The story was horrifying even before we knew the details.

Maternal deaths in the hospital are unusual; perinatal deaths are 100 times more common. There are so few maternal deaths in the developed world that they are measured per 100,000 and most of the women who die have serious medical complications like cardiac disease or pre-existing medical conditions. Death from a routine childbirth complication like bleeding is almost unheard of in an age of blood transfusions and surgical repair … but not in an age of homebirth.

Caroline Lovell was an Australian homebirth activist.

She wrote the following in response to midwifery legislation under consideration:

On a personal note, I am quite shocked and ashamed that homebirth will no longer be a woman’s free choice in low-risk pregnancies… I feel the decision to outlaw homebirth’s is contrary to women’s rights … Please find a solution for women and babies who homebirth after this date as their lives will be in threat without proper midwifery assisstance. And as a homebirthing mother I will have no choice but to have an unassisted birth at home as this is the place I want to birth my children.

Yours sincerely,
Caroline Flammea, Nick Lovell and daughter Lulu Lovell.

She never acted on her dare, but perhaps she would be alive if she did. According to a tribute published at the time:

Caroline Emily (Flammea) Lovell

LOVELL (nee Flammea). – Caroline Emily 15.07.1975 – 24.01.2012 Passed away suddenly after giving birth to a beautiful baby girl. Beloved daughter of Jadzia (Jade), loving wife of Nick and exceptional mother of Lulu and Zahra. You taught us how to love Always in our hearts

Instead, Lovell told her midwives that she was dying, and they, with stupidity that borders on the criminal, never even examined her.

“A mother told her midwives she was dying and needed to go to hospital in the moments after she gave birth to her second daughter in her Melbourne home, the Victorian Coroners Court was told on Tuesday…

But just over an hour after the “overjoyed” couple greeted their daughter in their Watsonia home, the court heard Ms Lovell told her midwives she needed to go to hospital. Ms Lovell, 36, died later that night in the Austin Hospital.

And so Caroline Lovell bled to death … slowly, preventably … because the midwives she depended on were too ignorant, or too ideologically brainwashed, to perform even the most basic midwifery tasks. Instead, as reported by midwife Melody Bourne:

Just over an hour after Zahra was born in a birth pool, Ms Bourne said Ms Lovell was light-headed and hyperventilating, telling her midwives she was dying and needed to go to hospital.

“Gaye [Demanuele, the second midwife] then questioned Caroline as to what she was feeling, in this conversation Caroline did not identify any physical symptoms,” Ms Bourne said.

“Gaye and I also made efforts to calm and reassure Caroline.”

Five minutes later, Ms Lovell became pale, cold and unresponsive and an ambulance was called. Examination by hospital clinicians revealed Ms Lovell had suffered two tears and a blood clot.

Any real healthcare provider will tell you that the most chilling words you can hear from a patient are: “I think I’m dying.” That’s because they probably are dying and it is up to you as the provider to undertake whatever examinations and tests are necessary to prove that they are not.

It would have been laughably simple for the midwives to have assessed Lovell BEFORE they reassured her. Her life threatening blood loss would have been easily diagnosed by taking her blood pressure or checking her pulse. Nothing sophisticated was required, merely the most basic of clinical skills.

Instead:

Under questioning by Tania Cristiano, the counsel assisting coroner Peter White, Ms Bourne said this could have been identified if the midwives had examined Ms Lovell.

“There were more pressing events and there didn’t appear to be any excessive blood loss,” Ms Bourne said,

More pressing events? What could me more pressing than checking blood pressure and pulse to see if their patient was dying?

And that wasn’t the only basic task the midwives ignored. They never checked her past obstetrical history to learn that Lovell was at increased risk of bleeding to death:

Ms Bourne, who said she has since “distanced” herself from midwifery, said she was not aware of Ms Lovell suffering a postpartum haemorrhage in the hospital birth of her first daughter, Lulu.

Ms. Lovell had been warned:

Ms Lovell saw three general practitioners from the same clinic during her pregnancy, where she was warned about the risks of home births on four occasions and underwent blood tests, which revealed she was anaemic.

Dr Daniel Bevz had told the court earlier Ms Lovell was steadfast in her decision to have a “natural” birth.

“She indicated she had discussed that with previous doctors at length and did not want to enter into further discussions,” Dr Bevz said.

Had Ms. Lovell given birth unassisted, she might be alive today. When she told her husband she was dying, he may have called an ambulance to summon real medical professionals.

Instead, Ms. Lovell trusted homebirth midwives and they “reassured” her she was fine even as her life ebbed away.

Ms. Lovell trusted birth and birth killed her.

A fitting memorial to Ms. Lovell would be very strict regulation of Australian homebirth midwifery, so that no other woman or baby dies while ignorant, brain washed, negligent midwives stand by and watch.

But I predict that Australian midwives will fight that tooth and nail. Indeed, I can’t wait to see how midwifery spokesperson Hannah Dahlen tries to spin a mother’s easily preventable death at the hands of homebirth midwives who couldn’t even be bothered to check a pulse.

The death rate of homebirth with American homebirth midwives is appalling. Indeed, it is so appalling that the Midwives Alliance of North America (MANA), the organization that represents homebirth midwives, hid their death rates for 5 years. When they finally released those death rates, they refused to compare them to the death rates for comparable risk women giving birth in the hospital, because that would have shown that homebirth midwives have a death rate 450% higher.

This is part of the homebirth campaign to bury babies twice, first in tiny coffins in the ground, and then again by erasing their existence from websites, blogs and message boards and by refusing to accept responsibility for those deaths.

Enough is enough! Several months ago, Jan Tritten, the editor of Midwifery Today crowd sourced a life and death situation among her Facebook friends while the baby was dying; then she deleted the thread and any mention of what she had done. The #notburiedtwice campaign was started in response. There’s a Facebook page, numerous tweets, and now, courtesy of doula Danielle Repp, there is a YouTube video. The video includes mothers of babies who have died at homebirth and other women who care passionately about babies who didn’t have to die.

Watch the video. When you do, you will never feel the same way about homebirth again.

Please join our campaign to make sure that the babies who die at homebirth are #notburiedtwice.

Yesterday I mentioned the racists tropes that are at the heart of natural childbirth (and therefore homebirth and UC) advocacy. To paraphrase:

Just like blackface performers often portrayed people of color as happy to be slaves, natural childbirth advocates (generally well off white women) like to portray women of color (albeit without the blackface) as without fear and happy to give birth “in nature.” Nothing could be further from the truth.

It’s not a surprise that this racist trope is at the heart of natural childbirth advocacy. It harks back to the racism of Grantly Dick-Read, the “father” of natural childbirth. Dick-Read viewed natural childbirth as a way for white women of the “better” classes to avoid “race suicide.” Ornella Moscucci explains the thinking of Dick-Read and his eugenicist peers:

… Dick-Read … claimed that primitives experienced easy, painless labours. This was because in primitive societies the survival value of childbirth was fully appreciated and labour was regarded as nothing more than “hard work” in the struggle for existence. In civilised societies on the other hand a number of cultural factors conspired to distort woman’s natural capacity for painless birth, producing in woman a fear of childbirth that hindered normal parturition …

In other words, “natural” childbirth is based on the racist assumption that “primitive women” (read “women of color”) are fundamentally different from white women, simultaneously simple (longing only to reproduce) and unafraid of dying in childbirth, rendering them immune to the pain and dangers of birth.

That racist trope is alive and well among contemporary natural childbirth advocates who pretend to themselves that they are re-enacting childbirth among indigenous peoples. Their little fantasy bears as much resemblance to childbirth in nature as a 3rd grade Thanksgiving play bears to the real relationship between the Pilgrims and the “uncivilized” Native Americans they came to displace.

But the racism extends even further. Natural childbirth advocates are positively eager to use the misfortunes of women of color to advance their own privileged agenda. They delight in pointing to relatively high rates of perinatal and maternal mortality in the US (as compared to other, “whiter” countries), yet ignore that they are the result of appalling death rates among African American women and their babies.Natural childbirth advocates and organizations have the unmitigated gall to imply that these women are dying of “too much” medical intervention when the reality is that they are dying of too little intervention for the serious complications they face.

Ina May Gaskin, a privileged white woman, has led the way in this exploitation. Gaskin never misses an opportunity to highlight mortality rates and even created a “Safe Motherhood” quilt project to draw attention to the problem. Gaskin represents herself as shocked at the current rate of maternal mortality. Yet as far as far as I can tell, homebirth midwives in general and Gaskin in particular have done NOTHING (no research, no education, no fund raising) to reduce the incidence of maternal mortality.

Anyone who visits the quilt website will notice something rather curious. There is NO information about the causes, treatments and research into maternal mortality. There are no scientific papers about maternal mortality. There is nothing about the epidemiology of maternal mortality.

That’s because Gaskin and other natural childbirth advocates care about the deaths of women and babies of color only to the extent that they can exploit them for their own ends, not because they care that they are dead and not because they have any intention of lobbying for an increase in high risk obstetricians to treat the problem.

The exploitation of women of color extends to the many ham handed attempts to increase breastfeeding rates. For example, ending gifts of free formula samples does NOTHING to increase the rate of breastfeeding. It’s only real impact is to deprive poor women (among which women of color are overrepresented) of a desperately needed resource for infant formula.

None of this is surprising. The natural childbirth movement is by, about and for privileged white women.

Political scientist Candace Johnson explores the role of “natural” childbirth as a philosophy of privilege in contemporary society 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. Therefore, the problem of medicalization seems to apply disproportionately to privileged women. In fact, some of the most serious pronouncements of medical interference in pregnancy and childbirth as a “natural, normal, woman-centered event” come from women of considerable privilege and authority…

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.

Natural childbirth rests to a large extent on misrepresenting women of color, while simultaneously exploiting the poor outcomes of those very same women in a thoroughly disingenuous critique of modern obstetrics.

It may be unconscious racism, but it is racism nonetheless.

Stuntbirth, known to devotees as unassisted childbirth (UC) or “freebirth” is about to get a reality TV show. It’s a marriage made in heaven!

Stuntbirthers are narcissists in the extreme and reality TV is made for narcissists who are so desperate for attention that they are willing to be ridiculed and/or humiliated for the TV.

The only surprise is that it took this long.

Stuntbirthers like to pretend to themselves and others that this is how birth happens in nature (no, across all times, places and culture, birth is assisted), that birth is so deeply personal and “sexual” that a couple must experience it alone (really, then why are you posting a video of it on YouTube for all the world to see?) and that it is safe. The entire practice would be nothing more than a punch line were it not for the fact that it kills babies, in fact a startlingly high proportion of the babies whose mothers were ignorant enough to embrace this stunt.

Perhaps more compelling than the statistics is the fun fact that both the leading American and Australian advocates of UC have ended up with dead babies as a result. Laura Shanley, the American, likes to boast that she had 4 wonderful unassisted births, but she has actually had 5. She deliberately and knowingly gave birth to a premature baby alone at home and, over the next several hours, watched him die without ever summoning help.

In April of 2009, Janet Fraser, Australia’s leading advocate of UC, experienced the death of her baby during labor. Fraser had proudly boasted to an Australian paper that she had no prenatal care of any kind, and planned to have no medical assistance at the birth. Her baby paid the ultimate price for her idiocy.

Unassisted childbirth is also, in its own self-absorbed, narcissistic way, startlingly racist. Stuntbirth advocates (like many homebirth advocates) like to imagine that women in nature, particularly women of color, did not fear childbirth, simply squatted down by the Congo River to give birth, and immediately returned to their fabulously healthy paleo lifestyle.

Instead those women in nature, often women of color, feared childbirth because they died in agony and in droves. Indeed, even today many women, particularly women of color, continue to die in agony and in droves. According to the World Bank, the life time risk of maternal death is the probability that a 15-year-old female will die eventually from a pregnancy related cause. In the US where modern obstetrics is available the risk of death due to pregnancy and childbirth over a lifetime is 1 in 1800; in countries that are predominantly white and ethnically homogeneous, the lifetime risk is 1 in 13,000. In contrast, a teenager in Cameroon has a 1 in 34 chance of dying of a pregnancy related cause over her lifetime and women in Chad have a 1 in 15 chance of dying.

You can bet that they aren’t crowing about the virtues of stuntbirth. They have the assistance of traditional birth attendants in labor; they may walk miles to deliver in a clinic, and they certainly don’t give birth outside by the river bank.

In a sense, stuntbirth is the childbirth equivalent of blackface, complete with racist stereotypes minimizing the childbirth horrors that women of color endured and still endure (look up obstetric fistula). Just like blackface performers often portrayed people of color as happy to be slaves, stuntbirthers (invariably well off white women) like to portray women of color (albeit without the blackface) as happy to give birth “in nature.” Nothing could be further from the truth.

Tragically, unassisted childbirth has no benefit for the baby and poses very serious risks or injury and death. It is a form of medical neglect based on appalling ignorance, extraordinary selfishness and clueless racism. In short, it is nothing more than an ugly and dangerous stunt.

Perfect for reality TV!

Awww, Katie Jenkins McCall (remember Sisters in Chains) is feeling angry.

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

Well, you know what, Katie? I’m feeling angry, too.

I’m feeling angry because ignorant, arrogant, irresponsible clowns like you support homebirth with ignorant, arrogant, irresponsible self-proclaimed midwives who fail to meet the basic qualifications for midwives in ALL other industrialized countries.

I’m angry because it doesn’t matter a damn to you that babies die at the hands of these ignorant, arrogant, clowns like yourself. All that appears to matter to you and your buddies, is your pocketbook.

I’m angry because you confuse your ability to fleece unsuspecting pregnant women with “birth freedom.” The only freedom you and your buddies appear to be interested in is the freedom from safety standards, taking responsibility and being held accountable.

I’m angry because it in your privileged white, middle class woman way you think YOU are persecuted just because a bunch of babies are dying preventable deaths at the hands of your buddies. You have no idea what persecution is.

You have no idea what ethics is, either. Ethics involves caring about the LIVES of the babies in your care. It involves caring about the LIVES of the pregnant women in your care. It does not involve your ability to profit despite your substandard education, substandard training, and overweening arrogance in thinking that you are capable of caring for human beings.

Donating to a legal fund for any midwife who is accused of hideously negligent substandard care because you like homebirth is like donating to the Aaron Hernandez defense fund because you like football. It betrays a fundamental contempt for the lives of the people you are supposed to serve.

Does Sorensen deserves a lawyer. Of course she does, and the State of Utah is obligated to provide her with a public defender, not a “lay” lawyer, not a self-proclaimed “lawyer,” not an self taught “lawyer.” Although homebirth “midwives” think that “lay,” “self-proclaimed” and “self-taught” are okay when it comes to medical care for women and babies, they are concerned enough about their own hides that they don’t want to settle for a public defender, but want to hire a professional who requires a $50,000 retainer. It would be the height of irony if it weren’t so tragic.

Katie, I have some unsolicited advice for you and your buddies:

Stop pretending that you are midwives; you are poorly educated, poorly trained lay people.

Stop attending homebirths. Too many babies have died because of clowns like you.

Stop prattling about “birth freedom.” This has nothing to do with freedom and everything to do with responsibility.

Stop giving new meaning to the term “blood money” by donating to support women who should not be allowed to care for anyone, let alone vulnerable women and babies.

And please, please, please stop feeling sorry for yourselves! You are not oppressed. You are not persecuted. You are just ignorant, arrogant and terribly dangerous.

A midwife in Utah allegedly presided over the death of a very premature baby after insisting that homebirth would be fine, interfered with an ambulance crew trying to rescue a hemorrhaging mother, lied on medical records, may have multiple dead babies buried on her property, and, nonetheless, homebirth advocates are supporting her; they’re raising money for her legal defense and even holding a benefit concert.

Why should we care?

We should care because it demonstrates that there is no will among homebirth midwives or homebirth advocates to institute ANY safety standards of any kind.

We should care because it demonstrates that homebirth midwives will NEVER hold each other accountable for even outrageous behavior, let alone simple negligence and malpractice.

We should care because #yesallbabies are treated as nothing more than props in the mothers’ and midwives’ view of homebirth.

We should care because #yesallbabies who die at homebirth are treated as unimportant collateral damage in the quest for “birth freedom.”

We should care because #yesallbabies are put at risk of death by the blind eye that homebirth advocates and homebirth midwives turn to the growing pile of tiny dead bodies.

We should care because American homebirth advocates and homebirth midwives are fundamentally unethical, promoting ignorance, arrogance and negligence.

But most importantly, we should care because anyone who has a heart cares about #yesallbabies who didn’t have to die.

Please speak out wherever you can and make sure that the babies who die at homebirth are #notburiedtwice.

People accuse me of being insensitive for writing about homebirth deaths, but I can’t hold a candle to homebirth advocates. They are giving new meaning to the term “blood money.”

We already know that they don’t give a damn about the growing pile of tiny dead bodies. Their credentialing organizations have no safety standards; they crowd source life and death decisions among their Facebook friends, and there isn’t a death that they can’t justify (to themselves). But do they have to grind their hideous lack of sympathy right into the weeping faces of the parents of those dead babies?

Apparently they do.

If there ever were a case where the homebirth midwife deserved to be disavowed by her colleagues, the latest homebirth death to hit the news in Utah would seem to be it.

Police say a lay midwife in Cedar City refused to take a laboring mother of premature twins to a hospital, falsified emergency medical information, and tried to stop the hemorrhaging mother from leaving the midwife’s in-home birth center in an ambulance as her infant son died.

But police documents connected with the investigation go farther, indicating that other babies died under the care of Vicki Dawn Sorensen and her daughter, Camille Wilcox, and reporting allegations that the midwives were burying infants’ remains in clandestine graves…

The mother began laboring in December 2012, at 32 to 33 weeks of pregnancy. The mother and the twins’ father “became greatly concerned” that the twins would be born premature outside of a hospital — Sorensen allegedly told them she would not try to deliver the babies before 36 weeks — but Sorensen allegedly told the parents not to worry because they could go to a hospital if problems were to arise, police wrote.

I hadn’t written about this yet because the existing details make the midwife sound mentally deranged and I wasn’t sure whether this was an example of the pitiful education and training of self-proclaimed “midwives” or an example of psychiatric illness. Homebirth advocates apparently don’t care what the proximate cause is, whether it is the ignorance of homebirth midwives or deranged behavior. If she calls herself a midwife, they are on her side.

Check this out:

Yes, you read that right. Families for Birth Freedom would like to start a fundraising campaign for Vicki Sorenson. So let me see if I get this straight: Sorensen has allegedly presided over the death of a very premature baby after insisting that homebirth would be fine, interfered with an ambulance crew trying to rescue a hemorrhaging mother, lied on medical records, and MAY HAVE MULTIPLE DEAD BABIES BURIED ON HER PROPERTY, and homebirth advocates want to send her money? Really?

What would it take for homebirth advocates to disavow a midwife. Would she have to shoot the baby in cold blood?

How about the grieving parents. Surely homebirth advocates are raising money for them, right? Not so far as I can tell.

So there you have it folks, the homebirth midwifery trifecta: ignorant, negligent AND heartless.

Don’t let them get away with it this time.

Please share this post on Facebook, Twitter and anywhere else you can think of, and include the hashtag #notburiedtwice.

Women need to know that when they choose homebirth, they are choosing practitioners who not merely abandon them after presiding over their babies’ deaths, but will actually give money to the midwives responsible.

And for any woman thinking about homebirth, you ought to think again:

This could be you, left with empty arms, a broken heart and midwives raising blood money to protect one of their own. Apparently homebirth midwives are more interested in their “birth freedom” than whether your baby, ANY baby, or MANY babies live or die.

More integral to homebirth than a birth pool, delayed cord clamping or a doula is the relentless boasting about it during and afterward.

So I have an existential question for homebirth advocates:

If you give birth in a forest, and there’s no one around to tweet it, video it, live blog it or create birth announcements that proclaim it happened outside the hospital, is it still a homebirth anyway?

Ever wonder how people fall for get rich quick scams?

I’m talking about the scams like emails that announce you have won a contest that you never entered, ads that claim you can earn $50,000 a month working from home, or expensive seminars that promise to make you a real estate magnate.

Who falls for those things?

It is understood that greedy people fall for these scams, but not most people who are greedy are also wary. The people who fall for these scams aren’t merely greedy; they want something for nothing. The rest of us understand that short of inheriting massive wealth, the only way to make large sums of money is to work for it. We are sadly aware that there is no such thing as “something for nothing.”

The perpetrators of get rich quick scams know that greedy people who want something for nothing are easy marks and tailor their approaches to appeal to people with that specific vulnerability.

Those who fall for science quackery are very similar. They too are greedy and want something for nothing. In their case, though, they aren’t looking for money. Victims of quackery are looking to boost fragile self esteem by claiming expert knowledge without doing the hard work of taking the courses, putting in the training time, and getting the degree. Professional quacks know that those who want to claim expert knowledge without education or training are easy marks and tailor their approaches to appeal to people with that specific vulnerability.

Those who would fight quackery would do well to understand this basic fact. A recent, apparently paradoxical study on anti-vaccination suggests that they don’t understand. The study, Effective Messages in Vaccine Promotion: A Randomized Trial, was published in the journal Pediatrics. The authors of the study started with the assumption that it is ignorance that leads to opposition to vaccines. Based on that assumption, they designed educational interventions:

A Web-based nationally representative 2-wave survey experiment was conducted with 1759 parents age 18 years and older residing in the United States who have children in their household age 17 years or younger (conducted June–July 2011). Parents were randomly assigned to receive 1 of 4 interventions: (1) information explaining the lack of evidence that MMR causes autism from the Centers for Disease Control and Prevention; (2) textual information about the dangers of the diseases prevented by MMR from the Vaccine Information Statement; (3) images of children who have diseases prevented by the MMR vaccine; (4) a dramatic narrative about an infant who almost died of measles from a Centers for Disease Control and Prevention fact sheet; or to a control group.

Much to the surprise of the authors, the attempts at education were completely ineffective at changing parental attitudes.

… Refuting claims of an MMR/autism link successfully reduced misperceptions that vaccines cause autism but nonetheless decreased intent to vaccinate among parents who had the least favorable vaccine attitudes. In addition, images of sick children increased expressed belief in a vaccine/autism link and a dramatic narrative about an infant in danger increased self-reported belief in serious vaccine side effects.

The authors were surprised because they assumed that being uninformed is what rendered parents vulnerable to anti-vax quackery. But most people lack the requisite education in immunology, virology and public health and they vaccinate their children anyway. Those most vulnerable to anti-vax quackery are a subset of the uneducated who are greedy to assert expert knowledge without education.

In other words, those most vulnerable to quackery aren’t the uneducated; they are the uneducated who wish to view themselves as educated without doing the work required.

That’s why educational messages are startlingly ineffective in combating vaccine quackery. Anti-vax is not about children and not about vaccines; it is about parents and how they wish to veiw themselves.

So how can you tell if you are an easy mark for a quack?

• If you are anxious to view yourself as more educated than others without actually getting the requisite education, you are vulnerable.
• Do you believe that you can “educate” yourself about medical topics without going to medical school, you are vulnerable.
• If you believe that “researching” a topic means using Google, you are vulnerable.
• If you believe that lay people can know more about medical topics than medical experts, you are vulnerable.

But the flip side is that if you understand you are vulnerable, you can take precautions to avoid being scammed. The first step is recognizing that flattery as an inappropriate component of medical information.

Doctors, scientists and public health officials do not sit around flattering each other about their knowledge. When someone tries to flatter you, you know you are in the presence of a quack, not a legitimate medical professional. Run in the opposite direction.

Americans tend to be pretty savvy about advertising. Put a box around claims, annotate them with the words “paid advertisement” or “sponsored content” and most people approach those claims warily. Unfortunately, the same people who are dubious about advertising claims are remarkably gullible when it comes to quackery.

That’s the bad news. The good news is that it is surprisingly easy to tell quackery apart from real medical information. Quack claims are typically decorated with red flags … if you know what to look for. What follows is a list of some of those red flags.

1. The secret knowledge flag: When someone implies they are sharing secret medical knowledge with you, run in the opposite direction. There is no such thing as secret medical knowledge. In an age where there are literally thousands of competing medical journals, tremendous pressure on researchers to publish papers, and instantaneous dissemination of results on the Internet, nothing about medicine could possibly be secret.

2. The giant conspiracy flag: In the entire history of modern medicine, there has NEVER been a conspiracy to hide lifesaving information among professionals. Sure, an individual company may hide information in order to get a jump on competitors, or to deny harmful effects of their products, but there can never be a large conspiracy because every aspect of the healthcare industry is filled with competitors. Vast conspiracies, encompassing doctors, scientists and public health officials exist only in the minds of quacks.

3. The flattery flag: Quacks invariably try to flatter potential customers by implying that those customers are uncommonly smart, insightful and wary. They portray non-believers as “sheeple” who are content to accept authority figures rather than think for themselves. A real medical professional does not need to flatter you. He or she knows what is true and what isn’t and shares that information whether it makes you happy or is the last thing you want to hear. You can believe it or not.

4. The toxin flag: I’ve written before that toxins are the new evil humors. Toxins serve the same explanatory purpose as evil humours did in the Middle Ages. They are invisible, but all around us. They constantly threaten people, often people who unaware of their very existence. They are no longer viewed as evil in themselves, but it is axiomatic that they have be released into our environment by “evil” corporations. There’s just one problem. “Toxins” are a figment of the imagination, in the exact same way that evil humours and miasmas were figments of the imagination.

5. The “brilliant heretic” flag: The quack often has no training in the relevant discipline, be it obstetrics, immunology or cancer care? No problem. A pervasive theme in quackery is the notion of the brilliant heretic. Believers argue that science is transformed by brilliant heretics whose fabulous theories are initially rejected, but ultimately accepted as the new orthodoxy. The conceit rests on the notion that revolutionary scientific ideas are dreamed up by mavericks, but nothing could be further from the truth. Revolutionary scientific ideas are not dreamed up; they are the inevitable result of massive data collection. Galileo did not dream up the idea of a sun-centered solar system. He collected data with his new telescope, data never before available, and the sun-centered solar system was the only theory consistent with the data he had collected.

6. The “quantum” flag: Quacks love to baffle followers with bullshit, hence the invocation of esoteric scientific theories that they don’t understand. Quantum mechanics and chaos theory are two incredibly abstruse scientific disciplines, heavy on advanced math. If you don’t have a degree in either one, you aren’t qualified to pontificate on them. The same thing applies to new, imperfectly understood areas of science like epigenetics or the microbiome. Both are genuine scientific concepts, but we are in the earliest stages of elucidating them. There is real danger in insisting that they have current practical implications. We should learn from the terrible mistakes that were made when radiation was first discovered and and radioactive compounds were added to everything from water to make up under the false belief that radiation could prevent everything from aging to death.

There is a saying in science that “extraordinary claims require extraordinary evidence.” Quack claims are typically extraordinary, but quacks don’t offer evidence, they raise some or all of the six red flags in an attempt to trick you into buying what they are selling, and they are invariably selling something. When you see one of these red flags, you can be virtually certain that you are in the presence of quackery. Run, don’t walk, in the opposite direction.