There’s no such thing as “natural childbirth.”

[originally posted on my old blog on 23 July 2008]

I am a natural childbirth advocate, in the sense that I believe that laboring and giving birth without interference (including but not limited to pain medication) can be an ecstatic and deeply empowering experience. I strongly believe that women who want to have their babies in this tradition should be supported in every humanly possible way. I also strongly believe that our medical system needs to make a lot of changes to be mother- and baby-friendly and stop pushing induction/augmentation and epidurals (and continuous fetal monitoring, etc., etc.) on women who neither want nor need them.

(Not incidentally, though, I also strongly believe that women who want epidurals or other forms of medical intervention should be supported in every humanly possible way in achieving their ideal births, too.)

However.

“Natural childbirth” does not exist for humans. This term is really interesting and really problematic. I don’t like to use it, for several reasons:

  1. Where do we draw the line? If I wanted to have a “natural” childbirth and gave birth vaginally, out-of-hospital, but took Nubain and had a glucose IV, was that “natural”? Or if my labor was induced or augmented, but I labored without further intervention–does it count as “natural”? Does it depend upon whether the induction/augmentation was through pitocin, homeopathy, AROM (breaking the bag of waters), nipple stimulation by a nurse, nipple stimulation by a partner, … ? Etc., etc.
  2. Take that one step farther. If I give birth inside a house, is that “natural”? With plastic down to catch my fluids, watching a clock to time some contractions, maybe hanging out in the bathtub or shower for a while, peeing in a toilet, using English to ask for water or a cool washcloth or whatever, with my partner and/or midwife who’s wearing clothes, and a phone available in case of emergency? That’s a culturally-constructed environment, drugs or no drugs.
  3. What does “natural” mean? Is it the opposite of “cultural”? (You can’t get out of culture, and I suspect you don’t really want to. Love is culturally constructed. My monogamous relationship with my husband is culturally constructed. His role as an involved attendant as I birthed our son is not only clearly culturally constructed but, historically, downright weird–as ‘unnatural’ as an epidural, perhaps?)
  4. When you get down to it, “natural” is usually used to imply that something is normal (as in, the norm from which deviants deviate), unchanging, unchangeable, and therefore in some sense correct–thus nasty arguments that homosexuality (or interracial relationships, or women working outside the home, or veganism, or whatever) is “unnatural.” Instead, I would argue that rules about who can have sex with whom, rules about food choice, rules about gender roles, and so forth are all socially constructed and (you’ll find, if you look) highly variable both amongst cultures and over time within a single culture. That’s also true for virtually everything about the practices of childbirth and parenting, of course.
  5. Using the term “natural” in a vague feel-good way (“I want to have a natural birth”) sets many women up for a sense of failure if medical intervention becomes necessary or desirable (Did I fail because of that damned IV?). It also makes epidural-choosing mothers feel judged–because the implication that my birth was natural and yours was unnatural is a harsh judgment indeed.
  6. Furthermore, this terminology reinforces the assumption that the nature/culture divide is real. And let me tell you, ladies, the construction of nature and culture as opposed terms has been used time and time again to screw over women (and people of color) in nearly every imaginable way. When I hear “nature” or “natural,” I get suspicious. “Nature” and “natural” make me think “agenda” and “ideology.”

I much prefer to think and talk about ‘low-intervention childbirth.’ (‘Unmedicated childbirth’ certainly also makes sense if that’s what you mean–that you specifically want to avoid drugs during labor). Another advantage of ‘low-intervention childbirth’ or a similar term is that it undercuts what I see as yet another major pitfall of “natural childbirth”: a lot of people think of natural childbirth as vaginal birth without an epidural, but that’s not all I mean when I say I’m “a natural childbirth advocate.” To get that ecstatic and empowering experience, women need a hell of a lot more than druglessness. They need caregivers and support people who truly believe in their ability to birth a child in joy and power. They need caregivers who accept this woman’s and this fetus’s timeline rather than trying to mold every labor into a textbook labor. They need an environment of peace, quiet, and respect. They need the power to determine their own birthing place and to make truly informed decisions about their care, without disrespect and struggles.

If you ask whether a doctor or hospital supports “natural birth” and are answered “yes” (meaning, sure, go nuts and experience the pain without an epidural), you’re not hearing whether they support and provide all of this other–far more important–stuff. The term”natural birth” is so vague that I believe it fails us in our work to create the birth culture we so badly need.

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10 Comments

  1. Posted 11 January 2011 at 3:22 PM | Permalink

    Thank you for this. I am currently negotiating preparing myself and my husband for this birth, with the idea that so many things are beyond our control – the hospital environment, but not to mention the fact that I might actually NEED interventions. From now on I’m going to think of myself as preparing for a low intervention birth.

  2. Posted 11 January 2011 at 7:54 PM | Permalink

    I have consciously changed my vernacular around this since my own unmedicated birth (or perhaps I should say my childbirth-formerly-known-as-natural?). And I’ve noticed that many, MANY women are saying natural birth when meaning simply a vaginal birth versus a c-section birth. How’s that for making a vague term even more vague?

  3. Posted 19 January 2011 at 7:02 PM | Permalink

    Yes, yes, absolutely YES. From its unwelcome normative dimensions to its problematic ambiguity, ‘natural’ is a term that I’d like to see wane from any and all discussion about pregnancy and birth (and breastfeeding, for that matter).

    In addition to using terms like “low-intervention childbirth,” I also like to use “informed childbirth.” It’s what I try and help my clients strive for (and even moreso than a low-intervention birth). And this is because (in my perhaps wishy-washy view), when a woman feels informed about her options and decisions, she can feel empowered even in those cases where lots of intervention become necessary.

  4. Posted 19 January 2011 at 7:09 PM | Permalink

    This is great, Kristen. Using vague terms like “natural childbirth” tend to just drives wedges between people anyway because we’re not communicating well and so much can be misunderstood. Love how you broke it down.

  5. Posted 19 January 2011 at 7:59 PM | Permalink

    I too find ‘natural child birth’ something of a misnomer, or at least potentially confusing. I prefer the term ‘physiological birth’ meaning whatever the body of the mother or baby physically requires. While my last birth was a low intervention, if it had been physiologically necessary for my to have an IV, augmentation, even c-section I still would have given birth in what I consider to be a prefered manner. I think most ‘natural’ birth women would agree that it’s not the NECESSARY interventions we want to avoid.

  6. Posted 20 January 2011 at 11:55 AM | Permalink

    So well written–a concept I have heard myself addressing countless times in my childbirth prep. classes. What was once an altruistic term became culturally and socially loaded quite some time ago. To use the term “naturnal childbirth” in any conversation anymore risks so many misunderstandings leading to conversation de-railing, adopting new terminology is nearly essential.

    Thanks for putting together a thoughtful post on this topic!

  7. Posted 20 January 2011 at 12:17 PM | Permalink

    I agree with Jespren-physiologic birth is my preferred term. It suggests that whatever your and your baby need is what should happen. And that we support the way our body works the way it should work.

  8. Molly
    Posted 20 January 2011 at 12:37 PM | Permalink

    Hi, everybody!

    Physiologic birth makes sense, too. Especially for discussions amongst birth professionals and scholars of birth-related issues/concepts. I don’t find it useful for everyday conversations, though–my very very smart and well-read grandmother (or aunt, or colleagues at the library) would probably not have an intuitive understanding of what I meant if I said “she had a physiologic birth–I’m so glad she was able to do it the way she wanted” or “such-and-such practice really doesn’t support physiologic birth.” So I do think it’s useful to have a slightly less specialized/unfamiliar vocabulary for talking about these issues without relying on the rhetoric of the ‘natural’, too. (Not that any of these terms are exact synonyms …)

  9. Brenda
    Posted 20 January 2011 at 4:37 PM | Permalink

    Thank you for this article! You bring up some excellent points. I recently completed my thesis on factors that motivate women to see a natural childbirth, and while I defined ‘natural’ as ‘no medial interventions’ it was a confusing term for many. I also reflected on the social construction of the term ‘natural childbirth’ as a carry over from the social activism in the 70s for women to gain more control over childbirth. The term natural birth was used to make a contrast to medical birth, so was used in a more political realm than an actual pratical one.

    Thanks for a stimulating contribution!

  10. Posted 28 March 2012 at 4:09 PM | Permalink

    When I teach prenatal I define my definition of natural childbirth on the first day of class. That definition being zero intervention, vaginal birth. Many women consider a vaginal birth a natural childbirth, even if there is pain medication, induction/augmentation or instrument delivery, and separation of mother and baby involved. For my clients who relate to my definition and are striving for a natural childbirth, I would encourage them to use the term zero intervention over low intervention when in discussion with their care provider. Zero is clear, low is not. I appreciate your cultural perspective.

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