Natural childbirth advocates adore facile arguments.
Consider radical doula Elisa Alpert’s screed in New York Magazine’s The Cut.
Alpert asks:
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]The natural childbirth industry’s commitment to bodily autonomy for women is a mile wide and an inch deep.[/pullquote]
Why is the delivery room the one place where a woman doesn’t have control over what happens to her body?
And:
But obstetric violence is the last culturally acceptable form of violence against women.
Ooooh, that sounds really edgy. She’s speaking truth to power! Except she’s not.
These glib claims sound deep and meaningful as long as you don’t stop to think about them. But when you unpack the natural childbirth industry’s purported commitment to bodily autonomy for women, you find that it’s a mile wide and an inch deep.
The reality is that the natural childbirth industry is committed to bodily autonomy ONLY in regards to their goods, services and recommendations. If they were truly committed to bodily autonomy, they’d be counseling women to have epidurals and maternal request C-sections, perhaps the ultimate expression of a woman’s right to control her own body. The reality is, though, that if they can’t provide it or profit from it, natural childbirth advocates don’t support it, bodily autonomy be damned.
The principle of bodily autonomy is very simple: mentally competent adults have the right to control their own bodies.
So if natural childbirth advocates believe that pregnant women have the right to bodily autonomy, that would mean they have the right to choose what happens to them during childbirth. But that’s NOT what natural childbirth advocates mean. Their claim is a stunted, truncated version of bodily autonomy.
When natural childbirth advocates invoke bodily autonomy, they mean “the right to refuse medically recommended interventions in childbirth, and substitute them with the products and services of the natural childbirth industry.” The natural childbirth industry can’t provide or profit from either epidurals or C-sections so they demonize and oppose them.
How is the choice of an epidural an expression of bodily autonomy? Because pain robs women of control.
Dr JaneMaree Maher of the Centre for Women’s Studies & Gender Research at Monash University in Australia, offers a way of conceptualizing pain and empowerment, one that resonates with the majority of women. In her article The painful truth about childbirth: contemporary discourses of Caesareans, risk and the realities of pain , she observes:
… Pain will potentially push birthing women into a non-rational space where we become other; ‘screaming, yelling, self-centered and demanding drugs’. The fear being articulated is two-fold; that birth will hurt a lot and that birth will somehow undo us as subjects. I consider this fear of pain and loss of subjectivity are vitally important factors in the discussions about risks, choices and decisions that subtend … reproductive debates, but they are little acknowledged. This is due, in part, to our inability to understand and talk about pain.
As she explains:
… [W]hen we are in pain, we are not selves who can approximate rationality and control; we are other and untidy and fragmented. When women give birth, they are physically distant from the sense of control over the body that Western discourses of selfhood make central …
Natural childbirth advocates are well aware that childbirth itself is uncontrollable. That’s why they emphasize giving in to, and reveling in the process. But most women have no interest in letting a bodily process control their minds and choices; they’d prefer to use their minds to control bodily processes.
Most women have no interest in letting menstrual pain control them for several days each month so they choose medications that can diminish menstrual pain and decrease heavy menstrual bleeding.
Similarly, most women have no interest in letting childbirth pain control them for dozens of hours. They choose epidurals to relieve that pain so they can be awake, aware and IN CONTROL as their babies are born.
Vaginal birth is even rougher on women’s bodies than childbirth pain. It can lead to everything from decreased sexual satisfaction to disabling urinary and fecal incontinence. Some women wish to take every possible precaution against unfortunate outcomes by choosing elective C-section instead. We can argue about the risks and benefits, but it is thoroughly disingenuous to argue as natural childbirth advocates do, that women shouldn’t be allowed to opt for C-sections by choice.
Arguments from bodily autonomy should be agnostic as to what women actually do with their bodies. If natural childbirth advocates truly respected women’s bodily autonomy, they’d treat all possible childbirth choices — epidural vs. unmedicated birth, C-section vs. vaginal birth — as equal and equally worthy of respect, but they don’t.
In my view, it is the natural childbirth industry who is perpetuating obstetric violence by insisting that women must be forced or bullied into enduring the violence of childbirth pain and vaginal delivery. They bully women because the natural childbirth industry believes it knows better than women themselves what is good for women — purchasing the products and services of the natural childbirth industry.
