Another maternal death: How the quest for the idealized birth experience continues to kill


There’s denial and then there is something so desperate, so illogical and so ridiculous that labeling it denial seems grossly inadequate.

The story is simple and straightforward. A pregnant woman was facing a C-section because all the obstetricians she consulted advised her that vaginal delivery might result in the death of one of her twins or herself. She decided to ignore their warning and gave birth at home unassisted. She died of a massive postpartum hemorrhage. Whose fault is that?

According to a fellow homebirth advocate who was her friend, it’s the fault of obstetricians. Let me say that again to make it clear: She was warned she might die if she attempted a vaginal birth. She attempted a vaginal birth and died. But supposedly she bears no responsibility for the choice that killed her.

The story of this preventable maternal death, My Friend Died: A Story of How the War Over Women’s Bodies Continues to Kill, can be found in the appropriate named journal Squat. Everything in the journal isn’t worth squat. It was written by Nekole Shapiro who “focuses on oxytocin-infused states, birthing parts and healing birth trauma.”

Our friend died last year.

She was pregnant with twin girls that would be daughters number 3 and 4… When she was 36wks pregnant, I received a text message that the family had exhausted their search for a provider who would support her to birth her twins vaginally… [T]he couple had decided to do it on their own.

This did not sit well with me. This was not a family who said, We would like an unassisted vaginal home birth of twins. This was a family who felt they were left with no better option since no one would support them in what they saw as the best and safest option: a spontaneous vaginal delivery…

What happened?

Next thing I knew, I got a text that she had birthed her twins: spontaneous labor at 38 weeks. I was elated and couldn’t wait to hear more. But then the second text came: she had lost quite a bit of blood and was in a coma…

Initially, the mother’s prognosis was unclear. Unfortunately:

Then they reported that there was only brain stem activity…

The next update I got was via this Facebook post, “[My wife] has not, and will not, wake up again. She has been moved to a room where she will be kept comfortable until the end.” Some days later she passed away.

Nekole grappled with tremendous cognitive dissonance:

At first, I was quite shaken by these events and I knew others would be as well. I knew people would quickly say, “See, you can’t trust birth. Birth IS inherently dangerous. How dare you be one of those people who support anyone thinking otherwise! See what can happen?” But, I also knew that this is one story of many and I did not want my raw emotional state to start dictating my view of the world. I reminded myself that many people die in car accidents, but we have not outlawed cars.

We don’t go around pretending that driving cars is “as safe as life gets,” either.

But cognitive dissonance is hard. Denial is easy:

Ultimately, this story is a horrific reminder of our broken system. If we walk out of a birth with this type of unfathomable outcome when in fact all the support needed was present, that is one thing. But, to have this outcome with a complete lack of support, that is simply unacceptable. Our system should be designed and focused on supporting mothers to birth the way they feel is best for them!…

No, no, no. This is not a horrific reminder of a broken “system.” It is a horrific reminder of a broken philosophy, the philosophy of natural childbirth.

Natural childbirth advocates encourage women to value process over outcome. They encourage women to seek an idealized “birth experience.” They encourage women to reject medical advice in favor of “intuition.” They encourage women to risk the deaths of themselves and their babies and as a result, women and babies die preventable deaths.

Obstetricians do not exist to provide support. They exist to provide safety. Women ignore them at their own peril. They have every right to do so, but let’s at least be intellectually honest enough to acknowledge what actually happened. A woman ignored the lifesaving advice of obstetricians and died as a result.

The people who bear responsibility for the outcome are not the people who warned her; the people who bear responsibility for yet another preventable death are the mother who made the choice, and the natural childbirth community who encouraged her to pretend that women are “perfectly designed” for childbirth, that obstetricians should not be trusted, and that women should make complex medical decisions by relying on intuition instead of education and training.

A philosophy that encourages women to value process over outcome is a philosophy that inevitably kills women and babies. Unfortunately, Nekole’s friend died as a result of that philosophy and left 4 motherless daughters as the true victims. Too bad Nekole and the editors of Squat didn’t learn anything as a result.