The National Review has a response to my piece in TIME, Not Discussing Down Syndrome Complications is Unethical and, as might have been expected, it utterly misses the point.

Writing about a woman who felt her doctor was pressuring her into termination of her Down Syndrome baby because he mentioned the option more than once, I noted:

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Her baby, her body, her choice — whether we are talking about abortion or about breastfeeding.[/pullquote]

… [G]ood medical care always requires providing complete and accurate information—not merely the information that a patient wishes to hear.

In response, Matthew Hennessey complains about Doctors’ Double Standard on Complete and Accurate Information:

Amy Tuteur, an obstetrician-gynecologist, also took issue with Baker’s letter. Writing at Time.com, Tuteur said it would be unethical not to discuss possible medical treatments (i.e., abortion) with a pregnant woman carrying a child with Down syndrome — even if, like Baker and my wife, the patient had already said she wasn’t interested in “terminating” her pregnancy…

That got me thinking: How far should a doctor go when providing “information” about odds-based medical and social outcomes to an expectant mother? Life is risky. Life is dangerous. There’s a lot that can go wrong. Should a doctor list all that stuff out at baby’s first ultrasound? A 2003 study published in The Lancet found that children who grow up with one parent are at increased risks of psychiatric disease, suicide, and addiction. Maybe physicians like Tuteur should impress on their unmarried pregnant patients the risks to their quality of life should they decide to “continue with the pregnancy.”

How far should a doctor go? Far enough to provide all the information relevant to making the medical decision at hand:

What are the chances that a Down Syndrome child will be intellectually compromised? 100%.

What are the chances that a Down Syndrome child with have a congenital heart defect? Approximately 50%.

What are the chances that a child in a one parent family will develop psychiatric disease? Nowhere close to either of these two salient facts about Down Syndrome.

Hennessey illustrates the problem of starting with the conclusion and attempting to reason backward. It is incompatible with medical ethics which starts with principles (autonomy, justice, beneficence and non-maleficence) and leaves all possible conclusions open. In addition, starting with a predetermined conclusion often leads to tortured logic and intellectual incoherence. In particular, it often leads to censorship, muzzling health providers to prevent them from giving accurate information so as advantage the pre-determined conclusion.

Hennessey wants to muzzle providers so they cannot provide women with the facts about Down Syndrome. He believes that the ends, preventing abortion of Down Syndrome children, justifies violating ethical principles.

I suspect that most people working in obstetrics and pediatrics recognize just how unethical such “counseling” would be.

But there is another, equally unethical counseling program that enjoys wide favor among obstetricians and pediatricians. It’s call The Baby Friendly Hospital Initiative.

It starts with the conclusion that all babies and all mothers benefit from breastfeeding and that the benefits are so large that they justify violating the ethical principle of medical autonomy. The truth is that the benefits of breastfeeding in industrialized countries are trivial. There is no evidence that breastfeeding rates have any impact on population based health parameters like term infant mortality or life expectancy. Breastfeeding can be lifesaving for preemies, but the majority of babies are not born prematurely. So the purported empirical justification for the violations of medical autonomy simply don’t exist.

Even if they did exist, the central “steps” of The Baby Friendly Hospital Initiative would still be unethical. It is UNETHICAL to muzzle healthcare providers, whether the issue is abortion or breastfeeding. It is UNETHICAL to attempt to manipulate a patient’s choices, whether that means mandating vaginal ultrasounds for women who want terminations, or locking up infant formula and forcing women to sign consent forms acknowledging the “risks” of formula feeding. It is UNETHICAL (and unscientific) to ban formula supplementation or pacifiers.

In medicine, the ends do not justify the means. Sure we could save lives if we forced people to donate kidneys, but that’s unethical since the most fundamental medical right is the right to bodily autonomy. In medical ethics, we reason FROM principles, not TO predetermined conclusions.

Mr. Hennessey fails to understand that, but he’s just one individual attempting to convince others to make the same choice that he made.

The ethical failure that is The Baby Friendly Hospital Initiative is far more egregious. It is an effort by healthcare professionals to ignore women’s bodily autonomy while insisting that the ends justify the means. They never do.

Her baby, her body, her choice — whether we are talking about abortion or about breastfeeding.

I usually write for lay people, but this post is directed specifically to medical professionals including pediatricians, obstetricians, midwives, postpartum and neonatal nurses.

Whenever a medical professional dares to question the exaggerated benefits of breastfeeding, or attempts to discuss the deadly risks of aggressive breastfeeding promotion such as hypernatremic dehydration or infant falls from hospital beds, he or she is shouted down by appeals to authority. Specifically, lactivists point out that breastfeeding is considered the standard of care by a variety of professional organizations.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Medical recommendations, including recommendations from professional societies, have been wrong in the past.[/pullquote]

It’s happened to me and I’ve seen it happen to Christie del Castillo-Hegyi, MD who has been working tirelessly to alert both parents and professionals to the risks of aggressive breastfeeding recommendations. She’s consistently shouted down by the insistence that if the AAP or the WHO recommends something, it is beyond questioning.

That’s both dangerous and unethical.

Medical recommendations, including recommendations from professional societies, have been wrong in the past. That is why it is critical to be able to question medical recommendations.

When I finished my OB-GYN residency, the standard of care was giving hormone replacement therapy (HRT) to all women. It was going to prevent heart disease and osteoporosis, with virtually no side effects. When I practiced at a large HMO, HRT was considered evidence based medicine and whether or not all post menopausal women were placed on HRT was considered a parameter for evaluation of physician care.

HRT had become the standard of care despite the fact that even at the time there were many people who questioned whether the benefits had been thoroughly documented. I can remember discussing it with a colleague who was also just out of residency. We agreed that by the time we were menopausal, we would truly know about the risks and benefits of HRT, as opposed to merely accepting preliminary data. Moreover, there were some, including breast cancer surgeon Susan Love, MD, who worked at my institution, who warned that HRT would increase the risk of breast cancer; few people paid any attention since HRT was standard of care.

Everyone “knew” that HRT was a good thing and naysayers were shouted down and silenced. We now know that the naysayers were right. We will never know how many women we harmed despite our best intentions.

I learned something very valuable from that experience: we should not silence naysayers.

Why did HRT become a standard of care despite weak evidence of benefits and plausible suggestion of serious risks? There was another player that everyone ignored, manufacturers of HRT. They pushed very hard to publicize the benefits and ignore the risks.

Why is breastfeeding the standard of care despite weak evidence of benefits and plausible suggestions of serious risks? There’s another player operating here: the breastfeeding industry, which has lobbied aggressively to promote weak evidence of benefits and suppress evidence of risks.

There is no doubt in my mind that over the next decade breastfeeding recommendations will be modified extensively in light of the actual scientific evidence, instead of basing recommendations on wishful thinking on the part of the industry.

Censorship in science is incredibly harmful. Censoring those who criticize the current standard of care is unethical. The benefits of breastfeeding have been grossly exaggerated, and the risks suppressed.

I don’t agree with everything that Christie Castillo-del Hegyi and other critics claim, but I strongly support the need to listen to them and anyone else who has plausible reason to question the aggressive promotion of breastfeeding.

They physicians who promoted HRT for all post menopausal women believed they were doing the right thing. They believed it every bit as fervently as breastfeeding advocates believe in the promotion of breastfeeding. But we shouldn’t forget that they are wrong and that breastfeeding advocates may be wrong, too.

If I were in a more forgiving mood today, I might feel sorry for the Trump Hate Brigade, caught as they are on the horns of a dilemma. Should they be happy or sad about the massacre in Orlando?

Latino gay people were killed (hooray, they had it coming) by an assault weapon (hooray, every citizen has the right to buy military grade weapons to protect themselves from those they hate) by a Muslim pledging allegiance to ISIS (hideous, all Muslims are terrorists). How is the Trump Hate Brigade supposed to feel when the people they hate are killed by other people they hate? See what I mean about the dilemma?

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]A dilemma for the Trump Hate Brigade: how should they feel when people they hate are killed by other people they hate?[/pullquote]

The Trump Hate Brigade should figure it out now, since in the United States of Hate, promoted by Hater-in-Chief Donald Trump, such dilemmas will become more commonplace. If you’re supposed to hate the Muslims, and the Jews, and the Latinos, and the disabled, and anyone who isn’t exactly like you, it’s inevitable that people you hate will kill other people you hate before you get around to doing it (or condone doing it).

That’s what happens when people give power to those who rule by stoking fear. The motto of rational thought was issued by Descartes hundreds of years ago: “I think, therefore I am.” The motto of The Hater-in-Chief and his followers ought to be: “I hate, therefore I am.”

The ultimate irony, of course, it that the Trump Hate Brigade has far more in common with the Muslim terrorist they condemn than they do with the Latino gay people who were killed. The club-goers were simply trying to live their lives while allowing others to live theirs. The Muslim terrorist hated gay people because they offended his religious sensibilities, so he killed them. How is that any different from the North Carolina legislators who hate transgender people because they offend their religious sensibilities? It isn’t.

The Trump Hate Brigade hate Latinos whom they suspect of stealing their jobs so they want to build a wall and keep them out; they hate Muslims as terrorists so they want to keep them out; some of the men hate women so they mock them in the crudest possible terms; they hate Jews whom they suspect as being more successful than themselves so they threaten them with pictures of ovens. Make no mistake, building a wall is not the same thing as murdering people, but we must never forget that murdering people often follows building walls to keep them out.

Hate leads to murder as night follows day. That’s why it’s critical to confront hate wherever and whenever we see it. That’s why it is crucial to ban discrimination on the basis of race, religion, ethnicity, gender or sexual preference. That is why it is imperative that we DON’T built walls, and we DON’T keep people out of this country on the basis of race or religious belief.

The United States of America was built on the principle that ALL men (and now women) are created equal and all are endowed by their Creator with certain inalienable rights. The Declaration of Independence deliberately does not specify the race, religion or sexual preference of citizens; anyone can be a citizen.

If Trump has his way The United States of America will die, to be replaced by The United States of Hate where straight, white men are full citizens and everyone else has fewer rights or no rights at all.

Trump claims that he is not a racist, not a misogynist, not homophobic. I wouldn’t be surprised if that were true; his emotional range seems to extend only from unmerited self-regard all the way to full-blown narcissism. It may be that he has no emotional band width left for any other hateful “-isms.” But he is well aware that his chief appeal for many of his followers reflects his effort to make the US safe for hate again; he plays to that, deliberately praising violence and refusing to condemn the ugly behavior of his followers.

Trump used this tragedy to praise himself for recognizing the threat of Islamic terrorism, as if the rest of us hadn’t noticed or cared about the deaths of those who died on 9/11 and in subsequent terror attacks. But he has far more in common with the terrorists than he would ever understand. When you encourage hate, you encourage terrorism.

Today gay people were murdered. True, it happened at the hands of a Muslim terrorist, but it wasn’t the fact that he was Muslim or declared allegiance to ISIS that made him attack gay people. It was hate officially sanctioned by religious authorities, Christian as well as Muslim, American as well as Arab.

Tomorrow it could be another despised group, and hate will be the cause.

This election is going to be a referendum on whether we want to continue to base our country on the values of healers like Washington and Lincoln or haters like Joe McCarthy. I love the United States of America precisely because our principles are the highest moral principles of freedom and justice. It would be a tragedy of extraordinary proportions if we allow Donald Trump to create The United States of Hate.

Thanks goodness for natural childbirth and homebirth advocates. They’ve rediscovered what our ancient ancestors knew all along: women’s bodies are perfectly designed to give birth!

[pullquote align=”right” cite=”” link=”” color=”#8B2626″ class=”” size=””]Trust birth![/pullquote]

How did they figure it out? They looked at basic facts about childbirth.

Consider:

There is no infertility.

No baby ever dies in childbirth.

No mother ever dies in childbirth.

There are no premature babies.

There are no stillbirths.

There are no miscarriages.

No babies are breech.

No babies are transverse.

There are no twins, triplets or higher order multiples.

No babies are ever too big to fit through the birth canal.

No babies are ever deprived of oxygen during labor.

No babies fail to breathe when they are born.

No babies ever get an infection during labor.

The umbilical cord never prolapses.

The placenta never abrupts.

The placenta never grows over the opening of the cervix.

The placenta is never retained.

The uterus never gets infected.

There is no Rh incompatibility.

There are no birth defects.

No woman ever develops eclampsia.

There is no postpartum hemorrhage.

There are no vaginal tears.

There are no vaginal fistulas.

There is no incontinence after birth.

There is always enough breastmilk.

No breastfed baby ever gets sick.

No breastfed baby ever dies.

No nursing mother ever dies.

So there you have it. Add it all up and it is obvious that women’s bodies are perfectly designed to give birth. That’s why the key to perfection is simply to “trust birth.”

Natural childbirth and homebirth advocates know this; how can those foolish obstetricians think otherwise?

This piece first appeared in November 2013.

My latest piece for TIME.com is Not Discussing Down Syndrome Complications Is Unethical.

There’s definitely a wrong way to give an unexpected medical diagnosis.

In 2000 I was diagnosed with a benign brain tumor, a meningioma. I knew that the tumor would need to be removed, but I was shocked when the ophthalmologist declared: “I’m so glad that I’m not the neurosurgeon who’s going to operate. It’ll be tough; that sucker is sitting in the middle of your brain in a lake of blood.”

But while it’s easy to determine the wrong way for a doctor to give unexpected bad news, it’s surprisingly difficult to figure out the right way to give a specific diagnosis to a specific person. That’s what I thought when I read the account of the mother who was angry at her doctor for the way he handled her baby’s diagnosis of Down Syndrome.

Read more here.

I have very few regrets about the years that I practiced medicine, but there is one thing that makes me embarrassed every time I think about it.

I was taught that “all breastfeeding women make enough milk.” It was a lie, but I didn’t know it at the time. My experience of breastfeeding my own children did nothing to disabuse me of this falsehood. I had a booming milk supply when I breastfed my own children, routinely pumping 10 oz. at each session.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Are we setting people up for diabetes when we warn them to eat right and exercise?[/pullquote]

The consequence was that I counseled women to breastfeed without giving them accurate information to help them. Even worse — and this is the source of my guilt — though I never told anyone outright that I thought they were lying about low milk supply as an excuse to stop breastfeeding, I didn’t believe them. I’m ashamed to think that when I should have offered support, I offered judgment instead.

The only thing I can say in mitigation is that it happened 25 years ago when scientists and physicians knew a lot less about the physiology of breastfeeding than they know now.

Sadly, lactation consultants are still spewing the same lies that I was fed.

Consider Rachel O’Brien IBCLC and her vicious piece You get what you expect; the psychology of low milk supply.

Do you remember what you heard about breastfeeding before you ever tried it yourself? Did you hear other families talking about having a hard time making enough milk? Did you see articles in parenting magazines that told you how to AMP UP YOUR SUPPLY or warned you that 49% of mothers said low milk supply was their biggest “booby trap” or that you may have “less milk than the baby needs”? …

I am NOT saying that all women can breastfeed, and I am NOT saying that low milk supply is a myth. I’m not discounting the stories of anyone who experienced low milk supply. My point is that when we hear about low milk supply over and over, response expectancy theory says that our bodies can respond in the way that we expect them to- by making less milk than we need.

It’s a self-fulfilling prophecy, and we may be perpetuating this when we give well-meaning advice and warnings to others. Are we setting families up for failure?

Low milk supply: It’s your fault; you did something to deserve it.

O’Brien blames the victim.

What’s the truth?

Nancy Hurst notes in Recognizing and Treating Delayed or Failed Lactogenesis II:

Although actual rates of failed and delayed lactogenesis are unknown, estimates ranging from 5% to 15%, respectively, have been reported.

Other studies have found rates even higher. In other words, insufficient milk supply isn’t merely possible, it’s relatively common.

Alison Stuebe, MD and member of the Academy of Breastfeeding Medicine recently acknowledged:

… a substantial proportion of infants born in the US require supplementation. Delayed onset of lactogenesis is common, affecting 44% of first-time mothers in one study, and 1/3 of these infants lost >10% of their birth weight. This suggests that 15% of infants — about 1 in 7 breastfed babies — will have an indication for supplementation…

Breastfeeding physicians and researchers are well aware that insufficient milk supply is real, but apparently they’ve neglected to tell the truth to IBCLCs.

O’Brien boasts:

For today’s blog post I considered just cutting & pasting my 21,397 word Masters thesis on U.S. mothers and perceived insufficient milk supply.

What evidence does O’Brien provide for the connection between talking about low milk supply and the subsequent development of low milk supply? None, of course, because there is no such evidence. Instead she cites out of date papers about response expectancy theory, a fancy term for the placebo effect.

The placebo effect applies to treatments. When a patient believes a treatment will work he or she may improve when unknowingly receiving a placebo instead. I’m not aware of any research that shows that when a patient is told about a hormone deficiency, he or she will develop that deficiency, but O’Brien bases her conclusions on precisely this inappropriate extrapolation.

Perhaps O’Brien will consider writing future papers like “Diabetes and perceived insufficient insulin” or maybe “Recurrent miscarriage and perceived insufficient progesterone.”

Shouldn’t the same principles enunciated in her blog post apply to diabetes and recurrent miscarriage, too?

It’s a self-fulfilling prophecy, and we may be perpetuating this when we give well-meaning advice and warnings to others. Are we setting families up for failure?

Would we change how we talk about breastfeeding and nursing if we knew that our words may cause problems for the person who is listening to us?

What would happen if we made an effort to discuss the positive parts of our breastfeeding experience AT LEAST as much as we warn about the negative parts?

Are we setting people up for diabetes when we warn them to eat right and exercise? Do we create a self-fulfilling prophecy when we routinely test people for high blood sugar? What would happen if we made an effort to discuss the positive parts of eating pastry and candy as much as we warn about the negative parts?

What would happen is that people would think you were both ignorant and cruel, blaming a sufferer for a disease over which she may have had no control.

And that’s exactly what O’Brien and other IBCLCs do. They blame the victims — women with insufficient milk supply — for the hormonal and anatomical causes over which they have no control.

That’s because IBCLCs are not medical professionals. Instead of offering accurate scientific evidence about insufficient milk supply, they offer lies leavened with a heaping helping of judgment.

That’s not patient care; that’s cruelty.

We’ve made progress; some of us are now outraged when rapists, such as Stanford University student Brock Turner, get off with a proverbial slap on the wrist.

But we haven’t made enough progress, since rapists still get off with only a proverbial slap on the wrist.

Not all rapists, of course, only the privileged rapists. And that speaks to our deep-seated cultural belief that privileged men have a right to rape.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Rape is a perk of privilege.[/pullquote]

To the victor go the spoils, right? And for the entirety of human history, women’s bodies have been the spoils. The only thing that has changed is our concept of victory. In the beginning, the victors were the men who were better warriors. They were men from indigenous tribes who raided other tribes for “brides.” They were men from primitive (and modern) wars who raped their way through conquered cities. They were men who decreed that raping their female slaves was the “master’s obligation.”

As Snopes notes:

The use of political power (or any exalted position in society) as a means of gaining entry into women’s beds has been with us for thousands of years. The name of this phenomenon has changed over the years (from ius primae noctus to droit de seigneur to “the master’s obligation” to sexual harassment), but the concept has remained the same.

Except that Snopes is wrong in one critical detail. The modern day incarnation of “droit de seigneur” is not sexual harassment, it is rape.

The right of powerful men to rape women of the was first codified as a “religious” right.

The custom of someone other than the husband being the first to engage in sexual intercourse with a bride after the wedding goes back several thousand years and is tied to the concept of God as the source of all life. If all life springs from the creator, then surely his earthly representatives … are guarantors of fertility …

It didn’t take long for the right to rape to be enshrined as a political right:

After the Sumerians developed the concept of a divinely-ordained king “descended from heaven” as the primary intermediary between man and his creator, kings supplanted priests as the vessels of fertility …

This codified “right” survived until relatively recently:

First night customs survived in parts of Europe into the Middle Ages (as the droit du seigneur), although by then it had been stripped of any pretense that it was a means of assuring fruitful harvests and fecund brides. Feudal noblemen were not of royal blood and had no claim to divinity; they were “lords” only by virtue of having been granted titles, and they simply used their positions of power over their vassals as a basis for asserting their “right” to substitute for any of them on the wedding night…

We don’t have official nobility anymore, but we do have the privileged and they apparently have no trouble getting away with rape. Wealthy men, athletes and celebrities are the new nobility and society seems to recognize them as such. In general, privileged white men are much more likely to get away with rape than other men. Had Brock Turner been a poor, black man who met a white women at a party and raped her, he would likely have received a lengthy jail sentence. But because he was a white man, and an athlete to boot, the judge in the case seemed to have spent more time considering the impact of punishment on the perpetrator than the effect of the rape on the victim.

Lest you think that this is purely an issue of race, consider that Bill Cosby has been allegedly drugging and raping women for decades without punishment.

To the victor go the spoils and wealthy men, athletes and celebrities are the victors in contemporary society. It isn’t merely that college athletes are valuable to the team that leads universities to protect them; it’s that they are stars and taking sex without consequences is believed (consciously or unconsciously) to be one the perks of being a star.

Obviously, it was Brock Turner who raped his victim and we don’t bear collective responsibility for the rape. But we do bear collective responsibility for a society that consciously or unconsciously believes that privileged men have a right to rape.

They don’t.

Yesterday I wrote a piece for Psychology Today entitled ‘When bad things happen to good mothers.’ In it I argued that the mother of the little boy who climbed into the gorilla enclosure at the Cincinnati Zoo, resulting in the death of the gorilla, does not deserve the vitriol directed at her on social media. The outrage she inspired tells us more about us and what we wish to believe about parenting, than about her. The truth, which is very difficult for some people to acknowledge, is that accidents happen even when mothers are as vigilant as they can possibly be.

Today’s social media clamor is also about parenting. People are justifiably outraged about the reprehensible letter written by the father of a rapist begging leniency for his son. The convicted rapist, Brock Turner, a Stanford University student-athlete was caught assaulting an unconscious woman outside his fraternity. Two men who happened to be bicycling nearby stopped the assault and held Turner until the police arrived.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]He’s a good rapist; he only raped one woman and it didn’t even take that long![/pullquote]

Turner was convicted and received a startlingly light sentence (6 months in jail despite being eligible for a 14 year prison sentence). Last week, his victim released an eloquent statement on impact of her assault. This week, a Stanford University Law Professor who is friend of her family released a copy of the letter written to the judge by the rapist’s father. To call it repugnant doesn’t even begin to capture its outrageousness.

Apparently being convicted of rape has been very hard on Brock:

As it stands now, Brock’s life has been deeply altered forever by the events of Jan 17th and 18th. He will never be his happy go lucky self with that easy going personality and welcoming smile. His every waking minute is consumed with worry, anxiety, fear, and depression. You can see this in his face, the way he walks, his weakened voice, his lack of appetite.

His father doesn’t understand why Brock has to endure this. He’s a good rapist; he only raped one woman and it didn’t even take that long!

That is a steep price to pay for 20 minutes of action our of his 20 plus years of life.

Actually, it’s not a steep price to pay for raping someone. A six month jail sentence is a small price to pay for the heinous act of rape.

Clearly this reflects what activists call “rape culture,” the casual dismissal of sexual assault as “boys will be boys” and “she was drunk so she deserved it.”

But I fear that there is more going on here. Is it possible that Turner’s father would have written the same letter if he had been convicted of drunken driving, possibly insisting that a prison sentence was a steep price to pay for only 30 seconds of action, running a stop light and killing another driver? I wonder if Turner’s father is the ultimate incarnation of the snowplow parent.

The “snowplow parent” is defined as a person who constantly forces obstacles out of their kids’ paths. They have their eye on the future success of their child, and anyone or anything that stands in their way has to be removed.

… Helicopter parents hover and micro-manage out of fear…

Snowplow parents may also micro-manage … but they do so with an eye on the future. They want to remove any pain or difficulties from their children’s paths so that their kids can succeed…

They are like the mother of an acquaintance of one my sons. When her daughter, a senior in high school, was found to have stolen an exam from a teacher’s computer, and was given a zero as a result, the mother threatened to sue the school for ruining the child’s chances of getting into a good college, and the school backed down.

They are like the parents who call professors when their children get a bad grade in law school or try to attend job interviews or negotiate for better pay on their children’s behalf.

They lose sight of the fact that the goal of parenting isn’t to raise a child with fabulous credentials; the goal is to raise a child with fabulous morals.

I don’t doubt that Dan Turner’s anguish over his son’s conviction and sentencing is entirely genuine. We hurt when our children hurt. But the job of a parent is NOT to beg sufferance for children’s illegal actions.

Turner’s father apparently believes that a bad thing happened TO a good rapist, his son.

But there are no good rapists and jail sentences for rape are not bad things that happen TO rapists, but well deserved punishments FOR rapists. We send people to jail for a variety of reasons: punishment, rehabilitation and deterrence for others thinking about committing the same crime. In this case, Turner and society can benefit from all three.

Brock Turner is an adult who committed a heinous adult crime. Parenting often means supporting our children, even our adult children, through the consequences of their actions, but it SHOULDN’T mean helping them avoid the consequences of their actions, particularly if their actions involve breaking the law and harming others.

While we should not vilify parents for accidents like the boy who climbed into the gorilla exhibit, it is entirely appropriate to vilify parents who excuse their child’s deliberate illegal action and beg for leniency in an effort to soothe his feelings and ensure his success.

Hi, folks! It’s Ima Frawde, CPM (counterfeit professional midwife) here with a retelling of that favorite children’s story, The Three Little Pigs.

I and my colleagues have performed a hermeneutical analysis of the story and uncovered role of the hegemonic patriarchy within. We’ve rewritten the story to more closely reflect our values.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Wolves are natural so there was no reason for the pigs to fear.[/pullquote]

Without further ado:

Once upon a time there were three little pregnant pigs.

One pig planned a homebirth in her straw house while the second pig planned a birth at the birth center made of wooden sticks. Their midwives came to them for home visits that lasted an hour, they avoided all those unnecessary medical tests, and then they sang and danced all day. Regrettably, the third little pig, having failed to do her research and educate herself, planned to give birth in a brick hospital.

A big wolf saw the two little pigs while they danced and played. No worries: wolves are natural so there was no reason for the pigs to fear. Sadly, many pigs have been socially conditioned by the patriarchal, hegemonic farmers to fear wolves. But these pigs, having educated themselves reasoned that if wolves ate pigs, they wouldn’t be there, all their ancestors having been gobbled up by wolves. They were still here, ergo there was no reason to fear wolves.

But just in case, their midwives taught them wolf affirmations to better trust wolves.

Coincidentally, all three pigs went into labor on the same day. They weren’t due on the same day, but due dates don’t really mean anything (just another way for farmers to frighten pigs), so it didn’t matter that the first pig was 3 weeks past her due date and the second pig was five weeks before hers.

The big wolf went to the first house and huffed and puffed. The first pig became frightened.

“What will happen if the wolf blows down my straw house?” she wailed.

Her midwife reassured her. “There’s no reason to be frightened of wolves. Even if he blows your house down, the hospital is only 10 minutes away.”

The wolf huffed and puffed and blew the straw house down, just as the first little pig was about to give birth. Everyone piled into the midwife’s car, which wouldn’t start. Fortunately, the midwife had an oxygen mask with her, just like the hospital does; unfortunately, the tank to which it was attached was empty. The midwife had been meaning to get a new oxygen tank but couldn’t because of her car trouble.

By the time the midwife had hot wired her car and driven 30 minutes to the hospital (there was traffic so it took longer than anticipated), the piglet had been born vaginally. It was dead, but that didn’t change the first little pig’s feeling of empowerment.

Meanwhile, the big wolf went to the second pig’s birth center that was made from sticks. He huffed and he puffed.

“What will happen if the wolf blows down my birth center made of sticks?” the second pig wailed.

Her midwife reassured her. “There’s no reason to be frightened of wolves. Even if he blows your house down, the hospital is only 10 minutes away.”

The wolf huffed and puffed and blew the stick birth center down, just as the second little pig was about to give birth. Her midwife had no car, so they called for an ambulance. In the meantime the piglet’s umbilical cord had prolapsed. By the time the ambulance arrived the piglet had been born vaginally but had not drawn a breath in 10 minutes. The piglet was transported to the hospital and placed on total body cooling treatments. Sadly the piglet died, but at least the mother was nearby on another floor in the hospital recovering from her massive postpartum hemorrhage. She posted on Facebook to tell her friends that she had had a successful vaginal birth.

Finally, the wolf arrived at the brick hospital where the third pig was in labor.

“Should I be worried the wolf will blow the hospital down?” the pig asked.

“That can’t happen,” she was reassured. “We’ve undertaken many interventions to prepare for exactly this scenario. The brick is just a facade for the hospital’s steel reinforced superstructure, the windows have been wolf-proofed, and in the unlikely event that the wolf breaks in we are prepared to cut him into pieces with a scalpel (a W-section).

The wolf huffed and puffed for hours trying to blow down the brick hospital with the steel reinforced superstructure, but he could not. Ultimately he went away. In the meantime, the third little pig had given birth to a healthy piglet.

What did everyone learn from their experience?

The third pig was happy and grateful that she had given birth to a healthy piglet in the hospital. The other two pigs were already planning for their healing second births. This time, though, there would be no attendant and they would both give birth at home. They were happy to have had vaginal births, but sad that their piglets had died. Surely they hadn’t trusted wolves enough. This time they would really trust wolves so they were building their new houses out of tissue paper!

Yesterday I wrote about the role of class and race in natural childbirth and breastfeeding advocacy. Natural childbirth and breastfeeding advocates, whether they realize it or not, define themselves in relation to poor women, often women of color.

One one hand, advocates claim to emulate poor indigenous women, whom they view as exotic, authentic and close to nature. On the other hand, they demonizing poor women (black and white) in their own countries whom they stigmatize as too ignorant to recognize the “truths” of natural childbirth and lactivism and too lazy to employ them when they learn of them.

I quoted from ‘The New Reproductive Regimes of Truth,’ a chapter in Alison Phipps book The Politics of the Body: Gender in a Neoliberal and Neoconservative Age.

Phipps offers food for thought on a variety of issues including breastfeeding and the lactivist obsession with representation.

Phipps writes:

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]The central tenet of lactivism isn’t “breast is best”; it’s “breast-feeders are best.”[/pullquote]

The new reproductive politics is largely concerned with representations of birth and breastfeeding and attitudes towards them rather than how they are structurally framed. A key element of breastfeeding activism, or ‘lactivism’, is the general public’s reaction, with initiatives such as ‘nurse-ins’ … and campaigns to prevent social media sites such as Facebook from deleting pictures of mothers with their nurslings under obscenity rules.

The obsession with representation now extends to endless brelfies (breastfeeding selfies), as well as breastfeeding stunts wherein women breastfeed while wearing uniforms, etc. Lactivists refer approvingly to their obsession with representation by claiming they are “normalizing” breastfeeding.

But that’s not what’s really going on.

Such campaigns are an example of the politics of recognition, the identity-based activism in which issues around representation supplant those of structure and socio-economic redistribution.

If lactivists truly cared about what was best for babies and mothers, they’d spend far more time addressing economic barriers to breastfeeding, and no time at all posting pictures of themselves breastfeeding. But that’s hard, and in any case, it is far more enjoyable to coerce women, “for their own good,” into lactivist approved behaviors like rooming in (by closing well baby nurseries), then bemoan the purportedly ignorant and slothful poor who quit breastfeeding as soon as they are out the hospital door.

The project of “normalizing” breastfeeding,” encompassing brelfies, breastfeeding stunts and complaints about Facebook censoring, are forms of “virtue signaling.” What is virtue signaling?

[It] is the popular modern habit of indicating that one has virtue merely by expressing disgust or favor for certain political ideas [or] cultural happenings …

Virtue signaling is a form of personal micro-branding. As Phipps notes:

‘Natural’ birth and breastfeeding have become part of an identity package around organic or holistic parenting, while formula feeding and birth interventions (and in particular, caesarean sections) form aspects of a negative Other associated with other practices such as ‘cry-it-out’, vaccination and corporal punishment…

How does the lactivist obsession with representation intersect with the issue of class?

Lactivists represent poor indigenous women who have no choice to breastfeed as authentic and closer to nature, when the ugly reality is that there is no “authenticity” in a subsistence existence and the only thing they are closer to is death. They represent poor women who bottlefeed as ignorant and slothful, when the reality is that many work far harder for their children’s wellbeing (multiple low wage jobs) than privileged women who have husbands to support them, as well as a store of intellectual and social capital (e.g. college educations) paid for by their own privileged parents.

As Phipps explains, natural childbirth and lactivism:

… often play into broader class and ‘race’ antagonisms in which the white middle classes judge other social groups as ‘lacking’ and attempt, through education and occasionally through ridicule, to force them into the dominant mode.

The truth is that lactivism isn’t about what’s best for babies or mothers. It’s about what’s best for lactivists.

Lactivists themselves don’t have a clue to what lactivism really embodies. It isn’t about breastmilk, which in countries with clean water has only few benefits compared with formula. Lactivism reflects power relationships and philosophical beliefs about mothering, feminism and economic privilege.

The central tenet of lactivism isn’t “breast is best”; it’s “breast-feeders are best.”

The ancillary tenets are:

• Ignore pain, inconvenience and  babies’ cries of hunger; if there’s no suffering, you aren’t really mothering.
• Women can and should be judged by the function of their reproductive organs.
• Institutions can and should violate women’s bodily autonomy to compel them to use their breasts to feed their babies.
• The views and values of who don’t breastfeed can be ignored because these women have no moral agency; they are victims of formula marketing.

The lactivist obsession with representation is not an effort to normalize breastfeeding; it’s an effort to enforce a particular view of women while simultaneously ignoring the extraordinary privilege required to hold that view.

When I write in opposition to lactivism, many people — mothers, lactation consultants, some physicians — are incredulous. How can I be opposed to breastfeeding?

But I’m not opposed to breastfeeding; I breastfed my own four children. I’m opposed to the conceit that breastfeeders are better than other women, the beliefs that suffering is integral to mothering, that women have no right to control their own breasts, and that women who choose not to breastfeed are pawns of the formula industry, incapable of independent thought.

In short, I’m thoroughly opposed to the notion that breastfeeders are best.

I don’t want to normalize breastfeeding; I believe that we should normalize support for all mothers, regardless of how they feed their babies.