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


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.

  • Morose57

    I’m just going to say, I came across the original article and loved it. I didn’t notice it was from a natural birth advocate. I have had two devastating c sections and both OBs have completely disregarded my feelings about it before, during and after the procedures. Both drs on multiple occasions have said to me “all that matters is a healthy baby.” I am glad you read many obstetrical textbooks but you obviously have not been in or part of many c sections being performed or conversations about c sections between mothers and drs. During my last c-section as I laid waiting for my baby to be cut out of me, my OB and others in the room were laughing and joking about women who eat the placentas. I’m sorry but I don’t feel like that was an appropriate conversation as I waited to meet my baby. I wish more than anything to have had vaginal births and if I truly couldn’t to have had more mother centered c sections. The author of the original article is spot on. you claim that obstetricians know that a healthy baby is not all that matters. Obviously you never met mine.

    • Amazed

      Because you have been part of many c-sections? Mighty two?

      How old are you? My mother’s age, if the 57 is an indicator. How many years have you obsessed over your c-sections?

      It takes a special kind of stupid to tell an obstetrician that she has not participated in many c-sections while you took part in whole two – your own. That tells me all I need to know about you. You’re an idiot. And you know, you could have had the thing you wish more than anything. You could have gone out into the wood to pop your kids out, dead or alive, or die trying to.

      • Morose57

        I apologize, I did not realize that the author is an OB. I only read the response to the original article. I stumbled upon this post while searching for the original piece. No I am not 57. I am 32 years old and my second c section was recent. No need to be nasty. I am currently trying to deal with my feelings over my birth experiences. I felt the need to post on this because in my experience, my OBs have said that a healthy baby is all that matters and this author is claiming that “a healthy baby is not all that matters. obstetricians have always recognized this.” I am just stating that is not true especially in my own experiences with two different OBs. I age ee with the original article that while a healthy baby is the most important thing, I count too. What good am I as a mother sitting here with postpartum depression to my healthy baby? Maybe my c section was necessary maybe it wasn’t. i don’t know. What I do know is, postpartum care counts and the birth experience women have matters to our overall well being as well – c section or vaginal.

        • Amazed

          Wow! You’re extremely polite to someone who was downright nasty. It really irks me when I see someone close to their 60s still lamenting the loss of their vaginal births (we’ve seen them on this site and I’ve met two such ladies in real life), so it automatically turns my NASTY button on. I apologize.

          Since the people commenting the way you did usually parachute straight fron NCBers sites and are well versed who Dr Amy is and ready to disparage her since she let her licebse lapsed, it really didn’t occur to me that you might not know. I apologize for that, too.

          I hope you come to peace with your c-sections. They happened and there were indications that showed that there might be a problem. Yes, they probably weren’t necessarry but you took the wise way, the way of caution. Because something MIGHT have happened. One never knows and that’s one of the moments when one’s children are at their most vulnerable. Your baby wasn’t cut out of you but born. You listened to the doctor’s reasoning, made up your mind, went to the hospital, underwent a procedure that led to your child coming into the world – could you really be more involved? Because “I wasn’t taking part, I wasn’t there, it was just pain that I could not control” is a common refrain of vaginal birth.

          Try to think of the pros: you won’t suffer the complications related to vaginal childbirth. Fecal incontinence is a problem linked to vaginal birth alone. I repeat the conversation my mom had with her doctor soon after her second vaginal, all natural childbirth (that almost killed her, she saw the tunnel of light and everything): “One day, you’ll sneeze and you’ll piss yoursellf.” She was like, “You mean, like now? Because that’s what’s beeh happening for weeks.” But that was a problem related mostly to pregnancy. Her being on the verge of fecal incontinence and getting worse with aging is a direct result of vaginal childbirths.

          • Morose57

            Thank you. I know if I had a vaginal birth it could have went badly as well however saying a vaginal birth went bad is much more acceptable then to say I am disappointed and upset over a c section. No one tells women to get over a bad vaginal birth however women who have cs are told this all the time. Anyway thank you for your kind words. You did make me feel a little better for now. Also what are NCBers?

          • Amazed

            NCB – Natural Childbirth. Here, we use it when we talk about the most ardent ones, those who deny that modern medicine have any role in childbirth and think that doctors are only there to get them. They repeat “Women have given birth for thousands of years and we’re still here!” “Trust Nature!” “Trust Birth!” One of them actually wrote that when her baby died in the hospital after her homebirth went south, that proved that “babies died in the hospital, as well!”

            You seem to have friends who are not crunchy enough. In crunchy circles, blaming women for feeling bad about their vaginal birth runs rampant. And “At least you have a healthy baby!” is a phrase I’ve heard often enough in real life about women who were left shell-shocked after their vaginal births. After all, that’s “a woman’s battle” and woe on thise who don’t behave like good little soldiers. Women who desire a c-section are labeled vain, uncaring about their babies and only caring about maintaining a tight vagina. It really goes both ways and it’s a shame because new mothers need support and… err, sleep, not judgment.

            Pay no attention to what people are telling you. I don’t doubt they mean well but the road to hell… If you need to share, find someone qualified. Those people aren’t helping.

          • Morose57

            I am not in a crunchy area at all. I have been told actually the opposite that I am lucky to have an intact vagina! Elected c sections are common here as well. Thank you for sharing that quote. It is very true. I cried when I read it and am going to try and keep it in mind when I feel down about my experiences!

          • Amazed

            Do try. And don’t forget that when all cofounders are taken out of the equation, elective c-sections have the very best outcomes for babies. Your children have all the brain cells nature intended them to have thanks to your decision to take the road of caution.

          • Bombshellrisa

            NCBers “natural childbirthers”

        • AllieFoyle

          I think we all agree here that the well-being of the mother is important and her providers should be professional and considerate, but I’m not really sure what you’re upset about or what you think you missed. Vaginal birth was humiliating, frightening, and excruciatingly painful for me. I didn’t choose it and I certainly didn’t feel like an active participant. You actually had a choice and chose the c-section! I understand regret and I’m sorry it wasn’t a great experience for you, but you’re wrong if you think vaginal birth is a wonderful, empowering experience for everyone.

          • Morose57

            I get that everyone has different birth ideas and experiences and some people would prefer c sections others vaginal births. I understands vaginal births aren’t all unicorns and rainbows. What upsets me is that it is ok for you to feel the way you do about your vaginal birth but when I talk about how I feel about my cs I am told I should t feel that w