Many women feel pressure to have a ‘natural birth’. Sarah Lang talks to some mothers about how this has affected them.
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Auckland accountant Maya*, 36, was determined to have a ‘natural birth’ three years ago. For her, this meant a vaginal birth and no pain relief. “I felt pressure to do this from ante-natal classes, my midwife, and society in general.”
“But I went into hospital, with my midwife, in case anything went wrong. I’m glad I did, because my son was in a strange position.”
Maya was offered a C-section. “I said no, feeling it’d be a cop-out.” She laboured for 48 hours without pain relief. “I thought it was important to feel the pain to have the full experience. Wow, that sounds weird when I say it out loud!”
Finally, the baby was delivered vaginally.
“Afterwards, I was told the fetal heart rate had slowed and they were about to insist on a caesarean. Looking back, I can’t believe I said no to a C-section. I was so wrapped up in the idea of ‘natural birth’ being almost equivalent to kicking off being a ‘good mother’.”
The long, difficult labour meant Maya had a prolapse between her vagina and anus, and until it had healed she had to keep the stitches clean and dry, even and especially while using the toilet. “I still have bad dreams about my body being torn apart.”
Natural vs Unnatural
The term ‘natural birth’ is generally considered to refer to a vaginal delivery with no interventions, including no pain relief, and no induction of labour.
But the word ‘natural’ in itself is problematic. Something called ‘the appeal to nature’ is a logical fallacy that occurs when something is claimed to be good because it’s perceived as ‘natural’, or bad because it’s perceived as ‘unnatural’.
It’s no wonder, then, that many women feel pressure to have a ‘natural birth’, or feel guilty afterwards if it wasn’t ‘natural’.
Still, why is ‘natural birth’ so prized, even seen as heroic? Because women once had no other option? For much of history, women frequently died in labour. That was ‘natural’. It used to be ‘natural’ for women to spend their pregnancies not knowing if they or their child would survive.
It’s a modern-day privilege to have trained professionals, hospitals with freezers full of blood, and the option to have C-sections, inductions, and/or epidurals (which numb the lower part of your body).
However, there’s this persistent idea that women giving birth should experience every iota of pain. But why wouldn’t you get pain relief for the agony of trying to push out a human over a protracted period of time? Do we refuse pain relief for extremely painful procedures elsewhere on our bodies? You could actually argue that it’s natural to want to avoid pain. And you have to wonder what childbirth would look like if men had to do it.
No one is saying that women shouldn’t have choices here. There are arguments both ways for natural and assisted births, and everyone has different circumstances. But I wonder whether, if there weren’t these external social and medical pressures, would we internalise these narratives and strive so hard for ‘natural births’?
And is that striving, consciously or subconsciously (and totally understandably), to gain approval, or at least to avoid disapproval?
The Pressure To Have A ‘Natural Birth’
I did a wee social-media poll asking mothers if they’d felt any pressure to have a ‘natural birth’. Half did feel pressured, which is, well, not great.
Tara* tells me: “I feel triggered by the use of the word ‘natural’ rather than ‘vaginal’ or ‘unassisted’. I don’t think any birth is ‘unnatural’, and I feel the term ‘natural’ often makes women feel ‘less than’ – and adds to that pressure some women experience – if their births are assisted.”
Absolutely. There’s a reason why I’ve put ‘natural birth’ in quote marks throughout this story.
The problem isn’t necessarily ‘only’ that some women are disappointed if they didn’t have a vaginal, unassisted birth. It’s also that some blame themselves.
Annie*, 35, felt internal pressure to have an unmedicated vaginal birth. “But I ended up with an emergency c-section.”
She logically knew that having a c-section or medicated birth was okay. “But I knew a ‘natural birth’ was ‘best’ and I beat myself up about it when it didn’t happen, like it was my fault. I’d read lots about ‘giving them [babies] the best start’ and how that starts with pregnancy and birth. What should have been a non-issue became a massive one to me. The guilt wrecked my head for years.”
Kyla*, 39, also felt guilt about having a (medically necessary) c-section. “At ante-natal class, there was a strong push to give birth as ‘natural’ as possible, with a negative focus on the ‘cascade of medical intervention’ that starts with taking gas and ends in a c-section.” Kyla hadn’t been informed further about C-sections so, after the birth, relied on her sister for tips.
“I was a bit older than most, highly educated, with experience in advocacy and health environments, and still took away unnecessary baggage from antenatal class about C-sections,” Kyla says. She feels “a bit bitter” about that.
For each of her three children, she had a medically necessary C-section. “Not til my third did I shuck off that negative stuff about C-sections.”
In an essay on The Spinoff, writer Monica Evans recounts how, with her two children, she wanted home births but needed emergency c-sections. She worried she’d done something wrong, whether she was up to being a mother. As she writes, “when we frame particular kinds of births – vaginal, unmedicated ones – as things that people can choose and have and own, we put those who end up needing (or wanting) C-sections or other interventions in a tricky spot”.
Kim*, 36, convinced her obstetrician and midwife to agree to an elective c-section. She told other people, or let others think, that it was medically necessary, worrying she might be judged.
What Matters Most
Capsule’s Emma Clifton felt a lot of pressure to have a ‘natural birth’ from social media. “None of my friends or family were crazy about pushing ‘natural birth’; in fact, all the people I know who had had babies were very much about ‘embrace what happens on the day.” But along the way in her pregnancy, she started to see the natural-birth message take centre stage, and she doubled down. “I got all the books from the library, I did the breathing courses, I read Ina May Gaskin’s Spiritual Midwifery… I went right down the rabbit hole.”
On the day itself, it took nine attempts to successfully administer an epidural and Emma ended up with an emergency C-section after experiencing placenta abruption, a rare complication that can come with a high mortality risk for both mother and baby.
“It was made clear to me by the surgical team and the hospital midwives that my baby and I were very, very lucky to have both survived. If I’d gone with the water birth of my dreams, there’s a chance one of us probably would not have.”
Has it changed how she feels about the pressure to have a ‘natural birth’? Yes, and no. “I try to be very even-handed in how I talk about birth to people who haven’t gone through it yet, but I’d say if you’re going to read Spiritual Midwifery, also read up on emergency C-sections. Because you truly don’t know which way the wind will go on the day.”
“But if I’m honest, there’s still a part of me that still feels like I didn’t get ‘the right experience:’ the euphoric delivery, the emotional high… all those things I associated with a natural birth. Which seems crazy to admit, considering how lucky I am that we both made it.”
Pain Relief, Please!
Wellington writer Kate*, 44, resisted pressure to have a ‘natural birth’. “I wanted it to be ‘unnatural’! Ante-natal classes went on about the benefits of no interventions, but I sat there thinking ‘why wouldn’t you get pain relief while pushing a pumpkin out of your vagina?!’. Some friends seemed shocked when I said that.”
She’d considered an elective C-section, but decided on a vaginal delivery. “But I was totally ready for a C-section if anything started to go wrong. I certainly didn’t want to labour for 48 hours THEN have a C-section.”
“At the hospital, gas accomplished absolutely nothing and I basically begged for an epidural, which was followed by too many ‘are you sure?’ questions from the midwife and nurse. I was like ‘Yes, I’m SURE! This is in my birth plan! Stick that needle in my spine!’ But they dilly-dallied, and then the epidural didn’t work, and they said ‘oh it’s probably too late to bother doing another’. I said ‘no, NOW, please!’. I got it. Labour lasted another three hours, so hell yeah I needed that epidural. Why are women still being pressured to have a ‘natural birth’?”
