Homebirth Debate — a closer look

Many of you fellow birth junkies probably recognize the title of this blog post as being similar to the blog ostensibly run by Dr. Amy Tuteur that supposedly is a place to debate the merits and demerits of giving birth at home. (I say “ostensibly” because the name of the blog owner is concealed, although other blogs attributed to this woman are not concealed. Why hide it, unless she’s just a front? Oh, I’m not saying she’s not in it up to her eyeballs — her condescending tone of writing reeks through anything I’ve read from her, on that blog or any of her other blogs, or any comments to articles or other blogs I’ve happened to read. But why hide it?) I say “supposedly” because it is hardly a fair debate — Dr. Amy is apparently the moderator, but she’s about as far from unbiased as a person can be.

If you don’t know who I’m talking about, count yourself as blissfully ignorant, and feel free to skip to the next post.🙂 I won’t link to her site, because the more hits she gets, the higher her rating goes. That’s also why I’ve sworn off looking at it, regardless of what I know must be being said on her blog as I type.

Here is a good summary post from a new initiate of Dr. Amy’s, written just today. Also today, someone on one of my email lists asked who Dr. Amy was. This is my response (slightly edited):

Dr. Amy Tuteur is virulently against home-birth. From what I can find, and some of what I’ve read on lists and things like this, she’s a former OB who quit her practice for some reason, and is no longer licensed. In addition to the aforementioned blog, she also has her website “Ask Dr. Amy” where women can pay to have her answer ob/gyn questions. (Is that legal? — since she is not a licensed physician but is still charging to answer medical questions?) She’s rude and haughty, and anyone without a medical degree has about the IQ of soap scum, judging from her posts. And medical professionals who disagree with her are quacks.

Here’s a link which sums it up quite well.

Problems with her “debate” website basically boil down to her extreme one-sidedness. Since the title sounds like it should be fair and open, many people are caught off-guard by the bias. Among other things that I have seen with my own eyes, she deletes posts that she disagrees with (I learned to save a copy of every post I did and just repost it — eventually it would go through — I guess she realized I wasn’t giving up?), gives incomplete information which is tremendously skewed towards her view, discredits what pro-homebirth or pro-natural birth people say while allowing similar types of comments from her minions (for instance, she told me I couldn’t play with numbers and statistics because I didn’t have the appropriate background in statistics, but one of her followers did precisely that and she didn’t jump down her throat, much less mention it). And she lies.

Some people might call it merely “skewing the information”, but she repeatedly says that the Johnson & Daviss CPM Home-Birth Study (published in the British Medical Journal in 2005, undertaken in 2000) shows a 2.5/1000 neonatal death rate, but that only happens if you count the intrapartum deaths as live births. However, intrapartum deaths are by definition stillbirths; and stillbirths are by definition *not* included in the NMR, but that doesn’t stop her from saying that these intrapartum deaths should be counted as NMR because they would have been born alive had they been in the hospital. (Oh, did I mention she sometimes confuses herself with God? Actually, from some of her comments, I have reason to suspect she’s an atheist or agnostic, and she’s extremely demeaning to those who mention religion at all, specifically jumping down the throat of someone who said that the female body is “designed” to give birth — she took offense because she believes in the blind chance of evolution and bristled at the term “design.” I’m not meaning this in a flaming way to anyone who may also be atheistic, agnostic, or believe in evolution, just showing that she can’t even respect religious beliefs or differences…. or at least, not as long as they’re espoused by pro-home-birth people.) I repeatedly asked her for stats that showed what the intrapartum death rate is in hospitals, because it isn’t mentioned in the Vital Statistics Report (intrapartum deaths would be a subset of stillbirths), but of course she never provided any evidence to back it up. And one of those intrapartum deaths happened because of AROM in the hospital. But that shows that homebirth is risky, right?)

Anyway, another thing she does is to require documentation of everything her opponents say, while providing none of her own, nor requiring her cronies to give any either. In a discussion on breech birth, I presented 3 different studies that showed that vaginal breech birth in some cases should be considered a safe alternative to C-section, and she basically said I had no right to post those studies since I couldn’t understand them (not being a doctor nor a statistician). She also said that the first study I mentioned (from the 80s) had been superseded by “many larger and more recent studies” that contradicted the conclusions of the study… but of course, I’m still waiting to find out which ones. The other 2 studies I posted were from 2001 & 2004, and didn’t breathe a word about any study along the lines of what she claimed. And the kicker? She wrote an article about breech birth that says that “Most babies will do very well during a breech delivery,” instead of by C-section. Oh, if I had known that article existed when I was in the middle of *that* discussion….!!! Anyway, you can go to my blog and read this post about her which has some links, including one to that article about vaginal birth being safe for most breech babies (although ACOG recommends C-sections for all breeches).

I used to go to her blog, but no matter what the particular topic was, the discussion would always end up being about the CPM 2000 study, with the same arguments for and against it. Plus, the more people that click on her blog, the higher on search engines she is, so it’s like feeding a monster by going there. So I’m taking the “ignore her and she’ll go away” tack.🙂

3 Responses

  1. I take the same tack, although sometimes it does take discipline not to click the links and see what new nit she is trying to pick. Her arguments are so tired. I find it amazing that she can spend so much energy picking apart the practices of 1% of women giving birth in America, but fails to ever see any of the pitfalls of the practices of the other 99%. It is also amazing that she thinks she is smarter than the editors of the BMJ and the rest of the British medical community that supports the option to birth at home.

    (yeah, yeah I know what she will say, the British midwives are better educated. As far as I’m concerned until she sits for the NARM exam herself she has no business making judgments on that)

    Oh, you’re making it so hard for me to keep from making snide comments about being a nitwit or about lice in general.🙂

    One difference is that out-of-hospital midwives have to know how to watch and care for the safety of mother and child without all the machines and interventions that are required and/or available in the hospital; while a hospital midwife must know how to operate and interpret the machines, and how to stay within hospital protocol, etc. These are two different skill sets. The overlap is, of course, in caring for laboring women; but much of the difference in midwife’s knowledge and education is inherent in the difference in birthplace. I’ve heard many birth stories of women laboring without intervention, and it changed their hospital-based caregiver’s view of birth — nurses and doctors marveling at women who have an empowering, unmedicated birth. I’d like to take some people who have only ever seen “typical” hospital births, and transport them to a home birth — that’s the only way I think they can appreciate the difference. (Right now, I’m envisioning Dr. Amy forced to just silently sit and watch as a direct-entry midwife labor-sits and *cares for* the laboring woman. You think that might help?)🙂
    -Kathy

  2. If this is posted twice, I apologize. I quoted you in a blog today concerning this topic. Thanks for your information.

    http://www.rhrealitycheck.org/blog/2008/07/18/whos-catching-your-baby

  3. Ah, the ubiquitous Dr. Amy!🙂

    Thanks for letting me know. I’ve posted a comment on that link (I’ve just checked and it’s just a little below your comment about not everyone being a white woman).

    Here’s her reasoning behind using just white women — the majority of women who give birth at home are white. For instance, in looking at the Johnson & Daviss homebirth study, they perform some calculations on their website that were not done in the original article, in which they took out all non-white births, which eliminated 200+ births out of 5000+. I prefer not to dwell on race myself, but race is always checked in statistics of this nature, and black women have about 4x the risk of maternal mortality of white women, and black babies also fare worse than white babies at just about every stage (although I don’t have the stats right in front of me — you can use the CDC query to look at it).

    Another reason I dislike Dr. Amy, though, is that she acts as if it’s genetic, because she’s said that women of African descent have worse statistics than women of European descent in every country. I’ve not called her an out-and-out racist yet, but her comments could certainly be construed that way. What she says is true, but one thing from England I read about the racial discrepancy said matter-of-factly that black women in their country tend to be recent immigrants, very poor, seek little or no prenatal care, etc. In other words, they made a distinction between race and other known factors in mortality and morbidity, whereas she acts as if black women are just genetically inferior. (I go more into that here.

    Here, I talk about neonatal mortality, and give the CDC link I mentioned on the “reality check” article.

    Thanks again!
    Kathy

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