Evidence based support: it doesn’t mean what this doula thinks it means

Evidence based practice

Australian doula Lizzie Carroll is miffed.

Last Wednesday I wrote about another dead baby born to a member of Meg Heket’s unassisted birth group, and the subsequent praise for the mother “achieving” her goal of a vaginal birth over a baby’s dead body. Meg Heket and the other women who encouraged this mother have blood on their hands; Ms. Carroll and other women who support dangerous homebirths have blood on their hands, too. They bear responsibility for the steadily rising death toll and, not surprisingly, they don’t like responsibility.

Carroll wrote:

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]There’s a big difference between supporting a person’s right to make a choice and supporting the actual choice.[/pullquote]

I got up this morning to find myself tagged in a comment in a group that I am in. I occasionally get tagged in this group by someone mocking my work and so that I can be reminded that I am a horrible human being. Or something like that.

The comment this morning that had my name against it went a step further though. No longer content to simply mock me, I am now being accused of killing babies, by way of supporting a woman’s right to bodily autonomy.

She ridicules those holding her responsible as illogical:

As a supporter of a woman’s right to choose homebirth, if she deems it to be the best option for her, I am responsible for any deaths that occur during homebirth. Regardless of whether I’ve ever even heard of the family in question. BUT what if I were to say (and rightly so!) that all women should be allowed to choose a caesarean if they deem it the best choice for them? Am I responsible for all the women who then die as a result of a caesarean? …

But it is Ms. Carroll who is having problems with logic on a number of different levels. Let us count the ways:

1. There is a big difference between supporting a person’s right to make a choice and supporting the actual choice.

We see this often in the area of free speech. For example, American free speech advocates DO support the right of the Ku Klux Klan to hold public rallies. They DON’T support the Ku Klux Klan and they don’t support what Klan members say.

My position on homebirth is analagous to this. I DO support a woman’s right (bodily autonomy) to give birth where and with whom she wants, up to and including unassisted homebirth. I DON’T support homebirth and I certainly don’t support unassisted homebirth; I often refer to is as “stunt birth.”

Ms. Carroll is being disingenuous when she claims that she is merely supporting a woman’s right to bodily autonomy. She actively and affirmatively supports homebirth itself both theoretically and practically; she profits from it. It’s the difference between supporting the KKK’s right to free speech and offering members a special Klan discount on the purchase of white sheets. This is not a subtle difference, but in her effort to absolve herself of responsibility, Ms. Carroll refuses to acknowledge that difference.

2. There’s a difference between supporting someone’s right to do something dangerous and claiming that dangerous choice isn’t dangerous at all.

Ms. Carroll writes:

What about those of us who support a person’s right to enjoy dangerous sports like rock climbing, horse riding, racing car driving? Are we responsible for any deaths that occur as a result?

If you encourage someone to participate in race car driving by telling them it’s NOT dangerous and the person dies as a result, then you DO bear responsibility for that death. That goes double if you are the one renting out the race cars. The reason that Ms. Carroll and other members of homebirth and unassisted birth groups have blood on their hands is because they refuse to tell women that it is dangerous, not because they support the right to have a homebirth or unassisted birth.

If you see a suicidal person standing on a ledge and you yell “Don’t Jump!”, you aren’t responsible for the person’s subsequent death when he jumps despite your plea. But if you see a suicidal person standing on a ledge and you yell “Jump! Your body is meant to survive jumps from tall buildings!”, you bear responsibility for his dive to death on the pavement below.

3. Evidence based support MUST be based on scientific evidence.

Evidence based support doesn’t mean what Ms. Carroll and her compatriots think it means. It should be obvious to them (apparently it’s not) that evidence based support requires scientific evidence. There is NO evidence that unassisted homebirth is safe. None, zip, zero, nada. So it’s ludicrous to suggest that support of unassisted homebirth is evidence based; it is in direct opposition to what the scientific evidence shows.

These are just the most egregious of the many logical errors in Ms. Carroll’s attempt to shed responsibility for encouraging and profiting from dangerous homebirths.

Ms. Carroll claims that her philosophy can be described as:

‘Throughout my pregnancy I deserve to feel well and whole, physically, emotionally and spiritually.’

I understand how dangerous homebirths and unassisted births contribute to Ms. Carrol’s financial well being, but I’m confused on how they help mothers.

Ms. Carroll, please explain how giving birth to a dead baby contributes to a mother’s physical, emotional or spiritual health. Inquiring minds want to know.