It’s hard to predict when a tipping point will occur but once it happens, everything changes.

For example, peremptory airline behavior toward passengers — over booking flights, bumping passengers — has been going on for decades, but everything changed when a United Airlines dragged a passenger down the aisle, bloodying him along the way, in an effort to get back to business as usual. The issue rose to public consciousness in a way that it never had before, prompting wholesale review of airline procedures, not to mention a large payout to the injured passenger.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Lactation consultants didn’t intend to lie to Landon’s mother; they just told her the same lies they tell themselves.[/pullquote]

Similarly, peremptory treatment of mothers by lactation consultants — ignoring their concerns about starving babies, in particular — has been going on for decades, but everything changed when Jillian Johnson shared the story of her son Landon’s death from dehydration due to insufficient breastmilk (If I Had Given Him Just One Bottle, He Would Still Be Alive). The issue rose to public consciousness in a way that it never had before, prompting new attention and hopefully a wholesale review of relentless effort to promote breastfeeding.

Landon cried. And cried. All the time. He cried unless he was on the breast and I began to nurse him continuously. The nurses would come in and swaddle him in warm blankets to help get him to sleep. And when I asked them why he was always on my breast, I was told it was because he was “cluster feeding.” I recalled learning all about that in the classes I had taken, and being a first time mom, I trusted my doctors and nurses to help me through this – even more so since I was pretty heavily medicated from my emergency c-section and this was my first baby…

So we took him home … not knowing that after less than 12 hours home with us, he would have gone into cardiac arrest caused by dehydration…

Landon died years ago and his story remained a private tragedy. Then the Fed Is Best Foundation was created by Christie Castillo-Hegyi, MD and Jody Seagrave-Daly, RN, IBCLC precisely to prevent such tragedies. Jillian felt that she could finally tell Landon’s story to medical professionals who understood, as opposed to lactation consultants who proverbially dragged her down the aisle, bloodying her along the way, in an effort to get back to business as usual.

Landon’s story has appeared in countless newspapers and blogs, in People Magazine and today it has reached television on the show The Doctors. Here is a deeply moving clip:

How could this have happened?

It happened because lactation consultants lie — first and foremost to themselves and each other, but most importantly to parents — insisting that breastfeeding is perfect and problems are rare. Regardless of the age, size and temperament of the baby, many lactation consultants claim that his mothers breasts ALWAYS make enough milk to fully nourish him and that ANY supplementation of breastmilk with formula destroys the breastfeeding relationship. Why? Because women were “designed” to breastfeed. But the truth is that breastfeeding, like any natural process, has a natural failure rate and complications are common.

It’s like insisting that nearsightedness is impossible because eyes are “designed” to see or claiming miscarriage is rare because women’s bodies are “designed” to produce babies. The truth is that 30% of Americans are nearsighted and the natural rate of miscarriage is 20%. Therefore, it should not be surprising that up to 15% of first time mothers (as Jillian was) won’t produce enough breastmilk to fully support a baby in the first few days.

This should not be news to anyone since across large swathes of the world, women offer pre-lacteal feeds in the first few days after birth, such as sugar water, teas and even honey, to their babies. Prelacteal feeding is practiced from Africa to Southeast Asia, to Central and South America, suggesting that a variety of peoples independently believed it to be necessary.

Not surprisingly, pre-lacteal feeds led to illness since they were often made with contaminated water. Lactation consultants looked at the phenomenon and drew the wrong conclusion. They decided that it was the process of supplementing in the first few days that was harmful, rather than the reality that it was the specific supplements that were harmful. It apparently never occurred to them to wonder why millions of women around the world and across the generations had come to the conclusion that colostrum was simply not enough.

Lactation consultants promulgated a variety of rules, embodied in the Baby Friendly Hospital Initiative, that are based on their belief, unsupported by scientific evidence, that every woman can make enough breastmilk and that offering anything other than the breast (formula, a pacifier) will destroy the breastfeeding relationship.

The scientific evidence actually shows the opposite: judicious formula supplementation actually increases the odds of extended breastfeeding and pacifiers not only don’t interfere with breastfeeding, they actually prevent SIDS.

Many lactation consultants lie to themselves and each other about the high rate of insufficient breastmilk and the high and rising rate of breastfeeding complications like dehydration, low blood sugar, permanent brain injury and even death. Their answer to any and all breastfeeding problems is “breastfeed harder.”

How can they ignore that harm that they are causing? They have conjured an all purpose excuse for breastfeeding difficulties, “lack of support.” Since they insist that breastfeeding is perfect, it must be mothers who are lazy or who aren’t being supported that are at fault.

It’s as if “vision consultants” suddenly started telling women that they couldn’t be nearsighted because their eyes were “designed” to see and therefore nearsightedness is rare. It’s as if they withheld glasses and contact lenses on the theory that if women just “looked harder” or got more “vision support,” all but an unfortunate few would have 20/20 vision.

No doubt the lactation consultants who told Landon’s mother he was doing fine while he was actually dying before their eyes believed what they were saying. That is what they were taught and that is what they continually tell each other. They didn’t intend to lie to Landon’s mother; they just told her the same lies they told themselves. Landon died as a result.

Worst of all, when presented with the evidence of Landon’s death, they are fabricating new lies. Some of the lies — such as the lie that Landon’s mother accidentally suffocated him — are extraordinarily ugly. The new lies speak to the desperation of lactational consultants and lactivists to continue believing their old lies that breastfeeding complications are rare.

Nothing will bring Landon back. Nothing will assuage his parents’ heartbreak. But we can hope that the story of his easily preventable death will serve as a tipping point so lactation consultants can’t go back to business as usual.

There he goes again.

Dr. Jack Newman has a disturbing tendency to rationalize or ignore the iatrogenic injuries and deaths causes by relentless promotion of breastfeeding.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Worst case scenario if you give a baby an unnecessary bottle of formula is — nothing! Worst case scenario if you fail to give a baby a needed bottle of formula is brain damage and death.[/pullquote]

Sadly, he resembles many physicians who refuse to take responsilbity for the preventable errors that are so prevalent in today’s medical system. Like the classic paternalistic doctor, he is sure that he knows best. Hence he refuses to acknowledge harmful errors, tries to blame others for the injuries and deaths, and justifies it all by implying that individual harms are acceptable in light of the overall good.

In a May 5th Facebook post, Dr. Newman wrote:

In many hospitals, 10% weight loss is used as an accurate measure of how the breastfeeding is going in the first few days after birth. In fact, it is nothing of the sort. All too often it results in babies getting unnecessary supplementation, often by bottle, and the mother and baby do not get the help they need to succeed in breastfeeding…

He presents NO data and NO scientific citations to support his claims (not surprisingly since there aren’t any). Instead he offers bizarre attempts to deny reality: the scales are wrong, people don’t use the scales properly, babies start out over-hydrated, babies can’t latch because women’s nipples and areolas are swollen from IV fluid.

He refuses to acknowledge the obvious: that breastfeeding, being a natural process, has an entirely natural failure rate.

Everything we know about human and animal reproduction teaches us that there’s an incredible amount of wastage and death associated with creating the next generation — from miscarriages, to pregnancy complications, to prematurity and infant anomalies. The historical reality of cemeteries filled with the bodies of babies and mothers who died in childbirth or shortly thereafter is testament to the fact that pregnancy, childbirth and breastfeeding are not perfect and that high rates of death are entirely compatible with robust population growth.

There is simply no question that babies are being injured and killed by overzealous breastfeeding promotion.

The evidence for iatrogenic injuries and death from breastfeeding promotion include:

• The revised United States Preventive Services Task Force (USPSTF) guidelines
• Interventions Intended to Support Breastfeeding: Updated Assessment of Benefits and Harms
• Unintended Consequences of Current Breastfeeding Initiatives

Together these papers showed that the premier effort to promote breastfeeding, the Baby Friendly Hospital Initiative doesn’t work, ignores the science on pacifiers, formula supplementation, and Sudden Infant Death Syndrome (SIDS) and leads to preventable infant injuries deaths when babies fall from or get smothered in their mothers’ hospital beds. These injuries and deaths did not happen until hospitals and providers began aggressively promoting exclusive breastfeeding.

We are also seeing babies injured or dying as a result of dehydration and starvation as a result of insufficient breastmilk (which occurs in up to 15% of first time mothers) and profound hypoglycemia (low blood sugar).

In the face of this scientifically documented reality, Dr. Newman offers a wall of denial.

What the baby needs [who has lost 10% body weight or more] is not automatic supplementation, but rather, first and foremost, the baby needs help getting a good latch. This requires good help from hospital staff and midwives, which may include reverse pressure softening of the nipples and areolas so that the baby does get a deep asymmetric latch and gets milk from the breast.

Unfortunately, in too many hospitals, the automatic first reaction is to give the baby a bottle of formula. And that definitely does not help improve the baby’s latch.

Why not give a baby a bottle of formula? Isn’t it more important to preserve the baby’s brain function than to preserve breastfeeding? The worst thing that will happen if you give a baby an unnecessary bottle of formula is — nothing! The worst thing that will happen if you fail to give a baby a needed bottle of formula is brain damage and death.

There’s something very ugly about promoting a process instead of an outcome. It is indisputable that a baby needs adequate nutrition. He or she cannot grow or thrive without it, and even a short term failure to receive adequate fluid and nutrition can result in permanent brain damage and death. A baby does NOT need breastfeeding; he or she can easily grow and thrive without it.

Lactivists like Dr. Newman have propagated the lie that insufficient breastmilk is merely an excuse for not breastfeeding, since every woman can make adequate milk if she just breastfeeds harder. This ugly edifice of denial is beginning to crumble under a large and growing body of scientific evidence demonstrating that aggressive promotion of breastfeeding leads to iatrogenic injuries and deaths.

Preventable infant injuries and deaths are a terrible indictment of the current system. The truth is that breast is not best for all babies. Lactivists’ insistence on promoting a process (breastfeeding) over outcomes (healthy babies) has led us to this point and we need a serious adjustment in the way we treat and counsel new mothers.

Instead of measuring breastfeeding rates (process), we should be measuring jaundice rates, dehydration rates, readmission rates, injury rates and death rates (all outcomes). We should recognize and acknowledge that hospital readmissions for jaundice and dehydration, as well as brain injuries and deaths are iatrogenic injuries. We are CAUSING them and therefore, it is up to us to PREVENT them, not to deny that they are happening.

The job of health care providers is to nurture babies, NOT to promote breastfeeding. The sooner that Dr. Newman and other lactivists recognize this, the sooner we can put an end to preventable iatrogenic injuries and deaths.

I might have wondered what Andrew Wakefield feels about sparking a measles epidemic among a vulnerable population in Minnesota, but I should have known that he would feel exactly like executives of Big Tobacco felts about lung cancer deaths.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]It’s hardly surprising that Wakefield apes the actions of Big Tobacco executives in denying responsibility. The fundamental strategy of anti-vax advocacy comes straight from the Big Tobacco playbook.[/pullquote]

The young mother started getting advice … Don’t let your children get the vaccine for measles, mumps and rubella — it causes autism, they said.

Suaado Salah listened. And this spring, her 3-year-old boy and 18-month-old girl contracted measles in Minnesota’s largest outbreak of the highly infectious and potentially deadly disease in nearly three decades. Her daughter, who had a rash, high fever and cough, was hospitalized for four nights and needed intravenous fluids and oxygen.

How could such a thing happen? Even though her sister died from the disease in Somalia, the mother believed that her children couldn’t get the measles in the US.

“I thought: ‘I’m in America. I thought I’m in a safe place and my kids will never get sick in that disease,’ ” said Salah, 26, who has lived in Minnesota for more than a decade.

Anti-vaccine activists repeatedly brought Andrew Wakefield to speak to the community. You may remember Wakefield, now stripped of his medical license, because he published a paper in which he lied about a connection between the measles, mumps, rubella vaccine and autism. Why did he lie? Because he was preparing to market a different vaccine that he was going to claim was safer. Despite the fact that he has been repeatedly and thoroughly discredited, anti-vaxxers still believe him. Not all that surprisingly when you consider anti-vaxxers have a perfect record in their 200 years of existence; they’ve never been right about anything!

So how does Wakefield feel about the harm he has caused:

“The Somalis had decided themselves that they were particularly concerned,” Wakefield said last week. “I was responding to that.”

He maintained that he bears no fault for what is happening within the community. “I don’t feel responsible at all,” he said.

Hmmm, why does that sound familiar? Oh, I remember; that’s the defense that Big Tobacco used for years to disclaim responsibility for lung cancer deaths from cigarettes.

The technique of blaming the victim is outlined in the paper Tobacco Industry Use of Personal Responsibility Rhetoric in Public Relations and Litigation: Disguising Freedom to Blame as Freedom of Choice:

The tobacco industry’s use of explicit personal responsibility rhetoric reached its height in the 1980s, during a wave of consumer litigation in which the tobacco defendants countered injured smokers’ lawsuits with claims that ultimately the responsibility for the consequences of smoking cigarettes belonged to the smoker who voluntarily consumed them.

As a Philip Morris executive wrote in 1985:

It all comes down to the individual’s right to make up his own mind and to take responsibility for his own actions.

It’s hardly surprising that Wakefield apes the actions of Big Tobacco executives in denying responsibility. The fundamental strategy of anti-vax advocacy comes straight from the Big Tobacco playbook.

We have access to tobacco company files that detail marketing strategy, including a memo from the late 1960s that provides an overview:

Doubt is our product since it is the best means of competing with the “body of fact” that exists in the mind of the general public. It is also the means of establishing a controversy. Within the business we recognize that a controversy exists. However, with the general public the consensus is that cigarettes are in some way harmful to the health. If we are successful in establishing a controversy at the public level, then there is an opportunity to put across the real facts about smoking and health. (my emphasis)

The memo is startling for its insight. Simply put, tobacco companies did not have to refute the scientific evidence about smoking and cancer; merely creating doubt in the mind of the American consumer was all that was necessary to maintain or increase demand for cigarettes.

It’s the same strategy employed to equally deadly effect by Wakefield and the anti-vax movement.

Doubt is their primary product. They don’t have to refute the scientific evidence about the safety and efficacy of vaccines (nor could they). Merely creating doubt in the mind of the American parent is all that is necessary to promote vaccine hesitancy and refusal. If it’s good enough for tobacco executives in promoting their product, it’s good enough for anti-vaxxers in promoting theirs.

Indeed, the overall strategy of anti-vaxxers maps that of Tobacco industry to a remarkable degree, including:

1. Denying the validity of the overwhelming majority of scientific evidence on the dangers of cigarettes/vaccine refusal.

2. Cherry picking and promoting the tiny fraction of studies that disagree

3. Insisting that science can never provide 100% certainty

4. Claiming the issue is a matter of individual freedom

Anti-vax advocacy has added its own little fillips: framing doubt, the most important product, as a sign of intellectual independence (“doing your own research”) and framing defiance of authority as a good in and of itself.

Andrew Wakefield is no different from tobacco executives — selling a deadly product, denying the scientific evidence, promoting dangerous choices as “freedom,” blaming the victims by invoking personal responsibility — and equally despicable.

What do climate deniers, anti-vaxxers and alt right supporters all have in common?

They are desperate to recuse themselves from reality, but reality bites.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Climate deniers and anti-vaxxers chortle with delight when they place their collective heads in the sand; their joy comes from recusing themselves from reality, but reality bites.[/pullquote]

Politicians in the state of Florida banned the use of the words “climate change” in official documents from its Department of Environmental Protection:

DEP officials have been ordered not to use the term “climate change” or “global warming” in any official communications, emails, or reports, according to former DEP employees, consultants, volunteers and records obtained by the Florida Center for Investigative Reporting…

“We were told not to use the terms ‘climate change,’ ‘global warming’ or ‘sustainability,’ ” said Christopher Byrd, an attorney with the DEP’s Office of General Counsel in Tallahassee from 2008 to 2013. “That message was communicated to me and my colleagues by our superiors in the Office of General Counsel.”

That is about as effective as King Canute’s command to stop the tides.

Canute set his throne by the sea shore and commanded the incoming tide to halt and not wet his feet and robes. Yet “continuing to rise as usual [the tide] dashed over his feet and legs without respect to his royal person. Then the king leapt backwards, saying: ‘Let all men know how empty and worthless is the power of kings, for there is none worthy of the name, but He whom heaven, earth, and sea obey by eternal laws.'”

Even back in the 11th Century, Canute realized that reality bites. No amount of commanding the tides was effective in stopping them just as no amount of banning the words climate change is going to stop large amounts of Florida from being claimed by rising sea levels.

So what’s going on here?

A disconnect between its political choices and climate reality is all too familiar in the Sunshine State. Florida’s newly re-elected U.S. senator, Marco Rubio, and its two-term governor, Rick Scott, are both climate-change dodgers. They shrug off the science that indicates 1 in 8 houses in their state will be lost to rising seas by the end of the century…

Meanwhile, an octopus swam into a Miami Beach parking garage in November during one of the city’s periodic “sunny day floods.” Massive sewer spills are poisoning Tampa Bay as local storms worsen. And beaches and shoreline are rapidly disappearing along the southeast Atlantic coast, where sea level rise is accelerating from 8 inches over the last century to a conservatively projected 3 feet by the end of this one…

Many Floridians imagine they can recuse themselves from the reality of climate change, but reality bites.

Anti-vaxxers in Italy have promoted fears about vaccination claiming (with no scientific evidence) that the risks outweigh the benefits because vaccines don’t work and the diseases they prevent aren’t so bad anyway.

But:

In an update on the measles outbreak in Italy, since the beginning of the year through the end of April, 1,920 cases have been reported, according to Italian health officials.

One-third of the cases had at least one complication with diarrhea, stomatitis, conjunctivitis and pneumonia being the most common.

Nine out of 10 cases were fully unvaccinated and 176 cases were reported among health care workers and some nosocomial outbreaks have been reported…

Anti-vaxxers imagined they could recuse themselves from the reality of vaccine preventable disease, but reality bites.

Donald Trump is the apotheosis of recusing yourself from reality. He constantly vomits forth a barrage of lies, nearly all of which involve simple, but wrong explanations for complex problems and advocate simple, but wrong solutions that will never work. Trump is hardly alone. Brexit supporters in the UK, as well as Le Pen supporters in France also subscribe to the belief that they can change reality by pretending it doesn’t exist.

There has been a lot of discussion about the reason for the resurgence of alt right populism. Many have pointed out that a lack of education is a key factor. In my view, that’s probably just a proxy for the real difference. Most voters accept reality even when it is unpleasant; alt right voters insist on recusing themselves from reality, but reality bites.

It’s almost as if climate deniers, anti-vaxxers and alt right supporters are engaging in a massive game of “hide and seek.” Babies chortle with delight when they play because they believe that when they cannot see you, you cease to exist. The joy comes from the “power” of making things disappear. Climate deniers, anti-vaxxers and alt right supporters chortle with delight when they place their collective heads in the sand; their joy comes from recusing themselves from reality, but reality bites.

Why do some people imagine that they can recuse themselves from reality? Because social media enables them to do so. Facebook and Twitter (as well as old fashioned cable news) has allowed them create a carefully curated faux “reality” and then lash out at those who dare to point out that it isn’t reality at all. The rise of climate denial, anti-vax, and alt right populism reflect the effort to force that faux “reality” down others’ throats often through the power of the ballot box.

But as King Canute demonstrated 1000 years ago, such efforts are doomed to failure. The only remaining issue is how long it will take (and how many people will be harmed in the process) for those angrily recusing themselves from reality to acknowledge that reality bites.

Tina Eschel wrote a fabulous piece that was excerpted on Mayim Bialik’s website Kveller.

Eschel explains how a traumatic experience with a lactation consultant made her give up on breastfeeding:

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Bialik should apologize. Eschel shared an intimate, distressing incident to make others aware of how lactation consultants behave and in return got shut down by a celebrity who apparently doesn’t give a damn[/pullquote]

I still remember that awful moment when the consultant first came to visit me. I was semi-conscious after a semi-emergency C-section, anxious at the sound of my hungry newborn crying, and exhausted by a long delivery and lack of sleep. What happened next scarred me for years.

Without permission, the consultant whipped open my hospital gown to expose my breast and began to squeeze and pull and poke at me, ignoring my feeble plea for privacy. She insisted I could breastfeed, even and despite the physiological challenges, and seemed to care less about the extraneous medical factors that were making it difficult…

I was exhausted, weak, and confused, and felt violated by how she kept touching my breasts and squeezing my nipples all without having asked if it was OK by me…

Inexplicably, Bialik uses her Facebook page to publicly invalidate Eschel’s experience.

I love when people have one bad experience with a person and use it to generalize about all of the lactation. community . This is what I call posting something for shock value. If anyone touches your breasts and it’s not ok with you, that’s a violation. Let’s not write posts about how all of the lactation community is shaming you for not breastfeeding. Enough already.

Bialik makes no effort to determine whether this has happened to other women, whether such behavior is sanctioned by lactation consultant credentialing organizations, or whether the lactation consultant involved was reprimanded for her inappropriate behavior. Bialik offers no suggestions on how to deal with the violation, how to deal with a hospital that hires someone who treats patients so shabbily, or how other women can be sure it never happens to them.

Let’s try a thought experiment:

Imagine if the person who squeezed, poked and pulled Eschel’s breasts was a man claiming that she needed an immediate breast exam. Can you imagine Bialik claiming I love it when a woman groped by a doctor uses that bad experience to generalize about male physicians? Or This is what I call posting something for shock value? Or Let’s not write posts about how some doctors sexually violate patients. Enough already?

I hope not. The last thing someone needs after having her body and her trust violated by a medical professional is someone who tries to invalidate that experience.

Bialik appears to believe that promoting breastfeeding is more important than Eschel’s trauma.

Many women writing in the comments share their stories of being violated by lactation consultants yet that doesn’t seem to move Bialik.

Indeed, she doubles down:

… That is NOT the entire lactation community. i meet rude people all of the time. to smear the entire breastfeeding community – who are simply TRYING TO HELP YOU FEED YOUR BABY THE WAY MAMMALS FEED BABIES – is ridiculous. bad experiences suck. i’ve had them too. but let’s not make it about breastfeeding advocates being horrible people.

Since she hasn’t bothered to investigate, Bialik has no idea how much of the lactation community engages in this type of behavior, but that doesn’t stop her from making assertions she can’t prove.

And what does how mammals feed their babies have to do with anything? It is not prescriptive for breastfeeding; some mammals eat their young but no one suggests that humans copy them.

Moreover, it is entirely irrelevant that the lactation consultant is trying to promote breastfeeding. It’s one thing if a health professional is trying to saving your life; that’s an emergency. It’s another thing entirely when she’s trying to promote her personal view of how women should feed their babies; that’s a violation.

This is NOT rude behavior. Making a nasty comment to a new mother is rude; grabbing her breasts without her permission is unethical.

Most importantly, this is not an isolated experience. Lactation consultants and their organizations have instituted programs that are literally KILLING babies from dehydration, starvation, smothering in hospital beds, or sustaining concussions falling from hospital beds. A significant proportion of their advice is contradicted by the scientific evidence. Pacifiers don’t interfere with breastfeeding; they prevent SIDS. Judicious formula supplementation doesn’t hamper breastfeeding; it actually increases the likelihood of long term exclusive breastfeeding.

The ultimate irony is that the benefits of breastfeeding in industrialized countries are trivial, 8% fewer colds and 8% fewer episodes of diarrheal illness across the entire population of infant in their first year. That means the the MAJORITY of infants will get no measurable benefit from breastfeeding. No doubt that’s not what Bialik believes, but I challenge her to show me any real world data from the US (not theoretical models) that the vast changes in breastfeeding rates in the past 100 years have had ANY impact on infant health.

Bialik should apologize to Eschel. She shared an intimate, distressing incident to make others aware of how lactation consultants behave and in return got shut down by a celebrity who apparently doesn’t give a damn about the way that lactation consultants have been making women and babies suffer.

Efforts to promote breastfeeding have gotten entirely out of hand, to the point where women are being traumatized and babies are being harmed.

Enough already!

Silly me. I thought I couldn’t feel more contempt for quack psychiatrist Kelly Brogan than I already did. Then she posted this:

Saying no to pharmaceuticals is an act of feminism. Every time you open that pill bottle, you are saying ‘nope, you don’t got this’ to your body, and you are instilling a message of oppression by a system that says feeling anything is dangerous.

First, it makes no sense — but then that’s true of a lot of what Brogan writes. She strings together the words and beliefs of New Age nonsense in apparently random order without any concern for what they mean.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Only someone who has never experienced severe, unremitting depression could make such an ugly, ableist claim.[/pullquote]

What system says that feeling anything is dangerous? Not any system I know.

Where is feeling disoriented from hyperglycemia, breathless from asthma or suicidal from depression a form of freedom? I’m not aware of any place like that.

And where does feminism involved in denying women the means to control their own bodies? Maybe on Planet Brogan, but nowhere else.

Second, far from being an expression of feminism, Brogan’s statement reeks of misogyny. The idea that women deserve to suffer has existed in nearly every time, place and culture. Indeed, it is embodied in contemporary natural parenting which views women’s pain and suffering, physical or emotional, as unworthy of concern.

Third, and perhaps most important, Brogan’s message is profoundly ableist.

What is ableism? According to StopAbleism.org:

Ableism – are the practices and dominant attitudes in society that devalue and limit the potential of persons with disabilities.

Ableism is a form of privilege. People without disabilities don’t understand the pain of, the contempt for and struggle by people with disabilities simply to live the life that the non-disabled take for granted.

Ableism is as old as time, as is the belief that a disability is merited punishment.

Traditionally, in many cultures around the world, people with physical, sensory or mental impairments were thought of as under the spell of witchcraft, possessed by demons, or as penitent sinners, being punished by God for wrong-doing by themselves or their parents.

Only an ableist, someone who doesn’t need pharmaceuticals or medical technology to live (or doesn’t recognize that are already dependent on such technology), could make the ugly statement that Brogan did.

Does Brogan wear glasses or contact lenses? If so does she think it is an act of feminism to throw them away and be unable to see? Does she think vision correction is a message of oppression that by a system that says experiencing anything other than perfect vision is dangerous?

I doubt it.

Does Brogan think that an insulin-dependent diabetic refusing insulin is an act of feminism? Does she think that an asthmatic’s inhaler is an instrument of oppression by a system that denies that feeling air-hunger is a form of liberation?

I doubt it.

But Brogan apparently thinks that feeling depressed, even to the point of feeling suicidal, is liberating.

She apparently believes that depression can and should be treated by magical thinking — “telling” your body that “you got this.”

And she apparently is unaware that treating depression does NOT leave women unable to feel anything; it’s just leaves them able to feel happy.

Only someone who has not experienced severe, unremitting depression, affecting themselves or a loved one, could possibly make such an ugly, ableist claim as Brogan has done.

Why does Brogan oppose the use of medication?

Is it because medication treats the actual causes of diseases, including psychiatric diseases, robbing Brogan of the opportunity to sell women books and seminars that only treat the symptoms?

That would be even more reprehensible than even her ugly ableism.

I reserve my utmost contempt for physicians who line their pockets by peddling pseudoscience, physicians like quack psychiatrist Kelly Brogan, MD.

Brogan’s website is a monument to quackery marketing. It includes:

[perfectpullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Brogan makes money from women who are indoctrinated into sexism, gullible and above all afraid of what they don’t understand.[/perfectpullquote]

• The standard quackery Miranda warning:
  

  You should not use the information on this site for diagnosis or treatment of any health problem or for prescription of any medication or other treatment.

• The typical encomiums from other entrepreneurs like “quacktresses” Suzanne Somers and Ricki Lake.
• And the opportunity to spend your money on worthless books and seminars.

Brogan, like other quack entrepreneurs relies on monetizing fear (of toxins, of medications, of physicians), monetizing gullibility, monetizing ego (“Sure I never finished college, but I’ve done my research!) and — as is the case for most lactivists and natural childbirth advocates — monetizing misogyny.

Her recent piece Homebirth: The Opportunity of a Lifetime is a paean to deeply anti-feminist and retrograde beliefs: women’s pain should be celebrated, women’s needs are irrelevant and women’s reproductive organs matter far more than their intellect, talent or character.

You can recognize childbirth misogynists by what they say. The biological essentialists among them are fond of catch phrases like “trust birth” and “pregnancy is not a disease.” They insist that obstetrics has “pathologized” childbirth. Those who are anti-rationalists as well are distinguished, not surprisingly, by their anti-rationalism. They dismiss science as a male form of “authoritative knowledge” on the understanding that there are “other ways of knowing” like “intuition.”

Brogan’s piece on homebirth hits all the misogynist high points:

You must choose whether you believe that the body has an innate wisdom, a vitalism that guides its natively harmonious performance…

And:

…In America, we treat birth like a medical illness.

And:

Childbirth is a woman’s initiation to her own wildness. Several hundred years of patriarchal dominance is vitally threatened by the prospect of a woman awakened to the power of her own vital embodiment.

And:

We are guided and protected by an inner knowing that suppresses any false leads our minds might present. We dig deep into our core selves, we flow with that primal universal power and our minds finally submit to a greater truth. And this changes us. Awakens us. And from that point on, we can no longer be controlled.

Who is stupid enough and gullible enough to believe this crap?

Like most quacks, Brogan suffers from logorrhea; she adores the sound of her own voice. She’s written over 2,000 words of nonsense glorifying homebirth, but she couldn’t be bothered to mention some critical points.

1. Pain. Childbirth is likely the most physically painful experience than any individual can have. Indeed, the pain is so agonizing that some women suffer PTSD as a result.

2. Pain relief. Like most misogynists, Brogan thinks women’s pain is not merely irrelevant, it should be celebrated. We have a word for that philosophy: sadism.

3. The inherent deadliness of childbirth. Childbirth is a killer of babies and mothers. Death is a natural part of reproduction. Just as pregnancy has a natural miscarriage of 20%, childbirth has an inherent neonatal death rate of approximately 7% and an inherent maternal death rate of approximately 1%. That’s why colonial cemetaries are filled with the gravestones of babies and mothers. But Brogan’s mindless celebration of female biology simply ignores that basic fact.

4.The inherent failure rate of human biology. Approximately 30% of Americans are nearsighted. So much for the innate wisdom of the body.

5. The other dangers of childbirth. Incontinence of urine, incontinence of feces, major tears of the vagina and surrounding structures, resulting painful intercourse are COMMON sequelae of childbirth. Nature doesn’t care whether childbirth leaves women disabled in the most intimate ways.

6. The death rate of homebirth. Even if you believe that the source of a woman’s worth is whether a baby transits her vagina, even if you believe that her agony is irrelevant, women still deserve to know that homebirth kills babies. The death rate at American homebirth is so high that even homebirth midwives acknowledge it.

The chart below, which uses data from the MANA statistic project, illustrates the increased risk of death at US homebirth, ranging from uncomplicated births that have a 3X high rate of ending in the baby’s death to breech that has a 56X higher risk of the baby dying than an elective C-section.

Instead of truth, Brogan offers sexist gobbledygook:

We need to come into our bodies and we need to radically heal our splintered and fragmented abusive relationships to them. We need to be shown, to feel, the incredible artistry of their design, their impossible power, their deep wisdom.

Tell that to the 2 million women around the world currently living with obstetric fistula.

Women are not their reproductive organs and it is deeply sexist and retrograde to imagine that women’s source of highest fulfillment is a baby transiting through their vagina. Women have fought for tens of thousands of years to have their intelligence taken seriously, to be recognized for their talents, to be allowed to take their rightful place in society as professionals, as artists, as moral authorities.

But quacks like Brogan can’t make money from women who are smart, capable and unafraid. They can only make money from women who are indoctrinated into sexism, gullible and above all afraid of what they don’t understand. And Brogan intends to keep them that way.

Another day, another group of funerals brought to parents and families courtesy of UK midwives.

According to the Telegraph:

Mothers said their children had died because midwives “couldn’t be bothered” to fulfil basic monitoring tasks, or to act on warnings that babies were in danger.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Twitter allows UK midwives to recuse themselves from the reality of the injuries and deaths they cause and rewards them with a never ending round of dopamine-releasing self-congratulation.[/pullquote]

Including:

Ella and Lola Greene – 2014. The twins were stillborn after the trust failed to properly read and interpret their heart rates

Oliver Smale – 2015. He died after his shoulders became stuck during a natural birth after his mother was refused a y Caesarean section

Kye Hall – 2015. His death was “caused or contributed” to by the trust, said the coroner, who failed to classify his mother as a high risk pregnancy or to listen to his heart beat

Graham Scott Holmes-Smith – 2015. The trust failed to properly monitor the foetal heart rate during labour

Ivy Morris – 2016. Ivy was born 10 days after Graham but died four months later in May 2016. The coroner ruled her death could have been prevented if appropriate monitoring of the heart rate had taken place during labour

Pippa Griffiths – 2016. An inquest concluded one-day old Pippa’s death could have been prevented if an infection had been spotted earlier

Families have raised questions about two further deaths over the period. They say there was no investigation into the death of Jack Stephen Burn in 2015, who died within days of Oliver Smale, or of Sophiya Hotchkiss in 2014.

It sounds like Furness General where 2 mothers and 6 babies died preventable deaths(Race probe over six deaths on a maternity ward amid claims midwives conspired to cover-up evidence).

It sounds like Queen’s Hospital where 5 babies died preventable deaths (‘If you don’t hurry up, I’ll cut you’: What one mother was told by midwife at NHS Trust where five died during labour).

It sounds like Milton Keynes where 11 babies died preventable deaths (Updated: ‘Not good enough’ hospital chief apologises over baby death toll scandal at MK maternity unit).

It sounds like Royal Oldham/ North Manchester General Hospitals where an appalling 7 babies and 3 mothers died in just 8 months!

You might think that this hideous death toll would inspire soul searching among UK midwives. You would be wrong.

Apparently nothing interferes with the endless round of self-congratulation that makes up UK midwifery Twitter feeds.

I have written repeatedly about the ways in which social media leaves laypeople simultaneously ignorant and arrogant in their ignorance, but that effect is not limited to laypeople.

I’ve quoted Carolyn Stewart who wrote in The American Interest:

We recuse ourselves from reality via the device in our hand, which rewards us for ignoring reality with a series of dopamine-releasing mini-tasks. From Candy Crush and Twitter to work emails, these activities hook us on a seeking-reward feedback loop that is infinitely more gratifying than staring at the commuter sitting across from you. These cyber preoccupations allow us to customize our surroundings, and accustom us to regulating and controlling the information that comes our way. This has several effects: an expanded sense of what falls under our personal social domain, an increased expectation of control over that domain, and a greater sensitivity to input that deviates from our preferences.

Social media, particularly Twitter, allows UK midwives to recuse themselves from reality and reward themselves with a never ending round of dopamine-releasing self-congratulation. That rewarding feedback loop is infinitely more gratifying than facing the injuries and deaths that occur because of UK midwives overweening self-regard. Twitter allows them to customize their surroundings by blocking anyone who might intrude (laypeople and professionals) with distressing stories of babies and mothers who were injured or died because of midwives’ unethical promotion of “normal birth.”

Don’t believe me? Check out the Twitter feeds of UK midwives like Sheena Byrom and RCM head Cathy Warwick on any day. You will rarely find any mention of the preventable deaths that flood the mainstream media (except to excuse them). Instead you will be treated to a fantasy world where midwives proverbially kiss and congratulate each other over and over and over again.

UK midwives prefer to think of themselves as beneficent guardians of normal birth and they are extremely sensitive to any input that deviates from their preferences. Twitter allows them to insulate themselves from such input. On Twitter they can they can dwell in their fantasy world and never give a thought to the seemingly endless parade of tiny coffins — babies who died preventable deaths to preserve midwives’ good opinion of themselves and their reckless commitment to “normal birth.”

Excuse me while I catch my breath from laughing so hard. Kate Tietje, Modern Alternative Mama, has ventured into the world of moral reasoning and the results are just as hilarious as her attempts at medical advice.

Combining the ethics, narcissism and contempt for expertise of a Donald Trump with the medical knowledge of a rock, Asking People to Vaccinate for Others is Unethical is a monument to selfishness and stupidity.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Tietje combines the ethics, narcissism and contempt for expertise of a Donald Trump with the medical knowledge of a rock.[/pullquote]

Our most basic rights are to our own bodies. We decide what we eat … where we go … what we do. No one else has the right to interfere with our bodies — unless, of course, we have interfered with their bodies, and they are defending themselves. And in that case, it must be an immediate and obvious threat, not a future potential threat…

According to Tietje, that right frees people to reject vaccination regardless of who else is hurt by the decision.

The idea that we need to vaccinate for others’ sake is predicated on the idea that not vaccinating may, someday, inadvertently hurt another person. Therefore, we must take steps to stop that from happening.

There’s a lot of nonsense to unpack here.

Let’s start with the easy stuff.

First, the primary reason vaccines are mandated is to protect vaccinated children. It is unethical not to vaccinate your own children because it places them at risk for preventable disease and death.

Second, vaccination benefits the entire population because of herd immunity. When a large proportion of the population is vaccinated even the unvaccinated (those who are too young or too immunocompromised to receive the vaccine) are protected. How? If a large majority are vaccinated, a disease cannot spread within a population and the unvaccinated are much less likely to be exposed.

Tietje doesn’t “believe in” herd immunity. That’s irrelevant. In fact, the surest sign of scientific ignorance is contempt for expertise and Tietje is nothing if not contemptuous for experts in immunology, vaccine science, medicine and public health from every country around the world, all of who accept the principles of herd immunity.

What about the ethics of refusing to vaccinate to maintain herd immunity? Tietje piece seems to be referring to normative ethics. According to Philosophy Basics:

Normative Ethics … is the branch of ethics concerned with establishing how things should or ought to be, how to value them, which things are good or bad, and which actions are right or wrong. It attempts to develop a set of rules governing human conduct, or a set of norms for action.

Tietje’ formulation of ethics seems to be that we can do anything we want so long as it doesn’t immediately and directly harm another. That’s not ethics; that’s just a variation of selfishness.

There is no right to do “decide what we eat … where we go … what we do.”

You can’t walk into a restaurant and eat the food UNLESS you pay for it.

You can’t walk into a building UNLESS you own it, are invited into it, or present evidence that you are entitled to be there for business or some other reason.

Tietje is correct that there is a right to bodily autonomy. But she fails to acknowledge that even the right to bodily autonomy is not unlimited. For example, there is no right to dodge the draft because you’re afraid of being harmed by war. So how do we decide what is ethical if you’re not entitled to do anything you want?

We can determine if something is ethical by considering what would happen if everyone did the same thing. If everyone refused to be drafted during war, we would be conquered by our enemies. It doesn’t matter that the result would be inadvertent or would not be immediate. That’s why there’s no right to refuse to be drafted.

But the army wouldn’t miss Tietje’s children, right? Having her children dodge the draft wouldn’t compromise the security of our nation, right? That’s the ethical conundrum known as the “free rider” problem. Free-riders are those who partake of the benefits of society without carrying any of its burdens.

The classic case of the free rider is a conservation water ban. People in a town are told not to water their lawns more than twice a week in order to conserve water. Most people, understanding the importance of water conservation, comply. However, there are always a few people who insists on secretly violating the ban. They believe that they will be protected from a water shortage because everyone else is conserving, and they don’t want to take the risk that their lawn will turn brown.

Free riders are unethical. How do we know? If everyone ignored the water ban the town would run out of water for people to drink and everyone would be harmed. So no matter how much you might WANT to water your lawn during a water ban, it is unethical to do so. It doesn’t matter that you are harming others inadvertently, that the harm is not immediate, or that no one can draw a direct line between your violation of ban and the lack of water.

So it doesn’t matter that people who don’t vaccinate their own children harm other children inadvertently, that the harm is not immediate, or that no one can draw a direct line between Tietje’s decision to withhold vaccines from her children to the injuries and deaths of other children from vaccine preventable diseases.

To summarize:

There is no “right” to do whatever you want. The right to bodily autonomy is not unlimited. Being a free rider is unscrupulous and dishonorable.

In other words, vaccine refusal is unethical.

It’s not up to me to accept or reject Ina May Gaskin’s apology for her racist comments:

…[M]y answer to a Texas Conference Q & A question has caused a great deal of hurt, and was insulting and demeaning to many, especially Women, and People, of Color. While the intent behind my answer was anything but racist or demeaning, I understand that impact is more important than intent, and I personally offer my genuine and deepest apologies. I have spent a great many years of my career shining the spotlight on the massive racial disparities in maternity care, and my comment at the conference is not a true reflection of my belief, and what I know to be true – that racism, and its denial, are the true root of the egregious inequalities in maternal and infant healthcare for people of color…

It seems to me, though, that it’s a non-apology apology. Why? Because Gaskin failed to apologize for, indeed did not even mention, her entire career of medical colonialism.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Gaskin stole the midwifery knowledge of indigenous women and presented it as her own.[/pullquote]

Colonialism is the practice one country occupying another country or region and exploiting it for the benefit of the occupier. Medical colonialism is the practice of gaining control over black bodies, knowledge and practices and exploiting it for the benefit of the white majority.

Classic examples of medical colonialism come, not surprisingly, from medicine. The Tuskegee experiments, when black men with syphilis were deliberately left untreated, are the most egregious example, but medicine has plenty more including the story of Henrietta Lacks and the use of her HeLa cells for research, and the work of gynecologist J. Marion Simms, who practiced on female slaves to perfect his techniques for repairing obstetric fistulas.

But midwives have enthusiastically embraced medical colonialism, too. As I wrote yesterday, Ina May Gaskin has built her career on it, including:

1. Her embrace of the racist foundational lie that indigenous women have painless labors

2. Her shockingly cynical exploitation of high rates of maternal mortality in general (her Motherhood Quilt), and black maternal mortality in particular, to critique modern obstetrics without doing anything to address it.

3. The profoundly disturbing trend of white homebirth midwives learning their trade (getting “catches”) on the bodies of women of color in developing nations.

4. Gaskin’s appropriation from Guatemalan midwives of a shoulder dystocia maneuver that, in the tradition of Columbus “discovering” America, she named for herself.

Considering that natural childbirth is a philosophy of white privilege, it comes as no surprise that many white women are acting as apologists for Gaskin. Their defense is that she isn’t racist and either didn’t mean what she said or is being deliberately misinterpreted.

As Arthur Chu has written, that’s the classic defense of “Mighty Whitey.” Chu was not writing about natural childbirth advocates, but he could have been:

We repeatedly tell stories about a white protagonist who goes on a journey of self-discovery by mingling with exotic brown foreigners and becoming better at said foreigners’ culture than they themselves are…

The frustrating thing about being annoyed by the Mighty Whitey trope … is that it’s so frequently employed by the well-meaning “good guys.” The whole point of “going native” is that the familiar Western civilization is portrayed as inauthentic, ugly, broken, flawed…

But when it comes to the tragedies of black maternal (and perinatal) mortality, it’s hard to see how Gaskin is one of the “good guys.” It’s not merely that she failed to understand the implied racism of her own comments; it’s that she has made a career of medical colonialism, exploiting the knowledge, practices and fantasies about black women for the benefit of privileged white women.

The tragedy of black maternal mortality puts Gaskin in a bind for a variety of reasons. First, it threatens the fantasy that “unhindered” birth in indigenous women is inherently safe; obviously it’s deadly. Second, it involves racism, which Gaskin’s philosophy has never bothered to address. Finally, it is not a tale of too much intervention in childbirth, but too little. Black women die from lack of access to the very lifesaving technology that Gaskin routinely decries. That’s not something that she wishes to acknowledge.

As I said above, it’s not up to me to accept or reject her apology, but as a bystander I seriously doubt her sincerity. No doubt she is not intentionally racist, but her career is built on medical colonialism. If Gaskin wants to show that she understands that, she could offer a meaningful gesture — going forward she could insist that the Gaskin maneuver be renamed the Guatemalan maneuver in acknowledgement that she stole the knowledge of indigenous women and presented it as her own. But that’s a sacrifice she is very unlikely to make.