For a long time, I’ve struggled with “science”. This end all, be all, god-like approach to life has rubbed me the wrong way since I was a little girl. When someone tells me definitively, this is the way it is - my response is - “oh yeah, why?” - possibly with my arms crossed and my weight shifted and a smirk on my face. Science pretends to like the question “why?”, but really, once the paper is published and the funds are deposited in those bank accounts, science and academics alike don’t always love that question, especially from the general public.

What’s so challenging for me as a Clinical Herbalist, is that I use science everyday in the way I understand plants and the body. It’s how I’ve learned how to help people with their health and how I’ve learned to make medicine. I view science the way I view the impact of technology, we enjoy using it and it’s improved our lives, but it’s also really fucked us up.

So how can we co-exist with science?

I think the way to do this, is with an open mind and understanding that science is just one way of viewing the world and comes with it’s own set of biases that interact and are influenced by our own.

Let’s unpack it using birth as an example.

“Using Evidence based birth won’t save us. It is derived from scientific studies, flawed, and biased.”

When I first started out as a Doula, I was trained with evidence based birth. My business partner and I structured our classes, social media, and hand-outs around the statistics and studies that supported doula-led initiatives in birthing spaces. We taught our clients to use this data with their care providers in prenatal care and how to bring the recommendations of scientists into their birthing space as a way to convince a care provider that they should follow their wishes. However, in practice, it never worked. Using evidence based birth as a foundation for our Doula work didn’t really impact our birth outcomes. Regardless of the studies and their supportive data in the favour of birthing positions, delayed cord clamping, vitamin K practices, and pushed coaching, for example, hospital policy and work-place practices reigned supreme. In some cases, care providers (midwives, ultrasound techs, nurses, anesthesiologists and doctors), delighted in using the hospital policies to undermine my advocacy work as a doula and my clients own advocacy as the patient (in instances when a doula was present and when she wasn’t). That was my experience in my company, however, If you speak to any other Doula or family that’s birthed inside the system, I gaurantee you, you will find similar stories.

Did they advocate enough?

Often times, this is on the minds of those who listen to the stories of obstetric violence. Did the patient advocate properly (whatever that means, no means no). There’s a tendency to individualize the problem. I say this all the time - even those of us who are the advocates for our clients can’t even advocate for ourselves in these spaces.

I’ve had clients who were in the police force, the military, who were doctors, dentists, midwives, and they’ve all had trouble within a medicalized birth advocating for their needs and receiving a YES to their clear YES or clear No.

So yeah - they advocated.

They were well educated, they know how to speak up, they run in powerful circles, they go up against the system on the daily, but at the end of the day were in the same boat as every other woman giving birth.

They did nothing wrong, yet the same science that dictates these experiences, fails them.

The system as a whole is functuning in an inhumane way.

Why does evidence based birth fail in the birth room?

I’ve actually been in the same trainings with nurses and doctors, specifically around skin-to-skin, first bath, and breastfeeding best practices, reviewing the same literature as everyone in the room, so I know we’re both reading the same thing, but then post-education in practice it still doesn’t influence staff behaviour and care, even when it’s woven in to hospital policy.

We are using the same science, right? I thought science was black and white.

Aren’t we working with the same science?

In order to understand how this gets so twisted we need to go back to the basics.

What is Science?

Science uses quantifiable data and systematic methodology to form an opinion on a hypothesized topic. Scientists gather numbers ("evidence") to prove or disprove a theory.

The scientific method is sold to us as this black and white thing in which we understand our world. Some white men somewhere figured out that if they boiled down a problem to the just the numbers and controlled the conditions of the study, they could have find answers to all of life's questions with very small acceptable margins of error. This is what we’re sold on as the concept of objective thinking or objective messaging.

Don’t get me wrong, I know as a population, we’ve genuinely believed for some time that scientific study was conducted with honest and earnest intentions for the good of all, but, we now have a better understanding that scientific studies don't just pop out of thin air. This has become especially evident in our most recent experience with the manipulation of data around the you know what pokey jabby thing that we can’t explicitly talk about without censorship.

“Science is influenced and funded by corporations, like big p h a r m a or individuals who are invested in a particular outcome.”

What is Scientific Bias?

Scientific studies are actually deeply flawed. They contain many biases that span a range from conflict of interest issues due to funding, to race, socio-economic status, classism, abelism, age, and geographical considerations for both researchers and participants.

Think of a pharmaceutical company hiring their own researchers to conduct a study on whether a new product is safe and effective for the public to consume. Whether they hire the scientiests from within the company, already on the roster, or externally, there’s a slow of conflicts of interest in gathering this data. We know these companies do tend to hire within, especially outside of Canada. The public is sold on this data as something objective and unbiased. It is shared with us as the gosepl truth and established findings that may be refuted, but likely will not.

Stick with me here! We’re getting to the question of why the science doesn’t equate action in the birth room.

Before science, there was religion. Religion dominated the narrative and dictated the way we moved and lived our lives.

Unlike the church, we don't gather to hear from lab techs or scientists in the same way as religious leaders, instead, we are instructed on how to behave in a Scientific way through the media.

The Medium is the Message

We’re not going to dive into Marshal McLuhan because that would be a whole university thesis, but, my point is, whether it is the news, a radio announcement, or even a meme, whatever the medium, we consume the messaging of scientific belief through our screens.

We LOVE media.

Our lives revolve around screens.

It's pretty easy to cultivate specific behaviours when the same messaging is repeated over and over again in every space you engage with.

Think about the government's roll out of pokey jabby things (v a c c i n a t i o n) and it’s use of the scientific narrative.

This is classic psychological manipulation at play. Do this thing and you'll be rewarded. Don't do it, and you'll be punished by your peers but inserted subtly, repeatedly, almost at a subconsicous level and with consequences so integral to our survival in this world that you almost can’t resist. In this instance, one of the biggest underlying messages was social shame.

Shame is the biggest psychological manipulator, and community and belonging is not only something we need to survive as humans, but an incredible motivator / reward.

We could literally earn a degree in this topic, so we won't go too hard into the details, but you can see how if we receive the same messaging over and over again and are rewarded for complying, that the majority of people are going to comply with the “scientific” narrative - even just purely out of survival.

How are we psychologically manipulated by the media?

Circle back to bias - who pays for the media to deliver the message? Let's be cognisant that the media is also funded, like the scientific studies themselves, by corporations, or individuals, or political parties who are invested in a particular outcome. The intereted party that pays the most, dictates the messaging.

“Hospitals, government funded or private, are businesses. They have bottom lines, stakeholders, interested parties, and political allegiences, whether they’re transparent about them or not.”

Hospital Bias

Here’s the thing. At the end of the day, a hospital is a business, just like a newspaper, or the CBC. It is biased towards it’s funding source. Even with BEST intentions of every single human working within the hospital, or the media company, this is the situation we find ourselves in.

Let’s recap

There’s bias in the scientific study.

That study is either released to the media and may or may not influence on hospital policy depending on the bottom line, or it is released at the academic level through journals (like the JOGC, Journal of Gynecology of Canada), regulating bodies, conferences, etc. to the industry, which trickles down into hospital policy BUT! We’re still left with the question - when we dig deep into the data and are looking at the same fucking numbers - why aren’t doctors and patients experiencing the recommendations in the same way?

"Evidence based" information can be used in any context, for any outcome, depending on what spin you put on it.

Let's look at reporting on c-section rates as an example of how "best outcomes" for birth can be reported.

You could read a news article that says

"Ontario's c-section rates rise to a shocking 24% of all births"

or, you could read an article in a different news outlet that says,

"Only 24% of all births are c-sections".

See the difference?

"Evidence based" information can be used in any context, for any outcome, depending on what spin you put on it. The numbers are the same but the messaging is different.

So even though the nurses and doctors and midwives etc. have access to the same information that I have as a Doula, they may have received the messaging in a different way then I received the messaging.

Can you guess which headline most people would feel concerned with?

Can you guess which side of the messaging is probably being trickled down through care provider work places?

It's like putting the emphasis on a different syllable.

The data can be spun in any way to make us pick a side and then operate from that place. I

This is not what most of us signed up for.

It’s easy to lump care providers into a category of people we can be mad at for obstetric violence or poor health outcomes, but the truth is, they’re stuck too. I want to honour the experience of these humans that work under these inhumane conditions that have them acting in ways they would otherwise not choose to act, but feel forced to do so, under durees of the subconscious and conscious conditioning of their workplace.

So even though you may have a nurse who wants you to birth that baby on your own, they are following the practices of their hospital to tell you to stop pushing so that an OB can be present to “deliver” your baby. If they don’t do that, there will be consequences which impacts their livelihood, which puts their entire family unit at risk and so on and so forth.

I also want to acknowledge this is not something one person can tackle on their own. A nurse from within, or a patient complaining to the one staff member that receives care-complaints, or even taking it up with the college of physicians, will not create the level of change we require. The medical-industrial complex is a one of the most dominating forces in our society and requires collective action on a grand scale to conquer. The impetus is always on how to make the most amount of money, regardless of the cost, including the cost to human life. That is how capitalism continues to function and hospitals and media outlets are a part of that.

Understanding the bias in science allows you to make informed risk based decisions

So now that we’ve worked through the various ways in which science is biased, how science is consumed by the general population and care providers, and how it trickles down into care practices, you can see what you’re up against. Now you know that if you are going to engage in western medicine in this way, you understand a bit about it’s origins, how the hospital is a business and what’s at stake if it doesn’t behave in a certain way, how the staff need to follow suit etc. Now you can enter into that arena with more information to make informed decisions for you and your family.

I know that was long, but I genuinely hope it helped. We’re going to continue to pick this apart as we unlearn the ways of the capitalist world, western medicine and “health care”, and replace it with more inner knowing and natural medicine. If this resonated with you or if you liked this in any way, please leave a comment and let me know.

—Nessa