A Sonicaid FMBR foetal monitor in 1978. (Photo by Hulton Archive/Getty Images)

Why demonise medical interventions for pregnancy?

We shouldn’t let nature get in the way of nurture

Artillery Row

Mother nature can be cruel — just ask a pregnant woman. From heaving over a toilet bowl for months on end to watching your toes disappear beneath an ever-swelling belly, the supposedly wonderful, natural process of baby-making can sometimes cause an unnatural amount of pain and discomfort.

The fetishisation of natural births goes beyond hospital care

Most women with wanted pregnancies (even women with serious problems like hyperemesis gravidarum or preeclampsia) will agree that nine months of difficulty is a small price to pay for a lifetime of joy with your child. But rather than utilising the technological advances of modern science to help thwart some of nature’s nastier symptoms, we seem to have developed an obsession with “natural” pregnancy, and non-interventionist childbirth. Pregnancy manuals now include advice for women to meditate to combat morning sickness, and doulas (not more doctors) are encouraged by health professionals to combat “life-threatening complications from childbirth”.

For women like me, letting mother nature do her thing was out of the question. After spending a fortune in Boots on LH tests, medieval-looking fertility suction cups and apps telling you when to have sex, it was clear that pregnancy was not going to take place naturally.

With the help of four IVF attempts, several surgeries and a never-ending stream of medication, I’m now happily 14 weeks pregnant with a baby who is shaping up to have my husband’s nose and my fidgeting habit. In my case, natural processes not only have to be supplemented but sidetracked — with regular drugs and drips helping to distract my immune system from attacking what it thinks is an alien growing inside my uterus.

Modern science is built upon the idea that man can and should innovate ways to control and intervene in natural processes, either to prevent harm or to boost better outcomes. Without this god-like confidence of humanity, we’d still be in danger of dying from a walk in the rain like a character from a Jane Austen novel. The recent invention of the Covid-19 vaccine was both a welcome innovation in saving lives throughout the pandemic, and a reminder to the nature-knows-best crowd of how important scientific meddling can be.

When it comes to women, the brilliance of intervention is unquestionable — we’ve created pills to allow us to enjoy sex without the threat of pregnancy and honed medical procedures to terminate pregnancy should mistakes happen. Rather than leaving baby making up to a gamble of life or death, we poke around in bloods and scans, screening women for diseases, genetic defects and complications. And when it comes to the (often) terrifying prospect of birth, we don’t leave women to bleed out on their bedroom floors — or at least we shouldn’t.

Knowing how modern medicine has rendered much of the pain and danger of women’s reproductive processes unnecessary, makes the recent scandal of Shrewsbury and Telford hospital trust all the more horrifying. Looking at cases between 2000 and 2019 (as well as some dating as far back as 1973), an independent review of maternity services led by Donna Ockenden found “repeated errors in care, which led to injury to either mothers or their babies”.

Over 600 cases are now being reviewed by police, after it was found that 201 babies and nine mothers “could have survived with better care”. The Ockenden report describes a range of reasons behind the shocking treatment of women and their children, including a poorly-organised senior team, under-qualified and over-confident staff and a failure to act when women raised concerns.

Despite reporting “episodes of severe uterine tenderness and tightening at 31 weeks”, the mother of baby Joshua’s care plan was not altered. When she reported “reduced baby movements the day before her labour”, his heart rate was not monitored either. As a result, Joshua was born with “no signs of life and died at six days old”. Maternal deaths were poorly investigated. Mistakes continued to be repeated over years — sometimes even to the same patients.

Admiration for nature has crossed over into luddite territory

As well as issues relating to staffing and resources, the Ockenden report found that feedback given to a Clinical Commissioning Group review in 2013 described how women were pushed towards choosing “natural” birth plans. One woman said she felt like she was “on a butcher’s slab”, and that she was “made to have a natural birth when an emergency C section was more appropriate just so they didn’t dent their precious natural birth rate target”. While a cynic might point out that hospitals often favour natural births over caesarean because it’s quicker to bounce a woman out of a birthing pool than it is out of bed after surgery, the fetishisation of natural births goes beyond hospital care.

Until last week, the National Childbirth Trust’s official advice on its website claimed that women who pushed were “less likely to experience psychological problems like depression” and “more likely to feel satisfied with labour”. Try telling that to my mother, who ended up having an emergency caesarean after being left for 55 hours of labour with me (a 10.8 pound baby).

The World Health Organisation runs active campaigns to reduce the rates of caesarean, as it is deemed not “medically necessary”. Of course, women have been popping out babies unaided for millennia, and many happily choose to do so today — but it’s not hard to see why some don’t want to risk perineal tears, ruptures and hours (or days) of extreme pain when the option of a quick and efficient surgical procedure exists. Neither is it difficult to imagine which option a man would pick when faced with the choice of lifting a watermelon out of his belly, or pushing it through something else.

The real kicker in all of this is that natural mothering is not really seen by those who swear by it, as really all that natural — they believe women need to be taught how to do the “natural” thing. The most striking example of this is in the cult-like mentality surrounding breastfeeding. Everyone from politicians to midwives feel the need to pressure women into “natural” feeding, despite many finding that bottle feeding is more convenient and effective.

There’s something almost archaic about the sexist desire to control women’s behaviour during one of the most vulnerable periods in their lives. At my first meeting with my midwife, I was asked how I would feed my baby — she didn’t seem amused when I answered “well”.

While being handed leaflets about the various breastfeeding workshops I could attend, Janet Tamaro’s book So That’s What They’re For caught my eye in the corner of the room — a handy manual for women who stupidly thought their 34D’s were only useful to fill out a top or get their boyfriend’s attention. It is crazy to put this much pressure on women who are only just getting used to the idea that their lives are about to change.

What might seem like a hippy earth-mother obsession with incense and doing things naturally is having real-life consequences for women’s freedom during pregnancy and motherhood. From the extreme of the avoidable tragedies in Shrewsbury and Telford to the almost daily panics about what women eat, drink or surround themselves with during their pregnancy, admiration for nature has crossed over into luddite territory.

Rather than asking how we can make individual women’s lives more easy and enjoyable as expectant mothers, we request that they sacrifice their freedom for an imaginary idea of what natural motherhood should be. We should listen to what women say they want and need, rather than filling them with fears of doing it the “right” way. Everything I’ve had to do to become a mother-to-be has been unnatural. Like most women, as long as I have someone to show for it in nine months time, I couldn’t care less how it happens.

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