Pat writes:

<I don't know how to do it. The revolution, that is.  We were a product of
the times, the 60-70's, the women's revolution.  What can we use to trigger
it this time?>

I don't know either Pat. I think the bottom line is economics.

I was working both as a maternity inservice clinician in OB and with
an independent childbirth education organization in the late 60's/early
70's, doing my part to help achieve the "first childbirth revolution", with
an accent on breastfeedomg education among all the other facets. (I had
decided to  "get around the doctors and the hospitals" and the institutional
environment that would not honor the need for prenatal breastfeeding
education and the early initiation of breastfeeding, etc., by going straight
to the parents themselves.) This was at the dawn of perinatal medicine,
which directly spawned the trend of managed obstetrical care in the late
70's and 80's.


From a position of some small authority inside the institution (privileged
to choose if I wanted to attend grand rounds, and having the role of
recording the minutes of the OB-GYN staff meetings, as well as those of the
the Perinatal Mortality Committee) I observed a gradual economic shift
precipitated by the drop in the birth rate. When the number of births began
to wind down after the WW II and Korean post-war baby boom had slowed,
simultaneously the development of BCP and other contraceptives gave women
more control over the number of children they would have.


This was a two edged sword for the OB profession (and the hospitals as
well.) I watched (and listened) as it dawned on the physicians to "search
for new markets" by co-opting the phrase "painless childbirth" and
encouraging hospitals to begin to offer their own childbirth education
classes. This made childbirth educators into hospital employees, thus
establishing an economic link of semi-control for the physicians that at
least made the CB educator very wary (as so aptly expressed by Nikki) of the
statements she made about medications, spinals, epidurals, etc. etc.


I have since watched in dismay for 2-3 decades the number of women I
encounter in the public health arena who see absolutely no need for
childbirth education (and thus miss a source of breastfeeding education),
"since I'm not going to feel anything anyway."


I did not openly attempt to educate my grandchildren about birth when they
were young, though they knew in a distant way what I did for a living. I
never dreamed the culture would reverse itself so rapidly. I thought we had
"done it, for good" when we accomplished some modest success in the "first
childbirth revolution" in our town. But the wheel has to be constantly, if
not reinvented, at least updated and redesigned. And advertised!


I recently watched and listened as my own granddaughter experienced all
this. She perfunctorily agreed to attend a condensed weekend childbirth
education experience with me as her husband was overseas. But her heart
wasn't in it, having been educated even before puberty by the horror tales
she had overheard. She had declared to me "I have known since I was 10 years
old that I wanted to be drugged and knocked out when my babies were born."
Although, when the OB very rationally explained the possible risks
associated with performing version on her baby in breech presentation, she
did turn to me and ask me what I would do it it were me, I had to honestly
answer her at that moment in time: "This is your body and your baby and you
have to make that decision."


At this late date in her life (21) she had "self-selected" her philosophy by
fortifying herself with more of the same CSI-SVU type horror tales she had
known by age 10. (BTW, I observed that she is a huge fan of this show and
others of the same genre, watching re-runs for hours.)


After 4 hours of early spontaneous labor a day before her scheduled CS, she
welcomed the IV with outstretched arms, and the epidural with great
gratitude, as the fulfullment of her expectations. (Thank heaven for my
updated knowledge about the power of skin to skin!). Now, it seems almost
too late to try to effect the thinking of my very "academically with it" 18
year old granddaughter, and even my very bright 14 year old granddaughter,
as they are part and parcel of the culture surrounding them. Each of their
own mothers has had some variation of a horror tale to tell them. (I haven't
given much thought to the grandsons' ideas of birth, as I feel more
motivated at the moment to use my grandmotherly mandate to address them all
about other aspects of reproductive responsibility;-)

If there is a glimmer of hope, I think it must lie in each mother and father
(and grandparents, aunts and uncles, etc.) being careful to contribute and
be vigilant about how the philosophy of childbirth (and breastfeeding)
becomes woven into the daily lives of young girls and boys when they are
much more of a "captive audience". This base must be formed in the early
years of childhood, for future reference, long before the tales (and TV
shows, and internet sites sponsored by profiteers) of the culture can reach
them, and certainly before the hormones of puberty make them "devalue"
advice from anyone but their peers and the media.


Sounds familiarly like LLLI has been telling us for years: For eons, women
have succeeded at breastfeeding because they have watched and assimilated it
into their fantasies of womanhood daily as children and are surrounded by
experienced women when they have their children.


Perhaps if there is to be another childbirth revolution, we must plant it
early, in the sunlight of our value system, and water and fertilize it
carefully in the fantasy life of our young children.

Jean
************
K. Jean Cotterman RNC, IBCLC
Dayton, OH USA

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