In 2004, Kate Winslet shared a secret. While she had claimed that she gave birth to her child naturally, she actually had an emergency C-section. (Gasp!) She felt shame about not being able to give a natural birth and took “great pains to cover it up”.
When Marissa got pregnant, I started learning more about pregnancy and birth and as part of that I’ve heard a variety of things around natural birth and parenting. For example, I’ve heard of the Lamaze Method but I didn’t know that it came from USSR doctors who weren’t able to get their hands on good painkillers.
As part of this research I came across an EconTalk podcast with Amy Tuteur who positions herself as a “Skeptical OB” that fights back against the natural parenting movement, especially the shame that women are made to feel if they don’t do things the natural way. She wrote a book summarizing her point of view - Push Back: Guilt in the Age of Natural Parenting - that I read most of, so this post is based on that podcast and some of that book.
To set the context, it’s important to remember what a “natural” birth actually is like. Before the rise of modern medicine, it was very common for the mother and child to die during birth. In the past couple hundred years, the maternal and child mortality rates have decreased over 100x.
Natural births were very dangerous, painful, and just a bad time in general. I definitely don’t want to go back to the time where the mother had a > 1% chance of dying while giving birth.
Interestingly, one of the most used modern birth interventions has ancient roots. The C-section is named after the Caesarian section and it’s so old that some people believe that Julius Caesar was named after an ancestor of his who was born via Caesarian section. But until the past 50 or so years, C-sections nearly always led to the death of the mother (that’s how we know Caesar himself wasn’t born via C-section).
In her book, Amy Tuteur narrates the history of the “Natural Parenting” movement. The Natural Parenting movement started in the 1940s with Grantly Dick-Read (funny name) who was a British obstetrician. Dick-Read was worried that the white birth rate in Britain was going down - so he argued that women fear birth and that fear creates pain. So if women simply didn’t fear birth, they would not feel pain while giving birth. He was telling women this at a time where birth was very painful and there weren’t many other options for pain control (epidurals become popular in the 1970s).
The movement continued from Dick-Read through the communists. Fernand Lamaze created the “Lamaze method” after visiting Soviet Russia and seeing how doctors there instructed pregnant women in special breathing techniques to avoid pain. In Soviet Russia, it was hard to get good pain relievers, so controlling your breathing was the best option they had. Yet the Lamaze method still caught on in Europe.
The Natural Parenting movement makes a few arguments. The movement isn’t a monolith, so these are just ideas that are associated with the movement.
- Epidural Skepticism — An epidural is a painkiller that is inserted around your spine and makes birth much less painful by reducing sensation to your lower body. From what I’ve read, epidurals seem amazing - they are incredibly effective and safe. If someone expresses epidural skepticisim, I give them a lower credibility score.
- C-Sections Avoidance — Natural Parenting advocates caution against C-Sections and claim that doctors have perverse incentives to push C-Sections. I (and Amy) think that there are probably cases of people getting C-Sections when they don’t need to — but on the whole, C-Sections are very good and safe intervention.
- Breastfeeding Over Formula — Formula was introduced and became popular in the 1900s and is indispensable for mothers who have trouble generating enough milk or cannot be with their babies all day. Natural Parenting advocates for breastmilk as they claim it will make the babies healthier. From what I’ve read, there are some small benefits of breastmilk over formula and in my view, this is the least objectional part of the Natural Parenting movement.
Tuteur’s refrain is that 1. you don’t want a truly natural birth because birth used to be very dangerous, 2. the medical system is not as evil as the Natural Parenting people make it out to seem, and 3. mothers should not feel shame for giving a medically assisted birth. I think it’s very reasonable.
Here are some other miscellaneous notes:
- Amy is critical of birth plans because they are often overly prescriptive and give the false impression that you can “plan” your birth. Our doctor brought up a birth plan with us! So this has definitely made it to the mainstream. It seems reasonable to talk through your preferences, but I agree that a birth plan is a bit silly.
- It’s worth re-emphasizing how dangerous birth used to be. If you understand how dangerous it was for both mothers and babies to give birth naturally, then you would know “Natural Birth” is something to be avoided at all costs.
- “Doula” comes from the Greek word for “slave”. I don’t think you can deduce much meaning from this, but it’s still a bit funny. Nevertheless, we will not be hiring a doula.