Jeffery L Nicholas
Philosophy and social theory
to building a society of flourishing people
united in common goods.
to building a society of flourishing people
united in common goods.
We are nearing the end of National Midwifery Week, so I want to leave you with something positive, something to continue motivating you to ask questions for your own care.
Midwifery is, not simply good health care, better for the mother and child and family, better for the community, but it is pro-woman. I've alluded to this before: the first role of the midwife is to help the mother trust herself and trust the natural process. The first role of the midwife is to empower others.
What we see in the US system is quite different. The system is based on fear: a fear of death ultimate, but that manifests as a fear of litigation and a fear of loss of control. Watch videos of women delivering and you will hear guttural--beautiful--noises coming from them. They are able to let go. Yet, we fear when to let our bodies go so often in this controlled society. We fear being too fat or too thin. We fear being sued because we have no control over the situation, so we try to tighten the screw. But like any normal screw, over-tightening leads to stripping the screw of its natural form, making it incapable of functioning. So we discard it.
The primary virtue--to be a little philosophical--of the midwife is trust. In the basis of that trust, she is able to help the laboring mother listen to her body, to trust what the body is telling her. Some times, the body tells her that it needs some medical help. That empowers the mother to exercise her agency, by listening to and trusting her body. She can make a decision grounded, not in fear, but in love and honesty.
I don't mean to romanticize the labor and birth. It's painful. Nor do I intend to demean any one who desires to numb the pain through an epidural. Rather, I'm simply inviting people to consider other possibilities. Possibilities grounded in the empowerment of women and of families. I've talked about the dominance of science in our country and asking ourselves where science and technology fit in human life. That is all I am doing here: at what point does technology and medicine in the birthing room support human life and at what point does it detract? A midwife is one of the best, if not the best, guide in helping to answer that question.
My interest in midwifery stems from the social justice issues around it. For me, as most of my readers know, social justice ties directly to community. Midwives, unlike obstetricians and other medical professionals, are more inclined to help build community.
Thus, in the movie "Why not home," several of the midwives commented on their role in building community. "We should help build communities around birth because that makes families stronger."
In the US, our culture is built on death--how could it not be when it is founded on the genocide of First Nation Peoples? How could it not be when it arose at the same time as the industrial revolution which often requires the death of community, the death of individuals, and the death of the land?
We need to change. As mindfulness and Buddhist teachings tell us, we do not have to keep on going the same way we have been. We can, instead, look at our past and realize what we would like to change about it, and move forward with that change. Beginning with a change in the status of midwifery in the US is a crucial first step in this change. Just because doctors, hospitals, and insurance companies have fought over dollars in the birthing room does not mean that we need to continue to let this happen.
I invite you, not just to accept what I write here as fact, but to question. Question your doctors and hospitals about their high infant and maternal mortality. Question why the increase in C-sections continues when it coincides with a higher maternal mortality. Look at the studies, not just the ones done in the US, but those done in the world. Look at the Frontier Nursing Service which provided midwifery services in Appalachia--some of our poorest country--for 20 years without an infant death, compared the the growing obstetric practice.
And remember that I am not advocating that we stop all technology and all hospital or obstetric led birth. Rather, I am asking us to do what most needs to be done: to integrate our science with a life-affirming way of life.
Last night, I had to wonderful opportunity to participate in a panel on the movie "Why not home?" by Jessica Moore at the Sarah Doyle Women's Center at Brown University.
The movie is simply wonderful, showing the beauty of homebirth while discussing--in a most balanced way--the issues involved. If you have the opportunity, please attend one of the screenings around the country. I am thinking of attending the one at Brookline in order to meet the film maker.
In the US, we spend more on birth than any other industrialized nation ($111million), while suffering worse outcomes. For example, the C-section rate has increased to 32% in the US over the last 12 years, while maternal mortality has increased--more mothers dying from birth. Further, our infant mortality rate has fared poorly compared to other countries--deaths have decreased only 13% in the US while they have decreased by 23% in other industrialized countries.
One other interesting point from the movie: the main study used in the US to discriminate against homebirth refused to include the major study from the Netherlands. Thus, the Netherlands' study involved 500,000 homebirths, while the US study involved only 50,000.
As I stated last night, when we deny people information, when we limit people's choices, when we refuse to share information with others, we dehumanize them. In the US, our medical field and the media dehumanize women and children every day, every year, killing many and making many others suffer. I ask you to inform yourself and your loved ones and all you know about the facts around birth, midwifery, and family life to make the best decision for you.
This article should both sadden and frighten us all.
Scientists have discovered that they can use any cell to begin reproduction through a form of parthenogenesis. Parthenogenesis is a cellular process by which some animals--mostly reptilians and amphibians--can reproduce without a male partner. You may be familiar with this term from the Jurassic Park movies, for they use parthenogenesis to reproduce the dinosaurs.
Like the scientists in Jurassic Park, our present story lacks any discussion of the why. Why should we use non-egg cells to reproduce new life? The reasons are easy enough,perhaps, to discover. A gay couple may want a child of their own genetic material. A rich, childless man may want an heir. Or perhaps it is the first step to immortality in one's own body, so to speak.
Or, to follow the thread here even further: we can imagine a future species like the Bene Tleilax who reproduce solely through cloning.
The title of the piece is telling here: "motherless" babies. The Tleilax use axlotl tanks for reproduction--women hooked up to machines, with no autonomy, no agency, simply used for the womb. For a long time, I have wondered about parthenogenesis as a story element for a male-less society. Here, though, in reality, the scientists are pursuing a female-less society. At what cost? What thought has gone into this? We already know that female fetuses are aborted at higher rates than males, that women have fewer opportunities for expansion of their agency throughout the world, etc. Imagine, it's not too hard, a China with a one child policy and this motherless science.
That possibility leads to greater threats of course. We know, for instance, that chimpanzee infants would rather cuddle a terry cloth robe than nurse from a bottle hooked to a metal mother-figure. Mothers in the US receive limited maternity leave. We devalue them everywhere. Yet, without mothers we become inhuman--we lack the basic touch that produces healthy men and women secure in themselves and in each other. We return again and again to a world filled with monsters but no human persons.
Someday, I hope soon, we may learn that wisdom must precede science. That is the real message of the masterful novel The Canticle for Liebowitz.
Robbie Davis-Floyd provided the first lecture at the HBHE conference on the three models of birth: the technocratic, the humanistic, and the wholistic. Robbie has worked long to spell out the technocratic model of birth, especially in Birth as An American Right of Passage. My comments here compliment and supplement hers, especially in light of the conference.
The technocratic model sees the human body as a machine, birth as a mechanical process, which typically is seen as breaking the machine or needing technology to assist in the mechanical process. This model dominates Western, modern culture. Since the rise of modern science and Newton's founding of universal scientific laws, we have viewed the world as a machine, which inevitably meant that we human beings were also machines. This worldview led to the problems of modern philosophy: Descartes' dualism which separates out the "soul" from the machine of the body, and Kant's noumena, which separated out free will from the every day world. When we examine the machine--the human body--we can find no ghost in the shell.
But of course, once we've given up the ghost, it's easy for us to think of ourselves as robots, to buy into the idea of the "selfish gene," for which our bodies are mere conduits of the will to live.
My work has focused on the underlying issues, specifically subjective rationality. Technological rationality is just one form of subjective rationality. As I define it in my book, subjective rationality is when reason is seen as merely instrumental or classificatory. That is, reason is only the slave of the passions, as David Hume says, and can tell us only how to get from A to B or how to classify objects. To have a healthy birth, we must be able to classify health: it's a certain heart rate, a certain color to the skin (measurable of course), a certain way the blood passes out of the foot when pricked. How do we get a healthy birth? We use our best technology to produce the results we want.
The problem is that subjective rationality is empty of ends. Thus, any ends are justifiable! Treating the mother like a machine, removing her agency, by, for example, giving her Twilight Sleep, or simply declaring the birth a danger and thus requiring a C-section, is justifiable because it serves the pre-given ends of the medical--technological establishment.
The rather abstract point I am making is this: we need, not only new values, but new ways of reasoning. We need to recognize that we can evaluate some ends as unjustifiable. As I define it in my book, reason is rather the giving and evaluating of reasons, of ends, and of values.
Here is where I think I disagree with something Robbie said in her talk and states in her book. She affirms that she would never question the way a woman gives birth. That is a personal choice. On the one hand, this claim is obviously true: we must all make our best decisions about what is right for our own health. On the other hand, though, it subtly gives the game to the subjective and technological rationalities. It does so because it refuses to question. In short, it reduces to emotivism: the idea that all values are based on mere emotion.
Yet, what we have to do is understand that emotivism is a terrible, terrible way to live. It turns us into either vampires or zombies (the subject of the book I am currently working on). It allows us to live as machines. It allows us to leave our encounters with the divine unquestioned. It allows us to escape responsibility. Emotivism, in short, leads to the technocratic model. In order to overcome that model, we must first overcome emotivism.
What HBHE did was provide us with new ways of reasoning based on new ends, new values. The task is to take that out into the world, primarily through education, whether formal or informal. Those who teach birth classes must fight long and hard to undermine the culturally ingrained subjective rationality. They must do so by beginning to question their own way of reasoning. Subjective rationality has its role in human life. We have to be able to move from one place to another. But the more important process is to determine whether what we are moving toward is a good end or not.
During several sessions, we heard about the need to resurrect and preserve the traditional forms of midwifery. We also heard about the need to synthesize the traditional ways with science. Michel Odent spoke of this mixing some In his call for a new metaphor to drive our lives, one away from domination and to symbiosis, of which I wrote here. The other expressed beautifully by Romiro Romero from Colombia was the need to incorporate the medicine of today with the healthy traditions of the grandmothers. He wants us to plant new seeds which we will see sprout fully in nine generations.
I've written on traditions and science before. But let's put this in context. People in modernity wanted to cast off the traditional knowledge. For Kant, enlightenment was the breaking free from self imposed chains of listening to others. For Descartes, we had to throw out all of our previous beliefs and build them on the foundation of knowledge. We must remember that these philosophers and others had good reason to make these calls. The Church and the political reality had grown oppressive, untrue to human nature.
Yet, what we are reminded of by people like Romiro or Angelina from Mexico, is that we have thrown out the baby with the placenta--literally. We yank the baby from the womb to cast it immediately away from mother's milk into a cold, scientific instrument to weigh and measure and classify and organize it. That is the domination of subjective rationality which I have attacked in previous blogs and other writings.
Traditions, rather, living traditions are people discussing-yes, arguing, but also clarifying and developing-- agreements--wisdom--about the good life and good practices. Living traditions are about loving life. So when the Catholic Church in previous centuries, and other witch hunters, denied life to individuals, it was no longer living. What we desperately need are to revive and resuscitate these living traditions to learn from them, as I argued in my book. This resuscitation requires a wholistic vision. We must reject the inhuman values of modern science and replace them with the human values of living traditions--of the indigenous people of Colombia, Brazil, Mexico, Spain, Scotland, the Lakota and the Cherokee.
These new values mean that we do science differently. And they mean a rejection of capitalism.
They mean simpler, but not primitive, lives.
And they must be grounded in the ground--living with the earth, loving the earth, for we are flesh of the earth, living earth breathed to life by God with each breath of each atom.
Please join us: Heal Thy Birth; Heal Thy Earth.
People often ask, and more so at this conference, What does my research, my life, my work, have to do with birth and midwifery?
A fair question, I suppose. I'm not a midwife. I've never given birth, though I've been present at the birth of each of my children. I am not a woman. So, why am I interested in birth?
Everyone experiences birth. It is central to our lives, to our humanity. The activities, values, social morés surrounding birth shape who we are as individuals and as a cultural. I initially approached birth from that perspective--What does birth reveal to us about human nature? And through asking that question, I discovered midwifery as a practice--a teleologically organized set of activities which are, can be, part of birth. Yet, in our society--by which I mean US American, but we can extend this description, unfortunately, to almost every society touched by modernity--midwives have been aborted from birth. In the US, only 7% of births involve midwife attendants, while science suggests that over 90% of births could occur safely at home.
Why did we end up here?
Well, the answer to that question has led me on this journey that I have now been on since 2009: it involves capitalism, subjective rationality in the form of the medicalization and technologizing of birth, the domination of men over women, and at the root of it all, the domination of "man" over nature--the central spiritual, existential crisis of the inheritors of Greco-Roman society, if not the central question of post-neo-lithic times. The advent of agriculture brought with it changes to the way we do birth--as Robin Grille has pointed out--the way we live in society, the relationships between the generations and the genders.
For me, then, the central question might be phrased as, How do we invite in new values and new practices so that humanity, rather than killing itself, instead lives in harmony with nature? Looking into how we do birth and how we treat midwives who are guardians of birth practices reveals, then, a path to reshaping society.
This question explains my attempt to critically integrate the Lakota way of life with the values of Jesus Christ and the heart of Buddhism.
I hope you can join me on this journey.
Jeffery L. Nicholas (Ph.D philosophy, University of Kentucky) is an associate professor at Providence College and an international scholar on ethics and politics. He serves as research associate for the Center for Aristotelian Studies in Ethics and Politics at London Metropolitan University and a foreign research associate at Universidad Sergio Arboleda in Bogotá Colombia. Dr. Nicholas is co-founder of and executive secretary for the International Society for MacIntyrean Enquiry. He is the author of Reason, Tradition, and the Good: MacIntyre's Tradition Constituted Reason and Frankfurt School Critical Theory (UNDP 2012), as well as numerous articles. Dr. Nicholas writes on midwifery and birth, the common good, friendship and community, practical reason, and Native American philosophy. He aims to develop a philosophy of integral humanism that synthesizes the philosophical traditions of Alasdair MacIntyre, Frankfurt School Critical Theory, and Feminist Care Ethics.