Epidural [guilt] trips and ‘natural’-birth bullies

The evolution of our big brains was costly. Compared to other mammals, including chimps (our closest living cousins), risk of maternal or neonatal mortality during or shortly after labour is enormous. The figure below, which shows infant head-size relative to the size of mum’s pelvic opening in chimps (left) vs humans (right) should make the anatomical basis of this excess risk pretty clear. Nevertheless, dogmatic labelling of “natural” birthing (occurring in the absence of analgesics or other medical interventions) as the “right” method continues to exert considerable pressure on expectant mothers’ decisions. Please know from the outset that we are not against home births or births given in the absence of medical intervention. We are advocates of women’s right to choose what they do with their own bodies, using good information (and not distorted propaganda), without the pressure of being made to feel guilty.

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Dr Kelly Brogan (who, despite her medical training, promotes pseudoscience, for example by writing pieces for “GreenMedInfo” with titles like “Why Vaccines Aren’t Paleo”), tells us that “when we “meddle with” labour, “we rob women of an opportunity for psychospiritual transcendence.” Judy Cohaine, also writing for “GreenMedInfo” asks – with the kind of sleaze that makes my skin crawl – “why so many women are taking the epidural trip”. She has this to say of anaesthesiologists:

“In many ways, epidurals are the drug trip of the current generation. Similar to street drug pushers, most anestheiologists in the delivery rooms maintain a low profile, avoid making eye contact and threaten to walk out if they don’t get total cooperation.”

It will not surprise you to hear that alongside atrociously bad analogy-drawing, loaded language and demonisation of medical professionals and mothers who choose “unnatural” births, the NB lobby also employs cherry-picked studies and a heavy slop of naturalistic dogma to “push” (sorry, I couldn’t resist) the view that the pain of childbirth is something women should accept – and gratefully  too – and that medical interventions are…BAD. This dumbed-down and blackened view of such an all-encompassing aspect of human life, and living it in the 21st Century, is a sadness.

The general safety of both C-sections and epidurals has been well established. While no medical intervention is risk-free, the risks are low and “natural” home birthing, which is painted by the NB crowd as the only truly virtuous approach to delivery, is certainly not risk-free either – that’s the very reason why these medical interventions exist in the first place. There is plenty of sceptical literature out there on the scientific data supporting them. See this, for example. Ultimately, though, a mother’s personal decision when it comes to the birth she is going to give is, well, just that – personal. Since each mother is different, these decisions should be the result of her own feelings, combined with individualised risk-evaluation. In other words, they should be made on a case-to-case basis, not on one of blanket statements, ideology, cherry-picked studies (or even crude statistics, for that matter). Despite the immense importance of context, arising from broad diversity in human physiology, desires and experience, as we see so often from the “holistic” camp (so often that the effect of the fantastic irony is beginning to wane), which claims to treat the “whole person”, “as an individual”, unfortunately, NB ideologists gloss over these individual differences and take the insensitive cookie-cutter approach that they claim to oppose.

The potential benefits of epidurals are not limited to pain-relief, but this effect alone is adequate to fully justify choosing to have one. You don’t need me to tell you that childbirth is associated with extreme agony! Some women find it easier than others – some women are in labour for 30 hours, others in 3. Different women have different pain thresholds. Different women have different psychological reactions to pain. Etc, etc.  Epidurals, as Amy Tuteur  points out, “as the most effective form of pain relief”, can “give women control over their own bodies and control over the way in which they behave. This allows women to represent themselves to others in the ways in which they wish to be seen, instead of pushing them into a “non-rational” space.”

Even if some scheduled C-sections are “based on fear”, as an NB advocate I know once argued, this fear is hardly unfounded. There are a host of specific risk factors, individual to each mother, that might in some cases compel some of them to opt for one. Being pregnant with triplets is one example. Having an infection that is more likely to spread to the infant via vaginal birth compared with C-section is another. Being of a very narrow build is another. And in any case, isn’t it perfectly “natural” to feel afraid of giving birth, even in the absence of these specific risk factors? Take another look at that picture. Countless millions of mothers throughout human history have died giving birth. This is not a fear that is instilled in women by the Evil Medical Industry – it’s a perfectly reasonable fear to have. C-sections circumvent some of the risks associated with vaginal births (such as tearing). Yes, they carry risks of their own. But different risks mean different things to different women. The heavy-handed idea that women “ought” to “transcend” the fear of vaginal birth in the absence of analgesics is philosophically unsophisticated, futile, and greatly lacking in empathy. It’s also hypocritical, if you’ll grant that being afraid of something that is painful and risky is “natural”.

There is no doubt that many people have had beautiful, meaningful experiences giving birth at home. And that’s great for them. But pitting “natural” births against those that do not fit the bill, as if women who have their babies in hospital or with medical assistance of any kind are forfeiting the “true” beauty of giving birth, is a nonsense. The banal idea that the beauty of giving birth is tied to the ins and outs of the birth plan is curiously materialistic for such a transcendental crowd. It’s a bit like being under the impression that you can guarantee your dinner party will be a hit as long as you get the décor right. Everyone knows that really it’s the people you’re with, your state of mind and a bit of luck (oh, and the main course, of course) that makes an experience wonderful – not the fancy lights, the bad music you were playing, or even the Sheffield-steel cutlery. The implication that women falling into the “unnatural birth” category have somehow failed to fulfil themselves as people, and should feel guilty for choosing what feels or felt right for them is essentially bullying – baseless, immature and mean.

Which is unsurprising given its origins. The NB movement began when Grantly Dick-Read, a British doctor practising during the 1930s-50s, published Natural Childbirth and Childbirth Without Fear, in which he espoused the view that pain experienced during childbirth consisted in nothing more than the fear of childbirth itself. His (incorrect) basis for this claim was that “primitive” women didn’t suffer labour pains. “Overcivilization” had planted in the minds of women the myth that labour was painful, and women then fabricated the pain accordingly. Dick-Read, it should be noted, also argued that (white) women who limited the size of their family were committing “race suicide”. Woman, whom he dubbed “the factory”, “fails when she ceases to desire the children for which she was primarily made.” He also believed that measures should be taken to prevent “bad stock” from reproducing too much, and encourage “superior stock” to make up the shortfall.

Social Darwinism aside, imputing superiority to a practice simply on the basis of its being “natural” is not wise, but reckless. While some women do get through labour without pain-relief or medical intervention, many millions of others would never have lived to see their child if such interventions had not been available. As a short anecdote, just before I was due to be born, I managed to get the umbilical cord wrapped three times around my neck. You would not be reading this post if C-section had not existed at the time! Portraying “natural” home birth as “spiritually” superior is unethical because it may (and indeed is meant to) influence women’s medical decisions – to groom them into actively rejecting and resisting medical intervention. When this avoidance manifests as turning down professional medical advice to undergo a procedure, unnecessary risk will inevitably accrue.

Once can’t help but notice the parallels between NB lore and Judeo-Christian narrative. Many Christians believe that the heavier physiological burden women carry in reproduction is God’s way of punishing Eve for taking the first bite of the apple. As one nit-wit put it, “Pain is a natural and intended curse of the primal sin. Any attempt to do away with it must be wrong.” NB propagandists remind me somewhat of Mother Teresa and her conceited attribution of beauty and virtuousness to poverty – enjoyment of other people’s pain and suffering, conveniently concealed beneath a smarmy “congratulations”.

Literature of the kind that presents “natural” births as more morally advanced than others employs fear – the very evil it claims to thwart, to harvest cultural (and commercial) success. Don’t let dogma make your decisions for you! 

Further reading: http://www.sciencebasedmedicine.org/childbirth-without-pain-are-epidurals-the-answer/

8 thoughts on “Epidural [guilt] trips and ‘natural’-birth bullies

  1. This article is particularly important, given that while the push for Natural Childbirth has increased, so has the number of women choosing to delay childbearing until their late 30s and into their 40s, where risks of complications are somewhat higher. Although C-sections come with their own set of risks, an older woman giving birth may have a higher risk of extremely serious events (such as heart attack or stroke) during delivery and therefore may NEED to opt for epidural or C-section to deliver safely.

  2. I gave birth in November and loved my epidural! For me, I was glad to feel I had a measure of control over my body and I could focus on what was happening. I wish I could have read your post for support back then. The amount ‘moral’ pressure from the NB crowd is enormous making it hard not to doubt your choices. It is hideously ridiculous to be told you did not truly ‘become a woman’ or ‘experience birth’ because you choose an epidural! Thank you for this article. I will be sharing it.

  3. When my wife was pregnant, she spent hours reading and watching documentaries on (potentially cherry-picked) birth statistics and “natural birth.” She had her heart set on it. A couple of days after the c-section, she came to agree that the attachment was too big for her outbox and that didn’t make her a terrible mother. The days leading up to that were pure hell though. When the midwives, nurses and doc finally recommended she go under the knife, she threatened to run away. Yet all it took was her own mom saying “you were born by c-section, are you calling me a terrible mom?” You really can’t judge a mom by the delivery alone.

  4. I agree with everything you write in this essay except when you say that people should be allowed natural births if it’s their choice. Of course they shouldn’t. Where an innocent life is involved they should be forced by law to have potentially life saving medical intervention.

    1. I can see the reasoning, but I think it’s philosophically very problematic, and the same reasoning behind anti-abortion. I feel that until a baby is out of its mum, it’s still ultimately got to be her decision whether she takes drugs or not. I would highly, highly recommend that she did, if there was a life-threatening situation, but I wouldn’t agree with forcibly medicating her. Are you only talking about situations in which there are identifiable risks such that a ‘natural’ birth would put the baby at a high risk of death or illness? Or does your view extend to all births?

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