Tuesday, October 24, 2006

Homebirthdebate causes controversy

Currently, Homebirthdebate.com is being discussed on at least 3 different message boards AND I've recently learned that I now merit my own personal page on Ronnie Falcao's homebirth website. Homebirthdebate.com was designed to be provocative, so it is not suprising that it has generated controversy. What is suprising to me, is the nature of the controversy that it has generated.

The bulk of the material on this site is factual information about childbirth and about obstetrics. Therefore, it is surprising that little if any of the current discussions involve these facts. Indeed, on the three message boards, there is not one single piece of evidence about anything. All the talk is on the order of "can you believe she said that?" but there is absolutely nothing contradicting any evidence that I have presented.

There is also a lot of suprise about my claim that natural childbirth advocates and homebirth advocates are often woefully lacking in knowledge of the basic facts of pregnancy and childbirth. Again there is a lot of "can you believe she thinks we don't know about scientific evidence?" reflecting that homebirth advocates like to style themselves as more "educated" than other women. Yet there is nothing, absolutely nothing, that indicates that they are aware of the scientific evidence. Reading the myths and lies perpetrated by many natural childbirth and homebirth authors is NOT a substitute for the scientific evidence and does not make you "educated" about pregnancy and childbirth.

The second interesting factor is the apparently irresistible urge to demonize anyone who disagrees. I discuss mostly factual issues. They are either true or they are false. Yet, over and over again, the facts and I are portrayed as good or bad. It seems to me to be another form of denial. It's sort of the intellectual equivalent of putting your fingers in your ears so you don't have to hear something you don't want to hear. Rather than look into the claims, it is so much easier (and emotionally safer) to imagine that I am a bad person, so no one needs to listen.

Leaving aside the issue of whether being a bad person have any impact on the truth of my statements (it wouldn't), it is really interesting to look at the words used by homebirth advocates in describing how they imagine me to be. "Bitter" and "disappointed in her own birth experiences" come up a lot. The choice of words says so much more about the accusers than it does about me. First of all, they don't know me, and they are well aware that they don't know me, so they are simply making up descriptions to fulfill THEIR needs. What do they need to believe? They need to believe that being a natural childbirth or homebirth advocate is a sign of being a "good" person. They need to believe that anyone who disagrees is not merely wrong, but is damaged in some fundamental way. They are so beholden to natural childbirth and homebirth advocacy and its implied and stated claims about the superiority of advocates that they simply cannot understand that I challenge the claims merely because they are false, and for no other reason. "I wonder what her real motivation is" comes up often, as if challenging false claims could not possibly be motivation enough.

I am most proud, though, that I rate my own page on a homebirth website. People are reading Homebirthdebate.com and they are asking questions. The longer that continues, the more pressure develops to have an appropriate response. Of course, this response falls woefully short. The is no evidence about any specific claims I have made. Not suprising, since my claims are true. There are two pieces of "evidence" about me as a person. One is about the chapter on episiotomy in a book I wrote in 1994 and is posted on AskDrAmy.com. I just revised that, so it's no longer true. The other is that I am no longer licensed, as if that affects the truth of my claims. I stopped renewing my license when I gave up clinical practice to be home with my four children. I find it delightfully ironic that a homebirth advocate who would find nothing wrong with a DEM being unlicensed, suddenly finds licensure to be deeply meaningful.

What I am most looking forward to, however, is the opportunity to debate specific claims. I think that opportunity is coming. In dramatic contrast to the spurious claims of advocates, homebirth is not "as safe or safer than hospital birth". Virtually every scientific study done to date shows that homebirth has an excess rate of preventable neonatal deaths. Sooner or later homebirth advocates are going to be forced to address that reality instead of constantly trying to dodge it.

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