Another day, the same old natural childbirth lies

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Presumably, in the name of journalistic balance, The Atlantic just published a new piece asserted the same old natural childbirth lies.

First, on March 15, 2012, The Atlantic published The Case for Hospital Births by Tufts obstetrician Adam Wolfberg. Using the story of Laura and her failed homebirth as a framing device, Wolfberg explained why obstetricians dread homebirth transfers. As could have been predicted, homebirth advocates responded with their typical combination of ignorance, petulance and anger.

Yesterday, The Atlantic, attempted to present an opposing view. No, they didn’t ask another obstetrician who also has experience with homebirth transfers. They didn’t ask an obstetrician at all. Instead, they published a piece of pure inanity by a professor of bioethics, Alice Dreger, under the absurd headline The Most Scientific Birth Is Often the Least Technological Birth.

It is a wholesale regurgitation of the natural childbirth community’s canard du jour that “obstetricians ignore the scientific evidence.” It is filled with the typical NCB combination of inane assertions and outright lies, as well as a brand new sanctimommy slogan that unmedicated childbirth is “sexy.”

Inane assertion #1:

… [I]f I wanted to scientifically maximize safety, I should give birth pretty much like my great-grandmothers would have …

Sure. Awesome idea. Oh, wait, wasn’t neonatal mortality 10 X HIGHER then? Wasn’t maternal mortality 100 X higher then? Oops!

Inane assertion #2:

… [W]hen the evidence still supports a low-interventionist type of pregnancy and birth management for low-risk cases, we’ve made virtually no inroads to making birth more scientific in the United States.

What scientific evidence would that be? Prof. Dreger doesn’t say. But she proudly announces that she “consulted” the scientific literature, when what she really means is that she read a few Cochrane Childbirth Reviews and thought that was the scientific literature. Apparently she didn’t consult the rest of the scientific literature including the paper on the Cochrane Childbirth Reviews, which shows that most are riddled with serious errors of statistical analysis that render their conclusions suspect or even useless.

Inane assertion #3:

Our midwife could be trusted to be scientific, whereas our obstetrician could not.

Now that’s funny. We are supposed to believe that obstetricians (with 8 years of higher education, extensive study of science and statistics, and four additional years of hands on experience caring for pregnant women), the people who actually DO the research that represents the corpus of scientific evidence, are ignoring their own findings while NCB advocates are assiduously scouring the scientific literature, reading the main obstetric journals each month, and changing their practice based on the latest scientific evidence.

I have the greatest respect for certified nurse midwives, but the concept that they are “scientific” whereas obstetricians are not is simply laughable.

Prof. Dreger disseminate the typical NCB drivel:

but I can’t count how many women have said to me that they “chose” pain medication during birth even though they were never told the risks of pain medication

What are those “risks”? She doesn’t say. Where are the consent forms that fail to inform women of the potential side effects of epidurals? She doesn’t offer any.

… [R]outine ultrasounds [do] not leave babies safer

Who said they did? No one. But how about ultrasounds to provide missing information or address a mother’s right to terminate a pregnancy if the fetus has a major structural anomaly or genetic defect? Prof. Dreger doesn’t say.

To learn more about the use or misuse of technology, Prof. Dreger doesn’t consult obstetricians. No, she asks a sociologist who has “compared birth in the US to birth in The Netherlands.” Dreger clearly has no idea that The Netherlands has one of the highest perinatal mortality rates in Europe and where midwife attended low risks births (home or hospital) have HIGHER perinatal mortality than high risk births attended by Dutch obstetricians.

It’s hardly surprising that Prof. Dreger’s article is filled with mistruths, half truths and total falsehoods. She wrote an entire article about the state of obstetric practice without consulting a single obstetrician.

Dreger finishes with a flourish that would make any sanctimommy proud. She offers the opinion of her doula:

“Birthing a baby requires the same relinquishing of control as does sex — abandoning oneself to the overwhelming sensation and doing so in a protective and supportive environment.” If only more women knew how sexy a scientific birth can be.

Sorry, Prof. Dreger, your choices don’t mark you as sexy, regardless of how much you’d like to think so. They mark you as a typical natural childbirth advocate, uneducated about obstetrics, science and statistics, and remarkably gullible.

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