Wednesday, February 14, 2007

A feminist reappraisal of the natural childbirth movement

Linda Layne is a feminist scholar who was drawn to examine the rhetoric and assumptions the natural childbirth movement by her multiple pregnancy losses and poor outcomes. Her unique perspective is thought provoking:
In this article I contrast the idyllic birth scenarios of natural childbirth discourse with reproductive disaster stories of members of pregnancy loss support groups... I argue that both biomedical obstetrics and the women’s health movement critique of it share a belief in the ability to control reproduction so that there will be a positive outcome... I argue that the women's health movement's emphasis on the importance of women being in control of their own bodies contributes to maternal blame and self-blame when pregnancies are not perfect.
After detailing the stories of several other women, the author returns to her personal experience:
I began as an economically privileged, low-risk, apparently healthy 30-year old who had been a college athlete and was receiving prenatal care from a midwifery group at a women’s health center—exactly the type of person most likely to enjoy the appealing, gold-standard birth scenarios described by Davis-Floyd. But my story goes quickly and rather doggedly downhill from there with five unexplained miscarriages in 5 years. Then 2 years after the adoption of my first son, I was unaccountably able to carry a pregnancy beyond the first trimester... A routine prenatal visit in my 27th week revealed that my blood pressure was up... After 14 days of hospitalization, my blood pressure had become so high that it was too dangerous for either me or the baby to continue the pregnancy and labor was induced...

... Jasper appeared to be fine... But before his 2 months of neonatal intensive care were over he ... was diagnosed with the most serious grade of intracranial hemorrhage which miraculously left him with mild, rather than the anticipated severe, cerebral palsy.
Layne moves on to discuss the philosophical underpinnings of the natural childbirth movement:
The primary agenda of the US women's health movement has been to restore to women the autonomy and control that had been wrested from them by biomedicine... [The] villains included both "specific doctors and the medical maze in general"... Although the goal was to reestablish control over all aspects of women's bodies, control over reproduction was a priority... Martin has noted that this emphasis on control, found in the rhetoric of "the largely middle-class women’s health movement", appeared with much greater frequency among the middle-class women in her sample. Working-class women, in contrast, more readily articulated the aspects of birth that were less controllable.
Layne addresses the role of bad outcomes in natural childbirth discourse:
... There is a place for problems in biomedical discourse. Indeed, biomedical discourse requires problems as challenges to be overcome. In the women's health discourse, however, negative reproductive outcomes are anathema. So focused has the women's health movement been in challenging biomedicine's pathologization of pregnancy and birth, it systematically minimizes and marginalizes negative reproductive outcomes.

In Our Bodies, Ourselves ... negative reproductive outcomes are segregated to a chapter of their own instead of being integrated into the four chronologically ordered chapters on pregnancy and birth...

Reproductive disasters are acknowledged even less in childbirth education classes. Anthropologist Katherine March contrasts the way Nepalese women talk ... about "infertility, repeat miscarriages, hard births, and deaths in and near birth", with the way we silence these stories and deceive ourselves with a "shared faith that chosen childrearing is always happy" and concludes "nowhere are we so
deceived as in...childbirth education".
On guilt and blame as consequences of the natural childbirth movement:
In addition to the erasure of negative reproductive outcomes, the rhetoric of the ... natural childbirth movement in particular, champions an ethic of individual responsibility. The fundamental premise of the women's health movement, that women must wrest back control of their bodies from physicians, especially during pregnancy and birth, reinforces the notion that positive birth outcomes are something women can control...

The ethic of individual control is embedded in a culture of meritocracy. Thus, the Bradley Method literature suggests that if one is only diligent and hard working enough, such problems can be avoided. The workbook contains a 44-item check list of things women should do on a daily basis throughout their pregnancies to be sure they "Stay Healthy and Low Risk"...

Donna Brunner ... vividly illustrates how the rhetoric of natural childbirth exacerbates the experience of pregnancy loss in a piece entitled "Me? Guilty?". She describes how after her first pregnancy which was a C-section, she attempted a "natural" vaginal delivery and lost her baby. She explains that she "held off those unnatural drugs for as long as possible", and now must live with the worry that if she had only taken pitocin sooner, she might have saved her baby.
Layne concludes:
...[I]t is time to own up to ... a number of unintended negative consequences of the women's health movement's position on birth. So focused has been the effort to portray birth as a natural womanly talent, that the movement has systematically obscured from view the women for whom pregnancy and birth do not come easily, if at all.

In its quest to assure women more control over the birth process, the movement has inadvertently set up women whose pregnancies end badly as blameworthy. The liberal emphasis on self-determination ... is often understood to mean that we have the right, ability and, in fact, responsibility "to control our fertility". An unintended and unexamined consequence of this is that women may be assumed to be responsible for their pregnancy losses...

...By and large, the discursive space for pregnancy loss and other misfortunes that contradict our cherished narratives of progress remains hidden ... Scholars of trauma have observed how critical, and yet how difficult, it is for those who undergo such disruptive events to find empathetic listeners who are willing to hear their stories because such stories "force us to acknowledge that we are not in control of our own [fates]"... Feminists have blindly been a party to this. It is time to face up to the reality of pregnancy loss. We need to put pregnancy loss, along with other negative reproductive outcomes, squarely on the women’s health agenda and to develop feminist frameworks for acknowledging and responding to these unfortunate facts of life.

Labels: ,

2 Old Comments:

It's a pity you don't have a donate button! I'd definitely donate to this fantastic blog! I guess for now i'll settle for book-marking and adding your RSS feed to my
Google account. I look forward to new updates and will share this
blog with my Facebook group. Talk soon!

my web site: forex steam review (

By Anonymous Anonymous, at 3:55 PM  

Ahaa, its fastidious conversation regarding this piece of writing
here at this web site, I have read all that, so at this time me also commenting here.

Feel free to visit my blog: banc de binary (

By Anonymous Anonymous, at 1:11 PM