What does the word “Alternative” mean to you? Does it mean something a bit whacky? Something you might try in a wild moment or if you were desperate for a remedy for an incurable condition? Here are a few uses of this annoying word which I’ve found on Wikipedia:
- Alternative comedy, a range of styles used by comedians and writers in the 1980s
- Alternative culture, a variety of subcultures existing along the fringes of mainstream culture
- Alternative dispute resolution, processes and techniques outside the traditional mainstream of jurisprudence
- Alternative fashion, for example Gothic fashion, Punk fashion, Fetish fashion
- Alternative lifestyle, a lifestyle that is not within the cultural norm
- Alternative media, media practices falling outside the mainstreams of corporate communication
- Alternative medicine, healing practice that does not fall within the realm of conventional medicine
Outside the mainstream; non-traditional; not conventional…these are all attributes of anything which is dubbed “alternative”, and the implication is always that there is a mainstream from which the alternative diverges. “Mainstream”! That’s such a nice safe word. Anything mainstream must surely be safe…especially compared with anything alternative, which hints at a flirtation with danger. Anything that is the “norm” must be more reliable, more effective, than what is “alternative”.
As a Hypnobirthing teacher I am always intrigued by how powerful certain words are in the conversations we have with mothers about their birthing. Take the positions women labour and birth in, for example.
It has been demonstrated over and over again that upright, forward and open positions in labour and birth utilise gravity, are more comfortable for the woman, improve blood flow to the uterus, and allow the pelvis to expand and mobilise to give the baby room to pass through. On every single count except one – the comfort of the attendant – “UFO” positions in labour are superior to being flat on your back on a bed.
Lying flat on your back or even semi-sitting on a bed is uncomfortable, exerts nwanted pressure on the blood vessels supplying the hard-working uterus, and traps the pelvis against the bed below it so that the tailbone cannot move outwards in the classic “rhombus of Michaelis” shape. The “beached whale” supine position is fraught with danger, risking a longer and more exhausting labour. Yet it remains the first position most people think of when they imagine a woman giving birth and still the vast majority of women find themselves birthing in this position.
We birth educators are always banging on about this. For example, take a look at the excellent NCT leaflet on positions for labour and birth here – it does not feature or suggest any supine positions:
No, not even as “alternatives”.
The supine birthing position, especially where a woman’s legs are raised up and fastened into braces called “lithotomy stirrups”, should in my view be designated as truly “alternative”. It should only be used in extreme, unnatural, artificially created situations – where a woman has an epidural, for example (and even then there may be easier positions for her) or where there is a genuine medical emergency which justifies using instruments to help the baby out. The “McRoberts manoeuvre” used where a baby appears to be at risk of shoulder dystocia involves turning the mother over onto her back and pulling her knees right back towards her shoulders – it often works. (So does the “Gaskin Manoeuvre” which is basically the McRoberts turned upside down.)
Yes, looking back at the Wikipedia list of alternative cultural elements you can see that we should definitely re-name the lithotomy position as “alternative”. Like alternative medicine, it’s not proven. Like alternative fashion, it has fetishistic aspects. And like alternative comedy, it belongs in the 1980s, not to today.