Folk wisdom and the tyranny of the experts

[updated below]

I’ve been thinking about birth a great deal lately. This is likely because birth in my family is just around the corner. Our second is due in July. In any case, all this birth-thinking and meeting with doctors and birthing experts and midwives and such has me pondering how we as a culture treat the act of giving birth.

I was reading an article yesterday from 1970 wherein the author discusses ‘new findings’ which show that the ‘traditional method’ of strapping a woman on to a bed on her back while giving birth is not in fact the best way to go about the birthing process. Indeed, it may even be harmful to the mother and baby as it cuts off circulation and raises blood pressure, and since it works against gravity, etc. More to the point, it may not even be traditional in any sense at all. ‘Primitive’ cultures birth squatting or on birth stools, the article notes, and in fact prior to the intervention of a clever French doctor in the 17th century, so did ‘civilized’ women. It turns out the doctor found it much more convenient to have the woman on her back, strapped down like some madwoman.

None of this was really new to me, but it was interesting to read it presented as big news, as some shocking medical revelation.

Modern medicine works like folk ways or folk wisdom used to work. Advances in medicine and medical technology and practice are built on the backs of failure and success, trial and error, and so forth. The irony, I suppose, is that so much of modern medicine is built in denial of folk wisdom and folk medicine. Certainly a great deal of our medicine is made from ingredients which were discovered looking at various potions and witch’s brews, but since the very beginning of modern Western medicine, the denial of the past has been very strong, and yet the process by which the experts in the medical field find continuous improvement is very similar, if far more formal, to the process of handing down remedies and recipes from one generation to the next.

Tradition is a funny thing. It’s often spoken about in the abstract. A great deal of the time it is invoked as something very conservative, immutable, unchanging – and of course, this is not at all true. A recipe handed down from grandmother to mother to daughter to granddaughter will inevitably change. It’s like that game telephone that you played in school, where all the children would sit in a circle and whisper the original message to one another and by the end the original had transformed into something else entirely. The grandmother’s recipe will have changed several generations down the line. The traditions of one generation may look in every outward way quite the same as the previous generation’s, but they have undergone some genetic shift, however imperceptible. Tradition evolves. Folk ways change.

Then, somewhere along the line, people decided that to progress things had to change much faster. If it could not be seen, it must not be happening. All these silly traditions had to be tossed out entirely. This began with doctors strapping women to gurneys while they gave birth, and continued in one form or another for centuries, its pace ever quickening. The most profound effect of all this wasn’t the loss of this folk tradition or that, but the shift – the sea change really – in how humankind viewed progress, change, and tradition – indeed, how we viewed wisdom and the transference of wisdom.

The expert class rose up out of the wilderness and commenced in tossing the baby out with the bathwater. Psychologists, nutritionists, and various other professionals (once all considered ‘quacks’) began putting the folk traditions through the shredder. Little bits and pieces of these traditions were co-opted, cherry-picked for the self-help books or the new and expensive prescription drug. Drugs like marijuana which were too effective and too easily democratized (or popularized) were demonized. The folk culture was demonized as well, cast as backwards and bigoted and dangerous. The people of the past became the new savages – a convenient ‘other’ if ever there was one.

And pretty soon – long before I was born at least – much of the folk culture had been driven into hiding or expelled from the public consciousness. Now strapping a woman to a table to give birth had become the ‘traditional method’ and the only remnant of the way we used to do things was found in ‘primitive cultures’.

Suddenly whole generations of people were cut off from any real tie with the traditional world. Their mothers and fathers and grandparents had only vague, suspicious memories of the past. They could not pass it along to us. We were cut off, too, and handed over to the tyranny of the experts – the bureaucrats and physicians and self-help gurus. And not just to them, since many of us still distrusted them, but to a culture subservient to their way of thinking.

At some point we veered off course, and instead of building upon the back of tradition and traditional ways, we created a new starting point, a new vantage point, a new and selfish belief in our own ability to reinvent ourselves and the world at every turn. Our wealth and our technology comforted us in this belief, and comforts us still. Who needs the old ways when the new ways are so good? There is always a handy anecdote at hand to point out how bad the past was because much of it was very bad. Someday there will be people pointing out how backward and stupid our own time was.

The problem isn’t that the past was good and the present bad. On the contrary, I’d say much of the present is far better than much of the past. But that still doesn’t make birthing on your back any better. It doesn’t mean that mysterious and supposedly ‘nutritional’ power bars are any better for you, or that our world of diets and fast food has in any sense of the word actually improved upon the common sense eating of the past.

Tradition and progress have always occurred hand in hand. Some eras have seen the honest efforts of much needed change quashed in the tyranny of the traditional or the status quo; and some eras have seen the wisdom of the status quo trampled on by the tyranny of experts and progress. But most of the time the two work in tandem, as a civilizational tango, in an ebb and flow of trial and error and innovation.

Innovation is key to progress, but I think it is also key to tradition. That is what so many traditionalists and critics of tradition forget. Folk ways are nothing more than a long series of small innovations. So is medical advancement.

I suppose the trick now is to restore some of what has been lost. I think this is a worthy conservative project. 30% of American women have c-sections instead of vaginal births – a number far higher than in Europe or elsewhere around the globe. Most women opt for an epidural to numb the pain (and can you blame them – especially since so many still are instructed to lie on their back to give birth?). Virtually all women go to the hospital rather than have home births – partly because this is now the ‘traditional’ way but also because most insurance companies don’t cover midwife services or home deliveries. Somehow it is far cheaper for most Americans to go to an expensive hospital with expensive doctors than to have their babies at home. Many of the wonderful technologies we have developed really do save lives, but that doesn’t mean they are always necessary or beneficial in most cases.

And of course birth is hardly the only area where scientism has displaced (or perhaps forcibly overthrown) conventional wisdom. The coup d’etat of folk or conventional wisdom has seeped into innumerable aspects of our life. Indeed, I am suddenly reminded of John Schwenkler’s excellent essay on food tradition, wherein he writes:

The modern diet is only one of a range of cases where the wisdom of convention has been forcibly displaced by our fascination with the new and allegedly scientific: think, for example, of the excitement over the return to classical principles of urban design that is non-ironically referred to as the “New Urbanism,” or of the growing recognition that the interfering presence of hospital technology can be a hindrance rather than a help in a safe and happy childbirth. The ways we raise our children, too, are subject to similar pressures: our culture has begun to turn the corner on the values of breastfeeding in contrast to the allegedly superior qualities of laboratory-developed infant “formulas,” but as Ann Hulbert shows in Raising America (2003) we remain thoroughly in thrall to the dictates of parenting “experts” who are ever-prepared to supplant parental intuition and familial custom with costly tools and half-baked techniques drawn from the latest fads. Hence parenting, like cooking and shopping and eating, seems to us less a natural and age-old human activity than a peculiarly modern challenge in which instinct and custom can provide no real help at all. And so does science assign itself, as if in the place of God, the task of making into foolishness the wisdom of the world.

The problem is that ‘familial custom’ has been all but erased. Our families are as dependent on the experts as we are. We no longer trust our ‘parental intuition’ and we’re constantly reminded that we shouldn’t – and again, there are enough good examples of disastrous parenting to make the parenting experts claims seem true. This ignores the fact that many of the current problems with child-rearing stem from a general loss of community, extended family, and so forth just as many of our modern ills are given modern remedies which tend to treat symptoms rather than root causes. Nor can we really remember why walkable ‘new urbanist’ communities make so much sense. Those few places where such communities have been built are still not really the organic, sensible communities that used to be the status quo, but rather expensive and very well groomed communities for the modern upper crust. The organic, the natural, the common sense and practical, all have fallen under the scalpel of modern expertise.

It will be a much longer project to restore them. We will have no self-help books to guide us.

Update.

Steven Donegal writes in the comments:

I’d would love to know where and when this status quo existed.  I’m about 60 years old and grew up in a small town in the Midwest.  My parents and their friends didn’t walk anywhere they could drive.  I really find this fascination with the glories of the past very peculiar.   It is a romanticized version of pleasant memories without recognition that the unpleasant and unhealthy parts were an integral part of the social and cultural package.  It’s fine to rail against the de-personalization of much of medicine, but when if you’re giving birth at home with a midwife and your wife starts to hemorrhage, the benefits of giving birth in a hospital start to become more apparent.

I think this both misses my point and helps enforce it.  First of all, I am not romanticizing the past. I am pointing out that the attitude toward the past can be destructive to those bits and pieces of wisdom that come with folk traditions. I am not advocating some glorious ‘good ol’ days’ that never were, and I have made pains to point that out. In case I did not make it clear enough in the original post: I think the past is a mixed bag, full of hardship but also the wisdom that comes from hardship. (To North’s point, yes often scarcity demanded people eat whatever they had, but again from scarcity can come a certain time-tested wisdom in how we eat. Certainly the nutritionist culture of diets and artificial foods is one we should look at with skepticism.)

Second, Steven mentions he is 60 and the past I describe was nowhere to be found in either his life or that of his parents. This is exactly what I mean by being cut off from history. We have several generations which have been effectively cut off from folk ways either in medicine, food, or community structure. This makes it hard to revitalize those paths.

And lastly, of course the benefits of hospital birth exist. I never claimed otherwise. My first child was born and couldn’t breath and was placed immediately under an oxygen hood, and its quite likely without hospital care she would not have lived. I am well aware of the benefits of hospital birth – but less certain about the benefits of strapping a woman on her back to actually push the baby out. Mixed bags you see.