Birth and Breastfeeding in Season 1 of Lost

There will, of course, be spoilers for Season 1, which is all I’ve watched so far. This is a warning re: such, and I’d really really appreciate it if you didn’t comment with spoilers for seasons *past* Season 1. Any such spoilers will a) make me all angry and annoyed, and b) not be approved. Thanks.

From the very beginning of Lost I was a little nervous about Claire’s pregnancy, since inevitably that would mean I’d need to sit through another pop culture wackaloon portrayal of birth, and it seemed evident in the beginning that Jack, as the doctor, would end up “saving” her heroically or something like that, so I wasn’t really looking forward to it.

As someone who has been pretty immersed in the world of birth work over the last decade, I find most pop culture depictions of birth and pregnancy to be pretty painful to watch. People say and do horribly stupid things, birth itself is commonly portrayed as dangerous and absolutely requiring of intervention, and of course doctors! Here to save everyone from the horrors of a non-medicalized birth! Even when they’re spinal surgeons!

And boy, when it comes to birth, Jack sure is a spinal surgeon. So I have two areas of critique, actually. The first would be Jack’s suitability as a source of knowledge and/or wisdom regarding birth, and the veracity of the information he gives. The second, however, would be the accuracy of the portrayal of what a dude like Jack would realistically say and do in such a situation. I have to say that he gets most details regarding birth pretty much wrong and his attitude is unhelpful. But that is actually exactly what I’d expect from a spinal surgeon with a rescuing everybody complex, so the portrayal was actually pretty right on. Here’s a few examples.

In one of the early conversations that Jack has with somebody or some group of somebodies he explains that he just doesn’t have any of the supplies necessary for “delivering” a baby. He very specifically mentions anaesthetic and does more than imply that it is absolutely required for delivering babies. This view is, of course, shared by many doctors, especially obstetricians, and are exactly what you would expect to hear from, for instance, a spinal surgeon.

Realistically, the lack of anaesthetic in the jungle on an island in the middle of nowhere when faced with the prospect of giving birth is not exactly the biggest concern. Women can and do give birth every day all over the world in all sorts of situations without anaesthetic and this is proven to be safest for them and their babies, especially in situations where there is no way to monitor the baby after the application of narcotic pain relief, no way to perform safe and effective surgery if it were to become necessary, no way to augment a labour stalled by the use of narcotic pain relief, and none of the drugs that might be necessary to revive a depressed drugged baby after birth.

Of course, for all his concern about Claire’s birth, Jack, who clearly thinks he will be needing to save her from birthing, like he saves everybody else from everything else, does nothing to find other, perhaps older, mothers* who have given birth themselves who could encourage or reassure her, nor does he ever sit down with her himself to engage her in the process of preparing for her unmedicated birth with, for instance, breathing or relaxation techniques or the like.

Later, when Jack is giving Kate instructions for how to assist at Claire’s birth, he gives her very clear instructions regarding the pushing phase. He tells her that Claire shouldn’t push too hard until the head is out, but that she should then push as hard as she can. This is actually an accurate portrayal of the medical attitude towards the pushing phase. In particular, the fear he is not naming, but is attempting to prevent with his advice is “shoulder dystocia”, where the baby’s shoulder gets “stuck” and the baby does not continue to come out and could be injured or even, in a worst case scenario, die.

But this is actually a great example of where the medical model creates the problem that it is trying to prevent. As a baby is being born it turns and rotates in response to the shape of the mother’s pelvic structure and its own head and body shape, in order to fit through the space available in the most effective way. In a physiologic pushing stage, the baby’s head is most commonly born with the baby’s face towards the mother’s back. Once the head is out, usually in a rest between pushing sensations the baby’s head can commonly be seen to turn spontaneously to face the mother’s thigh – nobody needs to assist this from the outside – and then the shoulders are born, first one and then the other, usually with the next pushing sensation.

Sometimes if a woman has an especially roomy pelvic outlet, perhaps due to positioning, or an especially small baby, or if the woman is receiving IV pitocin to enhance her body’s pushing, or for some other reason, this all happens very quickly without the short wait I’ve describe, but the short wait and turn is very common and normal. When a mother is encouraged to push as hard as she can before the baby has fully turned on its own, she is being asked to do something that is usually in opposition to what her body needs to do to get a baby out. Her baby can have difficulty turning into the best position to emerge, and in fact the exhortations to push and push and PUSH can cause the very problem, shoulder dystocia, that they are attempting to prevent.

Something else I found interesting was that when Claire was holding her breath and refusing to push right towards the end, Kate’s responsive was a very instinctive, “Oh honey, you can’t push if you’re holding your breath.” This is an interesting counterpoint to the usual hospital instruction to pushing women to hold their breath and push for a count of ten (also known as “purple pushing”), and I’m curious how conscious the writers were of this when they wrote that scene.3

Finally though, breastfeeding. Why, for the love of Maude, is there not one depiction of breastfeeding? Clearly breastfeeding is assumed, since nobody’s wandering around frantically seeking out milk for the baby, and of course, that’s good. But in a show that shows fairly gruesome examples of mutilated human bodies, that shows violence, sexuality, etc., can’t they show even a from a distance from behind shot of a woman breastfeeding a newborn baby?

*Aside from Rose and the french woman, in fact, I cannot think of any “older” women from the first season, actually.

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