I’ve been lurking at the Skeptical OB for a while and enjoying Amy Tuteur’s very effective criticism of some of the extremes of the homebirth movement. I had noticed that among some advocates of homebirth that were proposing risky behavior for pregnant mom’s that conflict with the literature that it appears to be a movement rife with denialists who promote the valorization of ignorance in Dr. Tuteur’s words. Mostly their problems seem to be with accepting there is a real, measureable increase in risk with homebirth, and rejecting the very real health benefits that medical physicans offer in preventing fetal and maternal mortality. She summarizes the argument for homebirth-advocacy-as-denialism here and my heart was warmed that she used our 5 criteria for identifying denialist argumentation.
I’ll also point out she has some really compelling posts I’ve read in the last few weeks that are worth a look for anyone who is considering homebirth using a CPM rather than an OB/Gyn. See:
Humbled by Birth
Latest in homebirth deaths plus a near miss
Homebirth midwife requirements “tightened” to include high school diploma
Yes it is your fault that your baby died at homebirth
even more homebirth deaths– in particular I was jumping up and down angry when I read about people describing their childrens deaths from group B strep! What the hell! This is imminently preventable, treatable, and such an example of an obvious preventable death I nearly fell out of my chair.
Dr. Tuteur does an excellent job of providing compelling data, experience, and examples of why this movement is bad for mothers and bad for babies. Denialism can kill. There are very real advantages to appropriate prenatal screening and testing offered by OB’s, and very real problems that can occur even with “low risk” births that may result in the death of an infant or the mother. People can argue about homebirth and rejecting medicine as a choice, but you can’t argue that this is risky behavior that is resulting in preventable deaths. The idea that a high-school dropout with a CPM certification (requiring passing a test and attending a handful of births) can offer the same level of experience and safety as an OB/GYN that has training in hundreds of deliveries, is a medical doctor, can perform prenatal risk assessment and screening, and has the ability to surgically rescue in an emergency is ludicrous. In my very limited OB experience as a medical student I’ve seen “low risk” go to “potential disaster” and the life of the baby and possibly the mother be saved by interventions as simple as fetal heart monitoring and ready access to an operating suite. These stories of people being in labor for 48 hours and delivering dead infants are very distressing because we can avoid this! It’s like choosing non-sterile surgery over anti-septic surgery because bacteria are natural. Why ignore decades of research, experience and the obvious improvement in perinatal and maternal mortality that obstetrics has provided over the last century?