Increasing trust in obstetricians: Step 1, confront homebirth advocates working tirelessly to undermine it

Evil obstetrician

Periodically a homebirth advocate will parachute in to the blog to school the rest of us on the appeal of homebirth. In the case of homebirth deaths and injuries, the claim is often made that the best way to avoid such tragedies would be to “increase trust in obstetricians.”

Rather ironic, don’t you think? That’s because the cornerstone of homebirth advocacy is the tireless effort to undermine trust in obstetricians. It is the centerpiece of homebirth (and natural childbirth) advocacy, and its most potent marketing tool.

Craig Thompson, professor of marketing at University of Wisconsin wrote about this tactic in Consumer Risk Perceptions in a Community of Reflexive Doubt in the September 2005 Journal of Consumer Research. Thompson marveled at the ability of homebirth advocates to market a “product” by directly defying common sense:

Advocates of natural childbirth seek to inculcate reflexive doubt by countering two commonsense objections to their unorthodox construction of risk: (1) medicalized births would have never gained a cultural foothold if they were so risk laden and (2) the medical profession would not support obstetric practices that place laboring women at risk.

In other words, it is absolutely critical to the natural childbirth project to convince women that doctors don’t know what they are doing, and willfully and cheerfully risk the lives of women and babies to promote a secret agenda.

I can’t think of a single prominent homebirth or natural childbirth advocate who does not work assiduously to undermine trust in obstetricians.

The approach may differ among individuals and organizations:

Ina May Gaskin resorts to new-agey nonsense, and animal birth, which she believes, in her absolute cluelessness, to be perfect. Whereas Henci Goer favors cherry picking data, selective interpretation of scientific papers and pandering to homebirth advocates’ desire to see themselves as “educated.”

Feminist anti-rationalists like Robbie Davis-Floyd deride rationality and insist that women have “other ways of knowing.”Clowns like Jennifer Margulis point to diseases they don’t understand and pretend they are caused by “technology.”

Every homebirth and NCB book, blog and website is predicated on the belief that obstetricians are “surgeons” “untrained in normal birth” who make millions performing unnecessary C-sections in the few moments they have each day between endless rounds of golf.

The tremendous successes of modern obstetrics and the fact that 99+% of women give birth in hospitals is dismissed as the result of an economic war perpetrated by obstetricians on midwives.

Childbirth lobbying organizations like the Childbirth Connection are front and center in the effort to destroy trust between women and obstetricians. How else to explain the endless iterations of the “Listening to Mothers Survey,” a giant push polling project that desperately seeks evidence that obstetricians are not “listening to mothers” and repeatedly finds that the vast majority of American mothers are very pleased with obstetric care?

Homebirth and natural childbirth advocates fiercely grab on to new methods for demonizing obstetric care, such as the unproven claims that modern obstetrics causes “traumatic birth,”  and the hope that C-section cause long term health problems which have heretofore escaped detection despite the fact that there are tens of millions of adults walking around who were born by C-section and appear no different than those born by vaginal delivery.

NCB and homebirth bloggers pile on with inane accusations like “every day 12 babies are given to the wrong mother.” That makes it sound like there’s an epidemic of women leaving the hospital with the wrong baby, when what it really means (if it is true at all), is that an attendant (and that includes midwives) may bring a baby into the room of the wrong mother and discover her mistake when she checks the ID tags on mother and baby.

What about the spectacular advances in modern obstetrics, dropping the neonatal mortality rate by 90% and the maternal mortality rate by 99% in just 100 years?

That is simply dismissed out of hand, with claims that hospitals actually kill babies, or at instigate the medical disasters from which obstetricians thereby appear to be “saving” babies.

Homebirth and natural childbirth advocates have an “answer” for just about every objection you can name to homebirth and those “answers” often involve misinformation, and always involve undermining women’s trust in obstetricians.

Of course, the irony of homebirth and natural childbirth advocates bewailing the very loss of truth between women and obstetricians that they themselves promoted is exceeded by another irony. That irony is the reflexive and unstated reliance of homebirth and natural childbirth advocates on obstetricians to save their lives when they’ve taken terrible chances and made hideous decisions.

The backup plan is always to head for the hospital with the expectation of immediate access to the care of …. you guessed it … obstetricians. Apparently those evil doctors, who can never be trusted, can always be trusted in an emergency.