemies. In any event, even though I am pretty new here, I just want to tell you all how much I love you guys. I’m currently sitting in the hospital bored out of my mind waiting until tomorrow morning to find out if I’m going to be induced for reduced fetal movement or C-sectioned for reduced fetal movement AND macrosomia. If it weren’t for you (and Dr. Amy, of course), I would be seriously freaking out right now without any understanding of the thinking process. Instead, I’m just sad to be spending the night before alone in the hospital.

      • The Bofa, Being of the Sofa
        October 9, 2014 at 9:39 am #

        Good luck. How about looking forward to the fact that you are going to have a baby…very soon!

        • SporkParade
          October 9, 2014 at 11:35 am #

          Thanks, guys! It’ll be interesting trying to sleep since they have me in the regular maternity ward with all the women who have given birth. I may have had a 10-minute freak-out about the fact that the baby is likely to be here tomorrow. 🙂

          • The Bofa, Being of the Sofa
            October 9, 2014 at 11:46 am #

            may have had a 10-minute freak-out about the fact that the baby is likely to be here tomorrow. 🙂

            That’s a legitimate freakout.

      • Young CC Prof
        October 9, 2014 at 9:40 am #

        Good luck! And sleep as much as you can tonight!

      • Amazed
        October 9, 2014 at 10:08 am #

        Good luck, good sleep, and a gorgeous not so little one to you! (I guess if macrosomia is a concern, the little one IS not so little after all).

        If you have some trouble sleeping, feel free to drop a line. Here, we come from all over the world and chances are that there will be someone willing to chat about all you want. (If you can do something for a very pregnant lady, an angel drops a feather of wing over your head, that’s my understanding.)

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