Childbirth

Painting of a birth-scene, c. 1800

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Childbirth is something that has been happening since 1953 mammalian life first appeared. It's a natural, normal, easy process, for most mammals at least. Of course, humans evolved in two distinct ways that made childbirth not so "normal" and "easy". 1) We evolved larger heads, and most importantly, 2) we evolved to walk upright, making the hips shift forward, and rotate down to cup the body — while at the same time making the pelvic opening smaller. OR, if you live in an alternative universe, Goddidit when Eve was punished for eating an apple.

Either way, labor is long and painful, and giving birth is dangerous. So dangerous that at the turn of the century, before medical intervention, maternal mortality was around 1 in 5 women who would die giving birth, or from complications of birth; Today, the number is closer to 1 in 10 worldwide. Progress! And even in Western nations, 1 in 10,000 women will still die during pregnancy or birth. And yet, roughly 90% of women will decide to bring new life into this world; some even more than once!

Consequently, especially in the parts of the world where money flows somewhat easily, the industry that has built up around pregnancy and giving birth is full of pseudoscience, woo, and myth. Even the medical establishment itself remains sometimes guilty of old world views on giving birth.

Natural childbirth

Natural childbirth is a euphemism for vaginal delivery (or, in simple terms, pushing a baby out of one's hoo-hoo), specifically sans drugs. Of course, this is the way that women have been delivering babies for millions of years, but that does not automatically mean that medically-assisted childbirth is "bad". The pain women typically experience during vaginal childbirth is simply a byproduct of the fact that the size of the human pelvis has not quite caught up to the recent evolutionary explosion in the size of the fetal cranium.

Nonetheless, proponents of nature woo and Eve's Curse insist that long, painful labour is a kind of rite of passage into motherhood, arguing that any technology designed to alleviate that pain (e.g., epidurals) wrongly deprives women of an essential life experience. Although both maternal and infant mortality have declined significantly since the advent of surgical interventions like forceps, Caesarean section, and ventouse, mothers who are forced by high-risk pregnancies to undergo these procedures (or who, God forbid, choose to do so) are still made to feel as if they have in some way failed.

Discussion of this topic tends to focus on the means of birth rather than on the infinitely more important ends (a healthy mother and baby). It also tends to neglect the fact that a few minutes, hours, or days spent in labour is only a very small component of the entire lifetime experience of parenthood.

Some feminists have argued that it also reinforces the whole "woman as animal", "woman as nature", "woman as mother" stereotype suggesting that if a woman says, "Fricking hell, no way am I going to hurt for this brat that will then suck me dry for 6 months," she is both ungrateful and does not understand the needs of the child and her role as "woman" (or, alternatively, that she is just a horrible person). The stereotype is also supposed to reinforce the "motherhood is all there is in life" idea by saying that the "experience" is more than the sum of its parts.

Scientology teaches that talking in a delivery room could cause trauma for the baby and therefore delivery rooms should be as quiet as possible. It also teaches that the mother should use as little anesthetic as possible; because somehow a mother giving birth in pain doesn't cause trauma.

It has been suggested that kidney stones are a "natural" part of life, and that we should encourage all people with stones to "experience all aspects of life" and pass the stone without pain killers.

Home birth

A home birth occurs when a woman consciously chooses to give birth in her own home (usually under the supervision of a midwife), as opposed to in a hospital, clinic, birthing center, or other medical setting.

Proponents of home birth such as Jennifer Margulis characterize hospital birth as an impersonal or even traumatic experience. They argue that "birth is not a medical condition", though hopefully with awareness that birth can lead to medical complications, and that pushing a small person out of a smaller orifice has historically led to a hideous death-rate (the death rate from giving birth having dropped from 1 in 10 to 1 in 1000 being entirely due to medical science).

Anyone feeling intrepid enough to watch Ricki Lake giving birth in a bathtub might be interested in The Business of Being Born, a pro-home-birth documentary, which received limited release in early 2008.

A blogger has debunked much of the propaganda and unsubstantiated claims made in "The Business of Being Born".

Studies in Canada, the Netherlands, and the United Kingdom all suggest that as long as the mother is healthy, and that competent obstetrics-gynecology care follows throughout the pregnancy, there is no statistical difference in the number of deaths — regardless of the location (home births, birthing centers, or full hospitals). In the UK, the National Institute for Health and Care Excellence (NICE) officially recommends home births (with a qualified midwife) for births expected to be uncomplicated.

In the United States, homebirth midwives largely operate outside the medical system, and often show statistics from Europe to prospective clients to mislead them about the lack of safety. Licensing requirements vary by state, with some requiring no license at all. The American Journal of Obstetrics and Gynecology published a 2010 meta-analysis showing a tripling of newborn mortality rate in planned homebirths compared to planned hospital births among low-risk infants. A 2020 original research study published in the same journal found an even larger gap in newborn mortality rate in planned homebirths versus planned hospital births. When homebirth advocates speak of "safety", they are referencing a lower likelihood of a caesarean section, while neglecting to mention the possibility of infant death. Ironically, after an emergency transport after a botched homebirth, many of the interventions women wished to avoid became necessary.

Today, though most of medical science as well as most practicing Ob-gyns are patient-focused, comfortable with and encouraging the use of midwives, and willing to use techniques like squatting or kneeling on all-fours which make labor easier for the mother, some medical procedures and practices survive that reflect the old "nature/female" vs. "science/male" dichotomy.

Freebirthing

“”No one ever talks about how traumatic it is for the OB team to receive these patients. We often have minutes to intervene and so the rush to prevent catastrophe is interpreted as "you only want to cut me open."

—Dr. Jennifer Gunter

"Freebirthing" is an extremely dangerous type of home birth done intentionally without the help of a doctor, doula, or midwife. Some women choose freebirthing when they want a home birth but midwives or doulas reject them (or do not like their options).

Freebirthing runs the risk of irreparable damage to mother and/or child (including permanent damage to the child or to the mother's ability to have future children) and even death. Multiple babies have died in freebirthing, at least one dying from problems that could have been prevented by adequate medical care. Risks increase the longer labor takes.

"Freebirthing" communities may discourage pregnant women from receiving any medical help during the pregnancy at all.

Modern medicine will need to find a way to reach out to pregnant women and ensure they feel empowered about their care, in order to reduce the risk of them foregoing medical help altogether.

Freebirthing is natural. So is becoming infertile. So is dying. So is watching your baby die. Modern medicine exists for a reason, and finding a doctor or midwife who is a good listener is far better than playing Russian roulette with a baby's life. Homebirth midwives don't have what is needed to save these babies' lives, like a fully staffed operating room and/or NICU, so women who choose a homebith midwife instead of no midwife are being lulled into a false sense of security.

One more thing...

Humans are part of nature, therefore everything we do is by default natural.

Beavers build dams, birds build nests, we build clinics. Just because our constructs are more complex doesn't make them any less expressions of nature. We are part of nature, everything inside the natural universe is, and we are fully part of (and more importantly: products of) this planet's organic ecosystem. If our stuff looks shinier, that's simply because we are very good at making shiny stuff. That's a skill, not something to be ashamed of. Plus, humans are naturally inclined to see their works as unique and superior to those created by other animals.

As a result of this, the entire term "natural birth" is meaningless. Births given in the woods are natural, births given in the home are natural, and births given in the most advanced clinic are also natural. Whether you scream your lungs out in a bacteria-infested bathroom or you are pumped full of morphine in a sparkling clinic while watching an OLED TV on the ceiling and think birth is the happiest time of your life ever, both are equally natural. Instead, what is going on is that people are comparing one form of natural birth to another.

The "natural birth" movement then should be seen not as increasing the "naturalness" of births, but rather making human births more primitive.

However...

There are valid arguments to avoid the medical interventions that "natural birth" eschews if possible. Epidurals have substantial side effects, including blood pressure drops and persistent (but treatable) leaks in the dura of the spine. Due to the effects on muscle control, epidurals make other interventions such as vacuum extraction, forceps delivery, and Caesarians more likely. For women who have tattoos on the lower part of their backs right over the base of the spine (colloquially known as a "tramp stamp"), they can also release a variety of toxic chemicals into the body, which is why they won't give you one if you have such a tattoo. If it means that it hurts that much more, well, maybe you should have thought of that beforehand; at that point, there's not really anything anyone can do.

See also

• Lotus birth
• Placentophagy
• Symphysiotomy

External links

• Skeptical OB: A blog by an anti-home birth, former ob-gyn.
• Mayo Clinic's view on home birth.
• Death Rate for Home Births, by Steven Novella
• Science-Based Medicine's view on water birth.