00:00:00.000This mother is compelled to be simultaneously like womb moon earth mama matriarch and also like squirting sex pot at the fucking same time, right?1.00
00:00:12.540She's not relieved of sexual responsibility or of the demand to be sexy even when a child is ripping its way out of her vagina, right?1.00
00:00:20.980She's expected to achieve an orgasm or at least to perform one even as she's giving birth.1.00
00:00:27.840Like, there's a word for this, and it's not fucking liberation.0.99
00:01:03.300So, for one thing, this episode is going to deal with a wide array of the things that can go wrong in childbirth.
00:01:13.620Wrong for the mother, wrong for the infant, or wrong at the hands of, like, doctors, midwives, doulas.
00:01:21.920And there are some dead babies in this episode.
00:01:25.140So one thing I want to make sure we said right off the back was please take care while you listen to this one.
00:01:30.980This one has moments that are pretty tough.
00:01:33.900The other thing I want to say before we get into this and that I've like encountered when I've written about the natural childbirth movement before is that like I just want to emphasize as a matter of principle, I and I think Adrian probably also you are completely neutral and agnostic about what you do with your body, right?
00:01:50.980The good way to give birth is the way that ends with a safe and healthy mother and child.
00:01:56.340The good way to feed your baby is the way that gets your baby fed.
00:02:00.360We might talk about some stuff in this episode that sounds like stuff you did during your pregnancy or your childbirth.
00:02:06.620Or we might talk about some books you read or some people that you listened to.
00:02:10.920And I basically think that in this story, the natural childbirth story, which does have some real tragedies as well as some kind of like farces in it.
00:02:19.360I think the bad guys who have meaningful responsibility here are more or less never the pregnant or postpartum women who consume this, like, content and the natural childbirth movement's agenda.
00:02:32.020So we're not judging you, even if maybe we are judging them a little bit.
00:02:38.480And the other, like, last content note I wanted to make before we, like, really dived in is that this is going to be a conversation about childbirth between two people who have never done it.
00:02:57.660But, you know, like one of the things you quickly realize when you start looking into the natural childbirth movement is that birth experience is a kind of credentialing factor for a lot of the women who find this movement appealing.
00:03:10.920And honestly, that kind of makes sense to me.
00:03:13.520Childbirth is an experience of acute vulnerability,
00:04:37.360And it's something that I needed explained to me by someone who had worked on it.
00:04:42.720And it turned out I knew a person who had worked on this.
00:04:46.380Yeah, you know, there's a natural childbirth movement kind of writ large, which by now at this point in 2025 is a really large, internally fractious and like internally dissenting group of people with a whole bunch of different opinions and approaches.
00:05:01.700And most of them are not really pushing the kind of stuff that we're talking about here.
00:05:07.060right yeah but we're also going to be trying to like trace the genesis of some of these ideas or
00:05:13.460some of these practices that don't always come like a lot of the ideas and practices that we
00:05:18.020live with and try to make the best of every day like some of them come from bad places right yeah
00:05:22.300and this is a set of ideas about pregnancy childbirth and early childhood that have been
00:05:30.920sort of long simmering we're going to trace like a lot of different ideas about childbirth but they
00:05:35.240kind of exploded into the American mainstream in the 1970s. And they've had something of a
00:05:40.980resurgence lately in particular playing what I think is an underappreciated role in the Trump
00:05:47.320phenomenon and particularly the rise of the Make America Healthy Again movement. Yeah. So like a
00:05:53.220lot of our stories of the sort of extremist fringe, this is a story about like real problems
00:05:59.340and legitimately victimized people being exploited further by a group of like cynical grifters0.99
00:06:05.420and sometimes well-intentioned idiots and sometimes genuinely dangerous quacks in ways0.99
00:06:12.220that rely heavily on prescriptive, narrow, and mostly kind of fantastical ideals about1.00
00:11:58.480If you ask me to pinpoint any decade, I'm like, this feels good.
00:12:02.860If it's gooey and hairy, I'm going to say it's going to be 70s.
00:12:06.540It feels like it's paisley patterned somehow and like wrapped in a lot of corduroy.
00:12:11.260There's an age track of Fleetwood Mac playing somewhere in the back.
00:12:14.720But like actually most accounts of the natural childbirth movement pinpoint its intellectual founder as a guy who was working in the 1930s.
00:12:43.820We've got Grantley Dickreed and Ina May Gaskin and Ina May.
00:12:48.140I mean, both of these people are real pieces of work, and we're going to get to them in a second.
00:12:52.820But first, I wanted to find what we mean by natural childbirth, right?
00:12:58.040Because it seems like a little bit redundant or possibly, in another sense, like a contradiction in terms.
00:13:02.860so grantley dick reed and ina may like most of their successors claim to be returning birth to
00:13:11.160this kind of like pre-lapsarian like pre-industrial quote-unquote natural ideal like the fundamental
00:13:18.440claim of the natural childbirth movement is it bad birth outcomes like the ones suffered by the
00:13:24.820distressed women we talked about or even like worse outcomes like stillbirth or maternal mortality
00:13:30.260are caused by like unnatural, technologically driven, industrialized, like human controlled
00:13:39.340and in some discourses like really explicitly male controlled childbirth and birth management
00:13:45.440styles, right? So like the aesthetics of the natural childbirth movement are really crunchy
00:13:50.000and the vocabulary that they use now in particular often partakes of rhetorics of liberation.
00:13:56.260But I characterize the natural childbirth movement as in many ways kind of conservative because it advocates for a return to this imaginary past when things were purer and better, right?
00:14:10.020And because it seems to suggest that instinct and nature are a better guide than reason and reflection, right?
00:14:17.760There's a kind of like trust your body the same way that in a previous age you would have trusted God, right?
00:14:22.780Yeah. Some of the like natural childbirth movement practitioners will be like pretty explicit actually about like rejecting standard enlightenment principles. Right. Like they speak of the body as if it has its own consciousness and as if it has like a quasi divine authority. Right. But like I tell you right now, the body is pretty stupid. The body has no information. It has no consciousness. It has some serious what we might call design flaws.
00:14:48.000My body walked into a lamp this morning.1.00
00:15:10.520She calls the natural childbirth paleophantacist, which I think is a pretty good coinage.
00:15:16.760The notion is that this like pre-modern, you know, like natural birth, like birth by a woman who is correct in her mindset, uncorrupted by modernity mentally and without medical interventions is necessarily going to be like a safe, painless experience or even a quote unquote ecstatic one.
00:15:38.880And keep that word in mind, because it's going to get pretty weird.
00:15:42.340So their idea is that, like, nature made birth perfect,
00:15:45.880and then it was mankind that fucked it up.0.61
00:15:48.200But how historically informed is this?0.62
00:15:51.340I mean, I know that the midwifery movement has a very clear narrative behind it,
00:15:55.660I think is essentially historically accurate about the professionalization of OBGYNs
00:19:34.340In a word, some kind of intervention, be it like midwife management, rudimentary pain medicine, movement, massage, oil, or just prayer in birth are about as old as birth itself, right?
00:19:51.620Opium was used to relieve childbirth pain for thousands of years.
00:19:56.060There's also like evidence of a lot of women chewing on willow bark during labor because willow bark actually contains a chemical compound similar to aspirin.
00:20:06.300I don't frankly know how much that helped, but it's something that they did.
00:20:09.560This was also something that had been criticized by religious authorities for a lot longer than anybody seems to be willing to admit, right?
00:20:20.140So like both the use of pain management and like drugs to reduce pain during labor is very, very old, way predates the industrial era and the medicalization era.
00:20:29.860And also the like condemnation of pain management during childbirth is also very old.
00:20:35.800So as we said, in the pre-medicalized era, maternal mortality rates were really high and infant mortality rates were like even higher, right?
00:20:46.220So in the 17th century, when the rate of maternal mortality and childbirth is thought to have peaked, it was at about 170 women per 10,000 births.
00:20:57.020So it's like a little less than 2%.0.96
00:21:01.820Especially when you consider that many women gave birth many times, right?
00:21:06.440So that's like a 2% chance every time you give birth.
00:21:09.340But if you're giving birth 5, 6, 7, 12 times, those odds go up and up and up.
00:21:16.780So for deaths of married women of childbearing age, which is defined in the study I read from Cambridge University of 15 to 49, that figure was 1 in 10.
00:23:17.960Now, none of this is to say that birth was like inherently deadly in the pre-medicalization era or that nobody knew how to handle it.
00:23:25.100Actually, a lot of people knew how to handle it.
00:23:26.920Some of them got burned at the stake for it.
00:23:29.540But like after the 17th century, maternal mortality began to drop pretty steadily.
00:23:35.020And in the 19th century, it dropped really precipitously.
00:23:38.200And this is generally agreed to be because urbanization led to an increased availability and quality of midwife care, right?
00:23:46.720So midwives were the like uniform, universal birth attendants until the latter half of the 19th century.
00:23:53.520They were basically all women, and they had a near total monopoly on obstetric and gynecological care.
00:24:00.400They tended to be, like, local women, people who, like, would kind of know you or know your family.
00:24:06.620They worked within small-knit communities, so, like, rural villages would have one woman who worked as a midwife in addition to other work who, like, everybody knew.
00:24:15.940but also like ethnic enclaves in places like the Lower East Side would also have a local midwife0.52
00:24:21.720and she would be able to speak the language of the immigrant population that she served right0.99
00:24:26.380she might be from the same part of like Poland or Italy as the people she was working with
00:24:33.080and she was able to be attentive to relevant local customs and this means that this is somebody who
00:24:39.600was respected for her skill and valued for the service she provided but she was not in this like
00:24:45.800rarefied higher status right she was an equal to the people who she was delivering am i right to1.00
00:24:52.720think that in the south often midwives were black even when delivering the babies of white women is1.00
00:24:58.000that right that's correct yeah it was also a kind of skill and something that you could be paid for0.97
00:25:05.680even if you were not from like a high status part of a community right so it was also like a way1.00
00:25:12.440for women to be, like, upwardly mobile,
00:25:15.260even if they would have had obstacles, shall we say,0.99
00:25:39.820And she built this, like, shockingly big fortune with her abortion practice and, like, built herself a mansion with an abortion clinic in the first floor, like, right across the street from what was being built then as St. Patrick's Cathedral, which I, like, I love.
00:26:26.360The medical profession for a really long time was basically entirely what the supplement market looks like now, right?
00:26:33.620There's a big mix of unregulated, unproven treatments, some of which are very helpful, some of which are useless, and a few of which are actively harmful, being hawked by people with like various levels of competence and honesty, right?
00:26:48.100Just a lot of male confidence in the medical field in the 19th century.
00:26:52.360So as you can imagine, there are like some drawbacks to an unregulated medical market, as I think RFK Jr. is going to remind all of us pretty soon.
00:27:00.020And so the medical profession sought to standardize, formalize, and professionalize, and they formed medical schools and licensing boards that gave out credentials and which would only give those credentials out to men.
00:27:14.020So the result was a war between the emergent, like, formal obstetrics profession, which was dominated by men, and the longstanding midwifery field, which is dominated by women.
00:27:48.020And the result was actually women who used obstetricians0.91
00:27:51.520in the beginning of the medicalization era
00:27:53.560died more often than women who used midwives.
00:27:57.160And this is because the obstetricians of this new field
00:28:00.580did not seek out the expertise of the midwives
00:28:03.500they were looking to like stigmatize and replace and drive out of practice.
00:28:07.180Yeah. They completely ignored those women as sources of information or expertise about safe childbirth. And the result is that obstetrics then had to sort of like set about reinventing the wheel and learning how to handle childbirth and its attendant emergencies without consulting all the people who actually knew how to do that. It's been called an epistemicide, which is another term I like. The knowledge of midwives was eradicated kind of on purpose.
00:28:33.200Yeah. For people who want to know more about this, there's a pretty famous pamphlet that Barbara Ehrenreich and Deirdre English wrote in 1972, which is midwives and nurses, which is both fascinating and one of the second wave's most influential and enduring critiques of medical misogyny, right?
00:28:59.140But this, like, obstetric revolution did mean that a lot of information about childbirth was being standardized and spread, like, fast, and ultimately safety eventually did increase.
00:29:12.660But attitudes among obstetricians towards women kind of did not improve.
00:29:17.540So most medical schools remained all male, and the obstetric field was often populated by the students who were considered to be, like, not quite smart enough for other specialties, right?
00:29:29.140So many of the men who wound up delivering babies professionally had this deep contempt for women, and they were encouraged by both their culture and by their profession to view themselves as the calm experts sort of standing against the laboring women's childlike hysteria.0.79
00:29:45.360Which still survives to the present day. That appears to be one of the explanations for the abysmally high maternal mortality rates among African-American women, right?0.55
00:29:54.580Yeah. I mean, black women are treated as sort of hysterical, as not reliable narrators of their own bodies. And particularly they're imagined to be capable of enduring pain more. That's like a weirdly persistent myth. And often they're just treated with negligence.
00:30:10.440So, like, in my neighborhood in Brooklyn at the City Run Woodhull Hospital, there was one anesthesiologist working in the labor and delivery department.
00:30:32.920And he actually also, he wound up murdering a woman named Sha'esha Washington, who I believe was like 21, she was quite young, having her first baby, because he like misapplied her epidural, and instead of numbing her, it killed her.
00:30:45.180And he eventually did get stripped of his license.
00:30:48.520But these kind of horror stories are really common among black women, particularly now in the post-Dobbs era, when, you know, these kind of medical complications that can attend to pregnancy and birth are met not just with like kind of a disregard for women's pain and particularly black women's pain, but also like fear of liability should anything go wrong.
00:31:12.120right? I should say the obstetric field now looks nothing like it did back then, right?
00:31:19.380For one thing, something like 60% of obstetricians now are women, which obviously does not mean that
00:31:25.160they're not misogynist, but the demographics of the field have changed. Residency classes
00:31:29.040in obstetrics are routinely something like 85% women. This is now like a woman's field.1.00
00:31:34.640And that's because like the demand for women obstetricians is a lot higher. And I think you
00:31:39.840can kind of understand why but it doesn't sort of fix every problem clearly yeah but for one thing
00:31:46.680these early obstetricians did also look into labor analgesics right for their patients many of whom
00:31:54.700at the start of the obstetric sort of field were wealthy white women as poor women sort of kept on0.96
00:32:00.800delivering at home often with like more informal or midwife care but the introduction of pain1.00
00:32:07.200management for these upper class births was greeted as an absolute godsend right but the
00:32:12.960painkillers that were used in sort of the beginning of the 20th century were like rudimentary
00:32:19.000marginally effective and often kind of weird so like ether was common chloroform was common these
00:32:26.980were like complete like total anesthetics they knocked women out later anesthesiologists developed
00:32:32.820a drug combination whose effects were known as twilight sleep.
00:34:26.920To just think that everything was fine.0.99
00:34:29.100And this, Adrian, is where we get the Lamaze technique, which does nothing but sort of encourage women to try and train themselves into calming down.0.93
00:34:38.700It does nothing to actually alleviate pain.0.98
00:34:40.500I'm fucking done. I'm out. This is it. You broke me. We're not even half an hour into this and you broke me. Fuck.0.99
00:34:47.420But the use of this kind of anesthesia and childbirth, like, also had its own increased risks, like, administered poorly, like it was to Asia, Washington.0.99
00:34:55.960these drugs can have like bad consequences they can hurt you right and also being drugged means0.64
00:35:01.780that women couldn't participate in their own labors right so a woman who is like knocked out
00:35:07.620she can't understand what's happening to her she can't alert the people around her to the quality
00:35:13.040of the pain or the sensation and crucially she can't push right which means that in this era of
00:35:20.020sort of like absolute or like total anesthesia in childbirth the use of episteotomies which are like
00:35:25.820vaginal cuts with scissors, usually to the perineum, increased a lot, as did the use of
00:35:32.320forceps, right? If a woman can't push, you got to grab that baby. Yeah. So this led to a lot of1.00
00:35:38.280vaginal injuries. And enter the man who coined the term natural childbirth. The gentleman we
00:35:45.400mentioned at the top of the show, Grantley Dick Reed. Adrian, what do you know about Grantley
00:35:50.620dick read not very much i mean as far as three names go that's not a great combination you put0.86
00:35:58.480in our doc here a picture of him with a cat which already makes me suspicious of him he's wearing a
00:36:03.860pinstripe suit he's like kind of a balding jowly guy with a pocket square he looks like if w.h
00:36:11.160auden was like a bond villain you know yeah he's like he's got a cat on that on the clinic mr bond
00:36:18.520so like he was a british obstetrician he had been a veteran in world war one
00:36:24.600and he was practicing in a london suburb like a pretty tony london suburb right and in 1933
00:36:30.680he published a book called natural childbirth in which he advocates for the ends of these
00:36:37.240kinds of anesthetics okay okay right fair enough what's the catch well mr dr grant reed was a
00:36:46.000eugenicist i was like when you said 1933 i was like how how long until that bell starts ringing
00:36:51.880fuck this is the other 1933 well no like in the 20s and 30s everyone was like oh what if they0.92
00:36:58.200died wouldn't that be better maybe yeah his idea was that pain management used in labor you know0.99
00:37:04.620he didn't object to them because they were ineffective although they kind of were
00:37:08.460he didn't object to them because they didn't allow women to participate in labor although they they0.98
00:37:13.140did. And he didn't object to them because they led to these like degrading, humiliating experiences0.99
00:37:18.980for women or some worth outcomes for mothers and babies alike. His critique was that he thought
00:37:26.440women who wanted pain management in childbirth were like decadent and weak. So he was, as you
00:37:34.000can imagine, very concerned about the birth rate. Classic. He thought that immigrant women,0.96
00:37:41.600non-white women and lower class women were having too many babies and crucially he thought that elite
00:37:48.920white women the ones he preferred were not having enough babies right but he also believed that
00:37:56.840elite white women's bodies had been conditioned to respond differently to childbirth than other
00:38:04.120women did he believed that women who had been quote over civilized unquote experienced more
00:40:13.320Not if you're pure and sufficiently feminine.0.97
00:40:15.740He did these, like, charity cases in the London slums among poor women and reported approvingly that they didn't have soap and that he had to bring his own soap and towel.0.90
00:40:25.480but he was more impressed that there was quote no noise and no fuss he also claimed that what0.95
00:40:33.640he called the quote-unquote primitive women uh did not have childbirth pain and that women in
00:40:39.260such quote-unquote primitive societies this man never left england by the way uh who died in
00:40:43.660childbirth did so without regret or sadness because they knew that they were fulfilling
00:41:30.360He said that if they adjusted their mindset and their cultural expectations, they could embrace their biological destiny and become less, quote unquote, civilized in the attainment of like a kind of feminine authenticity.
00:41:44.780and therefore their childbirths would naturally stop hurting
00:41:49.160and B, and this was indeed his claim, completely pain-free.
00:41:52.800He said that the human body in a function associated with health
00:41:59.340Wow. I mean, there is a modern version of this
00:42:01.820that people who've been through the experience
00:42:03.500can tell us whether or not this is true,
00:42:05.040that like there is a way to kind of lean into the pain
00:42:08.720and kind of like sort of use its rhythmicality in some ways
00:42:12.180so that it doesn't register quite as much.
00:42:13.940So there is, I think, there are ways of not panicking and in ways that like if you're having a very normal birth and the contraction aren't too bad, apparently makes it quite a lot easier.
00:42:23.780So I guess there's like, I can see what experiences might have set him down that path, but like ending up there strikes me as absolutely absurd.
00:42:32.580I don't know. I think that sounds like Lamaze to me.
00:42:34.660That sounds like just ring a bell and she'll stop thinking that it hurts when her uterus contracts.1.00
00:42:40.820Honestly, the modern natural childbirth movement doesn't like to bring Grantley Dick Reed up.0.98
00:42:46.340They know, for one thing, that it damages their credibility as these, like, earth mother, like, authentic women, that their field was founded by a man.
00:42:56.700Like, that's kind of a bad look in this world.0.99
00:42:59.320Moreover, a man who told him to just shut the fuck up.0.98
00:43:01.580Well, some of the natural childbirth pioneers also kind of have that opinion.1.00
00:43:06.680They know that it's a bad look, that he evowed eugenics, but they do really lean into this idea that the pain is not necessary, right?0.59
00:43:16.080They continue to espouse this notion that labor pain is psychosomatic and a product of what they call the fear-tension-pain cycle.
00:43:25.500They still say that it can be avoided by a woman with the right mindset.
00:43:29.460One of the things about the natural childbirth movement is that for a group of people whose, like, fundamental uniting factor is in the sort of meaning they try to make out of women's pain, they actually have, like, a bunch of different contradictory theories of labor pain.
00:43:45.980So there's also some people in the natural childbirth movement who say that the pain of contractions and of delivery is actually necessary for maternal child bonding and that therefore women who either A, have epidurals or B, have C-sections won't love their babies as much.
00:44:06.420Some of them say, you know, in one breath, if you're doing it right or if you're the right kind of woman, it won't hurt.
00:44:13.060And then some of them say, like, if it didn't hurt, you're not a good enough mother and you don't love your baby.
00:44:18.580So, like, Grantley Dick Reade's ideas begin to sort of gain some purchase among obstetricians, many of whom kind of disapproved of anesthesia and childbirth anyway, often for religious reasons.
00:44:30.560And his second book, 1942's Childbirth Without Fear, was aimed at pregnant women themselves.
00:44:40.200So when we talk about like the free birth movement, the extremists later, he is sort of like the first example of that model.
00:44:46.700He is like a natural childbirth influencer and like media personality.
00:44:51.220But like meanwhile, science is kind of marching along anyway.
00:44:53.780In the 1930s, anesthesiologists had invented a kind of spinal injection that they called an epidural, which could numb large sections of the body by like beginning at the spine and coating all the nerves in this anesthetizing drug.
00:45:07.560So like the lower half of the body, say, suddenly became very easy to sort of numb without having to make the patient unconscious and without having to make her totally unable to move.
00:45:17.720right? This was used for a lot of other stuff first, but they start, obstetricians start using
00:45:23.300it for childbirth in the 1960s. And by 1970, it was pretty widespread. Like today, a little more
00:45:31.560than 60% of women who deliver vaginally receive an epidural. It was like a total game changer.
00:47:25.180It's a distrust of authority and a drive for autonomy, right?1.00
00:47:29.540And that's beginning to be articulated as a desire by feminists,1.00
00:47:33.500But it was also a posture that found a lot of purchase in the hippie counterculture, which was also, like, characterized by a distrust of institutions, a reverence for the body, and these fantasies of, like, a purer, prelapsarian, often, like, kind of pastoral state of the natural.1.00
00:47:53.220And that is when we meet Ina May Gaskin.
00:47:59.960I had not, but you, again, put a picture of her in our doc here.
00:48:04.180And if you told an AI image generator, like, find me a hippie who told people not to talk to doctors before giving birth, this is who I had picture.0.88
00:48:12.940She's wearing tie-dye, she has impressive pigtails, she's sitting next to a man with a very ill-advised Lennon goatee, other Lennon, John Lennon glasses, and a Mao blue hat.0.98
00:48:30.780I mean, yeah, basically this man is just all your parents' college posters, like, if they all just fucked and had a baby.0.99
00:48:52.160But their cult in Tennessee, a group called The Farm, was still active until just a couple years ago.
00:48:58.640Wow. And Ina Mae Gaskin is the founder of the American midwife movement and still one of the most influential figures in the natural childbirth movement.
00:49:08.460So Ina Mae Gaskin was born in Iowa in 1940, like fairly like standard, pretty humble origins.
00:49:15.980She had an early first marriage that produced a child.
00:49:20.080And during that birth in the 1960s, Gaskin experienced the use of forceps by an obstetrician, which she found pretty traumatic.
00:49:29.540She left that first marriage not long after.
00:49:32.440And like so many wayward youths of the 1960s, found her way to our hometown, San Francisco.
00:49:40.560Once there, she met and married Stephen Gaskin, pictured here with the letting goatee, also in the tie-dye.
00:49:47.440A man who was giving what he called philosophical lectures to followers in Golden Gate Park.
00:49:53.860Nothing good ever starts on Hippie Hill, I'll say that.
00:49:56.120So, Stephen Gaskin was one of these, like, late 1960s gurus.
00:50:04.340He believed that he was receiving divine revelation while high on LSD.
00:51:16.320So her son, who she named Christian, was born two months premature without medical intervention, and he died the next day.
00:51:24.860Ina May seems to have still believed that this was a better birth experience than the one she had in the hospital, even though it ended with the death of her child.
00:55:14.200Yeah, it's meant to correct shoulder dystocia, which is something that can happen when an infant's like its head has been burst, but its shoulder is like caught and stuck on the pelvis of the mother.
00:55:27.060And what you do is you get on all fours and you, like, bring forward one of your feet to, like, under your front shoulder, right?
00:55:36.280And this is supposed to change the angle such that the baby can then be delivered.
00:55:40.440And this, like, does, by all accounts, like, reduce the level of C-sections.
00:55:44.540It's, like, a pretty good thing that she introduced to American obstetrics.
00:55:48.480She says she learned it from an indigenous midwife in Guatemala.
00:55:53.480Yeah. It's well known, right, that like the stirrups, lying down thing, you know, for some births it works, but it's at most birthing centers, I think pregnant people are extremely ambulatory and try out different things, right? You squat here, you stand there for a while, you lie down, you know, you try out different things. And it's one of those things about hospital births that like that's going to be somewhat limited there. You can't be as experimental as in a yoga studio in a delivery room usually.
00:56:18.700It does kind of look like a yoga move. I think I did that this morning.
00:56:24.360So in 1975, Ina, even though she is Stephen's inferior on the farm, becomes much, much, much more famous than he is because she publishes her first book, Spiritual Midwifery.
00:56:38.040And this book is widely credited as helping to revive the midwifery profession in the United States and popularizing the natural childbirth movement here.
00:56:47.140So she goes from being like a cult leader and sort of a folk guru to being really like a national celebrity in the birth world.
00:56:53.480And to be clear, most of the midwives you encounter today are not like this.
00:56:58.300They are like competent, compassionate professionals who are not to blame for any of what I am about to say now, because this is when it gets gross.
00:58:25.600Because like Grantley DeGreed, Gaskin thinks that pain relief is like insufficiently natural, right?1.00
00:58:31.300She thinks that labor pain can and should be alleviated by a woman's own efforts to really like change her mindset.
00:58:38.220But unlike Grantley DeGreed, Gaskin doesn't just tell women to like change their minds and hence stop feeling pain.
00:58:46.100She goes a little bit further and invites fathers and partners into the birthing process in a very specific way, encouraging them to, among other things, stimulate the laboring woman's clitoris, French kiss them, and issue like encouraging kind of platitudes.
00:59:04.980So like one famous case that Gaskin and her sort of followers talk about is a birth where this husband tells his laboring wife that she's marvelous.
00:59:17.620And then the woman later says, oh, those beautiful words, as well as I guess all the sexual stimulation, opened my cervix and invited the baby out.
00:59:26.960So sexual stimulation of birthing and laboring women is really crucial to Gaskin's idea of a good birth.
00:59:34.980not really what I would think like of the mood as being,0.92
00:59:39.880but she seems to think that this is pretty crucial to it.
00:59:43.080I think this is pretty grim, to be honest with you.
01:00:02.320that Gaskin claims that if childbirth is done correctly,
01:00:04.980With sufficient stimulation from the father and an appropriately enlightened state of mind on the part of the mother, women will climax as they deliver.
01:00:14.960So not only will it not hurt, ladies, but if you're feminine enough, you will actually come.0.99
01:00:21.280Like, there's a lot that I find kind of nefarious, honestly, about the natural childbirth movement.
01:00:25.900I think their claims about women's spiritual and biological destiny to be mothers are regressive, reductive, essentialist, and, like, ultimately pretty sexist.
01:00:37.440I think their faith in the body as, like, a wise knower is, you know.
01:00:50.320And I think that they exploit women's fear and anger at the ways that their own bodies have been taken advantage of and the ways it may betray them to recruit women into an ideology that ultimately opposes their thriving and their equality.
01:01:04.060But this is an aspect of natural childbirth that I find both like politically suspect and also just frankly kind of annoying is that it's like relentlessly prescriptive and actually like kind of competitive, right?0.75
01:01:15.300So, like, women in natural childbirth spaces are always trying to, like, one-up each other.
01:01:20.980It's not enough to forgo an epidural.0.59
01:01:23.700You have to not feel any pain even without it, right?
01:02:37.520Yeah. So that means that if a birth involves painkillers or fear or a need for a medical intervention or even an acknowledgement that it hurts or a failure to orgasm, then that birth and the woman who goes through it are necessarily less than. It's so fucking judgmental.
01:02:54.180And in that sense, the natural childbirth movement, which I think people are drawn to out of these noble desires to free women from the degradation and pain that they often endure at the hands of doctors, it begins to look really fucking sexist and cruel.0.98
01:03:08.780It's just, it's so, yeah, it feels Victorian in its repressiveness, doesn't it?0.71
01:03:12.480Yeah, I think there's something like really gross about this prescription for orgasmic birth because it merges a bunch of patriarchy's different demands on women into like one kind of gross image.
01:03:24.780Like you have to be caring, you have to be self-sacrificing, you have to be alluring and sexy.
01:03:31.240And it's all just like all at once, right?
01:03:33.240It's like this crucible of patriarchal demands.0.99
01:03:36.140So it's like this mother is compelled to be simultaneously like womb moon earth mama matriarch and also like squirting sex pot at the fucking same time, right?1.00
01:03:50.020She's not relieved of sexual responsibility or of the demand to be sexy even when a child is ripping its way out of her vagina, right?1.00
01:03:58.480She's expected to achieve an orgasm or at least to perform one even as she's giving birth.1.00
01:04:05.460Like there's a word for this and it's not fucking liberation, you know, it's so fucking dark, man.0.99
01:04:12.440And that brings us to the sort of occasion of this episode, the free birth movement and the recent expose in The Guardian.0.98
01:04:22.020Adrian, do you want to like tell us a little bit about the story and about these people?
01:04:26.760Yeah, so The Guardian piece, there's a big investigation by Sharon Kale and Lucy Osborne that came out in November.
01:04:34.540And it's about these two, what would you call them?
01:05:03.660The first is that they find their flock, such as it is, and it sounds pretty culty, through podcasts.
01:05:10.660It was like, oh, we have competition in terms of culty podcasts.
01:05:14.800The second thing that was very telling is like what makes them extreme is that they reject not just medical science or reject medical intervention of any, in some cases, even of pre-birth, some cases just during birth.
01:05:28.060They even reject midwives and many doulas because they work, as we said before, hand-in-hand with doctors.
01:05:36.140The third thing that was really striking is that they then, unlike a normal birth doula, they don't come to your birth.
01:05:46.720They seem to just be texting you through it, which strikes me as absolutely bizarre.
01:05:52.680They went to some births, but then decided to stop after a few infant deaths.
01:07:09.900It's like, no, they are just like it's another dead child.0.98
01:07:12.960And you're like, this is this is fucking rough.0.99
01:07:15.540Yeah. So I think the free birth movement is kind of the natural endpoint of the logic of natural childbirth, right? Like if you take those assertions to their conclusions, this is where you end up.0.97
01:07:31.100If you believe that as some of these natural childbirth people are fond of saying the body does not grow babies that it cannot birth, which sorry, it absolutely fucking does.
01:07:41.940If you believe that your own death or the death of your infant is a preferable outcome to a C-section, if you are really so allergic to any kind of medical authority, any kind of sense that the body might not be perfect,
01:08:03.680any kind of, like, epistemic humility about all the things you do not know about birth
01:08:09.400and all the things that, like, might be able to go wrong,
01:08:48.960And she's standing in what appears to be a meadow.
01:08:51.900And, you know, closing her eyes serenely, presented really as this, like, earth mother.
01:08:57.520This is from one of the Free Birth Society's in-person retreats, which they call Matriarchy Rising.
01:09:03.800I should say that this group, which used to describe itself in what were like kind of discernible to me as like cultural feminist sort of terms,
01:09:12.240as a radical feminist group, changed its politics after Yolanda Norris Clark decided that she wanted to submit to her husband.
01:09:19.880I think the notion that women are biologically and sort of spiritually destined to be mothers is one that will come quite frequently into tension with feminist principles.
01:10:17.160I think this notion that like women's pain and mother's pain is necessarily beneficial or better for their children is like absolutely everywhere and not really empirically supported, like quite nefarious.0.87
01:10:30.420So I just don't think that women for whatever like legitimate and often like egregious grievances they have about the medical establishment should trust these people or just trust their bodies necessarily.0.98
01:10:46.620I think if you want them, ladies, you should go ahead and take the drugs.0.99