Debunking Natural Birth Nonsense

A Scientific Skeptic Watches “Born in the Wild” (Georgia Episode)

Lifetime ran a short-lived television series during 2015 that focused on extreme natural birth activists who decided to give birth in extreme environments, far form any hospitals and often without properly trained medical personnel. These activists wrongly think that giving birth in a hospital is harmful and dangerous, but that giving birth in the wilderness of Alaska or in a windy plains near mountains is much better and safer (even though medical help might take at least 30 minutes to get there).

Although hailed by natural birth activists, the show only ran for a single season that consisted of six episodes in total. It was in many ways a perfect storm of anti-medicine pseudoscience and self-absorbed narcissism of privileged mothers who had no idea about the dangers that are potentially involved in giving birth. For instance, WHO puts the number of mothers who die during or shortly after pregnancy and childbirth to around 300 000 per year. Most of these occur in “low-resource settings” and likely could have been prevented. It is precisely these settings that many natural birth activists attempt to emulate.

Each episode has a common intro. Text appears on the screen explaining that the crushing majority of births in the United States occur in a hospital, but also that “Some women are choosing to have a very different experience. This shows document their journey.” A male voiceover lays out the point out the show by stating that “modern parents giving birth in the wilderness like their ancestors. No hospitals. No surgical intervention. No drugs. Just a choice. To return to the primal roots of humanity.” This show is a celebration to the ignorance involved in romanticizing nature and the past. Previous episodes giving birth in the wilderness of Alaska and the mountain plains of Utah. What happened in this episode?

Giving birth on a blueberry farm in Georgia

This episode is called “Georgia: Labor Intensive” and focuses on Levi and Phallin Black. They are both aged 28 and live together with their four children in Ludowici, Georgia. Phallin explains that she wants to give birth to her fifth child outside, because it has always been here dream. She says that people think it is a total batshit idea, but Phallin insists that it is perfectly natural, whereas a hospital setting is extremely unnatural. She highlights the perceived negatives with bright light, beeping sounds and having the baby taken away from the mother after being born. The historical reasons for why Phallin has gotten into the natural birth movement was because her mother had a bad experience during a hospital birth (concluding that doctors were clueless). They genuinely seem to believe that what they are doing is safe.

Unlike many of the other mothers featured on this show, she wants to have a certified nurse midwife with close to 20 years of experience supervising the birth. The certified nurse midwife is concerned with Phallin’s decision to give birth outside at their selected location. She encourages the mother to fill out her preferred hospital should they need to transfer her to it during an emergency if the baby becomes distressed. Phallin also has a doula (her best friend) that provides some emotional and practical support, but lack any relevant medical training. They discuss some of the criticisms they have gotten and how to handle specific issues like mosquitoes. The mother says that she is not afraid of mosquitoes or getting an infection (she calls it “dirt germs”) and thinks the risk from hospital-acquired infections is larger. Although the doula is her best friend, Phallin wishes that she would be more supportive.

What happened?

The next day, the entire family heads out to check their desired birth location, including the four children. Phallin thinks it will be a good experience for them. After all, she says, her children have watched a lot of nature documentaries about animals being born. The birth site is located at a 50 acre large blueberry farm. Because it is closed for the season, they are essentially alone. The site was selected because it is remote and quite as well as because it has nice oak trees with special kind of moss growing on it.

As if giving birth outside in the middle of the forest does not seem astonishing enough, Phallin explains that they will set up a pool and that she plans on having a water birth. The reason for this is that she believes that it reduces pain. She asks her military husband around to set up everything, including a tent and a campfire. She rests in a camp chair while her contractions are getting stronger. While the husband works and watches the kids, she takes a nap. He saws down some branches and trees in an effort to make a wooden construct around the pool that Phallin wants. After she wakes up, she is dissatisfied with it because the opening is on the wrong side. They bicker a little bit because she has an exact vision about how things should be. She claims that their argument is making her stressed, but she finally gets her wish.

They discover a poisonous spider on their wooded construction and she asks Levi to kill it because she does not like bugs. Levi wonders if she really thought this through and she admits that she has not really thought about the negative aspects of giving birth outside. He sets up a campfire. As darkness falls, they barbecue some food over the fire and get ready to get into their sleeping bags. But the night is not as quiet as the day. Their tent is visited by wild hogs. Levi yells at it and it runs away. By morning, she has not gotten much sleep. The estimated date for her delivery is the day after. Levi takes his rifle and examines traces of wild hogs in the surrounding area. Their youngest child is three years old. They are concerned about safety for the children, so they decide to let her mother take them home. Phallin’s mother is also concerned about the forest birth.

During the next night, a storm approaches and temperatures drop. Now they are on the same day that the delivery is estimated to take place. The mother has a second night of reduced sleep. The birth pool is a bit dirty from the night and contains some leaves, bugs and dirt. It is not really that warm anymore. She feels that she is in labor and calls the midwife. Despite her confidence, she does not think they can deliver the baby themselves. She has typically very fast labors, and they are waiting for the midwife while the birth place is not really cleaned enough. Levi creates a secondary birth pool with an electric generator. Finally, the midwife and doula arrives. They try to move the wooded structure, but it collapses. However, the mother does not really care that much about anymore.

This is because the temperature in the birthing pool is too high. They try to recirculate the water and the mother says that she needs to get into the water as soon as possible. They replace some of the water in the pool with cooler water. After a while, they manage to cool the water down and the mother gets into the pool. Phallin delivers the head, but then the midwife makes a starting discovery. The visibility in the water is reduced, but the head looks blue or purple. It turns out that the umbilical cord is wrapped around the neck of the child with two loops. They immediately lift her out of the pool and move her to a blanket. The midwife tries to clamp the cord and cuts it. The baby is then fully delivered. They clean the newborn baby as it screams.

Despite having the cord wrapped twice and some of her wishes not getting fulfilled, Phallin is happy that she did a birth outside in the middle of the woods on a blueberry farm, citing that it was natural, relaxing and wonderful. She wants to go camping there later and tell the daughter that this was the place she was born.

What were they thinking?

The justification claimed was the same as the mothers in previous episodes: the idea that it is natural to give birth outside in the wilderness, a reduced consideration of the dangers, fearmongering about hospitals and their alleged unnaturalness. The crucial difference in this case was that they used a birthing pool and that the cord was wrapped around the neck of the child. Had their not had a nurse midwife there, it might have ended very badly for the baby. Water immersion in water before and during delivery is not exactly optimally safe. According to a 2014 report written by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists concluded that “the safety and efficacy of immersion in water during the second stage of labor have not been established, and immersion in water during the second stage of labor has not been associated with maternal or fetal benefit.” Some of the risks included involve “higher risk of maternal and neonatal”, “umbilical cord rupture”, “serious hemorrhage and shock”, “respiratory distress”, “hyponatremia”, “drowning” and “perinatal asphyxia”. An updated position paper on the same issue from 2016 has similar conclusions and explicitly recommended against water births.

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