Natural childbirth and homebirth advocates go through memes like water. If one ridiculous meme doesn’t work (“obstetricians don’t follow the scientific evidence“), they just try another (“women think childbirth is painful because that’s the way it’s portrayed in the movies or on TV“).
The latest meme is “a healthy baby isn’t enough.” Consider recent pieces like these: A good birth experience is more than the baby being delivered alive, and Saying At ‘Least the Baby Was Born Healthy’ Isn’t Enough When It Comes to Birth.
The centerpiece of the “argument” is this:
But the fact that the mother and baby are still alive isn’t the only thing that matters. Certainly not in 2013, when birth is safer than it’s ever been: today, the risk that either you or your baby won’t make it is minute. So how come we’re still setting such a low bar for our ideas of whether childbirth was successful? And what damage is that doing to our children?
These questions are at the heart of a campaign launching today that calls for a rethink on what matters most in childbirth in the western world in the 21st century. Childbirth charity Birthrights is calling for a reappraisal of how we judge a successful birth: no longer should it be merely about physical health, but about psychological health as well…
I can see the point of the natural childbirth complainers. When birth is viewed as a piece of performance art where the mother is the star, the baby is irrelevant. When the baby is nothing more than a prop, who cares whether it makes it through the birth with all its brain cells intact? It’s certainly not compensation enough for being robbed of the chance to be an enact a romanticized view of the perfect birth.
Before we go any further, let me make one thing absolutely clear. I am not justifying or excusing anything less than respectful treatment of all women and informed consent for everyone. But the people most in need of greater respect and higher quality informed consent are not the privileged young, white, English speaking, relatively well off women who choose natural childbirth. The people most likely to be treated disrespectfully by the existing system are people of color, the poor, those for whom English is not their native language, the mentally handicapped and the elderly. If natural childbirth advocates really care about improving the treatment of patients, that’s where they’d start, not with their personal, trivial disappointments (“Ohmigod, ohmigod, the nurse bathed my baby outside my presence!”).
I’m going to go out on a limb here and suggest that this meme is going to be even less successful than the inane memes that proceeded it. Why? Because this meme exposes the ugly truth about natural childbirth: that’s it’s about process at the expense of outcome. In certain circles (Western, white, relatively well off women from first world countries), natural childbirth is a status symbol no different from a Prada handbag. It is something to wave about to boost fragile self esteem among ones peers.
Once you realize that, you can see exactly where these women are coming from. And you can anticipate exactly how they will react when their performance art is not appreciated or valued in the way that they value it. Criticize a woman for boasting about a Prada handbag, and odds are that she will retort that you are jealous. Criticize a woman for boasting about a natural childbirth and odds are that she, too, will retort that you are jealous. Both will have missed the point entirely.
The meme exposes another truth about natural childbirth advocates. They are implicitly acknowledging that modern obstetrics offers the safest possible birth and that they cannot compete on safety. Therefore, they’ve retreated to insisting that there is more to birth than safety. No doubt there are women who believe that, but they are few. Most women who might be attracted to natural childbirth’s promises that natural birth is a safer birth aren’t going to be impressed with the claim that a good birth experience is more important than safety. Indeed, they are likely to be horrified.
An implicit acknowledgement that modern obstetrics, with its monitoring and interventions, is safer does much to reduce the guilt of women who have a C-section or an epidural. If it’s safer to have a C-section, there’s no reason to feel guilty. If there is no safety advantage to refusing an epidural, there’s no reason to feel guilty about choosing an epidural.
In many ways, the meme that there’s more to childbirth than a healthy baby is an admission of failure on the part of natural childbirth advocates. They’ve given up the high ground of safety, and have settled on a poor defensive position of touting process over outcome. It is an acknowledgement of both of reality and of defeat.