The Birth Center of St Pete clinical staff after their first COVID-19 vaccine. From left: Michaela Danhousen, LM, IBCLC, Mary Kay Miller, DNP, CNM, Carmela Pedicini, LPN, IBCLC, Jessica Willoughby, LM, RN.
I am a home birth midwife. I gave birth to my daughter at home, supported by midwives, in a birth pool set up in my bedroom. She was exclusively breastmilk fed, we bed shared, baby wore and cloth diapered. She’s never had an ear infection or been on an antibiotic. I am also pro-vaccine. My daughter is fully vaccinated with no deviation from the CDC schedule. I’m not sharing my story to make people feel bad if they choose to parent differently or to “virtue signal” but because I think that the out of hospital midwifery community needs to speak up.
I believe, fundamentally, that the same science that proves midwifery and out of hospital birth are safe is the same science that proves vaccines and public health measures, like social distancing, frequent hand washing and wearing a mask, are safe and effective.
I’ve been trying to stay out of the shallows but a recent stroll through my social media has me disgusted by what I’m seeing. Fake stories and conspiracy theories about the COVID 19 pandemic abound and they aren’t just being shared by radical, fringe groups. I am seeing my midwifery colleagues and clients ‘like’ and share information that is misleading, harmful and downright untrue. Fake news is corroding the foundation of our public health systems while the out of hospital midwifery community is sitting idly on the sidelines. We must take a stand!
The arguments made against vaccines and public health measures by pro-midwifery people confuses me. How can we support the evidence behind midwifery and out of hospital birth but eschew it when it comes to vaccines and common sense public health measures like wearing a mask to stop the COVID-19 pandemic?
Facebook post shared by a local licensed midwife and liked by local midwives
Arguably, public health interventions such as hand washing and vaccines are the only progress we’ve ever made to improve health and wellness in society. Plus, if you really want to avoid Big Pharma and the medical-industrial complex, get vaccinated and follow public health measures so you don’t get sick. Preventing an illness with a vaccine or with basic public health measures will keep you safely away from the healthcare system you are trying to avoid.
Appropriating the argument for freedom of choice when it comes to vaccines and public health recommendations is an ethical stretch. I am in complete support of choice when it comes to healthcare decision making. What I am not in support of is the agendas being pushed by the anti-vaccine and other conspiracy theory movements with their manipulation of information that paints vaccines and public health measures as unsafe or ineffective choices. Shouting “do your research” and encouraging decisions based on misleading and inaccurate information is not protecting choice. There is the potential for risk with every choice, even the choice to ‘do nothing.’ Magnifying the risks (real or distorted) while downplaying the benefits of an intervention doesn’t protect freedom of choice- it completely eliminates the freedom to choose. Let’s use an example from midwifery to better explain.
Trials of labor after cesarean (TOLAC) are banned from some hospitals because they carry an increased risk of uterine rupture, infection and blood loss if they are unsuccessful. The patient and fetus could even die if the uterine rupture is severe. Consenting a patient by focusing only on the risks of TOLAC, including death of patient or fetus, while downplaying the benefit, a 60-80% likelihood of success, avoidance of major surgery, actual risk of uterine rupture being less than 1% and the risk of perinatal death of 0.2%, is not informed freedom of choice- it’s biased, agenda pushing.
As midwives and consumers of midwifery care, we have heard this story and similar ones over and over again. The story where risks are magnified and benefits are overshadowed, downplayed or ignored completely. We push back. We demand better. We want the information to be free of bias and manipulation. We want consumers to be given the autonomy to make the best choice for themselves and their families based on truth. So why do we hypocritically tolerate, and some of us actively promote, the same lies and distortion of facts when it comes to vaccines and public health measures? Enough is enough.
Choosing whether or not to vaccinate, or follow the public health recommendations, impacts all of us. Herd immunity is the theory that when enough people in a group are vaccinated, the whole group (or herd) is protected. The herd immunity threshold, which is the percentage of people needed to be vaccinated to protect the group, increases as a virus become more contagious, is new or reemerges when it was previously eradicated. The longer COVID-19 roars through an unvaccinated population, the more opportunity it has to change (mutate) and become more contagious. The current COVID-19 mRNA vaccines are highly effective at preventing severe disease and they are safe. Great news because pregnancy is an independent risk factor for severe disease. We can slow the spread of the COVID-19 virus and protect the most vulnerable by swiftly vaccinating people, continuing to wear masks and socially distance but we cannot do this if we continue to remain silent.
Recent email inquiry about midwifery care from a potential client.
Out of hospital midwifery has become a hideout for fringe ideas that support and promote fake conspiracies around COVID-19, question the safety of vaccines and refute the importance of public health measures. The disease of misinformation is infecting both midwives and our clients. The reputation of our profession and the health of every human is at stake! Midwives, myself included, are guilty when we do not take a stand and feverishly advocate for the truth. Hiding our inaction behind the guise of ‘patient choice’ is hypocritical when we do not work to dismantle the misinformation parading as facts that are used to manipulate “choice.”
We must listen to our public health colleagues by continuing to wear a mask, wash our hands and socially distance. To protect ourselves and others, we must get vaccinated as soon as possible and encourage our families, friends, colleagues and clients to do the same.
Let’s embrace the science that vaccines are safe and public health measures protects everyone because if you believe in midwifery, there’s no other choice but to believe it that as well.
