The dubious feminism of the natural childbirth movement

“There is no physiological function in the body which gives rise to pain in the normal course of health,”

Perhaps Yarrow addresses this in the book, but it seems to me the obvious counter example to this claim is menstruation. Menstruation hurts in the normal course of health. With mine, pain tends to be the first sign that it's starting, so it can't be fear of pain causing that pain. Would she consider me outside of the normal course of health for this reason?

But the righteousness of the natural childbirth movement’s complaints about exploitation and callous disregard by doctors can obscure the sometimes dubious empirical claims it makes about medical outcomes, or the essentialist and unsupported assumptions about women that motivate its reasoning. For one thing, the obstetrics field has changed dramatically since medicine was professionalized, and many of those changes have made obstetric practice and maternal care kinder and more skilled. For example, Yarrow spends a good deal of time decrying the use of episiotomies—surgical cuts made to the perineum during birth to create a larger opening for the baby to pass through. These cuts were painful and often conducted without the woman’s consent; sometimes, they were used to hasten birth when a bit more time and patience would have allowed a successful delivery without the painful and invasive genital incisions. But for all the horror of the episiotomy, the reality is that the procedure is only rarely practiced now. Its use began to decline in the 1980s, as a growing body of data showed that the incisions did not yield the beneficial outcomes they were believed to have, and in 2005, a definitive study disproving the supposed benefits of episiotomies led to a dramatic drop. Hospitals and ob-gyn departments respond quite well to empirical evidence, even if they do not respond as well as one would like to women’s own testimony.
Demographic changes in the field also make the natural childbirth movement’s narrative of male doctors exploiting female bodies—or, as the subtitle of Yarrow’s book puts it, “The Insidious Power of Men Over Motherhood”—not quite as straightforward as its advocates insist. Throughout Birth Control, Yarrow uses the word “men” as a stand-in for “doctors,” a move meant to contrast the so-called masculine empiricism of medicine with the supposedly feminine realms of intuition, tradition, and superstition that are favored by the natural childbirth movement. It’s a rhetorical move that obfuscates reality in more ways than one. For starters, the obstetrics field is now dominated by women. Perhaps no field of medicine has been transformed so quickly and completely in its gender composition: In 1970, just 7 percent of gynecologists were women; in 2018, 59 percent were. The field is likely to become even more female in the future. According to a 2015 report by the Association of American Medical Colleges, about 85 percent of obstetrics residents are women, a trend that is due in no small part to patient demand: Women tend to prefer female obstetricians and increasingly have the power to request them.

This brings us to the most troubling suggestion made by the natural childbirth movement: that giving birth is what women are for—their bodily destiny, their logical purpose, and in some sense their highest reason for being. It is here, in its rapturous faith in women’s reproductive role, that the movement begins to sound like the anti-choice zealots whose regressive and sexist ideas about pregnancy and childbirth now carry the force of law. As Yarrow asserts in a chapter called “Childbearing Hips,” women “[need] more stories that acknowledge the truth: we were born to birth.” Although Yarrow is pro-choice, how different is this contention from the one offered by the anti-choice extremist Laura Strietmann, who argued that pregnancy is not really dangerous even for little girls impregnated as the result of rape, because “a woman’s body is designed to carry life”?
Women are not “designed” objects; they are not mere vessels for the reproduction of humanity or animals marching toward their natural destiny. They are people—thinking, feeling, and intelligent human beings, even while they give birth. The natural childbirth movement is responding to a real concern: the justified distrust of the medical establishment by women and their reasonable discomfort with many of the ways that labor and delivery are—and historically have been—mismanaged and misunderstood. But practitioners like Dick-Read and Gaskin do not alleviate the suffering of women in labor. They simply deny it, burying it under layers of romanticizing naturalization, like so many paisley scarves.

Evolution has not selected women's pelvises particularly well for bearing our large-brained mutant offspring yet.

Let anyone who denies the impact of modern medicine read Antonia Fraser's The Weaker Vessel. It's a chronicle of women's lives in England from 1600 - 1700. One of the noteworthy statistics is that 1 in 5 women of the period could expect to die in childbirth, whether attended by a physician or midwife, or giving birth without any skilled aid. About a third of women would suffer debilitating consequences that caused lasting suffering and premature death. It was absurdly common for men to marry multiple times not through divorce, but because they outlived their wives so often.

It's arguable that women only began to gain parity with men's political power when their life expectancies rose as a result of safe C-sections (antibiotics, anesthesia, and life support) and other technological birthing and aftercare supports.

I had one kid in a hospital due to mild complications during labor, and two at home with a midwife. I found unmedicated birth to be painful and difficult but not excruciating or awful. The home births were far more to my liking. BUT I live a short drive to a hospital if things went wonky (like with the first). Everyone’s experience is different. I like what the author seems to be getting to: how about dropping the judgement (natural birth movement) and the control (the doctor will take over now, Dear) and let the “birthers” do what seems best to them?

I'll just add my anecdote for consideration.

Ultimately, my position as father was, whatever makes the kids' mom happy. I'm really grateful she chose a natural birthing process.

We were lucky to live in an area with a strong culture of natural childbirth and respect for women, including really incredible female ob and a supportive hospital with a diverse staff and birthing tubs and stools. The diverse staff was really important, as it's kind of a "joke" within the industry (I'm told) that birthing is where burned out, near-retirement nurses go for an easy gig to wind out their days. Our hospital was staffed by nurses and assistants who were very supportive of all the awesomeness that can happen around birth.

As a result, our kids births were perfect. We were in the tub, I caught my babies, prayed over them. Their mom had a painful, but transformative experience, was well taken care of, and was never more beautiful in the time around their birth. The kids didn't cry, they slept and ate and were just being wonderful. They were, are are, super healthy and resilient despite enduring a pandemic that was much worse than for most their age (they endured a move and a divorce at the same time). I attribute a lot of that to their awesome birth.