They say a picture is worth a thousand words and the images above and below are quite impressive. They compare the rate of autism over time compared to the rate of breastfeeding over time:

Over the past 4 decades, there has been a shocking rise in the prevalence of autism. Antivax activists have pointed out that there has been an increase in the number of vaccines that infants receive and conclude that vaccines cause autism. But as this graph shows there has also been a dramatic increase in breastfeeding rates. Indeed the two seem to rise in concert over time demonstrating a link between breastfeeding and autism.

Obviously more research is needed. We should be urgently investigating whether breastfeeding causes autism. We should reconsider recommendations designed to encourage breastfeeding and ask if we are ignoring the harmful effects. In the meantime, we should direct lactation consultants, La Leche League and the Baby Friendly Hospital Initiative to inform new mothers of the very clear association between breastfeeding and autism. How can women make an informed decision about breastfeeding if they don’t know about the link?

If you read this far you’re probably asking yourself what has happened to my reasoning abilities. Just because two phenomena rise in concert doesn’t make them linked. Sure, it raises the possibility, but it is grossly irresponsible for any medical professional or organization to announce a link based merely on a temporal association. I must be joking, right?

Sadly, I’m merely copying the efforts of the American Academy of Pediatrics to pressure women into breastfeeding. Their latest attempt to manipulate women, Breastfeeding and the Use of Human Milk was published earlier this week.

The press release highlights the disingenuous tactics:

Research has shown that breastfeeding is linked to decreased rates of lower respiratory tract infections, severe diarrhea, ear infections and obesity. Breastfeeding is associated with lower risk of sudden infant death syndrome, as well as other protective effects.

Notice that the authors do not — indeed CANNOT — say breastfeeding causes these benefits. They’re simply “linked” and “associated” with breastfeeding in EXACTLY THE SAME WAY rising rates of autism are “linked” and “associated” with breastfeeding.

The AAP paper continues:

There are continued benefits from breastfeeding beyond 1 year, and up to 2 years especially in the mother. Long-term breastfeeding is associated with protections against diabetes, high blood pressure, and cancers of the breast and ovaries.

The second sentence makes it clear that the first sentence is a falsehood. Long-term breastfeeding is merely “associated” with these benefits, NOT caused by them. In EXACTLY THE SAME way rising rates of autism are “associated” with extended breastfeeding.

I don’t for a moment believe that breastfeeding causes autism and neither should you. For the EXACT SAME reason, no one should yet declare that breastfeeding causes the “linked” and “associated” benefits touted by the AAP.

What’s really going on here?

Breastfeeding in industrialized countries is highly socially patterned. Breastfeeding and extended breastfeeding are far more common among women of higher education levels and higher socio-economic status. The purported “benefits” of breastfeeding are almost certainly benefits of wealth and access to health insurance and healthcare.

What does the scientific evidence really show?

The paper Is the “breast is best” mantra an oversimplification? is a comprehensive summary of the existing evidence and demonstrates that the benefits of breastfeeding have been overstated and the risks ignored.

The evidence for infant breastfeeding status and its association with health outcomes faces significant limitations; the great majority of those limitations tend to overestimate the benefits of breastfeeding. Nearly all evidence is based on observational studies, in which causality cannot be determined and self-selection bias, recall bias, and residual confounding limit the value or strength of the findings.

How is the average mother to understand the real benefits of breastfeeding (if there are any) when even the AAP is attempting to pressure them? Look at the actual wording of the claims.

When anyone tells you that breastfeeding is “linked to” or “associated with” myriad benefits remember that breastfeeding is ALSO “linked to” and “associated with” rising rates of autism.

Unless and until there is research to show that breastfeeding CAUSES a specific benefit, NO ONE — especially the AAP — should claim that it does. The touted “benefits” of breastfeeding are likely the result of higher socio-economic status, NOT breastfeeding itself.

Breastfeeding is the “normative standard.”

So says the American Academy of Pediatrics in a new paper entitled Breastfeeding and The Uses of Human Milk.

You know what else is the “normative standard”?

Right-handedness.

Heterosexuality.

Genotype determining gender.

Here’s what I say: fuck normative standards!

Why does the AAP give moral authority to nature when it comes to breastfeeding but deny that same moral authority when handedness, sexuality and gender identity are involved?

Why does the AAP pathologize women who don’t breastfeed, encouraging moral condemnation, but would be horrified by anyone who pathologized women who are left-handed, gay, or trans?

If the AAP believes handedness, sexuality and gender identity are perfectly acceptable NON-normative choices for those who wish to control their own bodies, why isn’t formula use equally acceptable for the same reason?

Philosophy professor Alison Suen gets to the heart of the matter when she discusses the dangers — for women in particular — of ceding moral authority to nature:

When nature becomes a “moral authority,” can it still make good on its initial promise to liberate women, allowing them to reclaim control over pregnancy and childbirth? Or does it liberate women from the tyranny of the medical establishment only to subject them to the new puissance of “nature”?

More to the point, giving moral authority to nature or subjugates women (and men) to misogynistic, homophobic, transphobic beliefs on how women ought to behave. Giving moral authority to nature would justify efforts to “support” left handed women into becoming (or pretending to become) right handed. It would justify efforts to “support” gay women into becoming (or pretending to become) straight. It would justify laws that limit access gender identity affirming care and protections.

But the greatest danger is this:

…[A]n appeal to nature that accords nature a moral authority does not necessarily promote diversity or tolerance, especially when such an appeal merely replaces one practice with another as the proper, normative practice. In other words, even if the language of nature may empower some, it is done at the expense of others…

When a biology is portrayed as a normative standard, those who ignore or reject that standard are almost invariably oppressed. For example, the most malignant expressions of homophobia are often justified by insisting, correctly, that heterosexuality is a normative standard.

Therefore, when the AAP represents breastfeeding as the normative standard, they are pathologizing women who cannot breastfeed or — heaven forefend! — prefer formula feeding.

Just as the biological norm does not and cannot justify homophobia or transphobia, it does not and cannot justify pressuring women to breastfeed.

The practice of medicine should NEVER be based on normative standards but rather on individual needs and desires.

The American Academy of Pediatrics is wrong — profoundly morally wrong — in promoting breastfeeding as the normative standard.

Everyone “knows” that the Black maternal mortality crisis is due to racism.

According to Ms. Magazine:

Maternal mortality is one of the most compelling indicators that America runs on racism. Here’s what we need to do to overcome this legacy and current reality.

WGBH Boston reported:

Despite all the modern advances in medical care, pregnancy and birthing can be dangerous for women of color. Massachusetts boasts some of the best hospitals in the world, yet here in the Bay State, Black women are nearly two times more likely to die from pregnancy-related causes than white women.

It’s a sobering statistic, and racism is largely to blame, local experts [claim} … Black women are often disregarded and ignored when raising concerns about their symptoms.

Hulu is about to release a documentary on Black maternal mortality entitled Aftershock:

The statistics speak for themselves: According to the CDC, Black and Native women are two to three times more likely to die from pregnancy-related causes than white women in this country. “Aftershock” is the result of tragedy, and the collaborative efforts of families who have endured the outcomes of systemic racial discrimination in reproductive health.

But for every complex problem there is a solution that is clear, simple … and more than likely wrong.

Such is the case with the effort to place the blame for the massive rates of Black maternal mortality on racism. While it is depressingly true that racism in America is active, ugly and apparently growing, the statistics about race and maternal mortality do speak for themselves — and they show there is no clear relationship between racism and maternal mortality.

Black people are hardly the only victims of racism in the US. Latinos, Native Americans and those of Asian descent are also victimized.

If racism were the proximate cause of maternal mortality we would expect to see mortality rates among ethnic groups proportionate to the likelihood of racism. But that’s not what we find.

These are the latest maternal mortality statistics from the CDC:

If racism were the cause of maternal mortality we would expect Hispanic women to have maternal mortality rates substantially higher than those of white women but not as high as Black women. Yet that’s not what we find. Instead Hispanic women have maternal mortality rates even lower than those of white women. So discrimination is not linearly related to maternal mortality.

That’s in contrast to factors like age and socio-economic status that are linearly related suggesting that — unlike racism — they are major contributors to maternal mortality.

If racism were the cause of increased mortality it would not be confined just to the weeks and months after birth. Overall mortality would also reflect the level of discrimination. Yet that’s not what we find. Instead Hispanic people have the highest life expectancy.

Mortality statistics from the CDC:

Moreover, women — who arguably face much higher rates of discrimination than men —nonetheless have higher life expectancy.

In my view, blaming racism as the primary driver of Black maternal mortality while satisfying to some is too easy and likely to be ineffective since there is no clear relationship of racism to mortality.

Consider that cardiovascular disorders are the leading cause of maternal mortality in the US, and Black women have higher rates of pregnancy-related heart attack, stroke, peripartum cardiomyopathy, and pulmonary embolism than White women, even when differences in age, health conditions, cesarean section rate, socioeconomic factors, and access to health care are taken into account.

Blaming racism isn’t going to help these women avoid cardiac complications or recover from them. That would require a commitment to increase the number of perinatologists and obstetric ICUs and to provide expensive interventions. It’s much easier and cheaper to pretend that Black doulas could improve maternal outcomes by ameliorating racism.

I would never deny the existence of virulent racism in the US. But just because racism exists and Black women die in appalling numbers does not mean that the former causes the latter. I fear that as long we focus on racism, and not on providing high tech obstetric care, Black women will continue to die in heart-breaking numbers.

The recently released Ockenden Report could not have been clearer. UK midwives bear responsibility for literally hundreds of newborn and maternal deaths and injuries. The report faulted a culture of “normal birth” at all costs and a refusal to both investigate and learn from mistakes.

In case you doubted the Report, we now have the apologia from the UK midwifery leadership and it is every bit as damning as the original report. Hundreds of babies and mothers are dead, thousands of families’ lives have been destroyed and UK midwives are overcome by … SELF-PITY.

Responding to the Ockenden Review: Safe care for all needs evidence-based system change – and strengthened midwifery is an ugly, self-serving screed.

How does this paper address the preventable deaths and injuries? With misdirection, grievance and self-pity.

Misdirection:

Failures of care at this scale and duration stem from failure of the maternity and wider health system and a lack of political will to support a high quality national health service. Multiple structural reforms of the National Health Service (NHS) and a decade of severe NHS budget cuts have led to chronic underfunding of the maternity workforce, resulting in shortages of midwives, sonographers, and doctors, cutbacks in professional development and training, limited time to care, burnout, low morale, and unprecedented retention problems.

Those claims are true, but they are not responsible for nor do they justify the abysmal treatment of women and babies at the hands of UK midwives. The authors are brazen in their attempt to blame everyone but themselves and their ideology.

Claims of persecution:

Reports of service failures have dominated the headlines and overshadowed the many positive developments in place across the country. Some professional, political, and media responses to this and previous reports are feeding a narrative that blames midwives and the physiology of birth itself despite clear failings by multi-professional teams and organisations. The search for someone or something to blame has led to the notion of a widespread ‘ideology of normal birth at any cost’ as the scapegoat for complex system-wide failings, despite a lack of evidence for this in the reports themselves.

The central defect of contemporary UK midwifery is the radical ideology of “normal birth.” The authors of the piece are so blinkered by their devotion to that ideology that it literally never occurs to them that their cherished belief — “normal birth” is both better and safer — has repeatedly been shown to be both false and deadly.

Self-pity:

It is essential to recognise that midwives are the only professional group who are by a woman’s side from her first contact with the health services until after she and her baby are settled together, or during and after care for perinatal loss. Skilled midwifery care can prevent problems, support early identification of and referral for complications, and promote multiple positive outcomes including physical and mental health and well-being. Midwives are especially important for women who have additional care needs, whether physical, psychological, social, or cultural.

Did the authors read the Ockenden Report before criticizing it? They seem to have missed the part where midwifery care CAUSED the problems and that reform of midwifery care is a sine qua non for preventing similar injuries and deaths in the future.

The authors’ response is a classic effort at self-justification.

According to the book ‘Mistakes Were Made (but not by me)’:

As fallible human beings, all of us share the impulse to justify ourselves and avoid taking responsibility for actions that turn out to be harmful, immoral, or stupid… most of us find it difficult if not impossible to say “I was wrong; I made a terrible mistake.” The higher the stakes—emotional, financial, moral—the greater the difficulty.

It goes further than that. Most people, when directly confronted by evidence that they are wrong, do not change their point of view or plan of action but justify it even more tenaciously…

When directly confronted by the evidence that the radical “normal birth” ideology of UK midwifery has harmed babies, the authors do not change their point of view or plan of action, but justify their allegiance to normal birth even more tenaciously.

Indeed, they conclude:

We already have good quality evidence, strong national policy, transformational UK-wide midwifery education standards, positive change programmes, recommendations for increased resources, and skilled and committed multidisciplinary professionals. There are informed and engaged advocates for women and families, and examples of excellence to draw on.

Hundreds of babies and mothers are dead, thousands of families’ lives have been destroyed at the hands of UK midwives, but shockingly these authors use the preventable tragedies as yet another opportunity to celebrate themselves.

Perhaps you want a homebirth enough to be willing to risk your baby’s life. But have you considered the potential impact on your older children and the baby of leaving them motherless? Neither did the mothers of these 25 children who experienced the ultimate catastrophe, all because their mothers wanted a specific birth experience.

– Florida woman Stephanie left 6 small children motherless, including her newborn, after choosing homebirth.

– Australian woman Caroline Lovell left 2 small children, including her newborn, motherless after bleeding to death in front of her clueless homebirth midwives.

– A young American woman left 4 small children motherless, including newborn twins after bleeding to death at homebirth.

– A 24 year old American woman left her newborn motherless after bleeding to death at homebirth.

– British mother Joanne Whale left her newborn motherless after bleeding to death from a uterine eversion at homebirth. Her midwife did not know how to start an IV that might have saved her life.

– British woman Claire Teague left two children motherless, including her newborn, after bleeding to death from a retained placenta at homebirth. Her midwife claimed in her defense that Claire “had a really lovely spontaneous birth at home and I hope Simon [her husband] in time will remember that.”

– Maria Zain, a prominent Malaysian-British advocate for unassisted homebirth, left 6 children motherless, including her newborn, after her 4th unassisted homebirth!

Now comes word of Australian yoga teacher Lauren Verona’s death a homebirth, leaving 3 motherless daughters.

On her Facebook page Ms. Verona had discussed her “countless pregnancy complications” including a low lying placenta and gestational diabetes; she didn’t even mention additional risk factors including postdates pregnancy and advanced maternal age.

On June 5 she wrote on her Facebook page:

… I hear my own children say “divine timing” when anyone asks when the baby is coming out. I love that they get it. I love that our children reinforce our own belief systems when we quietly question it, I love that it rolls off the tongue and the statement just stands. So here we are 41 weeks pregnant trusting the higher plan.

Now she is dead.

We are devastated, on behalf of Ryan, Allira, Evie and their families, to let you know that our beloved, inspiring, shining light Lauren passed away due to complications after giving birth to her beautiful, healthy, thriving baby girl – Lucinda …

In this time of darkness, we still have a shining light, not only in Lucinda, but also those who she leaves behind, especially Ryan and her daughters. May they and we all continue to share her light, her wisdom, her laughter, her tears for lifetimes to come.

No doubt her memory will provide inspiration and comfort for her daughters for years to come. But she could have provided a lot more to her daughters had she survived. They will feel the devastating pain of her loss for the rest of their lives.

So I ask: which was ultimately more important, her birth experience or their need for their mother?

Thinking about homebirth? Consider what your death would do to your children and think again.

Another day, another homebirth death.

A Perth newborn has died after an at-home birth with only a doula to support the mother ended in tragedy.

The girl was born Saturday about 3am inside a Wattle Grove home, however she became stuck during labour and wasn’t breathing when she arrived.

…[T]he father of the child began CPR as the doula did not know how to resuscitate the newborn.

St John Ambulance paramedics arrived at the scene 10 minutes after receiving the triple-zero call and rushed the baby to St John of God Midland.

She was transferred to Perth Children’s Hospital but could not be saved.

Yet another death that is not merely a tragedy but also a tragic irony. Why? Because in attempting to give birth “as nature intended” homebirth and freebirth advocates have missed nature’s most critical “intention”: that mothers — human and higher animal — will do whatever it takes to protect their infants.

For “Nature” success is measured by children who live to reproduce, the “survival of the fittest.” And the fittest are those who live, not those born without medical assistance.

Evolution doesn’t care one whit about the process of survival, it only cares about the outcome. Evolution doesn’t care whether a particular animal has black fur or white fur. It rewards the color that offers the best camouflage for the particular environment in which the animal lives. In our current environment, with easy access to technology, evolution rewards those who use that technology to survive. Women who reject lifesaving technology in order to recapitulate birth in nature aren’t winners; they haven’t achieved anything. If their babies die, they are losers.

Evolution doesn’t care about a vaginal birth; it doesn’t care about birth without pain medication; it certainly doesn’t care about a vaginal birth after a previous C-section. It cares about one and only one thing: whether the baby survives.

Women who let their babies die for lack of obstetric interventions at homebirth or unassisted birth DIDN’T do what “nature intended”; they did the exact opposite. They aren’t successful; they’re failures.

And they’re not responding to natural instincts; they’re defying them. Nearly every large female mammal will defend the lives of her offspring to the death. Everyone knows that there is no more dangerous animal than the mother who feels that her brood is threatened.

The woman who consents to a C-section for fetal distress is acting on that primal instinct. She is willing to let herself be cut open if that gives her baby a better chance of survival. The woman who chooses homebirth specifically to recapitulate birth in nature is acting AGAINST that primal instinct. She is more interested in herself and her bragging rights than in the baby’s life.

That’s not merely deadly; it’s shockingly UNnatural.

Freebirthers are often delusional.

According to Dictionary.com, delusional means:

characterized by or holding idiosyncratic beliefs or impressions that are contradicted by reality or rational argument.

Their delusions include:

The ahistorical delusion that childbirth in nature was often unassisted. In reality midwives exist in EVERY time, place and culture.

The bizarre delusion that childbirth is inherently safe. In reality, childbirth is —in EVERY time, place and culture — a leading cause of death of young women and THE leading cause of death of babies.

The racist delusion that when a privileged white women willingly gives birth without medical assistance she is emulating her sisters of color who UNWILLINGLY give birth without medical assistance.

But my personal favorite of the many delusions cherished by freebirthers is their delusion they that they curated the birth for social media not out of a selfish desire for attention but — get this — because they selflessly wish to help others.

Benni Cornelius, the partner of ocean freebirther Josy Peukart gives us a master class in this delusion.

Cornelius, apparently stung by my characterization of freebirth as remarkably narcissistic, had this to say in response:

Have you ever thought that it makes sense to show a natural birth to encourage other women. What is happening in hospitals is not good and the mothers-to-be are only important to make money.

I don’t have to explain to you that it is important to listen to the female body.

Incidentally, most complications occur in hospitals and not during free births…

It’s such a shame that people are so torn and full of fear that only the hospital counts and anyone who does it differently is judged.

Sure, it looks like they selfishly risked their baby’s life out of a desperate need for attention and validation, but actually they selflessly did it to educate US!!

Can you imagine that there are more reasons than our alleged narcissism to show a natural birth?!

Basically, it’s about encouraging women not to always let outsiders tell you what’s good for you.

If that’s not a delusion — grandiose and self-serving — I don’t know what is!

Why do breastfeeding advocates continue to put their precious babies’ lives at risk by bed-sharing?

Why do they ignore the fact that 9 out of 10 SIDS deaths could be prevented if bed-sharing were eliminated?

Why do they dismiss the scientific data and the exhortations of pediatricians in favor of anthropology nonsense like “The Safe Sleep Seven”?

Sadly, babies continue to die preventable deaths because their mothers fall prey to the Fatal Sleep Five.

1. False Dichotomy of Risk: “I’m low risk!”

False Dichotomy of Risk is based on the erroneous notion that the only possible outcomes are at opposite extremes when in reality there is a spectrum of risk. Lactivists like to pretend that bed-sharing results in deaths only in high risk situations and never in low risk situations. Therefore, they fantasize that since they are at low risk of a bed-sharing death, there is no risk at all.

As all too many low risk mothers can attest, such thinking is FATALLY fclawed.

2. Over-reliance on Personal Experience: “I practice safe bed-sharing!”

This form of poor reasoning is based on the unexamined belief that if it hasn’t happened to the individual before, it is never going to happen. It’s often the rationalization used by drunk drivers who have not yet been in an accident when driving drunk. Many are under the impression that they are “good” drunk drivers and therefore not at risk of a fatal accident. Similarly, many lactivists who bed-share are under the impression that they are “good” at bed-sharing since their infant has survived thus far.

As all too many mothers who are “good” at bed-sharing can attest, such thinking is FATALLY flawed.

3. Survivorship Bias: “We’re still here!”

Survivorship Bias is the effort to reason by considering only historical successes while ignoring historical failures.

Most of us above a certain age traveled in cars throughout our entire childhoods without ever using a car seat and we’re still here. Does that mean car seats are unnecessary?

The dramatically lower death rates for infants in accidents today compared to the 1960’s makes it clear that placing an infant in a car seat is much safer than no car seat. But if we only looked at people alive today even though they never used car seats, we might erroneously conclude that car seats are unnecessary. Putting a sleeping infant in her own sleeping space is like using a car seat.

As all too many mothers can attest, such thinking is FATALLY flawed.

4. Rationalization: “I’m different from the mothers whose babies died!”

When informed of a bed-sharing death, advocates of bed-sharing often appear heartless when they immediately blame the victim. “She was probably fat and I’m thin.” “She rolled over on her baby and I am always completely aware of where my body is relative to my baby.”

As all too many mothers can attest, such thinking is FATALLY flawed.

5. Face Saving: “I would never risk my baby’s life!”

Good mothers don’t risk their babies’ lives. In order for lactivists to bed-share and continue to view themselves as good mothers, they must practice iron clad denial of the risk of bed-sharing. The so-called “Safe Sleep Seven” codifies that denial and therefore helps mothers who are actually risking their babies’ lives to save face.

As all too many mothers who followed the Safe Sleep Seven can attest, such thinking is Fatally flawed.

Think bed-sharing is safe? Ask yourself whether it’s because you subscribe to one of more of the Fatal Sleep Five. Then stop bed-sharing.

In the wake of a leaked draft of a Supreme Court opinion that seeks to eviscerate abortion rights, it’s worth asking:

Is there anything more hypocritical than a reactionary Republican Party — that revels in cruelty and violence against its perceived enemies — claiming that their opposition to abortion rights stems from a respect for human life?

I doubt it.

The Republican Party, the same group of people who can’t be bothered to restrict guns, which kill more than 30,000 people per year, that separated immigrant toddlers from their mothers and put them in cages are rabid to restrict abortions. It has nothing to do with respecting life and everything to do with oppressing women.

How do I know?

By observing the monstrous gulf between what they say and what they do.

Check out their favorite slogans:

Choose life.

That’s an argument for universal healthcare, not an argument for banning abortions. Curiously, many of those who staunchly oppose pregnancy termination have no problem denying life saving healthcare for others, including children.

Providing health insurance for poor children is choosing life, but apparently for the anti-choice crowd all life is not equal. They are keen to protect life from conception up to, but not including, birth. Once you’re born, your life is worthless if you are poor or a child of immigrants or a child of color.

Abortion stops a beating heart.

You know what else stops a beating heart? Capital punishment. Despite that incontrovertible fact, many of those reactionary Republicans who profess “pro-life” beliefs have no problem letting government stop the beating hearts of those convicted of crimes. If your reason for opposing abortion is to preserve life, it is hypocritical to promote mandated death at the hands of government.

They feel pain.

We could argue about whether or not science supports the claim that an embryo feels pain, but there is absolutely no doubt that everyone born, regardless of age, race or economic class feels pain. So why do the same reactionary Republicans who feel they must protect the unborn from pain practically revel in the pain of Black families whose fathers, brothers and sons are shot in the back by police officers? Why do they support the police and not the innocents who are gunned down?

Pro-life means every life has value.

If every life has value, why didn’t Republicans support Colin Kapernick’s campaign to kneel when the national anthem is played in order to draw attention to the Black lives lost to police violence? Those opposing Kapernick justify it by claiming he is disrespecting the flag. That’s a lie, but even if it were true, are we supposed to believe that a piece of cloth has greater value than the life of a young Black man?

Abortion is murder.

We could argue whether abortion is murder, but there’s no argument that murder is murder. Guns facilitate murder. Indeed, hand guns and semi-automatic and automatic weapons have no purpose other than to murder or threaten to murder others. If reactionary Republicans actually cared about murder, they would ban murder weapons, but you won’t see anyone in Congress stand up to the gun lobby.

These five slogans of the anti-choice movement put its hypocrisy into high relief. The so called “pro life” crowd has no problem being anti-life whenever it suits them. So if ending abortion isn’t about saving lives, what is it about?

It’s about punishing women — but never men — for sex.

It’s about promoting misogyny, forcing women — but not men — to be slaves to their biology.

It’s about privileging radical white Christian nationalist ideology above the Constitution.

Because make no mistake, criminalizing abortion will not end abortion. It will just kill women.

Who cares? Certainly not the “choose life” crowd!

Kegel exercises to strengthen the pelvic floor are widely recommended as a panacea as well as a preventive for female pelvic organ prolapse and or incontinence.

What are kegel exercises? They are basically just repeated clenching of the muscles of the pelvic floor (the same muscles you use to stop the flow of urine in midstream). The object is to strengthen those muscles to reduce or prevent pelvic organ prolapse and/or incontinence.

They have several significant advantages. They are free; they are easy; they are unlikely to cause any harm.

But do they work?

That depends. (It’s not meant to be a pun).

It depends on who, what and when, among other things.

The pelvic organs are held up by a sling of internal muscles that cover the pelvic floor. The theory behind Kegel exercises is that prolapse and or incontinence are due to a weakening of the pelvic muscles. Such weakness allows the uterus (or the bladder or rectum) to fall through the normal openings in the sling that accommodate the urethra, the vagina and the rectum.

Whether or not Kegel exercises work depends on:

1. The fundamental cause of the problem.

Although prolapse and incontinence can be the result of muscle weakness, they can also be the result of permanent muscle injuries like tearing. Exercising any muscle can strengthen it but it cannot repair permanent injury. Therefore, Kegel exercises are useful when the cause is simply stretching of the muscles (as occurs in pregnancy) but not if the cause is tearing (as occurs from a forceps delivery or a vaginal delivery of a large baby).

2. The severity of the prolapse.

Once the pelvic organs are significantly displaced — for example if the cervix has descended enough to be visible at the opening of the vagina — no amount of pelvic exercising is going to reverse the problem.

3. The type of urinary incontinence.

Kegels can help prevent or improve stress urinary incontinence which occurs with increased intra-abdominal pressure due to coughing or sneezing. But Kegels can do nothing for incontinence that results from an overactive bladder or nerve damage to the sphincter.

4. The timing of the problem.

Kegels can be effective in reducing incontinence in pregnancy or the immediate aftermath but is far less effective in reducing incontinence long after pregnancy.

5. Age.

Pelvic organ prolapse and incontinence might not manifest until the time around menopause. That’s because the reduction of estrogen leads to weakening of the ligaments that hold the pelvic organs in place. Kegel exercises have no impact on ligaments.

The bottom line is that kegel exercises are hardly a panacea for pelvic organ prolapse or incontinence. They are an excellent first step in treatment, but depending on the cause, the severity and the age of the woman they may ultimately prove ineffective.