To: National Children’s Study
Circle Solutions, Inc.
2070 Chain Bridge Road – Suite 450
Vienna, VA 22182
From: Suzanne Arms
Open Letter to the U.S. National Children’s Study
For the past 25+ years I have been investigating pregnancy care, birthing practices, breastfeeding and bonding in this country, as well as adoption. I am a photojournalist and author of 7 books on these subjects, one of which – Immaculate Deception: A New Look at Childbirth – was named “A Best Book of the Year” by the New York Times and which is often pointed to as having ignited the Birth Movement in the U.S. I have given hundreds of keynote talks and workshops on four continents and am an advocate for non-violent birthing practices and the importance of natural, normal birth as it relates to fostering optimal health and well-being in babies and in mothers. I began my work as a nursery school and day care teacher and headed one of the first Head Start Programs in the country, back in 1966 in San Francisco in the African-American community.
Those of us who have a passionate interest in the public health and child-development implications of how babies and their mothers are cared for – and the decisions made by parents and professionals – regarding the time from pre-conception through the first year of life want to see your study be as far-reaching as it could be.
I am excited at the possibilities of this prospective study and wish to give my input. I am also concerned that the study be set up in such a way as to not only show us what standard contemporary practices are producing in terms of children’s health and development, but also that there be cohorts of people in this study who are exemplary in their health and decision-making regarding their babies and children and who may show us what decisions and practices are most likely to lead to optimal well-being and development.
I am worried that you may end up only studying the pathological practices of this modern culture. For that is precisely what happened in the late 1970s (I believe that was the date), when there was a study of birthing practices in the US which cost $110 million – a lot of money for that time. In that study there was no control group of normal, natural births. There was no cohort of women studies who chose to birth out of the hospital in order to have completely natural, spontaneous and normal births. Women having routine anesthesia, for example, were included as “normal”. And therefore the study was virtually worthless.
This study you are embarking upon could be very significant, depending on how it is set up.
Specifically, There is a growing body of scientific and clinical evidence from around the world showing that what is physiologically normal (which in most instances is also what was traditionally practiced in well-functioning tribal societies) includes:
women intentionally preparing for conception and conceiving consciously
women being prepared and supported to be in a high state of health before conception and to take care of themselves (and be cared for by their community) to remain health throughout pregnancy (in mind, body and spirit)
women birth spontaneously (that is, without any external intervention and who bring forth their baby under their own power and with their own hands receive their child)
women experiencing no separation from their baby in the first hour after birth and putting their baby to the breast during that time to initiate breastfeeding
women remain in close contact with their baby during the first 24 hours and then for most of the time during the next 6 weeks (or the baby being continuously in the arms of other women intimately connected to them
women exclusively breastfeeding for between at least 6 months and who continuing to breastfeed through toddlerhood.
In addition, this cohort of women would include those who sleep with (or within a few feet of) their baby throughout infancy, and who “wear” their babies next to their bodies for a many hours a day.
As you can imagine, the number of women who achieve all of the above is a minute fraction of mothers in this country. There is little to know societal support for any of it. Most women are subjected to numerous routine invasive tests and procedures in pregnancy, in birth, and afterwards, and their babies are therefore also subject to routine invasive procedures. However, that is what is biologically normal and natural and most likely to therefore result in high level wellness in babies and children, and in the closest possible bond between mother and child. Since each and every procedure done to a woman or baby has a risk of altering the course of the process and causing harm to mother, baby or both, we must assume that all procedures and interventions are suspect, even though they may well be necessary at time.
Many of us in this country who have spent our adult lives working to create the best conditions for health and well-being in children want to make sure that you will be studying not only standard medical care, as it is practiced in hospitals, when women are under the care of obstetricians, but also “holistic” care, which is based upon a clear understanding – and expectation – of normalcy.
We believe it is essential that you create and follow a cohort of women, ideally as the “control” group, who:
1). are well-informed about all aspects of childbearing and are either practicing responsible self-care or are being cared for exclusively by midwives (I would suggest that you divide into two groups those who are doing self-care exclusively and those cared for by midwives. And it will be important to select not just any midwives, but midwives practicing in settings where they are not under pressure to conform or adhere to medical standards but are able to practice true midwifery – which is the art and skill of protecting and fostering normal, natural birthing).
2) planning for and intentionally conceiving a baby, and conceiving “naturally” rather than through modern technological means
3) are planning to birth in the privacy of their own dwelling or in a birth center (and I would strongly urge you to separate into two groups those birthing in a birth center and those birthing at home, for the environments are indeed distinctly different)
4) are planning to reserve any medical intervention in birth for complications or emergencies that cannot successfully be handled with non-invasive measures
5) are planning to have full physical skin-to-skin contact with their newborn during the first hour and to allow their baby to find the breast and suckle during that time
6) are planning to (and getting the support they need in order to) be at home and not working apart from their newborn for the first 6 weeks and, during that time, are sleeping with or next to their babies and in the daytime “wearing” their babies next to their bodies for at least 6 hours per day
5) planning to breastfeed exclusively for 4-6 months and to continue well into toddler years, weaning only after the age of 3
If you fail to set up the study with such a group as at least a “cohort”, then you will not be able to know what true biological/physiological normal consists of and you will not therefore have any reference point from which to assess and evaluate standard medical care in birth.
I believe that you will want to include as a cohort those who do not put their child into daycare with strangers for more than 12 hours a week (or so) during the first 2 years and will probably want to include some children who not exposed to television and computer games until the age of 5, and who are home schooled. But I at least want to make sure that you provide for parenting and education of this type.
One last point, please will you include in the cohort of natural, normal birth, those who clearly understand and intend not to use physical punishment or verbal abuse with their children at any age.
Please let me and others whose names I would be happy to provide (nurses, educators, doulas, midwives, child development people, sociologists, anthropologists, pre and perinatal therapists and body workers) be involved in listening to your plans and helping you achieve the best possible study.
I am, by the way, currently co-producing (with documentary filmmaker, Christopher Carson) a made-for-TV one-hour special titled Birth: The Journey That Shapes Our Lives. It is intended to air sometime in 2008 on PBS.
author, Immaculate Deception II: Myth, Magic & Birth
556 Willow Drive
Bayfield, CO 81122