Archive for March, 2013

Science: Farce or Fiction?

March 30, 2013

ImageI’m afraid to say, that my life-long love affair with science is over.   I’m only touching the tip of the iceberg in my realisation that it is all a farce.  It is our modern day religion, telling us how to think, what to think, and believing that it has the final say on everything, and is the truth, the whole truth and nothing but the truth.  It is full of fantasy, power and influence. 

My disillusioned state follows a once held strong belief in science, not so long ago.  After all, science is necessary. It is a sign of our progress as modern humans.  It provides us with a tangible way of clarifying which interventions, services and drugs actually work.  The NHS needs science to help it decide which services to pay for, and which services to avoid.  As a mother, we need it to help us make important decisions.  For example, about whether to birth at home or in hospital, whether to have a section for a breech presentation, whether to insist on delayed cord clamping, whether to have antibiotics for Strep B,  etc. When I teach my classes, I only advise on areas which seem to be indisputable, according to rigorous, and repeated studies, such as that it is not advisable to cut the cord immediately after birth.  Areas that are not so clear, such as whether vitamin K is beneficial for a healthy full term baby, I do not advise on.  In other words, I use science to inform my teaching.

But, as I said, I am disillusioned. Of course, those of you who are more sophisticated in your thinking will recognise that I am going through an adolescent phase of rejecting my parental roots.  I know, really, that science has its strengths and its weaknesses.  It is not one or the other. But at the moment, I’m too busy rebelling and being cross to be sophisticated and wise.

The reasons I’m feeling so cross with science can be exemplified in the most ridiculously misguided piece of research I have ever seen.  And yet, it is the Rolls Royce of science because it is a “Randomised Controlled Trial” – the goal of all that is great and good in science.  Let me tell you a bit about it.  They were looking at the theory that if a mum has a back to back baby in labour, she can benefit from moving around in labour, to help baby turn to face her back.   We kind of “know” this in midwifery.  Mums intuitively move into positions that benefit the birth.  I’ve often said in class that if mum wants to swing from the chandelier, we must let her, because there’ll be a reason which we can’t necessarily see.   The youtube clip that is on my facebook page of a chimpanzee birthing ON HER HEAD kind of supports my assertion.  So, this RCT put this to the test.  Their conclusion went like this: “Our study failed to demonstrate any maternal or neonatal benefit to a policy of maternal posturing for the management of OP position during labor”.

Well, I was surprised.  Very surprised.  So I took a closer look at the study. I have been trained to critique research, but I didn’t need training to critique this gem!  These mums ALL had their waters broken in early labour – it was a criteria for inclusion.  If waters have been broken, mum has been PUT on her back, had her legs spread, while some-one not only puts their fingers up there, but do so with a knitting needle.  This is not conducive to normal physiological birth.  The second glaringly obvious and stupid facet of this research was that the mums were all told WHICH position to adopt and WHEN.  This is a sure fire way to interrupt the natural rhythms of labour.  Of course, the defining feature of an RCT is that all subjects are treated in exactly the same way, so that extraneous factors don’t skew the results, so I can see how they decided to make all women get in the same position at exactly the same time (with internal exams, held on their back of course). But this is the problem with RCTs.  You have to control things for it to be an RCT.  And the very essence of natural physiological birth, is not to intervene or control anything, because intervening or controlling will throw nature off course.  

This misguided piece of research was not only published, but overnight, it swept its way through all the forums that I am part of – as evidence that positioning makes no difference.  And now, if I am supporting a mother who wants to move around in labour rather than be tied to the bed with an electronic foetal monitor, the doctor can “inform” her that it will make no difference to her labour.

Furthermore,  other “clear” scientific information gets ignored.  For example, the NHS are still cutting the cord immediately when baby arrives.  The NHS are still be recommending that babies be left to cry themselves to sleep.  The NHS are continue to scan women routinely at 12 weeks.  The NHS are still routinely putting women on electronic foetal monitors. The NHS are still automatically doing caesarean sections for breech presentations.  The NHS do not support hypnosis as a tool for therapy.  It’s an irony that we are struggling to get the NHS to recommend delayed cord clamping,( in the face of overwhelming evidence of the harm immediate clamping does),  and yet one itsy bit of research about caesarean section for breech babies changed NHS practice overnight!  We are now spending years trying to undo the damage of lack of skills in delivering breech babies vaginally.

So, as I said at the beginning, science  is our modern day religion, telling us how to think, what to think, going unquestioned, as the truth, the whole truth and nothing but the truth.  But most religions have a heart.  Where is the love, the song, the joy, the positivity? I’m going full circle now, because science is catching up.  There is now so much out there looking at the benefits of loving, positivity, touch, humanity, giving, healing.  Okay, so they are measuring hormones levels in blood samples, and brain activity, but science is helping our society to understand the mind body connection better, and to understand the power of compassion, kindness, mindfulness, hypnosis and love.  Maybe science isn’t so bad after all.

 

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