Monday, August 04, 2008

More on eugenics and "natural" childbirth

There are several critical points that must be understood about the philosophy of "natural" childbirth. As Ornella Moscucci has explained in Holistic obstetrics: the origins of "natural childbirth" in Britain,
* Natural childbirth is an approach characterised by a bias towards physical and mental hygiene in the management of pregnancy and birth.
* It emerged in Britain in the interwar period as a conservative, antifeminist reaction to the demographic crisis of the early 20th century...
* Health reformers offered social regeneration through health policy. They believed that both reformist and hereditarian health policies were necessary for biological progress...
* The "philosophy of the natural" elaborated by health reformers entailed a return to the "state of nature" represented by the primitive.
* The definition of the "primitive" as physiological norm was bound up with beliefs about the pathological effects of civilisation...
The philosophy of "natural" childbirth cannot be separated from its basis in eugenics. It is this origin that explains how and why novel "biologic" theories of childbirth were simply fabricated in service of the eugenicist idea. Clare Hanson, in Save the Mothers? Representations of Pregnancy in the 1930s, explores the social and cultural mileiu in which the philosophy of "natural" childbirth was created. Hanson locates the philosophy of "natural" childbirth within the eugenics movement:
Eugenic thought in Britain had its origins in the work of Francis Galton ... Galton argued that heredity would ensure that like would breed like and implied that social classes thus corresponded to biological sub-types. The Malthusian question, for him, was of the relative breeding rates of the different classes...

In these debates of the twenties and thirties, the question of the relative importance of heredity and environment was being played out across the body of the pregnant woman. With the focus of medical interest moving towards foetal rather than maternal health, it was the viability of the foetus (in the broadest sense) which was becoming a crucial – and political – question in the thirties...
Hanson describes the influence of Grantly Dick-Read.
... One of Read’s principal arguments is that pregnancy and childbirth are not inherently burdensome or painful. He distinguishes between primitive women, defined as those 'whose mental development has not attained a state of civilisation', and cultured women who have for centuries been imbued with fear and told that 'labour entails peril and agony'. For Read, 'racial experience' impacts on the experience of pregnancy and childbirth, and it is the 'primitive' approach which he favours. He argues that Nature (sic) never intended pregnancy to be an illness, and describes the primitive woman continuing her work during pregnancy, so that 'the child develops while she herself lives a full and natural existence . . . the child then is born – small, hard and easily'...
Grantly Dick-Read started with his conclusions and simply fabricated "facts" that supposedly corroborated them.

Seventy five years later, when apprised of the origins of their philosophy, "natural" childbirth advocates claim that Grantly Dick-Read's sexism and racism do not undermine the validity of his philosophy. They point to the racist beliefs of the early birth control advocates, who were also motivated by eugenic concerns, and argue that racism does not impact the value of birth control. There is a critically important difference, however. Birth control advocates did not locate their claims of efficacy of birth control in racist or sexist beliefs. Their racist and sexist beliefs determined WHO should be given access to birth control, not HOW birth control works.

In contrast, the efficacy of "natural" childbirth depends almost entirely on the original racist, sexist claims of Read. They are so integral to "natural" childbirth, that these same racist, sexist fabrications are repeated verbatim by contemporary "natural" childbirth advocates:

"Childbirth in nature is not painful" is the modern formulation of "primitive" women do not experience pain in labor.
Women are "socialized" to believe that labor is painful" is the modern formulation of "Civilization has rendered cultured white women unfit to bear children."
"The cause of pain in labor is fear" is the modern formulation of "women must be socialized to their responsibility to bear children."
"Unmedicated childbirth is 'empowering'" is the modern formulation of "women should not refrain from having children because they are afraid of the pain."

Regardless of the way you dress it up, the philosophy of "natural" childbirth cannot be separated from its racist, sexist origins. There is no inherent value to "natural" childbirth. The value assigned to unmedicated birth is a social construct, predicated on racist, sexist assumptions about childbirth. Without those racist, sexist assumptions, the philosophy of "natural" childbirth is ideologically incoherent.

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