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Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA

A Comment on Natural Childbirth

by Carolyn Steiger
extracted from Becoming a Midwife, now out of print.

I once heard a woman who had recently given birth at a hospital describe her experience as "Natural Childbirth".  Her labor had been induced with pitocin, her membranes were ruptured artificially, a fetal monitor had been strapped on, she remained in bed the entire time, she was in the lithotomy position for second stage and she received pain medication throughout labor!

Things have gotten out of hand.  The cesarean rate is so high that any vaginal birth is now considered to be "natural".  Certainly, "natural" is not always best from our point of view.  Nature sometimes is destructive, whether in the form of a tornado or a pelvis that is literally too small for a baby to pass through, and sometimes we are thankful for ways to bypass nature.  But we shouldn't kid ourselves about what reality is.

Consider this analogy:

Would you feel that you had engaged in natural sexual intercourse and love-making if you had only performed it at a hospital, with a little gown on, after an enema and many hours without food?  Add to this an I.V. in your arm, a spotlight focused on your genitals, and strangers entering and leaving the room without warning.  People are telling you how to do it, when to do it, how fast or slow to do it, and everyone around you is dedicated to helping you perform noiselessly. They are also insisting you do it in the position most convenient for them so they are better able to look at your genitals and put their hands inside your body.  To help male readers further envision this scene, imagine that you are having trouble "delivering": the doctor could help you by making just a little cut!  Remember, too, that you are expected to perform according to the Steiger curve - too long or to short a time until you accomplish your mission and intervention will be necessary!

It would be absurd to call this "natural" sex.  Calling birth "natural" under these same conditions is also absurd.  But some physicians who clearly see the effects of psychological and emotional factors, environment, and stress on sexual potency and function are disdainful of people who suggest the same might be true of a laboring woman.  [Editor's note - See section on Birth Hormones.]

If people were forced to make love under these conditions, we would be shocked and offended.  We should be equally offended when it happens to a woman in labor unnecessarily.  Women now expect these indignities and numb themselves in preparation.  Even as midwives we become numb.  We can become accustomed to the indignities and powerlessness pregnant women endure.  We may become casual about intruding on a human experience that is inherently no less intimate, private, personal, special, or affected by environment than making love.

Refraining from intervention and acting respectful should arise, not from a calculated bedside manner aimed to please the client, but from a true reverence for the process, love and respect for the people involved, and gratitude for the privilege of being present.  Only then can we turn away from making birth an unnatural act.