When a parent stands at the cross-section of Perfection and Fear, they are opening themselves up to being preyed on by a host of companies.
It’s no secret that maternity care in the U.S. is under a lot of scrutiny. We continue to have the costliest maternity care in the world, yet despite all that spending, we still have one of the highest maternal mortality rates among industrialized nations. And that rate continues to rise. With just these two devastating and frustrating statistics at play — not to mention a host of other roadblocks to affordable, quality maternity care — it’s no wonder that many people are apprehensive about giving birth in this country.
All of which has led to an unsettling question: Could these fears and insecurities about birth and motherhood be exploited for profitable gain?
Two birth-related items give credence to this line of questioning. The first is a study on the too-high rate of C-sections performed for babies that are misdiagnosed as being too big to be birthed naturally. The other is a product designed to monitor every poop and snooze your baby takes, effectively turning your baby’s first few months of life into a digital spreadsheet that lets you analyze if they’re eating, sleeping, and defecating “correctly.” Both are profiting, directly and indirectly, from the same thing: a new mother’s fear.
A new report found that a number of pregnant people were incorrectly told that they were having large babies. As a result of being told about their large babies, these women were five times more likely to ask for a scheduled C-section, according to the research. Yet, in the end, the majority of the newborns ended up weighing less than 8 lbs, 13 oz (the medical definition of a large baby), not necessitating a surgical birth.
Could fears and insecurities about birth and motherhood be exploited for profitable gain?
A 2014 publication from the American College of Obstetricians and Gynecologists titled Safe Prevention of the Primary Cesarean Delivery provides guidelines for surgical births. Among them is one that notes that a large baby is only a “rare” indication for performing a C-section, and that doctors should actually not offer a surgical birth unless the baby is more than 5,000 grams (11 lbs).
While C-sections are absolutely necessary in some cases, many concerns have been raised by the fact that the U.S. has a 33% rate of surgical births. The World Health Organization states that the “ideal” C-section rate should be between 10–15% of all births. A C-section is a surgical procedure, and one that has many risks involved, both for mother and child. Yet, when pregnant people are driven by fear (i.e. “your baby will be too big to birth”), they immediately move their insecurities right into the birth process, and they’re willing to concede to a more potentially dangerous form of birth. That’s despite the outcomes consistently indicating that the procedure was, most likely, unnecessary.
That’s something Dr. Andres Ayuso, MD, an Ob/Gyn based in Jacksonville, Florida, has seen before. “I absolutely agree that moms are instinctively going to protect their babies even at the detriment of themselves,” he says.
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But that’s the rub, isn’t it? Women especially are taught — even before they’re pregnant — that they have to be the best, do everything they can, and not fail when it comes to parenting. So when told their baby will be too big and their bodies can’t handle a vaginal birth, most will consent to an unnecessary surgery without a second thought. Is it a stretch to say fear and profit are related in this instance? A vaginal birth in the U.S. averages around $30,000 while C-sections cost around $50,000, both price tags the highest in the world.
Dr. Ayuso understands how this all connects, and sounds as frustrated as many patients feel about it all:
“As a clinician, I try to root myself in what’s going to be best for my patient without allowing finances and/or convenience be a factor. Now, we’re all human and we sometimes succumb to other pressures (threat of litigation, administrative pressures to avoid adverse outcomes, student loans, mortgage, meeting payroll, making it to your kid’s baseball game, etc., etc.). I completely get it. But when we signed up for these careers we should have had within ourselves a code of ethics (prior to even taking The Oath) that compel us educate ourselves, educate the patient and make the best decision with the information we have before us. While we can never eliminate biases and influences, we can strive to reduce their effect on our objective decision making. In the same manner that we practice performing a safe and efficient C-section, we must practice how to effectively communicate our decision making process and recommendations without playing on maternal fears.”
And yet, the fear-fueled profit doesn’t end at birth.
Hatch Baby, a company based in Menlo Park, California, is hoping that the current popular “smart” product trend can be applied to to the care of newborns. Ann Crady Weiss and her husband David founded the company after worrying about daughter Maya’s weight gain. According to a quote by Weiss on the Hatch Baby website: “I couldn’t tell how much breast milk she was getting, and I was worried about whether I was producing enough. After way too many trips to the doctor to weigh her, I realized that this was a problem that could (and should) be addressed with technology and smart design. Hatch Baby was born out of that experience.”
At first glance, Hatch Baby sounds like a great product. A “smart” changing pad that tracks a wealth of information from soiled diapers to feedings, sleep patterns, and baby growth in both length and weight. All with the ability to easily share the information with whomever you’d like. But while this sounds helpful on the surface, it can easily amplify the normal and not-so-normal anxieties and doubts of new mothers. We all want to do what’s best for our children, and women in particular are tasked with the lion’s share of caring and feeding their newborns. It can be easily overwhelming, especially for those who are breastfeeding and may not know the exact amount of nutrition their baby is receiving.
However, is a $300 changing pad the answer? Kate Cropp, director of Lactation Services for Nashville Birth and Babies, reviewed the changing pad scale and discussed it with various private practice International Board of Lactation Consultants (IBLCs) around the country. While she feels it could be really good for post-NICU babies, where mothers are often empowered by having data, she told The Establishment that it focuses too much on data and not actually on the child or mother.
“The scale is not very sensitive, and goes down to only 10g, but the gold standard for determining a feeding volume is 1g. So for some babies, it will not register low enough for a feeding determination, and may prematurely lead parents to want to supplement,” Cropp says. “In my opinion, it leads parents to think in a formula-centered way about ounces instead of relying on age-old standards of overall health and basic weight gain. Micromanaging is what I call it in my office — something only to be used when truly necessary.”
Instead of creating a calm environment for baby, this product relies on a new parent’s uncertainty and fear of judgment. By keeping track of this “information you care about,” the pad and app force you to look at — and obsess over — every single facet of your baby’s life, whether it’s useful or not. In fact, this “smart” device seems to get the job done if you’re looking for something to cause worry. Which a lot of parents seem to want; after launching, Hatch Baby’s website indicated that their “current shipment [was] sold out due to overwhelming demand.”
Chelle Baldwin, a parent of two teenagers, is not a fan of this type of smart tech geared toward new moms. “This damn thing feeds into every level of insanity and fear that can eat new mothers alive if they are unsure,” she says. “I think the better thing to do with that three hundred bucks is to donate it to a shelter for women who have babies but lack the support necessary to properly house and care for their child.”
Pediatrician and mom of two, Dr. Erica Kates, understands why some parents could be wooed by a device like Hatch Baby, but ultimately doesn’t think there is a wide use for it. “I can see the utility of this if your anxiety as a parent is such that you are at the pediatrician’s office every other day for a weight check,” says Dr. Kates. “I have a few patients for whom the uncertainty is just too nerve-wracking. On the other hand, parenting (and life) is full of uncertainty, and there is probably a benefit to getting comfortable with this early in the parenting process.”
‘The better thing to do with that three hundred bucks is to donate it to a shelter for women who have babies but lack the support necessary to properly house and care for their child.’
Dr. Kates does note that the one group it could be useful for is parents of babies who are actually failing to thrive. She says that Hatch Baby might help identify the problem and some potential causes, for example, infrequent feedings leading to poor weight gain, as well as monitor recovery. But, she says that sometimes, too much information isn’t necessarily a good thing. “I am not in favor of having quite this much information at all times,” she explains.
“Weight, especially in newborns, can fluctuate with feeds and bowel movements. It can be confusing and misleading to try to interpret these frequent shifts (which are quite normal). There is a growing body of evidence in medicine showing that, despite our ever-increasing ability to monitor things, all of this monitoring has very little impact on outcomes.”
And, just as with the misdiagnosis of a “too big” baby resulting in an unnecessary C-section, a misdiagnosis of poor weight gain has the potential to cause more harm than good.
So, while this device is supposedly rooted in assuaging parents’ fears, in all but some extreme cases it really won’t have a big impact on your baby’s development. And that could be frustrating for parents who are finding themselves feeding into the fear that’s continuously perpetuated.
The fear begins during pregnancy when pregnant people are told “Eat this! Don’t eat that! Do this! But not that!” These sometimes-contradictory directives continue through birth and parenthood, but so much of it is predicated on fear. Fear that you’ll do something wrong and you’ll hurt your fetus. Fear that your birth plan isn’t comprehensive enough and that there will be complications in birth. Fear that you’ll fail at motherhood, somehow. While having a healthy dose of awareness is always a good thing, when it spirals into a fear so deep you’re spending $300 on a changing pad or changing your birth plan in a dramatic fashion, then we need to pause and reevaluate things.
Ashley Briggs, a mother of two young kids, agrees that products like Hatch Baby are based around fear and pressures for perfection. “I think this device was developed to appeal to the idea that perfect input leads to perfect outcomes,” she says. “You eat perfectly and take care of yourself perfectly while pregnant, and your birth will be perfect and your baby healthy. Then once the child is on the outside, you transfer that quest for perfection to him or her, fooling yourself into thinking that with enough breast milk, hand sanitizer, stimulating conversation, [insert latest child rearing craze here], nothing can go wrong.”
When a parent stands at the cross-section of Perfection and Fear, they are opening themselves up to being preyed on by a host of companies. Hatch Baby is hardly the only largely unnecessary product making money off of parental anxiety.
Mother of five and grandmother of three, Jill Benser sums up why the proliferation of these products is harmful:
“We are creating a generation of insecure, neurotic mothers. What happened to maternal instinct? It’s being replaced by study after study, expert after expert, new product after new product telling us what to do and not do with our children; often the opposite of what feels natural to us as mothers, only to be contradicted by the next study and expert, and new product.
“I will say that for the few acute cases, this technology will probably assist in saving many tiny lives, but how necessary is it for the average infant? It is my guess that instead of reassuring new and seasoned mothers, it will create a generation of hyper-anxious mothers, which we know for a fact translates into anxious babies, toddlers, and teens.”