"Whenever I go into a restaurant, I order both a chicken and an egg to see which comes first"

Monday, January 7, 2013

PC Coercion -Natural Childbirth And Breastfeeding

I remember going to Lamaze classes in the late Seventies before the birth of my daughter. My wife puffed and panted with the best of them.  I held her hand and tried to look sympathetic and caring; but to me it was all group-think bullshit.  I hated those classes, and we only went to two or three of them.  The sanctimony oozed out of every pore of instructors and students alike.  The room was cheerily depressing and pink. It had scam written all over it.

The Lamaze Technique was developed in the 1940s by Frederic Lamaze who was impressed by Soviet childbirth practices which focused on breathing techniques and the assistance of a midwife.  The practice was first noticed in the United States in the 1960s after the publication of a personalized account of the Technique, but it really caught on when the Sixties generation, advocates of natural everything and opponents of anything artificial, induced, or mechanical, began to have children.

Lamaze is not an evidence-based medical practices; and its benefits are derived from subjective values.  Current sites on natural childbirth tout its positive effects such as bonding with partner and baby, freedom to walk around, and birthing in a non-clinical environment; but never raise the issues of health outcomes.  There is simply no evidence that natural childbirth is any safer than normal childbirth.  A recent study showed that almost no articles written in midwifery journals focused on birth outcomes, and only on psycho-social ones. This is not surprising.  Dr. Amy Tutor, former Instructor of Clinical Medicine at Harvard Medical School has concluded:

Surprisingly, despite its nearly total cultural embrace, the claim that “natural” childbirth, meaning without any medical intervention, is at best ill-founded. (http://www.skepticalob.com/2012/09/the-real-difference-between-natural-childbirth-advocates-and-obstetricians.html).

Most obstetricians agree that women’s conclusion that they have experienced less pain during delivery is because of a placebo effect – either they have psychologically convinced themselves that they will have no pain, or will not admit it because of a socio-political conviction in favor of natural childbirth, or because the breathing technique distracts them.

Since there is virtually no difference between natural childbirth and ‘normal’ childbirth – that is, epidurals and fetal monitors have been repeatedly shown to have no negative consequences either for mother or baby – it really doesn’t matter whether couples opt for one or the other.  What does matter is Political Correctness – a disturbing trend to stigmatize women for not opting for natural childbirth.

Jenny McCartney, writing in The Telegraph (1.5.12) cites the calumny and opprobrium heaped upon her for publically stating her preference for hospital birth:

When I wrote in a previous column about how giving birth was a “feral and unpredictable” business… and how I’d prefer to do it in hospital, it infuriated a minority of readers. One angry man registered online specially to tell me that he was “incensed” by my “propaganda of fear” since his wife had very happily had two home births. Good for her – so why the easily kindled rage?

Another natural-birth exponent said that by my “cruel attitude” I had “added to the negative, fear-filled cultural meme about birth, and further doomed other women to be afraid and have their bodies malfunction”.

Most women have a normal, hospital, obstetrician-assisted delivery and are quite happy they did.  The epidurals allowed them to focus on the exquisite pleasure of delivery, and the fetal monitors and professional surveillance assured them that in the event of any complications, help was but a few feet away.  Yet these women are being branded as the enemy, the outlier, the apostate, all for no reason at all (see above, health outcomes).  It is PC gone wild…..yet again.

The authoritarian, doctrinaire, PC police are even more on the job when it comes to breastfeeding.  While there are well-documented studies demonstrating certain advantages to breastfeeding, the results have been contested.  Some researchers have challenged cause and effect, saying that mothers who breastfeed are from a motivated and more well-off socio-economic group and who have already adopted good health practices.  Others have focused on risk – although the risk of gastroenteritis may be halved thanks to breast milk, the total number of cases are so small that the actual risk is insignificant.  Still others say that the most highly-touted benefit – the reduction of ear infections – is not much of a benefit at all, since most illnesses can be easily treated by antibiotics.

In other words while there may be certain medical advantages to breastfeeding, they are so relatively small that women should not reject the bottle – a time-saving, economically freeing  product which liberated generations of women – nor underestimate the ease and moderate expense of medical treatment.

To complicate matters further, most of the purported benefits from breastfeeding come only if it is practiced exclusively. Few American women can afford the luxury of the 6-month exclusive breastfeeding period recommended by La Leche; and most supplement the breast with formula early on.  CDC estimates that fewer than 15 percent of women exclusively breastfeed at six months; and although the rate is expectedly higher at three months, the vast majority of women (almost 70 percent) give up exclusivity very soon after birth.

So why, then, in the face of these tepid scientific arguments, and the compelling notion that the opportunity costs for exclusive breastfeeding are exceedingly high, is there such a determined and insistent campaign to make women feel bad if they don’t follow La Leche?

The answers are predictably the same as those for natural childbirth:

Anything ‘natural’ is, ipso facto, better than anything not natural

Breastfeeding has become a women’s issue; and La Leche has milked it for all its political worth

Breastfeeding has become a rallying cry of the Left against big business, and greedy corporate predators who want to deprive women of their rights and their health

Breastfeeding is big business; and La Leche and their adherents have successfully managed to influence Congress to authorize hundreds of millions of dollars for exclusive breastfeeding programs around the world

The advocates for both natural childbirth and breastfeeding have tenaciously held on to their positions regardless of science; and have managed to convince legions of women that they are are not only good practices, they are the only practices.  There is big money to be made in public advocacy, great satisfaction in subscribing to theories that purport a return to basics, renewed respect for the natural environment; and a feeling of ‘empowerment’ through an expression of individual self-determination and anti-capitalism.

Who said science wasn’t political?

3 comments:

  1. My wife and I went through all the classes during her first pregnancy. Once labor started she hollered, "They lied! Give me drugs!" Not a shred of credible evidence that natural childbirth has any benefit whatsoever, except for the loonies who keep their names in the news promoting it.

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  2. go natural after that you will never go back I promise!

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