The Meaning of Scientific Research vs. Personal Experience

In many debates regarding homebirth (I can specifically think of two blog debates), the same progression of events, with the same heated emotional overtones, occurs. Doctors question the safety of homebirth, and the homebirth supporters retort with a long series of heartfelt insistence, personal stories, and talk about how much homebirth has meant to them personally. The docs list some studies and statistics, and while those might be discussed in a little more detail, most of the response is again anecdotal. All comments are delivered with increasing conviction, passion, and sometimes name-calling and utter defensiveness.

To this point I wish to discuss what kind of resolution we can gain from debating these topics, where doctors and birth practitioners have such different ways of approaching the same issue.

First of all, it should be immediately apparent that no one is likely to change their minds. I have been devoting a great deal of time to consideration and reconsideration of the points being made, and while I want to contradict some of the stronger arguments, I am unable to, and I am offering a possibly premature concession while I do more research. Yet my original stance remains unchanged.

This leads me to realize something inherent in these debates: Scientific research is not going to be the basis for change.

I do not believe that anyone truly bases their opinion of any topic, exclusively on the scientific conclusions of research. I do not think that those who argue against it have done this, though they will probably argue otherwise. Their opinions were forged elsewhere, probably in the OR, in medical school, or in the L&D unit of a hospital. We are reasonable creatures, but we do not use reason in this manner.

Because of this, we are never going to agree. We will always be in conflict.

That does not mean that change will not occur, but it will not originate in the broadcast or propagation of scientific studies.

Change will have its roots in three places: social influence, intellectual pursuits, and political muscle.

The homebirth/natural birth movement is a direct response to the horrid treatment of birth in modern hospitals. It is a protest of the management of healthy women in labor, a defense against the obstetricians who schedule cesareans so they can attend a barbeque at 4 pm (that is a real example). Many homebirthers are women who are recovering from a terrible hospital experience, having received a waterfall of interventions that made them feel violated, and stirred in them the desire to reclaim their bodies and their births. Certainly this does not encapsulate the motives of all homebirth advocates, but it does represent many of them.

The power of this birth movement is its social power. Homebirthers are not women in rural areas without access to hospitals; they are neighbors, sisters, urbanites. They have an affect on the women around them; their sharing of nightmare experiences makes other women reconsider their care. Doctors may dismiss the anecdotal as meaningless, but social change occurs anecdotally and not scientifically.

However, and not unimportantly, doctors have most of the political influence over childbirth. Most people trust doctors. Many women believe that doctors will never recommend a course of action that will harm them. And doctors are more capable of lobbying to influence change within the medical community than anyone, whether it is based on science or not.

So while women gather and share positive or negative birth experiences (stories that leave a deep mark on childbearing women), and doctors are digging deep into studies to back up their claims with a number, we are sitting at our computers debating our stances. Meanwhile, change is already happening around us.