10 birth decisions that are portrayed as momentous but are actually meaningless

Ten word on a corkboard

The natural childbirth industry likes to portray itself as existing in opposition to the unsafe, soul-deadening practices of conventional parenting. The reality is quite different. In large part the natural childbirth industry is based on unreflective defiance of authority, particularly medical authority.

Part of the portrayal of natural childbirth advocates as “educated,” enlightened and progressive is the elevation of trivial parenting decisions to momentous import. Those decisions can be used to set parents in opposition to conventional medical recommendations, and, conveniently to create the need for the books, services and products being peddled by the natural parenting industry itself.

Here are 10 birth decisions that women are encouraged to see as momentous that are actually meaningless:

1. Epidurals in labor: Here’s a secret about obstetricians and labor nurses: we don’t care whether or not you opt for pain relief in labor. It literally makes no difference to us because we are not feeling the pain. Sure we’ll offer it to you, the same way we offer pain relief to anyone else who is in pain, but we don’t care if you get it. Have an epidural; don’t have an epidural; it’s all the same to us.

We do feel sorry for you if you are under the mistaken impression that pain relief is harmful to you or your baby, or if you been drinking the natural childbirth kool-aid and actually imagine that refusing an epidural says something about your character. But don’t mistake that for imagining that we are scandalized, impressed or distressed by your decision. We don’t care.

2. Moving around in labor: Moving around in labor has a trivial impact (minutes) on the length of labor. If you want to move around, knock yourself out! But don’t expect us to fall for the idea that it is more important to move around than to monitor how your baby is tolerating labor, even if you fell for it.

3. Eating in labor: This has been studied quite a bit, and there is NO BENEFIT to eating in labor. Contrary to the fabricated claims of the natural childbirth industry, it doesn’t “increase your strength,” reduce interventions, reduce the C-section rate or do anything beyond increasing the risk that you might aspirate the food into your lungs if you happen to need general anesthesia for an emergency C-section. That’s because the intestines shut down during labor, hence the nausea that most women experience to one degree or another.

There is one “advantage”to eating during labor: you get to taste the food twice, once when you eat it and then again when you vomit it back up during transition.

4. Delayed cord clamping: There is no benefit to delayed cord clamping in term infants. Sure, they get extra red blood cells, but since every study has shown that they actually destroy those extra red blood cells since they apparently don’t need them, delayed cord clamping may be adding stress to the baby, not removing it.

Immediately after birth, the oxygen content of the cord blood begins dropping precipitously as the placenta begins to peel away from the wall of the uterus. No one has ever demonstrated any benefit in oxygenation from delayed cord clamping. That’s just another one of those things that natural childbirth industry made up in their ludicrous attempt to convince the gullible that a bunch of women with no education in science, statistics, obstetrics or medicine understand neonatal physiology better than physicians. It is amazing to me that anyone falls for that nonsense, but many women do.

If you want your provider to delay cord clamping, you should certainly ask for it. It makes no difference but if it is going to make you feel superior, go for it!

5. Immediate skin-to-skin contact: There is no scientific evidence of any benefit for immediate skin-to-skin contact. That’s just something made up by lactivists who have trouble distinguishing correlation from causation. If you want to hold your baby skin-to-skin, knock yourself out! But don’t imagine that it confers any benefit.

6. Vitamin K
7. Ophthamic eye ointment: These aren’t meaningless decisions, they are non-decisions. There’s a right choice and a wrong choice and refusing either or both is the wrong choice that exposes your baby to the risk of blindness, hemorrhage and death. But, hey, that’s a small price to pay for dissing neonatologists and pediatricians and showing solidarity with your equally ignorant friends who have been bamboozled by the natural childbirth industry, right?

8. Hep B vaccination: Wait, let me get this straight. You’re refusing a vaccine recommended by the CDC, immunologists, virologists, epidemiologists and public health officials because you read somewhere on the internet that you should? Surely you jest.

9. Circumcision: All things being equal, circumcision confers health benefits, though those benefits tend to be trivial in first world countries. If you want to circumcise your son, do so. If you don’t want to circumcise your son, don’t. It makes no difference to the rest of the world.

10. Breastfeeding: All things being equal, breastfeeding provides some health benefits, though those benefits tend to be trivial in first world countries. Of course, all things may not be equal for you, so there are plenty of reasons why you might choose formula feeding instead. Lactivists and the lactivism industry will be appalled and try to shame you, but just ignore them. They are looking to increase their self-esteem (and profits) by having you mirror their choices back to them; they couldn’t care less what is best for you and for your baby.

Why have these meaningless decisions been elevated to momentousness by the natural childbirth and lactivism industries? Three reasons:

First, the lay people of the natural childbirth industry (most “birth workers” are just lay people) don’t know much about the truly meaningful issues in obstetrics, the ones that can affect whether your baby or you lives or dies. As self proclaimed “experts” in “normal birth,” they don’t have a clue about serious complications so they can’t formulate recommendations for serious obstetric issues. Therefore, they have elevated trivial issues to momentousness to make the natural childbirth industry appear to be something other than irrelevant to the health and safety of babies and women.

Don’t get me wrong, the natural childbirth industry is definitely irrelevant to the health and safety of your baby and you. It’s just that by elevating the important of trivial decisions, they’ve made it seem to the lay public that they actually provide some value.

Second, the fundamental product sold by the natural childbirth and lactivism industries is distrust of the medical profession. You’re supposed to be gullible enough believe that obstetricians, neonatologists and pediatricians don’t care about your health and safety, while a bunch of privileged, Western, white women (birth workers!) who know nothing about obstetrics, neonatology, human physiology, science or statistics (and who take ZERO responsibility for the outcome of their “advice”), who get their information from random strangers of the internet are both more knowledgeable about your health and more concerned with preserving it.

Natural childbirth advocacy views conflict between patients and their providers as critical to selling their good and services, and they do everything they can to encourage women to be confrontational with their physicians. Elevating meaningless decisions to momentousness is just another way to create conflict and destroy trust. Think about it: women come to their providers with lists of demands and requests that are meaningless and then are shocked and angry that their providers view those decisions (appropriately) as irrelevant. Mission accomplished.

Third, elevating these decisions to momentousness is a form of marketing. It apes the practices of most purveyors of baby products. Baby furniture manufacturers imply that the choice of a crib is momentous. Baby swing manufacturers offer multiple variations at multiple price points. Baby bottle manufacturers imply that some bottles lead to better digestion than others. Baby toy manufacturers tout the benefits of certain types of toys. As consumers, we expect this and are able to recognize fact that manufacturers are attempting to move more of their own product in order to increase profits, and we take claims of superiority with a large grain of salt. We know that a baby toy manufacturer advertising the superiority of its products is not necessarily telling the truth. They are telling you what they think will get you to buy their products.

Mothers and mothers-to-be should apply the same level of skepticism to claims about birth decisions. Are they really momentous decisions or does encouraging you to view them as momentous decisions move more books, services and products? Does your obstetrician (who may be subject to large administrative, legal and financial penalties if he or she does not preserve your health and the health of your baby) really care less about ensuring a good outcome for you both than a bunch of random strangers on the internet whose chief motivation is selling their goods and services? Would obstetricians, pediatricians, and neonatologists really recommend medications and procedures that are harmful to you and your baby and the only ones who figured it out are a bunch of random lay people on the internet? Does that make any sense at all?

There are many momentous decisions you will make as a parent. These 10 birth decisions are not among them, no matter how much the natural childbirth industry pretends that they are.