Wednesday, August 18, 2010

Selfish and reckless...what next?

Every so often I come across an article that's so over-the-top that I can't not blog about it. This just in from Britain's Daily Mail: Planning a home birth? Sorry, but you're just selfish and reckless. It's a mother's argument about why women shouldn't give birth at home, based on her personal experiences giving birth. Nothing entirely new or even unreasonable in itself, but the author Liz Fraser takes a huge leap from explaining why home birth isn't the right choice for her to condemning and judging all women who choose home birth as reckless and selfish. And lots of other things.

What really irks me about this woman's piece isn't her personal choice to birth in a hospital setting, and not even her conclusion that home birth, to her, seems too risky. It's the blatant lack of research and the self-righteous tone that make her piece particularly insufferable.

Let's turn to the short piece of research she cites to back her claim that there is a tiny but increased risk to the baby at a home birth: the Wax meta analysis on home birth that's been making my Google alert on "home birth" go haywire for the past month. On the surface, this meta analysis seems fairly impressing: over 500,000 births in their data set and the news-grabbing conclusion that home birth "associated with a tripling of the neonatal mortality rate." The author obviously read no further than the news headlines, because a closer look at the Wax meta analysis reveals something else entirely. To come to the conclusion that home birth results in a 3x higher neonatal mortality rate, the study's authors eliminated around 95% of their data set, looking at only 9,811 home births--not hundreds of thousands. In addition, the 2002 Pang study contributed significantly to those numbers on neonatal mortality ("12 of the 18 neonatal deaths in normally formed newborns," according to Amy Romano of Science & Sensibility). The Pang study was based on birth certificate data and included unplanned home births in its data.

Now let's take a look at Fraser's tone. I understand why some women really prefer being in a hospital setting and truly feel safer there. And I don't try to talk them out of it, or convince them they're misguided, even though I might make very different choices. But Fraser's article isn't really about her--it's about you and me. About everyone who makes different choices from her. And it isn't at all understanding or supportive or even somewhat self-reflexive. Read a few of her sentences and you'll see what I mean:
Home is the perfect environment for many things, but there's one thing it's definitely not right for - and that's giving birth. For that, there are things called 'hospitals' and they are full of lovely people called 'doctors'....

We're talking about the life of two people here - and, by association, the lives of everyone they know - and I value that ever so slightly above the need for comforting personal effects and my favourite CD on the stereo. And to me, anyone who doesn't is being not only very foolhardy, but also incredibly selfish. As well as having written three books on parenting, I have given birth three times, and never considered having my baby on the Ikea rug in my living room....

[I]t's vital for mothers to maintain a sense of self, to keep meeting their needs and to teach their children that they are not the most important things in the universe. I wish more overindulging parents would try this. But where childbirth is concerned, I firmly believe we need to put our self-centred wishes aside, and be in the safest possible place just in case things go unexpectedly wrong....

Those in favour of home birth speak of it as being a ' positive' choice. Of the journey into hospital being 'unpleasant'. Of hospitals being 'uncomfortable' And for whom? For the mother - not for the baby. Now, I dislike strip lighting, the clinical smell and not being able to drink a cup of tea out of my favourite mug as much as the next woman trying to get a human out of her body. But these discomforts seem shamefully insignificant compared with the importance of having a safe, healthy delivery - even if the risk is tiny. And at least if I get myself to the hospital from the start, I know there's no chance I'll end up rushing there in an emergency, thus putting my baby's life at risk....
And one of the best ever--having a baby at home is selfish because the midwife gives you one-on-one attention for the duration of your labor!
And I only have to look to all the doctors I know who have chosen to give birth in hospital to know it's the safest place to be. The other selfish aspect of a home birth is that it requires a fully-trained midwife to leave the hospital and give one woman her undivided attention for the duration of her labour, which can be 24 hours or even much longer....There is no mention of all the other women in hospital who might need the midwife's care during that time. Thought is given only to the right of the woman to choose to give birth wherever she likes.
Never mind that one-on-one, uninterrupted care during labor is probably the safest kind available. And thus, in Fraser's reasoning, this should earn a mother gold stars for her concern about the baby's safety.

Let's leave behind the talk of selfishness, or the mythological notion that home birthers care more about "The experience" than their babies' welfare. The author condemns home birth (which she clearly knows little about in any breadth or depth) with a flourish of her sarcastic, snarky pen. That smacks of both shoddy journalism and a constricted worldview.


  1. The "just in case things go unexpectedly wrong" comment always gets me. Things go wrong all the time in areas other than birth. You could have a heart attack, or your appendix could burst. Does that mean we should all just go live in the hospital? It is, after all, "the safest possible place just in case things go unexpectedly wrong."

  2. I just miscarried my first baby. Obviously, I was totally selfish in trying to do that at home, where I felt safe and cared for.

    People like her are judgemental, misinformed, and are contributing to the downfall of the incredible life experience called birth. Yes, it's every woman's choice to birth how she pleases...but to be so critical of something you really know nothing about...well, that's just wrong.

  3. Blech. What tripe. Personally, I think it's even more selfish of people to only consider the MOTHER during birth. Sure it's great for us to have our twinkle lights. But an added bonus is a beautiful, peaceful, safe, respectful entance into this world for our babies, where they don't get tossed around like dead salmon at a fish market, taken away from their mommies, jabbed with needles, and have goop put in their eyes.

  4. I've recently decided that I'm now just going to agree with that. Yep, deciding to have my kids at home was selfish.

    It's selfish to want kids who are healthy, safe, and whose needs are met. I selfishly want my kids to have the highest chance of breastfeeding, to get what they need from their umbilical cords, to decrease their chance of having a mom with PPD, to decrease their chance of infection in the first days of life, not to mention avoiding bringing them into a world surrounded by people who have to do a list of "procedures" before they can move on with their work day. I selfishly want my older kids to have a loving and peaceful way to be involved in the birth so that they can have a tender acceptance of their new sibling. It feels unpleasant to me to be involved in creating painful and jarring experiences for a young baby, and I'd rather avoid that. Totally selfish, I get it. I could go on and on, the list of selfish reasons to give birth at home is really quite long. But I want to get to bed because if I don't I am likelier to be an ass to my children, and I hate feeling like an ass.

  5. Don't Feed the Troll

    Just to give you some context to this clearly delusional woman, the paper that she is writing for is the worst kind of ‘journalism’ representing the lowest common denominator of the UK.

    It’s the kind of paper that regularly starts witch hunts without a shred of evidence and loves nothing better than stirring up a good hate campaign.

    It has Lord Rothermere as Chairman – and a quick search on the web should tell you all you need to know about that man!!

    Pity them, and the idiots who buy their rubbish, it must be horrible to live such a small life.

  6. Yep, what the previous poster said - the Daily Mail is full of sensationalist, knee-jerk, poor journalism and most people here in the UK know that (apart from the people who read the paper, seemingly).
    But it certainly doesn't help me, as a first time mother to be, planning a home birth, to have this kind of reaction/opinion bandied about.

  7. I compare homebirth/UC to a person who has IBS or Chrone's disease. Even though they *have* digestive problems, they don't go to the hospital for every meal or every bowel movement. They only go when something's *wrong*. Otherwise, they eat at home, like every other healthy person does. Same thing with people who have diabetes. Even though they have trouble regulating their insulin or sugars, they don't sit in the hospital all the time.

  8. There is someone named "Liz" who posts a lot on Dr. Amy's website - recently she was writing about how a homebirth is a bad idea based on her experience of having a full placenta abruption during a home delivery.

    Firstly, while I am sorry for her loss, I wonder if it could not have been avoided by a late-term ultrasound to check for placental abnormalities in order to 'clear' her for a homebirth. If it were me, this is what I'd want. I'm not going to suggest that women who refuse all ultrasounds in pregnancy are reckless, necessarily, but after hearing some horrible stories about losing babies at home because of undetected placenta previa, this might not be a bad idea. Am I correct in this assumption?

    Secondly, while Liz's loss was traumatic, I don't necessarily think it's acceptable for her to write off homebirth as dangerous and irresponsible (assuming this is the same Liz - again, I'm not sure). For some people, it's not a good idea. I don't know if she was the "type" (pardon the stereotype) to refuse all u/s during pregnancy - those very women Dr. Amy regularly flames and criticizes - but I don't think it's the least bit fair to demonize all of homebirth because of your unfortunate experience.

  9. It's not the same Liz, since the article's author had all 3 kids in hospital.

    I don't think late-term U/S can predict placental abruption before it happens. Some women feel more comfortable with having routine ultrasounds (which are usually done around 20 weeks, though, not at the end of pregnancy) and others don't feel that the research evidence supports routine U/S for women with no indications. I fall more into that latter group myself. If there's something going on that warrants an U/S, sure, I'll have one. But otherwise I am not personally convinced that the possible benefits of routine U/S outweigh the risks (not necessarily grave health risks, but the risks of false positives, etc).

  10. Oh how sad for her. I actually feel sorry for women who write things like this. Sad that they will probably never understand the reality of what homebirth means, or why it is so important to have that choice available.

  11. I am confused how the Doctor saved her son by breaking her water. Could not a midwife done the same thing if at home and monitoring the FHTs during labor?

    And, to the previous commenter who mentioned an u/s to check for is my understanding that most MWs could pick up on signs of previa by listening for the placenta's 'pulse'.

  12. A lot of inflammatory language! This woman is clearly coming from a place of fear and trauma. How can you argue with that? You really can't, I don't think, with someone in this space. You just have to let her have her room to voice what she needs to on her own journey. Hopefully she will find some healing along the way.

  13. Agreed with above commenter when she said, "This woman is clearly coming from a place of fear and trauma. How can you argue with that?" Ugh. So tired of these, well, *tired* "arguments" against homebirths!

    Also tired of inflammotory arguments against homebirth/low-intervention birth that completely disregard the mother-baby dyad. I guess it points to the fact, though, that our culture really has little understanding of what that phrase even means!

    And like the previous commenter said, when a woman's beliefs about birth, the birth process, etc, are shaped by any multitude of negative factors, they will block her brain from being able to accept and rationally process objective information. I am so blessed to be certified as a CCE with an organization that puts their prenatal focus on working through emotions, beliefs, philosophies FIRST. And then, after allowing parents time to sift through all that, then we start talking more in depth about the birth process, comfort meausures, etc.

    I just commented recently on a blog piece asking readers to weigh in on the question, "Epidural or Natural?" I am so weary of such discussions. They totally miss the point! Why even ask that question? Why not first ask, "what do you believe about birth?, what did you learn about birth from your mother?, What types of images have you seen in the media portraying birth?, What are you greatest fears about birth?" Maybe a long ways down that path, then we can ask the question, "Epidural or Natural." I feel we really do a dis-service to women ( and couples) by starting discussions with such questions. Or similarly, like your post, people who pose the question, "Hospital or Home?"

    Great retort, as always, Rixa!

  14. Personally, I think your commenters have hit the nail on the head. a) she doesn't know what she's talking about and this is sloppy journalism b) journalism is a VERY STRONG word for what appears in the Daily Mail. They are the same people who will fill hundreds of inches of comment space lashing out at people who nurse in public.

    Kind of like dung on your shoes, you just have to flick it off and continue to live the life you choose and selfishly birth and attend your children. Or at least that's what I've decided.

    Now. I'd best go breastfeed my daughter who'se still asleep in bed with her daddy cause I'm just too darn lazy to make a bottle (and wash cot sheets. );p

  15. On that note, I wanted to share a link with you, Rixa to my recent home-birth story... It was a planned homebirth but almost ended up being a UC.

    Part 1 is at bottom. :)


Related Posts Plugin for WordPress, Blogger...