The end of summer is a slow time in the blogosphere, but in the world of homebirth, the crazy never stops.

Gems from this week include:

1.Women petitions for health service coverage of an HBAC (homebirth after cesarean) against medical advice

According to the Irish Times:

University lecturer Aja Teehan, whose second child is due on October 13th, applied to have the baby born at home in Thomastown, Co Kilkenny, assisted by a midwife.

She alleged the HSE is operating a “blanket policy” of refusing to cover home births for women who previously had Caesarean section births which means she cannot have her baby at home as a midwife will not get indemnity cover to attend. Ms Teehan has a six-year-old daughter born after a Caesarean section.

Considering that the Irish court has already ruled that there is no right to a homebirth at all, there was zero chance of Teehan prevailing. This was just a publicity stunt and the judge slapped her down pretty hard:

Ms Justice Iseult O’Malley today rejected her application and said it would be “manifest irrationality” for the courts to change the criteria for home births as set out by the HSE.

The judge will now determine whether Teehan must pay court costs.

2. Unassisted birth; unlimited stupidity

Whenever I bring up the topic of having an unassisted birth (a home birth without the presence of a midwife, or medical professional, sometimes called ‘freebirth’), people look at me like I’m crazy.

Really? Do tell.

What if something goes wrong?

Personally, education is my relief when it comes to this. I’ve read countless birth stories, researched every possible complication, and how to handle it, and also educated Arick on all of the issues as well. I know what warrants an emergency enough to head to the hospital, or even more to call an ambulance. But the thing is, a lot of the complications that are common in hospital childbirth are due to the interventions that are used. Complications in a drug and intervention free birth are very rare.

Who is stupid enough to actually believe this crap?

3. Introducing the VBAC doll.

Only a picture could do it justice.

Apparently the “attagirls” from the other members of your ICAN group are not enough. Now impresses your toddler and her friends, too … as if your toddler cares how her younger sibling exited her body and why you needed a healing VBAC to get over her (or his) C-section birth.

And it only costs $200!

Why are birth junkies so pathetically desperate for adulation?

4. Yet another homebirth advocate claiming that a numbingly typical homebirth is “unusual.”

This homebirth story could have been written by The Onion, it is so filled with cliches. Of course you wouldn’t expect anything else from a filmaker who created …

the FOOD MATTERS film, which helped heal my father from chronic fatigue syndrome, depression and anxiety plus free him from the pharmaceutical drug bandwagon.

It’s worth reading in full. You’ll howl with laughter. It includes the usual cast of thousands such as the midwives, the doula, the chiropractor, the lactation consultant, and the cranio-sacral therapist.

Just like in nature!

There is an overarching belief in contemporary society that natural is “better.”

Advertisers key into into it. Organic food purveyors rely on it. And it is obviously at the heart of natural childbirth advocacy, lactivism and attachment parenting.

Ironically, the belief that natural is better has arisen amidst a society that proves in every possible way that natural is NOT better. The average human life expectancy in nature is approximately 35 years. The average human life expectancy in first world countries approaches 80. What has been responsible for the doubling of life expectancy? It is technology, not nature.

Consider the greatest public health advancements of all time:

Creating a clean environment

• Clean water is not natural.
• Food free of harmful micro-organisms is not natural.
• Sewer systems are not natural.

Expanding the food supply

• Hunting with even the simplest weapons like spears and clubs is not natural
• Agriculture is not natural.
• Crop rotation, weeding and fertilizing with manure are not natural.
• Domesticated animals are not natural.

Protection from the environment

• Houses are not natural.
• Central heating is not natural.
• Clothes are not natural.

Protection from disease

• Treatment of disease is not natural.
• Soap is not natural.
• Antibiotics are not natural.
• Sunscreen is not natural.

Simply put, just about everything that makes our lives cleaner, safer, more comfortable and longer is not natural.

So why is contemporary society biased toward the natural?

Why is the mainstream media eager to report that technology (vaccines, bottle feeding, Cesareans, and pitocin, among other bugaboos) causes cancer, autism or any other currently poorly understood disease? The reasons have nothing to do with medicine or technology and everything to do with disappointments, distrust and marketing.

There is no group more disappointed with the fact that vaccines can cause serious side effects than vaccine rejectionists. Even though scientists have been thoroughly above board about the real dangers of vaccine, the anti-vax folks have transmuted their intolerance for anything less than perfection into wildly irresponsible claims about fabricated “risks” of vaccines.

There is no group more disappointed with the fact that hospital aren’t perfect than natural childbirth advocates. They wield the phrase “babies die in hospital, too” like a cudgel, transforming their profound disappointment in the fact that hospitals can’t yet save all babies into a bizarre conspiracy that hospitals are actually killing babies with “interventions.” Between them, Cesareans and pitocin save hundreds of thousands of lives each year in the US alone, yet NCB advocates live in a bizarre mirror world in which life saving treatments are dangerous and dangerous stunts like unassisted homebirth are without risk.

Americans in general are profoundly disappointed that modern business is concerned with making money, and not just with improving lives. They’ve turned that disappointment into reflexive distrust of “corporations” and bizarre conspiracy theories about manufactured products like medications.

But there’s more at work here than disappointment and distrust. Marketing has played an enormous, but largely unappreciated role in promoting “natural” in order to distinguish products in the marketplace. Marketers have woven a fantasy of benevolent “nature” that invariably costs more. From organic produce to supplements to “natural” treatments like chiropractic and reiki, Americans are urged to spend more on products that don’t do more or don’t do anything at all.

Not surprisingly, Americans with the most disposable income have the means to follow these trends. The fact that rich people choose to spend their money on a product makes it that much more desirable to everyone else. Organic food is a status symbol, wasting money on quack “treatments” is a status symbol, membership in a gym is a status symbol, having an unmedicated birth is a status symbol, and breastfeeding is a status symbol.

Breastfeeding is a particularly interesting status symbol. Infant formula became popular in a milieu where technology itself was a status symbol. The rich could afford the “superior” technological wonder of infant formula while the poor had to make do with breastfeeding. Now that most Americans can afford formula, it has become declasse. “Natural” is now the status symbol and that’s why breastfeeding is far more popular among white, well off women than among the rest of society.

From an objective point of view, there is no evidence that “natural” is better. Indeed, just about everything that has improved our comfort, health and life expectancy is not natural. Nonetheless, the bias persists that if it is “natural” it must be good even when there is a massive amount of evidence to the contrary. That accounts for the irony that vaccine rejectionists, natural childbirth advocates and lactivists use every technological method at their disposal (the Internet, advertising, and lobbying) to in an effort to argue that technology is bad and natural is good.

Ever notice how women who are planning to have a homebirth feel the need to justify it to the entire world?

There are literally hundreds of blog posts and web articles entitled “Why I’m having a homebirth” or some variation thereof. I’m not really sure why homebirth advocates think the rest of us care why they are having a homebirth, and for the life of me, I don’t understand why on earth they think their reasons are original. The posts and articles are always the same; indeed, I could write it for them.

Why you are having a homebirth:

1. For bragging rights.

You are inordinately proud of yourself as if you are planning to something that more than 90% of women who have ever existed haven’t already done, and are doing around the world every single day or dying in the attempt. Nonetheless, you feel the need to share this with the entire world as if you think we are going to be impressed.

You can save it for your crunchy friends who are competing with you for most risk-filled outlandish homebirth. To the extent that the rest of us care, it’s only to note that you are a fool.

2. To proclaim that you are “educated.”

This may come as a surprise to homebirth advocates, but most people who have real education do not refer to themselves as “educated.” In the world of the internet, that adjective is reserved for the ignorant who think they can actually do “research” online. Anyone with real education knows that it cannot be acquired by reading books and blogs written by lay people for other lay people.

3. You are ignorant of history.

Only a fool looks at the modern world and believes that childbirth is inherently safe. It’s like looking at the modern world and believing that highways are “natural” because you can’t remember a time when highways didn’t exist. Anyone with a modicum of historical knowledge knows that childbirth is and has always been, in every time, place and culture, one of the leading causes of death of young women and the leading cause of death of babies.

4. You are gullible.

You believe the racist, sexist claptrap made up by Grantly Dick-Read that “primitive” women don’t have pain in childbirth because they don’t have fear. In the first place, it’s not true; secondly, you seem to have confused correlation for causation. Fear doesn’t cause childbirth pain; the agonizing pain of childbirth causes fear.

5. You are selfish.

You seem to think that birth is about your experience instead of about your baby’s safety. You are dead wrong about that.

So the next time you are tempted to justify to the rest of the world your decision to have a homebirth, don’t bother. We already know why and we don’t care.

Startling finding announced in prestigious journal
by Gull E. Bull

Scientists have made an astonishing discovery about the cause of pregnancy. According to the study, published in the widely read journal JCS (Journal of Crap Science), researchers have discovered a remarkable and powerful association between maternity clothes and pregnancy raising the possibility that maternity clothes cause pregnancy. Lead author Publish R. Parrish explains that this remarkable association was found in a variety of different investigations.

1. Nearly all women wearing maternity clothes are pregnant (correlation coefficient 0.95) indicating a near perfect relationship between maternity clothes and pregnancy.

2. There is a startling association between the number of stores selling maternity clothes and the overall fertility rate (p<0.01). 3. The odds ratio for pregnancy for a woman wearing maternity clothes as opposed to non-maternity clothes, is very high (RR 35.7). For non-pregnant women, the number wearing maternity clothes drops off in a linear fashion from the day after delivery to approximately 6 weeks postpartum. According to Dr. Parrish: "The findings in this study are even stronger than the new study touting an association between induction and autism. We believe that our study deserves far more attention because the association is much clearer and even more robust." Asked if it were possible that the investigators had misinterpreted their findings, confusing the fact that pregnancy causes women to wear maternity clothes and not the other way around, Dr. Parrish acknowledged the need for further research. He admitted that correlation is not causation but pointed out that if the mainstream media could make such a fuss about crap research showing an association between induction and autism, his work should be able to get even more attention. As Dr. Parrish noted: "We aren't really concerned with what is true, but rather what can be published and publicized. The more sensational the results, the better. Why wait to reproduce results when you can submit crap to any journal, get it published and get it publicized in the newspapers? It's not like anyone is really checking the accuracy of our findings or the plausibility of our conclusions, right?" Indeed, Dr. Parrish admits that he has no intention of further research in this area. He is eager to move on to his next project: C-sections for macrosomia cause babies to grow larger.

To hear natural childbirth advocates and lactivists tell it, the entire story of mothering can be reduced to 3 body parts: uterus, vagina and breasts.

Alisa Quart points out in today’s piece in Salon that she mothers her young daughter with her brain as well.

That got me thinking about how I have mothered my four children over the past 26 years, and seems like I have used just about every part of my body.

Arms: I used my arms a lot, not merely to carry my children, although I carried them quite a bit when they were small. I used my arms primarily to embrace them. Hugs are the appropriate response in times of both happiness and sadness, or for no better reason that to be close. I cannot count the times I hugged my children, and even now, when they are adults, I still do.

Hands: I think I spent 10 solid years holding hands. Holding toddlers’hands when they learned to walk. Holding hands crossing the street and in the parking lot. Holding hands just because it is fun to hold hands.

I also used my hands to sew clothes for my children, to fill out a million permission sheets for field trips, to feel foreheads for temperatures, and to help with a billion school projects (if anyone needs pipe cleaners, I still have hundreds.)

Lips: I kissed my children over and over and over again. I kissed to heal boo-boos. I kissed to check for fevers. I kissed for no better reason than I loved to kiss them. Of course there were years I had to lay off the kissing because public kissing was just too embarrassing for teenagers, but those years are over now, and I can kiss again, at least for greeting.

Legs: I walked miles holding fretful infants in the middle of the night, shopping for clothes and shoes and toys, tramping out to baseball fields, football fields, soccer fields and basketball courts to watch countless youth sports games.

Mouth: I used it to tell my children that I loved them, but I also used to advocate for them, to seek out appropriate evaluation and therapy for learning disabilities, to explain them to teachers and to explain life’s leassons to them.

My entire body: Is there anything that gives comfort like a mother’s body? It provides comfort when you are awake sitting near your children, and even when you are asleep lying in bed next to them in bed after a nightmare.

Brain: I thought about my children constantly, when I was with them and when I was not. I taught them facts and I taught them morals. I worried when they were little; I worried when they were teenagers; and I still worry now. I shared my views on how they should treat others and how they should be proud of themselves (or not, as the case warranted). I conveyed my religious beliefs and my political views. I planned for them; I brainstormed with them; and I hoped desperately that I could give them what they needed to be happy, healthy and to reach their full potential.

Last, but not least, my heart:

Not my physical heart, although it sometimes felt like it when they were hurt or disappointed. I am referring to my metaphorical heart. I loved and I still love my children more than life itself and I have tried to convey that to them. They and their father are the most important people in the universe as far as I am concerned, and it is my deepest wish that they know it and feel it.

Yes, my children grew in my uterus. Yes, they transited my vagina when they were born. Yes, I nourished them with my breasts, but I don’t think that made much difference to who they are and to how I love them. I would gladly have had C-sections if there had been even the slightest chance that they were at risk during birth. I would have happily supplemented with formula if I hadn’t been lucky to produce enough milk. My children don’t remember those days, and frankly, they couldn’t care less.

That’s fine with me. Those body parts are not the ones that I want my children to think of when they think of me. I want them to remember holding hands when they were little, countless hugs and endless kisses. I hope they remember my physical presence beside them when they were sick, next to them in bed when they had bad dreams and in the bleachers or the audience for sports and plays and graduations.

Motherhood is so much more than whether or not your newborn passed through your vagina or whether or not you fed your infant with your breasts. In the grand scheme of motherhood, those body parts are trivial, eclipsed by the rest.

I mother with my entire body. Isn’t that what good mothers do?

Last week I posted this image:

It got picked up by Sanctimommy on Facebook who asked:

What do you think, does the fear mongering go both ways?

In this case it does because I created the image as a riff off of a similar image created by a lactivist organization featuring a bottle of formula in a coffin and declaring that “formula fed babies are 26.5% more likely to die in the first year of life.”

I contemplated responding to the bottle in the casket image with facts: a 26.5% increase is trivial; the increased infant mortality rate reflects the difference between babies who are formula fed (race, economic status, health care) from those that are breastfed, not the difference between formula and breastfeeding. I ultimately decided that a punch in the gut image like the bottle in the coffin would be countered most effectively by a punch in the gut image of the house in the coffin, which has the added virtue of causation, not merely correlation.

In other words, I created the image specifically to “go the other way” on fear mongering.

But the Sanctimommy had this to say:

I think Dr Amy and the Alpha Parent are on equal ends of the shock and awe parenting campaign. I don’t understand how you can love one and hate the other. The argument is different but the end result is the same.

I beg to differ. There are real differences that mean that Alison Dixley, The Alpha Parent, is a sanctimommy and I am not.

Do I judge? You bet I do. I judge mothers who can’t tell the difference between the internet and a medical textbook. I judge self-proclaimed midwives who couldn’t care less if babies die at homebirth as long as they get their birth junkie high and some money to go with it. I judge women whose babies died at homebirth and refuse to take responsibility for their own decisions.

Yes, judging is the sine qua non of being a sanctimommy. It’s necessary, but it’s not sufficient.

First, for a sanctimommy, there is only one right way: her way. My primary message about parenting is that there are MANY right ways to parent children and what works for one mother and her family may not work for another.

Second, being a sanctimommy is about denigrating other mothers in order to boost your own fragile self-esteem. But I don’t write about my children and my parenting decisions. I write about the central empirical claims of natural childbirth advocacy, lactivism and attachment parenting. Specifically, I write about the fact that they aren’t based on scientific evidence, but rather made up to suit the needs of activists.

Third, and most importantly, a sanctimommy wants the majority of women to feel bad about themselves and to feel guilty. My goal is the opposite. I try to reassure the majority of women that they shouldn’t feel guilty because they aren’t doing anything wrong.

Superficially it may seem that The Alpha Parent and I have a lot in common. We are both very aggressive. But she is aggressive in promoting her view that SHE is a better mother than you. I am aggressive in promoting the view that YOU are a great parent if your decisions are made with love and concern for your child, regardless of whether I might have made the same decisions. I have no skin in the game of mommy one-upsmanship, because my children are all young adults and the decisions that obsess sanctimommies are all in my rearview mirror.

Moreover, sanctimommy bloggers are writing as themselves. I am writing as an on line persona, chosen deliberately because it seems to work the best in combating the pseudoscience rampant in homebirth advocacy, lactivism and attachment parenting. As you might imagine, I’m not shy and retiring in real life, but I’m not this persona, either.

Do I judge? You bet I judge. I judge women who put their desire for bragging rights ahead of whether their baby lives or dies. I judge individuals and organizations that profit from spreading misinformation about childbirth and breastfeeding. I judge women who can only feel good about their mothering by tearing other mothers down.

But judging is not wrong. I also judge racists, homophobes and misogynists. I judge murders, abusers and child pornographers. I judge political parties that use hate to win votes and I judge countries that use violence against their citizens.

Judging alone does not make one a sanctimommy. Who you judge and why you judge matters, too.

I’m loud, I’m aggressive and I don’t hesitate to tell unpleasant truths, but that doesn’t make me a sanctimommy.

It makes me The Skeptical OB.

The dirty little secret about lactivism is that it has nothing to do with babies or even with breastfeeding. It’s all about lactivists and their desperate need to feel better than other mothers.
Lactivism is about hating and hurting. How else to explain the breathtaking viciousness of contemporary lactivists?

When it comes to viciousness, the Alpha Parent has no equal. Her recent endorsement of a guest post by James Akre on analogizing breastfeeding is a tour de force of the genre.

I like using the ordinary to approach what is commonplace for some but still unfamiliar for others. The purpose is twofold: to show how everyday analogies, images, metaphors, similes and symbols can be used to see breast milk and breastfeeding from a fresh perspective; and to suggest how this approach in turn can help others see breast milk and breastfeeding in ways they would surely never have imagined…

English to English translation: I’d like to beat you about the head with all the ways that I am better than you.

You must, must, must read the entire post. There is so much delicious venom that it would be a shame to miss a drop. However, in the interests of brevity, I will summarize:

Analogy # 1 Of pleasure and pain

You are so selfish that you willingly take on the pain of wearing high heels, but you can’t be bothered to endure the pain of breastfeeding?

Analogy #2 Flying civilly

Formula is like those oxygen masks that drop from the ceiling when an airplane cabin depressurizes in flight; useful in emergencies but inappropriate at any other time.

Analogy #3 Break glass only in case of emergency

The accompanying image says it all:

Analogy #4 The sky’s the limit

If we were to decline to provide our children with the nutritional equivalent of a plush suite in a five-star hotel by feeding them artificially, we would do well not to kid ourselves into believing that, by giving formula, we’re somehow at least replacing the suite with adequate three- or four-star accommodation. In fact, our children still end up eating in the basement.

My breastfed baby gets The Ritz. Your bottlefed baby gets the pits.

Analogy #5 Holding hands with history

When a mother who, herself, has been breastfed breastfeeds her child, she at once completes and forges historical links of great consequence.

Historical significance? Really?

Analogy #6 Row, row your fashion boat

We can easily afford to provide our children with the finest in tailor-made nourishment, and this for a fraction of the price of even vulgar mass-produced synthetic nutritional frippery.

Analogy #7 Just do your best, Dear

It’s true, some parents deliberately opt to provide their children with nutritional mediocrity; but rich or poor, top-of-the-line elite nutrition is accessible to all.

Analogy #8 Kinky accoutrements

A bottle of formula is just a kinky accountrement. What does that even mean?

Analogy #9 Before you buy shoes, measure your feet

In a critical piece of ground-based navigation software one development team had used Imperial units, i.e. inches, feet and pounds, while another had used metric units. Since the software hadn’t been told to do any conversions, it appeared that the Orbiter got its trajectory wrong and crashed into the Martian surface. Meanwhile, the Mars Polar Lander reached its target at the beginning of December 1999. After 11 months of traveling some 35 million miles (more than 56 million kilometers) in space, the $165 million craft was a mere 130 feet (40 meters) from landing when disaster struck, or rather both the Lander and its piggybacking Deep Space-2 probes were likewise destroyed when they struck the surface…

Formula, rat poison, it’s all the same. If you feed your baby formula, he or she will be destroyed in a spectacular flame out.

I could go on, but I think you get the idea. This sewage spewed forth by Akre and Dixley has nothing to do with what’s good for babies. It has nothing to do with babies at all. It’s self-serving viciousness for those who love to hate.

Here’s my analogy:

These people are vipers in the grass: all natural, and deadly. Their goal is to bite you and eat you alive, for the fragile self-esteem of lactivists is not supported by breastmilk; it is nourished by venom.

To hear lactivists tell it, breastfeeding has tremendous benefits in both health outcomes and IQ. Since the breastfeeding rating has varied dramatically over the past century, we have an excellent opportunity to determine whether those purported benefits really occur across populations and over time.

Below you can find a graph of US breastfeeding initiation rates from 1910-2000.

If the claims of lactivists were true, we would expect to see a decline in both health parameters and IQ when breastfeeding declined, but we see nothing of the kind.

Let’s look at infant mortality rates:

As you can see, there has been a precipitous decline in infant mortality over the past century completely independent of breastfeeding rates.

How about long term health? Here’s a graph of life expectancy vs. breastfeeding rates.

No obvious benefit here. Life expectancy has risen steadily over the past century and breastfeeding rates appear to have had no effect.

What about IQ?

American IQ has risen 25 points in a linear fashion from 1915-2000, and breastfeeding rates appear to have had no impact.

Taken individually or together, the graphs demonstrate that the impact of breastfeeding rates on mortality, life expectancy and IQ are trivial or non-existent.

Obviously, there were other factors at work in improving health and IQ, including better medical care, better nutrition and better education. Nonetheless, the fact that there is no observable effect of breastfeeding, despite the  dramatic swings in breastfeeding rates, suggests that breastfeeding has a negligible effect on health and intelligence.

And that’s just what you’d expect in looking at the breastfeeding studies show real, but very small benefits. Fewer colds, and fewer episodes of diarrheal illness in infants would not be expected to produce any discernible effect in overall measures of health. IQ variations of the same magnitude as the standard error of IQ tests would not be expected to have any discernible effect on IQ.

In other words, as I have been saying over and over and over again, the benefits of breastfeeding, while real, are trivial.

The next time lactivists are tempted to berate women who don’t breastfeed, they should take a look at these graphs. They show that breastfeeding rates have no impact on health or IQ.

And any mother who feels guilty for not breastfeeding should look long and hard at these graphs. There are still a lot of reasons for mothers to feel guilty, but whether or not they breastfeed isn’t one of them.

 

References:

Life expectancy in the United States. Shrestha, Laura B. Congressional Information Service, Library of Congress, 2005.

The Resurgence of Breastfeeding at the End of the Second Millennium, Wright A, Schanler R, J. Nutr. February 1, 2001 vol. 131 no. 2 421S-425S.

Trends and differentials in breast feeding: an update. Hirschman C, Butler M. Demography. 1981 Feb;18(1):39-54.

Sound familiar?

I wish I could go back to a time where I had enough self esteem that I could remain blissfully unaffected by other women’s choices about anything birth or breastfeeding related.

I wish I didn’t feel that every new baby was an opportunity to dazzle its mother with the story of my homebirth.

I wish had enough self confidence that when a mom tells me the nurse said she was starving her baby by breastfeeding, I could support her instead of rolling my eyes and demeaning her.

I wish I didn’t feel the urge to ask every new mother whether or not she used pain medication during her birth.

I wish I didn’t cringe when a new mom tells me she’s seeing a cesarean-happy OB practice, imaging that every woman should want the exact same type of obstetrician that I want.

I wish I didn’t notice when moms prop bottles in a newborn baby’s carseat, since it is NONE OF MY BUSINESS.

I wish I had had accomplished more in my life so that I wouldn’t feel that pushing a baby out through my vagina was my greatest achievement.

I wish I didn’t feel guilt every time the word “circumcision” is mentioned, since that demonstrates that I give greater priority to first world problems than to real problems.

I wish I didn’t get distressed about formula samples, because if I were more compassionate I would realize that taking away formula samples has a disparate impact on poor women of color and the last thing I should be doing is adding to their burdens.

I wish I could find another way to boost my fragile self-esteem that didn’t involve my breasts, vagina or uterus.

I wish I didn’t hear a total stranger announce her pregnancy and immediately pray that she’s seen “The Business of Being Born,” since that demonstrates that I am a gullible fool who thinks she can become “educated” by listening to a washed up talk show host.

I wish I could care about the well being of other women and their babies instead of viewing them as opportunities to demonstrate my well honed sense of superiority.

But …

… then I wouldn’t be such a sanctimonious fool.