The Misogyny at the Heart of Natural Childbirth

12 Jan

“The mother is the factory, and by education and care she can be made more efficient in the art of motherhood.”

That was written in 1942 by Grantly Dick-Read, widely considered to be the father of modern natural childbirth. Most people don’t realize that natural childbirth was invented by a man to convince middle and upper class white women to have more children and abandon their demands for political, economic, and educational equality.

Grantly Dick-Read’s theory of natural childbirth grew out of his belief in eugenics. He was concerned that “inferior” people were having more children than their “betters,” portending “race suicide” of the white middle and upper classes. Dick-Read believed that women’s emancipation led them away from the natural profession of motherhood toward totally unsuitable activities. Since their fear of pain in childbirth might also be discouraging them, they must be taught that the pain was due to their false cultural beliefs. In this way, women could be manipulated into having more children.

According to Read: “Woman fails when she ceases to desire the children for which she was primarily made. Her true emancipation lies in freedom to fulfil her biological purposes.”

The comparisons between “overcivilized” white women and “primitive” women who gave birth easily was not merely the product of racism but also reflected the anxiety that men felt about women’s emancipation. This anxiety was expressed in medicine generally, and in obstetrics and gynecology particularly, by the fabrication of claims about the “disease” of hysteria and the degeneration of women’s natural capabilities in fertility and childbirth compared to her “savage” peers. Simply put, the result of women insisting on increased education, enlarged roles outside the home, and greater political participation was that their ovaries shriveled, they suddenly began to experience painful childbirth, and they developed the brand new disease of “hysteria” located in the uterus itself.

Pain in childbirth served a very important function in this racist and sexist discourse: it was the punishment that befell women who became too educated, too independent, and left the home. The idea that “primitive” women had painless childbirth was fabricated to contrast with the painful childbirth of “overcivilized” women. Grantly Dick-Read was issuing a warning to women of a certain social class: if you step beyond the roles prescribed for women, you will be punished with painful labor. And if you have had painful labor, you should understand it as a punishment for ignoring your “natural” duty to stay home and procreate.

In light of this, the contemporary popularity of natural childbirth is more than a bit ironic. The central claims of natural childbirth—that childbirth is not inherently painful and that if you “prepare” properly, your birth will be painless too—were utter fabrications. (The modern day modification of these fabrications is the claim women should find the severe pain of labor “empowering.”) Dick- Read would be delighted that these fabrications have been embraced by many women and that his philosophy has been propagated so successfully that most women don’t even realize that the central tenets of natural childbirth are racist and sexist lies.

For more on Grantly Dick-Read and the history of natural childbirth (as well as sourcing of the quotes above), see Holistic obstetrics: the origins of “natural childbirth” in Britain, O Moscucci, PMJ 2003; 79:168-173.

54 Responses to “The Misogyny at the Heart of Natural Childbirth”

  1. slpierce January 12, 2012 at 10:55 am #

    Wow – that is quite chilling!

  2. Nora January 12, 2012 at 11:24 am #

    Oh my. You will most likely hear from those who believe that natural birth is the only option that good mothers choose. That opinion is likely to be applied to home birth and breastfeeding as well.

    I’m of the opinion that women should learn all they can and decide for themselves what is best for themselves and their family in their specific circumstances.

    That’s just me.

  3. Rebecca Potter January 12, 2012 at 5:03 pm #

    So when I was took prenatal yoga classes and gave birth with no medical interventions or even a man in the room, aside from my husband, I was actually bowing down (or, in this case, squatting down) to THE MAN?! Damn it.

    I have a lot of questions: If modern natural childbirth was invented by a man, what did we have prior to that? “Medical” childbirth? Who invented that one? And could that possibly have been the cause of women’s fear of childbirth?

    I’ll buy that women started giving birth less when they started getting out of the house more, and sure, it seems likely that Dick-Read, among others, had a problem with it. But to dismiss the probability that in childbirth a “primitive” woman may experience less pain than an “overcivilized” one is remiss.

    What might Dick-Read have meant by “overcivilized” anyway? The Skeptix blog is dedicated to giving voice to the rarely celebrated female skeptic. Why? Because women are lonely and often the work we do is not recognized. Most of us are not only out of the house, but also disconnected from the community that once would have been difficult to escape—mothers, aunts, sisters, grandmothers, many at home and available for private consultation and support. We, the “overcivilized” are those who suffer from the lack of a community of women and the wealth of information, support, and experience that could help prepare us for events such as childbirth.

    When the author jabs at “preparing” for childbirth: “The central claims of natural childbirth—that childbirth is not inherently painful and that if you ‘prepare’ properly, your birth will be painless too,” I have to wonder what the author sees as the alternative to preparation? The author goes on to suggest that enduring the pain of labor is not a worthy intent, “(The modern day modification of these fabrications was the claim women should find the severe pain of labor ‘empowering.’)” I don’t find pain empowering, but I do find it empowering to educate myself and make decisions, so that I can remain in control of my own body.

    What are the implications of “The Misogyny at the Heart of Natural Childbirth”? Just schedule a c-section? Is that the message here? Epidurrals and c-sections do not exempt a woman from pain, but they do exempt her, when not medically necessary, from being the most active participant in the birth of her children.

    Modern natural childbirth may have had its roots in misogyny, but its heart is in empowering women to be in control of the births of their children. May the prolific offerings of Western medicine be exhausted elsewhere. So thank you, Grantly Dick-Read, for bringing natural childbirth to the overcivilized.

    • Julia Lavarnway January 12, 2012 at 5:23 pm #

      Rebecca, you say “To dismiss the probability that in childbirth a ‘primitive’ woman may experience less pain than an ‘overcivilized’ one is remiss.” Why’s that? Accepting it as a probability suggests that there is something special about the “primitive” woman that accounts for her having less pain during the birthing process than an “overcivilized” one. What are you suggesting that might be? A woman is a woman is a woman whether she lives in England or in a small African village.

      • Rebecca Potter January 12, 2012 at 9:05 pm #

        Right Julie, a woman is a woman, but in some primitive cultures, support for the birthing woman is part of the tradition. Being in a familiar environment, knowing what to expect, having some idea of things SHE can do to help herself through birth and be in control all help reduce perception of pain– primitive or otherwise. The worst of western birthing models had women in a hospital, restricted in her movement and with hospital guidleines dictating when there would be further interventions– that woman is going to experience more pain. I’m just saying mindset influences perception of pain. Thanks for asking!

        • Julia Lavarnway January 12, 2012 at 9:16 pm #

          I completely agree with you on that one, Rebecca. And there’s even a name for its most extreme forms, birth rape. Any situation in which a woman’s autonomy is taken away, but most especially in something as personal as childbirth, is absolutely reprehensible. The problem with the natural childbirth movement as I see it is the attitude many of its adherents have toward women who choose not to go the natural childbirth route: that they are weak or lazy or selfish or whatever else. When a woman is shamed for “admitting defeat” and getting that epidural, that is misogyny at work regardless of the gender doing the shaming. Harriet Hall did a great post last year on natural childbirth (which Julian referred to in his comment) on the blog Science-Based Medicine.

          • gwynarina January 13, 2012 at 12:18 am #

            Just to play Devil’s Advocate for a second: you can also see the growing popularity of C-sections as misogynistic, when they are a result of a woman feeling pressure not to “loosen” her vagina and be less “satisfying” to men. I don’t know just how popular that viewpoint is, but I’ve heard it come up. Food for thought.

            Actually, I’m starting to think more about the idea of “shaming women” who have epidurals, etc., as an example of misogyny. Can we really say that? (I’m delving more deeply into English-nerd territory, here, I think.) I do think most of that type of thing comes from other women…and while women CAN be misogynists, I’m not sure if I would label this example as such. If you think women who take drugs during childbirth are weak or lazy, what are you really hating? Women, or weakness/laziness?

            • Dicty January 13, 2012 at 1:45 am #

              Personally, I find it misogynistic to suggest that women are requesting c-sections because they “feel pressured not to loosen their vaginas and be less satisfying for men”.

              You might want to work on that.

              And if you think women who “take drugs during childbirth” are “weak or lazy”, what you are really hating is women.

              Because you are a misogynist. HTH.

            • Amy Tuteur, MD January 13, 2012 at 7:39 am #

              “when they are a result of a woman feeling pressure not to “loosen” her vagina and be less “satisfying” to men.”

              How about when they are the result of women not want to sustain major tears that lead to a lifetime of painful sex? How about when they are the result of women not wanting to risk urinary or fecal incontinence?

            • gwynarina January 13, 2012 at 11:02 am #

              Dicty: wow, can we please remain civil here? I clearly stated that I was playing Devil’s advocate by bringing up another point I had heard. I did not “suggest” that that is always (or even often) the reason for women having C-sections, I merely stated that I had heard it come up ONCE and had no idea how popular the viewpoint was.

              Amy, yes, those examples are completely different. I have no problem with women having C-sections, I was just dispassionately bringing up a single point for us to mull over.

            • Julia Lavarnway January 13, 2012 at 11:45 am #

              Yes, civility please.

              I am actually really proud of this comment thread for generally keeping such a civil tone even though there is obvious disagreement among us on a subject that people have such passionate opinions on. So yes, let’s keep on with the respect and civility.

              Dicty, I believe Gwyn was simply stating (and she’ll correct me if I’m wrong) that a woman might have a c-section because of misogynist ideas or beliefs, such as “women should have c-sections so that her vagina will not become ‘loose’ and sex will still be ‘good for her man.'” This is a horribly misogynistic idea, but unfortunately it’s one I’ve heard put forth as well. Calling someone a misogynist is a very serious accusation. I think we’d all do well to read someone’s statements carefully before applying this label to them.

            • Dicty January 13, 2012 at 2:35 pm #

              I cannot believe I just got tone-trolled by a mod for pointing out the misogyny in calling women lazy and weak for getting an epidural and trotting out that hoary old myth that women put themselves under the knife so that they can remain acceptable sex toys for men.

              Screw that. If you need me, I’ll be over at skepchick.

            • Julia Lavarnway January 13, 2012 at 2:47 pm #

              Dicty, you did not get “tone-trolled by a mod for pointing out the misogyny in calling women lazy and weak for getting an epidural and trotting out that hoary old myth that women put themselves under the knife so that they can remain acceptable sex toys for men.” As I said, I agree with you completely that that belief is a disgusting example of misogyny. However, you implied that Gwynarina herself held that view and then out-and-out called her a misogynist. Maybe you honestly feel her writing suggested that she holds that misogynistic view. I did not interpret it that way and was quite frankly surprised that you did. If you decide to leave We Are SkeptiXX, I’ll be sorry to see you go. But if a call for respect and civility in comments on this blog is not something you can maintain while disagreeing with someone, I do not know what to tell you.

            • Dicty January 13, 2012 at 3:18 pm #

              I might expect another commenter to misunderstand the generic “you” (right after using it herself) when it suits her, but I certainly didn’t expect it from someone who should have no dog in this race.

              I did not call gwynarina a misogynist.

              Gwynarina said “If YOU think women who take drugs during childbirth are weak or lazy, what are YOU really hating? Women, or weakness/laziness?

              And I helpfully informed her that if YOU think women get epidurals because they are weak or lazy, then YOU are in fact, a misogynist. Because believing that “taking drugs” during delivery is weak and lazy?

              Is hateful to women.

              Which is so trivial a point that I am rather taken aback that a self-described feminist would bring it up as if it were a legitimate opinion that should be given the benefit of the doubt. (“Ohhhh! It’s not that i want women to suffer! I just don’t believe they do. They just want the drugs because they’re weak! And lazy!”

              “Well, I guess you’re not really a misogynist if you only hate the weak, lazy women.”)

              I could point out that an accusation of misogyny is not exactly far-fetched when leveled at someone who brings up two incredibly misogynistic ideas as if they were worthy of real consideration. But given that I was evidently mistaken in my surmise that that would be self-evident in this crowd I suspect that conversation would go nowhere.

            • Julia Lavarnway January 13, 2012 at 3:26 pm #

              Why do you suspect that this conversation will now go nowhere? I misinterpreted your “Because you are a misogynist” as being directed at Gwynarina. You just clarified that it was not directed at Gwynarina but rather people who actually do hold the belief that “‘taking drugs’ during delivery is weak and lazy,” a group which Gwynarina has made clear she is not among. It seems to me that the whole thing was a matter of misinterpretation that has now been cleared up.

            • Julia Lavarnway January 13, 2012 at 3:33 pm #

              “but I certainly didn’t expect it from someone who should have no dog in this race.”

              Full disclosure: I am good friends with Gwyn IRL and Rebecca Potter too. But if you read this whole post, you’ll see that I have disagreed with both of them more than once.

            • Dicty January 13, 2012 at 3:54 pm #

              *le sigh*

              Imma take a step back.

              I tend to go medieval on people who propagate memes I hate unaccompanied by a vociferous disavowal, whether they actually espouse them or not.

              This makes me occasionally suck.

    • Amy Tuteur, MD January 12, 2012 at 5:34 pm #

      Let’s start with the issue of “overcivilized women” first. It has a long and sordid history in Victorian and Edwardian England.

      In the paper ‘The Race of Hysteria: “Overcivilization” and the “Savage” Woman in Late Nineteenth-Century Obstetrics and Gynecology,’ Laura Briggs argues that the comparisons between “overcivilized” white women and “primitive” women who gave birth easily was not merely the product of racism, but reflected the anxiety that men felt about women’s increasing emancipation. This anxiety over women’s increasing education, independence and political involvement was expressed in medicine generally, and in obstetrics and gynecology particularly, by the fabrication of claims about the “disease” of hysteria and the degeneration of women’s natural capabilities in fertility and childbirth compared to her “savage” peers.

      Briggs writes:

      “Hysteria, we learned from feminist historical scholarship in the 1970s, was never just a disease. It was also the way nineteenth century U.S. and European cultures made sense of women’s changing roles. Industrialization and urbanization wrought one set of changes, while the women’s rights movement brought another. Together, these included higher education for women, their increasing participation in a (rapidly changing) public sphere, paid employment, and declining fertility. These cultural changes were accompanied by a virtual epidemic of “nervous weakness” largely among women, causing feminist historians to begin asking whether the diagnostic category of hysteria was simply a way of keeping women in the home… nervousness was often characterized as an illness caused by “overcivilization,” which located it in a scientific and popular discourse that defined cultural evolution as beginning with the “savage,” culminating in the “civilized,” but also containing the possibility of degeneration — “overcivilization.” In this literature, “savage” or “barbarian” was applied to indigenous peoples, Africans, Asians, Latin Americans, and sometimes poor people generally. As a disease of “overcivilization,” hysterical illness was the provenance almost exclusively of Anglo-American, native-born whites, specifically, white women of a certain class. Second, the primary symptoms of hysteria in women were gynecologic and reproductive—prolapsed uterus, diseased ovaries, long and difficult childbirths — maladies that made it difficult for these hysterical (white) women to have children.”

      Furthermore:

      “Against this backdrop, hysteria as symptom of “overcivilization” did two simultaneous kinds of cultural work in response to crises of “modernity”: stabilizing the meaning of “racial” difference while providing a (reactionary) response to the changing roles of women and meanings of gender. It is in this arena that the racial discourse of nervousness emerged in a very familiar form, one that had already been (and would continue to be) reiterated often in Euro-American culture: “overcivilized” women avoided sex and were unwilling or incapable of bearing many (or any) children, “savage” women gave birth easily and often, and were hypersexual. This is the discourse that was slightly later termed “race suicide.”Late nineteenth-century gynecological and obstetrical literature did more than simply naturalize opposition to white women’s political struggles by insisting that contraceptive use, abortion, education, and participation in the professional workforce could cause nervous illness. It also reconceptualized these forms of white women’s struggle for social and political autonomy from white men as a racial threat. That is, by insisting that white women were becoming sterile and weak while non-white women remained fertile and strong, it encoded white women’s transgressive behavior as a danger to the future of “the race.” That this was indeed the implicit trajectory of the concern about white women’s nervous weakness and childlessness is suggested by the subsequent development of eugenics. When Edward Clarke wrote of the shriveling ovaries of educated women, in other words, he tapped into the same discourse that found expression in immigration restriction acts and, four decades later, in Lothrop Stoddard’s rantings in The Rising Tide of Color Against White World Supremacy. The neurasthenic narrative shared with racist eugenics a concern about white women’s low birth rate and the fertility of non-white women.”

      In Brigg’s analysis, pain in childbirth served a very important function in this racist and sexist discourse: it was the punishment that befell women who became too educated, too independent and left the home. The idea that “primitive” women had painless childbirth was fabricated to contrast with the painful childbirth of “overcivilized” women. It is striking to me how reminiscent this is to the biblical interpretation of pain in childbirth. In both cases, painful labor is explicitly a punishment for women who “forget their place” and act independently.

      When Grantly Dick-Read and his peers claimed that “primitive” women had painless labors, they were issuing a warning to women of a certain social class: if you dare to step beyond the roles that we have prescribed for women, you will be punished with painful labor. And if you have had painful labor, you should understand it as a punishment for ignoring your “natural” duty to stay home and procreate. In light of this, it is more than ironic that some contemporary women are still insisting that childbirth is not inherently painful, that indigenous women have painless childbirth, and that if you “prepare” for childbirth properly, your birth will be painless, too.

      • Rebecca Potter January 12, 2012 at 9:27 pm #

        Hi Amy, Thanks for your response! So the modern idea of natural childbirth came from a shit hole of wrongness. I can accept that. And painless childbirth is just not a realistic goal, unless, perhaps, a woman is having her tenth child. A woman who is in distress (hmmm, one who has been ostracized by her community?) could experience more pain in labor than a (relatively) relaxed and confident (supported) woman. I don’t think that’s the way it should be or that women should be threatened with painful labors if they don’t straighten up and fly right, but I do think preparation and mindset have a huge influence on perception of pain, and I don’t think that natural childbirth is bad because it came from you know where.

        • Amy Tuteur, MD January 12, 2012 at 11:14 pm #

          “So the modern idea of natural childbirth came from a shit hole of wrongness. ”

          The problem is that contemporary natural childbirth philosophy comes from the same place, from biological essentialism. According to Grantly Dick-Read, women can only and should only achieve fulfillment through their biological “destiny.” All women are reduced to nothing more than vaginas and breasts, to make children, give birth to children, nourish children and nothing more.

          Unfortunately, contemporary natural childbirth philosophy also comes from biological essentialism. The fundamental assumption is that women can only achieve fulfillment through her reproductive organs. Women can purportedly only be fulfilled by pushing a baby through her vagina (C-sections are cheating), embracing and being “empowered” by labor pain, breastfeeding each child for years, and practicing attachment parenting (also known as intensive mothering), which, of course precludes working outside the home because the baby must be “worn” on the body to achieve true bonding.

          There is NOTHING about natural childbirth philosophy that is based in either science or history. Natural childbirth philosophy posits that birth is inherently safe, but the reality is that birth is inherently dangerous. Natural childbirth philosophy posits that women’s bodies are “designed” to give birth, completely ignoring the fact that women’s bodies were not designed, but evolved, and evolution does not produce perfection. Natural childbirth posits that women can and should embrace the pain of labor because … because … well for no good reason actually. And your claim that “A woman who is in distress (hmmm, one who has been ostracized by her community?) could experience more pain in labor than a (relatively) relaxed and confident (supported) woman” has no basis in science, either. That’s just another thing that Grantly Dick-Read made up because he felt like it.

          Natural childbirth philosophy purports to tell women that there is a “best” way to give birth. That is no more valid that claiming that there is a best color that little girls should wear, or a best type of toy that little girls should play with. It insists, like all forms of biological essentialism that the sum total of women’s purpose and fulfillment is in reproduction and reproduction in a very specific form. And like all forms of biological essentialism, it is misogynistic and wrong.

          • gwynarina January 13, 2012 at 12:56 am #

            I think one of the keys here is the use of the word “only.” You say, “The fundamental assumption is that women can only achieve fulfillment through her reproductive organs.” This makes it sound as though any woman who supports the idea of natural childbirth agrees with this assumption. And maybe some do, but I also think we’re forgetting about the women who agree with that statement only when the word “only” is deleted.

            I have yet to give birth, and feel free to call me naive, but I like to think that pushing a child out of my body is a unique experience that I would hate to miss out on. It’s something that no man will ever get to experience, and it’s something that reminds us of just how much we do share with the animals around us–because we ARE animals. And I think fulfilling that role as a “birther” before I die is as exciting and important as participating in any and all “natural” processes that our bodies are made to perform: eating, laughing, crying, having sex, orgasming, etc. It has nothing to do with men or misogyny. And it also doesn’t stop me from fulfilling any other role I might want to fulfill–or at least, no more than having a C-section would.

            Lastly, you said that Rebecca’s idea of a distressed, tensed-up woman experiencing more pain than a relaxed woman has no basis in science. What about a doctor’s advice for a person to relax before he or she is given a shot? What about the fact that people break fewer bones in a car crash when they are asleep (and therefore relaxed)? I don’t think Rebecca was saying that giving birth in a house surrounded by women would make the difference between a tortuous birth and a completely painless one, but I daresay there’s a lot of scientific evidence that shows that tension leads (either directly or indirectly) to an increased perception of pain.

            • Julia Lavarnway January 13, 2012 at 1:23 am #

              Gwyn, you say, “I like to think that pushing a child out of my body is a unique experience that I would hate to miss out on.”

              If you are practically delirious from the pain of labor and its accompanying exhaustion, there’s a good chance that you will miss out on the process for all intents and purposes. If you’ve taken pain medication or had an epidural and are therefore not delirious with pain, I’d argue that it’s possible you’d be more “present” for your vaginal birth than if you’d gone the all natural route–even if you were a bit woozy from the meds.

              I, too, have never given birth–and quite frankly plan on keeping it that way. And I do not feel that by not having children I will be any less “fulfilled” than any other woman who has been allowed to make her own reproductive choices.

              I do not agree with you that “any and all ‘natural’ processes that our bodies are made to perform” are “exciting and important.” There are many things women go through because of their reproductive organs that men will never experience, chief among them menstruation. But the thoughts that go through my head each month when I’m first getting my period aren’t “oh wow, look at this amazing womanly thing my body does,” it’s “Cramps suck, where’s the ibuprofen?”

            • Amy Tuteur, MD January 13, 2012 at 7:53 am #

              “I like to think that pushing a child out of my body is a unique experience that I would hate to miss out on.”

              Great, but the decision should be yours as to whether or not to “miss out” on it. The problem is that natural childbirth philosophy is based on the premise that women ought not to miss out on it.

              Julia used the example of menstruation and it’s a good one. If you suffer from severe menstrual cramps would you appreciate (or even believe) someone who told you that women are empowered by menstrual pain, that Motrin is the work of the hegemonic patriarchy and therefore you should not use it, and that if you just stopped being afraid of menstruation, the pain would be much more manageable?

              Birth control and abortion are other good examples. Would you appreciate (or even believe) someone who said that birth control is wrong because women are “designed” to become pregnant every two years whether they want a baby or not, and that you should be “empowered” by your ability to produce babies?

              How about someone who told you that you should never have an abortion because women are “designed” to get pregnant and give birth, you shouldn’t dare to interrupt that natural process for something as trivial as the fact that you don’t want and can’t handle a child at this point and that you should be “empowered” by an unwanted pregnancy?

              If you wouldn’t be empowered by an unwanted pregnancy or an unremitting series of pregnancies, why should you be empowered by labor pain? If you wouldn’t feel like you are betraying your biological destiny by using Motrin for menstrual cramps, why should you feel you are betraying your biological destiny by having an epidural to control the far greater pain of labor? And if you wouldn’t accept that fear causes menstrual pain to be worse, why would you accept that fear causes labor pain to be worse (especially since there is no scientific evidence for either claim)?

            • gwynarina January 13, 2012 at 11:31 am #

              Julie and Amy, thanks for responding.

              Julie, you say, “If you are practically delirious from the pain of labor…there’s a good chance you will miss out on the process.”

              Yes, totally. I wasn’t really trying to say that one has to go through completely med-free pain in order to be a “true” woman or anything. I just meant that personally, having a C-section is something I’d like to keep as a last resort, because I think bending over and seeing a little person coming out of my vagina would be pretty cool–even despite the pain. (Please note that this is a personal opinion, not something I think everyone has to agree with me on in order to be fulfilled, etc.)

              You also say, “I do not feel that by not having children I will be any less fulfilled”–yes, that’s exactly my point! When we take out the “only” in the sentence I quoted above, we can say that women can be fulfilled by childbirth, but also by many other things. Some women might be fulfilled by NOT having children. Some by starting an awesome blog that centers on women in the skeptical movement. You see my point. While the “fundamental assumption” of modern natural childbirth was apparently set up to include that “only,” we can take it out–and in doing so, I think we can realize that the women who support natural childbirth and the women who support having C-sections (and the women who support not having any children) don’t really have to occupy different sides of the argument.

              As for the examples of menstruation, birth control, and abortion: yes, they’re good ones. It’s true, all of that stuff is on a sliding scale, and each woman has to decide where her boundaries are when it comes to having medicine interfere with her body. Personally, sure, I’ll take ibuprofen when I’ve got cramps, but I would never take the kind of birth control that would stop me having periods all together. That’s my boundary. I would have an abortion if necessary, but would really rather it be a last-resort type of thing–I’d rather make choices earlier on that would keep it from being necessary–if possible.

              And of course, there are plenty of cases in which abortion is necessary–I’m not refuting that. I’m absolutely pro-abortion and will fight tooth and nail to keep it legal. Again, it just comes down to each woman’s boundaries. The idea of being TOLD where her boundaries SHOULD be is the problem–and I think this is the point of Dr. Tuteur’s post, but I also think that people like Rebecca and me can take offense at the title of the blog, which, in turn, makes us feel that we are being told that OUR boundaries are not where they ought to be, and that in keeping them a bit closer to the “natural childbirth” side of things, we are somehow bowing down to misogynists–or being misogynists ourselves! And I don’t think that’s fair, either. To each her own, indeed.

              (However, the key to an active blog is provocative titles–and look how well it worked! Discussion is a marvelous thing.)

            • Julia Lavarnway January 13, 2012 at 12:10 pm #

              “I would have an abortion if necessary, but would really rather it be a last-resort type of thing–I’d rather make choices earlier on that would keep it from being necessary–if possible.”

              Can we print this on T-shirts and put it on the top of all pro-choice literature? This is EXACTLY it! In one sentence. And this is EXACTLY what those people boycotting outside of women’s health clinics DO NOT GET. Pro-choicers do not love abortion; they do not want to see more and more abortions being performed. This is PRECISELY why pro-choicers are so keen on contraceptives. I do not know a single pro-choicer—and working at CFI, I know quite a few—who supports the idea of using abortion as birth control. By and large they, too, would rather abortion be a last resort. But they understand that the option has to be available because no woman should have her control over her own body taken away from her. She deserves to make the choice for herself, and no clergyman, politician, or Joe Schmo down the street has the right to make it for her.

          • Rebecca Potter January 13, 2012 at 9:57 am #

            I’m really sorry that a lot of people who support natural child birth also moralize it. My personal experience was that preparation made my births not painless, but possible, without drugs. I realize that is not scientific. I prefer not to take drugs. I’m glad that women can continue to make reproductive choices and that support exists for women who hope to give birth without interventions.

    • Nicole January 12, 2012 at 5:57 pm #

      Rebecca…are you telling me that I was not “the most active participant” in the birth of my children? My first baby WAS birthed via a medically necessary c/s and it was the RESPONSIBLE thing to do so that he was delivered ALIVE. THIS is called being a most active participant. Squatting down like every other mammal on this planet, and grabbing your offspring does not make you, well, any different from any other mammal who’s offspring pops out of their vagina. If your self-esteem, or any other woman’s, is so weak that you feel the need to excoriate other women or sanctimoniously critique their births to make yourself feel like a million bucks, then please, seek help. ALL women who birth babies..regardless of how it’s done..are “active participants” in the birth of their children. Let’s not be one-upping b!tches and imply that women who birth via c/s are inferior. In fact, Rebecca, I personally chose to have our other two children via c/s as well. I share this with you, so that you might know that women make choices..why they make them or what choices they make are not anyone’s else’s business. C/S is just the way I prefer to birth my children into the world, and more and more women are seeing it as a preferred way to birth. In fact, I rarely, if ever, see mothers who have birthed via c/s obsessively crusading against the other methods, which, frankly, have many of their own risks…many of which, I, nor many other women, are interested in assuming. To each, her own!

      • Rebecca Potter January 12, 2012 at 10:17 pm #

        Hi Nicole, I would no more want your choice taken away from you than mine taken from me. What I said was, “Epidurrals and c-sections do not exempt a woman from pain, but they do exempt her, when not medically necessary, from being the most active participant in the birth of her children.” When it’s medically necessary, I certainly see a medically assisted birth as preferable to risking the life of mother or her child, and I do see the mother who makes that choice as “being the most active participant” in birth. Women don’t always have advance notice that such an intervention is necessary and I think that’s a little sad and a lot scary for the mom, but, wow, how great that dying in childbirth is no longer a major concern!

        I don’t insist that every woman be “the most active participant in the birth of her children.” And I agree that those choices are none of my business.

        My intention was to separate modern natural childbirth from its misogynistic roots and not to suggest that women who prefer c-sections are inferior.

        • Julia Lavarnway January 12, 2012 at 11:45 pm #

          “Women don’t always have advance notice that such an intervention is necessary and I think that’s a little sad and a lot scary for the mom…”

          Don’t we know this to be the truth! And that is precisely what makes home birth so dangerous. I have no doubt that millions of home births take place without a hitch, in fact my cousin’s daughter is just three and was born at home with no problems. But when complications arise, there are some things that a midwife just might not have the training–and certainly not the equipment–to handle. It boggles my mind why some woman take that chance voluntarily. I’m sure your sis wouldn’t have chosen it.

          “But, wow, how great that dying in childbirth is no longer a major concern!”

          Thank science! Literally–because western medicine is responsible. “Nearly one in every 100 live births resulted in a mother’s death as recently as 90 years ago” in the US. Today it’s about 14 per 100,000, but it is sadly on the rise in some places in the US and most certainly much higher in developing countries.

        • Nicole January 14, 2012 at 2:29 pm #

          Who made you God?! I don’t care what you “said,” Rebecca. Who are YOU to legislate what qualifies as “active participation?” Your intention was obvious, so please, spare us the sugar-coating. Your intention was to imply that your preferred version of birthing is superior, preferred, idealistic if not utterly utopian! Your intention, was to inadvertently imply that women who birth “your way”, are somehow superior. I must “inform” you that you are sadly mistaken. Live mother, Live baby is what ultimately counts. Period. See, for me, having a baby “naturally” hanging out of my vagina dead, impaired or strangled by an umbilical cord was not an “empowering” form of active participation. Laying there, with the assistance of a skilled and caring team, hearing my baby’s first ALIVE and loud vibrant cries..actively participated my heart and my soul. You critics of cesareans and “c/s rate” obsessors engage in a form of covert maternal bullying. Are you even honestly happy for women who birth via c/s and are holding and feeding their babies just like everyone else? I’d say no. If you were, you’d congratualte the mother, you’d be supportive of the act of mothering, and you’d literally, step away from your vaginas, if not outright get over them. Weren’t your “natural” “vaginal” “water” “pine tree” “earthside” births good enough? I’m not buying it. If they were, you would not be sanctimoniously harassing women who birth via c/s in the ways that you do. Something to chew on..you think? If there is one thing I will say about c/s moms and their “rates.” It’s this. We LOVE and we ADORE and we VALUE our babies lives.

          • Rebecca Potter January 14, 2012 at 4:55 pm #

            Hi again, Nicole.

            “I don’t care what you ‘said,’ Rebecca.”
            Well, that seems clear enough.

  4. Noadi January 12, 2012 at 5:35 pm #

    The other part of this is there’s a huge naturalistic fallacy going on. You often hear it now as people insisting that other animals don’t have obviously painful birth. I like to ask those people to go watch a video of a hyena giving birth and ask them if they think that is painless.

    • Rebecca Potter January 12, 2012 at 9:29 pm #

      It is hugely unfortunate that hyenas do not have prenatal yoga classes.

    • Amy Tuteur, MD January 12, 2012 at 11:15 pm #

      “The other part of this is there’s a huge naturalistic fallacy going on.”

      Exactly!

  5. Michelle K January 12, 2012 at 5:50 pm #

    Give me the drugs.

  6. julian January 12, 2012 at 8:40 pm #

    Significantly less flame then when I saw this over at SBM…

    Anyway,

    Thank you for the information. I’m [sometimes] needlessly critical of anyone who advocates a ‘natural’ approach to pregnancy and other health issues. But ultimately I think my skepticism comes down to just how much of ‘natural health’ is rooted in moralistic ideas about what we should be.

  7. Cornets January 13, 2012 at 11:26 am #

    A friend recently was told by an OB, that in order for the doctor to deliver babies she “must have an epidural”. This will be my friend’s second delivery the first required no epidural or other drugs. How is what the doctor is proposing more feminist. Isn’t feminism about informed choice and doing what is right for each individual. How does the doctor’s statement fit that?
    Friend is expecting twins and that I’d this OB’s policy for twins cause 1 time she let woman labour naturally she required pain meds.

    • Amy Tuteur, MD January 13, 2012 at 12:25 pm #

      “must have an epidural”

      Are you sure that’s what your firend was told or was she told that she must have an epidural catheter placed in case she needs an immediate C-section for the second twin?

      The main risk in twin vaginal delivery is that in the wake of the birth of the first twin, the placenta of the second twin will begin to separate from the uterine wall cutting off the flow of oxygen to the second baby. That requires an immediate C-section to save the baby’s life.

      Typically immedatie C-sections require general anesthesia for the mother, which is far more dangerous than epidural anesthesia. However, if an epidural catheter is already in place, anethetic can be put in it at that time of the emergency allowing for an immedaite C-section under epidural.

      Too summarize: twin vaginal delivery is much more dangerous for the second twin, immediate C-section may be required to save the second twin, having an epidural catheter in place makes it possible to perform an immediate C-section with the least risk to the mother. If there is no need for a C-section, there is no reason that the mother needs to have anesthetic put in the catheter unless she wants it for pain relief.

      • Cornets January 15, 2012 at 4:09 pm #

        I would have to check with her if the OB said epidural or epidural catheter. She told me epidural (and she might have not heard the catheter part). Thanks for your insight into this matter.

    • slpierce January 13, 2012 at 12:55 pm #

      I think that how some doctors treat/infantilize some pregnant women is a whole other feminist issue. For instance, when my sister had her third child, she was told that because she had had her first child through c-section, she HAD to have her third child through c-section as well, even though her second child was born vaginally. She was basically told that she didn’t have a choice in the matter.

      It was a completely different doctor who told her that she couldn’t have her tubes tied after her second child, like she wanted, because she was “too young” to know what she wanted, and what if one of her children died, and she wanted to have a back-up child? (Yes, the doctor seriously said that.)

      • gwynarina January 13, 2012 at 1:26 pm #

        Yikes, Sarah–that’s awful! A “back-up child”–yep, I guess that’s the one you’d name “Justin Case.”

        /sarcasm

    • Rachel Wells January 14, 2012 at 7:00 pm #

      I guess I stuck it to the Dick(-Read) a bit by having a c-section when I had my kiddo, though it wasn’t intentional. I had a medically necessary c-section a month early due to my own medical issues, not the kiddo’s.

      What got to me was the insistence on breast feeding, which according to anecdotal stuff from my family and loved ones has just been recently pushed onto moms with the vengence it is. My daughter screamed the full three days we were in the hospital, and I knew she was hungry, and I tried to breast feed her every half hour around the clock for three days- I even begged nurses for a bottle of formula, and they all acted like I was the hugest failure as a mother ever because my breasts were producing nothing. Nada. Not a drop could be coaxed out of there, not at the hospital and not at home, and on the fourth day, we gave her a bottle of formula, and she was the happiest baby in the world after that.My milk never did come in. Had two boxes of brest shields all ready and never even used one.

      I guess if I was a GOOD MOM, I would have let her starve.

  8. Theo Bromine January 14, 2012 at 12:57 am #

    I’ve never read Dick-Read (though I think I have his book somewhere around, having inherited it from my grandfather who was a doctor). When I was having babies (in the 1980s), “natural” childbirth seemed to me an empowering thing for women. It was an alternative to the “medicalization” of childbirth, which was wrapped up with the marginalization and disempowerment of the mother: “Don’t worry, dear, just go to sleep and when you wake up you will have a lovely new baby.” On the other hand, as someone who used to read medical books for fun, I was (excessively) aware of the potential risks to mother and baby for childbirth if everything didn’t go quite right, and never even remotely considered a homebirth. As it turned out, my first needed an epidural for a forceps extraction, and my second was relatively quick and unmedicated. I did not feel a sense of failure for the first one, but I think I did feel a sense of accomplishment for the second (they don’t call it labour for nuthin’…). But the point is that it’s all about a woman’s right to make an informed *choice* – not to feel pressured to have or not have medication, C-section, or whatever she (with sensible medical advice) deems appropriate.

  9. Gwenny Todd January 18, 2012 at 5:51 pm #

    I’m sure I won’t be popular here, but I had four children without pain medication. Which is basically what “natural” means. I did it because there were studies during my childbearing years that show that the meds had a negative impact on the infant. My kids are all adults. Neither of my girl children has opted to spawn yet, with one saying for almost 20 years “oh, hell no”.

    And, it wasn’t that bad. I’m pretty healthy and I was very active as a child and I’m build to pop out babies, so it was easy for me. I used deep breathing to relax. The first one was a bit over an hour until the nurse told me to relax and I did. The last one was 2 pushes,. Almost didn’t get onto the table. before she dashed out. I could tell when it was time because I would ask the nurse if I could have a pain med and she’d say, “Too late. Baby almost here.”

    Personally, I say, if you want pain meds and you feel they won’t damage your baby, do it. I am aware that very few humans have as high a pain threshold as I have (I was telling jokes to the doctor during one delivery), so I don’t consider taking drugs that much of a wuss out.

    Especially now when they have things that won’t hurt the baby so much. That wasn’t true of the procedures in the middle of the 20th century where it was normal to totally sedate a woman so she didn’t even experience the joy of birth. I know you think you have a justifiable reason for hating on this doctor, but maybe if you knew what they were doing to women at the time, you might change your mind.

    • Amy Tuteur, MD January 18, 2012 at 8:28 pm #

      “but maybe if you knew what they were doing to women at the time, you might change your mind.”

      I do know what they were doing and I know why.

      Contrary to the claims of natural childbirth advocates, women were demanding pain relief in labor. The National Birthday Trust in the UK was started by the wife of a Prime Minister specifically to lobby for making pain relief in childbirth available to all women, not just those who had the money to pay for it.

      Moreover, twilight sleep, now portrayed by NCB advocates as an evil perpetrated on women, was actually a method of pain relief demanded by women. There were many people (particularly clergymen) who decried pain relief in childbirth as sinful because God meant to punish women with childbirth pain.Twilight sleep was felt to be a compromise because it allowed women to feel the pain, but not remember it. It was wildly popular.

      Interestingly, the greatest opposition to twilight sleep came from obstetricians who were concerned about its effects on women and babies, but women demanded it and doctors ultimately acceded to those demands.

      Twilight sleep was rendered obsolete by epidurals.

      • Gwenny January 30, 2012 at 1:35 pm #

        My mother was totally sedated in the 1950s when she was in childbirth. All of her friends were as well. NOT twilight sleep, stone dead unconscious. And those chemicals jumped the placental barrier and children were born drugged. I did a bit of research on it. And I have no problem with today’s safer drugs, but honestly, most women, if they did a bit of exercise, could give birth with very little pain. There’s nothing wrong with being willing to accept a little pain. There’s nothing wrong with doing things naturally. Hell, I didn’t even do it that way because of the doctor . . I did it that way because I’ve been a crazy tree hugging hippy since the 1960s and refuse medication unless there are no other options. So to ASSUME that all women are being lead astray by some stupid doctor in the middle of the last century is a bit . . .rude.

        Now, you might be fine with that. Because fat, rich white women DEMANDED they be put to sleep for childbirth. But you know what, folks have demanded a lot of stuff that was bad for them. You know, like cigarettes and alcohol and cocaine in their children’s teething aids. So saying that women WANTED this is not any recommendation. If I were to get pregnant now, I would STILL do it “naturally”. And most women who have done it my way agree. It’s not for the weak, broken, damaged or sick, but there’s a fair amount of us out here who can stand a bit of pain and prefer it to chemicals.

        This is my problem with you feminist types. You think your way is the only way. And anyone who does anything different is wrong and bad. You are JUST as bad as the stupid men who oppress women. Maybe worse, I always expect more from women because we are smarter. That is why I considered myself a feminist for about a month in the mid 1970s and then realized that far too many of them then were man hating bitches and I had no desire to be a part of it.

        There’s more than one way to do stuff. If you don’t like some of them, DON’T do it that way. But please, stop insulting people who do stuff differently.

  10. love2God February 10, 2012 at 11:21 am #

    I honestly see your point. I’m a liberal, so I am always on the lookout for conspiracy theories. Dicks-Read may be the father of the natural childbirth movement in his way, however, I am not so sure his views are as widely shared today as you think. In all my study and experience with NC, I have never been told to expect painless delivery. Birth is painful, traumatic, and dangerous, as is life (What a welcome!).

    However, I am of the opinion that modern day obstetricians and hospitals are much more focused on making bank off of the insurance and pharmaceutical companies than it is the women who come through their doors.

    When the C-section rate of this country is over 36% in the U.S. and the early-induction rate is 29% we have an issue. The U.S. is one of the only Industrialized countries with a 99% rate of hospitalized birth. Even obstetricians are admitting to the overmedicalization of birth. Those who are induced are twice as likely to have a C-section. Those who have C-sections must have subsequent surgeries for each birth following it. C-sections are emergency, critically invasive, major surgeries. The same risks apply as with any other surgery and they are not as safe as we are told to believe. Many women who undergo C-sections must return (and pay more) for blood clots, ruptures, and other unexpected conditions. They are afflicting healthy women with low-risk pregnancies under purely preventative circumstances. This is unacceptable!!

    Would I say NC is for everyone? No? Do I look down on women who opt for a different approach? No? Do I think it can be empowering and beautiful? Yes. Do I think mothers are being over-medicated and sliced open without cause across the U.S. to finance some C.E.O’s fourth divorce? Absolutely.

    My point is, when it comes to conspiracy theories that lead to the unnecessary pain and suffering of human beings, I have to concede that capitalism and big businesses trumps an anti-feminist.

    • Amy Tuteur, MD February 10, 2012 at 12:05 pm #

      I have to say that I find the Big Medicine/Big Pharma conspiracy theory profoundly anti-feminist, based as it is on unexamined sexist assumptions.

      What are the unexamined sexist assumptions?

      1. Big Medicine is assumed to be run by men – A major proportion of doctors have been women for decades now, (indeed the majority of obstetricians are now or soon to be women) but homebirth and NCB advocates persist in imagining all doctors and hospital administrators as men. Why is that?

      2. Big Pharma is assumed to be powered by men – It seems never to have crossed the mind of many NCB and homebirth advocates that many Pharma researchers, executives, board members, etc. are women.

      3. Women are too nice to be capitalists – There is a bizarre assumption that NCB and homebirth professionals, writers, and teachers are not making money from what they do. I have yet to meet the homebirth midwife, doula, or NCB educator who works for free. In fact, for these women 100% of their income is dependent on convincing women to buy into the subcultural beliefs of NCB and homebirth. Who then has the true economic incentive to aggressively promote their products and services?

      Natural childbirth and homebirth advocacy have their philosophical origins in profoundly sexist beliefs about women. Contemporary advocates appear equally mired in sexist assumptions that men hold all the important jobs and women are simply victims.

  11. anonymous May 31, 2012 at 1:18 pm #

    There’s a disturbing trend in feminist discourse that goes something like this:

    x (for example childbirth, breastfeeding, having a career or being a stay at home mom) is drawn to our attention as a locus of patriarchal control

    advocacy work is done to fight off the patriarchal control and encourage practices that are thought to be better/healthier for women

    the advocacy groups go a bit too far in their encouragement of the better/healthier practices and women begin to feel that their choices are now being curtailed in the opposite direction

    a backlash ensues in which we seem to feel that we have to deny the often well-documented and undeniable benefits of this thing the advocacy groups are fighting for.

    Hence you see feminists denying that breastmilk is nutritionally better than formula, or that births with fewer medical interventions are, generally speaking, safer for mothers and babies. And this puts us in a really strange and irrational position, because we’re having to deny facts that are well-established through mountains of research. So this whole thing is troubling to me, because this version of feminism requires women to behave in an irrational way, which simply confirms one of the most misogynistic assumptions our culture makes about women. Talk about playing into your opponents hands.

    • Amy Tuteur, MD May 31, 2012 at 1:36 pm #

      ” And this puts us in a really strange and irrational position, because we’re having to deny facts that are well-established through mountains of research.”

      Except that those claims are NOT facts and are NOT well-established through mountains of research. Those false and or exaggerated claims are part of going too far in fighting off what is characterized as “patriarchal control.”

      The other problem is that NCB advocates appear to be stuck in the 1950’s. Obstetrics is not longer patriarchal, if it ever was. Most obstetricians are now women. In fact the only people that still cling to the myths and lies of NCB are precisely those who lack basic education in science, statistics and obstetrics and are therefore easily gulled into believing that they can “educate” themselves by reading material for lay people written by other lay people.

  12. anonymous May 31, 2012 at 1:25 pm #

    And for me, personally, taking the natural route was also a defiant act of standing up to the bullying and the smirking and the micromanaging and the distrust of women’s bodies that’s so prevalent in the medical industry. It was me saying “Fuck you and your patriarchal fucking attitude toward my body and my mental toughness and my instinctive knowledge of how to birth my own fucking baby.” And I took on natural childbirth, which was tough and painful and stressful and one of the hardest things I’ve ever done, and I fucking kicked its ass, and it was an incredibly empowering experience.

    • Amy Tuteur, MD May 31, 2012 at 1:37 pm #

      “definant act”

      How pathetically immature!

      • shauna February 24, 2013 at 4:43 pm #

        Actually the appropriate way to give birth is in a field, squatting down and howling at the moon. All the self righteous morons who brag about giving birth without pain meds in a hospital did it wrong! You must be letting big pharma control you if you gave birth at a hospital…weaklings! Apparently satisfying your own selfish vanity about what hole your baby comes out of, instead of doing what’s best health wise for you and your baby, is more important to the profoundly stupid.

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