False dichotomy: the favorite logical fallacy of the natural childbirth and breastfeeding industries

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Natural childbirth advocates and lactivists don’t do nuance. For them, everything is black or white. You’re either with them or against them.

Consider the response of The Academy of Breastfeeding Medicine to my comments on their recent piece It’s time to disarm the formula industry.

The piece itself is a classic example of rallying the faithful by invoking an outside enemy. Rather than take responsibility for the shaming and humiliation of women and the outrageous exaggerations of the purported benefits of breastfeeding, both integral to lactivism, professional lactivists try to divert attention from their own deceptions and deficiencies by blaming their failures on “the other.”

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]If you aren’t agreeing, you’re “bullying.”[/pullquote]

When I tried to direct them back on track — demanding scientific evidence that their claim that if more women breastfed we could save hundreds of infant lives and billions of healthcare dollars — they invoked their favorite logical fallacy, false dichotomy.

What is a false dichotomy? It’s when a range of possible options is deliberately reduced to only two extremes. In the case of breastfeeding, the range is everything between “breastfeeding is the perfect way for every mother to feed every child” and “breastfeeding is a terrible way for every mother to feed every child.” The false dichotomy is presenting the extremes as the only two options.

How does it work? In the case of the ABM, whenever I ask for scientific evidence for the claim that breastfeeding has tremendous public health benefits, ABM members respond by accusing me of hating breastfeeding or trying to sabotage it.

Dr. Casey Rosen-Carole writes:

However, I would hope that you can at least agree that advertising campaigns designed to undermine a woman’s confidence in her own body are sadly off-target and should not be tolerated. After all, aren’t we all on the side of our patients, not industry?

False dichotomy: if you’re not with us in demonizing formula, you are against the wellbeing of babies.

Dr. Anne Eglash writes:

Have you ever thought about what your diet will look like when/if you are 90 years old? How would you feel if the doctor of your nursing home/assisted living (or maybe you will be lucky enough to stay at home with in home care) puts you on a formula diet of 6 servings of Ensure or Glycerna per day, as opposed to 5 servings of fruits and veggies, lean proteins, whole grains, and healthy fats each day? If you believe that Ensure or Boost is a good substitute for a healthy balanced diet, that would explain why you believe that a diet of infant formula can lead to equal health outcomes as breastfeeding.

She seems completely unaware that there’s a range of options between those two starkly opposing choices.

Dr. Eglash is so angry that I dare question the perfection of breastfeeding that she is reduced to libeling me:

You know as well as those of us reading this blog that your rants are analogous to those of anti-climate change individuals, choosing to ignore carefully evaluated science, for your own personal gains. Breastfeeding specialists don’t become wealthy from their research and support of breastfeeding. Much of our time spent advocating to improve infant and maternal health is done thru volunteerism. You, on the other hand, can easily rake in money by promoting large multinational corporations.

In this laughably fallacious view, you either promote breastfeeding or a are a corporate shill for the formula industry. Eglash seems to be incapable of even imaging that a physician could promote breastfeeding and choose it for her own children as I did, while recognizing that it isn’t the right choice for every mother and every baby.

Dr. Melissa Bartick, who has made extraordinary claims about the public health benefits of breastfeeding that she has been unable to substantiate with scientific evidence insists:

I would like to see Amy Tuteur obtain grant funding and conduct actual scientific research and publish it in a peer review journal so she would understand how it is actually done and what goes into this process. She has repeatedly demonstrated that she has no such understanding of science.

Because in the world devoid of nuance that lactivists inhabit you either agree with Dr. Bartick and her compatriots or you don’t understand science. It seems to have never occurred to her that I disagree precisely because I DO understand science and she hasn’t provided any.

The natural childbirth industry is also a world devoid of nuance.

I was recently interviewed by Medscape (a division of WebMD) and they titled the interview Ob/Gyn Wants Women to Stop Feeling Guilty About the Birthing Process. That title is made up of simple words, easy to understand, but members of the natural childbirth industry affect not to understand them.

Deborah Gedel-Beer, CNM writes:

As a nurse-midwife I find this “interview” disturbing and degrading. Instead of supporting services which help to educate and empower women, Dr. Tuteur expresses a patronizing point of view and pretends to reference this with scientic articles.

False dichotomy: if you don’t promote guilt among childbearing women, you oppose education and empowerment. That false dichotomy is especially ironic because I believe that making women feel guilty about their childbirth choices is the OPPOSITE of educating and empowering them.

New Zealand nurse midwife Robin Jones insists:

Dr. Tuteur is well known in childbirth circles for her unswerving belief in the superiority of obstetric care for women (as opposed to midwifery or any other sort of care). As a professional with strong beliefs she should know better than to take her experiences of her own four births and extrapolate these into data that she then applies to all other women. She could try to appreciate that for most women (who do not have her extensive pro-obstetric socialisation) the emotional content of their pregnancy/labour/birth experiences are dependent on their outcome vs their expectations, which will have been influenced by factors not at all under their control (such as their care providers preferences that they may not be aware of).

False dichotomy: either you want women to feel guilty about their childbirth choices or you think obstetric care is perfect.

Nurse Practitioner Holly E goes even further:

Dr. Tuteur is one of many people who find it inconvenient to witness the emotional fallout that occurs when the women she (sexually) violated and coerced are in recovery. Yes, women, the doctor said stop having feelings!

False dichotomy: if you aren’t making women feel guilty about not choosing unmedicated vaginal birth, you are promoting sexual violation and coercion!

Childbirth educator Amy Haas says:

Here’s the problem. There is a long history with this particular retired physician. She has bashed, bullied, belittled, and just been down right nasty to anyone who attempted to have an intellectual conversation with her about research, that differs from her opinion. She is known as a spin doctor in our industry. Fellow researchers stopped attempting to even communicate with her a long time ago, because there was no logical conversation that one could have. If she did not bash you, her cohort would. Promoting someone with such a skewed point of view ends up invalidating the few points she might have. All of this is not about guilt, but control. Her way or the highway. This is not the way to have a professional discourse about health care matters.

False dichotomy: if you aren’t agreeing, you’re “bullying.” Their way or the highway.

In the world of lactivism and natural childbirth, there is no nuance and no shades of gray, but in the real world, there are a range of choices available to women.

For professional lactivists and natural childbirth advocates you’re either with them or against them.

I’m neither because I’m with BABIES and WOMEN.