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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Wed Apr 11, 2012 5:08 pm 
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Oh, Audrey, your poor friend. I'm so sorry. I have a visceral response to that "your breathing doesn't sound like you're in labor" crepe because when I tried to have my son at home, the midwife popped in after I'd been up all night laboring to no avail and her first words were, "I thought I'd hear some screaming when I got out of the car! You're not having that baby anytime soon!" Thanks a million. And the sad truth is, especially with a first baby, I didn't know enough to know that things weren't going right. She even had us checking his heart tones ourselves, telling us over the phone how to use the doppler. We were scared to death, but it was all so surreal and I was so steeped in magical thinking at that point. Thank God she finally told me to go to the hospital or things would have gone bad pretty shortly.

Anyway - not to continue to hijack the vaccine thread, but just to say it's so easy to get caught up in the woo when it's saying what you want to hear. I tried to talk some sense to a mom friend who posted that BS from Natural News about whooping cough and the DTaP the other day, but the arguments just got weirder and weirder and I decided to drop it. I understand the fear - we spaced out vaccines with kid #1 because it just seemed too scary. But with kid #2 we're doing it on schedule and it's a huge relief. Spacing things out has turned a straightforward process into this endless train of shots, and my now three-year-old is way harder to convince that all will be well at the doctor's office - he gets a shot every time he walks through the door, poor guy.


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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Wed Apr 11, 2012 5:53 pm 
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It's awful that she lost her baby.. but babies die and are stillborn in hospitals AND home births. I think everyone's situation is different and we all have to weigh our own risks and where we want the tradeoff of different risks to lie. It's not an automatic, easy answer, weighing a very small chance of baby and/or mother dying against a very large chance of a csection and the associated risks and recovery. For me the experience and training of my midwife (CNM with decades of experience) and the proximity to a hospital (<5 min drive in an emergency) weighed favorably against the hospital whose care I initially sought (no NICU, risky births sent elsewhere, 20 miles from my home, bad experiences with prenatal care). And I was at peace with knowing I might be making my odds much better at the slighter peril of my unborn fetus's. I've said all this before, but I think we have to realize that whatever choice we make comes with some inherent risk and we have a responsibility to educate ourselves and figure out what risks we're willing to take - we can't eliminate it.

RE Mothering, I've only ended up there occasionally after googling something to make sure it's normal or whatever. I usually realize I'm on Mothering because there are 10 people in a row suggesting that the solution to any known or suspected medical issue is going to the chiropractor for readjustment of some sort and nobody laughing. Then I press my back button and follow a different link. I was an engineer in a past life, so medicine isn't too scientific for me; I bristle at it not being scientific *enough*.


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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Wed Apr 11, 2012 6:17 pm 
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Audrey wrote:
I have an acquaintance who had a horrible, horrible experience during her planned birth with the birthing center midwives I used last time. Ultimately her baby died; she claims it was from the baby being stuck in her birth canal for too long. She blames the midwives because she insists they prevented her from coming to the birthing center when it was time by telling her they could tell by her breathing and being able to speak on the phone that she wasn't in active labor yet. (It was also during Thanksgiving weekend so she's accused them of not wanting to cut their vacations short.) She has started all kindsa internet campaigns against them (stuff like ________ and _______ from The Brooklyn Birthing Center and Doula _______ _________ MURDERED MY BABY!) and is suing them I guess. I cannot fathom what she is going through; this was a first-time mother so I can't help but understand how much faith she had in them and how she relied on their judgment. It's a horrible situation all around and I feel like an awful person for thinking this - but perhaps she should've insisted on coming in or even gone to an emergency room somewhere. I just don't know what to think.


Holy shiitake. I googled and found the story and the FB link, and its so tragic.

And as far as she should have insisted (you're def not an awful person but), I was in labor and it was so much harder and faster than I had expected and my midwife didn't believe I was that far along. She thought I was just panicking. She told me that the choice was mine, but if I went in too early, I'd be risking having unwanted interventions. It was only because my doula came over to assess me that she saw that I was really in active labor (I had gone from no contractions to 2 mins apart in the space of 3 hours).

As a first time mother, I felt like they knew better than me, and I was terrified of "messing up" and having a medicalized, intervention laden birth, because all those damned classes kind of make you feel like if you have a c-section or interventions its because you did something wrong.

If my doula had said, stay home longer, I would have stayed home.

And my midwife, whom I adore, thought that I was just making a fuss, to the point that although she said she'd meet us at the hospital, she never bothered showing up until the hospital called her. According to my husband (who was in the hall) the nurses were yelling at her that she had to get there now because I was ready to push, before she decided to come across the street and check on me.

I just think that sometimes birth professionals think that they know better than the person delivering what the birth will be like, and that all first time mothers panic, go in too early and that its their job to calm you down and keep you out of the hospital and its tendency to go all intervention happy.

This story really just made me so upset, because I just feel like it could have happened to us. If my doula hadn't changed all her plans and come to see me, I might have just tried to keep laboring at home because that was what everyone was telling me to do. And the idea of losing Leela is just the worst thing ever.

Also maybe any dead baby stories could have a trigger warning on them in the future? I totally understand the need to share and talk about them, and they are really useful to think about, but this really upset me.

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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Wed Apr 11, 2012 6:48 pm 
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Quote:
It's awful that she lost her baby.. but babies die and are stillborn in hospitals AND home births.


The numbers are way different though, one is clearly the far riskier situation.
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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Wed Apr 11, 2012 7:09 pm 
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OK, discounting problems with data collection on this for right now, I think that even if fetal, neonatal, or perinatal mortality are >=2x as high for home births, it's (2+) * x of a fairly small number. When you compare that to, say, a 5x risk of cesarean (and I'm not sure that's exactly accurate - I was using my own midwifery practice's slightly <10% transfer rate and assuming that somewhere around 75% of those end in cesarean, which may not be the case, and comparing it to the local hospitals, which are close to 40%), it still means choosing between minimizing the risk of a very unlikely but awful situation vs. minimizing the risk of a very common but probably temporarily debilitating situation.

Now, as far as whether these numbers are exact for one's case, like I said, I think it depends on statistics. Issues at hand:

- in the US, the legality of home birth and midwifery vary by state
- these numbers aren't broken down by attendant training. They include births attended by anything from a CNM (nurses with extra training who also practice as primary birth attendants in hospitals and indeed if I'd given birth in the hospital I started seeing my birth would have been attended by a CNM not an OB/GYN unless complications arose) to a "lay midwife" with no guaranteed training at all.
- This doesn't say planned home birth, which is an important distinction. Unplanned home births are a totally different ballgame, but often the distinction isn't made.
- Since each set of numbers refers to a different group of patients, it strikes me as either heavily cherry picked or under-researched. Also, home birth scenarios vary dramatically. Some people opt for a home birth because they're too far to get to a hospital (say, Amish people in rural Pennsylvania), or maybe because of religious beliefs (some of which mean that people won't opt transfer for emergencies anyway), etc. ETA: another unusual risk scenario case that I think is a real problem in terms of people not being able to get the care they want in hospitals and feeling driven to home births possibly against their initial wishes is VBACs.


I would say that the availability of a CNM-assisted home birth and proximity to a better emergency hospital (level III nicu) absolutely affected my decision to give birth at home. There were not, however, statistics available on the risks of a CNM-attended home birth in Northern Virginia 5 minutes away from a major hospital for a low-risk first time white 30-ish year old mother, so I had to decide whether I was comfortable with the midwives' ability to deal with potential complications. For a better study on home birth risks, the recent major Dutch study is fairly comprehensive, although obviously the maternal care situation is very different there (and it too has its flaws and is, obviously, of limited applicability to the US).


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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Wed Apr 11, 2012 8:20 pm 
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annak wrote:
It's awful that she lost her baby.. but babies die and are stillborn in hospitals AND home births. I think everyone's situation is different and we all have to weigh our own risks and where we want the tradeoff of different risks to lie.

Hear hear. It is a risk we all take. Whether our doctor mistreats us is another risk we take in working with her (i got a malpractice payout, what i consider an admission of her incompetence, but looking back they seemed like a great practice and i wouldn't have chosen differently, it was an accident.). It's very sad but Very Bad Things Happen. It's even sadder to take your own experience and push it on other people who are just trying to have their own experience.

When my Bad Things happened, the forum I was on got very chilly, it seemed I must have deserved what I got, probably my own fault for birthing in a hospital (where, though our outcome was not positive, she *and* I would have both died had we not been there). fork that.

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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Wed Apr 11, 2012 8:36 pm 
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annak wrote:
I had different, but similar non-vaccine related experiences as ISYBB with the military hospitals.. They really aren't set up to deal with concepts like informed consent and patient choice. I had the best experience when I would use neutral language like "are there other treatment options?"


Livi got her first Hep B at Womack (Ft Bragg) and the nurses were so forking confused about what to do with a then 4 year old who'd never had a Hep B vax. They were running around and looking things up and whatnot.

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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Wed Apr 11, 2012 8:41 pm 
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keen_on_quinoa wrote:
It is totally sexist.
I'm all for the middle ground now. Breastfeeding is great, but it can be hard and exhausting, and formula is food too. Co-sleeping can work if it's done properly, but can be dangerous and doesn't work for everyone. Homebirths can be nice if you're low risk, close to hospital, have a qualified attendant, and you're willing to transfer at the first sign of a problem, but hospitals aren't as evil as they're made out to be. Vaccines aren't the devil and won't make your kid autistic. Dads can be parents, too (which is a mind-blowing concept for some on mothering). Kids won't turn into zombies if they watch a little TV every day. They won't drop dead from non-organic produce or plastic toys. They won't be scarred for life if you leave them with capable caregivers to get some time for yourself.
Sometimes I'd really like to go over there, give everyone a good shake, and tell them to mellow the fork out.

If you have to go back to work as soon as possible (I know someone who had to return after 4 weeks for financial reasons) and you are trying to balance recovering from childbirth (which is a hard core medical procedure) with working full-time and childcare, you might not be up to breastfeeding. I also think that the Mothering approach is classist and ignore what kind of privilege you need to achieve those goals.
My hospital birth was lovely. My nurse was Irish and told me crazy stories about what it was like to give birth when she was born. My doctor constantly asked me what I wanted to do, even when it was obvious that baby was not going anywhere unassisted.

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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Wed Apr 11, 2012 10:20 pm 
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My hospital birth was amazing as well. I also had complications after that would have made it so I would have had to go to the hospital and if that had happened, grey probably would not have been admitted and I would not have had help from the hospital staff with him, I wouldn't have been in the maternity ward in a private room with a bed thing for my husband.


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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Wed Apr 11, 2012 11:18 pm 
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Audrey's story wasn't about a home vs hospital birth though.

The woman was a patient at Brooklyn Birthing Center - she wasn't trying to birth at home.

Her midwife and doula both told her that she was fine and didn't need to go in but should labor at home for a bit longer, even though she wanted to go in. She trusted that they knew better, so she followed their advice

She finally went in, despite their advice, and it turned out her baby had been in distress for hours and had inhaled meconium and was deprived of oxygen during delivery. Because of the damage in birth, her baby only lived a few days and she had to make the decision to turn off life support.

Her issue was with the lack of support from her birth professionals, who told her to disregard her impulse to go in, and then after things got bad wrote her off (you're in the hospital now not our problem) and didn't offer counseling or even talk to her to apologize so she could feel heard. She is angry and feels betrayed and people are second-guessing her, because they prefer to think its the mom's fault (ie wouldn't happen to me) than that this is malpractice or negligence which could.

The FB page is so sad and the photos of her holding her dead baby just broke my heart.

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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Thu Apr 12, 2012 5:30 am 
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Yeah, none of this should be hospital vs home. We're all smart cookies and have done our research, and have decided on what works best for our personal situation. (I choose my hb midwives because I trust them more than any of the OBs nearby. I trust them because I saw how them handled the Very Bad Things. I also know that they take the mother's word above all other - when we called the first time, and our head midwife told me she wasn't going to come over yet, and I whined horribly, "But I want you here nooooow!", they were there in 15 minutes. I trust them. If I had found a local OB or hospital midwife who I trust, I would've gone with them. It's all about knowing and trusting your caretakers. Yes, bad things can still happen, but you're going into it with a much healthier outlook if you believe everyone is there for your health and well being.

I've definitely heard from mothers who have had incredible hospital births. I've also heard from some who had horrible ones - some of those moms chose hb next time, or a different hospital or birth center. I know plenty of women who have had great home births too - and some that went poorly, or they decided it wasnt for them. Those moms later on chose hospital births, or found a midwifery group that fit their ideals better. (one of my best friends had her baby at home a week before Ezra with our same midwives. She's pregnant again, but she's going with a different at home midwifery group. Nothing against our midwives at all, but she's learned more and knows what she needs this time around.)

It's all about choice. I'd hate to see this thread turn into a hb vs hospital argument, because we're better and smarter than that. We've all figured out what works for us for all kinds of different reasons, and it's awesome that we're able to make those choices.


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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Thu Apr 12, 2012 6:50 am 
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I think its also really important to remember that even if you are the smartest cookie ever, Very Bad Things can still happen.

It sounds like a big part of her pain comes from the fact that she feels like she "did everything right" - she hired a doula (about $1,000 out of pocket just for the security of having a woman who has btdt with you to help you make the best decisions for your baby), a midwife (someone less likely to go to a c-section) and a birthing center rather than a hospital, because she wanted a wonderful birth for her child. And in the end, she might have been better off had she not had any of it and just gone right to a hospital.

When I read her posts, all I hear is a ton of grief and pain and a sense of being betrayed and now going unheard. She sounds so upset that the doula and midwife were cold to her, didn't check on her, didn't offer her support in her grief or in her decisions. She has both the pain of not having the birth she dreamed of and the pain of losing a child, and no one is listening to her. Even in the threads she posts in people ignore her or say that she "should have known" and gone to the ER.

And I think that is a really important piece to remember, that everyone deserves to get heard and be supported in their grief if something goes wrong.

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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Thu Apr 12, 2012 7:02 am 
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I hope I didn't sound like I think I hb is bad, in fact it is something I am already considering if we have another baby. I have a ton of friends who had hb and they sound so incredible. I think there is a part of me that wishes I would have had a hb, but then I think about my complications and I have to remember that my hospital birth was what every woman wants from a hospital birth. I guess I just feel like there is a chance to have a great experience with a hospital birth. So often from moms I meet where I live it seems like they believe that hb is the only way and hospital is bad and I feel I constantly have to defend myself, so I am defensive here too.


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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Thu Apr 12, 2012 7:03 am 
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I think that as torque says, when a birth goes poorly, things get quiet and the mother can find that there isn't the same support that she had while she was happily pregnant or that she would have had if everything had gone well. I think we as a society have no idea what to do in the face of people that have suffered Very Bad Things (besides to tell them to get therapy), and especially if someone has lost a child, it triggers all our own fears, and we really can't listen well.

And I think its human nature to see a horrendous outcome and think "that would never happen to me" because its so painful to remember that it could. Its easier to judge and say its the mom's fault because she should have had a home birth or a hospital birth, should have had an ob or a midwife should have done something diifferent. This is just another flavor of the mother-blaming we see everywhere.

I wish we were better at hearing and supporting people who have lost a child. I just wish I could sit down with this mom, cry with her, and give her lots of hugs, because damn, she deserves them.

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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Thu Apr 12, 2012 7:15 am 
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thanks tlish, i wrote a response and dumped it because that's what i do.
Tofulish wrote:
I think we as a society have no idea what to do in the face of people that have suffered Very Bad Things... especially if someone has lost a child, it triggers all our own fears, and we really can't listen well.

moms seem to get the worst platitudes or ignoring. on this forum we have people who have lost babies and it broke my heart to hear what people said to them, or didn't say.
but you know what, i've also heard people *on this forum* say insensitive things (myself included, i am ashamed to say), then get kindly told why that was an inappropriate thing to say, and leave better equipped for the next situation. i really believe that people can learn to be more sensitive; it's too bad not everyone will before interacting with someone who is grieving.

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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Thu Apr 12, 2012 9:35 am 
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No littlebear, you didn't come off as anti-homebirth at all! I'm sorry if my words came out that way. I love hearing positive hospital birth stories - it makes me feel better that things will be ok if I have to transfer care again next time around. That's what I love about this forum - everyone has respect for each other and their choices, and we all get those opportunities to learn more about situations we haven't experienced before.

No matter how hard you plan a birth, you aren't guarenteed a positive outcome. I know a lot more about labor and birth now after all that happened to us. And I'm kicking myself now for not ever asking our midwives about hospital transfers, and their c-section rates, and all the other "what ifs" that could've happened. Frankly, I had a pretty darn smug attitude about it all - thinking that I was going to have that picture perfect birth because I had made all the right choices (a lot like all those MDC ladies). It humbled me a lot.

It breaks my heart when I hear stories like Audrey's friend who don't get the right sort of support from their caretakers when things don't go as planned. I don't want to get all "my midwives are awesome" on you guys, but I trust them so much more now that I see what they do in times of emergency and distress. They've experienced stillbirths before (personally and with their clients), and the two women who gave birth to babies born still under their care are two of their most faithful clients. They stuck by them through it all, listened to them, organized care for them, and celebrated with them when their next children arrived safely. One of the woman put it in a way I could never say myself: "They are the kind of midwives who have likewise been able to be present and attentive to the possibility of death as a part of birth."

My midwife never left my side when I transferred. She gave all my medical reports over to the OB on duty. Because of all this, our midwives are respected by most of the hospital staff in the area. They're professional, courteous, and know how and when to ask for help. We were in contact with them, over phone and email at least twice a day every day we were in the NICU. They arranged care for me - found me a great therapist and a great lactation consultant, and put me in contact with other clients who had to have c-sections under their care. And they were waiting at our home when we finally got back there, with plenty of food and hugs. They would never admit that they know everything or that they can do all without anyone else's assistance, and to me that's a great sign of a medical professional.


Last edited by flavabean on Thu Apr 12, 2012 9:44 am, edited 1 time in total.

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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Thu Apr 12, 2012 9:40 am 
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I totally wanted to use the Brooklyn Birthing Center but Tricare wouldn't cover it so we used Lutheran Medical Center.

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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Thu Apr 12, 2012 10:14 am 
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I am so sorry for your friend, Audrey. I cannot even imagine.


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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Thu Apr 12, 2012 12:00 pm 
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I appreciate all that you guys have to say. And this person is actually a friend-of-a-friend who I've met a couple times, fwiw.

Anyway, I am horrified on her behalf even more so because as Tofulish pointed out, the Birthing Center and doula have completely ignored her apparently. That is just insane - I understand them not wanting to take responsibility and being freaked out that she is going to endanger their practice with complaints, because its the only free-standing Birthing Center in the city and they have a long history of having to fight to stay open. But it sounds like they have offered no support and are trying to sweep the whole thing under the rug, and that is despicable.

also, I am so grateful to have this forum to discuss this. And yes, I probably should have warned y'all ahead of time about the story. My sincere apologies.

I will also add that I gave birth with these midwives, but at a hospital because of induction. I have somewhat lukewarm feelings towards the 2 women who attended; their bedside manner, to me, left a lot to be desired and that's definitely why I didn't go back to them this time. However, the head midwife there was absolutely wonderful and visited me in the hospital twice after I gave birth and really tried to support my breastfeeding in the face of the hospital's complete disregard of my wants/rights.


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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Thu Apr 12, 2012 12:31 pm 
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I also want to say that I have nothing against homebirth, and especially nothing against the very smart people on this board who've had their babies at home. I only used my own experience to highlight how tough it is to make the right call in the heat of the moment and how hard it is to get any perspective on what the "right" call is. I really appreciate the generally friendly tone here, and as torque said, that we can call each other out when we're out of line.


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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Fri Apr 13, 2012 4:26 am 
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This makes me feel better about my local birthing centre's very strict policy of transferring you at the first sign of distress and not taking you unless you are extremely low-risk. I thought that was kind of over the top, but now I am feeling better about it. (I had Raygold there and they were fantastic, I just thought their transferring everyone at the drop of a hat was a little zany.)

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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Fri Apr 13, 2012 5:28 am 
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Tofulish wrote:
Audrey's story wasn't about a home vs hospital birth though.

The woman was a patient at Brooklyn Birthing Center - she wasn't trying to birth at home.

Her midwife and doula both told her that she was fine and didn't need to go in but should labor at home for a bit longer, even though she wanted to go in. She trusted that they knew better, so she followed their advice

She finally went in, despite their advice, and it turned out her baby had been in distress for hours and had inhaled meconium and was deprived of oxygen during delivery. Because of the damage in birth, her baby only lived a few days and she had to make the decision to turn off life support.

Her issue was with the lack of support from her birth professionals, who told her to disregard her impulse to go in, and then after things got bad wrote her off (you're in the hospital now not our problem) and didn't offer counseling or even talk to her to apologize so she could feel heard. She is angry and feels betrayed and people are second-guessing her, because they prefer to think its the mom's fault (ie wouldn't happen to me) than that this is malpractice or negligence which could.

The FB page is so sad and the photos of her holding her dead baby just broke my heart.


That is so sad. When I was 9 months pregnant, my water broke on the way to a regular checkup with the doctor. I went on in because I didn't know what else to do. There was meconium in the amniotic fluid, the baby was in distress, and I was admitted to the hospital right away. I ended up having an emergency cesarean, and after all that my son was born healthy with no complications.

If a nurse, midwife, or the doctor had told me to go back home and wait after my water broke I would have listened to them. It's really hard to know what to do when experiencing labor for the first time, and things are not going as planned.

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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Thu Apr 26, 2012 1:21 pm 
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There's a free online class about vaccines through UPenn. I thought some people here might be interested in it.

https://www.coursera.org/course/vaccines


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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Thu Apr 26, 2012 6:10 pm 
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mollyjade wrote:
There's a free online class about vaccines through UPenn. I thought some people here might be interested in it.

https://www.coursera.org/course/vaccines


Yeah and its taught by non other that Paul Offit himself! I saw this posted a little while ago on the Skeptics Guide To the Universe forum and definitely wanna check it out

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 Post subject: Re: Can we talk about vaccinations here?
PostPosted: Fri Apr 27, 2012 8:27 pm 
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I just opened my EOB from Will's 2 month Dr visit and shots (3 shots, 1 oral)... $1317.00!!! That's crazy!
(We've more than met our deductible with the birth and all, but I still?!)

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