An acquaintance had her first baby on Friday. ¬†She has been asking me a few breastfeeding questions today (for once the obligatory nosy text on my part was well-received! ūüėČ ), and I asked about baby’s latch. ¬†Waiting for the answer via text, I was dreading a negative answer, and wondered why. ¬†Do I not really want to put out the effort to help? ¬†Don’t I want to put my expertise and information network to use?


Then I realized that I don’t want them to need me. ¬†I want them to have a normal, straightforward breastfeeding relationship. ¬†I want to be able to support them by simply saying, “You’re doing great. ¬†Keep up the good work.” ¬†And of course, that’s the deep desire of the best doulas, midwives, and other caregivers, too:
  • To be helpful and supportive, but not to be needed.
  • Not to be the hero, but to empower mothers to be their own heroes.
  • To be able to say, “You’re doing great. ¬†Keep up the good work. ¬†You can do this.”

I get the strong impression that the deep unspoken psychology of Western medicine is just the opposite. ¬†Anyone who has studied the differences between the physiological (“midwifery”) model of care and the medicalized (“obstetrical”) model of care knows that the medical mindset expects problems while the physiological mindset expects normalcy, but I’m talking about something deeper than skills training or habit.

I think the medical mindset’s expectation of problems stems from a need to be needed: a sense that if there are no problems to be “fixed,” then the caregiver has no professional value, and by extension, less personal value. ¬†And I think the¬†stereotype of doctors as egotistical and arrogant,¬†and the all-too-common lack of respect for pregnant and laboring women, have the same root. ¬†The more a caregiver thinks of women (or any patients) as foolish and incompetent and broken, the more the caregiver feels needed.


To this, I can only repeat the words of R. Buckminster Fuller: 
‚ÄúIn order to change an existing paradigm, you do not struggle to try and change the problematic model. You create a new model and make the old one obsolete.”


Let’s spread the empowerment paradigm until the paternalistic one fades into the oblivion it deserves.