The trouble with ignorance is that it feels so much like expertise.
So says psychology professor Dr. David Dunning. He ought to know.
In 1999, in the Journal of Personality and Social Psychology, my then graduate student Justin Kruger and I published a paper that documented how, in many areas of life, incompetent people do not recognize — scratch that, cannot recognize — just how incompetent they are, a phenomenon that has come to be known as the Dunning-Kruger effect. Logic itself almost demands this lack of self-insight: For poor performers to recognize their ineptitude would require them to possess the very expertise they lack. To know how skilled or unskilled you are at using the rules of grammar, for instance, you must have a good working knowledge of those rules, an impossibility among the incompetent…
Or, for instance, to know how knowledgeable or ignorant you are about childbirth, you have to have a good working knowledge of modern obstetrics including both normal and abnormal childbirth. Paradoxically:
What’s curious is that, in many cases, incompetence does not leave people disoriented, perplexed, or cautious. Instead, the incompetent are often blessed with an inappropriate confidence, buoyed by something that feels to them like knowledge.
When it comes to childbirth, we call these people midwives, doulas and childbirth educators. Not all, fortunately, have an inappropriate level of confidence in their own incompetence, but a significant proportion of midwives (including 100% of homebirth midwives) and an astoundingly large proportion of doulas and childbirth educators suffer from the of delusion believing themselves “knowledgeable” after having done “their research.” The world of celebrity natural childbirth and homebirth advocates is filled with what Dunning calls “confident idiots.” These include, but are in no way limited to, Ina May Gaskin, Ricki Lake, Barbara Harper of Waterbirth International, Jan Tritten of Midwifery Today, Jennifer Margulis, Jen Kamel of VBACFacts, Milli Hill of Positive Birth, and doula Teri Shilling, former president of Lamaze International, of My OB Said What??!!
How do people become confident idiots?
Very young children … carry misbeliefs that they will harbor, to some degree, for the rest of their lives. Their thinking, for example, is marked by a strong tendency to falsely ascribe intentions, functions, and purposes to organisms. In a child’s mind, the most important biological aspect of a living thing is the role it plays in the realm of all life. Asked why tigers exist, children will emphasize that they were “made for being in a zoo.” Asked why trees produce oxygen, children say they do so to allow animals to breathe… This purpose-driven misconception wreaks particular havoc on attempts to teach one of the most important concepts in modern science: evolutionary theory. Even laypeople who endorse the theory often believe a false version of it. They ascribe a level of agency and organization to evolution that is just not there…
Hence natural childbirth and natural parenting advocates claim that women are “perfectly evolved” for childbirth or that women who are breastfeeding “always” have enough breastmilk.
This idea of evolution misses the essential role played by individual differences and competition between members of a species in response to environmental pressures: Individual cheetahs who can run faster catch more prey, live longer, and reproduce more successfully; slower cheetahs lose out, and die out—leaving the species to drift toward becoming faster overall. Evolution is the result of random differences and natural selection, not agency or choice.
Similarly, childbirth and breastfeeding have always been, and are still governed by random differences and natural selection. Some pregnancies are too short and the baby dies; some pregnancies are too long and the baby dies. The idea that “the baby knows when to be born” is paradigmatic example of the purpose driven misbelief; it’s just as foolish as imagining that a cheetah knows that if it runs faster it will catch more prey. These purpose driven misbeliefs are behind many of the most egregious claims of natural childbirth advocates, from “breech is just a variation of normal” to “you can’t grow a baby too big to birth vaginally.”
The confident idiots of the natural childbirth world also suffer from motivated reasoning.
Some of our most stubborn misbeliefs arise not from primitive childlike intuitions or careless category errors, but from the very values and philosophies that define who we are as individuals. Each of us possesses certain foundational beliefs — narratives about the self, ideas about the social order—that essentially cannot be violated: To contradict them would call into question our very self-worth. As such, these views demand fealty from other opinions. And any information that we glean from the world is amended, distorted, diminished, or forgotten in order to make sure that these sacrosanct beliefs remain whole and unharmed.
The foundational belief of natural childbirth, lactivism and natural parenting is: “My birth, feeding and parenting choices make me a better mother than everyone else.” Many natural childbirth advocates literally cannot tolerate any evidence that threatens this foundational belief. Hence the epidemic of deleting and banning that afflicts natural childbirth websites and message boards.
How can we combat the epidemic of misbeliefs promoted by natural childbirth advocates? Dunning advocates a general strategy that can be applied to natural childbirth advocacy:
For individuals, the trick is to be your own devil’s advocate: to think through how your favored conclusions might be misguided; to ask yourself how you might be wrong, or how things might turn out differently from what you expect. It helps to try practicing what the psychologist Charles Lord calls “considering the opposite.” To do this, I often imagine myself in a future in which I have turned out to be wrong in a decision, and then consider what the likeliest path was that led to my failure. And lastly: Seek advice. Other people may have their own misbeliefs, but a discussion can often be sufficient to rid a serious person of his or her most egregious misconceptions.
Of course natural childbirth advocates have already cleverly “immunized” their followers against such a strategy. According to them, you should never ask yourself how you might be wrong because questioning birth inevitably leads to poor outcomes. “Trust birth!” sounds better than “Don’t think!” but it means exactly the same thing.
How can you protect yourself against the confident idiots in the world of natural childbirth?
1. The first step is to recognize that those who know the least often think they know the most. That’s why professional qualifications are so important. The people who know the most about childbirth are obstetricians. That doesn’t mean that they know everything, or that they are always right, but it does mean that they have a strong foundation from which to assess claims about childbirth.
2. Be wary of anyone who claims that formal education is unnecessary, or that obstetricians don’t follow the scientific evidence. Be wary of anyone who tells you what birth is like in the hospital when they have never worked in a hospital.
3. Be wary of anyone who makes claims about what is or is not normal in pregnancy without having extensive experience in caring for women who have pregnancy complications.
4. Don’t “trust” any natural process.
5. Ignore anyone who cannot tolerate dissent and deletes comments that call their claims into question.
6. Resist the temptation to succumb to flattery. Choices about birth and breastfeeding do not have much, if any, impact on whether children will become healthy, happy and competent adults. Anyone who tells you that the “right” choices make you a better mother is a confident idiot. Don’t let the desire to feel superior to other mothers make you a confident idiot, too.
