If you or someone you know has given birth, you know the phrase “natural birth.” People will often ask, “did you have a natural birth?” and not only is it incredibly invasive, it makes people feel bad. Giving birth is a personal experience, and you shouldn’t have to justify or explain your choices. Everyone is different, and you have to do what’s best for you.
Because of the pervasiveness of the term, The New York Times parenting section made the conscious decision to stop using it in 2019. As they explain, “we realized that the term ‘natural birth’ could shame women whose deliveries were deemed not ‘natural’ — whether they had C-sections, needed to be induced or simply desired pain relief.” No one should ever feel shame over their birthing choices. And that’s why the phrase needs to not exist anymore.
The main reason using the term natural birth is so damn difficult is because, what does it actually mean? That’s the tricky part, because it means different things to different people. For most people, it likely means a vaginal birth without any sort of medication administered. “Modern birth practices and the rise in midwifery tap back into our ancestral roots and return to unmedicated birth practices which are deemed natural,” reproductive psychotherapist, certified lactation consultant, birth doula, and founder and CEO of Oshun Family Center, Saleemah J. McNeil, told Parents. According to McNeil, insurance companies are also to blame for the terminology. “The cost of a ‘natural,’ unmedicated birth is significantly cheaper than a birth that utilizes medical interventions,” she explained.
Natural birth can also be an umbrella term for eschewing other medical interventions during birth. For those who take that approach, they may consider not having things like cervical checks, using eye ointment on their baby, giving them a vitamin K shot and deciding when to cut the cord part of a natural birth. Because there are so many layers to it (many of which people likely aren’t considering) it’s better to just not use it anymore.
Birth is an incredibly intimate and personal experience. And as anyone who has given birth knows, it’s full of decisions you have to make, only to have to change them at the last minute. You can go into delivery with the best of intentions, only to have the rug pulled out from under you. By using the term natural birth, you’re casting judgment on those who have made a conscious decision to honor their choices during birth. You are also unknowingly causing additional shame for the people who had things not go to plan.
But where did the phrase “natural birth” even come from? The origin of the term natural birth is quite interesting. British doctor Grantly Dick-Reed first coined the term way back in 1933. He (of course it’s a man) wrote a book, “Natural Childbirth,” where he theorized that the birth rate was declining for the upper and middle class because “civilized” women were afraid of the pain of childbirth. His goal was to make them relax (he believed their fears caused additional tension in the body) so they could help reverse “the decline in middle class fertility.” Dick-Reed believed that childbirth should be unmedicated — with preparation and deep breathing, women could easily handle the pain. You know, because men know so much about what childbirth feels like.
By time as he brought his thoughts on “natural childbirth” to the United States in the 1940s, it wasn’t a new concept. Except here they were calling it less shamey terms like “pain-free childbirth” and “prepared childbirth.” Granted, it was still the same ideology, that an unmedicated birth where the mother was relaxed was the most optimal way to deliver. And while the movement gained traction throughout the ‘50s and ‘60s, it really took off in the 1970s. That’s when books like Ina May Gaskin’s “Spiritual Midwifery” book became a bestseller. In it, Gaskin describes the joys of having an unmedicated home birth.
Doctors in the mid 20th century were total assholes and had a lot of questionable medical practices. Dr. Randi Hutter Epstein, author of “Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank” and writer-in-residence at the Yale School of Medicine, told the NYT that “doctors gave commands and handed out drugs.” The fervent push of the natural birth movement in the ‘70s was a direct result of that, and aimed to empower women and give them more control over their deliveries. She explained that some doctors believed “bloat” caused pre-eclampsia, so they gave women diet pills containing amphetamines so they wouldn’t gain more than 15 pounds! What the actual fuck?
But here’s the thing. A phrase that was once used to take back power is now being used to make others feel bad for their personal choices. And that’s why we need to change our language around the phrase natural birth. It isn’t the ’70s where doctors were pumping pregnant women full of diet pills anymore. People who are pregnant now have autonomy over themselves and their bodies during delivery. And whether we mean it or not, the language we use surrounding having children can be exclusionary. Not only does it make those who have medications or C-sections feel less than, but what about those who use a surrogate or adopt?
Language matters. And whether we realize it or not, consciously choosing to shift your language really does make a difference. When you use inclusive language, you’re telling someone that they, and their experiences, matter. And that is incredibly important, especially when it comes to birth. Motherhood is full of shame — it sucks, but it’s true. Commenting on someone’s delivery process is awful because you don’t know what choices they made to get there. Frankly, we don’t need anyone (family and medical professionals included) that should make us feel bad about how we give birth. But now hopefully this will start a trend of reframing how we talk about birth and delivery.
In their coverage of birth going forward, The New York Times is pivoting toward the phrase “good birth” instead of natural birth. Dr. Anne Drapkin Lyerly is an obstetrician, the author of “A Good Birth: Finding the Positive and the Profound in Your Childbirth Experience.” and a professor at University of North Carolina School of Medicine. She did her research for “Good Birth” while working at Duke University where she and her team interviewed 101 women from diverse ethnic and socioeconomic groups. Additionally, all of the women had varied birthing experiences. In her work, Dr. Lyerly found that there are five things that qualify a “good birth,” regardless of the way you give birth.
- Agency: the ability to make their own choices, even if their plan changes.
- Personal security: feeling safe during birth.
- Connectedness: to their medical care providers, their family and of course, their baby
- Respect: the acknowledgement that birth is a transformative experience
- Knowledge: understanding not only their bodies, but that birth is a live thing that is sometimes out of their control.
By using this kind of framing, you’re really empowering folks when it comes to how they look at birth. And while some people may balk at using the word “good” in terms of birth, it actually makes a lot of sense in the content of this framing. A birthing experience where you don’t have autonomy or feel heard and respected, isn’t a good birth experience. Feeling respected by your medical team and those supporting you should be the bare minimum when it comes to giving birth. It’s not about natural birth, it’s about having a positive birthing experience. Whether that means vaginal or C-section, medicated or not, that’s not the part to focus on. It’s whether or not you feel respected and heard — which should be the most natural thing in the world.