Thursday, November 20, 2008

"Women's Primal Wisdom"

Midwifery Today seems to be hiring writers from The Onion. They are starting to parody themselves. Consider Women's Primal Wisdom" by Lydi Owen, a self-described midwife of 36 years, featured on their homepage. Read it and then try to claim that direct entry midwives are trained in anything, let alone birth.

The thesis of the article is that if it happens, it must be normal. I've written about this bit of sophistry before:
Homebirth advocates like to pretend that almost anything that happens is "normal" simply by virtue of the fact that it happened. Are you still pregnant 3 weeks after your due date? Must be normal, since it happened. Are you in labor and stuck at 8 cm for the past 6 hours? Must be normal, since it has happened to some women in the past, and a few have even gone on to deliver live babies.

The corollary of the homebirth fantasy that almost everything is "normal" is the conviction that medical definitions of "normal" are utterly arbitrary and exist merely for the convenience of doctors. Nothing could be further from the truth...
The Midwifery Today article is nothing more than an elaboration of that fantasy:
There is a rule of labor that forbids a woman to push with contractions until her cervix is completely dilated to 10 cm. Women are warned that to push before this doorway is completely open and out of the way will result in a swollen and/or torn cervix...

Doctors, nurses, midwives, doulas and childbirth educators all warn that a swollen cervix will impede labor and increase the chances of tearing the cervix, thus causing hemorrhage. They have been taught that a swollen cervix is easily broken or pulverized. If this is indeed the truth, then why do most women during labor have an irresistible urge to begin bearing down before dilation is complete?

Could it be that the instinctual wisdom of our bodies has become our enemy? Is Spirit trying to destroy us instead of guiding us? ...
Let's see. Just what instinctual wisdom might the author be talking about?

Perhaps, it's the wisdom that prevents any baby from ever being born premature? Can't be that, since premature babies are born every day?

Maybe it's the wisdom that leads every woman's body to make just the right amount of oxytocin after delivery so virtually no woman ever dies of postpartum hemorrhage? No, can't be that, since women without access to pitocin die all the time.

Ah, it must be the wisdom that makes sure that no baby is ever to big to fit through the bony pelvis? That's not it either, since hundreds of thousands of women are suffering from fistula because their baby was too large to fit.

Perhaps it's the wisdom that keeps every woman's blood pressure low? No.

I could go on and on, but I think everyone gets the point.

There is no "wisdom" involved in childbirth, just like there is no "wisdom" involved in hurricanes. Both are natural phenomena and are therefore subject to the brutal laws of nature, not the magical thinking of undereducated, undertrained "midwives." Nature is arbitrary. Sometimes things work out, and sometimes everybody dies. That's the only "wisdom" of childbirth that's relevant. Any "midwife" who doesn't know that doesn't know much of anything.

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