Current Issue of Midwifery and Women's Health Journal Tackles "Normal" Birth

By Rachel Walden — May 4, 2010

The May/June issue of the Journal of Midwifery and Women’s Health is a special issue on the topic of “normal” birth. It begins with an editorial that recognizes the problems inherent in that term, asking, “It is a word that dichotomizes—if you are not ‘normal,’ then you must be abnormal, atypical, disordered, unhealthy, or irregular—and who wants those labels?”

The author of the editorial, Holly Powell Kennedy, CNM, PhD, goes on to summarize her view of the problem with our current approaches to birth:

I suggest that our culture has situated childbirth fully in risk and normalized childbirth interventions. It is a paradox in which tremendous resources are poured into preventing rare events rather than supporting most women to avail themselves of resources to sustain and improve their health. Fear of birth has become the foundation of childbearing in US culture…We live in a society where women are likely to have heard only birth stories that include epidurals and cesareans. It is a culture that deifies technology and control, with no room for uncertainty of any kind or for less than perfect outcomes…We have boxed ourselves into a corner and must, for the health of women and infants, find a way out.

Other articles in this special issue address midwifery, the case for VBAC, Dutch and English systems of maternity care, labor pain, approaches to “normal” birth, collaboration among care providers, lessons to be learned from home birth, and related topics.

The whole issue is interesting reading for folks interested in midwifery and birth; if you’ve read any of the articles and want to discuss them, feel free to share your thoughts in the comments!

5 responses to “Current Issue of Midwifery and Women’s Health Journal Tackles “Normal” Birth”

  1. The editorial illustrates the worst of contemporary midwifery.It is obsessed with labeling women, dividing them into those who give birth following the preapproved directives and those who do not. The language used, words like “natural” and “normal,” is deliberately and profoundly judgmental. Midwifery is obsessed with process; the outcome is virtually irrelevant and never even mentioned in the editorial.

    Women like Holly Powell Kennedy have appointed themselves arbiters of birth. They define, they judge, they pontificate. They are mean and they are wrong.

  2. Amy,

    It is blatantly false and deliberately inflammatory to claim that midwifery is not concerned with outcome and that process is the only important factor to those promoting normal birth.

    Furthermore “normal” does not have to be “judgmental”- it is describing the birth, not the woman. There is importance and value in distinguishing between physiologically normal birth and inappropriately manipulated birth, or births which require medical intervention and help.

    The process *does* affect the outcome, which is why midwives and others are passionate about protecting the normal process. In the vast majority of cases, promoting a normal process of labor leads to best outcomes for mothers and babies.

    Of course, for those moms and babies who need intervention and technology, it’s wonderful and appropriate to use it for them, **when it’s indicated** because their labors may not be proceeding normally. In other cases, when technology and procedures are used routinely rather than when individually indicated, it violates the principle of “First do no harm.”

    Why is that so hard to understand????

  3. It becomes so easy to dismiss someone who has a passion if you haven’t been in their shoes. Having seen first hand the long term damage that hits a family when there is severe trauma in birth – I will always stand strong for normal and natural birth – but more than that – I will stand for the mother’s rights and desires. A woman who has been molested as a child may need emotionally to give birth via cesarean – if she’s forced to birth “naturally and normally” it could be damaging…and we ALL need to respect the needs and rights of the mothers. No matter how odd we may personally feel about their choices. Lets focus on avoiding trauma instead of forcing people to do what we believe is best!!!

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