Are "natural" childbirth and attachment parenting bad for moms?

Amy Tuteur’s controversial new book, Push Back: Guilt in the Age of Natural Parenting, is a takedown of attachment parenting and our culture’s emphasis on so-called "natural," drug-free childbirth. Known online as The Skeptical OB, the Harvard-educated former-OB/GYN-turned-author has no time for what she says are the anti-female and elitist tenets of the alternative birthing and natural parenting movements: At best, it’s a bunch of pseudo-scientific hooey; at worst, it’s a plot to roll gender equality back a half-century or two.

Maybe that sounds extreme, but more than anything, Tuteur argues that we need to get over the notion that there is one superior parenting philosophy… and maybe ditch the idea of having a “parenting philosophy” altogether. (See, "Are we the worst generation of parents ever?")

We spoke with Tuteur about the trouble with competitive breastfeeding, how judgy moms are the new mean girls and why the “good old days” of natural childbirth were anything but.

Natural parenting was initially introduced as a movement to give women agency over their own birthing experience, instead of treating it like an illness or medical problem, which is obviously a good thing. Where did it all go wrong?

It’s true that the movement came along at the height of patriarchal medicine, when women had almost no power. Childbirth seemed like an obvious arena to seek progress, since these women were not actually sick. The original goals were for a woman to be allowed to remain awake during childbirth [instead]; to have her wishes respected; and to have a support person—generally her husband—allowed in the room during labour. The movement was instrumental in giving women control over their childbirth experience, but by the early ’80s almost everything it set out to do had been accomplished. Those behind the movement could have declared victory and gone home, but instead they moved the goal posts—they made it about the superiority of natural childbirth, breastfeeding and many of the behaviours associated with attachment parenting.

The fetishizing of the so-called natural is, you say, largely the domain of the more privileged classes.

Certainly, you have to get to a certain level of privilege in order to look back longingly on the natural. If you’re a single mother working full-time, there is no way you can be a successful parent based on these standards. There was a time when all childbirth was natural and everybody breastfed and everybody did all of these things that are now associated with attachment parenting, and it sucked. It was really bad. Babies and mothers died in droves, women were terribly oppressed. We now have what is called a “paleo-fantasy” about what life in nature was really like, and there’s this effort to recapture something that actually never really happened.

You describe many of the key tenets of natural parenting—the reverence for breastfeeding and attachment parenting—as deeply anti-feminist. How so?

This isn’t something I realized right away. I first began researching “natural parenting” because people kept asking me about it on my “Ask an OBGYN” message board. The first thing I noticed was that there is absolutely no science behind any of it. So why are people embracing it? What is the purpose? And then you look at the history, which is really ironic, because natural parenting was started by a guy. Grantly Dick-Read Childbirth Without Fear> was a British eugenicist who was obsessed with the issue of what he called race suicide—white women of the higher classes weren’t having enough babies. He thought that was partly because they were getting out in the wider world and seeking political and economic rights. For the first time, some women in some cultures were allowed to get educations, to have careers, to have their own bank accounts. A seismic shift like that doesn’t happen without a certain amount of push-back. On the right we see religious fundamentalism, which is all about putting women back into the home, and then on the left we see the rise of “natural parenting.”

So then the movement is explicitly trying to push back female progress? It’s not just a side effect?

It’s a Trojan Horse! We’ll take away women’s rights in the larger world by convincing them to be empowered by childbirth and breastfeeding. There are women out there who now insist that they are. It reminds me of an example from Betty Friedan’s book The Feminine Mystique, where she identified that women [in] were competing over who had the whitest laundry. If you’re competing over who has the whitest laundry, you’re not going to be bothering any men for political power.

And now new mothers are competing with each other over who had a drug-free labour, who breastfeeds the longest and who can spend the most hours babywearing?

Exactly. That’s not to say that any of these choices are a problem in and of themselves. I think I make it clear in the book that these are choices that I also made when my children were small. All of my children were born vaginally; I breastfed; we had a family bed policy and I carried my children around a lot, but I wasn’t empowered by it.

So it’s not about the behaviour so much as the pressure to behave in one way or another?

Yes. I made certain choices as a parent, but I didn’t think I was making the only right choice, or even the best choice. I wasn’t practicing a parenting philosophy—I was doing what worked for me and my family at the time.

There is a chapter in your book called "Natural Childbirth Advocates: Whitesplainin’ Birth to Everyone Else." How does race play in?

Natural childbirth advocacy is almost exclusively restricted to Western, white women of privileged class. One of the things I remember from when I was practicing obstetrics is that women from other cultures heard about natural childbirth and they were like, "You have got to be kidding me!" Did you ever see that movie Babies, the documentary where they followed four different babies from different parts of the world? It was super cute, but one of the things I found out afterward is that the mother from San Francisco had a home birth, but there were complications and they ended up in the hospital. While the mother from Mongolia, in order to agree to be part of the filming, her demand was that they pay for her birth in the hospital.

Home births are certainly a trendy option these days. You say they are more dangerous than people understand.

The essence of the natural childbirth movement and of contemporary midwifery in most places is that childbirth is inherently safe. The problem is, it’s inherently dangerous. In the field of obstetrics, we’ve been too successful for our own good, which is part of why people have this misconception.

In many provinces in Canada, midwifery is a more mainstream and very regulated field.

Yes, I’m actually working on a piece right now about how home birthing can be safe in Canada and not in the US, and it’s about regulating and standards. In the United States, where I live, we have the second-class midwives—the certified professional midwife, who isn’t really a midwife at all, she’s a layperson. They call themselves experts in “normal births,” but as I say in the book, that’s like having a meteorologist who’s an expert in sunny weather. Who needs that?

In your book you call out the judgy mommies. Who are they and why are they so judgmental?

It’s like the mean girls from elementary school grew up, but they’re still patrolling on the playground or at the Mommy and Me groups. It’s this whole “sancti-mommy” phenomenon: People who wouldn’t in a million years come up to you and talk about something as personal as whether you use pads or tampons now have no problem asking, “Oh, I see you have a baby—did you have a vaginal birth or a C-section?”

Any theories on why parents—and particularly mothers—feel the need to compare themselves to other parents, or feel smug about their parenting choices?

Parenting is really hard. You’re very vulnerable and you don’t know if you’re doing a good job. As a parent, you don’t get much feedback, like a letter grade or a review from your boss. Instead, we made up a completely arbitrary way of judging parenting—standards that are easy for some of us to meet simply by chance in many cases. And then, because one group met those standards, they declared that they’re better moms than everybody else. It makes me think of designer handbags: I like them, and sometimes I buy them, even though they’re ridiculously expensive, but at no point do I think I’m a better person because I carry one. This is designer parenting. It’s supposed to mark you as better, when in fact it’s worse. The worst thing about natural parenting is that it’s all about creating this exceptional child that you can brag about—and children become accessories.

And everybody wants the latest Prada.

Right. Exactly. And it’s not that having the Prada bag is bad—it just doesn’t make you superior.

Read more:

Choosing between a midwife and an OB Confession: my home birth sucked Drug-free vs. medicated childbirth: a guide to labour pain management Was your labour a letdown? Would you breastfeed a child past age two?