LIES, DAMN LIES, AND STATISTICS

‘There are three kinds of lies: lies, damned lies, and statistics.’ – Mark Twain

I’ve heard some really ridiculous things in my years attending births (and there’s even a website someone else has devoted to ridiculous things that have been heard called “my OB said what??”).

I’ve had a doctor – an OB – hold up a placenta after a birth and say, “I wonder what it is that tells the placenta it’s time to separate.” Umm….that worries me because if you don’t know how that works, how did you become a doctor? Seriously? You don’t know that?

I heard a nurse tell an expectant mother that they have to put the eye ointment into the baby’s eyes because babies are born with dry eyes and they have to lubricate them. HUH? Wow…amazing. For the record: the eye ointment is an antibiotic eye ointment used for the prevention of newborn conjunctivitis from untreated Chlamydia or Gonorrhea which can lead to permanent blindness. If, however, you do not have either of these conditions (that can even be checked for with a urine sample) – then there is no benefit to the eye ointment!! I’ve heard it claimed that it’s to protect the baby’s eyes from “any bacteria they may come into contact with in the birth canal.” First off, those poor poor babies going through such a nasty gross thing as a VAGINA!! (did my sarcasm come across in that sentence?) Second off, if you are worried about your babies’ eyes, the BEST thing for them? BREASTMILK!! That’s right Mommies…you hold magic medicine in them boobies, and it’s a more broad spectrum antibiotic than most any of the prescription drops you can purchase…all without any side effects or risk!! Yes, dripping breastmilk from your breast straight into the baby’s eyes a couple of times a day does the trick! (I’d tell you about the time I cleared my ENTIRE FAMILY of pinkeye – but my husband and teenage son would probably throttle me)

**random tip: to give a baby/toddler eye drops – lay them on their backs with their eyes closed. Put a drop of the milk/medicine into the inner corner of their eye. Open their eye and tip their head to that side and the liquid will just run straight into their eye…no fighting!**

I’ve heard statements like, “At 38, pregnancy is considered high risk because your chance of having a baby with chromosomal abnormalities is 1 in 259. That’s considered very high! So we recommend an amniocentesis. The risks from an amnio is very low – there is only a 1 in 200 chance that you will lose the pregnancy, so they are considered VERY safe. (looks at chart) Oh! Your last baby was a cesarean? So you’ll be having a repeat cesarean? VBACs are too dangerous – uterine ruptures occur in 1 in 500 births! If we did VBACs, there’s a 1 in 2000 chance that your baby could die! No, we don’t take that much risk – you’ll have to schedule a C-section which only has a 3.4 in 2000 chance of causing your baby to die – and even though there is a 3 times greater chance of you dying if you have a C-section rather than vaginal birth, we still consider that risk very very very low!”

RECAP:

Downs risks at 38                       1:259
Amnio risk of miscarriage         1:200
VBAC rupture risk                      1:500
Rupture baby death risks         1:2000
C-sec baby death risk                3.4:2000
C-sec mom death risk               3X greater than vaginal birth

These are TRUE statistics, so they are not mistaken in the stats – but I have heard the above statement almost verbatim on television and in person! I guess the term “too much risk” doesn’t have a real clear definition, does it? That being the case, shouldn’t it be the parents’ definition?

NOTE: the above stats/figures can be easily found online in multiple sources, but here are some quickies specifically for the numbers listed above:
Baby death rate C-sec
Mother dreath rate C-sec
Uterine rupture risk baby death
Downs Syndrome  risk by age

Amnio miscarriage risk
Uterine rupture risk

I recently had a friend of mine tell me that she heard a midwife once claim that if you’ve been induced with Pitocin, that your body can become ADDICTED to Pitocin and you will probably need it to give birth in the future – and asked me if I knew anything about that. I had never heard such a claim! It is unclear to me whether the midwife said this as a way to talk the mother into being induced or to prevent her from having a homebirth or keep her in the hospital or because she really believes this!! I know that I don’t know everything (far from it) – but after hearing that I did a little research, and nowhere could I find anything to support the idea that a HORMONE given years prior for just one day and which is considered out of your system in 3-7 minutes after we disconnect the IV,….that it could cause a uterus to become addicted to it!! Dat’s just silly talk.

I’ve heard the bait-and-switch game played with medical terms many many times. Mom says, “I don’t want Cytotec, I’ve heard scary things about that!” and nurse says, “Oh no, this is just a little pill called miso….it is just a little pill and will help induce labor.”. Miso…full name misoprostil…IS CYTOTEC!! That’s like saying, “I’m not going to give you a Tylenol…just a little acetaminophen..” BAH – it’s the same thing! Or, “Here we don’t do spinals, don’t worry…we’re going to do an Intrathecal instead”. Again – same thing! Two different names for the same thing! (Intrathecal is the name of the space it is administered into) And yes, a “little snip” is the exact same thing as an episiotomy.

Finally, I’ve heard someone say that their cousin had a homebirth, but that they wanted prenatal care and medical care during the birth so they were choosing an OB and hospital birth. I don’t know whether to laugh, or cry, or just sigh and walk away.

I’ll walk away.

27 Comments

  1. Michelle H wrote:

    I just heard last week that an OB tried to talk a woman out of a VBAC because her uterus has a 1 in 100 chance of rupturing. Um, so in other words, she has a 99% chance at a VBAC without rupture, right? Do people hear themselves when they talk?

    Wednesday, March 3, 2010 at 12:48 pm | Permalink
  2. Rose wrote:

    One of my favorites is that the epidural has no risks and/or doesn’t get to the baby. Can’t tell you how many times I’ve heard that one right before or after the signing of the “informed consent” form.
    I’ve also heard, “This is Pitocin, a completely natural synthetic hormone.” LOL

    Wednesday, March 3, 2010 at 12:53 pm | Permalink
  3. Maren Meacham wrote:

    Amazing how trusting people can be when a Doctor says something and don’t question it. I have become one that has to know it for myself. It’s amazing how misinformed people are. It’s like the game telephone, by the time it gets to you who knows what the truth was. Making an informed decision was the best thing that you taught me and that it was up to me.

    Wednesday, March 3, 2010 at 1:19 pm | Permalink
  4. lauren curleyhair wrote:

    everytime i read your blog, i just yes, really? wow! and i completely agree. I’m so glad someone does research – especially if they are a doctor!!
    who are these ” professionals!?”

    Wednesday, March 3, 2010 at 1:36 pm | Permalink
  5. Amy Drorbaugh wrote:

    Ditto on the “epidural has no risks”! It’s always amazed me how women will give up smoking, drinking, coffee, soda, sliced meats, and all medication while pregnant and then present themselves at the hospital to be pumped full of drugs!

    Stephanie- I’m glad I’m not the only mom pinning my older kids down and squirting breastmilk in their eyes! LOL It really works!

    Wednesday, March 3, 2010 at 1:52 pm | Permalink
  6. Rebekah C wrote:

    Wow. It’s amazing the powerful feelings that are roused from hearing some of that crap. I know for certain I could not survive in a hospital environment, if I ever do become a mw. It was this that decided for me that I would go the cpm route and not cnm. I would SO loose my job in a week, lol.

    Wednesday, March 3, 2010 at 1:53 pm | Permalink
  7. Jennifer L wrote:

    I *heart* your blog Stephanie! Thought I would share one of my favorite sites on the “Relative Risks of Uterine Rupture” (you will love the statistics) http://www.gentlebirth.org/archives/vbacrisk.html

    Wednesday, March 3, 2010 at 2:49 pm | Permalink
  8. Lindy wrote:

    It’s this kind of misinformation out there that makes me reluctant to say I’m even pregnant- let alone planning a home birth! UGH!!!

    Wednesday, March 3, 2010 at 4:26 pm | Permalink
  9. Emily Albright wrote:

    My OB told me it was impossible to get a yeast infection in my uterus. I wonder if they just make up information now?

    Wednesday, March 3, 2010 at 6:06 pm | Permalink
  10. elfanie wrote:

    Emily: I, too, have never heard of a uterine yeast infection….and a quick search online doesn’t show anything. can you tell me more about this? (and sources would be wonderful)

    Wednesday, March 3, 2010 at 6:34 pm | Permalink
  11. Thanks for the shout out! We encourage you to send these comments on to My OB said WHAT?!? to be shared with the MOSW readers. The words and actions that birthing women are exposed to really matter.

    Wednesday, March 3, 2010 at 7:59 pm | Permalink
  12. Jennifer Weston wrote:

    Shared once again. Brilliant as always.

    Wednesday, March 3, 2010 at 11:17 pm | Permalink
  13. Diana J. wrote:

    On the “pitocin addiction” thing – I had a friend whose labor was induced with pitocin (leading to cesarean). Her doctor told her that since her body hadn’t gone into labor naturally with her first labor, it would not “know” how to go into labor with any subsequent pregnancy and all of her subsequent labors would have to be pitocin-induced as well. Hmmm. Her second baby was induced with pitocin and turned into another unnecessary cesarean.

    Thursday, March 4, 2010 at 6:03 pm | Permalink
  14. Kelli wrote:

    On that note, I’ve heard so many women say things to the effect of “Oh pitocin made things so painful with my first two, it was so much easier to cope when labor started and progressed on its own with my other kids.” So how is it they know the difference in sensation if they had their first two induced, did they asto-project into a laboring womans body, or did their subsequent labors start and finish on their own? Which sounds more likely? I’m pretty sure their bodies work or we as women would be in one heck of a mess if we ever found ourselves stranded on a desert island and pregnant after an induction. Upon rescue they’d find us pregnant with a teenager, and if they thought that 8 pounder was a good excuse for a CPD c-section well….just imagine that.

    Thursday, March 4, 2010 at 7:06 pm | Permalink
  15. I can hear from this that you don’t have a lot of faith in the medical system, but a lot of what you area saying is quite inaccurate.

    Amnio risk for ruptured membranes is less than 1:500, and even in those cases they usually seal over. Your stats are based on very old data before the use of ultrasound and with much thicker amnio needles than we use now. Check the FASTER study by D’Alton et al for the newest data. Irrespective of that risk, some people would rather risk aborting a normal fetus than give birth to a T21 child. Its a personal choice. Pretty much the only reason to do an amnio at all is to give the opportunity to abort an affected fetus.

    Miso has never been shown to lead to fetal harm, and definitely speeds delivery. If you don’t like inductions fine, but miso is an excellent and safe induction agent.

    Pitocin is atom for atom identical to the oxytocin produced in the posterior pituitary, so the comment you quote is quite accurate.

    We don’t know exactly what makes a placenta detach, so I don’t know what is wrong with a comment correctly stating what we don’t know. We certainly don’t know everything. Your comment implies that you know exactly why a placenta detaches, so please enlighten the rest of the world.

    1:100 risk of uterine rupture is real, and a uterine rupture is a surgical emergency that can lead to fetal injury and death. Small chances of catastrophic outcomes are real and should not be discounted. I’m a VBAC supporter but to pretend that risk is irrelevant is to deny reality.

    You’re right that prior exposure to pitocin in a previous delivery would have no impact on a future delivery. That one was pretty off.

    Thanks for visiting my blog and podcast!

    Friday, March 5, 2010 at 2:04 pm | Permalink
  16. elfanie wrote:

    Dr Fogelson:

    While I did cite the websites I got quickly looked up and got the statistics from, with further looking I found a source I think that you will agree would be considered reliable by anyone..

    Amniocentesis: According to the CDC ( http://www.cdc.gov/mmWR/preview/mmwrhtml/00038393.htm) an amnio carries a 1:200 to a 1:400 chance of miscarriage. While you are correct that if someone is willing to risk the miscarriage of a healthy baby rather than carry a T21 (Downs Syndrome) baby, that is absolutely their right! My objection is to the conclusions that many people (and this is not exclusive to physicians) come to and state as to what is “safe” and what is “too dangerous”. In the example I gave in the post, to say that a 1:400 risk of miscarriage from amnio (that’s the ‘best case’ stat) is “very low risk – actually, that’s quite safe” and then to turn around and say that a 1:2000 chance of fetal death from a VBAC is “high risk! Too dangerous…we should do a c-section instead!” (which carries a much higher risk rate for the patient and the baby)…is absurd. The risks she is willing to take should be up to her with full disclosure.

    You talk about the 1:100 risk of rupture…that’s not accurate. That’s simply not true. According to Enkin (2000), the risk of rupture with a VBAC worldwide was .09-.8 in a systematic review. That is VERY below your quoted stat of 1% (if we take my ‘best case stats” for my argument since I give you the “best case stats” for your with amnio) When you say, “it can lead to fetal injury and death” – so can an ERC (elective repeat cesarean) – at a much higher rate. I don’t believe the risk is irrelevant as I keep any risk in the back of my mind…but I think you are gravely overestimating the risks. (and again – to say that the risk of death of the baby from an amnio of 1:400 is “low” but the risk of death of the baby with a VBAC rupture is 1:2000 is ‘high’ just seems a bigh askew to me.)

    As for detachment of the placenta…it’s initiated through involution and the discrepancy in vessel sizes between the placenta and uterus, is it not? (this was my teaching – while I’m not a placental expert and always welcome further educational opportunities and would welcome your thoughts)

    As for your comments on Miso….wow, and I’m CERTAIN that you will get plenty of comments in response from many many people…so I hope you’ll understand if I hold off on responding to that one for a while. (although I will say that I respectfully disagree. while i would never question the EFFECTIVENESS of it as an induction tool, I highly question its safety as so many others have, including Marsden Wagner, the former head of the Women and Children’s Health at the World Health Organization)

    My faith in the medical system is huge! Not only my faith, but my respect….(especially since I consider myself a member of said community). What i do NOT have respect for is stupidity…and that is absolutely NOT regulated to the medical system! (there are idiots everywhere!) You will notice that one of the things commented on was said by a midwife….

    But such thought provoking discussion is wonderful and I am beyond pleased that you are reading and contributing to the discussions on this blog!!

    Friday, March 5, 2010 at 5:29 pm | Permalink
  17. elfanie…. I just love you! rock on momma! you have the passion, and still have the where with all to do the advocacy! You make the birthing community proud! keep it up!

    Friday, March 5, 2010 at 6:33 pm | Permalink
  18. Shari wrote:

    “Pitocin is atom for atom identical to the oxytocin produced in the posterior pituitary, so the comment you quote is quite accurate.”

    Having experienced both pitocin-induced labors and spontaneous labors, I can assure you that atom-for-atom identical or not, the effect on my body (and, as an extension of that, I would venture a guess that what my baby was feeling as well) was NOT the same.

    Friday, March 5, 2010 at 6:49 pm | Permalink
  19. elfanie wrote:

    One of the reasons it would be so different on you and your baby, Shari….is because when oxytocin is produced by the pituitary in a natural labor, it ebbs and flows – going up and down constantly….as opposed to a constant flow (drip) into your vein. Also because your body would regulate how much to produce according to other things in your body…as opposed to us who usually want to get the contractions into an “adequate pattern” as quickly as possible. For example: with a natural labor you might have contractions 10 minutes apart for 6 hours, then 8 minutes apart for 4 hours, then 5 minutes apart for 6 hours….whereas we would turn the Pitocin up every 15-30 minutes until an “adequate pattern’ is established, which is usually ctx 3-4 min apart from that point until delivery.

    So while Pitocin and Oxytocin are molecularly the same…we can not mimick what the body does with it in labor (the ebb and flow as well as amounts)

    Friday, March 5, 2010 at 7:00 pm | Permalink
  20. elfanie wrote:

    Cytotec:
    some websites you might be interested in looking at..

    http://www.cytoteccase.com/

    (while this is from “midwifery today”, it is written by former director for the WHO Marsden Wagner)
    http://www.midwiferytoday.com/articles/cytotec.asp

    (an article by well know statistician Henci Goer)
    http://www.scienceandsensibility.org/?p=467

    (an article by Ina May Gaskin)
    http://www.whatisaids.com/cytotec107.htm

    http://www.oshmanlaw.com/pharmaceutical_litigation/cytotec.html

    Friday, March 5, 2010 at 9:28 pm | Permalink
  21. Shari wrote:

    Just another reason mother nature rocks! 🙂

    Friday, March 5, 2010 at 11:17 pm | Permalink
  22. Jennifer L wrote:

    I think the one piece of documentation that speaks volumes is the letter from the drug company itself: http://www.cytoteccase.com/FDA%20Safety%20Alert.htm

    Saturday, March 6, 2010 at 12:24 am | Permalink
  23. elfanie wrote:

    here is another link about Cytotec from the FDA that was passed on to me:
    http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm111315.htm

    Saturday, March 6, 2010 at 12:49 am | Permalink
  24. I recently started a group on facebook for those of use who have been (or know someone who has been) impacted by Cytotec induction for labor. The FDA released a warning to OBGyns in 2005. That in and of itself should be enough to have any doctor discontinuing this incredibly dangerous drug -when used for the purpose of inducing labor. That would leave me running from the office of the above doctor without question! How scary and pompous to be playing roulette with your patients.
    There are thousands of individuals who share their stories daily attributing Cytotec to deaths and disfigurements. Thanks to all of you who continue to shed bright light on the realities of induction of women and the risks that are involved!

    Saturday, March 6, 2010 at 6:20 pm | Permalink
  25. bronwyn wrote:

    dr folgelson

    cytotec / misoprostal is not indicated for use as a labour enhancing drug. it is indicated for gastric use. women have had uterine ruptures that have killed both them and their babies.

    here are some links.
    http://www.nrlc.org/news/2001/NRL01/randy.html

    http://www.midwiferytoday.com/articles/misoprostol.asp

    http://www.oshmanlaw.com/pharmaceutical_litigation/cytotec.html

    here’s the package insert, which clearly states that the drug is not to be used on a pregnant or labouring mother.

    do some research before you counter claims. i hope you dont use this drug in your practice

    Thursday, March 18, 2010 at 3:43 am | Permalink
  26. bronwyn wrote:

    sorry, here’s the package insert
    http://www.cytoteccase.com/Links.htm

    Thursday, March 18, 2010 at 3:44 am | Permalink
  27. Melinda Davis wrote:

    From what I’ve read here you are skeptical of what doctor’s and nurses in the medical field are telling you. However, who do you think writes the articles from which you are obtaining your information? Doctor’s. I’m not saying you’re wrong, but this needs to be mentioned.

    Friday, November 1, 2013 at 7:24 pm | Permalink

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