Why should you trust birth if you can’t trust pregnancy?

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Homebirth advocates, despite their claims of being “educated” about childbirth, are generally quite ignorant. They lack the basic knowledge of science, statistics and obstetrics that would allow them to evaluate what they read on the Web (or more importantly, to recognize that you cannot become educated by reading on the Web).

Ignorance is not the only deficiency. Homebirth advocates seem to suffer from a serious problem with magical thinking.

If trusting pregnancy won’t prevent a miscarriage, why would trusting birth prevent a baby’s death?

What is magical thinking? It’s the belief that your own thoughts have power to “magically” control events. It’s difficult to imagine anything more emblematic of magical thinking than the inane mantra, “trust birth.”

Does trusting hearts prevent heart attacks? Does trusting pancreases prevent type I diabetes? Does trusting breast prevent breast cancer? Obviously not, so how can any woman counsel another with a straight face to “trust birth” as a method of preventing life threatening pregnancy complications? And how can any woman actually believe that “trusting birth” is going to have any impact on anything?

The idea that women could actually believe that “trusting birth” will make a difference is especially remarkable considering that most women already recognize that trust has absolutely no impact on miscarriage, the most common life threatening (to the embryo) complication of pregnancy. Indeed, miscarriage demonstrates that the philosophy of “trusting birth” is completely farcical.

Your body is perfectly designed to give birth?

Really? Then why do 1 out of every 5 confirmed pregnancies end in miscarriage?

Miscarriages are commonly caused by devastating genetic defects, such as an extra chromosome or a missing chromosome. At some point in the reproductive process during the formation of the the ovum or during fertilization, a massive genetic error occurs and that error is incompatible with life. No amount of “trust” can prevent these genetic errors and no amount of “trust” can prevent the miscarriages that result.

Let’s think about what that really means: the same body that is supposedly perfectly designed to give birth will create embryos with the wrong number of chromosomes or other serious genetic defects approximately 20% of the time.

How trusting would you be of an airline if 20% of their flights crashed on takeoff and burned killing all aboard? How trusting would you be of an automobile manufacturer if 20% of their cars blew up the first time you turned the key in the ignition? How trusting would you be of a soup maker if 20% of people who consumed it got botulism and died? I suspect that you wouldn’t be very trusting at all. So how on earth can any woman trust any aspect of pregnancy when it ends in the death of the embryo fully 20% of the time?

How does trusting birth prevent a placenta that can’t transfer oxygen fast enough to a baby during labor? How does trusting birth prevent a breech baby’s head from getting stuck, killing the baby? How does trusting birth prevent the mother from having a stroke because of pre-eclampsia, killing her? Obviously it can’t prevent any of those things because “trusting birth” is nothing more than immature wishful thinking.

Why on earth would you think that a process that can’t even manage to assemble the correct number of chromosomes more than 20% of the time is going to result in a baby who fits perfectly, has a perfect placenta, and develops no life-threatening complications?

If trusting pregnancy won’t prevent a miscarriage, why would trusting birth prevent a baby’s death?

Can someone explain why “trusting birth” isn’t among the stupidest possible prescriptions for a healthy baby and a healthy mother? Inquiring minds want to know.

  • Allison

    If I had trusted birth, my son and I would both be dead. I have an abnormally narrow pelvis, he had an abnormally huge head. The result was cephalopelvic disproportion.

    Fortunately… I didn’t trust birth so far as I could throw it. We *knew* that I had an abnormally narrow pelvis. We *knew* that I had a family history of very large babies. And we *knew* that I was at risk for both cephalopelvic disproportion and shoulder dystoccia. And so our collective ass was in the hospital, where it belonged. We induced, hoping to avoid size-related problems. My doc (who knows me well enough to know I’d find it funny) nicknamed me ‘pitocin whore’ because I have a rather low response to it, and she has *never* had to order that much of it. She made sure that a second OB and the anesthesiologist on call were aware that she had a patient who might wind up going c section on very short notice. We had continuous electronic monitoring on him and a pulse oximeter on me (I have a history of exercise-induced asthma). I pushed for some 5 hours trying to get that kid out of there – and the only reason either she or I was prepared to let it go that long was because we *had* monitoring data, and knew that I was maintaining oxygen saturation, and he was tolerating the whole affair. Nonetheless, we wound up calling in the second OB and the anesthesiologist. At 5 in the morning. Three days before Christmas. In the middle of a blizzard. I don’t live far from the hospital, but if that had been a homebirth transfer gone to hell in a handbasket, there is no way either of us would have made it – the snow alone would have turned an 8 minute drive into a 24 minute drive, at least. But while the resultant c section was unplanned, it was not unexpected, nor was it emergent – there was no way in hell he was going to fit, but he and I were both doing okay.

    What got us both in more trouble were low blood sugar (no gestational diabetes, but he was over 9 pounds) and moderate to severe jaundice (we have an ABO blood type incompatibility). I had been brainwashed by lactivists into thinking it was dangerous to give him 20 mL of formula after he nursed. Fortunately, the nurses were willing to do it for me until milk came in and rendered it unnecessary. (I got over the formula issue later). He wound up spending the first 10 days of his life on bilirubin lights while he got rid of all of my type O cells. I’m not sure I want to ask whether a CPM would have caught just how high his bili counts were, and the potential consequence of that scare the crap out of me.

    He’s now a happy, healthy 5 year old. Fully vaccinated (and the next person who tries to draw a causal link between that and his autism, I swear I’m going to lose it – given that both parents are autistic, we don’t get to be surprised that he is), inquisitive, and entirely too smart for *my* own good – I’m thrilled to be raising a mini-engineer, but it’d be awfully nice if he’d engineer something other than ‘circumventing my attempts at child-proofing’. But without access to modern medicine, he and I would both have become a death in childbirth statistic.

  • Glia

    I would say I “trusted pregnancy” when I got pregnant the first time. At least, I certainly expected that I’d just do all the right things and take home a baby. Unfortunately, my trust and expectations did jack-all to protect my baby when my body didn’t produce what they needed to survive. My next two pregnancies I was extremely untrusting of pregnancy, but interventions let both of them result in healthy babies.

  • Inmara

    There are an awful lot of people who blame miscarriages on pregnant women – supposedly they either subconsciously don’t want the baby (seriously, that’s exactly what you can read in some type of “What doctors don’t tell you” magazines), or they don’t think positively enough, or they are not taking the right supplements etc. This is an aspect of “just world theory” and typically applied to all types of health issues.

  • Allison

    People assume that nature is some kind of benevolent entity, who always gets it right – after all, the human race has survived this long.

    But nature cares only about survival of the species – nature couldn’t care less about survival of any one individual. Nature can tolerate quite a high juvenile mortality rate without endangering the species, provided that the birth rate is high enough (and humans rather enjoy sex, so that’s not typically a problem).

    • Mel

      I’d disagree with the fact that nature even cares about the survival of the species; far more species have become extinct than are alive today.

      Nature is quite cruel.

    • BeatriceC

      The mortality rate in baby birds is about 70%. It can get even higher, though some of that has to do with climate change and other human catastrophes. There have been entire breeding season’s worth of some penguin species wiped out in the last few years. Nature is cruel and uncaring.

  • PeggySue

    I think, sadly, that trusting pregnancy has gone along with trusting birth. Folks might remember the story I wrote about some time ago–home birth, baby went into extreme respiratory distress at birth and went to hospital via ambulance, then mother had severe PPH and went to hospital via ambulance. It was found that baby had polycystic kidney disease and baby died in a few days, mother needed surgery, family in shock, midwives stated “this could never have been detected before birth.” Folks on this list helped me understand that it could have been detected, and parents could have known what to expect, and had much more choice about what happened. They didn’t do scans and it seemed the midwives’ fundal measurements weren’t too accurate either. So sad. So, yeah, trusting pregnancy and trusting birth are risky things to do.

    • rational thinker

      Prenatal monitoring is very important and like all things in nature pregnancy does have a failure rate. I was pregnant while in my senior year of high school when I was 17. The thing that blows my mind is that when I was a child I knew how important prenatal care was and I made sure I got it immediately, but a grown woman who trusts birth and pregnancy didnt and her baby paid for it. Very sad I only hope she learned from it and gets proper care for her next pregnancy.

      • PeggySue

        Yeah. To be clear, I don’t know if the baby would have survived. But the parents would have had choices: to terminate or continue the pregnancy, and, if they wanted to continue, to know what faced them at birth, and plan to have support in place and to bring meaning, as much as possible. They had a successful home birth prior, and here they were expecting a wonderful experience and a healthy baby by nightfall, and ended up in trauma and crisis which seemed to hit them out of the blue. So sad.

        • MaineJen

          Autosomal recessive PKD (likely what this baby had) is generally fatal, so probably not, sadly. Still, you’re right, the parents would have known what to expect and would not have been shocked at the delivery

          • PeggySue

            Yes, autosomal recessive PKD was what the baby had. That took a bit of time to establish, as the hospital was presented with a baby in severe respiratory distress after a supposedly completely normal pregnancy. Baby ended up vented and many scans and tests later the diagnosis was made. If I remember, the midwives told the family that doctors had contacted them to reassure them they did everything right and there was no way the problem could have been detected before the birth. I kind of doubt that.

          • swbarnes2

            A quick bit of googling…

            “The improved prognosis for ARPKD may be attributed to improved prenatal sonogram technology which allows doctors to diagnose many cases of ARPKD prior to birth. Accordingly, the birth of an affected child is better planned so the necessary specialists can be alerted. Importantly, the doctors are able to discuss with the parents what they should expect once the baby is born, advising them that the infant may need a breathing tube, may require dialysis, may have severe liver disease, and will require multiple evaluations and treatments to handle associated complications.”

            https://pkdcure.org/what-is-pkd/arpkd/

          • PeggySue

            Wow. Another case of, if you don’t look for it, you won’t find it.

        • rational thinker

          youre right at least they would have been prepared or had choices.It is probably emotionally easier to abort early. If it were me im not sure what I would do but if I carried to term at least maybe the baby could be an organ donor for other babies.

          • MelJor

            Or just gotten to spend its short life in someone’s arms, offered comfort measures, and not rushed to a hospital in an ambulance and given who knows what type of interventions (which are worth it if there is a possibility of a positive outcome). the idea that my baby died, perhaps away from me and my husband, while being given painful and unnecessary interventions is horrifying.