organic birth
lorna davies
A version of this article was also published in
MIDIRS Midwifery Digest, Vol 10, No 1, March 2000.
Reprinted with permission.
Whilst making coffee recently, my daughter asked if she
should use organic milk or 'normal' milk. I asked her why
she referred to the non-organic as 'normal' and she replied
that the organic milk, although more natural and less
interfered with, was less common and therefore not 'normal'.
I felt that this description lent itself well to analyse the
use of the word 'normal' in relation to birth.
The definition of 'normal birth' is subject to a huge range
of interpretations. However, it is apparent that the midwifery
model approach of evaluating each individual woman's birth on
its own basis to determine normal progress, has been superceded,
and normal birth has shifted from being perceived as a
physiological activity to being a medically assessed event.
Within maternity services in the UK currently, it is 'normal'
for most women to be hospitalised and to be cared for by a
stranger during labour. It is 'normal' for her to be offered
powerful pharmacological means of relieving the pains of labour,
and to be subjected to a host of other interventions from
augmentation of labour to routine administration of syntometrine.
Like my daughter's acceptance of non-organic milk as normal,
this commonplace approach to the care of labouring women
has likewise become acknowledged as the norm.
I recently watched a television programme about birth, where the
presenter suggested that the woman who had opted to birth her
baby at home (a beautiful birth incidentally) was 'very, very
brave'. The message that home birth is really not very normal
was clearly made. With a very small percentage of births taking
place in the home, for whatever reason, it is difficult to
contradict this commonly held opinion. The problem is that if
we consider something to fall outside the boundaries of social
norms then that thing becomes marginalised and therefore abnormal.
Ironically, many midwives would claim that the most
normal births that they have had the privilege to attend
have been home births.
As the so-called guardians of normal birth, it would seem
befitting for midwives to flag up the debate about the
definition of what really is or should be normal. Do midwives
want to be guardians of the current medicalised definition of
normal birth? Or do we need to redefine clearly what it is that
we mean? If by normal we mean less medicalised, less
interventionist and more physiological, we need to set out our
stall and be clear about the gains of a midwifery based
philosophical approach. Such benefits may speculatively be
demonstrated in increased satisfaction for both women and
carers, less long term health problems, less post-natal
depression and ultimately improved parenting.
Midwives need to inform the public, hospital managers and
doctors about the advantages of such a definition. We have to
counter the barrage of misinformation that is served to the
public from personal and social education in schools, to the
representations of birth within the media. Midwifery education
needs to take a long hard look at what it has become and where
it is going. Likewise, medical education must include a
'midwifery' element in addition to obstetrics.
I would suggest that the current use of the term 'normal' in
relation to birth is confusing the issue. Until we are able to
define what normal is within our own cultural landscape of
midwifery, how can we begin to expect to achieve a collective
societal vision of 'normal birth'?
Perhaps in the short term we need to dispose of the term normal
in relation to birth and find a suitable alternative.
Physiological birth perhaps, or even organic birth!