I thought toasters couldn't breed without human assistance?

I just started watching the new series on disc. (Never liked the old one, didn't even think much of Star Wars, and haven't paid attention to sci-fi in a decade.) It's a blast! Character driven, great effects for a series, and the phenomenally attractive Katee Sackhoff as one of the leads... I hear the quality falls off in the 3rd season, but I'm making a commitment here.

OMG dude. To this day, if I am with my dad and meet someone he knows but I have never met, the conversation goes like this:

Dad: This is my son.
Other person: Nice to meet you. (handshake)
Dad: When he was born, he had the biggest conehead. I thought I was stuck with a conehead for life...

I'll be sure not to do that. I'm convinced those caps they stick on newborns aren't as much for warmth as they are for making the first photos more palatable.

but he made it like a champ and was a very healthy 7 lbs, 6 ozs, even though he was a month premature. I'd hate to think what trouble we would have had he gone to term.

Damn, that's a big kid to be a month pre. My boy was a hefty 8 lbs, 15 oz, which in tandem with a low-grade fever for mom meant a section. Thankfully, she never got to the pushing stage.

I'm in full agreement, believe me. It's my understanding too, that it's possible to go ahead and give birth with a midwife present while having a doctor on call, and it's even possible to arrange to have that happen inside a hospital in case anything goes seriously wrong.

This is my and my wife's plan. There's a great midwife (midwifery?) clinic that is affiliated with a hospital. If anything goes wrong they have her in an ambulance to Maimonides Medical center lickety split, but otherwise they try and dispense with some of the practices that are more for the doctor's benefit than anything else (like putting the woman up in stirrups so the doctor can see what's going on instead of letting gravity help with the delivery).

My wife really has her eye on the birthing tub...

Edit: and here's FJM' take:

First thing: thank you, Cynthia Rodriguez for fulfilling the media's dreams by revealing that A-Rod is incredibly unclutch even in real life.

This is my and my wife's plan.

Yeah, it's the smart thing to do. I'll mention it to my friend, but she'll probably just smile and do whatever she wants to do.

arkitekton

wasn't your baby grrrl just born this april? i know you were just talking about her. and i am the same size as your friend. but your size really got nothing to do with how tough it is to have a baby - i mean there is small grrrls got no trouble and there's big grls who got all kinds of trouble. i know theres people out there who really REALLY don't think anything can go wrong as long as you have a good pregnancy.

ocdss,

how is the doctor supposed to see what is happening if you are not in the table? the doctor is there for the baby's benefit and if he/she can't see what is the use of that? and what mammal stands up to give birth? that is weird. and the whole idea of a birthing tub - yecccch. it is NASTY. and dirty. YECCCCCCCCCHHHHHHHHHHH. and totally against nature you talk about nature. there is no other land mammal has its babies born underwater. YECCCCCCCCCCCHHHHHHHH

This is my and my wife's plan. There's a great midwife (midwifery?) clinic that is affiliated with a hospital. If anything goes wrong they have her in an ambulance to Maimonides Medical center lickety split, but otherwise they try and dispense with some of the practices that are more for the doctor's benefit than anything else (like putting the woman up in stirrups so the doctor can see what's going on instead of letting gravity help with the delivery).

I can't say enough positive things about our experience with midwives. You get the best of both worlds, medically trained professionals without the assholishness you get with an MD. They didn't push us to get a c-section we didn't need, and at the same time they didn't pressure my wife to have her baby in a manger either.

Now, on the crunchy granola side there is as much BS as any MD will give you (we did Bradley birth classes, so I know this), but a good midwife is a medical professional who isn't going to push you into doing something silly (I saw the birthing tub video...I'm not convinced).

We had some pretty minor complications in our delivery, and overall it was probably easier than average. However, at one point there was a stalling of progress and my wife started to worry. She told the midwife that she was afraid that she was going to have to have a c-section, and the midwife just looked at her and said honey, I don't do c-sections, you're going to have this baby without one and everything is going to be fine. It was a bit of bedside brilliance that I have never seen from a physician in my life. And that's exactly what happened.

This is my and my wife's plan. There's a great midwife (midwifery?) clinic that is affiliated with a hospital. If anything goes wrong they have her in an ambulance to Maimonides Medical center lickety split, but otherwise they try and dispense with some of the practices that are more for the doctor's benefit than anything else (like putting the woman up in stirrups so the doctor can see what's going on instead of letting gravity help with the delivery).


There's a lot of romanticism about how deliveries used to be done - hence this notion that a midwife is all one needs and not an entire trained staff with the proper facilities on hand. Of course this is just a myth. I believe that it was Atul Gawande who cited that of all the medical specialities, it's actually obstetrics that has been most successful at reducing complications over the past few decades. People have this image that it's fairly simple to deliver outside of a hospital when the evidence shows that deliveries used to be (and in poor countries) are still dangerous. It was commonplace for the mother and child to die from complications.

A smooth L and D can appear simple to the outsider when in reality a lot has been going on behind the scenes. The vitals are monitored closely, the fetal position and general state are closely monitored. Things can change on a scale of minutes once labor begins. The operating room should always be close by.

I wonder sometimes whether most couples realize the level of risk they're undertaking when they choose to deliver outside a hospital.

I'm in full agreement, believe me. It's my understanding too, that it's possible to go ahead and give birth with a midwife present while having a doctor on call, and it's even possible to arrange to have that happen inside a hospital in case anything goes seriously wrong.

It's more than possible, it's the norm.

She told the midwife that she was afraid that she was going to have to have a c-section, and the midwife just looked at her and said honey, I don't do c-sections, you're going to have this baby without one and everything is going to be fine. It was a bit of bedside brilliance that I have never seen from a physician in my life. And that's exactly what happened.

I'm glad that the delivery went well. The midwife sounded wonderful, and she did a good job of reassurance. I'm not sure you should call that bedside brilliance - of course, I wasn't there and perception is reality at some levels. C-sections are not there for convenience, but rather for indicated situations. Given some of the posts here in this thread, I wonder if the medical field has done a good job of conveying that to the public.

I'm glad that the delivery went well. The midwife sounded wonderful, and she did a good job of reassurance. I'm not sure you should call that bedside brilliance - of course, I wasn't there and perception is reality at some levels. C-sections are not there for convenience, but rather for indicated situations. Given some of the posts here in this thread, I wonder if the medical field has done a good job of conveying that to the public.

I freely admit that I hold the decision-making priorities of the modern medical system in very low regard.

I freely admit that I hold the decision-making priorities of the modern medical system in very low regard.

I can understand that. It's also one shared by many in the public. Perhaps a bad experience(s) in the past?

All I can say is - watching the great Ob/Gyns at work, I appreciate what they do. It's probably one of the most stressful professions out there, certainly comparable to surgery. Perhaps the problem is that there aren't enough good Ob/Gyn units out there.

I can understand that. It's also one shared by many in the public. Perhaps a bad experience(s) in the past?

All I can say is - watching the great Ob/Gyns at work, I appreciate what they do. It's probably one of the most stressful professions out there, certainly comparable to surgery. Perhaps the problem is that there aren't enough good Ob/Gyn units out there.

They suck in the small city where I live. I'm sure there are some good ones, but I have sure heard a lot of horror stories. With outstanding midwives available, who share the same practice and facility as the Ob/Gyns, going with the midwives was a no-brainer.

And yes, I have had many bad experiences in the past. Who hasn't? It's a cover your ass system which undermines the best intentions of good MDs.

Okay, found the essay.

Atul Gawande - "The Score" - The New Yorker

http://www.newyorker.com/archive/2006/10/09/061009fa_fact?currentPage=all

Here are some great passages:

<quote>That’s if all goes well. At almost any step, though, the process can go wrong. For thousands of years, childbirth was the most common cause of death for young women and infants. There’s the risk of hemorrhage. The placenta can tear, or separate, or a portion may remain stuck in the uterus after delivery and then bleed torrentially. Or the uterus may not contract after delivery, so that the raw surfaces and sinuses keep bleeding until the mother dies of blood loss. Sometimes the uterus ruptures during labor.

...

There are a hundred and thirty million births around the world each year more than four million of them in the United States. No matter what is done some percentage will end badly. All the same, physicians have long had a abiding faith that they could step in and at least reduce that percentage. When th national reports of the nineteen-thirties proved that obstetrics had failed to do so and that incompetence was an important reason, the medical profession turned t a strategy of instituting strict regulations on individual practice. Trainin requirements were established for physicians delivering babies. Hospitals set firm rules about who could do deliveries, what steps they had to follow, and whethe they would be permitted to use forceps and other risky interventions. Hospital and state authorities investigated maternal deaths for aberrations from basic standards

These standards reduced the number of maternal deaths substantially. In the mid-thirties, delivering a child had been the single most dangerous event in a woman’s life: one in a hundred and fifty pregnancies ended in the death of the mother. By the fifties, owing in part to the tighter standards, and in part to the discovery of penicillin and other antibiotics, the risk of death for a mother had fallen more than ninety per cent, to just one in two thousand.

....

Doctors in other fields have always looked down their masked noses on their obstetrical colleagues. Obstetricians used to have trouble attracting the top medical students to their specialty, and there seemed little science or sophistication to what they did. Yet almost nothing else in medicine has saved lives on the scale that obstetrics has. Yes, there have been dazzling changes in what we can do to treat disease and improve people’s lives. We now have drugs to stop strokes and to treat cancers; we have coronary-artery stents, artificial joints, and mechanical respirators. But those of us in other fields of medicine don’t use these measures anywhere near as reliably and as safely as obstetricians use theirs.

...

Currently, one out of five hundred babies who are healthy and kicking at thirty-nine weeks dies before or during childbirth—a historically low rate, but obstetricians have reason to believe that scheduled C-sections could avert at least some of these deaths. Many argue that the results for mothers are safe, too. Scheduled C-sections are certainly far less risky than emergency C-sections—procedures done quickly, in dire circumstances, for mothers and babies already in distress. One recent American study has raised concerns about the safety of scheduled C-sections, but two studies, one in Britain and one in Israel, actually found scheduled C-sections to have lower maternal mortality than vaginal delivery. Mothers who undergo planned C-sections may also (though this remains largely speculation) have fewer problems later in life with incontinence and uterine prolapse.


And yet there’s something disquieting about the fact that childbirth is becoming so readily surgical. Some hospitals are already doing Cesarean sections in more than half of child deliveries. It is not mere nostalgia to find this disturbing. We are losing our connection to yet another natural process of life. And we are seeing the waning of the art of childbirth. The skill required to bring a child in trouble safely through a vaginal delivery, however unevenly distributed, has been nurtured over centuries. In the medical mainstream, it will soon be lost.
...
</quote>

Lots of other great passages. This is one of Gawande's best pieces and probably the best essay I've read on Contemporary Obstetrics.

arkitekton

wasn't your baby grrrl just born this april?

No, chick, but you are making me feel younger ;)

Okay, found the essay.

Looks really good, Rask. I'll try to get my friend to take a look. And thanks, all. If I can get her to read this thread it may help.

Raskolnikov Posted: May 08, 2008 at 12:19 AM (#2773298)

C-sections are not there for convenience, but rather for indicated situations. Given some of the posts here in this thread, I wonder if the medical field has done a good job of conveying that to the public.

obstetricians have reason to believe that scheduled C-sections could avert at least some of these deaths. Many argue that the results for mothers are safe, too. Scheduled C-sections are certainly far less risky than emergency C-sections—procedures done quickly, in dire circumstances, for mothers and babies already in distress. One recent American study has raised concerns about the safety of scheduled C-sections, but two studies, one in Britain and one in Israel, actually found scheduled C-sections to have lower maternal mortality than vaginal delivery. Mothers who undergo planned C-sections may also (though this remains largely speculation) have fewer problems later in life with incontinence and uterine prolapse.

- well rasky,

here you have doctors saying that every single baby should be born with a scheduled c-section.

they said stuff like that about episiotomies too

and when you read that an entire species who is supposed to give birth vaginally is now supposed to have an operation for each child you HAVE to get suspiscious.

i got a hard time believing that slashing open a woman's belly and cutting into her uterus is good for her or the uterus.

and with a husband and 2 kidz with asthma i read a lot of asthma stuff and c-section kidz are a LOT more likely to have asthma and allergies AND problems with digestion.

i don't know - this stuff about EVERY female got to have an operation to have a baby worries me. it is not like stuff can't go wrong in an operation. and i don't like it that they treat you and your baby like you got a disease

--------------

andere,

i went to a city clinic for high risk (because i was so sick and because i had twins) so no midwife does high risk. if i have just one baby the next time, if there was a choice, well, as long as i had the baby in a hospital.

but they were telling me when i wasn't even 6 months that i HAD to have a section JUST because i had twins.

----------------

arkitekton,

ah

well, you have not been here real too long, so i don't know if you are 25, 35, 45, 55, 65 or oldern harvey. or exactly WHEN your grrrl was born

- grinning

most of the other guys i been chatting with for years so like i remember when andere's son was born

and i remember the guys who born on my mama's or daddy's or brothers' birthday, whose daughter got the exact same birthday as my twins

stuff like that

us grrrrls we remember that stuff don't ask me why. i guess it is on the DNA you ain't got

how is the doctor supposed to see what is happening if you are not in the table? the doctor is there for the baby's benefit and if he/she can't see what is the use of that? and what mammal stands up to give birth? that is weird.

The thing is if there aren't any complications, what's the point of the doctor? If there are any complications we wind up in the hospital anyway. As for the position, it's not so much that she has to be standing, it's that she's free to get up move around, or do whatever helps her get the baby out. If she wants to lie down she can, but frankly, I don't see how that position helps her in any way. Our Midwife clinic has a much better

As for "natural," how many other animals have a similar body type to humans? I don't see any other primates (as opposed to Primates) reclining in stirrups with a third party standing around observing.

One of the big reasons we're using a midwife is for what happens after the baby comes. There's no reason for the nurse to take the baby away to do things like check the infant's vital signs or draw blood, or whatever. From what we've heard, it can also be a real problem to keep the nurses from giving the baby a bottle if you want to breast feed only. Hospital workers are like anybody else, they want to make their job easier, and are sometimes willing to cut corners against the parent's wishes. Local hospitals will also kick me right out when visiting hours are over, which is not the case with the midwife.

...and the whole idea of a birthing tub - yecccch. it is NASTY. and dirty. YECCCCCCCCCHHHHHHHHHHH. and totally against nature you talk about nature. there is no other land mammal has its babies born underwater. YECCCCCCCCCCCHHHHHHHH

Water births have been around for awhile; it's not like we're planning to hang around in it like it's a jacuzzi. (Didn't you need a shower after the birth anyway?) Besides, that's my wife's idea; I'm pretty much up for anything that helps her get through this.

There you have doctors saying that every single baby should be born with a scheduled c-section.

they said stuff like that about episiotomies too

and when you read that an entire species who is supposed to give birth vaginally is now supposed to have an operation for each child you HAVE to get suspiscious.

i got a hard time believing that slashing open a woman's belly and cutting into her uterus is good for her or the uterus.

and with a husband and 2 kidz with asthma i read a lot of asthma stuff and c-section kidz are a LOT more likely to have asthma and allergies AND problems with digestion.

i don't know - this stuff about EVERY female got to have an operation to have a baby worries me. it is not like stuff can't go wrong in an operation. and i don't like it that they treat you and your baby like you got a disease


No, I don't believe that anyone in the medical profession believes that c-sections should take precedence over patient preference. The evidence indicates that c-sections are at least as safe - probaby safer - than vaginal deliveries. But vaginal deliveries are safe enough that it makes sense to deliver by that method as long as everything is fine. I think that most, if not all, deliveries, however, should be done with an operating room close by, because situations can change quickly.

The bigger arc is that "natural" isn't necessarily "better." Yes, the species has delivered billions of babies vaginally without complication. But the public may not realize that historically, natural childbirth was dangerous. If any complications occurred during a vaginal delivery, the mother and the child died. That was accepted for millenia. I don't think most people in the US would accept that as the standard today.

I just started watching the new series on disc. (Never liked the old one, didn't even think much of Star Wars, and haven't paid attention to sci-fi in a decade.) It's a blast! Character driven, great effects for a series, and the phenomenally attractive Katee Sackhoff as one of the leads... I hear the quality falls off in the 3rd season, but I'm making a commitment here.

Re: effects:

I love Star Wars, but it was designed to be a WWII-era serial in space. So the physics of space flight took a back seat to visuals. Which is fine on its own, but it was such a huge phenomenon that everybody expected all sci-fi to be like that. So you get whooshing sounds, banking space ships, etc.

BSG actually gets it right, most of the time. Watch the vipers as they move in battles (when they're in space). My favorite is when they do a strafing run on a large ship (you probably haven't gotten to Resurrection Ship yet). They go full speed until they get next to the ship, then they fire their little steering thrusters to spin the vipers sideways. Of course the vipers keep going in the same direction that they were travelling, so now they're shooting by the ship, but pointed straight at it, so they can fire away and strafe the ship.

I haven't seen any other sci-fi do things like that.

rasky,

well, there is "safe" and then there is better for both the mother and child in the long run.

. ocd ss Posted: May 08, 2008 at 10:01 AM (#2773457)


The thing is if there aren't any complications, what's the point of the doctor?

- to deliver the baby

If there are any complications we wind up in the hospital anyway.

- yeah, but can you get there in time is the problem

As for the position, it's not so much that she has to be standing, it's that she's free to get up move around, or do whatever helps her get the baby out. If she wants to lie down she can, but frankly, I don't see how that position helps her in any way. Our Midwife clinic has a much better

- i don't know how how things are done anywheres else except where i gave birth and my friends give birth, but here you can move around all you want - i guess except when you start pushing. and you don't lie down to push, you are in this chair where you are almost sitting up

As for "natural," how many other animals have a similar body type to humans? I don't see any other primates (as opposed to Primates) reclining in stirrups with a third party standing around observing.

- no but they aren't standing up neither

One of the big reasons we're using a midwife is for what happens after the baby comes. There's no reason for the nurse to take the baby away to do things like check the infant's vital signs or draw blood, or whatever.

- well, we had premies. but they usually leave the baby with you for a while for you to feed then they take it to the nursery to weigh it and check it out for a few hours then you can have it back whenever you want. and there sure don't kick out baby daddy here. and they don't poke the baby until it is a day old anyhow. unless it is sick.

From what we've heard, it can also be a real problem to keep the nurses from giving the baby a bottle if you want to breast feed only. Hospital workers are like anybody else, they want to make their job easier, and are sometimes willing to cut corners against the parent's wishes. Local hospitals will also kick me right out when visiting hours are over, which is not the case with the midwife.

- really? less work for them to do. now i got a lot of shtt because i had premies, but normal babies if you want to breastfeed, they don't give it bottles unless it won't BF or is sick or something. or unless you ask them too


Water births have been around for awhile; it's not like we're planning to hang around in it like it's a jacuzzi. (Didn't you need a shower after the birth anyway?) Besides, that's my wife's idea; I'm pretty much up for anything that helps her get through this.

- yeah but you pee and shtt when you deliver plus all that blood and slime gonna go into the water and why you want a baby to take in a big breath of that underwater i do NOT get and you don't want all that stuff in your tore up places Down There neither

kevin

then i guess your ex-wife had to have a high-risk doctor - and she din't have to go to clinics and see someone different (and usually rude) every time

but the people who work at the clinic are from baylor medical school and that is not exactly the sticks you know

then i guess your ex-wife had to have a high-risk doctor - and she din't have to go to clinics and see someone different (and usually rude) every time


That sounds like a poorly designed clinic. Continuity of care is a first tenet for almost all medical care, but particularly in obstetrics.

from my personal anecdotal standpoint: c-section saved my wife's life. she had to have the baby taken out as soon as his lungs were close to being ready, because she was a diabetic and suffered from preaclampsyia (sp?) -- unsafe high blood pressure -- and it wasn't going to work to have the delivery naturally. bottom line, she would have died without modern medicine. our case is not representative, but not sure what good a midwife would have been.
as i understand it, the medicos just feel that there is more control with a c-section. it isn't any more risky than natural, and, as above, sometimes the only way to go.
our son was a month premature and spent two weeks in neonatal intensive care, even though he weighed seven lbs. ... we found out later most babies of diabetics are on the heavy side, even if they are born with complications. dayn, that might answer your question about heavy birth weight of a preemy.

as i noted before, kev, you are creeping me out. your son wouldn't be 19 this year would he?

That's funny because amongst the numerous complications that can occur, pre-eclampsia was the one I had in mind. And pre-eclampsia is a surgical emergency.

Maybe there are dedicated mid-wives who would check blood pressures regularly, but unless there is someone who would be willing to do that scut, there's practically no way of telling by observation whether someone was becoming hypertensive vs. the usual discomforts of delivery.

to deliver the baby

Which amounts to what in this scenario? Is that really something you think a nurse or midwife can't do competently if there are no complications?

yeah, but can you get there in time is the problem

It's 2 minutes away, and it's really only an issue if there are sudden complications

no but they aren't standing up neither

Try not to get too worked up about the "standing up." It's not the only position allowed, nor is it rigorously inforced. But how do you think people working in fields, or nomadic peoples delivered? It's not exactly unheard of.

Water births are a new age gimic. Land mammals don't give birth in the water, and haven't for 10's of millions of years, before they were land mammals.

But it does go towards proving that it isn't harmful (the baby has been living in a liquid environment for the last 9 months, the extra couple seconds before it winds up in air really shouldn't be a problem).

I'll bookmark this thread and let you know how it goes. We're due Sept 18th, so I'm hoping that I can get my paternity leave to coincide with the first round of the playoffs.

Here's a man who has his priorities in order.

I was going to say. How often does life fall in line like this?

us grrrrls we remember that stuff don't ask me why. i guess it is on the DNA you ain't got

There's a lot of that going around ;)

BSG actually gets it right, most of the time. Watch the vipers as they move in battles (when they're in space)....

I don't recall that particular maneuver, but have noticed other effects that look extremely well done. Very detailed reflections in cockpit glass, for example. That's a touch that surprised and impressed me. Does seem odd that they're going to quit after only four seasons. Any idea why?

That's a touch that surprised and impressed me. Does seem odd that they're going to quit after only four seasons. Any idea why?

Even though it regularly lands in critic's list of top shows, the ratings aren't that great. It's already on the SciFi channel, so there's not really any other network that would pick it up. There was some question as to whether it would be renewed for season 4, and when it was renewed they talked about it being a half-season. Also, the special effects are expensive for a show on the SciFi channel? Ever notice how they go through a 4-5 episode "filler arc" where they don't really leave the Galactica? That's because they've chosen to concentrate their SFX on a smaller number of shows.

Personally, I'm fine with them ending now. Any show with a defined purpose needs to have a realistic ending time frame. If you don't end your story, people will get bored. If you end it, but still have more seasons, then you end up diminishing the effect of your original story line. Lost is another example of this. Define your end point and work toward that. If you don't, you end up like Alias: "Crap, we've got to resolve this in five episodes because we got cancelled!"

Thanks for the explanation. I did notice some of the narrative choices allowed for inexpensive sets, much like the third season of the original Star Trek. True--once the crew finds Earth, where would you go from there? It would have to be something like, the Cylons find Earth, too, and then there's a lot of soap-operaish stuff. Once the show finds itself literally Earthbound, it becomes a different show.