I’ve already put up a post for today, but I just came across this and knew that you would not want to wait to see it.
And no, it’s not a parody.
I’m sure that we’ll all be on that call on Monday. I can’t imagine anything more exciting that being part of a “tribe of birth visionistas.” Can you?
A reader sent me a link to this piece 5 Ways Pitocin is Different than Oxytocin by Robin Elise Weiss. As she pointed out, it is “a bunch of crap.”
I want to lay down the gauntlet to Weiss: Prove it or remove it!
Weiss’ piece an excellent example of the alternate world of internal legitimacy created by natural childbirth and homebirth advocates to support their pseudoscience claim, a world that:
that mimics all the features of the mainstream research world — the journals, the conferences, the publications, the letters after the names — and some leaders have gained access to policy-making positions.
Simply put, the world of NCB and homebirth advocacy is an echo chamber. That allows to advocates to legitimize each other by citing other advocates in a never ending circle of misinformation.
Robin Elise Weiss, BA, ICCE-CPE, ICPFE, CLC, CD(DONA), BDT(DONA), LCCE, FACCE is one of the leaders within the echo chamber of NCB. You can tell right away that she is a quack because of all the letters after her name. That’s how quacks try to confer legitimacy on themselves. These made up designations meant to impress the faithful and to fool outsiders. What does it mean? Weiss is a “childbirth and postpartum educator, certified doula, doula trainer, and lactation counselor.”
How does that qualify her to write about pitocin? It doesn’t. But in the world of NCB and homebirth advocacy, having no idea what you are talking about is the perfect qualification.
Weiss makes 5 claims, only one of which is true (but not particularly relevant), and the rest are false or, at best, the data are conflicting. She provides no proof for her claims, but does offer the classic bibliography salad of papers that sound relevant but don’t address the claims at all.
As we examine Weiss’ claims, keep in mind that pitocin, a tiny molecule made up of only 9 amino acides, is chemically IDENTICAL to and INDISTINGUISHABLE from oxytocin.
1. Pitocin is released differently.
Oxytocin is released into your body in a pulsing action. It comes intermittently to allow your body a break. Pitocin is given in an IV in a continuous manner. This can cause contractions to be longer and stronger than your baby or placenta can handle, depriving your baby of oxygen.
Yes, oxytocin is released in a pulsatile fashion. That’s basically the only true statement in her 5 claims and their elaboration.
What Weiss neglects to mention (or does not even know) is that most hormones are secreted in a pulsatile fashion.
Secretion of anterior and posterior pituitary hormones, adrenal glucocorticoids, mineralocorticoids and catecholamines, gonadal sex steroids, parathormone, insulin and glucagon is pulsatile (burst-like or episodic).
The pulsatile nature of oxytocin secretion sounds important, but appropriate treatment of a hormonal deficiency does NOT require pulsatile administration. For example, type I diabetics are treated with daily insulin injections to reduce their blood sugar levels. Without insulin, they die. With insulin they live long and healthy lives. I don’t notice anyone suggesting that it is better to withhold insulin than to give it in a less than perfect simulation of pancreatic function.
Similarly, some babies will die if they are not born in the very near future. They can always be delivered by C-section, but pitocin by IV infusion offers an excellent opportunity for vaginal delivery. Is Weiss suggesting that it is better to withhold pitocin and let those babies die or subject their mothers to unnecessary surgery rather than give it in a less than perfect simulation of pituitary function? If not, then what is she suggesting?
2. Pitocin prevents your body from offering endorphins.
When you are in labor naturally, your body responds to the contractions and oxytocin with the release of endorphins, a morphine like substance that helps prevent and counteract pain. When you receive Pitocin, your body does not know to release the endorphins, despite the fact that you are in pain.
False. Weiss just made that up or gullibly copied it from someone else who made that up. She offers no mechanism or explanation of how pitocin cause your body to “not know to release the endorphins” (whatever that means). And of course she offers no scientific citations for the claim because there aren’t any.
3. Pitocin isn’t as effective at dilating the cervix.
When the baby releases oxytocin it works really well on the uterine muscle, causing the cervix to dilate. Pitocin works much more slowly and with less effect, meaning it takes more Pitocin to work.
Really? Where’s the scientific evidence for that? Weiss offers none.
4.Pitocin lacks a peak at birth.
In natural labor, the body provides a spike in oxytocin at the birth, stimulating the fetal ejection reflex, allowing for a faster and easier birth. Pitocin is regulated by a pump and not able to offer this boost at the end.
Really? The evidence is mixed. Of course, Weiss provides no scientific evidence at all. But even if it were true, it’s easy enough to remedy; just provide a bolus (extra dose) of pitocin during delivery itself.
5. Pitocin can interfere with bonding.
When the body releases oxytocin, also known as the love hormone, it promotes bonding with the baby after birth. Pitocin interferes with the internal release of oxytocin, which can disturb the bonding process.
Weiss once again fails to cite any scientific evidence. That’s not surprising however since, to my knowledge, there is not a single human study on this issue.
As my reader pointed out, Weiss has offered “a bunch of crap” on the subject of pitocin. She has no idea how it works; even the little we know about it is far more complex than Weiss implies, involving changing numbers of oxytocin receptors that mediate the effect of the hormone itself and the multiple other hormones that interact with it during pregnancy, labor and postpartum. But that doesn’t stop her from trying to convince women that it is “bad.”
So Robin Elise Weiss, BA, ICCE-CPE, ICPFE, CLC, CD(DONA), BDT(DONA), LCCE, FACCE:
Please prove it or remove it.
For every incidence of preventable death at homebirth that are write about, the are many more near misses, but even I was surprised to find two separate examples on the same day. The first is almost a parody of homebirth midwifery ignorance and irresponsibility, but no one was in any real danger. The second was gross incompetence that easily could have resulted in the death of the baby if the mother had not insisted on going to the hospital. Interestingly, she had no idea how thoroughly her midwife had failed her.
The first case is I let go of my self-righteousness and had a Cesarean delivery — and I’m thankful for it. I have to give the folks at Offbeat Mama credit for publishing it at all even (or perhaps especially) with this caveat:
We hope it goes without saying that we LOVE midwives and home birth on Offbeat Mama. That said, some home births don’t go as planned and no health care practitioner is infallible, and we want Offbeat Mama to be a place for those truths, too…
Rachel, the mother, writes:
When I got pregnant last January I was stoked about the joyful, carefree unassisted birth I had always dreamed of. My husband and mom, though, were concerned about the safety of freebirths and so I compromised with them and hired a Certified Nurse-Midwife who only did home births… When I caught her voicemail, I noticed she signed off with “Namaste.” I thought: “Wow, this is going to be so great! She’s just like me! I don’t have to worry that she’ll force me to have medicines or procedures done that I don’t want.”
Then the near parody continues:
I don’t want to go into the gory details of my labor, but I will say that it lasted 92 grueling hours. My mom and dad holed up in the spare bedroom, crying; my husband held me and the baby’s godmother poured me wine and stroked my hair to try to help me sleep when I had been awake for the first 48 hours…
And what was the midwife doing all this time? Knitting! I kid you not. Well, that’s what she was doing when she was actually there.
My midwife kept coming and going; she would drive over and check my cervix, which dilated excruciatingly slowly. She would leave afterwards, telling me in none-too-caring tones that everything was “normal” and that every other woman in the room had gone through this, so there was no reason I shouldn’t be able to handle it…
At one point she felt my cervix and told me I had reached eight centimeters, and that she’d check me again in two hours. When the two hours were up, I asked if she would do it again. She said there was no need (she was knitting a scarf serenely on my floor). “Do you feel like you need to push? Then push.” I did, but nothing happened.
So much for homebirth midwives who stay with you throughout labor.
Finally, Rachel decided to ignore the midwife and head to the hospital. Imagine her surprise when, contrary to what she had been told, the doctors and nurses were caring and supportive:
Once at the hospital the nurses, anesthetists and doctors were more than kind. The head nurse held me close to her while I got the epidural I dreaded, and I was able to sleep for the first time in days. The obstetrician told me I would probably be able to have the baby vaginally, but that my midwife had lied to me — I’d never passed seven centimeters. The baby was “sunny side up,” presenting the wrong part of her head downward. After a few hours it became imperative that I have a Cesarean section: I had a fever and Baby’s heart was starting to race.
I was terrified. The anesthetist cradled my head as she held the gas over my face, and crooned to me in Afrikaans. Long story short: Rowan was born, and she was perfect.
There was an interesting little coda to the episode:
A few weeks after she was born, a representative from the Commonwealth of Virginia showed up at my door. Turns out, my midwife had let her license expire a while ago, and that was why she disappeared when I wanted to go to the hospital. I never had to appear in court, but I was interviewed for the record.
The second midwifery screw-up was published on a different online magazine, also for women who pride themselves on being different. The article is entitled Home Birth to the ER: A Life Changing Personal Story. Chiara’s son easily could have died from a classic childbirth complication, and although Chiara understands that this was a near miss, she apparently did not understand that her midwife screwed-up in the worst possible way.
Chiara was never an appropriate candidate for homebirth because of a pre-existing medical condition (beta-thalassemia), but:
… After watching The Business of Being Born, Jason and I decided we were having a home birth. We were 4 months in, and we found Gracefull Birthing in LA. We quickly fell in love with the two midwives…
Chiara’s pregnancy was complicated by a hospitalization for premature labor, but she made it to term.
The night before the 37th week began, I went into labor. I was calm. I was prepared. I had watched videos of African women having babies to learn what labor was like, unaffected by society’s perception of the experience. They hardly made a peep. We called the midwife with 7 minute contractions at 10pm. By 12am, we called back with 3-4 minute contractions. By 1am, they were 1 minute apart. My midwife and her assistant arrived. This is when everything fell apart.
Her labor was abnormal:
I was handling the pain, but [the contractions] were coming quicker than normal. My midwife measured me, 1.5cm dilated. She told me to get into the shower to relieve the pain, so I quickly undressed and hurried to relief. I was only able to stay up for about 4 minutes before I felt sick, so I called Jason in and that’s when I started to bleed. The midwife ran over, listened to Luca, and measured me at 4cm. It took less than 15 minutes for me to dilate 2.5 cm. I laid down for 30 mins and they blew up the tub. “You’re having a very fast labor.”
The pain was damn near excruciating. My contractions were back to back with about 4 seconds of relief in between accompanied by bleeding, vomiting, and a knife stabbing feeling in my lower abdomen.
Vaginal bleeding, abdominal pain, rapid uterine contractions, often coming one right after another: a textbook description of placental abruption. The midwife was completely clueless, but even Chiara recognized that something was wrong and insisted on going to the hospital. Imagine her surprise when, contrary to what she had been told, the doctors and nurses were caring and supportive:
… The OB knew I was in the middle of a home birth and instead of pointing her finger in condescension, she tried to deliver Luca naturally. I don’t remember much of the next 10 minutes. The doctor broke my water to stretch me the last cm, but I wouldn’t stop bleeding. I remember feeling Jason’s hand shaking, holding mine… I remember hearing the nurses around me buzzing about how pale I was and how much blood I was loosing… And then I remember…
.. Baby’s in distress. Prep the OR.
Fortunately, they got baby Luca out in time.
Chiara, though, has no idea that her midwife demonstrated gross incompetence in failing to recognize an obvious abruption. When I retweeted her story as an example of a midwifery screw-up, she responded:
I’d like to clarify something. What happened is not to be blamed on the midwife. She was very experienced, she just hadn’t seen placental abruption before. (Less than 1%) I genuinely believe it was because of our connection and her continued support that I was even able to communicate efficiently in a moment of crisis… After the delivery, she worked closely with pathology and the doctors on my case to find out more about what happened. She came over and we discussed symptoms, signs, and everything under the sun so that she would be prepared if placental abruption ever crossed her path again. It was an unforeseen emergency and the hippie ways of home water birthing and midwifery is NOT to be blamed.
Of course homebirth midwifery is at fault and ought to be blamed. The midwife demonstrated gross incompetence. She missed a life threatening major complication that was so obvious that even the patient recognized it. Any midwife who cannot recognize a life threatening complication when it hits her in the face is a danger to babies and mothers.
Both cases highlight the fundamental problem with homebirth midwives: the cult like belief that every deviation from normal, no matter how far it deviates, is just a “variation” of normal. But contractions one on top of the other, excess vaginal bleeding and precipitous labor are not normal. A 92 hour labor is not normal.
The most crucial skill for every birth attendant, indeed every health care provider of any kind, is the ability to distinguish between normal and abnormal. Any midwife who lacks the experience to recognize a major complication when she sees it, or lacks the wit to recognize a major complication because she has been taught everything is a variation of normal, should not be practicing at all.
Has it really been two years since I first posted this? It seems particularly timely to repost it in light of the ongoing debate about attachment parenting.
How many times have we heard this? A lactivist, birth activist, attachment parenting proponent who insists:
Honestly, I don’t understand why other mothers think that I am judging them. If they want to raise their children by doing whatever is easiest for them instead of what’s best for their babies, that’s their decision and I don’t question it. I understand that some women love their jobs more than their children, and, after all, who wouldn’t if she had some fancy-pants career where she made tons of money. It probably makes more sense to her to put money ahead of her children’s well being.
Take my next door neighbor, for example. She makes oodles of money practicing law and leaves her baby each and every day in the care of strangers. I am impressed that her baby welcomes her home by reaching out to her, smiling and giggling. Fortunately, nature designed babies to recognize their mothers, no matter how little time those mothers spend caring for their children.
I’ll admit that I finder it harder to understand how women who aren’t even working give up on breastfeeding so easily, or refuse to allow their children to sleep in the family bed. What’s so valuable about their time or convenience anyway? But I keep my opinion to myself. I don’t let on that I am perfectly aware that there is no such thing as a breastfeeding difficulty that can’t be overcome with enough love and dedication. When other women claim they had a low milk supply or that breastfeeding was excruciatingly painful, I merely feel sad that they never had the unique opportunity to bond with their children that only breastfeeding offers.
And when it comes to childbirth, how can I possibly judge other women who haven’t taken the time to educate themselves the way that I have? I’ve read Henci Goer’s book three times, and Ina May Gaskin is my idol. Everyone knows that the first step to becoming educated on a topic is to join an internet message board. If I hadn’t joined the message boards at Mothering.com, I probably wouldn’t have known that birth is inherently safe and that all that stuff about “risk” was made up by doctors trying to steal business from midwives.
The uneducated women who don’t understand this can’t be blamed for acting like birth is some sort of disease and needs to take place in a hospital. Of course they give in and get an epidural at the drop of a hat because they don’t realize that there’s a difference between good pain and bad pain. And they don’t even understand the real risks of epidurals.
Oh, and don’t accuse me of looking down on women who’ve had C-sections. Sure, they didn’t actually give birth, and they have missed out on the peak experience of a woman’s life, but is that their fault? I know that almost all C-sections are unnecessary, but those poor women actually think that the C-section “saved” their baby’s life.
I don’t judge them, but I do think that I have a responsibility to open their eyes to the ways in which they have been misled. It would be wrong for me to refrain from enlightening them merely because it might hurt their feelings. Women need to understand that anyone who thinks her C-section was “medically necessary” is being duped by those who seek to medicalize childbirth for their own benefit.
Many women don’t realize it, but if they had more encouragement, they’d happily do what’s best for their babies. That’s why I tell my birth story to everyone, whether they want to hear it or not. It may seem unbelievable, but it’s often the very first time they’ve heard that they could have been empowered like me if only they’d made the same decisions I made.
And let’s face it, women don’t get enough encouragement to breastfeed. Some women actually think that a baby who is fed artificial milk (formula) can be as healthy as a baby fed with breast milk as nature intended. I consider it my duty to broadcast the dangers of formula feeding far and wide. It’s unfortunate that we have to scare mothers into doing what’s best by exaggerating the benefits of breastfeeding, but everyone knows that the ends justify the means.
Please do not accuse me of judging those other mothers who don’t love their children as much as I love mine. I’m well aware that different ways of mothering are right for different families. Of course women who are obsessed with their own convenience find that bottle feeding is right for them and their families. Obviously women who have been duped by doctors into fearing birth are going find that hospital birth is right for them. And inevitably those who aren’t really attached to their children are not going to be comfortable with attachment parenting.
I just want to be clear:
To those women who haven’t really given birth because they’ve had a C-section, to those women who gave in to the pain and got an epidural, to anyone who doesn’t understand that only breastfed babies are truly bonded to their mothers …
I am so not judging you.
This piece is satire.
Colleen and Jerusha Goodwin have hit the big time; they’ve made the national news. Today’s Washington Post carries an Associated Press article entitled, Case of suspended Idaho midwives show ongoing tension between home-birth industry, hospitals.
Unfortunately, the article confuses the main point. Any tension between homebirth midwives and other providers is the result, not the cause of the real problem: the grossly inadequate training of certified professional midwives (CPMs).
The Goodwins managed to preside over 3 neonatal deaths in a ten month period. Most obstetricians won’t have that many neonatal deaths in an entire career. There was a fourth incident that occurred in 2008 and resulted in an infant with a profound brain injury due to lack of oxygen. The Goodwins have just settled the resulting lawsuit for $5 million, although it is unlikely they will ever pay a dime since they did not carry malpractice insurance.
Both midwives have had their licenses suspended. They deserve far worse. There is not a single mitigating factor in any of these 4 tragedies. All four involved gross malpractice as well interfering with transport and lying by the midwives.
According to the Post article:
A former employee who trained at The Baby Place said hostility the Goodwins developed for doctors ultimately led to delays in emergency transports to hospitals.
Dani Kennedy told The Associated Press this antagonism caused them to make decisions against the best interests of mothers and babies, broadening the historic midwife-doctor divide to a wide gulf — with tragic consequences.
Coleen Goodwin “did hesitate to transport, and that was really upsetting to me,” said Kennedy, who trained at The Baby Place between 2007 and 2010. She left to open a practice in Hawaii, in part over these concerns.
Homebirth advocates are fond of claiming that the licensing of homebirth midwives will eliminate such tension, but the Goodwins were licensed. Therefore, the failure to transfer for complications was not because they feared being prosecuted for practicing midwifery illegally. Rather they apparently either failed to recognize the seriousness of the major complications that developed or they feared that their incompetence in improperly addressing the major complications would be exposed.
Far better for homebirth advocates, though, to portray this as a turf issue rather than a competence issue:
… [R]emedying feuds like the one Kennedy said influenced the Goodwins’ decision-making is growing more important, said Oregon State University professor Melissa Cheyney, a medical anthropologist and certified midwife.
Midwives often feel disrespected by the medical establishment, Cheyney said, while doctors’ objections to out-of-hospital births may harden with every traumatic transport.
This comes on top of the already-existing divide between the two views of childbirth, with midwives emphasizing the safety of natural births in a familiar, comfortable setting, while the American Medical Association contends women are best off in a hospital, where life-saving technology is nearby if something goes awry.
“You’re having this compulsory interaction between two value systems,” Cheyney said. “A transport means these two systems have to come together — and work together.”
Midwives feel disrespected by the medical establishment? They ARE disrespected by the medical establishment, but not because of their philosophy. They are unworthy of professional respect because they lack the education and training of ALL other midwives in the industrialized world.
As I have repeatedly pointed out, CPMs are not real midwives. They awarded themselves a pretend “credential” to disguise from lay people and legislators the fact that they have less education and training than midwives in Europe, Canada and Australia. The CPM is not recognized and is not eligible for licensure in the UK, the Netherlands, Australia. It used to be accepted in Canada, but they have abolished the CPM on the grounds that it fails to meet minimal standards for midwifery training, which include a college level degree.
The results of homebirth midwifery practice in Idaho (as well as every other state that has collected statistics) have been tragic:
Objective measures of Idaho’s midwife-doctor relationships — and their impacts on babies — are difficult to come by, because the state doesn’t keep comprehensive records of the outcomes of midwife-assisted births requiring hospital transports.
A private effort, the Idaho Perinatal Project run by St. Luke’s, documented 138 instances between 2005 and 2011 where mothers who planned a home birth were transported to a hospital.
Though its records are also incomplete — reporting is voluntary; there are no reports for 2012 — they do point to the trauma that accompanies a planned out-of-hospital birth where something goes wrong. There were at least nine cases where infants died at or before arriving at the hospital and several instances of birth asphyxia, fractures, post-partum hemorrhage and unexpected twins. (my emphasis)
These families have experienced unimaginable anguish because CPMs care more about being able to practice and make money than they care about whether babies live or die. Hopefully, these deaths will lead to stricter standards.
In my judgment, the biggest mistakes that homebirth midwives have made are the attempt to popularize homebirth and to license CPMs. Bereaved parents now have a mechanism to file complaints and states are now totting up the extraordinary number of deaths at the hands of CPMs. State governments will be forced to respond by regulating these self proclaimed “midwives” out of existence.
A great deal of the opposition to sex education is based on an absurd claim: if you teach children and teens about sex, it will encourage them to have sex. There’s absolutely no scientific evidence to support this claim, and it doesn’t make any sense. Teens decide to have sex with each other for many reasons, but the idea that they just heard about it for the first time and decided to try it out is ludicrous.
Similarly, the lactivism campaign to end free formula samples as US hospitals is also misguided and inane, not to mention completely disrespectful to grown women. The underlying assumption is that women who decide to formula feed do so because they just heard about it, have a free sample lying around, and decided to try it out. And just like abstinence only campaigns, so called “baby friendly” initiatives to promote breastfeeding have been complete failures.
Here’s a newsflash for lactivists: women formula feed because they want to do so and unless and until you address the real reasons, and stop pretending that this is a giant conspiracy on the part of “Big Forma,” all your campaigns are doomed to failure.
What is the Baby-Friendly Hospital Initiative USA? It is an attempt to foist guidelines created for the developing world onto women of the first world. It is led (surprise!) by a midwife and a lactation consultant.
The organizations’ precepts are based on the World Health Organization/UNICEF precepts for encouraging breastfeeding in developing countries. The use of formula in these countries is extremely problematic; indeed it can be deadly. When contaminated water is used to reconstitute powdered baby formula, serious illness is often the result. In the developing world, the WHO/UNICEF guidelines can make the difference between life and death.
Are guidelines drafted for countries where poverty is endemic, water supplies are contaminated, and starvation always a possibility, applicable to the US? No, they’re not, but, shhh, don’t tell any American women that. They must be convinced and shamed into breastfeeding by any means available. And that includes misrepresenting the risks and the state of the scientific evidence.
More than one million infants worldwide die every year because they are not breastfed or are given other foods too early. Millions more live in poor health, contract preventable diseases,and battle malnutrition. Although the magnitude of this death and disease is far greater in the developing world, thousands of infants in the United States suffer the ill effects suboptimal feeding practices. A decreased risk of diarrhea, respiratory and ear infections, and allergic skin disorders are among the many benefits of breastfeeding to infants in the industrialized world.
A million infants die each year? That’s right. Are any of them in the US? No (but don’t tell American women). The magnitude of death and disease is far greater in the developing world? That’s right. Are any term babies dying for lack of breastfeeding in the US? No (but don’t tell American women). Decreased risk of diarrhea, respiratory and ear infections and allergic skin disorders? Maybe (but don’t let American women know that these claims are in doubt).
What is the truth? The truth is that in a country like the US, breastfeeding has real benefits, but they are quite small. The quoted paragraph above is misleading and not strictly true, but for lactivists, the ends justify the means.
The biggest problem with the Baby-Friendly Hospital Initiative, though, is that it is a spectacular and expensive FAILURE. That’s not surprising, since there was never any scientific evidence that it would work in first world countries, just the heartfelt desire on the part of lactivists to shame and denigrate other women.
In Rethinking research in breast-feeding: a critique of the evidence base identified in a systematic review of interventions to promote and support breast-feeding, the authors note:
The volume of papers included – 77 primary studies and three reviews – might give the impression that there is ample evidence available to inform practice and policy. On the contrary, the most striking feature of this review is the paucity of findings from well-designed research to inform an important public health and policy issue. Even where studies had been conducted, details of interventions and processes were often scarce. Others have made similar observations …
Of course women might have told them that these efforts were bound to fail, but no one asked them:
It is notable that in a field in which the behaviour and views of women, their families and society are so crucial, few studies incorporated an assessment of participants’ views.
That’s not surprising. No one cares what women think. Lactivists only care what lactivists think.
Back to those who would restrict sex education with the express purpose of preventing sexual activity, Bioethicist Arthur Caplan made the following observations in regard “abstinence only” programs:
… there is no evidence at all that they work; common sense says they have no chance of working; and it is not clear that ethically they send the right message …
The same can be said about “baby-friendly” hospital initiatives:
Number 1 is self-explanatory.
Number 2 is only to be expected. Any program designed to change behavior is doomed to failure if the designers don’t even bother to ask women their reasons for formula feeding, let alone respect and address those reasons.
As for number 3, it is ethically suspect to exaggerate the benefits of breastfeeding, pretend that that breastfeeding is a matter of life and death in the US, mislead women on the state of the scientific evidence and above all, to shame and scare women about formula feeding.
Lactivists like to pretend that women stop breastfeeding because of lack of education, because hospitals give out formula, because of lack of professional support, because of lack of peer support, etc. etc. etc. All this pretending reflects the profound unwillingness of breastfeeding advocates to avoid addressing the real reasons that women stop breastfeeding or fail to start in the first place. The truth about breastfeeding, a truth that lactivists refuse to acknowledge, is that starting is hard, painful, frustrating and inconvenient. And continuing breastfeeding is hard, sometimes painful, and incredibly inconvenient especially for women who work, which in 2012 is most women.
“Baby-friendly” hospital initiatives are misnamed. It would be more appropriate to call them “lactivist-friendly” since the only thing they reliably do is make lactivists feel good about themselves and their own choices. No program can be “baby-friendly” if there is no evidence that it works, if it does not address the real issues, and if it shames and denigrates the mothers of those babies.
Elisabeth Badinter is causing controversy yet again with the American debut of her book The Conflict: How Modern Motherhood Undermines the Status of Women. According to Amazon:
Elisabeth Badinter has for decades been in the vanguard of the European fight for women’s equality. Now, in an explosive new book, she points her finger at a most unlikely force undermining the status of women: liberal motherhood, in thrall to all that is “natural.” Attachment parenting, co-sleeping, baby-wearing, and especially breast-feeding—these hallmarks of contemporary motherhood have succeeded in tethering women to the home and family to an extent not seen since the 1950s…
A bestseller in Europe, The Conflict is a scathing indictment of a stealthy zealotry that cheats women of their full potential.
Not surprisingly, the book is receiving tremendous attention with everyone from the New York Times, to Business Week, to the Huffington Post weighing in. That’s why I looked forward to online magazine Slate’s debate on the book. The debate involves Hanna Rosin, senior editor at The Atlantic and author of the very controversial article The Case Against Breast-Feeding, and Katie Allison Granju, who has been described as a woman who “literally wrote the book on attachment parenting.” I have been shocked and disappointed that Katie Granju has attempted to short circuit the discussion with a vicious smear of Elisabeth Badinter. Granju’s totally unsubstantiated claims about Badinter strike me as despicable discrediting of a feminist scholar to hide her inability to rebut Badinter’s arguments.
Granju claims, with no proof of any kind, that no one should pay any attention to Badinter because she is shilling baby formula.
According to Granju:
Elisabeth Badinter’s job is to increase sales of baby formula. Why is no one talking about her laughable conflict of interest?
Why would a leading feminist intellectual be shilling for manufacturers of baby formula?
… I discovered that not only does Elisabeth Badinter’s billion-dollar PR and advertising company represent Nestlé’s infant formula products, but Publicis also appears to be the go-to agency for the baby formula industry’s other major players as well, including Abbot Laboratories (Similac) and Mead & Johnson (Enfamil)…
The fact that the author of a major new book asserting that breast-feeding “enslaves” and “undermines” women also personally holds controlling interest in the agency of record for the three companies that collectively control much of the infant formula market share in the United States is glaringly disturbing… Publicis has been charged with marketing Nestlé to the public since at least 1984, and has been promoting infant formula on behalf of Abbott Laboratories since 1997. Just as her views on breast-feeding may not be new with this book, neither is her revenue stream as the result of marketing infant formula.
To read that one might think that Badinter works for formula manufacturers. The reality is rather different. Badinter is a shareholder in the multinational communications empire of Publicis. Her 10% stake (not a controlling interest), as a family member, makes her a billionaire. Publicis owns more than 20 different companies. Publicis includes advertising companies that represent formula manufacturers among their thousands of other clients.
In other words, Granju would have us believe that that a women with decades of scholarship in the area of gender studies, a woman with impeccable feminist credentials, has engaged in one of the leading issues in contemporary mothering and contemporary feminism for no better reason than to promote increase her income. Badinter is literally a billionaire. It is simply ludicrous to suggest that her philosophy is shaped by a desire for more money. But it is a rather clever way to avoid addressing Badinter’s arguments.
Never mind that, according to The New Yorker, Badinter is a feminist intellectual who:
… has written five blunt, admonitory best-sellers on the subject of those women and their men. They have made her a household name. She calls them “my contrarian feminist polemics.” Her first, “L’Amour en Plus”—a history of the changing notions of mother love—was published in 1980, when she was thirty-five. It dismissed the myth of maternal instinct as a sometime cultural construct…
Curiously, given Granju’s conviction that Badinter’s personal ties make her writing on mothering worth dismissing without discussion, Granju does not disclose her own conflict of interest. Granju never mentions that she has authored a book, multiple articles and runs a blog, all efforts to promote attachment parenting. That means that Badinter is explicitly or implicitly criticizing her work. Applying the same reasoning that Granju applies means that we should not be listening to Granju.
Agree or disagree with Badinter, she addresses issues of deep import to contemporary feminists and contemporary mothers. Are the ongoing attempts to moralize parenting choices and to promote biological essentialism just a new way to keep women confined to the home? After all, it is literally impossible to meet the myriad standards of AP is you work outside the home. Is that a coincidence or is that deliberate?
These are issues that should engage feminists intellectuals and mothers. It is deeply disappointing that Granju has devoted very little time to addressing these issues and instead has devoted a tremendous amount of time trying to blacken Badinter’s reputation. Granju owes Badinter a very public apology.
Why are some women devastated by a C-section? Why are VBACs portrayed as “healing”? Perhaps it is because those women experience C-sections as a narcissistic injury.
Narcissistic injury is a term from psychoanalysis. A narcissist is a person who suffers a deep sense of inferiority and masks it by projecting an air of grandiosity and excessive self regard. A narcissistic injury occurs when reality threatens the narcissist’s carefully constructed facade of perfection.
Narcissistic injury may lead to narcissistic rage:
Narcissists are often pseudo-perfectionists and require being the center of attention and create situations where they will receive attention. This attempt at being perfect is cohesive with the narcissist’s grandiose self-image. If a perceived state of perfection is not reached it can lead to guilt, shame, anger or anxiety because he/she believes that he/she will lose the imagined love and admiration from other people if he/she is not perfect.
Alternatively:
… rages can be seen as a result of the shame at being faced with failure. Narcissistic rage is the uncontrollable and unexpected anger that results from a narcissistic injury – a threat to a narcissist’s self-esteem or worth. Rage comes in many forms, but all pertain to the same important thing, revenge. Narcissistic rages are based on fear and will endure even after the threat is gone.
To the narcissist, the rage is directed towards the person that they feel has slighted them; to other people, the rage is incoherent and unjust. This rage impairs their cognition, therefore impairing their judgment. During the rage they are prone to shouting, fact distortion and making groundless accusations… [N]arcissists may even search for conflict to find a way to alleviate pain or suffering …
Sound familiar? It certainly reminds me of a number of VBAC and homebirth advocates, including their propensity to distort facts and make groundless accusations against anyone who disagrees with them.
In other words, for VBAC, homebirth and some NCB advocates, not having an uncomplicated vaginal birth is viewed as an imperfection. Hence the use of words like “failed” and “broken”, the insistence on comparing birth to competitive sports, and the use of goofy birth “affirmations” that are all variants of “I can do it.”
Keep in mind that a narcissistic injury is not simply an imperfection. It is an imperfection that threatens the narcissist’s protections against feelings of inferiority.
For example, many people need vision correction, but the overwhelming majority are able to accept that their eyes are not perfect without viewing it as a fundamental deficiency. Similarly, many women have C-sections and view the surgery as nothing more than one of many acceptable ways to have a baby. In contrast, a small proportion of women have such a fragile sense of self, and have constructed such elaborate defenses to protect against these feelings, that a C-section is experienced as a “failure,” a sign of being “broken,” and an insupportable assault on a very fragile sense of self-regard.
Experiencing C-section as a narcissistic injury can explain many confusing aspects of homebirth and natural childbirth advocacy, particularly among advocates who have already had a C-section. The refusal to see a doctor (with some women even refusing to see a midwife) can be explained as the inevitable result of regarding even the possibility of pregnancy complications as personal criticism, combined with the inability to tolerate criticism of any kind. Homebirth midwives are notorious for pretending that complications are “variations of normal” and for praising women for highly risky decisions. Unassisted birth can be viewed as an effort to make absolutely certain that there is no one to dent their fragile self-esteem by questioning them in any way.
It can also explain the seemingly inexplicable reactions to the death of a baby at homebirth. Reacting to a baby’s death by being “proud” of oneself for having a vaginal birth is extremely bizarre. However, it makes sense if the mother’s overriding preoccupation is to preserve her narcissistic mask of perfection and keep feelings of inferiority at bay.
The real problem, then, for women who view C-section as “failure” is not the C-section, but the outlook of the women themselves. C-section is experienced as a narcissistic injury, not because it really is an injury, but because women with carefully constructed defenses that keep feelings of inferiority at bay feel those defenses threatened by the lack of perfection.
Obviously homebirth and natural childbirth advocates will be loathe to acknowledge this. Narcissists are notorious for their lack of introspection and their insistence on blaming everything on everyone else. They could never acknowledge that the source of their distress comes from within; they are compelled to externalize it to others who are supposedly criticizing them or disrespecting them.
Adapted from a piece that first appeared on Homebirth Debate in November 2008.
I’m not sure whether this is an example of incredible hypocrisy or an example of breath-taking cluesslessness. Or maybe it’s both.
Gina Crossly-Corcoran, The Feminist Breeder, asks whether children of public figures are fair game.
She should be able to answer the question for herself. Obviously she thinks they are fair game. She’s a public figure and she writes about her children all the time. Okay, not really about them, but rather about how they make her feel. And that is very, very wrong.
Let’s do a little thought experiment:
Imagine your mother, the grandmother of your children, started a mommy blog from the perspective of a mother of adult children. Imagine she blogged about how your arrival disrupted her marriage, ruined her sex life and eventually led to stress urinary incontinence. How would you feel?
Imagine your mother shared stories of the times she was ready to tear her hair out over your behavior. Toilet training you was awful; you weren’t completely trained until you were 6 and still wet the bed occasionally at age 8. You came home from the prom and were so drunk that you vomited in the front hall. She warned you that your first husband was no good, but you married him anyway. How would you feel?
Imagine that you learned from your mother’s blog that she was deeply disappointed at your birth because you were a girl and she had wanted a boy, that she felt her postpartum depression was related to her disappointment and that she never bonded to you the way she did to your dearly desired younger brother. In reading your mother’s blog you learned that she deeply resented the attention your father showed you; she needed more of his attention and you stole it from her. And to this day, she loves your younger sister (who takes her advice, unlike you!) much more than she loves you. How would you feel?
Most likely you would be embarrassed, angered and deeply hurt. Now consider that those, like Gina, who blog about their young children are doing the same thing to them. The internet never forgets. What a mommy blogger writes about her children today will be there for them to read when the children are older. It will be there for their children’s friends to read when they are teenagers. It will be there for their employers and professional colleagues to read when they are adults.
Therefore, the answer to your question, Gina, is no. The children of public figures are not fair game … so stop using your children to promote yourself.
Remember the cruel behavior of those mean girls from middle school and high school who appointed themselves arbiters of the social universe? It was never enough for them to exclude the girls they didn’t like. Nope, they set out to punish anyone who wouldn’t fall under their sway. The classic mean girl line? “You can’t be friends with me if you’re friends with her.”
Gina Crossly-Corcoran, The Feminist Narcissist Breeder, has just pulled a classic mean girl stunt.
I am very, very sorry that I recommended the StillBirthday site. It has been brought to my attention that some of their “mentors” are former writers for “MamaTao” – the most abusive site I’ve ever come across. I wouldn’t put them within 100 yards of a grieving mother, and I am deeply sorry for posting that link…
Stillbirthday offers support for mothers grieving the loss of a child. It is a relatively new site, but it has quickly become an incredible source of support for loss mothers. I’m not connected to the site in any way, but I do know that the woman who started it, Heidi Faith, is one of the kindest, most selfless women on the internet. There are testimonials to her throughout the blogosphere. For example:
I have become friends with the maker of Stillbirthday, Heidi Faith, and she has been such a blessing and influence in my life. First, through her posts as administrator on a Facebook page called, The Pregnant Christian, which she has now handed over to me and then through various birth pages and groups online that discuss pregnancy, birth choices, safety, and loss. And also, her work on Stillbirthday, as a helpful resource for mothers, has reached me, too. She always tries to understand differences between people. I’ve always felt that I was empathetic to moms who have had such great losses, but I’ve come to see that though I am always sad for the passing of any baby, there were times that I have lost sight of the feelings of some of the moms I have encountered online because of differences in beliefs about things like birth safety and sometimes even just, birth semantics. But all moms deserve love and support and they deserve to be heard.
Or here:
I personally found them about 1 1/2yrs after the loss of my 2nd baby as I was searching on FB for babyloss resources. I am so grateful for this phenomenal exhaustive resource site. Heidi is a Christian Doula and heads this ministry up. She has an amazing love for God and commitment to truth and integrity with every mom or family member she encounters.
What did a sweet, caring, devout woman like Heidi do to warrant the Narcissist Breeder’s ire? Nothing, of course. But in classic mean girl fashion, Gina is trying to punish others through Heidi. Since Heidi is friendly toward everyone in the world, it is inevitable that she is friendly with women who refuse to praise Gina (a veritable maw of approval seeking desperation). If Gina can’t hurt those women, she’ll hurt Heidi instead.
What precipitated this outburst of immaturity? As far as I can determine, it happened because Mama Tao dissed Gina. Mama Tao is the online home of a group of women who satirize the homebirth and natural childbirth community. And if there ever was a target ripe for satirizing, it is the Narcissist Breeder.
Gina’s ire was raised by this piece, An Interview With the ‘Feminist’ Bleater. And since Heidi Faith is friends with some of the people who participate in Mama Tao, and (gasp!) allows those loss mothers among them to support other loss mothers, Heidi must be punished, because, as we know, you can’t be friends with Gina, if you’re friends with anyone Gina doesn’t like.
As Gina explains to Heidi (whose Facebook screen name is Adaleid Faith Doula):
I seriously question the judgment of anyone who would allow absolutely abusive people to “mentor” grieving mothers. I’ve been subjected to their abuse (and CONTINUE) to be to this very day. I’ve had moms come to me crying over their stalking and bullying and attacking. And now you’re letting them “mentor” unsuspecting mothers. I’m horrified. And I stand by my statement. There are much better places to find comfort than from people once dedicated their entire day to abusing others.
Just in case Heidi couldn’t figure it out, it has nothing to do with Stillbirthday; it has nothing to do with loss mothers; it has nothing to do with offering support to those who are grieving. It’s all about (surprise!) Gina. Gina’s been dissed and Heidi and her site are collateral damage as Gina tries to avenge herself on those who satirize her insatiable need for praise. [addendum: Keep in mind that there are no current Stillbirthday mentors among the current writers of Mama Tao.]
In a testament to the incredible work that Heidi does, and to the incredible person that Heidi is, many of Gina’s followers are refusing to kowtow. In fact there are so many who are refusing to kowtow that even after ruthless deletions, there are lots of supporters left. As one commentor explained:
… I just think that it’s a shame to not give people ideas on good resources because you disagree with something someone affiliated in some way believes when it isn’t actually a belief involving the topic at hand.
Sure, Heidi isn’t involved, but that’s irrelevant to Gina. And as we know (let’s say it all together now), you can’t be friends with Gina if you are friends with anyone who is involved with Mama Tao.
I know a secret, though. It really doesn’t matter whether Gina supports Stillbirthday. Everyone else does. I’d like to suggest that in a show of solidarity, anyone who has a blog or website put up a link to Stillbirthday. Let’s boost the popularity of a site that does an amazing job of providing support for an extremely vulnerable group. And let’s show mean girls like Gina that we’ll be friends with whomever we like … and there are very few people more worthy of our friendship than Heidi Faith.