Why don’t skeptics confront childbirth woo?

The same people who vociferously defend the efficacy and safety of vaccines, who fight against climate deniers, who battle valiantly against creationists, generally give childbirth pseudoscience a big, fat pass. Google the words skeptic and vaccines and you’ll find tens of thousands of sites and articles. Google skeptic and evolution and you will find even more. Google skeptic and childbirth, and you’ll find very few articles, most of them written by me.

My experience on Reddit, which has an active community of skeptics, indicates that far from questioning the pseudoscience of the natural childbirth and lactivism industries, skeptics have fallen for the same marketing tactics that have fooled so many women. Post or comment on an item questioning the science behind natural childbirth advocacy and you’re just as likely to be accused of “hating” midwives as you are to be supported in deconstructing their faulty, anti-scientific claims. This is unfortunate for skepticism, for women and especially for children, the victims of so many different forms of pseudoscience, (anti-vax, supplements, chiropractic, chelation therapy for autism, etc.)

Since most skeptics are men, I suspect that part of the reluctance to deconstruct and denounce the absolute nonsense spewing forth from many midwives, doulas, childbirth educators, lactivists, and birth and breastfeeding bloggers stems from the fact that they aren’t especially interested in childbirth and breastfeeding. Nonetheless, they ignore childbirth pseudoscience at their own peril.

Why?

Childbirth woo is the gateway to all other forms of health woo.

Combating childbirth pseudoscience would go a long way toward reducing the influence of quackery of all types, particularly anti-vaccination.

Ask any healthcare executive, and he or she will tell you that women are the undisputed healthcare decisions makers in any family. That’s why marketing of health plans and hospitals is often directed to them.

Women have long been the undisputed family health care decision-makers, making approximately 80% of family health care choices. According to a recent Kaiser Family Foundation report, they also choose their children’s doctors (85%), take them to appointments (84%), and ensure they get recommended care (79%). In short, they are the researchers, networkers, and hands-on care advocates. They are also social network power users. So they’ve taken their health activities online in “peer-to-peer health care”, which allows them to seek and share health advice from others at Information Superhighway speed and scale.

Their influence, already paramount within a family, extends to other families through the internet.

Women’s health care influence has moved beyond the family. … [N]early 70% of women use social networking sites, where they influence the health care decisions of the women in their online communities and those of their families. In a recent report, nearly half of consumers said social media-derived information would affect their health care decisions.

For most young adults, childbirth is their first experience with the healthcare system. And when a young woman finds out that she is pregnant, she heads to the internet for information. What does she find?

She finds a space dominated by a multi-million dollar natural childbirth industry busily hawking books, workshops, courses, movies (e.g. The Business of Being Born), childbirth education classes, hynobirthing tapes, doula services and placenta encapsulation “specialists.” It is a typical pseudoscience world of internal legitimacy with faux experts adorned with faux credentials, conferences, and journals (Birth: Issues in Perinatal Care, which masquerades as a peer review scientific journal, is actually published on behalf of Lamaze International, though you’d be hard pressed to find evidence of that connection on line). The natural childbirth and lactivism industries have created a vast echo chamber where it is possible to navigate literally hundreds of interconnecting sites without ever coming across actual scientific evidence. In other words, for many (? most) young women, their first experience of medical science is mediated by quacks.

This has important implications not only for childbirth choices, but for all health choices down the line.

Because the primary product of the natural childbirth industry is distrust of medical providers. Doctors, scientists and public health officials are supposedly all in the pockets of Big Medicine and Big Pharma. Anyone who questions the myriad near magical properties of breastmilk (“squirt it in your baby’s eye to treat conjunctivitis”) is in the pocket of Big Formula. The foundational message of the natural childbirth industry is that doctors, scientists and public health officials don’t care about your health or your baby’s health. They will actually actively try to hurt you to line their own pockets.

Sound familiar? It should. It’s the bedrock claim of all “alternative” health, especially vaccine rejection.

As a recent “Dear Prudence” column on Slate demonstrated, the natural childbirth industry is often the initial purveyor of the anti-vax message. The natural childbirth community is a particularly fertile area from which to recruit parents wavering on the issue of vaccination, especially after they have been primed by the message that doctors, scientists and public health officials are trying to hurt babies, not help them.

Childbirth is not a peripheral area in healthcare pseudoscience, it is ground zero. It is the gateway to the mirror world of pseudoscience, where experts are supposedly trying to harm you, high school graduates consider themselves qualified to opine on complex health issues and everyone has an online store.

I implore fellow skeptics to take note.