Lactivists and midwives demonstrate how to respond unethically to a recommendation that caused unintended harm

Typewriter Got Ethics

What’s the ethical response when a provider learns that a course of action she recommended has caused unintended harm?

Lactation consultants believe (because they teach and tell each other) that breastfeeding is best for every baby. As a result, they have harmed tens of thousands of babies and mothers for whom breastfeeding will never and can never be best. The Royal College of Midwives obliquely acknowledged that harm by reminding midwives that bottle feeding is a valid choice and that women who choose it merit respect and support.

Milli Hill, Amy Brown and Sheena Byrom among others are on Twittter right now engaged in this unethical behavior even as we speak.

Midwives in general and UK/Australian midwives in particular believe (because they teach and tell each other) that unmedicated vaginal birth, so called normal birth, is best for nearly every mother and baby. As a result they have harmed untold numbers of mothers and babies who have sustained birth injuries, brain damage or even died when complications were ignored in the pursuit of vaginal birth. The Royal College of Midwives obliquely acknowledged that harm by shuttering their Campaign for Normal Birth.

Those are nice first steps, but sadly the RCM did not go far enough. As a result the bullying of mothers continues and many of the rank and file feel free to ignore the admonitions. Medical ethics requires more of providers who issue a recommendation that causes unintended harm than simply stopping the harmful recommendations. Ethics requires acknowledgement of the harm, support of those who have been harmed and reevaluation of the scientific evidence that undergird the harmful recommendation.

Instead, lactivists, like UK/Australian midwives before them have done the opposite.

  • They’ve denied the harms.
  • They’ve derided the parents of babies who have been harmed and called them liars.
  • They’ve impugned the integrity of safety advocates.
  • They’ve dismissed the scientific evidence of harm.
  • And they’ve invoked their good intentions to absolve themselves of responsibility.

Milli Hill, Amy Brown and Sheena Byrom among others are on Twittter right now engaged in this unethical behavior even as we speak.

Imagine for a moment if the doctors who prescribed DES (diethylstilbestrol) had behaved like Hill, Brown and Bryom.

Diethylstilbestrol (DES) was first synthesized in 1938 and was the first orally active nonsteroidal estrogen that could be used for human therapy. At that time, endocrinology was in its infancy and this discovery was a unique and great advance. Recurrent pregnancy loss was a serious medical problem then as it is now. It was believed the problems were due to a faulty hormonal environment of the fetal-placental unit, rather than primarily to genetic causes, as we have subsequently learned.

The result was unforeseen disaster.

Then, in the late 1960s, eight extraordinarily rare cases of clear cell adenocarcinoma (CCA) of the vagina were diagnosed and treated in women in their teens and early 20s in the Boston area. No such cluster of cases in young patients had ever been seen previously. CCA of the vagina was known to be a cancer that rarely occurred even in older women. In an effort to understand the cause of this cluster, a case-control study was conducted at the Massachusetts General Hospital in 1971 that linked the appearance of these cancers to the patients’ mothers having been treated with DES …

Subsequently, DES use during pregnancy was associated with other adverse health effects in the exposed female offspring, including an increased frequency of anatomic problems in the female genital tract … all of which led to pregnancy complications including premature birth of offspring of the DES-exposed daughters…

How did the medical profession respond?

They acknowledged the harms, indeed they publicized the harms in an effort to inform any woman who might be affected.

They validated the harms that had befallen the affected women. They did not accuse them of lying about the harms; they did not impugn their integrity; they did not ignore the scientific evidence.

They did not invoke their unquestionably good intentions to avoid responsibility.

They reassessed the scientific evidence and the faulty conclusions they had drawn from it.

In contrast, lactivists and many midwives are still in deep denial despite both scientific evidence and testimonials of harm on both social and mainstream media.

Dr. Miriam Stoppard rightly takes them to task over their denial in regard to breastfeeding.

I don’t know which I feel more, anger or relief, at the announcement from the Royal College of Midwives (RCM) that mothers who choose to bottle feed their babies must be respected.

What took them so long to realise their rigid adherence to a policy of pressuring women to breastfeed was cruel and heartless?

Legions of bottle-feeding mothers have been humiliated and made to feel failures, guilt and shame by hard core midwives and health visitors who toed the party line and used “breast is best” as a whip to subjugate new mums.

I couldn’t have said it better myself!

The RCM is now all appeasement. “We know every woman wants the best for her baby and we want to be able to empower our members to support women to be the best they can be and enable them to make decisions that are right for themselves and their babies.”

But what about all those terrified mothers who were bullied and harassed by health care professionals making their lives a misery?

An apology would seem appropriate.

An apology would be nice, but a good first step would be to reprimand the Milli Hills, Amy Browns, and Sheena Byrons for their unethical behavior and publicly tell them to stop.

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  • J.B.

    I read the original paper questioning DES use for a project at one point. On the facing page there was an editorial claiming that the authors clearly didn’t know what they were talking about. It was a sobering reminder.

  • mabelcruet

    Byrom is a hypocritical liar. She re-tweeted a post in the last day or two from HealthWatch UK about how to discuss issues with your health care provider and what to ask in order for you to make an informed choice (eg side effects of possible interventions, alternative methods, risks and benefits). I absolutely agree-its essential that people make the choice that suits them. And yet she has been lying by omission for years-I highly doubt that she has been telling women the accurate risks involved with vaginal birth, downplaying the possible side effects and complications whilst exaggerating the risks of a section. And I doubt she’s been telling mothers true facts about breast feeding and potential risks, whilst exaggerating the problems with formula. Milli hill is the same-they are all for female empowerment but only as long as a woman makes choices that they approve of.

    • maidmarian555

      I have very much enjoyed watching Hill get her arse handed to her this week on Twitter by a group of mums who were just not prepared to tolerate her ‘but I’m just asking questions’ bullshit. Favourite moment was when she asked them what they thought it was she did and they all turned round and told her they didn’t know who she was and didn’t care either. It was glorious!

      • Chi

        Are you able to post a link to the thread? I’d very much like to read it.

        • maidmarian555

          https://twitter.com/godfrey_isaacs/status/1007219607231500288?s=21

          That’s the original tweet that started the thread off. It begins with a lot of lactivist back-slapping but as it splinters off in lots of different directions, there are a load of mums on there standing up for themselves and absolutely refusing to take any shit. It’s worth following it down all the sub-threads, although it’s enormous now as it’s been going for several days.

          • mabelcruet

            Milli Hill is doing her usual trick of gaslighting and then claiming bullying. All she’s asking us that Fed Is Best provides exactly the data she is demanding, limited to UK babies and research published only in the last 3 years, what is unreasonable about that? She only wants to provide evidence based information, not hyperbole, and she’s not an expert do she just wants to be guided by others. And then obviously ignores every single stat and paper and record presented to her whilst still bleating on about ‘I just want the facts…’. And then bitches that people are being mean to her by saying she’s ignoring the facts being presented to her, and that is bullying. Honestly, do you think lactivists get a crib sheet so that they all say the same vacuous shit over and over again? Do they get training to get just the right tone of injustice and grievance, and tips on how to ignore women, gaslight them, lie to them or make them feel guilty, or is it that type of nasty whinging idiot who is drawn to lactivism and sanctimommy behaviour in the first place?

          • Abi

            I thought lactivist bingo might be a good idea – googled it, look what popped up:

            http://www.skepticalob.com/2015/12/lactivism-bingo.html

          • maidmarian555

            I think many of the full-on NCB/lactivist lot are just plain old narcissists. Milli behaves like that mean girl we all had at school who’d spend all year tormenting you and then when you finally snapped, went running off crying to the teacher. She’s also a big fan of quote tweeting ppl who are ‘mean’ to her and setting her followers on to them (she’s done it to me before and I had a full 3 days of random weirdos yelling at me about their vaginas whilst simultaneously discussing with her how I must have some sort of mental health condition-FUN TIMES WITH SUCH AMAZING FEMINISM).

            What I really liked about that thread is rather than it just turning into one great big lactivist circle-jerk is that they properly got called out. And not just by FIB or Dr T, mums are really starting to speak out too on Twitter. Before I’ve seen ppl stand up and get shouted down (or ignored) but it really feels like things are starting to change.

      • Sarah

        Reminded me of that time she got monstered on Mumsnet. It was marvellous.

  • Mel

    Science requires that practitioners adapt ideas when other data becomes available. Lactivists refuse to do that.

    Religions require belief in the absence of scientific evidence and generally offer few immediate benefits or drawbacks in this life, but hold out some form of hope for a future life. Lactivists are all about immediate and longer-term benefits allegedly supported by science this life, so they aren’t quite a religion.

    Cults or other high-demand organizations require extreme sacrifices of their members in exchange for acceptance within a hallowed group of people. Questioning the practices of the group leads to restrictive behaviors or social ostracization under the guise of helping errant members return to the group.
    Once lactivists start doubling-down on sacrificial beliefs like EBF is worth increased infant morbidity and mortality while denigrating combo-fed and formula-fed infant/mother dyads, they’ve crossed into cult territory.

  • Platos_Redhaired_Stepchild

    you will never get them to admit wrong doing or apologize. they’ll double down.

    https://melmagazine.com/the-psychology-of-doubling-down-32a237c1570a

  • demodocus

    Since I’m not that cynical about human nature, I suspect most of them -believe- their comments and truly do not understand how their words sound to those of us who cannot give their children “the best”. Logic says it’s a much more complicated metric than they make it out to be, but logic is in precious short supply when our babies are concerned.

    Still and all, once people point it out, common curtesy says to apologize and stop doing it. You can’t claim obliviousness once you know about something.