Tuesday, January 25, 2011

A World of Safety Nets

“Differing definitions of safety also play a part. Doctors often feel unconcerned about side effects – even life-threatening side effects – provided they know what they will do to treat them and that the life-threatening ones occur reasonably rarely. So, two doctors writing for their colleagues can say reassuringly: “These [epidural] complications should not cause fatalities if trained personnel and adequate resuscitation facilities are available.” Loose translation: If a laboring woman develops a life-threatening complication from an epidural, she or her baby won’t die of it provided hospital staff are on the ball.”
From, The Thinking Woman’s Guide to a Better Birth by Henci Goer, page 127

“What has happened in the rich world is that, while removing the ideal food and feeding method, there has been progress in the elimination of other immediate risks. It is important to remember that it is still only a minority of the world’s population that can be artificially fed from birth without getting ill or dying.”
From, The Politics of Breastfeeding by Gabrielle Palmer

While these two quotes talk about two different things – medicated birth and artificial feeding – they are essentially saying the same thing about the world we currently live in. That those of us in first world countries live in societies filled with safety nets. And while that’s great for us, the rest of the world cannot manage to live the same way and afford the same healthy outcomes.

The switch from births happening at homes to hospitals and the rise of artificial milk for babies has followed a similar trend. They were at first disastrous. Dangerous. Doctors in hospitals and artificial baby food makers did not really know what they were doing. It was all trial and error, and many mothers and babies died as a result. With the awareness of germ theory, sanitation, and clean water sources, births in hospitals and artificial feedings improved. As the western world improved in wealth, it also began to take risks with its health. As long as they had a way of fixing the mistakes, it was okay to risk making them.

But living in a world of safety nets is a precarious world to live in. Walking a tightrope is risky, especially if there is not a safety net below. But even with the safety net, you will need to deal with the consequences of walking in a way that our bodies were not intended to walk. The feet of tightrope walkers tend to have many broken bones. Bodies react when we force them to do something outside of what they were intended to do.

When we interfere with the natural processes of labor, there will be reactions. Most doctors see these reactions as perfectly acceptable, since they tend to have plenty of safety nets set up in place – epidurals, pitocin, cesarean sections, drugs to bring blood pressure back up, resuscitation devices, and epinephrine. We believe that taking risks with our bodies while in labor is safe because we have become so accustomed to the safety nets. We have begun to forget what normal is meant to look like, and only what it’s like in a life of safety nets.

The same goes with artificial baby foods. A mother’s body is meant to breastfeed her baby, and a baby’s body is meant to breastfeed from it’s mother. When we alter this normal process, there are reactions. We have come to believe that ear infections, upper respiratory infections, and digestive problems are normal for infants because they happen so often. But these are reactions to altering the normal state of being. And this is only acceptable in our society because we have so many safety nets set in place. We have clean water to mix with formula. We have unbelievably easy access to fuel with which to heat the milk. We have easy access to transportation if our child becomes ill, and many hospitals, clinics and health care providers to offer care for our sick children. All of these are safety nets. Without such easy access to these things, feeding our babies with anything other than breastmilk would be dangerous.

But this alternate form of normal is acceptable in our society because a world of safety nets has become the new normal. And while I do not wish for these safety nets to stop existing – I am very thankful for them, actually! – I do wish that we would understand that safety nets are meant to protect us in case of emergency, not as a daily way of life. Normal labors should not routinely need to be induced or augmented. One third or our women should not need to have their babies removed from their bodies for them. Breasts should not be seen as so easily unable to provide nourishment. Ear infections and upper respiratory infections should not be common childhood ailments.

It does not take moving to a third world country to begin to understand the effects of a life based on alternatives without safety nets. What would we do in our comfy, wealthy society if these safety nets were suddenly sparse? It sounds unlikely, but all you need to do is consider Florida after the 2004 Hurricane Charley. Or the Gulf Coast after 2005’s Hurricane Katrina. We are not a country immune to natural disasters. And these disasters could easily wipe out all of our safety nets from beneath our feet.

In order for a medicalized birth to be above dangerous, there are many safety nets that need to be in place. Electricity, clean water, access to medications, availability of trained physicians, anesthesiologists, and surgeons. This may seem standard to many, but when hurricanes barrel through, earthquakes topple down, tsunamis wash away, or volcanos erupt around and upset all of this, we find that those must-have inductions and must-have cesareans become less urgent. We find that women can labor without being numbed, and that babies can come out without all the gadgets and gizmos set up in a hospital. And many see it as a tragedy that, because of a natural disaster, these women had to birth in a normal way!

In order for artificial feeding to be above dangerous, there are also many safety nets that need to be in place. How long does it take to boil water in order for it to be sterile? How many times must a mother do this in a 24 hour period for a formula-fed infant? How many gallons of water must she carry to her home? How much wood or other fuel source does it take to heat up the water for formula or for cleaning the bottles and nipples? How far is it to the nearest health care clinic, and how long would it take her to walk there with a sick child? How available is a health care provider in an emergency situation? During Hurricane Katrina, this is what formula feeding parents had to consider. In most of the world, this is what all parents have to consider.

I hear over and over again that formula feeding is perfectly safe ), and that breastfeeding really is not much better than formula feeding. What arrogance we have in our society! To take away the immunities and healthy digestive system our babies were intended to have, and replace it with a safety net of doctor’s trips, antibiotics, special hypoallergenic formulas, inhalers, insulin, etc. just because that is what is now normal, does not mean that it is safe. We can only claim it’s safety because we have all of the safety nets in place to catch our children when they fall. Those safety nets would not be as necessary if we followed the natural order our bodies and our babies’ bodies were intended to follow.

In our country, we have the ability to choose whether we want to have a natural or medicalized birth. We have the ability to choose whether we want to breastfeed or formula feed. But just because these choices are available, it doesn’t mean that they hold the same level of safety. At any moment we could be in a situation where our safety nets fail.