Homebirth and defining deviancy down


In the winter of 1993, Senator Daniel Patrick Moynihan published a deeply influential scholarly paper entitled Defining Deviancy Down.

He started from the premise of sociologist Emil Durkheim that there is a maximum amount of deviance that a society can recognize before that society begins to fall apart. In order to preserve society  if deviancy rises above that level, standards will change so that behavior previously recognized as deviant is no longer considered deviant. In other words, if society is not careful about enforcing standards, standards will constantly be lowered.

Moynihan wrote about crime in New York City, but the analysis has been extended to many disparate areas, and I’d like to extend it further … to homebirth.

Homebirth as a philosophical movement is only legitimate as long as its central premise is legitimate. The central premise is that homebirth is as safer or safer than hospital birth. But as homebirth has risen in popularity, it has become glaringly apparent that homebirth isn’t safe at all. There are far too many deviations from safety, including deaths, brain damage, and other permanent injury, for anyone to rationally conclude that homebirth is safe. Therefore, homebirth advocates have been defining deviancy down, by insisting that what is dangerous is actually safe, that what is a disastrous outcome could not have been avoided, and that there is more to safety than whether the baby or mother lives ordies.


1. The magic umbilical cord

It is common knowledge that any baby born blue, struggling to breath or not breathing at all, is a baby who has been compromised and perhaps seriously injured by oxygen deprivation. But in the world of homebirth, an appalling number of babies are born blue and struggling to breath or not breathing at all. How do homebirth advocates reconcile the purported “safety” of homebirth with the many babies born obviously suffering the effects of oxygen deprivation? Simple, they’ve redefined what it means for a baby to be born blue, struggling to breath or not breathing at all.

Instead of acknowledging that these babies are oxygen deprived, homebirth advocates have redefined blue babies to be “normal” and invoked the magical umbilical cord, which purportedly supplies copious amounts of oxygen after birth even though it wasn’t supplying enough oxygen before birth.

Voila! A blue baby is now “normal.”

2. Rejection of risk factors

Homebirth advocates often claim that homebirth is for low risk women, yet encourage high risk women (breech, twins, VBAC) to give birth at home. How does that make sense? It does if you define deviancy down an insist that what were previously considered deviations FROM normal are now merely variations OF normal. Presto-chango! Anyone can give birth at home because everyone is “low risk.”

3. The rejection of risk, aka “the dead baby card”

Homebirth advocates haven’t merely re-defined risk factors, they’ve redefined risk. Previously, when an obstetrician told a woman that she was at risk for a serious complication, she took that advice into consideration. Homebirth advocates have deliberately defined risk down, such that any risk that isn’t 100% isn’t a risk at all, just the obstetrician trying to scare the mother.

4. Any birth that doesn’t result in death is safe

We’ve recently seen this attempt to define safety down in the antics of Ruth and Jared Iorio desperately trying to pretend that Ruth’s birth involving a near death experience from postpartum hemorrhage, transfusions and a 2 day hospitalization is an example of the safety of homebirth. Ruth didn’t die, so homebirth is safe.

5. Dead babies are unavoidable

If you were naive you might think that a dead baby (or mother) was the ultimate example of a homebirth gone wrong. But now homebirth advocates have defined dead babies down, too. Whereas dead babies were previously recognized as homebirth disasters, they are now treated as inevitable deaths so that homebirth can be justified since the baby was going to die anyway.

Contemporary homebirth advocacy is a paradigmatic example of defining deviancy down.

Blue babies are now getting “enough” oxygen.
Risk factors are all variations of normal.
There is no such thing as risk.
If no one died it was a safe homebirth.
And even if the baby or mother died, it was inevitable.

The philosophy of homebirth is legitimate only so long as its central premise, that homebirth is as safe as hospital birth, is true. It can’t survive as a social movement otherwise. Since homebirth is obviously not safe, with mortality rates approaching 1000% higher than hospital birth and brain injury rates exceeding 1800% of hospital birth, homebirth advocates have been forced to define deviations from safety down, proving Durkheim correct. If we are not careful about enforcing standards for safe birth, those standards will be constantly lowered until they are meaningless, as they already are in the world of homebirth.