I’ve often written that the natural childbirth industry (midwives, doulas, childbirth educators, businesses like Lamaze, and lobbying organizations like the Childbirth Connection) is obsessed with process, in contrast to modern obstetrics, which focuses on outcomes.
Simply put, how your baby is born is more important to the natural childbirth industry than whether your baby is born healthy and whether you are healthy.
There are several reasons for this:
- The natural childbirth industry makes money from a specific mode of childbirth (unmedicated vaginal birth), so profits depend completely on promoting that mode as superior.
- The natural childbirth industry is profoundly ahistorical and lacks basic knowledge of medicine. Childbirth is and has always been, in every time, place and culture, a leading cause of death of young women and the leading cause of death of babies. Most members of the natural childbirth industry appear to be utterly unaware of this basic reality. They labor under the misapprehension that birth is inherently safe and always has been.
- The natural childbirth industry bears no responsibility for birth outcomes. If you refuse interventions because your doula told you to do so, and your baby dies as a result, the doula is never held accountable, legally or financially, for the tragic outcome.
These reasons explain the most critical difference between modern obstetrics and the natural childbirth industry: Modern obstetrics is always seeking to lower the maternal and perinatal mortality rates, and the natural childbirth industry thinks the current level of maternal and neonatal mortality is low enough.
[pullquote align=”right” color=”#026568″]Obstetricians seek to lower the maternal and perinatal mortality rates; the natural childbirth industry thinks they’re low enough.[/pullquote]
It’s not that the natural childbirth industry is unaware of contemporary maternal and perinatal mortality rates. They follow them assiduously and are quick to exploit the tragedies of maternal and perinatal mortality (particularly among women of color who suffer disproportionately) in order to promote natural childbirth. The “reasoning” seems to go something like this: if modern obstetrics can’t guarantee the lowest possible mortality rates then you might as well pay for the goods and services of the natural childbirth industry who couldn’t care less about ensuring the lowest possible mortality rates.
Don’t believe me? Ask yourself this: What has the natural childbirth industry done to lower mortality rates?
Absolutely, positively nothing!
They spend a lot of time prattling about maternal satisfaction and the birth experience, but I’m not aware of any action they have undertaken in the past 50 years to improve outcomes. They imply, and possibly believe (despite a complete lack of scientific evidence) that unmedicated vaginal birth is somehow safer than birth with interventions, and that’s good enough. They don’t look at mortality rates among their customers; they don’t care about mortality rates among consumers of their goods and services; and they certainly aren’t going to let a little thing like dead babies interfere with making money from their philosophy.
Where is the natural childbirth industry research funding for efforts to lower mortality rates?
There isn’t any.
Where are the techniques created and promoted by the natural childbirth to save lives?
There aren’t any.
Where are the drills practicing life saving maneuvers specifically designed for the service providers of the natural childbirth industry?
They don’t exist.
Where are the goals for lowering maternal and perinatal mortality?
Surely, you are joking. As far as the natural childbirth industry is concerned profits are derived from healthy women; women who have complications can be dumped on obstetricians and forgotten.
Don’t get me wrong. There is plenty of room for improvement in modern obstetrics, BUT (and this is the critical point) obstetricians are working EVERY day and in EVERY way to do better than they’ve ever done in the past, both in terms of the provision of services and perinatal and maternal outcomes.
The natural childbirth industry is doing NOTHING to improve perinatal and maternal outcomes because they don’t care about outcomes. They profit from process and that’s all they care about.
The natural childbirth industry thinks current levels of mortality are good enough and that is a scathing indictment of their business model.
They want your money. They want your choices about birth to mirror their own choices back to them. They want you to hire them and buy their goods and services.
But if your baby dies, or you die, they couldn’t care less. They won’t lift a finger or forgo a penny of profit to prevent it.
