Psychological defense mechanisms are strategies that protect people from emotional distress:
[They are] brought into play by the unconscious mind to manipulate, deny, or distort reality in order to defend against feelings of anxiety and unacceptable impulses and to maintain one’s self [image].
Denial is one of the most primitive and most powerful defense mechanisms:
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Homebirth advocates insist they are taking responsibility for their baby’s health … right up until the baby is harmed by their choice.[/pullquote]
Refusal to accept external reality because it is too threatening; … resolution of emotional conflict and reduction of anxiety by refusing to perceive or consciously acknowledge the more unpleasant aspects of external reality.
Denial is one way that women whose children have been harmed at homebirth try to avoid responsibility for the harm that resulted from their decision. For example:
I want everyone to realize something…because I was asked again today if I still agree with home birth. Let me make this clear…what happened with M would have happened in the hospital too!! Group B strep can go undetected and then when baby tries to breathe, they just can’t. It had NOTHING to do with birthing her at home! And arguing with me that she would have had better and quicker care in the hospital is bogus too. My midwife immediately began exactly what doctors would have done (minus cutting the cord as that is what was literally keeping M alive!). Doctors would have done neonatal resuscitation and oxygen first as well. Then moved on to ventilator. THIS WAS DONE!! Homebirth does not mean we birth in a cave with no emergency supplies. So stop asking me if I still agree with homebirth!
I AM 100% STILL IN SUPPORT OF HOMEBIRTHS AND I WILL ALWAYS RECOMMEND THEM TO WOMEN.
Again, homebirth did NOT cause M’s struggles…a horrible horrible infection did that.
I wrote about this mother and baby a few weeks ago, Another baby grievously harmed by homebirth; another mother desperately pretending it’s not her fault.
She was in denial then and she’s still in denial now.
This would likely not have happened in the hospital for a variety of reasons, but the most important one is this: we now test women for group B strep bacteria at the end of pregnancy and elaminate it before it can infect a baby by giving antibiotics in labor. The results have been remarkable:
The incidence of invasive early-onset GBS disease decreased by more than 80% from 1.8 cases/1000 live births in the early 1990s to 0.26 cases/1000 live births in 2010; from 1994 to 2010 we estimate that over 70,000 cases of EOGBS invasive disease were prevented in the United States.
Why didn’t M’s mother know she was colonized by group B strep and her baby was a risk of a brain threatening, life threatening infection? Because she declined the group B strep test at the end of pregnancy and therefore was not treated with antibiotics during labor.
But that’s not the only serious complication that Baby M suffered as a result of her mother’s choice to put her life at risk at homebirth.
She was deprived of oxygen during labor.
She inhaled meconium.
She needed an expert resuscitation with intubation.
She was unexpectedly breech.
Each factor ratcheted up the risk. Each factor was unknown or ignored at home and would have been treated very differently in the hospital.
The breech position would almost certainly have been diagnosed before labor and the mother offered an elective C-section; had she taken it, the baby would not have suffered a severe insult to her brain.
The oxygen deprivation during labor would almost certainly been diagnosed during labor by the use of electronic fetal monitoring. EFM has a very low false negative rate; it almost never misses actual fetal distress. Doctors would have recommended an emergency C-section and the baby would not have suffered a brain injury.
The meconium would have been taken into account in a diagnosis of fetal distress. Had the mother consented to an emergency C-section, the baby might not have inhaled meconium or would not have inhaled as much.
The baby would have received an expert resuscitation, intubation and immediate treatement with antibiotics to minimize any injury in progress.
What about the mother’s claim that it was delayed cord cutting that kept baby M alive? That’s nonsense. The problem was that baby M was not getting enough oxygen in utero. That’s why there was meconium; that’s why the baby inhaled it; that’s why the baby was born not breathing; the brain injury was already in progress. The idea that delayed cord clamping was lifesaving is foolish; it wasn’t providing enough brain preserving oxygen before the baby was born, it certainly wasn’t providing any more after the baby was born.
Homebirth advocates often insist that by choosing homebirth they are taking responsibility for their baby’s health … right up until the baby is harmed by their choice. Women who choose homebirth do so because they believe that routine hospital interventions are almost never needed. Yet when a baby is born injured because she did need those routine interventions but was deliberately deprived of them, many homebirth mothers retreat into denial. All of a sudden nothing is their responsibility; everything supposedly would have happened exactly the same way in the hospital.
Denial, as powerful as it is, rarely lasts forever. There will almost certainly come a time when the mother will have to reckon with what she did: she made a choice that profoundly harmed her baby and both she and her baby will wake up to that horrible reality every day for the rest of their lives.
Think homebirth is safe? Think again.
