It is a striking quirk of this country that childbirth and breastfeeding have become more politicised than abortion. We are now at a point where you could announce to a crowded room that you had two abortions in your 20s and chances are most people would shrug. But mention that you’re having an elective caesarean, or are giving your baby formula milk from birth, and too many will look at you as if you are advocating heroin for infants.
Strangely, you never hear people insist that the only way to have root canal surgery is with “natural dentistry”, or that you simply must opt for a “natural colonoscopy” to experience things as nature intended. Nor will you hear many acknowledge how much medical advances have helped reduce maternal and infant mortality rates in Britain, which have declined sharply in the past century. Instead, the theory that so-called “natural” childbirth is the ideal has become so established that it is a genuine shock to realise that the Royal College of Midwives’ “normal birth” campaign, in which women are strongly urged to think of birth without medical intervention as the goal, has only been going for 12 years. It is even more shocking to think this could now change.
When it was reported last weekend that the RCM is ending this campaign, and will now use less value-laden terms such as “physiological” instead of “natural” birth, the reaction was predictably fiery. Many natural birth advocates argued that midwives were being attacked, and there was doomy talk about natural birth itself being at risk of extinction, with the move compared to climate change denialism. Others tweeted that this will “curtail midwives and women’s power in birth”.
Given this is essentially a linguistic change, the reaction – even within the hysterically politicised world of childbirth – was striking: after all, the RCM is not changing its view that vaginal births are preferable. “If you have a caesarean section it doesn’t mean that you’re a failure. Something has happened in your birth that means you need some help and support, and it can still be a very positive experience,” the RCM’s chief executive Prof Cathy Warwick said. Thanks for conceding that safely giving birth to a healthy baby “can still be a positive experience”, professor.
Natural birth advocates insist they are on the side of women here. But for too long there has been the distinct sense of ideology taking precedence over individual reality, even humanity, with people’s stories being dismissed if they don’t fit in with the happy natural birth narrative.
James Titcombe lost his nine-day-old son Joshua in 2008. Instead of hiding away to grieve, as many bereaved parents would have understandably done, he worked tirelessly to improve hospital safety and expose flaws in the maternity unity at the Furness general hospital. This led to the exposure of the Morecambe Bay scandal, where a group of midwives who called themselves “the musketeers” insisted on natural birth “at any cost”. No one is suggesting the musketeers are reflective of all midwives, but it was bewildering last week to see so many react defensively to a minor change in a campaign that, when misunderstood or abused, has been shown to lead to deaths.
Natural birth advocates, who claim to care deeply about babies and parents, have been indefatigable in targeting Titcombe, a bereaved father whose campaigning has helped lead to this change in birth terminology. The Nursing and Midwifery Council, which regulates midwives, spent almost £250,000 on redacting information about how they had been monitoring him for the past decade. Beverley Turner, LBC radio presenter and founder of The Happy Birth Club, claimed last weekend that it is Titcombe’s “life mission to demonise all midwives”. (Apparently the Happy Birth Club only supports parents whose births are, as the name says, happy; those who have less delightful experiences may be slandered and vilified.)
Once, the idea of women giving birth without medical intervention was seen as a feminist riposte to a patriarchal medical establishment that too often ignored women’s voices. But the irony is that the natural birth movement has itself now gone full circle, becoming doctrinal and didactic, and dismissive of women’s fears and pain. Women are having babies at an older age, and those babies are getting bigger, so medical interventions are only going to become more necessary – and, because of that, more popular. This is a good thing. Because while there may be no such thing as a normal birth, there will always be an ideal one – and that is one in which both the mother and baby end up safe and well.
