07 June 2016

The day we decided to vaccinate our child.

Whew- this took many months to write. I'm not sure it's edited fully and ready to post yet, but I need to say it. It's just that important. 

I just opened up a can of worms!  And now everyone feels uncomfortable.

I've seen a lot of research lately.  I feel like part of the mommy instinct wants you to "research" and read and find out just exactly IS best for you and your family.

And I believe this looks different for all families.

I also believe this changes over time.

I'm not writing this post to tell you that what you've decided for your family is bad/wrong.  I'm also not writing this to be a definitive-go-to for mothers to defend why they choose to vaccinate their children.  I'm writing it so we can have open discussion.  So there is room for talk and debate.  And most importantly, because I like to express my views by writing.  This is for me.  And my family.  This is why WE have chosen to vaccinate our child:

I believe in science.

I also believe that I don't/ can't ever know everything.

I believe in good natural health/nutrition before medications/medical interventions.  
I believe in figuring out what is best, questioning what's out there.

But I super don't believe in Blogs/ news articles/ opinion websites as legitimate sources of information.  They often present one side of the story, incomplete evidence, and statistics designed to make you consider one side or one way of thinking.   I like the CDC because they have risks and side effects (more than just the ones your doctor will tell you about) displayed nicely.  The only drawback is that not all of the information is up-to-date on the newest vaccines.  But overall, its a trustworthy source and I'll use links to it below.  I know a lot of people "don't trust the CDC after the whistleblower incident."  But that study was later retracted from the magazine it was published in, because it was wrong. 

While I will never agree with you for not immunizing your kids, I won't slam you for it.

Just be careful, ok?  I have read far too many blogs with incorrect information about vaccines and herd immunity and risks.  These bloggers are fantastic writers, making you want to believe all of the conclusions they draw.  But they leave big gaps in their research and they draw incorrect conclusions.  But you have to also critically evaluate what these people believe.  Did you know Mike Adams, one of the main writers of NaturalNews.com doesn't believe that HIV causes AIDS?  (A fact science has known for years-just look it up on wikipedia)  He also believes in things like Chemtrails (a belief that airplanes are dumping chemicals designed to make us all stupid).  Is that someone you trust for scientific information on vaccines?

I hope not.

You can disagree with me.  Please ask me questions.  Critically evaluate the sources I've listed for you. If you have questions about things I don't address here, I'd be more than happy to answer them for you.

I use links from a lot of journal articles, some from wikipedia, and some from websites or blogs.  I make sure the person who wrote the blog I use has actual credentials. I understand that wiki isn't the best source....

But, this is WHY we have chosen to vaccinate our child. 

1.      The committees say to (here are committee position statements)

Anyone can find a few doctors who say "vaccines are evil" but what do MOST organizations and physicians say about vaccines?  The key word, in case you missed it, was MOST. Position statements are a good way to determine what a large group of physicians think.

American Academy of Pediatrics Statement: (over 60,000 pediatrician members)
“One very important step in ensuring the health of any child is to make sure he or she receives immunizations at the correct time. Whether it's a childhood MMR vaccine or an adolescent pertussis booster, these simple procedures can save lives – and AAP is here to answer any questions you may have about childhood immunization.”  http://www2.aap.org/immunization/

ACIP Advisory Committee on Immunization Practices: (15 experts)
“The Advisory Committee on Immunization Practices (ACIP) is a group of medical and public health experts that develops recommendations on how to use vaccines to control diseases in the United States. The recommendations stand as public health advice that will lead to a reduction in the incidence of vaccine preventable diseases and an increase in the safe use of vaccines and related biological products.”  http://www.cdc.gov/vaccines/acip/about.html

WHO (World Health Organization):
“In accordance with WHO’s mandate to provide guidance to Member States on health policy matters, the organization is tasked with developing evidence-based immunization policy recommendations. In 1999 an independent advisory group, the Strategic Advisory Group of Experts (SAGE) on Immunization, was established by the Director-General and charged with providing guidance to WHO on global policy recommendations and strategies. SAGE is concerned with all vaccine-preventable diseases and vaccination programmes for all ages.” http://www.who.int/immunization/policy/en/

People way smarter than me sit down in a group (the ACIP: Advisory Committee on Immunization Practices)  to discuss RESEARCH articles.  These are articles that a scientist submits to a paper, colleagues look over it and decide if it is legit, then it is published in the paper.  These research people make recommendations for what the vaccine schedule should be. They look at science. Not opinion or hearsay, cold hard science. They don't get paid for selling vaccines.  They aren't influenced by big, bad drug companies.  They have qualifications for research studies.  The studies often have to be double-blinded- placebo-controlled-randomized studies. They don't include all studies.  I've seen a lot of blogs cite a "study" that shows links of vaccines to autism.  Just because a study exists doesn't mean it is true, or the information contained in it is correct.  It  has to be peer-reviewed and published in a reputable journal.  It has to have a large population to be significant statistically.  So be careful when you "look at a study."

Never heard of the ACIP?  Here's more about who they are:  http://www.cdc.gov/vaccines/acip/about.html

I take my vaccination advice from scientists with medical degrees, not people like Jenny McCarthy and Jim Carey.  Her son didn't even have autism!  And yes, I understand a lot of people feel they have "spent more time researching than doctors have," but honestly, that probably isn't true.  Do you understand how long doctors go to school?  4 years of undergrad, and 4 years of med school, and 3-10 more years of residency/fellowships.  They learn how to research during that time, learn physiology and understand how vaccines work, and learn what sources to trust.  They are VERY well educated.  You may or may not be well educated.  Reading blogs and websites does not make you well qualified to make decisions about your child’s health.  

If blog's and websites were enough, emergency rooms and doctors offices would become a thing of the past. 

2.      What about anecdotes- people who say their child “isn’t the same” or something happened? Or what about a vaccine reaction?

Statistics don't lie.  Often anecdotal evidence is often unfounded.  You probably know someone that knows someone that claims "I know these shots gave my child autism."  People look at an event, like getting their child shots on a Wednesday, and then another event, fever of 104 that Saturday, and assume the two are related.  They may be related.  They may not be related.  You can't just look at anecdotal evidence.  That mom will always feel the vaccines caused the autism.  But if you line up 1,000,000 kids, they will find that its not the CAUSE of the autism, just an event that happened to occur before the autism. 

CORRELATION DOES NOT IMPLY CAUSATION.  I capitalized this because I think this is a huge falicy people make when looking at research.  For example: Did you know people who don't brush their teeth are statistically more likely to die in a car crash?  Why is that?  Does not brushing your teeth lead to reckless driving and death?  Or do these people share other characteristics that cause them to die?  (Spoiler alert-they do!)

Does getting a pertussis shot increase your risk for SIDS?  The only way to know that is by studying a large group of people who got the shot, and a large group who was randomized to receive a fake shot. (Which is unethical!) You can't just compare it to people who elected NOT to get the shot.  Then you have to compare SIDS rates in the two groups.  If it did cause SIDS it would have been pulled off the market. (I have studies about this later in the section where I talk about vaccine safety)

Here is a nifty graph I love when it comes to correlation and causation.  The following two things are perfectly correlated.  But does that mean one caused the other?  (Clearly, no)

The source: (it's a blog, and he's not very kind to people who don't vaccinate)

The US government used to give out money to people claiming to be "injured" by the pertussis vaccine (DTP- which is no longer used in America).  They said it caused seizures.  And SIDS.  So the supreme court paid them.  And finally, when there was research to back up that claim, they stopped paying.  Because the rate of seizures and SIDS was the SAME in the vaccinated group and unvaccinated group.  Now we use a safer vaccine called DTaP for children and Tdap for adults.  It is made of acellular pertussis instead of whole pertussis, and doesn't protect as well.  Which is one of the reasons we have seen pertussis come back: because it doesn't give lifelong immunity (just like getting "natural immunity" from a pertussis infection, but more on that later)

Wikipedia has a great article on this topic: http://en.wikipedia.org/wiki/Correlation_does_not_imply_causation  And yes, wikipedia isn't the end-all-be-all or the definitive resource.  But it does well to explain topics.

Here's an example about correlation vs causation stolen directly from the above link to wikipedia:

It tells something true, then reaches an over-generalization, then explains why that's not true.

"As ice cream sales increase, the rate of drowning deaths increases sharply.
Therefore, ice cream consumption causes drowning."

"The aforementioned example fails to recognize the importance of time and temperature in relationship to ice cream sales. Ice cream is sold during the hot summer months at a much greater rate than during colder times, and it is during these hot summer months that people are more likely to engage in activities involving water, such as swimming. The increased drowning deaths are simply caused by more exposure to water-based activities, not ice cream. The stated conclusion is false."

I have seen people draw the same conclusions about vaccines.  I will not draw my own conclusions.  I need to see good, peer-reviewed research.

Just because your child dies a week or even 1 day after the vaccine, does not mean the death was caused by the vaccine.  This article is a link to a website that says that girls have died and had immune system compromise following the Gardasil vaccine.  ALL their evidence is anecdotal, there is no scientific study presented.  http://sanevax.org/gardasil-vaccine-one-girl-dead/  The problem with anecdotal evidence is that people make correlation imply causation, similar to the ice cream causing drowning example above.  This is a dangerous train of thought! In the 3rd paragraph down, this article says that yes, 32 deaths "from the gardasil vaccine" are reported to VAERS.  But after autopsy, these children died from other things such as viral illness, illicit drug use, heart failure, and diabetes.  Just because a reaction is reported to VAERS doesn't mean it is actually caused by the vaccine.  VAERS is all anecdotal evidence.  The government looks into the claims and it pays for any actual injury where they see causation.

And you may know someone who knows someone that feels their child was injured by a vaccine.  But there are kids injured by vaccine-preventable things too, but no one talks about them.  Think I'm lying?  No one gets vaccine-preventable diseases anymore?  Think that everyone who gets a vaccine-preventable illness is "just fine with some rest and natural home remedies?!" Well, not all of them are. Check out this little book the doctors at Texas Children's Hospital put together:  http://web.texaschildrens.org/multimedia/flipbook/vaccine-book/
Here's a great story of a mother who did everything right.  She ate only organic foods.  She didn't vaccinate her kids.  Yet her daughter has autism anyway.   

Can we agree that autism isn't the end of the world?  Children with autism are still children.  Precious and loved by God.  The scientific community has rejected the lie that vaccines cause autism.  I feel it's high time others reject that too. (I'm looking at you Robert De Niro.) 

A child with rubella can kill the fetus of a pregnant mother.  Did you know that?? 

Heard Immunity is not a lie.  I've read blogs on that, and these great writers don't understand what they're talking about. And if you disagree with me, let's discuss this later. 

For a full discussion of safety, including links to papers written about vaccines, please see point #9 below. 

3.      What do you do when your kid stops breathing? Run to the ER?  If I trust those doctors to save my child's life, why don't I trust them with shots?

 I believe that vaccines work.  I believe in what I do.  I'm in the medical field.  I'm a PA-C. (Nationally Certified Physician Assistant/Associate)  I believe that vaccines work.  And while an antibiotic or drug will NEVER be my first choice for treatment, I believe that sometimes they're necessary.  I don't believe everyone needs a flu shot, but I agree that I should have one because it helps protect the community.  And children (even previously healthy children) can die from the flu.  Not to mention all the sick children and elderly folks out there.  But we'll get to that later. 

And what about the package inserts?  Haven't I read those? Doctors get accused of not reading those...

Well, yeah.  I have read them.  But they are legal documents, not medical documents.  Manufacturers are required to list ANYTHING that occurs within 6 weeks of the vaccine, whether or not it was related to the immunization.  So, the chicken pox/ varicella shot had a broken leg listed as a "side effect."  Although it is clearly not.

I trust my son's doctor when he gives me advice. If my son stopped breathing I would call 911 and have him taken to the nearest ER. I trust doctors for these things. I trust doctors, period. I believe (most) people become doctors because they care about other people. Especially doctors that treat kids. Pediatricians aren't the ones making billions of dollars. They don't make money off vaccines. At best most doctors break even with shots. Again, more about that later. 

4.      We have awesome vaccines.  But why do we have so many? (Ingredients and efficacy are addressed later)

This article in the NEJM (New England Journal of Medicine) http://www.nejm.org/doi/full/10.1056/NEJMms1215400
Shows "We estimate that 103 million cases of childhood diseases (95% of those that would otherwise have occurred) have been prevented since 1924; in the past decade alone, 26 million cases (99% of those that would otherwise have occurred) were prevented."  That's huge.  Vaccines work!  Anyone telling you something different is likely selling you something. (a book, "natural remedies," essential oils...)

If you think that diseases were eradicated by "better sanitation and hand washing" Please take a look at the photo (from the link below.  You can agree that by 1988 (less than 30 years ago!) most places had clean, running water.  Yet, there was so much polio.  Once we decided to help give the polio vaccine worldwide, that's when we started seeing polio eradicated!

Why do we have so many vaccines?  
I've seen this "meme" posted a few times on facebook:

(I found this online-I'm not sure where. It looks like the website is DrMomma.org) 

Yes, kids today get a lot more shots now than the average child that was born in 1983. Well, for one thing, we are protecting against A LOT more diseases.  In 1983 there was no vaccine for: Rotavirus, Hib (Hemophilus influenzae type b bacteria-not to be confused with the flu), PCV (Pneumococcal pneumonia), Hep B (Hepatitis B), Varicella (chicken pox), Hep A (Hepatitis A, Influenza (yearly because the flu strains change from year-to-year).  We also have a few different vaccines now.  The DTP was changed to DTaP and the OPV was changed to IPV.


In 1983 people still DIED from those diseases.

For example-this is directly from the website below: "Chickenpox (varicella) used to be very common in the United States before the chickenpox vaccine became available in 1995. In the early 1990s, an average of 4 million people got chickenpox, 10,500 to 13,000 were hospitalized (range, 8,000 to 18,000), and 100 to 150 died each year. Most of the severe complications and deaths from chickenpox occurred in people who were previously healthy. Each year, more than 3.5 million cases of varicella, 9,000 hospitalizations, and 100 deaths are prevented by varicella vaccination in the United States. For more information, see Monitoring the Impact Varicella Vaccination."

Yes, 100 or 150 previously healthy children died each year from chicken pox, but that's 100 children that don't die now.  If my child was one of the 100 that died, you would bet I would be devastated!  In fact, if my child was one of the 10,500 that had to be hospitalized each year, I would probably have been super frustrated.  Chicken pox is NOT a harmless disease! Even if my kid didn't die, just watching him miserable and itchy and in bed with a fever would be heartbreaking enough! 

Some parents say "I don't want my child getting the Hepatitis B shot at birth, because that's a STD and my CHILD won't be having sex."  Which is true.  But it can also be transmitted by an accidental needle stick or BY A BITE FROM ANOTHER PERSON. I work in healthcare, putting me at risk for accidental needle sticks.  The state of Texas will not let me work without a Hepatitis B vaccine.  And because I work in healthcare, I have SEEN someone who has a lifelong infection of Hepatitis B from a bite she got from another kid when she was 3 years old.  That is why we vaccinate so young! And I won't even go into the cases of child abuse I've seen. Sh*t happens! Protect your kids from it! 

And guys, you know there are a bunch of shots that AREN'T routine. There's a yellow fever shot- which we don't get (unless you're traveling overseas). There's also a typhoid fever shot. Shocking, right? If it was just a ploy to make money, we would all be getting these shots! (More on that later, but spoiler alert-it's not about making money!)

5.      The world is sick- I want to love the world

This world is sick.  Diseases, many which are vaccine-preventable, are just a plane-ride away.  I believe a vaccine is the best way to protect my children from diseases and death.

I know not all vaccines are 100% effective (flu and pertussis only cover some of the more common strains of the disease) but I would rather protect them 60% than 0%.  If parents in my clinic want to skip on shots, I want them to know what shots they're skipping, and how they're going to prevent the child from coming into contact with the disease.  This link agrees that vaccines aren't 100% effective http://www.vaccinateyourbaby.org/why/protecting.cfm

Here are some of the rates of effectiveness over time for vaccines:  http://www.immune.org.nz/category/tags/vaccine-duration

People say that catching the disease gives you lifelong immunity.  That's a lie for some diseases.  For pertussis, both the shot and the disease people are immune for a minimum of 4 years.  getting pertussis CAN have you stay immune for 20 years, the shot up to 12 years.  Neither are lifelong http://www.ncbi.nlm.nih.gov/pubmed/15876927

For measles, both the shot (if you get the recommended 2 doses) and the disease give you lifelong immunity: http://www.who.int/mediacentre/factsheets/fs286/en/ 

Interestingly enough (warning: this evidence is anecdotal) I work next to the employee health center of my hospital.  I don't work for employee health, but my desk sits there.  We draw titers on employees before they can work.  The state of Texas (made law by a senate bill) will not let you work in a healthcare center if you are not immune to measles, mumps, rubella, Hep B, and varicella (chicken pox).  I watch them draw titers all the time and call people that aren't immune so they can get vaccinated.  Most people, even our elderly volunteers and our younger volunteers who have had the shots, are immune to all these diseases.  Vaccines (some of them) can provide lifetime immunity!

Below is a nifty little explanation on why some vaccines don't give lifelong immunity and why some do.  Really, I want to make sure my kid can make it to age 2.  After that, I trust his body's immune system.  Before that all the anti-vaxxers make me nervous because the shots haven't been completed.  (and yes, I know this info is from a drug company, but it was the best, easiest to follow explanation I could find for why some vaccines give lifelong immunity and some don't.) 

Americans don't have to worry about their neighbors having measles.  (yet)  Some countries don't have that luxury.  I've seen mothers walk 5 miles each way to get their kid a measles vaccine.  Or a tuberculosis vaccine (BCG...and no, we don't use this in America because the risk of catching TB (tuberculosis) is so much lower here) because their neighbors in Congo have been re-locating closer and they have seen those children die of vaccine-preventable diseases. 

Here are some statistics of measles around the world: http://www.who.int/mediacentre/factsheets/fs286/en/
Think your non-vaccinated kid is safe outside of America?  They're not.  Even Mexico has cases of measles.

Not to mention things like polio, tuberculosis, and rubella that we aren't worried about in America.  Just like we saw Ebola and Zika, infections can get on a plane and travel to America very easily.  Or like the case of measles that started in Disneyland and spread to over 70 people. (most were unvaccinated or under-vaccinated. And yes, some were vaccinated- but that's a topic for another time) 

I want to love this WHOLE WORLD as God calls me to.  I want to take my children with me and that may include exposing them to higher populations of measles.  I don't want to say, "no, God, I will not take my children back with me to Zambia because that would needlessly be putting them at risk for measles."  I also don't want to say, "Wow, church, I'm glad you're passionate about loving the immigrants that come to Dallas, but they aren't all vaccinated and they could be harboring diseases so for the sake of my children, I won't help volunteer with them."  And I refuse to put my children in harm's way when a vaccine could save their life.

If you don't vaccinate your children, you can't safely travel with them worldwide.  You can't volunteer in refugee communities.  They can't work (or volunteer) in healthcare. That's a choice you made for them when you refused to vaccinate. 

People have been anti-vaxxers since the smallpox vaccine was created.  Its not new.  Its not the "cool" thing to do.  If you want some early history on the smallpox vaccine (and the beginning of the vaccine controversy) Wikipedia has a good article.  And I know, wiki isn't the best source of information.  But it does just fine for historical context http://en.wikipedia.org/wiki/Smallpox_vaccine

Lets all be thankful. 

Did you know one child dies EVERY 20 SECONDS from a vaccine-preventable disease?  http://shotatlife.org/learn/
Sure, none of these children are in America.  But they exist.

We don't use the OPV (oral polio vaccine) anymore because it isn't as safe as the IPV (inactivated polio vaccine) and our children will never experience the vaccine for TB (BCG vaccine) because that isn't a problem in this country.  We don't have massive outbreaks of malaria, TB, or measles like other countries do.  This keeps my children and your children-regardless on your stance for vaccination- safer!  Many people in countries around the world still loose children from vaccine-preventable illnesses because they simply don't have access to a vaccine.

Here's a link to find out more info on the vaccine used in America (IPV) and the vaccine used in mosst 3rd world contries (OPV).  Most parents don't know there is a difference in these vaccines.  Yes, there is a chance your kid can get polio from the OPV.  But since we do not use that form of the vaccine now, there is no longer that risk.

6.      I want to protect those around us, yes there is risk to us.

Some kids can't get vaccines.  Like kids with leukemia.  I want to help those kids.

Or the little newborn squishy babies that can't get shots. Or the elderly, fragile folks. I want to protect them too.  

Parents in this country have suffered from losing children to vaccine-preventable illnesses. 

You want to participate in government-run activities?  You want to be part of the freedom that America was founded on?  America wouldn't be here without people who stood up to protect us.  People who stood in our place to make the community safe.  That's what freedom is all about.

Would you be so selfish as to usurp that freedom and use it for only your own good?  What about the good of others?  We need to protect them.

If you don't want to take part in the civil-duty vaccinate, maybe you shouldn't be allowed to take part in other civil-liberties like school. I'm not saying anyone has to vaccinate.  I'm not for mandatory vaccinations.  But I do believe if you want to send your kid to school or even take your kid to the public playground, you should have to have them vaccinated.  

Vaccinating your kid isn't just a parenting choice like cloth vs disposable diapers or organic vs conventional apples, it DEEPLY impacts the entire society you live in. 

(But obviously, that's my opinion) 

7.      Is it just a money game, do pharmaceutical companies just make huge profit on vaccines?  It doesn’t look like it.

Vaccine manufacturers aren't making the big dollars on vaccines.  Less than 10% of a pharmaceutical company's revenue comes from vaccines.  They make the big money on other drugs.  If you think about it, it would behoove vaccine companies NOT to make vaccines so they could make more money on the drugs to treat the diseases...  People who adamantly oppose vaccines DO get paid by big lobbyists and lawyers.

This post lays out who really gets paid in the vaccine debate (as well as who gets paid from other avenues that are less than scientific)  http://scienceblogs.com/insolence/2014/07/16/and-they-say-im-in-it-for-the-money/ 

Can you open this link?  It is for GSK (GlaxoSmithKline, one of the big pharma companies that makes a lot of vaccines: rotarix, twinrix, etc).  If you scroll down to page 85 (I know, there's a lot of info) it has their financials.  They break it down, but esentially 3,000 of their revenue is from vaccines of their total 26000 revenue.  Thats less than 10%.  http://www.gsk.com/content/dam/gsk/globals/documents/pdf/GSK-Annual-Report-2012.pdf

And if you think about it, wouldn't "Big Pharma" want us to skip vaccines so we could use their meds when we get sick?  Wouldn't that make them more money than letting us get vaccinated and becoming immune to so many diseases?

Also, I'm a healthcare provider.  We legally can't take anything from "Big Pharma."  Not even a pen.  So I can't be paid-off to give vaccines.  Also, my paycheck is EXACTLY THE SAME if someone gets their kids a vaccine or doesn't.  There's no money-making conspiracy here. So you can't play that card, or call me a "pharma-shill" for my beliefs. 


If it was actually all “just about the money” we wouldn’t have vaccines.  They cost pennies compared to the cost of a child hospitalized for a vaccine-preventable disease.  Think about that.  Think about how much money you’re giving Big Pharma if your kid actually gets a disease and goes to the hospital for it. The real money makers for Pharma are the treatments for hepatitis- just look up the cost of ONE dose! By skipping that vaccine you are literally gambling with something no one can afford! 

8.      Could it be a conspiracy?  Really?  The government can keep a secret?  What about the "CDC Whistleblower?"

But what about the "CDC Whistleblower" Incident?  (If you don't know what I'm referring to, here's a little background:  A big paper was published in the early 2000s that studied the proposed link between vaccines and autism.  A paper was published with the result that no, vaccines do not raise the risk of autism.  The data set from this paper was also published so that others could do their own analysis of the data.  Then, last year, more than 10 yrs after the original paper was published, someone decided to come along and re-analyze the data.  He used the wrong test for the data (used a chi-squared test, claming it was the "simpleist" test to do, and analyzed data that was supposed to be analyzed as a case-controlled study as a cohort study.  Basically, he manipulated the numbers to show that in one group (african american males over age 3) that there could be an increase in autism.  Which is a pretty pitiful conclusion that no one has been able to replicate in other data sets.  IF it sounds fishy, that's because it is.)

Honestly, if you have taken even one statistics class, you know how important it is to analyze the data with the right tests.  And if you haven't taken a statistics class, you should do that before you analyze data. ESPECIALLY if you are going to publish it in a peer-reviewed (although not well respected) paper. 

Can the government keep anything a secret? Honestly? And if you think maybe the American government can- look at all the other countries. You can't hide something THAT huge! 

9.      The bottom Line: vaccines are safe and Benefits > Risks.

Vaccines are safe.  This ties into the correlation/causation discussion above.  You may disagree with me.  Many parents do, and that's why so many refuse to immunize their children. 

If you're concerned about additives?  Did you know the number of kids with autism is increasing, even after thimerosal was taken out of vaccines? There's a reason for that and it has nothing to do with vaccines! (And everything to do with more awareness and different DSM categories, which is another discussion for another time!) http://www.ncbi.nlm.nih.gov/pubmed/18180424

And yes, I want to give my kids vaccinations for things like chicken pox (varicella)  Why?  Because: 1, I don't want them to suffer unnecessarily, 2, If they were to get a secondary infection from scratching those pox, they would need antibiotics unnecessarily. 3, Some children, particularly those that are really young or immunocompromised, can't get the shot, and not giving my kids the shot puts those children at risk.

Yes, I am thinking about others when I decide to vaccinate my child.  Not that you're not thinking about others if you choose not to vaccinate, but I believe that it is my social responsibility to help keep herd immunity up to prevent disease outbreaks.  And I truly believe that THE BENEFITS OF VACCINATION OUTWEIGH THE RISKS.

Here's a large meta-analysis.  That's when someone pulls together all the studies they can find (usually there's some criteria they must meet: like they must be double-blinded: the researchers and subjects don't know what group they are in, have a statistically significant number of people, and have a well-designed study)  If you don't understand basic statistics, or you don't know what I'm talking about, it may help if you read more about statistics so you can make better informed decisions when reading papers.  This link may only open if you are at a library that has access to science direct.  (my medical center does)

It proves that not only are vaccines not linked to autism, but neither are thimerosal or murcury. Just in case you couldn't open it, I copied the study name, authors, and abstract below (I hope that's ok as far as copyright goes, I'm not trying to take credit for the study, I just wanted to prove it's out there.)

[Vaccines are not associated with autism: An evidence-based meta-analysis of case-control and cohort studies

·        Luke E. Taylor
·        Amy L. Swerdfeger
·        Guy D. Eslick


There has been enormous debate regarding the possibility of a link between childhood vaccinations and the subsequent development of autism. This has in recent times become a major public health issue with vaccine preventable diseases increasing in the community due to the fear of a ‘link’ between vaccinations and autism. We performed a meta-analysis to summarise available evidence from case-control and cohort studies on this topic (MEDLINE, PubMed, EMBASE, Google Scholar up to April, 2014). Eligible studies assessed the relationship between vaccine administration and the subsequent development of autism or autism spectrum disorders (ASD). Two reviewers extracted data on study characteristics, methods, and outcomes. Disagreement was resolved by consensus with another author. Five cohort studies involving 1,256,407 children, and five case-control studies involving 9,920 children were included in this analysis. The cohort data revealed no relationship between vaccination and autism (OR: 0.99; 95% CI: 0.92 to 1.06) or ASD (OR: 0.91; 95% CI: 0.68 to 1.20), nor was there a relationship between autism and MMR (OR: 0.84; 95% CI: 0.70 to 1.01), or thimerosal (OR: 1.00; 95% CI: 0.77 to 1.31), or mercury (Hg) (OR: 1.00; 95% CI: 0.93 to 1.07). Similarly the case-control data found no evidence for increased risk of developing autism or ASD following MMR, Hg, or thimerosal exposure when grouped by condition (OR: 0.90, 95% CI: 0.83 to 0.98; p = 0.02) or grouped by exposure type (OR: 0.85, 95% CI: 0.76 to 0.95; p = 0.01). Findings of this meta-analysis suggest that vaccinations are not associated with the development of autism or autism spectrum disorder. Furthermore, the components of the vaccines (thimerosal or mercury) or multiple vaccines (MMR) are not associated with the development of autism or autism spectrum disorder.]

Ok, but what about all the other scary-sounding things they put in immunizations like antifreeze, and aborted fetal tissue and stuff?

Straight from the CDC website: ( http://www.cdc.gov/vaccines/vac-gen/additives.htm )
"Common substances found in vaccines include:
  • Aluminum gels or salts of aluminum which are added as adjuvants to help the vaccine stimulate a better response. Adjuvants help promote an earlier, more potent response, and more persistent immune response to the vaccine.
  • Antibiotics which are added to some vaccines to prevent the growth of germs (bacteria) during production and storage of the vaccine. No vaccine produced in the United States contains penicillin.
  • Egg protein is found in influenza and yellow fever vaccines, which are prepared using chicken eggs. Ordinarily, persons who are able to eat eggs or egg products safely can receive these vaccines.
  • Formaldehyde is used to inactivate bacterial products for toxoid vaccines, (these are vaccines that use an inactive bacterial toxin to produce immunity.) It is also used to kill unwanted viruses and bacteria that might contaminate the vaccine during production. Most formaldehyde is removed from the vaccine before it is packaged.
  • Monosodium glutamate (MSG) and 2-phenoxy-ethanol which are used as stabilizers in a few vaccines to help the vaccine remain unchanged when the vaccine is exposed to heat, light, acidity, or humidity.
  • Thimerosal is a mercury-containing preservative that is added to vials of vaccine that contain more than one dose to prevent contamination and growth of potentially harmful bacteria."

As of 1999, thimerosal was removed from all childhood vaccines. If you want more specific ingredient lists for each vaccine, you can follow this link:   http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/B/excipient-table-2.pdf

Here's a nice blog loaded science-based with links disproving some of the scary stuff. Yeah, I know, I used a blog.  But they're different when they're not cherry picking the evidence. Any this nice blogger did such a great job explaining all the ingredients in vaccines so I didn't have to: 

There are no fetuses in immunizations.  Some of the immunizations, like chicken pox/varicella,  are derived from fetal-cell lines (babies that were already aborted) in the 1960s.  Fetuses are not used in the vaccines though.  Babies are not currently being aborted to put into vaccines, and they never will be.  These babies (from a long time ago) were already aborted by their mothers, but we were able to use them to further science. It is sad that the babies were killed so long ago, but babies are not being killed now. And by preventing your kid from giving a pregnant lady rubella you are actually helping PREVENT spontaneous abortions. Well done! 


SIDS rates go down with immunizations. As do Alzheimers.  Wait? You mean vaccines can actually be protective of more than just the diseases they prevent?  Yes. They can!

Alzheimers Prevention: (from getting the flu shot yearly)

SIDS Prevention:


The MMR shot gets a bad wrap, so here is some Measles specific safety info:

Vaccine reaction info:

Oh, and there are SOME studies comparing vaccinated kids to unvaccinated ones: 

Vaxxers vs unvaxxed:

A lot of people talk about there "not being enough research behind vaccines."  I've heard the complaint that there "aren't enough placebo-controlled, randomized trials."  I agree.  But, it would be very unethical to have placebo trial now that we know how well vaccines work.  I've attached two studies.  Both are older, and not done in America.  I'll describe each study, but please feel free to look at each one and see what they say. Last, I listed a study that was small, but was done in monkeys. 

This was a study done in Cambodia after WWII looking at the tetanus vaccine.  I have seen a lot of people talking about how the tetanus vaccine "was never studied."  In this study, they gave a flu shot as the placebo.  The group that got a tetanus shot had 0 cases of neonatal tetanus, and the group that got the flu shot had 7.8 cases in 100.  The tetanus vaccine works. 

Here's a more in-depth study.  Yes, I agree, it's not done in America.  But it was a well designed study. The first link is a blog talking about the study (and giving more reasons why we can't do a vaccinated vs unvaccinated study (but his tone is a little harsh against anti-vaccination, so beware)  The second link is a link to the actual study.  Its German.

An Anti-vaccine group funded a study in Monkeys to try to get a good look at a vaccinated group vs an unvaccinated group. Their results showed no difference in the two groups when they studied behavior and brain function:


The bottom line: Vaccines are Safe!! 

10.      What schedule will we use to vaccinate?

What schedule will we use to vaccinate our child?  The one recommended by the ACIP and AAP (American Academy of Pediatrics).  The schedule recommended by Dr. Bob Sears is ill-founded and HAS NO RESEARCH to support it (which he openly admits).  The AAP's schedule has been tested, researched, and is safe.   Dr. Sears claims doctors don't know much about vaccines.  That is true for some doctors, but not all.  I've done extensive reading on the topic. And so have all the healthcare professionals I work with.  Here is an article about the problems with Dr. Sears's schedule: http://pediatrics.aappublications.org/content/123/1/e164.full

And I'm not the only person that thinks this way.

I'm not the only pro-vaccinator. There are more people out there who love shots as much as I do: http://shotofprevention.com/

More reasons why you should vaccinate: http://www.vaccinateyourbaby.org/why/protecting.cfm  It terrifies me because none of the vaccines offer 100% protection from infection. The more the disease spreads, the more likely people, vaccinated or not, are at risk.  Getting the vaccine usually means if you catch the disease, you should have the disease for a shorter amount of time, and be less severe. (and yes, I've seen this happen in 2014 when the flu shot was not well matched for the circulating strain)  But we're forgetting about kids who can't be vaccinated because they have cancer.  I want to protect those too.


And here's the AAP's position on HOW to figure out if a "vaccine website" is legit.  https://www2.aap.org/immunization/families/faq/FAQ_Internet.pdf

They don't "overwhelm" the immune system.  Yes, we give more vaccines today because we PROTECT against more than we used to!  Vaccines provide the same natural immunity that an infection does.  Yes, some of that wanes with time, but getting the natural disease does too.  But not everyone will tell you that.

Those are my reasons.  And some of my "research."  Up soon, I will post an article on WHY WE WILL NOT BE USING ESSENTIAL OILS ON OUR CHILD.  If you think vaccines don't have enough research, how the heck do you think oils have enough research?  Yes, sometimes bad things happen with oils.  They aren't perfectly safe like salespeople tell you they are.  But more on that later. (Much later) 

We have decided to vaccinate our child.  We are thankful for vaccines and for the people who research them. The benefits clearly outweigh the risks. 

04 June 2015

The day I decided to give birth in a hospital.

First off, this post is for me.

So I can organize my thoughts, blogs I like, and scientific evidence in one spot, so I can be organized.  So I can fully know why I have chosen to give birth in a hospital.

I believe this choice is different for each person, and I'm not telling you what you should do.  I'm just trying to look at all the evidence and make a good choice for me.  Because a lot of "evidence" is biased.  As a general rule, when someone tries to sell you something, anything, on their website, I don't trust their "evidence."

What about the higher c-section rate?  What about the proposed link between birth-induction and autism?  What about the supposed higher death rate in hospitals? What about the supposed higher risks of hospitals, like higher rates of infection, less autonomy, not respecting a birth plan, or forced pain medication?  What about the risks of epidurals? 

What about the higher cost?  After-all, isn't birth natural, and the medical industry makes billions of dollars each year off of pregnant women and babies. 

I'm using links to science papers (peer-reviewed: meaning other scientists looked over them and confirmed their validity before being published in a respected journal) and blogs, even though as far as evidence goes, I don't respect blogs.  They are only opinion.  I only respect journal articles from a peer-reviewed journal (that haven't been retracted, and meet high quality criteria such as study design and number of participants...) I'll list those links also, for completeness.

I probably won't list links to where the studies were found.  Because anyone can go to PubMed and type in any number of words and copy-paste links "supporting" their side of the evidence.  For instance, if you search for "vaccines and fish" you will get a huge number of hits.  Which have nothing to do with what you're looking for.  

I'll also be looking at "consensus statements" made by large physician groups such as the American Academy of Pediatrics, the Centers for Disease Control and Prevention, and the American Congress of Obstetrics and Gynecology.  Because you can always find "one doctor" to say whatever they want.  But it takes a large body of evidence for the "consensus" of doctors to change their mind about anything.  They look at real proof, not just cherry-picked or biased studies.  Rarely, is the consensus wrong.

And no, I didn't write this post to "prove anyone wrong" or convince people that this is the best way to deliver a baby.  I wrote this for me.  And you, if you want to read it.

I challenge you to oppose my views.  Post contradictory studies in the comments.  Meet me for coffee to further discuss this. While I promise to look into any concerns, at the end of the day this is a decision I am going to make. (With the full support of my husband)  And FYI, natural news is not a reputable site.  I don't believe in what the author of that site believes (ridiculous things like chemtrails, HIV-denialism, and anti-vaccine propaganda) so I won't even bother responding to posts from that website or similar anti-scientific websites.


On home births:

Lets look at information from the scientific consensus:

Here's the committee opinion from the ACOG:

And here's what everyone's favorite web-based encyclopedia (Wikipedia) has to say about home birth:

Here's what one of my favorite blogs has to say about home birth:  (It has a lot to say on home birth...and if you're looking for anything science-based it has a lot to say.  It cites fantastic peer-reviewed studies.)

And my personal favorite: the Centers for Disease Control and Prevention.  Here's official information about the infant mortality rate currently in America. 

CDC report on infant mortality rate:

And finally, the British Medical Journal/s most robust study on homebirth, (The MOST downloaded paper on the subject of homebirth)

(the most pertinent quote in the study): "In 2005 the neonatal death rates were CNM in hospital 0.51/1000, MD in hospital 0.63/1000 and DEM attended homebirth 1.4/1000."

Look how much higher the neonatal death rate was in a homebirth than in the hospital! Neonatal death rate is more important to me than infant-mortality rate because infant mortality rate covers up to 1 year of life, and it's not the doctor or midwife's fault if the baby dies the day before it's 1st birthday.  The death rate for a midwife and MD in the hospital are similar (but remember that MDs (Medical Doctors) often are given the more-complicated patients: patients with pre-eclampsia, diabetes, etc, and CNMs (Certified Nurse Midwives) in hospitals are often given easier, low-risk patients or multiparous patients)  At least, when I was a student and I delivered babies, that's how the hospital I was at did things.

Moral of the story, midwife birth at home has a higher neonatal death rate.

I want to give birth to a baby that stays alive.  If that requires a c-section or medical intervention, I'm okay with that.  I will sacrifice myself/ my body and a "perfect birth" for the life/ health for my baby.

This is a science-based medicine blog perspective on the study listed above:  http://www.sciencebasedmedicine.org/a-critique-of-the-leading-study-of-american-homebirth/

The discussion shows that the paper listed above has an almost TRIPLE neonatal death rate for homebirth. 

TRIPLE the neonatal death rate for PLANNED homebirth.

Meaning, the paper only cites someone that has planned to give birth at home, with a midwife, and not people that accidentally don't make it to the hospital on time.  This is important to note because some people like to say "accidental birth skews the numbers in favor of hospital-birth")

AND the study includes the fact that no matter what "high risk births" (people with diabetes, high blood pressure, other medical conditions) are happening in a hospital.  So they compare the more low-risk births (as a general rule Midwives don't give birth to high-risk mothers) to ALL births in the hospital.  

Low-risk home birth vs. all-risk hospital births.  And hospital birth still has a lower death rate.

At the end of the day, I will risk any medical intervention if it means 1/3 less risk of death for me or my baby.  The medical system in America isn't perfect.  But I'd sure rather put my fate in the hands of a well-trained doctor in the hospital than in the hands of a questionably trained midwife at home. 

PubMed meta analysis (analysis of many papers) published in the ACOG journal:

I respect your right to choose.  A good compromise would be a birth in a home-like birthing center.  But I want no part of a home birth.

Some anecdotes about the babies I have watched get delivered:
I've seen high-risk births delivered by ob/gyns, low-risk births in hospitals delivered by midwives, and even rural-Africa (specifically Zambia) births delivered by a skilled nurse.  I've seen my fair share of births in a diverse number of places.  I was even invited to photograph a home-birth (for a mother who was later sent to the hospital since her midwife declared her unsafe to birth at home, and her baby ended up in the NICU for 1 month, and would have been dead if delivered at home).  

Being a student, I got to deliver some babies. 14 babies.  Most of them moderately low-risk babies that had adequate prenatal care.  All of the babies I delivered were healthy, thankfully!  But that doesn't mean I didn't see complications.

I saw one mom who had a problem with her placenta after the baby was born.  Her placenta wouldn't separate, and she kept bleeding.  She lost a lot of blood.  The interns and students were shoved aside while the resident and attending doctors did everything they could to save the mother's life.

10 minutes, an pitocin drip, and 2 liters of blood later, she was stable again. She would have died had she been at home, midwife or not.

I saw a woman who was delivering twins, who passed out from exhaustion after the first twin was born.  They almost couldn't wake her up.  They were starting to prep her for a c-section to save the second baby, when she woke up and started pushing again. 

I've seen babies who would have been born normally, who had fetal heart rate monitors on and had decelerations in their heart rate, and had to be urgently delivered.

I have seen so many things that "should have been" normal and perfectly fine.  So many moms that "should be able to give birth just fine" who almost didn't.  These moms or their babies could have died if they had delivered at home. 

Probably most moms who deliver at home would be just fine.  But really?  Do you want to take that chance?  Especially with your first birth?  I don't.

I just can't give birth at home, knowing that most moms are just fine at home, but having watched so many moms that "should have been fine" and weren't.  After you watch someone almost bleed to death, it changes you. And I'm okay with that.

At the end of the day, I want an alive baby and mommy.  And the best chance of that happening is in a hospital. (which makes most of the rest of this post a moot-point, but knowing that at any instant something could change, I want to be prepared for why I chose something or didn't choose something.)


On water births:

Who wants a water birth anyway?  Well, many people suggest that water births are safer, more natural, and they decrease the use of medication.  I'm all for reducing medication.  But are water births actually safer?  Are they actually more natural?

The highly respected AAP and ACOG opinion: (remember, I'm looking very closely at committee opinions- not the opinion of just one doctor who promotes themselves on a website or in a documentary looking to make money, but volunteers their time to be on a committee with other doctors to review scientific evidence)

And an article from Pediatrics Journal (by the APP):

Here's what the article says about the risks:
"Water births currently provide no apparent benefit in childbirth. The practice is based on misrepresentations of neonatal physiology and unsupported claims of safety and efficacy. This birthing method fulfills no need for the infant, is of dubious benefit to the mother, is associated with significant, avoidable risks of morbidity and mortality, and currently is unable to pass the risk-benefit test"

Woah.  So you know when you keep reading how great water birth is because of the "dive reflex" (babies won't open their mouth to breathe underwater)?  Well, that's a big myth (It's a myth in warm water, only in ice-cold water babies won't breathe).  Your baby MAY take a breath underwater, opening up RISK of drowning.  Yes, that's right, drowning so you can be more comfortable. 

And everyone's favorite again (Wikipedia):

Here are some science-based blogs on water births- the first one really spells out a lot of what pro-water-birth moms believe and shows why that may not be true.  I highly encourage you to read it if you are thinking about water birth! 
Here is a Chochrane review: (well, just the abstract, because that's free)

(The gist of the paper on water birth is this: there is possible benefit of pain relief in 1st stage of labor which ends when cervix fully dilated, the safety of water birth is not established after.)

Risks of water birth (in quotes because I borrowed these from the first link of the above science-based medicine blog):
  1. Increased risk of infection, especially after rupture of the membranes acting as a barrier between baby and the outside world
  2. Problems with temperature regulation in the baby
  3. Damage to the umbilical cord, or pulling of the cord out of the placenta, leading to severe bleeding complications
  4. Respiratory distress, hyponatremia, seizures and asphyxia from fresh water drowning

The risks don't outweigh the benefits: (article on real risks)

What it comes down to for me is that the risks don't outweigh the benefits.  Not at home.  Not in a birthing center.  Not in a hospital.  While it may be more comfortable for me, it isn't safe for my baby.  I won't be delivering this child in the water.

Now, the first stage of labor (before I'm fully dilated, before the "pushing" starts, before the baby is delivered-which actually occurs in the 2nd stage of labor) is a different story.  If hanging out in a warm water tub before my cervix is fully dilated keeps me from needing an epidural or another form of medication, then that sounds good to me. I can do that.  That's not risky.  Delivering there is.


On C-Sections:

Not many people want a c-section.  While some women prefer one, most people I meet don't.  But it's easy to forget that some people NEED one.

"The following situations are some of the reasons why a cesarean birth is performed:

  • Multiple pregnancy—If a woman is pregnant with twins, a cesarean birth may be necessary if the babies are being born too early, are not in good positions in the uterus, or if there are other problems. The likelihood of having a cesarean birth increases with the number of babies a woman is carrying.
  • Failure of labor to progress—Contractions may not open the cervix enough for the baby to move into the vagina.
  • Concern for the baby—For instance, the umbilical cord may become pinched or compressed or fetal monitoring may detect an abnormal heart rate.
  • Problems with the placenta
  • A large baby
  • Breech presentation
  • Maternal infections, such as human immunodeficiency virus or herpes
  • Maternal medical conditions, such as diabetes or high blood pressure"

Sometimes C-sections are the best option.  Even the best Midwife can't deliver a baby vaginally if a women has plecenta previa.  (the placenta in front of the cervix)  Midwives can't move the placentna for you.  They can maybe rotate the baby, but they can't move a placenta.

But what about the high c-section rate?  Aren't too many women getting c-sections?

Not all c-sections are bad.  With the way things are in America, (1/3 of the population, and 1/3 of mothers are obese) some people need c-sections. Especially if their baby is breech (see below).  Sometimes labor is going well and then a c-section is needed because the baby is in distress.  If I'm at home and my baby isn't hooked up to a fetal monitor, how will someone know if the baby is in distress?

Often, midwives don't know and they can't save the baby.  More on that later.

But if I am laboring and my baby is in distress (in risk of dying) and a c-section is an option to SAVE my baby, then by all means, cut me open and save my kid!

What about a breech baby?  Should that be reason for a c-section?

The Lancet journal, a respected peer-reviewed article on breach birth:

Here's my favorite blog again discussing breech vaginal delivery.  Many midwives proudly boast that they can safely deliver a breech baby.  But is it ACTUALLY safe?

I've seen similar stories in the news about why you may want a c-section for a breech baby and why not.  The bottom line is this:  While the NNT (Number of people needed to treat before a reduction in mortality is seen) is higher than I would like, at the same time, we're talking about people here.  Humans, that could have been saved.


Period.  That's it.  While the risk of death giving birth vaginally to a breech baby, the risk is higher than if you have a c-section.

If my baby is breech, we will have a c-section.  End of story. 

Another abstract discussing how the infant-child mortality rate decreases when the rate of C-Sections increases.  Fascinating. 


On induction:

Sometimes induction is necessary.  It involves risks though.  Why might someone need to be induced?

"Labor is induced to stimulate contractions of the uterus in an effort to have a vaginal birth. Labor induction may be recommended if the health of the mother or fetus is at risk."
(quote from the ACOG website listed above)

If our baby is at risk, I would rather be induced than place my baby in harm's way.  The ACOG website has more info, but sometimes when your membranes rupture early, but you don't go into labor, your baby can be at risk.  The longer you sit without delivering the baby, the higher your risk for infection is. 

Some people are looking at Induction and the risk of autism.  There are some questions about if the two are related?  Here is my favorite scinence website discussing the issue, and following is a study that also discusses it. 

A PubMed article showing CORRELATION, but not CAUSATION:

We all know that correlation does not imply causation.  For example, did you know that when more people consume ice cream, more people drown.  Those two things are correlated.

For this example, it is fairly easy to see that eating ice cream does not cause people to drown.  The fact is, more people eat ice cream in the summer, and more people swim in the summer.  Therefore, more people drown in the summer.

For other factors, correlation and causation get a little more confused.  It is one of the reasons people still think vaccines cause autism.  Because one day their kid is "normal" and the next day their kid is regressing and gets the autism diagnosis.  And they think "the only thing that happened is that my kid got his shots!" Plenty of studies have shown that vaccines don't cause autism, but people still think that they do.  There's more info on that in my upcoming blog post on vaccines.

There haven't been enough studies for me (or any MDs or scientists even) to say that induction DOESN'T cause autism.  But there also aren't enough studies to say that it DOES cause autism.  Most of the research we have now shows that autism starts in the womb.  It has a lot to do with genetics.

I won't be requesting an induction, but if I need one, I will not hesitate to follow the advice of my OB, because he's the expert. And I know he's only going to recommend something if he feels it is best for me and the baby. 

I defer to the experts when it comes to my 401K, to my cars, to banking, why wouldn't I trust the experts when it comes to my medical care?  No, I don't think there's a conspiracy.  If there was some kind of conspiracy, I would have learned about it in school. 

Again, this is for me.  I'm not telling you what to do or believe.


On pain management:

A book worth looking into:

Further expanded (cliffs notes-like version of the book in the 1st blog below:)

Probably the most interesting part of the posts above:

"Unrelieved pain during labor and post-partum has been shown to

  • Cause stress responses that can reduce the baby’s oxygen supply
  • Increase the risk of post-partum depression and post-traumatic stress disorder (PTSD)
  • Interfere with breast-feeding
  • Increase the risk of development of chronic pain conditions"
But what does Wikipedia say about Epidurals?  Do they cause more c-sections?

Quote from Wiki:
"Differing outcomes in frequency of Cesarean section may be explained by differing institutions or their practitioners: epidural anaesthesia and analgesia administered at top-rated institutions does not generally result in a clinically significant increase in caesarean rates, whereas the risk of caesarean delivery at poorly ranked facilities seems to increase with the use of epidural."

PubMed article on the risk of C-section with an epidural (spoiler: there is no increased risk)
With older-epidural techniques an increased risk of instrument-assisted deliveries (forceps, vacuum deliveries) was seen, with newer epidural techniques it is not. 

On early epidurals vs late:

Highly respected New England Journal of Medicine article on Epidural use:

More articles:

Am I definitely going to get an epidural?  Not necessarily.  Am I definitely not getting one?  No.  It will depend on how I'm feeling, my level of pain, and speed of progression.  I don't think they're unsafe, but if I don't need one, why get one? 

I've read UpToDate (a site for providers that compiles all of the research-based studies and makes recommendations) on pain control methods during birth and the two things shown to help with pain control (other than medications) were having a doula and using a birthing ball.  Other things MAY help you, but aren't proven to work.  

So, we'll use alternative forms of pain control if possible, and if not, I'll get an epidural.  I feel they're safe.  But, as I don't take pain medication regularly if I don't need it, I won't use an epidural if I don't need it either. 

A lot of people have personal reasons for not wanting an epidural.  Those views are fine.  I don't have any reason not to get one.  So I might.  


On ultrasound use:

I have seen people claim that prenatal ultrasounds are dangerous and that they should be avoided at all costs?  Why is that?  They say the more ultrasounds done, the higher the risk is that there will be a problem with the baby.

Is this true? 

My OB said he would do 2 sonograms, which is pretty standard.  The original ultrasound at 8 weeks, and the 20 week anatomy ultrasound. I got a few more ultrasounds (well, just 2 more than planned) because my placenta was low-lying and there was a chance it would be in front of my cervix requiring me to have a c-section.  (there's no way I could give birth with a placenta in front of my cervix-if not for modern medicine the baby and I would have died in childbirth.)  Thankfully, my placenta moved. 

More ultrasounds are typically only done with a high-risk baby, who is naturally at-risk for more complications because they are already high-risk.  Midwives would never dream of touching a high-risk patient.  And for this reason, it sometimes looks like they have a lower rate of complications.


A brief note on the Hep B vaccine and Vitamin K injection:

Vit K article- informational, not a study:

Yes, my baby will come out of me and get every standard medical intervention.  A shot of Vitamin K.  A Hepatitis B vaccination.  Erythromycin eye ointment. I've read the studies.  I don't want my baby to bleed out (like 4 kids have already done) because I don't want to give Vitamin K.  It won't hurt.  And if my kid happens to have some kind of clotting disorder, than it will likely save it's life. 

I have another blog post coming on my choice/beliefs on vaccination.  And it's a very similar post.  Nothing accusatory, just information and facts that I want to organize and remember.  There's more information about why I'm choosing to have the Hepatitis B vaccination at birth.  A lot of people refuse this, thinking that Hepatitis B is only passed by IV drug users and people having sex.  But this is not true.  It can be passed by an accidental needle stick, a bite from a kid at the park, etc.  Kids stick everything in their mouth.  I'd rather my kid be protected.  I don't foresee him running into hepatitis B a lot, but I also don't foresee getting into a lot of car accidents and you better believe I have him in the best car-seat money can buy...


And that should cover it.  It covers why I want to give birth in a hospital, why I am not having a homebirth or a water birth.  It covers pain relief/epidural use, c-sections, and it covers ultrasounds.  And I feel better knowing what I know from school and from looking up recent studies about birth.  Now I am ready to have this baby!