An aquaintance of mine is currently preggers. The baby is due in just a few weeks and appears to be adamant in his insistence that he be born ass-first, so like any good soon-to-be mother, my friend has explored the options available to her. The only trouble is that there don’t appear to be many options out there.
The most common result in a situation such as this is a caesarean section, which is the way my friend will probably go. It’s a choice that might seem obvious and everyday but in its own small way is really quite admirable and highlights the sweet lack of selfishness that defines parenthood: pursuing the option that presents the most protection for the baby, despite the slightly increased risk to the mother’s health. One recent study suggests that 27 of 1,000 women will face “severe morbidity” undergoing c-sections, compared to 9 out of 1,000 for vaginal delivery. (“Severe morbidity” refers not just to immediate death but also to the development of potentially life-threatening organ dysfunction, like severe hypotension and pulmonary oedema. For the generally accepted definition of “severe acute maternal morbidity,” about one in five such cases will die.)
On top of all that, of course, there is still some risk to the baby born via c-section. Basically, if you happened to be a remarkably intelligent and well-spoken fully-developed fetus with access to all the latest research and statistics, you would most likely choose to be born vaginally, head-first. (Unless in addition to your remarkable intelligence you are also blessed with a correspondingly large neuroses, at which point you may opt for the c-section for fear that the memory of passing through your mother’s vagina might leave you emotionally scarred and unable to establish meaningful relationships as an adult, but that’s another matter.)
With that in mind, it’s only natural that a caring mother would try her best to ensure a natural birth, by spinning her baby around to emerge head-first. There is a way to do this — it’s called external cephalic version, which is a fancy way to say “pushing the baby into place.” (While researching this procedure, I found this delightful quote from American Academy of Family Physicians: “Physicians can begin with the classic forward roll or the ‘back flip.’ ” Wheee!)
It works like this: the mother lays down and gets gelled up with ultrasound goo. Then, the biggest, strongest doctor in the office/hospital pushes hard on the mother’s abdomen, coaxing the baby into place. It works 40% – 80% of the time (depending on physician and gestation time), and from what I hear, it hurts like hell. I mean, just think about it for a second. Ouch.
When you consider that the only option is a painful procedure that might not work, who can blame a mother for going to the dark side? I speak, of course, about “alternative” medicine. Alt med isn’t always about ingesting herbal cure-alls — there are plenty of homeopathic and naturopathic substances marketed toward pregnant women, which can be very dangerous considering that such things aren’t well-regulated. In this case, though, the alternative to the scientifically proven method consists of reiki and “postural management.”
Reiki is a pretty word to describe waving your hands around like the Karate Kid, hoping that some magical combination of movements will result in a miraculous healing of the problem. No scientific study has ever shown that reiki cures anything that can’t also be cured by a good nap.
Postural management involves maintaining certain positions to increase the likelihood that the baby will turn on his own. An exhaustive study in 2000 concluded that there is, “not enough evidence on encouraging the mother to adopt different postures during pregnancy to change a breech baby’s position in the womb.”
Of course we know that all the carefully controlled studies in the world can hardly compete with power of superstition ingrained in communities, so people continue to try these methods. Most of you would, too, if you were just a bit less skeptical. Think of the benefits these methods have over external cephalic version:
- Harmless to the mother and child
- Performed outside the cold and sterile hospital environment
- Easy to do by yourself (positioning)
- All the benefits of a massage (reiki, often)
With all that going for it, one can hardly even notice the drawbacks:
- Added expense
- Completely ineffective for reducing breech birth
My friend’s doctor encouraged her to do version, repeatedly saying that she could try alternative treatments if she wanted, but, “I’m a scientist, and science says version is the thing that works.” The science talk did nothing at all to reassure my friend, who was facing a painful procedure. She decided to do reiki and positioning anyway, saying, “I know it probably won’t work, but if there’s a chance, why not try it? And I get a massage out of the deal.”
How do we go about stamping out superstitious, ineffective treatments when they present such a tempting alternative to the cold pain of science? Listening to my friend discuss her treatment with others, the word “science” came out like a slur. I’m reminded of the Gingritch-era Republicans’ savvy attempt to give an unfavorable connotation to words like “liberal,” public relations tactics that continue today. I can’t help but wonder if the alt med crowd has accomplished the same spin job on “science.” “Skeptic” is often misunderstood as “cynic,” something we critical thinkers fight every day. I know some people have considered abandoning the term “skeptic” altogether because it is so often used in a negative context. I’m not quite ready to give it up yet, but can understand the sentiment.
The word “science,” though, is not going away and we need to be protective of it now. Think about that the next time you’re discussing alternative treatments — or any pseudoscience — with someone who may believe in them. How do you use the words “science,” “skeptic,” “rationality,” “reason,” and “logic?”
It can be difficult to be aware of how you come across 100% of the time, and that’s something I’m always trying to work on, too. I admit that in the case of my pregnant aquaintance, I was unable to find an appropriate response that wouldn’t alienate her. So, I’ll throw it to you readers: what would you do if you were involved in a conversation like the one above, and how would your approach change depending upon if the pregnant woman is your best friend, your sister, your coworker, your boss, or a stranger at a party?