> There is a basic plan for birthing.  It's not a very good one, frankly.
> It's based on birthing babies that just barely fit through mom's pelvis
> and don't come out easily. So there are interventions to help with
> difficulty or catastrophe and their USE fits onto a spectrum between
> essential and unnecessary.   But surely they are used because someone
> believes they are necessary and needed at this moment, to ensure a
> healthy outcome, again, at this moment.=20
>
I agree with you that everyone involved in birth and baby care is doing what
they believe is best and most likely to contribute to health (although I
also have my cynical moments!). But I don't agree that the basic plan for
birthing "is not a very good one." It IS a good one, but I think we don't
always understand the complexity of the process and how the elements all
work together.

I think any interventions need to be approached with great caution. Birth is
an interconnected system, and an intervention intended to improve one part
of it can have negative and harmful effects on other parts. We give mothers
epidurals to reduce pain, then find ourselves dealing with non-latching
babies with poor suck and mothers with overly-engorged breasts. We do more
Caesarean births because it is believed to be healthier for the baby, but we
don't entirely know how that period of separation affects the development of
the mother-baby relationship. I remember Michel Odent talking about studies
that suggested people born by Caesarean were more likely to commit suicide
as adults and less likely to want to have children themselves. (I don't have
the references for these.) So there may be long-term consequences we are not
aware of.

We have a long list of interventions that were intended to be helpful, and
in fact may have been helpful in some cases, but which ended up being used
too broadly and caused problems. Heck, heroin was recommended at one time as
a tonic to improve health. We all know what's happened with formula use. We
had fetal monitors - intended to reduce problems during labour, they ended
up only increasing the Caesarean rate with no benefits. We had DES to stop
miscarriage. We had X-rays of pregnant women. When I was having my first
baby, the standard practice at the hospital was to deliver every baby by
forceps because it was believed this would be less harmful to the baby and
mother. Then they noticed all the mothers had incontinence problems (and
large episiotomies). So we keep messing with the system and trying to
improve it, only to end up causing more problems.

Yes, there are times when interventions are helpful and beneficial. The
danger comes in prescribing them widely. And yes, this is
breastfeeding-related because birth often has a profound effect on
breastfeeding.

Teresa Pitman
Guelph, Ontario

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