The Strange Nostalgia of Childbirth
Agnes Arnold-ForsterNostalgia inflects modern childbirth. When I first became pregnant, back in August 2022, I joined a few Facebook groups dedicated to home births. Partly motivated by curiosity, partly because I was considering the option myself, I spent some time scrolling back through past posts, reading through other women’s experiences, their questions and anxieties. By definition, people who advocate home birth also advocate “natural” birth, by which they mean unmedicated, vaginal deliveries, with minimal or no medical intervention.
In these social media interactions, women recorded their dissatisfaction with “modern” medicine, lamented the intrusion of male clinicians into the birth space, and yearned for a time when people were allowed to labor “as nature intended.” As a historian of medicine, it was strange seeing these sentiments in my own real life because I’d seen them before, elsewhere, in 1970s feminist critiques of reproductive care and in feminist histories of medicine.
Second-wave feminists concerned themselves with childbirth. Features in magazines discussed the empowering nature of home birth on the one hand, and the traumatic and humiliating experiences of women forced to labor in hospitals on the other. They adopted the language of the obstetrician Grantly Dick-Read, who coined the term “natural childbirth” in 1933. The first president of the UK’s Natural Childbirth Association, now called the National Childbirth Trust (NCT), he argued that labor would best progress without clinical intervention. There was a perverse nostalgia to Dick-Read’s theories: he argued that risky and problematic births were a product of “civilization” and that “primitive” (by which he meant non-white) women didn’t experience labor pains.
In the months approaching my due date, my partner and I attended a series of sessions run by the NCT. Together with seven other couples, we sat on too-small chairs in a Victorian school hall and talked about our hopes and fears for labor, birth, and parenting. The NCT was founded in the 1950s by a group of women troubled by the way childbirth was managed by the health service. Several had experienced traumatic births at the hands of a paternalistic, clinical, even cruel obstetric profession. They championed midwifery, community, and “natural” birth – and they turned out to be remarkably influential, not just on birthing people, but on maternity services in the British National Health Service (NHS).
One of their legacies is the continuing ubiquity of their antenatal classes. While other providers offer similar services, the NCT remains the most widespread and is for many parents synonymous with the process of learning how to give birth and care for babies. The classes are led by someone trained by the NCT–sometimes they’re ex- or current midwives, sometimes they’re lay mothers. In reality, practices vary, and the advice given depends very much on the personality and perspectives of the individual leading the classes. Our leader was not a midwife, but a mother of two, compassionate, thoughtful, eager to do right by us. She was keen to insist that there were many ways to give birth and that we should prepare for all eventualities. But still, we spent a lot less time talking about inductions, epidurals, and c-sections than supposedly “natural” alternatives. Almost everyone in the class planned for a vaginal delivery, ideally a water birth, and hopefully without pain relief of any kind.
Much like the women I’d read about on social media, and in an unintentionally similar way to Dick-Read, my fellow classmates and I were harking back to an old, supposedly lost way of giving birth. And while less explicitly racist in their narratives than Dick-Read, feminist activists and historians of reproduction in the 1970s were also nostalgic for pre-modern birth. They argued that prior to c.1800, childbirth in the United States and Europe was an exclusively female realm. Over the course of the late eighteenth and nineteenth centuries, the male-dominated medical profession extended into the domain of women’s health. Male obstetricians were increasingly involved in live births and began to challenge the social and intellectual authority of midwives. These feminist scholars implied that pre-modern childbirth was a positive environment and that the “modernization” of reproductive medicine made the experience worse for women: “The crowd of supportive friends and family disappeared with the arrival of the doctor.”
I gave birth in May of last year. My baby was two weeks overdue, and after four days of sleepless, induced labor, he was born via emergency c-section. This very non-natural birth was, then, the exact opposite of what I had planned. I am a historian of medicine, a historian of reproduction even, and I should have known better. Rates of induced labor and the proportion of births that end in emergency c-sections are high and on the rise. But more than that, my historical training should have inoculated me against the strange nostalgia of childbirth, the idea that birth before the coming of modern medicine was somehow safer, more life-affirming, and more meaningful. I should have been able to recognize the logical inconsistencies, the cruel ironies, and the perverse incentives of “natural” childbirth – realized that “natural’” is a historical construction, that “natural” is nothing to aim for, and that not being “natural” is nothing to be ashamed of. It is disorientating, dislocating to think you know something intellectually, but then being unable to apply quite the same critical faculties when it comes to your own life.
The women who founded the NCT were harmed by the healthcare system they birthed in. But feminist narratives of “natural” childbirth also failed me.
In the days and weeks after my baby was born – happy, healthy, loved – I felt desperate, gnawing shame. A midwife came to the house to discharge me and my son from their services. She weighed him, examined us both, and determined us healthy. She asked how I was feeling. I said fine, but that I was struggling to come to terms with how my birth had panned out. I felt like I had failed, and I felt a real grief that I had somehow been deprived of the experience I had planned and hoped for. I didn’t understand why it had worked out the way it did. I had done all the right things: drank red raspberry leaf tea, walked for miles, and consumed my own weight in dates. But my baby had refused to come on his own, and even after four days of drug-aided persuasion, he had defied our collective efforts. His heart rate dropped, we both became sick, and I finally agreed to a c-section.
I explained what had happened, accounted for my confused feelings, and acknowledged the absurdity of it all. The midwife looked at me, cocked her head to one side, and said, “At least you didn’t bring home a death certificate.” Of course, she was right; I’m glad both me and my baby survived birth. But she was also callous, failing to recognize the emotional, hormonal turmoil of those postpartum days, and refusing to admit to the powerful allure of the “natural” childbirth movement, a movement that many NHS midwives are themselves complicit in perpetuating and institutionalizing.
As a historian of medicine, my healthcare experiences and how I inhabit my body have, time and again, come in contact with my academic work. My encounters with the healing professions and my scholarship sit uneasily side by side. They should illuminate each other, and they do. But they also exist in tension. Despite making it my business to turn a critical eye on the cultures and ideologies of medicine, I was still seduced by a sentimental, idealized, and nostalgic vision of childbirth–a vision that made my experience of labor and postpartum worse, not better; harder, not easier.
Featured image caption: A home birth, oil painting by Karl Hagedorn, c. 1950-1959. (Courtesy Wellcome Collection)
Agnes Arnold-Forster is a researcher in the Social Studies of Medicine Department at McGill University. Her first book, The Cancer Problem, was published by Oxford University Press in January 2021. She is co-PI on the Wellcome Trust–funded project, Healthy Scepticism.