Childbirth organizations and first world problems

As the website First World Problems explains, "It isn't easy being a privileged citizen of a developed nation."

Consider:

The sun is too bright for me to read my iPhone screen.

Or:

I tried to unlock the wrong Prius today. Twice.

And my personal favorite:

I can't find the remote.

Evidently it isn't easy being a childbirth organization in first world country with extraordinarily low rate of perinatal and neonatal death. Hence the creation of first world problems that are the raison-d'être of childbirth organization.

As Madeline Akrich and colleagues explain in Practising childbirth activism: a politics of evidence:

What do childbirth organisations in Western countries do? A review of existing literature reveals a degree of similarity in their causes which cluster around four key goals: (1) problematising medical/technical intervention in birth; (2) promoting "natural"/"normal" or "mother friendly" birth; (3) demanding birth practices and settings that are attentive to and respectful of the desires of birthing women and their families and (4) championing women’s right to make informed choices about type and place of birth.

All four "causes" epitomize first world problems. By that I mean that these "problems" make no sense anyplace except where it is taken for granted that childbirth is incredibly safe and that access to emergency childbirth care is easily accessible, and always available.

In other words, contemporary childbirth organizations like Lamaze, the Childbirth Connection, etc. work tirelessly to convince women that first world problems are real, devastating and demand immediate action. It's a tough job, as evidenced by the first goal, which involves convincing women who are otherwise satisfied that there is a problem in the first place.

The authors describe that goal very well: problematizing birth interventions. It is absolutely critical for childbirth organizations to convince women that the interventions that save the lives of countless babies and mothers are "bad." They employ a variety of strategies to accomplish this critical goal. These organizations thrive by creating dissatisfaction and can't exist without it.

The strategies include claiming that childbirth interventions are:

• unnecessary
• unsafe
• overused
• harmful to the mother child-bond.

It doesn't matter whether the claims are true or not; most of them are false. Facts and scientific evidence have nothing to do with "problematizing" birth interventions.

It is this overwhelming need to "problematize" that explains some of the otherwise inexplicable tactics of childbirth organizations. The constant references to perineal shaving and enemas more than 30 years after they were dropped from practice is explained by the fact that existing childbirth practice are necessary. The demonization of C-sections is critical to convincing women that childbirth interventions are both unsafe and overused. Finally, the utterly fabricated claims about childbirth pain, interventions and bonding are used to convince women to fear and avoid the very interventions that can save their babies' lives.

All these strategies are deployed in an effort to create the ultimate first world problem: "My birth experience was ruined." All childbirth organizations, and many midwifery organizations, depend to a greater or less extent on convincing women that they have this first world problem and childbirth organizations have the solution: promoting "normal" birth.

“[N]ormalisation [of birth] is...the current driving force”... [T]he desirability of “normal” birth and guidelines to promote its achievement are widely espoused and integrated into international and national guidelines for the governance of health (WHO, 1996; NICE, 2007), into the professional self-definition of many midwifery groups at international and national levels and into the objectives of a range of lay childbirth organisations.

Both women and birth are reduced to their purported "essences," with the assumptions that technology destroys the essence of birth, and that the essence of all women is to desire a birth without technology. There is no room for individual beliefs and choices and indeed, these are denigrated as false consciousness resulting from societally induced "fear" of birth.

The third goal of childbirth organizations, ostensibly to demand processes that are more respectful of women, is a bit misleading. The real goal is to demand processes that are more respectful of natural childbirth professionals (like midwives, doulas, and those who run childbirth organizations). That's the whole point of "problematizing" technology in the first place. Practically speaking, "technology" is anything that cannot be provided by midwives, doulas and childbirth organizations.

The fourth goal, championing women's choices, is also misleading. Only specific choices (those that can be provided by midwives, doulas and childbirth organizations) are championed. For example, I'm not aware of a single childbirth organization that champions a woman's choice for an elective C-section or even for the general concept of applying more technology to childbirth.

The bottom line is that childbirth organizations exist to promote themselves. To that end they work tirelessly to create first world problems around childbirth and to convince women that they are the answer to the very first world problems that they have created.

The goal is to convince women they are suffering from the ultimate first world problem:

I had childbirth interventions and all I got was a healthy baby.