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Why We Need To Quit Using The Term “Natural Birth”

Written by Katie Hintz-Zambrano

Photography by Kate Danson

While the term “natural birth” seems to be particularly in vogue, beloved L.A.-based doula, Nuture author, and LOOM co-founder Erica Chidi Cohen thinks we should scrap the word “natural” all together when speaking about the birthing process. Below, she tells us why, starting with the history of the term and its patriarchal roots, and ending with suggestions on a new, modern, and fact-based vernacular.

The term “natural birth” is thrown around a lot today. When exactly did it start to pick up steam?
“‘Natural Birth’ became a prominent term in the 1960s, when—particularly in the United States—there was a pushback against the medicalization and paternalization of the birth process in the hospital setting. There was a feeling of wanting to reclaim the physiological experience of birth. The word ‘natural’ was used to help women reclaim their bodies and to give women more agency and belief in their bodies to do the work. However, few people are aware that the advent of the concept or term ‘natural childbirth’ was created by a man, Grantly Dick-Read. As Dr. Amy Tuteur, MD, explores in her book, Push Back: Guilt in the Age of Natural Parenting, Dick-Read believed that childbirth pain was a direct result of modern women’s struggles to obtain economic and political rights. In his ideology, educated women experienced pain where more ‘natural’ and ‘primitive’ cultures experienced painless childbirth. Clearly, ideology does not have a scientific basis. The term ‘natural birth’ continues to be problematic if it is used judgmentally to shame women about their birth choices. In 2017, I think one of the most feminist decisions you can make is to decide how you want to feel in labor.”

What’s so problematic about using the word “natural birth”?
“The word ‘natural’ is not a scientific term, it’s a nebulous emotional descriptor that doesn’t provide true clarity of the goal or outcome. Also, aren’t we as humans inherently natural? Currently, the term ‘natural birth’ creates more division than cohesion between women, which is what I think makes it problematic. ‘Natural’ is not an explanatory term and it doesn’t give women agency to optimize their birthing experience, especially for the predominant number of births taking place in hospitals. You can advocate for yourself better by using the real terms. When I hear a client say they would like to have a ‘natural birth’ or ‘I’m trying to birth as naturally as possible,’ one of the first things I’ll say to them is, ‘However you’re going to move through this process is going to be natural to you.’ No matter what a birth ends up looking like, there’s nothing unnatural about it, because it’s natural for women to be pregnant and have a baby—what you’re actually aspiring for is an ‘unmedicated physiological birth,’ which is something we can work together to help you prepare for.”

You’re a doula, and doulas are often thought to push the idea of a “natural birth,” meaning an “unmedicated” birth. That’s not necessarily the case for you.
“It’s not the case for me and many other modern doulas out there. Our job is to meet our clients where they are, whether they are having a unmedicated birth at home or a medicated birth at the hospital. As I doula, I know there are a myriad of empirical benefits to unmedicated physiological birth, and if I can help my client achieve that, I’m thrilled. However in this country around 60% of women are choosing to use medication in their birth, therefore it’s important to meet that need and provide doula support without judgement or expectation. I’m more interested in educating and empowering people on their anatomy and physiology, building their confidence in themselves and their body and intuition. For me, it’s about moving into more advocate-based, authoritative language and helping women learn about the interventions that may be offered to them, so that they can make informed decisions and work closely with their healthcare provider to optimize these interventions if they have to be used. That’s where women need to be.”

How can we all start to move away from the word “natural”?
“People will say you can’t call a birth ‘natural’ when interventions are made, but the truth is that language is elastic. We always have the opportunity to create new connotations and connections with the language we use. And within pregnancy and in birth, it’s a prime time to create as many positive connotations as possible. Instead of ‘natural birth,’ let’s try using the term ‘unmedicated birth,’ if you’re using an epidural, you could refer to your birth as a ‘medicated birth,’ and finally, instead of a ‘c-section,’ ‘cesarean birth.’ It’s a more compassionate and clarifying framework that creates more space for community and discussion, which is something that every new mother needs and deserves.”

Read more of Erica’s thoroughly modern take on pregnancy and parenthood in her book Nurture: A Modern Guide to Pregnancy, Birth, Early Motherhood – and Trusting Yourself and Your Body.

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