Language Matters: "Natural" Birth
When I first became a doula, and even when I first made this website, I wasn’t planning on having a blog. But the more I talk to people about this work, the more I think a blog could be a good place to get into some more difficult topics without having to simplify for the sake of a social media post or a quick answer. These topics can sometimes be painful, divisive, or challenging, so I want to make clear that my priorities in doing this are: transparency, education, curiosity, advocacy, and my own ongoing learning process. If I say anything that you want to hear more about, or that you take issue with, please please please let me know via email (firstname.lastname@example.org). Everything important I know about pregnancy and birth I have learned from thoughtful birth workers and birthing families, who have been generous enough with their time and experience to help me grow.
I want to start this blog here, with the phrase “natural birth,” because this is one of the first things people think of when they think of what a doula does. When I tell people I am a doula, they often will say one of three things:
1 › “oh, my sister/friend had a natural birth,”
2 › “I wanted a natural birth but it didn’t work out,” or
3 › “A natural birth just isn’t for me. Epidural all the way!”
This is a challenging moment for me for many reasons, and I usually can’t manage to say everything I’m thinking at the time. So I’ll try to say them all here, in the hopes that sharing these thoughts will help be helpful to at least one person.
The first thought I have in that moment is: no! you’re misunderstanding me! As a doula, I don’t only support people who want to have what most people think of as a “natural birth.” I support any birthing person under any circumstance. Labor is often a long and challenging process, even at its most joyful. A caring and knowledgable person can help you and your partner(s) navigate each part of that process with greater comfort and confidence.
What’s more, the overwhelming majority of people in the US give birth in hospitals, so if I didn’t support people in hospitals, I would have a depressingly narrow view of the experience of birthing people in my community. And those who know me know I can’t stand not to know the whole picture! And to be clear: I do not have a preference as to where people give birth. Hospital, home, birth center: what I care about is that you give birth where your knowledge of yourself and your options lead you to have your baby. Every pregnancy is different and every person knows what is best for themselves and their birth.
My second thought is but I don’t even like the word ‘natural.’ If that language is meaningful to you in your pregnancy and birth, I will use it wholeheartedly to discuss your birth with you. But, like other important language (see my FAQ post about gendered language), I don’t use it in my general writing or conversation. Even though it’s a common phrase, I find that in practice it has a couple of unintended effects.
1 › As many of my parent friends and doula colleagues have pointed out to me, “natural” can mean lots of different things, even just in the context of pregnancy and birth. It can mean “unmedicated,” “at home,” “without painkillers,” “vaginal” (as opposed to “cesarean”), or any number of other things. If possible, I’d like to use language that is more precise. It helps me help you have a positive birth experience. And it might even help you better understand your own needs and desires for your birth.
2 › This where I start to feel more resistance to the word in my heart: it’s hard to separate the word “natural” from the judgment that something is the most “good” or “right.” For instance, when you hear “natural food,” don’t you just think “that food is healthier or better than other food”? I do. But just because something is natural doesn’t mean it’s right or good for everyone. For instance, sugars are natural, but they aren’t healthier or better for people with diabetes. Droughts are natural, but they aren’t healthier or better for plants.
Don’t get me wrong: I think that we should always take into account what seems to be natural for a living thing when we think about how that living thing can flourish. But I think we should also avoid falling into the trap of thinking that natural is definitely, automatically better. I know many people who would not flourish (or even survive) without medical intervention, and to say that natural is always better implies that those people should not be able to flourish (or survive). What’s more, the word “natural” gets abused (as by food companies) to sell you things, and we should always be conscientious about what we are getting or doing, not just what it’s called.
3 › This one cuts deep for me, too: in some of our communities the word “natural” has painful connotations. In particular, I think of the LGBTQI community. A common way for people to reject and disenfranchise LGBTQI people is to claim that they are “unnatural.” Besides the fact that this is demonstrably untrue, it also gets used to prevent LGBTQI people from accessing human legal rights and raising children.
Someone who has had a necessary medical intervention in their pregnancy or birth might also hear the phrase “natural birth” and experience it as a painful indictment of their own birth experience. Perhaps they conceived their child with technological assistance. Perhaps they delivered their child with medical assistance. This article speaks movingly about the emotional struggle of going through the world as someone who had wanted a “natural birth” but ended up choosing otherwise. Every pregnant person (and every person, period!) is capable of making the right decision for themselves. To imply that there is a right way to give birth is to deny that, to believe that I know better than someone else what was best for their body. That goes against everything I believe and work to bring about in the world. Birth work is my starting point for creating a culture that respects the bodily autonomy of women, femme, and non-binary people. And the seed of that goal is the trust that each person is the best judge of what their body needs.
All of this isn’t to say that I think the phrase is without value. It orients us toward the normal range of physiological functions of our body, for one thing. It also encourages us to trust ourselves and our bodies more than we are used to doing, which I think is massively important. As a fellow doula put it, it can represent “a get back to basics mindset,” helping people to demedicalize the process. And that is important to me, because birth itself is not an emergency, it’s something that happens all the time! Sometimes in the course of birth an emergency will occur. But birth itself is natural—whatever that means. All birth.
So in closing, I offer you my list of alternatives to the word “natural.” These are the result of a brainstorm between me, my birthing friends, and my wonderful fellow doulas. All are more specific than “natural.” And who knows: maybe thinking about which alternative words appropriate to use, and when, will help clarify the kind of birth you hope to have.