Hannah Dahlen bemoaning birth disappointment is like the fashion industry bemoaning negative body image

Young anorexic

Midwifery Professor Hannah Dahlen is back, bemoaning “a toxic postnatal experience.”

Women have told us there is something worse than death – there is being alive but dead inside. There is being so traumatised by pressurised interventions in their birth plan that they can’t care for their newborn or have a relationship with their partner, and their own mental health is affected. Ms Tait’s comment that “whether a baby first glimpses the light of day via the stomach, in a pair of forceps, or via the vagina, what matters is that the baby arrives alive and the mother stays alive” is clearly naïve. We need women and babies to be more than simply alive; we need them to be well physically, emotionally and culturally.

That’s like the fashion industry bemoaning negative body image. Pious concern for women’s feelings is difficult to take seriously when it comes from the very people who make women feel bad about themselves. In the case of the fashion industry, idealized representations of the female body lead to self hatred when women’s bodies don’t meet the fashion industry norm. In the case of the natural childbirth industry, idealized representations of birth lead to self hatred when women’s birth experiences don’t meet the natural childbirth industry norm.

Dahlen may believe that she is speaking against pernicious obstetric practices, but the sad truth about the natural childbirth industry is while it promotes itself as empowering women, its insistence on a rigid, idealized view of childbirth promotes self-hatred.

As Jane Clare Jones explains in Idealized and Industrialized Labor: Anatomy of a Feminist Controversy, feminist critics of natural childbirth asserts that:

… women’s reports of “lower childbirth satisfaction” after cesarean should not be attributed to excessive and appropriative medical intervention. Rather, their negative evaluation of their birthing experience is produced by a cultural discourse of “natural” childbirth that encourages them to measure their labors against an inherently moralistic and ultimately pernicious ideal of birth.

This critique is:

… concerned with the alternative birth movement’s role in prescribing coercive norms that generate inflated expectations about the degree of control women can and should exercise over the process. Indeed, as Lobel and DeLuca note, one possible way to reduce the adverse effects of cesareans on mothers’ reports of “childbirth satisfaction” would be to encourage them to “develop realistic expectations” about labor, rather than educating them to resist obstetric practice—as has been the main strategy of the natural childbirth movement.

The leading exponent of the critique of idealized labor is Georgetown University philosophy professor Rebecca Kukla:

For Kukla, the alternative birth movement’s encouragement of such strategies as childbirth classes and birth plans, while originally laudable in intent, is responsible for establishing “completely unrealistic expectations concerning how much control one can possibly have over the laboring process.” As a consequence, the movement is implicated in “setting women up for feelings of failure, lack of confidence, disappointment, and maternal inadequacy when things do not go according to plan, even when mother and baby end up healthy”. Thus, critics like Kukla suggest, while the natural childbirth movement styles itself as concerned with empowering laboring women, its establishment of a normative ideal of birth is, ultimately, disciplinary and punitive. (my emphasis)

The normative ideal of birth includes claims like these:

Women who have pharmacologic pain relief in labor have “given in” and put their own needs above the “risk of exposing their babies to drugs.”
Women who have C-sections have “failed” at birth.
Women who follow their obstetrician’s advice and have inductions are personally responsible for the “cascade of interventions” that led to their ultimate failure.
Women who have pain relief can’t bond to their babies.
Women who have C-sections have ruined their baby’s gut microbiome AND changed the baby’s DNA in harmful ways.

Dahlen herself has repeatedly promoted many of these spurious claims.

Leave aside for the moment that none of these claims is supported by scientific evidence and most of them are lies. Such idealized representations (even if they are lies) have the power to harm fragile new mothers. Who would be so cruel as to promote these accusations to a new mother? Not anyone who cared about women’s mental health. Yet new mothers are bombarded by these accusations, either directly or as insinuations, before, during and after giving birth.

Dahlen and her colleagues CREATE the very anguish that they decry.

The solution to maternal anguish caused by anything other than an idealized, midwife-approved birth is NOT to promote ideals that lead mothers to prefer death to anything other than an unmedicated vaginal birth. The solution is to confront these arbitrary and corrosive ideals for what they are: shameless attempts by the natural childbirth industry to promote maternal guilt and then monetize it into greater employment opportunities for midwives and other members of the natural childbirth industry.