BURDEN OF PROOF

In this country (US), we pride ourselves on our “innocent until proven guilty” justice system. Why? Because the direction of the burden of proof makes an ENORMOUS difference in approach, fairness, and focus. If we assume you’re guilty, then we really aren’t in the mood to listen to what you have to say (after all, you’re a creep!) and how do you prove a negative? (I can prove you did it by providing evidence – but what evidence is there that you did NOT know the person or that you did NOT do an action??)

Which side you approach an issue from makes a huge difference in the reaction to those listening. Want an example of this? Watch a Discovery channel show on red foxes….

”The hungry fox wanders the snow covered field, desperate for food. The fat that she had put on for winter has been used up, and she knows that her newly born cubs depend on her hunting skills for their survival as they wait in the den for her return. A tiny movement catches her eye under the thrush – a rabbit is nibbling on some leaves peeking up through the snow, unaware that it has been spotted by the starving mother. The fox sneaks up behind the rabbit as quietly as she can, but her hunger makes her move too quickly and her foot breaks a branch. The rabbit hears her and the race is on! The desperate fox knows that this could be her only chance as she is in a race for her life….” You’re probably thinking, “Go little fox – your babies need you! Go fox!”

What if the program was from the point of view of the poor rabbit who spent the winter trying to survive, waiting for the reward of clover to signal success and the coming of spring, happily nibbling away on it’s treasured find…when suddenly *cue scary music* there’s a noise from behind! A FOX!! Run little bunny….run!!!

So can we agree that the angle at which we approach something can greatly effect our point of view and perception?

I get tired (almost in a physical sense) of having to prove an innocent (and our innocence). Take homebirths – we work tirelessly to prove homebirths are safe. MANA (Midwives Alliance of North America)  has been collecting data for years on the outcome of homebirths (in fact, I’ve been a part of this collection of data with my practice for the past 2 years) – MANA and has done a great job of this, and it shows that we have excellent outcomes.  But I still don’t understand why the burden of proof is on US! When hospital births have only been the norm for the past 100 years, why is it that THEY have NEVER been asked to prove that hospital births are as safe as homebirths? I am truly baffled as to how we got on the defensive here! Have there been studies to show that hospital births are safer than homebirths? We hear the statistics thrown about on a whim – America ranks 44th for infant mortality rate compared to other countries,
Amnesty International just said we have a “shocking” maternal mortality rate (although I’d disagree since a quick look at the statistics comparing nations shows us as doing alright). Where are the studies showing that hospital births are safer? Why is the burden of proof on us? Why do people assume hospitals are safer and place the burden of proof on homebirthers to prove that we aren’t DANGEROUS!? I don’t understand that.

one of the many posters promoting breastfeeding

Same thing for breastfeeding – why must breastfeeding be “better” for the mom and baby than formula feeding? Why is it that study after study must be released in the media touting the benefits of breastfeeding? That seems backwards to me – how about comparing FORMULA to breastfeeding?? Shouldn’t breastfeeding be the standard? If that’s the case, then you would see things like, “Formula increases risk of diarrhea and other intestinal complications in the infant”….not “breastfeeding decreases diarrhea and intestinal complications in the infant”. You may not recognize it immediately, but there’s a difference. Being subtle doesn’t make it less important of a difference (a mosquito may be barely noticeable – until he gives you malaria, then you will never forget that teeny tiny mosquito you tried to shoo away!) All of the wonderful posters and promotion for breastfeeding…because a formula mother might be made to feel “guilty” for formula feeding if the standard was breastfeeding and instead people were educated about the dangers and risks of formula. It’s okay to say how great breastfeeding is, so long as formula is the standard and is “good” (so as not to offend). The problem is that we have probably long ago accepted that we aren’t perfect and usually no longer strive for perfection. We have learned that being ‘good’ often means being ‘good enough’…and so yeah, while breastfeeding is “ideal” (read: ‘perfect’), formula is “good” and therefore there’s no reason not to go to formula, especially when people who we have been told we should respect (OB’s, pediatricians, nurses) recommend formula! It can be totally overlooked the fact that they have no training in lactation….and even overlooked when they give totally 100% asinine and STUPID responses when it comes to breastfeeding..they are respected and the PERCEPTION is that they know what they are talking about – even if they do not.

I, personally, have been told 9 different times through my nursing relationship that I would have to wean my baby because of a medication I was going to be taking – only to look it up and find out that it was totally fine for breastfeeding! I also had a pediatrician look at my petite 9-month old daughter and tell me with a straight face and totally serious that I should start, “supplementing her diet with butter, vegetable oil, and ranch dressing” because she had fallen off the growth chart. Yes…that’s a direct quote. Yes….those are the items that she recommended we feed my 9 month old daughter, despite my explanation that I was teeny-tiny as a young child and they were concerned about my growth for many years and everything was normal. Nope – she was smaller than their growth charts and therefore I should try and fatten her up by giving her those foods! Needless to say, I never gave her those foods…she is now 4.5 years old and totally healthy and normal for size!! (and sharp as a whip…she keeps me on my toes!)

So when did we go on the defensive? It’s a very smart strategic move of diversion – rather than trying to actually have transparency in the obstetrical field and trying to prove that hospital births are safe, let’s point a finger at homebirthers, paint them as uneducated hippies, and request that THEY prove that homebirths are safe….while we whistle and look around the room and hope that nobody notices the diversion. It’s proven to be a smart move…as we dodge bullets and try and yell back, “look at this study!” and they say, “What? Can’t hear you….”

ACOG: Prove to any of us that a low risk mother is safe delivering with an OB in a hospital!

FORMULA COMPANIES/BABY SPECIALISTS: Prove to any of us that formula is as good as breastmilk and/or is safe for babies!

7 Comments

  1. Jennifer Weston wrote:

    Forget it. I’m just going to put a link to your blog on every webpage that i make. clicking and copying every thime you wirte something that is perfect and shareable, is tiring, sence you do that every time you touch your keyboard. Right on, once again.

    Wednesday, March 31, 2010 at 11:25 am | Permalink
  2. Ana Hill wrote:

    What you write is so true. Birth is NORMAL. Breastfeeding is NORMAL. And a little story to go with your ranch dressing story: I’ll never forget the pediatrician (proudly displaying her FAAP certificate in her exam room) who told me that my active, petite children needed to be contained in a playpen so they would not develop hyperactivity and so they would gain weight. Sigh…

    Wednesday, March 31, 2010 at 12:23 pm | Permalink
  3. Amanda Vermilion wrote:

    Spot on! Dr. Gladys McGarey released a book (Living Medicine)that states your point exactly. Perception is skewed by language and presentation. What is proudly sold or broadcast as “normal” is in fact “abnormal” and vice versa. It’s all backwards. Thanks for sharing..

    Wednesday, March 31, 2010 at 12:47 pm | Permalink
  4. Amy Drorbaugh wrote:

    I’ve gotten the “feed your child more fat” line too. Honestly, it’s like they’re trying to fatten our children up like cows for slaughter.

    Great metaphors!

    Wednesday, March 31, 2010 at 12:51 pm | Permalink
  5. Anisa wrote:

    Right on! Why should we have to keep proving that birth and breastfeeding are normal and natural!?!? Sharing on facebook!

    Wednesday, March 31, 2010 at 12:56 pm | Permalink
  6. mishalee wrote:

    i love you stephanie. i’m not a homebirther, but through the az birth community i am learning so much. seven years ago i thought midwives were extinct, something from history, just because that’s how i grew up…babies are born in hospitls and drink from bottles, right? breastfeeding, aside from all the things we know healthwise, gives me a sense of accomplishment and pride. i feel sorry for moms who can’t/don’t/wont nurse their babies. i wouldn’t trade it for anything. education is key!

    Wednesday, March 31, 2010 at 3:59 pm | Permalink
  7. Lindy wrote:

    AMEN!!! The ACOG has its head up it a** and the formula companies are just another pathetic bolster for the corrupt dairy industry. Ugh… BTW loved reading “Milk, Money and Madness”.

    Saturday, April 3, 2010 at 3:08 pm | Permalink

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