Childbirth and breastfeeding have been hijacked by WEIRD women.
No, I don’t mean that natural childbirth advocates and lactivists are weird, they’re WEIRD: Western, educated, and from industrialized, rich, and democratic countries. It’s a term from psychology highlighting the fact that the bulk of psychology research is done on Western, educated people from industrialized, rich, and democratic countries and therefore, should not be extrapolated to everyone else.
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]WEIRD women view themselves as setting the standards for childbirth and breastfeeding to which other women should aspire.[/pullquote]
There’s nothing wrong with being WEIRD; I’m WEIRD myself. There is something wrong with imagining that being WEIRD makes you a role model for others or entitles you to speak for everyone else. Sadly, that’s just what has happened in the realm of childbirth and breastfeeding:
WEIRD women believe unmedicated vaginal birth and breastfeeding are best. They insist that the scientific evidence supports their beliefs, but in fact those beliefs are often logical fallacies or based on scientific research that is riddled with confounders. For example, claiming that unmedicated vaginal birth is safest is like claiming that those who don’t take blood pressure medications are healthiest. The correlation is real, but they’ve confused cause on effect.
Sure, those who don’t need blood pressure medications are often healthier than those who do, but banning blood pressure medications will not make people with high blood pressure any healthier; indeed it will make them sicker. And waiting until someone is in the midst of a heart attack or stroke to treat their high blood pressure will not decrease heart attacks of strokes; it will just increase serious injuries and deaths.
Sure, women who don’t need interventions in childbirth often wind up with fewer complications than women who do need them, but banning interventions in childbirth will not make people who need them any healthier; indeed it will make them sicker. Waiting until someone is in the midst of an obstetric crisis to use interventions will not improve outcomes; it will just increase serious injuries and deaths. That’s exactly what happened as a result of the UK Campaign for Normal Birth; it was inevitable.
Sure, women who can breastfeed exclusively often have children who are healthier, but that’s because women who can breastfeed exclusively have adequate supply, someone to support them while they step outside the workforce to breastfeed (or a job that allows them to pump), and are typically WEIRD, having more money, greater education and better access to healthcare. Demonizing formula use, as embodied by the Baby Friendly Hospital Initiative doesn’t make babies healthier; it makes many of them sicker. And waiting until a baby is hypoglycemic, dehydrated and or jaundiced to supplement with formula does not improve outcomes; it increases injuries and deaths.
WEIRD women insist that anyone who might want to use technology in childbirth (epidurals, fetal monitoring, C-sections) or infant feeding (formula) is either uneducated or brain washed. They imagine themselves as the ideal to which other women should strive. Therefore, any woman who is not striving toward that ideal hasn’t been properly instructed or is being duped by culture of industry.
There is a great deal of academic work in midwifery that attempts to place blame for the fact that most women don’t want unmedicated vaginal birth without interventions. Grantly Dick-Read, the father of natural childbirth, insisted that it is culture that causes women to believe that they want pain relief in childbirth. Contemporary midwives and natural childbirth advocates blame medicine for promoting technology, the media for (accurately) presenting childbirth as both painful and dangerous, and male physicians who wish to commit “obstetric violence.”
There is a great deal of academic work in lactivism that attempts to place blame for the fact that many women can’t or don’t wish to breastfeed. The villain of choice in these scenarios is the formula industry, an industry that engaged in villainous conduct in the developing world in the 1970s. But the unethical conduct of formula companies in the past had nothing to do with the safety of formula. Promoting formula in the developing world can lead to infant illness and death because the water used to make it was often contaminated. Formula companies behaved in an immoral fashion, but there is nothing immoral about formula.
WEIRD women practice medical colonialism by claiming to emulate indigenous women and by lobbying international health organizations like the WHO and UNICEF to promote WEIRD beliefs in developing countries. Sadly, WEIRD women are often motivated by a sense of class and race superiority. On the one hand, natural childbirth advocates and lactivists have created with an exoticized view the poor indigenous Other (generally black or brown) and claim to be emulating them. On the other hand, they are pleased to distinguish themselves from the poor industrialized Other within their own countries (both black and white) whom they conceptualize as ignorant and lazy.
Medical colonialism isn’t merely morally repugnant, it actually kills babies. Consider the plea from Doctors Without Borders begging for formula for infants in Mosul as reported by CNN, Don’t make babies rely on breastfeeding in war zones:
The mothers who need [formula] are those facing down life-and-death situations each day, often while caring for multiple children in the shadow of war. That giving infant formula to them is so controversial speaks to a policy tripwire few outside the humanitarian realm even know exists: global “breastfeeding first” policies.
Promoting breastfeeding is a laudable goal, but in some cases, international policy ends up determining women’s on-the-ground reality, even in wartime settings, rather than the other way around. In the process, policies run the risk of treating nursing mothers as children themselves, whose needs are best known by global policy makers sitting thousands of miles away, not doctors and humanitarians nearby doing their best to help.
WEIRD women practice medical paternalism, imagining that unmedicated vaginal birth and exclusive breastfeeding must be promoted as standards to which all women should be forced to achieve. Contemporary midwifery and lactivism are all too often based on the notion that midwives and lactivists know better than women themselves. In a bitter irony, midwifery and lactivism have exchanged the patriarchy for the matriarchy.
That doesn’t mean that contemporary female arbiters don’t believe completely in their view of childbirth; they do. But believing in the value of paternalism does not justify paternalism.
In countries like the UK where midwives are gate keepers of maternity care, it is the midwife who determines whether a patient needs pain relief and whether she gets it, not the patient. It is the midwife who determines whether a woman’s performance in labor is successful, not the patient. They have perfected delaying tactics (“You don’t really need it.””You’re doing great.” “You’re almost there.”), shaming tactics, and don’t hesitate to resort to simple obstruction by refusing to call for an anesthesiologist when the patient requests it.
Such paternalism isn’t merely unacceptable, it can be deadly as the UK experience with the Campaign for Normal Birth has shown. Scores of babies and mothers have died because midwives, in their belief that they knew best, refused to employ interventions to prevent or treat complications and refused to consult with the medical specialists who could have saved lives.
WEIRD women have moralized their ideology so that they can label those who have C-sections or formula feed by choice as selfish, lazy, ignorant and duped by culture or corporations.
This type of thinking has reached its apogee in lactivist memes such as this one:
If you don’t breastfeed you’re a selfish cunt.
Although the meme is crude, the sentiment at it’s heart is all too common. WEIRD women want to believe they are superior mothers. They wish to believe they are models that other women should emulate. And they need to believe that they set the standard to which other women not merely should aspire, but should be forced to aspire.
But WEIRD women aren’t a standard, not even for other WEIRD women; they’re just a particular cultural group whose views are not superior than the views of those who believe differently.
There’s nothing wrong with being WEIRD, of course, but there’s something very wrong with the conviction that being WEIRD means your views should be promoted by medical systems, governments and international health organizations. WEIRD women have hijacked childbirth and breastfeeding and we need to take it back from them.
