Yesterday I pointed out that Aviva Romm, MD encourages women to risk the lives of their babies at homebirth, but won’t take the risk of attending homebirths.
Today I’d like to correct the myriad of mistruths in her piece Homebirth: Why This Doctor Would Still Choose One.
Aviva says:
Yet the World Health Organization states that C-section rates in an average, healthy population should never need to exceed 7%!
No, the World Health Organization never said anything of the kind. The only recommendation it ever made for an optimal C-section rate is less than or equal to 15%. But even that recommendation was withdrawn in 2009, with the WHO acknowledging that there had never been any scientific evidence to support it.
Aviva says:
Birth by cesarean can make it more difficult for mom to breastfeed successfully because of physical discomfort.
Yet there is simply no evidence for this assertion.
Aviva says:
chorioamnionitis, an infection in the “bag” that holds the water around the baby … This infection is due almost exclusively to bacteria acquired in the hospital, and is commonly transmitted to the mother when excessive vaginal examinations are performed to assess labor progress.
Wrong. According to the paper Chorioamnionitis: from pathogenesis to treatment:
Chorioamnionitis is generally the result of a polymicrobial infection, with Ureaplasma urealyticum, Mycoplasma hominis and Gramnegative anaerobes being frequent causative organisms.
These organisms are present in the mother, not introduced by vaginal exams.
Aviva says:
Obstetric Evidence Is Reliable Only 30% of the Time.
Wrong. Aviva is deliberately misrepresenting the results of the paper Scientific Evidence Underlying the American College of Obstetricians and Gynecologists’ Practice Bulletins. The study found that 30% of ACOG recommendations are based on “highest quality evidence” (such as randomized controlled trials). But “highest quality” evidence is not always available and decisions must be made anyway.
Not only is Aviva’s claim wrong, but it is rather brazen considering that ZERO % of recommendations exclusive to homebirth midwifery are based on ANY evidence, let alone highest quality evidence.
But Aviva is right about some things. She explains:
As a midwife with 30 years of experience in the birth community, I will also readily admit that there are quite a few not so great home birth midwives contributing to not so great birth outcomes. In fact, in reaction to the problems found in medicalized birth settings, there’s a bit of a midwife ‘wild west’ out there – anyone can get “the calling,” attend some births, and call herself a midwife. Caveat emptor! It’s not black and white. A poorly planned home birth or a less than competent midwife (or physician, though most home births are attended by midwives), in the rare event of a complication, can be disastrous. There’s no romanticization about that from me – I’ve been in the birth trenches for 3 decades and I know some firsthand horror stories from the mouths of the moms and midwives themselves!
And what is the homebirth midwifery community doing about these “not so great” midwives? Nothing. What is MANA doing about the “not so great” midwives among their members? Nothing. Is there any homebirth midwifery organization that offers recommendations on how to tell those “not so great” midwives who preside over “horror” stories from competent midwives? Are you kidding. The first thing that happens when a midwife presides over a preventable death is that the “friends of homebirth midwives” hold a rally to raise money on her behalf. The dead baby and the bereaved family are utterly ignored.
For some reason, homebirth advocates can’t manage to promote homebirth without spouting mistruths, half truths and outright lies about both homebirth and modern obstetrics. For some reason homebirth advocates think it is justified to hide the real death rates from homebirth, protect rogue midwives who precipitate horrors, and lie about what obstetric evidence actually shows.
But call them on it and they respond with plaintive calls for girls to be nice:
…[E]verything I do is about creating a safe space for women … Therefore I reserve the right to delete comments that are irrelevant or hostile …
A safe space? Safe from what? Scientific evidence? Rational debate? Isn’t that a bit misogynistic? Why does Aviva think women are so weak that they cannot handle scientific evidence that doesn’t support their beliefs.
Men don’t need “safe spaces” to be protected from facts that they don’t like. Why doesn’t she respect women enough to assume that they are just as capable as men in dealing with scientific evidence, even with evidence that might make them “sad”?
I don’t think that grown women are so weak that they need to be protected from reality, including the reality that homebirth sacrifices the lives of babies who didn’t have to die. I’m not interested in behaving like a “lady” and creating a “safe space” for deadly lies.
Aviva Romm is happy to encourage women to risk their babies lives at homebirth. And she’s happy to twist, misrepresent and otherwise mangle the truth in her efforts. But she doesn’t dare take the risk of attending homebirths as a physician. And she thinks women must be nice and ladylike, creating “safe spaces” to exchange deadly lies, carefully “protected” from grownups who tell the truth.
Nonetheless, she has every right to refuse to attend homebirths. They are so dangerous that most other family practitioners and obstetricians won’t do it, either.
