Fierce Views Of Anti-Home-Birth Activist Questioned In Slate

Every time I (or pretty much any other journalist) writes about homebirth, it's a good bet that a scathing comment about its dangers will be posted by a former ob-gyn who hasn't practiced medicine in years. Her name is Amy Tuteur, or Dr. Amy, as she's often called.

At long last (according to some folks), a darker side of Dr. Amy has been unveiled in an excellent piece by Jennifer Block in Slate called "How To Scare Women: Did a Daily Beast story on the dangers of home birth rely too heavily on the views of one activist?"

That activist is, of course, Tuteur, who is extensively quoted in Michelle Goldberg's Daily Beast story about scary homebirths.

Block writes:

For many parents, home birth is a transcendent experience. ... Yet as the number of such births grows, so does the number of tragedies—and those stories tend to be left out of soft-focus lifestyle features. Now a small but growing number of people whose home deliveries have gone horribly awry have started speaking out, some of them on a blog, Hurt by Homebirth, set up by former Harvard Medical School instructor Amy Tuteur. “These people are beating themselves up over this,” says Tuteur, perhaps the country’s fiercest critic of the home-birth subculture. “They did it because they thought it was safe, and it wasn’t safe.”

Goldberg's reliance on Tuteur is an interesting choice. Also known as “Dr. Amy,” Tuteur let her medical license lapse in 2003 and created the blog Home Birth Debate in 2006, which she used to advocate for her position, which is basically: Home birth kills babies. “Even the studies that claim to show that home birth is as safe as hospital birth actually show the opposite,” she'd frequently post in response to a challenge, smearing the researchers of those studies in dedicated blog posts and igniting flame wars in the comments section. On other sites, including Nature and RH Reality Check, her comments have been flagged and removed for being defamatory or basically spam.

In 2009 Tuteur moved over to her new blog, The Skeptical OB, the name of which is, on the one hand, misleading because she hasn't been in practice for more than a decade, but is ultimately more appropriate because her old site was never really about debate. She wrote briefly for Open Salon, where she took issue with Amnesty International's research on maternal mortality, and had a mutual parting with the blog Science Based Medicine (“mutual efforts between the editors and Dr. Tuteur to resolve our differences came to an impasse,” managing editor David Gorski wrote in the announcement). Her prose tends to be inflammatory. “It's hard to beat homebirth midwives when it comes to stupidity,” she recently blogged on her own site.

In January 2011, Tuteur added a new domain to her brand, Hurt by Home birth, in which she invites guest posts—“and please include pictures if you can”—from tragedy-stricken mothers.

Surely it's no crime for Tuteur to have her point of view and blog about it. As I mentioned, she is one of the most prolific blog-post-commenters out there. The problem, Block writes, is "when a dogged journalist like Goldberg elevates Tuteur to expert. Tuteur is not a researcher, she's not currently affiliated with any medical institution, and more importantly, she's never published any of her kitchen-table calculations on the risks of home birth in any peer-reviewed journal. Yet she presents herself with the authority of a CDC epidemiologist when she writes, “Homebirth increases the risk of neonatal death. All the existing scientific evidence says so.”'

Block quotes Boston University epidemiologist and professor of public health Eugene Declercq, who says it's challenging to precisely quantify the absolute risk of homebirth. He says: “the outcomes tend to be pretty good...So when Tuteur says no study anywhere has found this, it's a crock. There are studies that have found good results.” But to really nail it down here in the U.S., he says, we'd need to study tens of thousands of home births, "to be able to find a difference in those rare outcomes.” With a mere 30,000 planned home births happening each year nationwide, “We don't have enough cases.”