So you’re pregnant and you’ve decided you want to educate yourself about childbirth. Or perhaps a friend or family member has called your decisions to give birth in a hospital, use an obstetrician and get an epidural into question, claiming that you’ll change what you want when you read what she recommends.
There are a plethora of birth blogs out there. How can you be sure that you are getting accurate information and truly educating yourself when so many are filled with mistruths, half truths and outright lies?
I’d like to suggest 5 simple criteria by which you can evaluate every birth blog (or message board or book).
1. Is the blog ideologically driven?
Does the blog start with a conclusion — e.g. natural childbirth is best, epidurals interfere with bonding, women who do it “my way” are the strongest, most empowered and best educated — and work backward from there? If so, you can be sure that the blog is not evidenced based (even, or especially, if it says that it is).
2. Is the blog based on the latest scientific evidence?
How can you tell? Does the author read the latest scientific papers in full, analyze them and encourage you to analyze them? That’s a good sign. Or does the author append an impressive looking list of scientific papers and ask you take her word for what they say? If so, odds are that she herself hasn’t read the papers and doesn’t know what’s in them. She just copied the list from another birth blog or book.
3. Are dissenting comments allowed and addressed?
This is critical. Someone who knows that the scientific evidence supports their claims welcomes dissent as an opportunity to clarify and to educate. Everyone else is afraid of dissent. Therefore, you can be 100% certain that you cannot educate yourself about childbirth by reading any blog or message board when only some of the comments are published, when only praise and agreement are published, when critical comments are published but ignored, when criticism is addressed by saying “don’t listen to so and so,” or when people with actual medical training are banned from commenting at all. Be especially wary about websites that claim to delete and ban “unsupportive” comments. If you are truly trying to educate yourself about childbirth, you are looking for evidence, not for support.
4. Is the site vetted by an obstetrician?
If not, it’s bound to be incomplete and possibly filled with inaccuracies as well. No one knows more about childbirth safety than obstetricians. After all, everyone agrees that they are the ones who have the most knowledge, the most training and the most experience in identifying, preventing and managing childbirth complications. No one else even comes close. So if anyone else besides and obstetrician tells you that something is “safe,” you can’t be sure that is true.
5. Are there circumstances under which the writer will acknowledge that new evidence shows that she was wrong?
This is a corollary to #1. If a website is ideologically driven, there is no way the author will ever acknowledge that the central premise is wrong. For example, a creationist website will NEVER conclude that God doesn’t exist. An anti-vax website will NEVER conclude that a vaccine, any vaccine, is safe and effective. Similarly, if you can’t imagine the author ever acknowledging that new scientific evidence shows that homebirth isn’t safe or that new scientific evidence shows that epidurals are safe and effective, you can’t get accurate information from that website.
Let’s use these criteria to evaluate a few influential birth blogs.
We can start with the Lamaze blog Science and Sensibility, since Lamaze is one of the most influential birth organizations out there. How does S&S measure up?
Is the blog ideologically driven? Absolutely. The blog will always support the central tenets of natural childbirth regardless of what the evidence shows.
Is the blog evidence based? The blog does offer analysis of scientific papers, but it never presents any papers which undermine its ideological stance except to criticize them. It ignores any papers or statistics that conflict with its ideological bias if the papers are well done or the statistics are incontrovertible, since the authors don’t want you to know about them. Of course, it’s impossible for anyone who doesn’t scan the obstetric literature on a regular basis, to know what’s left out, but there are telltale signs. As far as I can determine, S&S, over the many years it has existed, has never presented unfavorable papers or data except to criticize it. Another way to tell, is to see if I and other obstetricians are discussing papers and data that appear to be missing from S&S. Unfortunately, that happens all the time.
Does the blog allow and analyze dissenting comments. When it comes to Science and Sensibility, the answer is a big, fat NO. None, but the mildest dissent is tolerated and commentors who are able to accurate quote the scientific literature are not allowed to do so. The authors of S&S are well aware that they are presenting a skewed picture of the scientific evidence, so they go to great lengths to be sure that you won’t find out.
Is the site vetted by an obstetrician? Of course not.
Are there any circumstances under which the authors will acknowledge they were wrong? I’ve been reading S&S for years, I haven’t haven’t noticed a single one.
Based on these criteria, you can be 100% certain that you CANNOT become educated by reading Science and Sensibility, since it is ideologically driven, presents an incomplete picture of the existing scientific evidence, and will not allow dissent.
How about the website of the Midwives Alliance of North America (MANA) and the statements of their many spokespersons (Melissa Cheyney and Wendy Gordon, among others)?
Is it ideologically driven? Yes, 100% of what is on the website is based on the unalterable conviction that homebirth is safe in all but the rarest of circumstances.
Is the blog evidenced based? Absolutely not. It bears no relationship to the existing scientific evidence and routinely quotes “sources” that aren’t scientific papers at all. Not only does MANA hide the scientific evidence discovered by others, MANA hides its OWN scientific evidence, if it doesn’t show homebirth to be safe. That’s why years after they have collected the data, and long after they have publicly released the C-section rate, the intervention rate, the transfer rate and every other rate for the 27,000 homebirths in their database, they still are HIDING their own death rate.
Is the site vetted by an obstetrician? Surely you jest!
Are there any circumstances under which the authors will acknowledge they were wrong? Never. It doesn’t matter whether homebirth is safe or not; it won’t matter how many babies die; it won’t matter how many homebirth midwives are tried for manslaughter, MANA will never acknowledge that homebirth is unsafe.
The bottom line is that if you really want to become educated, you have to get your information from a scientifically accurate source.
When you come across a birth blog (or message board or book) ask yourself the 5 questions:
1. Is the blog ideologically driven?
2. Is the blog based on the latest scientific evidence?
3. Are dissenting comments allowed and addressed?
4. Is the site vetted by an obstetrician?
5. Are there circumstances under which the author will acknowledge that new evidence shows that she was wrong?
I’ll let you analyze the blogs and books and message boards for yourself, but I will make a prediction:
You will not find a single popular natural childbirth or homebirth blog that is able to fulfill the criteria.
You and I might quibble about certain details of each site, but every single one bans dissent. And if dissenting opinions aren’t freely published, if the authors are afraid to let you hear them and decide for yourself, then you can’t become educated by the site; you can only become indoctrinated.
