Wednesday, April 16, 2008

Free Advice

Free advice. You get what you pay for, right?
When it comes to birthing, feeding, mothering issues, we just need to pay people to keep their free advice to themselves.
It hurts mothers. It does no good.

For instance, there are some interesting rants going on right now in bloggerland about how important is it, really, to breastfeed your infant. These discussions are sparked by a study recently published in the March 2008 issue of Pediatrics. It is a large randomised, controlled study whose authors acknowledged surprising few wellbeing/attachment differences in older children based on how they were fed, breast or bottle. A much smaller study recently found lower than expected margins of difference in breast vs bottlefed infants in illness such as ear infections and diarrhea. Because of these recent findings, some breastfeeding mothers are being labeled as self-righteous,sassy mommie-martyrs, accused of looking down on bottlefeeders from a pedestal, falsely flying their "breast is best" flag in the face of poor beleaguered bottlefeeders. There have been a lot of ruthless comments.

And then there is this outrageous amount of activity going on at the Wall Street Journal blog about Jennifer Lopez not breastfeeding her twins. I mean people are getting downright mean about it!

My point is this: people have a lot of condemning, judgemental things to say about other mother's feeding choices, birthing choices, etc. It just seems like people can't keep their opinions on these mothering issues to themselves. Kind of like some people can't keep their hands to themselves! You know how some people are always wanting to touch and rub a pregnant woman's belly? People will just reach out a pat a pregnant woman's belly- a woman they may hardly know! It's like babies are this universal connection in an otherwise very isolated world.
When you gaze at a pregnant woman's belly you are connecting to the baby that is beneath. The boundaries that are usually there(that would keep us from caressing a mere acquaintance's abdomen) just disappear and people just go a rubbing and a patting away! We want to connect, for just a few seconds, to that human potential floating safely within!

I suppose people see the unborn, beneath that heavy belly, as an innocent that deserves this universal protection. We are all represented in that new life. Our possibilities, our potential, are somehow budding anew in that belly. We long to protect it, to save it, to rekindle it! Of course, when that freedom from restraint allows people to let lose with unsolicited advice/condemnation that is when it can get ugly.

The worst comments often come from older women, many years past their childbearing stage. Perhaps their voice is lost to their own children? They must shout out their stories to any new mother they chance to encounter?

While I was pregnant last year, I tried to avoid painful comments from critical coworkers regarding my birth plans. I was happy to engage my friends and family regarding my plans to birth at home. I was never afraid to discuss homebirth, safety issues, prenatal checkups, health issues, etc with anyone close to me. But, what I intended to avoid was any debates/discussions regarding homebirth with my work colleagues for the duration of my pregnancy. This was a special time in my life and I did not feel the need for me and my growing baby to bear the brunt of anyone's "hospital birth is safe-homebirth is deadly" agenda. Bear in mind, I was working in Labor & Delivery and was well aware that the attitudes of the majority of my coworkers regarding out-of-hospital birth was quite negative. Having worked alongside L&D nurses for years, I had gotten used to the "we make birth safe with all our gadgetry" mantras. It's just part and parcel of working in obstetrics, the nurses need to feel justified in all the disruptive things they do to women and babies- they need to cling to this idea that they make women and babies safer!

You see, over the years, I had learned that the vast majority of nurses working in L&D would argue tenaciously that their work made moms and babies safer, no matter the evidence based practice that was to the contrary. Every so often, I would mention that in thirty years continuous Electronic Fetal Monitoring had never been shown to improve fetal/maternal outcomes and in fact SEVERAL studies had demonstrated that it worsened maternal outcomes by causing unnecessary C-Sections and I would get frustrated looks/blank stares/eyes rolling. Most of the staff working within a Hospital Birth Setting just isn't prepared for the paradigm shift that challenges the Hospital Birth Birth Machine. It turns their world upside down. And no one wants that!

Throughout my pregnancy, as I was seeing my midwife for prenatal care, I was also seeing an OB as a sort of "back up" for ultrasounds, as needed, and bloodwork. Whenever a coworker asked about my doctor, I answered honestly. If they asked where I was going to deliver, I also answered honestly that I didn't know. This worked up until I was about 6 months along and then people expect you to have the hospital picked out by then. So, slowly, only if asked directly, did I begin reluctantly revealing to coworkers my plans for homebirth. I was truly amazed at the variety of responses, and was relieved to hear a wonderful, refreshing amount of positivity and congratulations. Many were skeptical and outwardly shocked, but they weren't unkind. I did receive my share of unsolicited advice, however, and one older nurse's tidbit was exceptionally hurtful. I was at the nurses station talking with a friend about my pregnancy and this older nurse, a woman I hardly knew, walked over and was listening from the periphery. She had obviously heard about me through the nurses gossip chain and seeing me already chatting about my pregnancy with someone saw her chance!
She asked, "So, are you the one who's planning a homebirth?"
"Yes," I replied.
" I guess some people just like Russian Roulette" she snapped hatefully and then she briskly walked away leaving me stunned.

I was left there wondering.... why?

Why did she feel it so important to say that hateful, insulting remark to me? Did she think I was going to change my birth plans after hearing it? Was she earnestly trying to save my baby from harm?
No.... the more I thought about it, it appeared that she only wanted to hurt me. She just needed to get that "dig" in to let me know she did not approve of my birth plans with the most extreme metaphor she could imagine. She was motivated by malice stemming from her ignorance and fearful attitudes about birth.

So, here's my free advice to all those brimming with free advice.

Stuff It.


pinky said...

See I think people's attitudes about birth do change. And I think, even though it may take a long time, things will change.

The other day I witnessed a Midwife doing scalp stim on a baby who was almost on the perineum. I was shocked. Every semianr I go to says "Don't use scalp stim on a low FHR baby." I almost kicked her under the table! I thought "when will folks learn?"

In order to do better, we must look at what we do in practice. And if someone has an argument, they need to back it up with information. Yes, there are studies that say EFM will increase your risk of C-section. There are also studies that show the opposite. Therefore, very important to read the studies and decide yourself.

I agree with you. More folks need to be open minded about how we handle birth. We cannot justify our actions just by saying "But we have always done it this way." That is just not an adequate argument.

gemma_marsh said...
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