At the end of their piece in yesterday’s NYTimes Room for Debate feature on homebirth, Drs. Grunebaum and Chervenak make a particularly apt comparison:
We are now seeing the damage done to children from the propagation of junk science about vaccines. It is imperative we, as a society, do not make the same mistake when it comes to birth.
With the advent of the recent Disneyland measles outbreak, it has become painfully apparent that the anti-vax position is and has always been spectacularly wrong.
The Disneyland measles outbreak was not the first incidence of the resurgence of vaccine preventable diseases; multiple children (generally infants) have been sickened, hospitalized and have died since pertussis (whooping cough) has come roaring back. But for some indefinable reason, the Disneyland measles outbreak became the tipping point. Similarly, literally dozens of babies are dying preventable deaths at homebirth each year, but though we are approaching a tipping point (as indicated by the framing of the NYTimes’ question Is Homebirth Ever a Safe Choice?) we probably won’t reached it until a prominent celebrity’s baby dies at homebirth.
Homebirth and anti-vaccine advocacy are ideological twins.
Indeed, it is rather startling to consider what homebirth and anti-vaccine advocacy have in common:
1. Both are based on pseudoscience
Both homebirth and anti-vax advocacy rely on ignoring, twisting or confounding the existing science. Advocates present bibliography salads of cherry picked and misleading citations written by discredited authors or subsequently reversed or retracted.
2. Both ignore the consensus of experts
Vaccination is promoted by nearly all the immunologists, pediatricians and public health officials around the world, yet anti-vax activists imagine they know better than the experts. American hospital birth has been declared safest by obstetricians, neonatologists and pediatricians, but homebirth advocates imagine they know better than the experts.
3. Both are based on the belief that “if I haven’t seen it, it doesn’t exist”
Anti-vax advocates pretended to themselves and others that there was no reason to worry about vaccine preventable diseases since they were so rare, never acknowledging (or possibly even realizing) that they were rare BECAUSE OF vaccines, not in spite of them. Similarly, homebirth advocates pretend to themselves and others that childbirth complications are both rare and easily foreseen in time for hospital transfer, never acknowledging (or possibly even realizing) that they seem rare BECAUSE OF obstetricians and hospitals, not in spite of them.
4. Both are propagated through echo chamber websites that delete non-conforming scientific data and ban commentors with actual expertise
This is a hallmark of pseudoscience. For both anti-vax and homebirth advocacy, a truly educated consumer is their worst customer, so intense efforts are made to to delete scientific evidence and ban commentors who might raise suspicions about the validity of anti-vax and homebirth claims. Advocates are spoon fed what they are supposed to believe and they can’t be allowed to question what they’ve been fed.
5. Both rely heavily on conspiracy theories.
According to anti-vax advocates, we’re supposed to believe that vaccines are a massive world wide conspiracy involving nearly every immunologist, pediatrician and public health official. Indeed immunologists, pediatricians and public health officials are so devoted to maintaining the conspiracy that they actually give their own children vaccines despite the fact that they secretly know that vaccines are useless and dangerous. Similarly, according to homebirth advocates, we’re supposed to believe that modern obstetrics is nothing more than an economic conspiracy to deprive midwives of their livelihood, and to cause childbirth complications so that obstetricians can pretend to be heroes.
6. Both rely on magical thinking, the belief that thoughts can control events
No one conveys that reliance on magical thinking better than homebirth advocates who declare (with straight faces, no less) that the safest place to give birth is where the mother feels safest.
7.Both believe the mystical power of food to ward off disease and complications
Both actually believe, with absolutely no scientific evidence, that eating “right,” and taking supplements and herbs can ward off both vaccine preventable illnesses and childbirth complications. The highest mystical power, however, is reserved for breastmilk, which apparently can do everything from preventing pertussis and measles (it can’t) to treating eye and ear infections by squirting it into eyes and ears.
8.Both have a libertarian streak that invokes rights and ignores responsibilities
The battle cry of anti-vaxxers and homebirth advocates it, “I don’t want to and you can’t make me.” Preventing the illness and death of others is irrelevant in this libertarian conception of citizenship.
9. Both are about parental ego
Both anti-vax and homebirth are forms of parental tribalism where parents distinguish themselves from other parents whom they deride as “sheeple.” Both are concerned with parental “empowerment,” not science. Anti-vax is not about vaccines and not about children; it’s about the need for some parents to view themselves as special, smarter and savvier than all the rest. Homebirth is not about birth and certainly not about babies; it’s about the need for some mothers to view themselves as special, smarter and savvier than the all the rest.
10. Both harm or kill children, not the adults making the choice
Not coincidentally, the greatest risk of harm of these adult choices devolves on innocent children who probably would have made different choices (to preserve their own lives) had they been given the opportunity.
It took years, and dozens of preventable deaths, as well as hundreds preventable illnesses and hospitalizations to finally reach mainstream recognition that anti-vax advocacy is dangerous pseudoscience. How many years, and how many preventable deaths will it take for mainstream recognition that homebirth is the ideological twin of anti-vax, based on faulty science and every bit as deadly?
