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Marge G's avatar

The point that you can’t use Canadian statistics for US outcomes is critical. I’d like to see regulation and integration of home birth services so US women who desire home birth can achieve those excellent outcomes. Home birth can be safe when part of a regulated (and non adversarial) system.

Amos Grünebaum, MD's avatar

I fully agree. In the meantime, home birth in the United States should be suspended until we have safe measures in place.

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Jan 17
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Amos Grünebaum, MD's avatar

This is an astute observation about how social media has fundamentally changed risk perception through what behavioral economists call "availability bias"—the cognitive shortcut where vivid, recent, emotional narratives override statistical probability in decision-making. You've identified something even more insidious: the perverse incentive structure where birth trauma becomes social capital, with influencers literally profiting (through followers, sponsorships, course sales) from narratives that frame hospital birth as inherently dangerous and unregulated homebirth as heroic liberation. The algorithmic amplification of extreme stories—where a woman's traumatic hospital experience or "unassisted" birth reaches millions instead of her village of 15—creates a distorted information ecosystem where rare events feel normative and evidence-based counseling about actual risk cannot compete with a compelling villain-hero narrative. We're essentially trying to do informed consent in an environment where patients have been algorithmically radicalized by content creators who have direct financial incentives to maximize engagement through fear and tribalism, all while our overstretched healthcare system sometimes provides the negative experiences that feed the cycle,