The philosophy of natural childbirth hurts women

Here’s an interesting thought:

… women’s reports of “lower childbirth satisfaction” after cesarean should not be attributed to excessive and appropriative medical intervention. Rather, their negative evaluation of their birthing experience is produced by a cultural discourse of “natural” childbirth that encourages them to measure their labors against an inherently moralistic and ultimately pernicious ideal of birth.

In other words, the philosophy of natural childbirth, far from empowering women, is destructive to women’s self esteem.

This is the central insight of the feminist critique of natural childbirth known as the “critique of the idealized birth.” As Jane Clare Jones explains in Idealized and Industrialized Labor: Anatomy of a Feminist Controversy, published last fall in the feminist journal Hypatia:

… [T]he idealization critique is … concerned with the alternative birth movement’s role in prescribing coercive norms that generate inflated expectations about the degree of control women can and should exercise over the process. Indeed, as Lobel and DeLuca note, one possible way to reduce the adverse effects of cesareans on mothers’ reports of “childbirth satisfaction” would be to encourage them to “develop realistic expectations” about labor, rather than educating them to resist obstetric practice—as has been the main strategy of the natural childbirth movement.

The leading exponent of the critique of idealized labor is Georgetown University philosophy professor Rebecca Kukla:

For Kukla, the alternative birth movement’s encouragement of such strategies as childbirth classes and birth plans, while originally laudable in intent, is responsible for establishing “completely unrealistic expectations concerning how much control one can possibly have over the laboring process.” As a consequence, the movement is implicated in “setting women up for feelings of failure, lack of confidence, disappointment, and maternal inadequacy when things do not go according to plan, even when mother and baby end up healthy”. Thus, critics like Kukla suggest, while the natural childbirth movement styles itself as concerned with empowering laboring women, its establishment of a normative ideal of birth is, ultimately, disciplinary and punitive. (my emphasis)

As I have written repeatedly, there are two critical problems with natural childbirth. First, it is based on a purported past that never existed. In fact, the past to which the natural childbirth literature refers is nothing more than a cultural construct:

… [The] alternative birthing literature constantly appeals to “the authority of nature,” conceived on the basis of “an emphatically ahistorical and anticultural notion of time.” Such invocations of timeless female physiology function … to posit a body that exists prior to or outside culture and that, moreover, conceals the fact that the “rhetorical recourse to the natural body” is “itself cultural” (Michie and Cahn 1996, 49). Thus, the alternative birthing movement is guilty … of grounding its normative ideals on a notion of “nature” that is rhetorically and culturally constituted…

Second, it a form of biological essentialism:

… [T]he idealization of nature is implicated in propagating an essentialist notion of femininity, one that allies “the female” to a host of traditionally devalued cultural categories. While second-wave “matriarchal” or “cultural” feminists undertook a celebratory re-appropriation of the equation of woman to nature, many feminists of the third wave remain leery of the emancipatory potential of re-inscribing binary polarities that have long served to discipline women’s bodies and behaviors…

This is not surprising considering that the two founders of modern natural childbirth philosophy were both profoundly sexist.

I have written extensively about Grantly Dick-Read who fabricated the philosophy of natural childbirth to aid in the eugenics battle against “race suicide” and drew upon widely prevalent racist notions of hypersexualized black women who reproduced easily and “hysterical” white women whose ovaries supposed shriveled as they acquired education and political rights.

In this paper, though, I learned about the sexism of Fernand Lamaze. According to natural childbirth advocates Sheila Kitzinger:

… [T]he disciplinary nature of Lamaze’s approach to childbirth is evident from Sheila Kitzinger’s description of the methods he deployed while working in a Paris clinic during the 1950s. According to Kitzinger, Lamaze consistently ranked the women’s performance in childbirth from “excellent” to “complete failure” on the basis of their “restlessness and screams.” Those who “failed” were, he thought, “themselves responsible because they harbored doubts or had not practiced sufficiently,” and, rather predictably, “intellectual” women who “asked too many questions” were considered by Lamaze to be the most “certain to fail”

The bottom line is that natural childbirth philosophy does not empower women. It subjugates them by “supervaluing the denigrated categories with which women have long been associated.”

The idealization of “natural” birth functions ideologically to impose a prescriptive normativity on women’s childbearing in a manner that deprives them of agency, inflates their expectations, and opens them to social stigmatization and a profound sense of shame if they fail to enact the ideal.

In other words, the philosophy of natural childbirth is just another way to accuse women of being failures.

92 Responses to “The philosophy of natural childbirth hurts women”

  1. Erinladyrn
    October 26, 2013 at 10:46 am #

    First I must say that I am an RN that works labor and delivery and also teach childbirth education classes and breastfeeding classes. That being said I have to say how offended I am of this critique of the NBM and Natural childbirth education. Yes, ‘the mommy wars’ are unfair and oppressive. And yes, NBM in the past was probably sexist and mysoginistic in a way. And yes, some of the ‘trauma’ and disappointment experienced by women is due to unrealistic expectation of natural childbirth. HOWEVER, there was no mention of the LACK OF evidenced based care in childbirth and how unnecessary and undesired interventions CAN HARM women and babies both physically and emotionally. Women NEED to be educated with unbiased information about the risks AND the benefits of many common interventions used in childbirth and when they are to be used appropriately and when they can potentially cause more harm than they are worth. Women NEED this because the current obstetric climate is NOT providing this information to them and they are making choices that may not be in their best interest because they don’t have all the information. Women are allowing themselves to be induced unnecessarily not knowing the risks, they are consenting to c-sections that are also not necessary. Sometimes these things are necessary and women need to know this information as well. Because too many decisions made by doctors, hospitals, and yes sometimes midwives are made based on convenience, money, and or fear of litigation than what is truly best for the mother. Women are also often treated with disregard or contempt and even sometimes with outright malice when she requests or expects a certain kind of care. When every women is treated with respect when discussing birth options regardless of the mothers choices (an unmedicated vaginal birth or an elective cesarean) and can be assured that those choices are made with accurate information then the ‘natural’ childbirth movement can rest its case. The NBM is more than just advocating for less intervention in birth it is also advocating for respectful maternity care and true informed consent. I felt this article was extremely one sided and very unfair.

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