There is a growing body of evidence that childbirth and breastfeeding professionals, ostensibly dedicated to helping women and babies, are harming them instead.
Over the years I’ve explored a variety of reasons for this — unthinking, ahistorical veneration for “nature”; desperation for professional autonomy; desire for profit — but there’s one that might be more important than all of the others. Childbirth and breastfeeding professionals are smug.
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Smug is the moral equivalent of the Dunning Kruger effect.[/pullquote]
According to Dictionary.com, smug means:
contentedly confident of one’s ability, superiority, or correctness
If there’s one thing that unites childbirth and breastfeeding professionals, from UK midwives to homebirth midwives, from doulas to lactation consultants, from Lamaze International to the Baby Friendly Hospital Initiative, it’s the fact that they are contentedly confident of their ability, superiority and correctness compared to other health professionals and compared to women themselves.
The thesaurus is rich with synonyms: complacent, egotistical, pompous, self-righteous, self-satisfied, conceited, holier than thou.
All can be applied to many childbirth and breastfeeding professionals, rendering them impervious not merely to criticism, but to reality.
Babies dying at the hands of homebirth midwives who are more concerned with promoting “normal birth” than live babies?
No problem. From Ina May Gaskin to Henci Goer to Melissa Cheyney, they are smug:complacent, egotistical, pompous, self-righteous, self-satisfied, conceited and holier than thou.
Women traumatized by UK midwives who are more concerned with promoting “normal birth” than promoting women’s autonomy, being denied epidurals, needed C-sections, and compassionate care?
No problem. From Soo Downe to Sheena Byrom to Cathy Warwick, they are smug: complacent, egotistical, pompous, self-righteous, self-satisfied, conceited and holier than thou.
Babies sustaining brain injuries and even dying because lactation professionals are more concerned with promoting breastfeeding that healthy babies?
No problem. From the Baby Friendly Hospital Inititative, to lactation consultants, to researchers who produce endless numbers of crappy papers hailing the “benefits” of breastfeeding, they are smug: complacent, egotistical, pompous, self-righteous, self-satisfied, conceited and holier than thou.
Smug is the moral equivalent of the Dunning Kruger effect.
According to Dr. Dunning:
What’s curious is that, in many cases, incompetence does not leave people disoriented, perplexed, or cautious. Instead, the incompetent are often blessed with an inappropriate confidence, buoyed by something that feels to them like knowledge.
What’s equally curious is that, in many cases, injured and dead babies do not leave childbirth and breastfeeding professionals disoriented, perplexed or cautious. Instead, impervious to the harm they cause, the smug are — say it with me now — complacent, egotistical, pompous, self-righteous, self-satisfied, conceited and holier than thou.
They “know” unmedicated, vaginal birth is best for every woman; they “know” that breastfeeding is best for every baby. The injured, traumatized and dead do not dent their overweening self regard and unwavering certainty that they are correct.
Those in the grip of the Dunning Kruger effect lack knowledge; they literally don’t know what they don’t know. Those in the grip of “smug” lack humility; they literally cannot imagine being wrong despite the injured, dead and traumatized who are screaming into their faces that they are hurting, not helping.
Doctors aren’t immune to smug. Indeed the history of medicine is a history of doctors feeling smug while injuring and killing patients by bleeding them, balancing their “humors” or feeding them arsenic and mercury to “cure” them. Those doctors “knew” the process was correct even though the outcome was dreadful. The operation was a success but the patient died; it must have been the patient’s fault because smug doctors would not admit it could be their fault.
Childbirth and breastfeeding professionals should learn from that embarrassing history. The birth can NEVER be a success if baby or mother are injured or die. Breastfeeding can NEVER be a success if a baby is brain injured or dies or if a mother suffers depression and guilt. Childbirth and breastfeeding professionals need to stop smugly asserting that it must be the patient’s fault — she was lazy, weak, didn’t trust birth and breastfeeding enough — because they cannot admit it is their fault.
When babies and mothers die in the pursuit of normal birth, midwives need to own it, investigate it and change their practices. When babies and mothers are harmed in the pursuit of exclusive breastfeeding, lactation professionals need to own it, investigate it and change their practices.
The last thing they should be doing is being complacent, egotistical, pompous, self-righteous, self-satisfied, conceited and holier than thou.
They shouldn’t be smug; they should be horrified.
