Homebirth advocates have countless fallback positions.
A homebirth advocate says: I’m having a homebirth because it is safe or safe than hospital birth.
Present the copious evidence that homebirth triples the rate of neonatal death and the homebirth advocate falls back to: I’m having a homebirth because even if it isn’t safest, it is safe enough.
Show her that homebirth has a truly unacceptable rate of neonatal death and she falls back even further: My intuition tells me that homebirth is safe enough for me.
The ultimate fallback position, when all the information is on the table, is this: A healthy baby is not the most important thing.
What are we to make of this?
First, it not true. For the vast majority of women (99+%), a healthy baby is the most important thing. That’s why they go to the hospital in the first place. It certainly isn’t for the fabulous food and the wonderful decor. It’s for the obstetric interventions that make childbirth dramatically safer and much more comfortable.
It’s not true even for most homebirth advocates because it misrepresents what the she believes. The average homebirth advocate is completely ignorant of the real risks, so she thinks there are no risks. The few who recognize the risks use their “intuition” to predict that they are not going to have life threatening complications; they are going to have a healthy baby regardless of whether they give birth at home or in the hospital. What they really mean is: Since I’m going to have a healthy baby regardless, a healthy baby is not the only important thing.
To a certain extent, these homebirth advocates are right. A healthy baby may be the most important thing, but that doesn’t mean that it is acceptable to be treated poorly as long as you go home with a healthy baby.
There is a tiny group, a fraction of a fraction of a percent, that really does believe that a healthy baby is not the most important thing. That tiny group can be further divided into two distinct subsets. One subset truly does not care about the baby. They may be ambivalent about the pregnancy or even in denial. They may have lives disordered by substance abuse and be incapable of thinking beyond feeding their habit. It is simply not important to them whether the baby lives or dies; in fact, it may be better for them if the baby dies.
The other subset contains women for whom the experience of childbirth is literally more important than the child. Most proponents of unassisted childbirth (UC) fall into this category as well as a few homebirth advocates. The baby is secondary to the self-image they are building.
Some will admit that they got pregnant or would like to get pregnant not to have a baby, but merely to have a birth. Some will proudly announce that they love the child of unassisted birth more than their other children if they have them. They are narcissists in the true sense of the word. Nothing, not even the life or death of their own child, is as important to them as their own self-image. Everyone in the world, even their own infants, are just props in the drama that is their life story.
They talk the talk and they walk the walk. Their number includes UC advocates Janet Fraser and Laura Shanley, as well as Ina May Gaskin, the doyenne of homebirth midwifery. All of them have let their own child die; Shanley and Gaskin actually watched their premature infants struggle for hours before finally succumbing. Then they went on to make careers out of the belief system that killed their own children. It’s difficult to imagine anything more narcissistic than that.
For some women, a healthy baby is not the most important thing, but those women deserve our pity and our condemnation. For everyone else, a health baby IS the most important thing and nothing else even comes close.
