Midwives and lactation consultants treat women like children

asian mother sitting on the sofa angry pointing

We treat children differently than we treat adults.

  • We presume we know better than they what they need.
  • We believe we have an obligation to guide them on the right path.
  • We know we understand risks better than they do.
  • To the extent they disagree, we ascribe it to immaturity and lack of knowledge.
  • We are sure that if they “understood” what was at stake, they would want what we want.
  • We accuse them of being inordinately swayed by outside pressures.
  • We feel obliged to force them to do things they don’t want to do “for their own good.”

All these reactions are perfectly appropriate if we are talking about a seven year old. They may even be appropriate if we are talking about a seventeen year old, although they may not. Surely, though, they are an inappropriate as a way to treat adult women.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]It is unacceptable to treat women like children even for “their own good.”[/pullquote]

Which begs the question:

Why do midwives and lactation consultants treat women like children?

Consider how midwives treat women who wish to have maternal request C-sections instead of vaginal births:

Most midwives assume that vaginal birth is better than C-section except in rare circumstances.

They imagine they have an obligation to guide women (“support them”) toward vaginal birth.

They believe they understand the risks better than women do even though they habitually ignore many of the risks that are most relevant to women like future incontinence and sexual dysfunction.

To the extent that women disagree, they ascribe this to lack of knowledge about the “real” (often rare, sometimes merely theoretical) risks.

They are sure (and they constantly reassure each other on social media) that women want what they wish to give even if the women themselves appear not to realize it.

To the extent that women disagree, they imagine that they are “socialized” to fear the pain of birth or swayed by obstetricians playing the “dead” baby card.

That’s how they justify their pressuring women to avoid C-sections, avoid interventions, and justify actively seeking to limit women’s access to epidurals.

But that’s nothing compared to lactation consultants:

Lactation consultants have codified treating women like children into the oxymoron of the Baby Friendly Hospital Initiative. It’s an oxymoron because it isn’t friendly to babies. It actually harms them by increasing hospital readmissions for dehydration and jaundice and by increasing infant deaths within the hospital from falls from or being smothered in maternal beds.

The baseline assumption of the BFHI is that women can’t be trusted to know what’s best for themselves and their babies. They must be subjected to a rigidly curated propaganda offensive.

Lactation consultants are sure (despite scientific evidence to the contrary) that breast is best for every mother and baby. They are so sure that they have enshrined their belief in the phrase “breast is best” and plastered it to the walls of midwives’ offices and hospital corridors. They endlessly harangue women about the “benefits” of breastfeeding, most of which have proven illusory.

Lactation consultants believe they understand the risks of formula feeding better than mothers do, but most of those presumed risks are based on poorly done epidemiological research riddled with confounders and have not occurred in real world experience.

To the extent that women wish to use formula, lactation consultants ascribe their desire to ignorance, lack of “support” and marketing by formula companies (despite the fact that they have banned marketing by formula companies).

Lactation consultants seek to restrain women who wish to use formula by placing stumbling blocks in their way: locking up formula in hospitals, forcing them to sign formula consent forms, limiting what health professionals are allowed to tell them on the topic.

Lactation consultants have gone so far as to fabricate risks that don’t even exist such as the “risk” of nipple confusion from a bottle and the “risk” of formula supplementation even though research shows that formula supplementation prevents hospital readmission and leads to increased rates of extended breastfeeding.

Lactation consultants are sure that their tactics are justified by an obligation to force women to breastfeed for “their own good” and their babies’ health.

But women are not children and it is completely inappropriate to imagine that they are. Women are adults capable of determining what is best for themselves and their children.

It follows therefore:

Women should not be pressured into avoiding interventions and epidurals or pressured into having a vaginal birth

Women who don’t find empowerment through their reproductive functions don’t need to be educated or “supported” into making choices that are different than the ones they articulate.

The arbiter of clinical practice MUST be scientific evidence, not intuition and certainly not providers seeking validation of their own choices by patients mirroring them back.

This applies equally to breastfeeding. As between breastfeeding and formula feeding there is no “best” way to feed a baby.

Midwives and lactation consultants need to hold themselves to a higher standard than what they currently embrace. It is completely unacceptable to treat women like children even “for their own good.”