"Forgoing Technology" in Birth?

MSN’s health section has a cool department called (creatively) “Birth Stories.” Cheers to this, given that way too many books and articles on birth erase the actual perspective of the person birthing, reinforcing the assumption that it’s the doctor (and all the technology) who delivers the baby, rather than the mother who births. Hilarious example: a book my partner bought for our daughter to prepare her for our second child’s birth explained that the baby would come out “when the baby gives one final push.” Ha! I’m the one who gives that final push, let me tell you.

Less hilarious example: Atul Gawande, writing an otherwise fascinating article for the New Yorker on birth, opens and closes with a woman named Elizabeth’s story, by way of illustration, yet throughout the rest of the piece she completely disappears, replaced by quoted doctors. The passages describing birth, even the bits about Elizabeth’s labor and delivery, are all from the perspective of the doctor, and we’re left in the dark as to what it feels like to give birth. I’m a fan of Gawande’s, but could the editors not in all the world and with all the prestige and money of the New Yorker behind them have found a woman who had given birth to write on the subject? Gawande seems to have some sense of this warping when he describes C-section: He describes C-section as “one of the strangest operations I have seen.” In the process of cutting and then pulling the baby out of the womb, “You almost forget the mother on the table.”

Even less hilarious example: The only place the experience of women appears in What to Expect When You’re Expecting, aka What to Get Anxious About When You’re Expecting, is in the brief descriptions of ailments, worries, and queries that preface the authoritative answers of the authors. Those answers always involve many repetitions along the theme of “Obey your doctor.” When I glanced at the book to check its advice on flying while pregnant, I read “Get your doctor’s permission.” Excuuuse me? Not “discuss it with your doctor.” Not “Get your doctor’s advice.” Get his permission. That’s when I threw the book across the room. (My unasked-for advice to pregnant women: Chuck What to Get Anxious About and get yourself a copy of Ina May’s Guide to Childbirth. It’s full of birth stories and it’s inspiring.)

This authoritarianism has dangerous consequences. There’s a high rate of poor childbirth practice in hospitals (The “Listening to Mothers” survey found that only a minority of women were treated with all the practices science has found to promote mothers’ and babies’ safety), a high rate of unnecessary and harmful interventions, and especially a high rate of unnecessary C-sections. (The World Health Organization found that C-section rates above 12 percent result in increased maternal mortality and harm, yet the U.S.’ C-section rate is a whopping 30-plus percent—and rising, along with our maternal death rate.) This means a woman giving birth in a hospital had better stick up for herself to ensure she receives proper care. Passive obedience is dangerous.

Back to MSN: The birth stories are a good thing. But they focus solely on highly medicalized birth. The one story I’ve found labeled “natural childbirth” isn’t. Headlined, “A Birth Story: One Mom's Tale of Natural Childbirth,” the subhead reads, “Why one woman forgoes technology to experience the pain (and joy!) of natural birth.” But the woman gave birth in a hospital, where she received an IV and continuous fetal and maternal heartbeat monitoring (which, by the way, have been found to provide no medical benefit and to result in unnecessary interventions). Hardly forgoing technology.

I don’t care to fight over exactly what counts as “natural childbirth,” and I think the term should be dropped because it’s so vague and loaded. But I do think amid all the stories of C-sections and heroic interventions it would be nice to hear a few about normal, non-technocratic birth. It does exist. For that, check out Ina May’s Guide to Childbirth. (And especially check out the statistics about her deliveries at the back of the book. Non-technocratic birth not only exists; it works.)