The Myths of Natural Childbirth

The campaign against medical intervention during delivery endangers mothers and children

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Pregnant women worry. They worry whether the baby is healthy; they worry if they’re eating right and avoiding everything that could possibly be harmful to the new life growing within. They also worry about the right way to give birth.

They shouldn’t, because there is no right way. Surprisingly, despite its nearly total cultural embrace, the claim that “natural” childbirth, meaning without any medical intervention, is best is ill-founded. The movement started with Grantly Dick-Read, a British doctor who practiced from the 1930s to the 1950s and wrote the books Natural Childbirth and Childbirth Without Fear. Dick-Read was a eugenicist concerned that white women were committing “race suicide” by limiting the size of families. He thought fear of childbirth pain was the problem and insisted that it was fear of the pain that was causing the pain. In other words, it was all in women’s heads.

Thankfully, we’ve moved beyond the fabrications of Dick-Read, but the assumed superiority of “natural” childbirth is still based on some powerful myths, such as:

Myth #1: Childbirth is inherently safe.
Childbirth is and has always been—in every time, place and culture—a leading cause of death of young women. For babies, the day of birth is the single most dangerous day of their entire 18 years of childhood.

(PHOTOS: The Perils of Childbirth in Afghanistan)

Myth #2: Labor is not inherently painful.
Natural childbirth advocates insist that labor pain (“good pain”) is different than other forms of pain. Not true. It is received by the same neurons, passed up the spinal cord, and perceived by the brain in exactly the same way as any other form of pain.

Myth #3: Epidurals are unnecessary and dangerous.
Advocates of “natural” childbirth insist the pain of labor can be managed naturally, or if not, should just be endured. That’s the naturalistic fallacy—the claim that because something is a certain way in nature, it ought to be that way all the time. But in nature, people endure all sorts of pain that we wouldn’t hesitate to treat; there’s no reason to make an exception for labor pain, which is arguably worse. Advocates also insist that epidurals are “dangerous” to both baby and mother. Not true. The risk of death from a labor epidural is less than the risk of death from a lightning strike.

Myth #4: Interventions are “bad.”
Since childbirth is inherently dangerous (see Myth #1,) interventions are simply preventive medicine. Complications are common and often preventable, so it is only logical to monitor pregnant women to prevent those complications, or treat them early rather than late.

Myth #5: Cesareans are almost always unnecessary.
On the contrary, C-sections are usually a necessary choice that prevents fatalities. In countries where the C-section rate is less than 10%, mortality rates are extraordinarily high. For example, according to a 2007 paper on international C-section rates published the journal Paediatric and Perinatal Epidemiology, Egypt with a C-section rate of 11.4% had an early neonatal mortality rate of 16/10,000 and the maternal mortality rate was 84/10,000. Conversely, the United States had a relatively high C-Section rate at 24 percent at the time, but an early neonatal mortality rate of 4/10,000, and a maternal mortality rate of 17/10,000. In 2009, the World Health Organization withdrew its recommendation of an ideal C-section rate of 10-15%, acknowledging that there was never any scientific evidence to support the claim that a rate under 15% is optimal.

The “natural” childbirth movement would have us believe that vaginal birth is inherently superior. It’s not. A birth that results in a live, healthy baby and live, healthy mother is inherently superior, and for a significant proportion of women, that birth is a cesarean section.

28 comments
RobynJackson
RobynJackson

Well, this definitely changed my mind about having a natural child birth in a birthing center.

Won't be doing it now !

AmyDClark-Smith
AmyDClark-Smith

This is not a well written article any more than the opposite extreme. Two groups attempting to demonize the other are ridiculous and doubtful not rational enough to listen to. This is an article to demonize natural child birth and claiming the natural child birth movement is all one sided. What people need is not extreme articles like this (which is very short and uninformative with no references to studies and very one sided.). People need to see neutral facts and make up their mind. I chose natural labor and hardly fit an uninformed or brainwashed person. For instance I an pro vaccine. The fact is nurse midwives have had medical training and usually work with doctors and often even in hospitals. On top of that they are usually women and have had children. To me that gives the old midwifery knowledge and medical knowledge both credence. I am talking about certified nurse midwives...not lay midwives.To think that those who support natural birth are dead against any intervention is judging a whole group by its extremist members which is ignorance. there are things that no doubt need to be questioned and looked at in the medical industry. But an emotional, poorly written article like this is not about presenting facts. it is merely a personal, one sides rant. Edited to add that the idea of natural child birth coming from eugenices is a discrediting and propoganda sounding statement.


smokeyrice
smokeyrice

I love this article! I totally agree with all of them. I believe myth #2 brings up a good point.  Since labor pains are "good" pain and natural birth advocates will strongly advise against  taking epidurals, yet I wonder why so many painkillers medications are prescribed to people for acute pain or yes, even more extreme pain. Having a baby is a good pain? I THINK NOT. But taking a painkiller for a headache, a broken bone, taking out wisdom teeth, etc, is ok but when a woman wants to take an epidural it's wrong? Who are we to determine what is good or bad pain. Let the science speak of itself.

I love knowing that I will have a c-section available for me instead of going through tremendous pain of contractions and the possibility of having my vagina tear which can definitely bring the quality of life down depending on the degree of your cut.  In every other aspect of our lives, we chose to avoid the pain, but all of a sudden MUST endure this specific pain. 




KayleighHerbertson
KayleighHerbertson

This is the *most* one sided article I've ever read. Much worse than even the "earth mothers" who demand that natural birth is best. If you want to give an opinion then it has to be measured, you should bloody well know that! Give us transparency and prove that you are *better* than the people you claim are offering nothing more than propaganda. Instead you join right in, making your entire argument invalid. You should be ashamed for the spurious and cherry picked facts that you present here. 

kstonge
kstonge

Wow! I disagree completely! It's a good thing I plan on going to medical school, so I can put a stop to this nonsense! Yes, birth is dangerous, but doctors don't need to push their "interventions" on patients. Your arguments, Amy Tuteur, would make sense if women had any real "choice" in the birthing room. Most women just go along with what the doctor tells them because they don't know any better. You fail to mention how much more money is gained by hospitals by introducing such "interventions" in the birthing room. You also fail to mention that epidurals and Pitocin can stop labor in its tracks when used unnecessarily and at the wrong time intervals. I had the unfortunate circumstance to be a victim of necessary medical intervention. I planned a water birth at the hospital. When I got there they didn't have my pool ready (and they knew I was on my way there), the water was cold, and my nurse kept offering me the epidural  repeatedly. Eventually, I gave in! I regret it with every fiber of my being. I thought I was uncomfortable before the epidural, boy was I wrong! The catheter collapsed and I had to have it done twice! Then my right leg was numb, but my labor pains were in full swing and I was unable to find comfort in walking because when your leg is numb you can't walk. I can't believe Time Magazine published this rubbish!


The university where this professor used to teach acknowledges the overuse of medical intervention. Nut job!

http://harvardmagazine.com/2012/11/labor-interrupted

jdaly83
jdaly83

Love all the self-educated, googlers on here telling a doctor, who spent a decade in school and residency, why she is evil and "so wrong".  

vanessagobes
vanessagobes

I had to scroll back to the top of this article to be sure that it's published by TIME.  This might be the worst article I've ever written and I can only assume that you yourself have never given birth naturally.  I have.  Three times.  It was a choice I made for a long list of reasons that you don't even graze in this dim, narrow-sighted article.  

AAG
AAG

Wow. As a childbirth educator, doula and mother, I am profoundly disturbed by the claims Ms. Tuteur makes. I sincerely hope no pregnant woman reads this.  

Is natural childbirth appropriate for every woman, in every situation? No. Is an epidural absolutely safe? No. Perhaps "The risk of death from a labor epidural is less than the risk of death from a lightning strike" but the risk of major complication stemming from an epidural (maternal and/or fetal cardiac deceleration, maternal fever, maternal and/or fetal allergic reaction, fetal intolerance to labour) is incredibly high (http://www.cdc.gov/nchs/data/nvsr/nvsr59/nvsr59_05.pdf). Epidurals lower blood pressure significantly and lead to a cascade of interventions.

" In countries where the C-section rate is less than 10%, mortality rates are extraordinarily high."... let's compare apples with apples here please. Comparing Third World nations where not only are csections not available, but sanitary conditions are, shall we say, "lacking" to industrialized nations where there are very little sanitary concerns is just plain ridiculous. In Tennessee, there is a birthing center called The Farm Midwifery Center. Over 40 years (197 -2010) of midwifery care (i.e. big scary natural childbirth), they have helped deliver 2844 babies and have had only lost 2 babies (of the 1048 born between 1970-1979, none since for a rate of 0.001%) . They have a 5.2% transfer rate (need to bring the labouring mom to hospital) and a 2% c-section rate. (http://www.thefarmmidwives.org/preliminary_statistics.html - notice how I give sources for my claims? Where are Dr. Tuteur's sources?) Most of the US has a 0.006% infant mortality rate and a 33% c-section rate. So let's not claim that natural childbirth kills babies or moms, ok? Some babies just don't make it, it's horrible, but it's not because they laboured naturally.

I find it appalling that someone would continue to promote such ridiculous views on labour and delivery. While I do not condone extreme homebirth movements (free birth, unattended births, etc). I feel it is beyond irresponsible to attack natural labour as primitive and unsafe. Doctors, nurses and midwives are experts in their fields and can be trusted with good maternal/fetal care. It is simply unfair to say that all medical interventions are necessary and safe. It is each future parent's responsibility to be well informed from varied, independent sources about the risks, benefits and alternatives to medical interventions. They are not all safe, and more importantly they are not all necessary.

chemery
chemery

"In 2009, the World Health Organization withdrew its recommendation of an ideal C-section rate of 10-15%, acknowledging that there was never any scientific evidence to support the claim that a rate under 15% is optimal."

This claim is just false. "Dr." Tuteur (everyone should recognize that she let her medical license lapse in her efforts to thwart homebirth and natural childbirth, by the way) is extremely fond of stating false facts without substantiation - so anyone who is reading her rants and raves should be wary. Here is proof: http://www.who.int/healthsystems/topics/financing/healthreport/30C-sectioncosts.pdf, a 2010 WHO report that states the following:

"Regarding the upper level, the best known recommended upper limit [of recommended C-section rates] is 15%, suggested by WHO in 1985. [9] Although these figures are based on theoretical estimates, two recent observational studies support that recommendation. [3,6] Both studies assessed the association between CS rates and mortality and morbidity in mothers and neonates, and found no reductions in those indicators when frequency of caesarean section was more than 15%. Moreover, one study showed that an increased rate of intervention was associated with higher mortality and morbidity in mothers and neonates. [6] Until further research gives new evidence, rates >15% may result in more harm than good."

katharine
katharine

Childbirth is not even in the top ten leading causes of death for young women. Less than 10% of births actually need medical interventions like induction, epidural or c-section.  Some statistics cite 1.5% of present births require interventions.  It's very interesting to note that this may be an increase from the maternal mortality rate before 1900 which some resources estimate as 0.7%.  Here's a very interesting record of births from 1925 - 1930 >  http://ajcn.nutrition.org/content/72/1/241s/T1.expansion.html that suggests a woman was about 100 times more likely to die if she delivered in a hospital. Women should remember that childbirth, at a basic level, is a bodily function and occurs without danger more often than not.

melindasue22
melindasue22

@Maya infant mortality is not a measure of prenatal/obstetric care. It covers death up to one year. You should be looking at perinatal mortality which we do very well in compared to other developed nations.

ChristineCanaria
ChristineCanaria

I'm sad that I can't find your site. Please get it back up and running. Anyone who legitimately cares about people cares about spreading the information and not charging people for it. 

I was born premature, so I've been told I have a higher risk of having a complicated pregnancy. I would not dream of having a baby anywhere but a hospital unless I had a death wish for me and my baby. If anyone says otherwise better have a good sample of evidence saying otherwise of they're just talking recklessly.  

MayaElisabethLanterman
MayaElisabethLanterman

hahaha america has the highest infant death rate then any other developed nation in the world. why? because of so many unnecessary interventions. and shame on you for ignoring the real risks of an epidural. 

drs in america use c-sections as an easy out when a woman is in labor. if labor has taken longer than they wanted they order a c-section. it is usually always unnecessary 

and normal, low risk childbirth is safe. again, shame on you for unnecessarily scaring new mothers. 

morganmichyle
morganmichyle

@RobynJackson Please don't let what this lady says persuade you against having a natural birth. She is a product of our culture and perpetuating fear. Honestly, I am really disappointed that TIME even lets her write in this magazine. As a Doula, I have seen both hospital and birth center births, births by both midwifes and doctors. I will ell you that watching a midwife guide a mom through labor (in hospital or birth center) is a completely different experience than watching a doctor manage and intervene in labor. If you have any questions, please email me!! My email is on my website: doulamorgan.com


Wishing you the most empowering birth experience!

AmyDClark-Smith
AmyDClark-Smith

I have looked into her blog. I wasn't impressed with her article and it seems she is an advocate for anti homebirth and lay midwives. So I can understand to some extent if she is referring to completely removing medical professionals from birth. She does not clearly state this however. She simply demonizes natural labor in the way she writes. Perhaps if she more clearly stated her views and why it would have more affect.  I cannot say that homebirth is wrong but I do not prefer it nor a hospital birth. I prefer freestanding birth centers and I do not prefer a OB or a lay midwife but Certtified Nurse Midwives. I have met some lovely OBs so don't get me wrong. I think she seems more interested in inciting debate and arguing than influecing anyone.

LisaMurakami
LisaMurakami

@KayleighHerbertson  This is a simple, straight-forward, factual article and everything in it is easily verified.  It continues to amaze me that simple science and facts often provoke such intense reactions among the "skeptical."  

LisaMurakami
LisaMurakami

@kstonge  "Most women just go along with what the doctor tells them because they don't know any better."  Wait... what?  You mean to say that people with no medical training or knowledge whatsoever don't override decisions made by their doctors?  What a crazy, crazy system.  I would love to hear back from you *after* medical school.  You remind me of my friend who was a nurse and then became a doctor... she was amazed to discover that so many times she thought doctors were making the wrong calls, she wasn't even aware of factors they were taking into account.  

kstonge
kstonge

@jdaly83 there are tons of other doctors who also spent a decade in school and residency who thinks she's wrong, so ...

LisaMurakami
LisaMurakami

@vanessagobes  It's always sad when women believe the NCB propaganda.  I bet you do have your long list of reasons.  And I bet at least 80% of them amount to lies you believed from an industry that knows its existence depends on making up reasons that women should fear their OBs, even though no such movement exists for cardiologists, primary care physicians, dermatologists, opthamologists, or any other MD specialty.

jdaly83
jdaly83

@vanessagobes As someone that has only given birth naturally, who are you to evaluate a "non-natural" birth?

LisaMurakami
LisaMurakami

@AAG  Thanks for starting this off with your lack of credentials.  You might as well start this off by saying "As someone whose 'profession' makes it a point to disbelieve science whenever possible... I disbelieve this science."  Carry on!  

jdaly83
jdaly83

@AAG Your "source" for your claim doesn't support your claim.  Perhaps you should re-read the discussion section before making claims.  What it does is outline several problems with making the claim you are trying to make throughout your entire post.

LisaMurakami
LisaMurakami

@chemery  Here's a new fact for you:  Doctorate designations like MD and JD are granted by the educational institution and not dependent on licensure in any state.


The rate of c-section in the US is high for a number of reasons.  First, we hardly ever do operative vaginal births anymore because many see c-sections as less risky.  These types of deliveries (forceps and vacuum) remain common in other countries.  Second, we are fat.  This alone increases all sorts of risk factors for c-sections.  For example, studies are unanimous that having a macrosomic baby (9 lbs 13 oz+) doubles your chance of a c-section; gestational diabetes and even pre-GD give us high rates of macrosomia.  Here are some other reasons:


http://whatifsandfears.blogspot.com/2012/07/the-c-section-rate-in-us.html

katharine
katharine

Sorry, 10 times not 100 times :)

LisaMurakami
LisaMurakami

@MayaElisabethLanterman  Guess what Maya?  You've been misled.  It's true that infant mortality in the US is high.  Do you know what infant mortality is?  It's the rate of death of any baby born alive who dies before 12 months of age.


Do you know what perinatal mortality is?  It's the rate of babies who die during labor (intrapartum deaths) plus the rate of infants who are born alive but die within a week (neonatal deaths).  Guess who has the best overall rate of that?  We do.  You can check out the WHO statistics if you don't believe our own scientific journals.  


Now... shame on whoever misled you.  Clearly it's either someone who has no clue what they're talking about - at best - and shouldn't be involved in discussions about obstetrics, or it's someone purposefully misleading women so that they can better sell a product or class.

AmyDClark-Smith
AmyDClark-Smith

@LisaMurakami @kstonge  I think this article mixes up natural labor itself with the lay midwives and homebirth movement. Please remember many midwives are certified nurses first and work with OBs and regular doctors and in hospitals and birthcenters. Some do home births also. It i not natural labor that is the enemy. It is those who think all medical intervention is bad and uneccessary or all homebirth is bad. Sometimes it is necessary to have medical intervention. I was certainly not impressed with this woman's writing and it certainly isn't going to influence anyone. I visited her blog to see what she is all about. We don't need to demonize either side. Both sides need to work together. Natural labor is not as extremely dangerous as this woman makes it sounds but the hospitals and doctors get the bad cases because they have more knowledge for when things go wrong. We need them in the loop and we need midwives who communicate and rely on them. I think midwives should have medical training and not just midwife training. I think before people start throwing stones over fences that devide them they need a more balanced and less emotional attitude.


AmyDClark-Smith
AmyDClark-Smith

@kstonge @jdaly83  Yes and many midwives were practicing nurses first and work with OBs and doctors who support them. So yes there are doctors who support natural birth. The article is a polarizing, not clear on its intent, and not likely to influence anyone to change their mind.




LisaMurakami
LisaMurakami

@kstonge @jdaly83  Not true.  I know many doctors in the Harvard system and none would disagree with anything in the above article.