Is natural birth more beautiful than any other birth?


The obstetrician wrote:

Occasionally I’m asked why we so often congratulate women on “beautifully natural births?” Some have commented, “all births are beautiful, why do you specifically call out natural births as though medicated births are somehow less beautiful?” …

I realize that this is a marketing message. This physician is trolling for more business and he believes he knows where he can get it.

Nonetheless the message Dr. Christopher Stroud is promoting is what is carefully crafted to be a dog-whistle for its intended recipients.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Congratulating a woman for having a vaginal birth rather than a C-section is like congratulating a woman for being fertile rather than infertile.[/pullquote]

A dog-whistle is:

… messaging employing coded language that appears to mean one thing to the general population but has an additional, different, or more specific resonance for a targeted subgroup. The analogy is to a dog whistle, whose ultrasonic whistling sound is heard by dogs but inaudible to humans.

Stroud’s marketing means one thing to the general public, but another to natural childbirth advocates:

When we congratulate a mother on a “beautifully natural birth,” we are actually congratulating her on achieving her goal; we’re calling out her success in her unique, personal journey; the achievement that she, for a variety of reasons, may have thought unachievable. We’re not in any way valuing a non-medicated birth over a birth aided by epidural anesthesia, or a successful VBAC over a scheduled repeat cesarean section, for example. Rather, we’re saying, often shouting, “you did it; you made it; you are strong, brave and wonderful.” The cheers are about victory; victory over doubt; victory over adversity; victory over what is too often bad advice from previous providers…

As an important aside, it is undeniable, however, that many women who desire an non-medicated birth experience feel as though they have to fight against the hospital staff and their providers to achieve what they want. We see many women for their second pregnancy after they’ve had a bad experience in pursuing natural birth in their first pregnancy. So when these women finally achieve what they have so desperately wanted there is a great sense of accomplishment; of overcoming what may have seemed insurmountable, and that leads to great celebration and elation. This experience is not better or more worthy of celebration than an uneventful labor with the use of an epidural, for instance, but the celebration is often just “louder.”

Silly me! I thought birth was about having a healthy baby! But in 630 words, “baby” is only mentioned once.

Dr. Stroud would like his marketing targets to think that he believes that unmedicated vaginal birth without interventions is more beautiful than any other birth.

The message was received loud and clear.

As one commentor noted:

This post was amazing! I switched to Strouds practice after having a pretty traumatic birth experience that ended in a c section with my first baby. From there, I specifically sought out Strouds practice which has allowed me to attempt 2 VBACs and has fully supported them. By having a supportive provider, it made me felt so empowered and made things so positive the next 2 times around. thank you for ALL you do for women and their families.

Let’s leave aside for the moment the question of why privileged white women deserve praise for something poor women and women of color are forced to do every single day in developing countries. Let’s examine instead the two most disturbing aspects of this marketing message, an obstetrician’s belief that any form of birth is better than any other and the ugly ableism that it implies.

Physicians are people. Obviously they are going to have private views that some patient choices are better than others, but in my judgment those private views are just that: private. A doctor may feel that waiting for marriage is “better” than pre-marital sex, but that view has no place in counseling a patient about contraception. He may feel that a biological child is “better” than an adopted child, but that view has no place in counseling an infertile patient, nor should it be broadcast to promote his infertility practice. Similarly, he may feel that an unmedicated vaginal birth without interventions is “better” than any other birth, but that view, like views on pre-marital sex and adoption, has no place in counseling patients nor should it be broadcast to promote his obstetric practice.

What personally bothers me more, however, is the ugly ableism behind the sentiment. The ability to have a vaginal birth without interventions rests on biological factors beyond a patient’s control. Women have no control over the size and shape of their pelvis, the size and position of their babies and whether or not they develop complications like gestational diabetes or pre-eclampsia, yet all these factors can be limiting factors when attempting vaginal birth. To praise a woman for having a vaginal birth rather than a C-section is to praise her for being lucky. Indeed, it’s similar to praising a woman for being fertile rather than infertile.

Dr. Stroud’s claim that women who have a vaginal birth without interventions have had to fight harder is patently absurd. There’s simply no question that it is more difficult to obtain a maternal C-section on request than an unmedicated vaginal birth. So why isn’t that more beautiful than a vaginal birth?

The most pernicious notion in all of this, a notion that Dr. Stroud does not question, is that one type of birth is more praiseworthy than any other. That notion was promulgated and has been promoted by the natural childbirth industry and is fundamentally misogynist. It is a form of biological essentialism that imagines that all women are alike, that one size birth ought to fit everyone and that those for whom it does not fit (or those who simply don’t want a one-size-fits-all birth) are lesser women.

That view is not beautiful; it’s astoundingly ugly.