Is natural childbirth a form of quackery?

I wouldn’t go as far as claiming that the philosophy of natural childbirth is purely quackery, but as science systematically eviscerates their claims, natural childbirth advocates are falling back on the defense mechanisms classically associated with pseudoscience.

This represents a radical departure from recent strategies. Unlike traditional pseudosciences (homeopathy, creationism) which have always denigrated scientific research, in the last decade, natural childbirth advocates have based the validity of their philosophy on the claim that it is supported by science while modern obstetrics is not. Indeed, as I have noted in the past, Lamaze International has titled its blog Science and Sensibility to emphasize the purported scientific basis of natural childbirth.

But it turns out that the central claims of natural childbirth advocates are NOT supported by scientific evidence, and many of their claims are completely undermined by existing scientific evidence. Modern obstetrics, in contrast, has always been, and continues to be based on scientific research. Midwifery theorists have recognized this, and celebrity natural childbirth advocates are becoming aware of this problem. To solve it, they are resorting to the tried and true tactics of pseudoscience.

I wrote yesterday about Amy Romano’s parting shot on Science and Sensibility. She is leaving one special interest group (Lamaze International) to work for a natural childbirth lobbying group (The Childbirth Connection), and I find it fitting that she uses her departure to firmly situate natural childbirth as quackery.

Consider what Romano wrote:

… [W]e all arrive at the point of healthcare decision making with a different constellation of factors that affect our choices. We may have different financial resources, health situations, hopes and plans for the future, tolerance to pain, tolerance to risk, prior experiences, and so on.

In other words, with the exception of practices that cause harm with no counterbalancing benefit at all or benefit with no risk of harm at all, there is no such thing as a good or bad healthcare decision. There’s only such a thing as a good or bad healthcare decision for a certain person. Evidence cannot guide practice without the other piece of the equation – the person to which the evidence is to be applied. (emphasis in the original)

Now compare it to a style of pseudoscience defense described by Boudry and Braekman in the recently published paper Immunizing Strategies and Epistemic Defense Mechanisms as “changing the rules of play”:

By undermining the standards of reasoning employed in a rational debate, one can safeguard one’s position from valid criticism. In many instances of this immunizing strategy, the very attempt at criticism is condemned as fundamentally misguided…

For example, in discussions about alternative medicine one often hears the claim that each person or patient is “radically unique”, thus frustrating any form of systematic knowledge about diseases and treatments. Of course, advocates of unproven medical treatments use this argument as a way to deflect the demand for randomized and double-blind trials to substantiate their therapeutic claims. If each patient is radically unique, there is no point in lumping patients together in one treatment group and statistically comparing them with a control group… The argument is so convenient that it has been borrowed as an immunizing strategy by countless alternative therapists …

Romano follows this description almost exactly. She is clearly attempting to undermine the use of scientific evidence as the standard of reasoning used in rational debate. She directly appeals to the notion that since each person is “radically unique,” there’s no point in basing clinical decisions on scientific evidence. Indeed, Romano is basically saying that scientific evidence is irrelevant, and can and should be ignored when it conflicts with cherished personal beliefs.

I doubt Romano even realizes it, but her post allows me to declare victory. I have been writing for years that natural childbirth has nothing to do with scientific evidence. Natural childbirth philosophy was developed by a eugenicist (Grantly Dick-Read) who lied about the pain of childbirth with the explicit intention of convincing white women of the “better” classes to have more children than “primitive” (read: black) women. It has been perpetuated by people who have disregarded scientific evidence. And now, in 2010, Amy Romano writing under the aegis of Lamaze is trying to provide a justification for explicitly ignoring scientific evidence.

The days of declaring that natural childbirth is based on science are over; they have come to an abrupt end because it has finally penetrated the consciousness of natural childbirth advocates that their claims are not and never were based on science. At this point, natural childbirth is perilously close to becoming nothing more than a form of quackery.

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