Monday, October 12, 2009

The Evidence Says: Historically We Should Know Better

I am in the midst of reading the new book Impact of Birthing Practices on Breastfeeding 2nd Edition by Linda J. Smith.

Admittedly, she had me hooked right away with Forewards by Nils Bergman and Michel Odent.

But then, it happened! She swept me away into history with a whole chapter on Historical Perspectives on Childbirth And Breastfeeding.

Hauntingly beginning this first chapter was a quote from Dr. Grantly Dick-Read: "The childbirth practices of a nation [are] the reflections of that nation's beliefs concerning the integrity and dignity of life, and [influence] that nation for good or evil, and ultimately the world itself."

Dynamic women throughout our recent past became the heralds of what is right for women and babies. From the beginnings of La Leche League, to Lamaze, to ICEA...including the 1989 shift by WIC to more breastfeeding friendly practices, Healthy People 2010 initiatives, and American Academy of Pediatrics strong 2005 policy on breastfeeding. It is all there plus the Baby Friendly Hospital far back as 1989 there was a call in the joint statement of UNICEF and WHO Protecting, Promoting and Supporting Breastfeeding: The Special Role of Maternity Services.

Sadly to date and some by no fault of anyone, doulas are being restricted in the labor/birth area of hospitals (now mostly due to the H1N1 scare), childbirth educators are losing their jobs (due to lack of attendance, in part due to care providers discouraging attendance and partly due to our hurried society), and many (too many) nurses still do not practice evidence based maternity care. From my colleagues I still hear: "Change is hard", or "We have always done it this way." or "Do you know how hard it is to change policy?".

Worse yet, nursing students are not being told in nursing school or clinicals about how to care for women who do not want or need medication during a birth. They do not receive the information. And frankly, neither don't most residents.

Imagine taking your car to the mechanic. You find out she has only been partially trained.

Imagine the repair man coming to your home to fix your oven. You find out he has only been partially trained.

The airline pilot on your next flight has only been partially trained.

The city bus driver who picks you up has only been partially trained.

After reading only the first chapter, I know that historically we should know better. I know that the mechanisms are in place for better practice. Linda Smith has over 500 references in this book to substantiate everything she says.

We just need to take Nike's advice:

Solid scientific evidence shows that minimizing interventions in birth and policies that preserve normalcy are associated with faster, easier births; healthier, more active and alert mothers and newborns; and mother-baby pairs physiologically optimally ready to breastfeed.
~ Impact of Birthing Practices on Breastfeeding
Linda J. Smith

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