Aug 102010
 

“Childbirth is one of the most dangerous things a woman can do today.”  -OB to a mother in the middle of her labor and birth.

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 August 10, 2010  birth, OB  Add comments

  344 Responses to “"Childbirth Is One Of The Most Dangerous Things A Woman Can Do Today."”

  1. Yeah, except get in a car, lol.

  2. As opposed to? Oh must be when there was no power or she did it in a field alone *shakes head*

    • thats not unsafe either..

      most of what they say about history is a myth..

      and the problems that were there have much been fixed by cleanliness and better nutrition.

      • Actually, the higher-class women were more at risk than the lower classes. That is because they would have their baby, then hand it off to a wet nurse and immediately commence trying for another as soon as they were able. The lower class women breastfed their own babies so it worked a bit as birth control.

  3. Actually, getting in your car and driving anywhere is more dangerous. Ugh.

  4. Well…it’s kind of true, but that was not the time to say stuff like that! What was that Dr. thinking?

    • Actually, it’s not even on the top twenty list, so no, it’s not even kind of true. Unless you’re THIS OB’s patient.

      • Yeah, this is about the time when I’d be wondering how many women die at this OB’s hands.

      • Actually, childbirth isn’t in the top 20 list BECAUSE of obstetrics.

        What about other less fortunate countries where many women and babies die from childbirth? Oh, yeah, those are just the unhealthy, malnoursihed women. They don’t count.

        The whole arrogant “birth is safe” attitude came from the false sense of security thanks to the advancement of modern obstetrics. Most women in the western world are priviledged when it comes to pregnancy and childbirth, and don’t even relaize it.

        • Yeah, but it’s still higher than it could be BECAUSE of the OVERUSE of obstetrics and non-evidence based obstetric practices. And so what if modern medicine in general (not necessarily “obstetrics” in and of itself) has improved outcomes overall? Great! That doesn’t mean that it’s an all or nothing thing. Even homebirth is safer because “Western” women retain the option to move to the hospital in case of complication. Great, again! Note that the doctor said “one of the most dangerous things a woman can do TODAY” (with the implication “in this ‘Western’ context.”) Please. Even aside from its rank in terms of causes of mortality, that’s an extreme exaggeration and a scare tactic. Anyone can think of 100 more dangerous activities– activities more likely to result in death or injury than childbirth. And the implication is that our overall lives have become more safe “today,” yet childbirth has become more dangerous? Hmmmm… Maybe that’s partly true, at least in the last 30 years or so (skrocketing C/S rate with no proportional improvement in outcomes). Wonder why… But, no, you’re right– people who want a balanced, evidence-based approach to childbirth are just spoiled, sheltered suburbanites who should shut up and do as the OBs tell them to. I forget– who’s arrogant again?

        • And you know what? This really peeves me. Food production and distribution methods and understanding of nutrition and hygiene, etc., have drastically reduced the incidence of food-borne illness and death, diseases of nutritional insufficiency, etc., etc., etc. Great, right?

          But does that mean that the average American now has an ideal diet? Does that mean that Wonder bread is the pinnacle of nutritional value (as was thought in the 1950′s)? Does that mean that eating local, maybe a little more organic, etc. (as was done in the past out of necessity), isn’t better for the vast majority than eating Hostess Twinkies and McDoubles all day?

          I’m thrilled that the USDA regulates the cleanliness of meat-packing plants. It’s fantastic that kids who need the Vitamin C can get oranges in the middle of a Minnesota winter.

          Similarly, I’m thrilled that we have the technology to save 28-week babies. It’s fantastic that C/S techniques have advanced to the point that they no longer impact future fertility so severely (not to mention the long-ago days when they were so injurious as to only be used on dead or dying mothers). Heck– even epidurals are a million times better than twilight sleep!

          Somehow I am able to appreciate the advances of technology while not mindlessly accepting them all, believing that they are ALL for my own good, and that any “old ways” are hopelessly outdated, useless, dangerous and silly.

          Yes, there’s a world of difference between homebirthing in a place and/or time where modern obstetrics is/was completely inaccessible and homebirthing with well-trained midwives in the vast majority of the US. And good! And so what? That’s not the choice we’re talking about here. I am a huge homebirth supporter, but if I had the choice between going back to 1890 to homebirth my baby or having one in a hospital now, I’d choose the hospital, now. Thankfully, I have another choice.

          Similarly, just because I appreciate the advances in nutrition and food regulation doesn’t mean it’s negligently dangerous of me to can my own fresh vegetables now. Sure, without knowledge of bacteria in the 1700s, people were significantly more likely to get ill and even die from improperly stored vegetables. This isn’t the 1700s, and I can get veggies from the store– and I ALSO have a lot of knowledge and access to technology that I wouldn’t have had 300 years ago, to make my home preservation that much safer.

          Good, good and good. I don’t have to buy canned vegetables from Del Monte JUST BECAUSE they’re safer than home-preserved vegetables from 1725, or because Del Monte was a leader in discovering safer ways to can vegetables or whatever. That’s ridiculous.

        • If obstetrics is what made birth safe in the developed world (as opposed to a combination of midwifery, better nutrition, handwashing, greater affluence, and better child spacing due to the mother being able to choose when she will get pregnant and give birth) then why is the United States, a country where practically all mothers use an obstetric surgeon as their care provider in pregnancy and birth, so unsafe to give birth in? Our maternal death rate is right up there with Croatia’s. We’re not in the top ten safest nations to give birth. We’re not even in the top thirty.

          JUST SAYIN’. :)

          • “Our maternal death rate is right up there with Croatia’s.”

            Indeed, I believe a report came out that it’s *safer* to give birth there than in California. And now to dig up the link…

            But I’m sure that the (selectively) Skeptical (ex) OB can spin that one away, too.

        • Shelle,
          Why do you think :”The whole arrogant “birth is safe” attitude came from the false sense of security thanks to the advancement of modern obstetrics.”
          Trusting birth has nothing to do with modern obstetrics. Trusting birth has to do with a woman’s power to birth her baby. Our bodies know how. Whether we are near any modern obstetrics or not, we can still give birth, sometimes quite easily. What matters is that the mother feels safe.
          Modern obstetrics in 2011 is so geared to protecting the hospital and doctor from lawsuits that the woman and her experience of birth are pushed further and further back.
          Mostly I want to know why you think it is “arrogant” to trust birth.
          I think it is arrogant of doctors to think they know best about childbirth when most of them have NEVER seen a home birth. Most of them have never seen an uninterveened birth. Most of them know very little about normal birth.

    • True if you allow every intervention from mankind! Naturally—not so dangerous.

  5. Compared to what?

  6. Just try to stand in my way, Doc. Trust me…it’ll be THE most dangerous thing you do today.
    How crazy is that? I’m taking a bigger risk getting on the interstate.

  7. Birth is safe. Interference is risky. Trustbirth.com

  8. A simple “How are you feeling?” or “I’m here to help” would have sufficed.

  9. *Edited to read, “Childbirth in a hospital is one of the most dangerous things a woman can do today.”*

    • Ding ding ding! You hit the nail on the head!

    • Took the words right outta my mouth…

    • Really? Unless you are one to suffer a complication that needs immediate access to a hospital.

      • It’s still true, though, especially if we’re talking morbidity rather than just mortality. If you birth in a hospital, you have a near 100% chance of suffering SOME injury or illness (even if sometimes minor) that was caused by obstetric treatment and very likely (though not always) could have been avoided. Now, if one has complications that require obstetrics, that risk may be outweighed by the necessity of being in the hospital. Fine. That’s life. Although less common, one may also end up with an “unnecessary” illness or injury at home. That’s also life. But it doesn’t justify the overuse of obstetrics for the vast majority of low-risk women.

        • Okay, tell a mother who lost her baby or a husband who lost their wife during childbirth, “That’s life”.

          Easy to dismiss away when it hasn’t happened to you.

          • Why would I be so cruel as to shrug off anyone who had experienced such a thing with “that’s life,” and why would you think I’m being dismissive? I’m not playing a game of shock-and-awe hyperbole here.

            I am making a statement of fact here. Life is risky. ALL decisions have risks and there are NO guarantees. The trick is to try and make the least-risky decisions possible, to improve your chances– not to guarantee an outcome. That is impossible. Homebirth with a qualified professional is LESS risky for low-risk women and their babies than hospital birth with an OB.

            Homebirth has no guarantees, and I will shout that from the rooftops. Hospital birth has no guarantees either. But the former is safER, particularly in terms of morbidity, for “Western” women with low-risk pregnancies.

            Here’s what happened in this thread. The original commenter said, essentially “Hospital birth is dangerous.” You said, “Unless you suffer a complication that requires treatment in a hospital.” And I said, “…and then it’s STILL dangerous, but the benefit outweighs the danger.” It doesn’t suddenly become not-dangerous because it is necessary, and the fact that it IS SOMETIMES necessary doesn’t make it necessary or safe when there’s no (or less) danger at home.

          • To analogize:

            OP: “Speeding in a car is dangerous.”

            Commenter A: “Not if you’re rushing someone who’s having a heart attack to the hospital.”

            Commenter B: “Well, yeah, it’s still dangerous, even though it’s totally justified and the best choice in that situation. Just because it’s sometimes the best choice doesn’t make it less dangerous or a good choice in other situations.”

            Commenter A: “Well, you just tell that to someone who lost a loved one to a heart attack!”

            Commenter B: “???”

            But that conversation would probably never happen, and you’d look at Commenter A as if he or she were a little off– even though it’s a pretty accurate analogy.

            The difference is that “we all agree” that speeding in a car can have dangerous consequences, and is inherently risky. But we don’t “all agree” that hospital birth as it stands today is filled with *unnecessary* risks– even though it is.

          • To analogize:

            OP: “Speeding in a car is dangerous.”

            Commenter A: “Not if you’re rushing someone who’s having a heart attack to the hospital.”

            Commenter B: “Well, yeah, it’s still dangerous, even though it’s totally justified and the best choice in that situation. Just because it’s sometimes the best choice doesn’t make it less dangerous or a good choice in other situations.”

            Commenter A: “Well, you just tell that to someone who lost a loved one to a heart attack!”

            Commenter B: “???”

            But that conversation would probably never happen, and you’d look at Commenter A as if he or she were a little off– even though it’s a pretty accurate analogy.

            The difference is that “we all agree” that speeding in a car can have dangerous consequences, and is inherently risky. But we don’t “all agree” that hospital birth as it stands today is filled with *unnecessary* risks– even though it is.

      • The obstetric standard is “thirty minutes from decision to incision” for an emergency c-section.

        Have you heard of these things called “vehicles?” Some are called “cars.” Some are really fancy and are called “ambulances.” They go really, really fast on these things called “roads.”

        Sometimes these “roads” can get backed up due to rush hour traffic, inclement weather, etc, but fortunately people can plan alternate routes to the hospitals that are located on these “roads.” In urban areas, this can also mean going to a different hospital than the one originally chosen in the “back-up plan” (wow, you didn’t know we had THOSE, either?) to expedite matters.

        And if you are a medical professional, you are of course aware that when the occasional untoward emergency crops up, people head quickly to this special part of the hospital called the “Emergency Room.” It’s a room for dealing with emergencies that require immediate attention, such as gunshot wounds, severe injuries, strokes, heart attacks, and life threatening birth complications. Fancy that, a room for dealing with medical emergencies! Usually it’s more than one room in larger hospitals. And there they do triage and a mother having, say, placental abruption would be rushed into an obstetric operating room for a c-section.

        Golly gee whizzikers! The things people come up with!

        So, you see, home birth is pretty doggone safe… even when the rare emergency occurs.

  10. getting in and out of the bath tub or shower is dangerous should we not shower or bath anymore?

  11. I heard this a few weeks ago on Boston Medical. The OB resident said “childbirth is the most dangerous thing an American woman can do” then proceeded to talk a mom into an epidural (or to have her water broken…. I don’t remember now) and say how she should still be able to have vaginal birth. I posted it to my fb page and others said they heard it too but when I watched the “full” episode online it was not there.

    • I watched online and it was there. but she was talking her into an epidural, not having her water broken. and they were saying they weren’t going to turn on the epidural unless she had a cesarean. but this sort of didn’t make sense to me because I thought that one of the main reasons not to have an epidural was because of the risk of paralysis? so how is it “just as if you never had it” if the risk of paralysis is there?

      • I saw it too and most of the OB stuff irked me. I still have it on Tivo, so I can get the exact quote, but my impression with the epidural was that she wanted to put one in, but not run the meds. (And yeah, I would think that this would carry the same risk of paralysis.) However, I was still confused as to why they’d need to put her under for a c-section if she didn’t have the epidural in place. Doesn’t it take a similar amount of time for the epidural to numb enough for surgery as it would to do a spinal? Plus the fact that nothing they mentioned was likely to turn into something so dire that it would need general. I was really curious to see if they’d start pushing her to use the epi once it was in, but they never showed her again.

    • That’s so perversely funny, in a way, and really goes to how tied together the fear of pain and fear of illness/injury/death are in “Western” childbirth. I mean, let’s say it was an epidural (b/c I’ve heard this reasoning with epidurals). Explain to me how pain relief (of a sort that comes with a laundry list of complications) makes childbirth SAFER. It doesn’t even always make it less painful, and only rarely impacts “safety.”

    • I am not having any luck googling – can you post the link here?

  12. Well, others beat me to it, but I was going to say that the typical HOSPITAL BIRTH complete with interventions galore, would probably rank up there as pretty doggone dangerous.

  13. One of the most dangerous?? So its as dangerous as oh say getting on a plane, getting in a car etc…?

    I’m waiting, Doctor.

  14. My DH just said: Well yeah, if she walks into a hospital and just says, “Take care of me.”

    • I can’t remember the actual stats, but I think maternal mortality actually went up the last year that they have information for. Mostly because of the way they treat women in the hospitals.

  15. Sure it is! Right after (car) accident, homicide, suicide, cancer and heart disease, if the mom is 20-24. Or after all those PLUS then also beat by death from HIV if the mom is 25-34. But those things are so boring to talk about during L&D.

    Check it out: http://www.cdc.gov/women/lcod/06_all_females.pdf

  16. Saying this to a laboring woman should be the most dangerous thing you could do.

  17. Wow, that’s useful information, helpfully timed.

    “Information” should possibly be in quotes there.

    What kind of response is he hoping for? “Gee, thanks Doc! Now that I know, I’ll just cross my legs and *not* have this baby!”

  18. hahahahahahahaaaaaa! I guess I’ll become a race car driver and stop having babies since birth is just TOO dangerous… *eyeroll*

  19. Well, my mom always said the most dangerous thing was running with scissors. I guess she just didn’t know.

  20. As a matter of fact childbirth IS one of the most dangerous things a woman can do.

    Childbirth is and has always been, in EVERY time, place and culture, a leading cause of death of young women. And of the eighteen years of childhood, the day of birth is the most dangerous by far.

    In nature, the neonatal mortality rate is 7% and the maternal mortality rate is 1%. Childbirth is far safer now because modern obstetrics has decreased the neonatal mortality rate 90% and the maternal mortality rate by 99% in the past 100 years.

    This is why obstetricians have a hard time taking NCB advocates seriously. They don’t know the most important fact about childbirth, which is that it is INHERENTLY dangerous. If you don’t know that, you don’t know much of anything.

    • Can you please explain why women and babies in the USA have the HIGHEST rate of maternal and neonatal death n the modern world then?

      • Oh, you know she’ll come up with something! Most likely the stats are “wrong/skewed,” or our women are just too fat or stupid to give birth safely. Anything but blame the doctors and needless interventions. *eyeroll*

      • “Can you please explain why women and babies in the USA have the HIGHEST rate of maternal and neonatal death n the modern world then?”

        They don’t.

        According to the World Health Organization 2006 report on perinatal mortality, the US has one of the lowest rates in the world, less than Denmark, the UK and the Netherlands.

        You can’t find out the truth about anything by reading the homebirth literature. Almost everything in it is made up.

        • Interesting that according to our very own CIA, our rate is in fact higher than Denmark, the UK, and the Netherlands.

          But that’s just made up.

          https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html

        • “Almost everything is made up.” It’s not. And just because you want to have your baby in a hospital (which is your right) doesn’t mean those of us who want to birth at home are wrong for choosing to do so. We are well informed of the risks, and most mid-wives today are medically trained. It’s not o.k. for you to try to shame or frighten us into not having our home births. And a 2006 stat isn’t going to hold up. It’s 2010, four years can change a lot of stats.

        • Now, I know this post is kind of old, and I’m no medical professional, but I am a research junkie with a sleeping babe in my lap, so I had a few minutes to check your source.

          Here’s the an official report from the WHO on maternal mortality: http://www.who.int/whosis/mme_2005.pdf
          The Maternal Mortality Rate in the US was 11 per 100,000 births.
          Denmark’s rate was THREE per 100,000.
          UK’s was EIGHT.
          Netherlands’ was SIX.
          Other countries with lower rates: Australia, Austria, Belgium, Bosnia and Herzegovina, Canada, Croatia, Cyprus, Czech Republic, Finland, France, Germany, Hungary, Iceland, Israel, Italy, Japan, Kuwait, Latvia, Malta, New Zealand, Norway, Slovakia, Slovenia, Spain, Sweden, and Switzerland.
          (Data on page 36 of the .pdf, marked as page 28 on the document itself, in Appendix 1)

          Now for the WHO numbers on perinatal and neonatal mortality: http://whqlibdoc.who.int/publications/2006/9241563206_eng.pdf

          Perinatal death rate in the US was 7, higher than Australia, Belgium, Canada, China, Czech Republic, Finland, Germany, Iceland, Italy, New Zealand, Norway, South Korea, Singapore, Spain, Sweden, and Switzerland.
          This it the stat where the US does the best, and the US still isn’t even in the top 15, let alone the top 10.

          As far as neonatal, the US rate was 5, which is higher than the rate in Australia, Austria, Belgium, Brunei Darussalam, Canada, China, Cuba, Czech Republic, Denmark, Finland, France, Germany, Greece, Guam, Israel, Ireland, Japan, Luxembourg, Martinique, Netherlands, New Zealand, Norway, South Korea, Slovenia, Spain, Sweden, Switzerland, and the UK.
          (Data from Table A1.1, .pdf pages 35-40, document pages 29-34)

          So where do you see that the WHO saying that the US has the lowest rates of these things?

          Did you just make that up?

    • ROTFLMBO…

      You say the current maternal mortality rate is 1%, and “modern obstetrics” has reduced it by 99%? Soooooo…that means that “before modern obstetrics” ***100%*** of women died in childbirth? And the neonatal mortality rate now stands at 7%, and has been reduced by 90%…which means that “before modern obstetrics” 97% of babies died as the result of being born?

      If that is the case…my great-grandmother never gave birth to 4 children, and I never met her. Unless she was a zombie the whole time! Dang zombie great-grandmothers and their zombie babies!

      Not to mention my own mother, who birthed me and my two younger brothers at home with lay midwives. By your figuring, since no obstetrician was involved, she is also dead…and I only had a 3% chance of surviving said birth. And my (seeming alive) mother is actually a zombie, with two zombie sons!

      Oh, and then there’s me. I birthed my last child at home with a midwife. Therefore, I am also dead, and my 3-year-old daughter (who is incredibly lucky to also be in that 3% neonatal survival group) had better watch her brains around zombie mommy and grandma!

      • “You say the current maternal mortality rate is 1%, and “modern obstetrics” has reduced it by 99%? Soooooo…that means that “before modern obstetrics” ***100%*** of women died in childbirth? And the neonatal mortality rate now stands at 7%, and has been reduced by 90%…which means that “before modern obstetrics” 97% of babies died as the result of being born?”

        You’re joking, right?

        I realize that homebirth advocates don’t know any statistics, but it appears that you don’t even know arithematic!

        Please get a basic math book and review fractions, decimals and percent.

        If the rate of maternal mortality was reduced by 99%, that means it is 1% of it’s previous level. It does not mean that it used to be 100%.

        And you wonder why no one takes you seriously? ROTFL!!!

        • If the rate of maternal mortality was reduced by 99%, that means it is 1% of it’s previous level. It does not mean that it used to be 100%.

          Ummm…that is NOT what you said above. You said:

          In nature, the neonatal mortality rate is 7% and the maternal mortality rate is 1%.

          Now…to be fair…Sada did misinterpret you. The correct interpretation of what you said is that the maternal death rather without medical intervention is 1 in 100 births, while it is reduced to 1 in 10,000 births with medical intervention. Similar with neonatal death.

          Of course Amnesty International has stated that the risk of an American woman dying in childbirth is 1 in 4,800; worse than in 40 other countries around the world (http://www.guardian.co.uk/world/2010/mar/12/amnesty-us-maternal-mortality-rates). They further state that “the death rate in the US is probably even higher than it appears, because there is no federal requirement for the reporting of deaths in childbirth.”

          Do you have any response to explain this? Oh, wait, I know…Amnesty International does not understand statistics and is just a natural childbirth advocacy front group.

    • Statistically speaking, the drive to the birthing center is more dangerous than birthing with a trained midwife at a birthing center. The maternal mortality rate is higher in hospitals, but I still don’t think it’s as dangerous as driving to the hospital.

      But then again, I also don’t think you’re really Dr. Amy, since this site doesn’t require any kind of verification. I could sign my comment as The Archangel Michael and there’d be nothing to stop me.

      • “Statistically speaking, the drive to the birthing center is more dangerous than birthing with a trained midwife at a birthing center.”

        Nope, that’s not true, either. Stop making things up and look things up to find out the truth.

        • I just looked it up. Accidents account for 35 deaths per 100,000 among women 25-34 in 2006, the last year for which we had data compiled online by the CDC. Maternal mortality for the same group during the same year was 1.2.

          Therefore driving to the hospital is approximately twenty times more likely to result in a fatality than delivering a baby in the hospital.

          • “Therefore driving to the hospital is approximately twenty times more likely to result in a fatality than delivering a baby in the hospital.”

            Wrong again!

            When you calculate how dangerous something is, you must include how often you do it. In any given year, people make hundreds of car trips over thousands of miles. In contrast, a woman can have only one birth (in rare circumstances two) within any given year.

            If 1.2/1000,000 car trips ended in death, the death rates from auto accidents would be a lot higher.

            If we assume that an individual woman makes at least 700 car trips a year (driving somewhere each day, then driving back) the death rate per
            car trip would be 0.05/100,000 per year. In other words, the maternal death rate is more than 20 times greater than the risk of death from driving to the birth center.

          • Your statement originally was that childbirth was the leading cause of death in that age range. The CDC disagrees with you.

            You can play the numbers game all you want, but the CDC database of all maternal deaths in the 25-34 age range provided at least three categories of death that were greater than childbirth for young women.

          • Jane, my statement is at the top of this comment thread. Everyone can see what it says. I wrote:

            “Childbirth is and has always been, in EVERY time, place and culture, a leading cause of death of young women.”

            LOOK IT UP. Stop pretending that what you think is a “fact” and find out the actual facts.

            The OB’s statement was 100% true. That you are making fun of it says volumes about homebirth advocates lack of knowledge.

          • And 100% RUDE to say while to a woman while she was in labor!!!! Is that when you do most of your debating? Oh no I read somewhere that you are retired from medicine and home with your kids. I bet you are still living in 1995 aren’t you. and bored out of your mind. Aw that was the year just before cytotec was “discovered” when VBACs were at their peak. Yeah you are really up to date on what is actually going on inside hospitals in 2010 aren’t you? But gotta defend the rude doctor even if you don’t know his or her name.

    • SO not in the mood for you and your kind of OB. My friend at work ended up with a c-section for a 7 lb 11 oz baby last week after a measly 8 hours of labor and no indication of fetal distress (right before dinnertime of course) There was nothing freaking wrong with her pelvis but now she thinks that she couldn’t have that baby vaginally because that’s what the all-knowing OB said. Maybe if they hadn’t augmented her labor (which hadn’t started yet really and her water was only broken for a few hours) and strapped her to a monitor and a bed- you know, all of those things that are NOT EVIDENCE BASED she might have left the hospital without major surgery.

      Yep, modern obstetrics is JUST GREAT!

    • Thank you Doctor Amy for being a walking talking billboard-sized example of why this site is needed.

      Some things that are very clear from your actions:

      *You do not care about women’s health and safety as much as you care about being “right” and being acknowledged and revered as an expert. If you cared about women’s health and safety, you would not be so quick to drive them further away from the medical care (which you maintain they so desperately need) with your vitriolic rhetoric and hostile attitude.

      *You view anyone with a differing viewpoint to your own as an inferior being, and elevate every thought in your mind as superior to even published medical journals.

      *You seem incapable of expressing yourself with even a modicum of respect, empathy, compassion or other human qualities that women seek in those who care for them during the emotionally vulnerable time of pregnancy and childbirth.

      Doctor Amy, you are a prime example of why women seek out midwives, and choose to birth in birthing centers and at home. We cannot trust that hospital-based care will treat us as human beings worthy of respect and dignity. We cannot trust that reasonable evidence-based requests for our care will be honored. We cannot expect that our questions will be answered thoughtfully and with accurate info instead of dismissed with rudeness and condescension. If you truly want women to choose to birth in the hospital (as you maintain is the only safe choice) STOP treating them like something you would scrape off your shoe, and STOP dismissing peer reviewed, evidence-based best practices as wacky fringe ideas.

      I realize this appeal will be met with your trademark sarcasm and rudeness, but I feel better having gotten it off my chest. Thank you.

      • No, Kat, this site is a prime example of why no one takes homebirth advocates seriously. Homebirth advocates literally have no idea what they are talking about.

        I notice that you didn’t bother to address any of my factually claims. That’s not surprising since my factual claims are correct. You are more interested in your feelings, and your feelings are hurt that someone pointed out that the ridicule poured out on this site says more about homebirth advocates than it says about obstetricians.

        I’m sorry that homebirth advocates feel hurt when it is pointed out to them that they are wrong. If you are wrong, then you need to learn the truth. This is, after all, a matter of life and death. When homebirth advocates have no idea what they are talking about, their babies can die and that is precisely what has been happening.

        • Yes, I know this is old, but I just have to respond to this statement.

          No, Dr. Amy, you’re the one who has failed to address factual claims.

          You continually expound on these subjects with no links to studies, or even articles. You expect your credentials to make everyone bow down to you as the expert and take your word as The Truth.

          In other words, you ARE a prime example of why this site was established, AND why more and more women are choosing homebirth.

          • I also know this is old, but I would like to throw out there that Dr. Amy is my inspiration for going into obstetrics and gynecology. No woman deserves to suffer at the hands of doctors like Dr. Amy. She’s nothing more than a fear-mongering, self righteous, misogynist ape who repeatedly and violently breaks her Hippocratic oath. Oops, forgot, I don’t agree with her so I can’t possibly right. Too bad my great-grandfather helped start modern obstetrics and gynecology. Oops.

          • I also know this is old, but I would like to throw out there that Dr. Amy is my inspiration for going into obstetrics and gynecology. No woman deserves to suffer at the hands of doctors like Dr. Amy. She’s nothing more than a fear-mongering, self righteous, misogynist ape who repeatedly and violently breaks her Hippocratic oath. Oops, forgot, I don’t agree with her so I can’t possibly right. Too bad my great-grandfather helped start modern obstetrics and gynecology. Oopsie.

    • We really need to post a sign at this site similar to the ones at zoos: DO NOT FEED THE TROLLS!

      http://www.mayoclinic.com/health/narcissistic-personality-disorder/DS00652/DSECTION=symptoms

    • Can you explain the reasons why women died? Not just because “birth is dangerous,” but because physicians refused to follow proper handwashing techniques, even though they knew well enough to do so? Completely releasing the physician of all “guilt” in his role for the death of mother, baby or both?

      I still support home birth – even though my own grandmother was a “casualty” of it, so to speak. She died of a massive infection, no doubt because of the unclean habits of her DOCTOR. He was known for not washing his hands before giving vaccinations, etc. and yet, in 1925, I doubt she had much choice other than to have him deliver her babies at home. Surely you know that many, many physicians contributed to childbed fever because they would routinely examine a patient who had just died and then move on to a living one, all the while spreading contagious disease. You wouldn’t eat a steak dinner with those dirty hands, would you? So why examine a patient with them? Doctors and nurses knew about infection control and proper handwashing as early as the turn of the century, and many of them refused to comply because of their arrogance. Think of the lives that could have saved – I’m curious if these deaths, which could have been completely prevented, are contributing to the figures that make you think “birth is dangerous.”

      And I am sick to death of your blanket statements that “homebirth advocates” have no idea of blah blah blah…As if every single one of them believes that c-sections should never be performed for any reason, etc. etc. If they do, I’ve never met one of them that is that vehement about it. Where are these women, foaming at the mouth insisting that every woman should give birth at home? I take it you haven’t been reading this site for very long – sure, our comments get ‘off color,’ for lack of a better word, but when you’ve had nonsense and BS poured in both ears over the course of multiple pregnancies, you started to get a little jaded over the whole obstetric system. Your attitude certainly doesn’t help. I’ll ask it again – if you don’t support home birth, what are you doing to make a hospital birth more hospitable? You yourself admitted on your blog that inductions raise the risk of c-section, and when women are either coerced or heavily influenced to be induced, what choice to they feel they really have? At one point in a pregnancy did this cease to be “my body, my choice”? At 16 weeks, when most abortions are considered illegal? Why do I have fewer rights if I decide to keep my baby than if I wanted to terminate?

      (I know … you won’t answer so why do I bother?)

      • “Not just because “birth is dangerous,” but because physicians refused to follow proper handwashing techniques, even though they knew well enough to do so?”

        No that’s not true, either. Really, you cannot believe what you read in the NCB literature since most of it is made up.

        The leading causes of death include hemorrhage, eclampsia, obstructed labor, prematurity, etc. None of them is affected by handwashing.

        The great innovations in public health (clean water, antisepsis) occurred in the late 19th century, but the neonatal and maternal mortality rates did not drop appreciably at that point since the primary causes were not infectious.

        Neonatal and maternal mortality began to drop precipitously in response to more and safer C-sections, safer anesthesia, blood banking, antibiotics, etc.

        Please, please, please read the scientific literature. I am trying to explain to you that no one takes homebirth advocates seriously because most of what they think they “know” is factually false. They’re like creationists; most of what they think they “know” is also factually false, and they can’t figure out why no one takes them seriously, either.

        • Go back a minute. You are saying that maternal mortality rate is 1%?! One out a hundred women die due to pregnancy related causes?! I guess its a great thing most women birth in hospitals if one out of a hundered of them die. Good thing the safe hospitals are there to save 99% of them.

          I think you’re pulling statistics out of your ass.

          • “Go back a minute. You are saying that maternal mortality rate is 1%?!”

            No, I said that the maternal mortality rate in nature, in the absence of modern obstetrics, is 1%. Without modern obstetrics we would expect that more than 40,000 American women would die in childbirth each year, making it a bigger killer than breast cancer.

            Childbirth seems so safe to you BECAUSE of modern obstetrics, not because it is safe in nature.

          • Actually the statistics you are referring to are about the general population, and do not differentiate between those who NEED help and those who do not. An increased rate of M/F mortality due to natural/homebirth is associated ONLY with those women/babies who are NOT “healthy” to begin with. Modern obstetrics HAS helped them. It has been a HUGE help. Hell, I would be dead without it. But then again, I am a type 1 diabetic with graves disease and a heart condition.

            But women who are healthy and birth naturally have a very low risk of death or injury. Less than 0.5% in fact. It is MORE risky for those women to birth in a hospital. I am not just talking death, but also injury (I know, you call them “episiotomy” and “tear” and “c-section” and “nosocomial infection”; We call them injury).

            The main influencing factor on then increased safety in child birth across the board is nutrition and GENERAL health care. Not obstetrics of its own, but GENERAL HEALTH CARE. Having access to medicine when it is needed.

            Birth is not a pathological process. We are designed to do it. It is not dangerous for a healthy woman to birth at home, with a midwife, with little to no intervention.

            It IS dangerous to impose blanket interventions and regulations on a very personal process, and it IS dangerous to birth ALONE when there is a risk that something MAY go wrong. I know there is always a risk, but for this purpose, I am sticking to the “unwell” people. Breaking it down further will just make too long a post.

            For the love of God, if you really are an MD and not just a poser, please PLEASE de-register yourself and go back to uni, because you are seriously misinformed and ignorant, and ignorance when you are in charge of another person’s life is a DANGEROUS thing.

            Would you like to know where I got my statistics? I just did a 420 page long critical review on all the literature I could find for it. ALL I could find.

            And I defy you to challenge me on this. I am particularly offended by your creationist remark.

        • Lady, you totally just shot yourself down. You misread The Deranged Housewife’s statement and twisted it to your own advantage. She was giving you known, historical facts about why mohters died in the early 1900′s because of doctors not washing their hands. She even gave an example of her own grandmother being a victim of that. You swooped in, applied what she said to present day “statistics” and then bashed her on the head for being ignorant and believing lies that NCB pamphlets give out. After that, you totally contradicted well known fact by saying that handwashing had nothing to do w/maternal death in the early 1900′s. If you don’t even know history that is taught in High School and general college science classes, then I don’t believe you know what you’re talking about in general.

          And where statistics are concerned, they’re all trash. I don’t care what study or college or group states them, they’re all trash. Yes, they can give us general ideas of how things are trending, but putting our faith in “cold, hard, statistics” is be ignorant. Fact is, studies and experiments are affected by so many things that you can’t look at one area and conclusively state something from it. So many things can skew results of studies and experiments that no statistic can be 100% infallible.

          What you are seeing on this website are women who have suffered at the hands of OB’s, medwives, nurses, and other fallible human beings who don’t understand they are not God. The women here are not advocating homebirth because they hate medicine and modern science. They are advocating that women know their rights, know what can happen in childbirth, and to take that information and make a decistion that is best for them and their family. The women on this site are telling about things that actually happened to them or their sister, or friend, not something they read in a pamphlet. They were personally, physically, emotionally scarred by what was said and done to them. By belittling that, you are belittling the woman that was sharing the story. That is what makes you come across as unfeeling, uncaring, uncompassionate, and the type of OB to flee from. Yes, emotions count….and I know that hormones affect how the women responds, but that still doesn’t mean you can demean the woman for what she is feeling. I think you need to take a step back and go read some birth stories. The Unnecessarean website has many birth stories that go into detail about how they were treated. Read some of those that tell how they were held down, cut, given IV’s and pitocin and other things against their will and against their direct consent. This is what this site is against….the inhumane treatment of mothers in labor. Dogs get better treatment and more advocacy than laboring mothers do!

          • Actually, Amy, the handwashing statistics have nothing to do with natural childbirth advocates. And recently I read another stat – again, not relating to NCB *at all* – that said a high percentage of doctors – maybe 80 percent? – revealed they do not practice proper handwashing techniques. I sure hope this isn’t the case during my next c-section…

            I lifted this text from Wikipedia, who gets their from outside sources such as your treasured medical journals and other articles:
            “Puerperal fever or childbed fever in the 18th and 19th centuries affected, on average, 6 to 9 women in every 1000 deliveries, killing 2 to 3 of them with peritonitis or septicemia. It was the single most common cause of maternal mortality, accounting for about half of all deaths related to childbirth, and was second only to tuberculosis in killing women of childbearing age.”

            Further down in the article, it states that hospital overcrowding, improper handwashing and the doctor going from one delivery to the next accounted for the rapid spread of infection. And there’s the admission of one physician who was horrified to realize that he himself had been the one agent most responsible for the spread of disease from mother and child to another mother and child.

            My grandmother died of peritonitis, BTW.

            You can criticize Wikipedia all you want, but the information is corroborated by other outside sources, if you take the time to look it up. I simply used it as a comprehensive “go to” guide for quick reference.

        • I’ve bitten my tongue all I can. I’ve read this far down in the post, and as my baby is getting bored I can’t read down any further. First, I want to say that if the education you received prior to medical school did not teach you proper grammar (“factually claims”)you should demand a refund. Secondly, these women are checking the sources YOU are providing and are finding them to prove you wrong. Maybe you should check the sources again before posting them. I’m not going to argue whether hospital or homebirth is safer, because I haven’t had both experiences yet and you obviously don’t want to hear the facts, but I will state that in a situation with a low risk birth where my child is turned the correct way and in the proper position, I know I would get more rest and respect in my own home than in a hosptial and most likely have a less stressful, more pleasant way to welcome my child into the world. In addition, I would get to labor and deliver in any position my body wanted to, rather than being ordered to stay laying on my back which has been proven (both in hosptials when it’s allowed and in homebirth situations) to speed labor and get babies into the proper position faster. So, without arguing the safety, a homebirth sounds like a much better option especially since stress during pregnancy and delivery can harm the mother and the baby.

    • Citations, please?

    • Childbirth is dangerous SOMETIMES, sure. There are complications that exist that do require interventions.

      Childbirth becomes MORE dangerous when there is interference when it is NOT necessary. That is why the U.S.A. has such an abysmal child and maternal mortality rate. There is a very tentative balance between the necessity of intervention and excessive intervention, because a lack or an excess of intervention will BOTH increase IMR/MMR.

    • If childbirth really is THAT dangerous, it’s a wonder any woman has survived to take care of the babies she’s birthed.

      Obstetrics is good, when it’s needed. The problem comes in when doctors want to c-section a baby that “might” be “too big” or induce because the woman is only a week “late.” Or because she’s been dilated to 2cm TWO WHOLE DAYS and nothing is happening. Situations like these are where obstetrics only contributes to the danger.

    • This comment has absolutely nothing to do with Home vs. Hospital birthing. Because an OB said it to a mother DURING labor I assume that she was already in the hospital. The point of this quote is that it is not something that should be told to a mother who is IN labor and has already made her choice on her place of birth.

    • Oh, I wish I could have been here for this roast! Unfortunately, I was otherwise occupied. I was resting in bed, enjoying my newborn baby, my fourth. Ten pounds, five ounces, thirty hours of active labour, some of which was spent in the bathtub, some of it draped over my oldest daughter’s Rody horse, five minutes or so of pushing once my midwives convinced me that I was probably a lot closer to actually *pushing* than I thought if I’d try squatting instead of staying on all fours; nuchal cord and hand, placenta about as large as the baby. No tears. High APGARs. HBAC. (In other words, “neener, neener, neener.” Yes, I’m feeling quite mature today, thank you.)

      Anyway.

      Your view of birth would make perfect sense if I lived in a village in the Sudan. But I don’t. I’m American, and despite my not exactly being high income (I technically qualify for Medicaid), I enjoy far better living conditions than the average woman in the third world. Hygiene and good nutrition make a huge difference. For instance, I don’t have ricketts, so my pelvis is not deformed. I’m not starved and dehydrated on a regular basis, so my tissues are elastic and healthy and I don’t risk fourth degree tears in my perineum. My midwife washes her hands, as did I when I did peri care after birth, so childbed fever was unlikely, but were I to contract it, I have ready access to antibiotics.

      Most of the things we are told justify considering birth inherently dangerous, death-defying even, do not even apply in developed countries. We also have much faster access to emergency care than people do in poorer countries – we can get to a well-equipped, relatively sanitary, efficient hospital in a matter of minutes, as opposed to hours.

      Other things widely advertised as risks of birth, and justifications for a ludicrously high rate of vaginal bypass operations (i.e. c-sections), such as foetal distress being indicated by the monitor (the monitor that Dr Hon himself said was never meant to be used routinely), failure to progress (in a way conforming to the Friedman scale, which was never meant to be prescriptive in the first place), cephalopelvic disproportion (which is easy to predict when a mother is on her back, narrowing her pelvic opening), etc are iatrogenic. However, I’m not sure there’s much point in belabouring the issues here, because you are reputed to not believe that anything is ever iatrogenic.

    • A final belated after-thought to the doctor Amy debate, which I am posting on this thread because it appears higher on the page:

      Even assuming, that childbirth *IS* definitely and in all cases one of the most dangerous things a woman can do today, isn’t that beside the point? Can Dr. Amy or anyone else provide us with ANY REASON why it would be good practice to state this, even if it is fact, to a mother in the midst of labor? Any reason at all why that would be prudent or wise to say that to a birthing mother? I would think that would only frighten her and stall her labor, causing it to be more dangerous, correct? And after all, the mother in this story is doing THE RIGHT THING by birthing in a hospital, under the care of an OB and near an OR, so she has thus accepted that is that safest move, at least for herself. So, again, why state that she is in mortal danger as she copes with labor? What will that accomplish, since she is already birthing in the SAFE place?

      You would think, even an OB who generally agreed with the factual correctness, would be appalled at saying that to a birthing woman. How would it help to tell that women that she is doing one of the most dangerous things she could be doing? That doesn’t seem like a standard of care OB’s should be rallying behind.

    • A final belated after-thought to the doctor Amy debate, which I am posting on this thread because it appears higher on the page:

      Even assuming, that childbirth *IS* definitely and in all cases one of the most dangerous things a woman can do today, isn’t that beside the point? Can Dr. Amy or anyone else provide us with ANY REASON why it would be good practice to state this, even if it is fact, to a mother in the midst of labor? Any reason at all why that would be prudent or wise to say that to a birthing mother? I would think that would only frighten her and stall her labor, causing it to be more dangerous, correct? And after all, the mother in this story is doing THE RIGHT THING by birthing in a hospital, under the care of an OB and near an OR, so she has thus accepted that is that safest move, at least for herself. So, again, why state that she is in mortal danger as she copes with labor? What will that accomplish, since she is already birthing in the SAFE place?

      You would think, even an OB who generally agreed with the factual correctness, would be appalled at saying that to a birthing woman. How would it help to tell that women that she is doing one of the most dangerous things she could be doing? That doesn’t seem like a standard of care OB’s should be rallying behind.

    • The leading cause of maternal mortality is actually homicide by an intimate partner and unfortunately obstetrics and surgery are not interested and unable to assist in this. Thank you for saving us, by the way. you are doing a great job!!!

  21. Actually, sweetie, the leading causes of death in women are heart disease, cancer, stroke, respiratory diseases, alzheimer’s, injuries, diabetes, pneumonia, kidney disease, and septicemia. Childbirth is not on the list.
    For babies ages 0-1, the top three are developmental and genetic conditions present at birth, SIDS, and conditions associated with prematurity and low birth weight (which, by the way, docs often cause by needlessly jumping the gun or counting weeks wrong). Still no childbirth.
    But nice try.

    • This was supposed to be a response to”Dr.” Amy’s comment.

    • “Actually, sweetie, the leading causes of death in women are heart disease, cancer, stroke, respiratory diseases, alzheimer’s, injuries, diabetes, pneumonia, kidney disease, and septicemia. Childbirth is not on the list.”

      Actually, sweetie, I said “young women.” You just recited the causes of death for ALL women. Go back and find the appropriate data and then get back to us.

      • From here: http://mchb.hrsa.gov/whusa08/hstat/mh/pages/237mm.html
        The maternal mortality rate in 2005 (15.1 per 100,000 live births) was 84 percent higher than the rate reported in 1990 (8.2 per 100,000).

        Now that’s interesting. One would think that the maternal mortality rate would fall, what with all the modern obstetrics we have and all the interventions women are receiving. After all, cesarean section is more readily available to American women than ever before. And yet we’re finding the opposite.

        But here, the CDC website
        http://wonder.cdc.gov/controller/datarequest/D43

        allows you to request death rates for any category and age range you desire. This is the Wide-Ranging OnLine Data for Epidemiologic Research

        Maternal mortality in the female/25-34 age range turns up as 1.2 deaths per 100,000. Accidents and other external problems show up as 35 per 100,000. That’s 20 times higher, no? Cancer (I think it’s cancer based on the category) is 2.0 per 100,000. Which is also higher than 1.2

        Diseases of the circulator system come in as 7.5 per 100,000.

        So don’t argue with a bunch of homebirthing lunatics. Take your arguments to the CDC because apparently the CDC is also a bunch of homebirthing lunatics, and either they’re falsifying their data, or else your data is wrong.

        • Jane, I mean this in the most platonic way ever, but I love you. Thank you for providing the links, you’ve helped me make up my mind, I’m having home births with all my children.

        • “One would think that the maternal mortality rate would fall, what with all the modern obstetrics we have and all the interventions women are receiving.”

          Wrong again, Jane. Wow, you’re batting 1000.

          If “one” did not know that birth certificates had been revised two separate time during those years specifically to make sure that maternal mortality was appropriately categorized, “one” might come to that erroneous conclusion. But of course, anyone who was familiar with birth certificates would already know that the supposed “increase” in maternal mortality is nothing of the kind.

          • Dr. Amy, I believe that the CDC death rates are based on death certificates NOT birth certificates. Even if they did make a change to birth certificates during the time frame it would NOT matter when you look at death rates. Now if you look at birth certificates for birth complication rates. Then it would show up. It might show up in the infant numbers, but not in the adult female numbers.
            I have to wonder what emotional issues you have to work out through this “web therapy” session.

          • It was the US Standard Death Certificate that was revised twice.

          • now that you have corrected yourself perhaps you can provide access to a link that explains how to correctly adjust for the changes in the DEATH cerificate reports. We would all like to see it. I maintain my opinion that hospital birth has become increasingly risky since the introduction of cytotec and the drop in available VBAC options. I’m very sorry to hear that the numbers to prove that have apparently been blurred by administrative BS.

          • ” I maintain my opinion that hospital birth has become increasingly risky since the introduction of cytotec and the drop in available VBAC options.”

            Really? How do you explain the fact that maternal mortality has dropped for the last 2 years in a row?

          • You are talking 2 years, which was probably 2006-2008 and I’m talking since 1980? Take a longer view and see what it says. Beside aren’t you home with your kids?

          • You know death isn’t the only risk. In addition to death (which doctors seem to see around every corner) and brain damage. There is also risk of unnecessary major abdominal surgery and unnecessary episiotomy and the risk of being spoken to like a piece of shit while doing the hardest work of your life. I understnd you had at least one natural birth and didn’t get the emotional high off of it that you were told to expect. I didn’t. I got an unnecessary c-section due to failure to wait. Then my Vbac turned into a necessary cesearan when 2nd baby was transverse. Then I got a third baby into the world by c-section after a prolonged dysfunctional labor which was caused by an open window in my uterine scar. At no time during my third birth was I given pitocin, cytotec or pain meds. Because that was the correct way to proceed in 1999. Now we have doctors inducing VBAC with cytotec. Thank God my doctor was of a vintage that knew better. I would be dead of a rupture uterus if some fool who thought he knew how to “manage” a VBAC but was really just using it as a marketing tool had gotten his hands on me. Don’t lie to me, Don’t talk down to me. I am your equal. And you are my employee. Remember that!
            So anyway going back to my statement that birth has become increasling risky. The VBAC rate has dropped. The c-section rate continues to climb. and the of few doctors who do still claim to do VBAC many either lie and change their minds at the last minute or have thrown the rule book for safe management out the window.
            BTW I found the correction factor for the change in the way maternal death is reported. it was in one of your links. The one about Ammesty Internation and hand wringing. It seems to be 5 out of 6.2 with the other 1.2 being an actual increase. I really want to know want that 1.2 is atributable to. My gut says ruptures of VBAC due to induction and augmentation of labor and perfectly healthy elective repete c-sections dieing on the table because of the inherent risks of surgery. So is it safer to stay home with a 5% chance of transfer or to walk into a hospital where 2/3 of all c-sections peformed are unnecessary?

          • Methinks Doctor Amy puts the same scare quotes around Michel Odent’s and Marsden Wagner’s medical titles as we like to put around hers. ;)

            World Health Organization? Nah, who needs the recommendations of an international group? It’s just a nanny state thing trying to tie the hands of independent doctors, anyway. Pithiviers? Bunch of dirty, flower-haired hippies. Oh, wait, that’s Ina May Gaskin’s commune.

            Evidence-based medicine? Consumer-group nonsense. We ought to go back to the good old days when patients did as they were told, trusted their betters, and kept quiet.

          • “We ought to go back to the good old days when patients did as they were told, trusted their betters, and kept quiet.”

            LOL! You just know that some of them RESENT
            that they can no longer write their
            prescriptions in Latin….

          • I can READ Latin. Also a tiny bit of Attic Greek, and old French. (Okay. Not just tiny. Miniscule.) Latin scrips? Bring them on.

            I also like to read the PDR and the Merck manual when I have nothing else to do.

      • If you believe you have better data, since you jumped in with the assertion it is on you to provide the links.

        BTW Your exact quote is:
        “As a matter of fact childbirth IS one of the most dangerous things a woman can do. ”
        You DO NOT specify young women.

        • Technically speaking if what she said was can do I bet we can come up with lots of this women CAN do that are more risky that they just don’t choose to do like bungy jumping, or going over Niagra Falls. There is such a thing as a risk worth taking. The question these days is it is worth it to risk going to a hospital with a known c-section rate of say 47% or is it safer to stay home with a professionally train midwife and only transfer to the hospital if truly necessary.

  22. This was mine; it happened to a friend of mine earlier this year. Interestingly enough, this was the same OB who’d attempted to fearmonger me out of my planned home VBAC…sigh. He’s a real piece of work. :(
    She was doing Hypnobabies, and was in the middle of a surge when he spouted out this gem. GRRR! I was appalled when she told me! Thankfully it was shift change, and the nicest OB in midwife’s clothing ended up coming in! She was extremely kind, supportive, and encouraging of my friends’ wishes, even down to not having an IV and pushing in whatever position she felt like. LOL at one point she was on her side and the dr remarked “Feel free to put your foot on my shoulder if you need to!” She was a doll. Whew! But yeah this guy….he makes it a habit to demean and hurt pregnant women. It’s so awful.

    **LOL that Dr Amy posted here. I just knew she was lurking. :D Gotta love her pseudo facts on NCB.

    • The doctor was probably unnerved by a mom who didn’t need him and wanted to break her concentration. That wasn’t thoughtless: that was timed in order to make the mom afraid when she wasn’t.

    • I’m heartened to hear that she had a supportive person with her for the rest of her labor.

      I think that someone in these comments has missed the point of these quotes and posts – even if this particular mother was doing the most dangerous thing she’s ever done you don’t tell her that when she’s doing it. What is she gonna do “Oh it’s dangerous? I guess I’ll just go home and not have the baby then. Thanks for the warning 9 months too late.”

      Any medical professional should know that no matter what the patient is doing it’s by far better if they’re positive and not stressed out. OB’s who say stuff like this are not doing their job – which is to have two healthy, unstressed, patients at the end of the day.

    • Just out of curiosity, was this the “hippo birthing” dude?

  23. Wow Amy condescending much?! I do understand statistics and yes modern obstetrics has helped some of the few women who would have died during childbirth in the past. BUT!!!! Most women *can* deliver their own baby without augmentation from doctors. There are a *small* few who have difficulties but most are fine and will not have an issue.

    It is when doctors like you interfere in every little aspect, a little pictocin here, episiotomy there and it becomes a dangerous activity.

    Do not patronise women for wanting to have a natural delivery. It is rude.

    • There IS a place for obstetics. It has helped many women who truly need it. That place is usually not in the average childbirth. There is a time and place for all medicine. It’s great, it’s there when we need it. But it needs to be used in moderation.

      I don’t see how a natural delivery could be dangerous for EVERYONE whether they plan it in a hospital or at home with an experienced professional midwife.

  24. “There are a *small* few”

    No, the numbers aren’t “small.” That’s what I’m telling you. The numbers are large.

    Don’t believe what you read in the homebirth literature. That’s all made up. Read the read scientific literature and you will find out the truth.

    • So what do you think about the studies that show similar outcomes with less intervention in birth centers and planned home birth? You can’t deny their existence.

      • “So what do you think about the studies that show similar outcomes with less intervention in birth centers and planned home birth?”

        What does that have to do with what we are discussing?

        • “So what do you think about the studies that show similar outcomes with less intervention in birth centers and planned home birth?”What does that have to do with what we are discussing?

          The studies that show similar outcomes with less intervention in birth centers and planned home birth are scientific literature. You told us to read it.

    • So, what about Europe where most of the countries are homebirth and midwife friendly? And still, according to the WHO have a lower infant and mother mortality AND morbidity rate? Should we not believe their studies and literature also?

    • Or read the mortality data from the CDC website I cited above. Unless the CDC has begun printing homebirth literature, they’re probably reliable.

      324 deaths for women aged 25-34 in 2006 from a population of 19.8 million women.

      (By comparison, 1394 deaths for the same group, same year, due to problems of the circulatory system.)

      CDC baby!

      (Check it yourselves! http://wonder.cdc.gov/ )

      • I don’t know why this is so hard for you, Jane. I said “a” leading cause, not “the” leading cause. See the difference?

        • Hiya Toots, too bad you can’t ban the opposition here. I was wondering when you’d show up and try to drive more traffic your way.

          Don’t let a few facts get in your way. You are the professional troll after all.

        • Actually, sweetie, I said “young women.” You just recited the causes of death for ALL women. Go back and find the appropriate data and then get back to us.

          Here ya go Sweetie, she found the data and you then go and misquote yourself.

    • Wow, so-called-Dr. Amy… Can’t believe an “actual” physician has the kind of time to sit around arguing on “bogus” websites all day. Especially with a bunch of unintelligent lunatics that will never change their minds despite the “facts” shoved down their throats. I mean, I am just a stay at home mom and I don’t even have the time to READ all of your posts, let alone type them.

      You must just be a very sad, argumentative person. I always feel bad for people who feel the need to defend their personal feelings to the death. They must feel so threatened by people who are not like them. They must feel so horrible about themselves that the only way they can feel better is by trying to demean or “defeat” someone else. I am glad there are SO MANY people here for you to fight against. Hopefully they will be good therapy for you.

      But wait, don’t get your panties in a wad! I am not a homebirthing wacko. I have chosen to give birth twice in a hospital. Though one of those was a VBAC, whew, really dodged a bullet with that one, huh? Can’t believe my baby and I came out alive.

      My first baby was a c-section for a very important reason- massive placental abruption. I am thankful for the OB that sliced me open a withdrew my precious, albeit BLUE, child and handed him off to the waiting NICU team? I think it goes without saying. Do I hate doctors or hospitals, um no. My child and I would both most likely be dead if I had lived without access to either.

      Yes, there are some dangers that are associated only with childbearing, but the vast majority of women still choose to have children. The children are worth the possible risk. The risk of my life and my child’s life was NOT associated with child BIRTH, but with PREGNANCY- which despite medical science is still the only way to bring children into this world. Are you going to argue no one ever become pregnant again? No, because bye-bye 90% of OBs… Not to mention the rest of the species. Are you going to argue everyone should have a c-section? I hope not, since you surely can’t skew the data to show that a c-section is safer than an uncomplicated vaginal delivery. We all KNOW you aren’t going to argue for vaginal delivery, since it is the most dangerous thing a woman can do today. What is your recommendation, Dr. Amy?

      Because there are hundreds of women waiting here for you to argue it with.

      • “Wow, so-called-Dr. Amy… Can’t believe an “actual” physician has the kind of time to sit around arguing on “bogus” websites all day.”

        This is what absolutely floors me. My God, if I were an out-of-work Harvard-educated medical specialist with time and money on my hands….just think of the good that could be done in the world. I could join Medicins San Frontiers to combat HIV/AIDS in Uganda. I could dedicate my life to repairing obstetric fistulas or provide other specialized care for women in need. Or I could just sit on my arse and work on a blog that lambasts women for their birthing choices. Tough choices…

  25. Keep going Dr Amy! These people are stuuuupid! ! The thing that always kills me is when they give birth at home and something goes wrong (becuase it has again and again) they rush themselves and hopefully a live baby to the hopsital and hand themselves over to the awful doctors expecting them to fix them and their stupid decision right quick. I wonder how unnecessary the Dr’s procedures are then. This site should be called : my stupid midwife said what?!”
    My favorite is:
    “before modern obstetrics” ***100%*** of women died in childbirth? And the neonatal mortality rate now stands at 7%, and has been reduced by 90%…which means that “before modern obstetrics” 97% of babies died as the result of being born?

    That just kills me! LOL LOL LOL

    • LOL LOL LOL

      “…it happens again and again?”

      Thank you for your scientifically-based contribution.

      Lots of things happen “again and again.” Is that a number like 1%? 10%? 60%? 99%?

      And it’s all in the eye of the beholder, isn’t it? The vast majority of homebirthers I know are completely open to going to the hospital if necessary. How is that “fixing” some “stupid” decision, when it was part of the birth plan from the beginning? By that logic, women who plan to go to the hospital and give birth vaginally are like, totally stupid and being hypocritical when they “go running” to the OR instead for emergent C/S.

      • Who needs logic when they have you smart people right!?
        “By that logic, women who plan to go to the hospital and give birth vaginally are like, totally stupid and being hypocritical when they “go running” to the OR instead for emergent C/S.”
        That doesn’t even make sense, but I will explain it further for you. I am pregnant with my second child. I had the best experience ever at the hospital with my first.
        (see here)
        http://www.cafemom.com/group/pregnancy/forums/read/11881898/Shhh_Dont_Tell_Anyone_My_Birth_Story?next=141

        I was definitely low risk and could have by your crazy theories given birth at home safely. However, how is low risk possible? Can you guarantee me that my body will never have a heart attack, never have a random blood clot, or like my sister have a brain hemmorage out of nowhere? You can’t! You are not God. So therefore it seems fishy to me when you preach against how horrible doctors are and then depend on them to save you and your baby when you have complications at home. Are you saying there has never been preventable deaths of woman and children attempting birth at home! I can list story after story. It just takes one for me to learn. HOw many does it take for you?
        Let’s not forget the true statistics where it is proven that hospital births are more safe! Did you really need a study to prove that though? It just takes a little common sense and the acknoweldgement that you are being decieved by insecure women who must not of passed the MCAT.

        • What in the world…?

          My mother is an MD. She fully supports my decision to homebirth. Please show me where I have “preached against” evil doctors. I greatly respect MDs and am a fan of big chunks of “modern medicine.”

          Also, please show me where I claimed anything in life is guaranteed? In fact, I EXPRESSLY stated that NOTHING in life is guaranteed. You can see that in my comments upthread. My position could not possibly be clearer.

          The problem here is not that I am giving anyone guarantees or pretending to be God. The problem is that many doctors and medical professionals tend in that direction, especially in obstetrics, which (as it currently stands in the US) is one of the least-evidence based medical practices out there. NOTE: I did not say that it is NOT evidence-based AT ALL! Just that it (for a variety of reasons, some of which are understandable) is one of the least, as compared to other specialties.

          The problem here is that one of the two main choices for low-risk women– homebirth with a qualified professional– is demonstrably less risky. It is NOT WITHOUT RISK.

          However, it is not a good solution to make the other common choice (typical interventive hospital birth) in order to somehow erase the risk of the first. There are risks in a hospital too! Many (though not nearly all) of which are not present or rare in a homebirth!

          This is like saying that it’s safer to drive from NY to LA than to take an airplane, because people have died in plane crashes. Well, of course they have, but your risk of being injured or dying when driving for 42 hours is a lot higher than your risk when flying for 5. The fact that people can and do die in plane crashes does not make driving safer or without risk (in this case, a substantially higher risk).

          But hey, you can say “It just takes one plane crash for me to learn! How many plane crashes does it take for you to swear off plane travel, duhhhhhhh?!!?!?!?!?!” That might make sense if no one died or was seriously injured in car crashes, and at the same or higher rates. Look, if we all avoided situations that could possibly lead to death or injury, we’d literally never do anything, as the alternatives to activities that involve any risk whatsoever are always OTHER activities that involve some risk.

          But guess what! That doesn’t mean that some aren’t MORE risky than others!

          Please, please point me to the studies that show that homebirth for low-risk women with a qualified provider (heck, in “Western” nations) has a higher rate of mortality and morbidity than hospital birth.

          My goodness. I’m attacked for saying “anything can happen at any time, in any situation,” and then I’m attacked for supposedly, at the same time, believing that being in a certain situation guarantees a specific outcome. There’s your logic.

        • Klee, if you’re worried about random heart attacks, blood clots and brain hemorrhages, I suggest you just rent a room at the hospital and never, ever leave. Then your problem will be solved and the rest of us can go on living our lives.

          • yeah, no kidding. what a hypocrite, only going to the hospital when something IS wrong, instead of sitting there in advance waiting for something to go wrong.

            by this logic, we should all only drive cars in the emergency room parking lot. if we know that car crashes do happen, even if the majority of the time they don’t, then it’s stupid and irresponsible to drive anywhere that isn’t within a block of an emergency room, right?

          • Not surprising that you missed the entire point. Even more scary that you are responsible for little ones.

          • We are kinda thinking the same thing about you KLEE.
            Perhaps you and Dr. Amy need to go back to the OP topic and re-read about the Dr. in the hospital harrasing his patient while she was trying to concentrate. He was being RUDE. She wasn’t being stupid. He was being rude. Almost every mom on here had her first baby at a hospital and was mistreated. Think about that one for a while. Many of us continued to have our babies at the hospital, but very carefully screened our doctors for certain personally traits so that we would be treated with respect and dignity. Ever heard of it??? Dr. Amy clearly hasn’t.

          • I just wanted to come back to this point as long as I’m here. Many of the mom’s who post on this site had their first baby in the hospital and WERE MISTREATED. Therefore Dr.’s of the ilk of the OP’s doctor and Dr. Amy are actually driving patients out of the hospital and according to her into more dangerous situations. Perhaps the first and most important thing that needs to improve is the doctor’s bedside manner. Whine all you want about how we crunchy mama’s want the experience AFTER you think about how the doctor can make or break even an emergency delivery with excellent vs. poor bedside manner and just plain out and out rudeness!

          • Anybody else think Dr Amy either made up Klee to create artificial dialogue, or dredged her up from somewhere and told her to go post on MOBSW because those awful birth activists were beating up on her and she needed some nice melodramatic “I was almost a statistic were it not for modern medicine” testimonials to make her look better?

          • How was that appropriate or necessary? This poster disagrees with your logic, and you decide to attack her ability to care for her children? That really does nothing to advance your point.

          • No, you are right. I said I would rise above this anti-Dr. nonsense and here I am just as ridiculous as the rest of you. I had the most amazing experience ever at the hospital. Maybe it comes down to attitude and not wanting to micromanage every part of life. I was informed, educated, and in love with my epidural. I guess I am insane for loving my OB and hospital experience. Good luck Debbie Downers.

          • KLee – I think you are misunderstanding what I’ve said, and assuming quite a few facts not in evidence. Where have I EVER said that home birth is the only way to go, that OB’s and hospitals or epidurals are evil? If you were informed and educated and made decisions based on that, then kudos to you. I also had a hospital birth, both times. One a C-Section for a squatting breech baby, and the second and unmedicated VBAC. I don’t judge women for having babies at home, OR at the hospital, medicated or unmedicated, as long as the decisions are made with all information (both pro and con) and prepared for the fact that plans sometimes have to change for the safety of mom and baby.

            So before you start jumping to conclusions, and painting me with a large brush, and getting overly defensive about the choices you made, which I, for one would not criticize you for, then please, stop and make sure you’re responding to what I said, and not what you THINK I, or anyone else, is saying. This is the only wayto have a civil, rational, productive discussion and debate on these issues. We need to avoid knee-jerk reactions.

          • “Insanity” as such is not a psychiatric condition; it’s a legal description that deals only with one thing: whether or not a defendant is able to tell the difference between right and wrong. You are probably not insane.

            Whether or not you’re nucking futs for loving your OB and your hospital is another story. Then again, one person’s paradise is another person’s purgatory.

          • What a sad response from an obviously very sad person. My biggest mistake here has been ever going to this site. I had to see it for my own eyes to believe it, but should not of taken part in such an incredible amount of hypocrisy and stupidity. An entire site dedicated to pointing out the faults and mistakes of others, through comments and posts means that the world truly is coming to an end. When I consider that many of you visit again and again hungry to read about some other person’s mistake eager to bash and ridicule without hesitation I want to vomit. What a sick group of women. If only we could all have someone follow us around all day to point out what we do wrong. When you consider how many stupid things you have said to people do you find yourself having a reason that you wish you could explain to people? Perhaps unlike these poor victims you had a chance to apologize. The only thing I can take from my very short experience with “my OB said what”is that I am so grateful to be able to be realistic that the world is full of people making mistakes and saying stupid things, especially after long days of work and really stressful work environments where saving lives is one of your job requirements (just a small little task right?) I hope that in 2011 you can find perhaps more forgiveness and gratitude for the people who are doing there best. Maybe by 2012 this site can become nonexistent and all of the “perfect” people on here can get a life. Who are we kidding though. Mocking and scorning others is your specialty and passion. Raising children and finding good in others is mine. Stay classy ladies!

          • Don’t let the door hit you.

          • I am a little worried about YOU being responsible for little ones… what, you were smart enough to breed?!??

    • Do you call the fire department everytime you cook? No because its silly to call on professional assistance when nothing is wrong. You could start a fire and burn your house down from cooking, just like you could die in childbirth. Thankfully when something does go wrong there are people to call who are trained to fix it. :)

  26. For all of those responding to “Dr. Amy” if you check out that name, you will find her all over the place, and very seldom will you find ANYTHING pleasant said about her. This is definitely not the first time she has continued to slam anything not 100% in line with the mainstream medical community. Here is my biggest issue, “Dr. Amy.” Why can’t you just say what you have to say, NICELY, and leave it for the woman to decide? The biggest issue I have with obstetrics on the whole, is that women are handed “facts” which are quite often highly disputable, funded by the medical community itself and not a third part, and then they are left no options other than what is given. What, exactly, is wrong with informed consent? If I consent not to let you do something you recommend, it’s my issue if I don’t get the desired outcome. What happened to compassion? First do no harm? And do half the people practicing obstetrics really even know what informed consent really means? THOSE are my issues. I’ll take my chances giving birth over walking down a dark alley any day. Have a great day!

  27. http://skepticalob.blogspot.com/2010/08/ignorant-and-stupid-winning-homebirth.html

    Another example of “Dr. Amy” not playing nicely.

    So now homebirth and natural childbirth advocates are IGNORANT and STUPID.

    I ask again, why can’t tact and compassion be part of any of these discussions when OB’s get involved? I know a handful of OB’s that I love. There are wonderful, COMPASSIONATE people. It’s not all OB’s, but those I know I can count on one hand. That makes me sad. You’re working with PREGNANT, EMOTIONALLY CHARGED WOMEN… Where did the kindness go?

  28. Ever heard the phrase, “You catch more flies with honey?”

    *brushes hands*

    All done!

  29. Oh my so I have a zombie baby do I?

    You said yourself that the mortality rate used to be 7% before modern obstetrics saved many more lives, but surely that means that 93% of women didn’t need the miracle of modern obstetrics to survive birth?

  30. “You said yourself that the mortality rate used to be 7% before modern obstetrics saved many more lives, but surely that means that 93% of women didn’t need the miracle of modern obstetrics to survive birth?”

    But that’s like justifying not putting a seatbelt on your child by saying “99% of children didn’t need the miracle of modern seatbelts to survive riding in a car.”

    Modern obstetrics dramatically REDUCES the risk of death. That does NOT mean that the risk of a death is 100% in the absence of modern obstetrics, just like the risk of death is not 100% if you don’t wear a seatbelt.

    If you put a seatbelt on your child because is reduces the risk that your child will die in the event of a crash, why wouldn’t you do what you could to reduce the risk that your child will die during birth?

    • In the early 1980′s when the c-section rate was only 20% modern obstetrics was probably helping more than it was hurting, But it has gone too far and doctors need to learn when they are needed and when they should not interfere. A c-section rate above 15% is criminal. Nationally we are at 31% On Long Island we are over 40%. It is time to use statistics to evaluate what is and what is not helpful. Many things in modern obstetrics are NOT helping.
      You can’t justify ALL of modern obstetrics by pointing to the overall improvement. You have to justify each and every interventing and that is not being done!
      You can’t justify sectioning a woman for big baby based on an ultrasound that said 10 lbs when baby turns out to be 8 lbs.
      And you can’t justify this doctor’s rudeness. No amount of improvement in outcome justifies a doctor being rude to a patient. First and foremost this site is about how amazingly rude doctors can be.

  31. Strange that Amy, I did think of my child and my own safety. That is why I gave birth to her at home with no interventions and had the most fantastic experience of my life! My perfect 9lb 5oz girl was born with no injur to me or her in the comfort of our own home.

    There was no risk of hospital acquired infection, of needing excessive stitching because the ob ‘slipped’ or my daughter having head trauma because the doctor put the vacuum cap on her wrong.

    I do agree there are *some* occasions where a c-section is needed but it should be a rare occurrence not at the 25%+ rate there currently is.

  32. Amy, I’m not a candidate for home birth, and gave birth in hospitals for both of my children (1 C-Section for breach, and one VBAC), so I have no dog in this fight, but I have to tell you, your attitude, your manner of posting, are *precisely* why I chose to go to a practice that had midwives instead of the practice that delivered my first. Doctors who treat their patients views and wishes with disdain and condescension. In short, doctors like you give OBs a bad name. If I was pregnant and looking for an OB, you would be the last doctor/practice I’d consider based on how you’ve chosen to conduct yourself, and the manner in which you’ve chosen to communicate your views.

    You’re a professional who is supposed to help women when they’re at their most vulnerable. Act like that’s what you do.

    • “Doctors who treat their patients views and wishes with disdain and condescension.”

      How would you treat people who claim to know more than you obstetricians life and death issues, and don’t have a clue that most of what they think they “know” is factually false?

      • Not with disdain and condescension. You can have a civil, rational conversation with someone, even someone you believe to be wrong, wherein you explain risks, and discuss the merits and problems with certain studies and arguments without crossing the line into disrespect. Certainly doctors tend to know much more about medical matters, if for no other reason than their years of schooling, but they don’t know everything.

        I just had a very dear friend who was facing a high-risk delivery, who, based on research she had read, asked that they wait till the cord stopped pulsing to cut the cord, because it has been found to improve outcomes for children facing heart surgery (which her baby was). And because the OB there at the time was unaware of those studies, he actually laughed at her and told her it was ridiculous and nonsense. Why? Because it was ridiculous and nonsense? No, because he didn’t know about it. Certainly there would be better ways for him to have responded, especially since he was speaking from arrogant pride (“you’re just a patient, what do you know? I went to MEDICAL SCHOOL” type of attitude), as opposed to actually knowing about the research and being able to argue it’s merits or issues.

        • “Not with disdain and condescension.”

          This entire site is BASED on disdain and condescension. I find it more than a bit ironic that you have a problem with disdain and condescension if you are reading this site.

          • If it’s a waste of time for anyone to argue with you, then I’m not sure why you’re here, Amy. That would mean that you have wasted far more time than any one poster here. Think about that.

            Look, I’m not a frequenter of this site, and I really only came here because of a link I followed. At any rate, my point stands: the way you have represented yourself, as a professional, has really just underscored and solidified the reasons that I switched to an OB’s office that used midwives for their hospital deliveries. You remind me so much of the cold, awful bed-side manner of the OB who delivered my first child. And even as a non-homebirther, based on your responses here, I wouldn’t have an OB like you anywhere near my hospital room if I ever gave birth again.

            If you want people to hear you, you need to find a better way of communicating. You have come across here very, very poorly.

          • This exchange with Dr. Amy reminds me (by comments from both “sides”) of a conversation I had with my father recently. I was describing an on-going situation in an organization I’ve worked with for many years that is going through a very divisive struggle. He finally stopped me, saying:

            “Teapot, this is just *dumb.* You can’t argue with dumbness.”

            Later he said,

            “”Some people are so impressed with their own opinions that they they blow off anybody else’s opinions.”

            He’s a wise man. We can all learn from him.

          • Amy, the reason all you see on this site is disdain and condescension is because that is all you have in your heart. This site is based on support for women who have been hurt, misinformed, outright lied to, or otherwise heard something out of a “care” provider’s mouth that shocked them. Sometimes we express our shock and horror with sarcasm or dark humor, sometimes we literally weep for those who experienced the death of a child (during a hospital birth, in most cases), and then had their pain made worse by the callous treatment of the medical staff.

            Sometimes we have a thoughtful conversation with open-minded medical professionals who are willing to listen, and willing to respectfully exchange ideas, something that seems beyond your ability at this time, sadly.

            I am not a “homebirth advocate” I am a woman, a consumer who has choices, and I am as deserving of respect as any other human being. Except in your eyes, because I am held guilty of the “crime” of disagreeing with some of your opinions and your manner of expressing yourself.

          • “This entire site is BASED on disdain and condescension.”

            Yes. … I suppose you could say we are just returning the favor.

            Read some more comments and then ask yourself, “As a physician, how was this an inappropriate way to handle the situation? How would I have done things differently if it were my patient?” You could actually learn something about patient/doctor interaction, you know. And yes, that does have something to do with the topic: just another reason why women are freaking fed up with being “processed” like guinea pigs and want a better standard of care that includes humane treatment.

          • Yeah. Im not in a particularly good mood for your crap today. I just found out I may have cervical cancer at 26yo due to immunosuppressive therapy, so Im gonna put this as bluntly as I can.

            Dr Amy = bitch.

            I know thats not a nice word, but, well, she is not a nice person and I pity the women she treats.

            Amy, would you like to tell me how Prednisolone (in low doses for short periods of time) is not associated with immunosuppression? I cant wait to argue with you over that one.

      • “How would you treat people who claim to know more than you obstetricians life and death issues, and don’t have a clue that most of what they think they “know” is factually false?”
        have you considered why pts have decided to close their ears? usually b/c they are talked down to and have been lied to/told half truths/given only the medics supporting/backing information before by medics – and i am putting all medical personnel on the table here including myself.
        I know that giving medical care can make us want to bang our heads at times but we need to remember that these are people with feelings and thoughts that must also be supported.

      • I as a healthcare professional would give unbiased information to enable the woman and her support to make an informed decision and respect that decision.

  33. “There was no risk of hospital acquired infection, of needing excessive stitching because the ob ’slipped’ or my daughter having head trauma because the doctor put the vacuum cap on her wrong.”

    And yet ALL the existing scientific evidence on American homebirth and ALL the national statistics on homebirth show that homebirth TRIPLES the rate of neonatal death. So you risked your baby’s life merely for your “experience.”

    I realize that you don’t believe that, but that’s because you don’t understand that what you read in the NCB literature is false. Read the scientific literature and find out the truth.

    You can’t expect to be taken seriously when you repeat lies that you read in NCB books written by laypeople for laypeople.

    • Oh Please do not tell me you are backing yourself up with the Wax paper – which should have NEVER been accepted and published in the fist place due to its flawed method of data collection! Many of the papers included in Wax’s analysis should have NEVER been included. One cannot compare a planned home birth to an unplanned one. it is comparing apples to oranges

      • That study also included “planned” homebirths as women who chose at 13 weeks to have a homebirth then for some reason (usually illness/congenital defect) birthed in hospital, often to a stillbirth…

    • What, kind of like the book you authored on childbirth? Looking at it it doesn’t look very scientific or esoteric, but rather a layperson’s guide on childbirth. Maybe based on fact, maybe based on your own opinion. (I’m sure there’s no chapter on home birth.)

    • The issue with AMERICAN homebirth literature is the retrospective and selective data and inherent bias within the literature.

  34. Why are you wasting your time arguing with me?

    Childbirth is inherently dangerous, period. No one has offered ANY data to the contrary, and most commenters have committed serious mistakes in logic and elementary math.

    Read the scientific literature! You cannot find out the truth by reading the NCB literature because it is filled with lies. That’s my advice to anyone who wants to be taken seriously. If you don’t care that no one takes you seriously than don’t bother finding out the truth and just sit around making fools of yourselves by ridiculing people who are being honest with you and patting yourselves on the back for all your faux “knowledge.”

    • My toddler does the same thing when I say something she doesn’t agree with. She repeats what she believes and stamps her feet really hard. Maybe if you stamp your feet hard enough it might come true. It doesn’t work for my toddler, but it might for you. Give it a try.

      • I particularly recommend stomping your feet when your client’s (excuse me, patient’s) water is about to burst, especially if you’re wearing Prada. A brand new pair.

        Make sure the twinkle lights are away from the splashing and stomping action, though, unless the Underwriters Laboratory has certified them safe for both indoor and outdoor use.

    • You insist we’re all uneducated, and yet there are certainly those among us (myself included) who boast post-secondary degrees in specialties that do give us particular knowledge of this issue.

      Of course, that would likely be why you didn’t bother to respond to my post–it’s too hard for you to argue with other people who actually have science and not just “standards of practice” (many of which are antiquated and worsen outcomes) on their side.

      • “it’s too hard for you to argue with other people who actually have science”

        Honestly, I didn’t see any science. Can you please specify what you are referring to?

        • Sure. Someone else asked, but I’ll reiterate now that it seems you’re actually paying attention. Tell me a little about Born in the U.S.A. by Marsden Wagner. Do you think he’s putting maternal health above infant health? Why do you suppose an experienced, world renowned health director from the WHO is speaking out against the American medical system for putting doctors and the system ahead of mothers and their infants? What about Michel Odent?

          It has long been recognized in anthropological circles, as well as within midwifery (and certain medical circles–namely the ones who do the research and actually read it), that medicine as it pertains to reproduction tends to follow often outdated standards of care. There are certain types of “knowledge,” and people apply different ways of knowing to different situations. These types of knowledge aren’t always the same thing. Myths within obstetrical care (such as that c-sections should be followed by c-sections or your uterus might explode, or that breech babies must be delivered via caesarian, or that episiotomies prevent severe tearing) do not often follow the knowledge provided by legitimate research. This isn’t just research performed by anthropologists’ or midwives: it’s also research performed by other doctors.

          I’m not going to sit here and spew statistics. Statistics have a great deal of value, and if you want some, I can provide you with them. But you can also find your “own” statistics from your own (potentially skewed) sources to back up your own outdated arguments. Childbirth can be risky, and indeed, does cost lives. However, the overzealousness of OB/GYNs and the American model of care has gone so far beyond benefiting women and improving outcomes that it is now detrimental to women and babies. Until you can explain the United States’ rather reprehensible title as the lead developed country in the world for maternal and infant mortality, your arguments are moot–because the proof is in the pudding, and it is clear that your model of care is doing a disservice to both mothers and babies. This model of care is what you tout as the best, and yet you can’t see beyond your own bias to recognize that the outcomes are not good. You are selling a broken system.

          • It’s a little amazing, as I sit here perusing the Dr. Amy argument months later, how anytime someone makes a particularly strong argument against her, that’s where the thread ends. Yes, there were a few weak arguments, which she quickly hounded and then used as laughable evidence of our group ignorance, but there were also informed thoughts and linked citations, all of which she failed to respond to. Curious, at best.

          • ^^^THIS!!!!
            I was observing the exact same thing!
            As of yet (and I haven’t read it all, but a lot of her comments) she has YET to site anything (other than the one laughable study… but if that is what she bases her opinion on, it’s no doubt she has the opinion she does! It’s sad, but it helps me understand her more).

            I kept reading in hopes of learning something by seeing the other side. I don’t mind being proven wrong, I simply want to make the best educated decision. She has yet to offer anything other than idiocy in the most condescending and juvenile way possible.

  35. Luckily I am in the UK and the statistics are stacked much more in favour of homebirth.

    The possible reason for American stats looking worse is because ob’s like yourself have managed to all but wipe out the ability for a midwife to attend a labouring mother in her own home!

    In the UK we are attended by 2 midwives during labour and are supported in our decision.

    You mentioned maternal mortality being high in the Netherlands for homebirths, that study did not account for the difference between planned and unplanned homebirth. The outcomes for a planned homebirth are much better. Most of my research was done via the NCT and UNICEF when I planned my homebirth. I also studied many studies in the BMJ (British Medical Journal for non-brits) so I knew my stuff thank you.

    • I may move to Europe to have my kids, it seems the medical community there are more in favor of actually letting a woman do what she feels comfortable with there.

    • Yes, I’ve remarked that I’d like to stay in England as long as I’m having kids (I’m American, but my 2 children have been born in England).

      • I won’t claim the UK system is perfect because I know it isn’t BUT at least here as long as you know your stuff you can get the pregnancy and delivery you want.

        At least most policies here are set for patient safety NOT for OB’s insurance premiums.

        Defensive practises cause more problems than they solve tbh.

    • Gemma, I’m an American living in the U.K. and while I’m ready to return home now I thank my stars every day that I had my 2 babies in the U.K. where I was delivered by midwives. There is no questions that i would’ve had a c-section with my first and then probably been refused a VBAC with my second.
      I’m going to have my 3rd at home! with 2 attending midwives who’ve most likely seen me through my pregnancy.
      it took a long time to get past the fear of needing more medical interventions from my American brain, but going by my second I went to hospital gave birth within 2 hours without interventions and stood and and went home. Brilliant. I’m still in disbelief that childbirth can be so easy if left alone.

  36. “Luckily I am in the UK and the statistics are stacked much more in favour of homebirth.”

    There are literally NO statistics on homebirth safety in the UK. The first set are due to be released later this year.

    “You mentioned maternal mortality being high in the Netherlands for homebirths, that study did not account for the difference between planned and unplanned homebirth.”

    No, I said that both perinatal and maternal mortality in all births in the Netherlands are among the highest in Europe and rising.

  37. There are literally NO statistics on homebirth safety in the UK. The first set are due to be released later this year.

    “You mentioned maternal mortality being high in the Netherlands for homebirths, that study did not account for the difference between planned and unplanned homebirth.”

    No, I said that both perinatal and maternal mortality in all births in the Netherlands are among the highest in Europe and rising.

    • Journal of the Royal College of General Practitioners, August 1985. p.390-394

    • no statistics, huh?

      http://www.imbi.uni-freiburg.de/OJS/cca/index.php/cca/article/viewArticle/4165
      “Results: The perinatal mortality was not significantly different in the two groups (OR=0.87, 95% Cl 0.54-1.41). The principal difference in the outcome was a lower incidence of low Apgar scores (OR=0.55; 0.41-0.74) and a lower incidence of severe lacerations (OR=0.67; 0.54-0.83) in the home birth group. Medical interventions were much less common in the home birth group: induction (statistically significant ORs in the range (0.06-0.39), augmentation (0.26-0.69), episiotomy (0.02-0.39), operative vaginal birth (0.03-0.42) and cesarean section (0.05-0.31). No maternal deaths were observed in any of the studies. Some of the differences may be partly due to bias. However, the findings regarding morbidity are supported by randomized clinical trials of elements of birth care relevant for home birth, and the finding relating to mortality is supported by large register studies comparing variously specialized hospital settings.”

      http://oregonstate.edu/cla/anthropology/reproductive_lab/sites/default/files/Johnson_Daviss_2000.pdf
      Conclusions: Planned home birth for low risk women in North America using certified professional midwives was associated with lower rates of medical intervention but similar intrapartum and neonatal mortality to that of low risk hospital births in the United States.”

      BMJ study:
      Results 655 (12.1%) women who intended to deliver at home when labour began were transferred to hospital. Medical intervention rates included epidural (4.7%), episiotomy (2.1%), forceps (1.0%), vacuum extraction (0.6%), and caesarean section (3.7%); these rates were substantially lower than for low risk US women having hospital births. The intrapartum and neonatal mortality among women considered at low risk at start of labour, excluding deaths concerning life threatening congenital anomalies, was 1.7 deaths per 1000 planned home births, similar to risks in other studies of low risk home and hospital births in North America. No mothers died. No discrepancies were found for perinatal outcomes independently validated.

      Conclusions Planned home birth for low risk women in North America using certified professional midwives was associated with lower rates of medical intervention but similar intrapartum and neonatal mortality to that of low risk hospital births in the United States.

      There was also an Oregon State University study proving the safety, but I can’t find it. Maybe someone else bookmarked it?

      • It’s a little amazing, as I sit here perusing the Dr. Amy argument months later, how anytime someone makes a particularly strong argument against her, that’s where the thread ends. Yes, there were a few weak arguments, which she quickly hounded and then used as laughable evidence of our group ignorance, but there were also informed thoughts and linked citations, all of which she failed to respond to. Curious, at best.

  38. “The problem with a collection of “facts” is that they can be made to appear in so many ways.”

    The problem with your “facts”, Dr. Amy, is that you are using only percents and not any actual statistics. You say that “in nature” the rate of maternal death is 1%. You say in the last 100 years “modern obstetrics” has reduced it by 99%. IS 1% with a REDUCTION OF 99%. Since “per cent” means out of 100, the “basic arithmetic” here tells me that 100/100 minus 99/100 (the supposed “reduction” in deaths) equals 1/100…and therefore, you are saying that “before modern obstetrics” 100% of women giving birth died. You did not say that it was reduced by 99% of some previous number (a number which you did not supply), you simply said that it was reduced by 99% to stand at it’s current rate of 1%. Apparently I’m not the one with no grasp of basic maths.

    But then later, you say that the “1% in nature” means that 1% of women giving birth WITHOUT an OB will die.

    Are you honestly saying that just by the *existance* of “modern obstetrics”, women not being attended by ANY birth professional are in less danger of dying? That is ridiculous on the face of it. It’s like saying that because of the existence of modern water treatment, the risk of death “in nature” (ie drinking from an untreated water source) has somehow been reduced.

    • I love it when a doctor proves another wrong using the idiot doctor’s words against them <3

      For the record, "modern obstetrics" didn't SAVE that many women. The realization that germs exhist did. Don't get me wrong, OBs have their place for high-risk cases and when something goes very wrong and a c-section is needed. But to say that there are two options, unsafe birth in nature and safe birth with an OB is just a blatant lie and Dr. Amy has ignored the fact that only a small % of women need any more care than a midwife can offer.
      Common…at least admit that with a death rate of under 1% when proper prenatal and birth care are given, you can hardly say that "Birth is the most dangerous thing a woman can go through" :P
      Lying to your patients doesn't get you any points.

    • “You say that “in nature” the rate of maternal death is 1%. You say in the last 100 years “modern obstetrics” has reduced it by 99%. IS 1% with a REDUCTION OF 99%.
      [...]
      “Are you honestly saying that just by the *existance* of “modern obstetrics”, women not being attended by ANY birth professional are in less danger of dying?”

      With all respect, I think that you are misreading her post. She is saying that still today the rate “in nature,” (that is, without access to modern obstetrics) the rate is 1%. For example, Sierra Leone currently has one of the higest death rates with 1,800 maternal deaths per 100,000 births, which is actually closer to 2%, but then sadly there is a lot more wrong than just a lack of access to care going on there.

      So modern obstetrics hasn’t reduced the rate to 1% in nature but rather that access to modern obstetrics has reduced the rate from 1% in nature to the current rates of countries with decent healthcare systems and OB access.

      Current maternal mortality rate in the US as of 2005 was 11 per 100,000 births. I’m not sure what the rate was a hundred years ago, but just to illustrate the math, if it was 1,100 per 100,000 births then (or just slightly over 1%), then that would mean it is now 1,089 per 100,000 less than it used to be. 1,089/1,100 = 0.99, or a 99% reduction.

    • “Dr.” Amy won’t respond to any one that has the medical evidence to pove her wrong… EVEN HER OWN ‘peers!!!” I believe she is just a mouthpiece for AMA and ACOG, trying to further bully and degrade women into believing their faulty press…. Remember folks, she never really practiced medicine with real patients. Here is her own bio off of her website: “Dr. Amy Tuteur is an obstetrician gynecologist. She received her undergraduate degree from Harvard College in 1979 and her medical degree from Boston University School of Medicine in 1984. Dr. Tuteur is a former clinical instructor at Harvard Medical School. She left the practice of medicine to raise her four children. “

      • If you think she’s a mouthpiece for ACOG and the AMA, you’re crediting her too much. I’m sure she’d love the job, but her main job right now seems to be that of “unpaid troll.”

        Besides, the sad truth is that ACOG and the AMA don’t need Dr Amy. Why would they? With Discovery Health, free publications like Baby Talk and American Baby, social networking sites like Baby Center and The Bump, and television and movie dramas that portray birth as terrifying, deadly, and excruciatingly painful, why would they need to pay a housewife who gave up her obstetric practice fifteen years ago as a mouthpiece?

  39. Amy – YOU NEVER PROVE ANYTHING YOU SAY.
    Prove it. Then I will believe it. You go on and on about what you *know* and what everyone else doesn’t/ But when anyone asks for proof of what you say, you completely ignore them.

  40. WOW, the MOST? Why didn’t anyone tell me this?! I never would have attempted it a third time. I mean, if it’s the most dangerous, then I bet I have like a 100% chance of dying since this is my third time, right? Surely the *MOST* dangerous has a very low rate of success. Idiot.

  41. Dear Amy and all,

    Dr. Amy you argue: “In nature, the neonatal mortality rate is 7% and the maternal mortality rate is 1%.”

    I’ll give you that, even though you do not site any stats. So then why would nearly 100% of women going to a hospital need some sort of medical intervention in their birth. You could argue to save more babies maybe 10% – 20% of women would need an OB to save their them, or their babies, but if over 50% – 60% of women get either pitocin, or cesarean, or both…well, do you see the disconnect? I have been to a number of births that the cesarean was absolutely justified, and I have been at births that the Dr. augmented the labor, (no reason given,) the baby distressed, and then was cut out. If in nature less than 10% of mother and babies die, why do OB’s treat ALL women like they are dying? And if you say that birth is simply dangerous, that is not a valid argument. You say you need proof. Where is the proof that each woman is in constant and immediate danger?

  42. “If in nature less than 10% of mother and babies die, why do OB’s treat ALL women like they are dying?”

    For the same reason you treat your children like they might die in a car accident and buckle them into seat belts.

    Do you say to your children: don’t bother to buckle up because less than 1% of all children die in car accidents? Why not? It’s true, isn’t it? Why do you insist your kids wear seat belts even though the chance of them dying is far smaller than the chance of a baby dying in childbirth?

    You know the answer. It’s because you want to minimize the risk. It’s not because you think the risk of your child dying in a car accident is 100%.

    Obstetrics works the exact same way. Obstetricians try to minimize risk to the lowest possible levels. It’s not because we believe the risk of dying in childbirth is 100%.

    • This would be a fitting analogy if wearing seat belts was known to be harmful to children. The benefits of wearing a seat belt clearly outweigh any risks. This is not always the case with procedures used in birth.

    • Minimize the risk, huh? Risk of what? Certainly not the risk of tearing since so many OBs refuse to support the perineum and cut unnecessary episiotomies. Certainly not c-section. The rate is 2-3 times what is considered “safe” and continues to rise. Certainly not the distress of the baby. They continue to use pitocin for inductions that are not medically indicated and crank it up as high as possible until a c-section is needed. What exactly are they trying to minimize? The death rate hasn’t declined as all this things rise, so if the death rate is what they are trying to minimize, they are failing miserably and they need to look back to natural birth which has better statistics – no matter where it’s attended.

      • “Minimize the risk … ” Bwa ha ha!

        Did you read about the one who ‘likes to get in there at 37 weeks and induce in order to control labor?’

        Or how about the one who did an episiotomy for no reason even though the patient expressly asked him not to?

        Oh wait … “A small cut is better than a big tear!” Wrong. Studies have proven this.
        “If you come in here with a birth plan, I’m going to schedule a cesarean section.” Hear this one a lot.
        “Youre getting drugs whether you want them or not…”

        Just scroll through a read. Please. Does this *really* sound like they’re honestly trying to minimize the risks? By thinking they’re pulling on the placenta when they yank out a woman’s uterus? Come on already. Give it up.

  43. Thank you, Dr. Amy, for enlightening us all. You have opened my eyes to the truth which I had refused to believe. Because of the knowledge you have given us and the truth behind your words, I have seen the errors of my ways and have completely changed my mind about homebirthing.

    …Which is to say, the next time I give birth, it will be at home. Even though the phrase “giving birth in nature” gives me the mental image of myself and my newborn being mauled by a Puma.

  44. Does Dr. Amy remind anyone else of Ann Coulter?

    • lol…or Bill O’Riley :) Hey, there always has to be some fanatic in each debate who spends more time making an idiot of him- or herself, right? She’s nicely set herself up to be that. What I don’t get is how she has any time to practice or do research if she’s trolling around on the internet all the time looking for a fight?! I feel bad for her children:( What a hateful bitch to have as a mother…she takes the “I’m right because I’m older and have been through more school” to a WHOLE new extreme! As if there were nothing else for her to learn. I bet she hasn’t read a single one of the studies that has come out in support of homebirth.
      If you Google her, you can’t find a single post in support of her. It’s all just post after post discrediting her and her lack of facts to back her up. It seems she missed that statistics class that teaches you can say anything you want but it doesn’t mean squat until you have a non-biased part doing the study.

      I just don’t understand why people get so angry. She’s clearly an idiot who, instead of looking at both sides to see if she’s right, just goes looking for whatever might substantiate her claims. That’s not research. I wish she could meet Marsden Wagner. I bet she’d think he’s somehow delusional. An OB/GYN in practice AND research, never took off time to raise kids so he’s been in the field for decades. the WHO’s Directer of Women’s and Children’s Services. Now the number one OB called in to testify in obstetrical court cases. He says OBs have no place in low-risk birth :)
      But I bet she knows more because she hasn’t been working as much as he has so she probably has more time to research ;)

    • Yes, all the time. I bet they’re bestest friends!

    • Somewhat. She also reminds me of “Doctor” Laura.

      At least she doesn’t remind me of Glenn “Abilify Poster Boy” Beck… yet…

  45. I’m saddened that we have allowed someone like the infamous Dr. Amy Teuter to derail a wonderful place like this. I say we stop feeding the troll. We have investigated the science, and don’t need to pay any attention to someone “massaging” the existing studies in order to twist them into something that supports her worldview. Anyone that advocates that all C-sections are necessary (even if we section half of all mothers), no OB ever does anything that’s not absolutely essential, the c-section rate is women’s due to women’s requests, all moms are stupid and need to be guided to the appropriate cutting and intervention, there was never any such thing as doctor-caused childbed fever, there’s no such thing as 5PM c-section syndrome, and that all midwives (even those that are L&D nurses for years) are untrained hacks should be out and out ignored.

  46. Reading this thread throughout the day, I kept getting angry. I wanted to say something, but believe I am above getting into a pissing contest with someone who would still proclaim the world to be flat even if they were taken into space to see it for themselves. However, merely thinking about this thread has given me voice.

    There has been quite a bit of comparison between childbirth and car accidents. Thinking about this analogy really shows you the two different forms of thinking. The natural childbirth advocates see the childbirth process as a car ride. They take safe driving precautions (such as proper diet, exercise, and taking their prental vitamins). Most have their seat belt (midwife in the event of minor complications) and air bag (hospital transfer in the event of major complications) in place in the event of getting into an accident (birth crisis).

    Modern obstetrics, however, views the childbirth process as a wreck in progress. They make every attempt they possibly can to save women from the wreckage that is childbirth.

    In a car accident, the use of a seatbelt or air bag can be life saving. However, it becomes a dangerous ride that will end in an accident if our seat belts were to constrict every time we shifted in our seat. Or the air bag to deploy every time we hit our brakes. Or someone sitting in the passenger seat decides you’re not driving to their satisfaction and reaches over to grab the wheel or step on the pedals.

    Just like with vehicular operation someone will get into an accident, either from their own negligence or no fault of their own, and require safety mechinisms we put in place. Some women will wind up with health problems because they refused to take proper care of themselves. Others will have random complications that no one could predict. Either way, intervention is required. And when applied in that fashion, it tends to be very effective.

    When women begin labor, the thought of a possible c-section is one of the last things on most minds. Most of them, unless planning a c-section, expect to labor normally and birth vaginally. Just like when we get into our cars, very few of us think that we could wind up in an accident. We expect to drive to our destination and back without any problems.

    Unfortunately, modern obstetrics overuses the safety mechinisms and causes many accidents. Many OBs feel it’s a driver’s ed car where they have full control in the passenger seat and can take over if Mom isn’t driving to their satisfaction. And if they hit a few bumps in the road, narrowly avoid a collission, or total the car……well, the car was defective.

    • I just wanted to say that I think this is the best extension of this analogy.

      Further, I noticed everytime Amy uses the seat belt analogy, she specifically uses the situation of buckling up children. She sees it as the Doctors are superior to the patients, not that the mothers are decision makers in their own right that can weigh the risks on their own and make a decision.

      • Great analogy: doctors as backseat drivers. Doctors are life guards who need to sit on their butts and wait to see if they are needed. Some do this. They get Thursdays. Some don’t get it and they get the other 6 days, along with the doctors who not only don’t get it but say rude rude things when they should have just kept their mouths shut. I’M DRIVING DAMN IT! It is my decision. Having a backseat driver along can be a distraction and cause an accident. Learn when to keep your mouth shut.

    • Awesome analogy.

      Too bad dr amy is not here anymore to say something asinine and nonsensical in response ;)

      This mother certainly didn’t need to hear this while she was hypnobirthing, in an attempt to scare her into submitting to whatever the doctor wanted her to submit to, that she obviously did not need since a REAL professional came along and supported her. Shame on the doctor.. for shame..

      And shame on you Dr. Amy for defending that sort of bullying. But, it really doesn’t surprise me that you would sink so low. I bet you’d have stood there and talked about baby’s dying and seat belts and how dangerous what she was doing was in order to break her concentration so you could try to talk her into.. whatever she did not need.. as well.

    • This is an excellent analogy. Can I perhaps excerpt it on my FB fan page? :D

      You rock.

  47. While I totally understand the frustration with the OB who is quoted up top here, the fact is, the events leading up to my daughter’s birth were, in fact, the most dangerous moments of my life. That hemorrhage was the closest I have ever come to dying, including the time I hitchhiked and wound up in a car with a drunk driver, the time I rode on the back of my boyfriend’s motorcycle (sans helmet) down the LA freeways, the time I got stuck under water with a raft flipped over right on top of me, the night my schizophrenic ex’s hallucinations told him to kill me, and six months of dating a guy who bludgeoned his parents to death rather than let on that he’d flunked out of college (good thing he didn’t know I knew that little fact, I guess). I came through all that unscathed because I was lucky and because I had help. It was a lot like birth that way.

    If not for an immediate emergency c/s and a world class NICU, my daughter and I wouldn’t be here today. To me, and people with experiences like mine, the words “Trust Birth” are a bad joke. Birth is a bitch who will jack you if she’s in a bad mood.

    Before I developed pregnancy complications, I had hoped for a homebirth, and did enough research to learn that some people who present themselves as midwives are unqualified, and some are crazy. I met wonderful, competent, caring professionals, and I met a couple of complete loons. All of these people claimed to have the same credentials (midwifery is alegal in my state), and all were making a living attending births. With even the very best of these CPMs, the emergency transfer plan was to take me to a convenient ER and hand me over to whoever happened to be on duty. Several of these midwives would have been willing to proceed without ultrasounds, and some would have persisted in that (for religious or ideological reasons) right through the warning signs of placenta previa.

    While I believe in the safety of homebirth under ideal circumstances, I do not believe that those circumstances exist in the United States.

    Do I think that OBs should be more hands-off than they are? Yes. Do I think that the practice of obstetrics could be improved? Absolutely.

    But do I think birth is safe?

    Not even a little bit.

    • Ebeth,

      Because of your story and a couple of near misses I myself have been at, I have changed my tune from “Trust birth,” to “Respect birth.” (Thank you Navel Gazing Midwife!) It is important to realize that there will be, for some women, complications, and that safety is an absolute priority. You have to find a midwife who feels the same. No agendas!

    • With all due respect to everything you went through, your story doesn’t disprove anything anyone has told us about the safety of low-risk homebirth. For SOME women, birth is risky. Those women are usually turned down by good midwives for homebirth care. It sounds like the same went for you. You developed complications and decided on the hospital in case those complications mandated a c/s. Thankfully, you were in the hospital when that c/s became necessary.
      However, to use your story as some sort of “proof” that all birth is inherently risky is a falacy. It’s like saying “That guy drove drunk, all driving is high-risk.” Sure, there’s always a bit of risk the minute you walk out your door – hell, there’s risk staying home. But you can’t use your story to tell other women that a low-risk homebirth is “the most dangerous thing they will go through”.
      I think the problem is that Dr. Amy just doesn’t understand midwifery. Most are well-trained, studied women. They carry with them all the same instruments and drugs an OB has for smaller problems like postpartum hemorrhage and everything they need to revive mother or baby, including intubation. And they can all see that “emergency” coming half-an-hour away. Transfers happen before the c-section is immanent. They don’t sit at home or in an office waiting for the nurse who is watching a monitor to catch bad fetal heart rhythms, then call the doctor to come and make an assessment. They are there the whole time, using their ears to listen to the baby’s and mother’s heart tones always knowing that as long as heart rates return to normal between contractions, everyone is fine.

      I’m sorry that you have been through so much in your life. But your birth isn’t at all proof that anything can happen at any time and women should therefor only birth within feet of an OR :(
      I respect Birth. I know my Body. I trust my Midwife.

      • “For SOME women, birth is risky. ”

        That’s the thing that some just don’t get: You don’t know who all of those women will be ahead of time. You don’t know if a low risk pregnancy will end low risk too. A labor, from a “low risk” woman, can be going smooth, and then an unexpected shoulder dystocia, or cord prolapse, hemorrhage, etc. happens.

        Then, just like that, you are no longer low risk. It would be nice if we could tell for certain which women would be totally fine. But we can’t.

        “And they can all see that “emergency” coming half-an-hour away.”

        Really? They can see an “emergency” like a cord prolapse or shoulder dystocia a half hour away? And all the time?

        “Transfers happen before the c-section is immanent.”

        Well, maybe sometimes, but not all the time. I think it depends on what the complication is, and/or who your care provider is. What about the women who have lost children due to sudden and unexpected emergencies in homebirth, where there were no signs that there were any problems beforehand. I also know a few who have lost their babies due to their midwives’ negligence, where there should have been a transfer, and it wasn’t done in a timely fashion, or at all. And these women trusted their midwives. They knew them. They knew others who raved about them and their expertise. But you just never know. Midwives are human, and make mistakes too.

        • Did you know that there are things you can do to keep a prolapse safe until you get to the ER? Did you know that the majority of cases of dystocia that OBs claim aren’t actually dystocia, if only they let women birth in natural positions like squatting or hands-and-knees? Most hemorrhages are stopped with PIT or cytotec OR A BITE OF THE PLACENTA, and these options will get the rest of the women to the ER for further care.

          You can play what if all you want, but at least play it on both sides. Look at ALL the babies put into distress for needless induction and augmentation. Look at all the women who are given c-sections because “labor lasted too long”. Look at the babies that die or are permanently injured or brain damaged as a result of bad forcept and vacuum extraction. What if all those women had stayed home?! They’ll never know.

          No one said midwives don’t make mistakes, but the assumption that the Almighty Dr. Amy never has is just plain laughable. Midwives are trained just as well to attend a birth and decide when surgical help is needed. the only difference is that they can’t give surgical care.

          A live baby isn’t all that matters. There’s a reason far more OBs get sued than midwives. Doctors don’t have all the answers.

          • “Did you know that there are things you can do to keep a prolapse safe until you get to the ER? Did you know that the majority of cases of dystocia that OBs claim aren’t actually dystocia, if only they let women birth in natural positions like squatting or hands-and-knees”

            Yes, I know about the protocols taken when there is a cord prolapse, but it doesn’t work all of the time.

            Shoulder dystocia happens everywhere, both in the hospital and at home. It happened to me at home, and it happened to an acquaitance of mine who lost her baby during a shoulder dystocia during her homebirth. And there are true SD’s that happen at the hopsital too. Sure, some OB’s may call an SD much too soon, but not all of them. BTW, I was very mobile when pushing — hands and knees, standing, etc, and the SD still happened.

            “Look at the babies that die or are permanently injured or brain damaged as a result of bad forcept and vacuum extraction. What if all those women had stayed home?! They’ll never know.”

            Look at the babies that died because they were home. It’s not hard to find these stories, either. What if they all went to the hospital? They’ll never know, either.

            “but the assumption that the Almighty Dr. Amy never has is just plain laughable”

            Who made that assumption?

          • Michele:
            Are you speaking against homebirth and midwifery based models of care, or simply speaking to the unpredictability of reproduction?

            Either way, I draw your attention to the fact that the United States’ model of care (hospital-based, OB-attended childbirth) has a higher perinatal mortality rate than Sweden (8 compared to 5 per 1,000, which is a lot when you think in terms of population), and a rate barely lower than the Netherlands and Denmark who also have midwifery based models of care. The United States’ perinatal mortality rate is also higher than Canada’s, which has a system that supports both midwifery and OB models of care both at home and in the hospital.

            There are always going to be a certain number wherein there is little that could’ve been done without prior knowledge. But comparatively, when you look at 8 to 5, it is clear that a home and midwife based model of care CAN be extremely beneficial and safe, and would indeed be an improvement to the American system.

            Additionally, study after study, even out of the United States, shows that maternal morbidity (that is, ill-being after delivery, such as fistulas, painful scarring and perineal pain and discomfort, etc) is much higher in hospital births than in home births. With lower maternal morbidity and lower perinatal mortality, I would happily take Sweden’s homebirth midwife based model over the United States’ hospital based model any day.

            http://whqlibdoc.who.int/publications/2006/9241563206_eng.pdf

      • Curllyq, I don’t think my point is that homebirth is inherently unsafe.

        You say that any good midwife would have turned me down for care. I agree with you.

        The problem is the abundant supply of *bad* midwives. Had I chosen, I could have signed on with any number of midwives who wouldn’t have recommended or insisted on routine 2nd trimester ultrasound, wouldn’t have insisted on checking for fetal heart tones, and would have gone right on not insisting as I developed the symptoms of complete previa. One of the midwives was a Christian Scientist who opposed medical intervention. One was a loon who, if the previa was discovered, would probably have told me it wouldn’t have happened if I hadn’t crossed my legs. In reading various parenting boards, it has become evident to me that no matter how obviously homebirth is contraindicated, a dedicated patient can find a midwife willing to help her try it anyway.

        If midwifery is going to be safe, there has to be sufficient trust and accountability between doctors and midwives. These professionals need to be able – legally and practically – to work together. Unless that can happen (which it can’t where I live), homebirth won’t be safe.

        • I don’t disagree unless you’re making the awful assumption that you’re better off with ANY OB than taking your chances with a midwife. There are as many or more OBs who are *bad* or *loony* as there are midwives. I think ANY OB who induces a women because *wah* she’s uncomfortable at 38 weeks is a BAD OB.
          Cummon…there’s some responsibility on every mother. She should be researching her care provider. It’s not hard to ask questions and find a good midwife.

          Just remember, even the med student with a C- is a doctor…80% of women spend more time researching their car purchases and planning the nursery than they do researching their birth options or writing a birth plan. And no one should be assuming their care provider is good at what they do, whether it’s a midwife or a doctor of any sort.
          All the statistics in the world can’t tell you how the person in front of you will treat you or attend your birth.

        • “One of the midwives was a Christian Scientist who opposed medical intervention.”

          I would argue that this midwife has no business being one, and it’s certainly not her place to assert her private religious beliefs on the patient unless asked to. Those are her beliefs, not the patient’s, and that’s reckless. Unfortunately, we see the same behaviors in doctors, though, and sadly just accept it as ‘the way it is’ sometimes.

  48. Oh, Dr Amy?!?!?!?!!?
    Your response to the FACTS posted by your peers????

    Did you forget to remember that they posted information that disproved you?

    Or are you only interested in talking down to people you feel are “less” than you?

    Are you too timid to take on your PEERS when they post information that blatantly contradicts you?

    There’s a word for that. It’s the one used to describe a vagina, or a member of the feline species.

  49. I don’t think Dr. Amy, and a few other posters, quite understand the context and WHY this was so inappropriate.

    First of all. This wasn’t a home birth.

    Second of all. It was a doctor breaking a woman who was hypnobirthing concentration ON PURPOSE with something shocking.

    It’d be like, me yelling out in the middle of my partners birthday party, with his entire family there, “You know, I have been charting my vaginal secretions and they are very thin and stretchy right now! I think I may be fertile soon and we should use condoms tonight!”

    In WHAT WORLD would that be even marginally appropriate? Just because it’s true, doesn’t mean I should SAY IT AT THAT PARTICULAR MOMENT.

    Dr. Amy obviously missed out on the first rule of readership: Always take into account the CONTEXT!!

    NO ONE in their right mind would ever claim that childbirth is without risks.

    What on earth that has to do with MODERN midwifery and MODERN medicine, which both take into account MODERN risks and MODERN monitoring techniques? And how that even begins to relate back to when NONE OF IT existed (for doctors OR midwives).. I have absolutely no idea.

    And further, how it even begins to relate to THIS PARTICULAR SITUATION.. isn’t even remotely sensible.

    What on EARTH is she defending?!

    A couple studies say home birth is unsafe. Several studies, and the practices of nations with far more advanced health care systems than we have, say it IS relatively safe. You can read a biased study and conclude based upon that biased study, just about anything.

    But, I still have no clue how on earth that relates to THIS particular post in THIS particular context?!

    • She decided to write a blog post that day about homebirthing and wanted some quotes that she could pull from this “debate” and misquote them to show how “silly and stupid” all NCB supporters are. She kept answering for awhile after posting her blog post, but disappeared and hasn’t been back since.

    • I think you hit the nail on the head. The quote had nothing to do with home birthing. It was about an OB sabotaging a woman’s efforts to hypnobirth in a hospital setting.

      And in her zeal to defend her profession, she missed the entire context, and ironically, ended up coming across as the very embodiment of what was wrong with the quote in the first place.

      I’ve since gone over to Dr. Amy’s blog, to see what her deal is, and to see if perhaps I’d bee misjudging her. Nope. I was floored by how incredibly nasty the tone of virtually every post was. It’s like she’s going out and scouring the internet for things to bash in the nastiest tone, possible. If it seems remotely “crunchy” or like something a home birther *might* be into, Dr. Amy is going to do a blog post about how stupid/dangerous/sanctimonious/ignorant/pretentious it is. What is the point of that? We talk about supporting women and their choices, and here is an OB that wants to do nothing but tear down any woman who makes a choice she wouldn’t. How is that helpful?

    • “What on EARTH is she defending?!”

      You’re joking right?

      It’s hard to imagine I could make my point any more obvious than it is. Which words in “childbirth IS one of the most dangerous things a woman can do” are you having trouble with?

      The most amusing of the many inadvertently hilarious comments here are those from women who boast that I haven’t changed their mind. What made you think I was trying to change your mind? I had absolutely no hope of changing the minds of people who pat themselves on the back for being “educated” when they don’t know anything about science, statistics, obstetrics, and even basic math concepts like percent.

      And obviously I have no hope of changing the minds of people who are so pathetically uneducated as to make statements like this:

      “And where statistics are concerned, they’re all trash. I don’t care what study or college or group states them, they’re all trash. Yes, they can give us general ideas of how things are trending, but putting our faith in “cold, hard, statistics” is be ignorant”?

      You can’t use logic to change the minds of people who don’t understand logic and think inanities like “trust birth” are profound observations.

      I was trying to discredit NCB advocates by highlighting their lack of basic knowledge, basic logic and their inability to think critically. You couldn’t have been more helpful. You fell all over yourselves with inane and illogical comments while simultaneously patting yourselves on the back for your complete ignorance. Way to go!

      I will keep this site in mind when people ask why no one takes homebirth and NCB advocates seriously. Nothing I could possibly say about you is as damaging to your reputations than what comes out of your own mouths.

      • Amy, you are in fact missing the point. The point quote wasn’t about home birth. And the point was that an incredible insensitive and callous OB made an off the cuff remark that, regardless of the veracity, was ill-timed. Why on EARTH would an OB feel the need to say something like that when a patient is in the MIDDLE of giving birth? Un-helpful and un-professional.

        You, madam, are as guilty, if not more-so, than anyone here, of damaging your reputation by what comes out of your mouth. You have been nothing but nasty, nasty, nasty to anyone who disagrees with you, and honestly, I expect more of someone who is speaking on behalf of, and in defense of, a profession.

        I took a gander at your blog, and wow, I was floored by the vitriol. It is as though the entire reason for your blog is to rant and rave about anything and everything you consider remotely related to NCB, in the most venemous and mean-spirited way possible.

        I don’t begrudge you your opinion, or your right to share your opinion, but you do so in such a nasty way that it really overshadows your information. I really think you ought to think about it. I even saw one of your frequent posters on your blog tell you she was going to remove you from her bookmarks, because even though she thought you were often right, HOW you were choosing to communicate it was getting so nasty that she just was totally turned off. That really should tell you something. Your Captain Ahab-esque vendetta against anything you deem remotely connected to NCB is destroying you as a person.

        • I am baffled by your priorities. You are most concerned about everyone’s feelings and I am most concerned about saving babies’ lives.

          These issues are not trivial. Babies die because of the misinformation spread by sites like these. And the worst part is that the mothers who are putting their babies very lives at risk are actually patting themselves on the back for being “educated.”

          You cannot be educated by reading propaganda written by lay people to trick other lay people and to boost their self esteem. This site is a prime example of that.

          • Dr. Amy, I haven’t at all prioritized an experience over the safety of any babies.

            AGAIN, I ask you…please state your rebuttal to the statistics from NON “lay-people” like the Drs. who posted above and Marsden Wagner. By your definition, it’s not propaganda if it’s coming from a doctor written for doctors, right? So, your comments on the book he wrote in hopes of changing American maternity care and lower death and c/s rates?

            You just can’t do it, can you?

          • “to the statistics”

            What statistics? Show me the actual statistical claim (the specific words in the specific scientific paper), and I’d be happy to rebut it if it is not true.

          • Dr. Tuteur:

            I’m quite glad you want to save babies. I do to. I have a firm belief in HEALTHY babies and HEALTHY mothers. Most moms with episiotomies, episiotomy-caused fistulas and pelvic floor issues, cesareans, permanent nerve damage from epidurals, abdominal adhesions, and a host of other things ARE NOT HEALTHY. Therefore it wasn’t a good outcome. It’s not HEALTHY MOM HEALTHY BABY. You act like the baby is the ONLY thing. It’s not. The mom has to be ambulatory and moderately stable to care for said infant, if she survives the intervention cascade at all. Therefore you are, from your words, claiming that as long as the baby is “alive” (I notice that you don’t mention HEALTHY, so ceserean cuts, lung issues, and whatnot are fine) everything is ok. It’s not. What happens when the MOTHER is not alive? Is the mom, trying to remain alive and healthy, just after the “experience”? No.

          • “Most moms with episiotomies, episiotomy-caused fistulas and pelvic floor issues, cesareans, permanent nerve damage from epidurals, abdominal adhesions, and a host of other things ARE NOT HEALTHY.”

            And how many women would that be? In order to claim that this these are important causes of disability, you MUST be able to tell us how many women suffer each of these outcomes each year.

            Moreover, you need to tell us how that number compares to the more than 40,000 maternal deaths averted each year in the US alone.

          • I have read in various places that often women have undiagnosed pelvic pain – whether they’re not sure that’s the connection, whether they just deal with it and it goes under- or unreported, or they try to tell their doctor and the OB just blows them off. In fact, I’ve heard this more than any other sentiment.

            I think the most fundamental underlying argument here is that Dr. Amy thinks women who want a natural birth are twits who are completely incapable of making a decision. Perhaps the psychology of the matter is that without meds, they are screaming, raving lunatics who vocalize their pain, make demands of the medical staff, and get belligerent when told they must submit to something they know to be completely unnecessary. Basically, when a woman has an epi, submits to the episiotomy, vacuum extraction, eye goop and all the other superfluous crap she probably could live without, it means less work for the doctor. Plain and simple. Once you start voicing concerns or an opinion, you are seen as “difficult” and not doing what the OB tells you to do, even though it IS your decision, whether they like it or not.

      • Ok. Let me agree the comment -is true-. Childbirth IS a pretty dangerous activity in the scheme of life. Modern advancements in medicine, nutrition, antiseptics, modern surgical techniques, clean water, safer infant feeding, etc. have decreased the casualties by a huge margin.

        But HOW does that comment/truth belong in the middle of a hypnobirthing labor?!?!

        And let’s address the argument in general.. why would a home birthing mother, with a competent midwife, 5 minutes from a hospital, be immune from these very same modern benefits simply because she’s at home?

        We need hospitals. We NEED obstetricians. I appreciate them for their surgical expertise and ability to save lives in some instances.

        However, at what point will any of them start to realize that meddling with nature regularly and without good purpose in all instances is just that: meddling with nature without good purpose, perhaps to detriment.

        I don’t care if they have high insurance rates and need to practice defensive medicine in order to keep up their livelihoods and “saving women”.

        If that’s the problem, push HARD for nurse midwives to be able to get practices separate from themselves (ie: their own insurance!!) and only take on high risk cases where intervention is actually necessary.

        And, at what point do you hurt more than you save with your defensive medicine? There is a point in which that threshold will be crossed, as the mortality for women spikes with c-section surgery.

        And, at that, Dr. Amy.. HOW did my complaining because you missed the entire context – snowball into an argument about NCB advocates?

        Whomever told you -I- was an NCB advocate ? Anyone? Anywhere?

        I’m a WOMEN’S RIGHTS advocate. I believe in informed choices, and in women. I don’t care if women choose an epidural (if they know the risks) I don’t care if women choose an induction (if they know the risks).. But the unfortunate truth is, women don’t usually know the risks to any of it. They’re patted on the head and told “Aww, not much! Here sign this.”

        If my rheumatologist did that routinely with the many powerful medications and invasive treatments HE prescribes, he’d lose his license!

        It is seriously getting ridiculous how much the doctors can get away with – without even so much as telling women “you might feel a little dizzy now”. How hard is it to have common human decency? THAT is what this website is about. Common human decency. NOT about home birth or natural birth advocacy.

        We’ve had women whose OB’s refused to believe them when they said they could still feel pain with their epidurals and so they started slicing into them.. OR completely performed the surgery sans any medications at all. Is THAT okay? I mean, he’s a doctor after all!

        Are we griping NCB advocates because we don’t like when women are threatened, lied to, misinformed, tortured, or otherwise assaulted?

        Are you telling me ALL doctors are perfect and they ALL do everything right ALL of the time.. NONE of them are sadists with God complexes.. so anyone who complains MUST be an idiot who misunderstood the “gravity” of the situation or how what they wanted was absolutely necessary/right??

        And — I — am the delusional one?

      • heehee…and as for the real stats that people provided to counter yours? You haven’t commented logically or illogically, you just ignored them. What about the 2 other doctors who must have had at least as much education and training as you had? Surely you realize they aren’t ignorant. What do you have to say to their replies?
        Cummon…you are such chicken $HIT! THAT is why no one will ever take you seriously.
        You what proof there is that people take NCB advocates seriously? The fact that OOH birth is on the rise.
        Like it or not, people are listening to the nice people like Marsden Wagner and Ina May Gaskin and Henci Goer and ignoring the “warnings” from fear mongers like you.

        Keep ignoring the facts people debate with, it doesn’t make them any less valuable to people who want to listen ;)

      • Wow Amy your arrogance astounds me!

        So because I advocate NCB I automatically have no intelligence?! I probably understand more about many scientific threories than you ever will! Including how an intervention free homebirth in MOST cases will give a better outcome to a birthing mother!

        Something I have thought, I wouldn’t be able to deal with the medical system outside of the UK. How can you trust a doctor who is paid per intervention? I couldn’t…..

      • Move along back to your blog, Dr. Amy. No one cares about your stupid warped opinions here.

  50. Dr Amy,
    STILL waiting on you to refute what YOUR PEERS posted.

    If you can’t, just say so.
    If you just come here to inflate your own ego and sense of self-worth, just say so.

    If not, then refute what your peers posted.

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