A Pound of Flesh?

 

I’m retired now, and my kids have long since passed the age when, even if I were so disposed, I would dare lay a hand on either them or their children. But of course I wouldn’t -parenting wasn’t like that in my family.

I suspect I rarely hung out in the Goldilocks zone in childhood. I was prey to all of the usual temptations on offer in a 1950ies Winnipeg, but it’s unclear to me just what things I would have to have done to require corporal punishments. I realize that sounds naïve, even all these years later, but my father was not quick with the hand. In fact, on the one occasion he resorted to it, he seemed more upset by it than me, his recalcitrant offspring. And anyway, I think it was my mother’s idea that he wreak some stronger retribution than she could inflict on me with her voice.

My mother was into noise, actually. I imagine I was a frustrating child for her and she would resort to yelling fits when things didn’t go well. Clearly I have a limited, and no doubt statistically insignificant data set when it comes to the effects of corporal punishment, but I would venture to say that I feared my mother’s mouth far more than my father’s hand. My mother’s facial expression bespoke rage, my father’s, though, suggested sorrow -betrayal…

But I do not mean to disparage either of them, nor to suggest that they meted out cruel and unusual punishments under duress -I’m sure they were well-intentioned. And anyway, anecdotal evidence is a poor substitute for well-designed research, so I was pleased to see a more recent attempt to summarize what has been learned about the effects of, in this case, corporally disciplining children: https://theconversation.com/why-parents-should-never-spank-children-85962 The article was co-written by Tracie O. Afifi, Associate Professor, University of Manitoba, and Elisa Romano, Full Professor of Clinical Psychology, University of Ottawa.

‘The use of spanking has been hotly debated over the last several decades. Supporters state that it is safe, necessary and effective; opponents argue that spanking is harmful to children and violates their human rights to protection.’ But despite how common and widespread its use, it has been banned in 53 countries and states throughout the world. ‘The research clearly shows that spanking is related to an increased likelihood of many poor health, social and developmental outcomes. These poor outcomes include mental health problems, substance use, suicide attempts and physical health conditions along with developmental, behavioural, social and cognitive problems. Equally important, there are no research studies showing that spanking is beneficial for children.’ And, indeed,  ‘An updated meta-analysis was most recently published in 2016. This reviewed and analyzed 75 studies from the previous 13 years, concluding that there was no evidence that spanking improved child behaviour and that spanking was associated with an increased risk of 13 detrimental outcomes. These include aggression, antisocial behaviour, mental health problems and negative relationships with parents.’ I suspect there were other things going on in both intent and degree that might have confounded these studies and led to the negative outcomes, though -apples are simply not oranges, and beating or assaulting someone is not the same as striking a buttock with an open hand as a way to deter an unwanted behaviour.

Of course, the researchers hasten to add that ‘this does not make parents who have used spanking bad parents. In the past, we simply did not know the risks.’ I think that lets my father off the hook; I’m not so sure about my mother, though. It seems to me that it is all too easy to condemn corporal punishments, while ignoring –or, perhaps, paying less attention to- the other forms of discipline that, intuitively at least, might be expected to result in equally detrimental  consequences for a developing child. One of these, of course, is verbal haranguing.

I don’t believe that I was ever subject to verbal abuse, however. I was never demeaned, or insulted by my mother –just confronted with my miscreant behaviour, and anointed with the requisite guilt- but I can understand how it could get out of hand under different circumstances and with different personalities. I find that worrisome –alarming, in fact. It is a behaviour that could all too easily slip under the radar. Be explained away.

I recognize that parenting is stressful, and that we all come to it with different temperaments, different abilities to tolerate stress, and different support structures that could be called upon in times of intolerable tension, but I suppose that is just the point. I wrote about this a while ago: https://musingsonwomenshealth.com/2017/05/17/time-out-eh/

But I fear that it sometimes requires the patience of Job to stand-down enough to be able to socially isolate the misbehaving child with a time-out. It is clearly preferable to spanking, to be sure, but I still wonder if what precedes it may be just that verbal abuse it seeks to avoid.

So, given our human propensity to react unpredictably and often adversely to stress, what am I advocating? Well, I have to admit that I have neither the background, nor the temerity to suggest that I have any productive answers. But although the Conversation article I quoted above was focused on spanking –physical punishment- it contains some suggestions that I think would be applicable to other punitive modalities like verbal abuse and insults.

‘Research already shows some evidence that parenting programs specifically aimed at preventing physical punishment can be successful. Some evidence for reducing harsh parenting and physical punishment has been found for Parent-Child Interaction Therapy (PCIT), the Incredible Years (IY) program and the Nurse Family Partnership (NFP). Other promising home visiting initiatives and interventions taking place in community and paediatric settings are also being examined for proven effectiveness.’

I know –education, education, education… But sometimes education is merely making people aware that alternatives exist. That there could be support out there of which they may not have been aware -both with friends and in the community. Remember that African proverb: It takes a village to raise a child

 

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The Venus Figurine

Pregnancy has always had a sacred place in mythology. From the Palaeolithic Venus figurines, to the various stories of deities born from virgins, pregnancy has been cloaked in mystery and draped in awe –the curious interregnum separating being from non-being. That special state when the woman is suddenly not alone in her body, and then, equally suddenly not just a person, but a mother –a transformation that is as miraculous now as it was in millennia past.

It is still a source of wonder for me, even after 40 years as an obstetrician. But I think one has to be particularly careful in its blanket ascription to every woman –To every thing there is a season, and a time to every purpose under the heaven. For many women, it has been a rite of passage, a validation of their gender, whereas for others…

I am always on the lookout for popular articles on pregnancy and its resulting motherhood –not so much for resolution of the pro-life/pro-choice conundrum, but mainly to understand the current societal prescriptions for acceptable attitudes and behaviours of mothers. How intrusive is social media in moulding conduct and beliefs? There were a few clues in an opinion piece in the Guardian newspaper: https://www.theguardian.com/commentisfree/2017/may/30/detach-myth-motherhood-from-reality-future-generations But, judging from the tenor of the piece, it would seem difficult to avoid dissenting views.

The author, Angela Saini, introduces the topic by saying, ‘It’s hard for any woman to escape the expectation to be a mother. The maternal myth suffuses every human culture, from Catholicism’s Virgin Mary to Hinduism’s goddess mother. It’s considered the most natural state of womanhood, leaving the childless woman the object of pity. Let’s not even mention the woman who doesn’t want or like children at all.’ And then she imputes an opinion to a famous restauranteuse who was criticizing the UK prime minister about something –that ‘motherhood somehow makes a person automatically care about not only her own children but everyone else’s as well; and that women who aren’t mothers don’t have the same caring sense towards future generations.’ Fighting words, as they say.

Saini goes on to write, ‘But maternal instinct is not a switch that exists in every woman, ready to be flipped as soon as she smells a baby. Relationships between mothers and their children are frequently far more fraught than the myth leads us to believe. It shocks us that mothers can be selfish. […] There is scientific evidence to suggest that the maternal instinct may even be contingent on a woman’s circumstances. […] maternal instinct may sometimes depend on whether a mother has the support she needs. We’re not a species designed to cope alone. Indeed, we’re at our most social when it comes to parenting, often recruiting many people around us to help. It really does take a village to raise a child.’

Her point, obviously, is that maternal instinct is not an all-or-none phenomenon –it can exist in degrees, and like a flower, it may take a while to fully bloom. ‘[…] motherhood is not always an against-all-odds epitome of selfless caring. Sometimes it can involve emotional calculation, weighing the needs of both parent and child. We all assume that a mother always wants the best for her child, above her own needs. What we seem to deliberately ignore is that a child’s welfare can also depend heavily on the mother’s own needs being met.’

And so, ‘For the sake of both mothers and children, we need to begin detaching the myth of motherhood from the reality. It’s unfair of any society to expect women to be the best mothers they can be without economic or emotional support, just because they should love their children. Not all women are happy to be mothers.’

She concludes by observing that ‘Many mothers will know that birth doesn’t always signal a rush of immediate love. The maternal bond may build slowly over time. For a small few, it may never appear. And some never experience the urge to have children. We think of all these as unnatural exceptions, bucking the normal trend of how a woman is supposed to feel. But the scientific and historical evidence shows that none of it is strange at all. […]The most unnatural thing of all is forcing a woman into motherhood in the anticipation that she will biologically fall into line when a baby arrives.’

As an obstetrician, my responsibilities ostensibly end with the birth of the baby, and yet how can a duty ever end? Delivery is seldom the last time I see the woman and her baby, and it is certainly not the last time I hear their stories. We are all stories.

Jennifer sat in my office crying inconsolably. It started out as most other visits start, as I remember. She was seeing me for her post-partum checkup, six weeks or so after the normal delivery of a healthy baby boy. It was her first pregnancy and everything had gone well in hospital. She had left smiling, if a little stunned at the rapidity of her labour.

When she came into the office she was the picture of contentment, although I did wonder why she hadn’t brought the baby. I don’t deal much with babies, but the mothers usually bring them to show them off. It’s always nice to see how they’ve changed since birth, and marvel at the almost constant eye contact between the two of them. Usually, I get the impression the mother is only half listening to my questions –she is completely involved in a world I cannot really enter.

But when I asked Jennifer how the baby was, her face changed. “Jonathan was marvelous for the first day or so…” she said, her voice trailing off. “But I was so amazed at him, so involved in his every move, of course he seemed perfect.”

The first tear slid down her cheek and she stared out the window behind me for a moment, as if she were afraid I’d ask her more. Then, she grabbed for a tissue from my desk and wiped her cheeks. “Doctor, he never sleeps! I feed him, I burp him, I change him, I rock him… And so does Tony, but it only works for a while, and then he starts again. We took him to the pediatrician, but she just smiled and reassured me. Some babies are like that, she said. It’s not colic, it’s not something Tony and I are doing wrong… And it will settle.

“But it hasn’t! Neither of us are getting any sleep and now Tony and I are fighting… I wish we’d never decided to have a baby…” She stopped talking and suddenly stared at me in terror as if she’d admitted to some unspeakable crime… And to the doctor who’d seen her excitement for her entire pregnancy…

She began to sob. “I don’t think I’m a very good mother, doctor. My friends seem able to manage with their babies… They don’t need any help!”

I waited to hear her out, but she just sat huddled in front of me weeping inconsolably. “Did your mother stay with you?” I said softly. “I remember she was with you in labour.”

She shook her head sadly. “Tony and I figured we could manage.” She wiped her cheeks again and grabbed another tissue. “She wanted to stay and help, but I’ve always been her independent child.” She sighed with a deep stertorous gulp of air. “I was kind of embarrassed to admit I might need some help, to tell the truth…” She stared at me with wide red eyes, like a doe peering out of the woods.

I smiled and sat back in my chair. “There’s an African proverb I’m sure you’ve heard, Jennifer: It takes a village to raise a child. I think it also takes a mother to help her child…That’s what mothers are for, isn’t it…?”

She stared at me for a second or two, a weak and wobbly smile fighting to control her lips. “You mean…?”

“Phone her,” I said.

And she did –right there in the office.