'Abortion fund' is going broke

The other day I read a blog post about how the New York Abortion Assistance Fund is "going broke" and they are making pleas for financial assistance. The non-profit organization provides money to low-income women for them to seek an abortion.

A couple things bugged me, and continue to do so. First, as a Christian, I have a problem with abortion, but - a BIG but - realize that sometimes there is no choice. An ectopic pregnancy, for instance, can threaten your chances of getting pregnant in the future and even kill you if left untreated. Although rare, they do happen, and apparently from some figures, are on the rise.

This is a topic that I tend not to write about, simply because it crosses over into difficult territory when it comes to matters of morality, politics, and spirituality. (I hesitate to use the term 'religion,' because there is a difference.) But this time, I couldn't help myself and it weighed so heavily on me that I had to say something.

I went to the NYAAF's website and saw they were having a number of fundraisers to help their cause. They spoke of a recession being to blame for donations being down, and were holding a bowl-a-thon and some kind of event with alcohol (wine tasting, maybe?) to raise funds. I kind of frowned, because the whole idea of a "bowl-a-thon to support abortion" seemed so bizarre and to almost trivialize the whole thing. That, and kind of thought, "Isn't one of the main attractions of their fundraiser - alcohol - probably what aids in more unplanned pregnancies all over the world?"

Ironically, the very recession that's causing funding of this program to dwindle should be the biggest motivator for people to make even more of an effort to prevent pregnancy.

I then went a little further by researching some of the reasons most commonly cited for abortions. Economics is definitely one of them, where many low- and middle-class women decide to have one because they just can't afford to keep the baby. Only five percent, according to the pro-choice Guttmacher Institute, are done because of situations involving rape or incest, and an equally small number are performed for life-threatening medical conditions.

Fetal abnormalities and sexual assault aside, the greatest number of abortions, according to the Guttmacher Institute, are done because of convenience reasons. I won't so much go into that as much as I am blown away by those who claim 'they had no idea' about access to pregnancy information, how to prevent one, or even claiming that birth control is "inaccessible."

I'm not sure I can believe this.

In today's age, we have unlimited access to the internet, computers, libraries and publications - the works - all at our fingertips. I am willing to bet a large percentage of those people who fall into the "low-income" bracket have a computer at home. At the very least, they can obtain a library card, which gives them unfettered access to library computers, magazines and other publications that can tell them all they need to know and more about birth control and its proper usage. I am wondering why more people don't take advantage of these resources.

You can also go down to any corner drugstore in probably every small town and big city in North America and buy a box of condoms or spermicide. Heck, you can even get them in a vending machine at the truck stop. I mean, is limited finances really a valid excuse anymore? Why not do something to prevent a pregnancy in the first place - because, we should all know that what goes in must come out - and avoid the heartache, emotional and psychological pain, as well as social stigma, whether right or wrong, of having an abortion?

In today's American classrooms sex education classes are usually offered. I have mixed feelings about this: personally, I think parents need to do a better job in educating their children about this stuff and tell their kids the facts, instead of letting them hear it on some talk show or off the street. It doesn't mean you have to hand out birth control; it just means you need to tell your kids that there is always a risk of getting pregnant any time you have sex. Period.

I can't help but think of a couple friends I have on FaceBook who gave birth before their twenties and are now entering grandmotherhood at age 34.

It's estimated that about 18 percent of abortions are performed on teens. And I'm guessing that a growing number of those teens fit the "low-income" category the NYAAF is talking about because they feel they cannot go to their parents for financial assistance when it comes to either having an abortion or raising a baby.

Conversely, I'm wondering just what parents are telling their kids about sex these days. From the looks of it, based on the questions I see on the birth boards I frequent, not a whole hell of a lot. One classic question came up the other day: "Can I get pregnant from having anal sex?" Excuse me? I hope this is bogus. As I told the person, "If you have to even ask this question, then you probably shouldn't be having sex in the first place." If we have such basic misunderstanding or complete lack of knowledge about our anatomy, it's not a wonder teens - and even adults - get pregnant.

Aside from the anal sex question, I have seen more than my fair share of "Am I pregnant?!" questions, including "Can I get pregnant from skipping two pills in my pill pack?" That's usually pretty common. I don't know what's going on here - either the sex ed they're doing in school is not working, or people need to read basic instructions. If you've ever had a prescription filled, you know that the pharmacy includes basic patient information on how to take your medicine. And even if it's not a prescription, there are the package inserts that come with condoms, spermicide - heck, sometimes it's even written on the outside of the box - that plainly say how to use it, when to use it, and that it could fail. Therefore no one can ever say "I had no idea," because it's all right there. Perhaps a milk carton campaign is in order - whatever it takes to get the word out. But its genesis has to start somewhere - and I do think that's squarely with the parents.

Unfortunately I think some parents believe this role should be approached by the public school or the government. And abstinence is always an option, although people quickly dismiss it and say "it doesn't work." As my physician father-in-law says, "Abstinence works every time it's tried." The problem is, it doesn't work because no one's trying it. I've heard the argument "that's unrealistic - humans are sexual beings," as if to justify why it's normal for someone to have sex even though they shouldn't be, as if they just can't help themselves. I'm sorry, but we aren't animals, and unless you're capable of either seeking treatment for an STD, preventing an unwanted pregnancy, taking care of a baby, or dealing with any of the other myriad problems that sexual intercourse presents, you shouldn't be having sex.

And not surprisingly, a lot of teens take a very cavalier approach to sex and pregnancy, comprising a growing number of people affected by STDs before they're even 18. Some I've read questions from use terms like "getting rid of it" to describe what to do in the event of an unplanned pregnancy, and many describe situations about having an abortion only to suspect that they're pregnant just a few months, or even weeks, later. I wonder, does the NYAAF endorse this kind of behavior?

Statistics say that half of American women will have had an unintended pregnancy by the time they are 45. I can say, that two summers ago, I became one of those women. I am happily married, but for whatever reason - namely, because I wanted to lose more weight - I was not planning on getting pregnant. Thinking I knew my cycle like clockwork, I got pregnant. That was a major shocker - I was totally unprepared, in denial, and scared. Then, after a few days of fits of weeping and sadness, I pulled my head out of my ass and realized that maybe this could work better than I thought it could.

As a woman who lives in New York State, I technically (probably) meet their "low-income" requirements. (We already qualify for WIC, which seems kind of laughable, actually.) However, I know that I can easily get reliable birth control, even without a prescription. I know that I have choices - they include not having sex, or protecting myself. And, ironically, the one time birth control failed me was when I did not use it.

Because I don't have a money tree growing in my yard, I sought out an alternative to getting prescription birth control: one that doesn't involve hormones, and is fairly convenient and easy to use. You can get it at Target, Walmart, and I'm sure lots of other places. I know people of all economic backgrounds shop at Target and Walmart, and so I'm wondering where the idea of having limited access to reliable birth control comes in.

Of the women surveyed by the Guttmacher Institute, "fifty-four percent of women who have had abortions had used a contraceptive method (usually the condom or the pill) during the month they became pregnant. Among those, 76% of pill users and 49% of condom users report having used their method inconsistently."(emphasis mine) A certain percentage reported getting pregnant while using those methods, and reporting consistent usage; we can assume that a) these people contribute to the reported failure rate of certain forms of contraception, or b) that perhaps their idea of 'consistent' isn't all that consistent. And, "each year two percent of women aged 15-44 have an abortion; half have had at least one previous abortion." That's quite a large number, when you consider the entire female population of the United States.

Even more alarming, is that of those surveyed, nearly 50 percent of them had used no contraception whatsoever. "Of these, 33 percent had perceived themselves to be at low risk for a pregnancy." Scary. The study goes on to say that, statistically, those people for whom non-use of contraception is greatest are those who are "young, poor, black, Hispanic or less educated." That opens up another can of worms for sure, a can so big I could devote an entire blog to it.

Interestingly enough, when I googled "pregnancy prevention" I found a lot of resources that dealt with teenagers. However, statistics show that women between the ages of 20 to 24 obtain 33% of all abortions, and around 24% of women aged 24 to 29 obtain one. As if to reflect the trend of abortion for convenience sake, one particular website offers the stories of unremorseful women who've had abortions - many, if not all, of which featured stories from women who got pregnant because of extreme lapses in judgment involving alcohol use, or because they simply did not use contraception (or both). I went round and round with one woman who supports the site not that long ago, who's newspaper editorial on the subject - and her rather blase attitude about the whole thing - started off a veritable firestorm of fury.

Of course we know birth control can fail. Prescription, non-prescription; we know it can happen. I remember one woman on a birth board who had like six kids, all of which were conceived while she was taking some form of birth control. If you are concerned at all about preventing pregnancy, then at the very least, use it. The Guttmacher Institute and others say that even though there is some margin for failure when using protection, it's still much better than not using anything. And if you're really concerned about getting pregnant, double up. If you have a known medical illness that could pose serious threats to your health should you get pregnant, double up. It seems rather simple, really.

It's hard not to draw some conclusions here: that people who choose not to use birth control and have sex, yet wind up pregnant unintentionally, are somehow not taking responsibility for themselves. Blaming an inability to afford it seems like a weak excuse when you consider the growing number of cheap, effective ways of preventing pregnancy. Coupled with ignorance about basic bodily functions and a complete lack of motivation to find out about them, it presents an alarming trend.

You don't really have to be a rocket scientist to prevent a pregnancy. I guess it just means you have to want to prevent one. I would (and probably do) dole out taxpayer money to educate women (and men!) to become better advocates of their own health - and to take charge of their fertility - before it's too late.

Being censored: by your OB?

Dovetailing on my last blog post, I received a comment from reader K, who said that many doctors are requiring releases be signed, among the mountain of other paperwork, that basically say you will not go on web sites like Rate MD's, etc. in order to leave bad reviews about them. I had no idea, but it makes perfect sense.

I've never seen such a release while filling out paperwork at any of my doctor's offices, but then again, I haven't really looked for it, either. K said that, tucked in between HIPAA regulations, this that and the other, is the form, which basically means you are effectively being censored - by your doctor.

This article basically states that if you sign such a release at your next visit and break that agreement, your doctor can effectively get your negative review removed, no matter how true it might be.

Now, I've never known anyone who's actually sued their doctor. Some lawsuits, for sure, are definitely warranted. I've known some patients who probably could stand to have sued - but didn't. Conversely, I also know that some physicians are sued when they shouldn't be, unfortunately. You will always have patients who, coupled with a shady trial attorney, will bring you up on ridiculous charges and somehow win. Perhaps that is less about the capabilities of our doctors but the state of our legal system. (Think lady who sued McDonald's for coffee that was 'too hot' and won, for instance.)

Instead of being able to silence patients, I think these doctors should perhaps take a look at their practices. Take Dr. Yacht, for instance, and his reviews. Judging from corroborated information from another physician, we know that there is probably some truth to those negative comments about his '8 to 5' delivery practices.

And I'm not sure what doctors are really worried about - yes, you will get a few wackos writing in who will always have something negative to say, no matter what. That probably can't be helped, but neither should their right to say something be removed. Doctors are concerned that ex-spouses, 'disgruntled employees' and others who are not truly patients will write something that could cause great harm to their reputations. However, for the few bad reviews there are million that claim "Dr. Yacht delivered all six of my babies by c-section and saved my life!", so it appears that no one is listening anyway. How easy would it be for a doctor to delete a dozen or so truthful comments about questionable medical practices, under the pretense that it's an angry former employee?

Interestingly enough, the blog post linked above mentions a trial lawyer who is developing a plan to countersue patients in a "three-pronged attack." I can see where this could benefit a physician who is being sued by a 'sue-happy' patient - there are lots of those out there. But in the case of obstetrics, this could present a problem. Many OB's get sued because the 'patient didn't get a perfect baby,' as they say. As a result, sometimes the OB's response to one problem is to implement measures to avoid future problems in all patients, which is no doubt where we've crossed the invisible line of necessary vs. harmful in obstetrical care. Too much care in the form of more monitoring, checking, etc. etc. has actually proven non-beneficial - but this is no doubt one of the reasons why. How can you prove your doctor was practicing unethically when he "pitted you (and all his patients) to distress"? When a certain percentage of doctors do this, is it considered mainstream behavior and therefore acceptable? Where do you draw the line?

All I can say is, read the fine print, ladies. Don't sign something before you've read it - which is easier said than done when you're contracting in labor and they shove a release form in your face. This is probably how many unwanted procedures happen - when they catch you at a moment where your guard is down and you are too distracted to read everything.

As one patient put it, "I would not be likely to even want to be treated by a physician that was so paranoid about what might be said about them by a patient so as to request that such a document be signed by them. For me, that would be a signal to get the hell out of their office asap and never go back."

My sentiments exactly.

Spreading the word on 'cut happy' doctors

Original photo credit: Gareth Weeks

There is a lively discussion underway on The Unnecesarean's FaceBook fan page about a doctor who's c-section rate is allegedly around 50 percent - and, not surprisingly, he has a yacht named "Sea Section." Nauseating? Yes. Surprising? Not really.

Apparently, several patients have complained on a doctor ratings web site that he is an '8 to 5' doctor who likes to deliver babies during his shift (at any cost) and then go home for pleasure cruises on his boat (just my speculating, here). One woman admitted that he actually turned down her epidural at the end of his shift - what, in an attempt to get her to consent to a cesarean? As punishment because she didn't want to submit to his brutality?

Another woman gleefully commented that 'both of her children were delivered by c-section by him and that she tells all her friends to go there.' Dear God, help us!

This is the interesting thing about recommending a doctor: if a patient feels they've had a good experience (whether it really was or not, it seems) they don't hesitate to tell all their friends. However, if the doctor does a terrible job, they often chalk it up to a bad experience and move on. If they know the truth behind what he did, do they talk about it to everyone? For those few women who do say something, those who are completely brainwashed seem to disregard it completely.

That ratings website is just one way we can be better advocates - it doesn't take you standing on the rooftops screaming full tilt about your episiotomy, or getting into anyone's face about it - but just leaving a review to speak about your experience in hopes of warning others. Cut and paste, and leave on another site. And another. There is nothing wrong with that. As long as you are level-headed and polite about it (and heck, even if you aren't, you have a right to be angry about it), it's a free country - you can say whatever you want. Why are we so afraid to 'hurt the reputations' of those who have hurt us? As long as it's the truth, it deserves to be told. And loudly.

This is the 'age of information,' where private and public details can be made known in the blink of an eye. It's easy enough to do the research and have the paper trail to back it up: at least one commenter on Jill's site said that a fellow physician could confirm that this doctor does, in fact, have a yacht named "Sea Section." His alleged rates (which can probably be confirmed quite easily as well) obviously reflect that, and by having a boat named that (lots of OB's do, apparently) is making a mockery of a woman in her most vulnerable moment. It's making a mockery of her pain (as the one reviewer could testify to), and of the beautiful experience that childbirth ultimately should be. It also seems like a slap in the face to the insurance companies who are paying for these procedures that often drive up costs for other people, all so Dr. Yacht can go and enjoy his long weekend.

I would love to see someone go down to that marina and take a picture of his boat - and then get testimonies from patients about what has happened to them - and take it to the local paper or television station. It may not result in much, but then again, it also might. If enough pressure is put on, maybe it can result in disciplinary action. Maybe complete loss of privileges. Maybe, at the very least, public scrutiny can cause this guy to change the way he practices medicine, because people realize it's not in their best interests and puts them at needless risk. To the wrong person, it might sound like a witch hunt - but then again, a news broadcast viewed by one member of the Florida State Medical Board might result in an investigation that could finally open the eyes of Dr. Yacht's entire patient base. You just never know.

My very first blog giveaway!

As I said on my FB fan page, I'm in the mood to give something away!

Once my fan page gets 50 fans, I'll give away a new copy of Jennifer Block's Pushed to a lucky reader! Read and enjoy, or pass it on to a friend who might be able to use it. It's great reference material for those arguments on birth we often find ourselves getting into, (what, me? Argue?! Never!) and a real eye-opener as far as what's truly wrong with maternity care in this country today. If you have a copy already, pass it on - heck, maybe even donate it to your local public library so there is one more copy of a reliable source of information out there besides the same old same old that's probably been on the shelves since 1986.

Click on the FaceBook box to the left to go to my fan page and click "Like" to be eligible. Hope to see you there!

And while you're at it, check out Jennifer Block's website at http://jenniferblock.com/ .

Woman wins right to keep placenta after birth

According to this news report , a Las Vegas woman has fought her battle with a local hospital to keep her placenta after the baby was born. She planned on encapsulating it and using it to combat postpartum depression.

The hospital put up a fight about it and lost, but not before they warned the patient not to ingest it because it could be 'contaminated.' They told her it was "contaminated medical waste and that federal law required them to dispose of it."

Apparently, the hospital told the woman that it carried risk of being tainted with Hepatitis, HIV, etc. which is all true. However, don't you think that a person interested in the benefits - however subject to scrutiny they might be - of eating their own placenta is aware of this? I'm also curious how, if she doesn't have any blood-borne illnesses now, she is going to get sick from eating it? If you already have HIV, for instance, eating your placenta isn't going to make you get HIV - you've already got it. Right?

It also makes me wonder what exactly they mean by 'contamination' - as if to suggest that perhaps their storage of such an organ is being compromised and she could get a blood-borne illness from someone else?

In my state, pregnant women are tested for many blood-borne pathogens such as HIV, hepatitis - the works. After three normal pregnancies and a stable sex life with one partner, I pretty much know by now that I do not have HIV or hepatitis.

One thing the article mentioned struck a nerve with me: it starts in about how the placenta is full of hormones, etc. but then goes on to say the practice of encapsulating and eating the placenta is "far from widespread." As if to imply, you're a complete nutjob if you even entertain the idea of doing this. It also mentions how the field of traditional Western medicine is skeptical that eating it can be useful for anything at all.

A physician quoted in the article said that 'animals eat their placenta for nutritional reasons,' but speculated that with our better diets, there was no need for humans to do this. It makes me wonder - sometimes we see things in the animal kingdom that make more sense than we realize, as if they're on to something that we don't understand yet.

I think we can recall a number of procedures that have slowly worked their way into our traditional medical culture: acupuncture, for one, is beneficial for many. Just because it seems weird doesn't mean it might not deserve a place in our model of medicine, where everything is over the top and excessive.

The article ended on this interesting note: there is no law in Nevada that says the woman can't keep her placenta (so the fact that the patient's hospital told her it was against "federal law" might be a lie?), but usually it's not kept unless a doctor needs it for medical tests, or unless a patient asks for it because of "religious or cultural reasons." So "just because you want to," even though it is a part of YOU and something your own body created, is not a good enough reason.

One woman who commented on the story through a FaceBook link remarked that her doctor wanted to keep her placenta to use for educational purposes. The doctor respectfully asked first, even though there was a good chance that the patient never would have known the difference. Perhaps this doctor recognizes that this organ - a unique one that only certain people at certain times can make! - was part of her body - not just 'medical waste.'

The Double Standard of Statistics, Scientific Literature and Anecdotal Evidence

Wow, that sounds like more of a dissertation than a blog post. Which this could easily turn into, because I must be on a tear or something.

Yesterday I was surfing My OB Said What?!? and was equally amused and horrified to see that Dr. Amy had joined the fray of commenters. (She even brought one negative Nellie with her, unfortunately, although her post thankfully didn't make a damn bit of sense.) Somehow I welcomed it, though, because it makes for interesting debate and dialogue, all while exposing her typical urgency and unprofessionalism. It's hard not to while in that forum because of the negative, condescending comments of the readers - and who can blame them? As I told Dr. Amy, how can we not be condescending when we're used to, over the course of one or several pregnancies, having lies poured in both ears, over and over again, which have only served to either make us paranoid of our own normal bodily function or cause us to despise and demonize doctors and medical staff?

It's the same condescension offered up every day to pregnant patients, but now that the shoe is on the other foot, it's a totally different ball game!

I think Dr. Amy was getting a little paranoid, because she was definitely not in her own territory. Her pleas of "read the scientific literature! Ignore all the home birth studies because they are lies!" kind of made me laugh - a desperate grasping at straws to get us to turn from our 'ignorance' and come rushing in droves to the hospital. Remember my friend's home birth story I posted a while back? Especially how she was approached by an acquaintance who works in labor and delivery, who literally bribed her with a fancy vacation in order to prevent her from having the birth she desired and deserved? My friend R knows perfectly well, as do many, many homebirthing mamas, that if a true need for medical care should arise, they will be en route to the nearest hospital. Once there, they should not be treated cruelly or with disdain, and neither should Dr. Amy assume that all home birth advocates are out for the 'experience' only, ready and willing to put their baby's life in danger. Honestly, who in their right mind does that?

Dr. Amy told us to 'read the scientific literature.' Okay, I will. But after many of us have read that 'literature,' we're criticized. We're told (especially by Dr. Amy) that we cannot possibly understand risk, interpret statistics, or be able to decipher complicated medicalese. So which is it, doc?

We're also criticized for where we choose to obtain that knowledge: often, the Internet. Sure, you can't always believe everything you read on the computer - Billie Jo's Guide to Pregnancy might not be as reliable a source as any number of good birthing sites or blogs out there. But most blogs and sites I frequent do one thing: post links to studies and cite sources. Is that 'researchy' enough for you?

Many of the same medical journals our doctors read can be accessed by us, the average pregnant lady. Sure, they might be a bit difficult to understand if you haven't recently completed a college course in Medical Jargon 101, but some people do have the mental capacity to look up those terms to get a basic grasp of what they're reading. *gasp!* I know, this sounds crazy, doesn't it?!

The interesting thing about studies and statistics is that they can and often are flawed. When it comes to the safety of VBAC (a relative term, I know) I remember reading one doctor on a message board presenting the highest possible rate of rupture to readers, which scared more than one away from even attempting a VBAC. I cited another study that presented the actual rate of rupture as much lower, but again, because I'm just a woman with personal experience and no lab coat, it didn't mean much to them.

As far as studies and statistics go, you also have to be able to read between the lines. A lot. Some figures estimate that 85 percent of women who attempt a VBAC are successful. That does not mean that in 15 percent of women they experienced a catastrophic uterine rupture, hysterectomy or loss of baby. Some people tend to see that 15 percent as a failure and nothing more, which to them totally overshadows the 85 percent.

Another thing doctors have a problem with is anecdotal "evidence." "They're just stories!" many of them say. Who cares if your grandmother's neighbor's sister's aunt had a VBAC. That's only one person!

To me, birth stories are important. They must be - we tend to get into the nitty gritty personal details of our parts and their functions with perfect strangers when it comes to talking about birth, yet otherwise would clam up tighter than a drum. Somehow when it comes to the state of our cervixes, we are all too willing to share. And that's okay!

Take a group of five women who meet weekly for play date. Say three of the women have all been attended by the same physician and were all induced, all ending in a cesarean for either "failure to progress" or fetal distress. Mom #4 saw a different doctor, and mom #5 is newly pregnant, new to the ballgame and wanting to know as much as possible in order to have a normal, low-intervention birth. If that were me, the anecdotes of these women would tell me that the doctor who attended moms 1, 2 and 3 might be a little intervention-happy and it's time to move on.

Don't the stories of these women account for anything? They should, because the number one thing most pregnancy websites recommend you do when searching for a new OB is to seek the advice and recommendations of friends.

It doesn't take a rocket scientist to realize that when hearing the stories of moms, that the c-section rate is through the roof, that inductions are heavily used and often completely unnecessary. Even though you aren't reading their chart or conducting a formal investigation, these stories definitely say something, loud and clear.

The thing that gets me about 'anecdotes' is that they're only bad when they're coming from you. You can tell your doctor about the dozen or so moms who have safely VBACed and have healthy babies, and yet you're told to completely disregard the stories of these moms. Yet, when I was weighing my options with my doctors (two separate physicians, two different pregnancies) both physicians felt obligated to tell me about previous patients who had experienced ruptures. Were either of these women induced with Pitocin? I asked, only to get a muffled response of "I don't remember" both times. Either you're making it out to be something it wasn't, doctor, or they weren't even your patients - because if they were really catastrophic ruptures resulting in hysterectomy, loss of baby or mother, that's something you're unlikely to never forget. So what makes my anecdotes dismissed, and yet suddenly my OB is more credible? Isn't he, in fact, doing the very same thing I'm doing - telling a story?

The problem with all of this, especially "scientific literature," is that it seems like you can always find a study that tells you what you want to hear. There are no shortage of studies that say VBAC is safe, and yet there are those studies that say it's dangerous. It's all in how you interpret it, or how it's interpreted to you. If you're cornered in the doctor's office with a fear-mongering OB who only wants to sway you away from making the Big Decision to VBAC, it's going to come off as a lot more dangerous because of his/her influence.

Lots of studies have come out now to completely blow most of the outdated practices of modern obstetrics out of the water: the often unnecessary use of episiotomies, using a c-section as a way of  avoiding pelvic floor damage , inductions leading to a higher rate of cesareans , and the importance of both maintaining an upright position as well as taking in light food and fluids in labor. Actually, to some this is old news, and has been practiced by old-school midwives for centuries. Any woman can access this information from countless books, reliable internet sources, and other places, and yet this continues to be status quo in many hospitals around the world, despite the studies and literature that proves otherwise. So it looks like the only person who isn't "reading the scientific literature" is the doctor.

Ultimately, though, especially with doctors like Dr. Amy, the research you do will never be reliable enough, never be good enough, never be the right study. The rules constantly change as the game is played, and it seems like the pregnant patient is rarely the winner, no matter what.

Stars who 'ditched the epidural'

A few months ago I posted a link to a study that suggested poorer, less educated women refuse the epidural.  When you see a list of celebrities who are opting out and choosing natural birth, it makes you wonder how accurate that study really is.

Granted, I know they're not in the majority. But it's refreshing to see celebs choose a more user-friendly approach to birth. And young women, too - I think that's awesome. They are sending a message that yes!, this is possible and no, you don't have to grow your armpit hair long and braid it or eat Grape Nuts cereal every day in order to want a natural birth.

Among the list are:

Gisele Bundchen - At the top of the list is supermodel-turned-birth-activist Gisele Bundchen. Everybody's heard about her bathtub home birth, and while some are riled about it, who gives a crap. She should be at the top of the list - but I'm not sure many people understand why. Given the fact that in her home country of Brazil the c-section rate is around 36 percent, and she chose an unmedicated home birth, I think this is of the utmost importance. We can only hope that her fellow countrywomen are looking on from afar, thinking, "Hey, maybe a vaginal birth isn't such a bad idea." I'd love to hear what Brazilians think of her as a result. And the reaction elsewhere? The Daily Mail says, "Gisele claims son Benjamin's birth didn't hurt." Claims? What, do you think she's lying?

Nicole Richie - The actress refused "even an aspirin" in labor with her daughter, which the author describes as "hardcore." Considering Nicole is a recovering drug addict, I can see her reluctance to have pain meds. What makes that "hardcore"? I think it's smart. This is probably one gray area that is often ignored - the addict who is managing pain of labor. I remember reading (maybe on The Unnecessarean?) about an addicted mother who refused pain meds, and the nurse made sure to come in early and often to badger the patient into getting an epi. I can't think of a more humiliating experience - having your addiction thrown in your face, especially when you're trying so hard to overcome it. 

Jessica Alba - This young, first-time mom had a very 'zen birth' with daughter Honor and apparently 'didn't make a sound.' The author's comment: "Ok, somebody's lying." Huh?

I found that vocalizing during labor helped, but it's different for everyone. Many women make noises, many are quiet - it's not all the way you see childbirth portrayed on soap operas. I've heard women claim that screaming is a 'sign of weakness,' which I think is complete garbage: we know that for some, vocalizing can help them manage pain and works as a release, of sorts. I tell people, "I screamed in labor not because of the pain, but because it was freaking hard work!"

Joely Fisher - Carrie Fisher's younger half-sister gave birth to daughter True Harlow Fisher-Duddy at home, in the company of doulas, midwives, and a doctor, according to mom. The author's comment: when we can't think of a jab to make about her opting out of pain meds, let's say something creative, like "Maybe each person got to pick one of the baby's million names?" What?

Interestingly, the article's author mentions a friend who'd recently had a baby and felt that she was manipulated into having a c-section for fetal distress. Of course, when the baby was born, it was perfectly fine. The author even mentions Ricki Lake's movie "The Business of Being Born." And yet, the overall tone of the piece is that women who choose to opt out of the epi are somehow crazy, liars or "hard core," which attaches sort of a freak label to the whole thing. For some who might be curious about a natural birth, this association alone might be enough to completely scare them away from the idea, and 'poor and less-educated' seems to have little to do with it: "Women who give birth without drugs are out to prove something, and are completely nuts."