The natural parenting conundrum: is a healthy baby all that matters?

Set of paper bubble cloud talk with shadow

There’s a tremendous overlap between natural childbirth advocates and lactivists. That leads to the central conundrum of natural parenting: IS a healthy baby all that matters or ISN’T it?

Natural childbirth advocates believe they know the answer. According to Milli Hill, writing in 2014, a healthy baby is NOT all that matters:

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Why is the woman who chooses high risk homebirth lauded while the woman who chooses formula feeding denigrated?[/pullquote]

Women matter too. When we tell women that a healthy baby is all that matters we often silence them. We say, or at least we very strongly imply, that their feelings do not matter, and that even though the birth may have left them feeling hurt, shocked or even violated, they should not complain because their baby is healthy and this is the only important thing…

In other words, women’s experience of birth is critical to their health.

Too often women who say they care about the details of their baby’s birth day are accused of wanting an ‘experience’, as if it is selfish to care about how their baby is born, how they feel or how they are treated.

Notably Hill doesn’t question the validity of women’s desires. It is enough for a woman to want a birth experience that differs from the hospital routine in order for her to be entitled to it.

Hill, like most natural childbirth advocates, is passionately committed to the principle that a healthy baby ISN’t all that matters … right up to the moment of birth. After that, Hill is equally passionately committed to principle that when it comes to infant feeding, a healthy baby IS the only thing that matters.

Wait, what?

Shouldn’t Hill’s claims about birth apply equally to breastfeeding? Doesn’t she believe that when we tell women that when it comes to infant feeding a healthy baby is all that matters we often silence them? How can we justify saying, or at least very strongly implying, that their feelings do not matter, and that even though breastfeeding may have them feeling hurt, shocked or even violated, they should not complain because breastfeeding will guarantee their baby is healthy and that is the only important thing?

How does Hill rationalize this hypocrisy? By questioning the validity of women’s desires:

But surely, breast or bottle, it’s all down to personal choice.

Every parent should have the freedom to decide how they feed their baby, and nobody should be judged for the path they take.


Except, that would discount the persuasive power of marketing.

In other words, the exact same women who wouldn’t and shouldn’t be pressured to knuckle under to the “obstetric industry” with its promotion of technological birth are supposedly dupes for the formula industry.

How ironic is this? Let me count the ways:

It’s a violation of women’s autonomy. A woman’s right to control her own body is not expelled with the placenta. If a woman has the right to refuse to let anyone put fingers in her vagina to measure cervical dilatation, she ought to have the exact same right to refuse to let a lactation consultant grab her breast and shove her nipple into an infant’s mouth.

It’s disrespectful of women. While Hill and her natural childbirth colleagues have no trouble believing that women who make alternate choices for childbirth are “educated” and empowered, Hill and her lactivist colleagues cannot imagine that women who make an alternate choice to breastfeeding are equally educated and empowered.

It is utterly inconsistent. Although a healthy baby is supposedly NOT the only thing that matters when it comes to childbirth, a healthy baby is purportedly the ONLY thing that matters when it comes to infant feeding.

It seems impossible to reconcile these diametrically opposed views of women’s autonomy, ability to make informed decisions, and importance given to a baby’s health.

But not if you look at it from a different angle, an angle that takes the views of natural parenting professionals as central. Their view is in that any conflict between what is good for women and what is good for them, their needs and desires ought to take precedence.

For Milli Hill and her colleagues who profit from promoting natural childbirth, encouraging women to buy their books, products and services is always an unalloyed good. That means that women who choose their experience over the health of the baby must be supported in every way.

For Milli Hill and her colleagues who profit from promoting breastfeeding, encouraging women to buy their books, products and services is always an unalloyed good. That requires that women who choose their experience over the purported health of the baby must be excoriated in every way.

The woman who chooses to ignore medical advice and have a high risk homebirth is to be lauded but the woman who chooses to ignore medical advice and formula-feed must be decried as gullible, uneducated and selfish.

What matters is not the health of the baby but the financial health of Milli Hill and her colleagues.

When you look at it that way, it all makes perfect sense.

67 Responses to “The natural parenting conundrum: is a healthy baby all that matters?”

  1. mabelcruet
    July 24, 2018 at 4:09 pm #

    Advisory: Don’t use Twitter, its not good for your blood pressure.

    Milli is now complaining about dentists-she asked questions of her daughters dentist is complaining of the ‘eyeroll (she) could feel under the face of the dentist’ and she ‘just knew’ she was annoying them, even if ‘they did not state this overtly’. It sounds like she asked questions and they were answered, but this is a perfect example of how she seems determined to believe in her own narrative that all doctors/dentists/non-midwife and non-lactation specialists are patronising and paternalistic misogynists who infantilise patients. She could ‘feel’ the eyeroll, she just ‘knew’ what they were thinking. Ridiculous woman.

    • maidmarian555
      July 24, 2018 at 4:34 pm #

      Bloody hell, that’ll be the next thing. Natural dentistry. tRuST tEEtH!! Just buy Milli’s book from this link she posts every five seconds about how to do it yourself at home! Why would you go to a qualified dentist when this woman who knows all she needs to know about teeth because she HAS teeth (for now, anyway) can enlighten you on how dentists have just been conning us all for years and want to control us with floss?! Anyone who tells you that you’re insane for not going to an actual dentist is just an agent of the patriarchy.

      • The Bofa on the Sofa
        July 24, 2018 at 5:01 pm #

        Tony Bright has beat her to it

      • Who?
        July 24, 2018 at 5:11 pm #

        We had a ‘natural’ dentist years ago, who I fell in with by accident when he bought my friend’s dad’s practice. What a steaming pile of woo he was pushing (and still is): wanted me to take my skinny energetic children off wheat and dairy because eating them is why they were skinny; recommended against fluoride drops; and recommended against fissure seals, leading my daughter who has natural deep fissures in her teeth to a mouthful of fillings. My son on the other hand has no fissures and no fillings.

        I left him in the end-when I realised what a lot of nonsense he was talking.

        • Madtowngirl
          July 25, 2018 at 1:01 pm #

          Ugh, my last dentist told me that I was going to develop sleep apnea because I clench my teeth at night. I explained that I had actually had a sleep study done and the doctor determined that I did NOT have apnea, but this dentist just retorted with “well that doesn’t mean you won’t develop it.” Okay sir, you are overstepping your scope of practice and I’m finding a new dentist. I’m much happier with my new dentist that focuses on his area of expertise – teeth.

      • seenthelight
        August 2, 2018 at 12:22 am #

        Don’t forget the fluoride! They’ve got our brains under control. It’s the dental-industrial complex. Shhhh, they’ll be onto us now.

        On a side note, there are CTs that say the population is intentionally dumbed down with flouride. They say it messes with the pitocin gland. There’s someone for everyone in this world, isn’t there?

    • Anna
      July 24, 2018 at 9:37 pm #

      Bet the Dr said kids teeth were fucked from night feeding a thousand times a night. Lactiverse says not possible amd dentists are just “uneducated”.

  2. mabelcruet
    July 24, 2018 at 5:53 am #

    First off, Milli Hill isn’t a medic, a midwife or a trained lactation consultant, so she doesn’t qualify as a professional colleague (she’s a journalist and author, so any other journalists on here, you can have her as a colleague, sorry about that).

    Secondly, she is a lying, gas-lighting, hypocritical, bullying, uni-neuronal nematode who embodies the worst that Twitter offers and exhibits some truly awful behaviour. Sheena Byrom and her little cluster of twitterati fangirls have stepped back a little from being directly abusive to women (and fathers), probably because of the very critical recent Health Profession Authority report into the Royal College of Midwives. The RCM executive team, including the chief executive who resigned a result of the report, was up in front of a government committee being questioned a couple weeks ago, so midwife behaviour is very much in the news. This means that Byrom and the like have to be seen to be acting professionally. Unfortunately, Hill isn’t bound by that, not being a professional midwife. So she’s free to carry on gas lighting and bullying.

    • July 24, 2018 at 6:46 am #

      I had no idea pathologists were so good at constructing insults–or perhaps it’s your Britishness. Marvelous.

      • The Bofa on the Sofa
        July 24, 2018 at 2:53 pm #

        Yeah, it takes a pathologist to come up with nematode as an insult.

      • mabelcruet
        July 24, 2018 at 3:12 pm #

        I blame my father-he was a Yorkshire man and an engineer, and both species are well known for being blunt and forthright!

        • Allie
          July 26, 2018 at 11:03 am #

          Ah, that explains a lot. I was going to say, those are some Shakespeare-level insults.

    • demodocus
      July 24, 2018 at 1:38 pm #

      uni-neuronal *snicker*

    • Sarah
      July 24, 2018 at 5:09 pm #

      She’s a professional something alright…

    • Anna
      July 24, 2018 at 9:39 pm #

      They’ll still have their private groups to denigrate women and bereaved parents in.

    • maidmarian555
      July 27, 2018 at 5:27 pm #

      Isn’t is Hill that has an actual degree in Drama or something similar? I mean, I have a bunch of Performing Arts quals and whilst I do not doubt I could beat anyone here in a karaoke competition, I’m not sure it would qualify me to advise other women on medical issues……

    • Chi
      July 24, 2018 at 2:37 am #

      Ugh the victim-blaming and ‘they did nothing wrong’ apologists in the comments is sickening.

      • maidmarian555
        July 24, 2018 at 9:53 am #

        One of the things I do notice within the woo-ey community is that they love to all claim ‘professional’ status (there’s a ‘professional’ acupuncturist and a ‘birth professional’ commenting there) but they have zero filter when it comes to spreading what is clearly personal or privileged information when it comes to these awful cases. It’s outrageous that people who were involved in that mother’s care (assuming they’re not liars because obvs we have no way of knowing) are already online before the case has been heard properly, slandering her and spreading details of personal conversations they had with a mother who must have been in a very vulnerable state. That inability to keep what should be private information private should be a big red flag to anybody thinking of turning to alternative medicine practitioners. It’s clear that they can’t be trusted.

        • Lilly de Lure
          July 24, 2018 at 5:26 pm #

          Yeah, I noticed that – just a thought but if they are registered as members of professional organisations (I know those registrations aren’t medically worth squat but they have legal force in some states, for insurance purposes if nothing else) wouldn’t those appalling comments count as HIPPA violations?

          • maidmarian555
            July 24, 2018 at 6:13 pm #

            That’s outside of my realm of expertise (although I’m sure others here would know). I think regardless it’s certainly a moral violation and seems to be frighteningly common among those sort of people.

          • Lilly de Lure
            July 25, 2018 at 12:24 am #

            Oh I agree, its not often I am shocked by these people but that did it – going on a media comments section to spread gossip about what a loss mother may or may not have said to her privately during a hugely vulnerable time in order to try to discredit a legal investigation into their mates? That’s beyond outrageous behaviour and if they were actually medical professionals (or even knew what the words meant other than as an advertising tool) they’d already have had their arses handed to them by their regulatory bodies for it.

        • Who?
          July 24, 2018 at 9:23 pm #

          I think it’s partly the blurring that happens between doing their job (whatever that might actually mean) and buddying up to whoever’s paying them. Perhaps also the busy-body temperament of some people who get into this game.

          They remind me of gossipy mean girls: all pallsy when things are going well, then talking behind everyone’s backs (including, I’d suggest, each others’) when things get a bit rocky or the story is particularly juicy. Not that it’s only women that are like that, my brother-in-law is a shocker for it. To the point where I don’t tell him anything at all confidential-he has a very nice manner and is good at wheedling things out-and I change the subject superquick if he starts with any family or neighbour gossip.

          I avoid those people in real life and absolutely do not expect or tolerate it when I’m dealing with someone on a professional level.

        • Anna
          July 24, 2018 at 9:49 pm #

          In the Australian context it starts straight away, the midwives know which loudmouths to feed a few lies to and within a few days everyone “knows” the woman refused transfer, or the midwives felt forced. They have time to get their stories straight and destroy evidence while the family is organising the funeral. Just heard of two fairly new homebirth disasters in Australia. One baby dead, one baby severe HIE.

          • maidmarian555
            July 25, 2018 at 10:32 am #

            It’s dreadful. The cruelty they demonstrate really shocks me. It’s not just that they’re reckless with the mothers and babies they work with, if they make errors and mistakes that lead to serious injury or death then they do everything they can to utterly destroy those families (who previously trusted them) so that they don’t get stopped from making future errors. Like those families haven’t been hurt enough already. There’s absolutely no interest in any introspection when things go wrong and nothing is ever their fault. There is no genuine empathy or even sympathy there at all. As a mother I find that chilling.

          • RudyTooty
            July 25, 2018 at 12:20 pm #

            I found this 13-page blathering response from a birth center (Baby + Co) in North Carolina to state regulators who investigated after 4 newborn deaths particularly chilling.

            So. Many. Excuses.

            Zero reflection, introspection, humility, apology.

            Chilling. Yes. Nothing is ever their fault.

            They never assume responsibility.

            It is not too much to ask/expect that newborns NOT DIE in low-risk, healthy, carefully-screened pregnancies and births.


          • maidmarian555
            July 25, 2018 at 3:57 pm #

            That was really hard to read. The arrogance and the total lack of humility is pretty staggering. I do wonder why it is that midwifery/birth support in particular seems to attract a disproportionately high number of people who appear not to actually care about their patients very much (if at all). I don’t know if it’s a power thing, where being in control of life and death makes them feel very important or what but I do know people with God complexes probably shouldn’t be doing a job that requires team-work and an ability to quickly recognise when you need to ask for help. You can see that in the report- the only thing she concedes they could improve is a few bits of documentation (and even that is given grudgingly). The inspectors aren’t qualified, the EMTs did things wrong, they aren’t breaking the law, they’re following best practice. Babies died. And yet there is *nothing* they could have done better? And clearly there is nothing they *want* to do better more crucially.

            My partner is an Air Traffic Controller, which is a job that appeals to people who definitely should not be Air Traffic Controllers but to become one, you have to go through such a rigourous weeding process, very, very few of those sort of people will ever make it through to actually being on a radar. He quite often has people getting really excited when he tells them what he does “oh wow, that’s supposed to be the most stressful job ever” or “don’t you find it scary having that much responsibility?!” and he always finds it a bit weird. He’s just not the kind of person that worries about how his job makes him perceived by others, to him it’s just his job and he quite enjoys it (and even though apparently it’s very stressful, he doesn’t find it to be so at all). I do wonder if maybe midwifery could be greatly improved by some sort of similar weeding process that kept these awful people away from other people’s babies in the first place.

          • RudyTooty, CNM
            July 25, 2018 at 5:05 pm #

            It was hard to read.

            Better standards – a weeding process – consistency and standardization of care and safety measures for out-of-hospital practice – these are all things I could get behind.

            I don’t know how to instill a sense of humility and desire to do better, though. That’s why we have standards regulations, I guess, for the folks who struggle reading their moral and ethical compasses.

          • Who?
            July 25, 2018 at 7:07 pm #

            The letter really isn’t for the regulatory authority, or other professionals, it’s really for their clients (you’ll note I did not say patients) and future clients. It nicely demonstrates how calm, reasonable, and respectful they are; it gives on some points and says they will up their paperwork as recommended; it quietly disagrees with some findings, and it says they will continue to strive etc.

            It also serves to kick the can down the road rather than giving anyone a reason (assuming they need one) to come in and shut it down.

            The fact that the content of all that is approximately zero isn’t the point, as I’m sure you know. It’s in this organisation’s interests to keep everyone talking, because talking isn’t doing, and doing is the enemy of what they are about.

          • RudyTooty
            July 25, 2018 at 7:21 pm #

            “The letter really isn’t for the regulatory authority, or other professionals, it’s really for their clients.”

            Marketing. Yes.

            It is also revealing, for those who want to read it critically.

            But you’re right, their clientele will probably not read it with a critical eye, and they will feel reassured and affirmed by it.

          • RudyTooty
            July 25, 2018 at 7:29 pm #

            “It’s in this organisation’s interests to keep everyone talking…”

            Curious – do you have experience or personal knowledge of people working in this organization? This comment makes me wonder if you’ve had personal interactions with this group, or if you’re making a general comment about an organization that wants to shirk responsibility.

            The AABC and the CABC should be held accountable as well. I wouldn’t be surprised if they provided input in drafting that letter. And I do have personal experience with folks at the AABC.

          • Who?
            July 25, 2018 at 8:39 pm #

            I don’t know anything about the organisation-wrong profession, wrong continent-but I have significant experience of organisations that want to shirk responsibility and look good doing it.

            Organisations like this don’t want an outcome-they will talk, consult, refer, communicate forever to avoid a final outcome. And while others dither, they continue to do what they do and make money doing it. The fact that people are dying or suffering injury as a result is just an extra layer of horror in this case.

          • MaineJen
            July 27, 2018 at 3:11 pm #

            I would say that midwives/doulas may become hardened from years and years of being around people in such extreme pain (labor sucks)…if I hadn’t had such wonderful experiences with labor and delivery nurses. They were THE BEST. So patient, very calming. I was seriously impressed. And I was similarly impressed with the OBs, but I never saw them until the end of labor!

            In contrast, the general impression I’ve gotten from midwives has been “Suck it up, the pain is good for you! It wouldn’t hurt so much if you did a b and c…” Does not impress me in the least.

          • maidmarian555
            July 27, 2018 at 3:45 pm #

            Having been through the joy that is a 3-day induction with my first and two babies, I got to see quite a lot of midwives (and a few OBs too). And, yeah, they do seem to fall into those categories. They’re either really lovely, kind and caring. Or they see you as just work. And a bit of an irritation. I do think that if they feel that way, they just shouldn’t be doing that job. The impact of a crappy midwife can be very long-lasting for a patient. I know there were a couple that ‘cared’ for me that if I ran into them in the street now, I’d probably have a panic attack, they were that bad.

            I get that what they do is hard. I get that it can’t be easy to do it day in and day out. But that doesn’t excuse them being arseholes to people on one of the most vulnerable days of their life. That doesn’t excuse refusing to acknowledge that as human beings they *will* make mistakes and that those mistakes may need some serious examination afterwards to ensure they don’t happen again. Clearly there are midwives that don’t feel that way. Despite working within the same systems and under the same pressures, they genuinely are there to support mums and babies and do so well. I think if you can’t be one of *those* midwives, you honestly have no business being a midwife. Some of them (certainly the fuckwits on Twitter) seem to think their best day is having a mother come in, labour without any help and deliver the baby by herself so that all the midwife actually has to do is catch said baby and slap it on the mother’s chest. Their ideal birth is one where they literally do fuck all and then get all the credit for it. Says A LOT about why they’re so hostile to mums that need a bit more intervention. God forbid they actually do any work!

          • PeggySue
            July 25, 2018 at 4:46 pm #

            They sound as if they feel very victimized. I liked the part that made it sound as if they had agreed to the state review out of the goodness and magnanimity of their hearts. I didn’t think you had a choice: if the state gets a complaint, the state doesn’t offer to review, it reviews.

          • RudyTooty, CNM
            July 25, 2018 at 5:02 pm #

            Gawd. *They* feel victimized.

            I just can’t with that.

            I. Can’t.

            If I understand correctly – the state of North Carolina does not regulate or license freestanding birth centers, so yes, it was out of the goodness of the midwives’ hearts that the state was allowed to survey and review the birth center. Which is all wrong.

      • just me
        July 25, 2018 at 12:04 pm #

        Oh I hadn’t seen the comments until now. Gah, that long first one, I’ve seen this person at a child’s birthday party. She also breeds, rents, and sells bunnies. So that says a lot about her supposed credentials and ethics.

    • PeggySue
      July 24, 2018 at 2:20 pm #

      Also OT–I posted about a home birth disaster a month or so ago–baby born after long labor, went into severe respiratory distress, transported to hospital, mom then hemorrhaged with retained part of placenta, also transported, baby found to have polycystic kidney disease, an autosomal regressive form, life support withdrawn 4 days later and baby died. The family stated the pregnancy had been entirely normal, no signs of anything wrong, etc., etc., though people here with far more knowledge said that there would have been warning signs, and certainly if the mom had been receiving regular obstetric care, scans would have revealed the abnormalities. I did meet with the grandparents in aid of donating to a fund for the family, and thanks to those who gave me the information about future choices, was able to warn them that each subsequent pregnancy for this couple would carry a one in four chance of an affected baby, and that thus a home birthing situation with hands-off care would not be a good option… However, they told me that “the hospital doctors called the midwives and assured them that there was no way this could possibly have been detected before birth…” and somehow I just don’t think I believe that. Grandparents reported parents were utterly shattered, barely coping a month after the death. Mom had to have at least one surgery for complications in addition to loss of their much-wanted baby, and of course now their home as well is the site of traumatic memories. Colorado homebirth midwives for the win. Again.

      • Jen
        July 24, 2018 at 2:57 pm #

        Nice how doctors always seem to find time to say that that the homebirth and/or midwife weren’t to blame. Odd how they only say it directly to the midwife or mother herself, rather than to other doctors or when writing articles.

      • mabelcruet
        July 24, 2018 at 3:33 pm #

        Cystic kidneys come in different forms. Cysts can affect one kidney, or even just part of one kidney (segmental dysplasia). Bilateral cystic dysplasia can result in neonatal death, as can autosomal recessive polycystic kidney disease, which affects both kidneys. The gold standard way to tell the difference between ARPKD and bilateral dysplasia is by autopsy, but a scan can give good pointers. The cysts in each condition are different microscopically and in different locations in the kidney itself, and sometimes you can have a form of cystic dysplasia where the cysts collapse and the kidney is left as a little shrivelled up nubbin of fibrotic tissue (that’s called solid adysplasia). In ARPKD, the kidneys are usually huge-enormous, filling the abdominal cavity and both are equally affected. They are so big that they push upwards under the diaphragm and that restricts the size of the thoracic cavity. In cystic dysplasia, the baby’s lungs don’t grow properly because they aren’t producing urine, so the baby can’t practice breathing. In ARPKD, not only are they not producing urine, there isn’t space for them to breathe in even if they had anything to breathe in. In addition, they can have horrible liver problems as well.

        I can safely say that every single autopsy case I’ve ever had where there was a clinical suspicion of cystic kidneys was confirmed at autopsy-it is something that is extremely easy to pick up on scan, even at a very early stage of development. By the time of a standard 20 week anomaly scan, it is usually blindingly obvious that something serious was going on.

        • PeggySue
          July 24, 2018 at 4:18 pm #

          Yes, ARPKD is what the baby had, and scans at the hospital diagnosed it. Poor little baby. It was just such a shock to the family, so much worse than if they had had time to prepare. Thank you.

          • mabelcruet
            July 24, 2018 at 4:40 pm #

            That’s one of the main reasons for anomaly scans-it means the parents have time to decide what to do if the outcome is going to be a bad one. In the hospitals I’ve worked at that the obstetrician and neonatologists would discuss all the different paths-some parents opt for ending the pregnancy, some parents choose to carry on, some may want ‘comfort care’ only for the baby after delivery for example. Being forewarned is important so that the necessary plans can be well embedded and everybody knows what to expect. The word empowerment grates on me, but that is what antenatal scanning does, it empowers parents to make the right choices for them, and does it at a time when they have the space and time to consider their options. It’s not for the doctors benefit, it’s for parents.

          • PeggySue
            July 25, 2018 at 4:23 pm #

            That was what I was thinking–they would have been able to decide what was best for them and their older child, and, if they decided to carry to term, have choices about who should be present, what care should be given the baby, what rites or rituals would bring them peace if the baby died, and etc. And I also think of the poor little baby in such respiratory distress, from birth at home to whenever they got to the hospital when at least comfort measures could be done.

        • MaineJen
          July 25, 2018 at 9:59 am #

          So similar outcome as renal agenesis, then. 🙁 Are there cases where children survive this, or is it uniformly fatal?

          • July 25, 2018 at 10:33 am #

            My best friend was born with a cystic kidney. It’s why she only has one. They took the cystic one out within a couple days of birth. But she only had it on one side.

          • mabelcruet
            July 25, 2018 at 3:47 pm #

            Yes, bilateral renal agenesis is uniformly fatal. The lack of fluid prevents the lungs from growing in utero so the baby asphyxiates after birth, they simply don’t have enough lung tissue to survive. Even if you could transplant immediately after birth (which to the best of my knowledge has never been done), the lungs would probably never improve-microscopically they don’t develop probably and the blood vessels are all wrong. And you probably couldn’t transplant successfully anyway-the renal arteries don’t develop so how are you going to find a blood supply for them? And the ureters and bladder are absent or severely hypoplastic, so how could they drain?

            Cystic kidneys can be survivable-it depends on how much functional renal tissue remains. If you’re missing one kidney that’s entirely compatible with life. If you’ve got segmental involvement, that’s survivable too. Often the other kidney compensates and gets bigger. There have been cases where the baby had bilateral renal dysplasia but there was reasonable renal function throughout most of the pregnancy-if the lungs grow enough then they can survive birth and the neonatal period.

            Autosomal recessive polycystic kidney disease is hugely variable-the most severely affected babies die immediately after birth, but if there is some residual renal function then survival is possible-it all depends on the extent of involvement and particularly on liver involvement-that can cause huge issues. But we are seeing more and more children surviving, usually they get progressive renal impairment and need a transplant eventually, but it is survivable. Giving parents accurate information about prognosis is difficult sometimes because its hard to estimate lung functional capacity before delivery, but that’s the main factor involved in survival. Pathologists use a ratio of lung weight to body weight, and a ratio less than 0.015 indicates lethal pulmonary hypoplasia, but obviously you can’t measure lung weight during life. Imaging and 3D modelling is definitely going to improve that though.

          • MaineJen
            July 27, 2018 at 3:05 pm #

            Interesting, thanks! I work in kidney transplantation, and I can’t imagine trying to do a kidney transplant on a newborn. Poor kids 🙁

      • RudyTooty
        July 25, 2018 at 12:30 pm #

        Without disclosing where I live – I want to say that I’m disturbed about the number of home birth deaths and injuries I am aware of – but that never make it outside of the few parties involved. Parents. Family members. Midwives. Receiving medical providers at hospitals.

        Sometimes I will look up a midwife’s website (after I know there has been a newborn death in her practice) – or a birth center’s website – and look at their ‘statistics’ – and it’s usually full of the nonsense: 6% cesearan rate, 11% transfer rate, 98% breastfeeding rate – but no mention of newborn deaths.

        That really is the important issue – and if a midwife practice is doing 50-100 births a year, and there’s a death every year (this is not an unheard of number – but this is anecdotal only) – shouldn’t parents hiring these midwife services be notified of this – so they can make a truly informed decision?

        It breaks my effing heart. It really does. It is sold as this perfectly safe and reasonable option. People are put at risk. Their lives are put at risk.

        There should at the very least be a statewide publication of statistics of newborn deaths under the care of out-of-hospital midwives. Does Colorado do that? I seem to remember that maybe they did… and the numbers were atrocious.

        • Madtowngirl
          July 25, 2018 at 1:05 pm #

          Your post just sent shivers down my spine. Before I was even pregnant, a local “birth center” went out of business/shut down (who knows what the real story was), and I was so disappointed because I had bought into the woo and I wanted to deliver there. When I finally did get pregnant, I wound up needing a c-section for a pre-term birth. I shudder to think what would have happened to me had that birth center still been open.

          • RudyTooty
            July 25, 2018 at 4:53 pm #

            No spine-shivering intended! But I understand – how is a potential client of a freestanding midwifery birth center, or midwifery home birth practice supposed to know what the *actual risks are* when all the practices do is promote all their beautiful, empowering, risky-but-so-beautiful births?

            It really is false advertising. And it is a horrible price – and unacceptable price – for families to pay for participating in that ideology.

            When I’ve talked with home birth or birth center parents who lost a baby, they often say, “It never occurred to me that this could happen. The midwives kept assuring me that I was low-risk, and that it was very safe.”

            “I risk out very conservatively” is a common refrain among out-of-hospital midwives. I have not found that to be true at all.

          • Anna
            July 27, 2018 at 5:11 am #

            They will also show you studies that show homebirth deaths to be equal to hospital but they dont tell you the numbers are too small to be significant and that half the homebirth deaths are not included in the data because even though those women qualified they dont meet the “low risk” criteria of the study.

        • PeggySue
          July 26, 2018 at 2:33 pm #

          Dr. Amy has in past written several posts (2009, 2012, 2013 at least) regarding Colorado home birth deaths; you’re right, they were awful–but I don’t know how to find recent ones. I looked at the CDHPE birth statistics site, but I couldn’t find on quick examination any way to select by location of birth. Which is not the best way to search anyway because that way the transfers count as hospital births. What is needed is a search by intended place of birth.

        • Anna
          July 27, 2018 at 5:08 am #

          Exactly. Theres a midwifery practice in Victoria Australia that has only been open a couple of years. They posted their “awesome” stats and it got shared all around as proof of how safe ooh birth ism. I asked on their page “whats your perinatal mortality rate?” fully expecting to get deleted and blocked but they actually answered me “one stillbirth”. Made it sound like an antepartum but I recently found out it was intrapartum (during labour), baby was alive and fine, then suddenly wasnt when it was born. Apparently they’ve also had a neonatal death. One midwife is under investigation I believe but I heard about another HIDEOUS case recently that resulted in a baby with severe HIE. Midwife hasnt even apologised and hasnt yet been reported.
          You are totally right. Women make the choice not knowing how many awful outcomes there are. They might have heard of one or two stories in the media, but you can be sure the midwives will be lying telling women those Mothers refused transfer. The ones that make the papers are the tip of the iceberg!

          • RudyTooty
            July 27, 2018 at 12:58 pm #

            I learned to be very suspicious of the word “stillbirth” when used by midwives.

            It implies that there was an intrauterine demise prior to labor – which sadly does happen. But when midwives, particularly CPMs and lay-midwives – use this term it’s often a euphemism: they mean an intrapartum death.

    • Guest
      July 25, 2018 at 11:52 am #

      Pretend midwives.

    • PeggySue
      July 26, 2018 at 2:23 pm #

      Went back and read the comments. Gosh. Such nasty stuff. I hope the investigation sorts it out, but the friends of these midwives are sure vindictive.

    • swbarnes2
      July 26, 2018 at 6:17 pm #

      You can’t tell what happened from that, but if the midwives told the parents “If the sh*t hits the fan, we can’t do what a hospital can do”, I don’t see how it’s the midwives’ fault. Presumably the plaintiff will say that the midwives assured her that it was impossible for anything to go wrong? Or they are claiming that the midwives didn’t call 911 fast enough?

      These parents were adults, they should have understood the risks in turning their back on prompt 21st century medicine.

      • Anna
        July 27, 2018 at 4:58 am #

        Midwives never tell parents that. They tell parents they will be MORE likely (because its one to one and theyre magic!) to spot something wrong and manage it or transfer you.

        • RudyTooty
          July 27, 2018 at 12:52 pm #

          I agree with you, Anna.

          Midwives utlize deceptive practices – in word and deed – when these midwives are licensed and authorized to practice, as they are in California, not only should the midwives be held accountable, but the state should be as well, in allowing this deception to continue.

  3. Krista
    July 23, 2018 at 9:55 pm #

    Love this. It doesn’t have to be the only thing but for most people it is the most important thing. If you support choices when it comes to mode of birth then I don’t understand how that doesn’t translate into choices when it comes to infant feeding. I support a woman’s right to have a home birth if she wants to but I do feel like it is a reckless and dangerous choice. Pointing this out which is well supported by real world statistics is somehow considered fear mongering but obsessing over miniscule supposed risks of formula feeding isn’t? It makes no sense.

  4. Who?
    July 23, 2018 at 5:39 pm #

    A lovely example of Who?’s first rule: If you don’t understand how something works, or why it works the way it does, follow the money.

  5. Ashley Ann
    July 23, 2018 at 2:33 pm #

    Homebirthers are gullible, naive Pollyannas. The other day I was at work and a customer starting talking to my colleague who is a mom about how she would love a homebirth. And I resisted temptation to school her on homebirth disasters. Should I have spoke up? Or was it right to mind my own business?

    • July 23, 2018 at 3:02 pm #

      I think you were right to refrain; workplace exchanges are not the best place to bring up controversial topics related to a customer’s health and medical decisions, especially since she didn’t bring up the matter with you.

    • Daleth
      July 23, 2018 at 3:54 pm #

      I would’ve spoken up. To avoid sounding preachy I would literally make up a friend (or mentally reclassify someone from an online forum as a “friend”) and share it like an anecdote: “You know what happened to a friend of mine? (Details of homebirth disaster).”

    • Who?
      July 23, 2018 at 5:37 pm #

      If it had been a colleague talking about homebirth, it’s fair enough to raise it, but not with a customer, particularly not if that involves butting in to a conversation. That said, you could mention to your colleague later ‘wow, how about that person wanting to homebirth, how risky is that?’.

      When my friend’s stepdaughter was planning a homebirth, my friend wasn’t that happy about it, but stepdaughter is a hospital trained midwife and being attended by hospital trained midwives, so my friend said little. I said to my friend I thought it was risky, particularly for a first baby. Labour was short, baby was fine, mum went to hospital by ambulance for bleeding. I’ve politely refused to watch the video-I’ve been in unmedicated labour twice, thanks, I don’t need any reminders.

      People are grownups, and will make their own decisions. While it bugs me that the baby is usually the one that pays the price at homebirth, that’s one of those things I just have to accept I can’t control.

  6. Daleth
    July 23, 2018 at 1:51 pm #

    That’s a brilliant point!

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