Did you see this? - Page 2

[olive&pimiento]

I truly think that you hit the nail on the head here.  My views on birth were a lot different in my first few years of midwifery training.  It wasn't until I had been to over 110 births that I saw some very scary complications.  It was quiet sobering and made me feel that my previous "trust birth" stance was very naive. I think Dr. Amy brings up some points that need to be addressed by the NCB and home birth community, but that her overall approach brings shame upon herself and the bitter gossips that follow her.   
 

Originally Posted by SympatheticDad 

Any OB/GYN resident working in a busy teaching hospital will see 20 to 40 deliveries per week.  1000 babies in 5 years sounds perfectly plausible to me.

It's possible that this gap in experience between OB/GYNs and many homebirth midwives is part of where the gap in understanding comes from.  To someone who has only delivered 40 or 50 babies ever, a "1 in 500" chance might sound low.  To someone who has delivered a thousand babies, "1 in 500" translates directly to 2 dead babies and 2 grieving mothers that you've seen with your own eyes, and is a situation you must be prepared for.

[peainthepod]

It's hard to imagine a lower pastime than cruelly mocking women who have lost babies at birth. I doubt a person who gets their kicks by doing such a thing is very stable. Certainly, the lack of empathy is unusual and disturbing. This woman claims to be in the business of healing people? What a bedside manner she must have...

Despite having had both babies at home with experienced professionals in attendance, I agree that the "trust birth" mindset can be extreme and dangerous. But it's possible to express our concerns without malice and brutality. The ugliness in her writing completely overshadows anything valuable she might have to say. What a pity that she chooses this approach.

[Youngfrankenstein]

Originally Posted by olive&pimiento 

 I think Dr. Amy brings up some points that need to be addressed by the NCB and home birth community, but that her overall approach brings shame upon herself and the bitter gossips that follow her.   
 

 

I think this sums it up for me.  The two things that bother me the most is that this person assumes that the HB mamma just decided out of the blue one day to have a HB.  The other is that she also assumes that these "posts" couldn't be duplicated for someone having a horrid experience with a hospital birth.  What about those adverse outcomes and "trusting the provider"? 

An even playing field is what every family deserves.

[Turquesa]

Originally Posted by peainthepod 

It's hard to imagine a lower pastime than cruelly mocking women who have lost babies at birth. I doubt a person who gets their kicks by doing such a thing is very stable. Certainly, the lack of empathy is unusual and disturbing. This woman claims to be in the business of healing people? What a bedside manner she must have...

It's beyond unstable.  It's clinically narcissistic. 

[peainthepod]

I don't feel qualified to diagnose her but it's definitely not an attitude I'd want in any doctor of mine. Can you imagine having to see someone like that for emergency care after such a devastating loss? I wonder if she has the audacity to tell her unfortunate patients these things in real life, or if she saves her venom for the relative safety of the internet. Somehow I doubt she'd say these things to a grieving mother's face, but I've been wrong before.

[SympatheticDad]

I'm not going to speak for Dr. Amy, but I think some attitudes are being attributed to her that she may not have.  In Teen Skepchick's interview with her, she goes out of her way to say that if a mother knows the facts and still chooses home birth, she has no problem with it.  Her objection, as I understand it, is that she thinks that mothers are making decisions based on incomplete or inaccurate information.  The specific sentence I remember from the interview was along the lines of "The risks of home birth are low, but they are real."

I agree that her presentation is brusque and often is in my opinion unacceptably rude.  But with a topic as important as this, that seems worth working past.  I'd rather hear the truth spoken by a jerk than pretty lies spoken by a nice person.

Link to the interview: http://sciencebasedparenting.com/2010/07/31/exclusive-interview-skeptical-ob-dr-amy-tuteur/

found the actual quote I was thinking of:

"The risk of home birth is small, but it’s real, and if you want to take that risk – OK, you’re free to take that risk. Everyone’s free to choose their medical care. The problem that I have with the American home birth movement is that they’re not honest with women. They insist that home birth is as safe or safer than hospital birth, and that’s just not the case. So, everyone deserves to make an informed decision about where she chooses to give birth, but you can’t be informed without the facts."

[themomadance]

When I decided that I wanted a home birth, I did MONTHS of research - WELL before I even started trying to get pregnant.  I certainly did not only look for the articles that presented it in a positive light and avoid the ones warning of danger.  I wanted to know EVERYTHING I could about it.  

If ONE article is going to change someone's mind, maybe it really isn't the best choice for that person anyway.

If ONE author is going to give a person an overall impression on a broad subject such as this, chances are the reader is not a professional in this subject area anyway, and his/her opinion will matter little overall.  (In terms of making it harder for someone to achieve a home birth if they want one)  

I read the article, I'm still planning a home birth, and I'm not scared or doubting my educated choice.

:)

[Youngfrankenstein]

Originally Posted by SympatheticDad 

I'm not going to speak for Dr. Amy, but I think some attitudes are being attributed to her that she may not have.  In Teen Skepchick's interview with her, she goes out of her way to say that if a mother knows the facts and still chooses home birth, she has no problem with it.  Her objection, as I understand it, is that she thinks that mothers are making decisions based on incomplete or inaccurate information.  The specific sentence I remember from the interview was along the lines of "The risks of home birth are low, but they are real."

I agree that her presentation is brusque and often is in my opinion unacceptably rude.  But with a topic as important as this, that seems worth working past.  I'd rather hear the truth spoken by a jerk than pretty lies spoken by a nice person.

Link to the interview: http://sciencebasedparenting.com/2010/07/31/exclusive-interview-skeptical-ob-dr-amy-tuteur/

found the actual quote I was thinking of:

"The risk of home birth is small, but it’s real, and if you want to take that risk – OK, you’re free to take that risk. Everyone’s free to choose their medical care. The problem that I have with the American home birth movement is that they’re not honest with women. They insist that home birth is as safe or safer than hospital birth, and that’s just not the case. So, everyone deserves to make an informed decision about where she chooses to give birth, but you can’t be informed without the facts."

The only was I'm disagreeing is that there is a huge hospital/medicalized birth problem in the US that is being ignored.  More mom's are dying in childbirth in the US now!  I don't want the HB "movement" (are we up to 1 whole percent in the US now?) is that the ACOG are not showing fair and even information.  They are choosing to use non evidence-based medicine over and over and over.  My biggest problem is that 90% + women are being induced or augemented for labor...how is that right? 

I know I'm making emotional arguements right now but I get where the Dr. is coming from, I would like to see her lay out her side as accurately as possible.  WHY are women wanting HB?  There are reasons that aren't being addressed by the ACOG.  It's not all touchy-feely stuff.

[sosurreal09]

The induction rate, c-section rate, and overall too much intervention is what scared me away from the hospital anyway. I was laughed at when I told my OB at 28 weeks I wanted NO DRUGS! She literally laughed at me and said "that doesn't happen in the hospital" so I searched high and low and found out about hypnobirthing and started that then finally found a birth center and drove 1hr+ for every visit there and back! It was worth it!

Now with our second we are choosing a HB, for lot's of reasons.

So yeah I would certainly agree that the "HB movement" is b/c of the bad practices at hospitals. Even if you deliver vaginally what are your chances of doing it drug free? The pitocin rate at many hospitals is like 90%....after 10 hrs people are being sectioned due to "failure to progress" even though birth (especially first) usually takes 24 hours.

And yes of course maternal and infant death rates in this country...

[seafox]

I think if more hospitals were like the hospital I gave birth (both times) at, there wouldn't be such a drive to birth at home. It does make more sense to encourage women to want to use the hospital, rather than scare them out of being at home, although I agree that one needs to be informed about the added risks.

My first labor was 72 hours, and I spent 48 of those at the hospital, I couldn't keep water down so I needed an IV, zofran, etc. I was stuck at 4cm forever (30 hours), it seemed (I was only 2cm when I went in, 4cm the next morning, and still 4cm the afternoon the next day) I would have been tagged with a 'failure to progress' anywhere else, and pushed into a c-section.

As it happened, they always gave me options. I opted for a morphine sleep on one night since i was so exhausted. I did agree to try pitocin the next day to see if it helped. (had already tried nipple stimulation, and moving around, with not great effect) Finally when my water broke that night things started to happen, but still, was pushing for 2 hours. If I had gotten an epidural, my ob/gyn (and the other ob/gyn there) firmly believe that my son wouldn't have handled pushing as well (as it was, he was barely tolerating it) and I would have ended up with a c-section. So I was pretty glad I still had a somewhat 'natural' birth - especially since pushing was difficult, and being able to feel where he was stuck/etc made a difference.

my hospital is proud of their low c-section rate, and their support of natural birth. They had birth balls, stools, tubs, etc., to labor in. They never pushed anything on me. They were super pro-breastfeeding and also did skin-to-skin right after birth, and breastfeeding as soon as possible.

I wish all hospitals in this country were like this, since then I don't think so many women would feel compelled to birth in riskier places. I certainly understand why one would given what I read on here about others' experiences.
Edited by seafox - 9/13/11 at 7:22am

[Imakcerka]

And if more hospitals and OB's would follow our wishes we wouldn't need a doula to stand up for us. I chose the hospital both times due to complications. I knew that a home birth would not be safe and I didn't want the risks. My first experience was terrible until the OB came in and she was Absolutely wonderful. Energetic and excited to help me through it all. The nurse I had was kicked out for calling me a baby and telling me to shut up. I did have drugs after 3 days of labor. The last day they were one on top of the other. It was insane. The second experience was beautiful, why did the OB have to be so hot? That one was easy and scary due to issues I had had through the whole pregnancy.

So yes, you need to be informed. Possibly some have issues with Authority, and try to gain control. Sometime instead of gaining control they move the Authority figure to the Midwife. And again that's not the control they were really looking for. I think as long as you're not blinded by anything or anyone and know when to trust and not trust then any decision you make will have a better outcome. I have met too many women complacent and treated poorly by their OB yet still go for another hospital birth with the same OB. And women who have had bad experiences with Midwives yet still will either use the same midwife or try to find another. Is it our EGOs? Our need to be right? Either way, we have options and we need to really think them through. What Amy says isn't the right way to go about it. However if she would highlight the good and bad on both sides I'd be more apt to give her more credit. Otherwise she's following her EGO and creating more division than needed.

I fully believe homebirths and hospital births are both safe. It's the Midwife/ Ob/US that needs to check our EGO's and find out why we're making or not making the decisions we make.

[nia82]

While there are valid points that she brings up, her manner is unacceptable. I looked at that site once and was quite appalled by tone and manner, and I remember she bashed delayed cord clamping. Now we can have a disagreement about homebirths or CPMs vs. CNMs, but delayed cord clamping has been shown in many scientific studies to be very beneficial and back home in Europe is standard for most obgyns with wonderful outcomes. She lost me at bashing everything that is out of the norm for American hospital births.

That being said, I had my son at a hospital, a small baby-friendly one but it was unsatisfactory, e.g. I was not allowed to push upright and held down by a nurse - gee I wonder why I didn't go back to a hospital? What kind of jail treatment is that?! I had my DD at a freestanding birthing center with a group of extremely experienced CNMs. It was a conscious choice, done after much research. And despite what one post of the skeptical obgyn claims, my birthing center employed intermittent monitoring every 10 minutes. The midwives were very pro-active at monitoring my birth - and have a long list of complications that risk you out to their wonderful backup-obgyn who probably would be a target for much hatred as he deliver breeches vaginally upon request and gasp teaches this to his residents. /sarcasm end.

Basically, my point it: she does have valid points on some posts she makes, but some posts are more opinion than science. And all of it is wrapped in cynical hatred - no manner of showing true concern.

[erigeron]

Dr. Amy's tone doesn't invalidate her points. But it may make it harder for her to accomplish her objective, depending on what her objective is. If she mostly just aims to blow off steam, then she's doing fine. If she wants to convince anybody on the pro-homebirth/natural birth side, she would do better to consider the reasons why women choose homebirth/natural birth, and address these reasons. She does not do this.

Despite her acerbic style, I continue to read Dr. Amy because she knows how to do science. I'm a medical professional myself. I see a LOT of bad science going on, and when I get sick of reading bad science I turn to Dr. Amy because she skewers it handily. Most people are not educated in medicine. That's fine, obviously--that's why we have doctors. But it's hard for a layperson to do research and make an informed decision on their own, because they don't have the background. Did they really read the study, or just the abstract? If they read the study, do they have the knowledge of study design, pathophysiology, current practice guidelines, appropriate clinical endpoints, statistics, etc. necessary to interpret it in an informed fashion? Did they read all of the studies on a topic, the majority of studies on a topic, the better studies on a topic, even a consensus guideline? Do they know to consider these things? There's a big difference between being an informed layperson and being a medical professional--there is a large body of knowledge to apprehend. My body of knowledge overlaps somewhat with that of a doctor, but there are things they know that I don't (as well as things I know that they don't), and the amount I do know makes me conscious of how large a body of knowledge doctors have. I don't accept everything a doctor tells me as gospel (and there are a few bozos, as in any profession), but in general I respect where they are coming from and their capability to interpret evidence. Doctors, as a group, know a lot more about medicine than laypeople posting on MDC.

[starrlamia]

Anyone who acts so childish and disrespecting doesnt deserve me reading their stuff. I dont care how well educated you are, if you are going to be that ignorant toward people then your viewpoints mean nothing to me. While I do agree with some of her very very basic points (after you strip away the ignorance and hate), there are much better ways to go about getting your point across.

erigon- dr. amy also supports bad science, she likes to point to badly done studies to support her viewpoints on birth, esp. homebirth. She seems to be so far into bed with ACOG she will never wake up to see the bad science they also support. Though I do agree there is a lot of bad science floating around these boards.

[scottishmommy]

I sometimes wonder if Dr. Amy isn't actually some Internet troll who is trying really hard to make obgyns look bad. I would be terrified to let her deliver my baby!

[jeminijad]

For those who are more worried about delivery than content... well, we are never going to agree. I'm also not going to start dragging out studies and statistics to try and prove or disprove anything, since frankly 90% of us here are unqualified to read astutely and synthesize. One thing I've heard the sharper members of both camps agree on is that there is a problem with quality numbers in tracking the safety of birth- all of the major ones have flaws, MANA isn't telling us what they've got, there is little impetus for midwives in certain states to be honest and accurate, and hospitals aren't going to be perfect in recording, either.

But I've seen more gentle, sunshiney out-and-out falesehoods in and around the NCB community than forthright, firm truth. This particular forum has improved, since it is no longer forbidden to tell a truth in case it might hurt someone's feelings, so IMO, that is a good thing. The bottom line is that there are many of us who are unconcerned with playing nice when it comes to the topic of babies' lives. And while it is easy to hate her, I do not believe that Dr. Amy "gets her kicks" from "cruelly mocking" mothers who have lost babies. She is the only internet presence that I am aware of that calls out mindblowingly incompetent practitioners (not only lay midwives, also MDs and CNMs.) She does not chose experience over outcome.

So if you "trust birth," we can just agree to disagree. If you are concerned with the safety of birth, don't turn away from another narrative simply because you think someone is "mean." I continue to read here, even though I disagree with much of it, because I want a balanced view of what is going on. 

[sosurreal09]

I don't get the "trust birth" thing here. How could you not trust birth? Is it not a biological function of a woman's body? Yes humans are more difficult to birth based on our pelvic size and infants head size, but it is still a biological function.

In true emergencies I am very thankful for the hospital, considering otherwise people would just die, which they have and did. So yeah there is that, but the majority of women should be able to birth a baby, healthily, with good outcome. No?

[jenniferlynne]

Originally Posted by sosurreal09 

I don't get the "trust birth" thing here. How could you not trust birth? Is it not a biological function of a woman's body? Yes humans are more difficult to birth based on our pelvic size and infants head size, but it is still a biological function.

In true emergencies I am very thankful for the hospital, considering otherwise people would just die, which they have and did. So yeah there is that, but the majority of women should be able to birth a baby, healthily, with good outcome. No?

The majority, yes, but not everyone.  There is a very small, true, but very real minority of women and babies who would die without medical interventions.  Therefore, I think it's unsafe and irresponsible to blindly trust birth (or intuition or what have you) in every situation.  That DOES need to be called out, as do the negligent, incompetent practitioners who allow these deaths to occur.  The bad science, as erigeron said, getting tossed around in the NCB community is dangerous and someone needs to speak out against it.  Take issue with Dr. Amy's tone if you will, but she does make some good points, and if the goal is, as I think it is, to have healthy births, then her viewpoint is worth considering.

[starrlamia]

delivery is incredibly important, if you look at it from a psychological standpoint, most people who treat others like Dr. Amy treats people are labelled bullies and fundamentalists. This is not the way to get a message across because it denotes immaturity, which belittles any points you try to make. It's called tact, and respect, and acting as immature as Dr. Amy does is neither of those. I really dont care what your message is, if you are a bully or fundamentalist then you wont get my support or respect.

 

Originally Posted by jeminijad 

For those who are more worried about delivery than content... well, we are never going to agree. I'm also not going to start dragging out studies and statistics to try and prove or disprove anything, since frankly 90% of us here are unqualified to read astutely and synthesize. One thing I've heard the sharper members of both camps agree on is that there is a problem with quality numbers in tracking the safety of birth- all of the major ones have flaws, MANA isn't telling us what they've got, there is little impetus for midwives in certain states to be honest and accurate, and hospitals aren't going to be perfect in recording, either.

But I've seen more gentle, sunshiney out-and-out falesehoods in and around the NCB community than forthright, firm truth. This particular forum has improved, since it is no longer forbidden to tell a truth in case it might hurt someone's feelings, so IMO, that is a good thing. The bottom line is that there are many of us who are unconcerned with playing nice when it comes to the topic of babies' lives. And while it is easy to hate her, I do not believe that Dr. Amy "gets her kicks" from "cruelly mocking" mothers who have lost babies. She is the only internet presence that I am aware of that calls out mindblowingly incompetent practitioners (not only lay midwives, also MDs and CNMs.) She does not chose experience over outcome.

So if you "trust birth," we can just agree to disagree. If you are concerned with the safety of birth, don't turn away from another narrative simply because you think someone is "mean." I continue to read here, even though I disagree with much of it, because I want a balanced view of what is going on. 

[IwannaBanRN]

Originally Posted by jeminijad 

Ladies... you are honestly creating fodder for them. Let me explain why.

Lower intelligence spectrum? I realize this particular blogger is hated here, but many of the regular commenters are physicians, researchers, and other highly educated & intelligent folks. Its just where they let their hair down. I read it to try and stay balanced.
 

Yeah, but most of those people are book smart, not common sense smart. Smart enough to get through med school and have high reading comprehension scores? Yes! Determine common sense and basic knowledge of the people that they are treating's needs? NO!