Thoughts on science and evidence based care

I have mixed feelings about "evidence based care" which has been a buzz-phrase in both midwifery and in medicine for a while. Evidence based care has drawn attention to the fact that much of what is done in medicine is less "scientific" than some would have us believe. This is particularly true of obstetrics where there is no evidence for most of the things that obstetricians and their institutional surrogates do to their women victims routinely. In my midwifery practice I have come to not only be skeptical of all standard obstetric routines, but actually skeptical of science itself. Although studies of medical evidence show up medicine, they also show up science. Science has been the source of so much interesting understanding but is so limited in design by its rationalist approach to the world. Rationalism is only one side of our amazing human capabilities.

Let the crazy irrational heart back into science and medicine. When we, as midwives allow that to happen, we are able to touch the true humanity of those we serve. This is what we hope to do as our awe of, and love for the way a pregnant woman grows and the way she opens up and gives birth brings us back to what matters with women and families and keeps us from seeing pregnancy and birth as the mechanistic process that it is not.