"Dr." Amy to speak at September ACOG conference

I just heard it through the grapevine that the formidable "Dr. Amy" of homebirth hater fame is on the docket to speak at an ACOG conference in September. And not surprisingly, one of her topics is "Everything an obstetrician needs to know about homebirth."

Of course, I don't know personally, but I'm going to take a wild guess that she's never attended a homebirth before. Yet she is probably considered the "expert" source on them, most likely because she squawks the loudest. Never mind what actually comes out of her mouth.

Here are her "credentials," according to the ACOG PDF handout:

Um, no, not exactly. Although I realize that the title "Dr." is often a courtesy after a physician has left practice or retired, this is incredibly misleading. My father-in-law is a retired physician that most people address as "doctor," but he certainly doesn't go around representing himself as a licensed, practicing physician. I would hope those in attendance actually know better when listening to her blather on for an hour about how much she hates homebirth and the women who choose them.

A Google search of her name produced the obvious results referring to her blog and "advocacy." She shows up on a number of websites like Healthgrades, listing a physical address to what would seem an office, but no reviews from actual patients. And when you search her name on the Massachusetts Board of Registration in Medicine database, you come up with this:

She spends countless hours trolling the internetz for every story ever published about homebirth and basically makes all natural birth advocates everywhere out to be liars. Yet she continues to represent herself as a licensed physician who is still practicing medicine. Hypocrisy much?

Since ACOG is trying to set guidelines that offer women the best care while treating them with dignity and respect, I'm not really sure how she fits into their lineup.

According to ACOG's website, they acknowledge that

"Most women have normal conception, fetal growth, labor and birth and require minimal-to-no intervention in the process. Women and their families have different views about childbearing based on their knowledge, experiences, belief systems, culture, and social and family backgrounds." (Really? They really believe that?! Who knew.)

It goes on to explain their idea of what "patient-centered care" means:

""Patient-centered" means that health care providers, and the system they practice within, accept that the values, culture, choices, and preferences of a woman and her family are relevant within the context of promoting optimal health outcomes." 

They also acknowledge that part of that patient-centered care includes having not only a skilled attendant (which can come in other forms besides an OBGYN), but also "supportive resources."

Based on their description, I don't think Dr. Amy fits into their scheme of things at all. Either that, or they're just very out of touch with the way a majority of births are carried out these days. Phrases like "support" and "education" are all relative, when you consider that many patients often get all their information from their physician and trust no one else in the process.

On the surface, healthcare initiatives and much of the jargon ACOG churns out sound great - but when you actually ask women about their experiences, it seems that there is a major disconnect. ACOG itself argues that they feel the hospital is the safest setting for giving birth, but admits that it "respects the right of a woman to make a medically informed decision about delivery." It's clear that Dr. Amy does not. I am really curious to hear how this one is going to play out.

From The SOb's website: What a caring, compassionate and professional
way to promote your "advocacy." Would you want someone this vulgar and
derisive in charge of your care? 

More reading:
The C in ACOG Stands for Castrated 

And you wonder why women don't want to give birth in hospitals ...

'Birth is inherently dangerous,' cries Dr. Amy, an outspoken 'skeptical OB' who seemingly roams the internet, looking for 'birth gone bad' stories in order to fan the flames of panic and worry. Skeptical of what? I wonder. That women can actually give birth without fear, worry and all the other trappings that come with it?

I've been pondering a couple of things lately: namely, again, the death of my great-grandmother, precipitated by my reading Tina Cassidy's book, and a recent visit from my mother. We talked about the physician who delivered my grandmother and again of his disgusting medical practices, even though the word about proper infection control was no doubt spreading faster than a colony of germs. She told me how classmates of hers remembered going to this same doctor for routine shots, and he would use the same needle on both kids.

Gack. No wonder my grandmother died, I thought. I'm partly tempted to use the 'they didn't know any better' defense for some of these a-holes, but yet I'm not sure that's entirely true. I mean, you wouldn't eat dinner with those filthy hands, would you? So why would you deliver some woman's babies with them?!

Dr. Amy wants us to believe that 'birth is inherently dangerous' because we never know what can happen around the corner. Yes, I suppose there is some truth to that. I can't account for every birth disaster or bad outcome, but neither can you compare it to the births of yesteryear (which I think she wants us to do). She relates that women routinely died in childbirth, but makes it sound (maybe not even intentionally) like it was a product of their own doing, a result of their body being 'defective,' rather than admit that many, many bad outcomes were a direct result of improper and inept physician care. (Cassidy cites this in her book, using the example of a well-qualified late 18th century midwife who had very positive outcomes, until a young, inexperienced doctor delivered one of her client's breech babies with fatal results.) She wants us to believe that being in a hospital is the safest place for us to birth our babies, even though we're treated like robots, or processed faster than a new Chevy on an assembly line in Detroit. (Never mind that, with modern obstetrics and interventions, the rate of neonatal death continues to rise in the United States.)

And anymore, it just seems like you can't put all your faith and trust in that guy in the white coat. Just because he has a diploma hanging on the wall doesn't mean he has common sense. In comparing my grandmother's death to medical practices of today, I found the curious 2005 case of Dr. Harvey Finkelstein , a Long Island anesthesiologist who was found guilty of reusing syringes in multi-dose vials, which put thousands of patients at risk for contracting blood-borne illnesses such as hepatitis and AIDS. So, do you want him giving you your epidural? Sadly, it is known that he is not the only doctor to have done this.

Even my dad, who attended my brother's birth in 1982, noticed the doctor arrived basically 'covered in blood' from another delivery and noted that he looked a mess. (Ironically, my brother suffered from severe group B strep after birth.)

But, if you are a health professional who happens to call your doctor on his/her mistakes, you just might get sent to prison for it. Anne Mitchell , a whistleblowing nurse from Texas, wrote an anonymous letter to  her boss, Dr. Rolando Arafiles, Jr. because of what she considered 'unsafe practices.' He promptly fired her. (At her trial, she was acquitted.) (More on the case here , where patients also stood up for the good doctor because 'he saved their lives,' including the town sheriff. It seems like poor Anne had the cards stacked against her from the beginning, maybe.)

Maybe this is why so many OB (and other) nurses don't complain about patient treatment when they work with a doctor notorious for being harassing or aggressive towards pregnant patients. Or, perhaps it's a case of 'if you can't beat 'em, you might as well join 'em.'

We know better now about infection control and safe medical practices, and have countless studies that prove some of the interventions and procedures performed on women might have the opposite effect on them. Yet doctors still blatantly disregard these common sense practices and throw all caution to the wind, often putting countless mothers and babies at risk for no reason.  Is it any wonder why women don't want to give birth in hospitals?

"Ricki Lake, please stop lying about homebirth."

This is the message on the May 3, 2009 blog posting of Amy Tuteur , whom I've mentioned here on this blog before. She is a mother of four herself, former clinical instructor at Harvard (I think we're supposed to be impressed and bow down, maybe?) and is hugely against home births. At least from her negative, biting, somewhat unprofessional criticism of it.

As I await a copy of "The Business of Being Born" on loan from the library, I think of how women have to fight every day to have home births in this country, and I bet Ricki Lake was like a shining ray of light in the darkness to them. A voice that said, 'Yes, you can do this!' Depending on where you live, it's very difficult, if not impossible, to get good support from the medical community when making this decision. And it's definitely a decision you don't make lightly. Whenever I'm in conversation with someone about the 'dangers of home birth,' I basically say, 'It's not like this person woke up this morning - the eve of their due date - and decided to do a home birth.'

It's interesting, though - if you do a Google search on 'celebrity home births' you'll get some fascinating hits. Celebs who have birthed at home include Meryl Streep, Pamela Anderson, Cindy Crawford, Christy Turlington, Demi Moore and Kelly Preston (some of them more than once). Maybe they wanted to avoid unnecessary interventions, avoid the paparazzi, or whatever - but who really cares? They did it. So how come I don't hear Dr. Amy blogging to Cindy, Pamela or Christy - all of whom have probably birthed less than a decade ago - to 'stop lying' about home births?  Did they either have just really supportive doctors and midwives or were they 'too beautiful, rich and powerful' to be told "no"? What the heck?

Another Google search will reveal tons of criticism about Ricki Lake, though. Included among the headlines are "Ricki Lake's home birth film upsets the AMA," "AMA to Ricki Lake:  No more babies in bathtubs, please" (as if), "Doctors unhappy about Ricki Lake's home birth movie," "Ricki Lake irresponsible to promote home birth," and of course the good doctor's blog headline. Curiously there is no criticism of the countless other celebrities who have also home birthed, maybe because they didn't have the guts to make a movie about it.

While I'm sure the AMA's fear about Ricki's movie is partly due to safety issues surrounding the baby and mother, it's also sending a very strong message to the mothers who want to avoid a hospital birth: not only do they not want masses of women 'jumping ship' and doing it 'their own way,' but that they don't trust you, or your care providers, to make good decisions regarding your care. Blogs like Dr. Amy's - "The Skeptical OB" - seem to reflect the feelings of the "industry" in general: that OB's are increasingly skeptical not only of women who deliver without interventions or pain meds, but also that women can make choices and decisions about their bodies and their unborn babies. Ironically, a woman's rights are more respected when she decides to abort her baby, but when she wants to keep it, it's as if she's merely a vessel and nothing more.

If anything, the movie should serve as a wake-up call to doctors and hospitals that perhaps there is a very good reason why these women chose to birth at home - and send a message to the "OB industry": that when YOU stop lying about c-sections, VBACs, and unnecessary interventions and get over your God Complex, Ricki will stop "lying" about home birth.

Home Delivery is for Pizzas

I was already in a bad mood yesterday. When I got to the grocery store, I happened to park next to a car with a bumper sticker that read, "Home delivery is for pizzas," with an image of a stork next to it. 

I wanted to blow a gasket. I searched female faces once I got in the store, wondering, "Was it her? Is it her car?", which is ridiculous, but still: I wanted to know who could possibly espouse such narrow-minded ideas. Surely, as a result of the great abortion debate, the mantra is, "Our bodies, our choice!", right? I guess only in certain situations. If you want to keep your baby, suddenly it's not your choice anymore what happens to your body or where and how you give birth. It's as if you've handed over all your rights to someone who suddenly knows your body better than you do. Lots of doctors (although not all, let's not lump everyone into that group, I suppose) use your baby as a weapon to coerce and pressure you.

While I've never had a homebirth, I was pretty darned close to the idea of one during my last pregnancy. I realize now it wouldn't have been the right choice for me (yay, two points for Dr. Congeniality and mom has to admit she is wrong!) but, had my child been in the birthing position, I was seriously considering going into labor on my own and having my friends at the local fire station attend their very first HVBAC. 

There are lots of reasons why someone might choose a homebirth: a terrible hospital experience, fear of being pushed into numerous unnecessary interventions, or wanting to birth in a natural place that was most comfortable to them. One look at the crazy ridiculous c-section rate in this country and I can totally understand, especially after having had two sections myself. I haven't met a doctor yet who doesn't see pregnancy and birth as a medical condition, a clinical process that has nothing to do with your mind and spirit as much as it has to do with your body being an amazing machine, really. They offer little support in the process and do more to tear you down than build you up. They could have witnessed thousands of successful births, but the minute you mention the words 'homebirth' or VBAC, they immediately start pulling out the horror stories to dissuade you from making a decision about your own body. Yes, it's important to know the risks - but more importantly, it's key to have support in your decision. 

I got online to read the statistics on the safety of homebirth, and once again was directed to the blog of Dr. Amy Tuteur, an OBGYN. While not discounting any of Dr. Tuteur's experiences, I couldn't believe the sheer arrogance expressed in her blog. She claims her site, homebirthdebate.blogspot.com, is for both supporters and opponents of homebirth. But it reads more like a bash session against homebirth and midwives than anything else, and supporters are probably few and far between. At one point, Dr. Tuteur actually says, in the comments section of her post "and they wonder why no one takes them seriously," that "midwives lack basic knowledge, and don't like what they find out when they do acquire basic knowledge." She goes on to say, "Midwives aren't knowledgeable, they don't like what knowledge shows them, and they place inordinate value on their own emotions."

Midwives aren't knowledgeable? What? Isn't that a bit of an overgeneralization? The certified nurse midwife who delivered my second child certainly seemed to know what she was doing. No woman, or midwife, should approach homebirth without a lack of knowledge. I also don't know many women who wake up at 39 weeks pregnant and say, "Oh, I think I'll have a homebirth!" Nor can I imagine a midwife who says, "Sure, let's do a homebirth! How hard can it possibly be?" You cannot approach a homebirth or VBAC without knowing the risks, and the facts - not the trumped up worries of a handful of people who think you're being selfish or dangerous. Tutuer is trying to separate the emotional from the clinical aspect of birth, and in my experience, you can't do it. You can't deny that birth is a very emotional, spiritual process, something that many cold, scientific doctors are unwilling to admit or lend credence to. If midwifery is not to be trusted, and midwives like Ina May Gaskin are so 'unknowledgeable,' then how do you explain her success rate? 

Whatever the case, yes, there are risks. But there are risks to doing everything: riding in your car, going for a walk outside, even having a fatal accident within the four walls of your own home. It's important to put this into perspective, rather than fall victim to scare tactics like the ones Dr. Tuteur has firmly seeded in the brains of women everywhere. The what if's that might never be suddenly take on a life of their own and completely overshadow everything else, and ultimately, there are risks involved that might be unavoidable, even in a controlled hospital setting. Because that's what it's ultimately all about: control, and how countless American obstetricians suffer from a God complex and are trying to control a process that is still not up to them. What she fails to mention is that women still do die during hospital births and after c-sections, even despite our wealth of knowledge and superior facilities. She also fails to mention that the intrusive and often unnecessary practices of her very cohorts are what drives many women to seek out a homebirth in the first place.