When I scheduled the ultrasound for the baby’s hips, I was told not to allow her to eat anything for three hours before the test. This sounded weird to me, but I’ve learned from experience with this hospital that there is not much point in asking the scheduler questions. She does not know why the baby is not supposed to eat; she only knows the instructions to give the patient. So I followed the instructions more or less, and I arrived for the appointment on time with a hungry, fussy baby.
When the nurse called me into the waiting room, she asked me if the baby took a bottle. I told her the baby was breastfed. She led me to the ultrasound room and the sonographer told me to feed the baby, then left the room. Later she explained - after I asked - that the reason for the three hour fast was so that the baby could eat during the ultrasound, which might make her lie still for the test.
I felt hoodwinked. There had been no real reason to let my baby go hungry. First, that method was obviously intended for bottle-fed babies only. Second, I know my baby well enough to know that no amount of feeding will make her lie calmly while she is on an examining table, held down by a stranger who has smeared her with goo and pressed an instrument into her hip.
I am not complaining about the sonographer; she did her job well and got the information we needed (hips not dislocated, just immature; stretching exercises only, no harness). I was just puzzled why I was not given full information so I could make the best decision for my baby.
Since I have had children, I have noticed a change in how the medical community treats me. While I have had good doctors and have no significant complaints, I see flashes here and there of a culture that treats information to mothers as a tool for producing desired behavior, rather than facts from which she can make her own intelligent decision. Information has become propaganda rather than education.
Take the issue of alcohol during pregnancy. At the hospital where I delivered all four of my children, they stress absolutely no alcohol during pregnancy. This seems to be the medical party line in the US. A swift survey of websites will tell you there is no known safe quantity of alcohol during pregnancy. That is, strictly speaking, true. It is difficult to ethically study the effects of alcohol on pre-natal life; doctors can’t exactly encourage women to remain part of the control group if it harms the fetus.
When I was considering getting pregnant the first time, I asked my gynecologist about alcohol. Could I unintentionally harm my baby if I drank without knowing I was pregnant? My doctor said there was no evidence that one drink per week harmed a fetus. That is not something I ever heard at the hospital where I ended up for my pre-natal care. I don’t think it was as simple as a difference of opinion between doctors; it was a different philosophy of what information should be given to a patient. The hospital did not trust mothers with information; the hospital used information to persuade mothers to do as they were told.
A more obvious example of this paternalistic attitude toward mothers can be seen in the changing policies over free formula for maternity patients. When my first two daughters were born, I received a diaper bag and free formula from a formula company. When my third daughter was born, I had to fill out a card at my OBGYN’s office to receive the formula. When my fourth daughter was born, I had to ask the hospital nurse to receive the free formula.
Many hospitals are changing their policies on allowing free formula. Patients now must request it. The goal is to encourage breastfeeding. When mothers don’t have the formula handy, they are less likely to use it. The claim is that when hospitals allow formula companies to give formula to mothers, the mother believes the formula comes with the recommendation of the hospital. She thinks to herself, If it comes from the hospital, it must be good for the baby, so I’ll use it. Wouldn’t it be better for her and her baby if we kept the big bad formula companies away from her so they can’t confuse her?
There are many things I find offensive about this thinking. First, I am thirty-six years old; I understand what an advertisement is. I do not believe that the formula companies are offering me free formula out of their deep concern for me and my baby, and I do not need the enlightened policy-makers to protect me from a basic element of life in the media age. Advertisements do not “make” anyone buy anything; if they did, we would all be drinking Tab and eating Reddi-Bacon. But since I know that I will eventually need the formula, I take it. I take it and fill out whatever forms I need to get more, because that’s stuff’s friggin’ expensive.
But let’s say that there are women who do not understand that the formula cans they receive at the hospital are advertisements, not prescriptions. What should we do with these confused and benighted women? Shouldn’t we, smart people that we are, kindly act in their best interests, hedging their choices so that they will be more likely to make the “right” one?
Here’s a simple rule: if the problem is a lack of knowledge, then the solution is the supply of knowledge. Explain it to them. My overwhelming objection to hospital policies that interfere with the free formula is that they try to encourage breastfeeding NOT by presenting accurate information and allowing women to make informed decisions, but by treating goods and info as tools for manipulating women into the desired behavior. It treats mothers not as responsible adults who need facts to determine choices, but as children who are easily confused and need a little cajoling to get it right.
I am not a child.
I think our ideals of motherhood sometimes become so important to us that as a culture or as an ideology or as a group of activists we decide we CAN’T let mothers think for themselves. Too much is at stake. If we leave it all up to her, she might make the WRONG DECISION. She might sip that champagne or feed her child that formula. She might decide she knows more about her child than we do, and act accordingly. And that would be a DISASTER.
But I think the real disaster is this: we compromise our standing as women when we deny mothers the independence and information to make up their own minds. Women have fought in past centuries to be treated as fully human, as rational beings capable of thoughtful decisions, rather than pretty, helpless things needing authority figures to make decisions for them. Yes, knowledge doled out carefully in little doses may help produce the behavior you desire, but it comes at the expense of something even more dear.
And it just ain’t worth it.