The Myth of Normal 122

I will not be advocating for any particular type of birth, “natural” or otherwise, or railing against any other, much less judging any woman’s individual choices around this vastly significant event. My interest, in keeping with this book’s overall focus, is the cultural context in which, these days, such choices are made—which includes by whom and in what manner they are made. As the poet Adrienne Rich put it in her book Of Woman Born: “In order for all women to have real choices all along the line, we need fully to understand the power and powerlessness embodied in motherhood in patriarchal culture.” Reducing women to passive recipients of medical care during perhaps the most momentous passage of their lives is dehumanizing, and not only figuratively: it disrupts physiological, hormonal, and psychological processes that have evolved in our species over millions of years to ensure the necessary bonding of mother and baby and the healthy development of our young. A few years ago I spoke with Dr. Michel Odent, world renowned for his embrace of and advocacy for demedicalized birth practices. “We have to deindustrialize childbirth, to stop disturbing the first contact between mother and baby,” he said in a charming French accent. “Imagine,” he said with a laugh, “the mother gorilla giving birth and you try to pick up her newborn baby. And then you will understand what a maternal protective aggressive instinct is. In our civilization we have suppressed that instinct for a long time.” Suppression of innate knowledge is one of medicine’s unfortunate tendencies. Medical intervention, which in a sane system would be deployed only when necessary to reduce risk, maximize health, and ensure survival, has become the default approach. A clear example is the steeply rising rate of the cesarean section: a lifesaving intervention when needed, a potentially noxious interference when not. According to the best estimates, about 10 to 15 percent of deliveries ought to end with C-sections to ensure healthy outcomes. Here in my home province of British Columbia that rate now approaches 40 percent, as it does in many other parts of the world, with some countries exceeding that mark; worldwide, the number of these surgical deliveries doubled between 2000 and 2015. “Markedly high CS use was