You can’t understand anti-vaccine advocacy unless you understand performative motherhood

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A tremendous amount of ink has been spilled by doctors, scientists and public health officials pondering the bizarre beliefs of anti-vaccine parents. How can they promote such obvious nonsense? Why don’t they respond to efforts to improve their knowledge base? Why can’t we get them to understand the risks they pose to society in general and their own children in particular?

Sadly, we’ve been asking the wrong questions because we have assumed that anti-vax beliefs are the result of scientific ignorance. While ignorance of immunology, science and statistics are necessary concomitants of anti-vax beliefs, they are not sufficient. The missing piece we have failed to consider is the rise of performative mothering.

Anti-vax advocacy is perhaps the acme of performative mothering. It only acquires meaning by being performed under the gaze of other mothers.

What is performative mothering? As I explained over the past two days, a mother used to be something you were; now it’s something you do, hence the term “mothering.” And you do it under the gaze of other mothers, micro-branding yourself by your choices, and disseminating a carefully curated portrayal through social media, artlessly seeking validation through the “likes” of strangers.

Anti-vax advocacy is perhaps the acme of performative mothering. It only acquires meaning by being performed under the gaze of other mothers, especially those on social media. Indeed, in a country where vaccination rates are high, it has almost no meaning unless it is observed. Until recently herd immunity meant that most unvaccinated children would never be exposed to most childhood infectious diseases. Therefore, there was no obvious difference between vaccinated and unvaccinated children. The only observable difference was the preening of anti-vax mothers.

Anti-vax advocacy acquires further meaning by being performed under the gaze of pediatricians and other healthcare providers. Behavior is not transgressive unless it is demonstrated to authority figures, eliciting the delicious disgust that gives meaning to the act.

As Pru Hobson-West explains in ‘Trusting blindly can be the biggest risk of all’: organised resistance to childhood vaccination in the UK:

Clear dichotomies are constructed between blind faith and active resistance and uncritical following and critical thinking. Non-vaccinators or those who question aspects of vaccination policy are not described in terms of class, gender, location or politics, but are ‘free thinkers’ who have escaped from the disempowerment that is seen to characterise vaccination…

…[Anti-vaxxers] construct trust in others as passive and the easy option. Rather than trust in experts, the alternative scenario is of a parent who becomes the expert themselves, through a difficult process of personal education and empowerment…

Ironically, despite the collective derision for experts, anti-vax advocates depend heavily on pseudo-experts like Dr. Bob Sears and similar anti-vax charlatans. What distinguishes Dr. Sears from other pediatricians? It isn’t merely his flexible ethics that allow him to pander to anti-vaxxers for profit. Bob Sears is fluent in the language of performative motherhood.

Consider how anthropologist and certified professional midwife Melissa Cheyney describes homebirth in Reinscribing the Birthing Body: Homebirth as Ritual Performance:

… As a socially performed act of differentiation, homebirths are constructed in opposition to dominant ways of giving birth, although just where the lines between consent and resistance lie are not always clear, shifting with each provider and each mother, over time and in the retellings.

Bob Sears understands that as a socially performed act of differentiation, anti-vax advocacy is constructed in opposition to dominant ways of protecting children.

Homebirth practices, thus, are not simply evidence based care strategies. They are intentionally manipulated rituals of technocratic subversion designed to reinscribe pregnant bodies and to reterritorialize childbirth spaces and authorities. For many, choosing to deliver at home is a ritualized act of “thick” resistance where participants actively appropriate, modify, and cocreate new meanings in childbirth.

Anti-vax, thus, is not an evidence based strategy to protect children. Bob Sears understands it is a ritual of technocratic subversion performed for the admiration and gratification of other mothers.

Bob Sears is fluent in the language of performative motherhood. To paraphrase Gallo and Cruz’s description of midwives:

Sears provides emotional support by sharing beliefs about the experience and by affirming the woman’s right to assign her own unique beliefs to vaccines. This seemingly simple service of association and presence is a critical social need in the context of anti-vax advocacy that depends on a shared cultural consensus for its significance.

As he notes in the final chapter of his book The Vaccine Book: Making the Right Decision for Your Child:

I’m sure you are trying to answer the question that is on every parent’s mind: What should I now do? How do you make the right choice for your child? I have offered you all the information you need to make this decision, but I have held back from actually telling you what to do. I want you to formulate your own decision without letting my opinion sway you one way or the other.

Whereupon he proceeds to give his opinion on an alternate vaccine schedule that has no basis in science but creates maximum scope for performative mothering. And he repeatedly panders to the pretentions of performative mothers.

Alternative vaccine schedules aren’t for everybody. It takes a lot of extra time, effort, and planning to follow them. In addition, some doctors will fight you if you try to “change the system.” …

You can’t walk into your appointment unprepared and ask your doctor to come up with an alternative schedule for you. There is only one standard schedule that doctors are trained to follow; working outside this schedule is foreign to most doctors. You must understand the diseases, feel comfortable with your knowledge of vaccines, and establish your own vaccine plan prior to seeing your doctor. The suggestions I offer in this chapter are a good place to start. If the doctor sees that you’ve thoroughly thought this through, he or she is much more likely to work with you.

Performative mothering is toxic for a host of reasons: it places women under tremendous pressure to perform for other mothers; it ignores the needs of the individual child in favor of the social approbation of the group, and — as in the case of anti-vax advocacy — it is dangerous, even deadly, for children.

  • Mel

    I still think the deepest level truth behind anti-vaxx is that some parents can’t bring themselves to go through the mildly unpleasant – but extremely transient – distress of having their kids get shots.

    I am so glad we have vaccines. I want to worship a deity in honor of whomever created the RSV vaccine.

    I also absolutely hated having to hold my increasingly larger baby down for multiple shots monthly during his first winter at home. I hated that my son started crying whenever a person wearing disposable gloves entered a room with an exam table. I hated it – and spent plenty of time crying in the shower the night before his shots – but I never missed a shot because that’s what a good parent does.

    He’s getting better about disposable gloves and exam tables now that he has far more medical appointments than appointments with shots now that he’s over 24 months on his vaccine schedule – but he still freaks out if you lay him on his back around medical professionals. Getting his stomach taped at PT requires me trying to comfort his as he rage – screams at his PT and tries to kick her…and he likes his PT. So…we’ll be working on that next – but so much better that than rebuilding his lungs after RSV…or whooping cough…or diphtheria.

    • Who?

      I like your thinking, but remember some of these people give their children bleach enemas, which lead to them eliminating chunks of stomach lining, so I doubt that squeamishness about hurting the kids is exactly (or mostly) what’s driving it.

  • Teddy

    Anyone think that anti-vaxers will have Ebola parties to make sure their kids get it the natural way now that there’s the experimental vaccine?

    These people need to spend some time in countries with no health infrastructure. It’s not pretty, and I bet they’d change their stance on modern medicine in about 2 seconds.

    • fiftyfifty1

      Well if they lived in a place without health infrastructure, they could vaccinate and still be special, because in those locations good medical care is reserved for the rich and powerful.

  • Box of Salt

    Dr Tuteur, I think you are off base on this one. Anti-vax goes way beyond the current transgressive mothering ideas.

    You are viewing anti-vax as a subset of current attachment/alternative/whatever they call it now mothering practices, but it isn’t. That movement pulled anti-vax ideas into their own, because they align well. But anti-vax pre-dates those ideas, and it will out last them.

    If you fail to recognize this, you cannot effectively combat anti-vax.

    The core of the today’s anti-vaccine movement in the US is groups of parents who latched on to vaccines as a problem because they had already perceived that they had failed as parents when their children were diagnosed with developmental delays.

    Your Mira is trying to prevent problems. The leaders of the anti-vax movement are well past that. They are responding to problems after the fact.

    Shining a light onto the Dr Bob Sears acolytes (such as fictional Mira) is good. But don’t keep the beam narrow, or you miss the vaccine injury parents descending on an Advisory Committee on Immunization Practices meeting back in October to berate members of thencommittee which approves the US vaccine schedule: https://vaccinesworkblog.wordpress.com/2018/10/26/mrs-antivaxer-goes-to-atlanta/

    Please keep an eye on both these avenues promoting harm.

    • space_upstairs

      Those who become anti-vax due to having a special needs child still micro-brand themselves among special needs parents, trying to “cure” their children with sometimes dangerous non-evidence-based therapies and special diets rather than just sticking to standard evidence-based classroom techniques to mitigate the learning delays. They still hope to “succeed” after their initial “failure” with their unconventional, expensive, heroic efforts. And one might argue that they’re doing this more for each other than for their children, to show that they’re top class parents in spite of already having a kid who, due to neurology, has no or limited future job prospects.

    • rational thinker

      Most parents of an autistic child go through some period of trying some of these supposed “cures” its the desperation that comes after the diagnosis I went through it myself, but all I did was the gluten/casin free diet for about 3 months. Which only made my child miserable. What is not normal is to continue all these bullshit cures after you go through that initial phase. In this case if the child was normal they would probably be doing the intensive mothering/natural parenting and/or bragging on face book.

      So its done for the same reasons they love validation and attention. A mother of an autistic child seeking attention and validation would immediately and easily get both from joining an anti vax group. So it is very much a subset group. For example I don’t belive you can cure autism but you can treat it with early intervention and a lot of therapy. Now in a anti vax or even attachment parenting group I would be viewed as a bad mom for not trying to “cure” my child. In that same group a mom who gives her kid a bleach enema and organic food is praised as a saint. The real thing these parents are after are praise and self validation, most times at the expense of the child.

      • Who?

        My sister-in-law went through this. Child not ‘quite right’, then identified as on the spectrum.

        She started with the diets and weird stuff, and then a month or two in realised they were busy enough with life, and what he actually needed (speech therapy and child psychologist) and stopped all the woo. She’s a pharmacist and said she knew the woo was ridiculous and couldn’t help, but she tried it anyway.

        Her essential down to earth approach didn’t stop others judging/offering advice etc, and didn’t stop her really having hurt feelings at various times, but did help her do what she believed was best, sometimes against quite aggressive criticism. It’s been tough for her and for the whole family.

        • rational thinker

          Especially the early years you get a lot of advice from others, one lady I worked with kept saying if I would just give her fish oil in her drink every day she would be able to talk, cause her friend did that and her kid is talking. I really just wanted to tell her that if cod oil cured their kid then he didn’t have autism in the first place. I actually had already tried cod liver oil when she was on the gluten free diet. Eventually people around you get the hint that you could do without the advice on a subject you know more than them about. Also just keep in mind these are the same people that will give you advice if the kid was normal. Instead of did you try gluten free? it would be “you should have breastfed”or “done it longer” or “you shouldn’t let him watch so much tv”. The type of person is the same they will just give different advice for a handicapped child. Eventually it wont upset you that much anymore you will just laugh off the stupid advice. My daughter is 14 now and partially verbal (with years of therapy just for that) she is still in diapers but she is making more and more progress every year. My daughter was labeled as hopeless by some teachers at school. We got lucky when she got a personal aide at school who went on to become an aba teacher. She helped my kid to learn how to communicate. It took several years but now she is verbal enough to tell me what she wants and she understands everything I say. Like I said we all go thru that process .Its part of adjusting to a major lifestyle change and I think we all fall for the cure bullshit, but usually not for long. Any autistic child is lucky to have a parent who realizes that they cant cure them but they can help them and its a long road with time and effort and the outcome is worth the work. Tell your sister in law not to feel bad over all the “advice” these are people that can only feel good about themselves if they put other mothers down and they have no idea what she goes thru day to day.

          • demodocus

            Gad. Dem’s grandmother was -always- giving him advice on how to be independent. But it was stupid crap because it was stuff her own child had made sure Dem knew how to do all that when he was a little kid.

            We also periodically get articles about this or that device/medical thingy that might help with certain forms of blindness, usually not what he has. Or something we’ve known about for years. Sigh.

          • Who?

            Thanks for all that, yes she has gone through a lot of what you describe. Her boy is a young man now, and not working or going to uni, just wants to play computer games all day. He’s got bad social anxiety which doesn’t help at all.

            She gets a lot of nonsense from her parents who still really don’t accept there is anything wrong with their grandchild, and who undermine her efforts to support him. There are also some other family members who bait her (and the boy) about various things. If I’m there when it happens I step up with moral support (and the odd telling-off) but it’s a hard road. She often has a little cry after family gatherings where things haven’t gone in a civilised way.

            Sounds like your daughter is doing well-sometimes it’s the lucky meetings that make all the difference to our lives.

            I resist giving advice because what would I know, I don’t walk in your shoes. Happy always to nurse the crying baby, run the washing machine, take the child for a walk or whatever, that is, something practical rather than drone on about what I did, or think I would do, in a particular situation.

            And always tell the parents who want the best for their kids that the best they can manage on a particular day, is, by definition, good enough.

        • Ayr

          My son is delayed in the speech area, so we have him doing occupational and speech therapy. The occupational because he gets hyper-focused on stuff to the point that he doesn’t even notice you call his name unless you are right there in his face. Anyway there are number of people I know who have severely Autistic children and a friend who has Asperger syndrome, they ask how my son is coming along in his therapy and at least 50% of them spend the conversation trying to convince me he is on the spectrum. He has been observed by professionals examined by doctors and none of them thinks he has Autism.
          I think unfortunately for our generation of parenting Autism has become the new ADD/ADHD. It has become the ‘in thing’ to diagnose and in a lot of cases no really true, which is unfortunate for a lot of kids.

          • rational thinker

            I agree I don’t know why anyone would want that diagnosis. It makes me very angry that it does seem to be the new in thing. Years ago I could just say my daughter is autistic but now I find my self explaining to people that she is really extremely autistic and I shouldn’t have to say all that. More than a few times over the years I have met people who tell me their kid is autistic then I meet the kid and think this kid is perfectly fine. Its unfair to the children that don’t have it but some how got a false diagnosis and its just insulting to people who do have it. My kid is 14 now and has to have somebody with her at all times and cannot be left alone for a second and is still in diapers cant dress or wash herself and is only very partially verbal and may be that way her whole life. I always tell any expectant or new mom who is worried about autism that actual autism is very rare. Thank you for saying what you did it means a lot that someone else sees this problem of over and false diagnosis.

          • Ayr

            That’s ridiculous! You’re right you shouldn’t have to explain. My orchestra director at church has four kids, his oldest is severely autistic like your daughter, she is in her forties now but she still wears diapers, talks like a toddler, and cannot take care of herself in anyway, but she is the sweetest person I have ever met. It breaks my heart to see kids like my son, who are just different, being labelled with something because everyone must fit into a box.

          • Who?

            It’s really hard. There has been an evolution around these diagnoses and there is a tendency to forget/not realise/not understand that what we’re seeing now has always been.

            I was born in the early 60s, and as someone else mentioned on one of these threads, when I was at school there were always kids (boys) who couldn’t sit still, couldn’t get on in class and spent a lot of time sitting on the verandah so as not to disturb the rest of us. They left school in their mid-teens and got jobs doing stuff outside. That was our normal-there was nothing to be done in any event and they mostly left school and found a place.

            Fast forward to the early nineties when my busy, highly talkative, very black and white son was born. Once he got a bit older a lot of well meaning folks told me he was ADD or similar. I was lucky to have good family support, got him some OT that he needed (his proprioception was terrible) and he fitted into school, took up long distance running and has done well.

            My nephew (whose story I shared in response to rational thinker) was born around the turn of the century, and he isn’t doing so well. He, like your child, is incredibly focussed and has had a lot of help with speech etc. Maybe if he was 10 years younger he’d be identified as not on the spectrum but more like your son.

            I imagine your friends want the best for your boy and think the little bit they know is enough to start diagnosing other people’s kids. People do that. By the time he’s grown there will probably be another way of looking at, responding to and treating not-perfectly-round pegs who need to fit round holes.

            Meanwhile, the holes and the hole-monitors are getting more prescriptive which does the differently-shaped pegs no favours. This is the bigger worry, in my opinion.

          • Ayr

            I am glad your son found his place and that your sister-in-law saw the light and is getting her son the help he really needs not all the woo. I hope he will eventually begin to improve and also find his place. I have a friend who is truly ADHD, he is actually the literal textbook example for doctors and he is nothing like a majority of those diagnosed. He has limited focusing capabilities, he gets antsy, but he can get hyper focused on something that really captures attention. He also gets obsessed with things very easily, and he talks non-stop, even in his sleep according to his wife.
            My son is on a gluten free diet because he is allergic to it, the results of him having gluten are never pretty, but there is no woo involved. It amazes me how many of my friends are into the woo. I actually had to end a friendship of nearly 20 years because my friend had gone full on crunchy mama and thought it gave her the right to tell me how to raise me son, including the evils of circumcision. (Not wanting to start a debate about that.) It’s like my generation is extra susceptible to the whole thing.
            I keep thinking about all the great inventors and innovators in history, they were all a little quirky, they didn’t fit in and people thought they were weird or crazy or both, but without those people we wouldn’t have electricity, light bulbs, etc. And it seems to me, that in the effort to make everyone fit into preconceived ideas of what is normal, we are suppressing those traits which would allow creative thinking. The experts are just too eager to jump to a diagnoses and shove pills and labels at us rather than really listen to what is going on. Whatever happened to square peg round hole? If you don’t fit in here, there is somewhere else you will fit in, we aren’t meant to all be the same.

    • swbarnes2

      The core of the today’s anti-vaccine movement in the US is groups of parents who latched on to vaccines as a problem because they had already perceived that they had failed as parents when their children were diagnosed with developmental delays.

      Is it? Do you have numbers on that? I always thought it was based on the far larger number of people whose children did not have delays.

      I see the core of it all as vanity. Vaccines and hospital births and non-organic food and plastic toys are good enough for poor people who don’t know better, but not their precious children, who have parents who are “educated”, and have the time and money to do the more difficult, and therefore, presumably better, things.

      • Box of Salt

        swbarnes2, with all due respect to both you and Dr Tuteur: you are following her presentation of anti-vax from a mothering viewpont, not from an anti-vax viewpoint.

        My point is that it is short sighted to follow only this point of view. Yes, anti-vax is part of the all-natural mommy blogger worldview, involving science denial, naturalistic fallacy, and the need to feel superior. It fits them and they embraced it.

        But anti-vax has a life of its own.

        Do I have numbers? No, but I have some names for you. Barbara Loe Fisher. J B Handley. Sallie Bernard and her organization SafeMinds. I have no doubt you have heard of Andrew Wakefield and Jenny McCarthy.

        Look into Seth Mnookin’s book The Panic Virus for the history.

        (link: https://www.simonandschuster.com/books/The-Panic-Virus/Seth-Mnookin/9781439158654 )

        What Bob Sears achieved was creating an avenue for anti-vax to become more mainstream by linking it to his family’s parenting philosophy.

        The noisy part of anti-vax in the US is still coming from the vaccine-injury crowd. We forget about them at our own peril.

    • AnnaPDE

      Yes, but: Those parents with autistic or otherwise not-perfect children didn’t come up with vaccines as the problem all by themselves.

      There’s a nice big undercurrent of people believing all wide variety of conspiracy-inspired rubbish: popular ones being zero-point energy or the cure for cancer being kept from us; chemtrails from planes or fluoridated water as a tool of keeping the population docile; and also vaccines as a form of deliberately infecting people with whatever the newest fad is.
      Having had a bit of family contact to such “alternative” circles, my guess is that this kind of idea stems from a deep-seated fear of not really understanding a scary, out-of-control world — but by people who are lucky enough to have a reasonably comfortable and safe life that gives them enough leisure to contemplate such stuff. They feel manipulated and taken advantage of by the people who seem to understand a bit more (eg: scientists) or have some power (eg: government) or money (eg: industry).
      So they resist: They retreat into a woo-ey world view, in which everything is simple and solved by love/diet/yoga/secret traditional magic or any combination of these, and reject as much mainstream stuff as they can afford as an expression of their defiance.
      Not vaccinating seems cheap: The chances of dying of measles look slim in today’s West (due to vaccines, but hey, that’s logic). The organic food mania is a bit more expensive but a great way to show off. Collecting your own rainwater to shower in is a bit more involved and tedious, but it makes an amazing impression at parties…

      The intensive mothering circles aren’t making this stuff up, they’re just lapping it up as a kind of bonus.

      • Box of Salt

        AnnaPDE “The intensive mothering circles aren’t making this stuff up, they’re just lapping it up as a kind of bonus.”

        Thank you: that’s my point.

  • Russell Jones

    Yes indeedy, the confirmation bias is strong with these clowns. Actual experts are vilified as money-grubbers, pharma shills and/or sheeple while those who hold the “correct” view, like Bob “Get Your Medical Exemption Right Here! Low Low Prices!” Sears, are deified. And then there’s Andy Wakefield, who directed and starred in that movie in which Andy Wakefield says that Andy Wakefield was right all along regarding autism and the MMR vaccine.

  • rational thinker

    With all the time they spend seeking praise from each other, being on facebook posting about how bad vaccines and formula are, telling other women they don’t even know how much better mothers they are than everybody else, do they actually spend that much time with the child?

  • MainlyMom

    I don’t understand how this group of parents even have the time or energy to keep up with all of the ever-changing nonsense they’re supposed to believe: where/how to give birth, feed, diaper, vaccinate, feed, clothe, chemical of the day, sunscreen or no?, how to play, discipline of the week, which school is crunchy enough? Holy moley folks, get a second job with that extra time or give back to a world that would love to share in some of your privilege!

    • space_upstairs

      See, I think that’s the thing: they fear that if they get a full-time job and don’t try to do (or better yet, outdo) everything Mrs. Jones does, they will lose all that privilege: not be allowed to send their kids to play with the little Joneses, not hear later about the great SAT tutor and college essay ghostwriter that the Joneses hire for their kids when they’re finishing high school, and then if the kids end up unemployed and living with their parents until age 30 it will be all their fault. While they can’t be blamed for having such worries, as someone mentioned on the other thread, if they play into this system they are just perpetuating the problem.

      • They’re creating their own worst nightmare. These over-parented kids will have a very VERY hard time jumping the nest in adulthood.

        • space_upstairs

          Yeah, I think preparing the kids for the harsh realities of today’s economy is probably a better strategy than trying to exempt them from such realities. If you grew up with a good standard of living, is it really so bad to have a little less than your parents? I never wanted more money or stuff than my parents, just less to whine about in work and love, and I’m pretty sure I got that.

          • BeatriceC

            I have a lot less than my parents. I still have a lot, but it’s a fraction of what my extremely well off parents have. I still have a nice house even though we’re putting off some major repairs because finances are a bit too tight. Our newest car is a 2005 and the classic cars are all in need of some restoration work, and we’re not doing it because we’re prioritizing other things. My kids wear Abercrombie and Fitch, Hollister, Lucky Brand, etc., not Prada, Armani, Versace, etc And in my parents’ world, that make me a failure. They can fuck off with that shit. And I’m happy. I gave up a lot to cut them out of my life, and to be honest, I’d rather be homeless than bound to their money. I’m doing a hell of a lot better than so many others and I’m extremely thankful for what I have.

          • Lol. From where I’m sat Abercrombie and Fitch, Hollister, Lucky Brand, etc. are the expensive clothes. In our house we wear… whatever they’re selling at Target.

          • BeatriceC

            Oh, of course. That’s why I opened with I have a lot. It’s just not nearly the level of financial comfort (and excess) as my parents. Also, those stores can actually be less expensive than Target if you’re patient enough to only shop clearance stuff when they stack additional percent off sales on top. And if you can tolerate being email spammed, sign up for loyalty programs. I just bought the middle kid a $150 puffer jacket for $30 between clearance, additional percent off, and loyalty cash.

  • demodocus

    Blind trust is appropriate in young children, blind distrust is pretty common among adolescents, but if they/we are wise, we know blind anything is not the preferred way of life.

    I trust medical professionals and scientists on vaccines because I’ve done reading from more sources than Dr. Sears, Mr. Wakefield, et al, including random things like the biography of Ben Franklin that briefly discusses his little son who died of small pox. The staff at President Garfield’s old home talk about how he lost his eldest and youngest children to diptheria and pertussis. Wandering around there with my own baby in his carrier, freshly vaccinated, really put an emotional spin on it, even more than my MIL’s pain at her adorable baby’s congenital rubella. Probably because he’s a reasonably competent adult and aesthetically pleasing to me Plus, I forget that he’s blind.