Friday, April 9, 2010

REACHE Conference.... more stirring the BirthNurse thought pot!

   Today I attended the REACHE conference. The presentations/speakers were enthusiastic, entertaining, and informative.
      I must admit I love me some research! Interestingly enough, I also enjoy data, statistics, and in particular... Evidence Based Practice (EBP). Several years ago I attended another REACHE conference where Henci Goer  (   was a presenter. She is a well known proponant of evidence and research in childbirth, but she also is very clear about how the data can be interpreted/misinterpreted and learning how to interpret research.
    Over the first few years of my doula career I picked up tidbits of research, data, EBP like I was flypaper and I became aware of the vast quantities of conflicting data and the lack of EBP in childbirthing. I began to cultivate an understanding of the ridiculousness of attempting to apply data to an individual woman. There is no real way to extract research from a particular study or even a group of studies that can be reliably applied to a particular situation and result in an expected outcome. People don't work that way, birth doesn't work that way. But many elements can be integrated into the way we approach caring for birthing women as a population, especially in the implementation of practice on a systemic level, as in hospitals, physcian/midwifery clinics/practices, etc. That is why we do these group things, form collaborations, beg for research money, because we want to change more than just one person's experience. We want the best for everyone, or as close to the best as we can get. But how do we know what's best??
   As one of the speakers at the REACHE conference alluded to today, as human beings we naturally chose things that meet our needs. With the internet at our fingertips we can easily find "research" that supports any view we may want to champion. Or even better, any practice that we want to adopt, or more likely, a practice that we are comfortable with and do not want to change!
    As I gathered more information, and attended more births, I began to change the way I talked with clients, instead of citing research that supported certain choices.. i.e. non-pharmalogical interventions, breastfeeding, etc. I began to cite research with the caviate "of course these studies don't necessarily apply to any individual, every experience is different", or something along those lines.
   As always, applying science to human behavior is a tricky business. This brings up my beef with Darwin, but I'll have to save that for later. Although birth is a physiological process, that is just one of it's many facets. Birth is also personal, emotional, familial, cultural, societal, public, private, the list goes on.
    Birth not only entails the individual experience of a woman having a baby, it also encompasses a fetus (or multiple fetuses), a family (however that may be defined), the care givers, attendents, and the combined experiences of all those involved, however indirectly. In other words we bring the entirety of ourselves into every situation we encounter, and so does everybody else! (How well we are able to seperate out the elements of ourselves we wish to display/use, and how each influences the other is a topic for another day). Not only is birth a complicated, unpredictable physical event, it is also a complicated human event, and it carries with it all the mess, misunderstanding, and uniqueness of all of our humanness.
   No Wonder we all have so much invested in Birthing. We have big feelings, big opinions, and big investments in Birth because it is a Big Deal!

1 comment:

  1. It was great to see you there! I hope you will consider an interest in the board next year! We will be in touch!