My Stake In The Dr. Amy Debate

I don’t talk about birth too much on here because I’m not pregnant and not going to be again.  So why would I care about what a retired OBGYN has to say about home birth?  Well, I have three daughters who I figure one day will have children and a son who one day could give me a daughter in law and grandchildren and I absolutely want to make sure it’s all safe for them.

So for those of you who don’t know, Dr. Amy Tuteur is a doctor and former Harvard Medical school instructor who is now retired to raise her children and is also extremely vocal about the safety or lack there of in home birth.  Doesn’t sound so bad, does she?

She writes a blog called The Skeptical OB.  Well, to those who advocate for home birth being a perfectly safe option for just about every woman she is evil and anyone who associates with her is also evil.  Guilt by association.

I do hope you all will hear me out here.  I am a part of a group that Dr. Tuteur is also a part of.  I have not had any one on one conversations with her, but I do respect what she has to say as a woman who has way more education on the subject than I will ever have.

Yes, education does trump my first hand knowledge of my body.  I might be perfectly aware of how my body parts work, but it doesn’t mean I know how to fix them when something goes wrong.  Just like I might be perfectly aware of how my car runs and can tell when something goes wrong it doesn’t mean I can fix it.  For that I turn to a mechanic.  So I have a hard time understanding why women think that their first hand knowledge of their body trumps the doctors education.  Even in birth because lets face it, when we’re pregnant our body does not act like it normally does.

I tell you all of this in the interest of honesty and full disclosure.  I am hoping that you all are still with me and have not just written me off as another one of Dr. Amy’s cronies who knows nothing.  Because I have researched the information and having been pregnant five times and having four pregnancies that made it to term I do feel that I’m relatively up on what’s going on.  I am not an expert by any means, but I want to make it clear I follow no one.  I take in all information and I make my own decision.  And that’s what I’m interested in providing.

My Opinion On Home Birth

So I just want to make it very clear to start off with I have nothing against women having the choice of home birth.  As a matter of fact I completely understand the desire to have one.  When I was pregnant with my youngest I considered a home birth.  Not because a doctor raped me or traumatized me in anyway, but because I wasn’t sure emotionally I could handle delivering a baby in the same hospital where I delivered and left behind a 20 week old baby who was stillborn.

Ultimately I did decide I had no choice to deliver in the hospital because of the many health complications I had.  Just to name a few there was VBAC (Vaginal Birth After C-section) and Gestational Diabetes.  Two things which any NCB (Natural Child Birth) Advocate would tell you is safe or made up by the medical community.  And in all honesty when I see that stuff I must scratch my head because even in my research on the internet on home birth everything I came across said that risked me out.  So honestly I can only imagine that the only way you would find information saying it’s safe is if you put into a search something like home birth is safe for a VBAC or Gestational Diabetes.

But anyways, I think giving birth at home is fine so long as you have a few things.  Things like…

  1. A truly low risk birth which means NOT breech, NOT gestational diabetes, NOT twins or any multiples, NOT Group B Strep Positive, and NOT a VBAC.
  2. A qualified birth attendant.  NOT a DEM (Direct Entry Midwife) and NOT a CPM (Certified Professional Midwife).
  3. A plan to transfer with a doctor backing up the midwife.
  4. Willingness to transfer at the slightest sign of a problem.

If people would really stop and listen this is all anyone who follows Dr. Amy wants.  And even if you take the time to really listen to Dr. Amy it’s what she wants too.  She doesn’t want to take the choice away.  She wants the choice to be a safe one.  She even wants to see a change with doctors and hospitals.  She wants the insurance companies to stop dictating how doctors have to practice.

The Real Truth Behind Maternity Care In The USA

When we see the debate over home birth there is a whole lot of attention being paid to stats from other countries.  That doesn’t do us much good when we’re trying to decide if it’s a safe option here in the United States of America.

How much education do you think a CPM has that’s delivering your baby?  Maybe she has been doing it for decades and has hundreds of births under her belt, but a doctor gets that under her belt before she even finishes medical school.  Having only done home birth and seen what’s supposed to be normal births how many times do you think a CPM has experienced when things go wrong?  Now a CNM (Certified Nurse Midwife) has to work in the hospital.  She gets her training in the hospital.  She is a nurse to begin with and has seen complicated births.  They see what complications look like hundreds of times.  She will know in an instant when a transfer is needed.

Then there is culpability in home birth.  Lets face it, we are all only human.  Even doctors have a bad day.  While it’s no excuse in life or death situations to say I’m only human doctors are held accountable for their actions.  If negligence is found, then there is malpractice insurance and there is a report made about that doctor.  There are public records that we can look up and have access to as patients.  What do you think happens with a home birth midwife in the United States when she has a bad day?  Nothing happens to her.  She continues seeing patients.  She won’t use you as a reference.  She’s going to give her future patients all of the positive reviews.  There’s no malpractice insurance.  If your child is born and there’s a trauma of some sort that causes a defect that could have been prevented you have no recourse.  And many times after the fact parents begin to find out that they likely weren’t the first negligent case.  But nothing can be done because the midwife is protected in these cases by her peers and oddly enough by the same group of people who argue heavily against doctor negligence.  Lawyers won’t touch them because it’s just not worth it.

This is the state of maternity care in the United States.  It shouldn’t be this way.  It doesn’t have to be this way.  But this is what we have.  So when the maternity care system is being compared to countries where home birth midwives have the education comparable to CNM’s here in the United States, but that’s not the midwife care American women are getting it all begins to make sense why people like Dr. Amy are important.  Even though she is blunt she has valid points that simply cannot be ignored.

But It Is Being Ignored All The Time

Women are feeling let down by the maternity system.  They are being made to feel that there is no way we can possibly be respected in the hospital.  There are many seemingly very overly exaggerated stories of how terrible hospitals are.  Hey, I get it, I gave birth in the hospital 5 times.  If I look back at each of my birth stories I could find something negative about each hospital experience.  With my oldest there was the arrogant doctor who came in after the midwife delivered my daughter to stitch me up.  Yes, I had a midwife deliver my oldest which was fine, but she also didn’t feel qualified to stitch me up and had to call in a doctor.  My perfectly normal natural birth ended with needing help from a doctor.  Good thing I was in the hospital.  He did a great job stitching me up, but my husband and my mother had to hold each other back from going after the doctor because he was hurting me and he didn’t listen when I said I could feel the needle going in me.  He just kept telling me to stay still.

Then with my middle daughter the doctor gave me an episiotomy and didn’t tell me what he was doing.  I felt something cold and asked what it was and he said it was just a needle, he was numbing me so he could cut me.  Now mind you I actually appreciated that since I tore so bad with my first I healed much easier with my second.

With my son, he was a c-section.  While I was on the table I was told if I felt nauseous to tell them.  I said something, no one responded to me, and nothing was changing so I repeated myself because I honestly felt like I was about to throw up.  When I repeated myself the anesthesiologist got a little snippy with me and said they know to give them a minute to get the medicine in.  It sure would have been nice to be told that I was heard the first time, I wouldn’t have said anything again.

Oddly enough my stillbirth I can’t think of anything that bothered me there.  That’s probably because nothing anyone could have done was worse than me already knowing I was going to be leaving the hospital without a baby.  The hospital was extremely helpful with that though and were even extremely careful to make sure no babies were leaving when I was being discharged and kept me separate from the women we were having babies and I even had a nurse in there chatting with me while I labored which helped me keep my mind off of things.

My youngest the doctor who delivered her bugged me even before we got to the hospital.  Because you could just tell he was annoyed that he was having to deliver another doctor’s vbac.  He kept asking me pointless questions.

Situations like this become reasons for women to decide they hate all doctors and hospitals and for me it was such a small part of my births that it just wasn’t bad enough for me to say all doctors are like this.  But if all women hear are horror stories about hospital births, then it’s not a wonder that they would be terrified to go to the hospital.  And then on top of it all they are being told that there is some sort of euphoria you experience when you have these natural home births.

I think I missed out on something with my natural births.  It was no more euphoric of an experience than my c-section or vbac.  The only thing that should ever matter in birth is the outcome of a healthy baby in your arms.  Not to discount mom’s feelings, but it’s hard to imagine that anything that anyone could have done to me in birth could take away from those first moments with my child.  Everyone is different though.

Censorship

When you end up on these NCB pages this is all that you hear.  Doctors are bad, midwives are awesome.  And if you have a bad experience at a home birth you must take ownership of your choice.  You picked a bad midwife, you didn’t trust birth enough, you didn’t do enough research.  Home birth loss moms who feel they were wronged in some way get ostracized in the community.

Kind of odd when you look at their reaction to a home birth loss mom who thinks she was wronged compared to a hospital loss mom who feels she was wronged.  Heck, not even a hospital loss mom just a mom who feels she wasn’t listened to in birth at the hospital.  She is hugged and patted on the back and told it’s okay it’s not your fault doctors are arrogant and just want to get to their next golf game.

Anyone who speaks out against this sort of reaction and questions just how safe home birth is immediately gets pegged as a Dr. Amy crony and banned and blocked.  This isn’t my first rodeo.  I have been banned from many pages because of my questioning of the so called facts that are being shared.  And for those of you who have been reading me long enough I’m sure you will see I don’t name call and swear.  That’s just not my style.  I don’t do it on pages where I disagree with what’s being said.  I present my argument in hopes of having a level headed debate.  I have been called names and even had my looks critiqued during a so called debate.  All things that any NCB group will complain that all of Dr. Amy’s “cronies” do all the time.

Dr. Amy is not a credible source because she has let her license lapse.  Not that she had her license revoked.  She is a retired OBGYN who practiced medicine and taught at Harvard Medical school.  She chose to raise her children and let her license lapse and that somehow makes her a source which we should not take seriously.

As a matter of fact I asked The Feminist Breeder, when she brought up how useless anything Dr. Amy has to say is because of her lack of license, what a person who has spent the majority of her adult life learning and studying a subject not renewing her license has to do with anything.  I was very promptly banned from her group.  And just for the record, I don’t feel that I was rude in anyway.  I did not name call.  I merely questioned why a lack of license because she chose to let her license lapse not because it was revoked mattered.  And since I figured I would likely get deleted for my question I got a screen shot of it…

Perhaps it was the last line she took exception to where I said her behavior was a little bully like.  However, I can assure you that even though Dr. Amy doesn’t agree with The Feminist Breeder’s point of view she would never ban her from her page.  Are we not all adults?  Can we not have a discussion?  Do we have such little faith in what we are saying that we have to make sure that the other side of the argument is not heard?

I don’t care that it’s her page.  This is my page and I absolutely welcome debate here.  If anyone is really interested in helping women and truly respects women, then she will allow all women to have a say and not just the ones she agrees with.  She will believe in what she says enough to let others come and disagree with her.  She will respect women enough to allow them to make a decision given all sides of an argument and not just the ones she believes to be the truth.

That is how adults behave.  That is how people who respect other people’s opinions behave.  Dr. Amy might be harsh and she comes off as cruel to home birth loss moms, but she respects women and their choice enough to give everyone a voice.  She embraces women who have suffered a home birth loss and have then been shunned by a community of people who claim to be so supportive of all women.

My Hope For The Future

I hope my daughters and possible future daughter in law does not get sucked into a group of people who are only interested in portraying one side of a story.  Truly I hope by the time they begin having my grandchildren that it is as safe as it possibly can be.  If home birth is something they want, then I hope by then we have home birth midwives who have the utmost training and accountability.  If they make a mistake it should not be swept under the rug.

Parents should be able to look up a database of home birth midwives and see what their stats are.  If there are too many cases of negligence, then they should not be practicing.  And midwives absolutely must carry malpractice insurance and not be practicing on roses and rainbows.  Because mistakes do happen and in any other service profession insurance is required.  If we are paying thousands of dollars to someone and they mess up, then they should not get away with it and there should be a financial consequence at the very least.

What do you want to see change about the maternity care system in the United States?

 

 

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Comments

  1. You have a very interesting point. I wish we had a way to feel as safe and protected and able to make choices as we do at home in the hospital. I also think that we all have our personal choices to make regarding childbirth. What works for me may not work for you but I’ll never bash anybody else for their choices.
    Thank you for posting about this. I think I’m going to look more into what Dr. Amy has to say.

    • I agree Maggie, we can’t make the choices for others, but we also can’t only get one side of a story. And as things stand now it is very difficult to know if you are truly safe in homebirth. The information is just not there, but for sure the regulation and education of homebirth midwives is definitely not consistent enough. I do hope that people will come to see that there’s not two sides to this fight. It’s not about taking away a choice it’s about making it safe. Instead of saying my numbers are better than your numbers we should be figuring out together how to make the hospital more desirable for those who really shouldn’t be birthing at home and how to make it as safe as possible for the low risk mothers to do so if they want to.

  2. Melissa says:

    Hmmm interesting. I gave you the fair credence and read the whole thing, even though I disagree in some points. I feel that women should be able to make the choice for themselves. Which it kinds of sounds like you agree, except you limit the people who are allowed to make that choice. Such as a breech birth. Yes, a breech birth is different from a normal birth, but it doesn’t have to be more risky. There used to be a time where doctors knew how to deliver breech births, but it’s my understanding now that doctors are often not trained in breech birth and will get you an automatic c-section. Even though I had my son in the hospital, I feel strongly that women ought to be able to choose homebirths freely, without restriction. Any good midwife would turn away a client that was too high risk. I know many people who have had successful homebirths, even with some of the complications you speak of. I am hesitant to place too many restrictions on homebirth because I have seen how in states where there are a lot of restrictions on it will just choose unassisted childbirth, which I think is the really risky thing. You won’t be able to stop homebirths, you’ll just drive them underground if you regulate them too much. I also think that you say Amy doesn’t engage in the same practices as the Feminist Breeder and you may be true that she doesn’t use the same language, but painting all homebirth advocates as uneducated and just indoctrinated. All of them. To me, I’m not a homebirth advocate, I believe it’s a woman’s right to choose (so maybe in some ways that makes me an advocate) but I would never want to paint a whole group of people as being a certain way because I haven’t met all of them. I expect that other people should show the same respect.

    • Thank you Melissa, I appreciate you hearing me out. My c-section was because my son was breech and no it’s not an automatic c-section, but they will not deliver a breech baby in the hospital. Doctors are no longer trained in it and there is a reason for that. There were too many complications. My doctor gave me the choice of having an external version with my son and going on to have a nice vaginal delivery or a scheduled c-section. Honestly, she would have preferred that I did the version, as we discussed it numerous times and she said my two previous births made me a great candidate for that. But there was a risk of complications and an emergency c-section. So given that I chose to schedule a c-section with him. And it ended up being the right choice as I would have ended up with an emergency c-section and a slightly premature baby. If someone were to ask me I would explain why that choice was right for me, but I wouldn’t shun a woman for going the other way than I did because it’s a perfectly viable option.

      And it sure would be nice to think that midwives are trained enough to know when a patient is too risky, but the fact is that’s not happening. There are reasons for regulations and training. The argument that doctors and hospitals used to do something a certain way doesn’t mean it’s safe. Why do you think they stopped doing it a certain way? Because it was working? And hey, my perfectly low risk birth of my first child that I had in a hospital naturally ended with something that my midwife was unable to fix and needed the assistance of a doctor. How many times do you think a tear like mine would have been left to heal on its own to only later cause numerous problems for a homebirth mother because of a midwife’s lack of knowledge in a situation? Yes, it happens. Midwifes are simply not as good as doctors. It’s not their fault, they just aren’t equipped to deal with the same things that doctors are. That doesn’t mean they shouldn’t be delivering babies, but it should be with the back up of a doctor.

      Even if Dr. Amy is painting the other side in a bad light she is at least allowing the other side to have a say in things. It’s a place where everyone does have a voice. So women can get two sides to the argument. However, if Dr. Amy is so evil then why are there so many home birth loss moms standing with her fighting for better? If a home birth loss mother were not shunned out of a community of such understanding women, then why would they turn to the evil Dr. Amy? She’s really not so bad. I have been involved in this group for just a year now and I have stumbled across a lot of the same stuff with plenty of vitriol thrown at me for presenting my side of the argument in an even keeled manner as I do here. Dr. Amy has been in this many many more years than I have and has seen way more. I can only imagine that several years of day in and day out having to say the same thing over and over again and having doors slammed in your face left and right is tough and wears on a person. I am not condoning any sort of meanness, but I don’t think people should let the message be clouded by that because there are valid points that need to be heard. Her being a “meanie” does not discount her education and training.

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