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

“Born in the Wild” was a short-lived television series that ran on Lifetime during 2015. They followed several natural birth quacktivists who wanted to give birth in extreme locations, from the wilderness of Alaska to the snowy winter of North Dakota, often without properly trained medical personnel present. They demonize doctors and hospital births, while praised “natural” birth because humans used to do it in the past. For many science advocates, this is clearly just an appeal to tradition fallacy, but many homebirth activists does not see the problem. The show was essentially a combination of alternative medicine quackery with extreme narcissism of mothers who fantasize about the kind of “natural birth” that kills 300 000 mothers per year according to the WHO (see previous installments in this series).

The common intro for each episode involves a narrator explaining 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.” The show heavily features a very romantic view of a nature and the past. So far, episodes covered by Debunking Denialism has given birth in the Alaskan wilderness, the mountain plains of Utah and a blueberry farm in Georgia.

What is in store for this episode?

Giving birth outside in the winter

This episode is about Hailee (23) and Evan Awes (25) who live in Manvel outside Grand Forks in North Dakota with their 20 month old son Isaac. Hailee has previously had a homebirth inside in a birth pool. She wanted a birth free of pain and drugs and claims to have done her research and the more research she did, the more her heart wanted a homebirth. What kind of research she did is unclear. When she gave birth to Isaac, they did the birth in their living room after just having had moved in (moving boxes were still cluttered around their home). This time, Hailee wants to do their homebirth outside instead. She acknowledges that people think that they are “crazy”, but she insists that hospitals are for sick people and giving birth is not being sick.

Because she does not make any scientific arguments or reference any scientific publications, it is likely that her “research” was not so much spending months reading the scientific literature and talking to real experts, but probably frequenting homebirth blogs and Facebook groups. Giving birth outside, she says, makes you “connected to nature” and is “the way women used to do it”. She is convinced that it will be a beautiful experience no matter how snowy or windy it becomes. She points out that most women cannot say that they have given birth outside and that she is sure that it will be awesome. Evan, the husband, feels a lot of pressure and concerned about the harsh winter and the temperature. He also feels bad over his previous performance where he could not get enough hot water to the birthing pool when Isaac was born.

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Her birth location is between two fields near a river at a very open space. It is currently 70°F/~21°C, but the temperature in the North Dakota winter can easily drop below 25°F/~-4°C. They set up their tent and plan to come back when Hailee goes into labor. They go to the store and buy hoses and buckets for making and transporting warm water for the pool. The shopkeeper is surprised, but gives them good advice on what water pumps to get. They are now one day before the due date, and the family visits their midwife (Rebekah Knapp), which is described by Hailee as “traditional” and “holistic”. Hailee says that a doctor would just want to medicated her, whereas the midwife is used to doing things “the natural way”. The midwife is concerned about the heat, but Hailee reassures her that they will be using a fire outside the tent and several space heaters inside it.

They visit Evan’s parents who the narrator says are “traditional”, but this is used in a wildly different way than when it was applied to the midwife. Evan’s mother is not at all happy with their decision and asks why they cannot do it inside. The response by Hailee is that it would be cool to do it outside and that this is how women used to do it. This triggers a heated debate, but Evan’s dad supports him by pointing out that this would give them a story to tell. No part of the discussion showed in the episode relates to the risks and harms with homebirth.

The two return to the designated birth location, but the wind has torn through the tent and knocked over a ladder. Evan says that this birth location is not safe and after much talk, Hailee reluctantly agrees to changes it to right outside their home out of safety concerns. They proceed to set up the tent outside their house, while Evan and his father shares an emotional moment over a letter written about the birth of one of their relatives in the 1920s. Evan’s father says that their relatives in the past were born at home in a barn and they had no problems. A science advocate would point out that this is merely an anecdote and does not take into account scientific data on the risks with homebirth, but this discussion never takes place between them, or at least not during the moments that are shown in the episode.

The tent is set up, but it is not heated and the pool is not ready to go. Hailee’s contractions are getting more intense, but the midwife tells her over the phone to try to sleep through it. During the night, temperatures drop to 3°F/~-16°C. The winds are 50 miles per hour (~22 m/s) and there are 2 inches (~5 cm) of snow on the tent. It is 2 am in the morning and Hailee cannot fall asleep because of too much pain. They decide to call the midwife and get her over there.

Suddenly, the power goes out. They are instantly concerned, because they need power for hot water and to power the space heaters. Evan goes outside and lights a fire and start heating pots of water for the pool. The temperature creeps below 0°F/~-18°C and the power has been out for 2 hours. The contractions are coming closer. Finally, the power comes back up, but the cold temperatures outside makes the pool water temperature drop too much. The midwife and doula arrives and the contractions are now three minutes apart. The narrator claims that the pool water will reduce stress hormones and release endorphin that will help with the pain. No particular evidence is provided for this claim, but it is probably just a fancy way of saying that some mothers feel subjectively better in a pool, but that would probably not sound as persuasive.

What happened?

Hailee goes outside to the tent in her bathrobe and some slippers. She likes the sound of the wind through the trees and against the tend and says that this makes her feel comfortable. She likes the water temperature, but begins to develop some discomfort. Evan gets into the pool and they switch positions, but she ultimately ends up vomiting in a bucket. The pain is so bad for Hailee that she even starts requesting pain killing drugs, but they both realize that if they want a “natural” birth, they just have to take the pain. She has now labored for more than the average for a women in her situation, and when she tries to push, nothing much happens.

They decide to have her standing up so that gravity will help a little bit more. She is in a lot of pain, but then her water breaks. After some pushing, she gives birth to a baby boy in the pool. She is happy, but the baby is initially very silent. After some encouragement, the baby starts screaming and everyone around them are happy. Hailee and Evan kiss just as dawn occurs. However, it is not over just yet. The midwife tells Hailee that she either has to try to get the placenta out or cut the cord. Hailee agrees to push out the placenta and it is placed in a bucket. The cord stays put.

Suddenly, they notice that the water in the pool is becoming increasingly red. The doula tells the midwife that Hailee seems to be bleeding quite a lot. Hailee says that she is feeling really dizzy. The Midwife says that they have to make sure that Hailee is not bleeding too much. At one point, Evan confesses that he thought that it looked like a horror movie or a butcher’s table. Evan takes the baby into the house as they are preparing to address the bleeding problem. However, Hailee goes into shock and passes out from the blood loss.

She is having a postpartum hemorrhage and goes in-and-out of consciousness. They quickly pull her out from the pool and try to stop the bleeding by manually stimulating the uterus to contract while keeping her warm. Hailee comes back, but she is not strong enough to walk, so the father carries her inside. She passes out yet another time. After she recovers, she is lifted to the bed and the bleeding is slowing down.

What were they thinking?

In an interview afterwards for the show, Hailee does not mention this at all, but merely says that now both of her children have interesting stories to tell. Neither parent regrets it and think that it was beautiful experience to do it outside. They do not seem to be concerned with the postpartum hemorrhage or the other risks involved in homebirth.

Throughout the episode, the reasons for why they wanted a homebirth has ranged from it “being cool” or “being connected with nature” to giving her or their children a story to tell. However, there is no regard or discussion for the safety of homebirth or giving birth outside in the winter or using a pool. They did not discuss fears of postpartum hemorrhage or any other potential harmful effect. This is, in many ways, typical of the families that this television series have covered. Their extreme homebirth is mostly about fulfilling the fantasies of the mothers of doing it “the natural way” and their underlying contempt for hospital birth.