Quickies

Skepchick Quickies 4.29

Amanda

Amanda is a science grad student in Boston whose favorite pastimes are having friendly debates and running amok.

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    1. Thanks for those links. Reading the article that Amanda linked, my eyebrows were migrating to the back of my head. Your links helped me clarify just what was bothering me so much about the article and the claims.

      1. Glad you found them helpful. Those guys blundered into an online community with a poorly thought out survey, ignored everyone who told them that their questions demonstrated a lack of understanding of gender and sexuality, and then published their flawed research anyway. I think it’s pretty clear that they started out with a preconceived narrative.

  1. The first article had some serious flaws; I’m glad you had sources. And they seriously pulled the women primarily want emotion/drama/story in porn thing? It’s like they’ve never even heard of Violet Blue and “Our Porn, Ourselves” project she works with.

  2. I’m afraid I don’t think the “Dentists medicalizing the tooth experience” is such a brilliant parody. There are many good reasons why people should have been, and should be, skeptical about standard medical theories and about pharmaceutical companies, but this “brilliant parody” just makes a big joke out of all people who might dare to question standard medical care.
    Now, if it were only making fun of people who don’t bother to evaluate evidence, or who put blind faith into untested alternative medical claims, that might be funny. But what it’s actually doing is showing that Dr Amy doesn’t have much respect for people who question her beliefs.
    Maybe Dr Amy in fact does have respect for people who want to weigh various medical options, and people who know her or read her blog every day are aware of this. But this post, taken on its own, does not leave a good impression.

    1. This is not about people who are skeptical (read: open to evidence that could convince them) of the standard of care. It is about the naturalistic fallacy and ideological mistrust of the medical establishment for intervening in “natural” processes.

      1. I know that’s what Dr Amy intends it to be about. But she leaves the strong impression that she doesn’t think anyone – sensible or loony – could have a good reason to disagree with her.
        I’ve been guilty of that sort of thoughtless assumption myself – how could anyone disagree with me when I’m clearly right? And people call me out on it, as they should.

        1. I think I’m missing the part of the parody where reasonable people with honest questions are being mocked.

          The “I’m just honestly questioning conventional wisdom” line is tricky regardless–it’s also used disingenuously by deniers and conspiracy theorists to make their positions seem reasonable when they are not.

          People are free to evaluate the evidence and come to a conclusion, but not all options are always created equal. At what point does a preponderance of evidence rule an opinion to be untenable in good faith?

    2. I agree, Kaloikagathoi. I think there is a tendency in the skeptic community to lump some people who ask questions about certain subjects together, effectively making those subjects taboo. For example, I have some serious reservations about some of the prescription drugs I have been offered to treat my attention deficit disorder, and the effects of pharmaceutical advertising on treatment. This based on studies I have read in peer-reviewed journals. This is not the same thing as rejecting evidence-based medicine or embracing some dubious herbal alternative. I have seen people who suggest that pharmaceutical companies have something other than our best interests at heart shot down on skeptic discussion boards and lumped in with anti-vaxxers and Rolfers, when really they are trying to determine the best treatment for themselves, based on the evidence available.

      1. Yes – as though it’s impossible for the person most affected by the proposed medical intervention to make a serious attempt to become informed, and then to make a valid choice between options. Sure it must be frustrating when people decide to reject real evidence in favour of someone’s flaky ideas, but why wouldn’t it be equally frustrating to have to deal with patients who won’t bother to learn about their own health problems?

      2. @prtsimmons: That’s a good point. I’ve declined medication for treatment of my own ADHD, because after being presented with the options and different treatment and med choices and what not, my therapist and I decided that it would be best for me, personally if we went with CBT alone.
         
        Does that make me a denier of science-based medicine? I think that there may be a finer line here.

  3. As a scientist, skeptic, and mother of a 10 month old, I researched my birth options extremely carefully. I have plenty of faith in Western medicine, however, the idea of having to remain in a bed, strapped to a electronic fetal heart monitor and an IV drip (neither of which actually improve outcomes) seemed to me like the height of ridiculousness. This is LABOR! And I will say that after doing plenty of research, I made an extremely confident decision to have a homebirth with a nurse-midwife. And things didn’t go according to plan, and I ended up being transferred to a hospital and having a C-section by an OB that I am extremely grateful was so talented at performing that necessary (for my situation) surgery. However, if I had to make the choice again, I would do it all the same. The hard research shows that midwives are extremely effective at dealing with low-risk birth. I say that genuinely as a skeptic. As a skeptic, I was not going to march into a hospital and tell the doctors to just do whatever they felt like. I wanted to get information for myself. Henci Goer’s “Obstetric Myths Vs. Research Realities” is a very good resource.

    1. Thank you for this! I find it frustrating that anybody who questions that current status of childbirth in America is lumped in with anti-vaxxers and homeopaths. The fact is; the evidence, as in published studies, indicate that fetal and maternal health outcomes are not where they should be in the US. It has been well documented that the extremely common lithotomy position is not the the best or most healthy child birthing stance to anyone except the doctor. I realize that there is a fine line between the people who make a very informed decision to work with a trained nurse mid-wife, somebody who has years of medical training, and those who have a home birth with a lay mid-wife who may advocate things like herbal remedies, etc. In many ways I feel like this issue stems from a lack of trust in women to make educated decisions about their health and a long history of paternalism tied to the medicalization of childbearing. There have been wonderful strides in maternal health. I have no desire to return to the days when labor and delivery carried a high risk of death, but it’s wrong to set up a false dichotomy between the horror of the past and the status quo.

      1. Haha I almost even commented on my comment that my son is fully up-to-date on his vaccinations, because I figured people would just dismiss me as an anti-vaxxer! I think that as a skeptic it only makes sense to question the status quo of childbirth in our culture. The definition of skeptic is MOST ASSUREDLY not someone who merely conforms to the mainstream norm!

    2. What I find frustrating and part of why I enjoyed the parody so much, is that so often people who push home birth make it a black and white prospect, as you have done. It is not a choice between home birth with a midwife or fully medicalized, strapped down with your legs up in the air and million needles in you hospital birth. There is a whole spectrum of options available between those two and more and more hospitals are realizing that if they want to continue having women come to them for their birthings, they need to offer a range of choices.

      The hospital I formerly worked at had just recently redone its entire obstetric section to include beautiful spa-like rooms for women to give birth in and it welcomed the inclusion of midwives and doulas in the birthing process. And if things took a turn for the worst, the mothers could still be just a floor away from some of the best surgical obstetric care in the region.

      I firmly support every patient’s right to determine their own health care plan, and because of that, I’m very happy to see this turn being taken by most major hospitals. I hope it encourages women who would be put off by the “medicalization” of birth to be more comfortable in seeking out a hospital setting so that if something does go wrong, there is a greater likelihood of both mother and baby receiving the intervention that they need.

      1. I can only go off of my experience and the research that I’ve done, but I don’t think that making a hospital room look like a spa makes the staff at the hospital any more likely to take a birthing woman’s choices seriously. Sorry, but I’ve been to a few of my friends’ births, and even when they rooms were REALLY PRETTY they were still talked down to by pretty much the entire medical staff. It’s obvious to me from the article that Dr. Amy is no stranger to talking down to her patients. And, as Lizzy stated, I think that maternal and fetal health outcomes are disappointing in America, to say the least, while countries that rely on a less medicalized version of childbirth do have the best statistics. So I’m sorry, but I find Dr. Amy’s article more harmful than it is helpful by mocking people who seek a perfectly safe alternative option. I wish that it was less black and white, but my experience and research just doesn’t show that to yet be the case.

        1. I read some other things on Dr. Amy’s blog and found her incredibly condescending. She has the attitude that as long as a healthy baby is delivered that is all that matters. As a woman that is not good enough for me. I want healthy babies, but I also want to be treated as an intelligent individual who is capable of making medical decisions about my body. I don’t necessarily think that I know better than a doctor, but I do want them to fully explain my options and why they recommend one course of action over another. My general experience with doctors, as a woman with some health issues, has been derision and condescension. I had to lie about my reasons for having my IUD removed because when I was honest, I was told that it wasn’t a good reason. After having the device for 2 years I would still get cramps 2-3 times a week that were so strong I needed to sit down in the aisles of a grocery store and concentrate on breathing. Apparently that doesn’t really happen, so I had to tell the doctor that I wanted it removed because my husband is Catholic, and the church objects to birth control. Both statements are technically true but not related in any way. I don’t know if I stand behind home birth; there is so very much that can go wrong, after all. I would appreciate a change in attitude on the part of medical professionals. I am not an incubator charged with delivering a healthy baby. I am a woman who deserves respect.

    3. I agree with the main thrust of your point, but I must point out that the hospital experience you describe (having to remain in a bed, strapped to a electronic fetal heart monitor and an IV drip) certainly happens but is not by any means the only way that hospital births are experienced. In my city for instance, the nurse/midwife practice that I chose is part of the hospital. I was in control of my experience in that hospital. At no time was I forced to stay in bed or accept any sort of limitation to what my body needed to do. I have no doubt that there are hospitals that still practice that way, but let’s not portray all hospital experiences that way. The field of obstetrics is changing. Too slowly, certainly, but it is definitely evolving away from the pregnancy as pathology mindset.

      1. That may be true where you live, but where I live there are no options. There is one hospital, the next closest are about a hundred miles north, east, or west. There are three general practitioners who also practice obstetrics. If it counts for anything, the local hospital just started offering epidurals in the last year. Not all of us have a range of choices, so it is vital that those choices have been trained to treat us with respect as opposed to heavy handed paternalism.

        1. I understand that not everyone has the same options, but I think it’s important as Amanda pointed out that we not paint this as a black and white issue that ALL hospital experiences are bad and that ALL doctors are condescending and don’t listen. I hear that a lot and I can honestly say that never in my adult life have I been talked down to by a health practitioner.

          I’ve always felt comfortable discussing my issues and insisting on being treated as an equal participant in my health care, especially my pregnancy and delivery. I would never deny that there are those that do have a bad experience, but there are those that that have good experiences as well.

          1. I would never say that all doctors or hospital experiences are bad. The problem is that in many places there are no other options and very little recourse when you do have a bad one. I think this is part of what pushes people into the natural childbirth world. They offer options and a more compassionate approach. I would prefer to see a change on the part of the medical establishment, but I can understand why some people think that is impossible, especially with people like Dr. Amy ridiculing women for the desire to know the doctor who is going to deliver their child.

          2. @Lizzy It’s never a bad idea to research all options and it is possible to find great solutions in the natural childbirth world, but keep in mind that research in that area is just as likely to turn up a veritable crap load of woo as it is to yield practical alternatives. If people are thinking that change in the medical establishment on this issue is impossible, they’re not paying attention to the forward strides that have been made. While it is true that not all places offer the range of options we’d like to see, it is also true that many more offer those options than used to. Progress is not as fast as we’d like, but that doesn’t mean it’s not happening.

          3. Kammy, I don’t think that natural childbirth the best alternative, nor do I deny that progress is happening. My problem is specifically with people like Dr. Amy, the woman who wrote the piece linked on the original post. If you read anything on her blog you can feel the contempt that she has for women who do not make the choices that she believes are necessary. She goes so far as to say that a healthy baby should be the only goal and that women need to let go of the idea of childbirth as an experience. She criticizes women who want to get to know their doctors before going into labor. This woman is an OB, she has taught at Harvard, she knows the science behind the issue, but the way she presents it is completely cold and turns women into baby machines with silly feelings that don’t matter. That is what upsets me about conversations surrounding childbearing options. On one hand you have potentially dangerous woo and on the other you have safe, but clinically cold condescension from experts who teach other doctors. It makes it very difficult for women in many parts (frequently rural) of this country to find a situation that they are comfortable with.

  4. Amy Tuteur is not good at tone on the internet, and it’s unfortunate. No matter how good her science is, the fact is she comes across such an asshole that it turns people off.

    I’ve heard her interviewed on podcasts and it’s a completely different experience – in conversation, the exact same information she conveys in her blog sounds infinitely more reasonable, not at all condescending, and her genuine concern for womens’ health really does come through.

    It’s frustrating, because parenting boards are full of woo, and I would love to be able to link to her and say “no, really, you do NOT want a water birth and here’s why” but her tone is so problematic that she’s not a helpful source.

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