Breastfeeding is not the only thing being oversold; natural childbirth is too.

Overselling natural childbirth

Kudos to Courtney Jung for a fabulous NYTimes op-ed piece, Overselling Breastfeeding.

It’s not surprising that I love the piece. I’ve been saying exactly the same things for years.

According to Jung:

Oddly, the fervor of breast-feeding advocacy has ramped up even as medical research — published in The Journal of the American Medical Association, BMJ in Britain and The American Journal of Clinical Nutrition — has begun to report that the effects of breast-feeding are probably “modest.”…

Why so much pressure to moralize and promote breastfeeding? Because breastfeeding is an industry.

What could possibly be more lucrative for an industry than marketing its products as a moral imperative?

…[T]he contemporary obsession with breast milk is also driven in part by big business — including the companies that manufacture breast pumps, the companies that make breast-milk-based nutritional supplements, and the companies that sell breast-feeding accessories. The A.C.A. regulation requiring insurance to cover the cost of breast pumps hands breast-pump manufacturers a substantial subsidy. Market analysts predicted that this regulation alone would expand the breast-pump market by more than 50 percent, to almost $1 billion a year in the United States alone, by 2020.

And that doesn’t even count the lactation consultant industry.

But breastfeeding is not the only thing being oversold for the benefit of the industry that profits from it. The philosophy of natural childbirth (vaginal birth without pain relief) is also being oversold and that industry is much larger and more lucrative. My book, Push Back: Guilt in the Age of Natural Parenting, available in early April 2016, encompasses not just the breastfeeding industry, but also the natural childbirth industry (and the attachment parenting industry).

Push Back cover

The natural childbirth industry embraces midwives, doulas and childbirth educators. It includes books, movies and Hypnobirthing tapes. It is aggressively marketed by everything from blogs that sell ads to large lobbying organizations like The Childbirth Connection. And it represents billions of dollars in profits.

As Jung notes in regard to the breastfeeding industry, people often confuse “industry” for “corporations.” The same thing happens regarding the natural childbirth industry. True, midwives, doulas and childbirth educators don’t make millions of dollars each, but for many of them, natural childbirth represents 100% of their income. That’s in dramatic contrast to obstetrician-gynecologists who may derive the bulk of their income from gynecologic surgery and the majority of whose patients have no interest in the philosophy of natural childbirth. It’s hardly surprising then that the purveyors of natural childbirth services, books and products are very motivated to promote the philosophy.

Though natural childbirth is marketed as safer, healthier and superior to birth with technology, there’s no scientific evidence and there has never been any scientific evidence to support those claims. But when it comes to marketing brilliance, the natural childbirth industry is second to none. Indeed, their marketing tactics are so seductive that many people who would have no trouble recognizing conventional marketing are chastened and distressed when they realize they’ve fallen for the marketing tropes deployed by natural childbirth organizations, celebrity natural childbirth advocates and by the legions of lay women who have been taught to proselytize the beliefs of the faithful.

Jung doesn’t merely echo what I have been writing about the industry of breastfeeding, but she also advances the same claims that I have made about the roles of privilege and race in both the breastfeeding and natural childbirth industries (Breastfeeding: how privileged women make privileged choices normative and Managing the birthing body: how privileged women have made childbirth a project).

The effect of the moral fervor surrounding breast-feeding goes beyond mere shaming. It also reflects, and reinforces, the divisions of race and class that have long characterized American social life. Although 91 percent of women in the top income quintile breast-feed, 71 percent of those below the poverty line initiate breast-feeding. Whereas 81 percent of white women breast-feed, 62 percent of black women do. Breast-feeding is a lifestyle choice the majority now make, but it is more common among white middle- and upper-middle-class parents.

In other words, the breast-feeding imperative has elevated the parenting habits of that relatively privileged minority to a universal standard of good parenting…

The philosophy of natural childbirth rests even more firmly on privilege. Nothing denotes privilege more emphatically than ostentatiously refusing something that those less privileged wish to have. In a world where millions of women, past and present, desperately beg(ged) for pain relief in labor, there’s no better way to communicate the unbelievable wealth, ease and self absorption of modern American life than elevating the refusal of easily available pain relief in labor to an “achievement.”

Follow the money. Both breastfeeding and natural childbirth are industries. What could possibly be better, or more lucrative for an industry than (falsely) marketing its products and services as moral imperatives?

  • momofmany

    And make no mistake, there is a lot of money to be made selling the “job” of being a lay midwife and doula. I have done work for many midwives who make the bulk of their money selling their “birth system” or classes to others. Most women can’t make money as a midwife, but they can make money off those who want to do what they do. It’s really sad and perpetuates the problem of the uneducated teaching the uneducated.

  • Akasaka

    NCB and breastfeeding have been hand -in-hand and gathering momentum in Taiwan. In the activists’ version of history, hospitals stand in for patriarchy and traditional childbirth represents a lost feminism.

  • carovee

    I didn’t fall for NCB hook line and sinker but I fell for it enough. I consider myself a pretty smart cookie but I relied on sources to tell me the truth about the “evidence” in favor of NCB. What a mistake. I did feel foolish after finding this blog and looking into the actual studies themselves.

    • nomofear

      Same here! There’s a lot of us.

  • Chris

    I tend to disagree, in part. My experience is not that its primarily driven by money but by narcissism. While certainly there are some exceptions, those that have successful careers and are self-confident tend not to gravitate towards natural birth and anti-vax. You primarily see it in parents that have low self-esteem for a variety of reasons (lack of education, career, etc..). Thinking you’ve bested the medical community and the majority of the population gives you a sense of confidence and success (false though it may be). I always hesitate to blame “the money” because no one can deny that there’s big money on the other side of natural birth, too. I don’t think hospitals would want to lose the income stream derived from births, but yet I don’t think that’s why doctors push scientifically based birthing decisions.

    • Toni35

      I disagree with your notion that NCB and anti vax movements are predominantly made up of parents who lack education, careers, etc. Quite the opposite, actually. The majority of NCB enthusiasts and anti vaxxers are white, educated (most have at least some college education, many have graduate degrees), fairly well-off women, on the upper end of the socioeconomic spectrum. That’s part of what is so frustrating about it. But, when you think about it, it makes perfect sense. Families that are just struggling to make ends meet are more focused on basic needs like food, shelter, and safety than they are on being “empowered” by a birth experience. These women care more about how to pay their deductible, how to obtain assistance for medical bills and/or food, and how to pay for daycare than whether or not they get a “natural” childbirth. They are also more likely to take medical advice from their doctor (or their child’s doctor) because they don’t have some over-inflated ego (I have a college degree and I’m a smart person, therefore I can go to google-u and become smarter than a doctor! – common sentiment amongst ncbers and anti vaxxers alike). It is partly motivated by narcisism, but it seems to me that those who are very successful in other areas of life seem to have a harder time accepting that they may not be qualified to understand and interpret the studies, while their doctor is. And caring about a birth “experience” (beyond whether or not mother and baby survive) is clearly a first world problem… Right up there with caring about all organic, nonGMO, vegan/paleo food. If you have a strong opinion about these things, odds are you aren’t busy worrying about where your next meal is coming from, or how you will make your next rent payment…

      • monojo

        I think it’s both. There are the Kate Tietjes of the movement, who are not highly educated, are very religious, and tend to distrust government and authority. There are quite a few strains of American Christianity that are at odds with scientific findings, and this hostility can lead followers to be extremely gullible and susceptible to alternative therapies/NCB,etc. Religion also leads these people to believe a woman’s place is in the home with the children. The virtuous mother should find pleasure in sacrificing herself for her family, and being in charge of hearth and home is the only authority a woman can hope for, so women are protective of it, and shame those women who take the easy way out.

        On the other hand, there are the Giseles, who do tend to be highly educated, and use NCB and AP to cement their status. These women have the means to do things “the hard way” while not being inconvenienced at all. They can have their homebirths with highly skilled attendants and quick access to emergency care if needed, as well as the photographers, fresh flowers, and other accoutrements of a beautiful birth experience. Sometimes those in the privileged class of natural health adherents were powerful and ambitious professionals before they had children, and this intensive mothering is a way to channel their intelligence, ambition, and desire for control.

        I think there is also a third group of NCB/anti-health establishment people: women of color who have been treated abominably by the medical system- and by society at large- for centuries. I don’t think it is unreasonable for them to look at the m&m stats for women of color, then look at the homebirth stats and say, “Why not? Why be treated like shit for the same chance of a bad outcome?” I understand why they turn to NCB and alternative health, and it makes me incredibly sad.

    • Chi

      It’s actually the ones who have the means to live in a ‘designer’ world. Designer clothes, food, houses etc. And yes, designer babies and the designer birth ‘experience’. These are the ones who buy into the emotional appeal of NCBers because who WOULDN’T want to give birth in a relaxing pool in their own home surrounded by love and serenity instead of in a cold, sterile hospital room with evil doctors pushing unwanted interventions on them at every turn?

      So I strongly disagree that they are narcissistic because of unhappiness in their career. Low self-esteem DOES definitely play a part because why else would you do a stunt birth and then post it on Facebook for the world to see? Because of course having a well-paying successful career is no guarantee of having good self-esteem.

  • Anna

    And it sells the feeling of self-satisfaction. YOU were educated and firm in your beliefs and did not let those doctors fool you and talk you into smth vile and unnecessary; YOU endured pain and labor for 3 days like a hero; YOU made the only right choice to breastfeed no matter what and made it through your baby loosing weight like mad in the first couple months.

  • Bugsy

    So glad you addressed Jung’s wonderful piece. 🙂

    How can we pick up a signed copy of your forthcoming book?

  • Hannah Hush

    I am hoping that Amy could write a blog post about an issue I’ve read about lately. The food babe and Dr. L of (Sugar the Bitter Truth) tell me that formula contains added sugar and that you should breastfeed so that their food doesn’t contain this “toxin.” Could Amy let us know if there is added sugar, or if there is a safe brand that we can buy?

    • The Bofa on the Sofa

      Any of the commercial brands are perfectly safe.

      What toxic sugar, exactly, do they claim is “added”? I know that similac has lactose as an added sugar, but that’s not a “toxin” in milk quantities.

      Of course, recognize that the sources are a couple of ignorant whackos, but I wanted to provide a semi-legitimate response in addition to just dismissing them out of hand.

      • Becky05

        Similac’s soy formula does contain table sugar/sucrose, or at least it used to. That is the one formula list I’ve actually seen cited by anti-sugar advocates. Otherwise formulas contain lactose or corn syrup solids, which is actually less sweet than lactose.

        • Hilary

          I think that’s actually their organic version that has the sucrose and has been criticized for being too sweet.

    • Roadstergal

      “added sugar”

      Well, if you want sugar in there – and you do, it’s an important energy source for a growing baby – you have to add it. Human milk has sugar, after all (and fat, and water, and protein).

    • Joy

      Breast milk contains a ton of sugar.

    • Charybdis

      Umm…breastmilk contains sugar as well. And I seriously doubt that any of the rabid breastmilk promoters would be willing to admit that. Although, they might, and claim that it is “all natural”. Well, the “ose” suffix means sugar. Lactose, galactose = milk sugars. Glucose, sucrose, fructose….all sugars. And, sugar is natural. Unless you start banging on about “high fructose corn syrup”…but it is considered sugar as well.

      Sugar is a carbohydrate…one that is rapidly converted to energy. In and of itself, it is not bad. Excess sugar (of any type) can be an issue, but the fact that it is in formula is NOT A PROBLEM. What do you think makes breastmilk sweet? Sucralose (Splenda) or aspartame (Nutrasweet)?

      • Joy

        There aren’t any formulas with HFCS. Some formulas have corn syrup, but that is different to HFCS.

        • Charybdis

          I knew some of them had corn syrup, but i wasn’t sure if it was high-fructose corn syrup.
          I don’t have a problem with HFCS. It makes my Dr. Pepper quite tasty.

        • moto_librarian

          Nutramigen has corn syrup precisely because it is for babies who cannot tolerate cow’s milk.

          • Joy

            Yes, but it isn’t HFCS, or at least wasn’t. As far as I am aware it is regular corn syrup.

          • moto_librarian

            Right, it’s regular. I didn’t make that clear. I do remember a friend posting some bullshit meme about it having corn syrup and I had to school her about why that was the sugar of choice.

        • Becky05

          Even then it is “corn syrup solids” which is not as sweet as regular corn syrup or even lactose.

    • SporkParade

      Is the claim that formula contains unnecessary sugar (fact: it contains exactly as much sugar as breastmilk and yes, I did the mathematical calculations on this last week) or that sugar itself is toxic (in which case, you need to see https://www.youtube.com/watch?v=8UZJRR8OHhY)?

      • seekingbalance

        thank you for bringing this bit of hilarity into my life!!

        • SporkParade

          I can’t take credit; someone else here posted it first. Also, check out the episode on local, sustainable cooking. 😉

          • Who?

            Dinner porridge, anyone?

    • Dr Kitty

      Formula has added sugar because baby humans need more sugar than baby cows, and formula is made from cows milk to replicate human milk as closely as possible.

      Formula is therefore no more “sugary” than breast milk.
      In fact, if you taste formula side by side with breast milk, I think you’d probably find the breast milk sweeter.

      Whether the sugar is glucose, fructose, lactose or galactose is meaningless unless you are one of the tiny minority of baby humans that does not possess the necessary enzymes to digest disaccharides into monosaccharides, in which case you don’t want breast milk OR normal formula, but instead a special medical formula which tastes like fish.

      • Bugsy

        Yep – I inadvertently tasted a drop of my milk back when #1 was nursing. Wow, was it sweet – lots sweeter than I expected.

  • mostlyclueless

    “Why so much pressure to moralize and promote breastfeeding? Because breastfeeding is an industry.”

    I think it goes beyond the financial incentives. This is among my more tin-foily and far-out-there opinions, but I think the breastfeeding hoopla is fundamentally misogynistic. I think there is a pervasive but unspoken message that women are SUPPOSED to breastfeed because that is what our bodies were constructed for — not to practice law or medicine or invent things or create art — but to grow a baby and produce milk to feed it. That is what we are good for, allegedly, so if we don’t even breastfeed then what good are women at all?

    • Amy M

      I don’t think that is so out there. I would agree that there are definitely factions who feel this way, and have tried to claim that it is feminist to breastfeed. I would say its feminine to breastfeed, but breastfeeding (though women should have the choice to do or not do it) does not do anything to create equality between men and women.

      And even if woman does choose it, the other side of that coin is that she’s probably not working full time. (White)women of the middle and upper classes have a history of not being welcomed into much of the workplace, and every time there is an economic recession, there are some who would still try to kick them out, in favor of men claiming those jobs. Often, people who think women should be in the home, try to claim that children suffer if their mothers aren’t there 24/7 and go right back to the biological essentialism that you mention. I don’t think ALL breastfeeding advocates feel that way, but certainly some of them do.

    • SporkParade

      I completely agree with you. If breastfeeding were actually important for any reason other than that it ties women to the home, there would be studies on the incidence of various breastfeeding problems, doctors would be counseling women about their risk of not being able to breastfeed, and protocols would be developed to identify and manage lactation problems.

      I’d even go a step farther and say that breastfeeding promotion, together with anti-abortion advocacy and rape culture, are part of a larger issue of women’s bodies being considered public property. And that, as much as we criticize the natural childbirth movement for its patriarchal attitudes for women, there’s still plenty of that in mainstream obstetrics (Mayo Clinic Guide to Pregnancy, I am looking at you).

      • Roadstergal

        “there would be studies on the incidence of various breastfeeding problems, doctors would be counseling women about their risk of not being able to breastfeed, and protocols would be developed to identify and manage lactation problems.”

        And there would be actions taken to research the exact components of breastmilk that contribute to the desired outcomes, and to replicate them in formula. Like is being done for NEC. That’s what you do when the outcome for the baby is the most important thing.

      • mostlyclueless

        Ever notice how the solution to most breastfeeding problems is to spend more time breastfeeding?

        • Megan

          Yes, and when you’re already doing the nurse-supplement-pump routine every two hours (counted from the start of nursing!) how on earth do you breastfeed more?? I found the lack of real help so frustrating. I wish they would’ve just said, “you just don’t make enough” rather than to just “try harder.”

          • Chi

            But if they say that it means *gasp* not ALL women can breastfeed which goes COMPLETELY against their mantra.

    • auntbea

      I actually think it’s something of the reverse: women who don’t have the skills or patience or the luck to become as successful as they would like outside the home valorize breastfeeding in order to feel that they are good at something of value.

    • Chi

      Well there is proof of that in one of the top-picks comments on the piece: According to a Mr Dave Stoller:

      “As a physician, a man, a husband and father, and someone who has specialized in evaluating the youngest children, their relationships and attachment and resilience, the evidence about the benefits of breastfeeding in an incontrovertible as the evidence supporting vaccines work. There are no two ways around this. That being said, whether a woman can/wants to/is prepared to/is allowed to/is supoorted to breast feed…and is taught to by nurses/La Leche specialists/etc… we have lost the generational education mothers and grandmothers passed on and down for millennia. We would not have survived as a species without breastfeeding. No other species drinks other species breast milk.
      What’s the commercial from the 70s. “Don’t fool with Mother Nature.” The rest is nonsense and tomfoolery and misplaced emotion and judgment.”

      I love how he feels he needs to state that he’s a man, as though that gives him extra cred to tell women what to do with THEIR bodies. *eye roll*

      • The Bofa on the Sofa

        Cat’s drinking cow milk and cream is so common to be cliche. Where does he get this nonsense about no other animals drinking other animal breast milk?

        We are the only animals with brains to know how to get it delberately

        • Roadstergal

          We are the only animals with the brains to formulate a replacement substance that is as close to breast milk as any other substance that exists. I see that as a win, myself. But I’m not A Man. :p

          We’re also the only animals that defecate in toilets. Are they somehow a bad thing?

          • Chi

            Exactly, he says ‘Don’t fool with Mother Nature’ but we do that every day when we live in the warm (mostly) houses that protect us from the elements, use medications and vaccines that protect us from diseases that used to wipe us out en mass. Hell when we drive, we defy Mother Nature. And toilets? Goodness forbid we try to prevent our excrement from harboring and spreading MORE disease.

            I really hate this natural fallacy. Mother nature is not benign. She doesn’t care if we live or die. Mostly she wants us to die.

          • Liz Leyden

            I defy Mother Nature every day by wearing glasses.

          • Sarah

            Yes, you should be giving birth in them instead.

          • Roadstergal

            *dying*

          • Sarah

            Yes, it’s fine if that happens too. As long as you didn’t have an epidural.

        • Empliau

          I thought cats were (mostly) lactose intolerant. My cat never gets milk because I don’t much like cat poop, but I really hate cat diarrhea.

          • demodocus

            I’ve heard that too, but nobody told my cat. Apparently, he doesn’t connect drinking milk with the nasty poop he’ll have later. Or maybe like my sister and her strawberry allergy, sometimes you just gotta do it even if it’ll make you grumpy later.

          • Outi

            My cats didn’t get the memo either. In fact, just last night one of them bit off the nipple from a baby bottle to get the milk inside. Sometimes I hate my cats.

        • namaste863

          My baby (yeah, yeah, I know, I am in grad school in student housing where she is not allowed atm and I miss her like crazy. She is living with my mom until I graduate) laps up cream like it’s going out of style. Goat cream, cow cream, you name it, she loves it. Never has GI problems, and it strengthens her bones, teeth, and fur. Same for humans. If mammals were designed to only drink the milk off their own species, why would it combat osteoporosis and cavities?

          • mostlyclueless

            Oh my god I thought you meant your actual child and was wondering what kind of sociopaths managed your grad student housing.

          • Who?

            Thankyou! Me too except I was wondering what kind of sociopaths give a baby cream! When I got to ‘fur’ it all fell into place though.

          • namaste863

            Awwww, that’s sweet. This is the baby in question

          • namaste863

            Shit, it’s upside down. How the hell did that happen?

          • Blue Chocobo

            That’s cats for you

          • Mel

            Yeah, I was about to start a massive uprising on your behalf.

      • Megan

        I found it very telling that he thinks the evidence supporting breastfeeding is as good as the evidence supporting vaccines. His reasoning boils down to, “because everybody just knows breastfeeding is best.”

        And by the way, Mr. Stoller, aren’t vaccines “fooling with mother nature?” This guy talks out both sides of his mouth. I’d say if anything is “tomfoolery and misplaced emotion and judgement” it’s the blind faith in nature. A doctor should know better; nature kills.

      • LizzieSt

        There it is! I knew it was coming! The New York Times reader push-back. And of course he’s gushing about “Mother Nature” and the beauty of natural breast-feeding being passed down through generations of women (who in historical reality pawned the beautiful, natural task of nursing onto wet nurses as soon as they had enough wealth to do so. How many Roman empresses breastfed? I bet the answer is: Not many)

        All part of the nasty old assumption that women are supposed to be the natural, primal, closer-to-earth sex while men are pure products of civilization.

        Harrumph to that!

        • Roadstergal

          “How many Roman empresses breastfed?”

          Oh, just let the wolf do it.

          • LizzieSt

            Exactly! There you have a perfect example of human infants drinking and thriving on non-human milk. Take that, Dr. Dave Stoller!

        • Joy

          How realistic is that whole we lost a generation thing anyway? I was born in 76, my mom didn’t bf me, but I was her last and at that point the tide had started to turn and bfing was gaining ground. But since then I have known a friend who bf 6, another bf 2, both extended/tandem fed, another who bf 2, my two sils one who bf twins and the other who bf two. I still didn’t produce enough milk at all.

          • LizzieSt

            Not realistic at all. My mother’s family had given up breast-feeding and switched to formula by 1935. To them, bottle feeding was modern and American. Breast-feeding was something that our impoverished ancestors living in the shadow of Mount Taygetus did. So for us it was more like “lost in three generations.”

          • Joy

            Yes, but since the late 70s bfing rates have only been climbing. 80% leave the hospital bfing now. Since I was born in 76, I am at the tail end of the no one bfs era and people my age and older aren’t going to have babies for that much longer. I had my baby late, but there are plenty of people who were born in the late 70s/early 80s who were bf, had kids, bf those kids and will soon have grandkids. So can this reason as to why we are all weak and turn to formula really be used for that much longer? Maybe they will have to face that facts that women are choosing formula for other reasons other than there was no one to show them how. Setting aside all the LCs and LLL and all that.

          • Roadstergal

            Hey, a fellow bicentennial babe. Because it was the majority at the time, I just assume I was bottle-fed, but I don’t know for sure because mom wasn’t all up on evangelizing ’empowering vaginal births’ or ‘all-natural breastfeeding for the microbiome,’ as it was more ‘get this kid into the world and fed, then get to the real work of raising her.’ (I appreciate that. Oh, and she was a farm girl from a two-digit-population Midwestern town, so no way did she not know about VB, HB, and breastfeeding.)

            And yes, breastfeeding rates have been climbing since the ’70s. As have the rates of everything breastfeeding is supposed to ‘prevent’ – obesity, asthma, allergies. You’d think _someone_ would scratch their head over that…

          • MaineJen

            “bicentennial babe”

            Hehe…funny story. A couple of friends in college and I discovered that we all had birthdays in late March/early April 1977. Then we figured out what was happening approximately 9 months before that…

            Bicentennial babies of a different sort. 🙂

          • Janie4

            I don’t think my grandmother breast fed (children born 1941, 1944 and 1955), and my mother didn’t (1973, 1977). But I do have a lot of friends who did breast feed, and their moms did, so if I were planning to have children, I’d have access to that wisdom.

        • The Computer Ate My Nym


          How many Roman empresses breastfed? I bet the answer is: Not many

          Yeah, and look how their kids turned out. Best breastfeed if you don’t want to be raising the next Nero or Caligula

      • indigosky

        Funny, Mr. Stoller. Every week or so on the Good News Network they have a story where an orphaned animal is nursed by a different species. Cat nursing squirrel, ferret nursing cat, dog nursing hedgehog, etc. Back in the 1950s my grandparents bred cats and dogs and apparently the babies would nurse the other species mom often.

        • Azuran

          We also even have access to multiple specie specific formula for various animals. Because even animals sometime cannot or even do not want to nurse their offsprings.

        • Nick Sanders

          30 seconds on google will turn up all kinds of pictures of one species nursing another.

          The craziest one I found was a cat nursing ducklings.

          • LeighW

            I saw that one. That poor Momma cat trying to keep her ducklings in the box with her kittens. I feel your pain MommaCat

          • indigosky

            I mistakenly did a Google search like that one day..I think my husband has some permanent hearing loss from my squees. The best way to cheer me up is baby animals 🙂

      • Nick Sanders

        A margarine commercial? That’s his evidence?

        Edit: Also, Dave, given that you are talking about inter-species nursing, “breast” milk is redundant unless you are bringing monotremes into it.

        • Blue Chocobo

          Remember the Echidna!

        • The Bofa on the Sofa

          Cows don’t have breasts, they have udders. As do goats.

          But I did catch that bit about drinking other species “breast milk.” As opposed to their OTHER milk?

      • Tumbling

        I remember that margarine commercial. The setup was Mother Nature being given a slice of bread spread with what she thought was butter but turned out to be margarine, and the tag line was actually, “It’s not nice to fool Mother Nature”.

        So the point of the commercial was that this artificial margarine was in truth indistinguishable from natural butter–exactly the opposite of the point that he thinks that he’s making about formula!

      • Sarah

        We had a mansplaining lactivist doctor here a few months back grossly overstating the benefits of breastfeeding. I wonder if that’s him? Either way, we are dancing towards NEWMANITIS here.

    • oceanlily

      Exactly. Breastfeeding and attachment parenting are to chase women back into the home. Formula feeding gave women the freedom to enter the workforce and now all this crap about what is supposedly better for baby conveniently means Mom can’t work. Like that wasn’t planned. It’s like what happened when they had to chase the women out of the factories after WWII. Women got the taste of that freedom and craved more, and the freaking GOVERNMENT even assisted in keeping women in what they thought was their place. And it’s happening yet again.

      You can take my job, my choices and my formula when you pry them from my cold, dead fingers.

    • Who?

      I wonder too if there is a subset of women with high levels of education who are quite happy to step out of the corporate world, who have husbands earning sufficiently big bucks that it isn’t a great hardship, and who use these values as cover for their desire to no longer play the corporate game.

      The corporate world can be pretty ordinary for everyone, and the glass ceiling isn’t going anywhere. There are plenty who do it without the cover, and it can work well particularly if husband works insane hours or travels a lot, but if you do want some ‘solid’ reason, buying into NCB, must bf forever and attachment parenting is an obvious gambit.

      • Bugsy

        Yep. The gal I know who adopted extreme attachment parenting had lost her job as an attorney right before she got pregnant. Hubby has never earned big bucks, but I think attachment parenting provided her with a way of proving her worth as a parent…in this case when the working world failed her.

  • Emily

    This is only tangential, but the professionalism of the look of your book cover would increase if you used a sans-serif font for your name, to match the title font style.

    • Amy Tuteur, MD

      Thanks, but Harper-Collins chose the fonts, not me.

  • LizzieSt

    Kudos to the New York Times for running that article. I’m sure they will
    get some angry push-back for it, because I imagine that a high
    percentage of Times readers belongs to the Breastmilk-or-Death (with
    apologies to Eddie Izzard) crowd.

    It would be great if they could
    take on Big Natural Childbirth in the same way. BNC is such an industry
    that it has its own celebrity spokespersons. Ricki Lake, Alicia
    Silverstone, Gisele Bündchen…..I’m sure I’m missing some. You know that society is in a sad state when many people don’t realize that they should not be taking medical advice from Ricki Effing Lake.

    • Chi

      Especially since she is against hormonal birth control, the ONE greatest stride to feminism in the last century, seeing as it gives US control over our fertility and means we can *gasp* enjoy sex without the huge worry that we’ll be making yet ANOTHER baby.

    • Bugsy

      Yep – the readership definitely seems to skew towards “Breastmilk or Death.” Read some of the comments yesterday, and the majority I saw definitely were along the lines.

      • Megan

        Yeah, I was really disappointed at the lack of real discourse in the comments. They were all just a bunch of “but everybody knows breastfeeding is good so this author is just ignorant -how dare the NYT publish this.” She never said that women shouldn’t breastfeed but that’s certainly how most of them seemed to take it.

  • 2boyz

    I’m one of the people NCB was oversold to. I felt guilty for “caving” and getting an epidural with my first. I made sure it wouldn’t happen with my second. I got my wish- labor was so fast, I couldn’t have gotten an epidural even if I HAD wanted one. I delivered 5 minutes after arriving at the hospital, so I also wasn’t in a bed (they were working on getting me into a room when the baby made his grand entrance), no IV, no monitor, just like the NCB people say it should be! Guess what? It wasn’t all that. I got a nasty tear from the baby shooting out so fast. I was actually completely traumatized from the pain and the panic. Suffered PPD (and was then told by a midwife that it wasn’t possible because NCB is known to prevent PPD).
    My physical recovery was somewhat better, but most second births are a better recovery and also it had been a very quick labor, so there are too many confounding factors to say that the easier recover was due to a lack of pain relief. Same with breastfeeding- had an easier start, but I had nursed my first for nearly 2 years, so it’s more likely that it came easier simply because I knew what I was doing.
    I’m due in a few months and though I haven’t decided for sure, I’m leaning in favor of induction at 39 weeks so I can get pain relief ahead of time. Labor pain is really, really bad and I want to avoid it if I can (I know, there’s still a lot that can happen, and I am prepared for the possibility of another natural birth and possibly an unplanned side-of-the-road or even homebirth, but whatever I can control, I will). People are so horrified when I mention it- what, and elective induction? For no medical reason? But what can I say, I did NCB and it sucked, and I’m going to do what I can to not let it happen again.

    • lilin

      I’m sorry you had such a tough time. At the very least you have the benefit of experience now and can steer towards something you know you want.

    • demodocus

      Good luck with #3! May s/he wait for your epidural. 🙂

    • Kelly

      I had the same reaction. While my second birth was not as traumatic as yours, I was terrified the third time that I would give birth at home. My problem was that I go early and so I really wanted to be induced at a late 38 weeks. One of my friends was appalled by my desire to be induced that early as she had seen a lot of kids with lung issues etc. at that age but I kept saying that since my other two kids did not have problems that most likely this one would not either. I did get my wish from a rare condition called cholestasis in which I was promptly induced at 37 weeks with a perfectly healthy baby who ended up being bigger at birth than my other kids. I also got an epidural before they induced because I was already at a 4 and had my baby about three hours later without a single pain and without tearing. It was surreal but exactly the birth I had been hoping for. I hope you get your wish and that it all works out.

      • Hilary

        Lung issues at 38 weeks? But that is full term …

        • Montserrat Blanco

          It happens sometimos. That is why some OBs would try to stop labor at 38 weeks. It is infrequent though.

          • Hilary

            Huh. My son was born preterm (and has lung issues). I was told that for future pregnancy they would do progesterone only until 36 weeks.

        • moto_librarian

          My naturally born first child had TTN. He was born at 38 + 3. NCB advocates must think my son is a unicorn…

        • Amy M

          You never know…my 36 weekers had no lung issues and didn’t need the NICU at all. My cousin’s 36 weeker spent a week in the NICU with breathing issues, and he’s a bit developmentally delayed. He’s not even a year old, so he may catch up and show no long-term evidence of his ordeal, there’s no way to know yet.

          • Hilary

            It’s true, my son was a 34 weeker and I got a lot of “Oh, 34 weeks isn’t bad” but he was on oxygen for over a year and has developmental delays. Obviously full-term babies can have problems, too. But since it’s so unpredictable, it doesn’t make sense to me that the OP would get grief for wanting to deliver at (early) full term.

            Best wishes to your cousin’s little one.

        • Kelly

          It happens but since my other two came early at 38 +2 and 39 weeks and were completely healthy, it would seem that I just cook them early. I was happy that I proved her wrong though because it annoyed me to no end. It was not like I was asking to be induced because I was sick of being pregnant, I just wanted the healthiest option of delivery.

      • Karen jj

        My second had tttn and was born at 39 weeks and 6 days (elective c section without labour). He needed oxygen for 24 hours. He was a big healthy baby at 8 and 3/4 pounds and had a 90th percentile head circumference. He’s still hard to get hats for.

        • KarenJJ

          That was me.. New phone…

    • moto_librarian

      There very nearly wasn’t a moto baby no. 2 because my “natural” birth was so awful. I remember feeling panicky during my first postpartum period because the menstrual cramps reminded me of labor. Our desire for another baby won out over my fears, but thank goodness for epidural anesthesia!

    • Jen

      My second birth was also ‘natural’, spontaneous labour, no drugs, quick but not so quick to be traumatic – he was born four hours after my first contraction, two hours after arriving at the hospital. I would go so far as to say it was the “perfect” birth (whatever that is). Except… after he was born and I was able to compare a drug free birth with my first (induced, pethidine) I couldn’t see that one was better than the other. And I ended up with post natal depression, so take that NCBers.

      Number three was an elective induction with a lovely shot of pethidine when things got tough. No sign of PND so far, my beautiful seven week old is the light of my life.

    • Mer

      I had a similar experience with my last child (going to be 2 in 2 months!) and swore that if I ever got pregnant ever again that I would either be inducing at 39 weeks or getting a c-section because the hell with natural precipitous labor. That freaking hurts and was so intense and out of control that I was terrified, plus I didn’t get the epidural that i was so looking forward too and I was at that damn hospital for at least an hour, plenty of time for one to be started if they given it right away. Not their fault that my veins kept collapsing for the blood draw though I suppose. Anyways I kept getting flashbacks every time I’d cramp for the next few weeks, tensing up and expecting that horrible awful labor pain to be hitting again. So yes I hope you get your induction and great pain management.

    • nomofear

      Precipitous labor IS a valid reason, though! It’s dangerous – you know, you’ve lived it. What if that happened at home, but baby was to big and you ran into shoulder dystocia? That happened to another commenter here, and her baby died. She was on the way to the hospital when bam, she was crowning in her kitchen…

      I elected for NCB the first time, and it was positively awful. The second, maternal request 39th week induction, and it was fantastic. And, boo to NCB – the recovery was amazingly easy with the induction. Thanks, pitocin!

      Good luck, you’ll be fine, do it, go ahead talk to your doc about it now – using the term “precipitous labor” – and if s/he hesitates, think about a new doc. Seriously, fast labor is nothing to play around with.

      • tariqata

        I know I’m late to the party on this thread, but I thought I’d chime in anyway. I gave birth to my first child a few months ago, in a midwife attended hospital birth (i gather registered midwives in Canada differ in their training and approach to practice from certified professional midwives in the US, but they are still supportive of low intervention births). I also got to the hospital just in time to start pushing, after a very fast labour that started very abruptly. My son was fine and I didn’t have any serious trauma and was able to cope well with the pain, but even so my midwife told me that if I have a second child, she will strongly recommend induction in a controlled setting to be sure I don’t have an unplanned home birth or worse, and I’ll definitely take her up on it. We were all okay this time, but I’m not going to risk an accidental roadside birth.

  • LibrarianSarah

    I would open it up even more to the point where the amount of control you have over your health in general is constantly being oversold. One of the greater sins of the “alternative medicine” movement is the marketing of the idea that your health is something you should be proud of instead of grateful for.

    The truth is you have limited control over many (if not most) acute and chronic illnesses and even when there are things you can due to reduce (not eliminate mind you) your risks of getting certain illnesses, those things might be difficult to impossible for a large segment of the population to accomplish due to factors out of their control (race, class etc).

    However, the most privilege among us eat up the idea that health is both a choice and a moral imperative because the idea comforts them on two accounts. First, is that nothing bad is going to happen to them and theirs because they do all the “right” things. I like to call this “the talisman effect.” The second is that they are entitled to their privilege. They aren’t healthy because of luck; they “earned” their health through various daily rituals.

    Unfortunately, the truth is life is unfair and you are not going to get out of it alive.

    • SporkParade

      This is true, and also the people who think like this don’t vaccinate. I recently encountered a woman who believed that her efforts beginning in pregnancy and continuing afterwards are the reason that her kids weren’t perpetually sick during their first year in nursery school. It must be very stressful to believe that your child having a cold is a sign of bad parenting.

      • MaineJen

        On my gosh, if that were the case I’d be the worst parent in the world to my younger one (the one I breastfed for over two years…the one who is almost constantly sick with one cold/fever/infection or another) and the best of the best for my older one (rarely if ever gets sick, could probably count on one hand the number of times he’s actually had a fever…only breastfed for 9 months because I couldn’t keep up with his appetite).

    • Who?

      This also feeds into various obsessive and unhelpful behaviours, particularly orthorexia. They only eat ‘health’ (not, you notice, ‘healthy’) food; they add all kinds of superfoods du jour to it; they disregard the environmental, social and economic evils those superfoods cause to the poor peasants who grow them, because our health is of superior importance, and those poor people are invisible.

      And things are quietly dropped when they are incontrovertibly shown to be useless-coffee enemas and fish oil come to mind-with a shrug, as the new obsession is adopted.

    • nomofear

      Ex-NCBer here – so it shouldn’t surprise anyone that I got sold in the idea that drinking a bit of Braggs apple cider vinegar every day would keep me from getting sick. “It worked” for nearly two years – it just happened to coincide with my working from home period, so I wasn’t exposed to much to begin with, but that kind of critical analysis doesn’t come natural to me. Anyway, a few months ago, I noticed that my lower front teeth were stained brown. I thought ugh, so much coffee. Then I really looked at them – and googled – and no, the effing enamel is disappearing, and the coffee is staining the layer underneath. At least only my top teeth show when I smile! Guess what eats enamel? Vinegar….I’m a moron. At least I know I can’t trust myself 100%!

      Off to the dentist Tuesday, hoping I won’t need a second mortgage to fix this.

  • indigosky

    ” By the time the teacher at our hospital birth class announced that she wouldn’t explain how to use formula because it was against hospital regulations, I was pretty fed up.”

    WTF?! I would have been lodging many complaints with the hospital. So a woman with no breasts, major medical issues who *has* to use formula will not be taught how to use it. That sounds like grounds for a discrimination lawsuit.

    • demodocus

      But, but, but, can’t you wait on your cancer treatment for a year or two? I mean, it’s only Stage III
      //sarcasm

      • Azuran

        A while back there was someone who commented that she had a preventive double mastectomy because her family had a super high incidence of breast cancer and she was a carrier of the gene responsible. Someone had the nerve to tell her that she should still try and ‘hopefully’ she had some breast tissue left and would produce milk.

        • Roadstergal

          Was that the Armpit Lactation Brigade?

        • MaineJen

          I still can’t believe that. I mean…who in the WORLD would say something like that? The kool aid can’t be that tasty.

        • demodocus

          I remember.

    • Roadstergal

      “woman with no breasts, major medical issues”

      Or parents using a surrogate. Sure, ‘I don’t want to’ should be all the reason required, but something more egregious is better grounds for a lawsuit.

    • KeeperOfTheBooks

      I swear, it’s like “just don’t tell your kids about sex and then they won’t have it,” redux.
      And we all know how well THAT works.
      No one at the hospital walked me through how to make a bottle. I literally had no idea; I’d planned on breastfeeding exclusively, and when that didn’t work, I was given some RTF bottles. No patient education on about how much a baby should eat how often or how to make up or clean bottles. ‘Cause, you know, that would make me give up on breastfeeding entirely, rather than just not be another source of massive frustration.

      • Roadstergal

        Seriously, the attitude is, ‘if we withhold information about the alternatives, they’ll be forced to do X.’ In what other effing arena of life is this considered acceptable behavior? Can you imagine if they tried to do that with any aspect of men’s health?

        • Blue Chocobo

          It’s like making speedometers that only go to 55 mph. Doesn’t mean people won’t drive faster, it just means they won’t know by how much and their ability to make related judgements will be impaired.

  • sdsures

    This part is my favourite:

    “The philosophy of natural childbirth rests even more firmly on privilege. Nothing denotes privilege more emphatically than ostentatiously refusing something that those less privileged wish to have. In a world where millions of women, past and present, desperately beg(ged) for pain relief in labor, there’s no better way to communicate the unbelievable wealth, ease and self absorption of modern American life than elevating the refusal of easily available pain relief in labor to an “achievement.””

    • Roadstergal

      The thing that gets me is that any sort of non-doctor-approved pain relief is fine. Breathing techniques, baths/jacuzzies, saline injections, nitrous, etc (I’m would be very surprised if medical marijuana isn’t suggested by some members of the crunchiest set). But the stuff that works the best is verboten. Just like how induction is fine as long as it’s stuff that doesn’t work well – sex, nipples, castor oil, etc.

      • AirPlant

        I know this makes me a bad feminist, but the nipple thing just freaks me out. I haaate when anything touches my nipples, it is just the worst nervy feeling, and I get this instant spasm of rage whenever it happens, I just cannot imagine being ready to pop pregnant and some asshole telling me it was nipple tweaking time. That bullshit will get you slapped.

        • Roadstergal

          I don’t see why having a strong sense of body boundaries makes you a bad feminist, m’self. 🙂

          • AirPlant

            It feels kind of sex negative and antifeminist to associate something that lots of women like with instant negative fuck all y’all rage. Like I should be respectful and open to other women’s stories and experiences but I hear nipple stimulation and turn into the angry nope octopus.

          • Roadstergal

            I dunno, I feel you can be respectful of and support other people’s happy things without diving into the details. Like, if a friend of mine gets off on being peed on, I fully respect and support him or her having a great deal of fun with that without wanting to hear the stories. Same with more ‘socially acceptable’ kinks – they’re all still kinks.

            (And even then, kinks are very situational. I do enjoy nipple play in the right context, but a supposed health care provider in an actual health care situation thinking it a sensible medical intervention – I’d get a little punchy, too.)

          • Charybdis

            I agree with you there. Something that I enjoy during sex has an altogether different context when in labor. If someone had even THOUGHT about suggesting that nipple stimulation would augment my labor and reached out to stimulate away, I would have stabbed them with a spoon.

            Thank God I had a scheduled c-section. Although labor did start about 2 in the morning the morning I was scheduled. The contractions I got to feel made me plenty happy for the epidural.

          • Who?

            I’m sure there was a story about one of the home birth hobbyists using clitoral stimulation during labour-which breaches so many boundaries that I don’t know where to start.

          • Chi

            Ina May Gaskin goes on about manipulating her patient’s ‘button’ in her horrible home birth handbook. I’m pretty sure that’s what you’re referring to.

            Pretty disgusting as it basically turns something that ISN’T in the least bit sexual (or at least SHOULDN’T be) and turns it into something perverted.

          • Who?

            Yes that’s her, wasn’t game to google as didn’t know what I’d end up with.

            I actually don’t much care about whether people find birth sexual or not, but the idea of doing that without some pretty specific consent in place. And as someone mentioned above, even if the woman wanted it, the staff might not be on board.

          • Bugsy

            I read one such request in a birth plan I saw online – the med staff declined it.

          • Blue Chocobo

            You can be sex positive in a general sense without having a personal appreciation for every possible sexual act or sensation. And just as you can respect someone else’s informed consensual personal appreciation for a specific thing you don’t enjoy, they can respect your personal dislike and avoidance of it.

          • SporkParade

            Maybe the problem is that my first encounter with sex positivity came from reading Savage Love, but I really can’t stand the way sex positivity pathologizes people, especially women, with firm personal boundaries when it comes to sex.

          • Erin

            Another Octopus here, even the thought of nipple stimulation has me reaching for a blunt instrument. In labour apparently I threatened to stick a fork into my husband’s left testicle with barely any provocation at all.. (he said “we’re” in labour) but nipple touching at any point in pregnancy would go straight from threatening to doing.

      • KeeperOfTheBooks

        Hell, I knew one woman who was really into the NCB, had several midwife friends, etc, who cheerfully told me once that one of her midwife friends had started injecting STERILE WATER just under the skin of her patients’ backs when they had bad back labors. When I said something about how much that must freaking hurt and why the hell would she do that, the (ex) friend explained that the pain of the injection would distract the moms from the pain of labor.
        What. The. @*#&!.

      • Sarah

        Whisky sours.

    • LizzieSt

      And somehow childbirth is the only situation in which refusing pain relief is a badge of moral worth. Headache? Here’s an aspirin. Having a tooth pulled? Of course you’ll have several shots of Novocain, you’re not a martyr. Back injury? Enjoy your Vicodin! Even in other aspects of women’s health care: I have never heard of a woman being shamed for having local anesthesia during a breast biopsy.

      But an epidural? Oh no, can’t have that. It’s bad for the baby because it’s not natural or something. Don’t ask me why it’s bad. It just is!

      • Montserrat Blanco

        A lot of my patients had an epidural for their surgeries. None has ever complained about epidurals side effects. I HATED the idea of the needle in my spine, and I still do, but that knowledge kept me sane during my epidural placement before my CS. And you know what? I did not have any side effects at all.

      • MaineJen

        I’ve shared this story before, but it bears repeating:

        A few years ago, my husband had a couple of very painful abdominal surgeries. Before each procedure, he had an epidural catheter placed, which would remain in place during surgery and for several days after, and through which he could receive more effective pain relief.

        During the first surgery, there was an incident where my husband’s blood pressure dropped (probably due to the epidural) and they had to pause the procedure and deal with that before they could move on.

        Despite that happening…AT NO TIME did anyone ever suggest that because the epidural had caused a minor hiccup like that, it would be better for him to power through and do without it. Treating his pain was top priority, and the epidural was the most effective way of doing that.

        Why is women’s pain less worthy of treatment than men’s? Why are we expected to power through labor with “gas and air” while our husbands get the good stuff and no one blinks an eye? Inquiring minds want to know.

      • Inmara

        There are some claims that births with epidural end up with higher incidence of instrumental delivery and tearing. I guess you get such data in a specific setting – where women are not offered epidural routinely but have to ask for it or even pay a lot of money (as it’s in my country). And then you get a sample of women who already have difficult labor for some reason (back labor, failure to progress etc.) which subsequently results in instrumental deliveries and tearing. Also I suspect that midwives who are proudly ‘experts in natural birth’ are not so good in couching woman through pushing stage with epidural and that’s why there’s more tearing.

      • sdsures

        Exactly.

  • Michele

    Yes!
    I’m now weaning Thing #2. No guilt! (Though hormones can be a bitch) He’s lost interest recently and I’m not about to force it on him.