The BBC today has an article titled "Confused, Guilty, and Pregnant," regarding the large amount of health advice given to pregnant women, and the fact that it's often contradictory. Below the article are readers' comments, such as:
I'm 25 weeks pregnant with my first child, and I feel completely overwhelmed by the amount of information I'm expected to digest. Thanks to books and studies I've found myself reading the back of every packet of food wondering if the contents are safe. At one point I found myself in tears over whether or not an e-number was dangerous. [An E-number is a code for a food additive, used in the E.U.] In order to put my mind at rest, I've stopped everything; no alcohol, no caffeine, no peanuts, and no herbs (apparently things like basil and sage are uterine stimulants). The amount of hearsay around to panic pregnant women is unbelievable....
I can empathize. I spent my first pregnancy glued to the computer, reading abstracts on PubMed and checking out various countries' health recommendations. (No two countries have the same policy on anything except smoking.) I refused a lot of tests and interventions-- no alpha-fetoprotein test, no ultrasound, no induced labor, etc. We have a genetic factor in my family that causes blood to clot more easily, and I decided not to test for that at all, since I would not have followed the advised treatment anyway if I had tested positive. And of course, I continued to read about labor and birth, all the moreso because I was planning to give birth very differently than most American women. (I have now had two unmedicated, natural births.)
But I'm not giving you the full flavor here... actually, for that whole first pregnancy, I was a complete freak. I cried in frustration after every prenatal appointment. I had imaginary conversations with my midwife. I once brought a bibliography to a prenatal (I so wish I was kidding!). I wanted approval for my well-reasoned decisions, but what I didn't understand was that due to the necessity of retaining her malpractice insurance, it was impossible for my midwife to condone my decisions because they went against medical protocol. So, every appointment I came in armed to the teeth with my reasoning for refusing yet another test, and every appointment Joan merely said "It's your choice," and left me feeling like she disapproved.
Modern medicine views pregnancy and labor as nothing more than a catastrophe waiting to happen, and their sole focus is on identifying problems and risk factors. If you educate yourself, you discover that many of their practices have a net negative effect. Denying women water during labor causes their uterus to work less efficiently, increasing the risk of complications. Not letting women move around slows labor, and increases the need for pain relief. Continuous fetal monitoring results in worse outcomes for the mother and baby than intermittent fetal monitoring. There is no reason to check dilation except at admission and when you get the urge to push, and every time they do so, they increase the risk of infection. Episiotomy, contrary to widespread belief, actually increases the risk of serious injury to the mother. Various pain killers increase the risk of a C-section (you may very well not care, by the time you're in active labor, but at least they should admit this). Non-medical methods of pain relief (massage, water, acupressure, acupuncture, and hypnosis) are usually impossible to include in labor, at least at most hospitals. Sure, they sell you on the jacuzzi tub, only to tell you later that you can't use it for one reason or another.
During pregnancy, certain tests make sense, but many are ridiculous. I worked it out that if I got the AFP test (for Down's syndrome), because there is a 10% false positive rate which then necessitates amniocentesis, and because there is a slight risk that an amnio can cause miscarriage, it was actually more likely that I would lose a healthy baby than that the baby would have Down's in the first place. I did the probability calculations by hand. I brought my little notebook sheet in to Joan, to prove to her how reasonable I was being. (She took the calculations and stuck them in my file, apparently as evidence in case of a future malpractice suit.)
When you educate yourself about pregnancy, labor and birth-- not simply by reading books by MD's, but by looking into the actual studies and considering all the alternatives-- you inevitably end up going against some protocol. At that point you run into strong resistance. They play on your fears, and fear is a very powerful emotion. They'll say things like "But what if something were wrong with the baby, could you live with yourself later?" Never mind if that particular risk is 1 in 1,200 or 1 in 10,000 or whatever it is. Fear is how they make you comply.
For anyone out there who's pregnant, I have this advice: be strong, recognize when they are using fear, and respond to them with science. But don't expect them to approve, and try not to give a shit when they tsk, tsk. (I actually loved my midwife, but she had to consult with OB's, and they were uniformly bastards.) I gave birth to an 11-pound, 4-ounce boy and his birth was faster and easier than the birth of my 7-pound, 11-ounce daughter, which I think is an example of nature finding a way. Natural selection over the millenia means that the vast majority of mothers and babies will be fine, with minimal assistance. Nature is on your side.
And for god's sake, if What To Expect When You're Expecting is anywhere in your home, take it out and burn it.