dairy_queen:

"Don't you have some housecleaning to do?"

LOLOL. Not only have you demonstrated that the typical homebirth advocate knows very little about childbirth, nothing about science and nothing about statistics, you've also done exactly what homebirth advocates tend to do when their lack of knowledge is exposed for all to see. You've resorted to classic sexist put downs of another woman.

Oh, the irony. The same people who babble about "empowering" birth and prattle about the patriarchial medical system, reflexively resort to sexism when challenged. Hence the comments about housecleaning. Interestingly, all the men who created and promote "natural" childbirth have not delivered any babies recently (some have never delivered babies), but homebirth advocates have no trouble accepting what they say (even if they make it up).

My goal is not to convince you of anything. I deal in facts and you glorify your personal opinion. I do hope that people who have been following this discussion walk away with the salient points:

The existing scientific literature shows that homebirth has an excess of preventable neonatal deaths compared to hospital birth of comparable risk women.

The scientific papers that CLAIM to show that homebirth is as safe as hospital birth are based on deception. They compared homebirth of low risk white women to general neonatal mortality rates including all races, all gestational ages and all complications.

The so called "risks" of medication in childbirth are almost entirely fabricated by "natural" childbirth advocates in an effort to impress themselves with their supposed superiority.

Childbirth is and has always been INHERENTLY dangerous for both mothers and babies. Just as pregnancy has a natural miscarriage rate, childbirth has a NATURAL death rate.

"Natural" childbirth was fabricated by Grantly Dick-Read because he was a racist and sexist and wanted white women to stay home and have more children than their "inferiors".

Women have the right to give birth at home. They also have the right to receive accurate information about the risks in order to make an informed decision.

Dr. Amy,

I've noticed that you don't have any pictures up on your three blogs. You also have no video, and rarely if ever, talk about your family.

You don't talk like a real woman. I have had contact with hundreds of women in my circle of life. Friends, my eleven sisters and sisters in law, those who took my childbirth class, and fellow Bradley Teachers etc etc.... And you don't express yourself like a real woman.

You are a caricature of a person spewing the party line over and over and over in the various places you post and write and defend to the death the obstetrical model of birth.

You know who I think you are?

I think you are four Public Relations dudes from Eli Lilly set up as a blogger to defend the staus quo on the web.

It is up to you to prove that you are real. Post a video of yourself on You Tube. And while you are at it, let us see your birth certificate and credentials in that video.

The thing about the web is, you can fool some of the people some of the time, but if you are a blogger fraud, you will be found out.

Times up DR. AMY, the onus is on you. Prove that you are real. DO IT NOW, and do not write one more word against home birth until you do.

The Reuters UC Birth article is up. http://www.reuters.com/article/healthNews/idUSL2148514320070522

You are swimming against a flood of evidence based birth practices and I believe it is simply time for you to go away.

Jenny Hatch

Oh, and Dr. Amy,

get a couple of people who have known you from birth, you know, maybe your mom, or your grandma or a neighbor, and include them in that video testifying that you are a doctor, and went to harvard.

Do it today. Now.

I posted a you tube video of myself up on my blog yesterday. It took about five minutes of my time.

Five minutes to prove to the world that Dr. Amy is legit.

Can you do it?

Jenny Hatch

PS You can Probably prove it about as well as Dr. Critten can prove he is just one lone doctor blogging for the status quo in the UK. I'm thinking he is six or seven PR dudes shilling for big pharma. Do you know what that is called?

Pharmaceutical whoring.

Now the unassisted birth advocates that have been posting on this board are showing themselves to be completely nutty with their paranoid conspiracy theories!

First of all, it ultimately doesn't matter whether the poster is a doctor or not. It doesn't make what she is saying any less valid. Secondly, since when do you need to verify your credentials to post on a board? I don't think Dr. Tuteur or anyone else on this board needs to prove themselves to you!

"Homebirth advocates tend to have minimal understanding of statistics."

Why, yet another classic juvenile response to criticism: just throw out a generalized and unsubstantiated attack, what a surprise coming from you! "You're crazy, stupid, and bad." Oh, okay, Dr. Amy. I'm convinced now, you're right about *everything*.

"Statistics are not something separate from the truth. Statistics ARE the truth. Statistics are simply the aggregation of lots of personal experiences. Most people want to know the likelihood of various outcomes if they choose to have a homebirth."

I'll say it again, and perhaps the logic will sink in this time: if 20 out of 100 people in a certain sub-group have a certain result, it does not follow that any given person in that certain sub-group has a 20% chance of having that same result. Individual circumstances are key to making decisions -- statistics in themselves are never enough, and used alone can lead to very inappropriate choices.

"At this point, what all the existing scientific statistics tell us is that there is an excess rate of preventable neonatal death at homebirth compared to hospital birth. I know you don't want to hear that."

You are so good with the subtle condecension, Dr. Amy! It does quite a bit for your argument too.

p.s. the existing statistics that tell us that are not actually scientific, as they do not account for confounding factors (religious groups than shun medical care, ill babies that are kept alive by machines only to eventually die being counted as "live" births.) I noted this before, but apparently "you don't want to hear that".

Me: "it has to do with a scientific understanding of the normal physiological process and what will facilitate it or cause it to become dysfunctional,"

You: "That's not likely to be true, either, since most homebirth advocates are woefully uneducated about childbirth."

Obstetrics is arguably the *most* unscientific type of medical practice. Care to talk about the physiology of birth on one's back? Do you know what it does to the pelvis and blood supply to the baby? Do you know anything about the science behind routine episiotomy? The effect of various drugs on the body's functioning? The effect of a clinical environment, with strangers sticking their hands in you? Do you understand anything about the role of the brain in the production and release of hormones? Do you understand anything about the domino effect of interventions? Do you understand, at all, that all interventions carry risks, but that (astoundingly) most interventions are routine? Do you know what the fetal ejection reflex is, and why it's the most safe way to allow birth to happen, and why it is rarely seen in hospitals? Do you know that telling the mother to bear down hard at "complete dilation" is a completely unscientific approach to second stage? Etc., etc., etc....

Regardless of whether homebirthers are educated about childbirth (and in my experience they are far more educated about it than the average woman and doctor,) the fact remains that to institutionalize, clinicize, and medicalize the birth process is to make it dysfunctional. Period. This is, sorry, quite scientific. And not only us dumb ol' homebirthing women are pointing it out. So are many highly intelligent people, scientists, respected researchers, academians, and (*gasp*) medical doctors. Marsden Wagner, Michel Odent, Sarah Buckley, Thomas Armstrong, Louis Mehl, Robbie Davis-Floyd, Thomas Verny, to name just a few that have actually spent some time thinking critically about traditional obstetrics rather than simply believing the myths and traditions passed down through medical school.

"childbirth is INHERENTLY dangerous;"

Life is inherently dangerous. Driving a car is inherently dangerous. Medicalizing birth is inherently dangerous. The question is not whether it is dangerous, but what the risk/benefit ratio looks like in an individual situation. It is not the same for all people; and hospital birth is not inherently safer than homebirth. It depends wholly on the details.

"childbirth is a leading cause of young women's deaths in all cultures, in all places and at all times;"

Even above disease and malnutrition? Hm... In any case, I'll give you that it's been up there historically. But think -- it couldn't possibly have to do with malnutrition and sanitation issues, dangerous cultural myths about what to do to a woman in birth (early obstetrics) and lack of access to medical care *when needed*?

Childbirth would indeed look very difficult and fraught with danger to someone who has never seen normal childbirth, coloring their perception of the meaning of historical death rates. But there *are* other factors involved and no one really knows to what extent.

"modern obstetrics and neonatology has dropped neonatal mortality 90% and maternal mortality 99% in the last 100 years;"

Again, that wouldn't have *anything* to do with doctors learning to wash their hands? Or nutrition and sanitation? Or antibiotics for that matter? Modern medicine and scientific understanding *have* reduced mortality. It does not follow that obstetrics is generally beneficial to the birth process.

"It is only the spectacular success of modern obstetrics that has allowed homebirth advocates to indulge in the fantasy that childbirth is safe."

Homebirth advocates don't take their belief in the normality of birth from their experiences in hospitals, believe me. They see what obstetrics has done to birth, that it has made it harder, more complicated, less empowering, more invasive. They see the damage it does to women's bodies, even in just the routine management of birth, and how it interferes with instinctive bonding. I know, you don't believe any of it. But then again what you believe has no bearing on the truth.