The Cynical O.B.
I was really excited to see a blog called “The Skeptical O.B.” Having read The Thinking Woman’s Guide to a Better Birth, I knew that standard O.B. practices are often more about intuition and tradition than evidence-based medicine. I thought it would be so cool to see an actual O.B. looking at the risk/benefit analysis on interventions like induction, epidural, and c-section.
Whoops! Boy is my face red. The blog could better be named, “The Hidebound Ideologue Against Natural Birth.” Now, I am interested in skepticism of natural birth practices as well as hospital practices. You don’t automatically get a pass from me because you’re doing something crunchy. But god damn, Amy Tuteur is so vituperative, condescending, and obnoxious in her approach, and so obviously devoted to propping up standard hospital practices, that I can’t read her blog even if it might offer some interesting info on homebirth safety or midwifery guilds run amok.
Amy typically storms into each post with a haughty and self-assured stance, declaring her position to be self-evidently correct and everyone else to be feeble-minded. Most recently, she announced “The largest, most comprehensive study ever done of homebirth has released its results and there’s nothing left to argue about: homebirth increases the risk of perinatal death.” The study she’s citing though, states almost the opposite take-home message in its Conclusions:
The results support a policy of offering healthy women with low risk pregnancies a choice of birth setting. Women planning birth in a midwifery unit and multiparous women planning birth at home experience fewer interventions than those planning birth in an obstetric unit with no impact on perinatal outcomes. For nulliparous women, planned home births also have fewer interventions but have poorer perinatal outcomes.
In my experience of her work, this is representative. She is the opposite of a skeptic – she decides on her position, and then twists and cherry-picks evidence to support it. It also doesn’t help matters that she is absolutely vile and superior to any commenter who dares to question her pronouncements and offer counter-evidence. In other circumstances, I’d be very interested in her information about the Midwives Alliance of North America keeping their statistics on births secret, and appearing to require almost a loyalty oath before giving someone access to it. But a.) I don’t trust her to give me all the information, and b.) I don’t want to don a bile-proof jumpsuit to wade through her excoriating commenters who offer other perspectives.
This was such a wasted opportunity. In my opinion, all birth practices need a good review based on the most recent evidence available. Honestly, I probably agree with Dr. Amy on a lot of things. I think unassisted childbirth is a terrifying new trend that exposes mothers and babies to too much risk. But I think that it’s useful to look at the hospital practices and insurance structure that drive women to birth without any attendant whatsoever, and try to reform our institutions so mothers can feel safe and secure in a hospital, or have access to a well-trained, licensed midwife. Dr. Amy thinks the answer is to sneer and call these mothers fools.