I’ve written often about the fact that homebirth midwives, CPMs (certified professional midwives), aren’t really midwives, just laypeople who awarded themselves a made up credential because they couldn’t be bothered to get a real midwifery degree. They lack the education and training of ALL other midwives in the industrialized world and would not be eligible for licensure in The Netherlands, the UK, Australia, Canada or anywhere else.

Statistics, datasets and scientific papers confirm that they have appalling rates of perinatal mortality. For example, in the State of Oregon in 2012, LICENSED homebirth midwives attending PLANNED homebirths had a perinatal mortality rate 800% higher than comparable risk hospital birth.

What’s less well known is that homebirth midwives demonstrate an appalling callousness toward the growing pile of tiny dead bodies they have left in their wake. Lest we forget, homebirth midwife Katie Jenkins McCall parachuted in yesterday to vividly demonstrate that callousness.

Who is Katie Jenkins McCall?

She is a homebirth midwife with a felony conviction from the State of California who set up the Facebook page for Sisters-in-Chains.

The Facebook page documents the “persecution” of American homebirth midwives for no better reason than a bunch of dead babies and a few injured mothers.

It does not mention a single dead baby by name; in fact, in the case of many of the deaths, neither the babies, not the fact of their deaths are mentioned at all.

How dare they hold homebirth practitioners accountable over something as trivial as a dead baby, or a mother who was injured … or for anything at all??!!

In June 2014, Katie was “feeling angry.” Why? Because her buddy, self-proclaimed “midwife” Vicki Dawn Sorensen, was arrested just because she allegedly presided over the death of a very premature baby after insisting that homebirth would be fine, interfered with an ambulance crew trying to rescue a hemorrhaging mother, lied on medical records, and may have multiple dead babies buried on her property.

Yesterday, Katie dropped by the comments section:

I took the opportunity to ask her how she sleeps at night knowing she is supporting people who let babies die just to get their birth junkie high (and get paid for it).

I learned a lot.

Katie couldn’t care less about the dead babies. In 133 comments (and counting), McCall has not mentioned a dead baby by name or circumstance, has not expressed grief, regret or anger about these deaths and instead treated us to an exposition of her philosophy, which apparently involves opposition to “statism” among other things. It’s difficult to pin Katie down, but as far as I could determine, she holds two wholly incompatible beliefs.

1. Acknowledging that homebirth professional organizations have no safety standards, she views the courts as the appropriate recourse for women whose babies have been injured and died.

2. She considers government attempts to regulate homebirth midwives and legal efforts (the courts) to hold midwives to those standards as unethical. Of as she so charmingly put it:

Because everyone knows guberment=ethics.

And those who hid Jews from the Nazis should have been cages because it was not “a legal option in (their) country.” *headesk*

I think we’ve come to the heart of the matter. McCall doesn’t want any safety standards at all. She want to leave regulation up to the government and then cry “tyranny” when the government acts on those regulations.

There’s a word for that: it’s hypocrisy.

According to Katie:

I believe organizations and local communities can set standards abs [sic] midwives can voluntarily agree to abide by them. And then ultimately, mothers can decide what kind of support they wish at their birth and choose a midwife according to the standards they prefer. Very simple, Amy.

And that gets to the core problem with homebirth midwifery. McCall and other homebirth midwives don’t want standards because they don’t want to be held accountable. They want to enjoy their birth junkie high, get some cash, and have no responsibility beyond entertaining themselves.

I understand that. That’s what I’ve accused homebirth midwives of doing all along. It’s nice to have Katie confirm it.

Katie Jenkins McCall and her homebirth midwifery colleagues would do well to keep the words of John Gardner in mind:

Self pity is easily the most destructive of the non-pharmaceutical narcotics; it is addictive, gives momentary pleasure and separates the victim from reality.

The new Childbirth Connection report, Hormonal Physiology of Childbearing, like so much that is produced by the natural childbirth industry, is a spectacular scientific flop.

Real science is reviewed, evaluated, discussed and argued about in scientific journals, at scientific conferences, and by professional organizations.

Dr. Sarah (“our culture’s discontent come[s] from the traumatic loss of our first possession: our placenta”) Buckley and The Childbirth Connection, the lobbying organization who hired her to write the report, have breathlessly claimed that they have elucidated how the hormonal physiology of childbirth “works best,” which is rather remarkable, since no one really knows how the hormonal physiology of childbirth actually works.

Many endocrinologists and obstetricians have been working on various aspects of this for the past 100 years. A discovery of the endocrinology of labor, how it begins, what supports it and what interferes with it, and how it goes wrong, would be a scientific discovery of the first order. It would likely be presented at a major national or international conference on endocrinology, obstetrics or both, meant to highlight the publication of the multiple forthcoming scientific papers that would required to fully explain and prove Dr. Buckley’s hypotheses.

Everyone who was anyone in the world of obstetrics and the world of endocrinology would be weighing in on it. Yet no one outside of the natural childbirth industry has paid the least bit of attention to The Childbirth Connection report. There is no scientific conference; there are no scientific papers; there are no endocrinologists publicly supporting it; there are no obstetricians publicly supporting it; there are no professional endocrinology or obstetric societies backing it. It’s a spectacular scientific flop!

Why? Because it’s not science. It’s propaganda meant to fool potential clients into purchasing the services of midwives, doulas and childbirth educators. No one else is paying the least bit of attention.

It’s just like Microbirth, the movie that supposedly explains the all important impact of interventions on the neonatal microbiome. No professional microbiology associations endorsed the movie because it was pure fantasy, reflecting the natural childbirth industry’s reflexive demonization of interventions.

It’s just like The Alpha Parent’s Book, Breast Intentions. Allison Dixley’s book has not been supported by any professional breastfeeding organizations, any lactivism programs, or, any major authors in the field whether they write for lay people or for other professionals. The book is just Dixley’s (rather repulsive) opinion and, therefore, has been ignored.

The Childbirth Connection report is being heavily publicized within the natural childbirth industry and among natural childbirth advocates. Facebook pages and Twitter feeds are buzzing with it, because it confirms everything that natural childbirth advocates want to believe. That’s not surprising; it started from the bedrock natural childbirth axiom that interventions are bad and cherry picked scientific studies to support that conviction.

Natural childbirth advocates should stop navelgazing for a moment and take note of the fact that no one else is paying the least bit of attention. Hormonal Physiology of Childbirth is not science; it’s a glossy brochure designed to be waved about by the natural childbirth industry to improve their employment prospects.

Hormonal Physiology of Childbirth is a scientific flop. Only time will tell if natural childbirth advocates are gullible enough to make it into a marketing success.

Yesterday afternoon, The Childbirth Connection hosted a Twitter conversation with Dr. Sarah Buckley, the author of its new report destined to become a pseudo-knowledge classic, Hormonal Physiology of Childbearing.

I tried to ask Dr. Buckley a question. The hormonal physiology of childbirth has yet to be elucidated. We don’t know why some women go into labor prematurely (and their babies die) or why some women fail to go into labor when pregnancy is threatening their life (pre-eclampsia) or the lives of their babies (postdates stillbirth). So, if no one knows how it works, how can Dr. Buckley be sure that “the hormonal physiology of childbirth nearly always works best when it is left to work at its own speed”?

She can’t, of course, so she deleted my question and blocked me as shown above.

Can you imagine the CDC deleting and banning someone who asked how we know that vaccines work? Me, neither. Legitimate healthcare providers and organizations recognize that they have an obligation to answer questions (even tough questions). But, of course, Sarah Buckley doesn’t provide healthcare; she sells natural childbirth propaganda. And The Childbirth Connection isn’t a healthcare organization; it’s a lobbying firm, always pressing for greater employment for its constituency: midwives, doulas and childbirth educators.

Natural childbirth advocates decide what to believe based on who wrote it. The imprimatur of author Dr. Sarah Buckley signals to them that they can be sure its conclusions are the same as the conclusions of all other pieces of drivel written by natural childbirth advocates: maternity care is “in crisis”; interventions are bad; midwives, doulas and childbirth educators are good; and the process of birth is more important than the outcome.

Those who are slightly less gullible, which is everyone else in the world, might wonder why The Childbirth Connection had to go so far afield to find someone to write their report. It’s ostensibly a report about the hormonal physiology of childbirth and the implications for American maternity care, yet Dr. Buckley is a New Zealand trained, non-practicing family doctor; not an obstetrician, not an endocrinologist, not from the US.

Apparently none of the usual wackaloons were available.

Not Ina May (“Sometimes I see that a husband is afraid to touch his wife’s tits because of the midwife’s presence, so I touch them, get in there and squeeze them, talk about how nice they are, and make him welcome.”) Gaskin.

Nor Michel (“[T]here is little good to come for either sex from having a man at the birth of a child.”) Odent.

No problem. Dr. Buckley is an acolyte of both … and equally wacky.

The testimonial of a midwifery professor that leads her bio inadvertently says it all:

Discovering Sarah Buckley is like being told, authoritatively, that chocolate is not only good for you, but is guaranteed to make you slim. And also beautiful.

In other words, Dr. Buckley tells natural childbirth advocates what they’ve always dreamed of hearing, even though it has no more basis in science than the claim that chocolate is guaranteed to make you slim … or beautiful.

I would have thought that Dr. Buckey’s history of nattering absolute nonsense would have given pause to the folks at The Childbirth Connection. But then I guess beggars can’t be choosers.

Dr. Buckley is best known for being a devotee of lotus birth, and waxing rhapsodic over the placenta.

What’s lotus birth? It’s the wackiest childbirth practice ever. Lotus birth is the decision to leave the placenta attached to the baby for several days until it rots off. It is a bizarre practice with no medical benefit and considerable risk, particularly the risk of massive infection. Dr. Buckley did that with 3 of her homebirth born children.

In an article written for the July/August 2005 issue of (what else?) Mothering Magazine, Buckley explained:

For the next three days we dried and salted Jacob’s placenta every 12 hours or so, then wrapped it carefully in a cloth diaper, and then in the red velvet bag I had sewn. Jacob’s “breaking forth” time—the time between his birth and the separation of his cord—was quiet and still as we honored his original wholeness …

Why did Buckley adopt this ritual which human beings never practiced until is was made up in 1974?

The relationship with the placenta does not end with its disposal, whether by ritual burial or by hospital incineration. Placental symbolism is everywhere in our culture, from the handbags that we carry—holding our money, datebooks, and other items of survival—to the soft toys that we cram into our babies’ cribs. Some believe that much of our culture’s discontent and our urge to accumulate possessions—including all of the aforementioned—come from the traumatic loss of our first possession: our placenta. And each year we honor our placenta by lighting candles on our birthday cake—in Latin, the word placenta means “flat cake.”

Jacob’s placenta has been his conduit, passing life from my body to his. Now this placenta—his womb-twin, his primal anchor—has gone back to the earth. Seven years after his birth, Jacob tells me “your placenta is like your heart;’ and I realize that he received more than physical nourishment through his placenta. Along with the oxygen, nutrients, hormones, and all the other placental gifts, Jacob also received my love, which was equally his sustenance in my womb, transmitted subtly but vitally by this amazing organ—the placenta.

But wait! There’s more in this article, Lotus birth – a Ritual for our Times:

My older children have blessed me with stories of their experiences in pregnancy and birth, and have been unanimously in favour of not cutting the cord, especially Emma who remembered the unpleasant feeling of having her cord cut (after it had stopped pulsating), which she describes as being “painful in my heart”. Zoe, at five years of age, described being attached to a “love-heart thing” in my womb and told me “When I was born, the cord went off the love-heart thing and onto there [her placenta] and then I came out.” Perhaps she remembers her placenta in utero as the source of nourishment and love.

Lotus birth has been, for us, an exquisite ritual that has enhanced the magic of the early post-natal days. I notice an integrity and self-possession with my lotus-born children, and I believe that lovingness, cohesion, attunement to Mother Nature, and trust and respect for the natural order have all been imprinted on our family by our honouring of the placenta, the Tree of Life.

Whom does Dr. Buckley credit with inspiring and influencing her ideas?

Many people inspired this article. Jeannine Parvati Baker contributed some core ideas and phrases; ecstasy in birth, ‘healing the earth, healing birth’: ‘giving birth is women’s spiritual practice’ and ‘the wound reveals the cure’, which is the canon of her Mystery school, Hygieia College. www.birthkeeper.com

Thanks also, for inspiration and ideas, to Leilah McCracken (www.birthlove.com) Michel Odent, and especially to my teacher Shivam Rachana and the women’s circle that we share in the International College of Spiritual Midwifery. www.womenofspirit.asn.au

Those are among the “thinkers” who have shaped the wacky world of Dr. Sarah Buckley.

This is who The Childbirth Connection hired to repackage their lobby campaign in scientific sounding jargon: a woman who thinks that handbags are symbolic placentas and who imputes the ills of the present day to “the traumatic loss of our first possession: our placenta.”

I guess they were desperate.

Can you say “conflict of interest”?

That’s the heart of the latest public relations effort by The Childbirth Connection, the leading lobbying organization of the natural childbirth industry.

The New York Times’ Motherlode blog notes, New Report Urges Less Intervention in Births.

But getting your information on birth from The Childbirth Connection is like getting your information on solar power from Big Oil.

Just like Big Oil has a financial interest in whether or not you choose solar power, the constituency of The Childbirth Connection (midwives, doulas and childbirth educators, aka “birth workers”) have a financial interest in whether or not you choose obstetric interventions.

The Childbirth Connection is well known for ignoring data, even its own data, in favor of promoting full employment for birth workers. The Childbirth Connection has published three “Listening to Mothers” surveys on the state of childbirth in the US, and each time they refuse to listen to what mothers tell them: approximately 90% of women in the US are happy with maternity care; the majority of women who use epidurals are extremely pleased with them; the majority of women who use alternative methods of pain relief find them to be ineffective, etc.

Despite what women have told them, despite the spectacular success of modern obstetrics, despite that fact that the only places in the world with low perinatal and maternal mortality are places with easy access to and liberal use of childbirth interventions, The Childbirth Connection insists there is a crisis.

“If overtreatment is defined as instances in which an individual may have fared as well or better with less or perhaps no intervention,” the report states in its forward, “then modern obstetric care has landed in a deep quagmire. Navigating out of that territory will be challenging.”

Dr. Sarah Buckley, who collected and interpreted the research and wrote the report, suggests within it a number of ways of escaping that quagmire, all based on the premise that the hormonal physiology of childbirth nearly always works best when it is left to work at its own speed. The benefits of the natural process, her synthesis of the research suggests, go far beyond what we had previously understood; preparing mother and baby for birth through hormonal changes up to and during the labor and birth process.

Dr. Buckley takes a page out of the playbook for challenging modern medicine. Paul Wolpe explains the steps in The Holistic Heresy: Strategies of Ideological Challenge in the Medical Profession.

1. Alternative health advocates must:

must portray the discourse as in crisis, must provide an alternative ideology to rescue the discourse, must legitimize their ideology through appeal to a reframed historical myth, and must portray the orthodoxy as a betrayer of the discourse.

Hence Buckley’s claim that modern obstetric care has landed in a deep quagmire. Really? In the past 100 years modern obstetrics has dropped the neonatal mortality rate by 90% and the maternal mortality rate by 99%! That doesn’t sound like a quagmire to me. The real quagmire is where “birth workers,” midwives, doulas and childbirth educators find themselves. They feel marginalized by lifesaving technology, so they demonize it.

2. Then offer the new philosophy, positioning it as the replacement for the old:

[The critic] draws from the marginalized or folk knowledge of the tradition and elevates the constructs found there to primary importance…

… [G]reat pains are usually taken … to show that the alien ideas are not in fact alien at all, but have existed in the discourse in a different form. [Critics] often import foreign, folk, and traditional forms of healing into their practices, [carefully describing] them as wholly compatible with Western medicine, scientifically valid, or historically present in other forms.

Hence, Buckley’s claim that “the hormonal physiology of childbirth nearly always works best when it is left to work at its own speed. The benefits of the natural process … go far beyond what we had previously understood.”

3. Blur the distinction between health and disease:

The goal of holistic health is more than the absence of disease; it is a state of optimal functioning, often referred to as ‘wellness’… [which] greatly expands the role of the [alternative provider] in medical intervention …

Hence the goal of The Childbirth Connection is more than healthy babies and healthy mothers, it is “normal birth,” a recapitulation of birth as practiced with the ancient wisdom of our foremothers.

4. Portray yourself as the savior:

The [critic] is the true keeper of the flame, the savior of the discourse, and should ascend to the position of power in place of the orthodoxy.

Hence Carol Sakala’s (director of Childbirth Connection Programs at the National Partnership for Women & Families) claim, “Our current high rates of intervention are not serving women well… But the community is really moving in the right direction. Professional societies are … talking publicly about the overuse of cesarean sections, the need to avoid constant fetal monitoring, and not permitting elective inductions or cesareans. “We are hopeful that the timing of this report will support that change.”

In the minds of natural childbirth advocates, demonizing modern obstetrics is the solution to the employment issues of birth workers.

Why? As anthropologists Caroline Bledsoe and Rachel Scherrer explain in The Dialectics of Disruption: Paradoxes of Nature and Professionalism in Contemporary American Childbearing:

If nature is defined as whatever obstetricians do not do, then the degree to which a birth can be called natural is inversely proportional to the degree to which an obstetrician appears to play a role. The answer to why obstetricians are described with such antipathy thus lies not in the substance of what obstetricians do … Obstetricians are … perceived as the chief source of disruption in the birth event …

And, not coincidentally, they represent the chief economic competition to midwives, doulas and childbirth educators.

For birth workers, fewer interventions = more employment opportunities.

To a hammer, everything looks like a nail. To a birth worker, every women looks like she needs a birth without interventions.

That doesn’t make it so.

Yesterday I joked about Gina Crosly-Corcoran, The Feminist Breeder, and her sancti-question (The Feminist Breeder is so not judging you for failing to breastfeed).

What’s a sancti-question? It’s sanctimoniousness disguised as puzzlement, e.g. I simply can’t understand why other women can’t be bothered to be as awesome as me.

Gina offered a classic of the genre:

I … don’t really “get” it when a woman chooses, without any medical or social barrier, not to breastfeed. To me it’s sorta like deciding not to take prenatal vitamins because you just don’t wanna, without recognizing that they do help build a healthier baby. I will NOT be all sanctimonious about it, I’m just saying I’m human and that one’s a head scratcher for me. We have lactating boobs for a reason: to feed the babies we make.

(Here’s a pro tip, Gina: Announcing you are not sanctimonious does not inoculate you from accusations of sanctimony.)

Today, though, I’m utterly serious. The Feminist Breeder’s comments are abhorrent, not merely because they are sanctimonious, but because they are deeply and profoundly sexist. Gina’s comment echoes the Quiverfull movement of fundamentalist Christianity that she probably deplores. How? She, like the Quiverfull, invoke biological essentialism, as justification for her beliefs. The idea that women should use their reproductive organs “as Nature intended” is a bedrock principle of sexist fundamentalist movements everywhere.

Here’s how it works:

Quiverfull claim that women should be subservient to their husbands because that’s what Nature intended.

They don’t use artificial birth control because women have monthly ovulation for a reason: to get pregnant as often as possible.

They don’t countenance abortion because women have a uterus for a reason: to reproduce constantly.

Many use lay midwives for childbirth because women have a vagina for a reason: to birth the babies they grow.

Women shouldn’t work outside the home because women have bodies that grow babies and produce milk: so they can stay home and take care of them.

See the problem?

Invoking women’s reproductive organs is a way to justify restricting women’s choices. Instead of giving women the opportunity to control their fertility, end unwanted pregnancies, and raise children in the way that each individual woman thinks is best, invoking women’s reproductive organs is a way to keep them in the kitchen, barefoot, pregnant and subservient. Invoking women’s reproductive organs in a discussion of women’s choices is sexism pure and simple. It’s meant to short-circuit any discussion of women’s rights, intellectual achievements, and character by implying that those things ought to be subservient to women’s biology.

No doubt it’s a head scratcher for fundamentalists that Gina’s husband had a vasectomy to make sure that she couldn’t get pregnant after only 3 children and even though she still has ovaries and a uterus for a reason.

It is deeply misogynist for Gina to justify her sanctimoniousness with appeals to women’s reproductive organs. This is not a public health issue, it’s a reproductive rights issue.

Let’s be very clear:

A women’s decision on whether or not to breastfeed is a reproductive rights issue, no different than the right to control fertility or to terminate a pregnancy.

It is profoundly anti-feminist to tell a woman how she should use her ovaries and how she should use her uterus. It is equally sexist and retrograde to tell a woman how she should use her breasts, or criticize women, implicitly or explicitly, for not using their breasts “as nature intended.”

Gina Crosly-Corcoran is confused:

I am brave (foolish) enough to admit that while I totally and completely support any woman’s right and choice to feed her babies however she needs to, I still, deep down in a place I don’t like to admit, don’t really “get” it when a woman chooses, without any medical or social barrier, not to breastfeed. To me it’s sorta like deciding not to take prenatal vitamins because you just don’t wanna, without recognizing that they do help build a healthier baby. I will NOT be all sanctimonious about it, I’m just saying I’m human and that one’s a head scratcher for me. We have lactating boobs for a reason: to feed the babies we make.

Kind of like:

I am brave (foolish) enough to admit that while I totally and completely support transgender people, I still, deep down in a place I don’t like to admit, don’t really “get” when a man or a woman chooses to be the opposite sex. To me it’s sorta like deciding not to get married because you just don’t wanna, without recognizing that heterosexual families are what nature intended. I will NOT be all sanctimonious about it, I’m just saying I’m human and that one’s a head scratcher for me. A man has a penis for a reason, and a woman has a vagina for a reason: to be the gender that they were born to be.

See! Not sanctimonious or judgmental at all!

Hi, folks! Jack Daniels here, spokesperson for CPRDD, the Committee to Promote Responsible Drunk Driving.

I’m sure you’ve seen newspaper accounts of horrific crashes that happened after someone drove drunk, but I’m here to tell you that just because a person died or killed someone else while driving drunk, does NOT mean that drunk driving led to those deaths.

Surprised? I’ll bet you are. But that’s because you’ve been subjected to the blandishments of Big Medicine working tirelessly to marginalize the role of alcohol in treating medical ailments. For hundreds of years surgery, from amputations to tumor removals, was performed with alcohol as the only anesthetic. Then along came doctors  who could not tolerate the economic competition and marginalized medicinal use of alcohol just to protect their own incomes.

How do we know that drunk driving is a safe and responsible choice? There are many reasons, but before I list them, I want to give thanks to my colleague Ima Frawde, CPM (certified professional midwife), the grandmother of American homebirth. Ima and her colleagues have come up with these fabulous arguments and I’ve simply adapted them for drunk driving.

1. Sober drivers die, too.

If you listen to those shills from Big Medicine, you’d think that no one sober ever dies in a car accident. Sure some drunk drivers are killed or kill others, but that hardly means that driving sober can guarantee that you will live. Ice is a major cause of car accidents; fog is another, but no one tries to demonize ice or fog the way that they demonize drunk driving.

2. Over 99% of drunk drivers will make it home without killing themselves or others.

Sure, you see reports of spectacular drunk driving accidents blaring from newspapers and TV, but those are the rare cases. As the many, many people who have successfully driven drunk can tell you, most drunk drivers will arrive home safely.

3. You are safest when you feel safest!

Just like homebirth is safe if you feel that it is safe, drunk driving is safe if you feel that it is safe. In fact, there’s an argument to be made that drunk drivers who do die or kill others simply weren’t trusting drunk driving enough.

4. Drunk drivers bring exactly the same skills and equipment to driving drunk as they do to driving sober.

Drunk drivers have access to the SAME brakes, gas pedal and wheel that sober drivers do. While drunk, they can perform EXACTLY the same maneuvers that they perform while driving sober.

5. Drunk drivers are responsible for their own health.

Who is the government or Big Medicine to tell me that I can’t care for myself in the way that I think is best? Making drunk driving illegal is the first step toward world domination by jack booted thugs who will implant us all with data chips to control our minds.

6. Drunk driving is empowering.

Those who have done it will tell you that driving drunk only increases the pleasure that you get from driving.

7. God is my co-pilot

Nothing happens that God does not intend should happen. If He wants a drunk driver to arrive home safely, it will happen. If the drunk driver dies or killed someone that surely means that God intended those deaths.

8. Some drivers aren’t meant to live.

Obviously!

There you have it, folks. These are just 8 of many reasons why drunk driving is safe. The next time you’re thinking about drinking and driving, remember, if those arguments are good enough to promote homebirth, they’re good enough to promote anything.

Rachel Hills has written a thought provoking piece for The New Republic, The Best Way to Combat Anti-Vaxxers Is to Understand Them.

Referencing the work of Jennifer Reich, a sociologist at the University of Colorado Denver, Hills claims:

It is not just anti-vaxxers, after all, who take pride in their ability to critically evaluate information, who do background research instead of trusting their doctor’s advice on faith, or who are skeptical of the motivations of government, pharmaceutical companies, or big business. Nor is it only anti-vaxxers who believe that every individual is unique, and that policies should be adapted to fit those idiosyncrasies, rather than applied one-size-fits-all. (As one mother Reich interview explained it in relation to vaccines: “Everyone has a different immune system. For some people, it may take three shots. [Others get] immunity that first time.”)

In an era of high individualism, ideas like these aren’t outliers or aberrations. They are hallmarks of the liberal middle-classes—the kind of people, say, who might read The New Republic online. And I’ll be honest: they sound an awful lot like me.

In other words:

At its heart, the anti-vaccination movement isn’t a product of ignorance, selfishness, or even fear … although each of these play their part. It is the logical fallout of a society in which knowledge is relative, institutions are fallible, and the individual reigns supreme. In such an environment, the real surprise isn’t that there are people who doubt vaccines. It is that most of us don’t doubt them, even when every social force around us is urging us to do otherwise.

According to Hills, if that’s the case:

All of which begs the question of how we might better respond to anti-vaxxers. One solution might be to rebuild the trust between individuals and medical institutions. It is well established that parents who choose not to vaccinate their children are a privileged group, but the deep suspicion that lies at the heart of vaccine refusal reflects their distance from power, not just their proximity to it. It stems from the same impulse that leads people to believe that the U.S. government creates fake ISIS videos as propaganda tools, or that media barons dictate stories to their journalists over the phone…

She concludes:

Whatever approach we choose, one thing is for certain: Dismissing vaccine skeptics as crazies or idiots won’t solve the growing public health problem their choices present. To do that we need to go deeper; to examine not only the ways in which they are plainly wrong, but the beliefs they hold that are more equivocal—and the unwitting role we might all be playing in allowing those ideologies to thrive.

As much as I admire Hills’ writing and clear exposition of her claims, I disagree profoundly.

Hills is right to focus on parents’ attitudes, rather than their knowledge of science. That’s because anti-vax advocacy is not about vaccine and not about children. It’s about parents wanting to see themselves as educated, empowered and not submissive to authority … with an important caveat. They want to burnish their self-image without doing the hard work of learning immunology.

Yes, neo-liberals (and old fashioned liberals like myself) want to take pride in their ability to critically evaluate information, do background research instead of trusting their doctor’s advice on faith, and are skeptical of the motivations of government, pharmaceutical companies, or big business.” But it is IMPOSSIBLE to critically evaluate information about vaccines if you don’t have a firm grounding in basic immunology. It is IMPOSSIBLE to do research by reading websites written by laypeople for other laypeople. It is IMPOSSIBLE to be educated about vaccines without being thoroughly educated about immunology.

Hills claims that anti-vax isn’t a product of ignorance, selfishness, or even fear, Unfortunately, it is PRECISELY a product of ignorance, selfishness and fear; ignorance of basic immunology, microbiology and statistical analysis, selfishness in eliding the dangers vaccine rejection poses to others, and an absurd, overblown, unreasoning fear of autism.

Hills insists that anti-vaxxers aren’t idiots or crazies and likens them to people who believe the U.S. government creates fake ISIS videos as propaganda tools. But those people are also idiots and crazies. They have literally no idea what they are talking about and have an abiding fascination for conspiracy theories based on absolutely no evidence at all. If Hills was trying to make anti-vaxxers look reasonable, she used a strikingly poor analogy.

Hills concludes that dismissing vaccine skeptics as idiots or crazies won’t solve the growing public health problem their choices present.

I beg to differ.

Anti-vax activism is about parents and how they want to view themselves. It would be very hard for them to present themselves as educated and empowered if everyone else believed them to be ignorant and gullible. Indeed, the tide is turning at this very moment, as anti-vax advocacy is devolving in the public view from being simply one of many reasonable approaches to vaccination to the growing public belief that anti-vaxxers are crazy conspiracy theorists who have been 100% wrong about every claim they’ve ever made. The resurgence of pertussis, measles (and even the furor over Ebola), along with a continuing rise in autism prevalence have combined to make anti-vaxxers look like fools.

Hills is correct that anti-vax advocacy is not about science and is not going to be improved by improving science education, but she’s wrong to claim it is a manifestation of neo-liberalism. Neo-liberalism places great stock in real education, not pretending to be educated by surfing the internet. That’s just lazy boastfulness.

Neo-liberalism values skepticism, which actually means “requiring proof” and not “refusing to believe what experts say.” That’s just foolish.

Neo-liberalism questions government, pharmaceutical companies and big business, but it does not allege that government, pharmaceutical companies, and big business are engaged in conspiracies so massive that they involve all the doctors and public health officials in every country of the world, who are giving their own children vaccines that they supposedly know are toxic. That’s just totally crazy!

Obviously any attempt to increase vaccination rates will need to be multi-pronged, but I suspect that humiliating anti-vaxxers is going to be by far the most effective strategy. I would draw a parallel to racist and homophobic jokes. When they were acceptable, comedians told them and thought those jokes made them seem witty. When racist and homophobic jokes were finally acknowledged to be hateful, and comedians were humiliated for telling those jokes, most stopped telling them. They recognized that those jokes made them look bigoted, not witty.

When declaring yourself to be an anti-vaxxers brings only eye-rolls, condemnation and pity, neo-liberals will start vaccinating their children once again.

Yesterday’s post, OMG! OMG! OMG! I was pressured to have a C-section just because I was a 40 year old insulin dependent diabetic with pre-eclampsia and bloody urine, was about Dr. Carla Keirns and her attempts in the professional and lay press to shoehorn her high risk birth into the natural childbirth narrative of the “unnecesarean.”

As I explained:

Dr. Keirns and her pregnancy were extremely high risk. She was 40 years old, which put her at risk right from the get go, but in addition she had a very serious pre-existing medical condition. Although Dr. Keirns implies that her diabetes was related to pregnancy, her need for insulin in the first trimester suggests that she may have type II diabetes unrelated to pregnancy. Furthermore, although she doesn’t explain the diagnosis, the fact that she was on magnesium sulfate to prevent the seizures of pre-eclampsia, and was spontaneously bleeding from her bladder, suggests that she was developing HELLP syndrome, a particularly dangerous variant that also affects blood clotting and liver function.

Nonetheless, Dr. Keirns wants us to believe that she was being pressured into a C-section that she didn’t need. How does she know that she didn’t need it?

… My son came out blue and not breathing. I listened for crying but didn’t hear any. I barely heard the doctors say it was a boy. Meanwhile, as the NICU unit was summoned to attend to my son, I began to hemorrhage …

After we were both stabilized, they handed the baby to my husband; I was too exhausted to safely hold him.

As I said yesterday, if nearly killing your baby and yourself qualifies as a “successful” vaginal delivery, I’d hate to see what failure looked like.

The people I really feel sorry for in this story are Dr. Keirns’ providers, not because I’m sure that they did everything right, but because they are being publicly humiliated without any chance to defend themselves.

Therefore, in one of several Twitter exchanges, I suggested to Dr. Keirns what is shown in the tweet below:

Dr. Keirns should absolve her providers of their obligation of confidentiality and let them tell what they think happened and why they repeatedly recommended a C-section. If the story that Dr. Keirns blared to the medical and lay press is true, they will be able to confirm it. If not, they’ll be able to defend themselves. Seems only fair, right? Otherwise, Dr. Keirns is just a very high risk patient trying to shoehorn her experience into the approved natural childbirth narrative.

I find it incredibly ironic that Dr. Keirns, a specialist in preventive medicine, utterly failed to understand that C-section in HER case was recommended as a form of prevention. I’d love to know whether her providers saw it that way, too.

I also find it deeply unfair that Dr. Keirns has publicly humiliated them without giving them an opportunity to explain what they thought was happening and why they made the recommendations that they did. As a physician, she knows that doctors are often subjected to second guessing by patients, and, when given a chance to explain their reasoning, can often help the patient understand why they did what they did, and said what they said. Since she publicly second guessed the doctors and nurses who cared for her, she should give them an opportunity to provide a public explanation.

How about it Dr. Keirns? Are you willing to allow your providers to speak publicly about your case? Think of it as a public version of Morbidity and Mortality Rounds. M & M’s are incredible learning opportunities. Everyone could learn something from your story: the public, your providers, and, I dare say, YOU.

All it takes is your consent, and we can hear both sides. Will you give that consent?

Extra! Extra! Get the latest from ImprovingBirth.org! Are C-sections Damaging Our Children?

I can save you the trouble of reading the piece by giving you the answer:

No, they’re not, but that doesn’t stop the folks at ImprovingBirth.org from trying to convince you that they are.

The release of the largest study of its kind [Cesarean Section and Chronic Immune Disorders] confirms yet again that the Cesarean epidemic in the U.S. deserves more attention, and women deserve better information and options. Evidence continues to emerge that birth by surgery, while sometimes necessary and wanted, is not benign.

Increasingly, researchers are finding relationships between Cesarean birth and babies’ future health. The latest findings come from a mammoth study including two-million full-term births over 35 years in Denmark—showing that children born by Cesarean had “significantly increased risk” of developing certain chronic disorders.

Does ImprovingBirth.org despise C-sections?

Is the Pope Catholic?

And just like anyone committed to free thought needs to take the Pope’s pronouncements on God’s wishes with a grain of salt, anyone committed to scientific evidence needs to take ImprovingBirth.org and Cristen Pascucci’s efforts to demonize C-sections with a whole salt shaker.

Why?

1. Bias

Getting your information about C-section from natural childbirth advocates is like getting your information about solar power from Big Oil. If you think they are going to tell you the truth, and the whole truth, then you are very naive.

2. Motivated reasoning

No doubt the folks at ImprovingBirth.org believe that C-sections are “bad.” And because that is non-negotiable, their reasoning is motivated to support their belief. They promoted papers that support their pre-existing convictions, and ignore everything else that doesn’t.

3. Training

Cristen Pascucci is a public relations executive and board member at ImprovingBirth.org whose claim to understanding the obstetric literature appears to be the fact that a baby transited her vagina.

4. A fundamental misunderstanding of the scientific literature

Just because a scientific paper is published doesn’t make it true. Reading a scientific paper is similar to reading a newspaper article. A Democratic leaning newspaper may have an article with the headline that Obama was born in Hawaii. A radical Republican newspaper may have an article with the headline that Obama was born in Africa. One article is true, the other is not. In science, publication of a paper means that it is worthy of discussion, NOT that the reviewers agreed with its conclusions.

5. A profound belief in the naturalistic fallacy

Pascucci and her natural childbirth cohorts are absolutely sure that if it’s natural, it must be good. That’s why tobacco, heroin and tsunamis are good. Oh … wait. But it is why getting the message to your followers by shouting it is better than using the Internet. Oh … wait I’ve got it! That’s why vaginal births are better than C-sections.

6. A serious misunderstanding of evolution

In a perverse way, natural childbirth advocates are eugenicists. They appear to be convinced that some peoples genes are “better” than other people’s genes. Hence the fatalism when babies die at homebirth that “some babies are meant to die.” Hence the unstated assumption that modern obstetrics must be weakening us in important ways.

7. A serious misunderstanding of chronic diseases of wealth.

Alternative health advocates in general and natural childbirth advocates in particular are desperate to pretend that chronic diseases of wealthy countries are “caused” by failing to follow the ancient wisdom of our ancestors. That’s absurd. Our ancestors died in droves from easily prevented and easily treated diseases. When you prevent those deaths, as modern medicine does, what’s left is chronic diseases of wealth. That doesn’t mean that medical care causes those diseases; it means that you can’t get those diseases unless modern medicine allows you to live long enough to get them.

Moreover, we have no idea of the prevalence in indigenous populations of diseases like Crohn’s or juvenile rheumatoid arthritis or defects of the immune system. We have no way to compare contemporary prevalence of these diseases with their prevalence in societies that lack modern medicine. Therefore, we are reduced to drawing conclusions from studies that trace prevalence over time or between groups within wealthy societies, limiting our ability to determine what modern medicine does or does not cause.

Let’s get back to the original study and see what it actually showed.

Pascucci acknowledges the difference between correlation and causation:

That is, they show a strong association between the presence of these immune diseases and the occurrence of Cesarean birth, but more research is needed to determine whether Cesarean birth is the cause of these problems, or merely an associated event.

Denmark saw an increase in the rate of C-sections from 5% in the 1970s to 20% in 2010. The U.S. saw a similar but even more dramatic rise to over 32% in 2012, according to Centers for Disease Control figures here. This is the same time frame during which we have seen an increase in immune-related disorders in westernized countries. The Danish study suggested this correlation was important, and their data supports that assertion.

Unfortunately, however, she never deconstructs the actual study and, therefore, fails to note it’s most serious flaw. Immune diseases like Crohn’s and juvenile rheumatoid arthritis have a large heritable component. Though the authors of the study took the mother’s history of immune disease into account, they failed to take the FATHER’S history of immune disease into account. Without that, they can’t draw any valid conclusions since it is entirely possible that the difference in the two groups of children is the results of differences in the fathers’ medical history, and NOT the difference in mode of birth.

Pascucci is careful to resist firm conclusions and instead settle for good old fashioned insinuation:

Emerging research points to the microbiome of babies as being a determinant in long-term health and even epigenetic changes [Actually, such research is in its infancy and offers no firm conclusions about anything] …

But this part is my absolute favorite:

At the same time, withholding information from women because we don’t want to cause hurt or guilt is a misplaced effort. It’s a perpetuation of what is truly hurting women and babies today: known but undisclosed risks of procedures like Cesarean section, biased information from care providers …

Excuse me while I pick myself up off the floor where I fell because I was laughing so hard.

Why was I laughing?

In the world of natural childbirth advocacy, informing women of the risks of death in childbirth is known as “fear mongering” and “playing the dead baby card” despite the fact that the statistics quoted are firm, reproducible and based on decades of data.

Obstetricians are bitterly chastised for “playing the dead baby card,” but now ImprovingBirth.org and Pascucci are advising us to play the “immune injured baby card” in the interests of full disclosure.

But they can’t have it both ways. And when we compare the known risks that a particular baby will die in childbirth without a C-section to the highly theoretical, unreproduced and unproven claims of future immunological diseases, C-sections win every time.

The folks at ImprovingBirth.org need to understand that what’s good for the goose is good for the gander. If you are going to condemn “fear mongering” over dead babies, you have no business fear mongering over theoretical risks of C-sections.