MOM WARS

06.27.14

Natural Childbirth Is Not a Cult

The mommy wars over how to ‘correctly’ birth a baby need to stop. No one wins. Mother shaming is not OK.

When Lifetime announced its new reality show, Born in the Wild—documenting the birth stories of mothers who choose to go it alone without any assistance from the medical profession, and oh yeah, in the great outdoors—the reactions weren’t mixed.

The new show was “shocking.” The cable network had “lost its mind,” and was going to “traumatize channel surfers.” Over at The Week, Elissa Strauss wrote that the show was evidence that “the cult of natural childbirth has gone too far.”

In fact, only the show’s producers seemed to think it was a good idea. “This isn’t [Discovery Channel’s] Naked and Afraid and we’re dropping people in the woods and saying ‘Go have the baby,’” Eli Lehrer, a senior VP at Lifetime, whose own second child was born at home, told Entertainment Weekly. “These are all people who have already had babies in hospitals who had unsatisfying experiences and who are choosing to have different experiences.”

But the Internet was not trying to hear that. Because nuance is so often the first thing to get lost when debate takes place in a series of tubes, most of the talk lumped natural birth, home birth, and unassisted birth families together either deliberately, or because articles were written by non-parents who don’t know the difference.

Strauss, who prides herself on the hands-over-her-eyes approach to childbirth, knows the difference and wrote: “As extreme as it may sound, the show is, believe it or not, a natural extension of a culture that has turned labor into a defining moment in women’s lives, their first chance to prove just how devoted a mother they truly are. The criteria for measuring this devotion are based on how little medical intervention they use during labor, meaning the ultimate mama, the sort who might appear in this new show, is one who relies only on her breath, the shade of a couple of pine trees, and a kiddie pool on top of a bed of leaves to get her baby out in the most natural method imaginable.”

To this, I say: Mother shaming is not OK. No, childbirth is not a contest, but it is “a defining moment” in the lives of many women. To deny, dismiss, or even mock the importance of a mother’s birth experience will only result in more extreme refutations of the old birth model, where women are casual observers to what is—after one’s own birth and death—the quintessential human experience.

Their existence tells us something important: The medical profession needs to do better at providing care for women who are demanding more control and better outcomes for their births.

Natural childbirth doesn’t mean rejection of care. It means care with a mother-focused doctor or midwife, sometimes in a place other than a hospital. The number of women who opt for this type of experience is too large to relegate to the fringe. Around 17 percent of mothers—of 2,400 women who gave birth in U.S. hospitals from 2011 to mid-2012—birthed without medication to ease the pain of labor, according to a national survey (PDF).

And an increasing number of women are skipping the hospital altogether. Home births have grown by 59 percent from 2004 to 2012, according to data from the Centers for Disease Control and Prevention. White, well-educated women drive the small but rapid rise, with one out of every 74 having an at-home birth.

So, are these women as crazy, reckless, stupid, and selfish as the Internet would have us believe? Hardly.

Eugene Declercq, a Boston University School of Public Health professor and a CDC statistician, spoke about their intentions. “They are not self-absorbed women. If you talk to them, they are serious people who have legitimate concerns about a prior hospital experience,” he told me. “They aren’t doing this out of their own needs, but out of a desire to protect their babies’ health.”

Many mothers cite safety as the reason for drug-free births, fearing a cascade of interventions like induction, synthetic hormones to speed labor, vaginal cutting, and caesarean section. And they have reason for concern. One out of every three births in the U.S. is a cesarean section, up from one in 10 in 1975, and roughly double the limit suggested by the World Health Organization (PDF). About a quarter of all labor is induced.

Others are suspect of a medical profession that looks at a woman’s pregnancy as a condition to be treated. They are looking for the woman-centered care found in midwifery practices, or in extreme cases, on their own. This need was made clear in a series published in The Lancet this week, which found that “over-medicalization” of pregnancy is threatening the health and well-being of women and their families. It addressed the importance of midwives and the need for maternal care in both developing and developed countries.

“Many of the needs of childbearing women, their babies, and families across the world are still not being met, despite long-standing recognition that women and their babies need access to health care which provides more than just emergency interventions for acute medical problems,” said Mary Renfrew, an author from the School of Nursing and Midwifery at the University of Dundee and author in The Lancet series.

I sometimes write about home birth and maternal health. The women I speak to are informed and passionate about both their babies and their bodies. Rani MacNeal, a 37-year-old stay-at-home mom with a degree in marine biology, had all three of her children at home, influenced in equal parts by friends, her Indian culture, and an “intensely deplorable” experience with an obstetrician and hospital treatment for a previous disorder. “I was not having my baby in a hospital,” she told me. Her third child came so fast that the birth was unintentionally “unassisted.”

My own son was born in a hospital without pain medication. I had the help of a midwife, a doula, and my husband. It was painful, sure, but it was agony with an end. I wasn’t vehemently against epidurals. I had done the math and decided if I wanted to be on my feet, during and quickly after the birth (a quarter of mothers who have caesareans describe (PDF) at least “quite a bit” of interference with routine activities in the two months after birth compared with 9 percent of mothers with a vaginal birth), if I wanted to avoid a catheter and major surgery, if I wanted to be out of the hospital and home with my babe sooner than later, it would be best to manage as much of the event as I could on my own.

Luckily for me, it worked out. But had I needed an epidural, had something gone wrong and I needed a caesarean, that would have been OK, too. In the end, though, as so many of the anti-natural birthers point out, it is the babies that mean the most to us. But healthy babies and satisfaction with the way they come into the world don’t have to be mutually exclusive.

It is no fairer to suggest that natural-birthing women are all the same than it would be to say that a woman who schedules her caesarean with a tummy tuck on the side is in the same camp as the one who asks for an epidural. A decade ago we were attacking the “too posh to push,” and now we’re going after moms who are pushing too hard.

It’s wrong to assign strictly competitive motives to women who choose natural birth, but it’s even weirder to blame the “natural birthing culture” for any guilt felt by mothers who deliver with the help of pain medication or via caesarean section as Strauss does in The Week. She even twists a quote from Mila Kunis, making it sound like Ashton Kutcher’s betrothed said that mothers who use epidurals don’t want their babies. There are, of course, vocal advocates for natural childbirth that undoubtedly go to far. But the majority of women (Kunis included, as far as I can tell) who choose a “natural” birth are doing so for personal, not political reasons. Why criticize them?

While I’m amazed that there are women who want to give birth in the great outdoors, and moreover, in front of a camera, their existence tells us something important: The medical profession needs to do better at providing care for women who are demanding more control and better outcomes for their births. The sooner we put an end to the so-called mommy wars and start supporting women, whether they choose to give birth in a hospital or a babbling brook, the sooner we’ll get to answering the more important questions.

Rather than demonize the natural child birth movement, Lifetime, or these “extreme” mothers, let’s ask what has caused them to completely reject the system and figure out a way to make birth—wherever a woman chooses to do it—as safe as possible. Maybe we can even improve the current system so that laboring mothers feel more comfortable going to a hospital than into a forest.