It’s that time of year again.  Jack Loudon, a Republican from Chesterfield, MO, is trying to revive his misguided midwifery legislation, which would decriminalize what is always an unacceptable and unnecessary assumption of risk during the process of giving birth.

Simply stated, uneducated lay midwives would be allowed to oversee deliveries at home.  The medical rationale for a woman to make such a decision is non-existent, for the simple reason that any pregnancy, no matter how “low risk” it is thought to be can turn south in an instant and there is no way to predict which ones will go south.  Once that happens, after 10 minutes, you are basically guaranteed to have at the very least a brain damaged baby.  If there is a cord accident during natural childbirth (a completely possible and utterly unforeseeable possibility for every pregnancy that ever was), you need a surgeon to cut that adorable little fucker out stat.  When you have no surgeon available, when you shut yourself off at home, when you do not continually monitor the baby’s vitals, when you decide to “go all-natural” (an instance of the “ad naturam” fallacy–what is “natural” is not always what is “best” or “most desirable”), you put the baby at unnecessary risk in several ways.  First, if you miss the point when the cord accident occurs (or any other of a myriad of rarer complications– blood pressure problems, mother’s heart swelling and exploding, among others), the clock is running whether you know it or not.  Second, if there is an accident and you somehow know about it, the midwife is not qualified to do anything but tell you how “powerful” you are as your child asphyxiates.  This leads to the third unnecessary risk that your unborn child assumes because of your selfish, weird decision, if the midwife calls an ambulance, the clock is still running.  Unless you live next door to a hospital, your going to be singing “The Blue Baby Blues” (sung to the tune of “Heartbreak Hotel”):

Well, since I killed my baby

I’ve found a new place to dwell,

In a state of perfect misery

In my own perinatal hell.

Why, dear god, am I writing about this again?  Because this morning I heard an interview with Jack Loudon on KWMU, the local NPR affiliate, and he was espousing palpable nonsense.  According to Loudon:

“Certainly it has popular support and it’s just a question of whether there’s a strong enough minority among the medical community to block it once again, or get their agents in the Senate to block it for them,” Loudon said.

The number of logical fallacies that he has compressed into this short statement is impressive, even for a politician.

1) “Certainly it has popular support.”  This is the “ad populum” fallacy.  What is popular is not necessarily right, not even in a democracy.  The vast majority of people don’t know a cervix from a cerveza; their opinion or favorable feelings about a topic doesn’t make the lay midwifery any safer or any more legitimate.

2) “Minority among the medical community.”   There are two equally disturbing ways to read this statement.  Given the context of the first independent clause, “doctors” are a certainly a minority within a population.  But they also happen to be the experts.  They aren’t infallible, but a physician can give a deposition as an expert witness in a malpractice case, while a lay midwife is qualified fetch the physician a glass of water while he or she is being deposed.  Certainly this is why we have experts, because the community at large is simply not qualified to practice medicine.  Because a midwife may have a modicum of experience before she (usually) starts practicing, having observed a certain number of births prior to starting her own illegal practice, it in no way compares to the sheer volume of experience that an actual physician acquires in their medical education or obstetric practices.

The other way to read this statement is that only a minority of people in the medical community, that is a minority of experts, oppose the midwife bill.  This is simply not true, for the simple reason that the Missouri State Medical Association opposes the bill: “Childbirth deaths have fallen dramatically in the last 50 years, and that’s clearly the result of the advancement of modern, obstetrical medicine…what this (bill) basically does is put us back into the 19th Century,” Howell said.  The MSMA represents 6,500 of the 14,000 physicians in Missouri.    This is not a piffling minority, and the MSMA, of course, only counts the ones who pay dues.   I think that it is probably a safe bet that at least 500 of the physicians who do not pay dues would agree that lay midwives are a really, really bad idea.  We’re moving into realm of the majority of experts disagreeing with Loudon.  I wonder how many physicians and physicians’ wives go to midwives?  I can almost guarantee you that 100% of obstetricians and OB’s wives see actual doctors.

Jack Loudon joined the cult of midwife idiocy because a midwife guessed, without scientific basis, that his wife, Miffy Loudon (I don’t remember her name), had a clotting disorder that was causing problems with the umbilical cord, if I remember correctly.  While it might appear that the midwife had special knowledge that the medical community didn’t have, in truth, she guessed, just like a psychic who happens to say something that appears to be spot on.  Now, let’s be generous and say that the doctor that Mrs. Loudon was seeing was somehow not a good physician.  He is representative only of himself, not “medicine at large.”  If psychic Sylvia Browne had said, “Your wife will eventually have a baby,” would Loudon write in language to his bill requiring people to see psychics before giving birth?  He’d have to, seeing as how Browne based her declaration on the same evidence as did Mrs. Loudon’s midwife.

The advances in medical technology that have made birthing seem more routine and less dangerous by improving outcomes is due to abandoning the old amateur midwife models of birth and adopting evidence-based practices.

I ask any readers in Missouri to write or call their representatives in the General Assembly and encourage them to oppose the dangerous midwifery bill.

HJ