Childbirth with fear


That’s not a typo.

Natural childbirth originated with the publication of Grantly Dick-Read’s book, Childbirth Without Fear, but in the intervening years, NCB advocates have made fear the centerpiece of their philosophy. Not fear of childbirth, despite the fact that is is inherently dangerous for babies and mothers. And not fear of pain; evidently only losers, the weak and the unempowered, fear pain. No, the centerpiece of natural childbirth philosophy, and its chosen and most potent marketing tool, is fear of doctors.

This strategy makes tremendous sense from a marketing point of view. After all, who is going to buy the services of someone who hectors you to avoid pain relief when you are in agonizing pain (a doula) unless you are afraid of something “worse”? And who is going to let her precious baby be delivered by a high school graduate who knows nothing about science and thinks gems have “energy” and flowers having healing “essences” (a CPM, a certified “professional” midwife) unless she is convinced that the alternative is “worse”? Who is going to waste hundreds of dollars on goofy ideas that rarely if ever work, like Hypnobabies, unless they are told that without it, they might actually break down and listen to those evil doctors?

Craig Thompson, professor of marketing at University of Wisconsin wrote about this tactic in Consumer Risk Perceptions in a Community of Reflexive Doubt the in the September 2005 Journal of Consumer Research. Thompson marveled at the ability of homebirth advocates to market a “product” by directly defying common sense:

Advocates of natural childbirth seek to inculcate reflexive doubt by countering two commonsense objections to their unorthodox construction of risk: (1) medicalized births would have never gained a cultural foothold if they were so risk laden and (2) the medical profession would not support obstetric practices that place laboring women at risk.

In other words, it is absolutely critical to the natural childbirth project to convince women that doctors don’t know what they are doing, and willfully and cheerfully risk the lives of women and babies to promote a secret agenda.

How do doctors promote that secret agenda?

… [T]he cultural dominance of medicalized childbirth is explained as the historical artifact of a fin de siecle struggle between midwives and physicians, where the latter group held a decided economic and sociocultural advantage. As this critical narrative goes, the medical profession leveraged its emerging economic-political clout and cultural affinities toward ideals of scientific progress and technological control to displace midwives (both socially and legally) as the authoritative source of childbirth knowledge.

Obviously, the only people who will believe such clap-trap are people who know nothing about history, childbirth or science. That’s why it is absolutely imperative for natural childbirth advocates to hid the fact that in the 100 years after its advent, modern obstetrics dropped the neonatal mortality rate 90% and the maternal mortality rate 99%.

Only if women don’t know that modern obstetrics has been so spectacularly successful can they be convinced that technological intervention serves no other purpose than to allow doctors to show off.

Through this cultural shift, the obstetric profession also imposed medical preferences for heroic, technological interventions on the birth process. Childbirth reformers interpret these innovations—such as forceps deliveries—as unnecessary intrusions whose primary function was enabling physicians to display technical skill.

Wait! It gets even worse:

… [O]bstetricians are trained in a technocratic model of labor management that has been institutionalized through hospital protocols and technological systems. This technocratic model is condemned for treating pregnancy and labor as a mechanistic process in which the woman’s body is fraught with treacherous design flaws that necessitate the administration of corrective technologies. As a result, women are routinely subjected to the unintended consequences of a cascade effect, whereby one technological intervention creates a problem that must be managed by yet another. The driving cautionary tale, oft repeated in the natural childbirth literature, is that the labor process can be so disrupted by this escalating series of technological interventions that a C-section becomes medically necessary.

The message, integral to natural childbirth advocacy is clear: Obstetricians can’t help women because their technology is useless (except in the rarest of circumstances). Obstetricians don’t want to help women; they want to make money, show off, and get to their golf games as quickly as possible. In fact, obstetricians actually want to HURT women by imposing their fancy technologies to ruin otherwise perfect labors simply so that they can apply even more technology. And (this is the big finish), the only way you can prevent obstetricians from victimizing you, hurting you and profiting from you is …. to buy our NCB products!

You need to buy books and visit websites, because if you don’t you will have no idea that you are lamb being led to the medical slaughter. You need to pay for classes and tapes to gain the fortitude to resist the apparently helpful intentions of doctors and nurses to prevent complications and even death. You need to pay a layperson to stay with you during labor to be sure that you don’t succumb to those apparently helpful medical professionals. And for the truly committed, you need to pay a high school graduate who is “trained” in normal birth (kind of like a meteorologist who is trained in forecasting only good weather) to do basically nothing except call 911 and disappear if things go wrong.

That’s a tall order when you consider that for women with health insurance, childbirth in the hospital costs almost nothing. NCB advocates must convince you to spend tens of dollars on books, hundreds of dollars on classes, and thousands of dollars for the company of women who are incapable of doing a blessed thing if complications occur. Very few women would hand over that kind of money unless they had been convinced to fear the medical professionals who can help them without expecting a cash payment.

Make no mistake: NCB advocates must work hard to market their product and thereby make a profit. They must fill women with misinformation about childbirth and keep those same women ignorant of what science actually shows. They must train women to suspect that those who seem to have good intentions secretly have only sinister intentions. Better yet, they must convince women to be belligerent in demeanor and obnoxious in their demands so that there is no possibility that they will form trusting relationships with their doctors.

Simply put, NCB advocates must create an alternative universe entirely unmoored from the reality of childbirth dangers, unmoored from scientific evidence, and unmoored from the truth that people in the helping professionals are actually trying to help.

The stakes are high. If NCB advocates do not successfully create a culture of fear and suspicion, no one will pay money for their books and courses, or pay thousands of dollars for what are essentially lay companions with no particular knowledge of childbirth and a function restricted to inculcating fear of anyone who does have knowledge.

When it comes to natural childbirth, follow the money. Without fear, NCB advocates won’t make money. Therefore every woman must be convinced to approach childbirth with fear.