Dr. Isis: “Your Home Birth is Not a Feminist Statement”

Dr. Isis has certainly struck a chord. Her post Your Home Birth is Not a Feminist Statement is being widely discussed on the web.

Here’s the “money quote”:

Home birth as a way to find a loving supportive environment and fight the enslavement of the patriarchy is absolute, utter nonsense. It’s one of the only medical scenarios I can think of where women place health and welfare in jeopardy in order to feel “in control” and avoid intervention.

She examines the data on the safety of homebirth and states:

If you can look at those data and still decide … to choose home birth, then I say “You go get ’em, Gloria Steinem!” But, you should know that I’m going to judge you. Choosing to deliver at home because it makes you feel empowerful isn’t a feminist act. It’s a selfish one…

She draws the obvious parallel with vaccine rejectionism:

It’s no different from the attitudes of the anti-vaccine mothers who choose delayed vaccination schedules, or no vaccines at all, because it makes them feel safe and in control of their children’s well-being. You might feel empowered, but the data tell us that you are hurting your children with your choices…

She concludes:

I can think of no other women’s health area – Pap screening, breast cancer treatment, HPV vaccination, in which forgoing a treatment shown to improve health outcomes would be flown on a feminist banner…

If feminists care about empowering women during child birth, they should do so in an evidence-based manner… We should be continuing to ask how can we make women feel empowered in an environment that offers the best chance of survival for their offspring. This home birth talk is shenanigans.

Dr. Isis was quoted approvingly here: Home Birther Logic. or “Logic” actually, but Kate Clancy, an anthropology professor, takes issue:

I empathize strongly with those who advocate home birth, and I am not completely against it. And I think that comes from a number of places… But when I see this population of women denigrated, called “homebirthers,” essentialized, and conflated with anti-vaxxers, I feel like something needs to be said.

What should follow is an exposition demonstrating that homebirth advocates do not believe in biological essentialism or are not more likely to be vaccine rejectionist, but Clancy offers no evidence to rebut Dr. Isis. That’s because there is no evidence. Biological essentialism is a critical component of homebirth belief starting from Grantly Dick-Read (the “father of natural childbirth”) right through Ina May Gaskin who is a staunch biological essentialist.

Moreover, it is well known that homebirth is closely associated with vaccine rejectionism. A CDC presentation, The Association between Birth Place, Birth Attendant, and Early Childhood Immunizations, offers compelling data:

Overall 132,473 Oregon births were included in this study… The 2,200 children who were born in locations other than a hospital or freestanding birthing center were 8.8 times more likely not to be seeking or receiving immunizations than those born in hospitals. Those with a direct-entry or non-certified midwife in attendance were 7.4 and 8.8 times more likely to not be shot seeking as those with an M.D…

When I presented this information in the comments, Clancy blew it off with this non-sequitur:

Amy, please read two of the comments above yours, both by scientists who have had home births, and link to their own birth stories and their own justifications for their home births, before you paint all women who advocate home birth with the same brush.

Then Clancy demonstrates a complete failure in her understanding of mortality statistics. She appears to believe that perinatal mortality (deaths from 28 weeks of gestation to 28 days of life) means deaths of premature babies starting at 28 days of gestation:

… It would be stupid to try and give birth to a baby at home before 38 weeks; it would be taking an unnecessary risk. This is why I take issue with Dr. Tuteur trying to change the metrics for evaluating infant mortality to include those births that it would never, ever make sense to have at home or in a birth center…

All and all, I’d say that Kate Clancy offers an excellent example of what I always warn against, women who think they are “educated” about obstetrics but have no idea what the scientific evidence shows and no idea what the scientific terms even mean*, and what Dr. Isis was highlighting, “women [who] place health and welfare in jeopardy in order to feel “in control” and avoid intervention.”

*rather startling that she claims to be studying the anthropology of women’s reproductive physiology but doesn’t know the definition of the terms used to measure women’s reproductive outcomes.