Monday, June 05, 2006

Who can make an informed decision based false and deceptive information?

Let's take a look at a homebirth advocacy website and analyze it for accuracy and marketing messages. This site is highly ranked in Google which means that many other sites link to it and reference it.

False: "Most of American obstetric practice in hospitals is not based on science but on myth. What obstetricians do may be the utmost in high-tech, but it is not true science."

Irrelevant marketing message: "In 20 other countries, more babies survive their first months of life than in the U.S."

Deliberate misrepresentation: "Respiratory distress among newborns was 17 times higher in the hospital than in the home. "

Irrelevant marketing message: "The U.S. has the highest obstetrical intervention rates as well as a serious problem with malpractice suits."

Lie or ignorance of the truth: "Studies done comparing hospital and out-of-hospital births indicate fewer deaths, injuries and infections for homebirths supervised by a trained attendant than for hospital births. No such studies indicate that hospitals have better outcomes than homebirths."

False: "While maternal death rates have vastly improved since the turn of the century, factors like proper nutrition and cleanliness have played a big part in the change."

Deliberate misrepresentation and irrelevant marketing message : "In 1939, Baylor Hospital Charity Service in Dallas, Texas, published a study that revealed a perinatal mortality rate of 26.6 per 1,000 live births in homes compared to a hospital birth mortality rate of 50.4 per 1,000."

Deliberate misrepresentation and irrelevant marketing message: "Midwives are the primary care-givers in countries with better neonatal mortality rates than ours. "

False: "Some hospitals still require women to birth lying flat on their backs with their legs held high in stirrups."

False: "Drugs are still available to laboring women in the hospital, though no drug given in childbirth has been proven to be safe for the baby."

False: "Women who have taken drugs in labor report decreased maternal feelings towards their babies and an increase in the duration and severity of postpartum depression."

False: "Normal household germs do not affect mother or baby."

Irrelevant marketing message: "Semmelweis was ridiculed by his colleagues, and it wasn't until five years after his death that his findings began to gain acceptance."

Deliberate misrepresentation: "In 20 other countries, more babies survive their first months of life than in the U.S."

Irrelevant marketing message: "Homebirth is not for every woman. It takes a high degree of commitment to health and learning and a high level of responsibility ..."

So, on one page a major homebirth advocacy website features 7 major falsehoods, 4 examples deliberate misrepresentation (some of which are marketing messages) and 4 irrelevant marketing messages. How can any woman make an informed decision about homebirth when offered falsehoods, misrepresentations and irrelevant marketing messages?

37 Old Comments:

what site?

By Blogger sailorman, at 8:59 AM  

False: "Women who have taken drugs in labor report decreased maternal feelings towards their babies and an increase in the duration and severity of postpartum depression."

Women have not reported that? This person is not reporting this as the conclusion of any study. Merely reporting it as what "some women" have said.

Perhaps you should invite Ronnie into the discussion formally before you rip her to shreds.

By Anonymous clever ID, at 9:14 AM  

Anyone is free to enter the discussion, and I would welcome the opportunity to question homebirth advocates about erroneous information on their websites.

By Blogger Amy Tuteur, MD, at 10:19 AM  

False: "Most of American obstetric practice in hospitals is not based on science but on myth. What obstetricians do may be the utmost in high-tech, but it is not true science."

I think this indicates a number. for example '4 out of 6 obstetric practices...' which isn't untrue.

Irrelevant marketing message: "In 20 other countries, more babies survive their first months of life than in the U.S."

This is true, and the inference is that it's because of the routine use of technology which would be better used on a case-by case basis. This applies, although is not directly relevant to the safety of homebirth. (which I don't think the intent of the site is to limit to this one thing)

Deliberate misrepresentation: "Respiratory distress among newborns was 17 times higher in the hospital than in the home. "

How should this sentance be written?

Irrelevant marketing message: "The U.S. has the highest obstetrical intervention rates as well as a serious problem with malpractice suits."

I agree, mostly irrelevant.

Lie or ignorance of the truth: "Studies done comparing hospital and out-of-hospital births indicate fewer deaths, injuries and infections for homebirths supervised by a trained attendant than for hospital births. No such studies indicate that hospitals have better outcomes than homebirths."


This is true, IMO, except for that last sentance. The Pang study should be represented in this paragraph. I realize you do not agree with this statement and that it's your main point against homebirth. However, you are in the minority when you disagree, and it's safe to make the above statement (save that last sentance) until your interpretation somehow becomes the accepted one.

False: "While maternal death rates have vastly improved since the turn of the century, factors like proper nutrition and cleanliness have played a big part in the change."

We've been over this one. The public health vs obstetrics debate. You have not proven your point. I believe the above statement on public health is correct.

Deliberate misrepresentation and irrelevant marketing message : "In 1939, Baylor Hospital Charity Service in Dallas, Texas, published a study that revealed a perinatal mortality rate of 26.6 per 1,000 live births in homes compared to a hospital birth mortality rate of 50.4 per 1,000."

I can't comment, I don't know anything about the above mentioned study.

Deliberate misrepresentation and irrelevant marketing message: "Midwives are the primary care-givers in countries with better neonatal mortality rates than ours. "


True statement, but irrelevant to your central point of neonatal mortality being the only point anyone should care about.

False: "Some hospitals still require women to birth lying flat on their backs with their legs held high in stirrups."

This is true, as my own experience has shown me. (or at least 3 years ago) note the statement says 'some' not 'all'.

False: "Drugs are still available to laboring women in the hospital, though no drug given in childbirth has been proven to be safe for the baby."

How can this be false? Just ask Sailor. You can't prove that any drug is safe for a baby. Just because you can administer another drug to negate the observable effects of the first, doesn't mean either one was safe. Nobody has done any long term studies, the data just isn't there. Nobody has proven any drug to be safe for babies.

False: "Women who have taken drugs in labor report decreased maternal feelings towards their babies and an increase in the duration and severity of postpartum depression."


This statement is true. A sample of women who had taken drugs DID report decreased maternal feelings and ppd.

False: "Normal household germs do not affect mother or baby."

I agree, False. Sentance needs re-wording to make it true. This is probably taken out of context, I'd like to see the site you're refering to.

Irrelevant marketing message: "Semmelweis was ridiculed by his colleagues, and it wasn't until five years after his death that his findings began to gain acceptance."

True statement, and relevant if the author is making the point that obstetrics is slow to change, even in the face of evidence. (episiotomys case in point)

Irrelevant marketing message: "Homebirth is not for every woman. It takes a high degree of commitment to health and learning and a high level of responsibility ..."

How is this irrelevant? This seems very relevant to me.

I think these statements may be all out of context, I'd like to be able to view the site first, before being able to adequately respond.

By Anonymous Anonymous, at 10:40 AM  

On a truely depressing day, you have managed to give me a chuckle.
Thanks

By Anonymous Anonymous, at 10:50 AM  

Irrelevant marketing message: "Homebirth is not for every woman. It takes a high degree of commitment to health and learning and a high level of responsibility ..."

This is where the homebirthing advocates always lose me. It's these not-so-subtle insinuations that you are somehow less of a person for not making their choice. When pressed, they say they're really all about choice, but when you read between the lines and pay closer attention, they're trying to tell you you're stupid and probably not a good mother if you choose to have your baby in a hospital.

When people are using that kind of language and putting that kind of guilt trip on women, then I know that whatever it is they're selling, I ain't buyin'. If you have to resort to cheap emotional ploys like this to manipulate people, there's nothing good about whatever it is you're advocating.

By Anonymous JDIAC, at 10:52 AM  

This is an excellent example of false and misleading information that is meant to lead women away from the basic question: does homebirth have an increased risk of neonatal mortality?

There are several key issues in this "marketing" campaign:

Engendering distrust of doctors:

MOST American obstetric practice is not based on science ...

While maternal death rates have vastly improved ... factors like proper nutrition and cleanliness have played a big part in the change.

no drug given in childbirth has been proven to be safe for the baby

Semmelweis was ridiculed by his colleagues

Desired take home message: Obstetrics is unscientific. It might look like it has been successful, but that's really because of public health initiatives. Doctors deliberately give unsafe drugs to women and they don't care. Obstetricians persecuted a valiant dissident (Semmelweis).

Misleading medical information:

Respiratory distress among newborns was 17 times higher in the hospital than in the home.

In 1939, Baylor Hospital Charity Service ... revealed a perinatal mortality rate of 26.6 per 1,000 live births in homes compared to a hospital birth mortality rate of 50.4 per 1,000

Women who have taken drugs in labor report decreased maternal feelings towards their babies and an increase in the duration and severity of postpartum depression.

Desired take home message:

Hospitals are so bad at providing medical care that they increase the risk of respiratory distress and death and cause decreased maternal feelings and postpartum depression.

Misleading information about putative achievements of midwifery:

Midwives are the primary care-givers in countries with better neonatal mortality rates than ours.

In 20 other countries, more babies survive their first months of life than in the U.S.

Desired marketing message: Midwives prevent neonatal mortality and doctors cause it.

An amalgam of falsehoods, misleading and irrelevant information is used to create the impression that midwives prevent neonatal death and doctors cause it.

By Blogger Amy Tuteur, MD, at 11:14 AM  

You need to disclose what site you are using.

If you are using Ronnie's site, you've misquoted much of this, as well as taken quoted statements way out of context and without the supporting statements. Or perhaps this is cherry picking your favorite quotes from a number of sites?

A little disclosure is needed here.

By Anonymous Anonymous, at 1:13 PM  

What jdiac said is so true for me, too. That's the same way that Christian fundamentalists turn me off. I'm not one of them, so they tell me that I'm going to hell. But oh no, they don't judge.

So let's say I'm a woman who chooses to have my child in the hospital with an epidural, will allow a c-section if it comes down to it, and might even, G-d forbid, use formula at some point. I get the very strong impression that most homebirth advocates might say aloud, "That's your choice" but truly do feel that I'm a bad mother for making that choice. That kind of guilt-tripping crap really does push me completely away.


And as far as the study done asking women who were medicated if their birth experience left them feeling more unattached to their infant and with longer periods of PPD, you've got to be freaking kidding me. Did every single mother who reported that also have a baby without medication to compare? I work with mothers who were medicated - and some of them very heavily so for various reasons - and not a single one of them has ever reported that those medications caused them to feel a lack of attachment to their infant or prolonged their PPD. That's a lame excuse someone would use. PPD does often lead women to feel less attached to their infant, but I know of NO scientific evidence that epidurals or other medications directly lead to PPD or a lack of attachment.

That claim pisses me off. Maybe some of you who believe that statement had that experience after a medicated birth - but then, most of you who advocate homebirth here appear so staunchly against the idea of having an otherwise normal pregnancy deliver in the hospital that I feel you would make this claim as one more nail to drive in your point that hospitals, and all who work in them, are evil.

I ought to check my blood pressure more often after reading some of these comments...sheeesh...

By Blogger NeoNurseChic, at 3:21 PM  

Here's the part I don't understand: why is it necessary to use false or misleading information?

If homebirth is as great as some of its advocates say it is, why not fill advocacy sites with stories of wonderful homebirths? Why is it necessary to denigrate medicine and to falsely boost midwifery? Why can't homebirth stand on its truthful attributes?

By Blogger Amy Tuteur, MD, at 3:21 PM  

What context would redeem those quotes?

I researched homebirth a lot. Sure, there were plenty of nice stories. But what Amy has shown here is a fairly accurate representation of how homebirth is marketed. Yes, marketed. They might not have any slick advertising agencies putting together a professional campaign, but there is a strong movement to 'educate' people about the evils of hospital births and the fairytale outcomes of homebirths. The homebirthing sites were decidedly aggressive against hospital and doctor attended births, as well as the attitude that jdiac and neonursechic have expressed.

I could not find a site that evenly dealt with the pros and cons in a substantive manner (as opposed to touchy feely). As much as some of you may not like this site and complain that it is not even sided or fair, it hardly begins to outweigh what is currently out there supporting homebirth.

By Anonymous Amka, at 4:03 PM  

-So let's say I'm a woman who chooses to have my child in the hospital with an epidural, will allow a c-section if it comes down to it, and might even, G-d forbid, use formula at some point.

Funny, neo nurse, that's exactly what came to my mind. That it's your choice! ;) I'm a woman who chooses to have my children out of hospital, would certainly allow a c-section if it 'came down to it', and might even use formula at some point. (although not likely in my case, I never experienced problems breastfeeding before, so don't anticipate having problems in the future... but, you never know!)

-as far as the study done asking women who were medicated if their birth experience left them feeling more unattached to their infant and with longer periods of PPD


Please note. THIS WAS NOT A STUDY, and never claimed to be one. It was a survey only, and the limitations of a survey must be recognized!!! If Amy is taking the info off the site I've looked at, it never presents this info as a study, nor does it try to extrapolate this to the general public. A survey has no scientific value, which was Amy's point I believe.

It has been really interesting to me to read these comments. I must come from a very sheltered area of the US, or else don't get out much...?!?!? because I've never heard some of the hard 'sales' you ladies are talking about. Of course, I decided on, and had, an OOH birth without ever having met anyone who'd done it before. So I guess I don't fit the steriotype. Of course once I met people through the birth center I knew many people who'd birthed OOH.

When I meet another mother at the park, or wherever the subject of birth comes up, people are usually genuinely interested in my experience. It feels really strange to see these very strong reactions. I imagine you ladies must have had some very negative experiences with homebirthers, or something...

Of course I understand why medical professionals, steeped in the medical model of birth would see things differently. The medical and midwifery models are very different from each other.

By Anonymous Anonymous, at 4:45 PM  

no one has to engender mistrust of doctors in me- on a personal level- If I can avoid seeing one I do. And this would be true of my parents, grandparents and great-grandparents-- would you like our list of having been malpractice - that we didn't sue for?
on this discussion you have been guilty of lies, misrepresentation , extreme bias... nuff said-

tell me doctor- the lithotomy position in birth has been "proven" the best for birth by controlled studies and I can read those studies where?
lets see -flat on the back- well half truth there what do you have a mini-wedge to shift to the side- legs up in stirrups --- unless there is a McRoberts manuver done then flat on your back is certainly the way that is done but legs are bent back enough to go under your arm pits--
which side is better for the wedge to be placed under left or right?
what is constant monitoring for? are there studies that show improvement in outcome? For who?
Are there studies that show not eating is the best way to conduct early labor? What are the reasons women cannot eat in labor?
what do the studies show about the safety of a urinary catheter ?
How does the US measure up to foreign countries as far as mortality rates , maternal, newborn and infant?

By Anonymous Anonymous, at 5:25 PM  

I imagine you ladies must have had some very negative experiences with homebirthers, or something...

Yep. And don't even get me started on LaLecheLeague...

Most of the homebirthing people I came accross were also pushing a religious agenda, so it was quite problamatic for me, an atheist.

I imagine I'm a bit older than most of you (my youngest child is graduating high school this year), and, in my day, the homebirthing/boobnazi crowd was beyond obnoxious. They were rude, aggressive, pushy and manipulative, and they definitely tried their darndest to make any woman who didn't see it their way and choose to do as they did feel like a failure.

My hospital experiences were fantastic, and that includes one very complicated, high-risk pregnancy, and I will be forever grateful to the medical staff who was with me every minute of every day through that pregnancy and who kept me sane, really, during a very stressful and emotionally difficult time. I can't say enough good things about them.

My daughter, now 17, perfect, brilliant and gorgeous in every way, is pretty damned grateful, too.

By Anonymous jdiac, at 6:17 PM  

as opposed to" touchy-feely " perhaps the core difference that you are not going to grasp. You can tell by tone and preference that touchy-feely is just not important to you -- most of the time we answer questions and give many articles and other things for clients to read- and we discuss.

If the medical model has no differences from how homebirth midwifery is practiced then why is it that the majority of homebirth consumers have had atleast 1 previous hospital birth with an OB? So maybe rather than let this unfairness continue we should recommend to clients to describe their hospital births in great detail.

By Anonymous Anonymous, at 6:38 PM  

-Most of the homebirthing people I came accross were also pushing a religious agenda, so it was quite problamatic for me, an atheist.

I can relate to this. I'm not a christian myself.

-My hospital experiences were fantastic, and that includes one very complicated, high-risk pregnancy, and I will be forever grateful to the medical staff

I am truly glad about your experience. And that is genuine. I wish everyone's experience with the hospital staff was just as nice.
anon 445

By Anonymous Anonymous, at 6:41 PM  

I am also an atheist... but you have to admit not many walking around. in any camp.

By Anonymous Anonymous, at 6:42 PM  

I don't know that there aren't that many atheists walking around, although they're definitely a minority in any camp, as you say, but maybe that you can't tell who they are is the whole point, if you know what I mean. It's not like they're sporting all kinds of religious symbols and messages like the religious people do.

It can be very disconcerting to be constantly seeing religious symbols strung around people's necks. You never really know what they're going to base their decision-making on. Look at all the controversies there are today involving religious people's "consciences" and the treatment people are or are not receiving as a result.

At least, in my non-religious hospital, I knew I was protected from someone deciding that was best for their "salvation" was going to trump what was best for my physical well-being.

By Anonymous jdiac, at 6:54 PM  

and when the nearest hospital is a religious one - thats where an ambulance takes you... KWIM

By Anonymous Anonymous, at 6:59 PM  

Ya, well, move....:-D j/k

Or just make sure you have a scrip for EC on hand just in case.

Not that that has anything to do with hospital deliveries, but women have to take responsibility for protecting their bodies themselves these days, what with all the religious nutters who would sacrifice your health or even your life in a heartbeat if they think they can earn points with whatever deity it is they're trying to get in good with. :-/

By Anonymous jdiac, at 7:28 PM  

you know amy I really like your split personality and like your other web site- patient advocates... seriously sick doc getting the run around...
in any case you wrote this :
"Here's the part I don't understand: why is it necessary to use false or misleading information?

If homebirth is as great as some of its advocates say it is, why not fill advocacy sites with stories of wonderful homebirths? Why is it necessary to denigrate medicine and to falsely boost midwifery? Why can't homebirth stand on its truthful attributes?"

For one I have read some beautiful homebirth stories- how about reading Baby Catcher not on line its a book
. on the other hand women who are homebirth consumers may be writing from the heart and you do not know that every experience that they talk about from lying flat on her back- which might not be done in your hospital but you cannot say with certainty that it doesn't happen in areas-to experiencing trauma and assault is not true- you work or have worked in a particular seems like sophisticated setting ( I say this because you have a neonatal doc who will show up for resuscitations) little podunc hospitals out in the sticks may have care providers 1 or 2 as the only selection and what they prefer to do is what is done--
how about cutting down to put a line into the bone of a neonate that is well hydrated and veins in full view? How things are done at a couple rural hospitals I know about.
the web is chocked full of glowing homebirth stories
a recent pole of homebirth mothers as to what influenced their decision to give birth at home- previous hospital experience(s). A friend having a home birth was last, not very influential.

By Anonymous Anonymous, at 11:44 PM  

The problem with the web being "chock full" of "glowing homebirth stories" is that there's no balance. These websites are set up to sell the homebirth agenda. They use carefully selected surveys and carefully selected anecdotal evidence to paint homebirthing as a wonderful, complication-free, Hallmark experience.

I think there are probably plenty of non-glowing homebirthing stories around, but it's not like the homebirthing crowd is going to include those stories on their websites.

I also know from personal experience that there are plenty of women who've looked into homebirthing and who've ultimately rejected it, and they don't get factored in to the picture painted on these sites, either.

By Anonymous jdiac, at 8:39 AM  

The women who look into homebirth and decide against it are factored in.... you know.... "homebirth isn't for every woman" That statement does not mean that women who don't choose homebirth are some how inferior, just that it isn't a decision that every woman is going to be happy with, just as hospital birth or birth center birth or elective c-section birth are not for every woman. You know, we all have to make our own choices when it comes to the well-being of our families. I don't think most homebirth advocates want everyone to birth at home or for that to be the only option, those of us who birth at home just want for our choice to be seen as a valid one and for people to understand it a bit better.

As far as the guilt trips go.... how can my decision to birth at home be enough to cause a guilt trip for a woman who birthed at a hospital? Just by me making a different decision? Because she might think that deep down I am judging her? So I should make all the same decisions as every other mother out there to be sure that no one feels judged? That is silly! I have noticed this with lots of aspects of parenting... because I breastfeed then occasionally someone who formula feeds assumes that I am judging them and consider them to be a bad mother or because I don't spank then a family member who does spank assumes that I am judging her. So, I guess I should just formula feed and spank so that those people don't feel judged. And birth in a hospital with an epidural (which I have done before) in order for other women to not feel that I am judging them. I have run into many women who judge me and concider themselves better than me because they use the top rated OB/GYN in the area while I birth in my bathtub and you don't see me getting my undies in a bunch over it.

As far as the birth stories go and how they aren't balanced.... sure they are! Look around on the internet and you find glowing stories of hospital births everywhere you look! You have to look harder to find the homebirth ones. There are tons of sites that are filled with information that are only directed at hospital birth, but you certainly can't expect a homebirth advocacy site to host pro-hospital birth info... that isn't their purpose. Just as I wouldn't expect an OB/GYN to host pro-homebirth info on their site. You won't find perfect balance on each website, the consumer needs to look at both ends for themselves and make up their own mind.

By Anonymous Anonymous, at 9:59 AM  

As far as the guilt trips go.... how can my decision to birth at home be enough to cause a guilt trip for a woman who birthed at a hospital? Just by me making a different decision? Because she might think that deep down I am judging her?

I'm referring to the rhetoric used on websites advocating homebirth and by the more militant, for lack of a better term, homebirthing advocates. I pulled the quote that was obviously designed to lay a guilt trip on any mother considering anything but a homebirth earlier in this thread.

Even some of the language on this thread has been subtley manipulative. I found the comment regarding my good hospital experiences, for example, quite loaded.

It's easy for anyone to find a crappy hospital and compare all homebirths to it. It's also easy for anyone to find one of the situations where homebirths went wrong because of lack of competent care and/or proximity to emergency medical resources and compare all hospital births to it.

It's about balance, honesty and facts. Leave out the touchy-feely overtones, the religious crap, the socio-political nonsense, and get down to the basic balance of risk v. benefit for individual women in their individual situations.

I'm all for choice, but only when the options proferred are all safe and based on documentable facts. Manipulative language has no place in a reasonable option.

By Anonymous jdiac, at 10:14 AM  

mostly you use a typical physician tactic and that is to be arrogant, superior and paternal--
so use-to making decisions for people if things don't go your way you raise the anti-- this is why physician's informed consents get thrown out first thing in court-- most people in this society including doctors do not believe patients can make informed choices-- and that is a double edged sword- the price of being an authority is the danger in being the authority - especially the authority that says do what we say and everything will be fine-- the risks are small... and that is the doc who is reassuring

By Anonymous Anonymous, at 10:28 AM  

"how can my decision to birth at home be enough to cause a guilt trip for a woman who birthed at a hospital?"

It couldn't. That's why people are not objecting to your decision, they are objecting to language used to describe the decision making process.

Take the quote that I mentioned:

"Homebirth is not for every woman. It takes a high degree of commitment to health and learning and a high level of responsibility ..."

The clear implication is that women who choose homebirth are better educated on the subject of birth, more committed to health and better able to shoulder responsibility than women who don't choose homebirth. First of all, it's not true, and second, it's a deliberate insult.

It's also very silly. The women who are undeniably the most knowledgeable about birth, have a lifelong commitment to health, and shoulder responsibility for the lives of many people beyond their families are obstetricians. They're not choosing homebirth.

By Blogger Amy Tuteur, MD, at 10:35 AM  

"The clear implication is that women who choose homebirth are better educated on the subject of birth, more committed to health and better able to shoulder responsibility than women who don't choose homebirth. First of all, it's not true, and second, it's a deliberate insult."

See, I think you are interpretting it all wrong. I believe what is being said is not that homebirthers are more educated and more dedicated and whatnot.... it is that homebirthers need to be educated and dedicated and all that jazz. A woman who isn't going to care for herself during pregnancy (such as by doing drugs, following a horrible diet, smoking, etc) is not a good candidate for homebirth. This is the way I have always taken comments like this. Not that homebirthers are somehow more superior, but that they need to step up to the plate in selfcare for the best experience possible. These comments that are being taken so personally, I don't think were ever intended to do so.

By Anonymous Anonymous, at 11:13 AM  

"It's also very silly. The women who are undeniably the most knowledgeable about birth, have a lifelong commitment to health, and shoulder responsibility for the lives of many people beyond their families are obstetricians. They're not choosing homebirth."

Do you have any stats to back that up? Percentages of OBs who homebirth themselves or their wives? Or is this just your assumption?

By Anonymous Anonymous, at 11:14 AM  

"Homebirth is not for every woman. It takes a high degree of commitment to health and learning and a high level of responsibility ..."

Interesting to read the rest of the quote:

"...to go against the majority who believe hospital births are better."

She's saying that:

* those interested in homebirth need to take good care of themselves to remain low-risk,

* those interested in homebirth need to be educated about it, and

* those interested in homebirth need to become familiar with the arguments for both sides.

I see no deliberate insult in this. In fact, I think it's very accurate. Education is crucial to deciding on whether to have a homebirth.

The most important point here is that homebirth is NOT for everybody. I doubt anyone, especially midwives, would disagree with the statement that women should birth where they are the most comfortable. If that's the hospital, then that's where she belongs. For most people this is the case.

By Anonymous wasting my breath, at 11:22 AM  

Wasting my breath-
Thank you for sharing the full quote. I wonder if it was purposefully only shared in partial before so that it could appear to be an insult, because in full it doesn't insult anyone at all and can't even be twisted into one.

By Anonymous Anonymous, at 11:37 AM  

"Homebirth is not for every woman. It takes a high degree of commitment to health and learning and a high level of responsibility ..."

Interesting to read the rest of the quote:

"...to go against the majority who believe hospital births are better."


How is this any better...? If anything, it's worse.

Here's a big news flash for y'all: It takes a high degree of learning, responsibility and commitment to be a productive, functioning adult in this society. Education, personal responsibility and commitment are necessary attributes for everyone in all situations across the board, period.

The implication is that women who are MORE responsible, BETTER educated, and MORE committed will choose homebirth, while those who are not as responsible, committed, blahblahblah will succumb to mindlessly following "the majority".

It is a completely unnecessary qualifier to the discussion, and the intent behind using it is purely manipulative.

By Anonymous jdiac, at 11:53 AM  

'The clear implication is that women who choose homebirth are better educated on the subject of birth, more committed to health and better able to shoulder responsibility than women who don't choose homebirth. First of all, it's not true, and second, it's a deliberate insult.'

I completely disagree. what the quote is saying is that a woman can't decide to stay home to birth and not educate herself about every little tiny thing about the birthing process.

Part of the reason is that midwives work WITH the client. That means every blood draw, every procedure, every risk and benifit and alternative, is discussed with the client in advance and the client makes the ultimate decision on if and when and what procedure is to take place. That's the 'responsible' part. women often show up at the hospital without reading anything past 'what to expect'. They have no basis to make a decision about their care, and it's often impossible for true informed consent to take place during active labor, when this is the first time you've heard of x complication or y procedure. This woman must simply take the doctor's word for it and move on.

The quote is pointing out that homebirth midwives do not operate that way. A woman is responsible for her own health care decisions. You must be educated and have a high level of responsibility to go this route.
1040

By Anonymous Anonymous, at 12:32 PM  

"Homebirth is not for every woman. It takes a high degree of commitment to health and learning and a high level of responsibility ..."

Interesting to read the rest of the quote:

"...to go against the majority who believe hospital births are better."

thanks for posting the full quote. obviously amy isn't sharing the source of her quotes because when read in full they aren't nearly as interesting.

OBs ARE sometimes choosing homebirth by the way, I know one personally, and several by association.

And it always takes a higher level of commitment and responsibility to depart from the 'norm'. Following the norm is simple and while there are many educated and responsible people who do it, it doensn't require either of those things.

By Anonymous Anonymous, at 12:39 PM  

And it always takes a higher level of commitment and responsibility to depart from the 'norm'. Following the norm is simple and while there are many educated and responsible people who do it, it doensn't require either of those things.

Oh, bollocks...

Heroin addicts and porn stars all go against the norm...not a lot of responsibility, commitment or education there...

It can be just as mindless to go along with an "alternate" option as it can be to follow a crowd. I've known people who make it a point never to do anything but freaky little alternative things for the sheer attention value alone.

Making decisions regarding something as serious as childbirth is never simple at all. It's always complicated. "Following the norm" is often the result of a great deal of forethought and research. Just because a thing is something that people choose most often doesn't make it bad. AAMOF, usually the reason it's the thing people choose more often than not is because it's the best option.

By Anonymous jdiac, at 3:56 PM  

If it is untrue that OBs use drugs that are proven dangerous for mom or baby, or if it is untrue that OBs use drugs that are not proven to be safe or unsafe, explain the following:

Thalidamide
DDT
Accutane
Cytotec

By Anonymous Anonymous, at 10:20 AM  

"Thalidamide
DDT
Accutane."

This is another example of making it difficult to take homebirth advocates seriously. Three of the four chemicals or medications you cited have NEVER been used by obstetricians.

By Blogger Amy Tuteur, MD, at 7:16 AM  

I think anon mean DES

By Anonymous Anonymous, at 11:44 AM