It’s been nearly 5 years since I first pointed out the unstated guideline for homebirth midwives: whatever the scientific evidence shows, do the opposite.
… So much of homebirth advocacy is simple defiance. If obstetricians or scientists show that something works, insist that it doesn’t. If they show that something doesn’t work, insist that it does. Don’t worry about not having any evidence, and don’t worry about issuing harmful recommendations that may hurt babies and mothers. Evidently, those issues pale in comparison to the righteousness and self satisfaction that come from defying authority.
I’m not the only one to have noticed. As Ellen Annandale and Judith Clark, authors of the widely quoted paper, What is gender? Feminist theory and the sociology of human reproduction pointed out:
… the lived experience of midwifery … is revealed only as the largely unresearched antithesis of obstetrics. An alternative is called into existence in powerful and convincing terms, while at the same time its central precepts (such as ‘women controlled’, ‘natural birth’) are vaguely drawn and in practical terms carry little meaning.
In other words, for homebirth midwives, every day is opposite day.
Obstetricians point out that breech increases the risk of neonatal injury and death; homebirth midwives insist it is just “a variation of normal.” Obstetricians (and pediatricians) note that Group B sepsis, a leading killer of newborn infants, can be prevented by IV antibiotics in labor; homebirth midwives insist that putting garlic in the vagina can do the same thing. Labor and delivery nurses encourage women to hold their breath to push more effectively; homebirth midwives insist that “purple pushing” is dangerous and ineffective.
There is really no limit to the deadly defiance of these midwives. Evidently there’s no limit to the ridiculousness, either. The latest “obstetric practice” deemed unnecessary: hatting!
Yes, you read that right. Homebirth midwives have come out against the practice of putting hats on newborns to protect them from loss of body heat. Do animals put hats on their babies? No, they do not; ’nuff said. Of course, animals don’t wear clothes, don’t sleep in beds and don’t live tweet their births, but that is totally different. If you couldn’t live tweet your homebirth, how could you possibly fulfilled your narcisstic need for praise?
Back to the outrage that is hatting. The midwifery opposition may have started with the notorious Gloria Lemay. She’s the Canadian lay midwife with no formal training who has learned nothing from presiding over a number of homebirth deaths or from serving a jail sentence for contempt of court. Of course even Gloria Lemay knows that it makes no sense to tell women the truth that she opposes things merely because obstetricians do them. Therefore, she makes up her own “explanation.”
Babies were not doing well after being born to medicated women and immediate cord clamping. The baby who has started off at such a deficit will lose body heat and be in very rough shape. Helping keep in heat by a hat might be a matter of life and death in this instance where the body is so weakened.
Contrast that to a baby born spontaneously and placed on his mother’s body. . . both of them wrapped together in a warmed blanket skin to skin. The cord is intact, the placenta continues its work of transferring just the right amount of blood back and forth to the baby while he/she adjusts to life in an air environment in a leisurely fashion.
And how exactly does pain medication and cord clamping affect a baby’s core temperature? Lemay doesn’t say. She just points out what we all know: no newborns ever died before the advent of obstetrical anesthesia and early cord clamping. Oops, that’s certainly not true, but no matter. Hatting is nothing less than visible evidence that a woman has given surrendered her autonomy over her sacred birthing experience by disfiguring her baby with a knit hat.
In contrast, after a homebirth:
[The mother] chooses the clothing SHE wants her child to wear; she dresses and grooms her own baby. . . she is in charge and has been born as the mother. No one and no article of clothing has come between her and her total impressions of that baby. Through skin, mouth, nose, eyes and heart she has claimed the baby as her own and the bond is strong.
Bringing medical birth practices to a natural birth is a sign that we lost so much knowledge in the dark years when homebirth/midwifery was wiped out. Now, we can look again at these things and lay them aside as foolish for well women and their infants.
But wait! Shouldn’t the mother lick of the vernix from the baby and eat the amniotic sac? That’s what animals do. Shouldn’t she build a nesting place from leaves and bits of detritus? That’s what animals do. And why put clothes on a baby? Animals don’t clothe their young.
And animals don’t hire homebirth midwives to assist them in labor, so shouldn’t Lemay be counseling women that her services are unnecessary?
Whoa. Let’s not get carried away here. Birth should be completely natural right up to the moment that the money changes hands. After all, is there anything more natural than a con artist who tricks the gullible into handing over their hard earned cash?
This piece is NOT a satire.
In 2010, a study (McCall EM, Alderdice F, Halliday HL, Jenkins JG, Vohra S) was carried out on preterm and low birth weight babies. The purpose of the study was to analyze hypothermia prevention on these higher risk newborns. The study found, among other things, that:
“Stockinet caps were not effective in reducing heat losses.”
Hmm. Science. At work.
Too bad it supports the opposite of what you stand for…but then one would have to be an actual practising OB with a current license staying up on ALL the new research coming out…by OB’s who aren’t afraid to actually see what science might support.
It never occurred to you that what applies to preterm or low birth weight babies might not apply to healthy, full term infants?
Buried the lede there, didn’t you?
“Authors’ conclusions:
Plastic wraps or bags, plastic caps, SSC and transwarmer mattresses all keep preterm infants warmer leading to higher temperatures on admission to neonatal units and less hypothermia. However, the small numbers of infants and studies and the absence of long-term follow-up mean that firm recommendations for clinical practice cannot be given.”
Basically, for low-birthweight and pre-term babies, the preliminary evidence suggests you need more aggressive intervention than cloth hatting (including plastic hats), not less.
Now, what does that have to do with cloth caps on full-term babies?
1. This article is 4 years old, why are you only showing up now?
2. How does your citation “support the opposite of what [Dr. Tuteur] stand(s) for”?
I love this!! AMEN!
ok, fine. Dont put a hat on immediately because the mother needs the scent and skin to skin can regulate the temp better. But what about when they’re in the bassinet or car seat.
Arent there enough things we guilt mothers about when it comes to childcare. Dont we do enough to make people feel inadequate?
I’m finding myself asking if you misunderstood the protocol. I was immediately admitted to my hospital when not in active labor when my water broke on my due date. I thought that was pretty standard procedure given that once your water breaks and you are full term you are usually “on the clock” to get the baby out at most hospitals due to the risks.