The Dr. Amy paradox

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I have a riddle for you.

What would I get if I added the following?

Nuance + Compassion + Dr. Amy =

Give up?

I would get IGNORED.

That’s the real answer to the riddle posed by Kristin of Birthing Beautiful Ideas. Kristen ponders:

That’s right. Sometimes, I agree with Dr. Amy.

But I rarely agree with her delivery. Sometimes it’s rife with logical fallacies*: straw man arguments, appeals to pity, appeals to authority, ad hominem attacks. It’s often mean-spirited and shrill and condescending…

And so after I read the piece from Feminist Midwife, I wondered: what might Dr. Amy’s blog posts look like if she injected nuance, compassion, a less dogmatic form of critical thinking, and some simmering-down-now (with a teensy bit of snark, just to let off some of her steam)?

At the end of her piece, Kristen highlights a previous encounter:

You’ve been here before, and you called me a “gullible, woefully undereducated women who’s likely never read a scientific study in its entirety.” It was fun(ny). In any case, I have read plenty of scientific studies in their entirety, though surely not as many as you have. Likewise, you may have read a bit of philosophy, but likely not as much as I have. Your training gives you the upper hand when it comes to expertise in practicing medicine. Mine gives me the upper hand when it comes to expertise in all things philosophical. These different trainings and types of expertise give us somewhat different approaches when it comes to reading said scientific studies: you will arrive from a clinical background based both on your medical education and your practice of medicine, and I will arrive from a philosophical background based on an in-depth examination of the philosophy of science and on a specialization in theories of autonomy…

Kristen is referring to this post, Newsflash: you did risk your baby’s life for your own experience. Not surprisingly, I stand by everything I wrote. I will add, though, that I have more training in philosophy than Kristen might imagine. I nearly completed a master’s degree in biomedical ethics with Dan Brock when he was still at Brown (everything but the thesis). Kristen would probably be surprised to know that my interest is also in theories of autonomy, especially as they relate to reproductive decisions. That’s why I disagree so vehemently with anyone who claims that homebirth ought to be made illegal; doing so is a violation of a mother’s right to medical autonomy.

Be that as it may, I believe that Kristen’s post deserves a reply.

In a way, Kristen, you have already answered your own question. You imagined what my blog might be like if I wrote in the same style as a midwife whom you admire. You didn’t ask what my blog might be like if I wrote in the style of Dani Repp at What Ifs and Fears are Welcome or Lisa Murakami of Married to Medicine or the many bloggers like them. Both Dani and Lisa are much nicer than me! They write about the same topic as I do with more nuance and more compassion, yet you didn’t mention them. Why? Either you’ve never heard of them or they made so little impression that you forgot them.

For better or for worse, nuance and compassion don’t attract readers. Years ago I briefly tried it and it nearly killed the blog. When I started the predecessor of this blog in 2006, I got about 550 visits a day, 500 of which I bought through Google Ad Words. I haven’t paid for advertising in years. Today this blog averages 6000 visits a day on weekdays, and often thousands more. For my most popular posts I’ve gotten 5,000 visits an hour. I’m sure that you’ve already guessed that the posts with the most traffic tend to be the snarkiest.

Simply put, snark is my schtick. Don’t get me wrong: my anger over the preventable deaths of babies and the misinformation spread by natural childbirth and homebirth advocates is real. I’m no different than the pediatricians who despair over the deaths of babies as a result of the anti-vax nonsense. But I’ve chosen to take a different approach. Recently a study was published that showed efforts to educate anti-vaccine parents about the benefits of vaccination have backfired. When public health officials have tried a respectful presentation of facts to educate parents about the benefits of vaccination, those same parents ignored the facts and figured that the public health officials had something to hide. In the best case scenario, they simply ignored the public health messages.

I take a very different approach because I attribute a very different cause to both anti-vax nonsense and natural childbirth/ homebirth. Both have nothing to do with medical facts and everything to do with the tendency of contemporary parents to judge themselves and others by their willingness to defy authority. Defiance and denial are at the heart of both movements: defiance of medical “authority” and denial that bad things can really happen to them and their children that no amount of good food or breastfeeding is going to prevent.

My approach can be summed up very simply. My snarky posts about parenting decisions tend to make the exact same statement:

You think that having an unmedicated birth, refusing interventions, giving birth at home, refusing vitamin K for your newborn, etc. etc. etc marks you out as an “educated” person and a superior parent. I’m here to tell you that it marks you as an uneducated, gullible fool.

Harsh, I know, but very effective at getting attention and causing people to question what they’ve been told.

And when I write about the luminaries of the natural childbirth/ homebirth world, I deliberate tweak the love of conspiracy theories that seem so prominent among advocates:

You think that Melissa Cheyney, Lisa Barrett, Lamaze International, the Childbirth Connection, etc. etc. etc. care more about whether your child lives or dies than her obstetrician or pediatrician? Haven’t you noticed that they have a greater financial interest in conning you to buy their services, books and products than either an obstetrician or pediatrician ever could?

Most natural childbirth/homebirth advocates lack the basic knowledge to understand a nuanced argument about childbirth, but no one lacks the basic knowledge to understand the desire to profit by convincing someone to buy what you are selling.

I have a goal that I am always working toward and that is the prevention of infant and maternal deaths. Although there are a few nitwits out there who like to put my title in quotes, I find that being retired offers a great advantage in gaining trust. Everyone knows, whether they agree with me or not, that I have no skin in the game. It makes no difference to my well being or the well being of my own children whether you listen to me or not. I write for YOUR children because I care about what happens to them.

If that isn’t nuanced and compassionate, I don’t know what is.