walkitout (walkitout) wrote,
walkitout
walkitout

the Third Rhetra of Lycurgus, midwives and What's Wrong with our Medical System

On page 377 of _Mainstreaming Midwives_ (review to follow at some point), Johnson says,

"Ironically, professional medical opposition, which has successfully constrained the practice of all midwifery in Massachusetts, has been the catalyst for spearheading the first united midwifery legislative effort in the country. In this case, circumstances favoring initial medical dominance may ultimately produce the very conditions that undermine medical control over birth."

According to Plutarch, Lycurgus' Third Rhetra for the Spartans told them not to fight the same enemy too often or too long, lest they become familiar with Spartan tactics and develop the training and motivation to successfully defeat the Spartans. (Agesilaus got into some trouble for this later on.)

Which is why I object to Johnson's use of the word "Ironically".

What is it the midwives of Massachusetts want? A joint regulatory board for all kinds of midwives, CNMs and DEMs/CPMs/CMs alike -- and not one under the thumb of nursing boards or medical societies. They want to be licensed and independent professionals, quite reasonably, and in line with the way things work in places where midwifery is thriving and leads to fantastically good outcomes for mothers and babies (like, say, the Netherlands). They haven't got what they want yet (feel free to direct verbal abuse to Pedone for not removing his hold on the legislation in this last session), but the amazing thing is that the split that had been dividing the midwifery community (between nurse-midwives and direct-entry midwives) has been replaced by a strong enough united drive for independent licensure that the AMA is running deeply scared and starting its own initiative to ban homebirth across the country.

You would think they'd learn. After all, Lycurgus pointed out the problem HOW many thousands of years ago? And every day in the hospital, as more people are infected with, sicken and die of resistant bacterial infections acquired _in_ the hospital, we see the same lesson: you fight the same enemy the same way long enough, they will come kick your ass, eat your flesh, drink your blood, violate you nine ways from, you get the drill. Er. Or something.

What _is_ wrong with our medical system? Well, I could babble for a while about the historical developments that got us to where we are today. I could talk about "insensitivity to feedback" (except it's not actually completely true). There are some amazingly good cheap shots in terms of economic incentives. I think I'll just go with, turf war. Specifically, you have to leave the other side with something they can live with. Unless, of course, you're prepared to really go with genocide, which usually, at minimum, leads to huge PR problems.
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