ok i want to go farther into why i keep a raised eyebrow toward ‘evidence based’ midwifery.

first off, there is almost no position in midwifery which does not have an acceptable amount of evidence behind it.  reknown scientists, large studies, analysis of anecdotal evidence and surveys, cutting edge discoveries, fundamental scientific facts, etc.  so when i watch debates between birth workers about what practices are the most ‘evidence-based’ it reminds me of being a debater in high school.  i could easily argue one side or the opposite and win.  and what i learned was that using the basis of evidence, i could sufficiently claim nearly anything.  logic and the scientific method are tools.  not truths.

some may say that this is a cynical point of view.  well, first you should probably wikipedia the word ‘cynic‘ and realize what  cynic really is:

Cynicism (Greek: κυνισμός), in its original form, refers to the beliefs of an ancient school of Greek philosophers known as the Cynics (Greek: Κυνικοί, Latin: Cynici). Their philosophy was that the purpose of life was to live a life of Virtue in agreement with Nature. This meant rejecting all conventional desires for wealth, power, health, and fame, and by living a simple life free from all possessions. As reasoning creatures, people could gain happiness by rigorous training and by living in a way which was natural for humans. They believed that the world belonged equally to everyone, and that suffering was caused by false judgments of what was valuable and by the worthless customs and conventions which surrounded society.

so i am fine with being a cynic. hell, i wish i was more cynical than i am.

but of course those who hear in my skepticism toward the automatic reification of evidence midwifery, a pronounced cynicism are probably perceiving me as thus:

The ancient Cynics rejected conventional social values, and would criticise the types of behaviours, such as greed, which they viewed as causing suffering. Emphasis on this aspect of their teachings led, in the late 18th and early 19th century,[18] to the modern understanding of cynicism as “an attitude of scornful or jaded negativity, especially a general distrust of the integrity or professed motives of others.”[19] This modern definition of cynicism is in marked contrast to the ancient philosophy, which emphasized “virtue and moral freedom in liberation from desire.”[20]

my problem with evidence midwifery is that for any position that a midwife advocates for there is an abundance of evidence upholding and illustrating her position.  is circumcision safe or harmful?  is pitocin dangerous or helpful?  what foods are the best to eat during pregnancy?  how much weight is proper to gain during pregnancy?  etc.

all of these and more questions i have seen being debated with both sides having a stackful of decent studies and theories backing them.

and then the question turns to: what is the appropriate and proper criteria that we should use to determine which studies are stronger evidence?

all the while ignoring that the big studies, the double blind ones, the years-long ones are the ones that get government and major university funding and support.  and so we are allowing the powers that be to decide what scientific claims have the most validity.  at the heart of  it, money, how much money a study receives, determines what is considered proper evidence based midwifery.

and i am too much an ancient cynic to trust the powers that be, the ones with the most privilege and the least amount of accountability, to determine what is best for me, my body and my child’s body.

so while scientific evidence allows for me to create a sort of intellectual, mental map of what is going on in terms of reproductive health, it does not, for me, determine any person’s path through pregnancy, birth and beyond.  the path is made by walking.  and each person’s is unique.

this is also why i say that while i may be a research geek, personally, i dont think it is necessary to be a research geek to attend birth.  the path is made by walking.  and you dont need to have a detailed map in order to walk and walk with someone.

trust me, ive traveled around the world and have the worst sense of direction, can barely read a map.  and yet, that doesnt stop me.  life isnt safe.  its an adventure.  and so is childbearing.

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