Last week, Jools Oliver, the designer and wife of celebrity chef Jamie, gave birth to the couple's fifth child. Shortly after, her husband tweeted what has now become gold-standard information in social-media birth announcements – not the name and weight of the baby (today, those are considered private information to be released later at the parents' discretion) but the method and process of birth, as performed by the mother in question. "He arrived safely," Oliver tweeted. "Mum was really, really amazing, unbelievably composed, natural birth."
So add Jools to the long list of celebrities and privileged women the world over (from Gisele Bundchen to Jennifer Connelly, Julianne Moore and Jessica Alba) who are proud to have given birth in what has become, over the past couple of decades, the only truly socially sanctioned and celebrated method of modern baby delivery: A straightforward vaginal birth without pharmaceutical pain relief. In other words, to use the language of midwives, doulas and prenatal yoga instructors everywhere, a "natural" or "normal" birth. As opposed to the other kinds of birth (involving drugs or, worst of all, surgery), which are considered, by extension, unnatural, abnormal and (the most feared term of all) medicalized.
I'm expecting my second child in just over a month, and while I planned for a non-medicalized "natural" home birth the first time around, this time, my only plan is to have no birth plan at all. Why? Because despite what you might read on Twitter, or learn in your hypno-birthing yoga workshop or from a Ricki Lake documentary, most birth plans aren't worth the maternity-ward clipboards they're written on. More to the point, the growing industry and cult of natural birth, lactivism and attachment parenting (all off-shoots of the so-called "natural way" when it comes to the ideals of women's reproductive health and mothering) are not just scientifically unproved in their supposed benefits, they are also detrimental to many women, particularly those of us who wish to work or simply maintain an identity outside motherhood.
I am not saying unmedicated birth is bad – a woman should be free to have triplets while somersaulting in a field of daisies if she wishes, so long as it poses no undue risks to her or her child – but what is bad is exaggerating the benefits of a birth method (and later a way of feeding and caring for a baby) that is often impractical, unpleasant and impossible for many women. Especially when there is little hard evidence to recommend that method, apart from a yearning nostalgia for the Stone Age (hardly a golden era for maternal health or infant mortality, by the way). But this is what the natural birth industry has done over the past 30 years: lied to women, shamelessly and for profit. Natural birthing, breastfeeding and attachment parenting are, for the growing number of people who work in this field, big business – and this is why the claims of their benefits have, over the past couple of decades, been grossly and, indeed, irresponsibly overstated. This strategy has worked enormously well because, guess what? It's easy to guilt an anxious new mother into feeling she ought to be doing the "right" thing.
Of course, like many covertly pernicious movements, the push for natural birth started from a place of real need. In the 1950s, most women in North America gave birth unconscious, under general anesthetic, and fathers were not even allowed in the delivery room. But with feminism came the popularization of organizations such as La Leche League (originally a Catholic women's organization) and Lamaze (a program of breathing techniques that was inspired by methods used in lieu of prenatal anesthetic in the cash-strapped Communist State).
According to Amy Tuteur, M.D., OBGYN and author of the recent book Push Back: Guilt in the Age of Natural Parenting, the natural childbirth movement made great gains in the early second half of the last century. "By the mid-eighties they'd pretty much accomplished everything they needed to. They should have congratulated themselves on a job well done, packed up their placards and headed home," she told me in a phone interview from her home in Boston this week. "But instead, they moved them into an area that was not supported by science. They went from saying 'Women should have a choice in how to give birth,' to 'Anything other than natural childbirth is dangerous,' which is simply not true."
If you are pregnant and/or a new parent hoping to be a competent carer whilst maintaining your life and sanity, consider Tuteur's mandatory reading. Here are just a few surprising – and empirically incontrovertible – facts you will learn from it:
1) There is absolutely no scientific evidence to show that pain relief (in the form of an epidural) slows down labour, raises the likelihood of caesarian section or interferes with infant bonding or breastfeeding after the fact. Withstanding labour pain is just as medically beneficial as withstanding pain during the "natural" passing of a kidney stone.
2) The vast majority of medical interventions during the birth process are neither unjustified nor injurious to women, nor are they responsible for raising the maternal or infant mortality rate. History shows that precisely the opposite is true: Most medical interventions during birth can be classified as preventative medicine.
3) Breastfeeding has some real short-term health benefits, but for babies in countries with reliable clean water supplies, those benefits are trivial. The most exhaustive landmark study on breastfeeding published in 2014 found that there are no proven long-term benefits to breastfeeding.
4) Attachment parenting (i.e., the popular child-rearing philosophy that recommends mothers practise extended breastfeeding, carry their babies rather than place them in strollers and co-sleep with their children instead of "sleep training" them) has no scientific basis and was invented and popularized by an evangelical Christian couple (William and Martha Sears) who fervently believed a woman's place was in the home.
For Tuteur – a woman who has seen thousands of women give birth during her career in obstetrics and has four children of her own – the modern obsession with natural birth and child-rearing has "very little to do with birth, babies or parenting and everything to do with the way we view women, motherhood and women's reproductive function as something to be carefully controlled and dominated." In other words, when it comes to the current fashion for natural birth and child-rearing, the matriarchy has simply replaced the patriarchy as the force that says, "Good girls do it this way. Now submit, obey and sublimate your own desires – or else."
For my own part as a mother, I have taken a very long and circuitous route to come to the rather obvious conclusion that when it comes to birth, outcome (i.e., delivering a healthy baby) is far more important than process. In the lead-up to James's birth four year ago, I spent an inordinate amount of time focusing on how wonderful and empowering my birth experience would be rather than taking a cold hard look at the risks of undergoing a first-time home birth on an untested pelvis. In retrospect, this was the ultimate bourgeois indulgence – and one that could easily have cost my son his long-term health or even his life.
Here's how my birth plan went:
1) First stage of labour – bounce gently on Swiss ball as husband inflates birth pool and aids in hypno-birth breathing techniques. 2) Second stage – home birth midwife arrives. Slip into the birth pool and enjoy her excellent massage techniques whilst moaning deeply into the lavender-scented water and preparing to meet my baby. 3) Give birth and experience a deep sense of joy and pure love as my child latches and nourishes himself at my breast as nature intended.
And here is what actually happened:
1) First stage of labour – wake up in the middle of the night from escalating contractions and spend the next five to six hours crying, screaming and vomiting from spectacular pain far beyond anything previously known or imagined. 2) Somewhere in the searing hurricane of medieval horror register the terrified face of the midwife saying something about "undetected breech" and that "for urgent safety reasons" she is calling the paramedics. 3) Experience the deep joy and pure love that is receiving an epidural and having a healthy perfect baby boy delivered via emergency caesarian section in a country with state-of-the-art universal health care. Ahhhh.
So it all worked out – except for my own unresolved expectations, which left me feeling guilty and bereft for months over the fact that I had failed to give birth in the socially sanctioned way. These feelings of inadequacy were not helped by the midwife who, in a follow-up appointment, said sympathetically that she wasn't surprised I felt badly, since in her view, I hadn't actually "given birth" at all.
I now see that what I once mourned as a failed natural home birth was in fact a successful C-section that may well have saved both my son's life and mine. For my next birth, my plan is simple: Follow the doctor's advice, focus on the outcome and hope for the best. With any luck, I'll get the same result.