I’m beginning to wonder if belief in NCB and homebirth pseudoscience will be an example of natural selection in action. The increased death rate of homebirth, the increased rate of death and disability associated with withholding vitamin K, the increased death rate of children who are not vaccinated mean that children whose parents believe in pseudoscience have less chance of surviving to reproductive age, weeding out whatever deficiencies led parents to these poor decisions in the first place.

Don’t believe me? Consider Mandy’s story:

I rouse myself enough to grab a diaper, and pull Ryder towards me. There is a puddle of blood on the bed. His umbilical cord stump fell off when he was just six days old, and it hasn’t stopped oozing since. A drop or two of blood each day. We weren’t worried. Now this? It’s like a wound… Starting to panic, I try to gather my thoughts enough to make a plan. We need to go to the hospital. It’s Sunday. This is a lot of blood.

Be sure to take a look at the picture that is helpfully included, showing the bleeding baby and the pool of blood.

There is the usual whining about the evil people at the hospital, then:

But Ryder’s bleeding times are very, very out of range. We’re going to admit him to the PICU. You’re going to speak to a pediatric hematologist and the pediatric intensivist. He needs a Vitamin K shot and a blood transfusion. I’m sorry.” The bed shook with my sobs. I held Ryder so tightly. They were going to have to start an IV. Another needlestick. They needed to draw more blood. My poor, sweet baby. This isn’t fair. This isn’t fair.

You bet it isn’t fair. Ryder is experiencing this pain because his mother thought she was smarter than pediatric hematologists.

The following morning, we were told that all of Ryder’s follow-up labs came back normal. He was officially given the diagnosis of “hemorrhagic disease of the newborn” which is caused by a vitamin K deficiency, and the reason that nearly all newborns birthed in a hospital are given a shot of vitamin K at birth.

So she’s learned her lesson, right?

Wrong!!!

Mandy had done her “research,” which had left her more ignorant than before, and despite what happened, she still believed it.

We chose not to get a Vit K injection after doing some research on the reasons it IS given. Hemorrhagic disease of the Newborn only occurs in 1 of every 10,000 newborns, and yet it is given to all. The dose given is something like 1000x what is required to prevent the bleeding disorder (forgive me, I can’t recall all of the exact numbers without looking them up again.). Vit k is also associated with increased risks of childhood cancers [Note: There is no evidence to support that claim.] The risk/benefit was high enough for us to decide that the risk felt safer – we trusted ourselves to recognize a problem if one arose.

It was just an amazing coincidence that Ryder didn’t get the vitamin K injection and then hemorrhaged. The real cause was mastitis (??!!).

I was taking large amounts of Vit K via spinach and kale smoothies, which was transferring through breastmilk… We had no issues at all until I got mastitis and was too sick to continue making sure I was elevating MY Vit K levels.

Spinach and kale smoothies? This woman is a walking parody.

And what about the next time?

In the future, I will probably STILL not give a vitamin K shot at birth, but try harder to be sure my own levels are sufficient.

This woman is a fool. She is extraordinarily lucky that her baby bled from his umbilical stump where she could see it. He could just have easily bled into his head and wound up dead or permanently brain injured. Having dodged a bullet, she drew the inane conclusion that she is bullet-proof.

She didn’t manage to kill her first baby, but you know what they say:

If at first you don’t succeed, try, try again.

There are lots of ways to tell the difference between science and pseudoscience. Most involve analyzing empirical claims. There’s an even easier way to tell the difference between websites and message boards that disseminate pseudoscience compared to those that adhere strictly to scientific evidence. Pseudoscience depends in large part on “belief buddies.”

Pigliucci and Boudry, writing in Philosophy of Pseudoscience: Reconsidering the Demarcation Problem, explain:

These groups collect and disseminate information on issues where scientific information and approaches are more or less relevant. They often feel that their views are neglected or stigmatized in society at large. As a result, these belief buddies consciously attempt to affirm contributions that further their agenda; dissent is discouraged lest it lead to a splintering of the group…

[B]elief buddies may not welcome criticism … Their job is to convey information that supports their core project and to reassure beleaguered constituents.

Science, on the other hand, involves critical communities. Their job is to challenge the information that supports their core project and everyone and everything is a target for criticism.

Simply put: pseudoscience takes place in supportive communities, while real science takes place in critical communities.

How can the lay person tell the difference? Sometimes it is obvious; a group of belief buddies may insist that their community will only allow members who support each other in their belief in the core project.

Over the years, for example, Mothering.com has been explicit in promoting its anti-vaccination message boards as places of “support.” In a charmingly Orwellian formulation, the editors explain:

… Though Mothering does not take a pro or anti stand on vaccinations, we will not host threads on the merits of mandatory vaccine, or a purely pro vaccination view point as this is not conducive to the learning process.

Therefore, a layperson can be sure that any community that exists to support a specific belief will be a community of pseudoscience and have nothing to do with science.

But what if the leaders of the community do not helpfully inform you that they have no interest in anything that disagrees with their core beliefs? That’s easy, too. Just look at whether the community allows or bans dissenting opinions.

For example, at every level of homebirth advocacy, from clowns like The Feminist Breeder, through organizations like Lamaze; from self-proclaimed “experts” in obstetrical research like Henci Goer to people with academic credentials like Darcia Narvaez, PhD, the delete button is integral to maintaining control over what people read and think.

As in the case of totalitarian governments, efforts to remove dissent and create the image that dissent never existed are tools to support beliefs that could never be defended in an intellectually honest way. Deleting and banning reflect the desperation felt by those trying to hold onto power that was gained by lying to people in the first place. Most importantly, women (and men) should understand that professional homebirth advocates are terrified of letting people have free access to information. Who knows what might happen if they treated women like intellectually capable human beings instead of like sheep?

When homebirth advocates tell you they have “educated” themselves, and done “research,” they mean that they have visited communities of belief buddies. But belief buddies deal in pseudoscience and that means that members are indoctrinated, not educated.

From The Tennesean:

A bleeding disorder in babies so rare that it typically affects fewer than one in 100,000 is becoming more common in Tennessee because parents are refusing vitamin K injections at birth, according to pediatric specialists.

Since February, four babies with no signs of injury or abuse have been sent to Monroe Carell Jr. Children’s Hospital at Vanderbilt with either brain hemorrhages or bleeding in the gastrointestinal tract. Dr. Robert Sidonio Jr., a hematologist, diagnosed them with vitamin K deficiency bleeding.

After discovering that all four had not received the preventive treatment, which doctors have been giving to newborns since the 1960s, he started making inquiries. Pediatricians told him parents are increasingly refusing consent because of concerns based on misinformation or the goal of having natural childbirths.

What happened to the children?

All four children survived, but the three who suffered brain bleeds face challenges.

“These are kids that end up having surgery to remove the large amount of blood out of their head or they would have died,” he said. “It’s early. It’s only since February, but some of the kids have issues with seizure disorders and will have long-term neurological symptoms related to seizures and developmental delays.”

That is about as spectacular a parenting fail as letting your child go through a windshield head first in a car accident because you thought refusing to buckle your child in a car seat made you look “educated.”

Even animals fight tooth and claw to keep their young from harm. Human parents should do no less. Instead, Western, white women thrill to the thought that immature transgressive behavior marks them as independent thinkers. It doesn’t; it marks them as ignorant, gullible and willing to take terrible risks with the lives of their children for no better reason that to preen to themselves and others.

I can only begin to imagine the life of agony that awaits these children and their parents. I’d like to see how the mothers explain to their brain injured children that they didn’t have to bleed into their heads; they didn’t have to sustain permanent neurologic damage; they were born without handicap and the only reason they are disabled now is because their mothers thought their friends on the internet were more knowledgeable about hemorrhagic disease of the newborn (HDN) than actual pediatricians with actual medical training.

What could these women possibly say:

1. Sorry you’re brain damaged but shots scare me and the tradeoff between brain damage and the mild discomfort of an injection seemed perfectly reasonable to me?

2. Sorry you face a life of disability, but the women on Mothering.com assured me that refusing the vitamin K shot was safe, and who wouldn’t believe them?

3. I wish you could walk and talk like all the other kids, but HDN is rare and I figured that pretending it couldn’t happen to you would prevent it from happening to you?

4. I believed that doctors were engaged in a giant conspiracy to inject babies with vitamin K for their own enjoyment and HDN was made up to scare mothers?

5. Hey, don’t blame me. I educated myself on the internet?

6. Shit happens and I’m sorry it happened to you, but you were probably meant to be brain damaged?

Or how about:

7. I am desperately sorry and will be for the rest of my life. In my ignorance and hubris, I thought I was educated when actually I was nothing but a fool?

Yes, that sounds about right.

In a startling discovery sure to change our perceptions of our distant ancestors, researchers announced the finding of ancient cave writing about natural parenting. Ima Frawde CPM of the College of Raw, Orgasmic, Totally Crunchy Homebirth (CROTCH) announced the finding and speculated on its implications. The scrawls on the walls of an ancient African cave appear to date back nearly 500,000 years and be written by a tribal “wise woman.” It took scholars nearly a decade to translate them.

Here for the first time is a complete translation:

Ladies, it is time to take parenting back from the patriarchal men who have filled it with interventions. Things are getting out of control.

I’m speaking, of course, about the fact that nearly 40% of all cave dwellers now make fires at the mouths of their caves every single night. The men say that it protects our infants and small children from predators … as if 40% of all babies would be eaten by predators each night if we slept without fire!

I say its just an opportunity to dazzle us with their technical prowess, and then take credit if our babies are not eaten in the night. If predators were really as dangerous as the men claim, we wouldn’t be here.

I’m not against all technology. I respect that some people feel that their lives are improved by stone tools and that hunters believe they catch more game with spears, but fire is going a step too far. We should be sleeping each night as Nature intended, sheltered in caves, whispering affirmations, safe in the knowledge that if we eat right and exercise our children will not be eaten.

I say: Trust carnivores!

Yes, I recognize that babies are less likely to be snatched if they sleep in caves protected by fire, but there is more to sleep than whether the baby survives the night. It may be true that babies who sleep in caves without fire are 10 times more likely to be prey for carnivores than babies who are protected by fire, but the absolute risk of getting eaten on any given night is really very low.

Moreover, in an emergency develops and a lion or jackal is has one of our babies in its jaws, we can light a torch then to frighten the animal away. There’s plenty of time to do that when the emergency occurs; there is no need to have a fire going each and every time darkness falls.

Plus, and this is something that men simply don’t understand, some babies are meant to get eaten.

Ladies, I encourage you to educate yourself about the risks of fire. Overuse of fire can lead to burned clothes, charred cave walls and even burn injuries to children. These risks are simply unacceptable! The fact that a few extra babies may be saved from tigers is a trivial benefit that pales in comparison to the risks.

You think I’m exaggerating? I doubt it. At this rate it is only a matter of time before 100% of cave dwellers sleep in caves protected by fire.

There must be limits to technology! If we don’t call a halt to parenting interventions like fire, the next thing you know all the men will be insisting that we cook our food with fire. Okay, okay, that’s probably an exaggeration, but let’s face it, technology should be reserved for emergencies. For 99.9% of the time, natural is best.

This piece is satire.

I’ve been at this for quite sometime. I started the predecessor of this blog, Homebirth Debate in 2006. Over the years, I’ve approached the issue from many different angles, but my central contention has never changed: homebirth increases the risk of perinatal death.

And now, yet another player in the homebirth debate has acknowledged the truth of that claim. In an article in today’s Wall Street Journal (in which I’m mentioned), Marian MacDorman of the CDC admits it:

Marian F. MacDorman, a statistician who studies birth trends, said that more families are choosing home birth to avoid what they perceive as unnecessary hospital interventions…

Ms. MacDorman said that planned home births might be somewhat riskier than hospital births, but that “the absolute risks of home birth are very low, no matter how you slice it.”

Apparently those hospital interventions aren’t so “unnecessary” after all.

In other words, homebirth advocates are giving up the lie at the center of homebirth advocacy: the lie that homebirth is as safe as hospital birth, and replacing it with another tactic. Yes, babies die completely preventable deaths at homebirth, but who cares, since the absolute risk of dying is still low.

As far back as November 2011, Hannah Dahlen, spokesperson for the Australian College of Midwives uttered this gem:

When health professionals, and in particular obstetricians, talk about safety in relation to homebirth, they usually are referring to perinatal mortality. While the birth of a live baby is of course a priority, perinatal mortality is in fact a very limited view of safety.

Really? On what planet would that be?

Even the Midwives Alliance of North America, the organization that represents homebirth midwives, and the organization that has hidden the death rates of its members for years is throwing in the towel. MANA executive Wendy Gordon CPM, LM, MPH, MANA Division of Research, Assistant Professor, Bastyr University Dept of Midwifery (and placenta encapsulation specialist!) wrote back in March of this year:

Let’s say that a person’s odds of getting struck by lightning in a heavily populated city are one in a million, and those same odds in a rural area are five in a million. These odds are called your “absolute risk” of being struck by lightning. Another way to look at this is to say that a person’s odds of being struck by lightning are five times higher in a rural area than in a densely-populated area; this is the “relative risk” of a lightning strike in one area over another.

A common approach of anti-homebirth activists is to use the “relative risk” approach and ignore the absolute risk, because it’s much more dramatic and sensationalistic to suggest that the risk of something is “double!” or “triple!” that of something else …

How amusing that Gordon and other homebirth advocates have suddenly discovered the difference between absolute and relative risk. The same people who have been howling about the “dangers” of epidurals (the risk of death from an epidural is less than the risk of being killed by a lightening strike), are suddenly insisting that the risk of death at homebirth, which is anywhere from 100 to 1000 times higher, is actually so small that you should ignore it.

As I wrote back in March, there are two important messages to take away from this:

Homebirth (particularly homebirth at the hands of grossly undereducated and undertrained CPMs) dramatically increases the risk of perinatal death.

More importantly, professional homebirth advocates have steadily and repeatedly lied about the increased risk of perinatal death. They should never have been trusted before, and cannot be trusted now.

Women contemplating homebirth need to ask themselves an important question: why should you trust anything that homebirth advocates have to say when they have been lying to you for years, claiming that homebirth is as safe as hospital birth, while simultaneously hiding data that shows that it leads to preventable perinatal deaths?

And let me point out: I told you so!

Perusing the morning papers, I came across this piece in The New York Times, The Sound (of the Crying Baby) and the Fury (of the Exhausted Parent), written by a man who is a psychiatry resident at Yale. I thought it was going to be about having more compassion for young, new parents who become overwhelmed and lash out at a crying baby. Not exactly.

It is about Dr. Rama himself and his profound anger at his baby daughter.

I don’t think I knew what real anger was until our daughter arrived.

Considering that infants and toddlers scream despite having been fed, changed, walked around, bounced, hugged and kissed, I am amazed by how rarely parents talk about just how furious our young ones can make us. I think about it frequently — during the day. At night, I am too consumed by that anger…

Those angry thoughts flood my mind when her cry suddenly cuts through the quiet of our all-too-short nights. The English translation of that cry is, “Tomorrow your 12-hour workday will be a groggy-eyed waking nightmare.” As her cry shifts into a throaty scream, I have sensed a slowly growing animus bloom inside me. I have felt my lungs fill with air in preparation to yell back at her. To make her feel as terrible as I do.

I understand what it is to spend hours at night trying to soothe a screaming infant, knowing that tomorrow will be a full workday. Nonetheless, I find the depth of this father’s anger to be frightening.

My fear is heightened into alarm by this:

Instead, again perhaps surprisingly, I keep my focus on me.

Before I step into my daughter’s room in the middle of the night during a maddening crying jag, I remind myself that I come first. I love myself first. I realize that these statements are anathema in a world that screams, “Your child comes first!” However, if I can’t love myself in spite of my constant sense that I am failing her, then I can’t really love her either…

I hear my internal alarm bells wringing because a grown man is experiencing extreme anger toward a helpless baby and personalizing that anger in a way that could be dangerous. It feels to me that this father may be perilously close to losing control since he has already lost perspective.

There are only 7 comments on the piece so far, and all have been supportive, praising the father for acknowledging the frustration of many parents. I understand just how frustrating a crying newborn can be, but this doctor’s fury scares me.

Am I the only one?

I’ve written many times before about the endless efforts of midwives to demonize interventions in childbirth.

Australian midwife Hannah Dahlen seems to be leading the charge and doesn’t shirk from using deceitful statistics and crappy research to do it.

Dahlen can’t seem to make up her mind about the actual “harms” from interventions. On any given day she might be suggesting that C-section might destroy the infant microbiome, or maybe C-sections might change the epigenetics of neonatal DNA. Today, birth interventions might increase the risk of suicide.

Her central contention is this:

So death from suicide and trauma rises significantly between nine and 12 months after birth; it is nearly four times the rate compared to the first three months following birth.

And:

The women who died had higher rates of intervention in birth, higher rates of early-term births, pregnancy complications and neonatal intensive care admissions. They also tended to have babies who were born with a low birth weight and were ten times more likely than other women to have their baby die.

Her “research” was published in a journal I’ve never heard of, with an impact factor of 2.8. To put that in perspective, high quality journals have impact factors ranging from 30-50.

It’s hardly surprisingly that Dahlen had to resort to publishing in one of the lowest ranked journal in the world. The “research” is crap.

Here is the central claim:

So death from suicide and trauma rises significantly between nine and 12 months after birth; it is nearly four times the rate compared to the first three months following birth.

Sounds impressive until you give it a modicum of thought.

1. Why are suicide and trauma lumped together? There’s a big difference (in cause, effect, a preventive approaches) between dying at your own hand and dying in a car accident. There is no possible justification for including trauma in an analysis like this besides artificially inflating the purported scope of the problem.

2. How does the supposed high suicide rate in the postpartum year compare to the suicide rate for women in the same age group who did not give birth in the past year? Dahlen doesn’t bother to tell us. So we have no idea whether the rate of suicide and trauma is any different following childbirth than it is in women who haven’t given birth. That’s a stunning oversight.

3. Dahlen notes that the suicide rate in the 4th quarter of the postpartum year is more than 3 times higher than the 1st quarter of the postpartum year and implies that this is a dramatic rise. However, it is equally likely that the suicide rate in 3 months after birth drops and then rises again to baseline over the rest of the year. Without the background rate of suicide in women of childbearing years, it is impossible to determine what has actually happened.

4. Dahlen acknowledges that the woman who died of suicide and trauma differed substantially from the rest of the population.

A large proportion of women who died from suicide (73%) had a history of mental illness or substance abuse, or both. Most of the women who died because of accidental injury also had a history of mental illness or substance abuse (or both).

How does that compare to non-postpartum women who commit suicide? Dahlen does’t bother to check. What is the suicide and trauma profile of the other 27% of women? Does it mimic that of women with previous mental illness or substance abuse? Dahlen doesn’t bother to check.

5. Dahlen acknowledges that the neonatal death rates among the women who subsequently died of suicide or trauma were 10 times higher than the death rate of women who did not die of suicide or trauma. Yet she did not ask the glaringly obvious follow up question. Was the purported increase in maternal death from suicide or trauma the result of grief and loss, and not the result of being postpartum.

The bottom line is that Dahlen could not get this paper published in anything other than an extremely low ranking journal because the paper doesn’t show anything. Dahlen waves a bunch of statistics around but fails to investigate whether those isolated statistics mean anything at all, let alone anything about suicide in the postpartum year.

Dahlen’s solution is to provide more “services” to women in the postpartum year. Yet Dahlen utterly failed to show (she didn’t even bother attempt to show) that being postpartum is the relevant risk factor, let alone that more services would decrease the rate of bad outcomes.

If this is what passes for quantitative “research” in Australian midwifery, the solution may not be more services for patients, but better basic math and logic education for midwives.

In 1984, the year I graduated from medical school, Libby Zion died.

According to the Washington Post:

After his 18-year-old daughter Libby died within 24 hours of an emergency hospital admission in 1984, Zion learned that her chief doctors had been medical residents covering dozens of patients and receiving relatively little supervision. His anger set in motion a series of reforms, most notably a series of work hour limitations instituted by the Accreditation Council on Graduate Medical Education (ACGME), that have revolutionized modern medical education.

Now, nearly 3 decades later, the results of those changes are in and they are an utter failure. In fact, reduced resident hours actually result in MORE mistakes, not fewer!

As a piece in The New Yorker by Dr. Lisa Rosenbaum, entitled Why Doesn’t Medical Care Get Better When Doctors Rest More?, explains:

… [T]wo recently published studies suggest that, right now, both quality of care and quality of education are suffering.

One study, led by Sanjay Desai at Johns Hopkins, randomly assigned first-year residents to either a 2003- or 2011-compliant schedule. While those in the 2011 group slept more, they experienced a marked increase in handoffs, and were less satisfied with their education. Equally worrisome, both trainees and nurses perceived a decrease in the quality of care—to such an extent that one of the 2011-compliant schedules was terminated early because of concerns that patient safety was compromised. And another study, comparing first-year residents before and after the 2011 changes, found a statistically significant increase in self-reported medical error.

Why have the reforms produced the opposite result from what was intended? There are two reasons for the failure:

1. The proximate reason for the failure is that Libby Zion didn’t die because the residents who cared for her were overworked. She died because they were grossly incompetent.

Libby was a college freshman with an ongoing history of depression who came to New York Hospital in Manhattan on the evening of Oct. 4, 1984, with a fever, agitation and strange jerking motions of her body. She also seemed disoriented at times…

[Later] Libby became more agitated. The nurses contacted Weinstein at least twice. Weinstein ordered physical restraints to hold the patient down and prevent her from hurting herself. She also prescribed an injection of haloperidol, another medication aimed at calming her down. Busy with other patients, Weinstein did not reevaluate Libby.

And that is malpractice. The woman had a fever. In no medical universe is it ever appropriate to ignore fever and neurologic symptoms in favor of restraining the patient and dosing her with powerful psychoactive medications. It had nothing to do with being tired; it reflected the doctors’ incompetence.

2. The larger reason, one we would do well to take to heart, is that the single most important thing patients need from doctors is their time.

The calculus is brutally simple. Reducing working hours without reducing patients numbers of increasing the number of doctors means less doctor time/patient and an increase in mistakes is an inevitable result.

Because, and this is the dirty little secret in medicine, being exhausted, overworked and irritated does not cause medical mistakes. Lack of time to talk with patients, both to listen and to explain, and lack of time to obsess about the details is what causes medical mistakes.

I will freely admit that the brutality of internship and residency did not make me a nicer doctor. When you are working 105 hours a week (staying up all night, every third night) you have little energy for being nice. But it did make me a better doctor.

I can hear younger doctors out there groaning about antiquated older doctors celebrating the hazing process, but the reality is that it made for better, safer patient care. As one of my chief surgical residents told me (actually he yelled it in my face) early in my career: “In medicine there are no excuses. YOU don’t matter; all that matters is what is good for the patients. I don’t care if you are hungry, tired or depressed. The only excuse for knowing less than everything about your patients is that you are currently treating a cardiac arrest or having one yourself.”

Rosenbaum relates the story of her own mother, also a cardiologist, who has the same work ethic that was beaten into me:

“Mom,” I said. “It’s 8 P.M. Why on earth are you going to the hospital?”

“I’m going to see my patient,” she said.

“But you have been working nonstop for five days,” I protested…

“Her boyfriend’s driving in,” my mom explained. “He really wants to talk to me.”

And then, without thinking, the words popped right out of my mouth: “But isn’t there someone covering you?”

“I’m her doctor,” my mom said. “I’ve been with her since the beginning. Don’t you think this is important?”

And it is only by providing long brutal hours of care and caring like these that doctors avoid mistakes.

It wasn’t the young doctors’ lack of sleep that killed Libby Zion; it was their lack of competence. It will only compound the tragedy if the legacy of her preventable death were more medical mistakes, not fewer.

In their solipsism and self-righteousness, lactivists are now threatening workplace equality.

That’s likely to be the ultimate effect of a poorly conceived, basically  frivolous complaint being brought by a New Hampshire mother in the federal Equal Employment Opportunity Commission.

According to the astoundingly credulous reporter at The Boston Globe:

The 42-year-old New Hampshire woman, who was terminated from her job last August for not returning to work after her maternity leave, says she stayed home because her employers would not agree to what she calls a reasonable request to accommodate her desire to breast-feed her child during the workday.

Imagine that. She was fired simply because she refused to come to work.

I know you’ll be shocked to find that the mother feels terribly sorry for herself.

“I felt like a volcano was erupting and heading straight for me and I was locked in,” she said of the drawn-out communications she had with her employer over her breast-feeding rights. Frederick had worked as a child support officer with the New Hampshire Department of Health and Human Services in Conway. “If I went back to work and did what I needed to do for my health and [my son]’s health, I would have been insubordinating.”

I know what you’re thinking, because I thought the same thing. Why doesn’t she pump breastmilk for her son? Alas, her special snowflake won’t take a bottle.

The Affordable Care Act and state laws require most employers to accommodate women who wish to breast-feed by allowing them to pump milk during the workday to later bottle-feed their children. But Frederick’s son Devon, like many babies, would not take a bottle at first; to breast-feed him, she would have to physically be with him.

That means she fell into a legal black hole in terms of protection: Employers aren’t required to let their employees breast-feed children during work hours — they just have to make it possible for mothers to pump their milk.

She hasn’t been to work for the past year? How old is this baby anyway? Actually, he’s not a baby. He’s a 14 month old toddler.

Legal eagle Jake Marcus (a woman, and Gina Crossly-Corcoran’s former lawyer in our ongoing court case) offered this bit of brilliance:

Jake Marcus, a Philadelphia lawyer and national breast-feeding advocate, calls that legal distinction between pumping and feeding “absurd.”

“Just the specter of having children in the workplace scares people,” she said.

No, Jake, that doesn’t scare people. It’s interferes with the purpose of the workplace … work.

Dr. Melissa Bartick weighs in. You may remember Dr. Bartick as the researcher who published thoroughly fanciful and fabricated claims about breastfeeding saving hundreds of lives and billions of dollars … as long as we ASSUME (!!) a causal relationship between breastfeeding and health benefits.

Dr. Bartick, vying for the role of lactivist bully-in-chief, has this to say:

“There are enormous risks from not breast-feeding,” said Dr. Melissa Bartick, chair of the Massachusetts Breastfeeding Coalition. Stopping breast-feeding earlier puts children at risk for many chronic diseases such as diabetes, obesity, and even leukemia, she said.

That, of course, is a bald faced lie, but when you are bullying, the truth apparently doesn’t matter very much.

But let’s leave aside the extraordinary factual problems with this case, including the absurd claims about the benefits of breastfeeding. This case strikes at the heart of workplace equality for women because it is predicated on a radical demand: employers ought to be forced to accommodate whatever a mother deems “best” for her child.

Women have spent decades convincing employers that they can be equal to men in all parameters of work. Now this woman is claiming that children have a need for their mothers that trumps the employer’s needs. Why stop at breastfeeding?

Why wouldn’t women argue that children have a need for their mother’s physical presence for 3 years and that they should be allowed to have 3 year maternity leaves? Why couldn’t women argue that children have a need for mothers to be home at night and therefore, women should not be asked to travel for business? What if the baby has terrible stranger anxiety? Does that mean that the baby should be allowed to come to work with the mother?

Kate Frederick may believe that her baby’s needs come before her employer’s needs. If so, she can act accordingly by putting her baby’s needs ahead of her employer’s needs and resign her job. But Kate seems to think that HER EMPLOYER should put Devon’s needs ahead of his own needs and that’s where she crossed the line.

Are women equal in the workplace, capable of performing at the same level as men? Or does being a mother mean that women can longer be a professional at work, but a mother first?

My generation of women, and the generation that came before me, struggled mightily to convince professional schools, employers and colleagues that women are every bit as capable and every bit as responsible as male employees. We managed to do so AND successfully mother our children.

Now a new generation of women is declaring that, no, women cannot be expected to be every bit as capable and professional as men. Once they have a baby, the baby trumps all and they must be allowed to do whatever they want, whenever they want, by saying the magic words, “it’s good for my baby.”

Lactivists need to grow up and own their own choices. Women can continue a successful breastfeeding relationship by pumping during working hours while still being stellar employees. If Kate Frederick and other lactivists think that’s not good enough for their special snowflakes, they can quit their jobs, do without the income, and accept the fact that their babies are not their employers’ responsibility.

Homebirth advocates are lamenting the court defeat of Aja Teehan. Teehan petitioned to Irish courts to force the health service (HSE) to PAY FOR a homebirth VBAC, against medical advice, attended by a non-HSE provider. Not surprisingly, she lost, in large part because her toddler level claims.

The arguments of homebirth advocates bear a remarkable similarity to toddler tantrums. Indeed, the language is the same.

Consider:

1. I want

Homebirth advocates, like toddlers, appears to believe that because they want something, they deserve to have it. It doesn’t matter that it isn’t safe. It doesn’t matter that others (the baby) may be hurt or die because of their choice; it doesn’t matter that other people (health professionals) must be forced to do things they don’t want; it doesn’t matter what it costs. They want it, and like toddlers, they appear to think that this is their most compelling argument.

2. Gimme

Homebirth advocates, like toddlers, appear to think that because they want something, everyone else has an obligation to provide it for them. Regulatory boards should violate their standards to admit uneducated, unqualified midwives; the most basic principles of safety should be ignored, and somebody else, be it an insurance company, the government or donors on crowd sourcing website. should pay for it.

3. Mine

In the world of homebirth advocates, everything is “mine.” My homebirth, my rights, my desires. No one else counts, not even the baby. Everyone else is just a prop in their little piece of performance art.

4. How do you know?

Homebirth advocates, like toddlers and even older children, have zero respect for the education and experience of those who are older, better educated and better trained. Like the second grader who asks for help with math homework and then whines that the parent is doing addition wrong, homebirth advocates insist that they know more about childbirth, medicine and science then people who have spent decades studying and practicing obstetrics. In exactly the same way as the second grader who needs help with his math homebirth believes that his mother doesn’t understand addition, homebirth advocates who transfer to the hospital in obstetric emergencies believe that doctors and nurses don’t understand childbirth. Such astounding naivete may be understandable in a second grader, but it truly defies comprehension in an adult.

5. You can’t make me!

The battle cry of toddlers and homebirth advocates everywhere.

That’s because defiance is the hallmark  of homebirth advocates as well as of toddlers. It’s true that we can’t force women to give birth in hospitals or hire real midwives instead of birth junkie self-proclaimed midwives, nor should we be able to force women to do so. Nonetheless, choosing to risk your baby’s life because you enjoy defying authority isn’t any more mature than the toddler who lies thrashing on the floor, whining “you can’t make me.”

6. It’s not fair!

Homebirth advocates, like children of all ages, have acute appreciation for fairness BUT ONLY as it applies to them. They are constantly wailing about injustice without giving a moment’s consideration to their fairness to others. Homebirth advocates, like small children, insist that their “rights” are being violated as if there is a right to homebirth. They simply made it up; there is no right to homebirth, just as there is no right to stay up past your bedtime.

Ultimately, homebirth advocates are going to find it impossible to achieve their desires as long as they continue to resort to toddler-speak. “I want” a homebirth does not incur any obligation on the rest of us. “Gimme” does not mean we need to pay for it. Insisting that the birth is “mine” and ignoring the baby’s well being just makes most people think less of you. “How do you know?” and “You can’t make me!” are cries of the immature. And “It’s not fair!” begs the question of fair to whom; the baby? the health care providers? the government?

Fortunately for babies, I don’t foresee homebirth advocates improving their reasoning skills. In the books they read, and the echo chamber websites they frequent, toddler reasoning carries the day. They can’t seem to figure out that what works for toddlers isn’t going to work in the world of adults and professionals. And so they are left to wail, yet again, “it’s not fair!”