The natural birth movement is encouraging healthy women to rely on and believe in their own physiological capabilities. The movement's lobbyists say epidurals and C-sections have their place for those who really need them.
May 12, 2017
The natural birth movement, first pioneered by British obstetrician Grantly Dick-Read in the 1930s, has seen a renewed global interest from feminists, natural birth activists, childbirth educators, humanistic obstetricians, midwives and nurses.
Natural childbirth refers to birthing without routinised, medical interventions such as the administration of Pitocin, a synthetic hormone used to speed up labour, the epidural injection for pain relief, anaesthetic medications and surgical interventions such as episiotomies and caesarean sections.
The natural birth movement arose in opposition to the dominant techno-medical model of childbirth in hospitals, which has remained the default in industrialised societies since the early 1900s. What has followed from developments in modern medicine and biomedical technologies is an almost unquestionable trust in biomedical doctors. The extent of this is such that, according to medical anthropologist Dr Nolwazi Mkhwanazi at the University of the Witwaterstrand, "for many women their only idea of giving birth is in a hospital; they are not aware that home births are an option or of the possibility that they can have midwives attend to them at home". Empowerment, she says, is "about having the knowledge that there is a choice."
Biomedical doctors are accused of perpetuating fearmongering among pregnant women, discouraging natural birth and instilling in them a fear that they are unable to birth naturally, often advocating for a caesarian (C-section) when more often than not, it isn't necessary. In 1965, when the U.S. first measured a caesarian rate, it was at just 4.5%. Since then it has increased sevenfold. Today, one in three women in the U.S. gives birth by caesarean section. This is more or less consistent with most developed nations.
There are two widely accepted reasons for this. The first is that obstetricians have busy schedules and do not have the time to allow every patient to give birth naturally. The second is that it is a means of self-protection for doctors. In 1987, more than 70% of all American obstetricians had been sued, a percentage higher than that of any other specialty. Insurance premiums for obstetricians are exuberantly high as a result.
why is a birthing woman [treated] like a broken-down car, and whence comes this mechanistic emphasis in obstetrics?
Marie Hattingh, head midwife at Genesis Maternity Clinic in Johannesburg, one of South Africa's leading midwife-led natural birthing clinics, said "it is very easy for insurances to pin a case of cerebral palsy [for example] to the birth; but whether it was the birth or another cause we'll never know".
Genesis Maternity Clinic has a strict policy of only taking on low-risk patients — women who are healthy with no medical conditions and who have been checked by their gynecologists. The clinic works closely with holistic gynaecologists and obstetricians who are on a list to which they refer patients. "Backup'" obstetricians, paediatricians and anaesthetists are on standby at the time of births in case of emergencies. Under ordinary circumstances women at Genesis either have water births in their bathing units or in the clinic's birthing rooms where the mothers are free to walk, rock, kneel or squat during labour.
Keabetswe Khutsoane, a 24-year-old mother of two, gave birth to her babies at Genesis Maternity Clinic and said she felt empowered in that she started believing in herself more and in her own physical ability. "There's just something magical that happens there [at Genesis]. They make you feel so confident about the birthing process, that by the second time I was very comfortable with the idea of even giving birth at home."
Epidurals have their place for those who really need it
In the early stages of her first pregnancy, she went to see a gynaecologist but was put off by the experience. "The gynae told me that I'm very petite and that I might have complications, so she recommended I go for a C-section. But my mom gave birth [naturally] to me when she was 16; she was way skinnier than me and I was a big baby, so if she could do it then so could I.
Being pregnant and having a baby is not an illness; We're designed for that; we're built for that. Women have been birthing for centuries. We've been birthing as a sisterhood."
"When it's your first baby, you want someone boosting your confidence. [The doctor] was like, no, you can't do this. She wasn't even interested in giving me an opportunity. She was like, we'll book you on the seventh at five and I was like, no. My midwife was the complete opposite. She walked me through every step and encouraged me".
"Through my experience, I realised that so much fear is put upon first-time moms. They're constantly being told they can't do it on their own," she said.
Oxytocin and prolactin, the hormones that drive the birthing process, work best in an environment that is non-threatening, says Hattingh.
"We dim the lights, play soft music, light candles and burn essential oils to make the mom calm. It's all about a state of mind. When you have calm mom that's managing her contractions well you usually have a calm baby that cooperates in their birthing process".
"Babies birth themselves in fact. They turn their heads, pull their chins in and then their shoulders. When the baby is ready, your body is ready. We try not to intervene. We let nature take its course".
There are changes that are happening at every stage of the birthing process and, as you go through those stages, you're listening to your body. The body and the mind know how to deal with the process
Genesis Maternity Clinic encourages partner and/or family participation, unlike most hospitals.
"Your partner never leaves your side. He was there when you made the baby so obviously he should participate", said Hattingh.
The natural birth movement is as much a feminist opposition to the treatment of pregnancy as an illness when in reality is a normal, natural process.
As a feminist, I wanted to claim my pregnancy, to be in control of my own reproduction, my own sexuality and my own experience of being a woman.
U.S. medical anthropologist Dr Robbie Davis-Floyd, in her journal article The Technological Model of Birth (1987), poses the question "why is a birthing woman [treated] like a broken-down car, and whence comes this mechanistic emphasis in obstetrics?"
The central claim of the natural birth movement in opposition to the techno-medical model is that "obstetrics, unlike other medical specialities, does not deal with true pathology in the majority of cases it treats: most pregnant women are not sick", writes Davis-Floyd. The natural birth and other holistic health movements rest on the premise of "the inherent wellness of the pregnant woman versus the paradoxical insistence of obstetrics on conceptualising her as ill and on managing her body as a defective machine".
Phindi Mashinini, a private midwife practicing in Johannesburg, says "in hospitals you are treated as if you are sick; a whole lot of women have come to realise this and to question 'why am I pinned on the bed; having drips and told I need pain relief when there's nothing wrong?' In some hospitals you are told you must have the epidural when you haven't even asked for it; they bully women into telling them what they need."
I felt like I could do absolutely anything. It was very special. I felt like I had experienced divinity in a real, personal way.
Natasha Pincus, a mother of two daughters, both of whom were birthed at home with the assistance of midwives, supported Mashinini's claims.
"Being pregnant and having a baby is not an illness. As women we're designed for that, we're built for that. Everything works in the most incredible way. Women have been birthing for centuries. We've been birthing as a sisterhood."
Pincus went on to say that when one falls pregnant, "suddenly the medical world just pounces on you ... From the beginning of your pregnancy you can feel like you're swept away from yourself. You're swept away from your own experience into something that's quite structured and patriarchal in many ways.
"As a feminist, I wanted to claim my pregnancy, to be in control of my own reproduction, my own sexuality and my own experience of being a woman."
The feminist lobby against interventional hospital births for healthy women is that the procedures "cumulatively make the birthing woman's body the stage on which the drama of society's production of its new member is played out, with the obstetrician as both the director and the star", writes Davis-Floyd. "The lithomy position, in which the woman lies with her legs elevated in stirrups and her buttocks at the very edge of the delivery table, completes the process of her symbolic inversion from autonomy and privacy to dependence and complete exposure, expressing and reinforcing her powerlessness."
Mashnini says that women who go through the natural birthing process are "empowered to know how their bodies work. There are changes that are happening at every stage of the birthing process and, as you go through those stages, you're listening to your body. The body and the mind know how to deal with the process."
"Epidurals have their place for those who really need it. Women's bodies are physiologically designed to be upright and mobile in labour, partly so that when pain is felt they can move around to aid the baby through the birth canal, and reduce the pain," Jennifer Hall, senior midwifery lecturer at the University of the West of England, told The Guardian.
Pincus describes her home birthing experience as follows: "I felt like I could do absolutely anything. It was very special. I felt like I had experienced divinity in a real, personal way. I was on a natural high for weeks."
Khutsoane said her experience empowered her on so many levels. "It's painful, but it's so worth it," she said.
For mothers to be, the best thing is to be informed. There is a wealth of information out there and pregnant women should make informed decisions based on what they feel is right for them.