A healthy baby is not all that matters? Who ever said it was?

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It’s getting ever more difficult for homebirth and natural childbirth advocates to defend safety claims. It’s pretty obvious that hospital birth is safer than homebirth and it’s pretty obvious that unmedicated childbirth is not safer, healthier or better in any way that childbirth with pain relief and interventions.

To camouflage their retreated on the safety issue, homebirth and natural childbirth advocates have conjured a straw man.

There is an entire medical specialty based on the assumption that there is more to childbirth than a healthy baby; it’s called obstetric anesthesia.

Milli Hill has been leading the charge in the UK. She thinks that she has discovered a deep, important, essential truth about childbirth:

… [A] healthy baby is not ALL that matters.

This article might push your buttons so before we go on I want to ask you to stay calm, grab a cuppa and keep your wig on. I need to be very very clear, because I know from experience that talking about this issue can cause an outcry. So please listen carefully. The following sentence is crucial:

When a woman gives birth, a healthy baby is absolutely completely and utterly the most important thing.

Got that? OK – do not adjust your wig, there’s more…

It is not ALL that matters.

Two things – just to repeat: a healthy baby is the most important thing, AND it is not all that matters.

Duh! Who ever said otherwise.

I own a lot of obstetrics textbooks, and I’ve read thousands of obstetrics papers, and never once have I seen anyone claim that so long as a baby is healthy it is acceptable to treat women shabbily.

Indeed, there is an entire medical specialty based on the assumption that there is more to childbirth than a healthy baby; it’s called obstetric anesthesia. A woman’s experience of pain is critical and attending to her desire for pain relief is a basic requirement for ethical obstetric care.

Oh, wait. According to natural childbirth and homebirth advocates, a woman’s experience of pain IS irrelevant. And that leads to some surprising “reasoning” on the part of proponents of “natural” birth.

Women matter too. When we tell women that a healthy baby is all that matters we often silence them. We say, or at least we very strongly imply, that their feelings do not matter, and that even though the birth may have left them feeling hurt, shocked or even violated, they should not complain because their baby is healthy and this is the only important thing.

Yes, when we tell women, as Grantly Dick-Read did, and as Lamaze and other natural childbirth organizations still do, that their pain is “good” pain, or “pain with a purpose,” we very strongly imply that their pain doesn’t matter. When we tell women as midwifery charlatan Ina May Gaskin claims that the excruciating pain of childbirth isn’t pain at all, just “surges,” we very strongly imply that how they experience childbirth is irrelevant. When we tell them, like quack Debra Pascali-Bonaro does that excruciating pain of childbirth isn’t merely a figment of their imagination, but is actually orgasmic, we very strongly imply not only that their pain is of no concern, but that they are gullible idiots to boot.

It is difficult for me to imagine a practice that more effectively silences women on their experience of childbirth than the entire natural childbirth movement.

According to Hill:

Too often women who say they care about the details of their baby’s birth day are accused of wanting an ‘experience’, as if it is selfish to care about how their baby is born, how they feel or how they are treated. But, as the saying goes, ‘when a baby is born, so is a mother’. If a mother feels broken, dispirited, depressed or traumatised, how will this affect her baby? Is this healthy?

That’s right. Too often women who choose pain relief in labor are made to feel as if they have failed. Too often women are told that if their baby did not transit their vagina, they haven’t really given birth. Too often women who choose C-sections to avoid the potential for vaginal tearing, future sexual difficulties or future incontinence are labeled “too posh to push.”

But Hill and her compatriots could care less about that.

Birth matters. To be respected, to be treated with dignity, to be in control of what happens to our bodies. To really feel the power of bringing a new life into the world – no matter whether in theatre or at home in a birth pool – why is it so wrong for women to want this?

It’s not wrong to want any of it, and no one, least of all obstetricians, ever said it was. What’s wrong is being willing to compromise safety to achieve it. What’s wrong is asserting without any evidence whatsoever that interventions and pain relief in labor hurt women and babies in an effort to chivvy women into opting for natural childbirth. What’s wrong is an entire group of medical professionals, midwives, promoting one form of birth, “normal birth,” above others.

How, pray tell, does discouraging epidurals promote women’s control over what happens to their bodies? How is a midwife delaying calling the anesthesiologist compatible with treating women with dignity? How does the relentless emphasis on unmedicated vaginal birth help women “to really feel the power of bringing a new life into the world – no matter whether in theatre or at home in a birth pool’? It doesn’t, of course.

Hill fails to see the irony when she insists:

What we do know is that many women DO care about what happens to them when they have their baby, but that they find it hard to talk about these feelings in a culture which persistently tells them that they really shouldn’t, and that what goes on in the delivery room is always acceptable as long as everyone survives.

The reality is that women DO care about what happens to them when they have a baby, but they find it hard to talk about these feeling in a natural childbirth culture which persistently tells them that what goes on in the delivery room is always acceptable as long as women refuse interventions, reject pain relief, and push their baby out their vagina.

Hill concludes:

A healthy baby is the most important thing, and it is not all that matters.

Respect, consent, choice, dignity – all that matters too.

If Hill and her compatriots really believe that they’d demand an end to promoting “normal birth.” They’d insist that a timely epidural is the right of every woman in labor. They’d favor giving every woman the option of a Cesarean by choice. And, as an added bonus, they’d stop the relentless campaigns to promote breastfeeding whether it is the right choice for the mother or not.

But that’s not what Hill and other natural childbirth advocates believe. They want respect for THEIR choices, not the choices of women who choose differently.

A healthy baby is not all that matters. Obstetricians have always recognized this. It’s time for natural childbirth and homebirth advocates to recognize that women’s experience of pain in childbirth matters. It’s time for them to recognize that sexual function after childbirth matters. It’s time for them to recognize that preventing incontinence matters.

It’s time for natural childbirth advocates to stop promoting “normal birth” and start promoting whatever women choose, whether they approve those choices or not.