Why We Need to Stop Talking About Giving Birth 'Naturally'
On the laundry list of inappropriate questions people leap to ask you as soon as they find out you're expecting is usually whether or not you plan on having a "natural birth." Aside from the fact that such personal and intimate information about how a pregnant person chooses to labor and deliver a baby is absolutely no one's business, the question itself is complicated. What does "natural birth" even mean? Is there actually a way to give birth "unnaturally?" Plus, even if you think you understand the question, you might still be undecided on the answer. In fact, most spend the bulk of their pregnancy still learning their options and deciding on their preferred birth plan (if they even choose to make one). At Parents, the editorial team is making the call to move away from the phrase "natural birth" to instead focus on what pregnant people actually experience during labor and delivery. Here's why.
What is a "Natural Birth," Anyway?
Historically, a "natural birth" has been used to describe a birth that occurs vaginally without the use of pain medications (like narcotics or an epidural) or medical intervention of any kind. There's been a shift in the last few years, however, in the language around "natural" childbirth. For instance, some people may say that they are hoping for a "natural birth," but confuse the description to mean having a vaginal delivery versus a cesarean section. These are two wildly different birth experiences, but who is to say that one is more natural than the other? And then there's the concept of medicated delivery versus unmedicated delivery. If you deliver vaginally, but use medication, is your birth deemed "unnatural?" After all, isn't the act of giving birth in and of itself the most natural thing we experience?
The History of the "Natural Birth" Talk
It's not to say that the terminology is being misused today—but rather that it's been misused for decades. "After the erasure of Granny Midwives in the 1900s, birth became increasingly medicalized and childbirth was viewed with a new lens," says Saleemah J. McNeil, reproductive psychotherapist, certified lactation consultant, birth doula, and founder and CEO of Oshun Family Center. "Modern birth practices and the rise in midwifery tap back into our ancestral roots and return to unmedicated birth practices which are deemed natural." As a result of these changes, there's been a new emphasis on giving birth without medication and it's falling under the umbrella term of being "natural."
Insurance companies have also fueled the fire when it comes to the confusion, with their longtime use of the term "natural birth" to describe a vaginal delivery. Their methodology? It all comes down to dollars and cents as a way to categorize labor and delivery costs. "The cost of a 'natural,' unmedicated birth is significantly cheaper than a birth that utilizes medical interventions," explains McNeil. "It is, however, an inaccurate term because the information provided to the insurance company is to classify the services rendered by the birthing person such as vaginal vs. C-section, medication vs. unmedicated, but not natural vs. unnatural birth." In other words, their use of "natural birth" has nothing to do with whether or not what goes down in a given delivery room is "natural"—it's all about the extent of medical intervention and resources.
Why Saying "Natural Birth" Doesn't Cut It
The main issue with talking about giving birth "naturally," according to experts, is that it is not inclusive of all birth options and birth circumstances, and doesn't always fit the description of a birth that someone has experienced. Instead of the conversation surrounding the concept of "natural," it should really be surrounding vaginal versus C-section and medicated versus unmedicated.
"A vaginal delivery is one where the baby comes through the vagina when being born whereas a Cesarean delivery is when the baby comes through an incision made in the uterus," explains Sherry Ross, M.D., OB-GYN and women's health expert at Providence Saint John's Health Center in Santa Monica, California. "A medicated delivery involves giving laboring women drugs, such as an epidural, intravenous medication, or laughing gas [nitrous oxide], to relieve pain and/or Pitocin to help improve the strength and frequency of uterine contractions."
Vaginal and unmedicated are the basics of what people consider a "natural birth," but then there are a few more layers of "crunchy" that come up in the conversation. These can include conversations around refusing cervical checks, when to cut the cord, whether or not to allow your baby to have a vitamin K shot or eye ointment, and the list goes on. If someone says they want to have a "natural birth" they are not always including these additional layers to the conversation, which makes the term "natural" even less relevant to what a real birth experience is like.
Another issue that arises amidst the discussion of "natural" versus "unnatural," is that it lends others to believe that one is better than the other, explains Jill Hechtman M.D., OB-GYN, medical director at Tampa Obstetrics and chairman of the department of OB-GYN at Brandon Regional Hospital. "At the end of the day, being pregnant is natural and having a safe delivery that provides a healthy mother and baby is what is important," she says.
How to Have the Right Labor and Delivery Experience For You
If a person wants to experience delivery without any medical intervention, it should be a matter of personal preference. In the United States, pregnant people are often able to work with their chosen prenatal care provider to decide between delivering at a hospital, a birth center, or at home based on their health and birth plan.
What you can do to prepare for your birth plan: Build a wide support system for yourself that includes friends and family as well as a birth team of providers you trust. "Even if your birth does not go as planned, building a trusting relationship with your birth team will help circumvent those adverse 4th-trimester outcomes," says McNeil.