Why did the natural childbirth movement become so “vagmental”?


It’s all about the vagina, folks!

At least that’s what natural childbirth advocates appear to think. The sine qua non of the contemporary natural childbirth movement is its “vagmentalism,” the privileging of vaginal transit over everything else, including the health of babies and mothers.

It didn’t have to be this way. The natural childbirth movement arose as a response to the pain of childbirth. Grantly Dick-Read claimed that “primitive” women didn’t experience pain in labor because they understood and accepted that their purpose in life was to have children. In contrast, white women of the “better” classes had been socialized to think they deserved political and economic rights and, as a result, their ovaries shriveled, they developed the disease of nervous hysteria (hyster is Latin for uterus), and their labors became painful.

[pullquote align=”right” cite=”” link=”” color=”#0102DA” class=”” size=””]Vaginal birth is portrayed as an achievement and C-section is portrayed as a failure.[/pullquote]

Lamaze was developed in the USSR in the years after World War II. Soviet doctors faced a problem. Whereas women in the West had access to pain relief in labor, the USSR lacked the money to purchase modern anesthetics. There wasn’t enough for surgery let alone childbirth. They hit upon the idea of using Pavlovian conditioning to abolish or reduce the pain of labor. It was presented as far superior to anesthetics because it was free and available to the proletariat while anesthetics were expensive and available only to the bourgeoisie.

The natural childbirth movement became popular in the US in the 1960’s as a response to the paternalism of American obstetrics and the sedating effects of contemporary anesthetic techniques. Women wanted to be awake and aware for their births, wanted to be accompanied by their partners and wanted to be spared the indignity of enemas and perineal shaving. The vagina had nothing to do with it.

In the 1970’s obstetrics was revolutionized by the introduction of regional anesthesia (spinals and epidurals). Women could now experience the births of their babies (even C-sections) awake, aware and pain free! Women were happy; doctors were happy; but the natural childbirth movement was not happy. Having achieved everything they set out to do by the early 1980’s, natural childbirth advocates could have declared victory and gone home. Instead they moved the goalposts and became rigidly vagmental.

Why? Vagmentalism reflects the contemporaneous (1980’s) resurgence of midwifery. Midwifery had all but disappeared in the US as a result of the improved safety and comfort of hospital birth. Natural childbirth, which gave primacy to the experience of childbirth, gave increasing relevance to midwives who strove to produce a specific birth experience. Indeed, midwifery grew from 275 CNMs in 1963 to more than 4,000 in 1995 to over 11,000 today. Midwives, not surprisingly, began to promote what they could do and to denigrate the things that only doctors could do, like epidurals and C-sections. Organizations like Lamaze reinvented themselves accordingly.

De Vries and De Vries writing in the Lamaze Journal of Perinatal Education explain:

Although there was a period when Lamaze . . . was accused of having sold out (the “Lamaze method” was charged by some with being a male invention meant to replace another male invention of obstetric anesthesia), in the early 1990s, the organization reinvented itself as the champion of normal birth.

In contrast to Grantly Dick-Read and the founders of Lamaze who promised painless birth, or at least comfortable birth, midwives and natural childbirth organizations began promoting physiological birth: vaginal birth. Hence the profound vagmentalism of contemporary natural childbirth advocacy.

This vagmentalism is reflected in a nearly pathological hatred of C-sections. It would be difficult to find a medical procedure that has saved more lives than C-sections have saved. It would be difficult to find a medical procedure that CONTINUES to save more lives each year than C-sections do. No matter, the profound vagmentalism of the natural childbirth movement leads them to insist that C-section rates in the industrialized world are a “crisis,” that C-sections harm mother-infant bonding (there’s no evidence for that), that C-sections lead to long term health problems in babies (they don’t), and, most recently, that C-sections harm the neonatal gut microbiome and change infant DNA (there’s no evidence for that, either).

The effect of this profound vagmentalism on new mothers is pernicious. Vaginal birth is deliberately portrayed as an achievement and C-section is deliberately depicted as a failure. For some women this leads to soul crushing guilt. The desperation of these women to have a vaginal birth leads them to risk their babies lives by refusing indicated interventions. It leads them to risk their babies and their own lives at home VBACs after 2 or 3 or 4 previous C-sections.

Even worse, midwives in the UK have become so committed to vaginal birth as an end in itself that they have let babies and mothers die by refusing to call in obstetricians. Doctors don’t share the midwives’ vagmentalism and consider that whether the baby lives or dies more important than vaginal birth; therefore, midwives want to exclude them.

Pregnant women and new mothers should understand that vaginal birth is not better, safer, healthier or superior in any way for than birth with pain relief or C-section birth. Midwives and natural childbirth advocates are profoundly vagmental because vaginal birth is better for midwives and natural childbirth advocates. Midwives and natural childbirth advocates encourage guilt about pain relief and C-sections so they can monetize that guilt.

The truth is that any woman can attempt an unmedicated vaginal birth; it’s not an achievement since most women who have ever lived have already done it. The achievement is to have a live baby and survive. In other words, the achievement is the outcome, not the process.

Vagmentalism is to midwifery what fashion judgmentalism is to the women’s clothing industry. It’s a way to move product. Vagmentalism is to natural childbirth advocates what race judgmentalism (racism) is bigots, a way to boost their fragile self esteem. It is ugly; it is unhealthy; and it should be rejected.