Wednesday, 2 August 2017
My doula training made much of Evidence. I learned to offer clients evidence relating to the decisions they would make, I heard about Evidence based Medicine or Evidence based Practice and I learned where to go for "evidence based information" ie.scientific studies.
Of course, my relationship with evidence started way back, humans start interpreting evidence from our youngest moments. In those early days we do it without the benefit of training and we might make poor conclusions but we do it anyway, exploring the world through trial, error and observation.
In my school days I did well at science, which of course is the whole formal process of collecting and interpreting evidence to make conclusions about the world we live in. I also learned to look for evidence in less scientific areas, analysing the message of say, a novelist, based on the evidence found in the text.
As our scientific understanding grows we seem to value evidence more and more, no longer interpreting the world through superstition, legend and religion but making serious, organised, scientific enquiry into all that concerns us. I think the rise of evidence based thinking is partly behind the decline in Christian religion in the western world. What rational, educated person believes in a God who has no proof? What could we possibly measure to prove or disprove the idea of God?
As a Christian, some areas of my life can't be governed by proof, I have to turn away from the idea of evidence and live in the realm of belief. (or confirmation bias) Many times I have thought that my scientific training and mostly logical approach to life don't match with my religious belief, I have wondered why I live with the dichotomy and I have wondered what it says about me.
As I meet more clients and attend more births, as I explore evidence related to childbirth and watch the process unfold, I notice that no client, no midwife and no doctor makes evidence based decisions all of the time. We decide through belief. If evidence is strong and we interpret it correctly and have no emotional baggage to muddy the process, evidence and belief will become the same thing. At this point we tell ourselves that we will make our decisions based on evidence but what I see more often is that belief creates reality. If a woman believes she can birth without intervention, she has a good chance. If she believes she was made with the capacity to make and birth a baby, she will. If a woman believes she might never have a spontaneous labour, she probably won't. If she believes she will need a caesarean section due to "large baby", "small pelvis" or "obstructed labour" she probably will have the caesarean. The Chinese woman who was told that Asian women can't breastfeed never did successfully breastfeed.
Evidence. It is at once, everything and nothing.