The feminist critique of “natural” childbirth

Close up of pregnant woman

There has been considerable furor surrounding midwifery professor Denis Walsh’s assertion that women benefit from the pain of childbirth. It is important to understand that although Walsh attempts to ground his claim in science, the scientific evidence does not support him. That’s because “natural” childbirth has nothing to do with science; it is a philosophy, not an impartial result of scientific facts.

From it’s origin in Biblical injunctions that childbirth pain is punishment for women’s inherent sinfulness, to it’s modern adaptation by eugenicist Grantly Dick-Read, preoccupied as he was with racist, sexist fantasies, it has never had any basis in science. That didn’t stop 19th Century opponents of anesthesia for childbirth from insisting that it was “unnatural;” it didn’t stop Grantly Dick-Read from making up “science” to support his racist and sexist claims; and it certainly does not stop contemporary advocates of “natural” childbirth from insisting that unmedicated childbirth is better, despite the fact that the scientific evidence shows that unmedicated childbirth is not better, safer, healthier or superior in any way to childbirth with pain relief.

So if “natural” childbirth has no basis in science, what about it’s validity as a philosophy?

There are quite a few problems there, too. That’s because “natural” childbirth makes assumptions about the nature of women, science and pain, assumptions that most people do not support. Indeed the most powerful critique of the “natural” childbirth movement is to be found in feminist philosophy. Feminist philosopher Katherine Beckett, in Choosing Cesarean: Feminism and the politics of childbirth in the United States, (Feminist Theory, 2005, vol. 6(3): 251–275) writes:

..[Feminist] critics argue that the idealization of ‘natural childbirth’ rests on the assumption that both women and childbirth have a true essence or nature that is respected by the natural childbirth movement but violated by the medical establishment: birth activists then ‘assert a nature to which birthing women must conform’…

Beckett points out that the claim of “natural” childbirth advocates that pain relief is pushed on women to their detriment is in direct contradiction of actual historical fact:

…[H]istorical scholarship indicates that women had long expressed a great deal of fear and trepidation about the potential pain (and danger) of childbirth. Indeed, many first wave feminist activists saw the right to pain relief as an important political issue and argued strenuously for women’s right to relieve their suffering … through the use of drugs, and specifically, scopolamine. These activists were outraged by obstetricians’ reluctance to provide pharmacological pain relief …

Beckett also addresses belief that childbirth pain is good for women, the belief that Walsh promotes.

Pain is a recurring issue for feminist analysts of childbirth … First wave feminists saw the right to pain relief during childbirth as an important political issue… [T]hird wave scholars, drawing on their experiences with alternative ‘birth culture’, have criticized the alternative birthing community’s knee-jerk rejection of (pharmacological) pain relief and understand this rejection as indicative of a kind of machisma, a belief that birth is ‘an extreme sport’. ‘Isn’t it interesting’, one such writer comments, ‘that the movement that’s supposedly feminist is the one that insists on women feeling pain?’. Another suggests: ‘Today’s natural childbirth purists don’t see moral punishment in pain but they do see moral superiority in refusing pain relief’.

The idea that women do (or should) savour, enjoy, or feel empowered by the experience of labour and delivery, they argue, romanticizes women’s roles as lifebearers and mothers, and assumes an emotional and physical reality (or posits an emotional and physical norm) that does not exist for many…

In short, some feminists perceive the alternative birth movement as rigid and moralistic, insistent that giving birth ‘naturally’ is superior and, indeed, is a measure of a ‘good mother’. The perceived moralism of this stance is quite troubling to some; according to one feminist critic, the ‘natural’ philosophy … is as tyrannical and prescriptive as the medical model, but pretends not to be …

It is against this background that Walsh’s claim should be evaluated. It is not science; it is philosophy and even as philosophy it has serious problems. The obsession with unmedicated birth is based on flawed assumptions about women and about pain. It is inappropriately moralistic, and consciously or unconsciously serves only to elevate the personal choices of “natural” childbirth/homebirth advocates, while denigrating the choices of most women.