Fighting–er, I mean debating about homebirth
Check out this article about how homebirth increases the neonatal mortality rate by Amy Tuteur, the Skeptical OB. I’ve been reading her blog for a while now. I started with her previous blog, Homebirth Debate. There is probably something appealing to many folks on Dr. Amy’s, whether you are interested in homebirth, or dead set against homebirth, or just wanting information about homebirth, or really, even if you don’t give a hoot about homebirth but just love to watch people get seriously into it with each other in the comments. I mean, these folks go at it. It’s kind of like the Jerry Springer of skeptical blogs. I can’t get enough. This article takes a look at recent data and finds that,
Homebirth increases the risk of neonatal death to double or triple the neonatal death rate at hospital birth.
And then go read the comments. Amy holds her own. I have to had it to her. I would probably wither in the face of such meanness. If you want to get the full impact, go back and take a look at the old Homebirth Debate blog, where there are often hundreds of comments per post, and people will just let the name calling fly.
Aside from the visceral thrill of reading so much vitriolic discourse, I enjoy Amy’s blog because she is such a staunch defender of hospital births, which is refreshing if you are surrounded by homebirth and water birth advocates, as I am here in LA. Amy cuts through the repeated lines of the birth cult folks and offers up real numbers to prove her points. In another post, she dissects a WHO paper examining C-section rates. I’m sure we have all heard that in the US the C-section rate is “too high,” but Amy argues that the “ideal” C-section rate is actually higher than we might think.
She also does a good job revealing the mythology and marketing behind organic food.
But whatever you read over there, make sure to read the comments, and if you’re in a fighting mood, maybe even make some of your own.
Deb Said,
July 29, 2009 @ 5:08 am
Out of curiosity, is there no middle ground in the US? In Australia birth centres, generally attached to hospitals but midwife run, are extremely popular. And a lot of hospitals are very laid back – I went with a private ob, but he considered intervention free, upright birthing, delayed cord clamping etc to be fairly standard.
Deb
molly Said,
July 29, 2009 @ 6:26 am
Ok. I am about to be one of the “mean” ones and engage in a few bitchy logical fallacies. yay me.
“Dr.” Amy (ad hominem!) is not a licensed physician and her views on the legitimacy of MY FAMILY are so violently cruel (Poisoning the well!) that I cannot stand to read one more word of her smug blog (more ad hominem!). I understand the feeling of needing an advocate for this position, but isn’t there a source motivated more by science and reason and less by ideology??
In this case, the enemy of my enemy* is just a cruel, homophobic blogger.
*to be clear my enemy is not homebirthers but merely the “woo” and misinformation attached to the “movement”.
molly Said,
July 29, 2009 @ 6:29 am
Ok. I am about to be one of the “mean” ones and engage in a few logical fallacies. yay me.
“Dr.” Amy (ad hominem!) is not a licensed physician and her views on the legitimacy of MY FAMILY are so violently cruel (Poisoning the well!) that I cannot stand to read one more word of her smug blog (more ad hominem!). I understand the feeling of needing an advocate for this position, but isn’t there a source motivated more by science and reason and less by ideology??
in This case the enemy of my enemy* is no friend of mine, just another homophobic blogger convinced she knows everything about How Things Should Be.
*to be clear I have no dog in the homebirth fight, my enemy is only the anti-science motivations of some homebirth advocates.
Julie Said,
July 29, 2009 @ 7:44 am
I haven’t seen any homophobic posts on her blog. Can you provide a link? That certainly would disturb me, as I am a huge supporter of gay marriage and parenting.
From what I’ve seen, her views on homebirth are backed by science and reason. That doesn’t mean that she’s 100% correct. One commenter pointed out that although Amy did provide evidence that homebirth with a direct entry midwife was three times as risky as hospital birth, the mortality rates in either case were very low. And he further commented that perhaps the solution was to improve the safety of homebirth to make it a better option, not to outlaw it. I thought it was a good observation.
molly Said,
July 29, 2009 @ 8:07 am
Tuteur blogged on Open Salon for a while before she took her ball and went home. She does couch her opinions of gay parents in “logical” terms but also admits that it is ideology, and not science, which drives this opinion of hers. here’s a delightful taste!
Bursa Vortex:
“You’re saying that gay men who conceive children through surrogacy and raise them without mothers are bad parents? You’re saying lesbians who raise children conceived via sperm donors are bad parents?”
I’m afraid so. There’s a difference between what adults want and what children need, and children’s needs trump adults’ wants.
AmyTuteurMD
February 23, 2009 11:09 PM
From her charming screed against single mothers: http://open.salon.com/blog/amytuteurmd/2009/02/23/are_fathers_optional
I fully recognize that this aspect of her opinions does not actually invalidate any other point she may want to make. However, there it is, I can’t get past it. It wasn’t relevant to the topic, I was just reacting. Sorry. I actually have nothing to add to a homebirth debate or birth discussion period: we adopted and have zero experience re birth.
Julie Said,
July 29, 2009 @ 8:27 am
Wow, clearly I have not read every post of hers, and I agree her opinions on these subjects are pretty offensive, if you’re someone like me. From the link you provided:
Um, what? She says in that post that on every measurable parameter of child well being, kids with fathers do better. But she doesn’t cite any sources for that opinion. I must admit I really can’t stand that particular opinion. We’re a two parent family, but I fully support any woman who decides to become a single mother by choice. I was almost there myself a couple years ago.
I have to agree that for me personally, the revelation of her ideological position on those issues somehow casts doubt upon her reasoning in general. Perhaps I’m particularly biased in this regard, because I feel so strongly that gay parents and single moms do fine. If there are studies that show that kids are harmed by these arrangements, I’d first of all wonder who commissioned the studies and what agenda was behind them.
In any case, I’ve only read her posts on homebirth, and I still think on that subject, she’s pretty cogent. If women want to give birth at home, that’s their choice, but movies like The Business of Being Born really do a disservice to mothers by presenting homebirth as the safer option. It seems to me that if you want to make that choice, it’s best to be informed about the actual risks. But certainly I can see that her staunch stand on other moral issues might make her a bit of a reprehensible personality to many.
Erin Ellis Said,
July 30, 2009 @ 1:23 pm
The problem with Amy’s arguments is that she tailors information to suit her side, often misrepresenting the evidence she cites. She has an agenda, clearly, and is willing to bend the evidence to that end. Unfortunately most people without statistical and epidemiological skill will not catch on to this, and view her arguments with trusting approval.
Looking beyond single voices on the subject, and toward international maternal and infant health organizations and experts–who are not competitors of midwives–the consensus is crystal clear: midwives are the most appropriate care providers for low-risk women in all settings-home, birth center, hospital.
Candace Said,
August 2, 2009 @ 6:12 pm
It is interesting that Amy’s information is counter to every single reliable source…even associations of physicians that have come out with clear statements against home births.
If she holds her own it is only because most rational people have just given up on engaging her and prefer instead to debate those who play by the rules of logic, factual information, and sanity.
Jodie Miller Said,
August 6, 2009 @ 10:20 pm
I’m in Australia too, and my children were born both in a birth centre and at home with competent and experienced midwives. I happen to think that the place of birth is irrelevant to birth outcomes at the population level, but it is how the individual mother feels about the place of birth that overwhelmingly affects her birth’s outcomes. Home birth is a choice on an equal par with birth centre or hospital birth, and every woman has a right to that choice. No one is entitled to an opinion on that choice. It is, and should simply be, choice.
In the case of some women it is bound to be ’safer’ (due to feeling comfortable and ‘letting go’ that is a necessary part of the process of birthing) and some women will have conditions present that complicate their risk profile whether they birth in a hospital or at home. It is still THEIR choice to make and it costs LESS on the public purse than the obstetric equivalent in the majority of cases.
No single person’s opinion is going to affect my knowledge of my own body in the intimacy of my own environment. If we stop thinking of hospital birth as the norm, handing birth choices (and education) back to women and giving space to every woman’s unique and individual needs in the vulnerability of childbirth is the only way to reduce the caesarean rate and give babies an optimal first meeting with their families.
I was once involved in grass roots birth reform at a local level. Now it is being debated in the Australian Parliament. I cannot understand how properly regulated home birth with competent midwives is not a basic right. The fact that this is even being debated on various fora and at high levels of government bodes well for my daughter’s choices, when their time comes.
Emilia Said,
August 9, 2009 @ 8:16 pm
I looked at a study showing that children of gay parents were less likely to be aggressive than children of heterosexual parents. I remember Amy Tuteur said that once as a resident she threatened to break the arm of an old woman with dementia she was assigned to in hospital. Hm… maybe she doesn’t like same-sex families becasue the kids in them will never threaten to break anyone’s arm! (By the way, I’m 100% heterosexual.)
Emilia Said,
August 9, 2009 @ 8:21 pm
Regarding home birth, I’ve never had any strong opinion on it or any interest in undergoing it myself (and now it would be totally out of the question for me because I’ve had a cesarean, though in the small likelihood I get pregnant again I might try for a vaginal birth in hospital). On the other hand, some studies in places like the Netherlands and Britain show that home birth can be safe if: 1.) the woman is not at high risk for complications (ex. conditions like a twin pregnancy or gestational diabetes would make home birth highly inadvisable); 2.) the birth attendant is highly trained (as midwives in the UK and Holland are); and 3.) if there is efficient transportation to a hospital if complications arise. Again, I have no personal stake in defending home birth and even if I could met the three above-mentioned criteria I probably wouldn’t give birth outside a hospital, but just a point to consider.
Emilia Said,
August 15, 2009 @ 9:27 am
I think endorsement of an individual like Amy Tuteur on a site calling itself “Rational Moms” is a bit like a website on evolution endorsing a creationist.
Trusted.MD Network Said,
September 1, 2009 @ 6:23 pm
Underground Moms…
I guess I’d have to say I am an underground grandmother, as my youngest will turn 21 in December. But I was definitely a free-range mother, and do what I can to support my two stepsons & daughters-in-law in fear-free……
Emilia Said,
September 20, 2009 @ 10:24 pm
One other thing about Amy Tuteur: she herself admits she has one child on the autistic spectrum (Asperger’s) and another with severe learning disabilities. I suspect that Amy Tuteur is unhappy with her family life and therefore tries to make herself feel better by attacking other families (specifically same-sex and single parent ones) and look “superior” to them. So perhaps we should pity rather than condemn her.
Let me add that by no means are all parents with autistic or otherwise disabled children like this. In fact, many I know are among the most compassionate people around. Sometimes children with a disability can bring out either the best or worst of human nature – and Amy Tuteur has shown which side she falls on.
Emilia Said,
October 27, 2009 @ 12:21 pm
One other tip: getting parenting tips from Amy Tuteur is like calling up the spirit of John Candy or Chris Farley for dieting tips!