The system that cried wolf or the emperor’s clothes are lost in transit. Permanently.

I am frequently bemused by the use of lies to support obstetrics when the truth is so easy to discover. Why are we so comfortable accepting at inquests that all the babies who die outside of hospitals would have lived in hospitals when hospitals are where more than 99% of our stillbirths take place? If hospitals had 100% survival rates of women and babies, they might have a leg to stand on. Why do we so readily accept the word of obstetricians that these babies would live in hospitals, when obstetricians routinely claim that almost every baby will die, in hospital, if you don’t follow their instructions? Why is it that when around 1 in 200 (Or 1 in 300, or 1 in 135, or 1 in …. We really don’t know and can’t agree on how to define stillbirth internationally.) babies die, thus proving obstetricians’ predictions of the apparent mass extinction of the human species wrong, we still believe their claims without question? Why is it considered inconceivable that women might consent before interventions and that only crazy selfish women believe they should have such a basic right in birth?

I find all this stuff very confusing based, as it is, in cognitive dissonance so powerful that nothing seems to break through it. It is pretty simple however that the equation we are sold that babies die because homebirth, is a total fabrication. To whit, and simply to give one year close to my heart:

Of babies born at home in 2009,99.8% were liveborn.

[Of babies born in hospitals] The perinatal death rate was 9.8 per 1,000 births in 2009, which comprised fetal and neonatal death rates of 7.8 per 1,000 births and 3.0 per 1,000 live births respectively.
What confuses me most however is that facts about this stuff are all readily available and yet journalists refuse to engage with them in any way and just go on repeating the same tired old lies about mortality in birth outside of hospitals.

Here’s another fact for you: there is a far higher likelihood that women will die during birth in hospitals than at home. It is also true that maternal death is under reported and under recorded in Australia. Shouldn’t we all be factoring that into our plans for a birth place? Maybe hospitals don’t tell women this easily researched fact? Do mothers for children not matter? Why aren’t journalists interested in this when I tell them about it? When I explain that we have no adequate sentinel reporting unlike other countries, that there is no real oversight body for maternal death?

And another fact: if your baby is sadly in the 6 or so who die every day in hospitals, you will be very very unlikely to achieve an inquest. The loss of not one, but two babies, in a Melbourne hospital, caused by the hospital, doesn’t need an inquest. Hundreds of women and babies affected, some deaths, countless injuries, barely rates a mention in the papers. Does not the double standard appear to anyone? I think I can safely say that many women simply feel if a searchlight is shone on so many births outside of hospital, which amounts to fewer than 1% in Australia, then why cannot a searchlight be shone where the vast majority of babies are born? Of course to apply the same rules to hospitals as homebirth would cause difficulty since doctors would be prevented from practicing immediately, their homes would be searched, their computers and telephones removed, police interviews over hours for everyone in the room (this could be 20 people in some hospitals), and their names would be made public along with any other deaths they attended so the system may need a little modifying?

Why are deaths in institutional settings, where we are told every life sustaining piece of equipment and personnel is available, the least likely to be publicly scrutinised? Most women, if questioned will say, after all, that they give birth in hospitals because they perceive them to be safer due to that very equipment. If we accept for a moment, the rancid illogicality that birthing outside of hospital is the most dangerous thing ever, then why are we so perturbed, offended and shocked by those deaths? Don’t we expect them? Why are we so resolutely facing away from the deaths which we are repeatedly told are all preventable when they occur outside of hospital, when they occur inside hospitals? Isn’t it more concerning that so many deaths occur in the presence of obstetricians and midwives in hospitals? Shouldn’t we be pulling each and every one of those deaths apart in an effort to see how our institutions are faring when a loss occurs? This is a remarkably unusual case and it is fascinating how little reportage there is around it when compared with deaths outside of hospital where causes are printed before postmortems are even performed. My baby was repeatedly declared dead by media due to heart attack before she was even cut, cut forcibly and without my consent, as is usual in homebirth stillbirths which attract the state’s attention. (Not all do. Isn’t that interesting too?)

Is it not possible that loss in pregnancy is normal in the human species and can be expected at every gestation? Given that miscarriage is very common, and stillbirth fairly common, and unchanged in several generations, maybe we can all start to see that using stillbirth as an excuse to condemn women’s birthing choices is a politically motivated action?

Those who speak out about the brutality women experience in hospitals are called fools, selfish unnatural bitches, murderers yet those inflicting the brutality are allowed to dodge their responsibility while pointing to a supposed body count due to normal physiological birth which doesn’t exist. Expecting to have human rights because you are human does not equate to not caring about whether your baby is alive or dead at the end of pregnancy. The cynical, misogynist lie of this is allowing obstetricians to pull the curtain over the damage they do to us and continuing the mythical supremacy of hospital as the safe place to birth. How much longer are we prepared to listen to lies like these?

More vital reading:

The mothers fighting back against birth intervention

What are human rights in childbirth?

Australia’s Mothers and Babies, 2009 and every other year you can find online.

Improving Birth

Healing after a traumatic birth

The assault on normal birth: The OB disinformation campaign

Mainstreaming midwives: the politics of change

“A further barrier to midwifery care has to do with the negative publicity that occurs almost every time there is a bad outcome at a home birth. Deaths in the hospital of baby or mother are rarely publicized because the hospital constitutes the cultural standard for safety, and physicians tend to protect their own from public view. Thus a death at home rings loud cultural bells, sounding the culturally ingrained message that home birth is an irresponsible choice for mothers, and that home birth midwives must be far less competent than hospital-based practitioners.”

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4 Responses to The system that cried wolf or the emperor’s clothes are lost in transit. Permanently.

  1. Annie says:

    That is so well written and so true. Thank you for writing this Janet. It’s sad that most people will believe without knowing any facts that someone who lost a baby at home would have had a living baby in hospital. So does that mean that a dead baby in hospital would have been alive at home? Knowing that at home there is no drugs, induction, forceps and vacuum?

  2. Janet says:

    It’s the great unknown of birth, life and death and I suspect that’s why many people struggle so much with it. Babies certainly don’t die from the massive injuries inflicted by those at home so there are obviously babies who would have lived if these weren’t administered but our cultural agreement is that intervention is always safer than normal birth. I think obstetricians are often sued over babies they could not have saved but that’s the price they pay for convincing the world, despite the wealth of evidence to the contrary, that EFM saves all the babies.

  3. Linn says:

    Great post, much needed!

    ” using stillbirth as an excuse to condemn women’s birthing choices is a politically motivated action”

    Nailed it.

  4. Janet says:

    Yes it seems so obvious.

    No one ever seeks to engage over maternal mortality and homebirth. Yet another indication that it’s not about safety it’s about control.

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