In the company of woo

I find myself in the company of woo, and as a skeptic it is bringing me some grief.

It's all about homebirth - planning to deliver a baby at home, attended by a midwife, rather than in a hospital.

Deena and I came to homebirth through an examination of the evidence. (Here's a discussion I participated in on the Bad Science forums before Kaia's birth.) We were convinced, by scientific studies and analyses, that planning a home birth here in the UK was at least as safe as planning a hospital birth, given a competent attendant and a handy hospital in the event of complications. So we went for it.

However, many people choose homebirth for less evidence-based reasons. They cite personal intuition, or the "naturalness" of it. Not just as reasons to prefer homebirth, but as evidence of its safety.

At Edinburgh's Pregnancy and Parents Centre (a haven for various types of woo, as well as useful support groups and great toddler activities), when we went to the "home birth support group" to relate our experiences and our evidence-based approach, it was alongside others promoting woo of various flavours as part of their support of homebirth.

A recent post on homebirth at Science-Based Medicine has stirred up an epic-length discussion, with passionate defenders on both sides. I've participated, but fear that just being on the homebirth side has made me, in some people's eyes, an advocate of woo.

This is the problem: I agree with the woo-birthers that homebirth can be safe, but I disagree (passionately, vigorously) about why this is a legitimate position. And the disagreement isn't immaterial. At the homebirth meeting, someone recommended homeopathy to treat post-partem haemorrhage. One of the most serious and potentially life-threatening complications of pregnancy, and she advised drinking high-priced water. That is dangerous advice, and I wish I'd been quick-thinking enough to respond persuasively (rather than sitting like a lump and grinding my teeth).

What is a skeptic to do? On the one hand, having someone agree with me in one breath, and back me up with an appeal to intuition in the next, makes me want to revisit and question my beliefs that much more carefully. (That's something a skeptic should be doing anyway, for all their beliefs, but who has the time?) On the other hand, to adapt Niven's 16th law, "There is no belief so true that one cannot find a fool believing it." Just because someone agrees with you for bad reasons doesn't mean you're wrong. I came to my belief about homebirth on the basis of the science, and I'm determined that only science will dissuade me.

But there's also the whole social side. Just as many of my fellow atheists wrinkle their brows at me when I say I go to church, many skeptics seem to do the same when I talk about homebirth. Atheists often assume that the word "church" is synonymous with supernatural beliefs and submission to a holy text, things that would feel alien in our Unitarian church. Similarly, many skeptics assume that, because it's associated with modern medicine, hospital-based birth is inherently safer.

I'm tempted to close by declaring, evangelist-style, that skeptics must beware of this tendency to take association as evidence. Its association with woo-birthers says nothing about the safety of homebirth; nor does its association with high-tech hospitals demonstrate the superiority of hospital birth.

But perhaps a more humble conclusion is in order. Here goes:

I promise to keep vigilant for evidence that might contradict my current beliefs.
I promise to honestly communicate any changes of position that such evidence might lead me to.
I promise to avoid being swayed by other people's assumptions (whether or not they are skeptics).
I promise to make every effort to pin my beliefs to the evidence, and nothing else.