Sadly, this is not satire.

Freya Kellet is a self-proclaimed “birth keeper, coach and mentor.”

I’m all too familiar with the ignorance, arrogance and privilege of natural childbirth advocates, but Freya sets a new standard for idiocy with her ‘Radical Guide to Postpartum Hemorrhage.’

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Postpartum hemorrhage is your ally??!![/perfectpullquote]

Hemorrhage is one of the most common reasons why women fear birth.

But, what if everything you know about hemorrhage is based in cultural misconceptions?

Cultural misconceptions??!!

Our body speaks in blood. A language of crimson and dots. Bleeding in birth is an expression of our bodies innate wisdom. not of pathology…

Hemorrhage is not a mistake in the female design … Hemorrhage during birth is a physiological response to a predictable constellation of events — intervention, observation and disturbance to motherbaby. Hemorrhage is a woman’s body speaking in blood, screaming a great and bloody NO to violation and control…

Not exactly.

Postpartum hemorrhage (PPH) causes over 80,000 maternal deaths each year.

It accounts for more than 45% maternal deaths in low income countries and almost 10% of maternal deaths in high income countries.

It is estimated that around the world one woman dies of postpartum hemorrhage every 4 minutes!

Moreover, the countries with the lowest intervention rates in birth have the HIGHEST rates of death from postpartum hemorrhage. But Kellet is clueless.

She thinks hemorrhage is an ALLY!

There are no mistakes in nature…

Hemorrhage does not occur randomly, it is extremely predictable and is the result of interventions and disturbances in the birth process…

Hemorrhage is the ancient ally of women.

Hemorrhage creates a holy blood boundary to boldly remind people of the importance of protecting undisturbed, wild birth.

My favorite part of this fatally stupid nonsense is Kellet’s suggestions for “treatment.”

Some women use the power of intention to resolve excessive bleeding by speaking to their uterus. You could try telling your womb that she needs to stop bleeding NOW …

If there is a sense that the mother is not present (spiritually, emotionally) some support people try boldly calling her back in into the room …

How well does Kellet imagine that works when the mother is unconscious from hypovolemic shock?

Where did Kellet learn this idiocy? From other equally clueless birth keepers, Yolande Norris Clark and freebirth advocate Emilee Saldaya.

What I really want to know is this: exactly how gullible do you have to be to believe this crap?

Apparently very, very gullible!

I’ve written in the past about performative mothering, a central feature of contemporary parenting culture. I framed the discussion as comparing a fictional grandmother Myrna to her fictional granddaughter Mira.

When it came to raising John, Myrna might have feared the judgments of her mother and mother-in-law but she did not particularly fear the judgment of her peers since they were all doing the same thing. Everyone went to the hospital to have a baby; everyone was unconscious at the moment of birth; everyone bottle fed. For better or for worse, there was incredible uniformity in parenting practices.

Mira, in contrast, faces not merely the judgment of her peers, but she actively submits herself to the judgment of the larger world by engaging on Facebook. Mira is a stylist of motherhood, selecting from parenting identities and practices to present a meticulously crafted mothering persona designed for the gaze of other mothers.

Which raises the question: how did mothering transmute from raising children to a form of self-expression.

A new book published just this week, The Problem with Parenting: How Raising Children Is Changing across America, addresses this issue.

Its central claim:

…[B]eginning in the 1970s, the family was transformed from a social unit that functioned as the primary institution for raising children into a vehicle for the nurturing and fulfillment of the self.

Though the dominant contemporary philosophy of natural mothering (aka intensive mothering) advertises itself as child-centered, it is in reality mother-centered and governed by the mother’s therapeutic imperative.

The book identifies the source of change in mothering as the sociological upheavals of the late middle 20th Century including women’s employment outside the home, the sexual freedom that arrived with The Pill and the easy access to divorce.

The author declares:

In the context of the shift away from a sense of common purpose toward the pursuit of self-fulfillment above all, reforms that might have appeared unequivocally positive permanently undermined the child-centered family.

Mothering, which used to about meeting the needs of children has been transformed to meet the therapeutic needs of mothers.

It developed into a full-fledged mode of childrearing that emphasized the parent-child relationship over the family, expert advice over instinct, commitment to the self over society, and lifestyle over a Good life… Parents would unwittingly transform childrearing into an act of their own self-expression confusing their own needs with those of their child and making themselves and their children miserable in the process.

The parent child relationship:

As Americans embraced the ethos of the “‘Me’ Decade,” namely that their highest purpose should be self-fulfillment within a single lifetime, they began to balk at traditional notions of childrearing. Adults who aspired to cast off their inhibitions and be themselves now hoped to raise their children to avoid these inhibitions altogether…

Expert advice:

The zeal to improve Parenting led to a culture of “chasing” research. Parents and policy makers alike overinterpreted academic research. For instance, a single study conducted in 1993 that seemed to show that listening to classical music created short-term enhancement of spatial reasoning spawned a multimillion dollar industry of children’s toys, CDs, and videos claiming to make children smarter, despite the fact that the effects observed were temporary and observed in young adults, not in children. The impact of infant brain development hadn’t been studied at all!

The changeable nature of Parenting advice in combination with the idea that every moment spent with children was of lasting importance worked to undermine parents’ confidence. Would a deviation from official advice, such as formula feeding instead of breastfeeding or allowing a toddler to “cry it out” cause permanent damage down the line? Parents constantly doubted themselves and other people second-guessed their decisions.

Self-expression:

Parents raised post-1970 … were finding it hard to square their own sense of self with the inevitable self-sacrifice of parenthood. They chronicled their angst in the wave of memoirs … each a variation on the themes of their struggle to be the kind of parents they aspired to be without allowing their own sense of self to be swamped by the demands of Parenting. Many parents of this generation resolved the conflict by transforming their childrearing into an act of self-expression. This brought them into direct conflict with other people, and any individual or rule that called their parenting into question became a personal slight.

The irony, however, is that intensive mothering, which is ostensibly designed to raise happier, healthier, more successful children has done nothing of the kind. To my knowledge, not a single parameter of child mental health has improved in the past half century and many — like child suicide — have actually gotten worse.

That’s just what you’d expect when mothering changes from nurturing children to maternal self-expression.

Most people understand that we live in an era of extreme political and cultural polarization and our country is suffering terribly as a result. It has been going on for the last 25 years, and it’s easy to forget that it hasn’t always been like this nor does it have to be.

Sadly, the polarization has been extended to mothering using many of the same tactics that were deliberately contrived to promote political polarization. Many mothers and babies are suffering terribly as a result.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Lactivsts, like gun rights activists, are extremists.[/perfectpullquote]

To understand what is going on in the world of mothering, it helps to review what is going on in the world of politics. It is critical to recognize that the current state of political polarization is not an accident. Certain politicians have manipulated people in order to get elected. How? They have promoted “identities,” created “threats,” stoked grievances, encouraged a sense of victimization, and constructed compromise as sell-out.

Consider members of the National Rifle Association. For 25 years, despite increasingly lax gun policies and soaring numbers of gun massacres, the members of the NRA tell each other that they face the “threat” of all guns being banned, that they are being victimized by anyone who wants common sense gun restrictions, that they must perpetually march loaded down with weaponry to display their sense of grievance and that they must never, ever compromise on their demands.

Gun rights activism isn’t merely a choice of many NRA supporters. It is their tribe and their identity. And the outsize anger of NRA members and their vicious treatment and portrayal of anyone who disagrees is a feature of gun rights activism, not a bug.

Consider extreme evangelicals. Christianity has NEVER been under threat in this country. Yet evangelical leaders tell their followers they are facing the threat of religious persecution, that they are victimized daily by “slights” such as someone saying ‘Happy Holidays’ instead of ‘Merry Christmas,’ that they must perpetually pressure their political leaders by displaying an unending sense of grievance and that compromise isn’t merely forbidden, it is satanic.

Evangelical fervor isn’t merely the religious belief of evangelicals, it is their tribe and their identity. And the outsize anger of extreme evangelicals and their vicious treatment and portrayal of anyone who doesn’t believe as they do is a feature of contemporary evangelical politics, not a bug.

The same techniques are also being used to create extremism in mothering.

Consider lactivism. Lactivism is NOT merely support for breastfeeding. Lactivism is the cultural belief that all babies “deserve” breastmilk, that all mothers should breastfeed, that breastfeeding should be normative (and formula feeding portrayed as deviant) and to the extent that other mothers can’t or choose not to breastfeed, they are the unwitting, uneducated dupes of large multinational corporations.

Spend more than two minutes with any lactivist leader or on any lactivist blog or Facebook page and you will see the techniques designed to create political extremism used over and over again.

Even though there has NEVER been more professional and institutional support for breastfeeding, lactivists imagine they live in a world of unending “threat” to breastfeeding, that they are victimized any time anyone proposes common sense breastfeeding policies (e.g. acknowledging that insufficient breastmilk is common). They perpetually display their endless sense of grievance by demonizing women who can’t or don’t wish to breastfeed and they view any form of compassion for women who make different choices as a sign of insufficient ideological fervor.

Lactivism isn’t merely a choice, it is the tribe and the identity of lactivists. And the outsize anger of lactivists and their vicious treatment and deliberate mischaracterization of anyone who is not a lactivist (they “hate breastfeeding”!!) is a feature of contemporary lactivism, not a bug.

Consider midwives, doulas and childbirth educators, particularly those from the UK and Australia. Spend any time with any midwifery leader or on any birth blog or Facebook page and you will see the techniques designed to foster political extremism deployed repeatedly.

There has never been more professional and institutional support for (cruelly named) ‘normal birth,’ yet contemporary birth workers pretend they live in a world of unending “threat” to unmedicated vaginal birth without interventions. They insist that they are being victimized any time someone points out that birth is inherently quite dangerous for babies and mothers. They perpetually display their endless sense of grievance by demonizing obstetricians as well as women who make different choices; it’s difficult to imagine anything more vicious and cruel than insisting on psychological evaluation of women who choose C-section on request. They view any form of compromise with obstetricians, neonatologists and pediatricians as betrayal of fundamental beliefs.

Promoting “normal birth” isn’t merely the occupation of many midwives and birth workers, it is their tribe and their identity. And the outsize anger of birth workers and deliberate mischaracterization of anyone who can’t or chooses not to pursue unmedicated vaginal birth without interventions (they “want everyone to have a C-section!!”) is a feature of contemporary midwifery and childbirth care, not a bug.

If you want to see the awesome power of extremist politics, just look at the mask “debate.” Right wing extremists aren’t merely willing to overlook the massive disaster perpetuated by the current governing party’s willingness to ignore science and tolerate both the deaths and the economic destruction of anyone besides its wealthiest members. The party’s extremists are willing to bring their own world view in line with the party even though the party is literally killing them. Refusing to wear a mask has become a sign of fealty to extremism.

Easing the current political extremism is beyond my purview, but I do have ideas for addressing the current tribalism among mothers. Lactivists, midwives and birth workers need to understand the ways they have been manipulated toward extremism. Neither breastfeeding nor vaginal birth are being threatened. Women who make different choices are not victimizing them. They should drop their outsize sense of grievance and welcome compromise for what it is — the stepping stone to a better world, not a betrayal of first principles.

I’m not hopeful that those who have tied their identity to lactivism and birth work will be willing to moderate their extremism. But fortunately we don’t have to wait for them. Individual mothers who deviate from lactivist and birth orthodoxy should recognize that making choices that benefit themselves and their children is more likely to lead to thriving families than attempting to placate those have situated their identity in and pledged their fealty to mothering extremism. After all, a thriving family is the ultimate goal.

There is a veritable epidemic of “broken” baby tongues, known colloquially as tongue-tie and scientifically as ankyloglossia.

The epidemic of tongue tie is surprising since the natural incidence has been estimated as only 1.7-4.8%

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]The same people who insist that women are perfectly designed to breastfeed can’t explain why so many babies supposedly aren’t equally perfectly designed.[/perfectpullquote]

But releasing (snipping) the tongue tie is big business. The surgical fee for frenectomy/frenotomy is $850. I presume that $850 is what the doctor bills; what he or she is actually paid probably varies by insurance company.

How effective is surgery for tongue-tie in reducing breastfeeding problems?

Not very.

A review of the literature published in the journal Pediatrics, Treatment of Ankyloglossia and Breastfeeding Outcomes: A Systematic Review, found:

Twenty-nine studies reported breastfeeding effectiveness outcomes (5 randomized controlled trials [RCTs], 1 retrospective cohort, and 23 case series). Four RCTs reported improvements in breastfeeding efficacy by using either maternally reported or observer ratings, whereas 2 RCTs found no improvement with observer ratings. Although mothers consistently reported improved effectiveness after frenotomy, outcome measures were heterogeneous and short-term. Based on current literature, the strength of the evidence (confidence in the estimate of effect) for this issue is low.

And the worst part? 70% of babies referred for tongue-tie surgery don’t need it!

That’s the conclusion of a new paper published in the International Journal of Pediatric Otorhinolaryngology. As Diercks et al. explain:

Despite growing popularity of the procedure, controversy remains surrounding the diagnosis of ankyloglossia, when to perform frenotomy, and whether frenotomy even improves feeding outcomes. A 2017 Cochrane review of lingual frenotomy concluded that lingual frenotomy reduces short term maternal nipple pain, but this did not translate to improvements in breastfeeding consistently and no data about long term breastfeeding success was available . This is further complicated by introduction of the concept of posterior ankyloglossia as well as consideration of the role of the maxillary lip frenulum in feeding.

The epidemic of tongue-tie has been driven by lactation consultants:

There is disagreement among health care professionals regarding the degree to which ankyloglossia impacts infant feeding patterns, with 69% of lactation consultants attributing breastfeeding problems to anatomic restriction vs. 10% of pediatricians and 30% of otolaryngologists.

Lactation consultants are grossly over diagnosing tongue tie. Up to 70% of patients they refer don’t actually need the surgery.

The authors studied all infants referred for surgery in their institution in a year. But before performing the surgery:

All mother-infant dyads were offered a formal feeding evaluation by a pediatric speech language pathologist specializing in infant feeding and swallowing disorders approximately 3 to 14 days prior to consultation with a pediatric otolaryngologist.

What happened?

Of the 153 participants referred for frenotomy, after multidisciplinary evaluation, a procedure was recommended for only 46 (30.1%) of patients. One patient had undergone lingual frenotomy prior to consultation elsewhere and a revision procedure was not recommended… Of the infants who underwent frenotomy, 11 (23.9%) underwent labial frenotomy alone, 5 (10.9%) underwent lingual frenotomy alone, and 30 (65.2%) underwent both labial and lingual frenotomies. 94 children (71.8%) had accessed lactation consultant services prior to assessment…

The authors note:

Rates of ankyloglossia diagnosis and frenotomy have increased sharply over the past decade, perhaps due to increased desire as well as pressure for new mothers to breastfeed.

They conclude:

The majority of patients referred for ankyloglossia may benefit from nonsurgical intervention strategies based on findings from comprehensive feeding evaluation. Frenotomy is associated with higher maternal feeding-related worry and reduced breastfeeding self- efficacy scores. While tongue appearance is associated with frenotomy, functional assessment is critical for identifying patients who may also benefit from lip frenotomy.

Why has the diagnosis of tongue-tie reached epidemic proportions followed by an explosion of unnecessary surgery?

I have a theory:

Breastfeeding is supposed to be perfect, yet it is clear that many babies and mothers aren’t doing well with exclusive breastfeeding. The obvious conclusion is that breastfeeding is not perfect, and may not even be a healthy choice for some babies. That simple, obvious conclusion leads to cognitive dissonance in the lactation industry and among lactivists themselves. For them, breastfeeding must be perfect; therefore, it is babies who are “broken.”

Curiously, the same people who insist that women are perfectly designed to breastfeed can’t explain why so many babies supposedly AREN’T equally perfectly designed nor why those babies apparently need (mostly unnecessary) surgery to treat breastfeeding problems.

How ironic!

There’s been a lot of handwringing lately about whether anti-vaxxers will be willing to take a coronavirus vaccine.

Pediatrician Phoebe Danziger writes in The New York Times A Coronavirus Vaccine Won’t Work if People Don’t Take It:

If a vaccine for coronavirus is developed tomorrow, will you take it?

Many people won’t. According to recent polls, half to three-quarters of Americans intend to get the vaccine if one becomes available — woefully short of what we’ll need to protect our communities.

I might not take it either and I’m about as far from an anti-vaxxer as anyone can be.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]An independent panel, convened by a scientific organization that has no ties to government or industry, should vet the vaccine before roll-out.[/perfectpullquote]

The handwringers assume that any COVID vaccine that receives FDA approval will be adequately tested, safe and effective. But that may not be true.

Dr. Danziger recognizes the problem:

They question the safety of a vaccine developed on an accelerated timeline, and in the shadows of political pressure — a concern that has also been raised by staunchly pro-science, pro-vaccine experts.

I’ve raised that very issue, We can have a safe coronavirus vaccine or a rapidly developed vaccine; we can’t have both!

Those worried about COVID vaccine uptake inexplicably ignore this legitimate concern.

It’s not a theoretical risk. It has happened before. In 1976, faced with the looming threat of a particularly virulent form of swine flu, President Gerald Ford rushed a vaccine into production and insisted on releasing it immediately. The result: more people were harmed by complications from the vaccine than from the flu.

Emergency legislation for the “National Swine Flu Immunization Program” was signed … on April 15th, 1976 and six months later high profile photos of celebrities and political figures receiving the flu jab appeared in the media. Even President Ford himself was photographed in his office receiving his shot from the White House doctor.

Within 10 months, nearly 25% of the US population, or 45 million citizens were vaccinated …

But the vaccine wasn’t safe. Over 450 people were paralyzed temporarily or permanently by reactions to the vaccine. The worst part was that the swine flu turned out to be less of a threat than the vaccine designed to prevent it.

Why did the debacle occur?

Ford was facing a tough re-election campaign that fall (one he subsequently lost) and he feared the impact of an epidemic on his electoral prospects. He was more concerned with producing a vaccine quickly than producing it safely.

We can’t trust the FDA or the CDC on this issue; they’ve been subverted by intense pressure from the Trump administration, an administration that has repeatedly demonstrated its contempt for American lives. Given the choice between preventing people from getting sick or falsely assuring people they won’t get sick Trump picks lying every time.

We can’t trust industry. The vaccine will be a financial bonanza for the first company to gain approval. The conflict of interest is enormous.

But I would hope that we could trust the medical profession and the public health profession.

Unfortunately, they seem to be putting the cart before the horse:

First, we must build a coalition of community leaders, public figures and other influential individuals to help combat disinformation and focus on the ethical importance of immunization…

We also need to engage community leaders and public figures who can help mediate national and community discussions about the values, moral principles and identity concerns about vaccination …

We should explore ideas such as offering “green vaccines” — manufactured using transparent processes and ingredients — that vaccine-hesitant Americans may be more likely to accept.

No, first we MUST ensure that any COVID-19 vaccine is thoroughly tested for safety and efficacy by scientists unconnected either to the administration or industry. An independent panel, convened by a scientific organization that has no ties to government or industry, should vet the vaccine before widespread roll-out.

This is all the more important when you consider that the first vaccines to market are unlikely to be traditional vaccines manufactured in traditional ways. We cannot and should not extrapolate from previous vaccines if the new vaccine doesn’t use previous technology. For example, a number of scientists and pharmaceutical companies are working on mRNA vaccines, a form of vaccine that has never been used in humans and therefore may have side effects and dangers that are unanticipated.

Contrary to the fears of the handwringers, the biggest problem we now face is not how to get people to agree to be immunized with the first vaccines that gain FDA approval. The biggest problem is how to be sure the the first vaccines that gain FDA approval are safe, effective and without major side effects.

I’m NOT opposed to a vaccine against COVID-19. I’d even be willing to be part of a study to test for safety and efficacy before either were assured. But I wouldn’t simply agree to receive a vaccine merely because it has been approved unless I saw high quality, long-term safety and efficacy data.

Let’s address that issue first — before we start worrying about who will refuse to take the vaccine.

Denialism kills.

Christine Maggiore was in prime form, engaging and articulate, when she explained to a Phoenix radio host in late March why she didn’t believe HIV caused AIDS.

The HIV-positive mother of two laid out matter-of-factly why, even while pregnant, she hadn’t taken HIV medications, and why she had never tested her children for the virus.

“Our children have excellent records of health,” Maggiore said on the Air America program when asked about 7-year-old Charlie and 3-year-old Eliza Jane Scovill. “They’ve never had respiratory problems, flus, intractable colds, ear infections, nothing. So, our choices, however radical they may seem, are extremely well-founded.”

Seven weeks later, Eliza Jane was dead. She died of AIDS related pneumonia in May 2005.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Denialism kills. Don’t let your children be victims.[/perfectpullquote]

Maggiore had a homebirth with Eliza because no doctor would care for her unless she agreed to take medication to prevent the transmission of AIDS to her unborn child. She was counseled not to breastfeed Eliza, but she did so, and published pictures of herself breastfeeding Eliza to show her confidence in her belief that HIV does not cause AIDS. She never allowed Eliza to be tested for HIV, because she felt that there was “no need”.

After her daughter’s death, Maggiore acknowledged that she never mentioned her HIV status, and the fact that her daughter was almost certainly HIV positive, because she did not want doctors to “discriminate” against her daughter. Although the autopsy report and the slides of the pathology examination were released publicly, Maggiore insisted that Eliza died of an anaphylactic reaction to antibiotics, not of pneumocystis pneumonia.

Christine Maggiore was responsible for her daughter’s death. Her denialism was more important to her than her daughter’s life.

Carsyn Leigh Davis, 17, died of COVID-19 last month for the same reason. Her parents’ denialism was more important to them than their daughter’s life.

Carsyn had a complex medical history and was immunocompromised.

No matter. Her mother posted a stream of denialist nonsense on Twitter:

Not surprisingly, she was also an anti-vaxxer:

How did Carsyn get COVID-19? Her parents sent her to this party at her church.

Her mother sent her to the party despite the fact that Carsyn had just about every possible risk factor for COVID death that any white teen could have. She had fought cancer, neurologic disease and was obese.

When she got sick, her parents (a nurse and a physician’s assistant) treated her with hydroxychloroquine. When she had trouble breathing, they gave her her grandfather’s supplemental oxygen.

It wasn’t enough. Only then did her parents seek medical care for her.

She was treated in a pediatric ICU:

Carsyn’s parents declined to have her intubated, and she instead started receiving plasma therapy, the report said. But by June 22, her condition wasn’t improving and “intubation was required,” the medical examiner wrote.

Despite “aggressive therapy and maneuvers,” Carsyn still didn’t get better, leading Brunton Davis to request “heroic efforts” even knowing that her daughter “had low chance of meaningful survival,” according to the report.

She died shortly after on June 23, twelve days after the “release party”, and only two days after her 17th birthday.

Why do denialists deny?

…[D]enialism is based on irrational and illogical thinking. Denialists do not generate new information to refute scientific claims. To the contrary, they ignore established knowledge, and distort reality to support a preconceived ideology. Denialism is grounded in rhetorical tactics that are designed to give the appearance of a debate among experts, when in actuality there is none. In fact, denialists manufacture doubt by identifying any sign of disagreement among scientists at any point in history and use that false reality to claim that the evidence is inconclusive… Discarding the objectivity and logic of science, denialists use emotionally charged assertions.

Why do some people become denialists?

Psychologically, denial is a natural coping response to threatening and traumatic experiences. It is a buffering mechanism that gives a person time to adjust before facing the threat. Denialism exploits denial as a coping response by offering an escape from the threat.

Paradoxically, those most vulnerable to the threat — like Eliza Scovill’s mother and Carsyn Davis’ parents — are most susceptible to denialism. Rather than cope with fear of severe, they deny that severe illness is even a possibility.

Do denialists ever learn?

Christine Maggiore didn’t. In December 2008 Christine Maggiore died of AIDS related pneumonia. To the very end she insisted that HIV does not cause AIDS and refused the medications that could have saved her life.

It remains to be seen whether Carsyn Davis’ parents will learn from their daughter’s death. That would require accepting responsibility for their role in causing it and I suspect that won’t be happening any time soon.

Denialism kills. Don’t let your children be victims.

Is there anything more ironic than refusing to wear a mask during the coronavirus pandemic?

While anti-maskers loudly insist that no one can tell them what to do, they are in fact doing exactly what President Trump has pressured them to do: risking their very lives to demonstrate political fealty.

We have an expression for that kind of behavior. It’s called “drinking the kool-aid.”

According to Wikipedia:

“Drinking the Kool-Aid” is an expression used to refer to a person who believes in a possibly doomed or dangerous idea because of perceived potential high rewards… In recent years it has evolved further to mean extreme dedication to a cause or purpose, so extreme that one would “drink the Kool-Aid” and die for the cause.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Refusing to wear a mask is risking death to demonstrate fealty to Donald Trump.[/perfectpullquote]

But why “drinking the Kool-Aid”?

The phrase originates from events in Jonestown, Guyana, on November 18, 1978, in which over 900 members of the Peoples Temple movement died. The movement’s leader Jim Jones … proposed “revolutionary suicide” by way of ingesting a powdered drink mix lethally laced with cyanide and other drugs which had been prepared by his aides.

Followers demonstrated their fealty by literally committing suicide.

Refusing to wear a mask is no different. It’s risking suicide to demonstrate fealty to Donald Trump.

It isn’t a mark of independence; it’s a mark of utter, cult-like dependence.

It’s the ultimate “power lie.”

In her fascinating new book Surviving Autocracy, journalist Masha Gessen describes the importance of the “power lie” to a demagogue.

…It is the lie of the bigger kid who took your hat and is wearing it—while denying that he took it.

…[T]he point of the lie is to assert power, to show “I can say what I want when I want to.” The power lie conjures a different reality and demands that you choose between your experience and the bully’s demands: Are you going to insist that you are wet from the rain or give in and say that the sun is shining?

The purpose of the power lie isn’t to get you to believe something that’s untrue, as is the case with ordinary lies. The goal of a power lie is to demonstrate extraordinary power over others by insisting that denying what you know to be true is proof of political fealty.

Donald Trump has deployed the power lie from the very first moments of his presidency. Claims that his inaugural had many more attendees than what everyone could see was his first presidential power lie. By forcing his press secretary Sean Spicer to lie in such an obvious way, he didn’t change the minds of the press nor did he intend to. He was demonstrating his power over Spicer by forcing him to publicly declare something the Spicer and everyone else knew to be a bald faced lie.

Power lies are outlandish lies:

Trump’s lies are outlandish because they are not amendments or embellishments to the shared reality of Americans—they have nothing to do with it. When Trump claimed that millions of people voting illegally cost him the popular vote, he was not making easily disprovable factual claims: he was asserting control over reality itself…

The coronavirus pandemic has resulted in an endless stream of Trump power lies:

When, in the winter and spring of 2020, Trump claimed that the United States was prepared for the coronavirus pandemic, when he promised quickly to triumph over the virus, when he said that hospitals had the necessary equipment and people had access to tests, when he promised health and wealth to people facing illness and precarity, he was claiming the power to lie to people about their own experience.

His followers’ refusal to wear masks marks them as willing to embrace the lie to show fealty to Trump.

It isn’t a victory over reality; it is a surrender to an autocrat.

Are you going to believe your own eyes or the headlines? This is the dilemma of people who live in totalitarian societies. Trusting one’s own perceptions is a lonely lot; believing one’s own eyes and being vocal about it is dangerous. Believing the propaganda—or, rather, accepting the propaganda as one’s reality—carries the promise of a less anxious existence, in harmony with the majority of one’s fellow citizens. The path to peace of mind lies in giving one’s mind over to the regime.

Are you going to wear a mask to protect yourself, or are you going to risk your life to demonstrate fealty to Donald Trump? Are you going to believe infectious disease and public health experts or are you going to grasp at peace of mind by believing outrageous lies?

Refusing to wear a mask is drinking the Kool-Aid. It’s not brave, bold or independent. It’s pathetic!

Last week I reviewed why natural childbirth philosophy is fundamentally and ineradicably racist. I quoted Rachelle Chadwick (Bodies that Birth: Vitalizing Birth Politics) in exploring an imagined racial dichotomy in birth where indigenous women of color are fantasized as “primitive and animal-like and thus primed to give birth (and breastfeed) easily and without pain or the need for medical assistance …”

The philosophy of natural childbirth is also deeply classist. It reflects the cultural preoccupations of privileged Western white women and entirely ignores the ugly, deadly realities of maternity care for poor women.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Privileged women worry they will be subjected to the “medical gaze”: poor women worry they will be invisible.[/perfectpullquote]

Chadwick has a lot to say on this topic, too, and I’m impressed with her framing of this issue, too. Despite being immersed in obstetrics for the past 35 years, this framing is new to me, though it provides an explanation for a widely known phenomenon — the terrible infant and maternal mortality rates of poor women.

Simply put, while the privileged white women of the natural childbirth movement have been obsessing over being subjected to the “medical gaze” of increased monitoring and risk mitigation, poor women (particularly poor women of color) have been suffering from their “invisibility” under the medical gaze.

That’s because, as Chadwick notes:

Problematically, studies of risk and birth have been overwhelmingly based on the perspectives of privileged women … There has been little examination of risk and birth from the perspectives of marginalized women …

Chadwick directly addresses this serious oversight.

Far from being subject to increased monitoring and surveillance, low-income women were often subject to biomedical invisibilization during labor/birth in which they disappeared, were forgotten and disregarded, and fell outside of the medical gaze. Monitoring, machines and interventions were often missing and many women were left to labor alone with no medical assistance or pain relief.

As a result:

…[W]hile the biomedical definition of birth as a risky event requiring medical care/intervention framed women’s experiences and narratives of birth across diverse sociomaterialities, biomedical risk was enacted differently according to positions of privilege/marginalization.

Privileged women worry about “medicalization” of birth, though even those who choose homebirth and freebirth assume that their choice to forgo medicalization is made safe by their easy access to high tech care should they need it.

Therefore:

The enactment of largely middle-class notions of ‘natural birth’ or planned homebirth are thus founded on privileged access to resources and the ready availability of medical care and technocratic interventions on demand.

Poor women — in both high resource as well as low resource settings — have a very different experience of risk.

While privileged women were concerned with the risk of ‘losing control’ and made birth choices accordingly, worries about ‘control’ did not appear in the stories of low-income women… For [low-income] women, entangled within a different set of risk politics, a key concern in relation to birth was not loss of control but lack of care.

Chadwick is writing about South Africa but her observations apply to most industrialized countries:

In public sector [maternity facilities] however, the biomedical risk economy is structured very differently and in some settings is marked by the absence of technological monitoring and machinery, indifferent care and a lack of surveillance. In these contexts, women’s laboring bodies are often rendered invisible and fall outside of biomedical optics.

Privileged women and poor women have very different experiences of maternity care:

While women utilizing the private medical sector are usually highly monitored throughout their pregnancies, poor pregnant women are generally not subject to the same degree of high-tech monitoring and risk management.

It is not surprising then that poor women suffer much higher rates of infant and maternal mortality. They and their babies are dying from a lack of the very technology that privileged women disdain.

For privileged, Western white women:

…[P]regnancy and birth often became an identity-making process in which a range of technologies and practices (3D sonograms, sonograms, acupuncture, pregnancy yoga, amniocentesis, hypno-birthing) were used as ‘technologies of the self’ to craft selves and identities.

Poor women, in contrast, are desperately hoping they and their babies survive.

Natural childbirth advocacy ignores these women. Indeed, to the extent that most midwives, doulas and natural childbirth advocates acknowledge the high infant and maternal mortality rates of poor women, it is purely instrumental. They mobilize these tragedies to argue — grotesquely — that poor women need more midwives and doulas when they really need more perinatologists and ICUs.

Processes whereby black and poor laboring bodies are rendered invisible and left to fall outside of normative modes of biomedical risk management (in some public sector contexts) speak to wider forms of societal power in which some lives are valued (and must be protected) and others are not.

As Chadwick notes:

Both the panoptical [medical] gaze and the absence or withholding of the gaze thus function as potential technologies of power and are embedded in sociomaterial relations of oppression, privilege and marginalization.

The racism of natural childbirth advocacy is usually covert, but back in 2017 Ina May Gaskin inadvertently showed hers.

According to birth workers of color who attended her talk, when asked about the problem of extraordinarily black maternal mortality, Gaskin blamed women of color for their own deaths:

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Gaskin appropriated the maneuver from Guatemalan midwives and in the tradition of Columbus “discovering” America, named it for herself.[/perfectpullquote]

Gaskin responded with anecdotal stories about Black women who lost their lives as a result of provider negligence, and blamed the Black women for not being more informed of their life-threatening symptoms. Moreover, Gaskin stated that “drug overdose” and the use of illegal drugs was the cause of the massive amount of Black maternal death rates. She also mentioned that communities “don’t pray as much as we used to” as a reason contributing to maternal death rates.

I’m not sure why people were so surprised. Gaskin has always trafficked in the language and habits of medical colonialism. Colonialism is the practice one country occupying another country or region and exploiting it for the benefit of the occupier. Medical colonialism involves control over black bodies, knowledge and practices and exploiting them 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. And 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. The Gaskin Maneuver. In a classic example of medical colonialism, Gaskin appropriated a shoulder dystocia maneuver from Guatemalan midwives; then in the tradition of Columbus “discovering” America, she named it for herself.

Natural childbirth is a philosophy of privilege. Political scientist Candace Johnson explores this phenomenon in The Political “Nature” of Pregnancy and Childbirth. Johnson asks:

[W]hy do some women (mostly privileged and in developed countries) demand less medical intervention in pregnancy and childbirth, while others (mostly vulnerable women in both developed and developing countries) demand more …? Why do the former, privileged women, tend to express their resistance to medical intervention in the language of “nature,” “tradition,” and “normalcy”?

And answers:

It is a rejection of privilege that simultaneously confirms it…

The fantasy of Third World women’s natural experiences of childbirth has become iconic among first world women, even if these experiences are more imagined than real. This creates multiple opportunities for exploitation, as the experiences of Third World women are used as a means for first world women to acquire knowledge, experience and perspective on ‘natural’ or ‘traditional’ birthing practices, while denying the importance of medical services that privileged women take for granted.

To be clear, I have seen no evidence that Gaskin herself discriminates against individual women of color, but that does not make her innocent of mobilizing racist stereotypes and practices. 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 racist fantasies about black women for the benefit of privileged white women.

Ironically, one of the most racist examples of breastfeeding advocacy that I’ve ever seen can be found on the website of a bastion of liberalism, National Public Radio.

Entitled Secrets Of Breast-Feeding From Global Moms In The Know, it exploits black African bodies to promote the values of privileged, Western, white women.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Invoking simple, contented black women who function based on instinct not intellect is racism, pure and simple.[/perfectpullquote]

It’s almost like in the U.S. we’ve lost the breast-feeding instinct. That Western society has somehow messed it up. [Evolutionary biologist Brooke] Scelza wanted to figure out why: What are we doing wrong?

So a few years ago, she traveled to a place with some of the best breast-feeders in the world.

In the desert of northern Namibia, there’s an ethnic group that lives largely isolated from modern cities. They’re called Himba, and they live in mud huts and survive off the land…

Moms still give birth in the home. And all moms breast-feed.

“I have yet to encounter a woman who could not breastfeed at all,” Scelza says. “There are women who have supply issues, who wind up supplementing with goat’s milk, which is not uncommon. But there’s basically no use of formula or bottles or anything like that.”

And Himba women make breast-feeding look easy, Scelza says. They even do it while they’re walking around.

See the simple, contented black women who function based on instinct not intellect!

It is a ugly illustration of the casual racism undergirding Western natural childbirth and breastfeeding advocacy described by academic feminist Rachelle Chadwick:

Colonial ideas about indigenous and black women’s bodies as primitive and animal-like and thus primed to give birth (and breastfeed) easily and without pain or the need for medical assistance, are rooted in ideologies of racial difference and Social Darwinism…

[T]he ‘primitive’ woman, “haunts western women’s birth stories” as a romanticized, racist ideal that valorizes the power of the instinctive, pure or ‘natural’ birthing body …

The NPR story checks every box of racist, colonial assumptions.

But that isn’t even the worst part of the casual racism displayed by NPR.

The article utterly IGNORES the fact that the babies of these women die in droves!

According to USAID, the infant mortality rate in Namibia — where all the mothers “instinctually“ breastfeed — is 32.8/1000. In the US, the infant mortality rate is 5.82/1000 — where Western white women have supposedly lost their instincts. The infant mortality rate among the Himba is higher still at an appalling 49.9/1000.

Prof. Scelza did not see fit to mention the fact that the babies of the Himba die in droves. It’s not that she didn’t know about the unusually high Himba infant mortality rate. I found the figure on her research website, a throwback to the casually racist National Geographic photo essays of my youth, complete with happy “primitives” with exposed breasts.

It is reprehensible that the NPR article doesn’t even mention infant mortality, let alone address it. It is a classic example of medical colonialism. Colonialism is the practice of one country occupying another country or region and exploiting it for the benefit of the occupier. Medical colonialism is the practice of exploiting black bodies, knowledge and practices and co-opting them for the benefit of well off white people.

Scelza and NPR actually think the major issue here is how to increase breastfeeding rates in the US (a preoccupation of Western, well off, white women) and ignore the REAL issue here, how to decrease the infant death rate among the Harimba people. But what’s few dead black babies when you are trying to convince white women to breastfeed? Not even important enough to mention, apparently.

“I think that there’s enormous pressure to succeed with breast-feeding in the U.S. and that you feel like if you can’t do it that this is a huge failing as a mother,” Scelza says. But Himba women didn’t seem to think the problems related to breast-feeding were a big deal.

It’s hard to imagine how Scelza and NPR could be more racist if they tried.