Has it really been two years since I first posted this? It seems particularly timely to repost it in light of the ongoing debate about attachment parenting.

How many times have we heard this? A lactivist, birth activist, attachment parenting proponent who insists:

Honestly, I don’t understand why other mothers think that I am judging them. If they want to raise their children by doing whatever is easiest for them instead of what’s best for their babies, that’s their decision and I don’t question it. I understand that some women love their jobs more than their children, and, after all, who wouldn’t if she had some fancy-pants career where she made tons of money. It probably makes more sense to her to put money ahead of her children’s well being.

Take my next door neighbor, for example. She makes oodles of money practicing law and leaves her baby each and every day in the care of strangers. I am impressed that her baby welcomes her home by reaching out to her, smiling and giggling. Fortunately, nature designed babies to recognize their mothers, no matter how little time those mothers spend caring for their children.

I’ll admit that I finder it harder to understand how women who aren’t even working give up on breastfeeding so easily, or refuse to allow their children to sleep in the family bed. What’s so valuable about their time or convenience anyway? But I keep my opinion to myself. I don’t let on that I am perfectly aware that there is no such thing as a breastfeeding difficulty that can’t be overcome with enough love and dedication. When other women claim they had a low milk supply or that breastfeeding was excruciatingly painful, I merely feel sad that they never had the unique opportunity to bond with their children that only breastfeeding offers.

And when it comes to childbirth, how can I possibly judge other women who haven’t taken the time to educate themselves the way that I have? I’ve read Henci Goer’s book three times, and Ina May Gaskin is my idol. Everyone knows that the first step to becoming educated on a topic is to join an internet message board. If I hadn’t joined the message boards at Mothering.com, I probably wouldn’t have known that birth is inherently safe and that all that stuff about “risk” was made up by doctors trying to steal business from midwives.

The uneducated women who don’t understand this can’t be blamed for acting like birth is some sort of disease and needs to take place in a hospital. Of course they give in and get an epidural at the drop of a hat because they don’t realize that there’s a difference between good pain and bad pain. And they don’t even understand the real risks of epidurals.

Oh, and don’t accuse me of looking down on women who’ve had C-sections. Sure, they didn’t actually give birth, and they have missed out on the peak experience of a woman’s life, but is that their fault? I know that almost all C-sections are unnecessary, but those poor women actually think that the C-section “saved” their baby’s life.

I don’t judge them, but I do think that I have a responsibility to open their eyes to the ways in which they have been misled. It would be wrong for me to refrain from enlightening them merely because it might hurt their feelings. Women need to understand that anyone who thinks her C-section was “medically necessary” is being duped by those who seek to medicalize childbirth for their own benefit.

Many women don’t realize it, but if they had more encouragement, they’d happily do what’s best for their babies. That’s why I tell my birth story to everyone, whether they want to hear it or not. It may seem unbelievable, but it’s often the very first time they’ve heard that they could have been empowered like me if only they’d made the same decisions I made.

And let’s face it, women don’t get enough encouragement to breastfeed. Some women actually think that a baby who is fed artificial milk (formula) can be as healthy as a baby fed with breast milk as nature intended. I consider it my duty to broadcast the dangers of formula feeding far and wide. It’s unfortunate that we have to scare mothers into doing what’s best by exaggerating the benefits of breastfeeding, but everyone knows that the ends justify the means.

Please do not accuse me of judging those other mothers who don’t love their children as much as I love mine. I’m well aware that different ways of mothering are right for different families. Of course women who are obsessed with their own convenience find that bottle feeding is right for them and their families. Obviously women who have been duped by doctors into fearing birth are going find that hospital birth is right for them. And inevitably those who aren’t really attached to their children are not going to be comfortable with attachment parenting.

I just want to be clear:

To those women who haven’t really given birth because they’ve had a C-section, to those women who gave in to the pain and got an epidural, to anyone who doesn’t understand that only breastfed babies are truly bonded to their mothers …

I am so not judging you.

This piece is satire.

Colleen and Jerusha Goodwin have hit the big time; they’ve made the national news. Today’s Washington Post carries an Associated Press article entitled, Case of suspended Idaho midwives show ongoing tension between home-birth industry, hospitals.

Unfortunately, the article confuses the main point. Any tension between homebirth midwives and other providers is the result, not the cause of the real problem: the grossly inadequate training of certified professional midwives (CPMs).

The Goodwins managed to preside over 3 neonatal deaths in a ten month period. Most obstetricians won’t have that many neonatal deaths in an entire career. There was a fourth incident that occurred in 2008 and resulted in an infant with a profound brain injury due to lack of oxygen. The Goodwins have just settled the resulting lawsuit for $5 million, although it is unlikely they will ever pay a dime since they did not carry malpractice insurance.

Both midwives have had their licenses suspended. They deserve far worse. There is not a single mitigating factor in any of these 4 tragedies. All four involved gross malpractice as well interfering with transport and lying by the midwives.

According to the Post article:

A former employee who trained at The Baby Place said hostility the Goodwins developed for doctors ultimately led to delays in emergency transports to hospitals.

Dani Kennedy told The Associated Press this antagonism caused them to make decisions against the best interests of mothers and babies, broadening the historic midwife-doctor divide to a wide gulf — with tragic consequences.

Coleen Goodwin “did hesitate to transport, and that was really upsetting to me,” said Kennedy, who trained at The Baby Place between 2007 and 2010. She left to open a practice in Hawaii, in part over these concerns.

Homebirth advocates are fond of claiming that the licensing of homebirth midwives will eliminate such tension, but the Goodwins were licensed. Therefore, the failure to transfer for complications was not because they feared being prosecuted for practicing midwifery illegally. Rather they apparently either failed to recognize the seriousness of the major complications that developed or they feared that their incompetence in improperly addressing the major complications would be exposed.

Far better for homebirth advocates, though, to portray this as a turf issue rather than a competence issue:

… [R]emedying feuds like the one Kennedy said influenced the Goodwins’ decision-making is growing more important, said Oregon State University professor Melissa Cheyney, a medical anthropologist and certified midwife.

Midwives often feel disrespected by the medical establishment, Cheyney said, while doctors’ objections to out-of-hospital births may harden with every traumatic transport.

This comes on top of the already-existing divide between the two views of childbirth, with midwives emphasizing the safety of natural births in a familiar, comfortable setting, while the American Medical Association contends women are best off in a hospital, where life-saving technology is nearby if something goes awry.

“You’re having this compulsory interaction between two value systems,” Cheyney said. “A transport means these two systems have to come together — and work together.”

Midwives feel disrespected by the medical establishment? They ARE disrespected by the medical establishment, but not because of their philosophy. They are unworthy of professional respect because they lack the education and training of ALL other midwives in the industrialized world.

As I have repeatedly pointed out, CPMs are not real midwives. They awarded themselves a pretend “credential” to disguise from lay people and legislators the fact that they have less education and training than midwives in Europe, Canada and Australia. The CPM is not recognized and is not eligible for licensure in the UK, the Netherlands, Australia. It used to be accepted in Canada, but they have abolished the CPM on the grounds that it fails to meet minimal standards for midwifery training, which include a college level degree.

The results of homebirth midwifery practice in Idaho (as well as every other state that has collected statistics) have been tragic:

Objective measures of Idaho’s midwife-doctor relationships — and their impacts on babies — are difficult to come by, because the state doesn’t keep comprehensive records of the outcomes of midwife-assisted births requiring hospital transports.

A private effort, the Idaho Perinatal Project run by St. Luke’s, documented 138 instances between 2005 and 2011 where mothers who planned a home birth were transported to a hospital.

Though its records are also incomplete — reporting is voluntary; there are no reports for 2012 — they do point to the trauma that accompanies a planned out-of-hospital birth where something goes wrong. There were at least nine cases where infants died at or before arriving at the hospital and several instances of birth asphyxia, fractures, post-partum hemorrhage and unexpected twins. (my emphasis)

These families have experienced unimaginable anguish because CPMs care more about being able to practice and make money than they care about whether babies live or die. Hopefully, these deaths will lead to stricter standards.

In my judgment, the biggest mistakes that homebirth midwives have made are the attempt to popularize homebirth and to license CPMs. Bereaved parents now have a mechanism to file complaints and states are now totting up the extraordinary number of deaths at the hands of CPMs. State governments will be forced to respond by regulating these self proclaimed “midwives” out of existence.

A great deal of the opposition to sex education is based on an absurd claim: if you teach children and teens about sex, it will encourage them to have sex. There’s absolutely no scientific evidence to support this claim, and it doesn’t make any sense. Teens decide to have sex with each other for many reasons, but the idea that they just heard about it for the first time and decided to try it out is ludicrous.

Similarly, the lactivism campaign to end free formula samples as US hospitals is also misguided and inane, not to mention completely disrespectful to grown women. The underlying assumption is that women who decide to formula feed do so because they just heard about it, have a free sample lying around, and decided to try it out. And just like abstinence only campaigns, so called “baby friendly” initiatives to promote breastfeeding have been complete failures.

Here’s a newsflash for lactivists: women formula feed because they want to do so and unless and until you address the real reasons, and stop pretending that this is a giant conspiracy on the part of “Big Forma,” all your campaigns are doomed to failure.

What is the Baby-Friendly Hospital Initiative USA? It is an attempt to foist guidelines created for the developing world onto women of the first world. It is led (surprise!) by a midwife and a lactation consultant.

The organizations’ precepts are based on the World Health Organization/UNICEF precepts for encouraging breastfeeding in developing countries. The use of formula in these countries is extremely problematic; indeed it can be deadly. When contaminated water is used to reconstitute powdered baby formula, serious illness is often the result. In the developing world, the WHO/UNICEF guidelines can make the difference between life and death.

Are guidelines drafted for countries where poverty is endemic, water supplies are contaminated, and starvation always a possibility, applicable to the US? No, they’re not, but, shhh, don’t tell any American women that. They must be convinced and shamed into breastfeeding by any means available. And that includes misrepresenting the risks and the state of the scientific evidence.

More than one million infants worldwide die every year because they are not breastfed or are given other foods too early. Millions more live in poor health, contract preventable diseases,and battle malnutrition. Although the magnitude of this death and disease is far greater in the developing world, thousands of infants in the United States suffer the ill effects suboptimal feeding practices. A decreased risk of diarrhea, respiratory and ear infections, and allergic skin disorders are among the many benefits of breastfeeding to infants in the industrialized world.

A million infants die each year? That’s right. Are any of them in the US? No (but don’t tell American women). The magnitude of death and disease is far greater in the developing world? That’s right. Are any term babies dying for lack of breastfeeding in the US? No (but don’t tell American women). Decreased risk of diarrhea, respiratory and ear infections and allergic skin disorders? Maybe (but don’t let American women know that these claims are in doubt).

What is the truth? The truth is that in a country like the US, breastfeeding has real benefits, but they are quite small. The quoted paragraph above is misleading and not strictly true, but for lactivists, the ends justify the means.

The biggest problem with the Baby-Friendly Hospital Initiative, though, is that it is a spectacular and expensive FAILURE. That’s not surprising, since there was never any scientific evidence that it would work in first world countries, just the heartfelt desire on the part of lactivists to shame and denigrate other women.

In Rethinking research in breast-feeding: a critique of the evidence base identified in a systematic review of interventions to promote and support breast-feeding, the authors note:

The volume of papers included – 77 primary studies and three reviews – might give the impression that there is ample evidence available to inform practice and policy. On the contrary, the most striking feature of this review is the paucity of findings from well-designed research to inform an important public health and policy issue. Even where studies had been conducted, details of interventions and processes were often scarce. Others have made similar observations …

Of course women might have told them that these efforts were bound to fail, but no one asked them:

It is notable that in a field in which the behaviour and views of women, their families and society are so crucial, few studies incorporated an assessment of participants’ views.

That’s not surprising. No one cares what women think. Lactivists only care what lactivists think.

Back to those who would restrict sex education with the express purpose of preventing sexual activity, Bioethicist Arthur Caplan made the following observations in regard “abstinence only” programs:

… there is no evidence at all that they work; common sense says they have no chance of working; and it is not clear that ethically they send the right message …

The same can be said about “baby-friendly” hospital initiatives:

1. there is no evidence at all that they work
2. common sense says they have no chance of working
3. it is not clear that ethically they send the right message

Number 1 is self-explanatory.

Number 2 is only to be expected. Any program designed to change behavior is doomed to failure if the designers don’t even bother to ask women their reasons for formula feeding, let alone respect and address those reasons.

As for number 3, it is ethically suspect to exaggerate the benefits of breastfeeding, pretend that that breastfeeding is a matter of life and death in the US, mislead women on the state of the scientific evidence and above all, to shame and scare women about formula feeding.

Lactivists like to pretend that women stop breastfeeding because of lack of education, because hospitals give out formula, because of lack of professional support, because of lack of peer support, etc. etc. etc. All this pretending reflects the profound unwillingness of breastfeeding advocates to avoid addressing the real reasons that women stop breastfeeding or fail to start in the first place. The truth about breastfeeding, a truth that lactivists refuse to acknowledge, is that starting is hard, painful, frustrating and inconvenient. And continuing breastfeeding is hard, sometimes painful, and incredibly inconvenient especially for women who work, which in 2012 is most women.

“Baby-friendly” hospital initiatives are misnamed. It would be more appropriate to call them “lactivist-friendly” since the only thing they reliably do is make lactivists feel good about themselves and their own choices. No program can be “baby-friendly” if there is no evidence that it works, if it does not address the real issues, and if it shames and denigrates the mothers of those babies.

Elisabeth Badinter is causing controversy yet again with the American debut of her book The Conflict: How Modern Motherhood Undermines the Status of Women. According to Amazon:

Elisabeth Badinter has for decades been in the vanguard of the European fight for women’s equality. Now, in an explosive new book, she points her finger at a most unlikely force undermining the status of women: liberal motherhood, in thrall to all that is “natural.” Attachment parenting, co-sleeping, baby-wearing, and especially breast-feeding—these hallmarks of contemporary motherhood have succeeded in tethering women to the home and family to an extent not seen since the 1950s…

A bestseller in Europe, The Conflict is a scathing indictment of a stealthy zealotry that cheats women of their full potential.

Not surprisingly, the book is receiving tremendous attention with everyone from the New York Times, to Business Week, to the Huffington Post weighing in. That’s why I looked forward to online magazine Slate’s debate on the book. The debate involves Hanna Rosin, senior editor at The Atlantic and author of the very controversial article The Case Against Breast-Feeding, and Katie Allison Granju, who has been described as a woman who “literally wrote the book on attachment parenting.” I have been shocked and disappointed that Katie Granju has attempted to short circuit the discussion with a vicious smear of Elisabeth Badinter. Granju’s totally unsubstantiated claims about Badinter strike me as despicable discrediting of a feminist scholar to hide her inability to rebut Badinter’s arguments.

Granju claims, with no proof of any kind, that no one should pay any attention to Badinter because she is shilling baby formula.

According to Granju:

Elisabeth Badinter’s job is to increase sales of baby formula. Why is no one talking about her laughable conflict of interest?

Why would a leading feminist intellectual be shilling for manufacturers of baby formula?

… I discovered that not only does Elisabeth Badinter’s billion-dollar PR and advertising company represent Nestlé’s infant formula products, but Publicis also appears to be the go-to agency for the baby formula industry’s other major players as well, including Abbot Laboratories (Similac) and Mead & Johnson (Enfamil)…

The fact that the author of a major new book asserting that breast-feeding “enslaves” and “undermines” women also personally holds controlling interest in the agency of record for the three companies that collectively control much of the infant formula market share in the United States is glaringly disturbing… Publicis has been charged with marketing Nestlé to the public since at least 1984, and has been promoting infant formula on behalf of Abbott Laboratories since 1997. Just as her views on breast-feeding may not be new with this book, neither is her revenue stream as the result of marketing infant formula.

To read that one might think that Badinter works for formula manufacturers. The reality is rather different. Badinter is a shareholder in the multinational communications empire of Publicis. Her 10% stake (not a controlling interest), as a family member, makes her a billionaire. Publicis owns more than 20 different companies. Publicis includes advertising companies that represent formula manufacturers among their thousands of other clients.

In other words, Granju would have us believe that that a women with decades of scholarship in the area of gender studies, a woman with impeccable feminist credentials, has engaged in one of the leading issues in contemporary mothering and contemporary feminism for no better reason than to promote increase her income. Badinter is literally a billionaire. It is simply ludicrous to suggest that her philosophy is shaped by a desire for more money. But it is a rather clever way to avoid addressing Badinter’s arguments.

Never mind that, according to The New Yorker, Badinter is a feminist intellectual who:

… has written five blunt, admonitory best-sellers on the subject of those women and their men. They have made her a household name. She calls them “my contrarian feminist polemics.” Her first, “L’Amour en Plus”—a history of the changing notions of mother love—was published in 1980, when she was thirty-five. It dismissed the myth of maternal instinct as a sometime cultural construct…

Curiously, given Granju’s conviction that Badinter’s personal ties make her writing on mothering worth dismissing without discussion, Granju does not disclose her own conflict of interest. Granju never mentions that she has authored a book, multiple articles and runs a blog, all efforts to promote attachment parenting. That means that Badinter is explicitly or implicitly criticizing her work. Applying the same reasoning that Granju applies means that we should not be listening to Granju.

Agree or disagree with Badinter, she addresses issues of deep import to contemporary feminists and contemporary mothers. Are the ongoing attempts to moralize parenting choices and to promote biological essentialism just a new way to keep women confined to the home? After all, it is literally impossible to meet the myriad standards of AP is you work outside the home. Is that a coincidence or is that deliberate?

These are issues that should engage feminists intellectuals and mothers. It is deeply disappointing that Granju has devoted very little time to addressing these issues and instead has devoted a tremendous amount of time trying to blacken Badinter’s reputation. Granju owes Badinter a very public apology.

Why are some women devastated by a C-section? Why are VBACs portrayed as “healing”? Perhaps it is because those women experience C-sections as a narcissistic injury.

Narcissistic injury is a term from psychoanalysis. A narcissist is a person who suffers a deep sense of inferiority and masks it by projecting an air of grandiosity and excessive self regard. A narcissistic injury occurs when reality threatens the narcissist’s carefully constructed facade of perfection.

Narcissistic injury may lead to narcissistic rage:

Narcissists are often pseudo-perfectionists and require being the center of attention and create situations where they will receive attention. This attempt at being perfect is cohesive with the narcissist’s grandiose self-image. If a perceived state of perfection is not reached it can lead to guilt, shame, anger or anxiety because he/she believes that he/she will lose the imagined love and admiration from other people if he/she is not perfect.

Alternatively:

… rages can be seen as a result of the shame at being faced with failure. Narcissistic rage is the uncontrollable and unexpected anger that results from a narcissistic injury – a threat to a narcissist’s self-esteem or worth. Rage comes in many forms, but all pertain to the same important thing, revenge. Narcissistic rages are based on fear and will endure even after the threat is gone.

To the narcissist, the rage is directed towards the person that they feel has slighted them; to other people, the rage is incoherent and unjust. This rage impairs their cognition, therefore impairing their judgment. During the rage they are prone to shouting, fact distortion and making groundless accusations… [N]arcissists may even search for conflict to find a way to alleviate pain or suffering …

Sound familiar? It certainly reminds me of a number of VBAC and homebirth advocates, including their propensity to distort facts and make groundless accusations against anyone who disagrees with them.

In other words, for VBAC, homebirth and some NCB advocates, not having an uncomplicated vaginal birth is viewed as an imperfection. Hence the use of words like “failed” and “broken”, the insistence on comparing birth to competitive sports, and the use of goofy birth “affirmations” that are all variants of “I can do it.”

Keep in mind that a narcissistic injury is not simply an imperfection. It is an imperfection that threatens the narcissist’s protections against feelings of inferiority.

For example, many people need vision correction, but the overwhelming majority are able to accept that their eyes are not perfect without viewing it as a fundamental deficiency. Similarly, many women have C-sections and view the surgery as nothing more than one of many acceptable ways to have a baby. In contrast, a small proportion of women have such a fragile sense of self, and have constructed such elaborate defenses to protect against these feelings, that a C-section is experienced as a “failure,” a sign of being “broken,” and an insupportable assault on a very fragile sense of self-regard.

Experiencing C-section as a narcissistic injury can explain many confusing aspects of homebirth and natural childbirth advocacy, particularly among advocates who have already had a C-section. The refusal to see a doctor (with some women even refusing to see a midwife) can be explained as the inevitable result of regarding even the possibility of pregnancy complications as personal criticism, combined with the inability to tolerate criticism of any kind. Homebirth midwives are notorious for pretending that complications are “variations of normal” and for praising women for highly risky decisions. Unassisted birth can be viewed as an effort to make absolutely certain that there is no one to dent their fragile self-esteem by questioning them in any way.

It can also explain the seemingly inexplicable reactions to the death of a baby at homebirth. Reacting to a baby’s death by being “proud” of oneself for having a vaginal birth is extremely bizarre. However, it makes sense if the mother’s overriding preoccupation is to preserve her narcissistic mask of perfection and keep feelings of inferiority at bay.

The real problem, then, for women who view C-section as “failure” is not the C-section, but the outlook of the women themselves. C-section is experienced as a narcissistic injury, not because it really is an injury, but because women with carefully constructed defenses that keep feelings of inferiority at bay feel those defenses threatened by the lack of perfection.

Obviously homebirth and natural childbirth advocates will be loathe to acknowledge this. Narcissists are notorious for their lack of introspection and their insistence on blaming everything on everyone else. They could never acknowledge that the source of their distress comes from within; they are compelled to externalize it to others who are supposedly criticizing them or disrespecting them.

Adapted from a piece that first appeared on Homebirth Debate in November 2008.

I’m not sure whether this is an example of incredible hypocrisy or an example of breath-taking cluesslessness. Or maybe it’s both.

Gina Crossly-Corcoran, The Feminist Breeder, asks whether children of public figures are fair game.

She should be able to answer the question for herself. Obviously she thinks they are fair game. She’s a public figure and she writes about her children all the time. Okay, not really about them, but rather about how they make her feel. And that is very, very wrong.

Let’s do a little thought experiment:

Imagine your mother, the grandmother of your children, started a mommy blog from the perspective of a mother of adult children. Imagine she blogged about how your arrival disrupted her marriage, ruined her sex life and eventually led to stress urinary incontinence. How would you feel?

Imagine your mother shared stories of the times she was ready to tear her hair out over your behavior. Toilet training you was awful; you weren’t completely trained until you were 6 and still wet the bed occasionally at age 8. You came home from the prom and were so drunk that you vomited in the front hall. She warned you that your first husband was no good, but you married him anyway. How would you feel?

Imagine that you learned from your mother’s blog that she was deeply disappointed at your birth because you were a girl and she had wanted a boy, that she felt her postpartum depression was related to her disappointment and that she never bonded to you the way she did to your dearly desired younger brother. In reading your mother’s blog you learned that she deeply resented the attention your father showed you; she needed more of his attention and you stole it from her. And to this day, she loves your younger sister (who takes her advice, unlike you!) much more than she loves you. How would you feel?

Most likely you would be embarrassed, angered and deeply hurt. Now consider that those, like Gina, who blog about their young children are doing the same thing to them. The internet never forgets. What a mommy blogger writes about her children today will be there for them to read when the children are older. It will be there for their children’s friends to read when they are teenagers. It will be there for their employers and professional colleagues to read when they are adults.

Therefore, the answer to your question, Gina, is no. The children of public figures are not fair game … so stop using your children to promote yourself.

Remember the cruel behavior of those mean girls from middle school and high school who appointed themselves arbiters of the social universe? It was never enough for them to exclude the girls they didn’t like. Nope, they set out to punish anyone who wouldn’t fall under their sway. The classic mean girl line? “You can’t be friends with me if you’re friends with her.”

Gina Crossly-Corcoran, The Feminist Narcissist Breeder, has just pulled a classic mean girl stunt.

I am very, very sorry that I recommended the StillBirthday site. It has been brought to my attention that some of their “mentors” are former writers for “MamaTao” – the most abusive site I’ve ever come across. I wouldn’t put them within 100 yards of a grieving mother, and I am deeply sorry for posting that link…

Stillbirthday offers support for mothers grieving the loss of a child. It is a relatively new site, but it has quickly become an incredible source of support for loss mothers. I’m not connected to the site in any way, but I do know that the woman who started it, Heidi Faith, is one of the kindest, most selfless women on the internet. There are testimonials to her throughout the blogosphere. For example:

I have become friends with the maker of Stillbirthday, Heidi Faith, and she has been such a blessing and influence in my life. First, through her posts as administrator on a Facebook page called, The Pregnant Christian, which she has now handed over to me and then through various birth pages and groups online that discuss pregnancy, birth choices, safety, and loss. And also, her work on Stillbirthday, as a helpful resource for mothers, has reached me, too. She always tries to understand differences between people. I’ve always felt that I was empathetic to moms who have had such great losses, but I’ve come to see that though I am always sad for the passing of any baby, there were times that I have lost sight of the feelings of some of the moms I have encountered online because of differences in beliefs about things like birth safety and sometimes even just, birth semantics. But all moms deserve love and support and they deserve to be heard.

Or here:

I personally found them about 1 1/2yrs after the loss of my 2nd baby as I was searching on FB for babyloss resources. I am so grateful for this phenomenal exhaustive resource site. Heidi is a Christian Doula and heads this ministry up. She has an amazing love for God and commitment to truth and integrity with every mom or family member she encounters.

What did a sweet, caring, devout woman like Heidi do to warrant the Narcissist Breeder’s ire? Nothing, of course. But in classic mean girl fashion, Gina is trying to punish others through Heidi. Since Heidi is friendly toward everyone in the world, it is inevitable that she is friendly with women who refuse to praise Gina (a veritable maw of approval seeking desperation). If Gina can’t hurt those women, she’ll hurt Heidi instead.

What precipitated this outburst of immaturity? As far as I can determine, it happened because Mama Tao dissed Gina. Mama Tao is the online home of a group of women who satirize the homebirth and natural childbirth community. And if there ever was a target ripe for satirizing, it is the Narcissist Breeder.

Gina’s ire was raised by this piece, An Interview With the ‘Feminist’ Bleater. And since Heidi Faith is friends with some of the people who participate in Mama Tao, and (gasp!) allows those loss mothers among them to support other loss mothers, Heidi must be punished, because, as we know, you can’t be friends with Gina, if you’re friends with anyone Gina doesn’t like.

As Gina explains to Heidi (whose Facebook screen name is Adaleid Faith Doula):

I seriously question the judgment of anyone who would allow absolutely abusive people to “mentor” grieving mothers. I’ve been subjected to their abuse (and CONTINUE) to be to this very day. I’ve had moms come to me crying over their stalking and bullying and attacking. And now you’re letting them “mentor” unsuspecting mothers. I’m horrified. And I stand by my statement. There are much better places to find comfort than from people once dedicated their entire day to abusing others.

Just in case Heidi couldn’t figure it out, it has nothing to do with Stillbirthday; it has nothing to do with loss mothers; it has nothing to do with offering support to those who are grieving. It’s all about (surprise!) Gina. Gina’s been dissed and Heidi and her site are collateral damage as Gina tries to avenge herself on those who satirize her insatiable need for praise. [addendum: Keep in mind that there are no current Stillbirthday mentors among the current writers of Mama Tao.]

In a testament to the incredible work that Heidi does, and to the incredible person that Heidi is, many of Gina’s followers are refusing to kowtow. In fact there are so many who are refusing to kowtow that even after ruthless deletions, there are lots of supporters left. As one commentor explained:

… I just think that it’s a shame to not give people ideas on good resources because you disagree with something someone affiliated in some way believes when it isn’t actually a belief involving the topic at hand.

Sure, Heidi isn’t involved, but that’s irrelevant to Gina. And as we know (let’s say it all together now), you can’t be friends with Gina if you are friends with anyone who is involved with Mama Tao.

I know a secret, though. It really doesn’t matter whether Gina supports Stillbirthday. Everyone else does. I’d like to suggest that in a show of solidarity, anyone who has a blog or website put up a link to Stillbirthday. Let’s boost the popularity of a site that does an amazing job of providing support for an extremely vulnerable group. And let’s show mean girls like Gina that we’ll be friends with whomever we like … and there are very few people more worthy of our friendship than Heidi Faith.

Last week I wrote about two Idaho homebirth midwives, Colleen and Jerusha Goodwin, who lost their licenses after presiding over 3 homebirth deaths in less than a year.

Both midwives have had their licenses suspended. They deserve far worse. There is not a single mitigating factor in any of these 3 deaths. All three involved gross malpractice as well interfering with transport and lying by the midwives.

These women should be in jail. But, in the world of homebirth advocacy, a pile of dead bodies is nothing more than an inconvenience. Predictably, homebirth advocates are rallying in support of these midwives.

I thought that the situation was appalling. Now comes word that there was a FOURTH incident that occurred in 2008 and resulted in an infant with a profound brain injury due to lack of oxygen. The Goodwins have just settled the resulting lawsuit for $5 million.

According to OregonLive:

Two midwives have agreed to a $5 million settlement with a couple who sued them for medical malpractice after their baby suffered permanent brain damage, an attorney said Monday.

Coleen Goodwin and her daughter, Jerusha Goodwin, reached the agreement to avoid a jury trial, said Eric Rossman, attorney for Adam and Victoria Nielson. The trial had been set to begin on Monday in Boise.

The Goodwins, who own a birthing center in Meridian, Idaho, had their licenses to practice midwifery suspended last month after three babies died. The cases that led to their suspensions were separate from the Nielson’s claim.

The Nielsons said their daughter was born without oxygen at The Baby Place in June 2008, leading to permanent brain damage.

“If we had to go to jury trial today, I think a jury verdict would have reflected what they stipulated, if not more,” Rossman said shortly after the agreement was reached.

It’s unlikely that the parents will ever see any money from the settlement.

Rossman said it’s likely that the Goodwins will seek bankruptcy protection.

Whether or not they receive money, the Nielsons have accomplished something extremely important. They have succeeded in holding homebirth midwives accountable for their negligence. The have made sure that these birth criminals are not free to devastate other families. And they have alerted the public to the dangers of homebirth.

I’ve said it before, and I’ll say it again, the biggest mistake that homebirth midwives have made is their attempt to popularize homebirth. The true homebirth believers might be willing to tolerate dead and damaged babies, but average women lulled by lies about homebirth safety will not. They will file complaints; they will sue; they will organize; and ultimately, they will force state governments to respond by regulating these self proclaimed “midwives” out of existence.

I’m looking forward to reviewing the new natural childbirth book by Henci Goer and Amy Romano, CNM when it is release this summer. Thus far I only know the title, and I find it to be quite apt and unintentionally quite revealing.

The book appears to be the next iteration of Goer’s Thinking Women’s Guide to Childbirth. The philosophy behind that title was quite simple: flatter the gullible reader by implying that if you read the book you are “thinking,” as opposed to the rest of the uneducated sheeple who rely on the expertise of their doctors merely because obstetricians have 4 years of college, 4 years of medical school, 4 years of advanced training and thousands of deliveries to their credity. No, “thinking” women trust Henci who has no training in midwifery, no training in obstetrics, no training in statistics and no training in scientific research.

This time Henci has turned away from flattering the reader to conveying her thoughts about birth. The title of the book says is all, Optimal Care in Childbirth: The Case for the Physiological Approach. In one brief phrase, Goer and Romano have managed to convey everything that is wrong with the philosophy of natural childbirth: the fact that more importance is attached to process and the execrable idea that there is an “optimal” way to give birth.

The average reader is not likely to know about the origins of the current NCB catch words “optimal birth” and “physiological birth.” Their history is quite instructive.

As far as I can determine, the phrase “optimal birth” was first popularized by midwives Patricia Murphy and Judith Fullerton in their 2008 paper Development of the Optimality Index as a New Approach to Evaluating Outcomes of Maternity Care.

The optimality index reveals the obsession with process over outcome. As I wrote at the time the paper was published:

… [Murphy and Fullerton] prefer this approach because it deliberately incorporates specific beliefs about what constitutes optimal care. For example, traditional medical studies would consider the birth of a healthy baby to a healthy mother the optimal outcome; the Optimality Index would subtract points from a perfect score because, in their view, having an epidural is a non-optimal outcome.

The following will cause you to lose points on the “optimality index”:

• NST
• biophysical profile
• prescription medication of any kind
• induction
• augmentation
• any medication in labor
• epidural
• continuous fetal monitoring
• directed pushing
• less than 45° head elevation at birth
• perineal laceration

But that’s not even the worst part. The worst part is that any of these events are coded as equivalent to:

• cord prolapse
• severe pre-eclampsia
• eclampsia
• abruption
• shoulder dystocia
• intraventricular hemorrhage
• NEC
• pneumonia
• renal failure
• neonatal seizures
• perinatal death

So if you have an NST, biophysical profile, induction, any medication in labor, an epidural,continuous fetal monitoring, directed pushing, less than 45° head elevation at birth, a perineal laceration and a LIVE BABY your optimality index is 47.

If you have none of those things and a DEAD BABY, your optimality index is 56.

In other words, Murphy and Fullerton are biological essentialists:

The optimality index has two primary explicit motivations and one primary implicit motivation:

First, it is designed to give far MORE weight to process than to outcome; a perinatal death is equivalent to having an epidural.

Second, it is designed to measure how closely a birth adheres to the values of midwives.

Third, it implicitly dismisses the opinion of the mother by assigning it no value at all.

Ultimately, the optimality index tells us nothing about birth, but a great deal about the midwives who designed it and the midwifery organizations who support it: It does not matter very much to them whether the baby lives or dies. Conforming to the ideals of midwifery is very important to them. The mother’s opinion, needs and desires are meaningless.

The phrase “physiological birth” is similarly indicative of the biological essentialism valued by midwives. As Holly Powell Kennedy, president of the American College of Nurse Midwives explained:

I propose that “normal” is commonly used by midwives as a way to describe a process that counters the common and escalating interventions in many birth settings. A more fitting term might be “physiologic”— that which reflects the innate capacity of a woman’s body to reproduce without intervention—and which most women would be able to achieve when left alone to find their strength, and supported as needed in the process.

There you have it: everything that is wrong with the contemporary midwifery obsession with biological wrapped up in two somewhat clumsy sentences.

As I parsed in my analysis of Kennedy’s claim:

1. “commonly used by midwives”

The definition that counts is the one that midwives select. There are no objective criteria.

2. “counters”

The correct views of midwives are oppositional. Whatever is common in current obstetrical practice is to be opposed. Do common practices save lives? Who cares? It’s about the process, not the outcome.

3. “innate capacity”

What is that supposed to mean? Every woman has the “innate capacity” to get pregnant, but that doesn’t mean that she can. Every women has the “innate capacity” to carry a pregnancy to term but that doesn’t prevent miscarriage. Every woman has the “innate capacity” to have a vaginal delivery, but that doesn’t mean that the baby will fit or that the baby will live through the process.

4. “reproduce without intervention”

Ahh, there’s that obsession with process again. And what’s wrong with interventions anyway? It’s as if Kennedy and other midwives oppose any interventions on the principle that they are inherently bad. No attempt is made to discern if the interventions are helpful or even if they are requested by a woman herself.

5. “most woman would be able to achieve”

Would the baby be alive at the end of this achievement? Would the mother be alive? Kennedy doesn’t say. It’s the process that counts, not the outcome.

The title of Goer and Romano’s new book unwittingly reveals the profoundly unscientific, biased and self aggrandizing nature of contemporary natural childbirth advocacy. NCB is obsessed with labeling women, dividing them into those who give birth following the preapproved directives and those who do not. Natural childbirth advocates are obsessed with process; the outcome is virtually irrelevant.

Goer and Romano have written the perfect book for those who are more concerned with their “experience” than whether the baby lives or dies. No doubt those women will eagerly scoop up the book.

However, if your priority is whether your baby lives or dies, or if you reject the idea that women should be judged by the function of their reproductive organs, you should probably pass on this exercise in biological essentialism.

Be sure to check out the comments.