‘Alternative’ and finding the right professional

During my last clinical block I have attended more antenatal (before birth) appointments than my fingers and toes can account for. Recently, I have been struck by the number of women newly arriving on my midwife’s doorstep having not found the right midwife for them. I pondered for a while what finding the right professional means in terms of the profession itself. For these women they could have disregarded midwifery care altogether. But because midwifery care in New Zealand straddles the fence between medicalisation and alternative, the socially accepted medical model enables women to seek another when the first did not work out. Much like finding a new G.P if your previous experience was unfavourable. Why don’t others do the same when seeking physiotherapy, massage therapy, chiropractic, or any other ‘alternative’ health care provider?

Firstly, alternative is defined as pertaining to unconventional choices and conventional is conforming with accepted standards; therefore alternative is pertaining to something not considered socially acceptable. Secondly, one must understand why other health care providers are considered an unconventional choice and what/who decided that the medical model was the accepted standard in the first place? Whilst I would love to say ‘x’ day was when society deemed medicine as the forefront of health care/promotion, societal changes and influences are not so definitively clear cut. What I can say is that society’s medicalisation justification has seen a shift in the way people rationalise their own health and how professions are categorised. The medical model has such an influential hold over health care (most likely stemming back to Descartes body-conceptualized-as-a-machine-that-could-be-fixed rationale, mentioned in my previous post) that finding someone medical didn’t work the first time was not because medicine doesn’t work, it’s because the professional wasn’t right for the person involved. Yet on the other side of that equation, people accredit one session or program from an alternative provider not working to that profession not working. And this is purely down to the mindset people receive from day one.

The end of midwifery care, around six weeks postpartum (post birth), gives women three options for continued health care of their infant; a Wellchild Provider (usually Plunket), their G.P, or no further health care. We facilitate the transition from a medical-alternative balanced profession into a purely medical one. Why are these the only two health providers offered? Simply, because society still views ANYTHING outside of the medical model as an ‘alternative’. If midwifery was not taught in the manner it is and was not backed by the government as facilitators of physiological birth then we would be considered an entirely ‘alternative’ profession. Given that we have the fence covered we should be able to facilitate societal change. I can safely say my next statement has come after profound awakening to the study, art, craft and science of Chiropractic – an alternative profession that should be as socially accepted as a medical-alternative balanced profession and therefore another option for primary health care.

Initially, I understood Chiropractic/chiropractors to be a specialized profession in bone manipulation and cracking, realigning spines after injury. How naïve and misinformed was I? A lack of knowledge meant these initial thoughts and perceptions couldn’t be further from the truth. Whilst I have come to understand that some focus largely on musculoskeletal issues, others have an unprecedented grasp on physiological full body functioning through correct nervous system operation which branches into health and wellness promotion. This is not to say one is incorrect, it’s more to say both are branches of the chiropractic umbrella, in the same way obstetrics is a branch of medicine or reiki is a branch of massage therapy.

Chiropractors with a sound understanding of physiological full body functioning through correct nervous system operation have an appreciation that the body knows how to be, that an imbalance in one of life’s various components affects the body in a multitude of ways. They understand that correct nervous system functioning from the start has a profound effect on growth and development. By allowing the nervous system to function at 100% the body will know how to deal with any stresses. But in order to adjust to this thinking people need to be armed with correct knowledge – the body cannot be in a state of protection and growth at the same time (Lipton, 2001). Whilst pharmaceuticals will fix the immediate symptoms, adjusting the nervous system back into ultimate functioning will allow balanced physiological healing. Plus (yes, there’s a plus), it prevents further chemical imbalances by the addition of pharmaceuticals. If the system is already upset, expressed through an ailment, adding a volatile chemical mix to the party is likely to exacerbate the problem in otherwise healthy individuals.

Bearing this in mind, should these and other practitioners (such as nutritionists) not be offered as other health care options to new mothers leaving midwifery care, other ‘alternative’ perspectives? I believe they should. Primary health care providers are those who promote health and wellness through prevention. Whilst G.P’s are primary health care providers their philosophy promotes treating documented findings usually with the addition of drugs. What the profession fails to see is how the addition of one drug resolves the initial problem but creates a second, usually solved with the addition of a second drug. If the body is primed to function at correct full capacity and people are armed with balanced wellness knowledge then is this not more beneficial to wellness promotion than treating after a functional collapse.

When society understands that ‘alternative’ professions should have an equally as acceptable social standing as the medical profession change will happen. Because finding the right professional begins with acceptance of alternative professions as conventional, with the acceptance of the medical model and the ‘alternative’ being equally as valid. After all, midwifery prides itself on the promotion of physiological processes and we are seen equally as accepted as the medical profession, so why can’t other professions?


Lipton, B. (2001). Insight into cellular consciousness. Bridges, 12(1), 5.

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Communicating through the balance of Art and Science

Suggestion or no suggestion this ‘Mills & Boon’-esque novel segment provokes your mental and emotional understanding of the balance of art and science. It also, without a doubt, deflowers my blog with a bang and includes the all vital ‘captivating erotisism’ aspect the western world is all too familiar with!

…With her foot propped on the baths edge she ran her soft oil smothered hands down her thigh allowing her newly cleansed skin to be enveloped in sensation…she knew he was watching…her every move tantalizing…but the suspense drove her equally as wild.

Science derives from the Latin scientia meaning knowledge, which enables you to understand the previously described physiological response to touch. Art, from the Latin artem meaning skill, shows how previous tactile experience enables you to mentally and emotionally relate to all heightened experiences. Without, prior knowledge new experiences gained have little meaning which is where the art of any craft is validated. Your response to the above comes through an equal balance of skills and knowledge, emotion and logic, art and science. However, this is not a discussion on arousal…

On a professional basis, the union of art and science is accounted for on these same response levels. Physically, visually and emotionally skills and knowledge are partnered and this is a concept many primary health care providers, and even some health care models, fail to acknowledge.

Linear taught knowledge can only account for half the real world application, the other half must come through physical experience. From my own discovery I have spent countless hours learning more yet knowing less and without hands on experience my taught knowledge has little real world applicatory benefit. My understanding did not truly take on meaning until I palpated my first abdomen. This first, like many other firsts, added little extra to my knowledge bank but through continued determination I no longer required visual stimulus to evaluate fetal positioning. My hands became my eyes, much like feelers on an insect, and I determined shapes within through skill and knowledge. Being able to communicate with ink is a skill in itself, but verbal communication combines perceived information with concrete understanding and in the real world is how practitioners convey thoughts.

Art and science are also linked through visual observation, in the literal sense. Professionals/people in general forget largely about the skill of observation and how subtle body cues and interactions are equally as important as those diagnosed though a test. This is one of the greatest skills a practitioner can have up their sleeve but at the same time it is one not easily taught. It requires perception and perception cannot be obtained without knowledge, but knowledge cannot be understood without perception. In other words the art of a craft cannot be fully understood without the science and vice versa, the key being vice versa.  By observing subtle cues one can determine pain or joy. For example, we know when a person limps it suggests they are in pain (learnt knowledge) and through continued experience we can determine by the way they are limping exactly what is sore (perceptive understanding). In clinical I have come to understand that I do not require a piece of technology to tell me how far along the birth process a woman is, her body language and subtle cues relate directly to her progress.

Like physically or visually combining skills and knowledge people also have an innate emotional response to a situation. Empathy, the feeling or capacity for awareness and ability to emotionally relate to another is a bridge between skill and knowledge. Using empathy to communicate, means using art to convey science and through our own personal world view understanding, we are able to define professionalism. I revert back to my first clinical experience, having never physically or visually experienced birth I used my emotional understanding of pain to relate to the woman. This empathy enabled connection and through a balance of art and science kept professionalism. Had I not emotionally found a connection no matter how much skill or knowledge I previously obtained I would not have gained trust…one of the fundamental principles of professionalism (which in itself is a balance of relating, art, and understanding, science).

When this balance is disrupted and tipped to either extreme many professions lose focus on the holistic goal intended. The medical model is one of the health sector’s greatest examples of the art and science homeostatic imbalance. It prides itself on definitive diagnosis via technology; all science, no art. It discredits anyone who is has a connection to their body, who is so in tune they can TELL you what is wrong regardless of any test. The medical model also prides itself on being at the forefront of healthcare. Yet how can something with such an imbalance be considered the epitome of wellness! It promotes the destruction of art through scientific over powerment and a lack of partnership based communication. But, this isn’t an argument on the medical model either…

Back in the 1640’s, Descartes spoke of Cartesian dualism, or the mind body split, showing how the body was conceptualized as a machine.  On the other hand, the mind was seen as something uncontrollable and if something could not be proven with technology it was deemed to be untrustworthy. Descartes was onto something here and the mind body split can be related to the art (mind) science (body) split and also to the medical model of practice. Thankfully today we have come to understand that the mind and body are an interlinked unit through which the nervous system, on both conscious and subconscious level, is the communicator. Technology and therefore science alone cannot fully explain this connection and it has been shown time and time again that a mentally/emotionally imbalanced mind directly relates to the physical body ailments and vice versa.

Balance is the key to existence and what is art without science. Physically, visually, and emotionally professions/professionals/ p-e-o-p-l-e need to find a way of communicating through connection. It doesn’t matter whether this is by using a slightly tantalizing segment, tactile perception, visual observation, empathy or just plain common sense; what matters is understanding skill has equal relevance to knowledge. When the partnership of art and science is acknowledged and accepted inter and intra professional communication will flourish.

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