Where did the natural childbirth and lactivism industries go so wrong?
Why do I receive emails and Facebook messages from desperate women nearly every day detailing their guilt, self-abnegation and torment over “failing” to give birth vaginally or to breastfeed?
Why, when I talk about my forthcoming book with friends and acquaintances, do women years removed from childbearing burst into tears about their struggles?
Yes, it’s true that the philosophies of both natural childbirth and lactivism were created as ways to convince women to remain in the home instead of seeking legal and economic emancipation, and we should never forget that when considering their harmful effects on women. However, their retrograde beginnings were shed (and hidden) when natural childbirth and lactivism reached the mainstream, and the original impetus from both advocates and adherents was strong and resonated deeply. The original goal of the philosophies of natural childbirth and lactivism was to reclaim women’s agency from doctors. Instead of doctors deciding that women should be asleep during birth, deprived of emotional support from partners and subject to unnecessary procedures like shaving and enemas, women insisted that it was their right to decide to be conscious, to be accompanied by partners and to accept or reject procedures based on informed consent. Instead of being convinced to forgo breastfeeding and forced to forgo it due to lack of breastfeeding support, women insisted that it was their right to receive encouragement and support in nourishing their infants in the way they thought best.
In other words, from the 1950’s to the 1970’s, the philosophies of natural childbirth and lactivism were about reclaiming women’s agency from doctors. [pullquote align=”right” color=”#cc33cc”]The name “Baby Friendly Hospital Initiative” is a deliberate slap in the face to women.[/pullquote]
Where did the natural childbirth and lactivism industries go wrong?
Both natural childbirth and lactivism went off the rails when they insisted that the only way women could reclaim their agency from doctors was to hand over that agency to midwives and lactation consultants.
Here’s what childbirth and lactivism would look like if women were in charge of the decision making:
All possible choices would be represented because women have a broad spectrum of needs and desires.
Birth plans would just as readily include maternal request C-sections as unmedicated vaginal births.
Pain relief would have a prominent place in birth plans since most women find they need pain relief.
Women would choose how to feed their infants based on what worked for them, and they would NEVER be shamed for bottlefeeding.
Free formula gifts would be available to those who want them.
In other words, every safe childbirth or feeding decision made by mothers would be respected by professionals and by other mothers, just in the same way that we owe respect to women for whatever decisions they make about who or if to marry, whether or not to have children, and whether or not to work outside the home if they have children.
Decision making would be bottom up: women would make the decisions and inform providers of their choices.
Instead, in the process of women reclaiming their agency from doctors, midwives and lactation consultants swooped in to steal if from them. Within natural childbirth and lactivism, decision making is top down. Midwives, doulas and childbirth educators decide what a “good” or “normal” birth should look like and they force that decision down women’s throats, complete with hectoring and shaming dressed up with the twin lies of being “better for baby” and “evidence based.” Lactation consultants decide how babies should be fed and force that decision down women’s throats, complete with hectoring and shaming dressed up with the twin lies of being “better for baby” and evidence based.”
The Baby Friendly Hospital Initiative (BFHI) is the paradigmatic example of how natural childbirth and lactivism reflect top down decision making and deprive women of their own agency.
The name “Baby Friendly Hospital Initiative” is a deliberate slap in the face to women.
It reflects the professional lactivists’ beliefs that they know better than women what is best for them and their babies, and, it is the apogee of mother shaming.
I am appalled that any hospital allows such an organization anywhere near emotionally fragile new mothers. Political consultants say that when you frame an issue, you own it. The medical community has regrettably allowed an organization of zealots to frame the issue of breastfeeding as “baby friendly” when it may be anything but baby friendly, to explicitly ignore the needs of mothers, and to ratify shaming as an acceptable tactic for manipulating women. Any women who does not breastfeed is branded as not “friendly to” her baby. The medical community has empowered a group of zealots with top down decision making authority over infant feeding. These zealots explicitly deprive women of agency. The assumptions behind the BFHI are that women cannot be trusted to make decisions for their infants, they must be hectored into breastfeeding, any alternative must be made as inconvenient as possible, and that bottlefeeding or combo feeding mothers can and should be deprived of valuable infant formula gifts.
Lactivists rationalize their abysmal and disrespectful treatment of new mothers as “better” for babies … just as midwives justify their insistence on unmedicated birth as a standard by claiming that is is “better” for babies and mothers … just as doctors justified shaving and enemas as “better.”
In every case, women are deprived of agency, purportedly for their own benefit.
Women should understand that standards for birth or infant feeding are efforts at top down decision making that ignore the individual wants and needs of women and babies. Unmedicated vaginal birth is no more “better for babies and mothers” than shaves or enemas. Both reflect the preferences of providers, not the needs of mothers or babies. And the Baby Friendly Hospital Initiative is the most egregious example of depriving women of agency. Its name should be changed immediately to expunge the stench of mother shaming and it’s goals should be modified to reflect the critical role of mothers in determining what is best for them and their babies.
Women can’t reclaim their agency from doctors by ceding it to midwives and lactation consultants. The guilt, self-abnegation and torment of so many mothers reflects that fundamental reality.
