Is natural childbirth about physiology or monetization?

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The fundamental conceit of the philosophy of natural childbirth is that it recapitulates childbirth in nature. But there’s nothing natural about books, courses, hired attendants, birth pools and refusing available pain relief. The ultimate irony of the philosophy of natural childbirth is that it isn’t about the physiology of birth but rather about the monetization of birth.

In nature, mothers were attended for free by wise women, family and friends. They purchased neither goods nor services. Childbirth, although occasionally deadly, was always free.

There is not a single aspect of pregnancy and childbirth that has not been monetized by natural childbirth purveyors of goods and services.

Consider childbirth in the 1950’s. Women gave birth in hospitals that charged money, attended by doctors who charged money. There was nothing else to purchase.

Consider the philosophy of natural childbirth in 2018. The opportunity for spending — indeed the mandate for spending — is virtually limitless. Nearly every single aspect of “natural” birth has been transmuted into an opportunity for conspicuous consumerism.

Birth attendant:

This is where you may be required to spend the big bucks.

For many, it isn’t enough to hire a doctor or hospital, typically paid for by an insurance company. “Natural” childbirth often involves hiring a homebirth/birth center midwife who charges thousands of dollars. But that’s just the beginning.

Even if you give birth in a hospital attended by a hospital based midwife, you must have a doula, a woman paid hundreds of dollars out of pocket for nothing more than pretending to be your friend and helping you avoid unnatural interventions.

Birth location:

If you prefer to give birth outside the hospital, you may have to pay for a birth center, possibly thousands of dollars out of pocket. If you are planning to give birth at home, you will need to purchase a birth kit, rent a birth pool, and purchase a birth ball or similar paraphernalia.

Education:

Often you must pay for childbirth education out of pocket, too. Obstetricians don’t provide childbirth education. Typically neither midwives nor doulas provide childbirth education as part of their fee for attending the birth.

Educational materials:

At a minimum you must buy books to “prepare” yourself and your partner for your natural experience and perhaps a hypnobirthing course as well. Midwives, doulas and childbirth educators offer online courses at a cost of hundreds of dollars to create the ideal mindset for the optimal birth experience.

Supplements and services:

During your “natural” pregnancy, your midwife may recommend the purchase of herbs, supplements, tinctures and teas. You might “need” cranio-sacral therapy both before birth, for example to encourage a breech baby to turn.

Birth photographer:

Obviously you are going to memorialize your unmedicated birth for your admirers on Facebook. What’s the point of having an unmedicated birth if not to brag about it? (The point is the baby? Be serious! That is not enough).

The photographer will cost hundreds, perhaps thousands of dollars. And don’t forget the photo sessions to show off your bump in late pregnancy, dressed up as a goddess. Of course a videographer is even better for recording the birth instead of or in addition to the birth photographer, and that’s even more expensive.

Belly art, belly casts, etc.

Everything is an opportunity to hire “professionals” and spend money!

The placenta:

They just throw it away in the hospital. Instead they could be monetizing it by encapsulating it, or making placenta prints and umbilical cord jewelry.

More goods and services:

You’ll need a private lactation consultant to teach you to feed your baby naturally, not to mention more cranio-sacral therapy to “adjust” you and your baby after your agonizing ordeal blissful experience.

The bottom line is that if you have insurance, a hospital birth with every possible technological intervention (or none) will cost you nothing. A “natural” birth will costs you hundreds, possibly thousands, possibly many thousands of dollars. That’s because there is not a single aspect of pregnancy and childbirth that has not been monetized by natural childbirth advocates. It’s almost as if natural childbirth is really about enriching purveyors rather than giving birth as nature intended. Ironic, isn’t it?

  • Angharad

    Unfortunately, even with insurance, you can be on the hook for ridiculous amounts of money in the US. I paid about $13,000 for my last pregnancy and birth (and the insurance company paid multiples of that). I developed preeclampsia at 27 weeks, had biweekly non-stress tests, weekly appointments with my OB, weekly appointments with my MFM, a 37 week induction with an epidural and interventions to save me from the hemorrhaging afterward. I obviously think the money was definitely worth it to save my life and my baby’s life (and no sane out of hospital provider should have even considered taking us as patients), but it wasn’t free.

  • RudyTooty

    The fact some people are monetizing DIY unassisted freebirth is quite amazing. Or, rather: dumbfounding.

  • Montserrat Blanco

    My birth in Spain costed:
    – doctors and CNM appointments and visits:0
    – tests at hospital of my choice and local GP surgery: 0
    – antenatal classes at my local GP: 0
    – books on pregnancy: 0. Admittedly you can spend here, 20-50 euros
    – supplements: vitamins during pregnancy: total pregnancy around 20 euros.
    – birth itself, admission to hospital for me, two months ICU for the baby: 0.
    – outfits for the NICU (optional): 50 euros.
    – lactation consultant at the hospital: 0.
    – breastpumping paraphernalia in order to be able to physically leave the NICU: around 200 euros.

    A preemie got me a total bill ( big part of it admittedly optional) of 250 euros.

    Of course I pay taxes, but still. I have one of the highest taxes in the county and they are about 30% of what I make (varies slightly from one year to the other).

    • In effect, those of us in Europe PREPAY our medical expenses through our taxes, and feel it’s not only a bargain, but that it removes a huge anxiety. Americans can’t see this — after all, what healthy American wants to subsidize a poor slob who might be sick and who “takes more than his fair share”? It’s an insane idea, since tomorrow you might be the poor sick slob.

      Birth expenses are also covered 100% in Israel — and the new mother actually gets a small cash grant as well for baby supplies.

      • RudyTooty

        There are plenty of Americans who would be happy to see the ‘poor sick slobs’ forced to freebirth rather than having access to appropriate and safe medical care funded by government programs.

        I’m worried that this reality is coming. It will be grim.

      • Bugsy

        The birth of my first son was in Florida – with full medical coverage, it cost us $500…never mind the copays on all of the medical exams and doctor’s appointments during the pregnancy.

        The birth of my second son was here in Canada. We paid for parking for 24 hours and for the cable television in the room. I’m still bitter that we had to pay for the cable tv.

        I would take this system in a heartbeat. My husband had emergency surgery over the summer for a testicular torsion. Totally cost, including ambulance ride? $0. Very thankful.

    • lsn

      I got the cost breakdown of just the tests done in NICU in the first year (actually ten months) of my son’s life as part of tax records and was totally shocked. It was over $250K, and we paid nothing – well, other than both being tax-paying individuals who had been working for almost two decades by that point. If we’d had to come up with that money at that time though we would have had to sell the house. I have no idea what a NICU bed costs here because it was covered under the health system.

      I did buy a breast pump second hand ($150ish?) and the attachments new (no idea). The biggest out-of-pocket cost was parking and petrol though – we spent about $3200 just on parking at the hospital (bastard private operators).

      Outside of parking the biggest cost was a specialist second opinion with the obstetrician who ended up admitting me to hospital – I was fine paying for that one, not least because I think the outcomes for both me and my child would have been a hell of a lot worse if I hadn’t had that appointment at that time. To steal a quote from the cardiologists – the best time to have your blood pressure take off like a bat out of hell is in an appointment where someone is measuring it.

      • mabelcruet

        In the UK, in all the hospitals I’ve ever worked at, families who had members being inpatients for more than a set period of time (usually two weeks) got free parking (mostly done by the ward staff validating your parking ticket before you left, and some who provide a pass card to be used). Usually it’s supposed to be only one person per patient can get free parking, but you’re allowed to share the card. A friend of mine had a child in ICU for 3 months following a head injury, and because they were separated, both him and his wife got a free parking pass to use. Patients who are attending clinics also get free parking-not the one off outpatients, but if it’s something like regular attendance for chemo outpatients or for haemodialysis then you get a pass. There’s a lot can be criticised about the NHS but there’s plenty of good practice too.

        • lsn

          It used to be similar at that hospital but they outsourced the parking to a private company. If you had a specific type of health care card you could get discounted parking, but only if you were the patient – after discharge when we were going in for weekly appointments I couldn’t get the discount despite my child having a card because “he wasn’t the driver of the car” (that conversation was the closest I came to having security called on me at the hospital.) There were charities that discounted parking for parents of kids with cancer and epilepsy but other than that at the time we were there other parents got nothing. I believe one of the prem baby charities is now offering parking discounts. It really annoys me as this is a major PUBLIC hospital – it’s not like people are driving there for fun, and while the access by public transport was OK if you lived on one train line it was pretty bad for everyone else (also I wasn’t taking my ex-prem baby who was still on oxygen on public transport, and even when he was just still in NICU I was avoiding people as much as possible so I didn’t get sick and (a) risk passing something on and (b) have to stay home. Sheesh.) I could rant for my country about this apparently, heh.

  • swbarnes2

    It’s all appeals to vanity: “You don’t wnat to give birth the way poor ignorant people do, do you? You are smart, you have resources, you do more, and you will get better outcomes.”

    • RudyTooty

      Yes. There is the privileged assumption that if one is able to afford to pay for all the frilly and presumed “empowering “ extras – and dutifully adhere to the Trust Birth dogma- one will be able to control the experience.

      • Bugsy

        I do newborn photography and regularly see the after-effects of moms who were falsely led to believe they could have the birth of their dreams (invariably all-natural, sometimes at home). It’s heartbreaking.

        • RudyTooty

          I shared a birth -photography video montage celebrating midwives recently here in the Disqus comments –

          I really hate them – and they really are Very Beautiful. But they’re incredibly deceiving.

  • space_upstairs

    Enlightened consumer choice – the kind that coincidentally lightens your wallet – is commonly billed these days as the key to the good life and the manifestation of good character, in a wide variety of realms. People think they’re fighting the system by rejecting old, large, mainstream providers of goods and services, but the ethos of the market today is one of divide and conquer, facilitated by the finely tuned personal advertising services of social networks, search engines, online retailers, and their massive data collecting (spying) and data sharing among one another. That means that those who buy into niches like “natural” care of their own and their (future) children’s bodies are at least as far from being outside today’s massive market machine as are those who actually prefer or cannot afford anything other than the older, larger, mainstream providers of goods and services. Whether they’re making the system somehow better by going for these niches is also questionable, especially given how often the well-to-do complain about living from paycheck to paycheck in order to provide all sorts of advantages for their families.

    Unfortunately, pursuing the good things in life outside of the realm of goods and services, choices of niche markets (strongly shaped and incentivized by technological algorithms and tribal instincts, so much less free as choices than we think), and consumer status competition seems increasingly hard to imagine. I’ve been feeling the need for a while to imagine something else, seeing how empty and discouraging it can all be, but I feel like I get only these brief glimmers of a different sense of meaning that are hard to keep in sight when I feel most in need of motivation. I probably need to work harder at it (and avoid overexposure to the daily niche market noise).