It doesn’t matter how hideous, it doesn’t matter how preventable, and it doesn’t matter whether the midwife broke the law. In the wake of every homebirth death, homebirth advocates console themselves with a variety of illogical claims. The recent arrest of self-proclaimed “midwife” Rowan Bailey in connection with a homebirth death is a case in point. Homebirth advocates are twisting themselves into pretzels to justify their support of yet another “midwife” who has presided over yet another death.
Let’s look at the various types of illogical argument constructed to justify homebirth deaths. They are all efforts to forestall the conclusion that homebirth increases the risk of perinatal death. To make this exercise easier to understand, lets substitute a claim of the same form that is obviously true, so we will not get sidestepped by issues of truth or falsity and can focus only on whether an argument is logical or illogical. This is important because illogical arguments are automatically invalid arguments. We’ll use the claim “there are more black cars in the US than lime green cars.”
I say: There are more black cars in the US than lime green cars. (The death rate at homebirth is higher than the death rate for comparable risk women in the hospital.)
Don’t say:
I saw a lime green car. (“Babies die in the hospital, too.”) – Can you understand how the fact that you personally saw a lime green car tells us nothing about the relative number of black cars and lime green cars in the US? That you saw a lime green car is perfectly consistent with black cars outstripping lime green cars 100 to 1, or even 1,00,000 to 1? Similarly, the fact that babies die in the hospital tells us nothing about whether the death rate is greater at homebirth.
I know ten people and not one of them has a black car. (I had two fabulous homebirths and my babies didn’t die.) – This is an illogical claim based on an unstated assumption. The assumption is that the small slice you observe accurately represents the whole. However, tiny samples are often unrepresentative. Knowing 10 people who own black cars is perfectly consistent with the number of black cars exceeding lime green cars, BUT it is also perfectly consistent with lime green cars exceeding black cars, so it can’t be used to support a specific claim. Similarly, the fact that you know ten women who had homebirths and not a single baby died tells us nothing about whether the homebirth neonatal death rate exceeds the low risk hospital death rate.
Lime green cars are prettier than black cars. (Homebirth is empowering.) – I hope it is obvious why value judgments about lime green cars tell us nothing about whether there are more or less black cars than lime green cars. Therefore, it should be obvious that claiming that women are more satisfied with homebirth tell us nothing about homebirth death rates.
You say that because you sell black cars. (You say that because you are a doctor.) – Whether or not I sell black cars is immaterial; it has absolutely no effect on the number of black cars or lime green cars. This is essentially an accusation that I am lying and offering as “proof” the fact that I have a reason to lie, but a reason to lie is not proof of lying. So don’t tell me that the fact that I am an obstetrician means that I am lying about neonatal death rates.
The people who make black cars have oppressed the people who make lime green cars. (Doctors have always oppressed midwives.) – Maybe yes, maybe no, but in either case, it does not affect how many black and lime green cars are on the road. Similarly, whether doctors have oppressed midwives has no bearing on whether the neonatal death rate at midwife attended homebirths is higher than hospital births.
There is a conspiracy against lime green cars. (Doctors are afraid of losing business to homebirth midwives.) – We are supposed to believe that the number of lime green cars would equal black cars except for a public relations campaign designed to make lime green cars less desirable. It is theoretically possible that there is a conspiracy against lime green cars, but it is far more likely that other factors account for the difference in numbers. And in any case, it doesn’t tell us anything about the relative numbers of black and lime green cars. So when confronted with the fact that homebirth death rates exceed hospital rates, it is illogical to counter with a claim that a conspiracy against homebirth exists.
There would be more lime green cars if the makers of black cars helped out. (There wouldn’t be so many deaths at homebirth if doctors backed up homebirth midwives.) – That might be true, or it might not. In either case, it tells us nothing about the truth of the claim that black cars exceed lime green cars. And while it might be true that the death rate from midwife attended homebirth would be lower if doctors were more supportive of midwives, it doesn’t change the reality of the current situation.
The Association of Lime Green Car Makers say that there are more green cars than black cars. (The Midwives Alliance of North America says that homebirth is safe.) – Cherry picking certain claims and ignoring all others is likely to lead people to the wrong conclusion. A lobbying group that disagrees with almost everyone else is not a reliable source of information. Similarly, professional NCB advocates and organizations are not reliable sources of information when they disagree with the bulk of the scientific evidence and the existing statistics.
The color of cars is influenced by culture. (Our culture promotes a technocratic model of birth.) – That is a non sequitur. It does not oppose the claim; it simply attempts to pin responsibility somewhere else and it is irrelevant. That’s why the claim that hospital birth is culturally favored is irrelevant to any argument about homebirth death rates.
There are more important things about cars than the color. (There’s more to birth than whether the baby lives or dies.) – That is what is known as “reframing the debate“. It is a tacit acknowledgment that there are more black cars than lime green cars and a barely concealed effort to divert everyone’s attention. That’s why when someone announces that there are more important things than whether babies live or die, I know they have accepted the fact that homebirth has an increased risk of perinatal death, and are trying to get everyone else to accept it, too.
Adapted from a post that appeared in February 2011.
Great article!!! I read more than I post, and wanted to thank you for all the good work that you do! You possible saved my future child’s life!!!
Possibly 🙂
I got a perfect 1600 on my SATs and I would choose a lime green car (if I had a job and money to buy one).
…but I’m too busy breaking down gender norms and AP’ing while taking Meyer’s Briggs personality tests to work.
Still, even though I ended up buying black cars, I really did think about those lime green ones I could have had.
And that’s a perfect example of why circumcision is unethical!
A topic that always makes me say, “Ouch!”
I work at a car dealership in NC and I personally know a number of car salesmen and even one race car driver who like lime green cars.
Amy, There are more lime green cars of the road if you dont include all the black cars on the freeways
The second someone says that there are “more important things than whether the baby lives or dies” I know that there is no common ground between us — it’s impossible to have a civil discussion if you don’t even have the same end in mind.
Long time reader…first time commenter. I just wanted to say that I love this post! Although I understand the confusion around the green car =??? and black car=??? the statements still clearly illustrate how they have nothing to do with the original claim, which is that there are more black cars than green cars.
Thanks also for the educating read that I get on a daily basis, not only by Dr. Amy, but also by the awesome commenters! This community is very special!
Maybe you should tweak your analogy – at first you’re talking about black cars being home birth deaths, then you equate black cars to being hospital births (because there’s a conspiracy against lime green cars).
The changing of what each car means in the argument just backs up
what Dr. Amy haters say about her all the time – that she changes
argument mid-sentence when it’s not working in her favor, or that she’s
trying to trip people up by changing what she means, and using logical
fallacies to mislead people into following her down some rabbit hole. I
think the seat belt argument works much better.
The question I have is, is the difference between black cars and green cars
statistically significant? Are we talking about the relative numbers (3
times more black cars than lime green cars) or are we walking about
absolute numbers 1.7/1000 cars are black, but .6/1000 cars are lime
green)?
I didn’t realize you could use feelings to calculate statistical significance.
Intermittent reader, first-time poster.
I’m sorry if I have misunderstood, but my reading of Dr Amy’s post was that it was about logical fallacies. There were 10 illogical counter-arguments presented to the statement, “There are more black cars in the US than lime green cars.” These were analogous to 10 illogical counter-arguments made by the NCB community to the assertion that, “The death rate at homebirth is higher than the death rate for comparable risk women in the hospital.”
I don’t see the need to equate black cars to home-birth deaths, or black cars to hospital births, in order to interpret the post. Nor to equate lime green cars to hospital-birth deaths, or lime green cars to home births.
I don’t believe that Dr Amy was trying to make an analogy about home birth or home birth death rates by comparing them to car colours. But rather to highlight – quite clearly in my opinion – the various types of logical fallacies and point out that “illogical arguments are automatically invalid arguments.” As such, the colour of the car does not have a specific meaning, and Dr Amy is not “changing of what each car means in the argument” and most certainly not changing “argument mid-sentence when it’s not working in her favor.”
The lively and amusing commentary that followed the post also failed to clearly specify the exact analogous meaning of the various coloured cars as they related to home birth, hospital birth, and death rates. But that was fine too, because it made for a good read. IMHO.
Try reading it again, slowly.
Soooooooooo……black cars wear hats? That was a lot for my little brain to comprhend. 🙂
In my experience, problems arising with lime green cars are very, very, very rare. That’s paraphrasing a comment on one of our pages by Carla Hartley. She didn’t know how rare and couldn’t pin it down with an actual number, but she knew it was rare. Sadly, even if someone made this post required reading, even though you have dumbed it down for them, they still won’t get it. I suspect it will fall under the “you’re meeeeennnnn” category.
Wait, are you talking about lime green cars, or black cars? Because Dr. A was talking about black cars = homebirth death rate, and you’re talking about lime green cars being the homebirth death rate.
Makes me think, it does not matter how rare the event is when it happens to you.
..and all it took was me bringing up the documented relative rarity of things like vasa previa (very rare), amniotic fluid embolism (most rare) and everything else (uncommon) and asking what her numbers were, and she posted on her own page insisting that her experience was all the science and evidence she needed.
..but didn’t post any of that on the original page where I could respond to it.
(pages referred to are FB: The Pregnant Christian and FB: Carla Hartley)
The other night, we had a tornado warning in our area. It’s the middle of the night, and we bring the kids, dog, and the bird downstairs to the basement, because that is the safest area in the case of a tornado.
Note that we did not wait until the tornado was imminent – in fact, it was made very clear that no tornado had even been sighted, only that the conditions were such that a tornado was possible.
Add in the fact that, even if a tornado did form, the chances of it hitting our house was still very small, such that, overall, the actual risk of being hurt by a tornado was pretty darn small.
Yet, we took shelter, because, you know, that’s what you do. We don’t wait for the tornado to be on top of the house before running down stairs…that is the whole point of a warning system!
Unfortunately, I have been hearing a lot of grumbling about tornado warnings lately, and how taking shelter is pointless.
So what would Carla Hartley do? Would she take shelter in a tornado warning? Or would she blow it off?
Trust weather! It’s natural.
I know it is a tangent, but I am curious. I live in MA, an area not known for tornadoes (though we had several a couple of years ago.) We had the tv on, and if we heard them suggest we shelter in the basement, we would have…but when the weather is that bad, the odds the cable and electric will go out are high. Do you all have battery operated radios to hear the warnings if you lose power? Or do they just warn you so far in advance that you will be down there before that happens? Also,how do you know when it is safe to go back up?
We do have battery operated radios around in case the power goes out. However, it depends on how extensively it goes out. For example, if the local cell phone tower still has power, we can follow news on the phone.
Our warning the other night came about 20 minutes before the storm arrived. We sat downstairs with the TV on (kids were sleeping)
Keep in mind that, given it was the middle of the night, our first warning was actually local civil defense sirens. We live about 8 miles from town, but you can hear them, especially at night when the house is quiet. So we wake up and wonder, is that tornado siren? I looked at my phone and there was a weather alert.
If power is out all over (including any cell phone signal) and you can’t know if the weather has passed and it is safe to go back upstairs, you don’t do it. Then again, we have a fairly comfy basement (actually, there is a spare bed in the other room, so our older son just went and slept in there; it’s actually pretty handy because the room is mostly sound isolated, so you don’t hear thunder), so it’s not a problem hanging out there, although beds are more comfortable.
Cell towers often have their own back up generators or batteries.
Because I am a geek, the first thing I do when the siren sounds is check the radar to see where the danger is. If the danger is too far north, south or east of us – I chill and keep an eye on the radar.
This requires some knowledge about the radar signature of tornadoes and a little practice spotting them. It makes me grateful for the technology to detect tornadoes so that people can take the shelter and lives can be saved.
Personally, I’m not keen on healthcare providers overtly making their religious beliefs a part of their practice, so any provider who did would be an automatic disqualifier for me (so posting on The Pregnant Religion-of-your-choice would count).
That is not to say that I think devout believers of every stripe cannot be excellent HCPs, just that it is a personal red flag if there is religious overshare.
My OB is a very religious man, but I know this because he is a friend of the family, it would never come up in our professional encounters.
In the UK saying things like “it was just God’s will” or “have you prayed about your choices” or “maybe God had a different plan” to a patient is a good way of being struck off.
If you are a person who supports homebirth and feels that it is nobody’s business where you choose to give birth, I’m sure this blog is offensive to you. If you believe that it is your right to choose homebirth over a hospital birth for your baby you might be wondering why so many other women are vociferously against homebirth and homebirth midwives.
You might even believe that giving birth in a hospital surrounded by cold sterile machines and impersonal nurses and doctors is not healthy for you or the baby. perhaps you believe that a hospital birth will deny you an important rite of passage and that giving birth in a hospital will impact your ability to bond with your infant.
But the crux of the matter is that hospitals with medically trained doctors and certified nurse midwives greatly enhance your chances of surviving childbirth with a healthy newborn, and with your whole lives ahead of you to believe in any other alternative lifestyle choices.
To me, the best analogous argument is that the safest way to ride in a car is to wear a seatbelt (childbirth parallel: the safest place to give birth is in a hospital). One could make arguments against seatbelts similar to the way homebirth activists make arguments against hospitals.
Seatbelt Argument 1: I drive every day without a seatbelt and I’m still alive. Counter-argument: Just because something has worked for you in the past, doesn’t mean it always will. You need to consider a larger sample size than your own experience or testimony of a select few.
Homebirth Argument 1: I have had three successful home births and I and my children are fine. Counter-argument: Just because something has worked for you in the past, doesn’t mean it always will. You need to consider a larger sample size than your own experience or testimony of a select few.
Seatbelt Argument 2: I’m only driving to the grocery store and I will go the speed limit. This is a very safe trip so I don’t need a seatbelt. I’m tired of people playing the “dead passenger card.” Counter-argument: It’s a safe trip until it isn’t. You may have every intention of driving safely, but a patch of ice or careless driver can turn a safe drive into a deadly one. While no one expects to have a car wreck, they do happen and your best chance of survival is to wear a seatbelt.
Homebirth Argument 2: I have had a perfect pregnancy and have researched
home birth. This is a very safe birth so I don’t need to be at a hospital. I’m tired of people playing the “dead baby card.” Counter-argument: It’s a safe birth until it isn’t. You may have every intention of having a “normal” birth, but a shoulder dystocia or prolapsed cord can turn a safe birth into a deadly one. While no one expects a birth emergency, they do happen and your best chance of survival is to deliver in a hospital.
Seatbelt Argument 3: I read in the news about a guy who flipped his car over a cliff and was killed, despite the fact that he was wearing a seatbelt. Therefore, seatbelts don’t help and I don’t need one. Counter-argument: Sometimes, a wreck is so horrendous that no seatbelt or air bag could ever save the driver.
Homebirth Argument 3: I read in a blog about a woman whose baby died in the hospital at birth. Therefore, hospitals are dangerous and I don’t need to deliver there. Counter-argument: Sometimes, babies or mothers have congenital abnormalities or conditions that cannot be prevented by any measure.
Seatbelt Argument 4: I know someone who was in a wreck and the seatbelt caused whiplash. Seatbelts are an unnecessary intervention that only causes problems. Counter-argument: While the whiplash is an unfortunate side effect of the seatbelt’s intervention, a far worse injury could have been sustained without the seatbelt.
Homebirth Argument 4: I know someone who has numbness around their C-section scar. C-sections are an unnecessary intervention that only causes problems. Counter-argument: While the numbness is an unfortunate side effect of the C-section, a far worse injury could have been sustained to mother or child without the C-section.
Seatbelt Argument 5: I know someone who was killed in a car wreck who may
have walked away had they not been wearing their seatbelt. Counter-argument: Very, very rarely does a seatbelt actually hurt the chances of survival in a car wreck. Statistics show, however, that you are much more likely to be saved by a seatbelt than harmed by one.
Homebirth Argument 5: I know someone who died in childbirth because the OB made a mistake. Counter-argument: Very, very rarely does doctor negligence contribute to an adverse outcome. Statistics show, however, that you are much
more likely to have a safe birth in a hospital than at home.
Seatbelt Argument 6: The only reason cars have seatbelts is because auto makers are afraid of lawsuits. Counter-argument: So what if this is true? People sue auto makers because people die in car crashes. Reduce the number of deaths = Reduce the number of lawsuits. Everyone wins.
Homebirth Argument 6: The only reason hospitals recommend interventions is
because they are afraid of lawsuits. Counter-argument: So what if this is true? People sue hospitals when someone dies or is disabled. Reduce the number of
deaths/disabilities = Reduce the number of lawsuits. Everyone wins.
Seatbelt Argument 7: If someone dies in a car wreck, they were not meant
to live. Counter-argument: Wow. What a sick thing to say.
Homebirth Argument 7: If someone dies in child birth, they were not meant
to live. Counter-argument: Wow. What a sick thing to say.
Or try the same thing with drunk driving. Note there ARE people who claim they are better drivers when drunk.
BTW, this would make a great guest post…
Exactly-and in my state, in the past few weeks there have been drunk drivers that caused fatalities while they were waiting for charges to come up from previous DUI incidents. A bit like some homebirth midwives.
Drunk driving makes more sense actually, because you are only endangering yourself when you’re driving a car without a seatbelt, while you’re also endangering your passengers if you’re drunk driving. In a homebirth, not only the mother is at risk (in which case I would not have much of a problem with it as an informed choice); her baby is at risk too.
“Everyone wins”
Except home birth midwives and doulas.
I don’t judge people who use seatbelts, but researching the google told me that humans were not designed to drive using seatbelts. Seatbelts embody a fearful attitude toward driving, which is natural and should not be feared. The author of Spiritual Driving says that FEAR is the main cause of car accidents. Confident, empowered, informed natural driving is the best way to prevent accidents, whereas seatbelts just encourage fearful attitudes which causes more accidents in the first place! Most people are perfectly capable of natural, seat-belt free driving but they aren’t informed of what the internet told me.
Yes! I would bet that 100% of people who had an accident were afraid right before that accident happened. Therefore, the fear caused the accident. QED mamas!
Either that or they had thought ahead about what they would do in case of an accident and their thinking “attracted” the accident.
Remember, your car knows how to be driven!
When trying to convince my older boy why he needed to wear a bike helmet, he just didn’t get it. Clearly I was too stupid to understand that an accident. Wasn’t. Going. To. Happen. And too stupid to understand that all the people I knew who had been in bike accidents (motorcycle + car accidents and bicycle + car accidents) were just too dumb to have not decided to not have an accident. I never figured out his reasoning (probably because there wasn’t any). But in all of these situations, this kind of thinking is frightfully common.
My family was wearing seat belts when a semi hit our Ford Escort and dad still got whiplash! Seat belts are useless!
This is great, but it reads a little confusingly for me, since what the black or green car stands in for changes statement to statement. Your statement “There are more black cars in the US than lime green cars”, the quantity of black cars stand in for the high rate of homebirth death, right? But then in the following statements, “lime green” stands in for hospital death, then home birth/homebirth midwifery.
In #s 1-3 the cars stand in for hospital and homebirth deaths, whereas in other statements they stand in for home birth or hospital birth, so the positive or negative value associated with each statement gets muddled. Sometimes a quantity stands in for another quantity – like # of deaths, and other times it stands in for safety.
If black cars = hospital births and green cars = homebirths, your original statement seems to make sense with (most of) the others. Maybe if you made car color = birth location and # of accidents = deaths, it would make sense. The first statement would be more complicated but make more sense if you added to it, saying something like “There are more black cars in the US than lime green cars (There are more hospital births than homebirths), so even though the total number of black car accidents is higher than the lime green car accidents, but the accident rate for lime green cars is much higher. (the total number of hospital deaths is higher than the total number of homebirth deaths, but the rate of homebirth death is many times higher than that of hospital death)
Anyway, maybe I’m being too nitpicky and it’s possible I’m just confused – I know the logic of homebirth advocacy is sometimes confusing and changes terms around – but I didn’t think you meant to be confusing.
It’s like – okay imagine 99 of every 100 cars are black, and the other 1 is lime green. On average, 5 of every 100 cars of any color wrecks in a given year. If you then looked at the raw numbers, you might determine (wrongly) that black cars are more dangerous than lime green cars.
This is essentially how homebirthers look at hospital death rates. Roughly 99% of women give birth in a hospital. Of course most babies and mothers who die do so in the hospital. But if the numbers were at the same rate for every 10,000 births – let’s pretend there’s a rate of 1 per hundred (much higher than reality but I’m just illustrating a point), then in a given year with 10,000 births, 100 would take place at home and 99,900 in a hospital, with 1 baby dying at home and 999 dying in the hospital. then someone who didn’t understand would imagine hospital birth is 999 times more dangerous than homebirth!
But the real comparison would be 3 babies dying at home for the 997 who die in the hospital. This doesn’t make a huge difference in raw numbers, but it represents a rate 3 times higher than hospital deaths.
Yup, I understand this, but if this is what Dr Amy means by laying out her analogy at the beginning, then it is unclear because it sounds like she is saying quantity of black cars = homebirth death rate
“I say: There are more black cars in the US than lime green cars. (The death rate at homebirth is higher than the death rate for comparable risk women in the hospital.)”
In the rest of the piece the bracketed statement seems like a ‘translation’ into homebirth/hospital terms. Maybe in this first case it is intended as a qualifier, in which case your explanation makes sense, but then 2 and 3 don’t make sense because “I saw a lime green car” is supposed to be the equivalent of “Babies die in hospitals too”, making lime green cars analogous to hospital deaths.
Black cars later stand in for hospital birth (“You are saying that because you sell black cars”) and lime green for homebirth (“Lime green cars are prettier”). So, anyway, my problem is with the consistency of the analogy and not its underlying argument.
Logic is the weapon of the patriarchy. My intuition tells me that lime green cars are safe and spiritual, so gtfo with your “facts”!!!1!
Trust lime green cars!
Your lime green car is not a lemon!
Note that very few people actually want lime green cars
LOL! My wife and I were in the car the other day and were behind a car that was a really goofy looking pink. We both laughed, and I said, the amazing thing is that someone, sometime, went to the car lot when that car was new and said, “I want that goofy-pink one!” You are on a car lot of new cars, you really can choose a color from among the options. Shoot, even if it is not on the lot, tell the dealer you want a different color, they will get you one. So someone chose that color for a car.
I understand if this is a cheapo used car or something. There you don’t have a lot of options, but in this case, the person went to the lot and said, “I want that one.” What were they thinking?
I was going to say: You’re racist if you prefer black cars (NCB is feminist and ties into women’s special ways of knowing. If you don’t see that, you’re probably deluded by patriarchy.) But you got there first!
Did you hear they arrested a car salesman who was selling lime green cars he stole? They are trying to take away our right to drive lime green cars! Free our salesmen!
WTF has patriarchy got to do with it? Not sure what the snark is about. Surely, a practice that maims women’s bodies (unrepaired tears, fistulas etc) and is often associated with a general perception that a mother should devote every waking moment to her kids at home should be gold for patriarchy. Proponents of homebirth are really objective allies of patriarchy, not the other way around.
Driving a black car is stressful and will cause you to crash into a lightpole. Driving a lime green car relaxes you so that you will never have an auto accident.
But what if you’re wearing a HAT?!?!
Hats are evil, they most likely set you up to fail and are an intervention.
What if you are driving and you like to CHAT with your passengers, or heaven forbid, PAT your dog or your child! Wonder if Whapio offers reiki for my car…
And if you get into an accident in a lime green car you were probably just never meant to drive anyway.
sigh. yep. have heard every single one of these. and it’s only going ot get worse, as we just just found out i’m pregnant (yay!) but i’ll have to stomach this BS from his family in the coming months… pray for me…
Congratulations!
stand your ground! You can do it! Focus on what’s important – having a healthy baby. Yay!
Congratulations!
Remember:
“That’s a good point. I’ll ask my doctor about it.”.
You know the unsolicited advice works both ways, right? I had 4
homebirths and 1 hospital birth and got lots of unsolicited comments from friends and family
that I considered BS. I just smiled and thanked them for the
information. And I said the same thing — I’ll ask my doctor about it. Because I DID have a doctor for care even when I was using midwives.
Some of us who support homebirth are not the idiots that Dr Amy talks about here. She generalizes just as much as rabid homebirthers do. Lots of us are somewhere in the middle, and I think we have more in common than you would initially imagine.
I’d like to understand where you’re coming from. Do you believe that homebirth is slightly dangerous, but it’s worth the small risk for you? Or do you believe that it’s safe? I’m wondering because I don’t see a middle ground here; either you believe homebirth is safe, or you don’t. Some things don’t have a middle ground, like creationism vs. evolution; either you believe we were created as-is, or you believe we evolved from lower life forms.
I think home birth can be perfectly safe. I was willing to take the small risk for my own mental health. I have a severe phobia of needles and hospitals. For me, feeling safe in my environment while laboring was vital. I also had highly trained and experienced midwives. I just can’t paint everyone with a broad brush and dictate what decision is right for them.
“I’m wondering because I don’t see a middle ground here; either you believe homebirth is safe, or you don’t.”
I don’t think this is at all true. It is absolutely possible to believe “Homebirth is reasonably safe for a low risk mother with a proven pelvis, cared for by a qualified midwife practicing according to evidence based standards of care, fully integrated into the health care system with established transfer procedures and reasonable proximity to the hospital.” “Reasonably safe” as in “no statistical increase in negative outcomes.” I think there is still a non-zero chance of an emergency that would have a better outcome in hospital, but the data suggests these are rare enough to not affect overall numbers.
I think that is actually what the evidence shows. I also don’t believe that exists most places in the United States. I try not to argue against homebirth in general, but against homebirth in the United States which does not seem to be as safe. I’d rather push for higher qualifications and standards of practice for homebirth midwives than try to outlaw homebirth. There’s really plenty of room in the middle.
I don’t think anyone here wants to outlaw homebirth; the goal is to have accurate information out there. Also, I think “reasonably safe” is in the eye of the beholder, and individual mothers should decide whether “reasonably safe” is enough for them, or whether “safest setting possible” is what they want.
“Also, I think “reasonably safe” is in the eye of the beholder, and individual mothers should decide whether “reasonably safe” is enough for them, or whether “safest setting possible” is what they want.”
Absolutely, which is one reason that I can’t agree with the statement that “homebirth is either safe or it’s not.”
Generalizing is not a rhetorical crime, but is rather a necessity. Without generalizations, it would be very difficult to make strong statements about political or ideological schools of thought.
Congrats!
I’m going to post this here..maybe not the best place for it but it might be helpful for you as you wade into the onslaught of NCB ideology that is the family you married into…just another perspective on OBs and midwives.
I have a good friend who is a practicing OB in a very major center in Canada. She does a lot of call and I love to hear about it. She always goes to work with the hope that “I don’t encounter a disaster” She states, with pride, that she has a very low c-section rate. I asked, “how come?” And she says, “I have OB tricks.”
Hmmm…says to her, I thought midwives were supposed to be experts at getting the baby out vaginally…what OB tricks are these? Midwives, she snorts, they don’t do anything…just persist with watchful waiting and consult me when its too late to do anything but a section. I’m very good with little bits of pitocin, she says. And I am very very good at manually correcting presentations (eg turning from OP to OA, correcting asynclitism)…and I have mean forceps and vacuum skills. Then she says, I hate csections. I didn’t ask her why she hates them…that’s a topic for our next glass of wine.
Our midwives here in hospital can order the low dose pitocin protocol and epidurals and some of them are able to use vacuums…but the philosophy of NOT interferring, of letting events unfold as they will, does not seem to allow corrective action to be taken in time to support a vaginal birth. Which is ironic because the women who seek out the midwifery model of care tend to highly value a vaginal birth.
You know, when I was pregnant and researching where to give birth I was off-put by the midwife (CNM) at our hospital birth center’s “meet the midwives” event when she responded to a question about whether and when they would order pitocin by saying something like “Don’t knock pitocin. Pitocin is great. It’s a powerful tool, and we use it when we need to to keep moms and babies safe.” You could almost feel the room of serene, big bellied, natural-birthin’-hopeful women shudder – “medwife!”. At the time I had been steeped in the NCB literature and wary of anything that sounded ‘interventionist’. In the end, the bulk of my labor was managed by this same midwife, to my chagrin, and it was augmented carefully by low doses of pitocin, also to my chagrin (at the time). I had lots of negative feelings about that and about her for a time after the birth, but now, having shifted my previously held views on natural childbirth, I realize that I was kind of the jerk in that situation. This midwife did a great job of balancing our safety and my desire for a vaginal birth using pitocin and monitoring (prickliness aside – and really, she may have just been justifiably annoyed by my tearful, uninformed responses to her recommendations and implementations of hospital policy)
Anyway, it sounds very probably true that the philosophy of not interfering has permeated even CNM culture. But there are definitely real midwives out there who aren’t scared to use interventions when they are indicated, and whose patients probably have lower c-section rates because of this.
The CNM who delivered my daughter was a “medwife”, but that’s why I have a healthy baby. But she made sure to tell me that even though I needed pitocin, I didn’t need a lot because my body was doing most of the work (with help from the wonderful epidural).
Three cheers for “medwives”! Mine was too. She was competent, kind, and very good at empowering me with unbiased information.
I always felt that my epidural helped me to avoid C-section. I remember my OB telling me how I needed rest from pain. I had an epidural and fell asleep. Three hours later I was ready to push.
I also have a friend who is an OB who brags about his low C-section rate for exactly the same reason, and who also has nothing but disdain for CPMs. I asked him once if he ever thought of getting involved in the homebirth scene and trying to either outlaw CPMs or trying to improve regulations. He said he was busy with his current clientele (many high risk, a few low risk) and that homebirthers were such a low proportion of the population that it wasn’t worth his time. He had cleaned up homebirth messes and didn’t like it, but preferred to cleanup the few and hope that his encounters with this group were rare.
I think this attitude–that homebirth is not worth the time to oppose or improve–is very common, notwithstanding claims by CPMs that OBs are threatened by their presence.
I’d expect that to the extent that OBs are threatened by CPMs, it’s because when a disaster occurs in a transfer, the doctor is more likely to be blamed than the CPM. Even if the parent doesn’t believe the doctor was responsible, once a lawyer gets involved I expect they’ll sue the doctor simply because the doctor actually has malpractice insurance.
Congrats on the bambino! I don’t have children but am shocked/horrified by my friends’ stories of unsolicited advice and berating from strangers!
Congratulations!
Tell them that they have to think positively about your choices or else all their negative energy might cause you to have…*gasp*…a c-section!
Congrats on the pregnancy!
As for stomaching the NCB stuff, you never know, it may not be as bad as you think. I’ve just hit full term with our first child and I was expecting tons of this crap both from people in town (I live in a relatively crunchy place) and my husband’s family (dad is a chiro, mom is a massage therapist of the most woo-ful sort, they don’t believe in vaccines, real medicine, etc.). But it’s actually been fine. Though it helps that we live across the country from my husband’s family so they get limited contact with us. And my family is full of medical types, so I don’t have to worry about getting it from them.
That said, I do see hints of having to deal with a lot of NCB-indoctrinated people in some of my interactions with the healthcare staff, both at my OB’s office and the hospital. Mostly in the form of pretty obvious relief when I make statements such as that I’m open to going “natural” if labor isn’t too hard for me but that I value having a myself and the baby be healthy far more than any specific aspect of my birth experience. The most obvious so far was when the nurse doing part of the childbirth prep class went to great lengths to explain that the vitamin K shot was NOT a vaccine and that she hoped we would seriously consider letting our babies get it even if we weren’t vaccinating.
You could do what I did, and look at them like the intrusive jerks they are, ask them when the details of your pregnancy/childbirth became open for public discussion and tell them that any and all information pertaining to it is personal and, unless you choose to share, private.
This reminds me of some of the arguments surrounding schools. The axiom is that “Public schools are in trouble” (you may or may not agree, but stay with me here a moment). Therefore everyone who can tries to find some other method of schooling their child. Those left in public school are those whose parents either disagree with the statement, can’t afford private school and don’t have the resources to homeschool, or (in a few cases) those who just don’t care. But one argument made by those who are annoyed with people who send their kids to private school goes something along the lines of “if you would all send your kids to public school, then you would have more clout to fight for them to be better!”
The problem with this argument is the same as the problem with the argument that there is a conspiracy against lime green cars (homebirth) and “there would be more lime green cars if the makers of black cars helped out. (There wouldn’t be so many deaths at homebirth if doctors backed up homebirth midwives.)” Both arguments decentralize the needs of the child (to good education, or good health) in favor of forwarding the ideology at an cost.
Of course, public school is nowhere near so dangerous as homebirth.
*at any cost
I dunno, these are pretty different. If parents committed to revitalizing neighborhood schools, they would be high quality. If parents committed to homebirth, lots of the problems would still never be fixed (like lack of immediate access to an ER). The same lines of logical reasoning don’t apply.
No they wouldn’t. Parents don’t stand a chance against the ridiculous red tape and corruption of the public school systems in America. It’s a lost cause.
The culprit is SEC. Maybe you’ve noticed that public schools in high income areas rarely have the same problems that public schools in low SEC areas have?
Shh, don’t you dare mention poverty and the problems that come with it! So much better to think everything is bad, and is so because of the government/school board rules and the “poor quality” teachers who cannot even be bothered to carry guns! Jeez.
I am beginning to thing that politicians are all hard of hearing. Teachers, librarians, principals and just about everyone else in the education industry is screaming about how poverty is a cancer to the educational process and all politicians are like “Testing? Did you just say we need more testing? Well more tests it is then.” And then I die a little bit more inside.
I think people over estimate the public school crisis, I graduated about 5 years ago from a poor school (We couldn’t afford the luxury of printer paper, i mean literally I had teachers say “If we could afford paper, you would all have a copy of this, but we don’t so you can’t”) and I had a poor family. I am in medical school this year, just because you come from the bottom of the turnip pile school doesn’t really say much about where you are gonna end up. I think we do a disservice to the kids in those schools when we go on the gloom and doom report.
“I am in medical school this year, just because you come from the bottom of the turnip pile school doesn’t really say much about where you are gonna end up”
Statistically speaking, yes it does. It does and it has for a while now. And there is no reason that it won’t continue to do so.
Which makes Wishful’s achievement all the more impressive.
Certainly does, but it doesn’t let us, as a society, off the hook for our failings.
I guess my thing is the problem is more in the mind set of how people view kids who come from those places. I mean on career day in my elementary school the best job there had to be the cop, seconded by the exotic dancer (they just said dancer, but come on she has half freaking nude, and this was in the class room). In high school we had a lawyer come in talk about the legal system. I spent 2 hours being told my rights when I get arrested and when I have to go to the station. Also what to really expect my first night in jail. Do you think they have that talk in the richer schools? I bet not. They told us because they expected it would come in handy some day. I think we need to focus more on telling kids you don’t have to learn “learn you place” or “be happy with a roof over their head”. I am all for fixing the broken schools, by all means. No amount of empowerment would make paper appear, but why not make the kids feel like their is hope while we are at it?
I definitely agree that the lack of role models is a big problem for schools in poorer areas. The university that I work at regularly recruits academics to give career talks in schools or host career day at the university.
The problem I see is that focusing on the few individuals who succeed against these odds allows us to ignore the grim reality that being born in poorer circumstances has the single largest effect on the outcome of a child’s life than any other factor.
But that doesn’t mean that you are not to be congratulated for your accomplishments. Indeed, I have had students like you and I try to let them know that their successes are very impressive.
How many of the other students in your class ended up in medical school? I think this might be a case of “I saw a lime green car.”
I think it’s also a case of Wishful being an intelligent, ambitious, hard-working individual, who is rising above her/his background by virtue of hard graft and sheer determination. Well done, Wishful, and good luck!
I admit it was the majority. I know my class had students go to Harved, Yale, and Spellmen. I also know we had students shot to death before hitting 21, drug dealers, and “whose the daddy?” baby mamas. The majority sadly in group II (and we are the top school in our district….yeah the others did worse). It really depended on who the kid was though. My mom taught in my district for 25 years, working at a bottom school (are school district is tired, they don’t have enough money to supply all the schools so they only sorta supply some of them and let the rest rot). She saw 2 kids in the NBA, several go to top schools, and some become high power professionals. She also saw crack addicts, drug dealers, and everything inbetween. I am not saying we don’t have problems, it is true we do. We start out the race behind the others in many ways, but I think not focusing only on the negatives and never the positives is a disservice after all most kids know you can become a drunk or a drug dealer, very few knew it was possible to become a doctor or lawyer when you start at the bottom.
“I admit it was not the majority” typing fail
Like your post times one hundred!
The testing isn’t designed to help the students in itself. It is to provide a metric so that we can track whether the programs we are putting in place to help low-income students are working, and *how*, exactly, they are succeeding or failing. Certainly, simply pointing out bad test scores doesn’t somehow magically grant teachers and administrators the ability to improve their schools, but we would be even more lost without those data.
The school district we are in refuses to give standardized test to their high school students unless they are practice SATs.
Well, that’s a shame. They’re depriving themselves of an incredibly powerful tool.
All the parents agree with them. There was not a single descent. I do agree that they can be a powerful tool before high school, but are redundant in high school. They should be SAT prep testing and that is a better tool for that age range anyway.
Then you run into the unholy terror that is special education and standardized testing. In some of the smaller schools, it only takes one student to irrevocably sink that year’s scores, and what can you do about it? Standardized testing may not be a bad idea in the abstract, but the current implementation of it is a nightmare, especially when it is used as a sort of targeting laser for unrelated budget cuts. So you run into, ok, those two siblings with the super rare familial mental and developmental disabilities? Yeah, get them up to par because we’re only allowed to have one kid not pass the tests this year. Severely autistic kid just lost his parent, and has had a huge developmental setback because of it? Yeah, you’re boned, lol. Sorry, teach!
Testing schemes are awful when applied in dumb ways, I spent like two days in an intensive intervention program my senior year because they decided that everyone who didn’t finish the SAT 9 test, must have done so because they could not read. It was never made clear to me if I suddenly lost the ability to read or if I was a fantastic guesser all these years. The reason of course I didn’t finish was a) I was a senior I was already accepted into college with scholarship, I didn’t give a hoot about the test b) I had a stomach bug and mistook the test as an excellent time to get some sleeping in. Testing sometimes puts interventions and aid in the wrong place when tests are being read by people lacking in common sense, or just context. Anyone at my school could have told you why I failed, even my teachers who didn’t bother to wake me up.
That is absolutely untrue. There are many excellent public schools in the US. But of course the point is, pro-public school proponents are not the same as NCB folks in terms of their logical reasoning.
In America, every school district is entirely independent from every other one. This depends critically on where you are located. The school district local to me is fantastic. When I ask my co-workers about their local school districts, *most* of my wo-workers are very pleased with the local school districts. Public school system officials vary WIDELY in their competence and corruption. This is not universal.
Unlike my local schools, my mother worked in a school district (in another state) that was closer to what you describe, which is why she eventually quit.
You are wrong about this. Of all the schools my children have gone to including a very expensive private school in Maryland the public school my daughter goes to now is by far the best. They have the best curriculum, college prep, child-teacher ratio, and the most educated teachers. It is 100% because the parents will accept no less. The funny thing is that they are always in trouble with the state because they will not do whatever the state wants.
“If parents committed to revitalizing neighborhood schools, they would be high quality”
I send my kid to school so I won’t have to educate her myself. I have no interest in “revitalizing” anything. I have no interest in PTA. I have no interest in shepherding her to a myriad of school-related activities. I accept that I should maintain a minimum of interest in my child’s education: food, housing, sleep, homework, even volunteering now and again.
The fact that other parents fail to engage at the minimum level should not indicate what my commitment should be.
The parents determine how good the schools will be, not the students. And more is not always better. There is a point where you reach diminishing returns.
That’s fine. I will probably send my daughter to private school. My only point is that pro public school folks aren’t using shoddy logic.
“Just because the CDC says there are more black cars than lime green cars doesn’t mean there are, because we know that the CDC is biased”
Not sure if the link will work, but this reminds me of a meme posted by Refutations to Anti-Vaccine Memes:
https://www.facebook.com/photo.php?fbid=490975684305779&set=a.414675905269091.96547.414643305272351&type=1&theater
The lime green cars are Pintos – any takers?
We had a Pinto growing up, and we never died! so, those who talk about Pintos exploding are LIARS!
I loved that car.
My next door neighbor had a lime green Gremlin.
In high school, my best friend had a Pinto and not only did we not blow up, but we didn’t even blow up when he jumped the rail road tracks in the pinto, and we left the ground, bounced, left the ground, and then landed. (Seriously.) Therefore, the Pinto was safe! (OK, the “safe” part I am not serious about.) Hey, we didn’t even blow up when he tried to throw a bottle rocket out the driver window, accidentally hit his hands on the window frame, and then realized the bottle rocket had fallen between his legs! (Sseriously. About the funniest thing I’ve ever seen, also, because he didn’t get hurt, just scared.)
Actually, the lime green cars are known for exploding at a rate more than 6 times that of the black cars (ie, babies die in home births at a rate that far exceeds that of hospital birth).
“People have been driving lime green cars for a long time.”
And the Netherlands has lots of lime green cars.
But more black ones than you’d think.
Yet always had great insurance.