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Push Back: Guilt in the Age of Natural Parenting
A Harvard-trained obstetrician-gynecologist, prominent blogger, and author of the classic How Your Baby Is Born delivers a timely, important, and sure to be headline-making expose that shines a light on the natural parenting movement and the multimillion-dollar industry behind it. The natural parenting movement praises the virtues of birth without medical interference, staunchly advocates breastfeeding for all mothers, and hails attachment parenting. Once the exclusive province of the alternative lifestyle, natural parenting has gone mainstream, becoming a lucrative big business today. But those who do not subscribe to this method are often made to feel as if they are doing their children harm. Dr. Amy Tuteur understands their apprehensions. “Parenting quickly feels synonymous with guilt. And of late, there is no bigger arena for this pervasive guilt than childbirth.” As a medical professional with a long career in obstetrics and gynecology and as the mother of four children, Tuteur is no stranger to the insurmountable pressures and subsequent feelings of blame and self-condemnation that mothers experience during their children’s early years. The natural parenting movement, she contends, is not helping them raise their children better. Instead, it capitalizes on their uncertainty, manipulating parents when they are most vulnerable. In Push Back , she chronicles the movement’s history from its roots to its modern practices, incorporating her own experiences as a mother and successful OB-GYN with original research on the latest in childbirth science. She also reveals the dangerous and overtly misogynistic motives of some of its proponents—conservative men who sought to limit women’s control and autonomy. As she debunks, one by one, the guilt-inducing myths of natural birth and parenting, Dr. Tuteur empowers women to embrace the method of childbirth that is right for them, while reassuring all parents that the most important thing they can do is love and care for their children.
384 pages, Paperback
First published April 5, 2016
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February 23, 2017
This book disappointed and depressed me. It had so much promise yet wound up feeling like just yet another example of how all discourse on motherhood needs to be a zero sum game, where no women get permission to make their own choices without some other group of women being put down.
I'm kind of not sure why I picked it up in the first place, since I am definitely done having babies (unless we are about to enter some horrific Handmaid's Tale dystopia -- highly likely -- in which they draft elderly women into involuntary reproduction -- thankfully less likely, so I'm probably safe). I guess I do know, actually: it's because I hate "attachment parenting" and am angry that it exists as a construct and wanted to have my personal views affirmed by an outside source, and because I'm still kind of trying to process my exposure to all the natural childbirth stuff and my own experience with contemporary childbirth culture surrounding the birth of my two kids (now eight months and two-and-a-half).
What was disappointing was that I agreed with a lot of what Tuteur wrote, but the way she said it was just so shitty and condescending. That echoes one of her points that I agree with the most: that as with anorexia, current bourgie American natural childbirth mores demonstrate how even some of the most privileged women who have ever existed in time or space must suffer and be made to feel miserable and inadequate, often by other women.
Where to start? Well, there were a lot of things I did like about this book. As I mentioned, attachment parenting really upsets me, and since I've always wondered how that idea developed from the Winnicott I remembered from social work school (whose contribution I've always recalled as the infinitely more helpful "good-enough mother") I was glad to see that explained here. And I've never liked those creepy Sears people who kept telling me I was evil to eat sugar while pregnant, so it was vindicating to see them unmasked as malevolent religious fanatics. I've been saying this whole time that attachment parenting and this intense breastfeeding push were both antifeminist plots, so it was kind of nice to see someone who agrees with me provide historical evidence to argue that.
So I guess I can't talk about my response to this book without reference to my own experience. I read a slew of natural childbirth books while I was pregnant with my first kid, and they scared the shit out of me. I read Ina May Gaskin. I hired a doula. I fretted about the hospital. I wound up, with that kid and the second, being extremely lucky and having very easy, unmedicated labors during which I stayed at home until what felt like the very last minute, then both times gave birth without complications or interventions within an hour of arriving at the public hospital in Miami. I feel really fortunate for these experiences, though the hospital part kind of sucked (especially the second time).
So I had positive experiences with unmedicated labor, breastfed both babies without incident and then, due to life circumstance rather than original intent, have been more or less stuck home with my kids, which pretty clearly puts me in the camp of pathetic anti-feminist bourgie ladies who should be out doing something important, like being an obstetrician. I do not sleep in a bed with my children and never have. I do own a product that attaches my baby to my body, which I often but certainly not always prefer over the stroller for practical reasons (hands free, can do stairs). I believe vaccines are among the greatest inventions of modern times. This book report is the closest thing I've done to mommy blogging. I don't think I'm exactly the natural-parenting moron Tuteur has in mind, but I guess I must be enough of one that this book did make me defensive.
The problem is that rather than get into some nuance and actual grey areas, Tuteur sets up strawmen (or straw-midwives) and is only interested in extremes. I understand that, because childbirth right now is a bizarrely polarized topic, and also because those extreme wingnuts that she cites do exist. I have seen them firsthand online, which is why I learned early not to google anything baby-related... Note to new moms: DO NOT ASK THE INTERNET ANY SLEEP QUESTIONS! Those message boards are dominated by demented sadists who will tell you that crying will damage your infant's brain... which is to say, I get it, I do, it's very ugly out there. But still.
Tuteur, being a doctor, is offended, appalled, and baffled that any woman of sound mind wouldn't embrace the full-on medicalized hospital birth with open arms. In fact, if they don't, those women are silly, entitled, selfish fools who want to relish masochistically in a trivial "experience" they're probably only allowed to have because they and their mothers were prevented from gory deaths by advances in the very branch of medicine they now abhor. The thing is, in her airy effort to dismiss any anti-medical witchery, Tuteur elides the reality that there in fact aspects of the hospital birth experience that women might reasonably wish to avoid. I have personally have a (male, older) ob-gyn tell me to my face that if people want to reduce unnecessary c-sections, they need to "make it worth our while" by changing the way doctors are reimbursed. That is reality. Getting yelled at and pressured by mean, tired nurses to take drugs you don't want is also reality. Having at least ten people you've never met before gathered around your gaping vagina screaming at you to push while your feet are in stirrups and you're bathed in fluorescent light and rigged to beeping machines does not seem like the best or only possible way to give birth, but it is reality. The reason I do share my own "birth story," despite knowing that's obnoxious, is that all the stories I'd heard while pregnant involved medical interventions or levels of suffering I found terrifying, and I seriously doubted that it was possible to give birth without either -- or more likely, both, because the ubiquity of those experiences is real.
Another thing that's real, for me, is feeling that childbirth was a meaningful experience for me, and I don't think that makes me a bad feminist. For me the major appeal of Gaskin and her ilk was that all I heard from the medical people was about what could go wrong, and how childbirth was a hazardous and awful experience. Now, I totally get this, and it's pretty obviously the major point of disagreement between Tuteur and her enemies: yes, things can go wrong, horribly. To deny or minimize that is both unethical and insane. I could have done without Tuteur's graphic example of a newborn's skull being crushed by forceps, but I guess this isn't simple fearmongering but an illustration of her central point: that childbirth is very dangerous. At one point she writes, "Claiming that 'pregnancy is not a disease' is like claiming that a gunshot is not a disease, and thus you should be allowed to heal unhindered."
Uh, wait, what? Okay so that really does seem to be how doctors see pregnancy (especially for elderly women like me), but to my mind pregnancy and childbirth are nothing like a gunshot; they are much more like riding a motorcycle. That is, they are inherently highly risky, but there are precautions one can take to make them somewhat less so, and each woman should decide which degree of risk she's willing to accept.
Personally, I would never ride a motorcycle without a helmet, but unlike many wiser people I would ride a motorcycle (and did, until I got pregnant and no longer found that risk acceptable). I think according to Tuteur's logic, staying at home until you are ready to give birth is probably a selfish, speeding-around-twisties behavior, since if there had been some problem during labor that would have been detected by a fetal monitor, it could have been missed; I'm not sure what she'd say. I can see a lot of selfish, arguably risky choices in my own preference for an unmedicated vaginal birth. I was very, very scared of having a c-section, in some small part because of the guilt-inducing natural childbirth literature, but mostly because I didn't want to have major abdominal surgery if I didn't need to. I didn't want to have an epidural for similar reasons: because I'd read about the cascade of effects Tuteur is so dismissive of, even while she briefly acknowledges that an epidural can make it difficult or impossible to push, and is much handier for a c-section. Having a baby vaginally is taxing enough on a woman's body; surgery? That sucks! The recovery time is much longer and there's a lot that can go wrong. I feel like she made it sound like efforts to achieve a vaginal birth are all part of some deluded, sad effort by overprivileged competitive women who don't know anything about science, and as if the only reason not to have a c-section is that the other women in your pumpkin-spice latte book club will shame you if you do your birth "wrong," and I find that patronizing.
I guess it's important to acknowledge that this book wasn't for me, because I did have a surprisingly (well, I was surprised) easy time with unmedicated vaginal delivery and breastfeeding, which leaves me in the minority among new mothers I know, who are primarily college-educated white women of economic privilege in their mid-thirties, i.e., the demographic described in Tuteur's book. And one of the reasons I was interested in reading this is because I did want something to recommend to any friends, going forward, to counteract all this pervasive hogwash out there about how you need to have a "natural" birth and breastfeed and then crucify yourself nightly with organic asparagus for your spawn. I already experience a ton of guilt about my innumerable failures as a mother despite having met the natural childbirth criteria, and I know I'd like to have more ammunition to counter those prevailing cultural trends, especially when I see someone I love agonizing about the prospect that she might need to poison her baby with -- horror of horrors! -- formula, or commit some other cardinal sin.
Another place I agree with Tuteur is that that is such bullshit, and she's absolutely right that there is this sick culture of guilt and competition that makes women feel bad if they don't do that stuff. Honey! If you want an epidural, get a damn epidural! Personally, I did not want one because mobility was more important to me than pain management, at least in theory, and I was so scared of surgery, and OBVIOUSLY, MAINLY because I had a very short labor with no complications. But I knew going into it that the drugs were an option that were available and that if things didn't go just how I wanted, I was going to take whatever I could get. And I think it's absolutely disgusting that anyone is bullied into feeling otherwise. That is why they made drugs in the first place, to have on hand at times just like these!
I have also seen women go to insane lengths over this breastfeeding business, and I secretly consider insane lengths to include pumping at work when the kid is over six months. Pumping is industrial dairy cow torture... and when I see people having problems with breastfeeding for whatever reason, going through all that pain and trouble, I feel like there must be something wrong with the gold stars we've plastered all over breastmilk. The main reason to breastfeed is ease and convenience, so if it's not easy or convenient, the hell with it. (The main reason NOT to breastfeed, in the absence of such obstacles, is that it is honestly staggering the extent to which this makes you not just the primary but kind of the only parent. I completely failed to grasp the implications of this before I started, and I wish we could have a reasonable conversation about the involved issues of capitalism and feminism, which is what I was hoping for from this book but didn't find in a substantive way.) I mean, look at all those Baby Boomers stomping around. I don't think most of them ever tasted breastmilk, and as a generation they turned out mighty hale and hearty, don't you think? To a large extent I agree with Tuteur that lactation consultants can be the WORST, since I heard the ones at the hospital make the most ignorant, judgmental, coercive pronouncements; this is a place where I found the anti-feminism she describes to be very pronounced. However, her descriptions of midwives and doulas I felt painted with an overly broad brush. I hired a doula because I didn't have friends or family where I lived and was terrified of the hospital, and she turned out to be completely unnecessary but she was certainly not this manipulative she-devil of the type Tuteur describes, and I'm sure would've been totally supportive of whatever decisions I might've made. There is a lot more nuance in this world than she sees, and I think she doesn't want to see it because she's fundamentally dismissive of the desire the natural childbirth industry is responding to.
As I mentioned above (I have to assume no one's reading anymore; I'm killing this bottle of wine and bag of Trader Joe's trail mix, please forgive me if you're still there), the medical model is focused on brain-dead babies and absolutely everything terrible that could possibly go wrong. Push Back catalogues how dangerous childbirth used to be (can't argue with that, obviously) and extensively details how much childbirth and breastfeeding both just totally suck.
Here's what I think she doesn't get: women don't want to feel like childbirth and breastfeeding just totally suck. Tuteur is very, very down on the "biological essentialism" of the natural childbirth industry, but you know what? That view is very compelling to a pregnant/postpartum woman. You know why? Because being a woman, even today, even if you're an extraordinarily privileged one, compared to being a man, pretty much sucks, and it always has. And the main reason it sucks is this whole childbearing thing, and everything that's attached to that... and so the doctors come along and they're like, "Yes, this is terrible. Your position in society is lesser, your biology screws you, and now you need to do this dreadful dangerous thing, ugh, and you might die and your baby might too, so we'll hook you up to these machines and scream into your vagina and do scary things and it'll all be over soon if you only do all that we say" but then the midwives et al. are like, "No actually having babies is completely amazing, and you're going to have this thrilling and revelatory experience that'll make you realize being a woman doesn't just totally suck after all, in fact it's magical and great" and that latter sounds much better, infinitely more appealing, especially when you are all jacked up with a growing creature inside your body wrecking it forever.
And you know what else? I think they're right. I think they're right and I think Tuteur misses why women are attracted to what they're selling because she think women who buy it are just dumb. And okay, a lot of us are dumb (especially the anti-vaxxers), but actually there is something there.
I read Ina May Gaskin's book and I thought she was a kook, but it did help me. It helped me because before that point, I'd really felt like I'd gotten myself into this impossible situation that only a lot of luck and some incomprehensible medical science could get me out of, and I was really scared. But then she, and all those other MacBeth-style witches, were like, "No, actually this is what your body was made to do," and that encouragement really helped me a lot, even if it isn't strictly evidence-based or peer-reviewed.
And actually, giving birth helped me a lot. I feel like so much of my life has been about taking note of ways that men are inherently better or more advantaged than me. After I had my first baby, I went back to my boxing gym where I was basically the only woman, and I looked at things in such a different way than I ever had before. I'd always felt weaker, but for the first time I knew I was actually stronger, and I just silently laughed at all the men thinking they were so tough with their big muscles and dumb games. For me, knowing I'd gone through labor and pushed a baby out had shown that to me. If I'd had surgery, I would've felt that demonstrated it even more. Tuteur thinks being unscientific and irrational and essentialist about this stuff shows you're weak-minded and buying a crap bill of goods, but I don't think so. I think childbirth and rearing has a meaning for many women that the New Agey hoo-hah types tap into, and I don't think it's all dumb, I think that need for meaning is real, and I think it compensates in a significant way for losses women feel in other areas of their lives (I do understand her argument that this can be a problem insofar as it recenters motherhood as the center of women's lives at the expense of other things, a real issue I'm dealing with in my own life so I'll need to get back to you on that). I also think childbirth is a legitimately significant event for many women, even if it's been problematically fetishized in certain circles.
Okay, so this has certainly gone on long enough. If anyone's still reading this, I apologize; I don't get out much these days.
Despite being massively turned off by her condescending and dismissive tone, I might recommend this book to pregnant women or new mothers who are being bullied or just overly saturated by a lot of "natural childbirth" malarky, especially if it's left you feeling bad about anything you are or not doing or might in the future do or not do. It's true that there are weird, culty cottage industries built around this stuff, and it's also true that these issues seem to bring out the worst instincts in women (I think because we are all so insecure and stressed about our own failings as moms, so tend to double down on what we're doing and deride what we're not). Remember that drugs can be great, safety comes first, and formula is not poison. Crying doesn't cause brain damage. Internet message boards are not helpful; if you need advice about your horrible screaming baby, ask an older person: their solution will be much less labor intensive. Do not ask your friends, especially if they live in California or Brooklyn. Also, don't worry too much about childbirth: it doesn't last long in the grand scheme of things. The hard part comes later. Finally: don't beat yourself up. Really. The world will do enough of that, because one of the only groups that gets more shit than women from all quarters is... mothers. And the sharpest critics are their peers, so pretty much just do what you feel, get as much help as you can, and try not to buy too much junk you don't need.
I'm kind of not sure why I picked it up in the first place, since I am definitely done having babies (unless we are about to enter some horrific Handmaid's Tale dystopia -- highly likely -- in which they draft elderly women into involuntary reproduction -- thankfully less likely, so I'm probably safe). I guess I do know, actually: it's because I hate "attachment parenting" and am angry that it exists as a construct and wanted to have my personal views affirmed by an outside source, and because I'm still kind of trying to process my exposure to all the natural childbirth stuff and my own experience with contemporary childbirth culture surrounding the birth of my two kids (now eight months and two-and-a-half).
What was disappointing was that I agreed with a lot of what Tuteur wrote, but the way she said it was just so shitty and condescending. That echoes one of her points that I agree with the most: that as with anorexia, current bourgie American natural childbirth mores demonstrate how even some of the most privileged women who have ever existed in time or space must suffer and be made to feel miserable and inadequate, often by other women.
Where to start? Well, there were a lot of things I did like about this book. As I mentioned, attachment parenting really upsets me, and since I've always wondered how that idea developed from the Winnicott I remembered from social work school (whose contribution I've always recalled as the infinitely more helpful "good-enough mother") I was glad to see that explained here. And I've never liked those creepy Sears people who kept telling me I was evil to eat sugar while pregnant, so it was vindicating to see them unmasked as malevolent religious fanatics. I've been saying this whole time that attachment parenting and this intense breastfeeding push were both antifeminist plots, so it was kind of nice to see someone who agrees with me provide historical evidence to argue that.
So I guess I can't talk about my response to this book without reference to my own experience. I read a slew of natural childbirth books while I was pregnant with my first kid, and they scared the shit out of me. I read Ina May Gaskin. I hired a doula. I fretted about the hospital. I wound up, with that kid and the second, being extremely lucky and having very easy, unmedicated labors during which I stayed at home until what felt like the very last minute, then both times gave birth without complications or interventions within an hour of arriving at the public hospital in Miami. I feel really fortunate for these experiences, though the hospital part kind of sucked (especially the second time).
So I had positive experiences with unmedicated labor, breastfed both babies without incident and then, due to life circumstance rather than original intent, have been more or less stuck home with my kids, which pretty clearly puts me in the camp of pathetic anti-feminist bourgie ladies who should be out doing something important, like being an obstetrician. I do not sleep in a bed with my children and never have. I do own a product that attaches my baby to my body, which I often but certainly not always prefer over the stroller for practical reasons (hands free, can do stairs). I believe vaccines are among the greatest inventions of modern times. This book report is the closest thing I've done to mommy blogging. I don't think I'm exactly the natural-parenting moron Tuteur has in mind, but I guess I must be enough of one that this book did make me defensive.
The problem is that rather than get into some nuance and actual grey areas, Tuteur sets up strawmen (or straw-midwives) and is only interested in extremes. I understand that, because childbirth right now is a bizarrely polarized topic, and also because those extreme wingnuts that she cites do exist. I have seen them firsthand online, which is why I learned early not to google anything baby-related... Note to new moms: DO NOT ASK THE INTERNET ANY SLEEP QUESTIONS! Those message boards are dominated by demented sadists who will tell you that crying will damage your infant's brain... which is to say, I get it, I do, it's very ugly out there. But still.
Tuteur, being a doctor, is offended, appalled, and baffled that any woman of sound mind wouldn't embrace the full-on medicalized hospital birth with open arms. In fact, if they don't, those women are silly, entitled, selfish fools who want to relish masochistically in a trivial "experience" they're probably only allowed to have because they and their mothers were prevented from gory deaths by advances in the very branch of medicine they now abhor. The thing is, in her airy effort to dismiss any anti-medical witchery, Tuteur elides the reality that there in fact aspects of the hospital birth experience that women might reasonably wish to avoid. I have personally have a (male, older) ob-gyn tell me to my face that if people want to reduce unnecessary c-sections, they need to "make it worth our while" by changing the way doctors are reimbursed. That is reality. Getting yelled at and pressured by mean, tired nurses to take drugs you don't want is also reality. Having at least ten people you've never met before gathered around your gaping vagina screaming at you to push while your feet are in stirrups and you're bathed in fluorescent light and rigged to beeping machines does not seem like the best or only possible way to give birth, but it is reality. The reason I do share my own "birth story," despite knowing that's obnoxious, is that all the stories I'd heard while pregnant involved medical interventions or levels of suffering I found terrifying, and I seriously doubted that it was possible to give birth without either -- or more likely, both, because the ubiquity of those experiences is real.
Another thing that's real, for me, is feeling that childbirth was a meaningful experience for me, and I don't think that makes me a bad feminist. For me the major appeal of Gaskin and her ilk was that all I heard from the medical people was about what could go wrong, and how childbirth was a hazardous and awful experience. Now, I totally get this, and it's pretty obviously the major point of disagreement between Tuteur and her enemies: yes, things can go wrong, horribly. To deny or minimize that is both unethical and insane. I could have done without Tuteur's graphic example of a newborn's skull being crushed by forceps, but I guess this isn't simple fearmongering but an illustration of her central point: that childbirth is very dangerous. At one point she writes, "Claiming that 'pregnancy is not a disease' is like claiming that a gunshot is not a disease, and thus you should be allowed to heal unhindered."
Uh, wait, what? Okay so that really does seem to be how doctors see pregnancy (especially for elderly women like me), but to my mind pregnancy and childbirth are nothing like a gunshot; they are much more like riding a motorcycle. That is, they are inherently highly risky, but there are precautions one can take to make them somewhat less so, and each woman should decide which degree of risk she's willing to accept.
Personally, I would never ride a motorcycle without a helmet, but unlike many wiser people I would ride a motorcycle (and did, until I got pregnant and no longer found that risk acceptable). I think according to Tuteur's logic, staying at home until you are ready to give birth is probably a selfish, speeding-around-twisties behavior, since if there had been some problem during labor that would have been detected by a fetal monitor, it could have been missed; I'm not sure what she'd say. I can see a lot of selfish, arguably risky choices in my own preference for an unmedicated vaginal birth. I was very, very scared of having a c-section, in some small part because of the guilt-inducing natural childbirth literature, but mostly because I didn't want to have major abdominal surgery if I didn't need to. I didn't want to have an epidural for similar reasons: because I'd read about the cascade of effects Tuteur is so dismissive of, even while she briefly acknowledges that an epidural can make it difficult or impossible to push, and is much handier for a c-section. Having a baby vaginally is taxing enough on a woman's body; surgery? That sucks! The recovery time is much longer and there's a lot that can go wrong. I feel like she made it sound like efforts to achieve a vaginal birth are all part of some deluded, sad effort by overprivileged competitive women who don't know anything about science, and as if the only reason not to have a c-section is that the other women in your pumpkin-spice latte book club will shame you if you do your birth "wrong," and I find that patronizing.
I guess it's important to acknowledge that this book wasn't for me, because I did have a surprisingly (well, I was surprised) easy time with unmedicated vaginal delivery and breastfeeding, which leaves me in the minority among new mothers I know, who are primarily college-educated white women of economic privilege in their mid-thirties, i.e., the demographic described in Tuteur's book. And one of the reasons I was interested in reading this is because I did want something to recommend to any friends, going forward, to counteract all this pervasive hogwash out there about how you need to have a "natural" birth and breastfeed and then crucify yourself nightly with organic asparagus for your spawn. I already experience a ton of guilt about my innumerable failures as a mother despite having met the natural childbirth criteria, and I know I'd like to have more ammunition to counter those prevailing cultural trends, especially when I see someone I love agonizing about the prospect that she might need to poison her baby with -- horror of horrors! -- formula, or commit some other cardinal sin.
Another place I agree with Tuteur is that that is such bullshit, and she's absolutely right that there is this sick culture of guilt and competition that makes women feel bad if they don't do that stuff. Honey! If you want an epidural, get a damn epidural! Personally, I did not want one because mobility was more important to me than pain management, at least in theory, and I was so scared of surgery, and OBVIOUSLY, MAINLY because I had a very short labor with no complications. But I knew going into it that the drugs were an option that were available and that if things didn't go just how I wanted, I was going to take whatever I could get. And I think it's absolutely disgusting that anyone is bullied into feeling otherwise. That is why they made drugs in the first place, to have on hand at times just like these!
I have also seen women go to insane lengths over this breastfeeding business, and I secretly consider insane lengths to include pumping at work when the kid is over six months. Pumping is industrial dairy cow torture... and when I see people having problems with breastfeeding for whatever reason, going through all that pain and trouble, I feel like there must be something wrong with the gold stars we've plastered all over breastmilk. The main reason to breastfeed is ease and convenience, so if it's not easy or convenient, the hell with it. (The main reason NOT to breastfeed, in the absence of such obstacles, is that it is honestly staggering the extent to which this makes you not just the primary but kind of the only parent. I completely failed to grasp the implications of this before I started, and I wish we could have a reasonable conversation about the involved issues of capitalism and feminism, which is what I was hoping for from this book but didn't find in a substantive way.) I mean, look at all those Baby Boomers stomping around. I don't think most of them ever tasted breastmilk, and as a generation they turned out mighty hale and hearty, don't you think? To a large extent I agree with Tuteur that lactation consultants can be the WORST, since I heard the ones at the hospital make the most ignorant, judgmental, coercive pronouncements; this is a place where I found the anti-feminism she describes to be very pronounced. However, her descriptions of midwives and doulas I felt painted with an overly broad brush. I hired a doula because I didn't have friends or family where I lived and was terrified of the hospital, and she turned out to be completely unnecessary but she was certainly not this manipulative she-devil of the type Tuteur describes, and I'm sure would've been totally supportive of whatever decisions I might've made. There is a lot more nuance in this world than she sees, and I think she doesn't want to see it because she's fundamentally dismissive of the desire the natural childbirth industry is responding to.
As I mentioned above (I have to assume no one's reading anymore; I'm killing this bottle of wine and bag of Trader Joe's trail mix, please forgive me if you're still there), the medical model is focused on brain-dead babies and absolutely everything terrible that could possibly go wrong. Push Back catalogues how dangerous childbirth used to be (can't argue with that, obviously) and extensively details how much childbirth and breastfeeding both just totally suck.
Here's what I think she doesn't get: women don't want to feel like childbirth and breastfeeding just totally suck. Tuteur is very, very down on the "biological essentialism" of the natural childbirth industry, but you know what? That view is very compelling to a pregnant/postpartum woman. You know why? Because being a woman, even today, even if you're an extraordinarily privileged one, compared to being a man, pretty much sucks, and it always has. And the main reason it sucks is this whole childbearing thing, and everything that's attached to that... and so the doctors come along and they're like, "Yes, this is terrible. Your position in society is lesser, your biology screws you, and now you need to do this dreadful dangerous thing, ugh, and you might die and your baby might too, so we'll hook you up to these machines and scream into your vagina and do scary things and it'll all be over soon if you only do all that we say" but then the midwives et al. are like, "No actually having babies is completely amazing, and you're going to have this thrilling and revelatory experience that'll make you realize being a woman doesn't just totally suck after all, in fact it's magical and great" and that latter sounds much better, infinitely more appealing, especially when you are all jacked up with a growing creature inside your body wrecking it forever.
And you know what else? I think they're right. I think they're right and I think Tuteur misses why women are attracted to what they're selling because she think women who buy it are just dumb. And okay, a lot of us are dumb (especially the anti-vaxxers), but actually there is something there.
I read Ina May Gaskin's book and I thought she was a kook, but it did help me. It helped me because before that point, I'd really felt like I'd gotten myself into this impossible situation that only a lot of luck and some incomprehensible medical science could get me out of, and I was really scared. But then she, and all those other MacBeth-style witches, were like, "No, actually this is what your body was made to do," and that encouragement really helped me a lot, even if it isn't strictly evidence-based or peer-reviewed.
And actually, giving birth helped me a lot. I feel like so much of my life has been about taking note of ways that men are inherently better or more advantaged than me. After I had my first baby, I went back to my boxing gym where I was basically the only woman, and I looked at things in such a different way than I ever had before. I'd always felt weaker, but for the first time I knew I was actually stronger, and I just silently laughed at all the men thinking they were so tough with their big muscles and dumb games. For me, knowing I'd gone through labor and pushed a baby out had shown that to me. If I'd had surgery, I would've felt that demonstrated it even more. Tuteur thinks being unscientific and irrational and essentialist about this stuff shows you're weak-minded and buying a crap bill of goods, but I don't think so. I think childbirth and rearing has a meaning for many women that the New Agey hoo-hah types tap into, and I don't think it's all dumb, I think that need for meaning is real, and I think it compensates in a significant way for losses women feel in other areas of their lives (I do understand her argument that this can be a problem insofar as it recenters motherhood as the center of women's lives at the expense of other things, a real issue I'm dealing with in my own life so I'll need to get back to you on that). I also think childbirth is a legitimately significant event for many women, even if it's been problematically fetishized in certain circles.
Okay, so this has certainly gone on long enough. If anyone's still reading this, I apologize; I don't get out much these days.
Despite being massively turned off by her condescending and dismissive tone, I might recommend this book to pregnant women or new mothers who are being bullied or just overly saturated by a lot of "natural childbirth" malarky, especially if it's left you feeling bad about anything you are or not doing or might in the future do or not do. It's true that there are weird, culty cottage industries built around this stuff, and it's also true that these issues seem to bring out the worst instincts in women (I think because we are all so insecure and stressed about our own failings as moms, so tend to double down on what we're doing and deride what we're not). Remember that drugs can be great, safety comes first, and formula is not poison. Crying doesn't cause brain damage. Internet message boards are not helpful; if you need advice about your horrible screaming baby, ask an older person: their solution will be much less labor intensive. Do not ask your friends, especially if they live in California or Brooklyn. Also, don't worry too much about childbirth: it doesn't last long in the grand scheme of things. The hard part comes later. Finally: don't beat yourself up. Really. The world will do enough of that, because one of the only groups that gets more shit than women from all quarters is... mothers. And the sharpest critics are their peers, so pretty much just do what you feel, get as much help as you can, and try not to buy too much junk you don't need.
April 12, 2016
As a feminist psychotherapist, I really wish I could give this book to so many of the women I know who struggle with PPD/PPA/PPP due to feeling like "failures" for not "achieving" natural birth/parenting 100%. I like how this book also takes on some of the class concerns endemic to natural parenting as well as the Evangelist origins of natural parenting.
Also, Grantly Dick-Read.
Also, Grantly Dick-Read.
April 14, 2016
Every new mother needs to read this book.
I have long lamented (at least to myself, if not aloud) the mothering culture that I live in that creates sad, desperate mothers who crave validation at every step of the process because their belief in their own ability to mother is so questioned. I say this as a woman that needs that validation too. That said, I don't think it's a symptom of my generation, but definitely of my privileged white mother status. Fighting the feeling of being a constant failure because you didn't have a natural childbirth, or know exactly what that rash meant on your kid, or because you couldn't breastfeed even though you tried and it hurt and it was so hard hard hard and you couldn't get used to the idea of being attached to your kid 24/7 and then there's the Sanctimommy that is ever present on every mom Facebook group.
Dr. Tuteur has it right: End the guilt Moms. You're worth more than what you're being told. Love your babies, and yourselves. You've got this!
I have long lamented (at least to myself, if not aloud) the mothering culture that I live in that creates sad, desperate mothers who crave validation at every step of the process because their belief in their own ability to mother is so questioned. I say this as a woman that needs that validation too. That said, I don't think it's a symptom of my generation, but definitely of my privileged white mother status. Fighting the feeling of being a constant failure because you didn't have a natural childbirth, or know exactly what that rash meant on your kid, or because you couldn't breastfeed even though you tried and it hurt and it was so hard hard hard and you couldn't get used to the idea of being attached to your kid 24/7 and then there's the Sanctimommy that is ever present on every mom Facebook group.
Dr. Tuteur has it right: End the guilt Moms. You're worth more than what you're being told. Love your babies, and yourselves. You've got this!
April 27, 2016
Four stars merely for the fact that we desperately need this book, and we desperately need an outspoken, brutally honest ob/gyn who will speak bluntly about the insanity, the existential sickness, that is modern mothering. I'm speaking specifically of those early years, when all of us mothers are a little insane. God knows I was one of them. I never abandoned science or reason, thank god, but I sure as hell got all worked up about things that, in retrospect, I needn't have. I was one of those mothers, for example, who was determined to breastfeed my children no matter how difficult it was, no matter how painful, no matter that I was unable to shower for the first six months of my children's lives (just kidding about that last part--sort of). And I did, until each child self-weaned around 12 months of age. But I was in agony for most of the process. I tried cloth diapers, I only did organics, I wouldn't let my mother use Johnson & Johnson because it had parabens. I turned myself into a pretzel trying to dodge all the "dangers" that seemed to be everywhere. Only later, and a little wiser, do I realize I'd been sold a bill of goods by the natural parenting mafia.
There was one saving grace in all this--my completely interiority, my social awkwardness, and my desire *not* to mingle with other mothers (at least the mothers I didn't know before they had children--my old friends were cool). And so I was mostly insulated from this weird competitive jijitsu that Dr. Tuteur chronicles in this book. Still, because I'm a vaccine advocate in my spare time, I am so aware of this world--the natural parenting world, that seems to encompass anti-vaccine views as well. That's why I was a very receptive audience for this book. And on to the book. The message is stellar and refreshing. Dr. Tuteur's breaks down the non-science of lactivists' claims about how formula is evil compared to breast milk (only in developing countries where the water supply is compromised can this even approach truth), about insane ideas promulgated by non-certified midwives that children face lifelong disadvantages if born by caesarean. She turns her eye toward the dangers of home birth, a choice that proponents paint as risk-free when, in fact, it's hugely risky and typically attended by individuals with zero medical education. The strongest parts of this book, in my opinion, are the latter chapters that deal with the truly troubling socioeconomic implications of the natural parenting movement. It is a movement that is overwhelmingly made up of white, wealthy women who eschew science in favor of "gut feelings" and whose unwitting and casual racism of glamorizing "primitive birth practices" without acknowledging the devastating health disparities that result in high maternal and infant mortality are profoundly disturbing. It really resonated with me, because one of the most reprehensible aspects of the modern anti-vaccine movement in the United States and Australia is its utter disregard for children in the developing world, who desperately need vaccines in order to, you know, stay alive. Another fascinating aspect that I knew nothing about was that the natural parenting philosophy came out of fundamentalist Christian principles, in order to keep the newly liberated woman at home with her child. Yikes.
Structurally, the book is choppy and repetitive--sometimes phrases are repeated verbatim. Some of this clearly is emphasis, but other times it simply felt exhausting. I believe this could have been handled in editorial discussions. I'm not sure why it wasn't--perhaps it was, and the advice was ignored (hey, I'm an editor--sometimes writers self-sabotage). Another minor point was that I don't think she did enough to differentiate between certified nurse-midwives (CNM--CNMs work in hospitals and both my kids were delivered by one) and "professional nurse midwives." She does mention the difference early on the book, but only once or twice. In a book that tears midwives to shreds, I do think that differentiation should be hammered home a bit more.
I also thought that there was a little nuance missing, and I only mention this because there may be some expectant parents who can be convinced to leave the birthing pools behind but who may need a little handholding. Dr. Tuteur is not here to hold anyone's hand, and while I really admire that about her, I do worry that this relegates the book to the preaching-to-the-choir shelf. After years of vaccine advocacy, and battling anti-vaxxers, I have come to realize that there is a large portion of the parenting population who are on the fence, and can be coaxed over to the side of science and reason, but they won't hop over if we yell at them. I might have modulated the tone just a touch here--and only a touch, because the outrage is powerful and warranted--to more strongly emphasize Dr. Tuteur's empathy for the mothers caught up in this nonsense. And I know she has that empathy--it's why she wrote the book and why she takes the endless amounts of abuse she does online.
Her most important message, in my mind, is that women should have no shame whatsoever about how they gave birth and whether they feed their children with a bottle or their own breast. They should, however, trust science, not gut feelings or platitudes from midwives, and they should do what is right for them. It's telling that Dr. Tuteur's book is going against the grain in this respect. We so need this book.
There was one saving grace in all this--my completely interiority, my social awkwardness, and my desire *not* to mingle with other mothers (at least the mothers I didn't know before they had children--my old friends were cool). And so I was mostly insulated from this weird competitive jijitsu that Dr. Tuteur chronicles in this book. Still, because I'm a vaccine advocate in my spare time, I am so aware of this world--the natural parenting world, that seems to encompass anti-vaccine views as well. That's why I was a very receptive audience for this book. And on to the book. The message is stellar and refreshing. Dr. Tuteur's breaks down the non-science of lactivists' claims about how formula is evil compared to breast milk (only in developing countries where the water supply is compromised can this even approach truth), about insane ideas promulgated by non-certified midwives that children face lifelong disadvantages if born by caesarean. She turns her eye toward the dangers of home birth, a choice that proponents paint as risk-free when, in fact, it's hugely risky and typically attended by individuals with zero medical education. The strongest parts of this book, in my opinion, are the latter chapters that deal with the truly troubling socioeconomic implications of the natural parenting movement. It is a movement that is overwhelmingly made up of white, wealthy women who eschew science in favor of "gut feelings" and whose unwitting and casual racism of glamorizing "primitive birth practices" without acknowledging the devastating health disparities that result in high maternal and infant mortality are profoundly disturbing. It really resonated with me, because one of the most reprehensible aspects of the modern anti-vaccine movement in the United States and Australia is its utter disregard for children in the developing world, who desperately need vaccines in order to, you know, stay alive. Another fascinating aspect that I knew nothing about was that the natural parenting philosophy came out of fundamentalist Christian principles, in order to keep the newly liberated woman at home with her child. Yikes.
Structurally, the book is choppy and repetitive--sometimes phrases are repeated verbatim. Some of this clearly is emphasis, but other times it simply felt exhausting. I believe this could have been handled in editorial discussions. I'm not sure why it wasn't--perhaps it was, and the advice was ignored (hey, I'm an editor--sometimes writers self-sabotage). Another minor point was that I don't think she did enough to differentiate between certified nurse-midwives (CNM--CNMs work in hospitals and both my kids were delivered by one) and "professional nurse midwives." She does mention the difference early on the book, but only once or twice. In a book that tears midwives to shreds, I do think that differentiation should be hammered home a bit more.
I also thought that there was a little nuance missing, and I only mention this because there may be some expectant parents who can be convinced to leave the birthing pools behind but who may need a little handholding. Dr. Tuteur is not here to hold anyone's hand, and while I really admire that about her, I do worry that this relegates the book to the preaching-to-the-choir shelf. After years of vaccine advocacy, and battling anti-vaxxers, I have come to realize that there is a large portion of the parenting population who are on the fence, and can be coaxed over to the side of science and reason, but they won't hop over if we yell at them. I might have modulated the tone just a touch here--and only a touch, because the outrage is powerful and warranted--to more strongly emphasize Dr. Tuteur's empathy for the mothers caught up in this nonsense. And I know she has that empathy--it's why she wrote the book and why she takes the endless amounts of abuse she does online.
Her most important message, in my mind, is that women should have no shame whatsoever about how they gave birth and whether they feed their children with a bottle or their own breast. They should, however, trust science, not gut feelings or platitudes from midwives, and they should do what is right for them. It's telling that Dr. Tuteur's book is going against the grain in this respect. We so need this book.
May 9, 2016
Probably more of a 2.5, mostly because of tone. I agree with probably the vast majority of Tuteur's critiques of the natural parenting movement, particularly the emphasis on "birth experience" over healthy outcomes for babies/moms AND the insane bullying that goes on in the breastfeeding community. But I still found myself bristling at her tone, especially when she's being borderline disrespectful to doulas and midwives (not all of whom are spiral-eyed science deniers -- I've used both, in a hospital setting both times, and they were helpful and lovely). I feel like there has to be a way to have this conversation without feeding into the mommy-wars vibe.
August 24, 2016
Let me say upfront that I wholeheartedly believe in a woman's ability to make her own choices when it comes to reproduction, from abortion to adoption to motherhood, from giving birth in a field surrounding by incense to being hooked up to every machine and painkiller known to humankind during labor. That doesn't mean I don't think this book isn't a scathing, necessary indictment of the mentality that elevates the giving birth in a field surrounded by incense type of birth experience over all others. (Note: I choose the word mentality on purpose, because I don't think it's 100% fair to criticize the women who have it - I think they are often victims of nasty cultural forces rather than general ignoramuses, a distinction, given the visceral anger often found in her tone, that I sense Tutuer doesn't aaaaaalways make.) Anyway. The thesis of the book is that various forces have created the natural childbirth industry, which guilts many women into thinking things like if they have a caesarean section they haven't actually given birth, or if they don't breastfeed they're seriously undermining their childrens' future success, or if they use painkillers they are lesser human beings. Tuteur produces plenty of convincing scientific evidence to undermine many of natural childbirth/attachment parenting advocates' beliefs. She makes some difficult-to-argue- with statements, such as: why are women thought of as "lesser" when they seek pain relief, when in almost literally ANY other situation we would not criticize anyone who was in significant pain the wish for relief? Why are women who can't or choose not to breastfeed criticized, when much scientific evidence suggests only relatively negligible benefits over formula feeding? Why is so much emphasis placed on the mother having the perfect birth experience, rather than making sure that the baby itself isn't perfectly healthy when it arrives?
This is an admittedly personal topic for me. I wish I had read this book fifteen years ago, back when I was an adorable, naive college freshman researching midwifery for a women's history course and reading all about how men had ruined the obstetric establishment with all of their meddling. That - and reading Naomi Wolf's book "Misconceptions", which came out a couple years later - left me convinced that when I had a baby, I was going to try really hard to do it at home with a midwife and without painkillers. It would be a profound, spiritual experience, a way for me to get in touch with my greatest strength and inner woman. Well, flash forward fourteen years later. I had a baby delivered by caesarean section after hours of labor spent hooked up to an epidural that I referred to as one of the greatest decisions of my life. My heart was not into breastfeeding, so when I had trouble and tears getting started, I went to the bottle. I now have an almost 2.5 year old who is happy, healthy, and pretty much the most delightful little girl ever, if I do say so myself. By the time she was born, I had changed enough to elect a hospital birth with all the trimmings. Still, while my pragmatic side did not make a birth plan and/or tried not to have any expectations because I knew all of it would probably go out the window, I realize I was still a little disappointed in the c-section, still a little disappointed in myself because I'd caved to the epidural pretty quickly. I realized I did believe I had failed in setting myself up for some kind of transcendent experience. And while by the time I left the hospital and chose to bottle-feed I was pretty much satisfied with my decision, having seen a friend really suffer in forcing herself to do something I don't think she wanted to do, I still felt guilty I didn't nurse. Maybe if I had read this book beforehand, I would have been - or would be - more forgiving of myself. Anyway, this is all anecdotal - one woman's experience, not meant to comment on or judge anyone else's - but I think it is important enough to share.
This is an admittedly personal topic for me. I wish I had read this book fifteen years ago, back when I was an adorable, naive college freshman researching midwifery for a women's history course and reading all about how men had ruined the obstetric establishment with all of their meddling. That - and reading Naomi Wolf's book "Misconceptions", which came out a couple years later - left me convinced that when I had a baby, I was going to try really hard to do it at home with a midwife and without painkillers. It would be a profound, spiritual experience, a way for me to get in touch with my greatest strength and inner woman. Well, flash forward fourteen years later. I had a baby delivered by caesarean section after hours of labor spent hooked up to an epidural that I referred to as one of the greatest decisions of my life. My heart was not into breastfeeding, so when I had trouble and tears getting started, I went to the bottle. I now have an almost 2.5 year old who is happy, healthy, and pretty much the most delightful little girl ever, if I do say so myself. By the time she was born, I had changed enough to elect a hospital birth with all the trimmings. Still, while my pragmatic side did not make a birth plan and/or tried not to have any expectations because I knew all of it would probably go out the window, I realize I was still a little disappointed in the c-section, still a little disappointed in myself because I'd caved to the epidural pretty quickly. I realized I did believe I had failed in setting myself up for some kind of transcendent experience. And while by the time I left the hospital and chose to bottle-feed I was pretty much satisfied with my decision, having seen a friend really suffer in forcing herself to do something I don't think she wanted to do, I still felt guilty I didn't nurse. Maybe if I had read this book beforehand, I would have been - or would be - more forgiving of myself. Anyway, this is all anecdotal - one woman's experience, not meant to comment on or judge anyone else's - but I think it is important enough to share.
May 15, 2016
Dr. Amy Tuteur has the knives out for the natural childbirth industry in this thought-provoking book. She details the ways in which natural childbirth acolytes and lactivists have commodified childbirth – understood for centuries as a high-risk endeavor that could mean death for mothers and babies – and repackaged it as an “experience” that says something about who we are as women and mothers.
She explains childbirth as only an obstetrician can: why birth is unpredictable; how interventions are actually preventative medicine; and why c-sections are recommended even though in retrospect they may be unnecessary. The ultimate goal of childbirth is a healthy baby (and how sad that a doctor has to remind well-educated, rational women of this). The advances in modern obstetrics over the last 100 years have, ironically, convinced many women that childbirth is inherently safe.
According to Tuteur, there is virtually no scientific evidence to support the claims natural childbirth activists make about the dangers of pain relief, the power of women’s intuition, or the evils of formula. Midwives, doulas, and lactation consultants only make money if people buy their products, and they can only do that if women are guilted into choosing pseudoscience over evidence-based medicine. She articulates what I think many of us already know: drug-free childbirth, exclusive breastfeeding, and attachment parenting are philosophies of privilege unattainable for many working women. They are status symbols with trivial (or nonexistent) long-term benefits to babies.
To be fair, this book is one-sided. If you had a drug-free, vaginal birth and consider it to be a defining achievement of your life, you will not like it. (Tuteur has tackled these issues for many years, and my sense is she’s utterly out of patience with the santimommies who vilify her.) I, for one, found this book compassionate and reassuring. If it had been published three years earlier, I might have been spared the guilt I felt over having a c-section and not breastfeeding exclusively.
She explains childbirth as only an obstetrician can: why birth is unpredictable; how interventions are actually preventative medicine; and why c-sections are recommended even though in retrospect they may be unnecessary. The ultimate goal of childbirth is a healthy baby (and how sad that a doctor has to remind well-educated, rational women of this). The advances in modern obstetrics over the last 100 years have, ironically, convinced many women that childbirth is inherently safe.
According to Tuteur, there is virtually no scientific evidence to support the claims natural childbirth activists make about the dangers of pain relief, the power of women’s intuition, or the evils of formula. Midwives, doulas, and lactation consultants only make money if people buy their products, and they can only do that if women are guilted into choosing pseudoscience over evidence-based medicine. She articulates what I think many of us already know: drug-free childbirth, exclusive breastfeeding, and attachment parenting are philosophies of privilege unattainable for many working women. They are status symbols with trivial (or nonexistent) long-term benefits to babies.
To be fair, this book is one-sided. If you had a drug-free, vaginal birth and consider it to be a defining achievement of your life, you will not like it. (Tuteur has tackled these issues for many years, and my sense is she’s utterly out of patience with the santimommies who vilify her.) I, for one, found this book compassionate and reassuring. If it had been published three years earlier, I might have been spared the guilt I felt over having a c-section and not breastfeeding exclusively.
April 20, 2019
A fiery, combative screed from one side of the parenting guilt wars. Amy Tuteur is an OB/GYN who used to teach at Harvard. Yo, I dunno what happened in the years that she practiced and taught, but this lady got real fed up with the current fashions of unmedicated births, exclusive breastfeeding, and attachment parenting. Or, I should correct, she got fed up with the guilt-tripping and shaming around this stuff.
On the one hand, I agree with Jessica's review, in that this book is basically a zero-sum-game bummer, especially if you have ANY speck of interest in any of the Big 3. (And I know many ladies who do! So a warning to you all.) Tuteur has her knives out and even though her beef is with the more radical and fundamentalist wings of these fashions, and the corrupted research underlying some institutions like the Baby Friendly Hospital Initiative, any individual woman who might be interested might still feel attacked. I'm definitely wary of recommending this to any pregnant friends, since it doesn't just close the door on alternative labor stuff - it slams it shut with a bang!
On the other hand, Tuteur shines a light on the origins of these three fashions - basically, as specifically-Anglo reactionary movements that reduce women back to their bio-essentialist parts: the vagina (a baby must pass through it!), uterus (a baby must grow in it!), and boobs (milk must flow from these!). She really has it in for the pseudo-science and anti-rationalist ("Trust your instincts, Mama!") ideologies of the founding fathers (there are a lot of dudes who founded this stuff) like Grantly Dick-Read (the "father of natural childbirth", who said that pain in childbirth is a myth and the neurotic consequence of over-civilized, over-intellectual white ladies HAR HAR HAR) and William Sears (the father of attachment parenting, who believed that the mother-child bond is fragile enough that anything other than constant, literal attachment will break it).
Some of Tuteur's criticisms are darkly amusing, such as her framing of the "mother-hero's quest" - with its "birth plans", "birth experiences" and "birth stories" - where the baby is a prop demonstrating the mother's morality and grit, and there are challenges (the unsupportive OB, the unsupportive spouse), sages (the doula, the midwife), and feats of strength (labor!). I do think she's super on-point with (1) the fetishizing of parental - but especially maternal - suffering (e.g. feeling guilty when it feels easy), (2) the way the Big 3 (Big Labor, Big Boob, Big Bond) naturally favor socio-economic privilege (pretty hard to do exclusive boob when you're a single, working mom with no maternity leave...) and ableism/heteronormative stuff (...or if you used a surrogate, adoption, or had any breast issues, etc), and - my favorite - (3) the idiotic appeal to the "pregnancy noble savage" ("This is how it's been done for thousands of years!", "This is how women in Africa do it!", etc). I was particularly gratified by (3) since (3) has always really bothered me - the ladies wearing their babies in traffic in Dar es Salaam are NOT expressing a parenting philosophy, but rather an economic need. Hunter-gatherer ladies also DIED A LOT IN LABOR. Also, (4) how parenting philosophies - a modern invention! - are always about the parent, never about the kid. Since how can one monolithic philosophy apply to all kids?! (Unless it's the French cultural monolith, passed down de génération en génération.) I also appreciated Tuteur's analogies of birth as a natural event like a hurricane - something to be respected, viewed with fear and awe - that, since the advent of modern medicine, has lulled people into a false sense of safety ("Labor is safe and natural!") and thus allowed women the privilege to start worrying about the "experience" and process of it, given the conclusion (safe mom, safe baby) is assumed.
Oh - and, like this review ho ho, the book could have been about 1/3 shorter. Eh.
On the one hand, I agree with Jessica's review, in that this book is basically a zero-sum-game bummer, especially if you have ANY speck of interest in any of the Big 3. (And I know many ladies who do! So a warning to you all.) Tuteur has her knives out and even though her beef is with the more radical and fundamentalist wings of these fashions, and the corrupted research underlying some institutions like the Baby Friendly Hospital Initiative, any individual woman who might be interested might still feel attacked. I'm definitely wary of recommending this to any pregnant friends, since it doesn't just close the door on alternative labor stuff - it slams it shut with a bang!
On the other hand, Tuteur shines a light on the origins of these three fashions - basically, as specifically-Anglo reactionary movements that reduce women back to their bio-essentialist parts: the vagina (a baby must pass through it!), uterus (a baby must grow in it!), and boobs (milk must flow from these!). She really has it in for the pseudo-science and anti-rationalist ("Trust your instincts, Mama!") ideologies of the founding fathers (there are a lot of dudes who founded this stuff) like Grantly Dick-Read (the "father of natural childbirth", who said that pain in childbirth is a myth and the neurotic consequence of over-civilized, over-intellectual white ladies HAR HAR HAR) and William Sears (the father of attachment parenting, who believed that the mother-child bond is fragile enough that anything other than constant, literal attachment will break it).
Some of Tuteur's criticisms are darkly amusing, such as her framing of the "mother-hero's quest" - with its "birth plans", "birth experiences" and "birth stories" - where the baby is a prop demonstrating the mother's morality and grit, and there are challenges (the unsupportive OB, the unsupportive spouse), sages (the doula, the midwife), and feats of strength (labor!). I do think she's super on-point with (1) the fetishizing of parental - but especially maternal - suffering (e.g. feeling guilty when it feels easy), (2) the way the Big 3 (Big Labor, Big Boob, Big Bond) naturally favor socio-economic privilege (pretty hard to do exclusive boob when you're a single, working mom with no maternity leave...) and ableism/heteronormative stuff (...or if you used a surrogate, adoption, or had any breast issues, etc), and - my favorite - (3) the idiotic appeal to the "pregnancy noble savage" ("This is how it's been done for thousands of years!", "This is how women in Africa do it!", etc). I was particularly gratified by (3) since (3) has always really bothered me - the ladies wearing their babies in traffic in Dar es Salaam are NOT expressing a parenting philosophy, but rather an economic need. Hunter-gatherer ladies also DIED A LOT IN LABOR. Also, (4) how parenting philosophies - a modern invention! - are always about the parent, never about the kid. Since how can one monolithic philosophy apply to all kids?! (Unless it's the French cultural monolith, passed down de génération en génération.) I also appreciated Tuteur's analogies of birth as a natural event like a hurricane - something to be respected, viewed with fear and awe - that, since the advent of modern medicine, has lulled people into a false sense of safety ("Labor is safe and natural!") and thus allowed women the privilege to start worrying about the "experience" and process of it, given the conclusion (safe mom, safe baby) is assumed.
Oh - and, like this review ho ho, the book could have been about 1/3 shorter. Eh.
January 12, 2018
I was hoping for a book that was more fair-minded but rather than promoting a message that encouraged mother's to make the best choices for their individual circumstance and not to let anyone make them feel guilty for what they decide, the author basically insisted anyone wanting to have a natural birth is stupid for thinking that's a good idea and the "natural birth industry" is evil for trying to push their own selfish agenda. Essentially she is doing to them what she claims they are doing to people who involve themselves with hospital births and interventions (medication, c-sections, formula feeding, etc.)
Although the author does make some good points, the book reads like an angry rant with overgeneralized views of the "other side". She relies heavily on anecdotes to make her points which also discredits her ability to claim her book is backed by solid scientific evidence. She essentially only uses studies that confirm her biases and dismisses (if she even brings it up) the data that does not.
I will say that this is would be an excellent book for any woman struggling with guilt over their decisions not to have a natural birth or breastfeed. She strongly defends that opting for a c-section or using formula does not make you a bad mother (I just wish she made the counter point that opting to parent naturally doesn't make you bad either) as long as mother and baby are safe and healthy that's all that should matter.
Although the author does make some good points, the book reads like an angry rant with overgeneralized views of the "other side". She relies heavily on anecdotes to make her points which also discredits her ability to claim her book is backed by solid scientific evidence. She essentially only uses studies that confirm her biases and dismisses (if she even brings it up) the data that does not.
I will say that this is would be an excellent book for any woman struggling with guilt over their decisions not to have a natural birth or breastfeed. She strongly defends that opting for a c-section or using formula does not make you a bad mother (I just wish she made the counter point that opting to parent naturally doesn't make you bad either) as long as mother and baby are safe and healthy that's all that should matter.
June 21, 2016
I wish I could wholeheartedly recommend this book because I think Tuteur has some remarkable and important things to say. Tuteur is an outspoken critic of the natural childbirth, lactavist, and attachment parenting movements and she brings her own experience raising for children along with her years as an OB/GYN into the fight. In my mind, she is a welcome voice of sanity for reclaiming real choice in the realms of infant feeding, childbirth, and parenting styles.
Unfortunately, I found that her book misses the mark on some key areas.
First, her understandable frustration with the "natural parenting" movement translates into a lack of compassion for women following the movement's rigid structures. She frequently makes the statement that women are participating in the "natural parenting" paradigm are doing so in order to feel superior to other women. I think this is a sweeping statement that doesn't hold true under closer examination. I think it is more accurate that women involved in the movement are doing their best and that for some discovering that their efforts might be unnecessary is threatening to their identity. There are people I'd like to recommend this book to, but I fear this would push them farther away from her views.
Second, I think she downplays the medical industries history of mistreating, ignoring, and abusing women. While I believe that the medical establishment has made great strides in improving life expectancy, especially for mothers and newborns, I think that there can't be a real discussion of why women would be distrustful of the medical establishment without a real acknowledgement of the establishment's history of harm. This discussion is missing from the book.
The most interesting sections for me are the ones where she discusses medical assisted birth as a feminist decision. I would love to read more, also, on her discussions of women working outside the home to the benefit of society. I think she has a lot more to say.
I also enjoyed her scientific analysis of breast feeding, birth, and attachment parenting. In this, though, there wasn't really much new information for me.
I recommend this book with reservations.
Unfortunately, I found that her book misses the mark on some key areas.
First, her understandable frustration with the "natural parenting" movement translates into a lack of compassion for women following the movement's rigid structures. She frequently makes the statement that women are participating in the "natural parenting" paradigm are doing so in order to feel superior to other women. I think this is a sweeping statement that doesn't hold true under closer examination. I think it is more accurate that women involved in the movement are doing their best and that for some discovering that their efforts might be unnecessary is threatening to their identity. There are people I'd like to recommend this book to, but I fear this would push them farther away from her views.
Second, I think she downplays the medical industries history of mistreating, ignoring, and abusing women. While I believe that the medical establishment has made great strides in improving life expectancy, especially for mothers and newborns, I think that there can't be a real discussion of why women would be distrustful of the medical establishment without a real acknowledgement of the establishment's history of harm. This discussion is missing from the book.
The most interesting sections for me are the ones where she discusses medical assisted birth as a feminist decision. I would love to read more, also, on her discussions of women working outside the home to the benefit of society. I think she has a lot more to say.
I also enjoyed her scientific analysis of breast feeding, birth, and attachment parenting. In this, though, there wasn't really much new information for me.
I recommend this book with reservations.
April 21, 2016
I wavered between two and three stars because I am in Amy's camp in hoping I never hear another woman plan to have a home birth and all the guilt-inducing au naturel standards that come with it. Her tone of anger makes sense on her blog, where her audience (including me) agrees about being women's advocates, but it doesn't work for her book which should be helping draw new folds in. Instead of carefully and calmingly assessing things like attachment parenting, my impression is that she just shouts what you should think (as another reviewer commented, making readers feel stupid), which is the title of one of her chapters: "There's No Science Behind Attachment Parenting" which doesn't go into scientific claims, just a long rant. Perhaps a future edition will make this necessary change of tone.
June 10, 2016
Dr. Tuteur holds no punches back as she systematically breaks down the misconceptions fueling the "natural" birth movement. I found this book utterly refreshing. Romanticizing how women birthed babies before the advent of modern medicine is dangerous and elitist. My favorite point that Dr. Tuteur hammered home after each chapter is that the most important thing for a baby is love, not how the baby came out of your body (if at all), how you feed your baby, or if you let your baby sleep in your bed until they are grown.
Other points I especially enjoyed:
-natural parenting is just as much about consumerism as any other "style" of parenting
-breastfeeding is NOT free
-women are more than their vaginas and breasts.
-breastfeeding is not demonstrably healthier for babies in first world countries than formula feeding.
-"natural" parenting is not feminist, especially if "natural" birth and parenting is the only approved choice.
-No other medical condition asks you to suffer through pain. Pain in childbirth is not necessary for bonding to a baby.
So many more - great read. I also appreciated that the book was fully cited, had a bibliography, and was fully indexed. I'll be keeping up with Dr. Tuteur's blog.
Other points I especially enjoyed:
-natural parenting is just as much about consumerism as any other "style" of parenting
-breastfeeding is NOT free
-women are more than their vaginas and breasts.
-breastfeeding is not demonstrably healthier for babies in first world countries than formula feeding.
-"natural" parenting is not feminist, especially if "natural" birth and parenting is the only approved choice.
-No other medical condition asks you to suffer through pain. Pain in childbirth is not necessary for bonding to a baby.
So many more - great read. I also appreciated that the book was fully cited, had a bibliography, and was fully indexed. I'll be keeping up with Dr. Tuteur's blog.
December 13, 2021
Big YIKES. Just another polarizing book for women to feel guilty about because they didn’t “do” pregnancy, childbirth, breastfeeding and motherhood the right way according to some expert using the internet as her platform and making money off an industry. Dr. Tuteur is just another hypocrite. Mommas I implore you, do your own research for all aspects of pregnancy and beyond. And in the end? You do you. It’s hard not to have any guilt about everything in regards to motherhood. Motherhood. Is. Hard. We all need to support one another. You had a highly medicalized birth start to finish? Great. You had a natural home birth? Great. You breastfed? Great. You formula fed? Great. We are all in this together.
Shame on you, Amy Tuteur. Perhaps you should be using your platform to bring mothers together instead of introducing yet even more guilt.
Shame on you, Amy Tuteur. Perhaps you should be using your platform to bring mothers together instead of introducing yet even more guilt.
January 17, 2021
3 rather than 4 stars because it's really a long diatribe and can get very repetitive. Most of my favorite parenting books are basically a friendly scholarly literature review and this is not that at all. It is an angry rant that happens to use scholarly citations. It is not always fair or kind to people who seek "natural" parenting approaches.
But: reading this was very cathartic. I felt validated in my frustration and anger at the misinformation that has been thrown at me as I try to learn about parenting. I wanted to read a diatribe because it matches quite a lot of how I feel right now! I am tired of being lied to about what the "evidence" shows. Reading this book made me feel less trapped and alone.
PS: God bless my university library access and PubMed.
But: reading this was very cathartic. I felt validated in my frustration and anger at the misinformation that has been thrown at me as I try to learn about parenting. I wanted to read a diatribe because it matches quite a lot of how I feel right now! I am tired of being lied to about what the "evidence" shows. Reading this book made me feel less trapped and alone.
PS: God bless my university library access and PubMed.
April 19, 2016
On one hand it cleanly debunks much of the pseudoscience around the natural birth movement. But on the other Tuteur is just so heavy-handed that I couldn't finish the book. Instead of alleviating guilt she just kind of makes you feel stupid.
May 27, 2024
I like the premise of this book, but I think the author took the message a little too far. The book consistently condemns "lactivists" and I agree with a lot of her opinion, but if you are condemning a group for being harsh and mean to others, let's kill them with facts instead of with harsh words against their beliefs.
July 28, 2022
Really eye-opening, I learned a lot! The author's arguments made sense, but she repeated herself a lot.
March 13, 2021
This book attracted me because I am skeptical of the natural parenting industry and wanted to learn more about the facts underlying the claims. The author makes some excellent points about the inconclusive and just plain bad science used to support the claims of natural birthers/lactivists/attachment parents, and if she had stayed in the arena of her scientific and obstetric expertise, the book would have been better for it. Instead the author veers into repetitive and vicious ad-hominem attacks against those to whom she is ideologically opposed, turning the book into something closer to an uncomfortable internet rant than a carefully researched work of nonfiction. Tuteur assumes the worst possible motives of anyone who disagrees with her. She frames midwives and their ilk as baby killers who would rather see women and children die than have a medicated birth. For all her talk of choice, she then states that she views unmedicated childbirth as an inferior, anti-feminist choice. She views women who choose these options as vying for attention and validation at the expense of their children.
While I am also a skeptic of natural parenting, I assume that women who practice these methods do so because they believe it is in the best interest of their children, not that they are anti-feminist, racist narcissists as Tuteur seems to believe. Which isn’t to say that Tuteur doesn’t make salient points about pressures within our culture, systemic racism and sexism, and the blindness of economic privilege -- she just goes too far in impugning the motives of anyone involved with natural parenting. While the book is well-written, I had to deduct a star for the pure nastiness of its tone.
While I am also a skeptic of natural parenting, I assume that women who practice these methods do so because they believe it is in the best interest of their children, not that they are anti-feminist, racist narcissists as Tuteur seems to believe. Which isn’t to say that Tuteur doesn’t make salient points about pressures within our culture, systemic racism and sexism, and the blindness of economic privilege -- she just goes too far in impugning the motives of anyone involved with natural parenting. While the book is well-written, I had to deduct a star for the pure nastiness of its tone.
September 9, 2019
I picked this up at the library one day because I recognized the authors name...I used to read The Feminist Breeder's blog for a long time when my son was younger and Amy Tuteur was something of a ....shall we say, troll? who harassed TFB. (I never followed it very closely, but apparently enough to have name recognition)
Anyway, as someone who once subscribed to the principals of attachment parenting and doing things naturally I have since moved away from those ideals as it caused a lot of grief and anxiety about my own personal ability to manage parenting/momming. That said, I think that Tuteur has some valid points that she brings up in this book that I agree with for the most part. Her way of presenting her arguments suck, though, and I feel that if I would have read her book when my son was little and I was in the *THICK of IT* I would have found her tone off-putting and preachy. I'm not sure she would convince many people to see it her way because this. Especially considering that her credibility is somewhat suspect and her past trolling and bullying of mothers for making particular parenting choices, so. It does seem ironic that she made a name for herself making women feel guilty for buying into a certain parenting practice that appeals to many people and then writing a book about how dumb they are for doing that. Ugh. My thoughts on it are complicated, to say the least, but I think its important to know some context of the author before you pick up this book.
Anyway, as someone who once subscribed to the principals of attachment parenting and doing things naturally I have since moved away from those ideals as it caused a lot of grief and anxiety about my own personal ability to manage parenting/momming. That said, I think that Tuteur has some valid points that she brings up in this book that I agree with for the most part. Her way of presenting her arguments suck, though, and I feel that if I would have read her book when my son was little and I was in the *THICK of IT* I would have found her tone off-putting and preachy. I'm not sure she would convince many people to see it her way because this. Especially considering that her credibility is somewhat suspect and her past trolling and bullying of mothers for making particular parenting choices, so. It does seem ironic that she made a name for herself making women feel guilty for buying into a certain parenting practice that appeals to many people and then writing a book about how dumb they are for doing that. Ugh. My thoughts on it are complicated, to say the least, but I think its important to know some context of the author before you pick up this book.
June 26, 2016
I'm very sad to see some of the statements and twisted truths in this book. I do understand that sometimes the natural childbirth and child rearing movement can have elements of pseudoscience (which is wrong and should always be corrected), but the midwives in Canada (where I am from) are very evidence-based as well as being advocates of natural childbirth and breastfeeding. To assume that the World Health Organization and UNICEF are delusional, as well as thousands of hospitals, obstetricians, pediatricians, and other health care professionals, for promoting breast feeding in the Baby Friendly Hospital Initiative -- really? Are they incapable of reading the evidence? There is A ABSOLUTELY evidence that breast feeding has advantages over formula feeding (as thousands of obstetricians, pediatricians, nurses, midwives, etc can attest). Can every woman breast feed? No. Should a woman be made to feel ashamed for that? Of course not. But to swing to the other end of the spectrum is harmful for women and children. That's just one issue with the book -- there are hundreds more -- but most of all, this book just made me sad. This book is not as evidence based as she makes it appear to be, so read with caution.
September 3, 2017
Reiz pirms daudziem gadiem biju nolēmusi pieņemt "informētu lēmumu" par sava bērna (ne)vakcinēšanu. Sēdos un lasīju, cik jaudāju. Pēc vērā ņemama laika un liela skaita izlasītu lapaspušu secināju - mani "čakarē" gan par, gan pret viedokļa paudēji. Atšķirība bija vienīgi motivācijā un apmērā.
Lasot šo grāmatu - dedzīgu apcerējumu PRET vecmātēm, dūlām, zīdīšanas konsultantiem, dabiskām dzemdībām bez atsāpināšanas un mājdzemdībām - sajutos līdzīgi - mani "čakarē" gan par, gan pret viedokļa paudēji. Atšķirība bija vienīgi motivācijā un apmērā.
Vēl vakar ar draugiem diskutējām par kritiskās domāšanas nepieciešamību un spēju analizēt argumentus, atpazīstot loģikas kļūdas. Patiesi nepieciešama prasme, lai orientētos viedokļu, apgalvojumu un arī atsauču uz pierādījumiem un faktiem jūklī. Meklēšu, kā sevi izglītot šajā jomā. Šī grāmata varētu būt lielisks vingrinājumu krājums.
Tikmēr grāmatas autorei novēlu viņas pašas paustu vēlējumu: "better be percise and kind". Neapgalvoju, ka autorei nav potenciāla tādai būt, tomēr tas nav autores biežākais grāmatā paustais noskaņojums.
Lasot šo grāmatu - dedzīgu apcerējumu PRET vecmātēm, dūlām, zīdīšanas konsultantiem, dabiskām dzemdībām bez atsāpināšanas un mājdzemdībām - sajutos līdzīgi - mani "čakarē" gan par, gan pret viedokļa paudēji. Atšķirība bija vienīgi motivācijā un apmērā.
Vēl vakar ar draugiem diskutējām par kritiskās domāšanas nepieciešamību un spēju analizēt argumentus, atpazīstot loģikas kļūdas. Patiesi nepieciešama prasme, lai orientētos viedokļu, apgalvojumu un arī atsauču uz pierādījumiem un faktiem jūklī. Meklēšu, kā sevi izglītot šajā jomā. Šī grāmata varētu būt lielisks vingrinājumu krājums.
Tikmēr grāmatas autorei novēlu viņas pašas paustu vēlējumu: "better be percise and kind". Neapgalvoju, ka autorei nav potenciāla tādai būt, tomēr tas nav autores biežākais grāmatā paustais noskaņojums.
Read
December 31, 2016I wanted to read this as a counter argument against natural birth. Disappointed to say the least. After making what are decent cultural arguments against the fad for "natural" things as superior she demonstrates how certain natural birth practices pose risks to babies and mothers. While she makes decent arguments about the rhetorical excesses of the natural birth movement she completely undoes her argument in three ways. First this book is riddled with horrible ad hominem attacks, second she doesn't address the possibility of balancing natural birth practices with medical supervision which would negate the majority of the harms she raises, and third she plays her hand to far by making tangential philosophical arguments backed up by information from Wikipedia. She would have done better to offer guidance and insight from her clinical experience to women seeking natural birth instead of scolding and shaming them.
March 22, 2019
I'd read quite a few books that sided more on the natural parenting side of the discussion and after I heard the author on EconTalk I wanted to hear a more flushed out version of her arguments. The best part of this book is it's argument and message that there shouldn't be any gatekeeping around who qualifies as having given birth or different castes of mothers where somehow different interventions define how dedicated the mother is.
That said many of the arguments read, to me, as very similar to the fear based arguments the author seems to decry on the other end of the spectrum. The author also doesn't really seem to address the huge indictment of the current state of obstetrics that well educated women are choosing much higher levels of pain and arguably more risk so they can get what they perceive as more humane treatment through the process.
That said many of the arguments read, to me, as very similar to the fear based arguments the author seems to decry on the other end of the spectrum. The author also doesn't really seem to address the huge indictment of the current state of obstetrics that well educated women are choosing much higher levels of pain and arguably more risk so they can get what they perceive as more humane treatment through the process.
December 19, 2016
This is a well-researched, well-written book by an obstetrician addressing some of the controversies in modern parenting. Tuteur examines key components of natural parenting (like attachment parenting, breastfeeding) explains the arguments supporters of these movements espouse, and from there tears them apart using her professional experience and scientific data.
I found this book FASCINATING and very clearly presented. Tuteur's arguments are logical and simple. The pseudoscience and anti-feminism behind the natural parenting industry was pointed out by using direct quotes from natural parenting resources.
Unfortunately, Tuteur's arguments get very repetitive. I felt like the entire book could be summed up in one concise essay instead of an entire 300 and some page book.
I found this book FASCINATING and very clearly presented. Tuteur's arguments are logical and simple. The pseudoscience and anti-feminism behind the natural parenting industry was pointed out by using direct quotes from natural parenting resources.
Unfortunately, Tuteur's arguments get very repetitive. I felt like the entire book could be summed up in one concise essay instead of an entire 300 and some page book.
May 11, 2016
This book is a scientific and moral evaluation of the "natural parenting" movement. It is a must read for anyone who is getting sucked into the vaginal-birth, breastfeeding, attachment parenting narrative.
August 8, 2018
Felt a little bit broad and repetitive towards the end. Tuteur had solid and research-supported arguments, but tended to use broad strokes when discussing natural parenting advocates so I think some nuance was maybe missing.
June 20, 2020
Yikes. I am generally on the “side”’of this author’s argument. But she manipulates facts and uses research selectively in just the same manner that she accuses natural birth proponents of doing. Do not read this book.
March 6, 2020
Obstetrician Amy Tuteur, M.D. is on a no-holds-barred mission “to help women escape the feelings of guilt [attendant to] the currently popular philosophies of natural childbirth, lactivism, and attachment parenting.” Though Tuteur readily admits that aspects of these movements have value (e.g., “There is a considerable body of scientific evidence suggesting that the presence of a doula can improve the childbirth experience”) and that those who embrace them mostly mean well, she takes each phenomenon to task for using falsehoods and pseudoscience to disempower women while claiming to do the opposite.
It can be difficult to swallow Tuteur’s unflinching assessment. “You or I might imagine that dead babies would cause midwives to reassess their aversion to technology,” she writes: “Instead it has caused them to reassess their aversion to dead babies.” But Tuteur makes a convincing case that her bitter medicine needs to be taken, and I found it manageable in small doses over the course of a week or two. Any attempt at a cover-to-cover read, a bolus, in the language of medical analogy she so adeptly employs throughout, is sure to end in frustration, however. That’s because the repetition and long-windedness of Push Back are as annoying as they are reinforcing.
I struggled throughout to decide whether I wanted Tuteur to tone it down a notch, to lay off the vitriolic gas and not flog quite so many dead horses. “Many midwives, doulas, and childbirth educators have an inappropriate level of confidence despite their own lack of knowledge, and a significant proportion of lay advocates suffer from the delusion of believing themselves ‘knowledgeable’ after having done ‘their research,’” she writes in an emblematic passage, concluding that “[t]he world of celebrity natural childbirth and homebirth advocates is filled with … ‘confident idiots.’” On the one hand, oof. On the other, she ain’t wrong.
In fact, she’s right about a lot of things. Labor is dangerous. The idea that it’s not has caused many women to internalize the message that an unmedicated vaginal delivery is both possible and ideal in all but the rarest cases. From this “glorification” of one birth method, we get the disappointment and shame that come with unmet expectations.
No one claims that if you eat with a spoon you ought to feel guilty because you aren’t eating “as nature intended.” Similarly, if you faint every time you stand up, no one claims that it wouldn’t happen if you just “trusted hearts.” So why should birth be approached so differently" with women being instructed to just “trust birth”?
As for inductions and c-sections, Tuteur writes:
"The natural childbirth literature is filled with stories of women who ignored medical advice to induce labor and their babies survived. That’s because induction is recommended when the risk rises; doctors don’t wait until that risk is 100 percent or even close to 100 percent. The same reasoning applies to putting babies in car seats."
Her defense of the medical establishment extends to formula: “The existing scientific evidence shows that breastfeeding has real benefits, but in industrialized countries, those benefits are trivial.” Nursing has nonetheless “been aggressively promoted in public health campaigns.” As a result, breastfeeding has become a moral issue in recent years, she writes, lending a little personal perspective: “Back when I was nursing my babies, breastfeeding was recognized as one of two excellent ways to nourish an infant. Breastfeeding was considered marginally better, but not so much so that it was worth hounding women.”
She keeps race and class in mind as she analyzes each of these trends:
"The dominant mothering ideology in the United States today is attachment parenting, also known, revealingly, as intensive mothering. It’s the dominant ideology not because it is the way that most people parent, but because it is the ideal held by middle- and upper-middle-class mothers who are often highly vocal on the Internet and social media."
There’s certainly a case to be made that Tuteur acts as an apologist for modern obstetrics which isn’t without its flaws. But she acknowledges some of them, and her thoughts undoubtedly add value, one-sided though they may be:
"Among middle school girls, there is probably no insult more devastating than 'no one likes you….' Among new mothers, there is probably no insult more devastating than 'your baby hasn’t bonded to you.' That’s why lactivist and natural childbirth bullies wield it so promiscuously among new mothers. There is no evidence that bottle-fed babies are less bonded to their mothers than breastfed babies; there is no evidence that C-section babies are less bonded to their mothers than babies born by vaginal delivery. That hasn’t stopped activists from repeatedly invoking bonding to force new mothers into compliance with the ethos of the group."
And Tuteur’s bottom line is difficult to argue with: When it comes to birth, feeding, and parenting, several methods are reasonable, and it should be up to individuals to decide, unencumbered by pressure to conform to ideals of dubious origin and validity.
It can be difficult to swallow Tuteur’s unflinching assessment. “You or I might imagine that dead babies would cause midwives to reassess their aversion to technology,” she writes: “Instead it has caused them to reassess their aversion to dead babies.” But Tuteur makes a convincing case that her bitter medicine needs to be taken, and I found it manageable in small doses over the course of a week or two. Any attempt at a cover-to-cover read, a bolus, in the language of medical analogy she so adeptly employs throughout, is sure to end in frustration, however. That’s because the repetition and long-windedness of Push Back are as annoying as they are reinforcing.
I struggled throughout to decide whether I wanted Tuteur to tone it down a notch, to lay off the vitriolic gas and not flog quite so many dead horses. “Many midwives, doulas, and childbirth educators have an inappropriate level of confidence despite their own lack of knowledge, and a significant proportion of lay advocates suffer from the delusion of believing themselves ‘knowledgeable’ after having done ‘their research,’” she writes in an emblematic passage, concluding that “[t]he world of celebrity natural childbirth and homebirth advocates is filled with … ‘confident idiots.’” On the one hand, oof. On the other, she ain’t wrong.
In fact, she’s right about a lot of things. Labor is dangerous. The idea that it’s not has caused many women to internalize the message that an unmedicated vaginal delivery is both possible and ideal in all but the rarest cases. From this “glorification” of one birth method, we get the disappointment and shame that come with unmet expectations.
No one claims that if you eat with a spoon you ought to feel guilty because you aren’t eating “as nature intended.” Similarly, if you faint every time you stand up, no one claims that it wouldn’t happen if you just “trusted hearts.” So why should birth be approached so differently" with women being instructed to just “trust birth”?
As for inductions and c-sections, Tuteur writes:
"The natural childbirth literature is filled with stories of women who ignored medical advice to induce labor and their babies survived. That’s because induction is recommended when the risk rises; doctors don’t wait until that risk is 100 percent or even close to 100 percent. The same reasoning applies to putting babies in car seats."
Her defense of the medical establishment extends to formula: “The existing scientific evidence shows that breastfeeding has real benefits, but in industrialized countries, those benefits are trivial.” Nursing has nonetheless “been aggressively promoted in public health campaigns.” As a result, breastfeeding has become a moral issue in recent years, she writes, lending a little personal perspective: “Back when I was nursing my babies, breastfeeding was recognized as one of two excellent ways to nourish an infant. Breastfeeding was considered marginally better, but not so much so that it was worth hounding women.”
She keeps race and class in mind as she analyzes each of these trends:
"The dominant mothering ideology in the United States today is attachment parenting, also known, revealingly, as intensive mothering. It’s the dominant ideology not because it is the way that most people parent, but because it is the ideal held by middle- and upper-middle-class mothers who are often highly vocal on the Internet and social media."
There’s certainly a case to be made that Tuteur acts as an apologist for modern obstetrics which isn’t without its flaws. But she acknowledges some of them, and her thoughts undoubtedly add value, one-sided though they may be:
"Among middle school girls, there is probably no insult more devastating than 'no one likes you….' Among new mothers, there is probably no insult more devastating than 'your baby hasn’t bonded to you.' That’s why lactivist and natural childbirth bullies wield it so promiscuously among new mothers. There is no evidence that bottle-fed babies are less bonded to their mothers than breastfed babies; there is no evidence that C-section babies are less bonded to their mothers than babies born by vaginal delivery. That hasn’t stopped activists from repeatedly invoking bonding to force new mothers into compliance with the ethos of the group."
And Tuteur’s bottom line is difficult to argue with: When it comes to birth, feeding, and parenting, several methods are reasonable, and it should be up to individuals to decide, unencumbered by pressure to conform to ideals of dubious origin and validity.
May 10, 2017
Having read and encountered lots of pro-"natural childbirth" views, I wanted to read something from the other side. Amy Tuteur's criticisms of the natural birth, breast-is-best and attachment parenting movements are incisive and bound to be refreshing to anyone who has found these oppressive or has been left feeling disappointed in their inability to live up to the standards they impose. She points out, for example, that the desire for unmedicated & intervention-free birth experiences essentially fetishises the "natural" and "primitive birth traditions", both of which are seriously misrepresented; and that this devaluing of medical interventions is made possible only by the privilege of living with access to good medical care - modern medicine being a victim of its own success here in a similar way as with anti-vaxxers. It's only when a good birth outcome is more or less guaranteed that people start fixating on the quality of the "experience", and feeling needlessly disappointed if they had to have a c section or an epidural.
However, the writing is very polemical and quite repetitive. Obstetrics and science do not yet know everything, and I feel she's too quick to dismiss aspects of the "art" of midwifery (such as the role of the woman's psychological state in the birth process) purely because they are backed only by anecdotal evidence at this point. I also found her summations of scientific evidence and of the history of obstetrics and midwifery in the West quite lacking in depth, and really only touched on to support her relentless tearing down of the "natural" movements' claims and intent. But she does make some interesting arguments and I think a lot of the shame-inducing pressure to breastfeed, parent intensively and so on which is based on outdated and overturned evidence - in some cases coming from public health organisations like the NHS! - does need to be debunked by books like this.
However, the writing is very polemical and quite repetitive. Obstetrics and science do not yet know everything, and I feel she's too quick to dismiss aspects of the "art" of midwifery (such as the role of the woman's psychological state in the birth process) purely because they are backed only by anecdotal evidence at this point. I also found her summations of scientific evidence and of the history of obstetrics and midwifery in the West quite lacking in depth, and really only touched on to support her relentless tearing down of the "natural" movements' claims and intent. But she does make some interesting arguments and I think a lot of the shame-inducing pressure to breastfeed, parent intensively and so on which is based on outdated and overturned evidence - in some cases coming from public health organisations like the NHS! - does need to be debunked by books like this.
January 10, 2020
There's a lot that I liked about this book....and a few places I thought it fell short. Overall, though, I think it is a good counterbalance to so much information/pressure out there on mothers to have perfect natural births and breastfeed exclusively until the baby self weans (or maybe beyond) and attachment parent, etc.... Not that any of those things are bad or wrong if they work for the mother and baby - but so many things that are good on the surface are pushed as the only way to do it and at the expense of the well-being of mother and baby.
What I liked:
*Author is an obstetrician with 20+ years experience who also had 4 children and I think she has a solid, scientific background/basis combined with real world experience.
*Her main point is that throughout history women have died giving birth and babies died being born. A lot. Modern medicine has reduced those mortality rates to the point that many people take a healthy mom/healthy baby as a guaranteed outcome of birth which it isn't.
*It was very interesting and eye opening to follow her as she traced the origins of the natural birth/parenting movements. From Lamaze starting in the Soviet Union because there wasn't a pain management alternative to the horrible sexist, racist father of the natural birth movement....
*Her thoughts on privilege gave me a lot to think about. "The natural childbirth movement is by, about, and for privileged white women."
This gave me a lot to think about. When my girls get older, I'd like them to get this perspective -not as the only voice but as one voice to counterbalance some of the other stuff out there.
What I liked:
*Author is an obstetrician with 20+ years experience who also had 4 children and I think she has a solid, scientific background/basis combined with real world experience.
*Her main point is that throughout history women have died giving birth and babies died being born. A lot. Modern medicine has reduced those mortality rates to the point that many people take a healthy mom/healthy baby as a guaranteed outcome of birth which it isn't.
*It was very interesting and eye opening to follow her as she traced the origins of the natural birth/parenting movements. From Lamaze starting in the Soviet Union because there wasn't a pain management alternative to the horrible sexist, racist father of the natural birth movement....
*Her thoughts on privilege gave me a lot to think about. "The natural childbirth movement is by, about, and for privileged white women."
This gave me a lot to think about. When my girls get older, I'd like them to get this perspective -not as the only voice but as one voice to counterbalance some of the other stuff out there.
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