Parenting

Advice for the Skepchick MILF-to-be

Last week, we here at Skepchick received an email from a reader who just found out, on Christmas Eve, that she and her husband are expecting their first skepling. While she is excited, she is also terrified. It’s hard enough to dodge Complementary and Alternative bullets when you’re the only target you have to worry about, but now you’re responsible for a brand new person who has absolutely no way to defend itself against any of it.

In fact, skepticism aside, pregnancy is scary stuff.  Its hard not to be overwhelmed.  Everyone you meet has “just one little piece of advice” that you absolutely will not survive pregnancy/parenthood without. Knowing what’s good information and what’s not is difficult and now you’ve got to figure it out when you’re barfing every 15 minutes and you’re running an hour late for everything because you can’t stop losing your keys. Dr Novella can quote studies all he wants about “pregnancy brain” being a myth, but for those of us who’ve delt with gestational mental retardation can tell you, it’s real and it’s unpleasant.

I have no idea if this reader has made any big announcements yet, so in the interest of privacy, so from this point on, said mom-to-be will be referred to as “Smitty” (for Skepchickal MILF-in-training).

First, let me say, on behalf of the Skepchick hive, congratulations!

Smitty wanted to know if the Skepchicks have any skeptical advice for navigating the pregnancy world, and asked if we had any resources we could recommend. The answer is yes. And there’s some really good news for the Smitties of the world – pregnancy advice is not hard to sort out.

Whenever you’re in doubt, your best resource is always your OB’s office. Make sure you have a good one. They’re used to dealing with pregnant women, your fears are not unique, and they are there to help. Don’t be afraid to call them. Don’t be afraid to ask a “silly question”. Don’t be afraid to sound like a whiner. Don’t be afraid to bombard them with questions. That is their job. If you haven’t called them to set up your first appointment, do that now.

One thing I can tell you is 20 to 30 years or so after having a baby, a woman’s ability to hear deteriorates. She will inevitably mishear the words I’m pregnant as Please give me outdated pregnancy advice and tell me every pregnancy horror story you’ve ever heard. This is especially bad in women with grandchildren (especially if their daughter or DIL took their advice, but even more so if she refused the advice and something terrible happened). So when someone gives you the advice to not look at a monkey because it will make your child hairy and stupid, feel free to explain, in your loudest voice (so they can hear you), “Medical science does not support that claim, but thank you for your concern.”  Prepare to offend anyone whose terrible pregnancy advice you refuse to take.

Honestly though, the good news is that most “bad” pregnancy advice you get is just stupid, not harmful. There is too much at risk when doling out advice that is potentially harmful to babies.

As far as resources go, there are lots of really good ones. The old standby is What to Expect When You’re Expecting. It does a bit of “catering to everyone” including granola new-agey moms, but I found the information to be solid, and the advice is kept up-to-date with the most recent edition published in April 2008. You can find most of what you’re looking for in the book, and it will help you to understand what’s going on with you and when to be concerned. It’s no substitute for your doctor, but if you’re looking for a good preggo primer, this is it.

The majority of bad pregnancy advice given has to do with labor and delivery. Smitty is a long way off from having to make any real decisions about what kind of birth she wants to have, but there are probably some readers who aren’t so far off. Smitty can come back and read this later.

Don’t worry too much about what kind of birth you want to have. The Natural-birth movement people are going to try to make you feel guilty about not choosing a “natural birth”. Whether that’s home-birth, bathtub birth, medication-free birth, or orgasming during birth. Don’t buy into it.  Too much emphasis is placed on the “miracle of childbirth”. The reality is that without modern medicine, in places like sub-saharan Africa for example, 1 in 16 women die from pregnancy. Reality: that we now can have safe and painless deliveries is the “miracle”.

You’re going to be exhausted, sweaty, and hormonal like nothing you can imagine. (When I was in labor I was livid that people were talking in my presence, and got even angrier if they stopped… then wanted to kill them when they started again.) The important part of the delivery is that everyone gets through it alive, uninjured, and healthy.  A home birth can seem very romantic. Your baby is born in his home, his very first surroundings are his own – his bed, his room, his blankets; his family is surrounding him. He doesn’t have to spend the first moments of his life in the sterile birthing room of a hospital where they’re charting and documenting everything so later they can nickle and dime you and your baby. This is a very sweet notion when things go well, but delivering a baby can – though not usually, not rarely either- turn into a life-threatening medical emergency for the mother or baby or both. While it’s still the exception to the rule, it happens. And in those situations you may not have time to get an ambulance to the house and get mom and baby to the maternity ward in time.

Remember: your doctor and hospital have nothing to gain and everything to lose by letting something go wrong.

Things will likely go fine, but let’s face it, once that bugger is in there, there aren’t too many ways to get him out. Things don’t always go as planned. Don’t let your child’s birth be your statement against the medical establishment.

Now you’ve decided to get your butt to the hospital! Yay! Next issue: Are you a complete failure as a mother if you choose to not tough it out and you get some of that sweet sweet pain medicine shot into your back? No, you are not. There are women out there who will try to guilt you into not getting pain meds. They will try to scare you into not getting them. They will try to convince you that strong women suck it up and wimpy women can’t take it. Don’t listen to them.

There are pros and cons to getting an epidural. There are pros and cons to going the “feel everything” route. In the end, they cancel each other out. They’re equally safe… but only one offers you the chance to not be a crazed demon writhing in pain. And I don’t care what anyone says about the pain being “not that bad”. Those people are filthy liars. It hurts. Worse than anything you’ve ever felt. I thought I could suck it up after living with gall stones for years, but I could not. (Name that logical fallacy. If you guessed Argument from Ignorantus Pregnantus Delusioni you are correct!) After my water broke, I was willing to have my gallbladder put back in my abdomen even if it meant having it shoved in, through my skin, with a soup spoon. Because that would be a downgrade in pain. Get the drugs.

The worst reason I’ve ever heard not to get an epidural: I don’t like needles. Seriously. If you’re not able to handle a needle, you’re probably not going to survive your vagina opening up to 10 cetimeters… then pushing out a 12 centimeter head. (Name that logical fallacy.)

Really, so much pressure is put on women to have a wonderful birth experience. You’re going to have all these plans. You’re going to have checklists. You’re going to have things you absolutely won’t do.  When I was pregnant, I refused to read anything regarding C-sections because, “I’m not having one of those.” I was going to have a “real birth”. Whatever that meant. But it was going to be perfect. I was going to tough it out, no pain killers. And I was going to push that puppy out, and jog out of the hospital the next day… wearing the jeans I wore in high school.

Turned out, Mr Moose was looking the wrong way and his giant melon wouldn’t squeeze out. My options were to:

A. Leave him in forever

B. Cut the kid out

I wish I had read something, anything, about C-sections. All I knew was what stuck in my head while spacing out during that portion of childbirth class.

Turns out, labor and delivery is a lot like your wedding day: most things go as planned, there are a few hiccups, you think you’re going to freak, you don’t, and in the end you remember almost none of it. Just don’t wear a white dress to give birth; you’ll regret it tremendously.

The other big issue you may deal with is alcohol. Everyone has an opinion on how much alcohol you can and should be drinking, and people are incredibly passionate about it. Don’t drink during your first trimester, no matter how many stories you hear about babies that “turned out fine.” It’s not worth it, no OB will say it’s okay. If your doctor does says it’s okay, get a new doctor.

After the first trimester, different doctors advise differently. Some say you can have a drink a week, some say less, some say none at all. If you desperately need a drink, discuss it with your doc. Personally, I think it’s a pretty simple sacrifice to make to not have booze for a few months. Certainly no harm will come from abstaining completely. If you do choose to have a glass of wine or a beer at some point during your pregnancy, be wary of where you do it once you are showing… strangers, failing to see the irony, have no problem telling you that you are a total asshole.

Other things no one tells you:

You may hate being pregnant. Even if you feel great physically. You may not bond with your baby. You may not feel overjoyed and amazed whenever your baby kicks. You may find it annoying. You may feel gross having a person inside you. This is not a sign that you will be a terrible mother. Once your baby is here, you will love it. But tell your doctor if you’re feeling depressed or having excessive anxiety.

You may not love your baby at first sight. You may look at your newborn and feel nothing. Even if you don’t experience post-partum depression, sometimes it takes time to bond. It will happen.

Don’t worry about “getting it right”.   Do your best to stay healthy, and things will probably be fine. Think about it – people have been making babies for almost as long as there have been people.

If it seems goofy, it probably is. You don’t have to read books to your fetus. Don’t put headphones on your belly and play Mozart or Beethoven or Handel or Chopin or Will.I.Am. It won’t make your baby smarter. It might wake him up and make him kick you, a choice to be weighed carefully as you may have a foot on your bladder or stuck up your rib cage.

You can totally play the pregnant card at the grocery store. If you don’t want to wait in line, put one hand on your back, arch and groan while you rub your belly with the other hand. Once the person in front of you is looking, wince. Usually, you can get cutsies. It’s always worth a shot. It’s also a great passive-aggressive way to make the guy in front of you feel like a dick if he’s arguing with the cashier about the 15 cents he was supposed to get off on generic 1-ply toilet paper.

And finally, you already know what’s bunk. Don’t take herbal medicine. Don’t go to a chiropracter. Don’t get accupuncture. Don’t drink raw milk or eat raw meat or cheese. Don’t expect magic crystals to protect you from harm. Don’t pay a psychic to tell you the sex of the baby. Don’t pee into a cup of DrainO… don’t drink DrainO… or pee. Really, if you’re already a skeptic, you probably have a better grasp on this than you think.

Now, Smitty, go get some rest. Get as much of it as you can now. And start planning a few romantic weekends with your hubby before your little one gets here.

Good luck and Congratulations!

Good links:

Womb to Bloom

What to Expect

Pregnancy.org’s cool fetal development calendar

Elyse

Elyse MoFo Anders is the bad ass behind forming the Women Thinking, inc and the superhero who launched the Hug Me! I'm Vaccinated campaign as well as podcaster emeritus, writer, slacktivist extraordinaire, cancer survivor and sometimes runs marathons for charity. You probably think she's awesome so you follow her on twitter.

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128 Comments

  1. I’d like to echo Elyse’s advice that Smitty should not fear the possibility of a C-section, and she certainly should not worry that this procedure could affect the baby. I was born by C-section and I turned out to be a perfectly normal adult, with no lasting effects from the procedure. Except that every time I leave my house, I go out through the window.

  2. Take the drugs.

    There is comfort in knowing the science.

    You will see your feet again and they will return to their normal size.

    You will never take for granted being able to tie your own shoes again or getting up without help.

    Don’t let complete strangers touch your tummy, it’s still your body.

    Don’t feel stupid or over reactive for calling the dr about concerns. It’s your baby and you have every right to have your concerns addressed.

    Mostly, just have fun and enjoy it. Share things with your husband. And if it makes you feel better, every time you get kicked in the ribs, do the same thing to him just to make sure he shares the moment, too.

  3. Thank you Elyse. I feel like no one tells the truth about pregnancy and childbirth until (maybe) you’re actually pregnant.
    Hence, I’m completely freaked out by the possibility and have sworn off children. Your column was a breath of (painful) reality, that allowed me to reconfirm my commitment to having any baby I ever carry (not that I will) in a hospital with a doctor, AND to maybe think that there might be people out there telling the truth if I do decide to take the child-bearing road.

  4. As a counterexample, my skepwife had an epidural for her first labour but hated the needle-in-the-spine thing so much that she just toughed it out second time round. Admittedly it was a much shorter labour.

  5. “The worst reason I’ve ever heard not to get an epidural: I don’t like needles. Seriously. If you’re not able to handle a needle, you’re probably not going to survive your vagina opening up to 10 centimeters… then pushing out a 12 centimeter head. Name that logical fallacy.”

    This is the single greatest thing anyone has -ever- said.

  6. This sentence is bad: “I thought I could suck it up after living with gall stones for years, but I was not.” Thought I could, but was not? Tsk, tsk.

    Also. Didn’t anyone else find the use of MILF a bit odd? Has it somehow slipped into mainstream with an altered meaning? Or [censored]?

  7. Mozart – no effect, but reading Sagan or Randi to your bump …

    Having been a supporting actor in this drama three times now, I will add a few things to Elyse’s list.

    Take the time you need to do right by you and your body. Beg, hire, or guilt someone into massaging whatever needs to be rubbed. This can help make you less uncomfortable in the later months. Also, get your exercise if you can early enough to do some good. My wife’s career made gym and workout time difficult at times and by the time the last trimester came along and she could have benefited from increased ab and back tone, it was too late to do much.

    Second, get whatever cushions or pillows, you need to sleep as comfortably as possible. Waiting until you’ve got a week or two of poor quality sleep thinking you can make it another couple months doesn’t do anybody any good. And just in general get as much sleep as you can when you can, because you never know when Junior is going to do 2am acrobatic routines (my wife was usually kind enough to wake me up to let me know she couldn’t sleep), so weekend naps are also in order.

    PS Congratulations and good luck.

  8. “Didn’t anyone else find the use of MILF a bit odd? Has it somehow slipped into mainstream with an altered meaning?”

    No, it has the same meaning as you think. But its becoming something of a complement or term of endearment (think: Nigga). Language is weird.

    My favorite skeptical moment when my wife was pregnant was when people would predict the sex of our baby becuase it was riding high in my wifes belly:

    INSUFFERABLE PROGNOSTAGIST: Oh! its riding high, you are going to have a boy!

    ME or MY WIFE: Really? Because the ultrasound shows that my daughter is missing a penis.

    As for drugs: The only one my wife took was Nubane, no epi. She was in a lot of pain. She doesnt remember the pain at all. She remembers she was in pain, but not the pain itself. Epi’s are safe (although our doula showed us a vid of a single woman who had a hell of a bad experience with one. I’m not really one for anecdotes, and I told her so. If you want an epi, get an epi.

    Congrats to Smitty! And my hat is off to all MILFs (oops! can males use that word in its positive connotation?). I have no idea how you go through pregnancy without significant psychological damage. I would be a whiner.

  9. @Bjornar:

    Sorry. Last night I meant to schedule the post for the morning but accidentally chose “publish immediately”. I just decided to leave it.

    MILF means what you think it means. It’s used to say that a mom is sexy. If she’s a skepchick, she’s hot, and a MILF.

  10. Congrats Anonymous!

    When my wife and I found that she was pregnant a doctor friend recommended an OB in the area we lived Medford, MA. His name is Dr Matthias Muenzer. One of the first things he did was hand us a sheet with websites containing information for us. One of the sites was Quackwatch! I was instantly convinced, he was definately doing good for rational people by sending people to that website. Not that this helps you any…. but it may help someone in the Medford, Ma Area!

  11. @FriendlyAtheist:

    Here at Skepchick we do not encourage or endorse the black market sale of babies. That is our official stance. I’ll be outback having a cigarette, care to join me? I can answer any questions you have about our official stance.

    And I obviously don’t have any tasty recipes for babies given that Moose is still running around. You might want to hit up someone other than me or Jen… you know, the Skepchicks who are suspiciously without offspring. (I hear Amanda has an amazing recipe using Maine lobster and newborn tenderloin)

  12. Lots of good advice here. If you and SkepDad need a laugh about what is to come, I suggest an oldie, but goodie: Bill Cosby’s Labor and Delivery skit. It’s hilarious…and so-o-o-o true!
    (Disclaimer: My wife is a RN/BSN specializing in Pediatrics, Labor and Delivery.)

    Forget the naysayers. There’s nothing wrong with using all the best medical technology available, including epidurals, to get a healthy baby delivered without torturing Mom to death. My wife went for epi’s both times. She almost had to have a C-section with our first. There’s no value or honor in suffering needlessly. But remember this: There’s a reason that they call it the “medical arts.” There are no guarantees in the medical world. You want a guarantee, buy a toaster.

    Nap when you have to while you can – Believe me, the days will come where you will be very desperate to sleep!

    Work out care schedules with your other half before the baby arrives…Mom shouldn’t be the only one changing diapers and feeding at 0200…! I did it, so can you! ;-)

    I agree with colddayinapril: COTW! My wife said that guys can ‘sort-of’ sympatize with labor pain by imagining passing a bowling ball. Through their penis. :-o

  13. The worst reason I’ve ever heard not to get an epidural: I don’t like needles. Seriously. If you’re not able to handle a needle, you’re probably not going to survive your vagina opening up to 10 centimeters… then pushing out a 12 centimeter head. Name that logical fallacy.

    I believe that particular fallacy is called Argumentum ad Gladdem Tobemalem, alternatively known as Argumentum ad Owowmotherfuckingow.

  14. “And I don’t care what anyone says about the pain being “not that bad”. Those people are filthy liars. It hurts. Worse than anything you’ve ever felt.”

    I once came to in the bent and twisted wreckage of a 2001 Crown Victoria with my limbs going in ways they were never intended to go. Does it hurt worse than that? (Warning: If you say “yes,” I’ll go into everything I experienced after that.)

    My first wife had our two children sans drugs. My late wife had her first two (from a previous marriage) sans drugs, and her other two by c-section. They both testified that the pain isn’t anywhere near as bad as people make it out to be. My late wife told me that she’d rather have a child naturally than go through the epidural. My sister said the same thing.

    Apparently, the only thing the epidural does is take the “edge” off—which may be desirable, except that they’ve told me that it’s the edge that makes it feel as if you’re going through something productive. Dulling the pain without bedding it down makes it feel as if you’re suffering for no reason.

    Not that I’d know; I’m just a messenger here…

  15. I’m now really curious as to the MILF frequency-of-use outside of porn and objectification of women. Unfortunately out of the 100 first hits on milf on google 84 were porn sites (or so I assume from the URLs and sample text, I didn’t check each one out), 5 were definitions of MILF, 3 were those odd pages with links to various sites, 7 were about the Moro Islamic Liberation Front, and only 1 was relevant, a link to the blog Magazine MILF.

  16. Let me offer a happy first pregnancy labor story.

    A good friend of mine (disclaimer – she was in excellent physical shape during her first pregnancy) felt a little “off” about two weeks before her due date around 10 am. Nothing specific and nothing painful – she just didn’t feel “right”. She works on the administrative side of medicine (she helps doctors cut through the paperwork) happened to be in her hospital and her OB was doing rounds, so she gave him a call.

    He agreed to look at her quickly; since she’d complained of almost nothing during her pregnancy he took her complaint seriously. Once in the lovely stirrup position, he popped his head right back up and announced she was 5 cm dilated and he was sending her down to the maternity ward right then and there.

    About 4 moderately relaxing hours later, they had her push. She pushed exactly three times and out came her little girl. Her husband jokingly asked the doctor that since my friend was in apparently no great distress, did he think it would be okay if she came home and cooked dinner? (TOTALLY joking).

    The hair and makeup she had done for work earlier that morning weren’t even out of place. You look at the pictures of them holding the newborn in the hospital bed, and it’s almost like a soap-opera or something (except the soap probably would have artfully messed up the actress’ hair and given her a glycerine sweat sheen).

    Not every pregnancy is going to be difficult, and neither will every labor.

  17. Our Bodies Our Selves, that old adolescent standby, has a great pregnancy book. It’s a good counterpoint to some of the fear mongering and pro-doctor stance of What to Expect. I’m definitely not a SCAM adherent of any sort, but in the field of pregnancy and childbirth, many standard doctor practices are not evidence based which, as a pro-science pro-medicine person, I find to be incredibly frustrating. I hate having to say “doctors don’t know everything,” but I feel I have to with regard to obstetrics. I should limit that to refer to American doctors because obstetric care in Europe is radically different than here.

    If you want to read just a general book on the topic, Naomi Wolf, author of Beauty Myth, wrote a fairly light book on the journey, Misconceptions. It’s not heavy on the research, but it is interesting and eye opening to hear the interviewees be so candid. So, in all that spare time you probably don’t have, you might want to pick it up at the library.

  18. You may hate being pregnant. Even if you feel great physically. You may not bond with your baby. You may not feel overjoyed and amazed whenever your baby kicks. You may find it annoying. You may feel gross having a person inside you. This is not a sign that you will be a terrible mother. Once your baby is here, you will love it. But tell your doctor if you’re feeling depressed or having excessive anxiety.

    You may not love your baby at first sight. You may look at your newborn and feel nothing. Even if you don’t experience post-partum depression, sometimes it takes time to bond. It will happen.

    That is a really great bit of advice that no one tells you. I remember really feeling that way when I was pregnant with my daughter and it took me a while to really bond with her. She didn’t nurse, she was colicky and cried all the time. 0_O Eventually she and I sorted things out and she is now 8. I love her like crazy, but no one ever tells you that you might not take to motherhood like the glowy pregnant moms, and that’s perfectly ok.

  19. My advice TO YOU is to stop using the expression “MILF.”

    Right now.

    Forever.

    It is not clever or hip. It is a term of exploitation devised by male pornographers who see women as nothing more than appealing configurations of penis receptacles. It is not a compliment, and for a woman to use the expression is positively tragic.

    My advice to the future mother: if you have a daughter, I hope you find better role models for her than women who use the expression, “MILF.”

  20. Yay! Babies babies everywhere!

    Lil Nugget of Advice from Childless Jenn:
    Find a skeptical knitter friend to make endless supply of skeptical themed knits and toys: JREF The other day I found…wait for it…a pattern for a stuffed Pi. Oh. SO. MUCH. FUN! Of course, bonus points if this knitter has no offspring and can spend oodles of time just knitting for you and yours!

  21. Congratulations to Smitty and thank you Elyse for for such great advice!

    While I’ve never successfully had a baby I have been pregnant four times now. (I’m now recovering from an ectopic that was diagnosed Christmas Eve.) I’d like to add two things.

    1) Stay away from online pregnancy forums! There is always one crazy hippie mom who hijacks threads with natural cures and testimonials about how raspberry leaf tea will cure everything or how evil doctors are. They will also try to convince you that your body knows best ect. If you think something may be wrong or you just feel off don’t ask the internet ask the doctor. If I had listened to what I read on the internet I probably would have had ruptured ectopic and ended up in the ER with internal bleeding. Thank goodness I listened to my doctor when he told me slow rising HCG and spotty bleeding required an ultrasound.

    2) There are a lot of people out there who are overly passionate about breast feeding. If you do it, great. But if it doesn’t work out for what ever reason don’t let people tell you you are a bad mother or that your baby will be scarred for life or unable to bond with you. That’s a load of crap. There are plenty of healthy intelligent babies that were formula fed.

  22. I’m nearly 38 with 2 kids, if someone finds me sexy enough to call me a MILF, well that’s fine with me.

    As for the pain issue, I remember every excruciating moment from my first. I had back labor for nearly 18 hours before I went to the hospital and found out I was having contractions. I was not due for another 8 weeks and thought I had a kidney infection. With back labor, contractions are constant, no down time between them. I remember being very upset that epidurals are not immediate, they take about 20 minutes to kick in. Pain like that overrides all other higher brain function.

    Not trying to scare anyone, my case was pretty extreme. Second time around, I went full term and had a much easier time. Still got the epi and I was glad for it.

  23. I hate to drag science into this, and I need to make clear I wanted my wife to have all the drugs she wanted for two deliveries. In the years since then, though, I’ve studied a lot of cutting-edge (heh) biology, and there are some biological things about childbirth that we just don’t know or understand fully right now.

    I’ve studied two mammal models. Both of them have critical hormonal events that happen during childbirth. Well, one of them is definitely during childbirth, the other one hasn’t been pinned down yet. In the first, the maternal/child relationship is keyed entirely on pressure in the birth canal. Even Caesarean birth prevents these critical events from happening. In this particular mammal, this is enough to prevent the mother from ever recognizing or feeling any responsibility toward the child, and probably prevents the release of hormones that the child needs to develop.

    In the second mammal, at some point during pregnancy/childbirth the mother’s brain changes so that she responds differently to cries from a baby. It’s a rather stunning change, with differences seen all the way at the auditory cortex (A1), where the sound of the baby’s cry enters the brain.

    There is no knowledge at all about what changes are caused in humans by interference or suppression of various aspects of pregnancy or childbirth, out of necessity or convenience. I personally don’t think that this ignorance is good reason to endure the pain “just in case.” But I think we should realize that there may very well be negative consequences from many of the current medical practices, both for the mother and the child.

    I probably need to say that I find MILF to be very demeaning towards women, too.

  24. @shanek: I once came to in the bent and twisted wreckage of a 2001 Crown Victoria with my limbs going in ways they were never intended to go. Does it hurt worse than that?

    ———

    Typically, when people say “you” in that sort of context, they mean “you, the average person”, not “you, the guy who experienced multiple compound fractures”.

  25. The thing about ease of delivery, is it’s hugely variable between women and even their individual deliveries.

    At one extreme, there are women who just “pop ’em out”, with little pain or fuss. Most women will take at least a few hours, and some take more than a few — one of my sisters had a 48-hour delivery! (Long or short, the amount of pain varies almost as much.) And then there’s the cases for whom a C-section is mandatory, who in prior times would have been ugly fatalities.

    Your OB/GYN knows a lot about this sort of thing, and a good one can make a decent guess as to how tough your delivery will be. If possible, you should also seek out the experiences from any female relatives who’ve been through it, especially those who match your own general body type.

  26. @Codswallop:

    Not a term created by male pornographers out to exploit and enslave women. It’s a term created by the writers of the movie American Pie.

    I have not yet met a woman who objected to being called a MILF. I’m with DNA Mom, I would like it if people used to term more often when referring to me.

    I’m sorry you find the term offensive, it was meant to be fun.

    @shanek:

    I don’t know if it’s worse than the pain you felt in your accident. But for the record, it’s not a contest.

    I’m glad to hear your wives did not feel the kind of pain that I did (or that most women experience). The epidural, when done properly, kills the pain completely. After I got mine, I was able to patiently, quietly and happily wait out the rest of my labor until it was time to push. My mother and husband, both in the room, appreciated the fact that I was quieter and happier.

    @Chasmosaur:

    Glad to hear your friend had a happy, fantastic birth. Let’s just be fair though, and admit that camera ready hair and makeup is not typical! (Hell, I rarely have camera-ready hair and makeup when I’ve prepared to get my picture taken!)

  27. @David Harmon:

    Very true.

    Also, it’s my understanding that your body gets more efficient at “popping ’em out” with each kid. While #1 might require 36 hours of labor, #5 will probably fall out while you’re at the grocery store picking up Nutella and eggs.

    (Note: if you’re pregnant with #5+, wear sturdy, but loose fitting underpants)

  28. I will say one thing about delivery though…. the woo-ier the better if you can still be in a hospital.

    OK I know that sounds wierd coming from me, but let me explain.

    where I am you can deliver babies in 3 or 4 places (besides your home or at the home of someone claiming to have a birthing center in their house). Two are normal hospitals, so having a kid there is probably what you would expect, hurried, clinical, and so forth. The third is a women’s hospital where you would have expected something more. no such luck also hurried clinical and sterile.

    We had our kid in a hospital (its a religious type hospital) that has a birthing center. You get a large comfortable room, with soft music if you like. The had a small jaccuzzi if you wanted to unload the weigth on your back. Now they have a birthing pool becuase some mother are more comfortable with that (although I think they may be becuase they think its better for the baby, but I think that may be unsupported). The whole floor is pretty quiet, the restrict who can even come to the floor. There is a doctor there, but it is mostly midwives, who are gentile, patient, and calm.

    If a C-section is required there is a doctor on call and a room just for that.

    The only downside is that if there is something truly wrong, they do have to move the baby to a better hospital, by helicopter or ambulance. But this is why we have prenatal diagnostics, if there was a significant chance of any of that we would go elsewhere.

    I couldn’t give this place higher grades with respect to having a baby, but I also couldn’t give it lower grade with respect to any other health matter (i’ve been there for a couple of things as it is close). My wife was very comfortable, it was a good place get used to the new baby.

    Anyway, I guess I am saying, you dont have to have the baby in the biggest or nearest hospitals. I highly recommend a center that has midwives. Check it out before you go. It was really great for us.

    I also want to second the comment about breastfeeding. If you can’t or dont want to: No Big Deal. Its not anyones business and perfectly healthy babies are brought up with formula (mine was). But be prepared for perfect strangers to come up to you to make sure you are breast feeding (but Dog forbid you do it in public!)

  29. @Elyse:

    Oh, it’s *SO* not typical, I agree. I just wanted to reassure “Smitty” that not every labor – despite what other mothers will tell you – is a life-sucking, horrible event.

    And to be fair, my friend (my college roommate to be precise) has many un-camera-ready hair moments. She’d just happened to have a meeting with the bigwig hospital admins that morning, which required excellent hair and makeup (as opposed to everyday hair and makeup).

    And as my mother puts it – sure, you’re in pain for a while…but you have *such* a wonderful prize at the end.

  30. I soooooo love you for posting this!

    I am due in 9 days, and I have been bombarded by quack advice for the last 9 months!

    I have been thinking of posting something on my blog about the skeptic’s take on pregnancy and conception advice (the crap floating out there to try to “help” women suffering from infertility and recurrent miscarriage is even worse IMO).

    Thanks for addressing the plethora of myths bombarding the mom-to-be!

  31. @docgrumbles:

    The infertility stuff is absolutely awful. It took us three years to have Moose. It was pills, shots, ultrasounds… those tables that tip backwards. I had friends telling me to “try folic acid”, “just relax” or that my body just “knew” it wasn’t my time to have a baby… because my husband and I were renting. I guess homeless crack-addicted pregnant prostitutes are doing all the right things.

  32. @docgrumbles: Congratulations! All the best to you. All the best to “smitty” too.

    Don’t get me started on the infertility-associated woo. Just reading that sent my blood pressure a-soaring. Ah, happy memories…

    I’m not one to give pregnancy advice – none of my pregnancies lasted longer than 5 months, and we eventually adopted – but I think Elyse gave some awesome advice there.

  33. 20/20 last night was all about “extreme parenting”. It was an amazing collection of wack jobs advocating everything to custom made infant dolls women carry around as some form of emotional surrogate for a miscarriage to a couple women still breast feeding their six, seven and even an eight year old child. Of curse the home birth fascists were also well represented. I appreciate that some women want to have their baby at home. But even if your plan includes going to the hospital if there is a problem the problem can result in a child’s death or permanent brain damage, or serious risk to the mother before you get to the hospital! It’s like driving over a mountain pass in the winter without chains just because you know a tow truck might be along to help if you get stuck. It simply does not seem reasonable or rational if safety is a primary concern.

    As a guy all I did was try to be as supportive as possible to Ms Fox when our two were born. And while my level of participation was somewhat removed during the pregnancy, after the child was out of the womb I was equally responsible for the child’s care and safety and my opinion about whether there was a doctor near by mattered a great deal. I’d recommend to anyone starting a family to find a good doctor who believes in science based medicine and parents please make safety and rational decisions a higher priority than your feelings and what you will be getting out of the experience.

    And anyone who is still breast feeding their child when the kiddo is old enough to help dad change a flat tire… , I just never want to hear about it.

  34. @Elyse: Yeah, I should have said “popularized by pornographers.” As a cultural reference, it’s high on the list of fourteen-year-old boys everywhere. In any case, it’s an objectifying and degrading term, not cute, and certainly not inoffensive to anyone who actually cares about women and bothers to think these things through. As a husband, I find it severely offensive. As the father of a teenage girl who may choose to become a mother someday, I find it even more offensive. As the father of two sons, I have made my detestation of the word (or more precisely the attitude it indicates) sufficiently clear.

    Any woman who thinks “MILF” is OK needs to re-read The Feminine Mystique. Any man who thinks it’s OK should be beaten into unconsciousness with the 40th anniversary edition.

  35. Codswallop:

    I think it’s just as useful and helpful as the frequent use of “nigguh” is among young African-American men. They’ve certainly taken “ownership” of the word away from Old White Men, but I’m not sure it’s any more constructive than it was originally, since it seems to glory in a poorly educated and violent lifestyle.

    On second thought, I’m sure that has no relationship to “MILF”.

  36. @Codswallop:

    You may choose t o believe that I am not someone who “actually cares about women”, but I think I am. And as someone who “actually cares about women” I refuse to walk around playing the victim card every time someone uses a word I don’t like.

    My “feminine mystique”: I’m bigger and stronger and better than that. I will not walk around whining that someone used a term to describe me in such a way that indicates they’d like to do sexy things to me. The most offensive thing about this whole exchange is that you have come in here and told me that I need protecting from an acronym because it’s a word used in porn.

    Even worse is that you are here, threatening to beat any man who uses the term. How ironically patriarchal of you, sir.

  37. @Codswallop: Well, I’m offended by anyone telling me, a woman, mother (of a daughter) and feminist, what I should and should not be offended by. Women are perfectly capable of making up their own minds about the terms they choose to use with condescending lectures from men who don’t like it. I’m not going to run screaming in fear from pornography or sexual culture – I would rather face it and own it. It’s not up to you to define Elyse’s meaning, and decide what she can and cannot think. And if you think that she, or I, don’t have the right to speak up and and say that, I think it’s you who need to educate yourself on what feminism is really about.

  38. “The word is vulgar, insulting and inappropriate. Period.”

    Sorry but that is just your opinion.

    You failed to address your threat of violence?

    Anyone who thinks a word is a bigger problem than acts of violence is someone to stay away from.

  39. @spurge:
    Not very good at this whole rhetoric thing, are you. I don’t actually commit acts of violence. Or did you also imagine I would literally use the book itself as a weapon? It’s 500 pages, but the edition I have only weighs about a pound.

    I can’t believe people on this blog–women included–are actually defending this misogynistic word. You are so open-minded your brains have fallen out.

  40. @Codswallop:

    You’re taking that quote out of context. I was pointing out your hypocrisy in threatening violence against anyone who doesn’t submit to your particular view of what feminism should be. An act, presumably, meant to be in defense of the women these men are supposedly offending.

    And I did address the word, you’ve chosen to ignore my comments about it.

    I’ve also apologized to you for offending you. I assure you I do not use the word in a way that is demeaning or insulting towards women and instead use the term as a fun way to embrace our sexuality… a sexuality that does not evaporate immediately upon the completion of reproduction (as you, the father of three, should certainly understand).

    Now, I’d like to get back to talking about pregnancy.

  41. If you are so good at “this whole rhetoric thing” why don’t you actually address the responses to you instead of repeating your outrage.

    I for one will ignore any more melodramatic outrage from Codswallop.

  42. Great article Elyse. I still plan on having a midwife (one of our dear friends) involved in the pregnancy and birth – but have it at a hospital with my OB/GYN.

    My Mom and I almost died during my delivery because an OB didn’t think my movement was ‘possible’. Finding a good OB who listens and not being hyper-reactive (calling him constantly over small things) can make all the difference in the world. As with everything, being educated and understanding the biology of your body is imperative.

    Oh, not to nitpick, but it’s the cervix, not the vagina that dilates. Unless I missed something in my bio classes.

  43. @ Codswallop:

    I agree completely. Where do these women get off thinking that they can make decisions for themselves regarding such things as semantics, humor, or interpretations of nebulous philosophical, political, and social concepts. God forbid, next they will be wanting to vote!

    Glad to see that there’s at least one other person out there understands that the only true feminist is man. Naturally, we are the ones in a position to know what is best for these delicate flowers of Eden.

    Imagine the notion, having there own “opinions” (such as they are capable) regarding things, people, or the various other nouns. The very idea!

    If you would like, you can borrow my personal hard cover copy of the Feminine Mystique, which I have convieniently affixed with broken glass and rusty nails in order to prevent the various women in my charge from picking it up and sullying there delicate minds with this “reading” business. I believe it would be equally suitable for your purposes.

    Sincerely, your Feminist brother in arms,
    -Mark

  44. I’ve had one child. I hated being pregnant so much I will never do it again. Not that there was anything particularly gruesome about my experience, it’s just not for me.

    I was the happiest woman alive when they stuck that needle in my back after 18 hours of labor. All the pain went away, and I actually got a nap in before the delivery. If I had known the science I know now, I would have asked for my epidural much sooner (studies show that EPIDURALS DO NOT PROLONG LABOR).

  45. My apologies for creating such a derail. I do have to point out though, that the term was _not_ invented by the American Pie writers, even if it was probably obscure before it.

    I fully support everyones rights to be Humpty Dumpty, but as you see, you’ll create a serious dissonance in the minds of those of us who’ve gotten used to this being a pornographers’ term. I personally don’t think it should be used when you wouldn’t write it out in full.

    Mother-I’d-Like-to-Fuck to be does seem a bit crude doesn’t it?

  46. @shanek: “How is the term “MILF” any more derogatory than the term “hottie”?”

    Well, I guess that “hottie” just means that you think someone is hot. Since “Milf” is an acronym for “mom i’d like to f**k”, it is more than just an opinion about someone’s comeliness – it is a declaration of wanting to have sex with someone, specifically a “mom”. I think it was originally meant to connote a specific age of mom, though – one at least over 35. Calling Jamie-Lynn Spears a “Milf” doesn’t really jibe with the intent…

    Speaking of Milf: how’s this for offensive?

    I was at Disneyland two years ago on MOTHER’s day. I spotted a real, um, ‘Merican kind of little family..mom, dad, two sons around 12 and 8. Dad’s t-shirt read, in the “got milk?” ad campaign font, “Got Milf”?

    Real classy. Extra points for wearing it on mother’s day at freaking disneyland.

  47. Oh, and Elyse, great post! I’ve always wanted kids, and always been terrified of labor. I took 36 hours to get born and my mom had some problem with her epidural…now that I’m in my early 30’s, well, it’s on my mind a lot more. But yeah, I’m glad I live in this century, in the first world.

  48. “I was at Disneyland two years ago on MOTHER’s day. I spotted a real, um, ‘Merican kind of little family..mom, dad, two sons around 12 and 8. Dad’s t-shirt read, in the “got milk?” ad campaign font, “Got Milf”?”

    If he’d turned around and smacked her in front of their children then there’d be something worth raving against. This sounds like a case of a guy trying to be witty and pay his wife a compliment at the same time.

    Do you stop girls who have ‘Like ‘Em?’ written on their shirts? C’mon. With all the real issues out there is this really something worth getting all bent out of shape over?

  49. I think it’s just as insulting to be told that you absolutely should get an epidural as it is to be told that you absolutely shouldn’t. Every woman needs to be responsible for researching her own choices (NOT her doctor or midwife) and making her own reasonable decision. It’s fine either way if a woman chooses to have an epidural or to have natural childbirth…so long as she has done her homework and made the right decision for her.

    I’m tired of being told that I a) am insane, b) just wanted to be a martyr, and c) was just lucky to have a “short labor” (16 hours is not short) and “small baby” (6 lb 11 oz, while small, is perfectly normal) because I chose to do natural childbirth. And I’d like to have my next one at home, should I be lucky enough to get pregnant with a keeper. Most of the “life threatening emergencies” that people talk about during childbirth can be anticipated (and prevented, since there is time to get the mom to the hospital) with the equipment that homebirth midwives bring with them.

    Again, if people have actually researched these things and made their own decisions, that’s fine–if they haven’t and are just spouting off whatever opinions they’ve heard, that’s not. That’s just as ill-informed as taking an epidural/choosing natural childbirth without being prepared. Both of those are statements about the medical establishment: one is of blind trust and the other is of anti-trust. Neither is acceptable.

    I had a great and supportive OB-assisted birth in a hospital with our oldest son. We made choices about preparing for natural childbirth that were supported by our OB. Had we researched equally and decided to get an epidural, that would have been fine.

    It has nothing to do with being “strong” or “wimpy”. It has to do with being educated.

  50. About the nausea that sometimes accompanies pregnancy, usually in the first trimester. There is a positive correlation with nausea and good pregnancy outcomes; that is the worse the nausea usually the better the pregnancy outcome. In the first trimester you don’t really need to eat very much extra (if anything at all). Mostly what is happening is differentiation, which is extremely tricky and can be sensitive to all sorts of teratogens. When teratogens have effects and what effects they have depends in great detail on exactly what is going on. For example, thalidomide will produce autism, but only in a few day period right around when the neural tube is closing. At other times it causes other birth defects.

    There is some thought that the nausea of the first trimester evolved so that women would eat less, and eat very simple food that was easy to digest and didn’t have a lot of phytochemicals in it that the liver would have to detoxify. Some of those phytochemicals might be ok for an adult to eat, but might be teratogens if given during differentiation, such as alcohol. Alcohol (in my opinion) should be completely avoided especially in the first trimester.

  51. Just to reiterate, there is a tremendous amount of disinformation out there on the web, especially disinformation about the relative safety of home birth.

    A very good site is

    http://homebirthdebate.blogspot.com/

    The author is very knowledgeable, and subscribes to the same high standards of evidence and science based medicine that skeptics require. Everything she says she can document by citation to peer reviewed literature. Something the home birth advocates don’t do, instead they lie. An OB degree from Google-U is no substitute for competent medical advice from trained, degreed, licensed, practiced and insured practitioners.

    It is simply false that all emergencies can be predicted in advance. It is false that home birth is as safe as hospital birth. It is false that all emergencies can be dealt with quickly enough by transfer via an ambulance. Maybe most can be, but if the emergency you have is one that can’t be, that is a small consolation for a dead or injured baby or mother.

    Deaths of mother and fetus are rare, but they are more common in home births than in hospital births.

  52. @Bjornar:

    Think of MILF like FAQ. Yes, the long version is “Frequently Asked Questions” but if you read them you realize that no one ever really asks those questions. FAQ really just means “a list of questions we’d like to provide you the answers to”.

    In the same way, MILF means “hottie mom”.

  53. daedalus2u @10:14

    For example, thalidomide will produce autism, but only in a few day period right around when the neural tube is closing.

    I think you’ve got your scare stories mixed up here. Thalidomide is not known for causing autism, but for much more blatant birth defects. And if something bashed fetal development “when the neural tube was closing”, autism would be the least of the kid’s problems — if they survived, I suspect the result would resemble spina bifida.

  54. Congratulations to Smitty!!!!!!

    Fantastic post Elyse,

    The Skepchick site is really ROCKING the last couple of days.

    I had all sorts of problems through both pregnancies (that are not relevant to this discussion). The one thing I really want to stress the importance of is recognising Post Natal Depression.

    Ye Gods, my depression started even before number one was BORN!!!!

    Because neither he or I could get the hang of breastfeeding, we tried for 7 days. The crunch came after I stayed up all night attached to an ‘expressing’ machine and getting (I shit you not) 30mls, which Matthew proceeded not to finish…..

    But the crap I copped because I didn’t breast feed was really bad. I had one ‘mother’ who was breastfeeding walk up to me tell me that I was a compete bitch, I didn’t deserve a baby and that my baby would die from SIDS.

    Nice.

    Any wonder the PND got progressively worse? (Also no wonder I just didn’t go out in public from then on)

    Ah, also contributing to my depression was the fact that I caved in (after being in labour for nearly two days) for an epidural. It felt like such an epic fail. I had been consuming the books that were all “do not get an epidural – do not have a cesarean”, you can do it. Everybody must do it… Well I couldn’t.

    My Post Natal Depression was so bad that I tried to kill myself a few times, ended up in the psych ward on more than one occasion.

    Educate yourself.

    Do not be swayed by woo. If possible, find a birth centre staffed by qualified midwives, with an attending Ob.

    Do not panic.

    Graham Chapman from Monty Python (a qualified doctor) once wrote that ‘childbirth would be a lot less painful if grandmothers had their lips sewn together’…

    Elyse, thanks again for the post on something that should be blogged about – Skeptical Pregnancy 101.

    PS, I am totally with you re Dr Novella. I was yelling at the iPod when they covered that one on SGU!

  55. My wife pointed me here. I’ve been trying so hard to get her to see how cool the skeptical movement is, but then she sees this and tells me how un-evidence-based it is. I can agree with some of what you say, but I must disagree with some of the things you say.

    Firstly,

    your doctor and hospital have nothing to gain and everything to lose by letting something go wrong.

    While I agree that this is strictly true, I don’t think it means what you think it means. I think that this means that the doctor and hospital will manage the woman’s pregnancy for the best outcome for them. This is not necessarily the best outcome for the mother. It may be that, for the hospital and the HPs, how the woman feels about her birth experience is not high on their list of markers for a successful outcome, whereas things like scheduling and throughput management for the birthing suite might be. For some women, this means that important decisions about their birth can influenced simply by what is convenient for their healthcare providers. For example, I know that the hospital closest to me arranges inductions to be started late at night so that they can claim overnight procedures from their funding body, and the resultant labour can be dealt with by the day shift.

    Get the drugs.

    Yes, there are pros and cons to an epidural. Not feeling any pain is surely a pro in most people’s opinion. Not feeling anything might be a pro or a con, depending on how you feel about having your baby. One of the cons is that once you’ve had the epidural, you’ve significantly increased your chances of having to use further interventions to get that baby out. If you feel that what you want is as close to a ‘natural’ birth as possible, having an epidural will make that harder.

    Other drugs, like pethadine, will affect the baby and make things like initiating feeding more difficult.

    A pro of a C/S is that you will almost certainly end up with a live mother and baby. The con is that it’s major surgery and requires significant recovery. You won’t get to carry your baby out of the hospital a few hours after the birth.

    The Natural-birth movement people are going to try to make you feel guilty about not choosing a “natural birth”.

    Not quite an ad-hominem, but close (poisoning the well?). Please don’t confuse advice and information offered by people who genuinely care as an attempt to ‘guilt’ anyone into doing anything. I’m involved with breastfeeding advocacy, and I can tell you it’s terribly frustrating to be perceived as trying to emotionally blackmail someone into doing something, when what you’re trying to do is give them the information they need to make an informed choice about something they may later come to regard as one of the most important things in their life. It’s even more frustrating than watching people make decisions that they will later regret simply because they didn’t know all of the options they have.

    The reason that there are so many ‘natural birth’ folks out there is that too many women have been through the hospital system and found it profoundly unsatisfying. Too many women have been forced to hand control of their bodies over to disinterested others during an event that forever more defines their life as a mother. They even use terms like ‘birth rape’ to describe their experiences. I’m not going to get into an argument about that term and whether it trivialises rape or overstates the birth experience, but the simple fact that some women feel justified in using the term shows that some women find themselves feeling violated even when they have a successful outcome, ie, living mother and baby.

    Don’t get me wrong – I appreciate what modern medicine does for us, I really, really do. I certainly don’t hold with Freebirthing and told my darling wife that I would carry her myself to a hospital if she couldn’t find a midwife she liked, but when I did my own research, I was comfortable with the level of risk in homebirth for us. As I see it, birth mostly goes right (about 95% IIRC), and modern medicine is there to take over when things don’t go right so that hopefully things don’t go terribly wrong. Yes, this is why we in the west are much better off than mothers in, say Africa. We have choices they don’t.

    My advice to Smitty would be to find people she likes and trusts to get advice from (she’s doing that already, though). Listen politely (or not) to advice that’s offered, do her own research and work out what sort of birth she wants. Hang out with parents she likes, who parent in a way that shes thinks would be right for her. Find a health care provider who can respect her. Write out a birth plan that says what she wants so that in the heat of the moment she doesn’t have to think too hard. Discuss it with the father, so that he can look after her and her wishes. Be prepared to change everything in the case of a medical emergency – what matters most is living mother and baby.

  56. @Elyse:

    To you, yes. To me, it will still mean “Woman over 30-35 whom we fed lobster to on camera, with permission to sell the footage, for very little money.”

    I’ll try to read it your way when it’s meant that way, but it’ll be hard. (Purely accidental turn of phrase there, but it’s apt.)

    Also, I’ve seen a lot of FAQs created by supplying a standard answer to a question frequently asked, even if that’s no longer always the case.

  57. “Dr Novella can quote studies all he wants about “pregnancy brain” being a myth, but for those of us who’ve delt with gestational mental retardation can tell you, it’s real and it’s unpleasant.”

    I can’t believe I just read that.

    I don’t care about your fancy evidence, my mommy instinct trumps all. Sound familiar?

    You’ve flatly denied evidence in favour of a personal anecdote that may not even be accurate. There are a number of reasons you may have perceived yourself as more dumb (confirmation bias, for example). If the argument is that the evidence is of poor quality and more research is needed to draw a conclusion, fine. Because that’s an evaluation. Saying “I know better because I felt it” is not a good argument, as many rightful Jenny bashings demonstrate.

  58. @daedalus2u
    That’s an interesting site. I intend to spend a good deal of time there seeing what she has to say.

    Being the husband of a certified nurse midwife who has both performed and experienced her own homebirths, I’ve always been curious (and critical) about just how much either side knows about about the safety comparisons between hospital birth and homebirth. The one side, the side that makes sense to most people, is that wouldn’t you want to be at the hospital JUST IN CASE something suddenly goes wrong. The other side, the side of the midwives, will tell you that unless you are “risked out” early on, the hospital environment and its interventions (from simple things like IV’s and laying on your back through bigger things like pitosin and epidurals) are more likely to CAUSE problems in their efforts to prevent them.

    I’m honestly not sure who’s right because frankly listening to the explanations from both sides often sounds suspicious of data manipulation. Though one thing I do notice about that site you mentioned was that her main beef seems to be with Direct Entry Midwives who perform homebirth. It seems to be a bit misleading because I imagine if you compare their outcomes with a CNM’s outcomes and you’d see homebirth as coming off much safer.

    Anyway, I intend to spend some more time over there and see what she has to say. Thanks for the link.

  59. Kimbo’s the first to be gobsmacked by this incredibly irrational comment? wtf, let’s just dismiss evidence and research over personal reference, sounds like a plan. When’s the next article about the perks of visiting a chiropractor or acupuncturist, btw? I don’t mean to seem strident on this, but c’mon, I thought this was a refuge for reason.

  60. @Kimbo Jones:

    Actually, the study that discussed on the SGU wasn’t actually a study done on so-called pregnancy brain. It was a study done on women then they went back and re-examined the evidence to see if they could see a decline in “intelligence” during pregnancy.

    When you’re pregnant, you’re tired and you’ve got a whole lotta stuff on your mind. It’s the kind of stuff that causes people to be distracted and seem air-headed even without the raging hormones. I meant it to be a light-hearted comment.

    Your IQ may not drop, but it’s a pretty normal thing to feel like you’ve completely lost your ability to think.

  61. David, thalidomide can cause autism-like symptoms as well as many other birth defects.

    http://web.mit.edu/autism/Eng&Sci%203,10%20'06.pdf

    This is a paper by Paul H. Patterson, who is a researcher at Caltech, specializing in neurodevelopment. I went to a talk by him at MIT. His current focus is more on how the immune system interacts with neurodevelopment. Some viral infections can cause autism and schizophrenia too. It is the immune response that does it, not the infection or any “toxins” from the infection. DNA that doesn’t code for anything will cause birth defects too, showing that it is the immune response to DNA, not the infection that does it. Incidentally every researcher he had ever talked to recommended that pregnant women get flu vaccine because getting the flu during pregnancy is potentially so bad. Every woman planning to get pregnant should make sure she is fully up on all of her vaccinations including MMR, chicken pox, flu, etc. Getting those when you are pregnant can/will cause birth defects.

    Rats Acre, postpartum depression and postpartum psychosis touch on my nitric oxide research which I discuss here (warning, some of the discussion is disturbing)

    http://daedalus2u.blogspot.com/2007/08/low-nitric-oxide-acute-psychosis.html

    I see them both as “normal” responses of physiology to metabolic stress and I think that PPD can progress to psychosis if the metabolic stress is not relieved. Stopping breast feeding relieves that metabolic stress. I see the postpartum psychosis as an evolved “feature”, a feature to cause a woman to shed an unsustainable metabolic load (I appreciate this is a disturbing concept, but your genes don’t care how you feel, only that they are successfully replicated).

    PPD is a life-threatening disorder and needs to be dealt with as the life-threatening disorder that it is. I think that any woman who experiences PPD can transition into postpartum psychosis if her metabolic stress is not relieved. I think that is what happened to Andrea Yates. Putting more stress on a woman with PPD will make it worse (putting stress on anyone with depression makes it worse).

    Coran, what virtually all women want out of a “birth experience” is a healthy baby and a healthy mother. For most people everything else is so far down the list of priorities that it doesn’t even register. Is a home birth experience worth a 0.1% increased risk of infant or mother death? Not to me, but others can make their own decisions and some may decide a home birth experience is worth an increased risk of injury or death. They should make those decisions based on facts and logic, not wishful thinking, lies and the woo-speak that the pushers of CAM and home birth advocates use. The home birth advocates manipulate the data to try and make it appear that home birth is “just as safe” as a hospital birth. It isn’t. There are some emergencies that cannot be dealt with at home, sudden hemorrhage for example.

    FFFearless, my mother was an RN, CNM (from Johns Hopkins) who worked for Frontier Nursing and delivered babies in the back woods of Kentucky. All of her children were born in a hospital. She is passed away now, but I don’t think she would have ever considered a home birth. She was very much evidence and science based. She did have difficulties with the OBs while she was giving birth. One of them tried to give her anesthetic gas just as she was trying to concentrate, and she said she had to slug him (this was a long time ago and things have changed since then). Although those interventions may cause “difficulties”, they don’t increase baby or maternal mortality. For me, I would put up with a lot of “difficulties” if it increased the likelihood of a healthy mother and baby. I agree that given the screening such that only very low risk women have home births, you would expect better outcomes. Unfortunately the data doesn’t support that which given the cohort giving birth and the observed outcomes, home birth is a lot less safe than birth in a hospital.

  62. @elyse: I think it was the wording that I found galling. Saying that sounds like someone can present as much evidence as they want and you wouldn’t change your mind because of your prior belief.
    If that’s not what you meant, super.

  63. @Kimbo Jones:

    No, I was referring to one particular study on one particular episode of the SGU. There’s actually plenty of evidence that it’s a real affliction of pregnant women, but not a permanent one, thought it can last up to a year after giving birth.

    The actual causes of it are unknown.

    I certainly do not advocate, in any way, dismissing overwhelming scientific evidence.

    This study in particular struck me as the ones that determined that PMS is all in our silly little girl heads and just an excuse for being bitchy and lazy.

    @exarch:

    Yeah, exactly. There aren’t enough studies to determine the actual cause of “the preggo stupids”, but exhaustion is certainly one of the favored explanations.

  64. @daedalus2u
    Although those interventions may cause “difficulties”, they don’t increase baby or maternal mortality. For me, I would put up with a lot of “difficulties” if it increased the likelihood of a healthy mother and baby.

    The thing is that there IS a world of space between infant and maternal mortality and “healthy” babies. Just because everyone survives the birth doesn’t mean there won’t be health effects related to drugs and fetal stress brought on by interventions. I’m not saying the studies point toward one way or the other. Like I said, I have viewed the interpretations of BOTH sides with suspicion. But homebirth proponents (right or wrong) actually DO consider health of the baby as the reason they give birth at home. It’s not just about “having a beautiful birth experience.”

    Unfortunately the data doesn’t support that which given the cohort giving birth and the observed outcomes, home birth is a lot less safe than birth in a hospital.

    Is that backed up by more than just the study that blog put up, because again, she was comparing homebirth with Direct Entry Midwives next to deliveries with OB’s in hospitals. What about homebirths with CNM’s compared to in the hospital.

  65. I figure home-birth is ALWAYS going to be a little more dangerous than at the hospital, for the simple reason that in an emergency, time is lost getting to a place where appropriate care can be given.

    Or to paraphrase a quote about medicine I really like:
    Doctors don’t go to school for 8 years to learn how to perform a 15-minute appendectomy, they study that long to learn what to do when things don’t go as planned.

    I would suggest the same thing applies when giving birth at the hospital. In the unlikely event that you’re the one in a one-in-a-X chance, it’s best to be AT the place that can handle the problem swiftly and immediately.

    It’s why people pay money every month for various different types of insurance.

  66. I hated every second of being pregnant. All the dumbasses that told me I’d miss feeling those kicks can kiss my ass.

    My labor sucked. I was in labor for three days before the emergency cesarean.

    Speaking of which, the recovery sucked too, and my perma-muffin-top is a bit of a downer.

    And no matter what uppity lactivists will tell you, it’s entirely possible for your baby to be latched on 100% properly and for it to hurt on a level comparable to those three days of labor.

    But most importantly, after all that crap, I still love the bejeebus out of my 4-month-old sugar munchkin. Congrats to all the moms-to-be on here!

  67. Also, as far as studies go, you can’t simply compare hospital births with home births and say either one has more or less chances of something going wrong.

    If you’re in a high risk group, no doctor in his right mind is going to agree to let you have your baby at home.

    On the other hand, if you’re in a high risk group, there’s a higher risk of something going wrong. Hence the term “high-risk”.

    But that also implies that on average, the mothers having their babies at home are more likely to be strong healthy women who don’t look like they’re going to encounter a lot of issues, while on the other hand among the women who go to the hospital a higher number are already bound to have something go seriously wrong, no matter where they have their baby.

    Any serious comparison needs to take that factor into account, and it doesn’t seem like studies of that nature have been carried out.
    So all that’s left is the subjective impression that moms giving birth at home will probably be more relaxed, etc… vs. the subjective impression that moms giving birth at the hospital will probably feel more secure and, well, the outcome is most likely the same, the type of person just isn’t.

  68. @66: “Do you stop girls who have ‘Like ‘Em?’ written on their shirts? C’mon. With all the real issues out there is this really something worth getting all bent out of shape over?”

    Um, where did I say that I stopped him, and how did I get bent out of shape? It bent me out of shape the same way I get “bent out of shape” when I see someone with “Juicy” or “porn princess” written across their velour sweatpants – it’s just tacky.

    Oh noes! There are babies starving in the world! You can’t have an opinion on what someone wears because the babies are starving!

  69. FFFearless, I have read a lot more than one paper and the studies do point one way. To pretend they don’t is disingenuous. It is akin to the “balance” that tries to compare EBM and SBM with CAM. A hospital birth has fewer dead babies and fewer dead mommies. Unless the population you study is large enough to capture the rare fatal events, it isn’t going to have sufficient precision to reliably show that. A midwife’s experience in 500 births doesn’t give very much information on what happens in the one in 10,000 births, or the 1 in 20,000 births.

    A CNM at a home birth can’t do an emergency C section. If doing an emergency C section is necessary to save the life of the baby, a CNM can’t save that life at a home birth. Has anyone ever shown that there is never a need for an emergency C section at a home birth? No, and it is not something that anyone rational would expect. Even with the best fetal monitoring, the need for emergency C sections is not always predictable in advance. With less information available at a home birth (i.e. no fetal monitoring), the need for an emergency C section is less predictable.

    Home birth advocates consider the “birthing experience” ahead of the health and safety of the mother and baby. Are their any studies that show that the “birthing experience” actually does have effects on the health and/or safety of either the mother or the baby? Or are those statements just anecdotes about how people feel? Anecdotes about how people feel doesn’t cut it on this site. If you are going to bring up better outcomes from home births, I expect a citation.

    What I consider very telling is that the midwifery advocates won’t release the data on what the actual morbidity and mortality data is for home births attended by a midwife even though they have that data. The data is kept secret under a confidentiality agreement which forbids its disclosure.

    When your wife does a home birth, is she covered by malpractice insurance?

  70. What I’m wondering is, when a home birth DOES go wrong and the labouring mom is carted off to hospital, do they count it as a strike against hospital births if the mother and/or child die there?

    Look, they were fine up until those doctors got their grubby little hands on them.

    Because that’s what the homeopathists do …

  71. I’m guessing the vast majority of skeptics here support a “woman’s right to choose” when it comes to abortion. Why isn’t this same standard applied to home births? Why can’t a woman be allowed to research the outcomes of both experiences and decide which environment she, individually, would prefer giving birth in? If it is misogynistic to insist all pregnant women MUST make the same choice to KEEP the pregnancy, wouldn’t it ALSO be the same to insist they all pursue the same method of birth?

    Pregnancy and childbirth is the time when perfect strangers ALWAYS think they know better than the woman in question. The writer of this blog points that out. And then does the same thing. Women who weigh their childbirth risks and decide on a home or hospital birth based on what THEY decide will be best, and will be an acceptable amount of risk for a course of life they would prefer, should not be condemned. Living always contains some risk, unless you go live under a rock (metaphorically speaking), and the person best qualified to weigh that risk is the person directly involved.

  72. Anecdotes about how people feel doesn’t cut it on this site.

    Not sure if that was fired at me or not, but I never claimed how people feel is indicative of anything. In fact, I said that for a lot of the women I’ve come into contact with via my wife, the homebirth wasn’t for warm fuzzy FEELINGS. It was because they genuinely determined, based on whatever research they did that it was the best idea for the health of their baby. They were low risk women who felt that the hospital environment and hospital interventions would have a greater risk of causing problems than being at home.

    As to the data, hold that thought. I’m going to have to pull that from my wife who is the one who actually researches all this stuff.

  73. I am certainly not saying that women can’t choose to have a home birth. I am not faulting women who choose a home birth unless they used whacked-out reasoning to make that choice.

    People who are advocating home birth should not lie to pregnant women about what the risks are. That is what they are doing right now. Home birth advocates lie and say that home birth is “as safe” as a hospital birth. They are using a wacked-out definition of what “as safe” means.

    To me, “as safe” means the same or fewer deaths/injuries for the same cohort of women giving birth in a hospital. With that definition, home birth is not “as safe” as a hospital birth.

    If you use the whacked-out definition “as safe as a hospital birth if nothing goes wrong”, then yes, home birthing is “as safe as a hospital birth if nothing goes wrong”, but the definition of “as safe”, then precludes any other conclusion. I could use the same “definition” to characterize any behavior “as safe”. Driving at 150 miles an hour is “as safe” as driving at 15 miles per hour (if nothing goes wrong). Drinking drain cleaner is “as safe” as drinking water (if nothing goes wrong).

    I am faulting the home birth advocates who lie to gullible women. If the home birth advocates told the truth and said “yes, the chances that you or your baby will die or be injured during a home birth are greater than during a hospital birth, but you will have a more comfy experience at home”, I would not fault them. But that isn’t what the vast majority of them say; they lie and say home birth is as safe as a hospital birth when it is not. I think most of them actually believe it and are lying to themselves too. That is true about most non-skeptics. They believe what ever bullshit they have been told without applying critical thinking skills to it.

    The reason that some women come to the conclusion that home birth is “as safe” as a hospital birth is because they have been lied to and have believed the lies. That is what skepticism is about, seeing through the bullshit and lies and basing decisions on facts and logic. You can decide to have a home birth for any reason, including because you think then your baby will have moonbeams shining out of its ass. That is not a decision a skeptic would make using skeptical thinking. Most skeptics do support a woman’s right to choose. They don’t support her right to have muddled thoughts and sloppy thinking while calling herself a skeptic.

  74. @jemand:

    I certainly believe that a woman should research her options and choose what is best for her. I’m not telling anyone what to do. Smitty wrote us, she asked us for advice. This is my advice. My advice includes getting the epidural and going to the hospital.

    I don’t believe for one second that anyone is reading this blog and thinking “Well my doctor said one thing and it’s what I’m most comfortable with, but Elyse over at Skepchick said something else so I’m going to go with that.”

    If you are, then Skepchick is the absolute wrong place for you to be… as is the maternity ward.

  75. @jemand:
    I’m guessing the vast majority of skeptics here support a “woman’s right to choose” when it comes to abortion. Why isn’t this same standard applied to home births?

    It is. But the choice has to be based on facts and truth. A fair warning is in order.

  76. Okay I did some searching over on PubMed for “home birth” and actually it seems like a good majority of the studies on there say that home birth has comparable rates of death and APGAR scores to hospital births. I actually only found two reports that said the death rates for homebirth were higher, and even those studies said that the higher rates weren’t “statistically significant”. What all the studies did agree on is that home birth had much much lower rates of interventions. I’ll keep looking but so far I fail to see any evidence to indicate that low risk women should be discouraged from home births and birth centers.

  77. @FFFearlesss:
    From the sound of it, they really are comparing apples and oranges (as in comparing the raw percentages, then concluding that home-births require less interventions, probably for the simple reason that all the high-risk cases go straight to the hospital anyway).

    In that case, equal outcomes is actually a bad indication, as even including all the high risk cases that inevitably lead to trouble, hospital births still do just as well as home births where survival rates are concerned.

    Something to think about …

  78. Actually I found the opposite. That’s actually been one of my reservations with trusting the stuff my wife and other midwives were telling me. I figured they were comparing the low risk home birth women against ALL hospital births: low and high risk. But from as near as I could understand the abstracts, it really looked like the studies only analyzed comparatively low risk hospital births for their study, as well as weeding out things like congenital birth defects and whatnot from both sides. Again, maybe I’m reading it wrong, but it looked fairly apples to apples to me.

  79. Of course, that still leaves the question what is understood with “intervention”.
    Something that might be done as a precaution at the hospital might be seen “and billed” as an intervention, while a midwife might do the same thing and not consider it too much out of the ordinary, or a reason to move the whole operation to a hospital for fear that might actually make things worse than doing nothing and sitting it out for a while.

    I think it’s important to figure out the selection criteria for which cases are included in the study and which aren’t. Which makes me think that perhaps you’re much more likely to have your request for home-birth declined by your doctor unless you’re the textbook case of a healthy pregnancy.

    What is the ratio of home versus hospital births anyway?

  80. Sorry, I was the one generalizing, not them. In the studies, interventions were classified as things like epidurals, c-sections, episiotomies, pitosin, and constant fetal monitoring (which necessititates a woman laying in bed).

  81. The incidence of deaths in hospital is quite low, a few per 10,000. You need a large study to get good statistics. “Not statistically signficant” may (most likely) means that the study was simply too small.

  82. So a woman planning to go “the natural way” at the hospital, then deciding she’s gonna get the shot in the back anyway since she can is an intervention. At the same time, the woman at home is probably more likely to have to suck it up (assuming the midwife is even allowed to give an epidural, or has the necessary equipment along).

    Similar arguments can probably be made for other things on that list.

    But hey, once again, I’m not trying to discredit studies I haven’t read. Just questioning whether they’re really comparing and giving statistics about what you or I think they are …

  83. dude, this is about as bad as hearing a chiropractor or acupuncturist gabbing about about their pet quackery of choice. Total ignorance and refusal to read the studies or listen to the facts, just blind “more medicine is always better medicine” rhetoric.

    but probably I should give you the benefit of the doubt, you’re just questioning again and again like a good skeptic should. But that’s what creationists do to, question increasingly random details instead of seeing the big picture. And the big picture here is that a woman can rationally come to the conclusion that what she wants for her low risk pregnancy is a home birth without subjecting herself or her fetus to undue risk.

    Besides, I’m guessing that the vast majority of women who choose home birth would be the same women who would opt NOT to have an epidural at the hospital, to answer exarch’s latest objection. Just a personality guess.

    Part of my strong feeling on this comes from the fact that, while quackery from acupuncture to chiropractic etc, pretty much gets a free pass, legal restrictions on home birth abound and seem to be increasing from knee jerk reactions such as “it couldn’t POSSIBLY be safe” such as that modeled by exarch here, the upshot of this being when my sister had to be born with a total stranger presiding because of a cease and desist order. So I feel pretty strongly about this, and about the right of choice here.

  84. @daedalus2u
    Actually, I’m in almost complete agreeance with you. I’ve seen and experienced the sort of whacked-out nutjobbery that can accompany ‘alternative birth’. At the same time, though, I do think that, as in this case, too many health professionals flippantly dismiss the ‘birth experience’ as unimportant (“so far down the list it doesn’t register”), as if the only measure of whether a birth was ‘succesful’ is whether the mother and baby survived. I agree that it’s the most important consideration, but I don’t think it’s the only one.

    I completely agree that the information should be out there and that people should be able to make an informed choice. I agree that homebirth in inherently riskier than hospital birth, and I think that the choice to birth at home should be based on a risk/benefit evaluation.

    It pains me though, to see various and potentially valid options, and what they mean to the women that experience them (anecdotal or not), summarily dismissed from consideration because of their association with the woo-meisters. It is somewhat analagous to disregarding TENS because some acupunturists use electricity.

    <anecdote warning>
    My wife and I took a calculated risk for a particular benefit. We factored in things like how close we are to the hospital (an ambulance would be here and back before the theatre was prepped). We controlled the risk as best we could (informed the hospital what was going on), and we accepted that in the worst case, say placental abruption, there was a significantly increased risk to mother and baby. We weighed the likelihood of those factors against my wife’s strong desire to birth in a space that she was comfortable in and that she had some control over.

    Our last homebirth midwife was a burning torch of stupid. Buteyko, Pauling, naturopathy, “natural” foods, selenium deficiency, tarot, she was totally alternative. But I wasn’t hiring her for her dietary advice (which was crap). I hired her for her medical expertise in delivering babies. Turned out that she was worse than useless anyway, but we were prepared, and probably lucky too. However, my response to this is not to dismiss the whole possibility of homebirth in its entirety. My response is to desire better training and certification requirements for midwifes, better environments to be made available for women to birth in relatively safely (more birth centres at hospitals) and, for the sake of others, to take steps to deal with one incompetent individual.

    I like that site you linked to, BTW. It may be the first sensible site on the topic that I’ve seen.

  85. @exarch
    Based on several of your responses it seems like you don’t actually know what a homebirth midwife does. In general they don’t accept ANY high risk women for home births… not to say that they won’t manage their birth in a hospital setting. But previous c-sections are risked out. women with high blood pressure are risked out. If any anomolies are noticed on the ultrasound they are risked out. Obese women are risked out. Etc., etc., etc. Homebirth seriously is relegated only to women who the midwife can feel secure in handling outside a hospital. And it’s not like they don’t bring supplies and equipment to deal with issues on the spot. And if there is any ANY change that causes them to worry for the health of the mother or baby, there is no screwing around. You up and drive to the hospital. In the extremely rare case of a sudden life and death emergency, you call an ambulance. Midwives don’t do ANY medical pain relief, epidurals or otherwise, at home. And yes, to answer your question, they DO have malpractice insurance. They have backup doctors and backup hospitals where they also have privileges to deliver. I’m speaking only of Certified Nurse Midwives. I honestly don’t know what the rules are for direct entry midwives and lay midwives. But it’s not like they’re just going into this saying, “Oh everything’s going to be fine no matter what.” They take the safety of the mother as serious as any doctor and in fact are often the ones who have to smack the uber crunchy hippie “everything-with-birth-is-always-perfect” mom to get her ass to the hospital when it becomes obvious that an intervention will be genuinely beneficial.

    @dedalus2u
    You keep indicating that the research proves that homebirth is more dangerous. You’re going to have to give me some links because again, even a quick cursory search of PubMed is showing me that the literature supports home birth for low risk women saying it’s just as safe as a low risk woman delivering in the hospital with less chance of interventions. Here are just a few of the ones I found (here’s hoping it gets past the spam filters):

    http://www.ncbi.nlm.nih.gov/pubmed/8568573

    http://www.ncbi.nlm.nih.gov/pubmed/9271961

    http://www.ncbi.nlm.nih.gov/pubmed/15961814

    And here are the only two that had anything negative to say. The first one says that the higher risks weren’t statistically significant and the second one doesn’t give the comparitive numbers to hospital birth (at least in the abstract).

    http://www.ncbi.nlm.nih.gov/pubmed/18607818

    http://www.ncbi.nlm.nih.gov/pubmed/12151146

  86. As I have no baby upcoming in the near future, and am not a woman myself, this entire discussion is merely academic to me.

    The reason I keep questioning this is because it appears to me that somewhere, someone is downplaying the risks of home birth. It sounds ludicrous to me that giving birth at home, with the risk of a total whackjob midwife who’s “worse than useless” is also a risk that needs to be taken into account. And maybe the fact there aren’t that many more mishaps is precisely because there are certain reservations concerning who can have their baby at home.

    At the end of the line, I’m not advocating for a complete ban. I’m just surprised that some people are suggesting it’s “as safe as” hospital births, based on the same few studies that make me wonder about the possible statistical flaw that’s skewing the results.

    I would still not deprive a woman of her choice to give birth at home even if that’s proven to be twice as likely to result in infant death compared to the hospital. But then at least there’s some decent facts to support the risk analysis and the choice is a fair one.

    It appears that doesn’t occur right now. Apart from studies citing “less interventions” which make it seem like, hey, perhaps there is something to it while failing to look at possible reasons for this statistical occurrence. Women may choose to give birth at home based on some studies that say it’s “as safe as” but fail to account for a number of factors, or gloss over them too lightly.

    Especially in a discussion about pregnancy advice for skeptical women, it shouldn’t be a bad thing to ask some annoying questions or clarification …

  87. What I meant to say with that last bit is, that it shouldn’t bother anyone to question statements that seem to fly in the face of common sense.
    If home birth is safer, which some people claim, then it would be nice to see some explanations as to why that would be so. If just out of curiosity.

    Perhaps if a decent explanation could be given, it wouldn’t appear to be so unlikely a result any more. Something better than “perhaps the women just feel more comfortable at home”. Something like “women who give birth at home are the badass type who are bound to tough it out no matter what, they’ve taken the whole thing more seriously and done more research, had more lamaze class and exercise, ate more healthy in the first place, planned their emergency route to the hospital better just in case, etc…

    Right now, it’s all just speculation as we can’t even tell for sure if the results in the studies cited are at all meaningful.

  88. As a mother of three girls (17, 6,4) I hear crap all the time. YES women are MORE scared of needles than a baby coming out of a vagina. I don’t know why that’s so hard to believe but I KNOW it’s true. There are women so scared of doctors they don’t see them for anything but a vital emergency, and even then are really bad patients.

    Here’s my voice of experience dealing with Woo mamas.

    1. Any baby born healthy is ‘Natural’. No matter where it comes out from. Unless it’s your ear. That would be weird, but if you and baby are fine then who cares. And I guess it’s still sort of natural LOL

    2. Sign up for an epidural when you get to the hospital. I get the MOST kudos over this one.

    You may never want nor need one. BUT in the rare instance that you DO need medical intervention it’s ready and you don’t have to throw up or hyperventilate like I did the first go ’round waiting for papers to be signed. I’ve done it with and without meds.

    Meds ROCK.

    3. There IS a mommy-sense. I know you all make fun of it, but there is something to it. Mostly it’s a BS-ometer. Being a skeptical parent I guess.

    Examples. My 3 year old had a headache. One that got worse and worse. Cried 5 hours straight, slept an hour, cried 5 hours, slept one etc. for a week or more. Tylenol, Tylenol with codeine (which I insisted from the dr) did nothing. All the Doctors (4) patted me on the head and said she’d be fine. Finally I went in and demanded some testing, as her right eyeball was starting to protrude. I ‘knew’ something was wrong. Was it a mommy sense? Or just good sense? Critical thinking? I don’t know. But we were admitted to a hospital and it turned out she had an intercranial staph infection in the back of her head — between the skull and brain.

    Four days of antibiotics did the trick but it took a few days of mama-panic. If only one Dr. took me seriously we wouldn’t have had to tak her to the hospital. Everyone said that it was that ‘mommy sense’ but I think it was just looking at my child, assessing there were real issues and finding a dr. to take me seriously. The MRI showed the blockage CLEARLY.

    Another example. My middle daughter was almost 2 when she was diagnosed with “Failure to Thrive”. I figured ‘whatever — we’re all skinny’ and blew it off. No mommy-sense at all. Fast forward a year and she’s not digesting any food at all. Finally had her tested by a microbiologist from Stanford and had a medical study written up about her in JAMA and how probiotics can help cure bad bacteria in the gut. (which was her problem) A little probiotic (which I considered Woo at the time) and she was a different child. I feel it saved her life. So did her doctor.

    With all my girls I’m careful with shots. They have all of them but I do read the information they give you. For a short time I was influenced by some woo friends I asked about the now required Hep B Vaccine. (My MIL is STILL enraged I gave it to all my girls. ) Let’s see — cancer or no cancer. I choose no cancer for my children, thanks. I asked the nurse what she thought. If abstinence is the way to go, or the shot. She said of course we encourage abstinence but you never know, if there is a car crash, and your child is in the ER with all kinds of blood around, why take the chance? What if your child makes ONE mistake, or is raped? Made sense to me. Shot’s done.

    So, pay attention to your kid. Don’t over analyze stuff but get help as needed. Be your child’s advocate. Find a doctor that agrees with you about basic child care. Read Lenore’s Blog here about Free Range Parenting:
    http://freerangekids.wordpress.com/

  89. “Actually, the study that discussed on the SGU wasn’t actually a study done on so-called pregnancy brain. It was a study done on women then they went back and re-examined the evidence to see if they could see a decline in “intelligence” during pregnancy.

    When you’re pregnant, you’re tired and you’ve got a whole lotta stuff on your mind. It’s the kind of stuff that causes people to be distracted and seem air-headed even without the raging hormones. I meant it to be a light-hearted comment.

    Your IQ may not drop, but it’s a pretty normal thing to feel like you’ve completely lost your ability to think.”

    I must have missed that show. I have very few brain cells left over from birthing three children. My heart is in a constant state of panic over their well being. I don’t sleep well. I don’t eat well. I’m sure my brain function is down. It’s slowly coming back though, thanks Rebecca et al.

  90. @exarch,
    I agree it does seem ludicrous, more so in retrospect, less so when faced with a pregnant loved one whose lizard-brain is telling her to find a dark place to have the baby. I think perhaps our biggest mistake was overestimating the midwife’s ability. On the basis of having had three previous midwife-assisted births, one at home, I still think the problem was more with this midwide than the situation. Our previous midwives were excellent (and worked through a hospital birth centre).

    I’m not surprised that passionate homebirth advocates would downplay the risks. I’ve met them on-line and IRL. They can be every bit as loony as any true believer and so you get a problem because in some cases they’re the only alternative for women who are averse to birthing in a hospital. Sadly, there appears to be little middle ground.

    I’d be surprised if any well-done study found that homebirth was as safe or safer than hospital birth. It seems obvious to me that even a small number of unforseeable catastophes that are more survivable at hospital would more than tip that balance in favour of hospital. I think a lower incidence of interventions at home births could be accounted for by the simple fact that fewer interventions are even available.

  91. @skeptical momma

    kudos for reading all the vaccine info, I think that while blindly following the standard vaccine schedule is TONS safer than not doing vaccines, it’s still best to be well informed! One thing not so advertised (because they NEVER want someone to go home without shots in case they’ll never be back) is that in some cases delaying a course of shots only a couple months results in a significant reduction of the number of shots required. So for diseases (such as Hep B) which will likely only become a problem as an adolescent, waiting a couple years even wouldn’t be bad (in my opinion), and for an infant who never goes to day care or is otherwise exposed much to the world, delaying other vaccines a few months (as long as you are careful to actually go get them in the end) would reduce the number of shots, and thus the statistical likelihood of an adverse reaction, and yet still keep the child safe.

    As for the homebirths being as safe for low risk women… a hospital is a very impatient place, hundreds of childbirths are induced for no other reason than convenience and hurrying along a woman’s body seems to be a recipe for disaster in a certain statistically significant subset of the population. Also, impatience can work it’s way into a birth that is taking “too long” resulting in a c-section that might 1) not have been absolutely necessary and 2) is invasive surgery that has serious health implications for a statistically significant subset of women. These things are obviously a different set of dangers than those present for homebirth, but both sets of dangers are low enough for so called “low risk pregnancies” that they may be a statistical wash.

  92. @jemand:

    Remember, in a hospital you can tell them that you are not ready for X. You can tell them that you don’t want pitocin. You can say you want to try a little longer before c-section or epidural. You still call the shots.

    At home, you can’t tell the ambulance to arrive quicker. You can’t make the hospital closer.

  93. @Elyse

    Not everyone is rational or skeptical, and many will do whatever their doctor says with little to no reflection, besides there can be SIGNIFICANT pressure in a hospital, until the doctor gets his or her way. Note my point was to provide a reasonable mechanism whereby some marginally more risky procedures may be performed that may statistically match the risks of homebirth for low risk mothers, not to talk about individual cases. And assertive doctors and authority accepting new mothers abound… statistically.

  94. FFFearless, in the Johnson and Daviss study they fudged the numbers by choosing an inappropriate comparison group

    http://homebirthdebate.blogspot.com/2007/01/johnson-and-daviss-study-shows-death.html

    Using an appropriate control group the rate of neonatal death at home births was 3 times higher that at hospital births (2.7 vs. 0.9 per 1000).

    jemand, you are correct:

    ”Not everyone is rational or skeptical, and many will do whatever their [midwife] says with little to no reflection, besides there can be SIGNIFICANT pressure in a [homebirth], until the [midwife] gets his or her way. Note my point was to provide a reasonable mechanism whereby some marginally more risky procedures may be [not] performed that may statistically [increase] the risks of homebirth for low risk mothers, not to talk about individual cases. And assertive [midwives] and authority accepting new mothers abound… statistically.”

    It is a reasonable hypothesis that giving birth in a hospital increases some risks while it decreases others. The way to test that hypothesis is with research which yields data, not anecdotes. Hospitals keep records and allow qualified researchers to use those records as source material for publications. Midwife organizations do not. If homebirth is safer, or as safe as hospital birth, the data should show that. Unfortunately midwife organizations have that data and will not allow that data to be published. My presumption is because the data will show that homebirth is not as safe as hospital birth.

    http://homebirthdebate.blogspot.com/search/label/midwifery

    The number of avoidable deaths at homebirths is not small.

    http://homebirthdebate.blogspot.com/search/label/search/label/homebirth%20death

    How many avoidable deaths are acceptable? To me, one avoidable death would be too many. Dr Amy has documented 14 home birth deaths among those posting on MDC (Mothering dot com) this year alone.

    The top post on this last link is telling. When a tragedy happens, people spin what happened to mitigate their injury and to tell themselves (even if it is a lie) that there was nothing they could have done. Spinning what happened to mitigate your injury isn’t rational or skeptical. Not learning from your own or others mistakes isn’t rational or skeptical either.

  95. Actually, that might be an evolved “feature”. In utero, the baby is microbiologically sterile. The baby needs to get colonized by the proper “good” bacteria so they will protect it against infection by “bad” bacteria.

    Also, what better way to provide resistance to having shit shoveled on them but by inoculating them in the process of birth?

  96. You are right on, Elyse, about the unsolicited parental advice stuff. From the moment we announced our pending skep-spawn, we were absolutely inundated with advice. Much of it was bad, but even the decent advice amounted to personal preferences. For some reason, parenting is one of those topics in which everyone is a bloody expert. Total strangers at the supermarket have dumped their sage wisdom on us without provocation.

    The best was when a very earnest friend of ours said, without a touch of irony: “I’ll just give you this suggestion, don’t listen to anyone’s advice.”

  97. Daedalus2U @11:58: The study on immune responses sounds interesting, but your link is hosed, and I can’t seem to get a working permutation. Repost, please?

    All: Dismissing the “birth experience” as unimportant is flatly misogynistic, part of the same strain that regularly dismisses women’s health problems as “all in their heads”. That sort of experience goes a long way toward explaining why so many women don’t trust doctors, and are eager to avoid them during the most vulnerable moments of their lives.

    I note that a fair number of hospitals have in fact made serious efforts to correct their “machine that goes ping” problem, with better environments and more attention paid to the mother’s wishes. But a lot of other hospitals are still very much maintaining the pathologization of pregnancy and birth… caveat emptor.

  98. Wow, nothing like bringing up mommy issues to get things rolling. More exciting than robot sex. Apparently.

    I’ve had two (children, not sex robots), one birthed with help from an epidural, one w/out, and thus I’m qualified to say that in my case, I did the right thing each time. With no particular downside.

    I wrote an article on birthing options in my state, and found some pretty solid evidence that homebirths — at least here, at least at the time I wrote the article — really are less safe than hospital births, given that birthing has always been a dangerous thing for women. “Natural” as it may be. This isn’t to say that lots and lots of women haven’t had lovely homebirths with healthy children, but it’s risky. I interviewed many doctors who had to deal with emergency trips to the hospital; would-be homebirthing moms rushed in because a birth went wrong. A common story, especially here where the granola-mom percentage is high.

    But the concerns of these women are driving hospitals to create more home-like experiences for birthing women, which is great. I got to sleep with my babies, never was apart from them, got them on my breast right away, got to choose my pain control methods; AND I got to labor in a warm tub of water, which was better than any drugs. None of this was available to my mom. The type of woman who wants a homebirth? She inspired this sort of change.

    And breastfeeding really is better for the baby and the mom. Incidentally.

  99. @David Harmon:

    The idea that we should all be having these beautiful, 100% self-directed births that will end with infant latching onto the breast as we bond with our babies for the first time is not realistic.

    Should women be respected? Yes. The experience shouldn’t be one where the mom felt intimidated or that her wishes were ignored. She should be treated compassionately and she should be informed and kept up to date on the progress of her labor.

    She should be able to hold and nurse her baby as soon as possible after giving birth. And, save for instances where extra medical intervention is required, she should be able to be with her baby at all times after the baby is born.

    But sometimes things are not picture perfect, and health and safety come first. There’s no benefit in being able to cuddle and nurse a baby in a birthing tub in the living room if he’s stuck in the birth canal with his umbilical cord wrapped around his neck or if his mom is hemorrhaging.

  100. @daedalus2u: that article on flu and schizophrenia was completely fascinating. I only recently learned that there are two types of monozygotic twins, those sharing a placenta and those with their own placenta, and now here’s an article talking about it. The idea of maternal infections having a link with autism and/or schizophrenia is also interesting … I’m going to have to search for more on that.

    And thank goodness I’m done being preggers! Something else I don’t have to worry about anymore.

  101. sylvan, I have some stuff on autism on my blog, and how I think it is caused/exacerbated by low NO both in utero and later in life.

    http://daedalus2u.blogspot.com/index.html

    Autism (in most cases, excluding things that are simply autism-like) is a developmental disorder, and much of it has to occur in utero. That is the time that the brain structures that are observed to have different morphology are formed and the only time their structure can be modified.

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