Why does Lamaze think that your birth is their business?

The folks at Lamaze have (inadvertently?) given us insight into their belief that your birth is their business. Sharon Dalrymple, discussing the forthcoming 5th International Normal Labour & Birth Research Conference, taking place next week in Vancouver, bemoans the fact that Lamaze is having a tough time convincing women to do it “their way.” Hence they have embarked on an elaborate public relations campaign:

Lamaze International hired a public relations market research firm to conduct research and identify which messages are the most effective for persuading women to adopt normal birth practices. (my emphasis)

Well, at least she’s honest. Lamaze considers its mission not merely to supporting women who want a birth without interventions, but, in addition, convincing other women to want what they want.

This reminds me of nothing so much as a dominating, interfering mother. You know the type: the mother who believes that every choice her daughter makes is a statement about the value and correctness of the mother’s personal choices. The mother who believes that her daughter’s choices are not merely different, but a personal reproach. The mother who believes that it is her mission in life to convince her daughter to do it her way.

And, as is often the case with the domineering, interfering mother, she starts with the premise that if her daughter only understood the intrinsic wisdom of her mother’s choices, she would copy them. But Lamaze, like many domineering mothers, has a problem. Most women aren’t sure what their mothers are complaining about. In particular, women refused to accept that an intervention free birth is the only “normal” or “natural” way to have a baby:

Indeed, the research showed that the meaning of the words “normal” and “natural” was not interpreted by the women and educators the same way. For example, 36% of women felt that ALL vaginal births are “normal birth”, while 63% of Lamaze Certified Childbirth Educators defined “normal birth” to be a birth without medical intervention. Women and Lamaze childbirth educators are likewise divided when deciding if the terms “natural birth” and “normal birth” are generally similar or generally different in meaning.

Lamaze had been hoping to trade on the cultural assumption that “normal” and “natural” are intrinsically superior and that, therefore, “normal” and “natural” could be used as code words for “best.” Evidently some daughters women are too dense to make the connection so coded appeals must be dismissed in favor of more overt declarations:

Lamaze International found that the words safe and healthy are the most effective words for communicating and promoting the birth practices Lamaze has endorsed for years. Everyone wants a safe and healthy birth. Mothers are particularly motivated to keep their baby and themselves safe and healthy…

Just like a domineering, interfering mother, Lamaze wants you to know that its choices aren’t merely the best choices, they are the safest and healthiest choices. Just like a domineering mother, Lamaze declares: if you really cared about your baby’s health and safety, you’d do it my way.

Not only is this as obnoxious as any interfering mother who proclaims the superiority of her personal choices, it is just as wrong. The practices that Lamaze declares to be the safest and healthiest are nothing more than their personal preferences.

Consider some of the 6 “best” practices that Lamaze promotes:

Let labor begin on its own: There is no scientific evidence that a spontaneous labor is better or safer for babies. Indeed, there is copious scientific evidence that the risk of stillbirth begins increasing before 38 weeks and rises steadily with each day that passes. That risk must, of course, be balanced against any risks of induction to the mother, but, even so, it is factually false to claim that spontaneous labor is safer. Indeed, as the rate of induction has risen in the US, the rate of late stillbirth has fallen dramatically.

Walk, move around and change positions throughout labor: There’s no scientific evidence that moving around or changing positions has any impact on labor, let alone a beneficial impact. According to the Cochrane review on position in labor, “There were no differences between groups for other outcomes including length of the second stage of labour, mode of delivery, or other outcomes related to the wellbeing of mothers and babies.”

Avoid interventions that are not medically necessary: In other words, refuse an epidural; yet there is no scientific evidence that childbirth without pain relief is better, safer, healthier or superior in any way to childbirth with pain relief. No matter. The women at Lamaze think that they are superior for refusing pain medication, so you should refuse it, too.

Dalrymple concludes:

As a result of these and other findings, Lamaze International updated our six evidence-based key practice papers in Fall 2009 to ensure women realize that these practices simplify the birth process with a natural approach that helps alleviate fears and manage pain, with the ultimate goal of keeping labor and birth as safe and healthy as possible for each individual woman. Every woman needs clinicians who promote, support, and protect these six practices.

These practices simplify the birth process? Where’s the evidence for that.

These practices alleviate fears and manage pain? They most certainly do not.

These practices keep labor as safe as possible? All the existing scientific evidence indicates nothing of the kind.

Every woman needs clinicians who promote these practices? Exactly who is Lamaze to tell women what they “need”?

The folks at Lamaze sound just like the domineering, interfering mother who tells her adult daughter: do it my way or else. And as in the case of the domineering interfering mother, the adult daughter should ignore the remonstrances and reproaches, recognizing that they have nothing to do with the daughter’s wellbeing and everything to do with the mother’s self-justification.

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