Natural or Unnatural?

More than a century of medical progress designed to make childbirth a "more comfortable and happy event" is being slighted in the current craze for "natural childbirth," says a team of four Baltimore physicians. "It is no longer considered smart talk at the bridge table to discuss twilight sleep or painless labor," the doctors* say in Psychosomatic Medicine. "The woman of the day is one who can vividly describe every last detail of her delivery, including the ecstasy of the unassisted expulsion of the placenta."

This sort of thing prompts the doctors to ask: "Is natural childbirth natural?" Up to a point, yes, they reply. Unreasonable and unfounded fear of labor pains undoubtedly makes the pains worse, so it is a good thing to get rid of the fear. The "natural childbirth" training prescribed for pregnant women by Britain's Dr. Grantly Dick Read helps to relax the patients, the Baltimoreans concede. They also grant that, as practiced by well-drilled specialists in the U.S., the method may do no great harm.

But the first thing to recognize, in the judgment of the Baltimore doctors, is that a good deal of pain is normal in childbirth. Secondly, the worst of the pain can be made more easily bearable by the use of drugs. If a woman knows that this will be done, she is not so likely to have unreasoning, exaggerated fear of the pain itself. Moreover, there is a further distinct problem: many women have deep-seated anxieties which have nothing to do with physical pain--e.g., fear of increased responsibility, loss of personal freedom, economic hardships and overcrowding of the home.

Worries of this kind, say the Baltimore researchers, can make childbirth more difficult if they are not treated properly. And, they are confident, the Read method is not the right way to treat them. On the contrary, it can mask them and make them worse.

The authors are amused by what they call Read's "psychological lobotomy," and by some of his recent claims, e.g., "Children who have been born according to the laws of nature will be evidence of its psychological value as they grow to maturity. It will be easy to recognize [them]" The Baltimoreans' conclusions:1) "natural" childbirth, as peddled today, is nothing of the sort; 2) it can help some women to get by with smaller doses of pain-killing drugs; 3) its advantages are being so grossly exaggerated in "unbridled publicity" that tried & true methods are suffering unfairly by comparison.

*Drs. Arthur J. Mandy, Theodore E. Mandy, Robert Farkas and Ernest Scher.

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