Extra! Extra! Get the latest from ImprovingBirth.org! Are C-sections Damaging Our Children?
I can save you the trouble of reading the piece by giving you the answer:
No, they’re not, but that doesn’t stop the folks at ImprovingBirth.org from trying to convince you that they are.
The release of the largest study of its kind [Cesarean Section and Chronic Immune Disorders] confirms yet again that the Cesarean epidemic in the U.S. deserves more attention, and women deserve better information and options. Evidence continues to emerge that birth by surgery, while sometimes necessary and wanted, is not benign.
Increasingly, researchers are finding relationships between Cesarean birth and babies’ future health. The latest findings come from a mammoth study including two-million full-term births over 35 years in Denmark—showing that children born by Cesarean had “significantly increased risk” of developing certain chronic disorders.
Does ImprovingBirth.org despise C-sections?
Is the Pope Catholic?
And just like anyone committed to free thought needs to take the Pope’s pronouncements on God’s wishes with a grain of salt, anyone committed to scientific evidence needs to take ImprovingBirth.org and Cristen Pascucci’s efforts to demonize C-sections with a whole salt shaker.
Why?
1. Bias
Getting your information about C-section from natural childbirth advocates is like getting your information about solar power from Big Oil. If you think they are going to tell you the truth, and the whole truth, then you are very naive.
2. Motivated reasoning
No doubt the folks at ImprovingBirth.org believe that C-sections are “bad.” And because that is non-negotiable, their reasoning is motivated to support their belief. They promoted papers that support their pre-existing convictions, and ignore everything else that doesn’t.
3. Training
Cristen Pascucci is a public relations executive and board member at ImprovingBirth.org whose claim to understanding the obstetric literature appears to be the fact that a baby transited her vagina.
4. A fundamental misunderstanding of the scientific literature
Just because a scientific paper is published doesn’t make it true. Reading a scientific paper is similar to reading a newspaper article. A Democratic leaning newspaper may have an article with the headline that Obama was born in Hawaii. A radical Republican newspaper may have an article with the headline that Obama was born in Africa. One article is true, the other is not. In science, publication of a paper means that it is worthy of discussion, NOT that the reviewers agreed with its conclusions.
5. A profound belief in the naturalistic fallacy
Pascucci and her natural childbirth cohorts are absolutely sure that if it’s natural, it must be good. That’s why tobacco, heroin and tsunamis are good. Oh … wait. But it is why getting the message to your followers by shouting it is better than using the Internet. Oh … wait I’ve got it! That’s why vaginal births are better than C-sections.
6. A serious misunderstanding of evolution
In a perverse way, natural childbirth advocates are eugenicists. They appear to be convinced that some peoples genes are “better” than other people’s genes. Hence the fatalism when babies die at homebirth that “some babies are meant to die.” Hence the unstated assumption that modern obstetrics must be weakening us in important ways.
7. A serious misunderstanding of chronic diseases of wealth.
Alternative health advocates in general and natural childbirth advocates in particular are desperate to pretend that chronic diseases of wealthy countries are “caused” by failing to follow the ancient wisdom of our ancestors. That’s absurd. Our ancestors died in droves from easily prevented and easily treated diseases. When you prevent those deaths, as modern medicine does, what’s left is chronic diseases of wealth. That doesn’t mean that medical care causes those diseases; it means that you can’t get those diseases unless modern medicine allows you to live long enough to get them.
Moreover, we have no idea of the prevalence in indigenous populations of diseases like Crohn’s or juvenile rheumatoid arthritis or defects of the immune system. We have no way to compare contemporary prevalence of these diseases with their prevalence in societies that lack modern medicine. Therefore, we are reduced to drawing conclusions from studies that trace prevalence over time or between groups within wealthy societies, limiting our ability to determine what modern medicine does or does not cause.
Let’s get back to the original study and see what it actually showed.
Pascucci acknowledges the difference between correlation and causation:
That is, they show a strong association between the presence of these immune diseases and the occurrence of Cesarean birth, but more research is needed to determine whether Cesarean birth is the cause of these problems, or merely an associated event.
Denmark saw an increase in the rate of C-sections from 5% in the 1970s to 20% in 2010. The U.S. saw a similar but even more dramatic rise to over 32% in 2012, according to Centers for Disease Control figures here. This is the same time frame during which we have seen an increase in immune-related disorders in westernized countries. The Danish study suggested this correlation was important, and their data supports that assertion.
Unfortunately, however, she never deconstructs the actual study and, therefore, fails to note it’s most serious flaw. Immune diseases like Crohn’s and juvenile rheumatoid arthritis have a large heritable component. Though the authors of the study took the mother’s history of immune disease into account, they failed to take the FATHER’S history of immune disease into account. Without that, they can’t draw any valid conclusions since it is entirely possible that the difference in the two groups of children is the results of differences in the fathers’ medical history, and NOT the difference in mode of birth.
Pascucci is careful to resist firm conclusions and instead settle for good old fashioned insinuation:
Emerging research points to the microbiome of babies as being a determinant in long-term health and even epigenetic changes [Actually, such research is in its infancy and offers no firm conclusions about anything] …
But this part is my absolute favorite:
At the same time, withholding information from women because we don’t want to cause hurt or guilt is a misplaced effort. It’s a perpetuation of what is truly hurting women and babies today: known but undisclosed risks of procedures like Cesarean section, biased information from care providers …
Excuse me while I pick myself up off the floor where I fell because I was laughing so hard.
Why was I laughing?
In the world of natural childbirth advocacy, informing women of the risks of death in childbirth is known as “fear mongering” and “playing the dead baby card” despite the fact that the statistics quoted are firm, reproducible and based on decades of data.
Obstetricians are bitterly chastised for “playing the dead baby card,” but now ImprovingBirth.org and Pascucci are advising us to play the “immune injured baby card” in the interests of full disclosure.
But they can’t have it both ways. And when we compare the known risks that a particular baby will die in childbirth without a C-section to the highly theoretical, unreproduced and unproven claims of future immunological diseases, C-sections win every time.
The folks at ImprovingBirth.org need to understand that what’s good for the goose is good for the gander. If you are going to condemn “fear mongering” over dead babies, you have no business fear mongering over theoretical risks of C-sections.
