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Did you see this? - Page 5

post #81 of 128
Quote:
Originally Posted by jenniferlynne View Post




Nope, I still don't get it.  How does reading her site with a critical eye lend her credibility?  That makes no sense to me at all.  Believe me, I don't care in the least if you read her site or not, and I understand taking offense at her tone, I just don't understand the instant dismissal of what she says as "nonsense" because you don't like the way she says it.  Whatever, we may just have to agree to disagree on this one.

 


well, it would be one thing if she was posting results of her own research. Its not like you can't get the data somewhere else, no? so getting it from someone who presents it without their personal opinion and without inflammatory language might be more pleasant, and easier to actually see what is data compared to opinion.

ETA: Its also difficult to communicate in a comment area on a blog rather than a forum, at least for me. Its super slow, comments kept showing up out of order, no quoting possible, and the box to write in is only a few lines, so editing isn't easy unless its super short.
Edited by seafox - 10/6/11 at 4:14am
post #82 of 128
Quote:
Originally Posted by SympatheticDad View Post


And this is where we can see the fundamental misunderstanding in action.

 

Mothers do not need intervention ... except when they do.


Babies can be born without problems ... except when they can't.

 

An OB's primary job is not to respond to emergencies, although they do that too.  An OB's primary job is to prevent the emergency from developing in the first place.  That's worth saying again:  Obstrectic medicine is primarily preventive in nature.  The reason OB's engage in so many (so-called) "unnecessary" interventions is because, ideally, they're intervening before an emergency develops.  So instead of waiting until your baby has been suffocating for an extended period of time, they respond to changes in fetal monitoring that indicate that a problem may be developing.  After the fact, it's easy to look back and say "Well, that was unnecessary, because nothing bad happened," but that's not how one properly uses statistical analysis.  You don't claim that wearing your seat belt was unnecessary just because on a given car trip you didn't crash.

 

I find this line of reasoning preposterous at best and dangerous at worst.

 

As a parent, my primary job is to keep my children out of harm’s way.  Parenting is primarily preventive in nature, so I’ll go ahead and make my children wear helmets at all times (you never know when a head injury could occur), eat only at home (you never know when a disgruntled employee could spit in their food and spread an infectious disease), lock them inside (to shield them from such outdoor dangers as pedophiles and West Nile virus), lock them outside (less chance of dying from household fire or suffering from indoor contaminants), and above all, avoid letting them ride in the car, which poses a 1 in 6500 chance of certain death.

 

To use a more fitting analogy, I could take the preventive approach of surgically removing both of my breasts and uterus.  Such interventions, after all, literally cut out the risk of cancers targeting those areas. 

 

There’s prevention, and then there’s overkill.  And even the world's most well-reputed, independent researchers know what constitutes overkill.

 

As to your fetal monitoring example, ideally doctors and hospitals would ditch the anti-evidence EFM for low-risk women and employ intermittent auscultation.  But AT LEAST they could respond to that eyebrow-raising reading with back-up confirmation by auscultation before wheeling a woman in to get her belly sliced open.  (Struck through until I can find the source). 

 

Sympathic dad, perhaps you would be *more* sympathetic if you would consider the plight of women forced to lie down to give birth (when other positions may help turn a baby, speed labor, or at very least feel more comfortable),  forced to have painful labor augmenting drugs for no medical reason other than “failure to progress,” forced to fast or eat the almighty ice chips when they actually need caloric intake to what could be their most athletic endeavor.  You say that you can refuse an intervention.  It's not that simple.  Unaware of their legal and fundamental rights, most women sign hospital consent forms, while in the throes of labor, that give hospital staff carte blanche to intervene whenever and however they wish.  And as a guy, you're never going to know what it's like to be in transition.  It's a whole new world in which you can barely utter the one-syllable, four-letter words that are on your mind....let alone argue with a doctor about a pending intervention.   

 

Finally, your argument begs the question; it rests on the underlying assumption that OB's always know what they're doing.  That would be nice.  If only it were true. 

 

 


Edited by Turquesa - 9/18/11 at 4:54pm
post #83 of 128

 

 

 

Quote:

As to your fetal monitoring example, ideally doctors and hospitals would ditch the anti-evidence EFM for low-risk women and employ intermittent auscultation.  But AT LEAST they could respond to that eyebrow-raising reading with back-up confirmation by auscultation before wheeling a woman in to get her belly sliced open. 

 

I don't want to argue about individual interventions, but EFM tells you the heart rate of the baby, and how it responds to contractions.

 

I don't see what information would be added by listening to the heart rate of the baby with a different instrument. At that point you already know what the heart rate is, not just in that moment, but over a long period of time.

 

 

post #84 of 128
Quote:
Originally Posted by kathrineg View Post

 

 

 

I don't want to argue about individual interventions, but EFM tells you the heart rate of the baby, and how it responds to contractions.

 

I don't see what information would be added by listening to the heart rate of the baby with a different instrument. At that point you already know what the heart rate is, not just in that moment, but over a long period of time.

 

 


EFM, in most cases also restricts mom to bed, on her back, which makes labor even more painful and more likely to get an epidural when she didn't want one in the first place. In low risk women that are not being induced, there is no need for the monitors. A fetal doppler or fetoscope is much more appropriate for mother's NATURAL pain management.
 

 

post #85 of 128


For the record I did say in my first post 'Can you blame them?" (the OB's about the legal issues)

 

The reality is that we have too much intervention in this country. 1 out of 3 women do not need c-sections. That is major surgery that very much increases risks and death. I can't imagine anyone who really understands c-sections as being major surgery saying it does not increase maternal death risks. A lot of women/babies in the US die after they get home from the hospital, are they recorded and counted in this? IDK I didn't do the research.

 

Dr. Amy writes a lot of BS articles that just make fun of home birthers and birth advocates. She certainly doesn't use any science in that...

Quote:
Originally Posted by coocoocachoo View Post



What is bad is the fact that there are a lot of factors playing into that number:  How each country records maternal deaths (did the mother die DURING childbirth or a few days after?  If she dies a week later from an infection, it may count as a maternal death here where it would be considered unrelated elsewhere).  Over what period of time have these numbers been gathered?   What the reasons for death are.  The article gives a nice summary of some reasons, it looks like the top reason is preeclampsia.  OK, so preeclampsia is serious stuff.  There are more cases of preeclampsia in the United States than there are in (it looks like the article is trying to say...) any other developed nation.     The number one risk factor for preeclampsia is also something the US is number one at:  obesity.  More obese women getting pregnant=more preeclampsia=more maternal death.  This has little to do with the hospitals, though it is frustrating that it seems like not much can be done for these women even in 2011.

 

Regarding the below post, I have seen Business of Being Born.  It's awfully melodramatic in my opinion, and tries to be taken seriously by tugging on the emotions of pregnant women.  What makes a talk show host a credible source of information?  This is what really gets me...Ricki Lake is seen as credible because she's all 'kumbaya' as she is spewing distorted truths and flat-out lies.  But Dr Amy is (ok, WAS) a medical professional, proves her points with facts and science,  but since she's a bitch she CAN'T be credible!  To touch on the part about doctors being "afraid of legal issues" argument:  Would you not be afraid of legal issues if you had the means to save a baby's life and didn't; just for the sake of giving a mother 'the birth experience she wanted? 
 

Quote:



 

post #86 of 128

Again, I don't want to argue for or against continuous EFM (especially because I don't support continuous EFM nor do my OB or the hospital where I will be giving birth).

 

My point is that ascultation is not more accurate than EFM--it's essentially the same thing (measuring the baby's heart rate) with a different tool. You would get the exact same information, the baby's heart rate. 

 

If you physically held the heart rate monitor on the mother's stomach it would be exactly like using a doppler, except that instead of just listening, you'd  also have a computer helping you calculate the heart rate at any given moment and recording that heart rate.

 

If you didn't trust the computer to do the calculations, you could listen to the heart rate with the fetal monitor in the same way you would use a doppler--when I've been hooked up to it I ask them to leave the sound on and I listen to his heartbeat the entire time. 

 

ETA: Just to be clear--I'm talking about the idea that doctors should use a doppler or stethoscope to "confirm" the readings of an EFM before a c-section.

post #87 of 128


 

Quote:
Originally Posted by jenniferlynne View Post




Nope, I still don't get it.  How does reading her site with a critical eye lend her credibility?  That makes no sense to me at all.  Believe me, I don't care in the least if you read her site or not, and I understand taking offense at her tone, I just don't understand the instant dismissal of what she says as "nonsense" because you don't like the way she says it.  Whatever, we may just have to agree to disagree on this one.

 

I think it kinda comes down to the fact that it is not how she is saying it or who she is, but the truth that the issues she is making a mockery of are serious and real and they are real from a home birth perspective and from a hospital one. She, or you or I or a credible/non credible MW could have written a very similar, mainstream fill in the blanks about an ob/hospital pregnancy and birth experience with just as sad and true outcomes. All this goes both ways. And the fringe folk are always gonna get poked and made fun of by those type of personalities that are flooding our media and power-places. And when people really take a critical eye to the statistics and facts made up LARGELY by our hospital/ob/birth perspective, one can clearly see where danger/damage/abuse and trauma start from. The bully-ing and mocking of us on the mdc by this woman is just another way to push apart the relationship and connection between people. Furthering the goal and need for co-commitment to OVERALL better safety and healthier outcomes for women and babies in this country by birth "professionals".
 

 

post #88 of 128


Cite?  Any evidence I have seen that points to c-sections increasing death rates haven't been very credible.  Correlation is not causation.  Why are you so passionate about something that you won't even bother doing any further research on? Where are all these women dying at home after c-sections? It makes no sense.

Quote:
Originally Posted by sosurreal09 View Post


For the record I did say in my first post 'Can you blame them?" (the OB's about the legal issues)

 

The reality is that we have too much intervention in this country. 1 out of 3 women do not need c-sections. That is major surgery that very much increases risks and death.

 



 

post #89 of 128


gives her page views, more page views= people thinking she deserves it, etc. We may have to agree to disagree on this one :P


 

Quote:
Originally Posted by jenniferlynne View Post




Nope, I still don't get it.  How does reading her site with a critical eye lend her credibility?  That makes no sense to me at all.  Believe me, I don't care in the least if you read her site or not, and I understand taking offense at her tone, I just don't understand the instant dismissal of what she says as "nonsense" because you don't like the way she says it.  Whatever, we may just have to agree to disagree on this one.

 



 

post #90 of 128
I think we should just stop arguing this. We all should be fine with Amy's critical eye. She has every right to take our beliefs and stomp all over them. Hey it gets her page views. We can all agree quite a few people will not learn from her type of "teaching". So... she's obviously not trying to actually reach anyone who may have a differing view. However if her intent is to actually reach anyone other than other snarky women who just love to bash others and may need a place to fit... then she's failing.

meh... I'm done caring about her lets start a new thread that highlights the good and bad of home births and hospital births. Without AMY.
post #91 of 128
Quote:
Originally Posted by Turquesa View Post



I find this line of reasoning preposterous at best and dangerous at worst.

 

As a parent, my primary job is to keep my children out of harm’s way.  Parenting is primarily preventive in nature, so I’ll go ahead and make my children wear helmets at all times (you never know when a head injury could occur), eat only at home (you never know when a disgruntled employee could spit in their food and spread an infectious disease), lock them inside (to shield them from such outdoor dangers as pedophiles and West Nile virus), lock them outside (less chance of dying from household fire or suffering from indoor contaminants), and above all, avoid letting them ride in the car, which poses a 1 in 6500 chance of certain death.

 

To use a more fitting analogy, I could take the preventive approach of surgically removing both of my breasts and uterus.  Such interventions, after all, literally cut out the risk of cancers targeting those areas. 

 

There’s prevention, and then there’s overkill.  And even the world's most well-reputed, independent researchers know what constitutes overkill.

 

 

 

Finally, your argument begs the question; it rests on the underlying assumption that OB's always know what they're doing.  That would be nice.  If only it were true. 

 

 



The chance of dying in a car crash is 1 in 6500, or .0153%, where (this number is absent in your post, I did a quick search on CDC for these) the death rate within the first 28 days of birth is 18,782 and 4,138,573 live births in 2005, or .45%.  With the assumption that some of these deaths are not related to birth, taking a look at the death rate within the first 7 days is 15,013 out of 4,138,573 live births, or .36%.  For mothers, death rate is 15.1 per 100,000, or .0151%.   The mother is slightly less likely to die in labor than she is a car accident, but there's obviously more than one party involved in childbirth. Another thing to consider with the number you gave for the car crash is that is your chance in the ENTIRE YEAR.  I drive just about every single day, so 1/6500=.000153/365 days per year=.0000004191 or .000042% per day, and I could break it down even more as I drive more than once per day.  I do NOT, however give birth every day.  I am about as likely to die driving for an entire year as I was to die in a 12-hour event during the year.  My son was 24 times more likely to die in his first week of life than I was.  Here are my links if you care to see for yourself on the perinatal mortality rates, the CDC has some interesting perspectives. 

http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_08.pdf

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2409165/

 

It's interesting that you bring up that a lot of OB guidelines are based off of weak data and opinion.  What data do DEM/CPM's base their guidelines?

post #92 of 128
I just want to say, that my hospital had these wireless monitors for CFM that I thought were pretty awesome (since I could move around, etc) I'm surprised more hospitals don't have them, since it would make the tradeoff of monitoring/movement moot. I think they were even waterproof, if I had wanted to use the tub/shower.
post #93 of 128
Quote:
Originally Posted by seafox View Post

I just want to say, that my hospital had these wireless monitors for CFM that I thought were pretty awesome (since I could move around, etc) I'm surprised more hospitals don't have them, since it would make the tradeoff of monitoring/movement moot. I think they were even waterproof, if I had wanted to use the tub/shower.

And I just wanna say that so does my hospital but I was made to lay on my back for 30-45 minutes at a time so they could get strips on the monitor. So, wireless or not, they will still make you lie still on the bed.

 

 

post #94 of 128
Quote:
Originally Posted by IwannaBanRN View Post



And I just wanna say that so does my hospital but I was made to lay on my back for 30-45 minutes at a time so they could get strips on the monitor. So, wireless or not, they will still make you lie still on the bed.

 

 


oh weird!! mine did not do that. I think it was printing out strips no matter what? that is odd that they'd make you lie down anyway.
post #95 of 128
Quote:
Originally Posted by seafox View Post



oh weird!! mine did not do that. I think it was printing out strips no matter what? that is odd that they'd make you lie down anyway.


And my hospital had the units but "couldn't find them" when I was in labor. Ahaa.

post #96 of 128
Quote:
Originally Posted by seafox View Post



oh weird!! mine did not do that. I think it was printing out strips no matter what? that is odd that they'd make you lie down anyway.


It still prints out strips, but me moving made the strips inaccurate so they made me lay down.
 

 

post #97 of 128
Quote:
Originally Posted by IwannaBanRN View Post




It still prints out strips, but me moving made the strips inaccurate so they made me lay down.
 

 


jeesh, what is the point then? I call BS on that, having fiddled myself with RF transmitters/receivers. I mean, if they were getting interference, maybe somewhere specific in the room would be better, but movement shouldn't make a difference if they are made correctly. I do remember when my *son* moved a lot they'd get a bad patch of reads, since the monitor wouldn't be placed quite as well (near to his heart) suddenly, but that could happen regardless of what I was doing. And that *does* at least make sense monitor-wise! That's like saying a two-way radio wouldn't work unless both parties were sitting still. My husband probably would have offered to try and fix it if they claimed that was an issue!
post #98 of 128
Quote:
Originally Posted by seafox View Post



jeesh, what is the point then? I call BS on that, having fiddled myself with RF transmitters/receivers. I mean, if they were getting interference, maybe somewhere specific in the room would be better, but movement shouldn't make a difference if they are made correctly. I do remember when my *son* moved a lot they'd get a bad patch of reads, since the monitor wouldn't be placed quite as well (near to his heart) suddenly, but that could happen regardless of what I was doing. And that *does* at least make sense monitor-wise! That's like saying a two-way radio wouldn't work unless both parties were sitting still. My husband probably would have offered to try and fix it if they claimed that was an issue!


I won't say this to argue but I know that during my induction with my son, they had a hell of  a time getting that thing to stay put and work while I was sitting on the bed.  It was infuriating.  The effort that goes into making those disks be accurate is such a head ache.  During my hb, the midwife took the baby's hearttones once with a doppler.  I had a very, very short labor.  It took about 30 seconds.  The belts around the belly, the sitting still (which is what I had to do) was a complete pain.  I also don't like EFM on everyone because it causes everyone, including dad sometimes, to stare at the machine and ignore mom.

 

post #99 of 128
Quote:
Originally Posted by seafox View Post



jeesh, what is the point then? I call BS on that, having fiddled myself with RF transmitters/receivers. I mean, if they were getting interference, maybe somewhere specific in the room would be better, but movement shouldn't make a difference if they are made correctly. I do remember when my *son* moved a lot they'd get a bad patch of reads, since the monitor wouldn't be placed quite as well (near to his heart) suddenly, but that could happen regardless of what I was doing. And that *does* at least make sense monitor-wise! That's like saying a two-way radio wouldn't work unless both parties were sitting still. My husband probably would have offered to try and fix it if they claimed that was an issue!


They kept losing trace on the heartbeat and me moving was making the contraction monitor slip out of place and it would read funky looking contractions. After I told the nurse I needed to keep moving around she said they needed good strips of contractions and heart tones so I had to lay down no longer than 15 minutes. 45 minutes later..........I was writhing on the bed in pain when she came in and said it was okay to get up.
 

 

post #100 of 128
Quote:
Originally Posted by IwannaBanRN View Post




EFM, in most cases also restricts mom to bed, on her back, which makes labor even more painful and more likely to get an epidural when she didn't want one in the first place. In low risk women that are not being induced, there is no need for the monitors. A fetal doppler or fetoscope is much more appropriate for mother's NATURAL pain management.
 

 

Bull. This is not the case for most women. Maybe for you or others you have talked to, but anecdotes are not data. Tell me, how do you track variability by fetoscope or doppler?
 

 

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