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    Questions? Ask Henci!


    Find out what other moms-to-be are asking. Join in the discussion with Henci Goer, whose expertise is determining what the research tells us best promotes safe, healthy birth. If you would like to contact Henci outside of the Ask Henci forum, send an email to Goersitemail@aol.com.

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    Archived User

    Can someone please tell what the deal is with that blog? I'm doing some work on homebirhs and I was excited to see the blog and thought 'what a great idea'. Until I realized that it wasn't a debate at all but a tirade against anything not pro-interventionist obstetrics. When I said something 'out of line' , I was personally attacked and accused of endangering my child (I mentioned that I'd had a large fetal size estimate but still had a natural birth, which is in accordance even with ACOG guidelines as the estimate was just under their limit). I was absolutely shocked, to say the least. I found my words twisted, changed and out of context and when I pointed out glaring errors, they were completely ignored. Is this site actually rabidly anti-homebirth? Who is the blogger? Is she really a doctor? Is her critique of Johnson and Daviss justified?

    Thanks!

    Henci Goer

    Ahh, I see you have run across Amy Tuteur, our very own Bill O’Reilley of the birth world. Like him, her intent is to steamroller you; any overlap with the facts in her rants is strictly coincidental.

     

    Some weeks ago, someone e-mailed me asking who she was. I said that I didn’t know, but it might be interesting to poke around on the internet and find out. A week or so later, my correspondent got back to me. She wrote that she could verify that Amy is a real person, but not that Amy is an M.D., much less an obstetrician. At least, she could find no license to practice medicine for Amy. My correspondent also found that some of Amy’s domain names are held publicly, but who holds the registration on homebirthdebate.com is not, which is something that can be done at an additional fee. This raises the question of why she would conceal the domain backer, especially since she has not done this with the others. She has also gone to the trouble and expense of copyrighting homebirth debate, which denies others access to the term. My correspondent speculates that Amy may be fronting a disinformation campaign. Blogs have become a common tool for this sort of thing. It’s an interesting, if somewhat paranoid, thought. If she is, an obvious suspect comes to mind for which entity might be backing her. It is certainly one that has deliberately spread disinformation in the past.

     

    My advice to you is the same as was given to me when she started posting on my Forum: Don’t feed the dragon. I had no idea who she was at first so I refuted her objections to a study showing that elective cesarean surgery increased the neonatal death rate. That segued into her criticisms of the MANA 2000 study, which I rebutted as well. If you look at the top of the topic list, you will see a link marked “search.” If you search this Forum’s posts on “Tuteur,” you should turn up our exchange and see my defense of these studies, and how I handled her. My strategy worked well. She hasn’t been back.

     

    -- Henci

    Archived User

    Here's a bit of irony for everyone to enjoy: I found this forum through her blog. How funny is that? She mentioned this forum in a recent post whining about how Henci won't debate her. So at least some good has come from her site- I now have the privilege of communicating with THE Henci Goer! I must say, I was quite geek-happy to find this forum.

    The comment that I left on Amy's blog was something to the effect that Henci doesn't need to debate, because she isn't so desperate to have people believe her like Amy. Henci simply writes from her perspective, and shares her wisdom with those of us who want to learn from her. (Something for which I am eternally grateful) Amy's behavior, on the other hand,  reeks of desperation and defensiveness. Henci's sage righteousness (not to be confused with Amy's SELF-righteousness) is afforded only to those who speak the truth.

    While I know that talking to Amy is definitely a lost cause, I must say that some of the regular contributors are actually quite reasonable people. I have engaged in respectful, productive debate on that site. I do so because I see the politics of birth becoming very polarized. While it certainly can be frustrating at times, I feel as though it's important for me to reach across the chasm rather than just 'preaching to the choir'. My debates tend to be more philosophical than scientific. My take is that we need to look at WHY women want homebirths in the first place, and support measures like the Mother-Friendly Childbirth Initiative (www.motherfriendly.org) We need to make hospitals more, um, HOSPITABLE!

    Oh but something very suspicious about that site- "Dr. Amy" always responds to posts almost instantaneously, EVERY single time. I have visited the site at different times on different days and "she" is always there. Amy Tutuer may be a real person, but the "Dr. Amy" persona is, in my opinon, clearly more than one person. No one can be online 24/7. That, coupled with the fact that the domain backer is concealed, definitely tells me that something's rotten in the state of homebirth debate.

    Keep up the good work, Henci.

    Henci Goer

    Thank you for those kind words. I find it delightful that you found this Forum via her blog.

    I am fascinated by your statement that "Amy Tuteur" always responds immediately to posts. How is it possible to know this? Arguing somewhat against the theory that Amy isn't one person is that she seems to have a distinctive voice. Arguing for it is that the idea of a disinformation home birth blog isn't as farfetched as it would seem. Mothering Magazine recently outed some supposed breastfeeding info sites that were actually being run by formula companies.

    -- Henci

    Archived User
    I ran into her blog by an ad by Google...so someone has to be forking out green to get her out there. I found her logic to be very flawed. I read one of her posts that commented on the percentage of Americans who didn't know simple facts like how much of the Earth is covered in water, and how far away the moon is. She used these statistics to show how "dumb" we Americans are, and then pointed out that only because we're so dumb we would choose homebirth. It occured to me that the VAST MAJORITY of people use hospitals, so her logic is extreemly flawed, especially since there is no way to prove that the people who don't know those facts are the very people who choose homebirth.

    Anyways, I wasn't impressed. I went looking for studies and for facts that would help me decide if homebirth was a bad idea. I didn't find any.
    Henci Goer

    Being able to detect flaws in logic will never do for Tuteur's blog. You'll do much better here. 

    -- Henci

    Archived User
    Found this about Dr. Amy Tuteur:
    http://www.askdramy.com/articles.html?x=99&y=79

    From the back of her book:
    "Amy B. Tuteur, M.D. has delivered thousands of babies and given birth to three of her own. A cum laude graduate of Harvard-Radcliffe College, she received her medical degree from Boston University School of Medicine. Currently (1994), she is an obstetrician/gynecologist with the Harvard Community Health Plan and a clinical instructor in obstetrics and gynecology at Harvard Medical School. She resides in the Boston area."

     
    Archived User

    Gee...I'm a scientist by schooling (B.S. Biochemistry, some graduate course work...), and I don't know precisely what percentage of the earth is covered in water (I think it is about 75%, is that close enough for Dr. Amy???) nor do I have the foggiest clue how far away the moon is.

    But does not knowing these things have ANY impact on my day to day life?  Not in the least.  What does have an impact on my day to day life (because I'm an Environmental, Health, and Safety Specialist) is EPA and OSHA regulations...which I'm quite well versed in, and I'd bet in a pop quiz on those topics I'd beat Dr. Amy quite soundly.  And really, the principles behind these regulations have MUCH more of an inpact on working Americans than knowing how far away the earth is from the moon or how much water is on earth.  Because...uuummm...oh, wait...I guess I'm not helping Dr. Amy out with my job because...

     

    ...the primary function of my job is to KEEP PEOPLE OUT OF THE HOSPITAL.

     

    LOL.

    Archived User
    Posted By n/a on 03/12/2008 12:27 AM
    Found this about Dr. Amy Tuteur:

    From the back of her book:
    "Amy B. Tuteur, M.D. has delivered thousands of babies and given birth to three of her own. ... Currently (1994), "
     
    Is it just me that is scared by this thought?  I mean really...the picture of "Dr. Amy" that is posted on her website looks like she is *at most* in her late 40's.  So she'd have been graduating from medical school in the mid-80's, and then on to her residency/internships.  Giving the benefit of the doubt, lets say that she started catching babies in 1984--10 years before this comment about her delivering "thousands" of babies was written.  To qualify as "thousands," that means at least 2 thousand.  So she was catching a minimum of 200 babies a year???  That would mean she saw 14 prenatal clients (a healthy woman tends to have 14 prenatal visits during pregnancy--even though I read an article once that said that research showed that anything over 8 really didn't improve maternal/fetal outcomes) and caught a baby EVERY working day of the year (52 weeks in the year, 5 work days per week, assume that she took 10 holidays, but no vacation or sick time).
     
    Ummmm...did she fit GYN patients in there anywhere?
     
    What kind of a super-human person is this woman, really?
     
    Or...here's a thought..."Dr. Amy" has put up a fake picture.  Is the real Dr. Amy actually retirement age, and as such, had already put in a good 30 years of catching babies prior to writing her stupid book in 1994.  And really, it is stupid--you can read it for free on her "Ask Dr. Amy" website.  She insists that the "real work of labor" doesn't start until pushing stage...gee, so the 33 hrs I spent in labor with my first daughter was less "work" than the 20 minutes I spent pushing?  She writes in a very condescending tone that indicates that she doesn't believe that her reader--an expectant mother--can really handle language above about a 5th grade level.
     


    Archived User

    all i know is after reading about this "dr amy" I searched in the following places for her credentials and found that she does not exist anywhere:

     

    Massachusetts Board of Registration in Medicine

    abma

    ama

    acog

    harvard medical school alumni

    harvard medical school facilty

    harvard university

    Henci Goer

    Interesting, but not surprising. If you go up to my post of 8/27/2007 in this same thread, you can see what information, or rather, lack of information, a correspondent was able to dig up.

    -- Henci

    Archived User

    This is interesting... I came across "Dr Amy" the very first week that I found out I was pregnant, and that was also the same time that I came across the idea of having a homebirth (or at least a non-hospital birth) and was immediately convinced that this was the right thing for me to do.

    There was a Baltimore Citypaper front-page article on underground homebirths in Baltimore- some performed by "illegal" midwives and some without any birth attendant at all.  In the state of Maryland it's illegal for midwives, or any medical professional, to attend to a birth outside of a hospital setting.  Well, the state's initials are "MD," and we are home to John's Hopkins and a number of other big medical institutions.. so it's no wonder.

    I was so intrigued by this article, which just barely outlined the risks of hospital birth & unecessary medical interventions, that I went online to get the article and email it to friends.  That's when I found the reader comments, where there was a huge debate raging, and "Dr. Amy Tuteur" was at the center of it.  She was so ridiculous in her complete disregard for any arguments against hospital birth, I found her to be a charicature and couldn't help but laugh at anything she wrote.  I think she helped convince me that the only way I was going to give birth was out of the hospital and away from lunatics like her!

    So there it is, maybe "Dr Amy" is good for the homebirth movement?

    Henci Goer

    She's done me an inadvertent good turn as well. Several people have posted that they found their way to the Normal Birth Forum because of Amy's posts about me. I think you should write her a nice note thanking her for helping you on your way to deciding to have a home birth. ;-)

    -- Henci

    Archived User

    ... if you can't figure out that Amy Tuteur is indeed a graduate of Harvard University (you can find her on a reunion website for Harvard-Radcliffe), a graduate of Boston University Med School (you can find her on one of their websites as well), and a former teaching member at Harvard Med School.  She's said on her website that she was a hospitalist and then retired to take care of her 4 children.  You can even find her maiden name and a picture of her 4 children as well as personally identifying information about the family, including where the older ones go to high school and college (some pretty elite schools in there -- this is not a dumb family).

    To suggest that she really didn't go to Harvard suggests that someone can't even do Google 101.  It's all out there.  Disagree with her if you like, but she is who she says she is.

    Archived User

    Dr. Amy has been debunked so many times on the internet, but she keeps trolling looking for new people that don't know her game.

    Her latest attempt: http://vbacfacts.com/2008/09/07/rebutting-dr-amys-information/

    Archived User
    I also saw Dr. Amy pop up on Amazon book reviews....Can't remember which book I was looking at, but there she was.  More negative misinformation.  
    Archived User
    I also ran across Dr. Amy's "debate" when researching different birth options for my second child. I am very lucky to have something most people don't have access to....my very own Harvard trained PhD epidemiologist and biostatistician. I have had him look at a number of her statistical claims and arguments that she has posted on the site and he dimissed almost all of them as bad, twisted versions of what true epidemiological or statistical arguments would look like. This isn't to say that some of the homebirth studies don't have their own flaws....but they are not any where near as misleading or glaring.

    Take for example her most recent posting on why one should use EFM on ALL mothers because although it would cause 116,000 (or so) more UNNECESSARY c-sections per millions mothers, 100 more babies would be saved per million. According to my husband, you simply can't extrapolate like this - it is totally unscientific. There are studies where one specifically DESIGNS a sample to represent a larger group but her example is pure conjecture on every level. She also doesn't address any risks caused by 116,000 unnecessary c-sections to either the hypothetical mothers or babies in her model.

    I'm not going to post on her site because I have no need or desire to get into a "debate" with her over this. I've read enough to know how those turn out. And I'm pretty confident in my own, unbiased information source to not need to discuss this
    Archived User
    I have also decided not to reply, but that has been challenging.   I wonder who Dr. Amy REALLY is and who is REALLY behind this site?   When I read through the replies, I think that some of those may be "staged".   Some of them are unreal.  Something just isn't right all around.   I still visit frequently and am glad to see that many people find their way here to Henci.     I try to tell everyone I know about this wonderful resource. 
    Henci Goer

    I'm glad you find the Forum a useful resource. Thanks for the boost!

    -- Henci

    Archived User

     Thums up to anyone who inadvertantly causes a surge in us doing something better for our children.(and ourselves)

    I.like other prospective homebirth mums to be, went to DrAmy's site for objective material, and ended up being called 'ignorant' (???) and that I must get my facts right,etc etc. Constantly being bombarded one recent evening (its all there on her site) by pro-medic people who wanted to diss anyone with homebirth as a preference.

    It was the subject of why I know 'what happens to a mother during pregnancy,labour and birth can have a direct effect on the psychology of baby and mother and may cause complications'  that got me upset and finally stopped posting replies (for the benefit of baby and me).

    The ones that replied to me, stated catagorically that what happens to the mothers mind during pregnancy,up to birth,is of no consequence, at all. they completely dismiss that mind and body are related,linked,work hand in hand. I even tried my best to stay calm,focused and re-educate them (how arrogant of me huh?) by explaining in simple terms, how, if a mother becomes stressed,paranoid,scared, it can have such implications,they manifest physically. They really didn't get it and started mocking me with 'so you just think happy thoughts and you won't get shoulder distocia, or deviated placenta etc.

    They really hadn't got a clue and were so fixed on vague studies that haven't been monitored exactly. I've read many studies and varying results,depending upon what appropriate questions are asked and how or IF they are answered CORRECTLY; they become confusing and cause us to aks, but did they take A,B or C into consideration or IS IT UP TO DATE, or are the dates relevant? List is endless...

    Until we get studies that are monitored so carefully, the results may as well be plucked out of a hat (homebirth OR hospital birth (I have to be fair!) But there is one thing for sure - it IS proven that when we have a natural birth, without medical intervention and the mother in the best possible setting,without stress and without signs of complications,the baby and mother recieve greater benefits physically AND psychologically. Hospitals are beneficial, only if some problem is likely to occur, and of course the use of the medical equipment is validated.

    Stay positive,focused and keep a sense of humour! Tracy

      *"Your going to get HUGE!!!" *(Ina May Gaskin quote)

    Archived User

    Ms. Goer,

     

        So, since we're on the topic of discussing actual credentials, what are your credentials?  What is your BA in?  Where did you graduate from?  What makes you an expert on obstetric research? 
    Are you a maternal-child health epidemiologist? Obstetrician? Nurse Midwife? Sociologist?

    Henci Goer

    My credentials are in my bio on the home page of my website, but if you want more details, I have a B.A. in biology from Brandeis University; I have a library of books and a collection of several thousand papers, including books and papers on how to analyze and interpret medical research; and I have been writing and speaking about what the consensus of maternity care research establishes as best promoting safe, healthy birth for over 20 years. That being said, my preeminent credential is illustrated by this anecdote: Penny Simkin was once called on the carpet by an anesthesiologist, irate that she had written a handout listing the potential trade-offs of epidural anesthesia when she was not a doctor (although he did not dispute her accuracy). “What are your credentials?” he demanded. “I can read,” she mildly replied. So can I. 

    Furthermore, if you think being a clinician, even a prominent one, makes you an expert on the research, you are sadly mistaken. Here is a quotation from Ralph Hale, writing on behalf of ACOG about the dangers of VBAC:

    In two percent of cases the result can be a rupture of the old scar. If this happens, then death of the baby is almost certain and death of the mother is probable. Even if the mother does not die, virtually 100% will lose their child bearing ability.

    In actual fact, According to a systematic review that contained an analysis of pooled data, the VBAC scar rupture rate is 0.5%, one-quarter the rate he alleges, 6 babies will die per every 100 scar ruptures, and the maternal death rate associated with scar rupture was 0. According to the same review, hysterectomy rate with planned VBAC was low--about 1 per 1000 planned VBACs--which was similar to, or lower than, rates with planned repeat cesarean. If you want to be picky, Dr. Hale's remarks were made in 2008, and the review was published in 2010--except that there was an earlier review, very well known, with practically identical data published in 2003. Or take Dr. Amy Tuteur. Some years ago, before I knew who she was, we had an exchange on this Forum in which she argued that the Johnson and Daviss (2005) analysis of MANA data showed that more babies died with planned home births. I pointed out that she was comparing neonatal mortality rates in hospital births with stillbirth plus neonatal mortality rates in the home birth data, which was an apples to oranges comparison. When one compared neonatal mortality rates, the rates were the same. Anyone can make a mistake, but to my surprise at the time, she went right on making the claim. Now, of course, I know her better, and I'm not surprised.

    ~ Henci 


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