You can’t understand anti-vaccine advocacy unless you understand performative motherhood

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A tremendous amount of ink has been spilled by doctors, scientists and public health officials pondering the bizarre beliefs of anti-vaccine parents. How can they promote such obvious nonsense? Why don’t they respond to efforts to improve their knowledge base? Why can’t we get them to understand the risks they pose to society in general and their own children in particular?

Sadly, we’ve been asking the wrong questions because we have assumed that anti-vax beliefs are the result of scientific ignorance. While ignorance of immunology, science and statistics are necessary concomitants of anti-vax beliefs, they are not sufficient. The missing piece we have failed to consider is the rise of performative mothering.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Anti-vax advocacy is perhaps the acme of performative mothering. It only acquires meaning by being performed under the gaze of other mothers.[/pullquote]

What is performative mothering? As I explained over the past two days, a mother used to be something you were; now it’s something you do, hence the term “mothering.” And you do it under the gaze of other mothers, micro-branding yourself by your choices, and disseminating a carefully curated portrayal through social media, artlessly seeking validation through the “likes” of strangers.

Anti-vax advocacy is perhaps the acme of performative mothering. It only acquires meaning by being performed under the gaze of other mothers, especially those on social media. Indeed, in a country where vaccination rates are high, it has almost no meaning unless it is observed. Until recently herd immunity meant that most unvaccinated children would never be exposed to most childhood infectious diseases. Therefore, there was no obvious difference between vaccinated and unvaccinated children. The only observable difference was the preening of anti-vax mothers.

Anti-vax advocacy acquires further meaning by being performed under the gaze of pediatricians and other healthcare providers. Behavior is not transgressive unless it is demonstrated to authority figures, eliciting the delicious disgust that gives meaning to the act.

As Pru Hobson-West explains in ‘Trusting blindly can be the biggest risk of all’: organised resistance to childhood vaccination in the UK:

Clear dichotomies are constructed between blind faith and active resistance and uncritical following and critical thinking. Non-vaccinators or those who question aspects of vaccination policy are not described in terms of class, gender, location or politics, but are ‘free thinkers’ who have escaped from the disempowerment that is seen to characterise vaccination…

…[Anti-vaxxers] construct trust in others as passive and the easy option. Rather than trust in experts, the alternative scenario is of a parent who becomes the expert themselves, through a difficult process of personal education and empowerment…

Ironically, despite the collective derision for experts, anti-vax advocates depend heavily on pseudo-experts like Dr. Bob Sears and similar anti-vax charlatans. What distinguishes Dr. Sears from other pediatricians? It isn’t merely his flexible ethics that allow him to pander to anti-vaxxers for profit. Bob Sears is fluent in the language of performative motherhood.

Consider how anthropologist and certified professional midwife Melissa Cheyney describes homebirth in Reinscribing the Birthing Body: Homebirth as Ritual Performance:

… As a socially performed act of differentiation, homebirths are constructed in opposition to dominant ways of giving birth, although just where the lines between consent and resistance lie are not always clear, shifting with each provider and each mother, over time and in the retellings.

Bob Sears understands that as a socially performed act of differentiation, anti-vax advocacy is constructed in opposition to dominant ways of protecting children.

Homebirth practices, thus, are not simply evidence based care strategies. They are intentionally manipulated rituals of technocratic subversion designed to reinscribe pregnant bodies and to reterritorialize childbirth spaces and authorities. For many, choosing to deliver at home is a ritualized act of “thick” resistance where participants actively appropriate, modify, and cocreate new meanings in childbirth.

Anti-vax, thus, is not an evidence based strategy to protect children. Bob Sears understands it is a ritual of technocratic subversion performed for the admiration and gratification of other mothers.

Bob Sears is fluent in the language of performative motherhood. To paraphrase Gallo and Cruz’s description of midwives:

Sears provides emotional support by sharing beliefs about the experience and by affirming the woman’s right to assign her own unique beliefs to vaccines. This seemingly simple service of association and presence is a critical social need in the context of anti-vax advocacy that depends on a shared cultural consensus for its significance.

As he notes in the final chapter of his book The Vaccine Book: Making the Right Decision for Your Child:

I’m sure you are trying to answer the question that is on every parent’s mind: What should I now do? How do you make the right choice for your child? I have offered you all the information you need to make this decision, but I have held back from actually telling you what to do. I want you to formulate your own decision without letting my opinion sway you one way or the other.

Whereupon he proceeds to give his opinion on an alternate vaccine schedule that has no basis in science but creates maximum scope for performative mothering. And he repeatedly panders to the pretentions of performative mothers.

Alternative vaccine schedules aren’t for everybody. It takes a lot of extra time, effort, and planning to follow them. In addition, some doctors will fight you if you try to “change the system.” …

You can’t walk into your appointment unprepared and ask your doctor to come up with an alternative schedule for you. There is only one standard schedule that doctors are trained to follow; working outside this schedule is foreign to most doctors. You must understand the diseases, feel comfortable with your knowledge of vaccines, and establish your own vaccine plan prior to seeing your doctor. The suggestions I offer in this chapter are a good place to start. If the doctor sees that you’ve thoroughly thought this through, he or she is much more likely to work with you.

Performative mothering is toxic for a host of reasons: it places women under tremendous pressure to perform for other mothers; it ignores the needs of the individual child in favor of the social approbation of the group, and — as in the case of anti-vax advocacy — it is dangerous, even deadly, for children.