American homebirth midwives, like all quacks, are incredibly paternalistic.
That’s because when a homebirth midwife admonishes a client to “trust birth,” what she is really means is “trust me.”
She’s decided to gamble with your baby’s life … literally. She bets that the odds of everything working out fine are high enough that she can put your baby’s life down as her marker and you will walk away with a live baby. She doesn’t plan to do a single thing to improve the odds, since she doesn’t know how to do anything to improve the odds, besides dial 911 and get real medical professionals involved.
She is no different from an gambler who asks to borrow $5000 to invest in a deal that “can’t go wrong.” You’re a fool if you hand over the money and you’re a fool if you hire a homebirth midwife.
I wrote earlier this week that homebirth midwives have a one size fits all approach to pregnancy and birth. That’s because they “know” that everything is going to work out fine. Obstetricians, on the other hand, despite their tremendous reserve of obstetric knowledge and experience, freely admit that they don’t know how your pregnancy and birth is going to turn out. And because they don’t know for sure that everything is going to be fine, they recommend everything that can raise the odds that your baby will be fine. That includes prenatal testing, ultrasounds, prophylactic treatments, fetal heart rate monitoring, and giving birth in a place that has the emergency equipment and personnel to handle just about any disaster, whether it was predicted in advance or not.
Although most of us find comfort in certainty, by the time we’ve become adults, we recognize that there is very little certainty in life. We buckle our seatbelts in the car, not because we think we are going to be in an accident; we don’t. We buckle them because we want to be prepared for the rare but life threatening possibility that we will be in a car accident. We try to eat healthy and exercise, not because we believe that we will definitely get ill otherwise, but because we want to decrease the odds of getting ill to as low as we possibly can. We seek shelter during a lightning storm, not because we are sure that we will be struck by lightning if we stand in the open, but because we want to minimize the chances that disaster will happen.
Homebirth midwives are masters at emotional manipulation and they recognized long ago that there was not going to be much profit in telling women “Trust me to be sure that everything is going to work out fine even though I am just a layperson with no idea how to prevent or treat disaster.” So instead they hit on the idea of telling women “trust birth.”
It sounds so much more transgressive and romantic, to trust birth than to trust obstetricians. The irony is that obstetricians aren’t asking you to trust them. They are admitting up front that they can’t guarantee your baby’s health (or your health), but they can do a wide variety of things (tests, treatments, etc.) to dramatically raise the odds that your baby will be fine. They have the track record to prove it. Over the past century, modern obstetrics (and pediatrics and anesthesiology) have dropped the neonatal mortality rate by 90%. And it didn’t drop because they trusted birth.
There’s also a quasi-religious element to trusting birth, as if Birth were a goddess that requires your praise and your sacrifice. The implication is that if you trust “her,” Birth won’t ever send complications your way. Homebirth midwives, in this scenario, are like those who practice religious snake handling:
… the religious ritual based on a Bible passage: People hold deadly snakes, believing that a poisonous snakebite won’t hurt anyone “anointed by God’s power.”
Similarly, homebirth midwives, the high priestesses of Birth, hold babies’ lives in their hands, believing that Birth won’t hurt anyone anointed by her power.
Inevitably, many of these snake handlers die, even the one who had his own reality TV show:
Tragedy struck [Pastor] Coots this past weekend when he died of a rattlesnake bite during a church service — following his wishes, his family reportedly refused medical help …
Inevitably, tragedy will strike homebirth advocates, too. Their babies will die at even higher rates than those who didn’t trust birth. The critical difference, though is that Pastor Coots chose to gamble with his own life. Homebirth midwives and advocates choose to gamble with a baby’s life, a baby who had no say in the matter, but surely wanted to live.
Homebirth midwives are gamblers and they their gambling has quasi-religious overtones. Just cede all control to them; your baby’s survival is a sure thing, so long as you trust them birth.
Make no mistake. Homebirth midwives, like all fundamentalists, are deeply paternalistic. They “know” what you should do. They “know” that everything will turn out fine. They “know” that if your baby dies it isn’t their fault; it’s your fault for not believing enough in birth.
Homebirth midwives are con artists whose only redeeming feature is that they actually believe their own con. But that’s not particularly surprising since they are too uneducated and untrained to believe otherwise.
So women who are contemplating homebirth need to ask themselves:
Do I want to bet my baby’s life that a layperson can predict the future?
Do I want to bet my baby’s life that Birth will protect my child if I just believe fervently enough?
Or am I mature enough to recognize that the world is full of uncertainty, no one knows what the future holds, and those who take precautions are more likely to survive than those who don’t?
The con artist knows that the con is always more comforting than reality. The real question for mothers contemplating homebirth is whether they prefer the paternalism of the con over the uncertainty of reality … and are they willing to risk their babies lives in exchange for the comfort of trusting birth?