Sunday, November 23, 2008

Homebirth advocacy and immature reasoning ability

One of the earliest achievements in cognitive development, occurring at approximately 5-6 months of age, is the understanding of object permanence. Babies who are only 3 or 4 months old do not understand object permanence. If you show them a toy, they will reach for it, but if you whisk it behind your back, they will not even attempt to look for it. They do not understand that the object is permanent. If they can no longer see the toy, they believe that the toy no longer exists.

Once a baby understands object permanence, he or she recognizes that the object still exists when no longer visible. Hide a little ball in your fist, and the baby will try to pry your fist open to get it.

Some people appear to have the same problem with risk that tiny babies have with objects. If they don't see it, they think it doesn't exist. If a safety measure decreases a risk, they actually think that the risk is gone, instead of recognizing that preventive measures hide the appearance of risk.

Don't believe me? Check out almost every homebirth and "natural" childbirth advocacy site. They almost always demonstrate immaturity in reasoning. MDC, for example, is a on-going festival of immature and stunted reasoning ability.

Homebirth and many "natural" childbirth advocates are generally not well educated and have some serious deficiencies in basic reasoning. They have difficulty understanding things with which they have no direct experience. Indeed, they have so little ability to understand that they actually believe that if they have no experience of a risk, that risk no longer exists. Hence the absolutely perverse insistence, in the face of massive historical and contemporary evidence, that childbirth is inherently safe. Only people who are incredibly stunted in their reasoning ability could come up with the inane motto: Birth, as safe as life gets.

In the US today, there are relatively few deaths from postdates or shoulder dystocia, or pre-eclampsia. However, that does not mean that postdates or shoulder dystocia or pre-eclampsia are either rare, or no longer dangerous. They are common and exceedingly dangerous, but bad outcomes are routinely prevented by medical intervention.

Over the past two years, at least 24 healthy, term babies of MDC members died from preventable causes at homebirth because the mothers, and the MDC members who encouraged them, could not reason beyond what they could see. Most of these women had never seen death from:

breech - but now they've seen 1 baby die unncessarily
postdates - but now they've seen 3 babies die unnecessarily and 2 sustain serious anoxic brain damage
shoulder dystocia - but now they've seen 2 babies die unnecessarily
chorioamnionitis - but now they've seen 1 baby die unnecessarily
cord accident - but now they've seen 2 babies die unnecessarily
chronic hypertension - but now they've seen 1 baby die unnecessarily
uterine rupture - but now they've seen 2 babies die unnecessarily
fetal distress - but now they've seen 9 babies die unnecessarily

Deaths from fetal distress, breech, postdates and cord accidents are not rare; they're common. Homebirth advocates have not seen or heard of them because modern obstetrics prevents them.

The toy is still there even when the tiny baby cannot see it. Similarly, the risk is still there even if the homebirth advocate cannot see it. Asking a homebirth advocate about risk is like asking a tiny baby about object permanence; neither understands that the real world extends far beyond what they can see.

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