Homebirth midwifery: follow the money

Let’s do a little thought experiment. Instead of evaluating the claims of homebirth midwives through the prism of ideology, let’s assess each claim by asking whether or not homebirth midwives profit. I’m going to go out on a limb here, and repeat a prediction that has been made by regular commentors on this blog: homebirth midwifery recommendations are driven by whether they impact midwives’ ability to make money.

1. Pain is empowering and pain relief is unnecessary.

This is probably the central therapeutic recommendation of homebirth midwifery, and (surprise!) it has a tremendous impact on the ability of homebirth midwives to make money. Simply put, homebirth midwives can’t make any money from women who want pain relief. Therefore, considerably energy is spent trying to convince women that they don’t need and shouldn’t have pain relief. That involves a variety of false assertions:

childbirth isn’t really painful
childbirth is actually pleasurable (orgasmic birth!)
childbirth pain is empowering
relieving childbirth pain is harmful to the baby
relieving childbirth pain increases the risk of C-section

Pretty clever when you think about it; they cover all the bases: childbirth isn’t painful; it is painful but the pain is good for you; and it is painful but relieving the pain is bad for you. This is the threshold issue for homebirth midwives; if they can’t convince you that pain relief is unnecessary or harmful, they can’t make money from you.

2. Electronic fetal monitoring is unnecessary

Yet another amazing coincidence! Homebirth midwives can’t provide EFM so it is critical to convince women that it is unnecessary or, better yet, harmful: it restricts women and slows labor; it leads to “unnecessareans”; it doesn’t improve outcomes. It doesn’t matter whether those claims are true; all that matters is convincing potential fee paying patients that they are true.

3. Birth is inherently safe.

The entire rationale for hospital birth is the incontrovertible fact that childbirth is inherently dangerous. Without liberal use of the technology and interventions of modern obstetrics, an appalling number of mothers and babies will die in childbirth. Who’s going to pay thousands of dollars to be attended by a layperson whose primary qualification is that she is a “birth-junkie” if that means taking on an increased risk of death? Almost no one.

Therefore, it is critical to pretend that childbirth is inherently safe and to hide the mounting evidence that homebirth with an American homebirth midwife kills babies who didn’t have to die. That’s why MANA (the Midwives Alliance of North America) is strenuously attempting to hide their death rates from the American public.

4. There’s no reason to prophylactically treat group B strep, or (an equally efficacious lie) group B strep can be prophylactically treated with (surprise!) stuff you can buy in the store like garlic (?) or antibacterial soap.

Most homebirth midwives don’t have access to IV antibiotics, the ONLY effective treatment for group B strep. If they intend to get any money from women who are group B strep positive they must convince them that IV antibiotics aren’t necessary or can be replaced by things from the local grocery store.

5. Rh- women don’t need Rhogam.

Most homebirth midwives don’t have access to Rhogam or getting access to Rhogam would require them to interface with real medical professionals and expose their illegal status. In acknowledging the need for prenatal Rhogam, homebirth midwives risk loss of money and legal action. Far better to lie about the need for Rhogam.

This brief list merely scratches the surface. I’m sure if we put our heads together we can compile a far longer list. The list will contain a variety of heterogenous and even contradictory claims, but every element will be united by one common theme. For homebirth midwives; if you can’t make money from it, you must convince women that it is unnecessary or even harmful.

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