Natural childbirth is an industry


Why do even sophisticated people fail to recognize that natural childbirth is an industry?

It’s probably because they equate “industry” with large amounts of money. True, individual natural childbirth professionals don’t make a lot of money, but for most, it represents 100% of their income. That’s why they have a tremendous financial incentive to convince you to buy their products and services.

[pullquote align=”right” cite=”” color=””]Midwives fought to wrest control of patients back by deriding what obstetricians offered and offering the exact opposite.[/pullquote]

The advent of modern obstetrics, and the dramatic drop in maternal and perinatal mortality that it brought, set the stage for the development of the natural childbirth industry. This created both a problem and an opportunity for midwives. The problem was that obstetricians could promise safer outcomes.

Midwifery succumbed to the success of obstetricians who were only too happy to supplant midwives. While midwives themselves make much of this economic competition, blaming deliberate action by obstetricians in an attempt to stifle competition, the fact is that women came to prefer hospital birth because of its safety and increased comfort. Previously doctors were called to childbirth in only the most dire circumstances. With the switch to routine hospitalization for birth and the routine presence of obstetricians, and, in particular the easy access to pain relief, midwifery went into decline.

The increased safety of childbirth also created an opportunity for midwives: the chance to emphasize the quality of the birth experience. Modern obstetrics made childbirth seem safe. Since safety was now a given, midwives fought to wrest control of patients back by deriding what obstetricians offered and offering the exact opposite.

  • If obstetricians medicalized childbirth to make it safer, then midwives would de-medicalize it to make it more enjoyable, and, for added impact, would declare that childbirth was safe before obstetricians got involved.
  • If obstetricians offered screening tests and measures to prevent complications then midwives would insist that “trusting birth” was all that was needed.
  • If obstetricians offered pain relief, midwives would proclaim that feeling the pain improved the experience, tested one’s mettle and made childbirth safer.
  • If obstetricians whisked babies off to pediatricians to make sure that they were healthy, midwives would claim that skin to skin contact between mother and infant in the first moments after birth was crucial to creating a lifelong bond.
  • If obstetricians insisted that modern obstetrics was based on science, midwives would accuse them of ignoring science, and if that didn’t stick, they’d insist that scientific evidence was not the only form of knowledge.
  • If obstetricians placed the highest value on a healthy mother and a healthy baby, midwives would place the highest value on a fulfilling birth experience.

In other words, no matter what obstetricians offered, midwives would insist that it was unnecessary, disempowering, harmful and contradicted by the scientific evidence. Midwives would wrest childbirth back from paternalistic doctors and give it to those to whom they believed it rightly belonged  …  the midwives themselves. And the entire project would be promoted as being in the best interests of women and babies.

The natural childbirth industry in general, and midwifery in particular, became unreflective (and completely reflexive) defiance of modern obstetrics.

That’s doesn’t mean that those who promote natural childbirth don’t believe in it. Its advocates believe fiercely in what they promote, and sell — normal birth as the holy grail of childbirth, midwives as the guardians of normal birth and distrust of obstetricians (whom they correctly identify as their chief competition) as the people who medicalized birth … and thereby made it safe.