Monday, February 14, 2011 at 3:16PM
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Reader Comments (31)
I say, I say, I do declare. This made me lose mah water. I am finding that I have to rinse out mah panties.
I've been lurking/reading The Unnecesarean for a while now (leading up to my successful homebirth a month ago, yay!). Thanks for being here--your posts are interesting and informative. I have a pet peave I've been wanting to vent about with someone besides my husband, and this seems like a good place to do it. Your blog, actually, gave me the language to describe a major reason why I chose homebirth with a midwife over other options: it's all about evidence-based practice. I've also been lurking on other forums, like the large AP/crunchy-granola one sponsored by a parenting magazine (I'll refrain from mentioning it by name in case that is bad form). I've noticed that while their members are pro-homebirth, pro-cloth diapering, pro-natural parenting--all views that I share, whether I actually practice them or not--they are also overwhelming supporters of anti- or selective-vaxing, and homeopathy, which I vehemently disagree with, due in large part to the lack of evidence surrounding those practices. That forum goes as far as deleting posts which contain pro-vaccination viewpoints.
I have also observed the same association in the choice of doctors in my area: the midwife/homebirth community recommends a local homeopath and M.D. as a pediatrician. (I believe this is partly due to the fact that I live in a state that does not license CPMs, so they are operating under the radar, and prefer to stay out view of regular doctors; also, the homeopath doctor will do a post-birth home visit and make the birth cert process easier.) The association of evidence-based midwifery with decidedly NON-evidence based homeopathy irritates me to no end. (Homeopathy = treatment solutions which have been diluted past the point where NONE of the active ingredient is present, with the premise that the water somehow retains a memory of that substance.) The fact that communities are built around these practices that I see as opposing forces makes no sense to me. I think this association makes it more difficult for the general public to accept the practices of midwifery and the acceptability of homebirth.
One related thing that bugs me, too, is that I've observed on the same forum that herbal remedies--many of which are definitely effective, even though there are few clinical trials to show it--are often lumped with homeopathy, which (in my not-so-humble scientific opinion) is a complete sham. Again, devaluing the thing that works by associating it with something that doesn't.
I hope I framed this well enough to make my thoughts clear, and I look forward to reading other people's responses.
An acquaintance of mine had twin girls vaginally at 38 weeks! She has 2 older girls, too. I'd love details, but I'll have to wait until I see her. I do know she gave birth in the OR "just in case." She's breastfeeding them, too. :)
"I say, I say, I do declare. This made me lose mah water. I am finding that I have to rinse out mah panties."
MomTFH,
As long as this is said in the voice of Foghorn Leghorn dressed like Boss Hogg, who had a baby with Harry Carey and is sitting on his porch with a mint julep, then mah word! I do agree!
-Your valentine
Tara,
I know what you mean. On top of it all, there is an assumption that it's all a package deal-- that is, that those who x also do y.
I'm going to repost this on Facebook and see who feels the same way, because I suspect there are a lot.
Thanks for delurking!
Jill
Suzan, that is so stinking wonderful that she's not trying to recover from a c-section while tending to the needs of four kids, two of whom are newborns. Thanks for sharing!
Re: Tara, I have had the same frustration. I will say that until a few years ago, I had never bothered to look up just what homeopathic meant, assuming it was equivalent to a term like 'natural' that has an extremely vague extension. And when I learned better I was astonished that I hadn't known. I suspect some portion of people who talk about homeopathy and maybe even are casual consumers thereof (eg buy homeopathic teething tablets but visit MD pediatricians, say) are in the same position I was.
It pisses me off when Voldemort groups everyone-and-her-Mississippi-goddamn-sister under the umbrella of "natural childbirth advocates" (a term I'm convinced is original to her) and makes sweeping generalizations about what "NCA" say or believe. Obviously any group larger than 1 person is going to be heterogenous. Not that you said anything about her, but I needed to get it off my chest! :)
I understand the point of view of your post Tara, however I disagree with your stance on Homeopathy. Regardless of what can be found on paper to back it up or not, I have found Homeopathic medicines to be extremely effective, especially for my children.
I do agree though that believing in natural childbirth and the benefits of using a midwife does not necessarily imply or require a belief in natural medicine.
I tend to think that if it works for you and it's doing no harm, does it really mater if there is not a study confirming your belief?
I think many of the forums around at the moment are doing themselves and everything they profess to stand for a lot of harm by not allowing open discussion on all areas that might be relevant to those involved. Just because someone makes a decision that differs from the 'majority' that does not make it invalid or wrong. Why is it that groups that are trying to gain acceptance for their own 'alternative' practices have a habit of 'shooting themselves in the foot' but refusing to allow discussion from all sides. How will people brought up in the mainstream ever hear about or gain real understanding of why people make alternative choices if they are harpooned as soon as they open their 'mouths'?
Sorry I guess I went a bit of topic there.....and please don't think this is directed at you personally. (the only part that was I guess is that I think Homeopathic treatments have merit)
Jill, you're welcome! I love to share good news.
Tara,
Congratulations on your home birth!
As another home birth mom in a non-CPM-licensed state, I've also noticed both those associations. It seems to me that in the US, to be open to home birth means you are willing to defy the mainstream culture, so people who support home birth here are more likely to hold other views that are outside the mainstream. I came to support home birth in what sounds like a similar way you did - the evidence was in favor of it. I had also experienced (and disagreed with) the mainstream view of "care". But I can easily imagine how women might decide to have a home birth for reasons other than it is evidence-based. They may be more likely to support non-evidence-based practices because evidence is not something they consider or find valuable.
I also agree that it discredits the practice of midwifery in the eyes of the culture when it is lumped together with other "alternative" practices.
Ex post facto salty language + mean-spiritedness warnings hereby issued.
Tara, I completely hear you and agree. Homeopathy is nonsense, and if used instead of a needed real treatment, *dangerous* nonsense.
Great treatment of this topic: http://darryl-cunningham.blogspot.com/2010/06/homeopathy.html
It upsets me greatly, because it often gets recommended by people with whom I've had perfectly fact-based conversations about actual medical studies.
I feel the same about herbal remedies; I am not against them, but I don't want to take anything that hasn't been tested and is not certified at manufacture, which they are not. I want to know exactly what I'm taking.
And yes, I believe in vaccinations, though I think the whole autism scare was greatly fueled by the complete inability of doctors to take worried parents seriously, or to explain why something like thimerosol was being used and why it wasn't dangerous. I got pregnant right at the tail end of all that and worried a great deal because autism is so scary. And it angered me also to hear doctors treat my fears as unwarranted and even stupid, because of course if they were wrong, the stakes were enormously high for my child. In the end I decided to vaccinate anyway, but every round of shots had me knotted up with worry.
And now we have a whole community of people refusing to vaccinate at all because their belief in that aspect of medical science is gone.
A lot of us in the middle feel like on the one hand, we are insisting that the medical profession take us seriously, even if only to prove what they say with good science rather than continue to go on tradition or convenience and insist that they always know best. On the other hand, we have allies who have decided that few to no doctors can be trusted.
I always come back to power imbalances, but in my opinion this situation is a classic case of what happens when a group of people, this case patients, especially women patients, are consistently marginalized, manipulated, and sometimes hurt (because of course doctors do make mistakes, and everyone remembers what happened with thalidomide) by another group with power over them (doctors and hospitals). Trust is broken. Fear and anger take their place.
"They may be more likely to support non-evidence-based practices because evidence is not something they consider or find valuable."
Suzan, I find that statement a little unfair, I know very few people who choose 'alternative' medicine etc. without considering evidence. There are many kinds of evidence that can be considered when making a decision and not all of it comes from a medical/scientific study. How about first hand experience?
Tara, when people go against the grain and find it rewarding, it only makes sense that they would continue to want to be "alternative" in other areas. Especially when they've found a community that welcomes them, as long as they conform to the expectations of that community.
I agree with you that homeopathy makes absolutely no sense and should not work. I have also seen it work, on other people, on my kids, and on me. My very best guess is that it is the placebo effect. There was recently a news headline about how the placebo effect is still potent even when the recipient knows they are taking a placebo. So, while I know intellectually that homeopathic theory is absolutely ridiculous, I still use it a bit now and then, and recommend it to people who often bring me rave reviews about how nicely it worked for them. It isn't really hurting anybody. I know it seems like a complete sham, but when you've seen it seemingly work, especially when other things have failed, why wouldn't you try it when you know it can't possibly hurt you?
I am also the only midwife I know who has vaccinated her children. And although I've never gotten a flu shot, I had the flu this year and I really think I may get a shot next year. Most of my friends either don't vaccinate or do it selectively. I have looked at the evidence and I vaccinated my kids. I refuse to believe propaganda from either side. Regardless of whether you vax or not, there's a small chance that your choice will cause harm to your kids. It is a fact of life and hard to accept. It is easier to believe the black or the white and feel sure that you are making the right choice, so most people pick, black or white. I know it is grey. It is uncomfortable here. I know the shot could be harmful; I know not getting it could also be harmful. It kind of sucks.
There are lots of things about midwifery that are evidence-based, but there is a lot of stuff that isn't. Some of it works sometimes, and not others. Some of the things that most American midwives believe are positively out there, WOO WOO stuff... but it isn't perceived as hurting anybody. I do some of it myself. One example: I tell women with breech babies to "Talk to your baby, tell your baby it is time to turn and get ready to be born." Has there been a randomized clinical trial of breech babies with a control group etc. that tested out whether this works? I doubt it. And if there has been, I doubt the results have been replicated and all that. Who knows if it works? Not me. Some midwives swear it does. I figure it can't hurt, as long as I'm also recommending other things that are more evidence-based.
To conclude my ramble, some stuff is evidence-based, some stuff isn't, and we're all trying to figure out what we believe in and why and what works even when we don't believe. Look hard enough and you'll find exceptions to every rule in the book. And finally, you're not the only one, no matter what you're talking about.
Tara, just wanted to say that I know how you feel. I am ready for the anti-vax moms I know, online and in real life, with whom I agree on many areas of parenting (birth, sleeping, feeding, etc) to recognize that their anti-vax stance is fueled by fear and not evidence. And also, the forum you mentioned has deleted one of my posts before, which was not about vaxing but seemed very unfair all the same.
I offer an apology for any mean-spiritedness - it wasn't intended. Can I cite sleep deprivation?
Robyn,
You make a good point. I was using the term evidence in the way that I assumed Tara was when she mentioned evidence-based practice. Of course there are other forms, including first hand experience. I was just trying to say that I don't/can't/shouldn't know why others choose to have a home birth, but I think it is a good assumption that there are other reasons besides the ones I give for having one myself.
Leigh, you are so correct about the woo-woo stuff! I have always talked to my babies and asked them to turn the right way, etc... and whereas it didn't necessarily do anything for their position, it didn't hurt and it made me feel better to do it. I have never used homeopathy and wouldn't try it before medicine if the situation warranted it (cancer etc), but if nothing else works you might as well try a homeopathic remedy - if you are desperate for a cure you will try anything even if it is nuts-sounding!
It is easy to think of midwifery as sort of woo-woo when a commonly used midwifery textbook is very woo-woo. Like, made-up names for body parts and all. Still a good textbook, but I prefer to call my vulva by its correct name thankyouverymuch. Ya know?
(Suzan - I meant I was being mean-spirited, not you anyone else! My comment timing was just off.)
Thanks everybody for your responses, I'm glad to see my post sparked an interesting discussion!
In response to the commenters on the Facebook post, no, I have not tried homeopathy, and I don't plan to. I don't see how they can be effective from a scientific standpoint (and as I have degrees in biology/biotechnology, that's my personal filter on the world), except as a placebo effect (which can actually be real). But it's true that in general they do no harm (Zicam was an exception, but it was also not quite a true homeopathic), so in general there's no harm in using them for non-critical ailments.
JMT, I too didn't look up homeopathy until after our pre-natal appointment with the homeopath/MD that I mentioned, and that's when I started forming this opinion and noticing these associations. I'm sure you're right that a lot of people using these remedies may not be aware of all the details behind them.
Wish I had time to write responses back to each poster here, there are interesting points in each post! But I need to go to bed so I can get up to nurse in an hour... Will check back though.
Now now, yoni isn't made up, it is Sanskrit! But I am personally advocating for using the word goose. That's the word for yoni we used as kids. How woo-woo is that?
Leigh, I like your take on things. Working inside and outside the medical model, I think a lot about the anthropological concepts of healing vs. curing. (I have a draft of a post on that topic germinating.) Things like homeopathy, certain herbs, talking to your baby to ask it to turn, etc. may not be curative for what they purport to treat; but they may be healing for people who feel that they are able to do something proactive to address a condition they otherwise feel helpless to control. And they may have a placebo effect that is indeed curative. I think what we have to ask ourselves is whether something poses significant psychological, physical, or financial risks. For example, is this a highly anxious woman who will beat herself up for not asking her baby to turn often enough? Does that herb have potential serious side effects? Is this going to be an significant and/or ongoing outlay of $$ for Dr. Quack's special magic vitamin? If it's relatively harmless, then what the heck - like you said, if it works, great, and if not it's not a big deal.
I am curious though, do you ever feel hesitant about recommending certain things to your patients that fall under the "kind of out there but harmless" category? Do you worry they'll think "oh no, my midwife is a closet homeopathic shaman!"? Do you tailor your recommendations to people you think will be receptive (i.e. find them "healing")?