Doulas, Shamanism, and Sham

My thanks to Yulia Massino for sending the link http://domrebenok.ru/shop/618/mezhdunarodnaya_konferentsiya_onlayn_uchastie/

where (by using Google translate) we can read about the June 2015 international midwives conference in St. Peterburg, which drew participants from the U.S., Ukraine, Russia, and other countries. This article uses the term doula in what appears to be a broader way than is usual in the U.S., where a doula is usually a “birth companion” who attends and comforts the laboring mother rather than actively focusing on the baby. We also tend to use “midwife” to describe a person trained to work with the delivery and the baby, but without the medical training of an obstetrician or a neonatologist. The Google translation as I read it seems to mix the vocabulary describing these functions.

As many readers will know, a rebound from the intense medicalization of childbirth as it took place before World War II was underway in the 1950s and increased greatly in the 1970s in the U.S. Resistance to medicalization caused some real changes, including the presence of fathers or other relatives in delivery rooms and the establishment of birthing centers that had medical services but a relaxed atmosphere where a family’s older children would be welcome. This movement, added to insurance coverage changes, led to shorter hospital stays for healthy mothers and babies. The motivation of medical facilities to please birthing families also began  not only to allow fathers or grandmothers to be present with the laboring mother, but to permit a doula who might be a friend or relation (but who might also be hired by the family) to stay with the mother and give her the help that nurses rarely have time for.  

Those of us who gave labored in isolation and gave birth while attendants shouted at us in the “old days” can appreciate the changes that have been made, and appreciate the idea of a nurturing, supportive environment during labor. Because being alone during labor is frightening for most women, having a relative or a hired companion with us seems like a wonderful idea. This swing of the pendulum to an older, less medicalized has many advantages.

BUT!

Regrettably, whatever may be the attitudes of individual doulas or  midwives, organizations of these persons have a strong tendency to pursue the opposite pole from mechanistic, objectively-evaluated medical practices. Rather than simply humanizing some unnecessarily problematic medical approaches to childbirth, and reaching some sensible central position, the organizations have often gone far from center toward New Age beliefs and practices that stress subjectivity and the supernatural. This tendency is seen in the material at the link given above. For example, one recommendation has been to keep a large pyramid over the mother’s head during labor and delivery—an idea that seems directly related to Wilhelm Reich’s “orgone box” which was claimed to keep life energies from dissipating. Similarly, it was suggested that the umbilical cord and placenta should be left attached to the baby for several days after the birth, in order to “drain” back into the child all the beneficial substances that had been taken in during gestation.

The article on the St. Petersburg conference is difficult to follow because of some of the vagaries of Google translate, so I took the opportunity to look at web sites of some U.S.participants. For example, Gail Tully at www.spinningbabies.com mentions a number of ideas that involve rituals of sympathetic magic and shamanistic approaches--  for example, visualizing the unborn baby moving into an ideal position for birth, in order to create this desired outcome. This web site makes clear the connections between organizations of midwives and doulas and the Association for Pre- and Perinatal Psychology and Health (APPPAH).

APPPAH members promulgate a variety of beliefs about embryonic and fetal life that fail to be congruent with what is known about prenatal development or with basic assumptions of developmental studies, such as the connection between consciousness or memory and considerable advancement of nervous system maturation.  APPPAH members have claimed that the unborn human being is aware of external events from the time of conception or even before (some suggesting that each human being has memories of life in sperm form and life in ovum form). These views are quite similar to those stated by L. Ron Hubbard in Dianetics and repeated in other Scientological discussion. APPPAH has also supported and repeated the views of Lloyd DeMause, the “psychohistorian”, about the psychological pain and suffering of the fetus before and during birth, and how this trauma marks each personality and distorts its development.

Not to put too fine a point on it, when I see APPPAH links, I understand that any systematic evaluation of treatment outcomes has been abandoned by the linker. It appears to me that except for the rare individual doula or midwife, these entire professions have been contaminated by an APPPAH-like perspective on reality that abandons all scientific knowledge about prenatal life and development. In addition, the commercialization of these fields has moved them from shamanism right on to sham.

What was gained by past efforts to give families more healthy choices about the conduct of childbirth has unfortunately come to offer a choice between the simply outre’ and the outrageous and dangerous. The New Thought period has been over for many decades. It’s time for reasonable people to stand up and say we want potentially harmful alternative practices to be regulated.