The dangerous obsession with ‘natural’ childbirth

Imagine going into hospital for a procedure you expect to be relatively painless. You are led to believe you will be given a strong painkiller to get you through it. Only once you’ve taken the painkiller, you are still in excruciating agony. Worse still, no one believes you. This is the terrifying story told by The Retrievals, a new podcast from the makers of the Serial true-crime series.

In 2020, a medical scandal unfolded at Yale Fertility Centre. The Retrievals podcast explores the incident, in which a number of female patients failed to receive proper pain relief. The fentanyl they were supposed to get during their fertility treatment was secretly replaced with saline. It would later turn out that a nurse had been stealing the opiate to feed her addiction.

There is more to the story than one rogue nurse, however. The Retrievals takes a deeper look at why the women were dismissed when they claimed to be experiencing excruciating pain. Many of them said they felt totally ignored and were even treated as hysterical. A few complained afterwards about their treatment, but the theft was only discovered when an anaesthetist noticed that one of the fentanyl vials had been tampered with. Why were these women’s concerns not taken seriously when they first complained? Why were they expected to just deal with the unbearable pain? Sadly, this is not an uncommon theme in women’s healthcare.

The Retrievals reminded me of my own experience during labour and delivery. I had to push hard for an epidural when I wanted one during the birth of my second son. It felt as if the medical staff saw me as histrionic and annoying, just for demanding the pain relief I needed. And I know I’m not alone.

Earlier this month, Conservative MP Theodora Clarke was interviewed in The Times about her recent experience of poor postpartum care. Clarke talks of indifferent and callous nurses who hadn’t ‘bothered to read her notes’. Clarke says she was ‘hooked up to a catheter, a drip and… paralysed from the waist down’. When Clarke’s newborn baby began to cry and she could not pick her up, Clarke pressed the call button for help. Instead, she was told by a nurse: ‘Not my baby, not my problem.’

I had a similar experience after receiving a spinal tap. I was paralysed from the waist down. When I called for help with my newborn son, a nurse told me off for bothering her. I had to be very insistent and assertive to get what I needed, even though I was immobile, exhausted and disoriented from giving birth.

So what’s going on here? Why are so many healthcare workers so reluctant to provide pain relief? And why are so many nurses seemingly unwilling to help women in need?

One culprit may be the rise of the natural-birth movement, which is surprisingly influential in Western maternity care. In the 1970s, the natural-birth movement stressed the need to ‘demedicalise’ pregnancy. Its aim was to push back against a paternalistic medical establishment, which failed to see women as individuals who are capable of making choices about their own bodies. Paradoxically, despite its seemingly feminist goals, the natural-birth movement pushed deeply traditional ideas about labour. It started to glorify unmedicated childbirth as a more ‘noble’ option for women. It encouraged mothers to go without pain relief for as long as they can stand it. This was supposed to turn giving birth into a more empowering experience.

It is understandable for women to want more autonomy in their healthcare. However, it is highly irrational to reject the advances in medical science that have made labour dramatically safer and less painful.

As a consequence of this push for more ‘natural’ births, much of the support that existed for new mothers disappeared as well. The nurseries where newborns were once taken after birth so their mothers could rest are now long gone. Instead, we are told there needs to be almost constant skin-to-skin contact between mother and baby, and all feeding should be done via breastfeeding. On top of all that, women are no longer encouraged to stay in hospital for extended postpartum care.

The natural-birth movement was an attempt to give women more control over their experiences of childbirth – that in itself is not without merit. Yet it failed to reckon with the fact that there are times in a woman’s life when she really is vulnerable and in need of help. We need healthcare systems that can respond adequately to those needs. Instead, women are sometimes being left to fend for themselves and are shamed for showing ‘neediness’.

A modern healthcare system should be able to combine highly advanced medicine with lots of social support. But we are falling far short of that when it comes to maternity care. That has to change.

Candice Holdsworth is a writer. Visit her website here.