Treating Mothers As Grown-Ups
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.
Julia
I am super sympathetic to your line of reasoning here and think that the medical system does patients (and for whatever reasons, pregnant and nursing women especially) a disservice by not presenting information clearly and honestly, just like you say, whether it’s soft cheese and pregnancy or almost any drug and BFing. On the other hand, I do think there is something pretty skeevy about the free formula hand-outs; it seems so obviously to me a de facto endorsement by the hospital that is inappropriate, given what research has shown about FFing. We’re a medical/science-y family over here and I think ideally doctors/hospitals/whatnot would fairly and accurately present what we know from good research without endorsing a consumer product. All the free formula in the world can disappear with my hearty approval.
Jane @ What About Mom
Very interesting (and glad the baby’s hips are just immature).
One reason I’ve been so fascinated with my friend Rixa’s (rixarixa.blogspot.com) experiences and thoughts as she writes her dissertation on unassisted childbirth (and embarks on her second pregnancy after giving birth totally alone) is that it has at its heart the idea that women know (or can know) their own bodies and can (and should) make their own decisions about laboring issues. (Which I respect and admire, though I’ve had 3 epidurals and 2 inductions, myself).
So I’m very much in agreement with your “take back the power” stance, but (and I have no idea whether you intend this) your post kinda seems like a Trojan horse for a pro-choice argument. Is it?
ewe_are_here
The formula battles are alive and well over here, too, with activists and the government pushing for no coupons, no handouts, no specials on formula for babies in the stores, and having to ask for it in the hospitals, so parents don’t make it their first choice. I resent these policies. A lot. Because basically, they’re punishing people financially for ‘choosing’ to use formula… and it’s not always a ‘choice’ for some, including me… because formula for babies under six months can’t be on special, or count towards shopping points, or be advertised… Sucks.
Dana~Are We There Yet?
I’m with you on this one. Give me the information and let ME decide. Will I make mistakes? Certainly. But only then can I LEARN.
Our first and third born children have disabilities, and I’m very familiar with the treatment you received prior to your daughter’s ultrasound. I was a Physician Assistant (PA) in my life before becoming a mom, so I can weed out a lot of the senseless junk and just do the pertinent thing. I also ask a lot of questions and don’t subject my children to things I don’t understand or agree are in their best interest. It’s a shame that we have to be so defensive as moms.
I could go on for days on this issue, but I’ll stop here. You’re welcome.
Veronica Mitchell
Jane, it occurred to me when I finished writing this that someone might interpret it that way, but no. Anytime anyone uses the word “choice,” people will see the abortion issue in it, but I was not addressing it here.
Melissa @ Anxious for Nothing
Yup. I heart midwives and do not trust doctors. In my experience, midwives treat a woman as the one who knows what is best for her and her baby. She is ultimately in charge, she calls all the shots, she has the final say. I have always felt respected and valued as an intelligent human being by midwives.
In contrast, with my last pregnancy, I had to go to a few appointments with an obstetrician because of concern of a possible complication, which turned out to be nothing. But I inwardly seethed when the doctor spoke of “possibly LETTING me go as late as late as such-as-such weeks” before inducing labor or scheduling a C-section. I’m normally a gentle and mild-mannered person, but I was biting my tongue so as not to say, “Hey, it’s my body and my baby. You’re not going to force me to do things on your timetable.”
Tonggu Momma
This was very thought-provoking, Veronica. As an adoptive momma, who had to convince other “professionals” that I’d make a good mother, I think a little outside of the box on this topic… probably because I think everyone would benefit from the classes the husband and I had to take in order to qualify as adoptive parents. Still, as you said, personal freedom and responsibility are fundamental to our society.
And, just so you know, this post - with its ultrasound mention and its formula focus - felt very painful to me. The Tongginator will be scheduled soon for a renal ultrasound. Why, you might ask? The China baby formula crisis. She’s been home a long time, but she’s exhibiting some of the symptoms. Sigh.
The Diaper Diaries
The blogosphere is a better place because of you “troublemaking”. Please keep it up. And as someone who is very pro-breastfeeding, it really angers me that mothers are forced to feel like criminals if they end up using formula. I know many a mom who has tried and tried and beats themself up over and over because they ended up using formula. There is enough guilt about all sorts of mothering choices to go around. Let us stop.
Karen
Yes, while I kinda hate the formulas are out there pedaling their goods at places where women receive medical care (I’d prefer them to pedal in the marketplace, but it is my preference and not my right), I agree completely that the natural birth community (pro natural birth/pro-midwifery, pro-breastfeeding, pro, etc, etc) both dilutes and demeans its own message, usefulness and meaning by resorting to similar tactics of manipulation & information control. It is using the model of having power over someone to achieve a behavior, rather than using power to serve, inform and support people.
Very well argued.
lyrl
Because basically, they’re punishing people financially for ‘choosing’ to use formulaAdvertising does not come free. Those cans of formula that are never used due to breastfeeding, and the discounts they give to certain groups, are paid for by higher formula prices.
From a meta-analysis done in 2000:
Babies get less breastmilk when moms are given formula or coupons for formula. Babies get more breastmilk when free and discounted formula is less available. It’s not a matter of questioning women’s judgment, it’s a matter of statistics.
I completely agree that denying information to groups (mothers or otherwise) to make them “behave” is wrong and has consequences that come at a high cost. But making discounted formula more difficult to get for new mothers does not deny them information. I don’t believe the line of argument in this post applies to the free formula issue.
Mary-LUE
I gave birth in the good old baby swag days, diaper coupons, parenting magazines, formula samples. What you describe is disturbing.
I find a similar “we know what’s best for you” attitude in my education classes. It is subtle, but its there. Drives me crazy.
Excellent post.
Kelley
This is an excellent point.
As a mother who medically couldn’t breastfeed her daughter I was horrified by the behavoir of peope in the La Leche League as well as the hospital staff at what they called “my decision” to formula feed my child. I recieved calls with breast feeding help for about the first six months of my child’s life. I was also refered to a family services organization by one of the breast feeding staff. The implications of that on a mother who is post-partum and scared to death are incredibly horrible.
Mad
Very well argued.
I’m not a fan of formula companies hawking their wares in hospitals but as someone who desperately needed that free formula after weeks of agony and tears, I kinda resent a system that is designed to deny me any kind of information, knowledge or product that exists beyond a sanctioned doctrine. And yes, in some ways breastfeeding has become doctrinaire. I know this because my very real health care issues were denied and ignored in favour of false rhetoric.
Coralie
The underlying issue here, and illustrated further by the dissenting opinions regarding free formula, is that when pressed, most people believe that they are the only ones intelligent enough to make the right decisions for society. It’s not just medicine, it’s education, journalism, government, even entertainment. We think WE (whoever we happen to be) need to make the decision for everyone else “for their own good.”
This isn’t a pro-abortion argument, as the “pro-choice” movement routinely bar pregnant women from relevant science and information regarding their child, because they believe that with that information, those women would make the “wrong” decision to keep their child.
Theresa
Excellent and very well written post. Makes me wonder what other information the medical community withholds in order to “steer” us in a certain direction — vaccinations, prescription drugs, etc. And what about outside the medical community … banks, schools, government (gasp!).
Veronica Mitchell
Theresa,
Doughnuts prevent heart disease. You heard it here first.
Veronica Mitchell
Coralie, I think you get to the heart of the matter, but I would say rather that we all have a TENDENCY to believe we know what’s best for society. Part of maturity (and a significant element of spiritual discipline in my own Reformed faith) is acknowledging and embracing limits on our own power over others.
And just in case we don’t want to embrace those limits, eventually our children become teenagers and kick us in the teeth with it.
Jeana
I was going to mention the government and education system as well. People often ask what I have to do to be “allowed” to homeschool. The fact that they don’t think this is a ludicrous question proves that the government indoctrination is working. Not only do these people seem to believe that the government knows what’s best for my child, they have accepted that the government has the right to carry out what they think is best on my child and overrule what the parents think is best.
Herb of Grace
THANK YOU.
*gives Victoria a standing ovation*
*sits down*
Jeana, you have brought up a pet peeve of mine… A variation on that theme that I often hear is “You have your babies at HOME? I didn’t know you were allowed to do that…” and ditto your commentary on what that says about the effectiveness of the indoctrination.
Julia
I was thinking about your post some more this evening and decided to write in defense of doctors, seeing as how DH is one (a pediatrician, to be specific). The vast majority of patients/parents he sees don’t have the educational background and socioeconomic advantages that you and I have; a lot of them make bad decisions about their health and their children’s health, ranging from extremely bad decisions leading to calls to CPS to just feeding them a really horrendous diet. I think a lot of the medical instructions or info out there that feels condescending to you or me as an educated woman/mother able to take a nuanced view of a complicated issue are put in place to “produce a behavior”, as you put it, in a population that largely does not think so deeply about subjects. I think you would argue that it’s not fair or it doesn’t change the rightness/wrongness of making the info simple and thus limited. When I think about my DH doing this, though, I see him as being an utter pragmatist, trying to keep his patients safe and healthy and doing what seems most responsible for the people in his care.
midlife mommy
Oh, amen, amen. I am having my own bout with paternalistic doctors right now. As for drinking while pregnant, I had an honest doctor too. Very refreshing.
Grafted Branch@Restoring the Years
I don’t know anything about free formula, but I’ve been mad for 13 years that my first child was birthed with what turns out to be the common, narcotic-infused epidural. That one required forcepts.
My second two were delivered with what is called a “clean” epidural. In those instances, there were no mind-altering narcotics or muscle relaxants or whatever they spike them with–just a plain and simple numbing agent that took the edge off. Those were glorious births…even the 11 pounder!
I’m mad because the doctors take it upon themselves to decide that laboring moms are too delirious or hysterical or something to make any informed decisions for themselves. It’s really hard to find doctors that don’t carry a “god complex” into the exam room.
Kelly @ Love Well
Living in California, I quickly learned the motto of most institutions was “We’re here to protect you from your own stupidity.”
Exhibit A: Almost every turn signal in the Bay Area allows left turns on green arrows only. We the people can’t be trusted. Who knows what we might do if left to our own thinking?
Great post, Veronica. Bravo.
Minnesotamom
I have, since before even marrying, done my own research on birth control, NFP, pregnancy, child-birthing, child-rearing, etc. I am one of those mothers whose doctors roll their eyes because I don’t take everything they say at face value. I have a general distrust of all medical professionals.
That said, I think there are, sadly, mothers out there who don’t give a da**. I think some (hope most) doctors are doing what they can to protect people with the knowledge base they have (which is not infinite, no matter how much they like to pretend so), and I can appreciate that. The hardest part for me is finding doctors who can provide the care for which I as a well-informed mother am looking.
Proactive mothers inspire me; keep it up!
TeacherMommy
One of the reasons I have been so faithful to both my ObGyn practice and my pediatrician/family practice doctors is that they believe in working WITH the parents. The decision to have both boys via c-section was a carefully discussed and considered one, with me and my family as an integral part of the decision-making. Treatments, medications, hospitalizations for the whole family are discussed and explained, not simply given with the assumption that we will follow blindly. It makes me trust them, and it makes their jobs easier because we aren’t withholding information in turn.
The angriest I’ve ever been on the behalf of one of my children was when my oldest was hospitalized for RSV and HIB at the tender age of eight weeks. He was there for a full week, and towards the end his IV blew up (horrendous). When the nurse and DO said they needed to re-insert the IV, we asked why–and were told it was because of the pneumonia. PNEUMONIA? WHAT PNEUMONIA? Turns out the most recent chest x-ray had shown a mild incursion. The nurse and DO had assumed we had been told already. The head pediatrician (not ours) had chosen not to inform us because, and I quote, “You might overreact.”
I hope the formal complaints that were issued to the head nurse, the patient advocate, and eventually to the hospital administration (in writing) were enough to convince her that NOT informing us was far more likely to result in an “overreaction.”
Kimberly
I, too, get irritated with the “dumbing down” of information. And thankfully, I have found an OB this go-round who thinks that I, as a mother, am better positioned to tell him what is going on inside of me than he is. And he doesn’t seem to be bothered when I ask questions. His response to me when we were trying to figure out a due date (late ovulation, conflicting data points) was, “well, Mama, when is this baby coming?” And when I told him, he wrote it in my chart.
It really DOES take extreme effort on the part of the medical profession to treat everyone as individuals, with differing levels of information and abilities.
The interesting thing about the B/F vs. formula debate is that it has swung 180 degrees twice in the past 50 years. After WWII, women were actively discouraged from B/Fing their babies because “scientists” had come up with a better “formula” for feeding babies that was “advanced” and “scientific”, and really told women that what they could provide was inferior. My grandmother was told this. And for two generations, women mostly believed this. And therefore we, as women, lost much of the ability to help each other in community on things like breastfeeding (and childrearing and childbearing, etc. as we fell prey to the idea that “they” knew better about what to do with our bodies and our children than we did.
I think what you are seeing now is a reversal of the specific policy that formula is better. However, the idea that “they” know best still prevails.
I’ll tell you what chaps me more than the hospitals not giving out free formula (’cause I certainly would take it, too, given my history of only being able to provide my child with about half of what he needed in terms of breast milk) is the realization that the federal and state WIC programs (which are aimed at the less educated and less advantaged, and presumably less informed among us) will give out free formula but not things like support and breast pumps and other support that might help the very babies who most need the benefits of breastmilk.
Thoughtful as ever. Thanks VM.
Kimberly
Wow, that was long. Sorry.
Beck
Really wonderful post.
When The Baby was still undiagnosed, the medical establishment wasted MONTHS of time proving to themselves that she wasn’t the victim of moronic neglect and/or outright abuse - despite no evidence AT ALL to either of those claims. She could have been diagnosed MONTHS sooner had they treated us as responsible adults from the outset, but no - this was the way that Failure To Thrive cases are treated and there would be no deviations from it, even in the face of glaring commonsense.
Still a bit mad. Can you tell?
colicmommy
Veronica, I agree in priniciple, but in practice, the large majority of mothers are not educated and do not have knowledge. You posit that we should then educate them. This is something that an academic would say. I chose to work with a midwife when pregnant with each of my 3 kids, and that midwifery practice worked with very low-income and immigrant groups. My midwife told me how day after day, she would try to educate mothers in the simplest way she knew about why they shouldn’t eat dirt, for example, during pregnancy, or why they shouldn’t allow the baby to sleep prone, or why breastfeeding should be the first choice that you try unless medical reasons bar formula-feeding. She noted that it was mostly in vain. There are cultural and historical beliefs that no amount of education can easily change. Mom and grandma ate dirt, so I eat dirt. Mom and grandma put baby to sleep on tummy, so do I. Mom used formula, so do I. etc.
As an educated mom, I’m irriated, as you are, with how paternalistic the medical field can be. But, I get it. I understand why. They don’t care about the mother’s intellectual right to choose. They care that the baby doesn’t die of SIDS, that the toddler doesn’t ride without a carseat or doesn’t drink Coke in his sippy cup with meals, and that pregnant moms don’t eat dirt or starch just because their culture encourages them to. And yes, they care about breastfeeding in the same way, because it is medically better for the baby. (I get it that not everyone can or wants to, and I’m fine with that, but you can’t argue that breastfed babies get fewer infections).
In a perfect world, the medical community could educate until it stuck, but in reality, costs are so high, time is so short, it’s not generally possible.
Mad
Just a word in follow-up to a couple of the comments. The problem with policies of no free formula isn’t so much that it allows doctors and nurses to make our decisions for us, it’s that it allows POLICYMAKERS to do so. These policies not only treat mothers as uniformed and unable to make choices but they also are paternalistic within the healthcare profession. What they say is that an individual Dr, nurse, or lactation consultant should not be able to make decisions about who can and cannot be given free formula based on circumstance.
Whether these policies are effective (i.e. have the desired effect of increasing lactation) is a different matter from whether or not they respect individual decision making within the family and within the health care system.
I’m still not 100% sure where I stand on the issue but I do see the issue for what it is.
Mad
Duh. I revised the grammar right out of that first sentence… Sorry.
gretchen from lifenut
When I was pregnant with my first, my OB told me to drink a glass of red wine on the nights I couldn’t sleep/relax during the final weeks of my pregnancy.
I doubt she’d say that today. I wonder how many OBs and midwives would LOVE to tell the truth, but are told by their malpractice insurance companies and in-house lawyers they cannot?
Perhaps they treat us like children because too many moms acted like children, something went wrong, lawsuits here, lawsuits there? They could be playing defense by treating everyone like drooling dummies.
canadacole
First, glad to hear that Baby is well.
Second, wonderful post and comments. I love coming here, there are always things to think about and thoughtful discussion. I see the same problems here. Just before our first child was born, Hubby informed me that he didn’t believe in giving immunizations. How this hadn’t come up before, I don’t know (I might not have married him had I known). I know how to research, and I immediately set out to educate myself (and him) with literature from both sides of the debate. What I found was appalling. Heavy rhetoric and fear-mongering on both sides with almost nothing in the way of actual research or even case studies. I want facts, not fear. And when we were referred to a pediatrician when dd was 8 months old with a deep chest cough, I was treated to a blistering lecture on my endangering of my child (because I had delayed immunizations) from the intern taking histories, followed by what can only be called a screaming tirade from the doctor himself. When I tearfully told Hubby that I couldn’t take it any more and he would have to be present at any future appointments, I discovered that HE was treated respectfully and immunizations were only mentioned briefly. I try to tell myself it was just that doctor, but I’ve run into this again and again. Fortunately our family doctor is wonderful and SHE treats me like a reasonable adult. She’s always happy to provide research and opinion and be clear about which is which.
Sorry, that got away from me. Apparently I’m still not over it. Carry on.
Linda
It is called pandering to the lowest common denominator in the name of lawsuit avoidance.
Sadly, not all mothers have the insight or intellect
I love you blog.
Linda
YOUR blog.
fern
I agree–and it extends into other professions, too.
I had my first baby by C-section so I was in the hospital for 4 days. At one point my baby was very fussy and I was very tired and I asked the nurse for a pacifier for the baby. She said I couldn’t have one unless my dr okayed it. I told her I was the mother and to bring a pacifier (she did).
I am an early childhood director and in that position, a lot of parents ask me for advice. I always give a number of different suggestions, possibly research from a couple of sources, and sometimes my opinion. I will tell them what I have had the most success with, or why I think certain methods are not in the best interest of their children–but they are the parents and often need to feel confident in making decisions. I offer a number of programs and look to the parents to see what they are interested in. I actually had a former supervisor say to me — “you have to tell with her, I thought it was insulting to the families. Parents do know what they want–although may not know what is available or what options they have. Education helps us make educated decisions. We are trying to teach children to think for themselves, why would we expect less from the parents?
jean
Excellent post. I tried to write more but I got carried away. Let me just say that I agree with you.
Aubrey T.
Good post. As a family physician who delivers babies (and loves it!), I do dislike our hospital’s policy of still giving women lots of free formula. As someone already mentioned, there is good research that when women are given free formula, they breast feed less. Many of my patients, no matter how much I try to educate them about the benefits of breastfeeding, are insistent on bottle feeding. Obviously, I am going to support them in whatever decision that they make, and there are certainly some women who are not able to breast feed, or who work, or who try to do it and fail. And yes, there are benefits to breast feeding, but there is nothing wrong with bottle feeding. But I still want to make our hospital as supportive of breast feeding as it can be. I am not trying to be manipulative, I just really want all infants to have the chance to receive the health benefits of breast feeding, even if just for a few weeks or months. I try to discuss breast feeding vs. bottle feeding with all my patients and encourage them, and again right after birth talk to them more about breast feeding. Of course, then our labor and delivery nurses just bring them a bottle. And it’s like all the talking I just did means nothing.
I do agree, though, it’s silly that you weren’t given all the info about this ultrasound. I certainly want my patients to have all the necessary information they need. And as a physician, I do my best to involve all my patients and their families in the decision-making process, which I guess is part of being a family doctor. After all, if the patient or their family doesn’t agree with the treatment, then it’s just not going to go well. I hope my patients realize that I want to be on their team and help them be the healthiest that they can.
flipflopmamma
((Applause!)) Awesome post! You said everything wonderfully!
Courtney
i could not agree with you more about this suject. I find it very disturbing that they dont trust us enough to give us accurate information so that we can make educated decisions. When i had my first son and i told them i didnt know if i wanted to breast feed instead of giving me accurate info they told me that formula might cause my baby to have reflux and stomach problems. It is wrong and we need to ban together to do something about it.
Jodie
Amen to that. And again, amen.
Aubrey T.
Sorry to intrude again, but I just thought of a recent example about why I wish our hospital did not give away free formula….
One of my favorite patients is a 20-something young woman, single, who found herself in an unplanned pregnancy. She did the brave and amazing thing and decided to keep this baby, without help from the baby’s father, who has rejected her, or even her parents, with whom she has little relationship and live several hours away. She was very, very interested in breast feeding, and we had a great delivery. She was breastfeeding within minutes of giving birth. She was, though, given free formula, which she used some. Within a week or two of giving birth, she had mastitis. I treated this and tried to encourage her to continue breastfeeding. She almost immediately gave up.
This was someone who loved breastfeeding, and was planning on pumping even while she worked. Part of me wonders if the free formula she got made the idea of continuing to breastfeed seem like too monumental of a task, even though she did know about all of the benefits of it. It’s hard to say. But I do think it’s possible.
Sherri E.
In a followup to Kimberly’s comment, Virginia WIC actually does provide breastfeeding support in the form of pump loaner programs and more food for exclusively breastfeeding mothers. Dunno about other states. (OTOH, they only allow regular peanut butter, full of horrid trans fats…grrrr.)
Actually, the place I have noticed this trend of patronizing medical professionals is not in my own experience but my father’s as he deals with diabetes. He’s on medication to control his blood sugar, but he actually has frequent episodes of hypoglycemia because he has– get this– actually adjusted his diet and become more physically active. He actually mentioned to his endocrinologist once that he had some hypoglycemia episodes after working strenuously in the garden, and the doc said,
“Oh, on days you know you’ll be highly active, you should halve your medication dose.” Which confirms my suspicion that the doc was just assuming that my dad would, like many of his diabetes patients, continue a lifestyle of poor eating and insufficient exercise, so he just prescribed medication from the outset– when likely much of the diabetes, at least in its early stages, could be controlled by the appropriate lifestyle changes.
I have some sympathy here– my impression is that many docs are taking the “utter pragmatist” approach mentioned above by Julia. Many many people, for whatever reason, do not practice appropriate self-care, no matter how much information they have. Since so many docs are trained to intervene as a matter of course, letting people suffer the consequences of their willful self-destructiveness is probably an option not even on their radar.
I have an older have sister with diabetes far more advanced than my dad’s, and she cheerfully shovels in whatever she feels like eating, sugar content be damned. But creating a space where she is at liberty to do so still seems to me the best way to allow the most human beings the liberty to practice rational self-government. Where the desperate wickedness of the human heart fits into that whole ideal of rational self-government, though, I do not know.
I’m ready for Advent; how about you?
Shayna
I just read an article today about how midwives are being forced to become licensed, which is for the most part a good thing. But for those wanting a home birth that can be taken away from them if the state decides they know a better birth plan for the mother. It was appealed, saying it interfered with a woman/mothers right to privacy, and was denied. That while we can make the choice to terminate a pregnancy, (which I am opposed to, but need the statement to make my point!) we can’t make a choice about how to deliver our child.
M Light
All too true!
My kids are older, and what currently bugs me is when doctors talk *only* to them. I think it’s a good thing that doctors treat teenagers with respect and explain things to them. But I hate it when doctors make me feel like an interloper for asking questions - but a 16 yo doesn’t know all the questions she needs to ask - particularly when the doctor mentions that, for her foot problem, she might need surgery to lengthen her calf muscles.
My dancer 16 yo was freaking out (quietly) at that point, and I was the only one of us capable of questioning the doctor and getting the details.
Fortunately, at the next appointment, orthotics turned out to be the way to go in the long run. She’s still mad at the doctor, though, for upsetting her that way.
Sis
Wow- who knew free formula was such an explosive issue? I say bring on the free handguns and porn. At least we can all agree on those, right?
Jennifer
YES! YES! YES! This has been a huge issue for me with my prenatal care during my second pregnancy. I have been using the national health system and have had the unfortunate experience of seeing a doctor for almost all of my appointments who withholds information and treats me much like a small child rather than an adult capable of making informed decisions.
I haven’t asked this doctor about drinking, but during my first pregnancy my OBGYN laughed when I told her I abstained. Half a glass with a meal was fine, she said.
Jennifer
Also, I would have been furious at that ultrasound when I found out that I’d forced my infant to fast for no good reason at all.
edj
I knew my OBGYN personally, and once when I was visiting his house while very pregnant, he handed me a glass of (alcoholic) ginger beer he’d made himself. It felt so very odd, especially because at that point I was getting dirty looks in pubs even though I was drinking lemonade! He was a great OBGYN though, and I’m sad for him because more and more women won’t go to him because they want to go to a woman, believing she will empower them more. I loved this post because I have seen and dealt with this issue, not just in the areas surrounding medical care, but in other areas as well.
Ironically, I faced pressure to give my twins formula. My ped couldn’t believe I was producing enough milk for 2. It was rough but I was determined to exclusively BF, in part because my life was hectic enough w/o having to make formula in the middle of the night. We did use the free formula though, those first few frantic weeks.
Jennifer in MN
As soon as hospitals give out free nursing bras, pumps, lamisil cream, breast pads and FREE lactation consultants 24/7–that’s when free formula will be okay. This has nothing to do with giving full informaton. This is formula companies getting women and babies “hooked” on formula and hosptials allowing and even endorsing it (certainly not stopping it, they might get something for Free from the company!). Breastfeeding is supply and demand and when you mess with that before breastfeeding is established, breastfeeding ends. Those early breastfeeding days are tough, I know because I’ve done it 6 times. I KNOW the benefits of breastfeeding and having free formula around tempts me. Once upon a time, formula was prescription only. I think it still should be. Breastfeeding should be the norm and formula the exception. You don’t think you pay for all these “free samples”? Huh, you do pay, eventually, through the high cost of the formula so others get the free samples, the coupons and so on.
If you want to use formula, go ahead, but I don’t think the hospital or docs should be handing the stuff out!!
Emily
You’ve done it again, Veronica! This is a simply fabulous post, and I think the principles you address are especially telling in the political climate that we’re in. It appears that perception rules the world these days, and that is always a tenuous place to be. I think that Coralie, et. al. were right, as well. Take education, for instance–when you raise up almost an entire generation of children on disconnected facts, disrespect for authority, and primacy of peer interactions, you receive a nation that blindly follows anyone (think media) willing to pull the wool over their eyes with sophistry and ‘glam.’ History does repeat itself, doesn’t it?
jubilee
I sure appreciate your post. Thanks.
Tina @ www.antiquemommy.com
The comments on this post are really thoughtful. I particularly resonate to what Gretchen/Lifenut said.
I have not had the forumla/hospital experience and find it very interesting. I had no idea and wonder if that is sort of a universal hospital policy or particular to your hospital or region of the country or some other factor.
Because of the meds I take, breast feeding was never an option for me, so it was either formula, starve the baby or give the baby the same meds I take through breast milk and maybe that is why my hospital was so free with the formula. All that to say there are a lot of reasons women formula feed their babies other than laziness. I was glad to have the free formula because as you say it is is incredibly expensive.
Oh and I also had several margaritas before I knew I was pregnant, since I was technically infertile, and guest what? My kid is fine.
Very well written post Veronica.
Karen Edmisten
Great post. Got here by way of Beck. Thanks to both of you.
Melanie
Amen! And Amen!
Marie
Unfortunately, there will always be those moms that don’t have the intellectual ability or maturity to make to best decision for their unborn child and somethings just have to be put in a black and white presentation to them. Spoken from the perspective of an adoptive mom of 7 chilldren, that all show some signs of Fetal Alcohol Syndrome …some mild…some severe……….
Anne
Just jumping in on the breastfeeding vs formula question. I was one of those mothers who “failed to lactate”. I don’t know why. I wanted desperately to breastfeed, but my body did not cooperate despite regular feedings, pumping like a mad woman, hand expressing you name it. The day that I managed to pump 10 mLs I was very very excited. I should have been pumping 10x that amount. After a week of doing everything known to modern man, my lactation consultant insisted that I begin supplementing with formula. My 5 pound 12 ounce baby boy was losing weight at a rate of about 4-5 ounces a day despite being fed every three hours round the clock. He was so small that he couldn’t afford to lose any mroe weight. I didn’t want to supplement, but could see that if I didn’t my baby was going to starve. I asked the lactation consultant for some suggestions on which formula to use. She was prevented by law from offering ANY suggestions. DH and I had to go to the shop and look at the bewildering range of formulas and try to make an informed decision with no information. Have you ever heard of anything more ridiculous.
We ended up choosing the one that had a teddy bear on the tin because as far as ingrediens went they all looked the same. I didn’t “choose” to formula feed my baby; it was a decision forced on me. In the ultimate irony, with our second child I had enough milk for the entire nursery, but a baby with lactose intolerance and my milk was making her sick. I had to supplement her feeds with lactose free formula and she eventually became totally formula fed - again it was not my “choice”.
Shannon M
You already have lots of great comments, but I just had to add mine:) I’ve noticed, too, that “professionals” seem to think I’ve had partial lobotomies and not c-sections. After my 4th child was born, the pediatrician who saw him (not our regular) released him from the hospital but gave the nurse a sheet of “instructions” for me because the baby was somewhat jaundiced. Stop nursing for 24 hours, start him on formula instead, and bring him back the next morning for blood work. When I asked to speak to the doctor I was told that he was gone for the day and we wouldn’t be released unless I agreed to his instructions. Needless to say I got my baby out of there:) If he had bothered to ask I could’ve told him that I’d dealt with jaundice before, was pretty sure it was caused by him keeping the baby in the nursery all day when he was born for totally unneccessary chest x-rays so that he didn’t start nursing soon enough and my milk was taking longer than usual to come in b/c of that. SO the baby needed more nursing, not stopping altogether which might have really screwed up my milk supply.
When we stop treating mothers like idiots maybe the ones who *are* happy to go along with whatever the professional says will step up to the plate.
Emily
One thing I’ve appreciated about my local ‘Health Region’ (I live in Alberta, Canada with socialized health care run by provinces) is the nice fat book of pregnancy and baby care information complete with where to get free classes if desired (and lots of advertising but then that does reduce the taxes needed to pay for the book). It would have been very nice to have during my first pregnancy and beyond (particularly the pictures of healthy breastfed baby stools AKA they are supposed to look like that). I think it’s a pity more places don’t have a similar resource.
They don’t provide free formula without being asked but I’ve observed that it isn’t hard to get formula samples if breastfeeding isn’t going well. I think it works well to not offer without either being asked or baby isn’t doing well breastfeeding.
Fiddledeedee
You hit that nail right square on the head. Yes you did! Good job.