Real Reproductive Choice

In a country where women supposedly have won the right to reproductive health care, women are losing the right to natural childbirth without medical intervention.

That’s because feminists use the term “reproductive health care” to mean contraception and abortion. Options for women who choose to give birth are apparently irrelevant.

Why do women reject some medical technology? Perhaps because the United States, one of the most technologically advanced countries in the world, ranked 20th in the world in perinatal mortality in 2000 and 34th in maternal mortality in 2005, according to the World Health Organization. The technology that saves lives in emergencies will endanger lives when used routinely.

The World Health Organization maintains that a Cesarean-section rate higher than 15% indicates overuse. Yet in 2007, 29% of all babies in the United States were delivered by C-section, according to the National Center for Health Statistics. A mother who gives birth by C-section is four times more likely to die in childbirth, warns the World Health Organization, and her baby is five times more likely to require assistance breathing, reports the Coalition for Improving Maternity Services.

The mother also faces increased risk of infection and many other problems after birth and in future pregnancies, in addition to recovering from major surgery while caring for her newborn. Furthermore, women who have had one C-section are often denied the right to give birth vaginally ever again: The International Cesarean Awareness Network reports that 300 hospitals in this country explicitly ban vaginal birth after C-section, although many experts, including the Mayo Clinic, assert that a vaginal birth after a C-section is safer than a second C-section.

Other routine interventions include the episiotomy, an incision that supposedly eases delivery but lengthens recovery time. Women are told that their doctors do episiotomies “only when necessary,” yet many midwives can prevent tissue from tearing during birth without episiotomies. Pitocin, a drug used to start or speed up labor, causes more painful contractions and sometimes even fetal distress, which can lead to a C-section, yet in 2002, one of every five U.S. births was induced, according to the National Center for Health Statistics.

Electrofetal monitoring, which keeps the mother in bed during labor so the nurse can monitor the baby’s heartbeat, is routine even though it does not decrease perinatal death, according to a study conducted in 2006 by the National Center for Biotechnology Information. Epidurals, which are used to provide pain relief for laboring mothers, sometimes cause the pelvic muscles to relax too much, preventing the baby from descending into the birth canal and ending in a C-section. Epidurals are also associated with many other side effects, including severe headaches and hypertension. After abstaining from even the mildest medication for the last nine months, some mothers are concerned about the effect these powerful pain-relieving drugs may have on their unborn babies. They prefer to use natural remedies like herbs, hot tubs, positioning and relaxation to relieve labor pain. But electrofetal monitoring and intravenous pitocin make using these natural methods inconvenient at best and sometimes impossible.

Laboring mothers, made vulnerable by pain, exhaustion and the emotion of labor, can easily be frightened into accepting unnecessary interventions by doctors and nurses who tell them that refusing medical interventions would selfishly endanger the lives of their unborn babies. Consequently, more women today seek the services of midwives who use a more natural approach. But today American midwives are told to deliver babies the same way as obstetricians do, or risk being denied birthing privileges at the hospital. Usually, the midwives develop a more medical approach so they won’t lose their practices.

This dilemma confronted my own midwife, Laurice Dunning. Despite the fact that the mothers whom Ms. Dunning attended had satisfying births and healthy babies, a local hospital terminated her birthing privileges because she protected her clients from unnecessary C-sections. She was the last midwife in the area to be forced out of practice by the medical establishment.

And women are the ones who suffer.

The Catholic Church encourages couples to be open to new life, but how much harder it is to go through many pregnancies and births in an environment where pregnancy is treated like an illness and birth is considered a medical crisis. When a woman lies in bed in a helpless and painful position, hooked up to machines, and “helped” to give birth by an episiotomy, how is she to realize that childbirth is a beautiful, natural event designed by an all-loving and all-wise God? In those intense, traumatic moments, she is taught that birth is a painful and frightening medical emergency. Her confidence in her own ability to be a mother and in her body’s ability to give birth plummets.

In contrast, a woman who, through natural means, is enabled to bear the pain of labor, who is allowed to choose the position that feels most comfortable for delivery, and who accomplishes birth without episiotomy or other interventions — what a rush of elation she feels. What a burst of confidence in herself and in her Creator who designed her body to perform this amazing feat. This crucial moment of birth will long affect how she views herself as a mother and how she feels about giving birth to more children.

Of course, not all women desire childbirth without pain medication. Every woman’s labor is different, and circumstances can have a significant effect on a woman’s experience of labor pain. A woman should have the right to choose pain medication if she desires it. Nevertheless, she should be informed of the benefits and risks of each medical procedure — and midwives, with their more natural approach, should be made available.

Feminists talk a lot about empowerment. But abortion and contraception do not empower a woman. They bring death, depression, guilt and darkness. Meanwhile, there is nothing that empowers a woman more than motherhood, the bearing of new life into the world. Natural childbirth enables mothers to experience this empowerment in a unique and profound way.

Sadly, for some, natural childbirth is impossible. Some women do need medical intervention, and we thank God that obstetricians are able to save lives in medical emergencies. Yet, we must wonder why women with low-risk pregnancies are offered so few choices regarding childbirth. If feminists were truly concerned about women, they would be rallying behind banners to bring back midwifery, to permit more vaginal births after Cesarean sections, to reduce C-sections and inductions, to do away with episiotomies, and to allow women to give birth in whatever position they choose. That is what reproductive choice should mean.

Agnes M. Penny is the mother of seven children and the author of Your Labor of Love and Your Vocation of Love, both published by Tan (