Why Did a Leading “Freebirth” Advocate Change Her Story?
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Commenter desiree at The Skeptical OB alerted me to an interesting change in “freebirth” promoter Laura Shanley’s website: she has changed her story about the birth and death of her premature son.
Shanley, for those who don’t know, is one of the foremost advocates of a a practice known as unassisted childbirth or “UC” (aka “freebirth”), in which a woman deliberately chooses to give birth without a midwife, doctor, or other medically trained assistant in attendance.
Proponents often assert that UC is safe because birth is natural, that a woman who is not “interfered with” is less likely to experience complications, and other patently ridiculous claims.
Shanley has four living children, all born without the assistance of a midwife or doctor. Her fifth child, also born without medical assistance, died shortly after birth.
The original version (scroll down after clicking the link) of this story (courtesy of the Wayback Machine) posted on Shanley’s site acknowledged that the baby was premature, that he had obvious congenital defects, and wasn’t breathing when he was born:
“At best, I was 35 weeks along, and while my pregnancy was normal, it was obvious there was something wrong with this baby. He wasn’t breathing, and the bones in his chest were malformed. Instinctively, I breathed into his nose and mouth. Suddenly he came to life. But several hours later, he simply closed his eyes and died. “ [Emphases added.]
The amended story now posted on the site omits the fact that Nicholas was likely more than one month premature, and that he had a possibly serious congenital defect:
“The baby wasn’t breathing, so instinctively, I breathed into his nose and mouth. Suddenly he came to life. Over the course of the next several hours, he nursed and slept. My boys woke up, David came home, and everyone was excited to meet our new baby.”
Both versions note that Shanley later called paramedics to take Nicholas to the hospital, and that he could not be revived.* A subsequent autopsy revealed that the baby had “a[n unidentified] congenital heart defect, influenza, pneumonia, and sepsis.”
In the original version, Shanley wrote:
“The coroner also said that Nicholas would have died regardless of where he had been born. Prematurity (let alone prematurity combined with a heart defect) is the leading cause of infant death, even in the hospital.”
The new version omits the comment about prematurity, and adds a new detail to the coroner’s reported remarks, specifically attributing the baby’s death to his heart defect:
“The coroner also said that the defect was severe enough that he didn’t feel Nicholas would have survived regardless of where he had been born.”
Why would Shanley change her posted story?
In styling herself leader of the UC “movement,” and using her personal stories as “evidence” of the benefits of UC, Shanley has come under scrutiny for both her public advocacy and her private actions. Recent media attention to the practice of UC has only increased that scrutiny.
The original version of Shanley’s story provides fodder for serious criticism:
- She knowingly chose to give birth to a baby at least 5 weeks premature without medical assistance on hand;
- She acknowledged that prematurity is the leading cause of neonatal death;
- Despite the fact that the baby was not breathing, and had obvious serious congenital defects, Shanley did not summon help until several hours later;
- The baby suffered from other life-threatening ailments—pneumonia, influenza and sepsis—that would likely have been detected and treated had he been born in hospital.
The new version effectively whitewashes Shanley’s behavior by removing any reference to the baby’s prematurity (and her knowledge thereof), the seriousness of prematurity, and by adding the new detail of the coroner’s speculation that the congenital defect would have killed Nicholas regardless of his place of birth.
In my opinion, the changes to Shanley’s story are a deliberate attempt to make UC appear safer, and Shanley herself less culpable in Nicholas’s death by painting it as an unavoidable event rather than the consequence of Shanley’s intentional choice to eschew medical care that might have saved her son.
* Edited 6/15/09 for clarity: It is unclear from Shanley’s story whether the baby died at home or in the hospital; her account seems to contain conflicting statements.
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I know this post is old, but I still feel compelled to comment on it. The amount of judgment passed on a grieving mother saddens me. I do not know that much about Laura Shanley but based on what I have read regarding her previous experiences, I would guess that she chose natural birth because it had worked for her FOUR times previously and familiarity is something that we as humans seek out. I think she probably thought she was doing what was best for her child at that time (and maybe she was). I certainly would not liken this to Munchausen by Proxy based on the information that I have found available. I do feel that women and their partners should be able to choose how they want to birth their children and make that decision based on the information that they personally have at hand; information which I am guessing NONE of us are privy to. In response to her advocating for a method of birthing which she believes in, I firmly feel that she has every right to do so. She did have four children via natural birthing after all, and is much more qualified than I to make such a statement. Furthermore, I believe that most people do possess intact critical thinking skills which enable them to weigh both sides of an issue to determine what is right for them so I am not that concerned about Ms. Shanley’s story unduly influencing others.
Please excuse my correction…I meant to type she had four “healthy” children via natural birthing. I did not mean to discount the child who passed away. I apologize for my omission.
How strange!
A strange world that attacks individual choice.
I have reviewed my birth stories because perspective and knowledge changes.
I have no interest in debating the merits or safety of unassisted childbirth. I have made my thoughts clear on my web site and in my book. It was a personal choice, and you are free to disagree with me. But briefly I will say that I changed my story for two reasons. I was nursing when I conceived Nicholas (and therefore not getting my period), so I cannot say with complete certainty that he was born prior to 37 weeks gestation (although I do think he was early). I changed the comment about the bones in his chest being malformed after researching “protruding chest bones” and discovering that this isn’t a true deformity and generally goes away on its own. But the fact remains that Nicholas died as a result of a congenital heart defect that was severe enough that medical intervention couldn’t have saved him. I know this both from my own intuition and from speaking with the coroner. I was treated very kindly by the paramedics, hospital staff and coroner, and it was never suggested that I was responsible for his death.
That being said, are there babies that have died at home that might have been saved had they been born in the hospital? Yes. But there are also babies who have died at the hospital that might have been saved had they been born at home (and I have letters from mothers who will attest to this). Medical errors are made everyday, especially in the field of obstetrics.
But sometimes a baby dies and no one is to blame. A baby is stillborn in an American hospital every 15-20 minutes. According to a report on my local news, this is double what it was 10 years ago. Some of those deaths most likely could not have been prevented, but some are undoubtedly due to induction of labor, early c-sections and other unnecessary interventions. Yet how many bloggers are questioning the safety of hospital birth? It’s simply easier to attack those of us who give birth at home than it is to seriously take on the medical establishment. I am not anti-doctor but there is something very wrong with the way birth is handled in hospitals and I will continue to challenge it. Unassisted childbirth was the right choice for me. To each their own.
Thank you for adding your comments. First, I am sorry for the loss of your son, however it occurred.
Briefly, I don’t believe questioning your story, or your advocacy of “freebirth” constitutes an attack on those who choose to give birth at home. Homebirth and unassisted childbirth are two entirely different things.
Moreover, I would not attack someone for a simple personal choice; I do, however, feel free to take issue with those who publicly maintain, as you do, that those choices are superior to others’, and who attempt to advise others (without any relevant expertise) to make the same choices.
I won’t attempt to address your “babies die in hospitals” strawman; I assume most readers are intelligent enough to understand it as an obvious logical fallacy.
You may have changed your story to align more closely with the actual facts of your son’s birth and death, but at one time–and, presumably at the time of his birth–you believed that he was possibly at least one month premature, and that he had what you suspected to be a congenital defect, and one for which you did not know the prognosis at the time of his birth, yet for which you declined to get medical help until several hours after birth. I continue to maintain that these acts were irresponsible, regardless of the lethal heart defect, of which you were, as I gather from both versions of your story, unaware at the time of his birth.
I don’t believe your “intuition” means anything at all, and I would certainly hope that none of the medical attendants you saw would have told you that you were responsible for your son’s death, at least not at the time. That does not, however, mean that you were blameless–only that the caregivers showed appropriate compassion for a grieving mother.
I continue to believe that the change in your story was disingenuous, because it appears to remove some foreknowledge of the POTENTIAL danger in which you deliberately placed your child.
While I am glad you appear to be at peace with your decisions, I think your work in advocating for freebirth is unconscionable.
what’s the big deal?
Personally, I am getting increasingly interested in that question. I don’t think it stems from quite the same root as Munchausen’s. If it is simply attention you want, then a Munchausen type “interesting” pregnancy full of obscure complications and gaining the attention of lots and lots of interested doctors would seem more to the purpose. This seems to be a much more complex form of attention seek, based in an ideology of womanliness, a rather strange construction of the feminine which seems to combine empowerment with a very conservative view of a woman’s role. Several aspects of it fascinate me. The sense of certainty which must NOT be challenged, the virulent attacks on nay sayers – and, very odd to an English person, the need to have a large family; the switch from “birth is safe” to “death is part of it” As far as my limited understanding goes, Munchausen addicts seek attention, and love hospitals, birth junkies seek admiration and control, and some of them seem to have a very neurotic fear and dislike of the medical profession. I can see that a negative first birth could cause that, but I think it is more complicated. A form of mass hysteria perhaps?
Liz,
Yes, I think Munchausen’s (or M. by Proxy) is a specifically pathological state, while extreme birth “philosophies” seem to have a specifically sociological root, given all the pseudo-political, and often religious, trappings the latter seems to entail.
It seems to me very closely aligned to the current zeitgeist that embraces the naturalistic fallacy.
My (very limited) understanding of Munchausen’s is that there is frequently concomitant mental illness, and that the victim cannot control his/her impulses for self-harm. Moreover, Munchausen sufferers don’t attempt to recruit others. The same cannot be said for “extreme” birth advocates.
(As an aside, during my tenure at a Big F-ing Hospital, two of “my” patients turned out to be suffering from Munchausen’s, and I saw first-hand how utterly devastating an illness it can be. It left me with a great deal of sympathy for sufferers. One actually persistently introduced fecal matter into a limb wound to produce an infection that wound up requiring amputation. The other was a medical worker who caused a condition that almost cost him his pancreas, which seemed to be his intention. Very, very sad.)
As I’ve said several times in the past, I’m not sure that the baby even actually had a chest malformation or an inevitably fatal heart defect. Lots of things about this story simply don’t add up.
Premature babies’ chests look a little bit deformed, because they don’t have enough body fat — I initially wondered if there were something wrong with my 35.6 weekers, too, and was told it was normal. Another commenter at Dr. Amy’s has posited that it also might have been chest retractions, which are signs of a baby who is struggling to breathe.
I also wonder if the heart defect was a patent ductus arteriosus, which is very common in preemies. In normal babies, the blood vessels of the heart are connected prior to birth, and close off from each other hours or days later, but those of premature babies often don’t close off. Even in normal babies, it might be open a few hours after birth, when this baby died. It’s surgically correctable.
Of course, that’s my own speculation, and it’s certainly possible that something more serious was wrong with the baby. However, it’s incontestable that she chose to birth prematurely — she said her labor was two hours long, plenty of time to get to a hospital — and not to have the baby monitored more closely afterwards. She certainly intended to give the baby the opportunity to die of prematurity, whether or not that was his actual cause of death.
Interesting observation, Emma.
Any way you slice it, Shanley deliberately deprived her baby of a chance to live. Based on her flowery statements about death, I’d guess her argument would be that the hospital would have needlessly subjected him to futile procedures. If so, my next question would be why she even bothered to call the paramedics when he stopped breathing later, unless she believed there was a chance he would live with medical attention?
Moreover, if, as she says, Nicholas had already “died peacefully in his own home,” why would the ER physicians attempt to revive him, as she reports? Is it standard to attempt to revive a DOA in the ER?
I know of accounts of baby’s who have been declared dead in the hospital only to “revive” on their mother’s chests
Meaning?
Meaning babies spend a significant amount of time away from their mothers in the hospital and reunion after declared dead may be delayed or not possible… a child that may otherwise have survived if left with their mother. On the other hand I believe in prenatal care and intervention for mothers who need it… But not routine intervention for all.
Normally I find Dr. Amy a little too skeptical and perhaps snarky at times, but when I read her post on “stuntbirthing” I thought she was right on the money! This change in one freebirthers story confirms my suspicion that it’s a sad thing when women are so stubbornly afraid of the hospital setting that they won’t go in for even a premature baby situation!!
It just strikes me as a supremely foolish and selfish attitude. Much as I disagree with it, it’s their prerogative to choose to do it. People like Shanley, who gratify their egos by not only needlessly justifying their choices, but elevating them to a false level of superiority, are an utter menace.
I am seeing this as a sort of Mumenchausen by proxy (I know I mispelled mumenchausen). you know, the mental illness where women hurt their kids in order to get sympathy and attention from other folks. Sick, sad world.
It certainly strikes me as a way of feeding the mother’s psychological needs at the expense of the baby.
It does seem like a minor form of Munchausen’s/Munchausen’s by proxy to me, too– they clearly aren’t going to actively harm their children or themselves for attention, but they figured out they could get positive attention through denying care.
It does seem to be all about the attention. If you want to have your baby at home without assistance, go right ahead. Why advertise it on the internet, start support sites, or post your birth on Youtube?
As advocates are fond of pointing out, women have been giving birth without medical assistance for millenia, so what’s the big deal?