Wednesday, February 21, 2007

Childbirth and Nature

What is the nature of nature? The answer to that question has important ramifications for the philosophy of natural childbirth.

Let's leave aside for the moment the fact that "natural" childbirth as it is understood in 2007 does not share much, if anything, in common with childbirth as it existed in nature. For the purposes of this discussion, we will accept the erroneous beliefs of advocates that "natural" childbirth is truly natural childbirth.

The designation "natural" is viewed very differently by different schools of philosophy. Advocates of "natural" childbirth, though they may not realize it, are referencing Rousseau's concept of nature. According to Rousseau, "everything is good as it leaves the hands of the Author of things; everything degenerates in the hands of man." The modern expression of this belief is the idea that "natural" is inherently better than "technological". We hear this expressed often, and in a variety of ways, by advocates of "natural" childbirth:

Childbirth is "designed" to produce a healthy baby and mother almost every time.
Women are "designed" to give birth.
Women should "trust birth" or "trust" their bodies to give birth.
If childbirth weren't "designed" to work almost perfectly, "we wouldn't be here".

Rousseau's ideas of nature were a response to a very different philosophy of nature articulated by the philosopher Hobbes. According to Hobbes, life in the state of nature is: "solitary, poor, nasty, brutish and short." Hobbes believed that civilization, specifically hierarchical arrangments like monarchy, were necessary to rescue people from what would otherwise be a very grim existence.

Both Hobbes and Rousseau antedated knowledge of evolution by hundreds of years, yet their philosophies prefigured the conflict about evolution that is still going on today. Did a Creator create a perfect world for us? Or is what we see the result of evolution, the death of those less fit to compete and the consequent evolution of the more successful forms that remain today? When it comes to birth, is childbirth as it occurs in nature "designed" to produce healthy babies and healthy mothers, or is childbirth itself a forum for evolution, in which the less fit simply die and only the fittest survive.

These differing philosophies have profound implications for how we understand birth. Is birth in nature "designed" to work out well the vast majority of the time, and therefore we should expect to intervene only in unusual circumstances? Or is birth, yet another forum for evolutionary competition, requiring vigilance to forestall the inevitable deaths and disabilities that would otherwise result?

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