I do not usually read the New England Journal of Medicine for kicks. The graphics aren't sexy. The headlines aren't reader-grabbers. Frankly, I have trouble getting into pieces called "Plasma-Cell Dyscarsia and Peripheral Neuropathy With a Monoclonal Antibody to Peripheral Nerve Myelin."
Furthermore, the closest you get to humor is an ad, like one for Colace that features a locomotive steaming out of a tunnel under the heading, "The Great Laxative Escape."
Nevertheless, the lead story in this biweekly issue could be straight out of Punch. It is, in some ways, the perfect satire of scientific expertise, a case study of how to be-labor the obvious.
It seems that no less than five medical doctors, all specialists, working with grants from two foundations and the public health service have startled the medical world with the following information: it's better for women not to go through labor alone.
Stop the presses.
To arrive at this blockbuster of a notion, the men traveled far, to a hospital in Guatemala. There they assigned an untrained lay woman to stay with each new mother in the experimental group through labor, to hold her hand, rub her back and chat.
The women with a constant companion got through labor and delivery more easily then the women alone, who were only attended by medical people at delivery. They also had a better attitude toward their babies.
So, in a truly risky conclusion the obstetrical-shop quintet said, "The findings of this study suggest the importance of human campanionship during labor and delivery."
Well, I don't doubt the sincerity of these doctors, but this is not exactly fresh information. The study reminds me of the old Sean O'Casey story about the Irish woman who listened while two priests described labor as the crowning glory of womanhood. When they were through the woman replied, "I wish I knew as little about it as you do."
It seems to me these men could have gone out into the streets of Cleveland, whence they cometh, walked up to the first two dozen women they met and asked them: would you feel better going through labor alone or with someone holding your hand? They could have published those answers and used the rest of the grant money to fund a study on How to Use Common Sense in Medical Practice.
Instead they have produced a piece that really should be printed as classic in the Annals of American Expert-itis.
We seem to belong to a culture that trusts its experts more than its instincts. Somewhere along the scientific way, we gave up childbirth to the doctors out of fear and trust. Doctors began "delivering" babies as if mothers were merely assembly-line workers strapped to tables in hospital factories until they produced.
Under "modern" hospital policies, very few women had a relative or friend around. Now we have more experts telling us what our grandmothers knew in the first place: this "civilized" childbirth was an abomination.
The new research is like the recent studies "conclusively proving" that chicken soup is good for a cold.
In the medical establishment nothing is true unless it's "proven." It isn't enough that every woman "knows it's less frightening and more comforting to be surrounded by people -- especially people who care -- during labor. They need statistics and charts, and double-blind crossover studies, and chi-square analyses.
In the past 10 years, pregnant women have formed one of the more effective "consumer movements" in the health field. They've helped create birthing centers and resurrect midwifery; they've insisted on getting fathers into the delivery room and indiscriminate anesthesia out of it.
But in many ways, the scientists and not the mothers are still in charge of childbirth. We give them authority, like Elaine May, because "that man is a doctor ."
There is certainly a need for science and expertise in childbirth, to sort out the use from the abuse of fetal monitors, to curb the epidemic of Caesareans, and all the rest.
But even in an overly "experted" society like ours, doctors don't need a report by their peers to believe that a lonely labor is a scary and unhealthy thing. All they have to do is listen.