Is midwifery/breastfeeding research real scientific research?


There’s a critical difference between midwifery/breastfeeding research on the one hand and real scientific research on the other. Indeed, midwifery/breastfeeding research has more in common with Big Pharma research than it does with actual science.

What’s the difference?

Scientific research seeks to learn, specifically to learn how the human body works and how to maximize healthy outcomes. Midwifery/breastfeeding research, like Big Pharma research, seeks to justify the product that they are already selling.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Midwifery/breastfeeding research, like Big Pharma research, seeks to justify the product that they are already selling.[/pullquote]

Don’t believe me?

The hallmark of Big Pharma research is that it always shows that the drug being tested is safe, efficacious and worthy of being prescribed routinely. No doubt Big Pharma does research that shows that it’s drugs aren’t safe, don’t work and shouldn’t be prescribed, but that research is never allowed to reach the light of day.

Search any midwifery journal for whichever years you choose and you will find that anything a midwife can do is safe, efficacious and worthy of being prescribed routinely. You will never find a paper that calls into question any aspect of contemporary natural childbirth advocacy.

Similarly, if you search any breastfeeding journal, you will find that every single article concludes that breastfeeding is safest, always better than formula and therefore worthy of being forced on every mother and baby. You won’t find papers that call into question the assumed superiority of breastmilk.

That difference extends to professional conferences.

Attend obstetric conferences and you will find countless sessions on “controversies in obstetrics.” When is induction appropriate? What’s the right C-section rate? What’s the best way to prevent postpartum infections? In those sessions there are always people on both sides of the controversy, arguing their point of view vigorously and the attendees are encouraged to make their own decisions based on what they have heard.

Attend any midwifery conference, in contrast, and it is a festival of mutual support and midwifery promotion. There are no controversies in midwifery because everyone agrees a priori that midwifery care is the ideal, vaginal birth is the goal, and safe outcomes are secondary and perhaps not even mentioned.

There are no controversies in breastfeeding either. Everyone in the profession agrees a priori that breastfeeding is the one and only spectacularly superior way for every mother to nourish every child. Everyone agrees that the central focus of breastfeeding research should be finding new benefits and. New ways to promote it and no one is discussing any drawbacks.

This reflects a profound difference in focus.

Scientific research always starts with the null hypothesis: the new technique/drug/intervention is no better than the old. The object of scientific research is to determine if the null hypothesis is true or false. Either conclusion is acceptable since the point is to learn.

Midwifery/breastfeeding research starts with the conclusion: unmedicated vaginal birth/breastfeeding is superior and worthy of being promoted and sold. It bears a striking resemblance to Big Pharma research which starts with the conclusion that the product under study is great and should be marketed as such.

That’s why it’s nearly impossible to take most of midwifery/breastfeeding research seriously. It isn’t research if the conclusion has been determined in advance.

There’s another important difference in midwifery/breastfeeding research and real scientific research and that is the arrow of time.

Real scientific research looks forward and believes that we can often do better than nature, cure more disease, save more lives. Midwifery/breastfeeding research, in contrast, always looks backward to prehistory, believing that we can’t possibly improve on nature and ignoring the fact that infant and maternal mortality in nature are astronomically high.

That means that we should approach midwifery/breastfeeding research the same way we approach Big Pharma research, alert for conflicts of interest and aware that the research was designed to reach a predetermined conclusion. That doesn’t mean that all midwifery/breastfeeding research is wrong; just like Big Pharma research, there is plenty that is correct. But no one should think that either is real scientific research.