No, homebirth advocates, you are not educated

There has been considerable comment on Michelle Goldberg’s piece, Home Birth: Increasingly Popular, But Dangerous. In addition to the nearly 300 comments on the site itself, a related piece on Jezebel, Homebirths Are Actually Kind of Dangerous, garnered more than 500 comments and the discussion is still continuing on Facebook.

Almost all the myriad comments from homebirth advocates have two things in common:

1. The first is that homebirth advocates invariably described themselves as “educated” on the topic of homebirth.

2. The second is that those same, self-described “educated” women are actually quite ignorant of the the bulk of the scientific literature on the topic, the state, national and international statistics that demonstrate the increased risk of perinatal and neonatal death, and even the basic terminology used to discuss the issue.

Why is there such a massive discrepancy between what homebirth advocates think they “know” and what they actually know? The basic reason is that a degree in “Cut and Paste” from the University of Google is worth no more than the paper it is printed on. The second speaks to the “immunizing strategies” of the homebirth movement.

Many celebrity homebirth advocates are well aware of deficiencies of their claims. Therefore, they take the precaution of deploying immunizing strategies such as those described by Boudry and Braekman in their paper Immunizing Strategies and Epistemic Defense Mechanisms.

What are immunizing strategies? They are used to “immunize” true believers against the data and arguments of those who disagree. By introducing small bits of those data and arguments, professional homebirth advocates seek to train followers to ignore and discount the valid data and arguments to which they will be exposed.

As Boudry and Braekman explain:

… [A]dvocates of a theory may resort to certain generic strategies for protecting a cherished theory from mounting adverse evidence: cherry-picking the data, shooting the messenger, distorting findings, special pleading, discrediting the methods employed in research with unwelcome results, accusing the new ‘orthodoxy’ of a hidden agenda etc.

These generic strategies are on faithfully deployed in the comments of self-described “educated” homebirth advocates, and include citing a few, non-representative (and inaccurate) scientific papers, insisting that obstetricians are trying to protect their “turf” and my personal favorite version of shooting the messenger: “Don’t listen to Dr. Amy because …”

Professional homebirth advocates also employ specific immunizing strategies to deal with specific data and information that is harmful to their cause. These include:

  • Deliberately conflating infant and perinatal mortality
  • Claiming, falsely, that countries that employ midwives have lower rates of mortality
  • Claiming, falsely, that homebirth studies combined planned and unplanned homebirths
  • Claiming, falsely, that only the flawed Wax study shows increased rates of mortality
  • Claiming, falsely, that modern obstetrics is not supported by scientific evidence
  • Suppressing their own data that shows homebirth increases mortality

So let me speak plainly to the self-proclaimed “educated” homebirth advocates and offer a few pieces of advice:

1. The surest sign that someone is ignorant about childbirth, science and statistics is that they claim to have “done their research” and to be “educated.”

2. It is literally impossible to become “educated” by doing internet research.

3. Most of what you think you “know” is factually false.

4. Professional homebirth advocates routinely lie, distort and misinterpret the existing data.

5. Professional homebirth advocates routinely hide and suppress their own data when it shows homebirth increases the risk of death.

In summary, you are not educated; you are indoctrinated, and it is a testament to your ignorance of science, statistics and obstetrics that you can’t tell the difference.