Why do homebirth and natural childbirth advocates have so much trouble with the truth?

improvingbirth false graphic

There seems to be a big problem with telling the truth in the homebirth/natural childbirth universe.

Yesterday I wrote about the lactation consultant who lies to her patients about her vaccination status, assuring them she has had a pertussis booster when she has not.

I’ve written in the past about the homebirth midwifery guide that advises lying to your patients about what procedures and medications you use.

Wendy Gordon, CPM, a member of the MANA Division of Research (and placenta encapsulation specialist!) included a bald faced lie in her effort to discredit the study that showed that homebirth increases the risk of a 5 minute Apgar score of zero by nearly 1000%.

Now Improvingbirth.org seems to be having trouble with the truth. Their latest infographic appears to include yet another bald faced lie. The graphic states very plainly that “the most births per day in the U.S. occur on the Tuesday before Thanksgiving.” There’s just one itty bitty problem. It’s not true and it isn’t even close to being true.

A data table compiled by a Harvard economist reveals that the most popular birthday of the year is actually September 16, and that the entire month of November includes no days that are among the most common.

Matt Stiles, data journalist at NPR, turned the table into a fabulous chart, seen below:


The most common birthdays are dark and the least common are light. It is easy to see that the Tuesday before Thanksgiving isn’t even close to being the most common birthday. I can’t imagine where they got that faux “statistic.” Perhaps they simply made it up.

According to the Improvingbirth.org website, their mission is:

To bring evidence-based care and humanity to childbirth.

Really? They might consider the fact that statements that are flat out false are not “evidence-based” at all.

If you cannot trust homebirth and natural childbirth websites like Improvingbirth.org to tell the truth about even the most basic, easily checked statistics, how can you trust them to tell the truth about anything?

Addendum: Improvingbirth.org is not the only natural childbirth organization to make this claim, so I wondered where it originated. I suspect it came from here, Births by Day of the Year. It’s a critique of the heatmap I posted above. There, the data is posted by day of the week superimposed on day of the year. Take a look at the last graph with represents the year 2000.

What’s immediately obvious is that numbers of births per day follows a pattern that cycles each week. Tuesday has the greatest number of births and Saturday and Sunday have by far the least. This has been known for some time and appears to be driven by scheduled C-sections. Simply put, the most common day of the week to schedule a C-section is Tuesday, presumably because the mother will be discharged from the hospital by the weekend when there will be many family members and friends available to help her. No C-sections are scheduled on the weekend. No inductions are scheduled on the weekend, either, making those the days with the least births each week.

There is also an observable pattern around holidays. Holidays which result in days off for the staff also have no elective C-sections or inductions, lowering the number of births for those days. Where did the rest of the births go? They were switched to the days before or the days after. So there’s no evidence that the overall number of C-sections or inductions has changed because of the holidays, only the days on which they are scheduled have changed.

In the year 2000, the day with the highest number of births is indeed, the Tuesday before Thanksgiving, but in other years, it is the Tuesday before or the Tuesday after Christmas or New Year’s Day. So there is no question that the Tuesday before major holidays and the Tuesday after have the highest number of births, BUT that’s NOT because of medically unindicated inductions. It merely reflects the holiday trend superimposed on the weekly trend. There are no scheduled C-sections or inductions on major holidays. Any delivery that was going to be scheduled ANYWAY is moved to a day that is not the holiday.

So, the Improvingbirth.org statistic is misleading because in most years it is factually untrue, and because it does NOT reflect additional inductions as implied by Improvingbirth.org, merely inductions moved earlier or later by a few days.

Finally, it is extremely misleading because the statistic that counts is mortality, not the number of babies born on any given day. Improvingbirth.org has provided no evidence of any kind that ANY babies or mothers are harmed by these schedule changes and there is no reason to believe that there would be any impact on mortality by scheduling changes of a few days.

The ultimate irony is that natural childbirth advocates are forever wailing that obstetricians “play the dead baby card” by warning of bad outcomes as a result of refusing interventions. Not only is Improvingbirth.org use the very tactic that they claim to despise (“Don’t be a Thanksgiving statistic!”) hypocritical, it is actually worse. In contrast the obstetricians’ warning, which is actually true, Improvingbirth.org’s warning is factual false. There is no evidence that more babies are born on Tuesdays before and after major holidays has any impact on mortality or morbidity.