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Water Birth (Again)

Note: I had just finished writing this article when I discovered Dr. Jones had beat me to the punch with his March 28th article on the same subject. He did an excellent job, and of course reached the same conclusions I did (it’s not that great minds think alike, but that we base our conclusions on the same body of evidence). Rather than let my efforts go to waste, I decided to go ahead and publish my shorter, more idiosyncratic article. If it’s worth saying, it’s worth saying twice; and different approaches may appeal to different readers.


“Humani nihil a me alienum puto.”

Nothing human should be alien to me, and I can understand why people do most of the strange things they do, but water birth is something I have really had difficulty with. Why would anyone want a baby to be born underwater? Why would they want to buy a special pool, set it up in the living room, fill it with water, keep the water at the right temperature, and then have to deal with emptying the pool and cleaning up afterwards? I read about it and tried to understand, and now I have some insight into their reasons; but I think they are poor reasons, and the whole concept remains pretty alien to my mind.

The claims

I found a fuzzy feel-good rationale on the Waterbirth International website. Mothers feel it is the gentlest of gentle births. Warm, luxurious water cradles you and gives you complete freedom to move during the greatest achievement of your life. “The women who have experienced the support and comfort of water for their labors and held their newborns in their arms speak more than any scientific article or paper on the subject.” In other words, “We don’t need no stinkin’ science!”

They went on to make some specific claims of benefits:

  • Water facilitates mobility and allows the mother to assume a comfortable position
  • Speeds up labor
  • Reduces blood pressure
  • Gives mother more feelings of control
  • Provides significant pain relief
  • Promotes relaxation
  • Conserves energy
  • Reduces the need for drugs and interventions
  • Gives mother a private protected space
  • Reduces perineal trauma and eliminates episiotomies
  • Reduces C-section rates
  • Is highly rated by mothers and by “experienced providers”
  • Encourages an easier birth for mother and a gentler welcome for baby
  • Placing a pool of water in a birth room changes the atmosphere immediately. Voices get softer, everyone becomes less stressed
  • The easier movement with buoyancy helps open the pelvis
  • The body is less likely to secrete stress-related hormones and more likely to produce pain-relieving endorphins

The research

They said these benefits are supported by research. They didn’t provide any citations, so I consulted PubMed. Here’s what I found:

  • There have been only two randomized controlled trials of water birth vs. land birth. They found minimal benefit to the mother and no benefit to the baby.
  • A Cochrane review found a reduction in epidurals but no reduction in C-sections, assisted vaginal deliveries, or perineal trauma.
  • Another Cochrane review found a decrease in reported maternal pain with no effect on labor duration, operative delivery rate or neonatal outcomes.
  • Still another Cochrane review found no difference in the use of pain relief, duration of labor, meconium staining or perineal trauma.
  • A 2004 systematic review found 16 citations of adverse effects including drowning, neonatal hyponatremia, neonatal waterborne infectious disease, cord rupture with neonatal hemorrhage, hypoxemic encephalopathy and death.

In short, there was only one systematic review suggesting a decrease in epidurals and it was contradicted by another systematic review. There was no research to support any of the other claims. Even the reported decrease in epidurals is suspect because of confounders. These women had strong expectations of pain relief and were part of a culture that frowns on epidurals.

The history

I couldn’t help wondering who ever thought up the idea in the first place. I found this:

We tend to think of labouring in water as relatively new. However, a writer on water births, Janet Balaskas, says that’s not so. She describes legends [emphasis added] of South Pacific Islanders giving birth in shallow seawater and of Egyptian pharaohs born in water. In some parts of the world today, such as Guyana, in South America, women go to a special place at the local river to give birth. [Maybe they want ready access to water to wash away the blood and amniotic fluid. River water and sea water are cold, not warm. And why would anyone want to imitate legends or the practices of a few women from a pre-scientific culture?]

Giving birth in water (rather than labouring in it) is a relatively recent development in the Western world. The first water birth that we know about in Europe was in 1803 in France. A mother whose labour had been extremely long and difficult was finally helped to give birth in a tub of warm water. [Uncontrolled anecdotal evidence. How do we know she wouldn’t have given birth just as soon without the warm water?]

Expert opinion

A joint Committee Opinion from the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics says water birth is not recommended and should not occur outside the setting of a clinical trial due to the potential risks. You can read their whole report here.

Their conclusions:

Immersion in water during the first stage of labor may be appealing to some and may be associated with decreased pain or use of anesthesia and decreased duration of labor; however, there is no evidence that immersion in water during the first stage of labor otherwise improves perinatal outcomes. Immersion therapy during the first stage of labor should not prevent or inhibit other elements of care, including appropriate maternal and fetal monitoring.

In contrast, the safety and efficacy of immersion in water during the second stage of labor have not been established, and immersion in water during the second stage of labor has not been associated with maternal or fetal benefit. Given these facts and case reports of rare but serious adverse effects in the newborn, the practice of immersion in the second stage of labor (underwater delivery) should be considered an experimental procedure that only should be performed within the context of an appropriately designed clinical trial with informed consent.

Although not the focus of specific trials, facilities that plan to offer immersion in the first stage of labor need to establish rigorous protocols for candidate selection, maintenance and cleaning of tubs and immersion pools, infection control procedures, monitoring of mothers and fetuses at appropriate intervals while immersed, and protocols for moving women from tubs if urgent maternal or fetal concerns develop.

The Skeptical OB, Amy Tuteur, has stronger opinions. She considers water birth tantamount to delivering in a toilet. The water in the birthing tub will unavoidably become contaminated with skin and fecal bacteria. In fact, it is even worse than the water in a toilet because the warm environment promotes bacterial growth. The number of reported complications continues to rise; even deaths have occurred. The idea that the “diving reflex” will prevent babies from inhaling the water has been refuted. In compromised infants, the diving reflex is over-ridden and we know they can inhale thick meconium (essentially prenatal feces) in utero. Would you want to risk your baby inhaling toilet water?

Conclusion

Laboring in water offers minimal benefits if any, and delivering in water offers only risks without benefits. Patients who understand the science may still want to try it for their own personal fuzzy reasons, and I support patient autonomy as long as patients can give truly informed consent; but I suspect that most women who choose water birth are not adequately informed about the scientific evidence (or rather the lack thereof). And I wonder about the ethics. Mothers may have the right to reject science and believe that “The women…speak more than any scientific article or paper…,” but do they have the right to risk the health of their helpless infants?

Posted in: Obstetrics & gynecology

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44 thoughts on “Water Birth (Again)

  1. Windriven says:

    It surprised me to learn that hyponatremia was linked to water birth. Any speculation on the cause?

    1. Andrey Pavlov says:

      Windriven, my understanding is that is has to do with ingestion of water leading to either dilutional hyponatremia and/or natriuresis from volume overload. It could also hypothetically come from aspiration leading to significant enough atelectasis which lead to increased pulmonary vascular resistance and thus RV strain and natriuresis. But that is speculation based on physiological principles. I don’t know that the question is actually answered.

      1. windriven says:

        “that is has to do with ingestion of water leading to either dilutional hyponatremia and/or natriuresis from volume overload.”

        I presume we’re talking about the perinate rather than the mother.

        I’m going to be in New Orleans for a 3 day weekend. Let me know if you have time for a beer Saturday thru Monday. windriven@gmail.com

        1. Young CC Prof says:

          Yes, the baby! Water birth can’t cause hyponatremia in the mother. Low salt levels occur if the baby swallows a significant quantity of the water, which apparently does happen sometimes. New babies are only supposed to have milk or formula, other liquids disturb the baby’s electrolye balance.

          1. Jon Brewer says:

            Let’s not forget that we’re also talking about possible fecal contamination in a water birth. A number of gastrointestinal infections take the fecal-oral route, and those lead to diarrhea, which disrupts electrolyte balance as well.

            Of course, dilution explains whatever can’t be explained by (again) germs.

    2. sullivanthepoop says:

      Yes, it is caused by swallowing water.

      1. Windriven says:

        @Young and Sullivan

        Thanks. In my first reading I misunderstood that the mother was becoming hyponatremic. Yes, I understand hyponatremia from too much water.

  2. Emily says:

    Many years ago, a co-worker had to undergo a hastily arranged C-Section. She said just at the OB-GYN was about to use her scalpel, she (the co-worker) said “WAIT.” And after a brief pause, added, “let’s do this underwater.” Everybody laughed and the dr. got on with her work. I gotta admire someone who can tell a joke just as the scalpel is about to be applied.

  3. MTDoc says:

    A bit of historical perspective, or at least my perception thereof. As a GP, I delivered over a thousand babies between 1960 and 1985. I accept the criticism that we treated deliveries as “operations”, carried out in well lit and equipped rooms, with sterile precautions and techniques. We were also ready to handle any emergency that might arise, no matter how rare that might occur. However, we were made aware that disasters were frequent in past generations, made clear from family histories of maternal deaths in the early 20th century. The “delivery revolution” began in my neck of the woods in the mid 1970′s, with both good and troublesome aspects. The birthing room was OK, but working in the darkened room made it real tough to do an apgar, and placing the newborn on mommies stomach under a blanket led to at least one unnecessary resuscitation. I drew the line on water births, but fortunately had enough rapport with my patients to avoid the problem. Incidentally, prenatal visits were not 5 minute belly checks, and mom and I were generally on the same wavelength. My two younger partners, both talented ladies, recruited most of the “new” OBs after 1978, and I was backup for C sections and such, which increased in frequency after continuous fetal monitoring became standard. Oh, the good aspects? Formal (hospital) maternity classes were generally helpful to patients, and I got more sleep.

    1. Chris says:

      “The birthing room was OK, but working in the darkened room made it real tough to do an apgar, and placing the newborn on mommies stomach under a blanket led to at least one unnecessary resuscitation.”

      In the late 1980s I had my first baby in a newly constructed birthing center in a community hospital. It was lovely and very homey. But the bed was constructed to provide birthing support, and to roll quickly to elevator directly to a surgical room. It also had directed task lights. The baby was not immediately placed on the stomach after birth under a blanket, but to a special table with a task light.

      I was the only one in that ward of eight rooms for the first one. There were complications (my child and I would have died at home), so I had to stay a bit longer. My baby got to stay with me, where I saw his first seizure. He was taken by ambulance to a children’s hospital, and I got to spend a very sad lonely night in the hospital.*

      My next child born two years later was one of three born during that day. Much better experience. The same with baby #3 (who would have been born in the car if there had been traffic). I really liked the veggie lasagna the hospital sent us home with each time. Also for second child they were doing hospital construction, so we also went home with small stuffed bear (his shirt “Thanks for bearing with our expansion”). That child loved that bear, and it is now it is part of our Christmas decor (wearing the red coat and hat his five year self insisted I make for it).

      * Though it had one small bit of humor. Near midnight as I tried fitfully to get to sleep I heard a very interesting conversation at the nurses station. Someone came up from the emergency department asking to borrow a pair of forceps. They had a patient with an apple shoved up his bum. They tried clamps, but they kept slicing through the apple.

      1. Renate says:

        An apple? Well that’s something else than a coffee enema. I prefer consuming my apples the other way, in at the top and out at the bottom (at least what remains after consumption).

      2. CHotel says:

        New goal: insert as many puns as I can into my hospitals.

        1. Jon Brewer says:

          You’ll have to work at it. Euphemisms like eternal care unit (i.e., death) have existed for a long time.

  4. Sastra says:

    Back when I was in college in the ’70′s I took a psychology class which contained what I now know was a fair amount of woo — and it included a section on water births.

    As I recall, the focus wasn’t on the mother and how easy it made labor. No, it was mostly on how good it was for the baby. The infant goes from a warm, peaceful, wet environment in the womb … to a warm, peaceful, wet environment just outside of the womb. Only gradually is it gently raised from the bath and welcomed to the world in a smooth, harmonious, natural way. No harsh lights, no jarring and sudden dryness. Water births were a way to extend the comfort of the uterus to a child’s introduction to the cruel outside world. The babies subsequently ate better, slept better, and cried less.

    The part I really remember from that class though was something which jump-started my incipient skepticism. The teacher claimed that the benefits of water birth were apparently long term. Studies had been done of children who had been born in water which compared their progress at various stages to that of children who had NOT been born in water. The results were staggering. On virtually every milestone and level the water-born babies did better. They walked and talked earlier, they smiled sooner, they fought less, they were more intelligent and more peaceful … and so forth and so on. Water births had made a difference. Write that down.

    I raised my hand and asked a question: wouldn’t mothers who had chosen to birth their babies in water so the child would not be startled by sudden change simply be more likely to be the kind of mothers who would be very involved in their children’s development? Or perhaps the personalities of the people who care about this sort of thing are passed on to their babies genetically? At any rate, if water birthing wasn’t assigned at random (and the narrative had made it clear that it was all self-selected volunteers) — then how could we know the water birth had any causal effect at all?

    To my surprise the teacher agreed and said that 4 or 5 years after this remarkable study “a psychologist” had also wondered the same thing. I didn’t think “gee, I’m smart.” I thought “wait — this took 5 years? For all of psychology? They didn’t come up with this problem up front? Nobody is trying to replicate the experiment with better controls?” That was it for me. Given my experience, English Lit seemed more rigorous than Psychology.

    Interesting that neither you nor Dr. Jones was citing any claims about how water births squirt out Super Children. Either the studies didn’t replicate — or (my suspicion) they were so obviously flawed and fringe that only the eager young professor I happened to have had would have presented them positively in an undergraduate psych class.

    (Iirc, that was also the class which spent half the semester teaching I’m Okay;You’re Okay.)

    1. Chris says:

      “no jarring and sudden dryness.”

      Had these people never left a heated pool and felt that sudden chill?

  5. Naomi Rivkis says:

    I have no problem with the evidence showing that actual delivery in water is a bad idea. I worry, as a birth doula, about the pressure implicit in this article against women using water as a relaxation method during first stage labor, however. There’s no evidence suggesting it does either mother or baby any harm, which puts it — one would hope — into the wide range of potential pain-reduction tools available to a large group of women. Like any other wide swath of humanity, these women are going to have different responses to different pain-reduction methods. Taking away a harmless option which may help some women (in the same way that hot water often helps reduce any other muscle aches) seems unwise. This is a totally different category of risk — or lack thereof — from actually delivering in water, which may make Mom feel better, but actually involves the infant, whose need to be protected from unnecessary neonatal risks gets involved. I am in no way attempting to defend water delivery, but I do think there can be benefits to laboring in water before it gets to 2nd stage.

    1. Calli Arcale says:

      The other article was more clear on the distinction; in both cases, the argument isn’t against laboring in water, which appears to be fine as long as the usual safeguards against slipping are observed (there is a reason the bathroom is home to so many accidents; wet floors are dangerous), but against birthing in water.

    2. Chris says:

      “I am in no way attempting to defend water delivery, but I do think there can be benefits to laboring in water before it gets to 2nd stage.”

      The birthing center at the hospital where I had my kids installed a soaking tub for labor, with hand rails, steps and someone there to make sure all was safe. I was hoping to give a try, but my daughter was born ten minutes after I got to the birthing center. :-/

  6. Naomi Rivkis says:

    I have no problem with the evidence showing that actual delivery in water is a bad idea. I worry, as a birth doula, about the pressure implicit in this article against women using water as a relaxation method during first stage labor, however. There’s no evidence suggesting it does either mother or baby any harm, which puts it — one would hope — into the wide range of potential pain-reduction tools available to a large group of women. Like any other wide swath of humanity, these women are going to have different responses to different pain-reduction methods. Taking away a harmless option which may help some women (in the same way that hot water often helps reduce any other muscle aches) seems unwise. This is a totally different category of risk — or lack thereof — from actually delivering in water, which may make Mom feel better, but actually involves the infant, whose need to be protected from unnecessary neonatal risks gets involved. I am in no way attempting to defend water delivery, but I do think there can be benefits to laboring in water before it gets to 2nd stage.

    1. Zoe says:

      This is one case where anecdote can prove that warm water does help at least one woman. I labored in water with each of my three unmedicated births. It helped in the same way that a bath can feel good after a marathon or athletic event, relaxing your muscles. I can’t imagine birthing in the water, mostly because there is nothing to lean or grip on for pushing, and it appears to show at least some risks. If the warm water feels good in labor, what could possibly be the harm? Infection if the tub isn’t clean? Did doctors at one time argue against baths for pregnant women altogether? My labors were all average (around 16 hours, around seven pound babies) and I believe my then husband said that he felt justified complaining about being hungry and tired the whole time because he couldn’t tell I was in any pain. ;-) Water helped more than breathing, massage, walking, and any other common pain reduction techniques.

    2. MTDoc says:

      Perhaps those ” benefits to laboring” could be better meant by more conventional and rational means. Those benefits are largely due to conditioning and suggestion, actually placebo effects. And in a controlled setting, e.g. hospital environment, having a different setting for 1st and 2nd stage sounds to me to be a recipe for disaster. I do respect your thoughts on the subject, and I am indeed a dinosaur, but honestly, anything that developes without a sound scientific basis scares me to death. As a result, I practiced for 40 plus years without getting sued, although my insurance premiums have put several unrelated persons through college. Just saying, a strong relationship with a qualified caregiver is far more effective than hot water. It’s a shame that’s harder to come by in this day and age.

      1. Windriven says:

        ” It’s a shame that’s harder to come by in this day and age.”

        It certainly is. I worked long and hard to find my PCP in New Orleans – and we had that kind of relationship. When I moved to the northwest I went for three years without a regular PCP as I worked my way through the ranks until I found a keeper. I pity those who haven’t the free time and financial resources to pursue the quest. At some point your life may depend on that relationship. Is that the moment when you should be figuring out if you trust their judgment?

        1. MTDoc says:

          Ironically, I have the same problem, even without moving! Everyone I trust either retires, moves, or dies. And it is really hard to get around sharing the visit with that damned computer. That of course is my problem, being a one on one, face to face kind of guy. Appreciate your thoughts.

          1. CHotel says:

            I know how you feel. I’m in a rural area so it seems most of our physicians are perpetually leaving, I’m going to be on the hunt again in a few weeks.

            I also have the double edged sword of being a hospital pharmacist in 3 regional hospitals. In the rural setting we generally don’t have hospitalists, the FPs take care of all the inpatients (their clinic is in the same building). It’s easier to make a selection when you get to see so many of the orders the write, but it’s hard to not be constantly judging them when they write something I disagree with.

      2. Amy says:

        I must say that I had a baby last year and I LOVED my OB. I trusted her 10000%. I know too many women who had babies around the same time who were doing “research” on Google to find out if what their OB was telling them was right….when they really should have just found a doctor they trusted.

  7. Dawn Platte says:

    “Mothers may have the right to reject science and believe that “The women…speak more than any scientific article or paper…,” but do they have the right to risk the health of their helpless infants?”
    I take this to mean you would therefore be opposed to abortion, since science would definitely prove that it is a risk to the health of a helpless infant?

    1. Harriet Hall says:

      @Dawn Platte,

      “I take this to mean you would therefore be opposed to abortion, since science would definitely prove that it is a risk to the health of a helpless infant?”

      That doesn’t follow, because pregnancy is also a risk to the health of the mother, and there are many other considerations. One might just as well ask whether a fetus has the right to parasitize the mother’s body, risk her health, and complicate her life. It is a self-evident fact that abortions harm the fetus: that isn’t something science needs to prove. Opinions about abortion are based on religion, philosophy, ideology, or law, not science. Science’s role is only to inform decision-makers about things like the development of the fetus and the physiology of pregnancy.

    2. WilliamLawrenceUtridge says:

      This question carries within it the assumption that abortions are performed on children rather than on fetuses. Legal and practical realities are such that abortions tend to be performed well in advance of any potential viability of the fetus. Best practice for and most tasteful way of performing an abortion is to undertake it as close to conception as possible, which makes it curious* that so many efforts are made to delay and inconvenience people who seek them out.

      *Well, it would be curious if the concern were maternal health and autonomy. But generally those who oppose abortion are uninterested in maternal autonomy and are more interested in exerting social control over women’s bodies for reasons I can’t really understand. I mean, it’s not like the ones who oppose abortions are doing so because of a dearth of adoptable children. I prefer to think they’re just dicks.

  8. Zoe says:

    “I take this to mean you would therefore be opposed to abortion, since science would definitely prove that it is a risk to the health of a helpless infant?”

    I absolutely think this is relevant, and I come from a different POV from most here. The language of the final line is emotional rather than fact based, but regardless, in pregnant and childbirth, women still should have complete control over their own bodies. I won’t even call the fetus an infant or baby until it is born. That doesn’t mean a provider has to participate, but in the case where hospitals won’t provide water births, women will deliver at home, in some cases alone. Hospitals around here, however, do offer water birth in carefully screened cases. I wonder if that will change. My guess is that the risks of water birth are pretty small or the studies would have shown some type of mortality or morbidity, not just anecdotes or citations. I like how Dr. Hall included that she does indeed support patient autonomy.

    1. mtbakergirl says:

      I think you have made an interesting point, perhaps contrary to your intent. As soon as the fetus is expelled it becomes an autonomous being with a right to evidence based care. Immersing a neonate in water contaminated with blood, urine and feces would be abhorrent in any other situation- why would the standard change immediately post-birth?

      I used warm water for pain relief during labor and did find it very helpful in the absence of an epidural (the hospital I delivered at sent me home to labor, it is all that was available at my house:). Warmth is quite soothing in other pain, I found this principle to apply quite nicely, but I don’t find the benefits would override the risk to the baby of delivering in the water or the utility of having my care providers able to accurately evaluate my labor and the need for any interventions,

      If the risks are small then a well designed trial will demonstrate that and the practice can resume widely then, until that time lets not let the natural fallacy over-ride an assessment of the risks and benefits of this INTERVENTION.

      Finally, the right of a mother to have an unassisted birth is unassailable, and should not be used as a threat to force providers to use non-evidence based care in their practice.

  9. Jon Brewer says:

    I want to add, Harriet, that with indigenous cultures, it’s important to always add a [citation needed]. Most of the time, the original source is a sailor’s story or some missionary somewhere, leading to cries of “Show me the mermaids!” (Worst-case: I remember one dude I met online citing one Charles Sarlin, which led to a citation of Erikson, who quoted a missionary and clearly indicated he believed the missionary was lying. Sarlin was uncritical of the missionary.)

    I would also assume that rivers aren’t the same as pools. Pools, especially pools of warm water, are breeding grounds for bacteria.

    I wanted to highlight this:

    “Reduces the need for drugs and interventions
    …eliminates episiotomies
    Reduces C-section rates”

    I can see a huge post hoc here: Some OBs are more knife-happy (or needle-happy, as the case may be) than others. Not that that matters: Most couples who go in for water births don’t strike me as the type to go to a licensed OB anyway (and thus unlikely to ever see an epidural, episiotomy, or C-section), unless the OB gains a certain notoriety among water birth advocates as ‘someone you can go to who won’t bother to remind you of germs or anything like that’.

  10. Roadstergal says:

    So – for the UK folk – I have heard often that midwives in the UK are more science-based than in the US, have licensing standards in excess of US midwives, and aren’t as permissive to woo and anti-science as in the US. Does the organization/body for the UK midwives have an official stance on water birth? I have a friend in the UK who is generally pretty science-based, but when I tried to show her this link about water-births, she lashed out at me in a way I hadn’t experienced before and went on about her dislike of doctors and – well, everything mentioned above, about how water-births are the most wonderful thing ever and make the birth safer and more comfortable and C-sections more rare, etc, and importantly, that UK midwives are very much behind it – and that she’s planning a water birth for her second child. Are there any official statements from UK midwives on this?

    I’m a sciencey person, but as someone who doesn’t have kids and has no intention to, of course, any advice I give is utterly invalid. But I think she would listen to midwives.

    1. WilliamLawrenceUtridge says:

      US midwives are not a unitary body. There are two tiers – Certified Nurse Midwives (actual nurses, several yeasrs of college education, direct medical experience and training in the delivery of babies, hundreds of hours of required training and experience, supervised, generally science-based and practice in hospitals and birthing centers – probably less supportive of home birth and water birth) and Direct Entry Midwives. The Skeptical OB (Amy Tuteur) posts regular scathing critiques of the latter, who need at most a high school diploma, require only perhaps a weekend course, and are far more likely to support “stunt birthing” like water births, and oppose things like medical care, C-sections and obstetrics in general.

      I believe the US is unique in this two-tier approach, and the UK has only CNM (i.e. the trained ones who aren’t bonkers) as official professionals acting in this capacity.

      1. Roadstergal says:

        Yes, I’ve been spending some time on the Skeptical OB site after making that post, and it’s very interesting reading indeed.

  11. Rebecca Byers says:

    You should be ashamed of yourself for being so brain washed is to where you actually spend time bashing people who chose to eat what they want. If they do the research and want to heal their body through food- them they are wise and will live long. you my dear are brainwashed. and let woman have babies how they want.

    1. WilliamLawrenceUtridge says:

      Hi Rebecca,

      Food doesn’t always heal. Surely you’ve heard of lethal peanut allergies, have you also heard of favism? Look it up. Also, did you know that mentol is dangerous in sufficient quantities? Know where you find menthol? Mint. Also, do you like your kidneys? In which case, avoid aristolochia. Do you like your liver? Avoid kava.

      Food is absolutely necessary to fuel our bodies, and protein is necessary to build and rebuild cells, tissues and organs. A good diet, high in fruits, vegetables, whole grains, beans and pulses, as recommended by the USDA, the CDC, your doctor, and yo mama, will do wonderful things to keep you healthy. But food alone will not prevent or cure all disease, it won’t cure cancer, and it won’t guarantee a safe birth.

      As for water birth, you are correct that women are free to have babies how they want. But don’t you think that women should be informed of the real risks of water birth? Don’t you think they should be told that water birth stands a far-from-zero chance of drowning your baby, or causing it to die of overdiluted blood? Or catch an infection from their mother’s blood or feces? Shouldn’t women know that water birth is not particularly safe, presents unique dangers totally absent for a “dry” birth, and there is no evidence that it makes birth easier or quicker? Doesn’t it bother you that women are being lied to about water birth by some proponents? For some reason, being lied to about medicine strikes me as wrong.

  12. Rebecca Byers says:

    also, woman were created by God to give birth. all healthy woman can give birth without medical interference!

    1. WilliamLawrenceUtridge says:

      Well first off, if women were created by God, he did a right shitty job of it. Bipedal posture presents some truly terrible compromises when it comes to birth, it’s very hard to have a narrow pelvis (required for efficient bipedal locomotion) and safely deliver a giant-headed human baby. That’s why men have narrower hips than women generally – they don’t have to compromise, worry about their pelvis cracking open like a brittle stick because something is being forced out of it.

      Second, are you sure all healthy women can give birth without medical interference? Because in every culture, birth is seen as a time of risk and fear for men, women and of course babies. And how do you explain the many things that even natural child birth advocates worry about, such as breech birth? What about a woman bleeding to death due to a tear of the vaginal wall during delivery?

      Certainly birth is less dangerous than Russian Roulette, but that doesn’t mean it’s risk-free. Medicine and modern obstetrics are the reason why the death of a mother or child is now a tragedy rather than a fact of life – it’s far, far less common.

    2. Chris says:

      By the hammer of Thor, which god?

      And truthfully, I don’t like your god because without medical intervention both by baby and myself would have died.

      1. Chris says:

        Oops; “my baby and myself would have died.”

        Though the two younger ones were fine. The first one had a huge head that ripped me from stem to stern, and he got stuck. Obviously showing how stupid that “intelligent design” was… including the subsequent bacterial infection.

    3. Harriet Hall says:

      And you know this is true because…?

      Do you ever wonder why so many women died in childbirth throughout human history and how many still die in areas where medical “interference” is unavailable?

  13. Lea says:

    I didn’t see you reference this comparative study. What do you think of it?

    http://www.ncbi.nlm.nih.gov/pubmed/10971083?dopt=Abstract

    1. Harriet Hall says:

      I think it is trumped by the more recent systematic reviews I cited.

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