From Issa:
That's really funny. Regardless of what anyone thinks of the content, as far as blogs go, this one is really successful. There was a post the other day with over 500 comments! 
I'm tempted to vote for you so you can win this silliness!
From Squillo:
Maybe first prize is an all-expenses-paid trip to the "Trust Birth" conference. (Second prize: TWO trips.)
From Dianne:
Looking at the nominees, I'd say they come in two types: truly awful blogs and blogs that have offended someone who is hoping that this nomination will be some sort of revenge. Guess which category I'd put this blog in...
From A Sarah:
LOL. How original.
Well, for my part, I've invented a virtual drinking game of home birth advocate cliches. Care to help me expand it?
"'Dr.' Amy," with the title in scare quotes = take a drink
"as safe or safer" = take a drink
"designed to give birth" = take a drink
"OBs are surgeons" = take a drink
a post in which someone simultaneously uses an outright insult (i.e. "idiot") and then tells Dr. Amy and everyone who agrees with her to get over their anger issues = take five drinks
confusion of perinatal/neonatal mortality = take a drink
Any version of "My midwife has attended SEVENTY-FIVE WHOLE BIRTHS and not ONE has resulted in a dead or damaged baby or mother" = take a drink
"How can you say I'm uneducated when I've spent hours and hours 'educating' myself by reading material from MDC, Mercola, and ICAN!" = take a drink.
You should try it. It makes the comments threads a lot easier to bear sometimes. I'm thinking of just starting to respond to some of the silliest comments with a simple 'Glug!' and leave it at that.
From Dianne:
A Sarah: Other possibilities:
Asks why Dr Tuteur's license is not active or reports (as if a major discovery) that it is not: take a drink.
Explains how deaths in childbirth (maternal or fetal) are necessary to make the species "stronger": take 2 drinks unless you're one of the people who they wish had died in childbirth, in which case drink the whole bottle.
From Dianne:
Oops, almost forgot: Mentions MRSA: take a drink.
From Susanne:
LOL!
How about "CPMs are more trained than OB's because they sat bedside for the 10-20 births they attended in training, and didn't just run in to catch the way the OB's did when they were residents." Glug!
Hey AyCarumba, check out this thread ... don't say we don't have a sense of humor!
From A Sarah:
Dianne: "take 2 drinks unless you're one of the people who they wish had died in childbirth, in which case drink the whole bottle."
SNORT!!! Roflol....
From m:
Awesome, A Sarah!
Ok - take a drink when someone says OBs do a certain thing because of LIABILITY or MALPRACTICE as though that meant they'd do things *extra dangerously* to avoid them.
From Squillo:
A few more:
1. Mentions off-label use of Cytotec = 2 drinks.
2. Uses Semmelweiss in a sentence = 2 drinks.
3. Capitalizes "Midwifery Model of Care" = 1 drink.
4. Uses phrase: "...forced to lay [sic] flat on her back..." = 1 drink.
From Chris:
Take a drink when the buzz words "passionate about X...." Get thrown around...
From Chris:
also "woman centered' and unhindered. Which makes me think the baby could be hypoxic in there but hey this is woman centered!
From Desiree:
oh this is hysterical. here are mine:
"cascade of interventions" = 1 drink
mentining thalidomide = 1 drink
From Susanne:
"ACOG is a trade union!"
Bottoms-up!
From Susanne:
"I don't wish to be numbed from all that life has to offer."
"There's a certain amount of inevitable wastage in birth."
Cheers!
From m:
drain the glass when someone provides a link to a totally unsubstantiated essay, full of the above cliches, about how great homebirth is, like they figure it'll BLOW OUR MINDS!!!
From EverCurious:
But first, line up a liver transplantation donor. You'll need it!
Also: any mention of 'medwife', drink.
Equating CPM with CNM, drink.
Implying that OBs and hospitals are mean and either driving DEMs away or just plain refusing to work with them out of meanness, drink.
Anytime a bibliography salad is posted, drink.
...
Wouldn't preparing a bingo card be, um, safer?
From Susanne:
"Amy, have you ever SEEN a homebirth? You'd change your tune if you saw it."
"Amy, have you even give birth? I don't believe it. How did you give birth, anyway?"
I'm about to get cirrhosis over here from all this drinking. Maybe I should go find a direct-entry gastroenterologist. The qualifications are that you've digested food your very own self!
From Desiree:
"every study ever done has shown homebirth to be as safe or safer than hospital birth" followed by a link to the J&D study ( this is my personal favorite) = a round of tequila shots on me
(and a round of sparkling ciders for the 5 or so of us pregnant ladies that hang around here)
From Stephanie:
Okay-two sides can play at this game. If you gals all have such a great since of humor...
"birth is inherently dangerous"-take a drink
"Homebirthers are white, well off, and moderately well educated" take a drink
"homebirth is like saying don't wear your seatbelt, I'm a safe driver" take a drink
I guess things will get alot more fun if we are all inebriated, but there will be a lot more typos!
From Stephanie:
I'm not even drunk and I'm making stupid mistakes! I meant sense of humor
From Student_Midwife:
You guys forgot...
Unnecessary CS...5 drinks.
Davis and Johnson said...1 drink
From Esther:
A person can get nice and drunk from every time the J&D study is dredged up as "proof" homebirth is as safe (or safer) than hospital birth.
Just sayin'.
From Amy Tuteur, MD:
A Sarah,
You're brilliant!
Women have been giving birth for thousands of years without doctors = take a drink.
If birth weren't safe, we wouldn't be here = take a drink.
Birth is as safe as life gets = take a drink.
Use empowered in a sentence = take a drink.
Unmedicated birth is an achievement = take a drink.
Use "birth" as a verb = take 2 drinks.
From Kim:
The term "mama" - drinks on me!
From FRMRL&D:
ROFL!!
How about- Hospitals are meant for sick people, not women giving birth?
Take a drink.
From Squillo:
In the spirit of fairness, here's a few for you, Stephanie:
"DEMs are woefully undertrained..."
"I don't need a BFF..."
"Childbirth has always been a leading cause of death for young women..."
"Homebirthers choose to place their experience ahead of their babies' safety..."
(That I agree with most of 'em doesn't make them any less cliche.)
From Stephanie:
Oh Squillo, I love it! I'm feeling tipsy already. This is a nice deviation from the norm.
From Stephanie:
Oh Squillo, I love it! I'm feeling tipsy already.
From Stephanie:
OOps The first one didn't post for a long time so now there are two! Amy you should delete the second one!
From Sailorman:
Y'all are forgetting some of my favorites!
If you think you can reduce Type II error without raising Type 1 error: drink.
If you use terms like "unnecessary" and "unneeded" without understanding error at all: drink.
If you confuse a prospective view with a retrospective view ("the baby was fine, so she didn't need a C section after all!") then that's my personal favorite: have a whole bottle!
From Sailorman:
More:
If you talk about MD training without knowing what MD training entails (yet another one of my favorites.)
If you use the words "science" and/or "logic" in the same paragraph where you assert an unsupported "belief."
If you talk about what God does while simultaneously ignoring all those facts (you know, what god did, if you believe she exists)
From Aubrey:
So what do you do if you are guilty of saying some of those things? Drink double?
From Stephanie:
Aubrey-there you are!
From Aubrey:
Yes, Ello!
From Stephanie:
I just looked and the results are in. Dr. Amy came in eighth place for worst blog below Perez Hilton and The Drudge Report.
From Carrie:
How about this one
YOU GUYS ARE A BUNCH OF IDIOTS!!
Drink yourselves silly!
Tootaloo!
From Emma B:
Anytime a bibliography salad is posted, drink.
Drat, EverCurious, you stole mine!
Here's another: "We do dangerous things every day, like getting in a car and driving."
And one for the other side:
"Unmedicated birth is a preference, just like chocolate versus vanilla ice cream"
Sadly, this is not a very good game for a pregnant woman who is having trouble keeping liquids down today... but I appreciate the laughs!
From Emma B:
Oh, another favorite of mine:
Use of the phrases "birth trauma" or "birth rape"
From angela:
Sadly, I must join the gestatin' non-drinkin' ladies, but I have long wanted to create a Jeff Foxworthy list of "You might be a home/natural birth advocate if ..." (in the tone of "You might be a redneck if ...").
Have you ever waxed indignant about big epidural needles in your spine? Thennnnn ... you might be a natural birth advocate!
Do you like to go on and on about epidural risks, yet not dwell much on the risks of home birth? Thennnnn ... you might be a home birth advocate!
Do you often use the phrase "cascade of interventions" without questioning whether it is true or relevant? Thennnn ... you might be a natural birth advocate!
Have you ever said a doctor just wanted to get back to his golf game? Thennnn ... you might be a natural birth advocate!
Do you often find yourself saying, "Well, we don't know for sure that intervention X is not risky"? Thennnn ... you just might be .... a natural birth advocate!
Do you often make neat, tidy distinctions between "low risk" and "high risk" as if never the twain shall meet, or when they do, they seamlessly transfer from one state to the other? Thennnnn ...
Have you ever said the words "fear-pain-tension" cycle?
Assumed a 5-minute drive to the hospital equals ~5 minutes to help?
Thrown out the words "routine episiotomy" or "lithotomy position" to bolster your argument?
Accused intelligent, clear-thinking women of being (merely) "left-brain" thinkers, not feelers like you?
Debated the simple seatbelt analogy to death until it no longer resembles the simple, but powerful point it was originally supposed to make and you yourself can no longer see the forest for the trees, but are satisfied enough that you lodged your vehement and tedius disagreement?
From Stephanie:
Emma B-
"Birth Rape" deserves its own bottle of Patron!
From Susanne:
Do you believe that a nurse repeatedly offering you an epidural ruins your birth experience, but not realize that fetal bradycardia at home without access to an operating room really ruins a birth experience even more?
Thennnnnn .....
From A Sarah:
Carrie: "How about this one
YOU GUYS ARE A BUNCH OF IDIOTS!!
Drink yourselves silly!
Tootaloo!"
Tut tut... So sad when people can't hold their liquor, lol.
From Aubrey:
LMAO A Sarah!.....still laughing!
From Erica:
How about a drink for:
Eating protein prevents preeclampsia (Take 2 drinks if you HAD preeclampsia.)
Shoulder dystocia is always easily managed with the Gaskin maneuver. (Take 2 drinks if you had shoulder dystocia.)
Breastfeeding being "sabotaged" by epidurals, c-sections, etc. (Take 2 drinks if you breastfed your child.)
Using the terms "sliced open" or "cut out of me" to describe a c-section. (Take two drinks if you had a c-section.)
From Caryn:
You know, that means for an awful lot of *single posts* around here I would need to take 6 drinks.
From Squillo:
D'ya suppose Carrie is a homebirth advocate or a Temperance Unionist?
(And we all owe big bucks to the PF for this thread.)
Caryn, my check's in the mail.
From Fiona:
*hic*
From Liz 1:
Well, I know you are all to drunk to care, but I think this is a very sinister. Worst blog? Wow! Bit like a bunch of troglodyte who thinks we should all go and live in caves. Who are these HBs? More cult-like than ever.
From Dianne:
D'ya suppose Carrie is a homebirth advocate or a Temperance Unionist?
Wasn't there a famous prohibitionist who went by the name Carrie Nation? Or am I confabulating?
From Carrie:
Homebirth Advocate!
From Diane:
I have a terrible hangover, but it was so worth it!
From Anonymous:
I have often wondered why HB advocates, who constantly complain about exclusion from the mainstream health care system, don't appreciate all of the time and effort that Dr. Amy puts into this site. The majority of OBs discourage homebirth, but most assume that their reasoning is obvious, and would not put their energy into debating it. On this site, every argument, no matter how repetitious or unsubstantiated by research gets a thorough and thoughtful response.
I have personally learned a lot here. Namely, that when confronted with a suggestion of an alternative medicine solution, I should apply the same standards of EBM that I would apply in any other situation. Thank you, Dr. Amy. Although I don't personally know you, I know that you are a great teacher.
From Liz 1:
I may be lacking a sense of proportion, but I would have hated it if "they" had voted in large numbers. There is so much drivel on the internet, and if you don't like a site, stay away from it. Back handed compliment, I suppose. A bit of reality, and their bubble might get burst.
From Antigonos:
[Squillo]2. Uses Semmelweiss in a sentence = 2 drinks.
~~~Only ONE drink if "Semmelweiss" is spelled correctly.
LOL!
From Antigonos:
[Susanne]I'm about to get cirrhosis over here from all this drinking. Maybe I should go find a direct-entry gastroenterologist. The qualifications are that you've digested food your very own self!
~~~And had a life-changing experience from eating!
From Amanda:
Congrats, Dr. Amy. You should be proud to have put such a bee in their bonnets they resorted to this.
From Jenni:
I think that Dr. Amy's blatherings are just that. She goes on and on because she and her cronies at ACOG are threatened by the increase in patients making choices.
Drink all you want... just shows how silly all of you really are... sad that you are so uninformed.
Proud, educated home birth mama, who has had 2 babies with a 3-year direct entry, licensed midwife.
From Kneelingwoman:
So, while you all were having such a riotous time insulting each other; nearly 400 babies died in subsaharan Africa because there are no Doctors OR Midwives around to attend them....oh, yeah, I forgot, you're all here drinking while they die...silly me!
I recently attended an international conference for the Millenium Deveopment Goals on Maternal Health and the number I quoted is accurate! Why are we all here? Why are any of you spending this kind of time quibbling about homebirth in America while an entire continent of mothers and babies are dying completely preventable deaths? If "preventable deaths" and "babies dying because of someone's choice" is the core issue here; then I am simply not seeing something crucial in this dialogue. Why is this one, small issue so outrageously important to you all?
From Caryn:
If "preventable deaths" and "babies dying because of someone's choice" is the core issue here; then I am simply not seeing something crucial in this dialogue. Why is this one, small issue so outrageously important to you all?
In my case, frankly, it's that I spend hours and hours out of my week explaining to frightened and/or grieving women what, exactly, preeclampsia is, and working to support an organization which has, among its other aims, funding research into preeclampsia, and extending the protection of magnesium sulphate into countries that cannot currently offer it. This website is merely an amusing distraction -- the number of midwives who come in touting the Brewer diet makes it really obvious that we've got a lot of work to do, yet, considering how many of them seem utterly unaware of the lack of research support for Brewer's claims.
And my midwife *completely screwed up my care* because she didn't know better.
Why yes, I do take being lied to personally. Don't you?
From Liz 1:
And I was one of Caryn's women (not literally) and the complacency that allows any women to believe that childbirth is a kind of private extreme sport and ignore the fact that less priveleged women are still suffering unimaginable horrors offends me. I'd sign on for any campaign to alleviate that. Personal choices aren't detrimental but public rhetoric is.
From Amy Tuteur, MD:
Kneelingwoman:
"So, while you all were having such a riotous time insulting each other; nearly 400 babies died in subsaharan Africa because there are no Doctors OR Midwives around to attend them....oh, yeah, I forgot, you're all here drinking while they die...silly me!"
I am so glad that your son is recovering from his recent illness.
With all due respect, I never understand comments like that above. Those 400 babies would have died in sub-Saharan Africa regardless of whether we were commenting on this blog or not. Why invoke their tragedy to make the claim that we are wasting our time here? You can't possibly be suggesting that what we do here contributes to their deaths or that what we do here keeps us from preventing their deaths.
This is just the tip of the iceberg of an important problem in philosophy. Are individuals to be condemned for going about their daily lives, with it small disappointments and enjoyments, while others are suffering?
Is it acceptable for you to offer 1-2 hour appointments to well off American women while millions of African and Southeast Asian women have no appointments at all? Is it morally defensible for you to spend your professional time helping middle class American women have a certain kind of birth experience while tens of thousands of women around the world are dying for lack of skilled birth attendants? I believe it is acceptable and that American midwives should not be condemned for providing what amounts to luxury services for a small group of privileged women while at the very same time, women and babies around the world are dying for lack of basic services. I believe that it is acceptable for you to spend time on your personal blog and on interacting with the people who read it. I hope that you believe that I am entitled to do the same.
From Antigonos:
I want to apologize in advance if this post offends anyone because that is not my intention.
I began my career in a New York hospital that catered originally to an Orthodox Jewish population. Over the years, while we still had a lot of religious Jews (largely because the hospital kitchens were kosher), we found our catchment area becoming more and more Puerto Rican. I felt much less connection with them than with "my own". Then, when I moved to Israel, I thought, now I'll be helping Jewish mothers, a thought which pleased me. Except that the Arab birthrate in Jerusalem's hospitals is extremely high. As long as they are Israeli Arabs, I can't really object; they are citizens as much as I am. But when my tax money goes to pay for a Palestinian who wants me and my children dead, and who glorifies suicide bombers, my compassion runs thin. I care for them, but not with any real enthusiasm. Does this make me morally defective?
This debate is almost exclusively about the state of home birth in the US. It's not about Africa. If the state of the maternity services in Africa distresses you, there's nothing to keep you from going there (assuming you can get the requisite permission to practice). I, for one, find I've got quite enough work right here for me, with my own people. And I suspect that midwives, labor coaches, doulas, etc. in the US have enough to keep them busy. Besides, if we're talking about helping the disadvantaged, uninsured, destitute, there are plenty of them in the US--you don't have to travel half around the world.
So please, let's keep things in perspective. There are those who can organize and feed literally thousands in Darfur and there are those whose impact on the world is one on one. If my contribution here, for example, has made Aubrey and Stephanie re-evaluate their plans on how to become midwives, then I can claim a small victory. If I give a woman in need of support, whether in labor, or having fertility treatment, or with an impending miscarriage, a shoulder on which to lean, then I've succeeded in my "mission". Nothing else really matters. I can't solve the world's problems.
From Susanne:
"This debate is almost exclusively about the state of home birth in the US. It's not about Africa. "
Which also begs the question as to whether the best use of limited health care resources in the US is *really setting up a second, inferior class of midwives to provide homebirth services to middle-class American women solely because their lower lips tremble and they get all Sad at the idea of going to a hospital because they won't get their Very Favoritest Experience (TM).
From Chris:
"So, while you all were having such a riotous time insulting each other; nearly 400 babies died in subsaharan Africa because there are no Doctors OR Midwives around to attend them....oh, yeah, I forgot, you're all here drinking while they die...silly me!"
And while you are writing this sentence my friend Rita is in Costa Rica helping out in a substandard OR. She does this every winter. She is an OR nures. My other coworker Melissa is in Kenya working on a orphanage. The girls on my floor at the L&D department gave her hundreds of dollars all together to make the trip and help out the orphans.
We save everything we do not use in the OR and ship it to Kenya with Melissa.
My Daughter is currently finishing her scrub tech course so she can join Doctors with out borders. I don't agree with her plan and I hope she changes her mind or at least I hope the border is South America.
I also support a group that is starting a girls school in Afghanastan. So we can multitask... We can insult each other and do our little piece to help the world.
I am not unusual. Most of the nurses and Doctors I have worked with have done some type of volunteer work in their career.
I appreciate a well thought out insult. I find it entertaining. No matter who is getting insulted.
From Susanne:
"So, while you all were having such a riotous time insulting each other; nearly 400 babies died in subsaharan Africa because there are no Doctors OR Midwives around to attend them....oh, yeah, I forgot, you're all here drinking while they die...silly me!"
Tell that to the doula community. They serve as hand-holders and cheerleaders to middle-class American women who want for nothing when it comes to health care but just want an Even Better Experience (because the birth of a child is, apparently, not satisfying enough as it is). That's pretty frivolous when you put it in the context of underserved women both in the US and abroad, no?
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