After years of working in the arena of childbirth, a new thought has
jumped into my head: Maybe we shouldn't be so tolerant of people's
choices.
Before I get flamed, just think a minute. We have been saying that
people need to have freedom of choice loudly and clearly for years;
it is even the philosophy of a childbirth education association.
Where has it gotten us? Our attitude about being tolerant of choice
is not effective; we've been saying it for years and look where we
are now. Birth technology is booming and being exported. The national
epidural rate is over 60% and the national cesarean rate is rising
again, to nearly 21%. The cesarean section rate in some private
hospitals in Mexico is 90%, which shows how the technology is being
exported.
Where are these kids that take guns, shoot their parents, then take
the gun to school and shoot their peers coming from? Joseph Chilton
Pierce made the observation that at the turn of the century, no one
ever heard of a child committing suicide. Now suicide is a leading
cause of death for young people, including children under age 10.
Why? Evidence shows that it may be the result of our birthing,
feeding and parenting practices. Just read Ghosts from the Nursery by
Kerr-Morse and Wiley. [Editor's note: Also read Reclaiming the
Spirituality of Birth by Begin Mauger, to be reviewed in the Sept.
issue of Midwifery Today.)
It galls me to say to a mother who weans her baby at two weeks, "Good
job. You did the best you could." That might be true for her, and
lord knows I want to leave the door open for her to breastfeed longer
next time, but how would we react if she only used an infant car seat
for two weeks or resumed smoking cigarettes? Sometimes I feel like I
am pussyfooting around when I avoid saying something like "You are
weaning now? Too bad. What happened to lead you to that decision?"
I've been taught not to hurt the mother's feelings; don't get her
upset. I want her to like me, and hear what I am saying. Yet how does
it make sense to support her choice to hurt her baby?
When the medical system that has the power decides something, it
happens, as in "use a car seat," and "tobacco is dangerous." People
are not being reminded about their choices with those campaigns.
Choice is inherent in US society today. We don't need to be reminded
of it all the time.
Choice has been perverted in the medical system that has the power.
Witness the "informed consent" that folks have to sign before
undergoing any medical procedure. Just how "informed" are they? I
learned how to manipulate people in nursing school. Of course, it was
for their own good, so that made it okay. Now women are scared into
lying down, and having their labors started before they and their
babies are ready. They are manipulated with false promises to have
drugs in labor, and get their babies cut, pulled, or sucked out. "No
pain, no problems, just get that epidural." This is choice??
Maybe with childbirth, we could stop reminding people that they have
choice all the time. Instead, focus on evidence: "You want a healthy
baby, breastfeed; there is no way around that fact." "You want an
easy baby, have an unmedicated birth." People can understand that
there are no guarantees, that wearing a seat belt does not guarantee
survival in a car crash. However, it boosts the odds enough in their
favor that it is worth it to do.
You need sperm and egg to start a baby, no choice about that. Some
things, like health, are beyond choice. You need clean air, clean
water, and good food to live well and be healthy. No choice about
that. We can be proactive and stop reminding people about their
choice all the time. Perhaps it is time to resurrect the concepts of
responsibility and consequence. What do you think?
-Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI, CSTP
Elkins Park, Pennsylvania
supporter of the WHO Code and the Mother Friendly Childbirth Initiative
Reprinted from Midwifery Today E-News (Vol 2 Issue 22 June 2, 2000)
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