When referring to physiologic birth, media outlets and journalists often use the words “natural” or “naturally.” What they mean, however, is this: A baby came out of a vagina.
In May, Anemona Hartocollis used “natural” to mean “vaginal” in the very first sentence of a New York Times article. A few months later, Darlene Cunha did the same thing several times in her op-ed for the Washington Post. Here’s another example over at Yahoo! News. And yet another, from South Africa’s Times Live. There are exceptions, of course, but all too often, “natural” is synonymous with “vaginal,” creating a convoluted, confusing, and highly value-laden judgment of women’s experiences and women’s bodies, which can lead to compromised emotional and physical health. And in a country where one in three women will give birth via surgery, the words we use to talk about how babies are born matter.
First of all, the avoidance of proper terms for cisgender female anatomy in relation to childbirth is indicative of a serious, profoundly scary misogyny embedded in our cultural vocabulary. Acting as if the word “vaginal” is too dirty, too shameful, or too embarrassing to say in mixed company (or in newsprint) reflects a real fear of female bodies and their capabilities. In turn, this fear creates a psychological and sociocultural distance from our female bodies, both in the context of childbirth and the rest of our lives.
Proper terminology aside, the common conflation of “natural” with vaginal is problematic in other ways too. Sure, a birth that happens with medical interventions, including surgery, isn’t how “nature” intended babies to be born. But in the context of our contemporary language, “natural” no longer means “as occurring in nature.” There is no universal connotation of the word “natural,” other than that it’s supposed to be wholesome and good. It’s like labeling a food as “natural” as opposed to, say, organic: Organic means food that is grown without pesticides, while “natural” means whatever the hell the manufacturer wants it to mean. And in the same vein, conflating “natural” birth with vaginal birth implies that other ways of being born are “unnatural”—in other words, inferior.
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In every birth, a baby was grown inside of a body and it came out of that body. That is beautiful, however it happens. Using “natural birth” as a synonym for vaginal birth, the way media outlets and everyday people frequently do, can traumatize many women whose births do not happen vaginally. Giving birth is an extremely personal experience; some people who need or request medical intervention during the process might not mind at all if they end up with a cesarean birth, while others may feel as if they missed out on the “rite of passage” of vaginal birth, a biological process that they very much wanted to experience. When these women share their birth stories with friends and family later, they can again have feelings of shame or guilt at having “failed” at something female bodies are “supposed” to be able to do.
I am a certified birth doula. I am a strong supporter of physiologic (defined by midwives as “powered by the innate human capacity of the woman and fetus”), unmedicated, vaginal birth. But I am also a strong supporter of birthing where, how, and with whom you feel comfortable, whether that is “natural” or not.
To complicate things even further, in the birth professional community that I am a part of, “natural birth” often specifically means vaginal birth that happens without the use of pain medication or medical intervention. This adds yet another layer to the convoluted terminology that can lead to families feeling confused and hurt after the births of their children. Privileging drug-free birth in this way—again, by referring to it as “natural” and therefore “better”—can leave individuals feeling as if they weren’t strong enough or brave enough if they do request medication.
As a whole, splitting birth into “natural” and “unnatural” contributes to the dangerous, ever-present dichotomy between medicalized and non-medicalized birth. That dichotomy contributes to a mainstream stereotype of birth professionals and activists as believing that doctors are evil and that epidurals are poison. This false binary vastly oversimplifies the complex web of caregiving and decision-making that leads to healthy mothers and healthy babies, both individually and on a systemic level. I think you’ll find that doctors and doulas, nurses and midwives, birth centers, hospitals, and parents are united in their desire for birthing people to have healthy, happy, and fulfilling experiences, whatever that may look like for them. The idea that you must align with one side—one birth ideology—reduces the very real power that pregnant people have to make dynamic, evolving choices and decisions about their own care and that of their baby.
There should be room in our culture for birthing choices and experiences that incorporate both the primal instincts that have guided birth since humankind began and the amazing medical care we are lucky to be able to use at the beginning of the 21st century. I believe that there are many, many problems with the maternity care system and the way we look at birth today in the United States, including the astronomical rise in cesarean rates and continued violations of the right to informed consent—but I also believe that the multiplicity of options and feelings involved in pregnancy and childbirth should be treated with respect. Respect begins with language. The language we use now is convoluted and confusing, infused with implicit judgments that can both alienate and upset birthing people.
I advocate for the use of the term “unmedicated birth” for birth that happens without pain medication, because unmedicated is a more neutral word that’s based in fact rather than in significance. I advocate for the use of “surgical birth” or “cesarean birth” rather than “c-section”: Remember, it’s a birth, not just a procedure! I think that when we are talking about a baby coming out of a cisgendered women’s vagina, whether interventions are involved or not, we should be saying “vaginal birth.” I also think if someone who is transgender or gender variant is giving birth, we should be using the terminology that person prefers, whether it is vaginal or some other term that resonates with the individual. And I think the word natural, which is an increasingly loaded term in our culture, generally shouldn’t be used in conjunction with childbirth. There are so many more precise ways we can talk about the life-changing experience of giving birth, so much possibility for opening up the discussion to include clarity and compassion rather than categorization and judgment.
Language matters. Language shapes our lives and our perceptions of our lives. Let’s pay more attention to the words we use when we speak about women’s bodies and childbirth and maybe, just maybe, we’ll start to change the way we think about them, too.