Is Dr. Brad Bootstaylor another Dr. Wonderful?
Long time readers may remember the story of the original Dr. Wonderful, Robert Biter, MD. Back in 2010 Dr. Biter had his obstetric privileges at Scripps Encinitas suspended. Natural childbirth advocates held marches, conducted a letter writing campaign, and blogged in support, all without having any idea of the charges against him.
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]It’s almost as if they don’t care about the babies harmed at their hands.[/pullquote]
It turned out that he was facing multiple malpractice suits for having harmed multiple patients. His behavior was so egregious that he was eventually stripped of his medical license.
At least in that case, Dr. Biter’s supporters did not know why privileges were revoked and simply assumed that is was because of his support for homebirth, waterbirth, etc.
In the case of Dr. Brad Bootstaylor, his supporters profess surprise and anger that his privileges have been restricted. His practice, See Baby Midwifery, is organizing a rally in support and has contacted multiple media outlets to express their outrage.
There’s just one problem. They KNOW that many babies have been injured and harmed by Dr. Bootstaylor and the midwifery practice; they’re simply lying about it to the public.
On August 21, See Baby Midwifery posted the following:
To our amazement and disappointment, See Baby Midwifery was advised by DeKalb Medical on 8/17/16 (Wednesday) that we can no longer support birth options for mothers to include VBAC, water birth and vaginal breech births. This sudden and unexpected lack of support brings great concern to us and our community.
Temporarily, all VBAC eligible and breech presenting patients will be birthing at Emory Midtown with Brad Bootstaylor, MD.
Water birth has also been discontinued however water labor, of which the majority of patients benefit most, is still supported and available to you (birthing pool, shower, tub, etc.).
Midwifery services will continue at Dekalb Medical for all other patients…
Having this type of news come out of nowhere, is something we are empathetic to, and we share in that frustration wholeheartedly… (my emphasis)
But, in truth, they’ve known all along that multiple babies have been harmed by their practice.
In a private group planning the protest, a supporter acknowledges:
… I saw some information about this whole policy change being due to a bad outcome with a VBA2C birth this week…
Indeed:
There was no loss. There was a transfer [from home] that resulted in a rupture but mom and baby are alive… This was a significant complication. Catastrophic.
Evidently there are problems with Dr. Bootstaylor’s use of forceps, too, which elicited this chilling acknowledgement:
I am a bit biased and I truly love Dr. B but forceps are not his strong suit.
But wait! There’s more!
…[T]here have been many bad outcomes over the months regarding water birth. She said there have been more babies being sent to the NICU since See Baby [Midwifery] was there than ever before…
There was an emergency meeting of the DeKalb OB department last night. A doula reports that Dr. Bootstaylor told her:
30 OBs at the meeting. Many felt waterbirth was forced upon them. See Baby [Midwifery] was invited there in the beginning… He says it feels that they are now being uninvited…
Could it be because their obstetrician presided over a homebirth disaster, is so unskilled with forceps that the support staff has noticed, and an unusually high proportion of babies from their practice is ending up in the NICU?
The OB department wants to restrict Dr. Bootstaylor’privileges:
Was forced to sign the VBAC and breech and forceps or lose privileges. Voluntary refrainment of these practices.
The restrictions on Dr. Bootstaylor and See Baby Midwifery have been put in place in the wake of bad outcomes that represent real babies who have been harmed, possibly grievously, possibly permanently.
Has See Baby Midwifery been honest with its patients and other members of the community about what has happened. Of course not!
See Baby Midwifery shared that Dr. Bootstaylor’s privileges have been restricted, but not why they have been restricted. It’s almost as if they don’t care about the babies harmed at their hands, only about the ones that they can still profit from.
What did See Baby Midwifery do about their bad outcomes? Did they perform root-cause analyses? Did they modify their practice to prevent further outcomes? Of did they just bury them, hoping no one would notice about the trail of damaged babies they left in their wake?
The outrage here is NOT that DeKalb Medical Center moved to restrict Dr. Bootstaylor’s practice. They are legally and ethically required to act. But Dr. Bootstaylor and the midwives of See Baby are ALSO legally and ethically required to act. Instead, they tried to rally support for their harmful practices and figuratively bury the babies that have been injured at their hands.
They should be ashamed of themselves.
It’s nuts because he delivered my first baby. My son loss oxygen after a nurse put her hand in me and I started bleeding badly. After that, I had to have an emergency c-section. I was also charged unnecessarily for a doula who stood in the corner majority of the time. I guess they charged me because she brought a bunch of “stuff” to make it “easier”.
OT: Anyone want to pop in on the comments on this http://www.usatoday.com/story/news/nation-now/2016/08/25/wife-mother-3-has-aneurysm-four-days-after-giving-birth/89332568/ and refute the incorrect comments made by Rose Voltaire?
Wow, that women doesn’t seem to have a clue about what an aneurysm is.
I’m have no idea how she thinks a c section could have caused a brain aneurysm. In fact if anything, a c section would be preferred in someone with an untreated brain aneurysm as pushing could increase the risk of a rupture.
She’s probably thinking of an embolism, but it is still a stupid post to make.
I mentioned in the comments on the “24 week free birth in the bathroom” story that I have attended three cardiac arrests in bathrooms. One of them was a guy who suffered a ruptured abdominal aortic aneurysm while straining on the toilet – so different part of the body but the physics is much the same. And usually giving birth involves harder pushing than pooping.
I’d reply to her but I don’t really want people like that seeing my real name and Facebook profile. I prefer to keep the crazies at arms length.
I’m going to add this here, since the thread below is long and meandering- disqus timeline is confusing.
In regards to home birth not being as safe as hospital birth, even for low risk situations. Things happen, and when they happen it is safest for them to be handled quickly and well before they become an emergency.
MiniKatt’s birth went wonderfully- BECAUSE we were in a hospital, surrounded by competent staff and their equipment, and they were able to stop little things from becoming big things in a hurry. Had I decided to give birth at home (and I admit to briefly entertaining the idea) it would not have ended so well. There would have been an emergency transfer for me at least, and a stuck/dead baby and bleeding out mom at the worst.
Because of the monitoring I waited to push until they told me it was OK, otherwise by body wanted to push EARLY. I felt pelvis pressure and the need to poop from contraction one all the way through. Had I listened to my body and trusted birth as is advised by homebirth midwives, I would have been pushing on an incompletely dilated cervix- which would have swollen.
Because of monitoring again, they knew when MiniKatt started to take a wrong turn and were able to have me change position and help put her back in position. Without that monitor, we wouldn’t have known and I would have pushed her at a bad angle.
She had the cord wrapped around her neck, which the Dr expertly removed. She come out, as my Mother puts it, a “power punching superbaby!” fist out with her head. Again, the Dr was able to manipulate her as she came out to help her not break a shoulder- she could have gotten stuck or been injured. That takes training and skill.
I had multiple tears*, she pooped in me, the placenta had to be manually removed in pieces, and there was a lot of blood. Because I was already in a hospital these things were all handled quickly and with minimal effect on me, considering. I chatted with the Dr as she stitched me up and my baby was checked over. I needed antibiotics and post-birth pitocin to help the bleeding stop. Potential problems were recognized, treated, and stopped. This would not have happened at home, I would have needed a transfer while bleeding with a retained placenta and tears- getting worse off all the way to the hospital, and a baby who might have aspirated merconium. I’m glad there was a Dr already right up in my business.
The nurses took care of both of us. With only one midwife- only one of us could have gotten help at a time, and a very little bit of it. It’s not just that Dr’s are in hospitals- it is the WHOLE STAFF and environment. Nurses, peds team, whoever else was in there, emergency help down the hall not down the road. I had 4 people just holding my legs, and a whole team waiting to take care of the baby in addition to the Dr, and everyone was expert.
If I had a homebirth with a midwife, I don’t know what would have happened. They don’t have the training, equipment, or manpower to handle these situations. What was a rather fun birth experience in a hospital would have been a tragic emergency at home. Everyone around me knew what to do, and did it beautifully.
My family in the corner didn’t even notice anything went potentially sideways, it was fixed too quickly. And while it was great to have them there with me, they’re not OBs, nurses, or pediatric specialists. Moral support is great and all, but competent care is better.
* The tear was my fault. I suddenly realized how long I had been pushing and that she had crowned and retracted several times- not good- time for labor to end! So I grabbed my ankles, put my feet heel to heel, pulled them to my chest, and PUSHED through a whole contraction. That did it 😉
I pursued a VBA2C because I wanted a large family and there are inherent risks in 4, 5, 6 cesareans. I went on to have not one but two VBA2Cs, in a hospital, with a condoning OB. So for me, it was about desired family size and nothing else.
I will admit ignorance on the subject of VBAC and I only have a handful of anecdotes to go on so I am not sure. I just have an honest question and if I come off as offensive to moms then I am sorry. I have had all my children delivered via vaginal birth but if I ever had to ever have a csection my future children would come by csection just from what I understand about the risk involved in vbacs.
So my friend had a csection because her son got stuck. She was in labor for an incredible length of time and could not dilate past 4cm with pitocin. So she said if she gets pregnant again she will be having another csection. She already discussed future pregnancies with her OB who also suggested that a repeat csection is safer for her as many mothers than attempting a VBAC. He told her no to VBAC it’s not safe for her.She took the advice and is going to go with it when she is pregnant again.
Then I know this other woman whom I am not friends with but she’s pushing for a VBAC at all costs. She changed OBs 3xs in her first trimester because the Ob would not agree to assist in her VBAC and said as time progresses he’d look at scheduling her repeat csection. She told this story on a public forum it’s the only reason I know it.
I would genuinely like to know why women are obssesed with their vaginas and vaginal births so much that they will be this adamant and dig their heels in no matter the cost. What about breech? Are people actually suggesting a breech birth be delivered vaginally? I thought csection was the safest option in case of breech. I was delivered via c section because I was breech. I guess my mom never thought of it as a bad thing and didn’t question it.
Again I don’t know. What are the risks associated with vbacs? My little brother was my moms safe VBAC but then after a few more kids she started having premature labors. No idea if the csection followed by a VBAC then another vaginal birth is what caused the next two to be born premature or not.
I just wonder why this is being pushed so hard. If csections are safer in these cases isn’t that what matters and not what hole the baby comes from?
Just for what I’ve learned here and read in some ACOG bulletins…
The biggest risk in VBAC is uterine rupture. Once you’ve had a cut on the uterus, the odds of it rupturing increase a lot. For a woman with a low cut, the odds of rupture are about 0.5% to 0.9%. Odds are higher if you have a “classical ” incision. If it does happen, that’s a fly-down-the-hall emergency C-section that maybe the baby doesn’t survive. ACOG wants VBACs to take place in a hospital that is ready to handle the flying down the hall emergency C-section, so that’s one reasons why some hospitals just won’t do them. But avoiding that is the major safety reason for doing a repeat C-section.
If your friend keeps being turned down, it’s probably because she’s either asking at hospitals that just don’t do them, or she has some other condition going on that makes it either not very safe to try, or they think that even if they give her a Trial Of Labor, that she’ll end up with a C-section anyway.
I should just like to note that a common misunderstanding about the technique of C/S is that the scar tears in a uterine rupture. The scar itself is very strong but inflexible; the uterine tissue adjoining it pulls away from the scar. In a repeat C/S, the surgeon will excise the old scar and suture the two edges of the uterine tissue together, so a repeat C/S doesn’t mean that a woman has a uterus with multiple scars.
BTW, the worst uterine rupture I ever saw, which resulted in a hysterectomy and multiple transfusions,was in a para 7, 6 months pregnant, all uncomplicated vaginal births, and not in labor.
And yeah, for breech, vaginal breech births are more dangerous that C-section, so it’s a no-brainer for hospitals to insist on C-sections. No one wants the baby to get stuck.
I just had someone tell me a breech birth is a normal vaginal birth. I am sure that is false. Everyone I’ve heard of that had breech babies had to have a csection.
poison ivy rash is normal too
Well, they’re right. Nature doesn’t mind if the baby gets stuck, is oxygen deprived, etc. Nature doesn’t give a good damn whether mother, baby, or both live, much less are healthy. It’s normal to lose a lot of mothers and even more babies without interventions. Normal has been redefined with modern obstetrics as a healthy mother and baby – and for that, breech vaginal birth tends to be the exception rather than the rule. To say you demand the outcome without the process is childish and unrealistic, which is how I would define a lot of those “my body, my choice” types. Yes, it’s your body, but making the choice means you choose the outcome also. I still don’t get why such a big gamble with their baby’s brain function and life is better than a scar.
That’s some woo that gets passed around the NCB community to encourage women to have breech births at home with a midwife.
“Breech is a variation of normal! Of course you can have the kiddo at home, who cares if it’s without oxygen for 6 minutes?
Basically true… although with carefully selected moms, access to emergency cesarean section, and skilled attendants, breech vaginal deliveries appear to be as safe as cesarean sections (PREMODA study). And certainly safer done in hospital with support than at home without support. Unfortunately, the skill set for vaginal breech delivery has been lost – in 16 years I’ve never delivered a live breech baby that wasn’t a second twin – and so I am unable to ethically provide vaginal breech deliveries for women who want them – in my hands (and the hands of almost all north american OBs), CS is far safer.
I obviously can’t speak for everyone but after my emcs I felt neutered, useless and repulsive*. I couldn’t bear my husband touching me and I still can’t say I gave birth. From the various groups I’ve been in, I think those are relatively common feelings and that there are a lot of women who pursue vbacs to try and prove to themselves that they aren’t broken.
Then you have narratives like “My body knows how to give birth” and “Birth is what you make it” from the NCB crowd. Oh and my personal favourite…”You get the birth you deserve”…clearly I was a very very very bad girl in a previous life. When you have midwives/friends and relatives pushing that message, it can do a lot of damage. My notes (I’m in the UK) had “failed natural birth” in great big letters on them…that’s not a particularly positive message to a woman already wracked with guilt. When you get told it was your negativity, cowardice, decision to have an epidural or your waters broken or induction or in my case, my rape trauma which led to your section (all things midwives have said to women I know), it’s easy especially in the fog of hormones to turn inward, to try and do it “better” next time. Especially if you buy into the “babies born by section will be obese, less intelligent, have more allergies” or that it’s harder to bond with a section baby or any of the other theories expounded on the internet.
*I was mid mental breakdown so not thinking rationally.
“Oh and my personal favourite…”You get the birth you deserve”.
Fascinating. I hadn’t heard that one before.
It is both a very evil and a very silly thing to say. Evil because obviously they say it on purpose to bully women at their most vulnerable. Silly because it is so obviously false (to anyone not in a a postpartum fog…and I’ve been there myself). Silly because each birth can be so different but the woman is the same, so it doesn’t add up. My first was a bad and difficult experience (vaginal birth with avulsion of levator ani and long horrible recovery). My second was one of the best and happiest experiences of my life (planned CS with easy recovery). What changed in me between baby #1 and #2 that made me deserve misery the first time and bliss the second?
Well based on my behaviour since my son’s arrival, I probably deserve an even worst experience. Can’t wait, although I did breastfeed…surely that means I get sparkles and unicorns this time?
I think that’s a point that usually gets missed too. I know plenty of women who had terrible vaginal births for various reasons and yet, they get silenced in so many forums because the narrative has to go Vaginal = good, section = bad, unnecessary, lazy etc.
I remember sitting in a cafe with my ante-natal group about 3 weeks after my son was born. 2 of us there had already delivered, both by section (the other baby was an elective for breech) and 3 who hadn’t. One of the three said she was really happy that we’d had all the problems we’d had (a third member of our group had also delivered by section but wasn’t there) as that meant she would be fine and would avoid what she felt was the worst possible outcome (a section). I avoided throwing my cup of tea in her face and went home and cried.
Yep, she avoided her “worst possible outcome” but got a forceps delivery in theater instead, a couple of nasty cuts/tears and multiple blood transfusions having come very close to needing a hysterectomy. With hindsight, she would have taken a section any day.
Gah. People are the worst.
I hope you have better friends now.
You were sick-you didn’t ‘deserve’ any of the horrible things you went through.
Please be kind to yourself.
Argh! If your boy is anything like mine, he’s adorable and exhausting and if it weren’t for your PTSD rearing its head, no one would give a damn about it in 4 years.
He’s mostly adorable.
I’m actually in a really good place at the moment, the odd wobble like the other day aside.
I drew something last night for the first time since before his arrival.
The vindictive side of me thinks that she got exactly what she deserved: an instrumental vaginal delivery fraught with nasty complications. Wonder if she is still overly enanmoured with vaginal birth these days.
She’s most definitely not. They offered her the chance to go to straight to a section and she refused. Having first described what she calls her “Frankenstein” bits, she asked to see my scar about 6 six months afterwards. She wishes she’d taken the section.
I actually feel a bit sorry for her.
I’ve just never told any family sorry that they had a csection. When they’ve felt bad about their csection I’ve said “Well I know that’s hard for you! But you did it and you have a beautiful child.” Or something similar. I mean it’s not scripted but I’ve never down played the csection as not a birth. I feel like my friends and I are all women and all of us whom have had kids have given birth and it doesn’t matter how they got here they are alive.
A csection would have saved my husbands first cousin but he died in birth because the doctors let the mother labor for 72 hours without intervention.
In fact my one friend was talking about her repeat csection. She and I were talking and somehow VBAC got brought up. She said she wouldn’t do one she would rather a csection and besides that she liked the idea of scheduling her second child’s birthday.
Two for one. I said “Well that’s fun. I hope all goes smoothly and you have a great birth experience.”
I guess my mom having a csection gave me a different perspective on birth. If the baby comes out, you gave birth. But that’s not to diminish your feelings. I don’t tell other women how to feel. I just believe birth is birth. Alive is best.
For most women, the safest option will be the go to option no question asked.
But no matter how mentally balanced one can be, ever since we were little, we were still bombarded with ‘messages’ from society that might not actually be meant to hurt you or influence your views, but will still forge your opinion over time.
Even as a little girl, maybe 5 years old, I wanted to have kids. For not other particular reason than that was apparently what women are supposed to do.
And as I understood more about birth as I got older, I knew I was going to give birth vaginally, and I wasn’t going to have an epidural. Because whenever someone told me their birth story, they always made it sound like it was a bad thing, that they regretted it, that they had failed. That when you see the baby, you just magically forget all the pain. When a people announced a c-section birth in the family, it was always announced as if it was less joyful, people said ‘sorry you had to have a c-section’
I was also going to breastfeed. For the same reason, everyone did it, it’s what you are supposed to do. Those who didn’t bemoaned how they had failed at it, and wish they could BF.
And no one in my family is ‘crunchy’ or part of the NCB community. They were just ordinary people, who unknowingly repeated the info they were told by their own mothers and community.
Even though we rationally know that a c-section is a totally acceptable way of having a baby. Even outside of the NCB community, there is still this general feeling that getting a c-section means you failed. Because since we were old enough to understand where babies came from, we were told vaginal is the normal, expected way. And once you start having this feeling of failure, it’s easy to fall prey tot he NCB propaganda that you can fix yourself and prove that you are a real woman by having a VBAC.
“And as I understood more about birth as I got older, I knew I was going to give birth vaginally, and I wasn’t going to have an epidural. ”
That’s so interesting – I remember learning about C-sections when I was a little girl, and it sounded like just the most awesome thing ever. I might not have known much, but I knew that the whole vagina region was a rather important bit that I did not want something the size of a baby trying to go through. A C-section just sounded so neat and tidy and controlled!
I found Dr Amy’s blog I think when it was still hosted on blogger? Anyway it was 2008 and I was having my first. All these baby center moms were telling me what to do. One mom linked to skeptical ob. I felt a lot better reading her blog than any of the over the top opinions of the sanctimommies. I felt relieved that I didn’t have to write this lengthy birth plan for my doctor. I became fearful that I was doing birth wrong because I didn’t write a plan. I didn’t know what my plan should be. But skepticalob and rational moms told me…if I deliver with my OB in a hospital I don’t need a plan if I feel safe with what we’ve already planned in the office then nothing else matters. So I felt relieved. I checked in to be induced on my due date. The whole thing went smoothly. I labored in active labor for all of 2 hours after being afraid that being induced would cost me days. The Ncb crowd filled me with fear and my dr just wanted to induce for a variety of reasons none of which were to harm us or rush me. The epidural didn’t slow things down and neither did being induced. It was actually a pleasant experience. I was kind of resentful from then on at the Ncb crowd and their fear mongering and lies.
I know my experience is outside the range of normal.
Most first time moms experience long and exhausting labors. But I almost didn’t do what was best for me and baby because of some loud “mouths” on a baby board. He’s a healthy normal 8 year old.
I will never try to appease them. They aren’t worth the thought. I’m sorry so many women feel like the Ncb gods need to be satisfied with their birth.
That’s ridiculous.
The Ncb movement is going to end up cannibalizing its own at the rate they are going as they’ve already alienated so many mothers.
I think one of the problems is that a C-section is a procedure, so risks have to be disclosed – but vaginal birth is a thing that is considered to just ‘happen,’ so there is no disclosure of the risks.
A UK OB was recently quoted as saying that she does not give honest risk/benefit summaries of C/S and VB, because then ‘too many’ women would choose C/S.
I have to say that my first vaginal delivery I tore so bad I actually envied the c section moms. After my first I kind of “knew what to do” and didn’t tear the second time and labored a lot more quickly (30 minutes from start to finish) but that being said I felt I got lucky and not that I was superior because a kid came out of my lady parts. I was just so happy I didn’t tear myself a new ahole, quite literally. I had so many stitches and even jacked up my cervix from the first birth that I was traumatized when I got a positive test when I was pregnant with the second.
I also don’t know if it’s true but I felt like the epidural was the only reason I labored so fast. I panic in that level of pain so I would have stalled labor if I had gone natural with any of my kids. I think at lest I’m no expert. I just think panic and hyperventilating are not ways to have a smooth labor and delivery and if pain relief is the only way around that then so be it.
But had I known what kind of damage I would have taken from my first birth like hindsight being 20/20 I might have chosen a section for him. It was horrendous. Months of healing. Gads.
Vaginal birth and c sections both have risks, but they are different risks. In general a vaginal birth is thought to be safer for the mother and a c section is thought to be safer for the baby, although there are lots of factors that influence that. A successful vaginal birth after a c section is probably safer for the mother than a repeat c section – but note the key word “successful”. An unsuccessful attempt at a VBAC can often result in an emergency c section, which is the most unsafe scenario for both mother and baby. So when you’re looking at the safety data for VBAC, what you need to look at is not the successful births but instead look at those who underwent trial of labour after caesarean (TLOC).
What the actual risk is will depend on the individual. If a previous c section was done for a non-repeating reason such as breech, then it’s more likely that a VBAC will be successful. Whereas your friend who never dilated in labour is much less likely to be able to have a VBAC. If you’ve had a previous vaginal delivery, that increases the odds that a VBAC will be successful too. The risk of a repeat c section will also depend on the individual. For example, the risk of c sections increases significantly with each subsequent c section. So a woman who wishes to have a large family will benefit more from a VBAC than a woman who is planning for this to be her last pregnancy.
Also each individual woman will have her own opinions on which risks she feels comfortable taking. Some women will prefer to take any risk on themselves rather than on their babies. Some women will prefer to take the risks of abdominal surgery over the risk of incontinence and sexual dysfunction. Other women will prefer to place a slightly higher risk on their babies in order to avoid an operation. At the end of the day it is a woman’s choice as to what risks she takes to her own body (although a doctor cannot be forced to provide treatment that they do not feel is clinically beneficial). The important thing is that the woman in question needs to be given accurate unbiased information about all the risks involved and must be able to make a fully informed decision.
My SIL had a VBAC for her second child. Her first was an 11 pounder full breech. She had a hard time taking care of the kid and herself the way she wanted to, so if she could avoid the surgery the second time around she’d do it. Thankfully in our family only the boys are such behemoths, the girls are more average in size and her second kiddo was just 7 pounds. There was some weight her doctor refused VBACs for and my SIL’s baby was far from it.
There is simply a LOT of propaganda against c-sections, even in supposedly “evil mainstream” publications like “What To Expect When You’re Expecting” and the like. When you’re pregnant, you’re likely going onto due-date-club groups, pregnancy communities, parenting forums, where the vast majority of posters have no medical background and are bringing their own misconceptions into the conversation. When the conventional wisdom is that “c-sections are bad,” it gets repeated and magnified.
Then, there’s the group ICAN. I feel fortunate that I got sucked into them for ONLY about a year and a half. They’re extremists. I’ve mentioned before that the two events that pushed me over the edge were the way they treated a mother who’d had a rupture and lost the baby in a VBAC attempt (and was as a result more pro-cesarean and planning on having all future babies via cesarean), and the way they oohed and aahed over another mother whose baby died in a VBAC but “at least she got her VBAC.” It was appalling. Some of these women’s kids are now teenagers and ALL THEY DO is anti-cesarean activism.
That’s really sad. I’m pro whatever works for your body. I can’t believe the take away (by adults) from that was “at least she got her VBAC” and not “Wow I’m sorry for your horrible loss.” God, people are awful and stupid. How can a grown up miss the point like that? I mean it makes me think these people are 7!
So wanting to do a natural vaginal birth makes women “obsessed with their vaginas”? C-sections are not safer, it’s major abdominal surgery. Do some research first. In this sue- happy country doctors prefer to avoid any situation where they might end up at fault for something, so they do what’s convenient for them and their pockets. It’s very possible to deliver a breech baby vaginally, it’s done all over the world. But for surgery happy doctors its easier to just cut the baby out, regardless of the added risk to both mom and baby.
My mother-in–law had two of her babies as breech deliveries. She told my wife that it hurt like he’ll.
And she keeps the Poise company in business with her incontinence.
Even if it didn’t have a much higher risk of mortality, why wouldn’t you want to avoid that?
It’s abdominal surgery, but it also avoids the risks of urinary and fecal incontinence, organ prolapse, pelvic floor dysfunction, and shoulder dystocia for the baby. There’s pros and cons both ways; vaginal birth isn’t exactly risk-free either.
C-sections are slightly safer for the baby and slightly riskier for the mom than vaginal births from an overall perspective. In individual cases, of course, the risks and rewards can swing wildly one way or the other, but for the most part, I fail to see why you think C-sections are so awful. Breech babies are birthed vaginally worldwide because there aren’t better options; the rates of death, severe brain injury, shoulder dystocia are extremely high for vaginal breech births. So are the rates of maternal morbidity- the baby coming wrong way out causes tears, incontinence, vaginal damage, and all sorts of unpleasant things for the mom at a high rate. Why is it unreasonable to avoid all those risks with a safe, commonplace surgery?
And all over the world women deal with fistulas. Do your research! Check to see if your local library has the documentary A Walk to Beautiful. So besides the higher likelihood of a dead baby, you can avoid a C-section for surgeries to *maybe* repair prolapses and fistulas. Makes all the sense.
The short answer I think is sexism. These women have bought the line that their virtue as people depends on the ability of their body to do “feminine” things, like breastfeed, or give birth vaginally. These women think if they can’t give birth vaginally, they are worthless.
In general, breech = automatic C-section. The dangers are way too high. There are homebirthing midwives who think that doing a breech at home is okay, so I’m sure there are some OBs who will support breech vaginal birth.
The docs here can elaborate on the dangers of VBAC, but the biggest is, once you have a cut in your uterus, you might have a rupture. That’s a run down the hall to the OR emergency, and there’s a chance the baby doesn’t get out in time. ACOG estimates the odds of that to be 0.5% to 0.9% in a woman with a favorable incision. If 3 docs told that woman they wouldn’t do a VBAC, either they were at hospitals that weren’t well-equipped enough to do them at all, or her circumstances were such that the docs thought there was a high likelihood of her ending up with a C-section, or maybe an emergency C-section.
OT: I really enjoyed the interview with the reporter of this piece!
http://www.theglobeandmail.com/life/parenting/leah-mclaren-birth-shaming-is-about-controlling-women-not-protecting-babies/article31550367/
The author did a terrific job. I loved the part where she describes her own experience with birth.
I know Leah! (And have been reading her for years and years.) She’s fantastic! Love her article. Glad you spoke to her. 🙂
OT: Biting toddlers (as in toddlers who bite, not pregnancy cravings taken to the extreme), how do you stop them?
I thought he’d grown out of it, but then last night when unimpressed about a nappy change, he bit his Father so hard that through a quite thick shirt and pocket, that he drew blood in multiple places.
Oh, that’s always a tough one. Sometimes, just the yelling of OW by an adult will startle them enough. One that worked for me was, when the mouth opened, I quickly moved THEIR arm to the mouth. They only bit once after that.
When my niece was a toddler, her mom used the same kind of trick to deflects attempts at biting, punching… Deflecting her attention elsewhere. And give her a stuffed toy or cushion that can be bitten without problem.
The loud “ow” didn’t work for her (girl just got more excited!) but making a hurt face and turning away did trouble the kid.
Hurt faces work with some kids. But when my daughter bit herself – and hard, because she was just that mad right then – she never did it again because each time she started to try, I’d grab her arm and put it towards her mouth again. She remembered that pain! Took a few weeks for the habit to end, if I recall correctly.
Deflection works, too, for some kids. We used it with her later on, because she was pulling her hair out – literally – at night. We gave her a doll with yarn hair (well-sewn – took some real pulling to get a strand out) and told her to pull out the doll’s hair, not her own. Again, took a few weeks, but she stopped pulling her hair out. The doll was about snatched bald, though!
What worked for me when my kids bit, hit, etc. with me was to give them a sad, disappointed look, set them down and walk away, and not say anything to them. Kind of “shunning” them. I only had to do it once or twice to get the point across.
tried that, ended up needing to bite back (just enough to hurt). That resolved it
Me too. Biting back (just enough to hurt) solved that in a hurry.
Someone I know was in a conundrum as to what to do with her wolf cub (wording hers). No talking, no punishments, nothing helped. One day, she flew into a rage (another kid crying because her wolf had bitten again.) So she paid him in kind, and NOT just enough to hurt. She said she saw red. She literally left him with a blue spot, the way he did other kids. She isn’t proud of that but that was the last time he bit anyone. Again, not something that she recommends but letting her wolf cub biting all around as she talked sweetly was not an option either.
My kid’s preschool put biters together. No matter how tempted, an adult can’t bite the toddler to show it hurts – but one can let them show each other.
Clever! 😉
The preschool I went to some 43 years ago, didn’t have a rule like that. So, practically the first thing I learned was that the teacher would bite me enough to hurt if i bit another kid. I’m told I learned that… quickly.
That is a good idea, however he’s not in preschool yet. He doesn’t go to nursery either as I gave up work when I was pregnant with him. He does mix with a lot of other children at various activities, classes and groups but no one else seems to bite.
There will be one. In my kid’s class of 20, there were 3 or 4. It’s pretty normal.
Love it! My son got bitten at daycare a few weeks back. The staff were really really apologetic – I was just relieved he wasn’t the biter!
My son went through a pretty bad biting phase when he first started daycare – we were so afraid he was going to be kicked out! What ended up working really well for us was a firm rubber chew toy that we clipped to his shirt. Whenever he bit or the teachers noticed him trying to bite they would tell him to chew on the toy instead.
OMG. The Shana Maria Verghis massive derail has to be one of the strangest trolls yet on this site.
She’s a Certified Professional Journalist.
HAHAHAHA
You win Analogy of the Week
http://1.bp.blogspot.com/-PgaM-PLMbO4/Vex8b55VJaI/AAAAAAAAKsU/P56Rp6eltKk/s320/Laughing.gif
Thank you for your quips. I have to restrain myself from constantly commenting “lol,” because that’s such a waste of space in threads, but just know that you crack me up
There’s something strangely intriguing in trying to follow her tortuous logic.
I do continue reading in large part to try to work out what on earth her point is.
I just got started reading it when it was still only just “large”, not “epic”, but then had a personal issue that needed to be attended to. I’m just getting back to it. Not sure if I’ll be able to finish the whole thing.
For those of us who haven’t had time to read the ENORMOUS thread, what is the gist of her message? I got the homebirth-can-be-as-safe-as-hospital-birth bit; is there something else?
I’m damned if I can follow her point. For a ‘journalist,’ she sure is good at using a lot of text to say fuck-all. And she contradicts herself a lot.
Reminds me of Celia Farber, famous for HIV/AIDS denialism. Now a former journalist (if she ever was one) writing for anti-vax and conspiracy blogs.
I don’t know that there’s any real message in her nonsense. We are “defensive,” we “prove [her] point,” which has yet to be made clear, she’s going to use all the information we’ve given her by “reading between the lines,” and “hahahaha! LOL.” I say “we” but I personally haven’t given her any information.
She believes that minimally trained midwives aren’t really a problem, or that the fault lies with the medical establishment for not appreciating their special talents. She wants the med establishment to “bring [CPMs] into the fold,” which would remedy any safety issues and make hospital care more warm and fuzzy. Suggests that if training lay midwives in India improves birth care in India, the US also would benefit from better midwife training.
When other posters disagree or point out weaknesses in her argument, she accuses them of being emotional, being mean to her, etc.
Here’s the twist: she claims to be a journalist researching the issue. Displays a lot of immaturity for someone claiming a professional purpose in joining the discussion.
From what I can surmise, she’s “researching” a story about…..something to do with midwifery? It’s hard to tell what, exactly, though. Wants to know what everyone here is going to “do” about making birth safer. Spends a lot of time insulting people and telling them what they should be thinking, saying, and doing.
No kidding. I just got up to speed on that situation. It’s like she thinks everyone came here to talk to her.
And that we are all to take turns, respond immediately if asked a question by her and not repeat any point made previously by any commenter.
Especially if she was that commenter.
The biggest flaw in this entire article is that the hospital has admitted the review was not due to safety concerns. Dr. B’s medical licence is not in question and never was.
http://www.11alive.com/news/health/hospital-birthing-policy-change-upsets-pregnant-women/305104514
Go on the video to minute 2:21 for proof.
But we’ve heard about what was said at the obstetricians meeting and apparently it was entirely due to safety concerns.
True
Ha, ha, ha, Anisha Perez. That’s your third screen name but it’s still you:
http://www.atlantabirthdoula.com/about-us/anisha-perez-gainesville-doula/
Ahhh….someone doesn’t understand ISP addresses?
Or how statements to the media are carefully worded.
The news story is not proof. Bootstaylor, See Baby Midwifery and some of their misinformed clients contacted 11 Alive News. Are you actually an M.D. Dr. Quail? I did a google search, but didn’t find anything about you. I suspect you are one of Brad Bootstaylor’s acolytes, because you refer to him as Dr. B as do the rest.
You clearly have no idea what constitutes proof.
Can someone please let the loss mom initials JV in the Fed Up With Natural Childbirth group that I sent her a facebook message that iwll go to her “Others folder” in messages?She made posts in Aug 2016 I am not FB friends with her so it goes to an alternate mailbox. Thanks!
ot: everytime i run across that dietdee’s “Breastfeed!” response to my concern for my baby, I get seriously enraged.
That stinks. I’m sure it’s very hurtful to see. I know it’s difficult, but try not to get too infuriated; she’s a total loon who thinks vaccines are eeevil. She’s basically a caricature, and her responses mean zilch.
“See Baby Midwifery”? More like “See only what we want to see”…
“See Jane Run” springs to mind.
I wish everyone would just STFU and focus on delivering healthy babies.;C
That is what Dr Amy is concerned about.
Home births put babies and mothers at risk, particularly home births attended by incompetent lay midwives.
‘Incompetent’ being the key word.
If they are trained properly it doesn’t make much of a difference where the birth is happening. Even in parts of rural India for instance, where hospitals are far away, they train midwives and reduce infant mortality rates.
And in that case, “trained properly” should include “learning to recognise when they’re out of their depth and having the humility to act upon it. Risk out women when necessary, transfer as soon as trouble occurs that necessitate more knowledge and/or technology. In other words, be a healthcare professional, not a birth junkie.
Of course. I think there are some trusted NGO groups doing this kind of work. I also feel a lot of the problems happen from infection.
if I’m not mistaken.
But there’s another game here. I read that hospitals also act really horrible if you come to them at the last minute, during an emergency, without using their ‘sales’ facilities earlier on.
I think that’s really really mean and cheap and wicked of them.
Home deliveries I suspect are being demonised so hospitals do more business-I mean apart from the issue of incompetent, quack midwives.
I think hospitals act “horrible” if you come in the last minutes because it is a 100% predictable emergency situation.
You can’t have a person coming in labor and simply make a CS. You need information. Which often are either unavailable in a botched homebirth situation or flat out false (was the baby in distress? How long have you been dilated and for how long have you pushed? Are you GBS positive? Things like that).
And you have a person who is in an emergency here, lets not forget. Who is often not-cooperative with guidelines (not eating, for example) and has a lot of demands in spite being in grave danger (“No CS”, “no Pitocin”, “immediate skin to skin”, etc)
So yes, they aren’t very cushy or interested in your feelings in these moments, and so it can seem they are “mean”. But they aren’t there to provide emotional comfort, they are here to save yours and/or your baby lives.
True. I guess you have to be detached. And about to be moms aren’t very detached. I have heard horror stories about labour wards.
I also spent a week living with nurses above a hospital when I was a student. Some weren’t very enthusiastic about their patients either.
As an onlooker it was actually very interesting to hear some of them bitching about mothers in pain without any sympathy. It makes you look at this whole process of birth etc in a very different practical way.
It’s far removed the ideal of motherhood and pregnancy etc as all sweetness and light and comfortableness. Its kind of brutal in a way.
The point is that giving birth is a momentous moment for a woman, but it is just another day for the nurse/OB.
It is the same for many kind of hospital procedure, of course. When my father had one of his kidney removed was a terribly fraught moment for us but well, for his doctor it was quite normal routine. A long operation, perhaps, but nothing he hasn’t done before. To ask to any doctor to pander to our emotions in that moments would have been silly of us. I don’t mean they were cruel, or mean, or even cranky. It was just that we were very emotional and, compared to us, they may have seemed cold or distant. Which is totally ok.
I think that’s understandable. Being detached. Otherwise they would be crying over every patients. However it was not so long ago that doctors were getting rapped over the knuckles by seniors in the establishment over their bedside manner.
I think this was because it was more initimate in the earlier environment of the family GP and the doctor who made midnight calls. However it seems that this kind of doctor might be coming back again. Like the new smaller stores that are reminiscent of mom and pop stores which existed before chain stores. Since wellbeing is the focus at the end of the day, It doesn’t matter if it comes from a superspeciality hospital or a smaller establishment. 😉
It does though.
It has been shown, time and time again that concentrating expertise in big specialised centres where staff see the rarest complications repeatedly is MUCH safer for patients than smaller, more general centres.
You don’t want your surgery in the local hospital with a surgeon who operates on everything from knees to noses- you want it 3 hrs away in the big teaching hospital with the surgeon who does nothing but operations for people with your specific problem.
BTW- I’m a GP in the UK…we never went away, and while there is a place for expert generalists, you also need expert specialists.
Interesting point: a impartial interviewer generally leaves their personal opinions out of the actual interview. The purpose of this is to get information that the respondent actually believes rather than getting information based on what the respondent thinks will please the journalist.
I strongly recommend that you do some reading on proper interview techniques. Your failure to identify yourself as a journalist is sloppy at best and unethical at worst; you are collecting sources from a open-comment section of a blog where you cannot easily verify anyone’s credentials; you are letting your personal biases towards medical trends and how various people on the blog interact with you affect your professionalism.
This is not behavior that will benefit your career in any way.
(Before you write me off as a non-doctor, I should probably inform you that my career involves interviewing people on sociological topics for qualitative analysis of trends.)
Shana, my goodness for someone who makes a career out of writing your intentions are rather opaque in what you have written here.
Most of us here believe the following:
Home birth is less safe than hospital. This is a fact bourne out by much research. the UK Birthplace study shows that a primip who gives birth at home is twice as likely to have dead baby than if she delivers in hospital.
That is in a small country where you are never more than 45 minutes from a hospital, with well trained and well integrated midwives working in tandem with doctors and with universal prenatal care. Additionally, the Birthplace study had strict risk out criteria, so only low risk, healthy women with low risk, healthy babies were delivering at home.
So double the risk of mortality is the BEST case scenario for a primip.
Now, twice a very rare thing is still a very rare thing, but it is not inconsequential.
AND YET
In the USA CPMs, who have no degree, no nursing experience, and very little in the way of training or oversight claim that home is “as safe or safer” than hospital to their clients, or that “the hospital is only X minutes away, and that is plenty of time for them to save you and the baby”.
The culture of homebirth in the USA is about denying or minimising the the risks inherent in the choice to give birth at home, and overstating the risks of hospital birth.
You can see that in Anisha/wisemammas post below.
When it was pointed out to her that from their own data the Midwives Alliance of North America (CPMs professional organisation) had a 1% mortality rate for HBAC attempts, she replies with
“The risk of death/complications from a repeat cesarean is much worse!”
Which is a blatant untruth.
1 in 100 babies whose mother attempt HBAC with MANA members will die.
Fewer than 1 in 750 babies whose mother opt for ERCS in a hospital will die.
If your midwife tells you HBAC is “as safe or safer than hospital” and you trust her and believe her you might well decide to give birth at home.
If your obstetrician tells you it is more dangerous, and you are mistrustful of her and think she is trying to get your money and scare you into surgery for her convenience, you might not believe her and might well decide to follow the advice of your midwife.
Your midwife is still lying to you and your doctor is telling you the truth and you are not giving informed consent to HBAC because you are not in possession of all the facts necessary to make a balanced decision.
Midwives (properly trained midwives with adequate professional oversight and malpractice insurance) are an excellent choice for low risk women who want low intervention hospital birth or homebirth and who are fully aware of the risk/benefit breakdown of that choice.
However, they should not be trying to increase their market share by overstating their competence, understating the risks or preventing their clients from making truly informed decisions.
Year ago, a speeding car hit me crossing in the crosswalk. It was like the movies – I popped up, rolled down the windshield, the hood, and onto the pavement of a busy road. I ended up in the gutter (literally) and then being put in a neck brace, on a board, and taken to the ER. I realized that there was a possibility I was so injured I would not walk. (spoiler – all good now).
No one was very warm to me in the ER. I was screaming in terror. The cut my clothes off without warning, they shoved fingers up my ass, they shined lights in eyes, poked with needles, and who knows what else. No one really explained anything to me. I don’t think I was asked to consent to anything. You know why? It was an EMERGENCY and they were trying to save my fucking life and make sure I could walk out of there.
God bless them all!!!!!
Glad you survived OK!
Thanks. The only lasting effect is that I look both ways about 5 times before crossing the street.
OMG — I just realized what I need is a healing car accident.
No, hospital staff can get cranky if you come to them with a foreseeable train-wreck disaster which they could have prevented.
Especially if you now expect them to fix the mess you have got yourself into and have unrealistic expectations of how fast and how successfully you can do that.
Think how maddening and frustrating it must be to think “if she had only come in last month/last week/yesterday/an hour ago we could have prevented this”.
True. Probably the way some doctors feel with a patient who comes to them in a developed stage of cancer.
Not really.
Late cancer diagnosis is either because of genuine denial (they know there is something awful and can’t face it), because they know there is something awful and don’t think anything can be done, or because it genuinely isn’t clear to them that there is something terrible going on until they are very unwell.
Cancer patients aren’t rolling the dice and hoping for a good outcome and then coming in and demanding I fix them when their luck turns bad.
I have more sympathy with a heavy smoker with lung cancer than some of the stuntbirth proponents.
As I said, a poor attempt to deflect attention. But sure, keep hammering about evil doctors. Let’s forget about murdering midwives, amirite?
Hahahhaha. Who on earth was going on about evil doctors. I think I was making a pretty balanced assessment. I have actually done some stories on the ground among midwives and doctors through UNICEF projects so I am somewhat familiar with the topic, You need both and it usually depends on the location. Some women are naturally skilled at this. Some doctors are skilled too.
So I think one can make a place for both sets of skills.
And also work in coordination in a crisis, instead of wasting your time in demonsing everyone else because they are not part of your tribe. That is known as synthesis.
Why, you were going on. Breathlessly explaining about how doctors just get annoyed with their patients. You even threw doctors who treat cancer patients in and that was just disgusting. You demonise the people who work on some of the most heartbreaking cases and then have the audacity of comparing them to people who are less than thrilled when a defensive homebirthing princess in distress rushes in, demanding to be saved at the wave of Harry Potter’s wand and then you LAUGH about it? As I said, not impressed.
The matter at hand is two-fold and American homebirth midwives aren’t doing fine on either account but you’re terribly eager to sweep them under the carpet of, “Doctors are equally bad. They torment patients!”
Madam, get your BP checked. You obviously have some unhappiness in your life that needs attending to. You are not helping the situation with your bad attitude.
Go back to school and learn percentages. You don’t even realize what a ridicule you’re making out of yourself. I guess you also chant, “The majority of people who get ill with vaccine-preventable diseases are vaccinated, so clearly vaccines are useless?” That makes about as much sense as your claim that homebirth is a threat to hospitals.
How did you ever graduate with such poor understanding of basic maths?
Very aggressive for a caregiver I must say….hmmmm….this might be the REAL PROBLEM.
Very unable to grasp logic and follow a stpr for a journalist, I must say… hmmmmmm… Please tell me that you don’t write about science?
The REAL PROBLEM isn’t that I am a bad caregiver. I am not a caregiver at all. The real problem is that you can’t understand the problem of bad midwives which makes you a bad journalist. And unfortunately, your being a journalist is likely to sway people. As I said, not impressed with your cognitive abilities. Pity that you’re in position to have sway over people.
Madam, check your misogyny at the door please. Don’t you dare write off a woman strongly disagreeing with you as “life unhappiness” and a “bad attitude.”
Quit this abominable shit. Quit accusing perfectly rational commenters like Amazed of being unstable, just to give yourself some perceived edge in the conversation. It’s vile.
It isn’t a conversation, though. It’s her thinking herself so smart, although she knows nothing about a topic. Worse, she knows nothing about writing an article.
Though she did write pieces about books and films for Indian news outlets sometimes. And seems to do a lot of Amazon reviews. Very positive. Maybe paid? Hmm.
Oh my, Amazon reviews! The bane of my existence. Publishers are all like, “Well, WHY do you call it garbage when Amazon reviewers are all raving about how wondeful it is?”
Very positive? Always? Definitely paid.
Oh dear, who was complaining about “low low blow” (sic) the other time? Why, but that was Shana Maria! Methinks she knows a thing or two about being base herself.
You really are not very clear. Are you talking about trained midwives vs total lack of care far away from medical facilities, well trained midwives integrated into the health care system in many developed nations or are you talking about midwives in the US, in which case there is still a wide variation in training and integration with the rest of the health care system?
I’m talking about midwives as a cluster and how their position can be used to advantage in the healthcare system as a foil to doctors.
So that both options are useful for the patient and present good alternatives for them.
Which healthcare system though? There isn’t one universal system. There’s quite a gulf between countries served by UNICEF and the American CPM “credential.”
I am aware of that. I am referring to the American one, since that is under discussion. I am very curious about whether you have any cases where there is symbiosis between both parties or is it ALWAYS conflict. The main thing is that there should be a healthy environment before a kid is born.
I’ve got to tell you that I find your comments very ambiguous. What do you mean “there should be a healthy environment before a kid is born”? A healthy physical environment? Healthy relationship between parents? Physical/mental/emotional health? Or do you mean everyone (meaning healthcare professionals and CPMS) should be getting along?
Also, I’ve seen you say several times “I’ve read” or “I’ve heard” something. Can you cite specific sources and link them?
Do you understand those three are very different situations?
Why do doctors need a foil? Do you feel other specialists do, or only OBs? Do mechanics need a foil too? Plumbers?
Ah, I see. That apparently then is the crux of the problem. The heart of the matter is a healthy child and mother. I think we are all agreed on that at least?
What do you see is the crux of the problem? You really seem to be posting snippets of thoughts at a time.
Of course a healthy baby and a healthy mother is the goal. The percentage who achieve that goal is lower at home birth. Hence the anti-home birth opinions here.
SHANA MARIA VERGHIS, any chance you could attempt to answer the question?
In the USA, midwives are NOT a cluster. There are properly trained ones and they make up the vast minority of homebirth midwives. The vast majority are something different.
And even in countries where midwives are properly trained, their outcomes are still bad. Clearly, they aren’s useful for patients who develop unexpected complications that cannot be dealt with effectively at home. Nothing wrong with choosing a midwife. Much wrong with presenting midwives as the superior, equally safe or safer choice.
Fair enough. I think that is a balanced assessment. Safety should be the priority. And one should have the genius to make it a priority without going into violent war over it. 😉
I do think safety is very important. But I believe informed choice is the key. Expectant mothers might lead a life that’s all kind of unhealthy and that’s fine with me. I might dislike and condemn it but I’ll fight tooth and nail to protect their right to lead it. But the picture changes if someone who enjoys authority tells them that this kind of life is healthiest and best. Then, they aren’t making an informed choice. And that’s what American homebirth midwives do, or at least the vast majority of them do. They assure mothers that homebirth is safest. They generally don’t say, “There is an increased risk, although the absolute risk is a very small one.” They deny there is any risk at all. And that isn’t fine in my book. Throw in the woefully lacking education and the lack of malpractice, and the result is, predictably, not a pretty one.
The problem is indeed a complex one. But the way it is, homebirth isn’t safer in countries with trained homebirth midwives and in the USA, it’s much less safer. At least three times more dangerous, and that’s a number that has been consistent in a good number of studies.
Ah I see the distinction.
As someone on this thread pointed out they don’t provide insurance etc, so there would have to be some form of legislation to which they are held accountable if something happens. Since they want to play doctor. They might as well deal with the responsibility.
The thing is, they don’t want the responsibility. They actually sued a hospital that disclosed their bad outcomes despite the fact that said hospital DEALT with their “emergency transfers” and THAT triggered the decision. And I have a reason for the “”. Too often, transfers are too late, midwife has no pertinent information to disclose since it’s *medical* information that they want in the hospital and not “the heartbeat was strong” or “It was all going great and she was fully dilated but then she closed just like that and I rushed her in immediately”. Or “It was all good but suddenly, the baby flipped and turned breech.” And that’s if they accompany the mother to the ER at all. Too often, they don’t. Or they run before the ambulance come, telling the mother not to disclose their presence since they’re in a state where they go unlicensed. Or they don’t disclose what they gave to the mother which might impede the proper treatment. Or – which is the worst of all, IMO – they don’t even tell the mother that they’re doing an illegal procedure on her. Like inducing her with cytotec.
They just want the props. The money. The respect. They currently crave to be able to bill mothers’ insurances companies. But responsibility? No.
ETA: Our midwives on this site hasn’t been active lately but we have them. AntigonosCNM is one – I saw her post a few hours ago. If we’re unfair to homebirth, they’re surely judges and executioners alike. They are NOT happy campers with the way homebirth “midwives” are going.
Well it seems to me there should be sustained campaigns, preferably on the scarier side, to highlight people about the dangers of using unlicensed midwives. After all we are talking about danger to mums and kids.
You, I mean generic you, could do it on youtube and in places where this is more common. At schools too, where you have lots of teenage pregnancies.
Basically you would be working towards making it so that people only approach someone with a license. With that being the end goal….
If you feel so strongly about the issue then people will have to put energy and resources behind it to make it work. And stricter monitors.
CNM here (though I don’t practice any more and never did home births). You can’t scare people away from a belief. I have friends who swear that home birth is *safer* than hospital birth and nothing – no stories, no studies – will change their mind.
And you won’t get them to understand the difference between a CNM (who my friends won’t use “because they’re too medical and might send us to the hospital”) and CM (who at least has some training) and Susie-down-the-block who claims to be a midwife because she’s birthed 7 children of her own, all at home, and helped many other neighbors birth at home because it’s all natural, ya know.
Sounds like Creaitionists and Evolutionary Biologists. But everything in its due course. Unless people come to their own moment of realisation, relentless haranguing might not be very effective. Unless its strategic.
There are many reasons for giving scary information, even if the true believers’ minds are made up. Because there’s always a few lurkers, undecided, just sifting through health/birth websites for something to help them make sense of their situation or clarify their options. For them, a story about a homebirth catastrophe can be the “human data” that makes them realise the true costs of what they were about the embark on. And if they stick around for more posts with the epidemiological data, the background info on anatomy and physiology, they can truly make an informed consent. Whatever their choice is ultimately.
But it’s curious how you seem intent on avoiding any debate about homebirth risks…
Me! That was me! I was totes sold on all natch til happening on this site
Hehe, I remember your arrival. You were pregnant and on two weeks of Dr Amy feast. And ready to charge to the hospitals, guns blazing, and request all that medicine NOW. After all, you had missed on that the first time around because natcherel.
I was like the Aladdin song “a whole new world…”
I’m familiar with them, I have done a couple of issue-based stories on them. So I don’t want to flail that cat again.
The regulars here end up having to “flail that cat” over and over because homebirth pushers (and anti-vaxxers and anti-circers) parachute in all the time to edumacate us and call us shills.
You are here to provide fodder for an article, yes?
I am planning to write an article myself. But apart from giving me the general background and accusations, which for me are for general purposes only, I haven’t heard anyone here talking in terms of moving on, past mess and working on solutions. Then the conversation goes to rant. vent. rant, vent. Its boring. I need more meat. But people here are carrying too much personal baggage. Too many heavy loads they carry.
well you came in like the homebirth pushers, so pardon us if we react to you like that. It’d have made more sense to ask us for what you want specifically right from the beginning.
Hmmm. I don’t think so. I have been able to do a lot of reading between the lines and the noise. Very informative. Apart from one or two sane voices. Most of them sound like people who don’t actually do fieldwork or attend to real live people. Because when It comes to solutions they’re beating around the bush.
So you are doing a story, and you are going to use the comment section of an open to the public blog as your source of information and you are going to verify whether this person does actual fieldwork or “attends to real live people” by deciding if in your personal opinion they *sound* like they do? Really?!
Tsk, tsk, tsk. Defensive. Go on and you’ll walk straight where I want you to. Question. No information.
Ooookay. “This person, ‘Heidi,’ on the internet on the comment section of a public blog, who I think wasn’t sane because I just didn’t think she sounded like it, because she sounded defensive. Question. No information. She walked straight where I wanted her to. She probably doesn’t do fieldwork and she probably hasn’t ever worked with real live people. Maybe she’s like a mortician and works with dead people or something. So whatever my article is about, this proves I am right.” Is that along the lines of what you are writing?
Hahahah! Heidi was little Swiss girl who probably didn’t know what a moritician was until her grandfather passed away.
Still can’t argue a point, still engaging in personal attacks to distract from the fact you have no argument.
I also think it’s interesting that in this comment, you appear to be acknowledging you have no journalistic credibility and are hoping to elicit specific responses to support a conclusion you’ve already drawn.
Low low blow. Owch, owch, owch. I think you forgot its just words. And my business is words.;)
You say your business is words. Prove it. Give us some news sources that have printed your byline or stop pretending to be a journalist.
Thanks, Shana. I’ve been long wondering why I get such shitty books from journalist writers. They’re so bad that I have to say just one line. “Do. Not. Publish. This. Garbage.” Sometimes, they’re even worse than the efforts of a self-taught newbie fancying themselves as the next Updike. (And only delivering the complex prose with nothing behind it. Just like you.) You answered this. Those “writers” are your kind of journalist.
Not low, actually, I think you don’t like it because it’s totally to the point! You do seem to want specific answers, and so keep posting the same loaded questions. Are you trying to wear people out? Do you think that would make the end product more truthful? Since you seem already sold on one particular narrative, why don’t just go ahead and write it? It would be as worthwhile as anything written in this fashion.
Asshole.
‘I have been able to do a lot of reading between the lines’ Wow, such professional reporting work.
Doing my job. People don’t just HAND you important information. Because its IMPORTANT information.But otherwise irrelevant to topic.
Your job is trolling?
Does it pay in fedoras and cheetos?
Well. I’ve read between the lines (I’m good at it as well) And I’ve come to the conclusion that you are a shitty reporter.
*blinks*
You need some more training in journalism and interviewing in specific if you don’t realize that people are generally more than willing to hand you important information if you ask.
And you’re as shitty journalist as the midwives you’re defending are shitty providers.
Funny how any topic you don’t like is “irrelevant”. But of course, it is. You try to paint yourself as an investigative journalist while just reading comments and asking disjointed questions, only to dismiss what people tell you.
Worse, you have now flat out declared that you need to “read between the lines” because people don’t tell the “important” stuff. This reads like conspiracy mongering. Wich strikes me as silly on a blog that is as clear about its goals as this one! The agenda is right there in the articles, the comments, the book, the links to videos and interviews in the right column. You might try to ask again and again, good luck getting a different, sinister answer!
Oh, and something else: from the few articles with you byline Google came up with, I gather that you aren’t s science writer, you have experience with culture and lifestyle but not medicine. (I may be wrong, but it’s consistent with the way you write here.) Maybe you really intend to write something about subcultures in childbirth, maybe you’re under the delusion that you can skip research and write a piece comparing India and the USA and conclude that homebirth is no more dangerous that what goes on in rural India so why worry!
Or maybe this thing about writing an article about childbirth is you bullshitting us. You just enjoy trolling. If I had to bet, guess what I would say…
No, you are being deliberately obtuse. We have told you, numerous times, that abolishing the bogus CPM “credential’ needs to happen. Seeing as they are illegal/not licensed to practice in many states, this SHOULDN’T be a problem. But it is, because they lurk in the shadows and have a sort of “rebellious, non-sheeple” cachet about them. And the women who are hurt by them often don’t want to press charges.
So you start hitting them in the pocketbook. Hefty fines and jail time for giving/having medications without a DEA# or prescribing privileges. (Pitocin, cytotec). Operating medical equipment without proper training (vacuum extractors), if that’s a thing (not a lawyer, so not sure). Carrying a very flammable substance (oxygen tanks) without proper placarding on their vehicle. Improper handling and disposal of biohazardous material (placenta, blood-contaminated towels, chux pads, gloves, etc. Do they carry and use red biohazard bags/bins for tissue and bloody materials?), improper disposal of sharps; (for when they slip you a shot of pitocin or do sterile water injections as a “painkiller”), do they carry a proper sharps container and use it? Do they have an autoclave to sterilize instruments and is it certified? When was the last time it was checked/verified for proper sterilization? Is the certificate valid? Things like that.
I don’t think it will be possible to do something big and major that will abolish them in one fell swoop. It will probably be a death of a thousand cuts if we start insisting on and fining/prosecuting all the little things that get overlooked.
Or, you know, just basic ‘practising medicine without a licence’ would do.
Yeah, but that can be denied by both the midwife and the mother…”She’s just a concerned friend who stopped by to check on me” or something like that. Harder to play off transporting a placenta (somebody just as ked me to hold this for a minute then they disappeared) or a bag/bin of biohazardous waste.
But having pitocin and oxygen in the car is going to be hard to explain.
Seriously, who is hiring you as a journalist? “Ugh, you guys booooore meeee, but I still hang around. Dead and injured babies anger you! Get over your personal baggage.”
Exactly.
Yeah, this is not only abysmal professional behavior for a journalist, it’s also incoherent.
The solution from my point of view is to make their practice illegal. If you want to look after pregnant ladies get a proper degree as we all have done and carry the proper insurance. They do not carry insurance because 1) it is too expensive for them (it is very expensive for me and I still pay it, it is compulsory to work) and 2) there are very few insurers that are willing to take them. That is mostly because the CPM degree is a joke.
Basically, if you want to be a healthcare provider act as one.
IN theory fine. But what about practice and implementation, Is anyone doing anything since you know this could be a solution. Or are they going to go on ranting, to avoid having to take action?
What personal actions are you taking to help the Syrian refugees?
Irrelevant and OT, your honour.
And where are you writing, anyway, Shana? “Honour” is a dead giveaway that you’re not in the US, so you don’t know how it works here.
Well, you seem to think that since we have an opinion on something, we have the obligation of actually be acting to change how things are happening. Surely you don’t think this apply only to homebirth.
Individual states license/allow CPM’s to practice or not. Most of them don’t care if they are legally allowed to do so and will work unlicensed. WOMEN WHO USE THEM DON’T CARE THAT THEY ARE UNLICENSED. If something goes badly during a birth, they oftentimes will dump a laboring woman at the closest ER with little to no actual important medical information in their so-called “charts” or “notes”. Numbers of them will, when shit hits the fan, pack up their stuff and move on to another state and continue their so-called “practice” in another state. They carry no malpractice insurance because it is expensive, but one of them has written a book on how to avoid prosecution: what to say in court, how to protect their personal income and assets from a lawsuit, etc. I can’t remember/find the name of the book at the moment; someone here might have the name at hand.
The other hard part about trying to force them to some sort of professional standard and requiring rigorous education and a Board test to obtain a license to practice is that the women who hire/use them to attend their baby’s birth WILL NOT PRESS CHARGES against the midwife. Not sure if it is due to embarrassment (that they fell prey to the midwife), guilt BECAUSE they believed all the ego-stroking (you’re SO beautiful and strong! Pregnancy agrees with you! This is a sacred and magical time for you, Mama, you are a Birth Warrior getting ready to bring a new life into this world! You should trust your instincts and your body and birth!) or misguided faith and trust in the midwife’s abilities and not wanting to believe that she would allow things to go badly. “She was my FRIEND! We BONDED over those hour-long prenatal appointments! She told me that this would be a fantastic journey that we would go on together and that it was a sacred, mystical feminine experience bringing my baby Earthside and that she was HONORED that I chose her to help guide us on that journey. It’s NOT her fault that the baby got stuck and suffered oxygen deprivation and that the cooling therapy didn’t work. These things happen in the hospital too. It just wasn’t meant for my baby to live. She is as devastated as we are! I can’t sue my friend the midwife!”
Until women start filing suits against their incompetent midwives and getting some judgements in their favor and taking these CPM’s for all they have (not a lawyer, so not sure if you can get liens on their homes/cars whatever or garnish wages from whatever job they have) and demanding actual prison time or house arrest from the midwife so that the message gets out that you can’t duck responsibility, then this will continue to be a problem.
You know, the correct way to go about this would have been to announce yourself as a reporter trying to write an article RIGHT AT THE START and then ask people if they had any interest of talking with you in private over the matter. Asking Dr. Tuteur for an interview would probably have been the best way to go at it. But I guess you are just a shitty ‘reporter’.
We are a public blog. We are not some kind of charity organization nor a group of activist trying to change the system. Hell, a huge part of the people on this blog are not even from the United states.
We are a bunch of people with somewhat the same opinions on a certain topics having discussion together. What where you expecting to find here?
As usual you’re a couple of hours behind. The problem is some of you are reactive so I indulge you with some responses. Meanwhile people who have less baggage are ALREADY giving me stuff I require. Your type takes up a lot of time in ranting rather than respondng Its called PTSD SYNDROME in your case.
I don’t even have to give you a response because I’ve actually had a very fruitful interaction with someone else here right from the beginning.I have just been indulging you, but you mostly rant or repeat stuff I’ve learnt already.
Technically, I answered to a comment made 1 hour ago. So not a ‘couple’
Tell me, when you write your ‘article’, are you going to ignore all comments that are posted after 1 hour because your article was so ‘1 hour ago’
PTSD? are you for real? PTSD from what? (that’s actually really insulting and demeaning for people with real PTSD)
Well, this was fun. I would stay and chat more with you. But I happen to have a real job that I must go to.
Calling people “reactive” to undermine their points without having to do the hard work of presenting a counterargument – check
Not understanding how internet comment sections are asynchronous – check
Accusing Azuran of having “baggage” because you can’t address Azuran’s point – check
Not realizing Azuran might have a life outside of this comment section – check
Oh, yes, tell us all about PTSD. You’re an expert in psychology as well as birth?
Well she’s read some blogs and spent a couple of hours on google, she’s practically a doula!
No! She read between the lines in the comment section! That’s all you need. No google required.
Why don’t you actually ask the questions you want answered?
“Hi all, what do you think we could do to make homebirth safer in the US?”
“How could we better integrate CPMs into mainstream care, or do you even think this is a good idea, and if not, why not?”
Instead you are basically randomly pushing people’s buttons hoping to get some ideal response and then bemoaning the fact that you haven’t got it.
Which is like ringing a doorbell and running away and then complaining that the homeowner didn’t stand on the doorstep and offer a guided tour of their home to whoever rang the doorbell.
The only article I think likely to come out of this is a piece on mothering.com about how Dr Amy’s commenters were mean to you for “just asking questions”.
WTF? this blog is one of the meatier solutions-focused places on the internet, with a very highly educated commentariat. what kind of reporter calls her sources “carrying too much personal baggage” in a public forum? very odd. have you ever been part of an online community before? by your use of all caps in your screen name, I think maybe you don’t spend much time online?
You go for it, Shana. You work on that strategic plan. We’ll support you 100%.
In the meantime, Dr Amy is using her own approach. And, while you may not like it, it does work. Maybe not for everyone, but there is no one-size-fits-all solution.
So you can knock off with the concern trolling. You think there’s a better way, do it. Lead the way, instead of sitting here and whining.
But that’s what you all do. You try to hide behind the “oh, you are mean and it turns people off” nonsense, but, sorry, I don’t buy it. We’ve seen it all before.
Prove me wrong. Show me that you are different from all the other whiners.
I was thinking in terms of policy, legislation and integrating the unlicensed midwives into the fold. How, THINK about it, if they have skills to use.
That was tried. It didn’t work. See the comment with Judith Rooks and the CPM credentialing. Another problem is that in most other countries, midwives are credentialed nationally. Here in the US, it’s state-by-state and a lot harder to do.
But they don’t. Those who have skills have become CNM and ARE integrated. You want to be integrated? Become a CNM and learn the REAL skills. CPM have no skills that actual doctors and CNM don’t already have (and are actually way more skilled than CPM).
Asking doctors to work with CPM is like asking a high school teacher to work with a 12 years old babysitter.
(BTW, are you still reading this tread? Or is it too ’17 minutes ago’ for you?)
But out of hospital work is common with low risk women. Seems if hospitals are doing business then they aren’t exploiting this potential.
Low risk =/= zero risk
Especially when dealing with hobbyist “midwives”, because according to them everything is just a “variation of normal”, “babies know when to be born”, and “some babies just aren’t meant to live”
So? Then what?
“You want to be integrated? Become a CNM and learn the REAL skills.”
Do some homework. Homebirth has a perinatal mortality rate 2-3X higher than ALL hospital birth. Since only low-risk women should be giving birth at home, the rate should be far lower than for all hospital births, given that all births include extremely high risk cases.
But it’s still done with actual medical professionals, like nurses and CNM. Lay midwives have nothing more to offer to the system.
Why on earth would that be a good idea?
If they want to get into the medical field there’s nothing stopping them. They can become CNM’s.
It’s not like calling your cousin who’s good with cars to change your oil. If he screws something up you might have a mess on your driveway, not a dead baby and mother to bury.
Why? Why would you want to bring inadequately prepared providers into the fold?
As a chemist, I don’t want to bring in wannabee chemists with inadequate training. I want to insist that EVERYONE be brought up to the appropriate level.
And CPMs don’t have any skills that would benefit the professionals. “Experts in natural birth”? Anyone can handle the easy cases. Cab drivers can catch babies when they are born without incident. The question is, what happens when there is a problem?
Hmm. You’re a chemist. I’d rather speak to people in the field. Your opinion as far as I am concerned, does not count for my article. It’s like the doctors themselves having problems with NON QUALIFIED PEOPLE?
Then wtf aren’t you asking Dr. Tuteur for an interview instead of trolling her page’s comment section?
I don’t give a shit about being in your article, what I am trying to do is to explain to you that, for actual legitimate professions, the solution to “these guys aren’t adequately qualified to practice our profession” is NOT “let’s try to bring them in and try to incorporate them anyway”, but it is to insist that they get trained properly first.
Especially in a case where you already have incorporated qualified versions.
You want to be a midwife, be a CNM. Doctors work with them all the time. But CPMs don’t do want to do that.
If CPMs wanted to work within the medical system, they would just become CNMs. They won’t, of course. Usually because they don’t want to bother doing through the training that it takes to be qualified.
And you think the medical system should try to incorporate them? Ha!
“And you think the medical system should try to incorporate them?”
Well, I suppose she is just proposing that the term “midwife” be treated as “journalist” is now. Back in the day, being a journalist meant something. It meant you were skilled enough at journalism to be hired by an actual paper. Now, with the internet, all sorts of wanna-be losers without skills or ethics can post something and then claim to be a journalist.
Plus, any self-respecting journalist who was collecting information for a published article would have identified herself as such clearly at the beginning.
Maybe you should actually try interviewing a fucking doctor instead of sticking your nose in here and insulting the people who make up the regular community of commenters?
I think there are 2 problems with that. Firstly, it would involve getting out of the comments of the countless blogs she is sting on today and secondly, she would have to find an actual doctor who would agree to an interview.
Third, if she actually did an interview, she would have to ask real questions instead of this non-specific jumping around that she is doing here.
I did consider including that issue, but decided the first two were likely the main barriers.
Hmm. YOUR article, as far as I am concerned, will only be useful to polish my boots with in January. Since you’re so smug about us doing nothing and you think you’ve “caught” us being all talk, let me ask you: what the hell are you doing in this comment section, instead of emailing the leading author and practicing OB/Gyn who has problems with NON QUALIFIED PEOPLE if you want to write an article that’s worthy of something more than polishing a pair of boots with? And no, I am not telling you the name. Guys and galls around here, PLEASE don’t tell her the name either. Being a journalist, she should be able to find out who I mean.
When there’s a problem they either,
1) say its a variation of normal (and pray)
2) say not all babies are meant to live
3) Call the real professionals to fix their screw ups
They don’t have skills. They are lay people who call themselves midwives, not real midwives!
So are you working towards banning them completely?
Yes. Did you see my Op-Ed in The New York Times:
http://www.nytimes.com/2016/05/01/opinion/sunday/why-is-american-home-birth-so-dangerous.html
Yes thank you very much madam, I just gave it a quick read. Two points were ones I discussed here. Informing women and banning CPM. From a journalist’s perspective I feel those points got buried towards the end. So we come to the main issue here. How do you drive this forward. Are you taking it up with legislators?
Clearly you know very little about this issue. I encourage you to read more and then we will have something to discuss.
I know the background, what I’m primarlly interested in is what is going to happen next? The points you listed are already familiar topics to those who have been dealing with the subject for a long time. What is going to happen next. What action will you take to make the words effective?
“The points you listed are already familiar topics to those who have been dealing with the subject for a long time.”
What would you consider to be dealing with the subject for a long time? Would being a professional in the field, writing two books about it, and blogging specifically about the dangers of home birth for a decade count? You realize that’s Dr. Tuteur’s background, right?
Are you here to gather quotes for your story? Because comment threads on a blog aren’t really seen as a reliable source for a serious story, unless the story is about, you know, comment threads on a blog.
if she’s really interested in what we think without knowing a reporter is there, she can always read the other comments sections. As she points out, we get repetative.
Actually, if she is asking questions in her capacity as a journalist, she should specify the story she’s working on and who it’s for. It’s one thing to look at comments as background to get a feel for an issue; engaging and prompting discussion that may be used in an article requires full disclosure.
For which publication are you writing this piece?
I wonder if she’s the Shana Maria Verghis who writes for English-language South Asian websites. Google seems to think so. (Hence the reference to rural India, I guess.)
Could be. I did question her about her spelling of “honour” with the extra u
I do that too, despite being American, because my autocorrect and spell check are both British as I now live in the UK. I don’t switch them over when I’m on a US site or physically back in the US. I’m willing to give the benefit of the doubt on that one, and frankly being foreign is no reason she should not be writing about the US system. Her ridiculous methods of gathering information and apparent total lack of knowledge about her choice of where to gather information are, but her nationality is not.
That’s logical, Wren. And I don’t mind where she’s from; her writing to argue the points being made about the US issues as if they are invalid is wrong.
And as a midwife who worked hard, did nursing then a midwifery course in NZ , I have to say I would be totally pissed off if lay people calling themselves midwives started working here in NZ putting mums and babies at risk. And to be totally honest I have attended home births with low risk women as per our strict well regulated guidelines allow……however when a member of my family chose a hospital birth option, I confess to being relieved, very relieved indeed. In the event of an emergency, even with the highest level of training in handling emergencies, there is no doubt that hospital remains the safest option.
Second point: a couple of years ago, the ACNM set out to try to set minimum standards for what constitutes safe homebirth. They surveyed the homebirth policies from countries around the world, countries where homebirth is part of the system, and found the minimum standards they all had in common. These are the minimum standards that every country that allows homebirths sets for their providers.
And what happened? The HB CNMs rejected them, on the grounds that they “restricted their autonomy.” Imagine that? The minimum standards, shared by all of the countries doing homebirth around the world, are considered too restrictive for HB CNMs! And remember, CNMs are nominally the GOOD ONES!
So the ACNM can’t even control them!
And you want to work on policy? It’s been tried. It failed.
They could, say, attend and graduate from nursing school, pass the boards, undergo advanced practice training and licensure, and become real nurse-midwives. Just a thought.
I have zero interest in “integrating the unlicensed midwives into the fold,” because they themselves refuse to adhere to basic standards of education, clinical training, and scope of practice. They don’t want to be part of the medical model of care, and many of them promote themselves as being distinct from this model. There is no place for CPMs, DEMs, and lay midwives within our healthcare system. They don’t want to play by any rules. They don’t want to have any accountability. And they sure as hell don’t want their turf infringed upon in any way.
” focus on the stuff that works instead of browbeating about the stuff that does not.”
“there should be sustained campaigns, preferably on the scarier side”
“I wish everyone would just STFU”
So which is it? Dr. Tuteur should just STFU and stop browbeating and mind her own business about the dangers, or she should continue her sustained campaign that includes scary examples?
What the hell do you think the purpose of this blog is????
Here’s just a fraction of what women need to know.
The YouTube video you suggest was made long ago and is in the sidebar.
I’m more interested in an update. Since many here seem so keen on getting rid of unlicensed midwives. What have you been doing to keep them offlimits to pregnant moms?
Shana, go look at the message boards on mothering.com
Safety is clearly not the priority for some women, and if you have any idea how to reach them, why don’t you let us know.
Logic and reason doesn’t work.
Appeals to emotion doesn’t work.
If you have an idea how to reach someone who has decided to forgo all antenatal care and have a post dates unassisted childbirth in her tub despite losing a baby to previous preventable pregnancy complications, by all means tell me.
Here’s your modern system with integrated midwives “as a foil to doctors.” http://www.skepticalob.com/2015/03/maternity-horror-at-morecambe-bay-is-the-inevitable-result-of-the-radicalization-of-midwifery.html Enjoy unnecessary damage and death?
Your comment implies women aren’t Dr’s.
And of course it depends on the location. Having a midwifew is safer than squating alone in a ditch to give birth, just like giving birth in a hospital with properly trained medical professionals is safer than giving birth at home with a midwife who has a high school diploma and a CPR course.
I treat cancer patients. Some people do come in a very late stage and they could have come earlier with a better outcome. It is not usual but it does happen. Sometimes we can help and sometimes we can not help. It is really strange to have a patient that comes so late that can not be helped and complains all the time and does not help us with treatment. Extremely rare I would say. It has happened to me about twice in 15 years of practice, so it is not common. I do admit it was very annoying but I was calm and polite and tried to do my best despite the situation.
When someone gets to us late and should have come earlier I do not feel bad or upset or annoyed. I try to focus in what I can do now and I do my best with that patient. I know what happened of course but I am not cross, I am not upset and, for the record, I do have great relationships with patients that refuse every single advice I give them: their body, their choice.
What is extremely difficult to stomach is someone that you have been telling: I advice this and that because of this and that, refuses treatment/procedures and then comes complaining because what you said would happen did happen. That is hard and someone without the greatest patience in the world could have a problem with that. Something also difficult is when you recommend this and that because of this and that, they refuse, things go south and they appear on your door expecting you to seve them, and you have to deal with a very complicated situation that would not have happened if they had done what you recommended in the first place. If you do not have a great patience then yes, you might act upset, we are human after all.
If you do things agaisnt my advice then, well, it is up to you, of course, but do not expect I can save your life. And do not complain if the worst happens, because it is your fault. It is something that some people have a hard time understanding, fortunately they are the very minority of my patients.
True, I think you have explained the situation very beautifully. And you sound like a fantastic doctor.
I actually don’t have to look very far, because I just have to look at my mom. If she’s got sick and I’m telling her what she should do, then she’ll come to the same situation in a roundabout way. Its’ hugely annoying but I do the same thing. As you put it, its called being human. And can easily be sorted with some patience and unconditional love. 😉
I said before it is the very minority of my patients, I think twice in 15 years, that someone does not follow my advice and comes back complaining when things do go south. Very rare. For what I read here and in some NCB boards it does not seem so uncommon in childbirth. Maybe having cancer makes you think you might die of it but having a child does not. That might explain the reaction of some of the staff looking after emergencies in childbirth.
There is a situation that is particularly stressful: you get called at 3 am because a patient (not a patient of yours, you happen to be on call) is worse. You examine the patient, you have a deep look at the clinical history and you realize that person is dying and you will not be able to save him or her. You go to a nice quiet room to talk to the family and they are expecting the NICU, the OR and a brain trasplant that very night. That is an awful situation to be in. And that is what seems to happen with a lot of homebirthers: we are at the hospital, you have to save me and without a CS!
I do try to avoid that kind of situations by saying to my patients and families: well, if things go south we will not be able to save you and we will make you comfortable and let Nature take its course. They do understand and I know it has made a huge difference for a lot of 3 am calls.
I think it would be better if homebirth midwives would tell the truth: look, if things go south the death rate for you and your baby is higher at home than if you were at the hospital, just because the time it gets to get you to the hospital and perform a life-saving procedure is going to be higher than if you were already at the hospital.
If you doubt this has happened please do read the hurt by homebirth page stories.
Oh I don’t doubt you for one bit. I have heard of mishandling, so I do know it exists. But since I’m a journalist I’m leery about jumping to conclusions because of the cases that go well. And in a hospital scenario too it can go both ways. Though I am not doubting that a well-equipped hospital environment with a trained staff would be a better place to be born. If those environments presented themselves.
My point as I began this was again, to say, focus on the stuff that works instead of browbeating about the stuff that does not.
Well, the mortality rate for babies with homebirth is far higher than for babies with hospital births. I would really like all homebirth practicioners to disclose that to the pregnant women they look after. I do disclose the death rates due to chemo before prescribing it.
Another difference: I carry malpractice insurance. If I prescribe a lethal dose of chemotherapy you will get a compensation from my insurance. It might be a genuine mistake and you get a compensation. Homebirth midwives usually do not carry insurance, they will just declare to have nothing and you will get nothing for your dead or disabled baby.
Call me silly but I choose to focus on changing that kind of things.
Yes, I see this is a very valid point. So there needs to be policy making and legislation, so they have some form of valid authority, instead of being casual birthers. This will also make them more accountable.
Alternatively, they could just go and get proper credentials, equivalent to those in other developed countries, and work within the health care system.
Here’s an easy bit of policy making and legislation. Make it illegal for CPMs to attend birth. CNM or GTFO (and require malpractice insurance to attend homebirths). Look, easy.
You are right, things can go badly even in a hospital. However, those things that do go badly are likely to be truly unfortunate circumstances (the statistics do have to come from somewhere and someone has to be the statistic) and not from a mishandled labor and delivery.
When midwives “transfer” a patient who is GBS positive, has had her membranes ruptured for 72 hours and been pushing for 6 hours and is now spiking a fever, that less than desirable outcome is now counted as a “hospital issue”. Because the baby and mother now need antibiotics, possibly a CS and a NICU stay for the baby, all of which happen in a hospital. It didn’t happen on the midwife’s watch, the midwife claims, so it can’t count as a less than desirable outcome for her history.
CPM’s regularly lie to and manipulate their clients, preying on their fears and portraying hospital birth as it was in the 50’s and 60’s: enemas, shaving, strapped down, IV’s, bright lights, equipment everywhere, baby ripped from your womb using forceps and immediately taken away from you to be evaluated and cleaned up, then kept away from you in the nursery until you are ready to leave. They will starve you, too. So they lie to the mother: “Your body won’t grow a baby you can’t give birth to”, “Trust Birth”, “Women have had babies at home since forever and we’re still here”, “You don’t need pain medication, it’s bad for the baby. You can manage pain with vocalizing, changing positions, laboring in the tub or shower, using a birth ball, walking around, etc.”
Hospitals have responded to the way women want to deliver their babies. They have homelike rooms with a place for a second person to stay at night. The rooms may have a large tub for laboring in. They have birth balls, bars, etc available. Some will do intermittent fetal monitoring and I understand that wireless monitoring is getting better and more prevalent, so you aren’t confined to bed. The lights are adjustable, you can play your music or birth affirmations or whatever and the “medical stuff” is cleverly concealed in cabinets, closets, whatever, but is immediately available when needed. The medical side has adopted many of the tenets of the NCB movement, because women want a lot of that. Midwives (CPM’s) will not recognize this, and continue to lie to women and misrepresent themselves as more competent than they actually are. There are successful home births where everybody comes through it just fine. This is pure luck. Calling that out and expecting those who peddle home birth as “just as safe” as hospital birth is not uncalled for, nor does it need to stop.
Thanks a lot for that. I’m actually talking to the Dr now. Or at least I thought I was. I haven’t got a response for my second question.
“the Dr”? Which of the many commenters here who are doctors? Or the author of the blog? Which doctor did you mean?
But that’s the point. Often it CAN’T be sorted with patience because there IS NO MORE TIME. It’s now do or die. Literally.
Then again, when a person were to do this out of neglect, it might cost them their life.
When the pregnant patient comes in with a train-wreck disaster, a BABY dies. A victim.
If that cancer patient were taking someone else out with them, you can bet the doctors would not be too happy about it.
Any loss of life is a tragedy for us all.
Especially if it could have been avoided in the first place.
Not always. I had a prof who was a big time alcoholic, and made no bones about it. But he also made it clear, he knew it was going to kill him (it did), but he went out as he wanted. His line was, “You see people the coffin and they ask, ‘How’d he die?’ and they say, ‘Natural causes.’ I don’t want to just die of natural causes. I want to die doing something I like.”
He died in his 70s due to liver disease. Was his death a tragedy? Certainly not to him.
And that was his choice. He was perfectly willing to die that way and take consequences for his actions.
On the other hand, had he taken someone else out with him, then THAT would have been a very different story.
I’m sure his family was upset he died. He wasn’t, and I have to say, I wasn’t either.
So you speak “for us all” now?
I’ve been on the receiving end of gruff, cold treatment. I don’t mind. I have a couple severe food allergies. One of them is severe enough I’ve ended up intubated a couple times. A few times, I’ve arrived at the hospital in bad enough shape that the doctors and nurses were in “that” mode. They’re not nice. They’re not sweet. They’re not patient. They have a job to do, and that job is to save my ass. Thankfully the few times it’s happened where I remember it, the doctors weren’t concerned with my feelings at all. Their ability to chuck out all the niceties and get down to business kept me alive.
Home delivery sounds so commercial, though…
But no, this blog isn’t about demonising women who want to give birth at home. Or padding a hospital’s bottom-line (Dr. Tuteur is required anyway). It’s about giving accurate information about the real-life risks of homebirth in the United States. Not rural India, mask you! We are talking about a country where high quality medical care is available (not always cheaply, it’s true, but then homebirth midwives and doulas don’t work for nothing either). And a country with high quality medical education – but also a high level a woo, including in some of the NGOs involved in patient advocacy or helping bring healthcare to impoverished communities.
By the way, your answers make me think you see home births as something women turn to for lack of resources. Some of them, sure, but there’s also a thriving industry of “natural childbirth” (NCB) catering to affluent, educated and mostly white women who have been convinced that this is the better option for them and their baby.
Helping women, all women, to sort the woo from the evidence-based care is the job this blog does, and from all I can see, doing it well.
My point was if they are able to train midwives in remote parts of India, then surely a developed nation should be able to do better.
I am aware that some affluent people do opt for it, and that’s a personal choice. But I also said there are NGOs working in this field to contain some of the risks of home births. I still feel that to some extent hospitals have a vested interest in this. Because its business for all parties concerned, even if that sounds cynical, But its the truth.
And our point is that no matter how developed a nation is, a homebirth can never be as safe as hospital birth. Multiple studies from developed nations with properly trained midwives had proven this.
You are big on pointing out the vested interest but you’re silent about midwives’ vested interest in keeping women in their care. Being a midwife in a remote part of India where no hospital is available isn’t the same as being a midwife close to well-equipped hospitals with OB/Gyns whose training trumps yours any day of the week and twice on Sunday. This isn’t an insult on midwives, BTW. It’s just pointing out the limits of their competence – or “competence”, in the case of the vast majority of American homebirth midwives. And their vested interest in keeping their clients who are vastly inferior in numbers to those who prefer hospital care is the truth.
Can a developed nation develop a better midwifery system than India? Certainly. Can it develop a midwifery system that is as safe as a hospital-based system? No. And that isn’t a condemnation. It’s a fact. The problem is that people – you included – act as if a better midwifery system in a developed country can be equally safe. And then midwives lie that it is.
I don’t think you saw my earlier post. I already wrote about quack midwives. I think your argument only reinforces my point that hospitals and midwives are preying on patients,hence the dissing,
I’d have to hear the viewpoints of midwives here to get a more balanced perspective. And from of the posts I read they aren’t doing badly, Since they are being used by many of the affluent women.
In my country, its mostly the poor who use midwives. And that’s for places that cannot get proper access to hospitals. Excepting for the few who might opt for it like a fashionable fad and have a birthing room in the house. Since this is also (apparently), not rare in the US, it seems the American midwives couldn’t be as horrible as you paint them to be.
We paint them to be? What about “studied paint them to be”? What about “they paint themselves to be”?
Your attempt at damage control is poorly executed. Your assertion that they’re all equally bad, hospitals and “midwives” alike, so midwives are great and unfairly painted, the poor dearies, is poorly executed.
BTW, I saw your earlier post. As I said, a poor attempt at damage control.
I don’t think this is a place for analysing essays as you are not correcting my midterm paper. If you have information to share on the subject, kindly do so. Otherwise there are loads of other sources to use.
And you’re using them all the wrong way. Midwives ARE more dangerous. Before you rushed here to explain how posts – where did you read them? – show that they do good job, perhaps you could have used some of the sources given on this very site?
You’re here to defend midwives and deflect attention. We’ve seen it before. You – generic you – can never do it convincingly. No wonder since you have no real leg to stand on.
India being the prime example for safe birth? Please.
Again you are on the defensive. ‘We’ve seen it before….’
Your going on the defensive tells the truth for itself.
You don’t even need to explain a thing more. I was right after all.
*Shrug*
You were right? Can you do basic maths? You clearly can’t. After all, you said with straight face that homebirth midwives are viable competition to hospital providers. Says all one needs to know about your cognitive abilities. I am just not impressed.
I hope you are not a doctor or nurse. Because I would be very wary about being treated by your infinite, compassion, patience and kind words.
Obviously you have some chip on your shoulder which you will have to sort yourself, my dear. I am not your shrink.
I think you’re a midwfe, dearest. Only midwives and NCB freaks think hospital providers can feel threatened by homebirth.
I hope you aren’t anyone’s shrink, as deceptive as you are.
She’s not a midwife. She’s a reporter.
A reporter? Aren’t they supposed to avoid bias?
She thinks she’s doing “fair and balanced” but doesn’t realize that the balance may not be an even one.
Forget bias. Plenty of biased reporters out there.
How about…
A reporter? Aren’t they supposed to be able to communicate clearly and effectively?
Got this a little before you posted your reply. I was a little surprised. I expected more clarity from a reporter.
Oh look, it’s that tired bullshit again. “You’re angry and mean and sad, so you’re bad and must be wrong.” No. Again, it doesn’t work that way. Address the content of what Amazed is saying. When you try to deflect into calling Amazed (or any other commenter) a mean, mean person, you are resorting to childish tactics.
You’re trying to derail the conversation into a discussion about whether or not Amazed (or any other commenter here) is a valid person. That’s underhanded and a sneaky way to avoid addressed Amazed’s points.
Right about what?
I live in a country with fairly good midwifery fully integrated into the hospital system. Homebirths and birth centre births are not unusual and occur within the system. Birth is still safer in the hospital. Emergencies can occur unexpectedly at any birth and no training is equivalent to a fully staffed OR and NICU.
The fact that you perceive someone as being “on the defensive” doesn’t mean they’re wrong. The two things are unrelated. You cannot reasonably argue, “Oh, you did a behavior that I don’t like, so you must be incorrect. Doing that behavior is an automatic invalidation of your argument.” No. That’s not how it works.
That analysis doesn’t contribute anything to the topic.
I’m not arguing the topic. I’m pointing out that you are using personal attacks to keep yourself from having to defend your argument.
No, it actually does contribute to the conversation. You are trying to discredit her arguments by calling her crazy and saying she is too emotional. But you don’t address her arguments. It’s important that people call you out on this.
Nope. She’s deviating. And so are you. And I already covered that ground.
You’re essentially calling people crazy so that you can feel smug that you undermined their credibility. It’s not just an invalid argumentative technique, it’s also incredibly childish and shitty of you.
It absolutely matters that you cannot refute Amazed’s points, so you resort to telling her to tend to her blood pressure. It’s disgusting. And it’s VERY transparent what you’re trying to do. Any 10 year old could see through it.
TROLL ALERT.
Unless you’re referring to yourself, no.
Thank goodness you’re alerting people to your presence and intent in the thread.
You’re employing a literal logical fallacy; the ad hominem attack. Just because someone is irate, their argument does not become invalid. Your response is an entirely fallacious attempt to invalidate someone else’s point without actually addressing it.
TL:DR version: you have yet to adequately address other peoples’ assertions that you are incorrect.
I don’t know, I’m pretty much here every other day or so? I’m not a parachuter like you, and I’m not posting things just to get people agitated. I’m just pointing out that you’re behaving really badly.
Indeed.
There’s not enough irony on the Internet for this.
That’s phrased better than how I said it, so thank you.
Ah, but yours does? Please explain how.
But it’s how the art of gas lighting starts. She doesn’t have a leg to stand on so she’s starting the campaign to make others look crazy and/or stupid. It’s a pretty standard ploy.
Also, as has already been pointed out, in many developed countries (most of Europe at least), midwives are integrated in the hospital system, working in team with OBs, anaesthesiologist, etc.
Midwives don’t work out of the goodness of their hearts nor do they work for free either.
Training people to be midwives in remote parts of India (or other countries) is about bringing a LITTLE more safety to a dangerous endeavor. A little medical knowledge (starting an IV, stitching, oxygen tank, gloves, etc), increased sanitation during labor and delivery (disinfectants, antibiotics and a trained and practiced eye to recognize when things are going south and recommend the journey to the medical clinic or hospital is going to help a lot with simpler issues. The midwives are NOT able to help with any resulting fisutlas and these women are ostracized and demonized for being unclean.
Most developed nations have a midwife/home birth model, with strict risking out criteria and their homebirth safety record is STILL LESS than giving birth in a hospital. Some appear SO enamoured of this system that they do not recommend transfer to the hospital and/or a CS, even when it is clearly evident that a transfer to the hospital is NECESSARY. One of the regulars here labored for 81 hours before a hospital transfer was advised.
In the US, we have Certified Nurse Midwives (CNM’s) who are the equivalent of the midwives in other developed countries. They have a nursing degree (RN) and extra schooling/training for the midwife certification. They, for the most part, do NOT do home deliveries (although there are a few that do) and they work in a medical setting with OB backup and hospital privileges.
We also have the abysmal CPM’s (Certified Professional Midwife) who just recently tightened their educational requirements to require a HIGH SCHOOL DIPLOMA. In training, they are required to work under another CPM for something like 50 births before they can take their online test to become an “official” CPM. They can then hang out a shingle and start practicing. These are the dangerous people who view everything as a “variation of normal”. Twin deliveries with the first baby being breech, breech deliveries of all varieties, first babies, histories of shoulder dystocia, histories of macrosomic babies, VBAC, VBA2/3/4C, post-dates of 41, 42 and 43+ weeks gestation, you name it, is is all totes okay and just a “variation of normal”. They don’t tend to test for gestational diabetes or group B strep and will deal with GBS with “garlic in your vagina” or “hibiclens douching”, neither of which is effective. They don’t believe in hospital transfers, but will tell expectant mothers that they have a relationship with XX OB at YY hospital and they will have plenty of time to get to the hospital if something goes wrong, because the midwife will see it coming from a mile away and the hospital is “only 5-10 minutes away.” They fudge due dates, don’t keep accurate charting notes, slip mothers pitocin and/or Cytotec on the sly, monitor with dopplers (often incorrectly) and do all they can to keep the mother from going to the hospital/calling 911 for help. These are the dangerous midwives who risk both the mother’s and the baby’s future health and well-being by their ignorance and insistence that they know what they are doing, despite all evidence to the contrary.
You should have to qualify FOR a homebirth: have a proven pelvis, no history of shoulder dystocia, GBS negative, etc and there should be a strict “risking out” policy. It should not be the default position, EVER. Even under the ideal conditions with the ideal candidate, things can go very wrong in a very short amount of time and you need to have a competent caregiver without ego who will do what is right for the mother and baby. CPM’s are NOT those people.
Excellent summary!
I like the clarity. Which then brings us to solutions next
If you know the problem area, then its only a step to remedies.
You require some pronged programmes to make their disadvantages or advantages productive for the health care system as a whole. Because pointing out defects isn’t going to do anything than waste energy. Solutions have to be worked out to eradicate the tumour. I mean as in getting rid of the problem areas, not eliminating people. Using their strengths-I’m sure they have many-in everyone’s favour.
“Excellent summary!
I like the clarity. Which then brings us to solutions next
If you know the problem area, then its only a step to remedies.
You require some pronged programmes to make their disadvantages or advantages productive for the health care system as a whole. Because pointing out defects isn’t going to do anything than waste energy. Solutions have to be worked out to eradicate the tumour. I mean as in getting rid of the problem areas, not eliminating people. Using their strengths-I’m sure they have many-in everyone’s favour.”
No offense, but this post is so vague and content-free, it reads like a bot. It’s impossible to engage in a conversation with you about homebirth safety when you may as well be talking about obesity or cancer. Address Charybdis’ many arguments or come up with your own counterpoints, but don’t tell us we have to come up with a solution that benefits the people who’ve caused the problem in the first place. That’s goal-post moving nonsense.
not to mention a bit teacher-encouraging-a-young-student-ish
Actually, I just got home from some professional development, and that last post of hers reminded me uncannily of the content-free jargon education “reformers” use when they’re trying to sell teachers and administrators on some BS program (from which, of course, the reformers profit handsomely).
Now that’s a shock. Reminds me of some of my edu classes from a few years ago.
And again with the “don’t point out the defects” of the American homebirth cottage industry.
If you had, say, a pain in the head after a fall, and your doctor told you “I’m not going to do an X-ray or MRI, you don’t want to hear bad news, do you?” – would you agree that ignorance is bliss?
I doubt it. But this is exactly what you’re saying. And homebirth midwives seem too often to operate in that paradigm.
Hahahaah! I’ve been around babies and they don’t make me irate…maybe i’m missing something. Maybe they should have.
Hahhahahaah!
Oh, I think you’re missing something, all right.
You seem indicate that it’s necessary to reform health care systems to provide a comfortable place for minimally trained midwives and the clients who choose them, so that everyone is happy and accommodated and validated with no compromises to safety. That ignores the reality that pregnancy, labor, and delivery are inherently capricious events with the possibility of grave outcomes. Avoiding those outcomes with the best resources available doesn’t always leave time to pretend that the CPM’s aromatherapy and the mother’s dream of fluffy unicorn birth are useful contributions.
Good points but I’ve already covered this ground.
At the very minimum, it should be made impossible to deliver new CPMs diplomas. As long as it’s a valid career path, there will be more people who get in and call themselves midwives.
And that’s why we have CNM, and why the CPM credential has to be abolished.
But here’s the thing, what is available in rural India and in the USA is entirely different. The technology they have is extremely different. There are lots of babies in India whose death is probably unavoidable, while in the USA, such a death should never happen.
So our midwives actually need a way higher level of education than those in rural India do.
So what solutions are you looking at?
There is only one solution. Abolish any lay midwife credentials. Those who wish to practice as midwives should get a CNM.
Your idea of new programs to bring CPMs up to date has been tried. That’s what led to the CPM credential in the first place. Look for Judith Rooks, a CNM and a longtime champion of homebirth, said in her official report after Oregon homebirth midwives refused to release their mortality rate. (It was horrendous.) Basically, she said that some thirty years ago, the CPM credential was created as a temporary bridge for skilled midwives of long experience so they could be integrated into the system. Instead of serving its purpose and be done with, it has been used, to her disappointment, by young women who didn’t want to spare time and money to get an actual midwifery education ever since. And here we are, with them being loose and demanding more and more privileges.
They had their chance to get their education up to date. They should have been this bridge. They chose to play it another way. The CPM should be abolished. It just didn’t work.
What if you tried looking around on this blog, oh, I don’t know, using that newfangled feature called a “search box”?
Hahahahah, you are very funny.! ;D
I said it clearly: Abolish the CPM credential
You want to be a doctor? Well then you you do school and become a doctor.
You want to be a nurse? Well they you go to school and become a nurse.
Want to be midwife? well then you freaking go to school and go learn to be a real midwife. Becoming an actual CNM is too hard for you? Well though luck you are just not meant to be a midwife.
Baby’s and mother’s lives are at stake here. There should not be an easy way.
I already reached that point over an hour ago, however johnny and jilly come lateliess keep coming in back to visit stale old threads, so I have ceased commenting. I think I discussed this with Amazed but she was unhappy with my idea of integrating those same people into the system. Apart from policy and legislation and implementation.
Honey, it’s an internet blog, with people in a lot of different timelines. If you can’t handle to hold a conversation for more than 5 minutes, than the internet is not for you.
I know you meant timezones, but the idea of us being in alternate timelines and somehow all crossing on this blog was a highly entertaining break in my day 🙂
Although, being form different timelines ie alternate realities might explain a few things . . .
Can I be on the timeline with the female Rimmer and Lister? #RedDwarf
Johnny and Jilly come latlies? This is the first post on this blog that you’ve ever posted to. Not everybody sits in front of a computer and reads blog posts the instant they appear, you know.
You asked the same question (how to make homebirth safer) several times. Several people have offered the same answer (get rid of the CPM credential). Maybe it’s time to stop with the “yes, but” and “someone already said that” – and just reflect upon that.
Oh, and what’s with the complaints about using the same argument or going to the same points? This is not figure-skating, this is not poetry. In matters of health and science, you don’t want to judge the validity of an answer on style, but on content. Some points get repeated over and over because they’re true. Because they contain hard truth than people need to hear, even if it’s unpleasant.
Oh, ok. So you “reached that point,” therefore that has been settled. How fortunate we are to have you so that we don’t have to muddle through discussions whose points have already been reached.
And are you happy now with your idea, now that you know how it worked out? Plus, it’s rather strange, you know, for a newcomer to come and deem who should answer them and when. Let alone the fact that it’s quite strange for a journalist gathering information to speak so neglectfully of old threads when they’re so informative, studies and all. What is fresh for you? What the people whose bloodied livelihood you defend have to say? (Hint: They lie. On the second thought, that’s a stale old news. Won’t be interesting to you since you’re all positive and so on.)
It’s very difficult to integrate people who don’t want to be integrated. Sure, they pay lip service to the idea of integration to make homebirth safer, but they aren’t willing to do anything meaningful to make that happen. Mandatory licensing? Nope. Mandatory malpractice? Forget it. Clear risk-out criteria? Surely you jest.
They really only want integration in terms of recognition by other professionals and the right to bill third-party and government payors. That isn’t integration, or QI, that’s entitlement.
All the evidence suggests that non-CM/CNM midwives in the US have little interest in making homebirth safer. How many clinical practice bulletins or guidelines has their professional organization produced? As of today? Zero. Take a look at the programs for their professional conferences and see how much content is geared toward improving practice.
Instead of asking a bunch of commentators on a blog what they’re doing to make birth safer, why don’t you ask the actual practitioners and the organizations that represent them?
A friend just had a surprise baby. Went to the er because she felt ill, not knowing she was 7 months pregnant (she’s overweight and had no obvious symptoms that couldn’t be blamed on something else). They induced her that night because she was pre-eclamptic. No one was mean to her despite never being there before or for not noticing what most consider obvious. (It really wasn’t obvious; she’d been moving a bed and a dresser into my 2nd floor apartment 2 weeks before and we couldn’t tell at all.)
Hospitals and doctors do not act purposefully horrible in a way to punish women. Homebirth is about what, 1-2% of births max? And birth itself is what when compared to all the other stuff that hospitals do?
So no, hospitals and doctors are not financially affected in any noticeable way by home birth.
Let’s say you have a homebirth disaster. Most of the time, said person didn’t get pre-natal care at the hospital. They don’t know her, they have no medical history. She’s just showing up after labouring for 3 days and the head of her breech baby has been stuck inside her for 45 minutes.
After the initial shock of: ‘why the fuck didn’t this women came in freaking 2 days ago!!!’
Everyone will scramble around trying to figure out who she is, what exactly is going on, working the paperwork to get her admitted, assessing the baby and do everything to save it’s life.
So of course the Doctor is going to take care of her. But with a potentially dead or dying baby, in an unknown emergency situation, there is no room for smiles, politeness and small talks. Everyone is going to be silent, serious and concentrating on saving that baby, doing all the ‘evil’ monitoring and ‘evil’ vaginal exams.
So of course the ‘natchural’ mother, who is used to talking about cupcakes and rainbows with her midwife for 3 hours during each visit is going to find everyone is cold towards her. (like the idiot who freebirthed her 24weeks preemie, and was complaining that the doctors didn’t rub her belly and go all ‘ohhhh hello there little pumpkin’)
They have a baby to save.
I am sure they can save the baby without the cupcakes-or the coldness. But I get your point. But actually you came in a little late. We actually covered the ground a while ago.
Nevertheless, one more point of view is always a good thing,
Thanks for the share. I liked the last para. Hahahha. 😉
Still equivocating, I see? “I get your point” / “Oh but let me patronise you while pretending I agree”
With a smiley in the end as if you were giving a compliment.
*Sigh*
Yes, it’s so frustrating when people won’t just fall in line with what you tell them.
It’s not much being cold, it’s about being in charge, and working fast, precisely and effectively because each seconds count.
The coldness is only perceived by the people outside of the medical field, who can’t understand what is going on. But right now, their feelings are not what matters.
I’d like to see you try to be all friendly and warm while trying to save a life. Good luck.
I find it fascinating that you seem to believe that you choose the “ground” that will be covered, and you deem the covering complete.
“I am sure they can save the baby without the cupcakes-or the coldness.”
Nice false equivalence.
The ‘coldness’ is due to the fact that, as noted above and below, the care providers are too focused on figuring out WTH happened with the transfer and how to best manage the disaster that has been dumped on their laps. Their focus is re-branded as ‘coldness.’ So no, the best chance at saving the baby is likely to involve some of that ‘coldness’ you consider soooo horrible.
And if the doctors did take time off in that emergency to make small talk, and there was a brain injury to the baby, crunchy mom would sue the hospital for malpractice.
This group isn’t anti-midwife. A number of us used CNMs and had good experiences. But homebirth isn’t being demonized here. False claims about the safety of homebirth is.
And you heard this from the egotistical morons who thought they had everything under control, who thought they knew more about having babies than doctors, right? What kind of journalist doesn’t consider that such sources might be biased?
Home births are only a tiny fraction of births in the US. Hospitals aren’t losing a significant amount of business to them.
On the other hand, when Oregon passed a law saying that Medicaid wouldn’t cover risky homebirths, homebirthing midwives were not pleased. So if homebirthing midwives have a significant financial dependence on serving high risk women who should be in the care of an OB, who really has sinister financial motives here?
” I also feel a lot of the problems happen from infection.
if I’m not mistaken. ”
She is mistaken. As we’ve discussed before, major causes of maternal and neonatal death in the developing world are the same as they are in the developed world – obstructed labour and bleeding.
And if they are, so what? What’s more important; having a live, healthy baby and mother, or having people be nice to you? I work in a hospital. If you aren’t satisfied with your care, you can report the caregiver. And likely get more satisfaction than a midwife who beats feet when things go wrong.
No one has to demonize home deliveries. unqualified midwives are doing that just fine on their own.
Seriously, my kid’s music teacher just told us “It’s time to go to a clarinetist. I can teach the first year or two, but I’m primarily a sax player and I’ve taken kid as far as I reasonably can. I’ll try to get you a few names.”
And no one is in danger of losing their life or health in this case.
I am a perinatology and I have worked in Bangladesh traing women to deliver babies in remote areas. These women still are better trained than some CPMs, because a large part of what they are taught is when to transfer. They are government employee and get paid regardless how many deliveries they attend or transfer out. That being said, the point of training these women was more to improve maternal outcome than fetal outcomes. Monitoring of the fetus is labour is minimal, and there is nothing they can do but transfer at the first sign of trouble. However, transfers are slow and long and frequently babies don’t survive. However these rural birth workers have impacted maternal mortality, they have not had as robust effect on neonatal mortality. They have improved outcomes, but only in cases where transfers can occur, things that happen acutely will still kill the baby, but hopefully they can save the mom.
It is really not a comparable system at all to developed countries. No women should have to accept less than standard care. I work in an area with a higher than average homebirth rate (about 3-4%). We have had bad outcomes in the hospital and bad outcomes with home births. We have well trained midwives. However, I have yet to see a case where baby was harmed or died in the hospital that would have had a better outcome delivering at home. However, I see cases every year from homebirths where the baby would have fared better with a hospital birth. It doesn’t matter how good your midwives are, they are still midwives and they do not have the same emergency skills that an OB with a hospital to support them does. These bad things may only occur 1/10,000, but that is not an acceptable risk for me – particularly because I can see no benefit to the baby from a homebirth (actual documented benefits, not touchy feelly benefits that are often touted. Also fewer maternal interventions without proof of improved outcomes means nothing, so I am not sure what the maternal benefits of homebirth are either)
And they are at it again… At the FedUp page, they’re howling how unsupportive the commenters are being because they don’t respect the mother’s wish not to be commented on, even if that helps prevent another death caused by malpractice. Yes, they spelled it clearly. Doves up nicely with wisemamma’s defence of choice, I guess. Keeping deaths in the closet and then supporting choice!
Once again, I am left wondering what the hell do mothers think. This one blames everyone and everything under the sun for being mean to her. At least she recognizes that the midwife she trusted sat by as her child was starving to death inside her. But she keeps saying that NOW she knows, NOW she realizes she was lied to… How the hell does that even work? Nowadays, the simplest google “research” that all homebirthers seem to make will show the articles. The stats. The danger. How do they miss them? They’re there, on the first page. If you bother to google “risk” and “homebirth” together, you can’t miss them.
I didn’t even have to go that far to find this page! I just googled “Ina Mae Gaskin” and good old Dr. T was the third or fourth link down. And that was over a year ago.
Years ago, I would have seen how they can miss that. I, myself, had no idea that anyone might WANT to birth at home, right until someone did, the baby died and the story evolved the way you can say. It went on the TV. I am not kidding you, when I tried to find out what the blazes those wonderful American homebirth midwives the homebirthers here seemed to venerate, I was this close from wondering if I was the only one of sound mind in a mad world ot the other way around. There was NO information on the first pages. Zero. Nada. None. I don’t count “homebirth great, let’s sing kimbaya and fly to the moon’ as “information”. Now, it’s different. It’s there. How can anyone who has personal interest to know the good, the bad and the ugly miss it? I can accept it for homebirthers of, say, 5 years ago. Not today.
Meh. I decided long ago that no-one is of sound mind – the point is whether someone’s particular cracks are dangerous or not.
Dr. Amy was right when she said in that thread, “If
you don’t want people to talk about a story, don’t publish it to all 7
billion people on the planet.” The mother in question didn’t just publish information about her truly horrible experience and her midwife’s unforgivably bad prenatal care – she started a GoFundMe.
That is a completely fine thing to do, if you want. It really is. But you can’t solicit attention, and then be surprised that you got that attention. If someone, somewhere, is reacting with misogyny or straight-up cruelty, OF COURSE that’s wrong and totally indefensible. But that’s not what they’re angry about. That’s not what was happening in that thread. They’re angry they got the “wrong” kind of scrutiny on the situation, and that one person was a tad insensitive about why someone would want a birth certificate for a stillborn child. They’re upset that they couldn’t regulate tailor the entire world’s reactions to their liking.
Frankly, the mother doesn’t look like a very nice person at all. Wishing death on Dr Amy’s children because Dr Amy hadn’t rushed to give her all her money and croon softly in her ear, “Oh poor dear, you couldn’t have known!”
I think the group was kinder in their assessment of her character than I am. I am sympathetic to her loss but I don’t think I would have liked her if I met her in RL. That isn’t a grieving mother being too sensitive, IMO. That’s the real her. Grief can make you go off the board but it can’t change your character.
Kind of makes me think that might be why this particular mother didn’t seek a second opinion for a symptom that worried her. Midwife made her feel good about herself. The thing is, I can relate to this to some extent. I also like it better when my providers can see how awesome I am. Fortunately, this far I have never been placed in a situation where my health could be compromised by deciding to stick with the provider who makes it all about my awesomeness. I guess some loss mothers weren’t this lucky.
WELL, I missed the part where she wished Dr. Amy’s children would die! Holy shit, that’s rotten.
I really struggle with being generous to NCBers who have it blow up in their faces. My kneejerk instinct is to emphasize with their pain, unless they were one of the egregious cases like Paala or Ruth Fowler Iorio and her garbage husband. Because I think midwife/NCB culture is very predatory on insecure women, and predators tend to get pretty skilled at targeting their prey.
But as a group, NCB true believers are so awful, so smug, so narcissistic. When they get lucky despite their horrible choices, they never hesitate to use it as a bludgeon against other women. Or as a masturbatory aid for themselves. And when they get unlucky, everyone else is so mean for wondering why they didn’t act like adults in the first place. They’re never to blame.
In essence, I’m always torn between feeling bad for NCBers when it all goes wrong, and thinking, “You had every chance to avoid this nightmare, but you chose to believe in fairies and have your ego stroked instead.”
I definitely agree with your assessment of this particular mother. I’m very sorry for her, but I don’t think she’s a decent person. You’re probably right that this woman stuck with the midwife because the midwife was telling her what she wanted to hear. I have an inborn suspicion of flattery, myself. So I don’t get why people fall for it. But they certainly do, in droves.
(Don’t get me wrong. I like genuine praise as much as anyone. Flattery is different, though.)
She’s already taken it down and apologized. Rings false to me but whatever. If you don’t mean it, it won’t occur to you. I occasionally write, “Fuck you” and other obscenities but wishing on someone’s children to die before their eyes has never crossed my mind, so it never crossed my keyboard either.
The problem with flattery is that with skilled cons, you can’t always say they aren’t genuinely praising you. Homebirth midwives have turned flattering in part of their job.
I agree about being of two minds about NCB losses. Especially now when the studies are there and can be found in google if you only type “risks”. Everyone knows how Google freaking works. They don’t know the truth because they choose to focus only on things within their birthing “bubble”.
Which doesn’t mean that the con artists shouldn’t be prosecuted, I mean persecuted.
And the midwife in question is already in action, it seems. Someone sent her a link and she’s busy threatening the mother with a lawsuit for endangering “her livelihood”.
How do these women achieve it? I mean, most of us in real world do realize that we fuck up sometimes. I’ve had my share of critics for some things I did wrong with a BOOK. No one died. Nothing. And some of the critics were unfounded. Others were not. I simply made some fuck ups. How do they never question their infallibility? I thought that was only reserved for the Pope.
Abby Reichardt comes to mind. She was so sure that no one will suffer due to her mistakes because that’s the kind of provider she’d be. They never seem to even consider the chance of making mistakes. WTH?
I may have told this story before, but here’s an actual professional conversation i had with a client a few months ago.
Actual client: Do you think my case could have come out differently and I could have gotten more money?
Me: I don’t see how, but if you ever figure out that I miss something, that’s why I have malpractice insurance.
Actual client: Oh, no! I would never sue you. You’re the best! You’ve stuck with me when no one else has. [Adds more about how I fart unicorn sparkles.]
Me: No. I am human. I make mistakes. You deserve to be fairly compensated for what happened to you. If I screwed up, sue me.
Either discus isn’t showing all the comments, or I’m missing something. What situation are you referring to?
Its a conversation on the Fed Up with Natural Childbirth Facebook page.
Thanks
They Google “research”. Google only turns up the outcomes that they want to find. That’s how Google’s algorithms work. The top results are the most popular ones. The majority of people who search ‘ homebirth safety’ want results that tell them homebirth is safe therefor those are the results they get.
Exactly. It’s a common bias to start with a hypothesis (“homebirth is safe”) and only test that hypothesis (looking up “homebirth safety”) in Google). Testing alternate hypotheses (“homebirth risks”) would have turned up a different pattern, but you have to think about it first.
I’ve made a rule for myself that if I have no clue about a subject I should google something like:
“[subject] pros and cons.”
If my kneejerk reaction is “Ewww…” then I start with “subject Pros.” And if my kneejerk reaction is “Wonderful!” then yeah…I start with “subject cons.”
I still have to use my brain, of course, but I find this is a decent starting point.
I like it!
Fortunately, this blog does come up sometimes – came up for me when I searched Ina Mae Gaskin in my NCB fervor
I have a couple of small tumors on my face which are basal cell carcinomas. Now, I’m a registered nurse and a midwife, and I probably know a bit more than the average layperson about the condition, but I’m certainly not an expert. So I go to a dermatologist who has done particular training in the best surgical method for removing the growths. I trust her judgement. If a woman uses a particular OB/GYN she should be able to have confidence that he/she won’t simply confirm the woo-ish ideas she has, but is fully competent to deal with any and all situations. A doctor who is not competent with forceps should only do office gynecology, and maybe not even that. He certainly should not be anywhere near laboring women.
I cringed when I saw the forceps bit. And the “forceps are not his strong suit” just make me go wide-eyed. Are there any depths to which they wouldn’t sink?
Your point here was really proven in the last day or so, when this mother claimed she spent “years and years” researching home birth and never heard of any bad outcomes. That’s almost impossible to believe, unless she deliberately avoided everything but NCB websites and books.
I guess he must be doing something right if the hospital has backed off and Dr. B and all of his patients have heard dozens and dozens of apologies. Options are still available for all mothers at Dekalb!!! Thank you Dr. Bootstaylor!!
Nah, it’s just that lawsuits are really expensive, even if you’re right.
Dead and injured babies don’t bother you, I take it?
Except for those pesky foreceps and water deliveries. He still can’t do those. BUT YOU WON, YOU WON THE BATTLE BIRTHMAMAS.
They need to make some more pointed ‘threats’ to get those back.
http://a.disquscdn.com/uploads/mediaembed/images/4146/4016/original.jpg
So I’ve been thinking about this. As I was thinking, I recalled a situation with a teacher that I used to work with. Teachers, like doctors, are extremely difficult to fire. Maybe more so, because if a teacher kills somebody it’s pretty much automatic, but if a doctor kills somebody, even negligently, it’s not always automatic. Anyway, in order to fire this man, my administration team had to document his behavior for almost two years. At the end of the first year he was put on what’s called a performance improvement plan. He failed to meet the terms and my principal started the process of termination. Then the lawyers came in. Even though it was perfectly clear that this man was not only incompetent, but an actual menace, my admin backed off for a little bit. With the lawyers, they put yet another improvement plan in place. The school board’s lawyers and my admin later admitted that the second plan was devised to give the bad teacher just enough rope to hang himself with, while doing a minimum amount of damage.
So I’m wondering if this hospital’s seeming reversal of some of their earlier stipulations is something similar to what my admin did to the horrid teacher: everything has been documented in front of lawyers, and they’re counting on him to screw up something minor fairly soon so they can bring the hammer back down.
We had a receptionist who was stealing from the clinic. She was stealing everything: pet food, medications (including narcotics), medical supplies, changing what vets charged to her account when she brought in sick pets and even money from the cash register.
She didn’t have a union or anything, yet It still took over 6 months of getting a mountain of proof to be able to fire her legally. And when she applied to another clinic and they called us for reference, we couldn’t even legally tell them that she was a thief.
So yea, firing a doctor must be extremely hard.
Oh, you make a good point…
Yep, sure that the hospital lawyers were scared by these threats.
No respectable Doctor would be posting garbage like this. As simple as that. Ignorance at its finest. You can’t argue with stupid. Have your ignorant blog. This is full of fake people and fake doctors.
Have your doctor butcher. Why do you natcherel folks always have to go with the ones who have no idea what they’re doing or are sexual predators? Ah yes, because the smart ones don’t want to have anything to do with you.
LOL ad hominem attack is the best you can do? Oh, honey. You’re out of your depth.
Riiight…because there’s no possible way people may see things differently than you; nope, any one who disagrees must be a fake person….
Anisha, stick to your original screen name. Stop pretending that you are more than one person.
Haha, so it’s her again? I anticipated this. What’s the matter with directors of any kind of natcherel organizations of any kind rushing here and then resorting to cheap tricks?
They accuse Dr. Amy has thousands of fake accounts to troll their private groups. But they don’t see the hypocrisy in cooking up several different names to post here.
Rules are different for them and the rest of the world.
Pretty sure the new name is as obvious as it would be if I suddenly decided to also start commenting under the name “Crazy Parrot Lady”.
I’d never know it was you! Honest!
As opposed to those fake midwives and others masquerading as competent medical personnel there at See Baby.
When do the “accidental” water births start happening? “She was laboring in the tub, felt pushy and before we could check her/get her out of the tub, the baby was born! These things sometimes happen, especially with a multip *wink, wink, nudge, nudge*. Amirite, fellow CPM’s/CPM’s in training (such as it is)/doulas/birth junkies?”
Willfully endangering people is not a good selling point. At all.
The irony is so thick I could choke on it.
So, someone using multiple names to comment on a blog to accuse the other commenters of being fake.
Projection much?
I’m not fake, I’m genuine faux! Or a deeply sarcastic SAHP with a degree in history and enough sense to realize childbirth is deadly in and of itself.
Prove that, please.
For example – can you find where Dr Amy had her medical license retracted?
Wow, parachuters were sure quick!
Wisemamma. WISEMAMMA. Poe-tastic.
I’m new here, had a baby about 10 weeks ago and found this blog when I was feeling guilty about giving up on breastfeeding. I have to know, what is with the obsession with eating during labor with the natural childbirth people? By 3 AM I was thoroughly regretting the meal I’d had the previous afternoon before I even knew I was in labor. I cannot fathom wanting to eat anything at all while in labor. Although maybe my lovely, lovely, lovely epidural interfered with my body’s natural urge to eat.
i was hungry with #2 during the early hours of contractions, ’cause i hadn’t eaten since noon and my toddler jumped on me shortly before I was going to start dinner. I had a lot of popsicles, lol.
But were you the soul of misery because you had a few hours of no food? Did it scar you for life? If not, you were not properly obsessed. I mean, abused.
‘course not. ’cause i’m not that big a twit.
though i have suspicions about playgrounds
And then those same women have no problem with their babies starving until breastfeeding is well established. No matter how many weeks – months – it takes. They call a baby’s desire to wean themselves before mommy is ready to let go off her breastfeeding momma status a “nursing strike” and cure it with starving the kid until they accept the breast again.
Mommy’s gut must be well stuffed because not eating for a few hours or a day is so terrible to their sensitive souls. Baby’s tummy for days, weeks, and months? Who cares! They won’t die of starvation!
I’d love to see how quick they’d change their tune if someone said, “You don’t eat if your baby doesn’t eat.”
I’d say, as a general rule, whatever the Doctors recommend, they will recommend the opposite.
If doctors recommended eating, I swear to god, they’d say that fasting is the natural way to go about it.
Oh, Azuran. If only that was the case. The quibbles are usually about the hows and the whats.
I’m not discussing the whats before coffee.
As for the hows….let’s just say that agreeing on the correct orifice to insert drinks in is apparently too much to ask.
I was never NCB, but I really wanted to be able to eat in labor. I get migraines when I skip meals sometimes, and I get really irritable every time I skip a meal, so potentially not eating for up to 48 hours just seemed like a really bad idea. How could I push a baby out if my head was pounding and I wanted to just crawl into a cool, dark hole until it passed?
And when I was induced, it was after being held in triage for five hours without access to food and they wanted me to not eat anything at all before starting the induction. I was already having symptoms of headache. I admit – I ignored them and ate an apple (my CNMs and I had discussed eating yogurt being okay, but as the induction wasn’t planned I didn’t have any yogurt on me). I did have surgery the next day. I guess I was at risk for aspirating if I had needed general anesthesia, but my epidural worked fine. But the way the hospital nurses explained it to me, they were only worried that I would vomit during labor and I didn’t understand how that was a risk and not just an annoyance. (I had the dry heaves ones when they pitocin was up to high, and again during the surgery when they were closing up, but never vomited). I don’t know, though, my migraines can really lay me out and it seemed like a really bad idea to court one.
Nobody suggested an alternative, like, I don’t know, IV glucose to help with the migraine? I’m genuinely curious if it would have helped.
If there’s anything I’ve picked up about NCBers, is that their immediate physical and emotional comfort trumps absolutely every other concern. It’s always about how they feel right now, not about what would be the smart thing to do. They evaluate the correctness of any decision, based on how it makes them feel. Not by its actually efficacy.
Hey, Zoe, why delete? Come back! Got a cold feet, eh? Can’t have women seeing what you write here if you want to pocket their money for providing birth “services”.
Screenshots, anyone?
Seems I missed it entirely. I’ve actually got a lot going on right now, so I’m not as glued to my screen as I want to be.
The parachuters are here! Pardon me while I go make some popcorn and settle in for the show.
Ew, what kind of troll lifts snippets of gossip from Facebook? Lame ass.
Dumbasses of the world, join Laurel in her extreme sport of risking lives!
What kind of a troll is more worried about the rights of homebirth midwives than a brain damaged baby?
Amy Tuteur, MD is a disgrace to women! Those clips were taken out of context. The complication rate is well within average .05%. This blog has no facts!! Only rumors! Total BS!!
Amen my friend!
Total complication rate of what? Of whom? What complications?
The HBAC death rate for babies of women who’ve never had a previous vaginal birth is 1/100 according to MANA.
Who are the variables? The risk of death/complications from a repeat cesarean is much worse!
If you are so sure of that , post a citation as to what they are. And be honest, you can only include scheduled C-sections of full term healthy fetuses and mothers. No emergency ones. Nothing where the C-section is because mother or fetus is gravely ill, and might die for that reason.
Looking at CDC WONDER, using singleton babies weighing at least 2500 g, 37-42 weeks, I get a C-section neonatal death rate of about 0.91/1000. And that’s including a lot of emergencies, a lot of very sick mothers, etc. That’s FAR safer than 1/100, even if C-section #2 is more dangerous than C-section #1.
Obviously that’s not the case. For example, how many deaths and serious injuries have occurred at Dr. Bootstaylor’s hands when he does elective C-sections? Are his complications spread across his practice or only when he violates basic obstetric standards?
For who?
Not for the baby.
An elective CS increases the risk of TTN and minor nicks to the baby but completely removes the risk of intrapartum hypoxia, shoulder dystocia and clavicle fracture or obstetric brachial plexus injury, head entrapment in a breech delivery, scalp or brain trauma from ventouse or forceps, GBS sepsis, herpes transmission, intrapartum chorioamnionitis.
It also reduces the risk of pelvic organ prolapse, perineal trauma, urinary and faecal incontinence, sexual dysfunction and retained placenta.
Which set of risks is “worse” very much depends on the perspective of the person deciding between them.
Attempting a VBAC has a 20-30% risk of EMERGENCY CS…which is higher risk than Elective repeat CS.
Choosing a 100% risk of having a safer surgery over a 25% risk of having a more dangerous surgery, plus the risk of uterine rupture, plus the risks associated with labour.
Attempting VBAC may be presented as choosing between having a surgery and not having a surgery, but it isn’t.
Opting for TOLAC is just that- opting to try labour and see how it goes. It does not guarantee you will have a vaginal delivery.
It most certainly doesn’t guarantee you will have an uncomplicated normal vaginal delivery- there is at least a 10% risk the delivery will require ventouse or forceps (increased risk to baby of brain and skull injuries, increased risk to mum of urinary and faecal incontinence and chronic pain).
For at least 1 in 5 women TOLAC ends in an emergency CS which is riskier for them and their babies than ERCS- emergency CS is associated with lower APGARS and increased risks of maternal haemorrhage and infection than elective CS.
Put it like this.
You have a choice:
I can either give you $3 or you roll a dice and you get however many dollars come up.
You might roll a 4,5 or 6.
You might roll a 1,2 or 3.
Opting for TOLAC is rolling the dice and hoping for a six.
Some people will choose to play it safe and take the $3.
And if you get a 1, they might hit you over the head and steal your shoes instead.
Out of context? What possible context would make such behavior acceptable?
Giving women the right to choose their birth is pretty acceptable to me.
Because you belong to the scum who feed women rubbish about their options and then say, “But of course, it’s your choice”.
The right to choose without having the facts? I see. You must not realize that isn’t informed consent. I shudder to think what you’d say if a “mainstream” OB didn’t lay out every possible shitty outcome for a CS but when it’s your boy it’s just fine, eh?
Honestly? Yes. In her infinite wisdom, wisemamma is all for laying out the RISKS of “medicalized birth” and the WONDERS of “natural birth”. See? She’s all for choice!
Women are allowed to choose their births. But you can’t force the hospital to allow things that are against best medical practice- if you want to do something stupid, find someone who will let you, no one is stopping you. You have no right to force SOMEONE ELSE to support you.
If you use hospital facilities, they get to dictate what you are and are not allowed to do with those facilities. In turn, the hospital is governed by a complex web of rules, laws, and regulations to make sure it provides top-notch medical care to everyone. That’s how it works.
Hiding relevant information and attacking the people who do provide this information is pretty much the opposite to *giving the right to choose*.
So you think it’s ok to hide the complications that the facebook group acknowledges in the interest of….what, exactly? Your freedom to take stupid risks with your baby’s health, or is that with your clients’ baby’s health?
Anisha, I see you are the marketing director of the Georgia Birth Network. Not exactly ethical to try and hide complications from your clients, don’t you think?
She doesn’t.
No one is hiding anything. Birth has a risk of complications. Every OB knows that. Dr. Bootstaylor is the only one concerned in lowering those risks and keeping them within the .05%. And he has done that, but what women chose is out of his control. He is just giving options…not dictating anything, as this blog wants to make it seem like he is doing.
You’re hiding your activity, for one. How much do you get paid to maim and kill pretending to be knowledgeable?
“The only one”? Wow. You have a messiah complex by proxy for this dude.
Poor Dr Biter. How can natcherel folks be so cruel? How can they deny his greatness and his caring?
“Dr. Bootstaylor is the only one concerned in lowering those risks ”
Except it’s the exact opposite of that.
“Forceps are not his strong suit”? Seriously? And he needed to be told by on-high to stop using them, after his own supporters were cringing at his lack of skill? When was his concern with ‘risk-lowering’ going to get to the point of making that decision himself?
You keep saying .05%.
Which is one in 2000.
And not clearly spelling out which “complications” you mean.
You’re the marketing director of GBN (thanks, Addi!)? I must have missed your declared conflict of interests.
Lying scumbag.
You don’t even have a real name. Have fun getting paid you troll. Being within the average .05% of risk in birth is not lying. It is a fact. It is lower than a cesarean. Since when is an organization for informed concent a conflict of interest? Ignorant much?
That’s not how we decide whether a doctor is dangerous. We don’t calculate his mortality and morbidity rates; we look at the individual cases of people he has harmed.
If a doctor carved his name into your abdomen during a C-section (as happened in Australia), would you consider it an adequate defense if he claimed he didn’t carve the majority of his patients? No, I wouldn’t either.
While a high rate of complications and deaths can alert authorities to particularly dangerous doctors, that doesn’t mean that those who have only a few spectacular disasters when they violate the standards of medical care are off the hook.
By the way, how would you know Dr. Bootstaylor’s complication rate?
What? What?! I’m trying to comprehend this, and I just can’t.
There are actually a few cases of this around is you look it up. Some doctor apparently carved his initials on a woman’s skin after a c-section. Another one carved in initials on a patient’s liver during a transplant in Britain. A third one branded the uterus of a woman during an hysterectomy.
I don’t think that’s what teachers had in mind when they admonished us to always sign our work……….
W.T.F.
http://www.nytimes.com/2000/01/22/nyregion/doctor-carved-his-initials-into-patient-lawsuit-says.html
Let’s be absolutely and completely honest here.
The risk of UTERINE RUPTURE during a TOLAC after ONE LSCS is approximately 0.5%.
It is higher than that with classical or T incisions and higher after multiple CS.
It is is higher than that with prolonged labour or co-existing Chorioamnionitis.
Uterine rupture is only one of the possible causes of foetal morbidity and mortality in a TOLAC, making the risk to the baby of a TOLAC higher than the risk of an ERCS.
Where is your proof Amazed is getting paid?
Well, she gets paid for lying so she supposes someone else gets paid for telling the truth. Naturally!
Ssh….your sister’s talking. 😉
Getting paid to troll? That’s rich, coming from people who profit from NCB.
Wisemamma is actually your real name?
If you think they’re out of context – then why don’t you try posting the whole videos?
I guarantee you did bit join that private group by disclosing who you really were. Trolling deceptively.
Teresa she’s way too scared to introduce herself on there. She’d be crucified. 🙂
Do you lead the charge against everyone who is against you piling away money for presenting yourself as a professional while putting lives at risk?
Do you honestly think Dr. Amy has time to read the entire internet every day? Multiple people inside your group probably sent her stuff.
You people are paranoid as hell.
Trolling deceptively? Well, nobody can accuse you of that. It’s obvious you’re a troll.
If you think anything you post online is ever truly private, you’re deluding yourself… Computers and the internet do not have perfect security.
You should be ashamed of yourself. Trolling private groups and taking pieces of conversation or of context. .You are awful and hateful. Shame on you.
You should be ashamed of yourselves, hiding the truth from women who need to know it!
we aren’t the ones doing the hiding, or the lying.
Really? They are hiding that babies are being injured. There are no lies here.
I didn’t see them hide anything. Or deny anything. They weren’t asked. I’ve been to a birth where it was blatantly the Dr’s fault (NOT the Dr in “question” here) that the baby died. You think he hopped on his website or social media and announced “well, I just killed a baby”. You are comparing apples and oranges here
Listen, you asshole! Hiding the truth by presenting one side of it and being tactfully silent about the other IS hiding and lying. Can’t you find another job? Do you have to put lives and health in danger simply because you have an Ina May Gaskin-like perverse sexual need to scratch through other women’s birth, or are you just too stupid to be accepted in any educational program where real brains are needed?
“Midwife” or doula? What are you?
I love how you seem to think that lying in a Facebook group (which you don’t know that she did. Someone in your practice might have qualms about not disclosing anything to the people who trust you) is worse than presenting a false front to your clients while knowing precisely why your doctor’s privileges were suspended.
You should be able to lie with impunity to people who trust you with the lives of their children, but no one should be able to lie on Facebook!
She doesn’t need to stalk Facebook groups. Members of these groups send her the screenshots themselves for all sorts of reasons.
I’m fascinated by the woman who said she is “missing out on a twin birth” because of the changes. I wanted to say, oh my, does this mean your twins can’t be born? I’m not a doctor, but I’m pretty sure they’re still going to be born, one way or another.
Twin delivery with first one breech. No thank you! That is NOT evidence-based care.
My eyes about popped out of my head when I saw this. A twin delivery with Twin A breech????
But it IS a variation of normal. Nothing whatsoever to worry about or spare an iota of concern over. /s
C-section isn’t birth, don’t you know that?
A C-section that results in two healthy babies isn’t a ‘birth.’ Dead babies out by the vaginal route is a ‘birth.’
I was actually told this, more or less, by a nurse I saw yesterday.
In fairness to her, she was responding to the complaint I’d just made that the cervical smear I’d just had was “More painful than giving birth.”
You have GOT to be kidding. A nurse actually said that to you? I hope you reported her.
I made that sound worse than it was. The conversation went more like this:
Me: *Gets dressed after 1st ever cervical smear is finished*
Nurse: Are you OK?
Me: That hurt more than giving birth!
Nurse: *Skeptical look/voice* Really?
Me: My son was a C-Section.
Nurse: Well, that doesn’t really count!
It’s hard to convey the tone of the conversation using only text, but we were both just joking with each other.
Ah..OK. My sarcasm meter is off today. 🙂
Oh my! Can’t all these women, I don’t know, choose ANOTHER extreme sport? Jumping from a bridge with bungee or something? Why don’t they become gymnasts in circus? Preferably WITHOUT dragging another tiny innocent life tied to their chest? I mean, their wide bosom nourishing peace on earth with birth and liquid gold?
birth is an extreme sport? You are instantly discredited.
You don’t think birth risking your kid’s life for your “birth experience” is an extreme sport? YOU are instantly discredited.
Oh yes yes, that’s exactly what I said. Yup, that I wanna risk my kid’s life. Thanks for translating for the other idiots
Update:
Supporters are declaring victory, but I’d wait and see. You may recall that Dr. Robert Biter had his privileges completely restored in a similar situation right before he resigned them.
What about water birth and forceps?
“Made some threats.” Interesting. “Nice evidence-based practice you have here. Would be a shame if something happened to it.”
Well you know, the baby is really secondary anyway. It’s all about warrior mom and whether she’s able to deliver at home. If she gets a live baby out of the whole episode that’s a bonus.
Oh totally. That’s exactly what the point of all of this was. Nailed it. Idiot