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Comment by croo | Hacker News Reader

Everybody is joking half sarcastically here but childbirth as a process in hospitals do have serious problems and modern day labour leaves deep mental scars in most women while being one of the most important thing in their life. This is definitely a step in the wrong direction however laughable the idea is.

Do you know what is the most uncomfortable position for labour is? Yeah, layin on your back. It's just the most comfortable position for the _doctor_.

Giving birth is similar to the act of vomiting in the sense that you don't have to do anything, it happens to you when the circumstances call for it. Using this method is as bad idea as to use this method to make the centripetal forces pull the content of your stomach out.

It may happen but not for the reasons described.

I cannot describe well enough how utterly stupid this idea is...

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> modern day labour leaves deep mental scars in most women while being one of the most important thing in their life.

> Do you know what is the most uncomfortable position for labour is? Yeah, layin on your back. It's just the most comfortable position for the _doctor_.

You are looking at it from the eyes of the Health System that you know.

I lived in countries were elective C-sections are a thing and the father is just a guy we need to notify at the end of the ordeal.

But I also lived in countries where birth (inside the hospital) in a birthing pool with the music and light and drugs of your choice is a thing, with the father right next to the mother.

_Culturally_ different health systems can be less or more 'medicalized'.

Here in Oxford, UK, both the above are available in the same hospital - we could choose what we wanted. Is that not normal elsewhere?

This is available in the US, but you make the choice based on the facility, typically. You can have the more medicalized experience at a hospital, or you can do home birth and hire a doula to assist, or you can go to a birthing center, which is sort of an in-between but more intimate atmosphere than a hospital. Usually the birthing center will be close enough to a real hospital to intervene if something goes wrong during the birth.

Which of these options does medical insurance cover?

My wife has had kids in all these settings, except the home birth was through the same provider as the birthing center. All of them were covered by insurance, except the birthing center is out of network. There’s an in-network one the next city over.

(This is a perfectly ordinary HDHP/HSA plan through a large company that you’ve heard of.)

Squat birthing is a nice idea, but you have to look at the evidence, it's good for some things and maybe not great for other things like cesarean (RR 2.26 in this meta analysis)

https://www.sciencedirect.com/science/article/pii/S030121152...

> conclusion: The available evidence does not show the squatting position during childbirth to be beneficial. As there is no evidence for or against squatting, women should be able to choose the position they prefer.

I would also recommend to let the soon-to-be-mother decide how she feels about squatting? You don't read evidence what's the best positure for shitting when you need to shit like hell. I promise you will take up the best positure for your shit.

Also there is more to childbirth than a new life as there is an already existing life it very much affect - the one who's giving birth and I see no such consideration in the linked evidence.

Sure, patient (mother) gets to make decisions about what treatments they want, clinician advises them on the pros/cons of each option. Just pointing out squat birthing isn't the panacea some people paint it as.

The study wasn't about the mental well being of the mother & birthing method, I'm sure you can find some literature on that (but it's not a valid criticism of the study methods).

Thanks for sharing this. It's so crucial to know that we have actually lost this information and we're getting worse.

>Do you know what is the most uncomfortable position for labour is? Yeah, layin on your back.

My wife and I were shocked when we had our first. We were recommended a "natural birth" course that taught us this, and everyone gave us crap about being "woo-woo" and "denying science".

Everyone.

We also had to forcibly tell doctors "no" to forceps, pumps, drugs, and all the interventions. They made such a big deal about being two days past the due date, that they pulled her aside and asked if I was abusive.

The birth of our first was not too difficult (her words), she did it her way, listened to his she was feeling, followed her gut, and I just had to run interference.

Doctors and nurses make a big deal about things like "the cord is wrapped around the neck" when the baby isn't even using its throat to breathe yet. It still has the cord for everything they need.

Now we're having a second and we're gonna go home birth. The morphology scans can't seem to decide if we're at 18 weeks or 19 weeks. Due dates my ass.

cord wrapped around the neck can potentially block blood flow to the brain, causing brain damage

> home birth

Isn't the rate of complications higher at home than in a hospital? Statistics is your friend here. Not sure I would want my wife to experience pre-hospital rates of complications.

Maybe tough to study tho, as I'm sure women who have had smoother pregnancies (or a good first like your wife) are the ones more likely to home birth.

If you don't count "complications caused by intervention" and things like that, then no it isn't.

We've decided that it will be safer and more comfortable for us to do it at home with professional help. Thankfully the public hospital here had a home birthing unit, which was only started about 3 years ago.

I was amazed at how many complications were caused by their scheduling decisions.

There's a maternity hospital near me that we learned (through experience) has a simple method for simplifying scheduling: approximately everyone gets booked for an oxitocin-induced birth.

Rate of complications will be the same, outcomes from those complications won't be the same. Accident rates on the highway might be say, equal among people who do/don't wear seatbelts, but outcomes are not.

Look at common complications, like postpartum hemmorrhage (usually > 500 ml blood loss). "estimated 76.7m delivery hospitalizations, 2.3 million (3.0%) were complicated by postpartum hemorrhage. From 2000 to 2019, the rate of postpartum hemorrhage increased from 2.7% to 4.3% ... proportion of deliveries to individuals with at least one postpartum hemorrhage risk factor increased from 18.6% to 26.9% ."

https://pubmed.ncbi.nlm.nih.gov/36701615/

Bottom line with a home birth, everyones training is around when things go smooth. Medical center is where people have thousands of hours of training on how to save your life.

> They made such a big deal about being two days past the due date, that they pulled her aside and asked if I was abusive.

There's no relationship between those two things. The "do you feel safe at home" questions are required by law; I get them whenever I visit a hospital, including when I go by myself with a question about toenail fungus.

By the looks of it you are denying science...

Hopefully you live close enough to a hospital. Pregnancy complications can happen suddenly and require immediate medical assistance.

DIY health is all fun and games until something goes wrong, and then suddenly the experts are important again. For some reason the experts apparently don't really understand the "simple" things that can be attempted at home.

> denying science

science isnt a religion, you cant deny it or follow it, there is a rigorous process and sometimes the results are wrong, misleading, or lead to the wrong decisions.

Do not pretend there's an absolute in science, especially medicine, where one can say "this is the only good way" and know it to be true.

"Denying science" usually means denying scientifically proven facts.

https://blogs.loc.gov/headlinesandheroes/2022/04/10-strange-...

You seem to be denying the scientifically proven facts that science gets things wrong... constantly... to the detriments of people suffering the catastrophic effects of those errors.

Humor me, what did science actually get wrong in this article?

The milk transfusions were shitty solution for lack of blood during a cholera epidemic, but the articles claims are false "In the late 19th century, milk was believed to be the perfect substitute for blood"

Soothing syrup did it's job (pain), we now shy from it because of perception of risks, but no one's ever run clinical trials on small amounts of alcohol + opioids on childrens gums showing any adverse outcomes.

Chloroform is an effective treatment for asthma, and the best we had before the discovery of beta-2 receptor agonists. See this paper for details on the physiology in mice.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5702405/

Cocaine (stimulant) is also likely a somewhat effective treatment for allergies. Take a look at this clinical trial which showed antihistamine + ritalin being a more effective treatment.

https://www.jacionline.org/article/S0091-6749(04)00017-X/ful...

Malaria for treatment of syphilis also makes sense, it was incurable at the time, and the other options were mercury based, ineffective and had horrific side effects. Malaria was better than mercury.

Tobacco enemas can be thought of as a large nicotine delivery mechanism. Newspaper clip says it's helpful with meningitis, inflammation of the brain, nicotine is a vasoconstrictor, crosses the blood brain barrier. Maybe it did something, who knows.

I don't know those exact cases, I'll grant you that. It was fairly lazy googling in my part.

However, the cases that I do know of are the food pyramid recommending the vast majority of your caloric intake to be processed carbohydrates, lobotomy as a treatment for mental illness, and the case of David Reimer, who was raised as a girl following a botched circumsicion. Then there's thing like the missaligned incentives between sales reps and doctors leading to hundreds of thousands becoming addicted to OxyContin.

We act as though doctors and scientists are above some standard, and some even believe they follow a falsifiability principle, but there are cases - childbirth being one of them - where a common sense approach that tells you not to follow recommendations might actually be the right thing. It's a fine line, but we should have open conversations about the fallibility of science. Often, and in the comment that I was responding to, the implication is: science says it so it is correct. That's simply not the case.

Dude, what common sense approaches about pregnancy do you think go against the scientific recommendations?

Please take a look at the CDC data over the last century. In 1915 infant mortality was _10_ percent. Maternal mortality was around 0.8% in 1900.

https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4838a2.htm

Are you seriously claiming that these things dropping an order of magnitude has anything to do with common sense, or not listening to doctors?

Western science is extremely useful in mechanical type of interventions such as emergency c-sections. It is well known that the intervention first approach is not the ideal, and we have been in a 50 year journey away from it. The term 'cascade of interventions' is extremely descriptive of this phenomenon, and I've seen it first hand. Yes, it's getting better now since the last 50 years, yes, it's great that science can come in with extremely precise machinery, and yes there is a tendency to over rely on the machinery by people in the field. I'm not a science denier or anything, just saying that doing more natural approaches to childbirth shouldn't be as vilified as it is now, given that we do have millenia of practice with that practice.

There is no proof unless its math, theres just unfalsifiable facts, which just have not yet been falsified.

> [...] although planned home birth is associated with fewer maternal interventions than planned hospital birth, it also is associated with a more than twofold increased risk of perinatal death (1–2 in 1,000) and a threefold increased risk of neonatal seizures or serious neurologic dysfunction (0.4–0.6 in 1,000).

https://www.acog.org/clinical/clinical-guidance/committee-op...

I mean, they did say "everyone" so I suppose the science drop was not unexpected :)

The term "run interference" is so much more accurate than I think folks who've never done this realize. My wife submitted a birth plan that explicitly stated no drugs except in the case of emergency. After the fourth time one of the floor nurses asked my wife if she was ready for her epidural I ended up gently insisting she not step foot in our room again. On three occasions I physically barred entry to the room to a lab tech that thought 3am was an appropriate time to do routine blood draws. Twice I caught and stopped a group of 10 (!!) med students about to enter the room for no medically obvious purpose. To the extent that there was any peace during or after my wife giving birth it was because I was belligerenly guarding the door.

I applaud all that with the possible exception of the routine blood draws. Not for childbirth but both my wife and I have been in the hospital and appreciated the monitoring. Things can go south quickly on many medical issues, wouldn't a timely blood test catch things early?

It’s difficult unless you know how the hospital works. If you’re recovering on the standard medical floor, they follow some idiotic process ordered by a hospitalist whom you’ll never see. Basically you’re there because some rule says so.

If you’re on an OB floor, ICU, PACU, or dedicated unit, you’d better know why she’s there and they are doing those blood draws as you’re putting mom at risk for a variety of problems.

If all is well, she’s going home in a day or two, and being an obstructionist is just delaying that process and an actual good nights sleep.

I'd say it's situational. In this particular instance my wife showed no signs of any complications before, during, or after the birth and the labwork was as much to do with billing our insurance as anything else. They still got to do all of the labwork they wanted, just a few hours later at a more reasonable time of day.

Same here. Prior to birth my wife and I were told by the medical professionals that baby will be waking up frequently for feedings, and we need sleep too, so we should sleep when baby sleeps.

After a C-section once my wife were back in our postpartum room, no one seemed concerned at all with her sleep. Every 15-20 minutes there was another visitor. At this point she had been awake more than a day, had a few hours of extreme exertion before a pivot to surgery, and was full of pain killing narcotics.

She could barely stay awake.

I ended up being her sleep guardian. Every time I heard the sliding door to our room crack open I was on my feet to turn people away.

In retrospect it was good exercise in being assertive with authority figures in service of others. I think I’ll be doing plenty of that as a father.

Next time chat with nurse and doc. Nurse facilitates discussion, gets order from doctor to relax the rules (maybe no meal delivery, no room cleaning, decreased vital signs, bundled care, etc) and ask for a sign placed on door asking for “no entry-see RN first”.

Asking about abuse is a standard question in the US now during hospital interactions not just births and not just natural births.

Thanks for sharing. This lines up so well with my experience as a translator in the ER — doctors are constantly catastrophizing and make it seem like everyone is going to die all the time and seemingly massively overtreat/overtest most patients. It really turned me off and decided not to go to medical school. Maybe it’s their version of upselling.

I think it's more likely that it's their version of "if I do this and something goes wrong, I'm less likely to lose the lawsuit."

I think it is also about seeing the most difficult cases and having them stick in your memory as a med student. I have friends who practice medicine and they show the same behavior even when there is no monetary incentive at any stage for them. They do this even for their own parents and kids.

Be safe. The United States has the highest maternal mortality rate among developed countries. In 2020, there were 23.8 maternal deaths per 100,000 live births in the US.

That number includes both hospital and home births.

However studies have found home births with certified professional midwives in the US to have very low rates of maternal and infant mortality, comparable to hospital births for low-risk women.

I don't disagree that there are real problems, but these statistics don't really help much. The home birth group is less likely to include high risk births. Many issues are detected during prenatal care and most of those parents will choose a birthing environment better equipped to deal with crises.

As far as high US mortality rate, I wonder if this is more of a reflection of general poor health issues from terrible dietary choices rather than the birth process itself.

Demographics plays a significant role here. In the U.S. women in the middle 3 quintiles of income have fewer children than the top, and far fewer than the bottom. In countries with more generous maternity policies I believe the trend is not as strong.

> studies have found home births with certified professional midwives in the US to have very low rates of maternal and infant mortality

Does this factor in that high-risk births might be more likely had in the hospital?

> In 2020, there were 23.8 maternal deaths per 100,000 live births in the US.

How does that compare to 1920, or even 1820 when home births were the norm?

A little over 800 per 100,000 in 1900 per CDC data. Infant mortality was 10% in 1915.

https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4838a2.htm

Does anyone know how the phrase "denying science" crept into people’s vocabulary?

I find it incredibly creepy since it sort of treats science as a religion, and usually people who say it seem to know basically nothing about actual science.

If I think back before about 10 years ago I don’t think I had ever heard it before. In the past, non-technically minded people didn’t really cite “science” as a concrete reason to do anything, and the people who did generally at least kind of knew what they were talking about.

"science denier" sounds like it's language the flat earth folk et al use, coined (I'd imagine) to speak to them in their language, or by themselves as a positive trait?

my eccentric high school English teacher once pointed out that the original connotation of "x denier" is of the holocaust

Good point!

From my viewpoint (in europe though) I only started hearing/seeing it during coronavirus.

In the US we got a head start on it with climate.

In Poland, I first started hearing it around vaccines and climate discussions couple years before COVID - but that may have been because I was hanging out in various social media groups discussing those topics (and/or just mocking the "science deniers"). The term however seems to have exploded in use since the pandemic. I think it's because it suddenly became relevant to mass audience and journalists started using it.

was that in Polish? if so, what is the Polish version?

There isn't a set one. "Antynaukowy" (lit. "anti-science") is the most common I've seen, perhaps because it's close to a well-established term "antyszczepionkowiec" ("anti-vaxxer") - but most often, it's just any of the expression that contains the core term of "anti science" or "denying science", such as "antynaukowe poglądy" ("anti-scientific beliefs"), "zaprzeczasz nauce" ("you're denying science"), etc.

Lol that last word has a z, a prz, a cz, and a sz.

They should really switch to Cyrillic!

I see this argument raised quite often and it's a bit like saying English should have it's own alphabet because latin alphabet wasn't made for whatever amalgamate of languages modern English is. There are cultural factors at play as well, Poland was historically a Catholic country and that came with latin included. Basically: digraphs are prevalent in many languages and Z is as good a letter as any.

Wrt. English, it still technically has stuff like Æ, so it too may just as well switch to Cyrillic.

I’m confused by both of these replies. Wasn’t Cyrillic created expressly for Slavic languages? And isn’t Polish a Slavic language?

Other than not having to use diacritics, what benefits does it present for modern Polish users to switch to an alphabet designed for Old Church Slavonic?

also how would it look politically

In the US,this went mainstream for the pandemic. It was an existing undercurrent in different communities.

Reactionary people weaponized vaccines with Gardasil - good Christian boys and girls are chaste until marriage, so vaccination is unnecessary. Sinners get gods punishment.

Crazy left-wing people cling to the autism rumors about vaccination.

All of this is magnified by politics and propaganda. Certain religious sects punch above their weight because of political factors - you can usually correlate this with measles outbreaks. Foreign influence operations encourage and stoke this stuff to encourage general unrest as well.

> I find it incredibly creepy since it sort of treats science as a religion […]

This has been a thing for a while:

* https://en.wikipedia.org/wiki/Scientism

This is different from what I observe though. One can believe that the scientific method is the best way we know of to understand reality, without assigning dogma status to any particular artifact that comes out of this process. Doing so is, ironically, actually anti science (in the scientific method sense), which is probably what makes it so creepy.

The difference is that people denying science are not doing it because they have supporting data that conflicts mainstream scientific beliefs, they are denying science because it allows them to claim superiority or display allegiance to a tribe.

For example, drekipus provides no data and no specifications about their claims, and even if their experience was true, it is 1 datapoint. Contrast that with the conclusions someone who has a systems level view of outcomes from numerous births.

Go ahead and contradict the norms, but provide supporting reasoning and evidence. Note that even the medical “establishment” constantly updates their guidelines as new information is evaluated.

Usually people clinging to folk medicine were ignorant people due to circumstances.

Now, people who live in a modern society actively pursue ignorance as they perceive it to be some sort of virtue. Many people want to aspire to home water birth, exclusively breastfeed and only used organic cotton diapers, because…

Others seek cures from goop.com or gurus of various stripes because it makes them feel empowered. Look at Steve Jobs - a fricking billionaire with access to anything possible, who delayed meaningful treatment to chug papaya juice or whatever for his cancer.

It dogmatic thinking just as wrong as the doctor who pushes for a c-section so he doesn’t get called on Christmas morning or miss his football game.

Empowerment and ego can often fool us. And marketers have monetized or.

> exclusively breastfeed

What's wrong with doing this before the baby is ready for solid food (around 4 months IIRC)?

> only used organic cotton diapers

What's wrong with using those types of diapers if they're better for the environment compared to a standard disposable diaper?

Many of the things in the GP comment are idiotic or wrong at very basic levels, so it's possible the "denying science" comments have a root in truth.

It's one thing if you've studied a given field, are aware of the limitations in current research, and have a well-informed opinion. It's something completely different if you don't seem to understand the blood is transmitted through the UC and the concern around it being wrapped around the neck has nothing to do with the respiratory system, or that asking if a pregnant patient is safe at home is completely routine and happens in 100% of cases.

If the doctors say "the cord wrap will stop breathing" and I say "that doesn't make sense" am I denying science or is it just.a normal disagreement?

> "the cord is wrapped around the neck" when the baby isn't even using its throat to breathe

This effects blood flow no? This happened to our first born and his heartrate began to drop by half and we began to prepare for an emergency c-section.

I find it crazy that you’re bothered by scans having a margin of error measured in single digit days.

It's not a problem if the error margin means nothing - the baby comes out between 38-42 week is all good.

It is a problem because if you run out of the pre determined terminus based on erroneous scans you will get c-section because protocol.

Of course this is a personal anecdote and may not apply to your country.

Same, I linked him a paper on the error margin of these scans in another comment. The poor assumption here is the error margin at 18-19 weeks is the same at 36 weeks.

Might be worth reviewing the ACOG's recommendations on post-term deliveries https://www.acog.org/clinical/clinical-guidance/committee-op...

The problem isn't the single digit days. We were totally fine with this and we just put it down to "the baby will come out when they're ready"

I'm saying that you need to tell that to the doctors, who raised all manner of forcible induction on the mother at N+1 days.

Why is a week within margin, but the day after due date isn't?

I said read the guidelines. Casually scanning the literature on pubmed shows babies that come out after IDK 39 weeks have sometimes not great outcomes, and it gets worse as time goes on.

You say "the baby will come out when they're ready", but what would you reply to "what if the baby wants to come out stillborn?"

When do you want forcible induction to be advised by the clinician? 39 weeks + 2-3 days for you to feel comfortable about the decision? Maybe a week if you're seeing a psychologist or like astrology?

I'd caution you to take this attitude in this case. Modern medicine isn't run by boogiemen out to get you. Nuchal cords really do increase risk, and you're making a cavalier and poorly informed statement to justify your reasoning with "the baby isn't even using its throat to breath yet." [1]

Forceps are generally reserved for emergencies, and could save your baby's life.

Birth goes ok, 90%+ of the time. I don't think it's right saying doctor and nurses are overreacting, their job and where they make a difference is in the 10%. And there's no knowing where you'll fall until after.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5719938/

Imagine working with this guy on a software system. Says no to established best practices across the board "no" to version control, CI/CD, vulnerability scans, patching and all the interventions.

Gets one project off the ground by "following their gut", and it wasn't a disaster, concludes this is the way to go.

> Doctors and nurses make a big deal about things like "the cord is wrapped around the neck" when the baby isn't even using its throat to breathe yet. It still has the cord for everything they need.

This is just wildly ignorant, they're concerned about occlusion of bloodflow through the cord and/or the carotid artery.

> The morphology scans can't seem to decide if we're at 18 weeks or 19 weeks. Due dates my ass.

What are you upset about? The error margin being well within the stated limitations in current research?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7844476/

I don't disagree but "established best practices" have an enormous range from no brainers to obvious cargo cult bullshit. For every dev rightly suggesting people use CI/CD I've met 10 that twitch at the slightest suggestion that maybe we don't need whatever half baked library their favourite medium blogger or tweeter is raving about this week.

I think it's stupid to disregard a doctor's advice, but as someone without a medical degree you really have no good way of knowing whether you're getting the healthcare version of "use version control" or "I just used Svelte for 5 minutes and it's the best thing ever!!!!!!!". You just have to roll with it like you'd roll with a shit dev over someone who's never written a line of code in their life.

You are acting like an ignorant first rate asshole.

As example of your ignorance is your lecture about the dangers of an umbilical cord wrapped around the neck. That is, in fact, very common and it is incredibly rare for it to lead to complications. https://unmhealth.org/stories/2022/12/nuchal-cord-managing-d...

Which leads to your willful ignorance of the fact that the guy was exposed to a lot of research about problems in medicalized interventions. "This guy"'s critical experience was almost certainly running across that research. And not on his personal anecdote. I've seen enough of that research myself to know that the interventions that he's questioning really aren't equivalent to any of the software best practices in your straw man comparison.

As for an example of your being an asshole, take your question about what he's upset about with due dates. You are right that it is a medical fact that the date chosen is imprecise. He knew that as well. But you are wrong to have not noticed his story about having his wife be asked about abuse because she wasn't getting induced 2 days after her due date. That behavior on the part of the doctor is an excellent reason to get unhappy.

Now why do doctors behave that way? According to research I saw close to 20 years ago, because they really want to control when the baby comes. It is more convenient for them to have a baby come during the work week rather than interrupting their Sunday golf game, and so they pressure mothers to make that happen. They do this both by recommending medically unnecessary Caesarians, and by inducing when there is no medical need.

Which is an example of the arrogance of the medical industry that illustrates why people get upset about this.

Did you stop to consider that perhaps the reason complications are rare from the umbilical cord wrapping around the neck, is because medical professionals are actively monitoring for it and mitigating the issue?

I absolutely did consider that. Did you consider that I might actually have looked into this reasonably seriously at one point? Like, say, when I was on my way to being a father?

The link that I provided explains the characteristics of the umbilical cord that have been evolved to minimize the probability of problems. It really isn't a problem. Even in childbirths where people don't worry about the umbilical cord.

This shouldn't come as a surprise. Evolution has selected for safe natural childbirth. Unfortunately in homo sapiens there is a conflict between our recent evolutionary pressure for large heads, the needs of walking, and for safety during childbirth. And so childbirth is much more dangerous for us than for other mammals.

Modern humans also have the problem of mothers in poor health. Reasons vary from drug use, to age, to sedentary lifestyles. Of these, drug use is the most dangerous. Despite most mothers not using drugs, drug use is a factor in something like half of childbirth deaths.

Then there is the list of usual complications. Breech birth, infection, blood type incompatibility, diabetes, heart attack and so on. It is a long list. It interacts with the previous lists - for example breech birth is made more dangerous because of our large heads. Complications from knotting of the umbilical cord is very far down the list of things that go wrong.

>Did you consider that I might actually have looked into this reasonably seriously at one point

Pretty much the question I was asking.

While I don't appreciate OPs mockery around CI/CD, what they said about the unbilical cord was accurate. I don't see where the supposed lecture on dangers you mentioned came from.

The post that started this thread was mocking doctors without a proper understanding of the mechanics involved. But sure, it must be a valid criticism by someone who has done their own research.

Not something I've looked into before and I've learned that it seems like it is rare for it to cause issues.

Personally I'd still want a professional on hand to be on the lookout, your posted article links to research where 0.6% of births had the cord wrapped around 3 times and that was correlated with infant death. That's something I would think is of concern even if not of very high chance.

The supposed lecture was:

> This is just wildly ignorant, they're concerned about occlusion of bloodflow through the cord and/or the carotid artery.

And no, this is not an accurate lecture. Most of the time that particular lecture is delivered by doctors who actually know it is not an issue, but want to scare patients into being in hospital for other reasons.

As for the post that started this thread, I have a context that you don't. I recognized the circle of ideas that would have been in that natural childbirth class. And so had context for where they would come from.

Thread started with OP claiming that doctors were worrying over something which is completely safe.

OP was then corrected as to the mechanics of the situation.

Yes, it might be relatively rare for the complications to occur.

Yes it is your choice if you have issues with medical care and choose to stay away.

None of this changes the reality that OP was talking nonsense and your response is pure speculation and anecdote.

Of course he hasn't. Imagine talking to this guy in the delivery room. "Evolution has selected for safe child birth, nuchal cord isn't a problem".

At that point every professional in the room is thinking "How do we get this guy the fuck out of here".

I'm certainly an asshole, and drunk, but at least I can read and look up studies on pubmed.

What are you even arguing about nuchal cords? They're common and we should ignore them? Who cares that the "complications" are fetal death?

You read some papers 20 years ago? Care to share any of them?

How confident are you about your hand waving claims around sunday golf games? Have you bothered to review the clinical literature around hour of birth and outcomes? Have you considered it may be related to the hospital being better staffed & rested during the day vs at night?

People have so many weird superstitions around childbirth. I guess if there's no harm, the doctors should be willing to accommodate. When you bring your car in for service, you'd never tell the mechanic "I ask that you only use Snap-On wrenches, only work on one part at a time, and NO AIR TOOLS!" But, when it comes to medicine, they have a list of requests about how the doctor should do his work. "You be you" I guess.

you'd never tell the mechanic, "...and NO AIR TOOLS!"

Oh, yes, I most certainly would. This is a great example of the tools being there for the convenience of the practitioner, not for your convenience or comfort (I'm sure the reader can draw parallels to child birth on their own).

When you, the mechanic, put the wheels back on you will use a torque wrench and torque the nuts to the proper values. Just I like I used to do 30 years ago when I was a mechanic. Because no one should find out at the side of the road that the air gun torques those puppies to 146ft/lbs, and you're not getting them off with that weenie little wrench that came with the car.

If your mechanic doesn't at minimum use a torque-limiting extension when putting lug nuts on you need a new mechanic. Even Walmart uses torque wrenches for that. Source: am a torque-wrench-using non-automotive mechanic, used to work in Walmarts shop.

OTOH, childbirth is a somewhat special case because it's effectively a prolonged surgery process, and standard practice 'till recently effectively denied personhood to the mother. Now we can have differing opinion on the degree this process should be streamlined and optimized for convenience of healthcare practitioners, but if the hospital does ask the patient for their preferences wrt. procedures and standars of care (and/or is required by law to do so), then it's just wrong (and possibly illegal) to then completely ignore those preferences.

This is yet another case where staff is optimizing short-term efficiency by burning long-term trust in healthcare system of entire generations.

>> Doctors and nurses make a big deal about things like "the cord is wrapped around the neck" when the baby isn't even using its throat to breathe yet.

>they're concerned about occlusion of bloodflow through the cord and/or the carotid artery.

Yep. Our #5's cord was looped 3 times. He was born with no vitals but staff was able to resuscitate him. He was effectively dead for the intervening time.

It’s a tough process in the US because healthcare is a mess in the US and obstetrics is dominated by defensive medicine, especially if there’s a significant number of Medicaid patients.

Most of the hysteria is because they get a lot of women who show at at 42 weeks, no prenatal care, gestational diabetes and no support system. Even worse, if mom is hooked to opioids, and that baby costs $2m to deliver.

America in this area is basically the privileged who get world class care and the proles who get whatever.

>We also had to forcibly tell doctors "no" to forceps, pumps, drugs, and all the interventions. They made such a big deal about being two days past the due date, that they pulled her aside and asked if I was abusive.

Guy who has delivered zero babies telling the team who has delivered many babies what to do.

>Doctors and nurses make a big deal about things like "the cord is wrapped around the neck"

Lol.

> Do you know what is the most uncomfortable position for labour is? Yeah, layin on your back. It's just the most comfortable position for the _doctor_.

Almost. The reason the hospital makes you do that is not that the position is comfortable for the doctor.

It's that the doctor wants to follow a set of guidelines for what should be happening when according to how dilated the mother's cervix is, all of those guidelines use measurements from a supine mother, and changing the mother's position changes how dilated the cervix is.

But you're correct that the supine position is bad and we should stop doing it.

(Source: my mother is an OB/GYN, and is particularly interested in natural birth and similar hippie considerations. In this case, my sympathies are with the hippie considerations.)

>Giving birth is similar to the act of vomiting in the sense that you don't have to do anything, it happens to you when the circumstances call for it.

Is it? I imagine the mortality/morbidity rate for women before modern medical interventions during childbirth was much higher.

My wife had to have her amniotic sac manually broken by the doctor after 12 hours of labor to resume her dilation.

Yep, women body is able to give birth.

I agree, mortality was most likely higher because when complications happen, modern intervention is much better, cleaner, we know about bacteria and other stuff exists and stuff like that.. but that's only like 10% of the cases(anecdote).

About your wife: if you take a woman in labour from home to an unknown place where strangers stare at her vagina and put stuff in guess what happens? Labour stops. Now you need artificial stuff to make it happen regardless - drugs, breaking sac, more drugs, suction cup, whatnot...

My problem is that we butcher the 90% of cases where there is no need for any intervention to the process.

>I agree, mortality was most likely higher because when complications happen, modern intervention is much better, cleaner, we know about bacteria and other stuff exists and stuff like that.. but that's only like 10% of the cases(anecdote).

Data would be nicer than anecdote. But even at 10%, if you are a woman, at 10% probability of needing experienced professionals with medical training and equipment, are you taking a chance at home or at the hospital?

More common than mortality is morbidity, and evolution does not quite care about that as long a woman survives well enough to procreate again. But women themselves most certainly care about hemorrhoids, tears, pain, infections, etc.

Back to the point though, if the implication of comparing it to vomiting is to say that the mechanism is "simple" enough so as to be reliable enough to not need intervention, I think most women would disagree and prefer having intervention available if necessary. Perhaps many interventions are unhelpful, or the tradeoffs not worth it, but many are helpful, and the medical field does seem to eventually abandon the bad ideas once shown unhelpful.

Doctors' discomfort is also why they are so eager to slice women open like a fish, because baby needs to come on their schedule or they'll be late for tee time.

[[citation needed]]

To my knowledge Caesarean Section is a last resort.

It is not. My mother was forced out of a hospital once for not giving a Caesarean section. (The baby was fine throughout.)

And I had a college roommate (male, no children) who espoused the idea that making women give birth without the benefit of a Caesarean section was barbaric.

Not who you are replying to.

Anecdata, but my sister-in-law had 3 children, her first was at the same hospital I was born (in the Texas Medical Center), and he was a standard birth, the last 3 were at our small region hospital. With her second child after only an hour of labor they told her they HAD to do a C-Section, and to top it off, they only gave her 2 nights to recover from what is major surgery (first night being the night she gave birth). The reason for the remaining C-Section was that she "needed" a C-Section before.

I'm not saying that its so the doctor can go play golf or something personally repugnant like that, but that they are short staffed doctors, and a C-Section typically has no complications and they know how long it takes to get a baby out when they cut you open versus you taking up a bed that could be turned over to the next C-Section. There is an incentive to flip beds as often as possible.

Same here. They just got sick of waiting. Turns out private equity has optimised the birth process.

> The reason for the remaining C-Section was that she "needed" a C-Section before.

Yeah she probably had a vertical incision c-section, which clinically indicates a c-section for the next birth. You can read about it, the fibers heal better from a transverse incision.

That's all fine and good, but many patients can only have so many C-Sections without complications. It isn't universal, and maybe it comes down to the doctor that did the C-Section in the first place, but its an invasive procedure to optimize the time it takes to deliver and not (usually) to optimize the health of the baby and mother.

I'm all for medically necessary procedures, but here in America, so many procedures are not medically necessary, they are there for optimizing the bottom line of the for-profit medicine-industrial-complex.

Depends very much on the country. In eg Brazil, 55% (!) of all births are by C-section.

https://www.bellybelly.com.au/birth/highest-c-section-rates-...

That is some of the most depressing data I have seen / read. :(

I've seen it first hand. Had to fight them off.

Far from last resort. How often it's used is based on location. Let me do the citation:

https://worldpopulationreview.com/country-rankings/c-section...

First is Mexico and Turkey with more than 50%! USA is 32%. Norway seems to be quite low with 16% as far as first world countries go.

N=1 but this is certainly NOT true for my obstetrician friend. Couldn't be further from reality for him.

In the US, both east and west coast, my wife was never told anything like this. In both scenarios, the OBGYN doctor group had a rotation of doctors on call. You likely will not get your specific doctor, but my wife was seen by every doctor in the OBGYN group over the course of the pregnancy.

Lots of resources were provided for vaginal childbirth, and the hospital had dedicated birthing suites with hot tubs and yoga balls and all sorts of equipment you could use. There was zero pressure once admitted too to take medication.

However, the fetal heartbeat monitor or whatever they strap to the mom is annoying as hell because it slips off constantly since it is positioned on a rounded belly and a nurse constantly having to come in to adjust it because I presume the hospital is covering its ass from liability.

in my city, C-section is becoming a big problem because for-profit hospitals earn 50x more for a C-section so they create artificial scarcity with regards to keeping women in hospital beds and await an empty surgery room. Just the moment there is a vacancy, the doctor comes up to the family and creates an urgency "oh the baby is in danger, we need to do surgery now, like now" and even "we need to do this surgery now or else you are responsible". As if there are malpractice laws here.

I have read in books about women doing normal day's work or chilling at home or driving and they going in to labor and then the rush to the hospital.

here the a pregnant women assumes the physical properties of glass. They are treated with super gentle care as in no work, no nothing, no exercise, 3-4 days before the "expected date" they are put in hospital beds......

https://www.thequint.com/gender/kashmir-what-is-behind-the-a...

https://www.greaterkashmir.com/todays-paper/op-ed/why-are-c-... https://kashmirobserver.net/2020/12/14/i-feel-like-crying-c-...

It’s a patent from 1963. It expired in the 80s apparently. I guess it didn’t do too well, or even perhaps wasn’t made. Either way, a patent can be made by anyone. Don’t see this as a serious modern attempt at solving child birth. (Edit: auto correct)

Wife and I had our first at a hospital with a trained Nurse-Practitioner Midwife group.

We only had to see the OB on call once, and otherwise got to let baby’s and mom’s timetable and needs lead the way, with minimal medical intervention. She was induced because there was a small chance of a kidney issue with baby (a common result on ultrasounds) and we were a few days past due date.

Ultimately, labor lasted 30+ hours and she needed to get an epidural so she could get some sleep through the night to make sure she had enough strength - but she had a vaginal birth and got to do skin-to-skin, and baby only had to leave her side for a hearing check on the following day.

I guess I share all of that to say that a balance can be found. This place was very respectful of our wishes and the NPMW group was incredibly well trained - and we had the peace of mind knowing if anything went south, we were seconds from pediatric surgery, etc…

But to everyone saying “JUST TRUST THE DOCTORS BRO” - use some critical thinking. The medical profession can be dogmatic, arrogant, and hasty. It took a nurse to point out that MDs coming straight from necropsy should wash their hands before delivering a baby to avoid killing mother and child from infection. Doctors are not infallible machines of perfect medical skill, and we know that every medical intervention comes with risk; but humans have been giving birth for eons. Obviously medicine has improved that process in many ways, but medicine is best applied only when needed, so always ask questions and think for yourself.

Which country do you live in? We had ours two years ago, and my girlfriend was able to choose. We choose to have it in the hospital as if there is something bad happening, the reaction time is much faster than at home (or other clinics/birth houses).

The hospital we choose, has Swimmingpool/Bads but we just ended in a room full of devices to even have the baby in a situp position.

After delivery we needed to share the room though. Even that was a nice experience (we were lucky with the other family).

In third world countries they do what you say, and the mortality rate is higher.

> Do you know what is the most uncomfortable position for labour is? Yeah, layin on your back.

Well, the more G-forces, the more lying down becomes like standing ...

This belongs in the Chindogu museum along with vibrating belt "exercisers" and sweat booth "weight loss machines".

This reminded me of the Zero Punctuation review of Diablo 4. Talking about the big villain demon lady: "Yes, she was summoned in a nightmarish ritual of blood and tearing flesh, but aren't we all?"

https://www.youtube.com/watch?v=vjovy5kHo7g

We found the excessive amount of poorly designed sensors and monitors also forced her to be on her back. And significantly limited movement

What are the ideal positions? Back seems ideal at a naive glance

I guess it's different for everyone but by anecdote on all four or squatting, preferably in bath.

For hours?

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