More on the theme of THANKS, MEDICINE!
The content of this post may be of little interest to an audience of people who have to move heaven and earth to conceive, so are unlikely to be in my baby-hoarding situation. But it involves bitching about the medical profession, and that’s always worth reading, yeah?
I had a checkup with a nurse midwife student, my own OB being overbooked. I asked her whether pregnancy really did result in such a significant reduction in milk supply that I’d have to wean (as my pediatrician had suggested would happen). No no, she assured me, if I ate and drank lots, I’d be fine. Makes sense, I agreed. After all, how could our species have survived if women couldn’t breastfeed while pregnant? But she wanted to check with the actual nurse midwife just to be sure. The nurse midwife came in after about, oh, sixteen years, and said No, no, breastfeeding causes a release of oxcytocin, which results in uterine contractions, which could cause premature labor. I needed to wean by 20 weeks, so I’d better get started now. I felt my lower lip stick out. I felt tears spring to my eyes. Really? I said. Now? Yes, she assured me. I departed. I resolutely thought of my annoying students as I made my way across campus, so that I didn’t bawl. Turns out that while I didn’t know it, I am not ready to wean.
Once in the safety of my office, I let the tears flow while firing up PubMed. Hey! Guess what? There’s no evidence on either side of this question. All I could find was ONE very recent study showing no difference in pregnancy outcome or birthweight between a group of women breastfeeding while pregnant and one not. La Leche League told me that of course I can breastfeed while pregnant. But am I going to put my unborn child’s life in the hands of La Leche League, a biased source?
I stewed a bit. I wondered where the hell this business about uterine contractions came from, whether some jackass decided it was a possibility and since who really cares, it’s just nursing, better safe than sorry? I thought about the fact that Medicine is not always right, that it takes an absurdly long time before relatively conclusive research leads to changes in recommendation. I thought about the fact that I’d decided the introduction of solids at four months via spoon feeding was not for me, and that co-sleeping was, so it wouldn’t be the first time I’d ignored a doctor… But it’s different to make choices for a baby, where you can see the results and change your mind, and to make choices for a fetus, where the wrong decision could leave you hating yourself for the rest of your life.
As we were preparing Bun Bun for bed that night, I talked it over with Mr. Bunny, who was on board with whatever I wanted to do. And then the phone rang. It was the nurse midwife student. She’d talked to my OB, who had corrected her. Since I’m not at risk for premature labor, I can breastfeed unless I am feeling contractions or experiencing any bleeding or cramping. But also, that my supply will most likely vanish, so I’ll probably end up weaning.
SIGH. It’s encouraging that my OB isn’t telling me to do something that doesn’t appear to be backed up by evidence, but it’s discouraging that there’s a lack of consensus on a basic issue like this one. Is it just that we live in a nation of people who don’t breed prolifically anymore, or don’t breastfeed if they do, or don’t have science done on them if they do both? Is it just that lower breastfeeding rates a few decades ago mean there’s a dearth of information on the topic? If it just that it’s such a low priority concern that no one has gotten to it? If so, FINE, but why the hell have a recommendation on it, then?
I’m not overly cowed by medical authority, but it’s not like I’m inclined to trust my own conclusions over those of doctors. Sure, I can use a database and interpret research, but I am also clever enough to know about things like confirmation bias. So I guess the only possible conclusion is TRUST NO ONE. *Looks furtively over shoulder, draws blinds*