The Inner Ring of Natural Birth Elitism
When the method of giving birth becomes the measure of a mother's worth
“A woman is capable of more sustained sacrifice than man. Man is more apt to be the hero in one great, passionate outburst of courage. But a woman is heroic through the years, months, and even seconds of daily life, the very repetition of her toils giving them the semblance of the commonplace. Not only her days but her nights, not only her mind, but her body, must share in the Calvary of Mothering. She, therefore, has a greater understanding of redemption than man, for she comes closer to death in bringing forth life.”
// Ven. Archbishop Fulton J. Sheen //
My senior thesis in college was on motherhood’s exercise of the common priesthood–the offices of priest, prophet, and king. The writing process was a healing one, coming on the tail end of a tumultuous and anxious time of discerning religious life. As that door slowly closed, I found myself longing not yet for marriage, but for motherhood in a way I hadn’t thought possible–but mystified by it at the same time, and disenfranchised by the way it was often presented. When it came time to select a topic for my thesis, I approached motherhood with a raw, tender, hopefully studious heart.
This quote from Ven. Fulton Sheen was one that seared itself in my memory in the midst of my reading and studying. That was the idea that tugged at my heart, increasingly, every day–the desire to sacrifice myself to bring forth life in a family. It would be several more years before it became a biological reality, but the idea of joining Christ on Calvary never left me–but its inspiration honed in on the concept of labor and childbirth. I think I decided then that if I were ever to give birth, I wanted it to be unmedicated–I wanted to experience the fullness of what that union with Him could look like. What I thought that fullness could look like.
When it came time to birth my first child, my daughter, we tried to intentionally select a place that would be both medically accredited and allow space for my goal to give birth naturally. After a move to a new state at 32 weeks pregnant for my husband’s job, we settled on a birth center that had the qualifications we were looking for. The prenatal care felt thorough and holistic, and I was grateful.
I tried to prepare myself for a life changing experience that I could not escape–I felt excited, nervous, terrified, even trapped at times. The only way through labor was…through. At the behest of natural birth voices, I learned breathing techniques, positions, and anything else that might help me labor naturally. “You were made for this,” I heard each resource say. “Your body was built for birth.” The birth center, its midwives, and every book, video, or birth class I encountered operated from the same foundation: trust your instincts and body, and surround yourself with positivity. With these tools in your hand, no labor would be too difficult.
The tone surrounding birth in Catholic circles has become a point of fascination (read also: dread) for me in the past few years, even alongside my choice to pursue my first birth the way I did. I noticed a condescension about medical interventions, sometimes of any kind–a deep distrust of hospitals, a view of epidurals and C-sections as some sort of failure. There’s been a growing recognition of the spiritual significance surrounding birth, which I find refreshing. But the assignment of that spiritual significance tends to go to only one way of giving birth–something I did not fully realize until my experience with that way was nothing like what I was told it would be, and pursuing a different path for a subsequent birth left me riddled with guilt and opened me up to unwelcome comments from others.
In my first pregnancy, two different women gifted me Made for This by Mary Haseltine, a Catholic birth doula who compiled what the subtitle calls “A Catholic Mom’s Guide to Birth.” I read it cover to cover in my first pregnancy, feeling equipped by the information and affirmed in my decision to pursue an unmedicated birth. Haseltine emphasizes the Catholic spirituality of labor, birth, and the postpartum period, which I did and still do appreciate. But on second read two years later, during bouts of insomnia in the third trimester of my recent pregnancy, I found a new angle that I didn’t see earlier, perhaps due to no longer being part of the “club.”
Haseltine’s book is far from the only resource that now causes me more pain and pause than peace, with highly critical rhetoric surrounding hospital birth–and sometimes any avenue other than homebirth–leaking into my social circles and crowding women’s Instagram feeds. The result is not necessarily more peaceful, safe births that honor the dignity of both women and babies; rather, the result is becoming far more division and condemnation of fellow sisters in Christ. The “inner ring” of Catholic pregnancy and birth, to borrow C.S. Lewis’ language, becomes ever more small and narrow–and leaves more and more women out, never to be counted as having completed the sacred rite of passage that transcends any method of giving birth.
On a Saturday midday just over two years ago, my water broke beyond a shadow of a doubt. After following the birth center’s instructions to let labor progress at home, we made the 30 minute drive across Tampa Bay, only to be sent home after they broke one more bag of fluid. I found the whole encounter puzzling: the first question the midwife asked was, “Are you sure your water broke?” Her tone was the beginning of a wedge being driven between me and my bodily instinct that I had been taught to prize above all else, including medical expertise. Her very own practice had instilled this in me over the past two months of care.
As my contractions very quickly became more painful, I leaned over the exam table and swayed as the midwife spoke to my husband, instructing him to bring me back when I seemed like I was in active labor. He rightly questioned how he would know, because I seemed like I was in a lot more pain right then. “Oh no,” she said, looking at him. “She probably has–now don’t shoot me,” as she cast a glance at me, then back at him. “--at least 24 to 36 more hours of this.”
Hearing this broke the part of me that felt trapped by labor and birth–a part of me that had paled in comparison with my excitement and resolve–right open. I was already in intense pain; to hear from the person attending my birth that I wasn’t even worth admitting yet terrified me for what was to come. We were ushered into the car with instructions to pick up castor oil to help my labor progress, only for my husband to turn around after almost making it home because I was screaming with every contraction.
I was admitted to the birth center that night at 9 pm, 7 hours after my water had broken, and in excruciating pain. I proceeded to labor in the shower and on the toilet, until 1 am, when the midwife told me I was not dilated enough, and encouraged us to go home. Again.
“You’ll labor easier at home,” she reiterated, and I was dumbfounded. We had already expressed that laboring in the middle of the night, 30 minutes away, in a new apartment that didn’t yet feel like home did not feel like the safest option. The midwife departed the room, and my husband had to dig his heels in for them to allow us to stay. What followed were the most painful hours of my life–any breathing technique, position, or mantra completely left. I felt abandoned, despite even the loving care of my husband, and left alone to labor in a dark room, with a nurse or the midwife only coming by occasionally to check the baby’s heartbeat and poke around on an iPad screen. They said nothing; I still remember what it felt like to be laying on my side trying desperately to breathe–racked by pain for 2 minutes at a time, with only a minute-long break between–only to look up and see the only medical professional in the room sitting in the corner, lit up by the glow of a screen.
I shouted prayer after prayer because they were all I could remember anymore–St. Ignatius’ Suscipe in particular became the only one at a certain point. Despite feeling abandoned, I felt a closeness to the suffering Christ I had never felt before. It was just me and Him, and that was enough.
Contrary to what the midwife had predicted, I delivered about 3 hours after she had told us to go home again. If we had followed her instructions, there’s every chance our daughter would have been born at home or in the car on a bridge crossing the bay in the middle of the night (moms and dads who have had unplanned home or car babies, I salute you!). But she wasn’t. She landed in my arms pink and screaming, and I fell immediately into a daze–a mix of joy, shock, and dissociation.
In the weeks following, I tried to make sense of what had happened. The natural birth I had planned was technically a “success,” but I felt none of the benefits (other than a quick physical recovery) that I had been promised. There was no sense of accomplishment, no feeling of being incredibly in touch with the capability of my body–certainly no “birth high.” I left the birth center feeling viscerally that I could never have another child–not if birth was like that. The peace, tranquility, and joy that I was promised I would feel when I birthed outside the “influence” of drugs was not mine. There were beautiful days, but there were dark ones. That sense of abandonment–the midwife ignoring the voice that I had been told was so valuable and indispensable and primary, my own–stayed with me.
“Rachael, this sounds like trauma,” my best friend said on the phone when she called me in very early postpartum. “I think your birth was traumatizing, and it’s okay to say that.” It felt like relief to acknowledge it, yet a failure at the same time. The trauma was compounded by the early days of nursing also being extremely painful. When I told the nurses at the birth center at a follow-up appointment that I was biting my hand in order to counter the pain of nursing, they told me it was normal, and that it would get better–just don’t interfere with the process. It wasn’t until I saw a lactation consultant that I was told it was indeed not normal to have to nearly draw blood on another part of your body in order to feed your child.
A colleague once told me that trauma is what happens when we experience something confusing or painful in the absence of an empathetic witness. When someone helps us make sense of our pain, it holds less sway on us long-term. That was what I felt, beneath it all–that no person around me who had the expertise to make my pain make sense, and to offer me help, had done so.
For many women, they experience trauma within the hospital setting, in the care of providers that do not have their best in mind. I’ve heard many such stories, and I find them tragic. Betrayal from those in authority in any field is truly traumatizing, especially in a place as sensitive and sacred as birth. These stories of hospital trauma have spurred many of the voices that now advocate for natural birth, whether at a birth center or at home, and understandably so. The downside to this widespread advocacy is that it moves the place and method of birth from being an incredibly private choice to one that is influenced by the voices and experiences of countless others. Women who have had poor experiences in hospitals blanket the entire medical system with the lack of safety that they encountered, rather than letting it influence only their own discernment. Their trauma matters, and they should have access to options that make them feel safe and honored in light of it. But to proffer their experience as fundamental truth–that’s a different story. That creates an inner ring.
The thing about Inner Rings is that they’re tempting–they’re attractive. A feeling that we have “discovered” birth as it was meant to be–that we have somehow accessed some sort of gnosis that other women have not, finding a level of fulfillment previously inaccessible to us–can feel empowering. But, as Lewis posits, that empowerment can be based in a fear of being rejected from the Inner Ring we so desire, and a condemnation of those we deem on the outside: “As long as you are governed by that desire you will never get what you want. You are trying to peel an onion; if you succeed there will be nothing left. Until you conquer the fear of being an outsider, an outsider you will remain.”
The rhetoric and attitudes that make women feel like outsiders when it comes to birth, specifically in Catholic circles, is becoming to me ever more real. Just a few weeks ago at a friend’s kid’s birthday party (oh yes, what an era in my social life), I was talking with a new mom who had given birth 6 weeks prior. I asked how things went for her, and she proceeded to share how positive her experience was with the women standing around. Her voice fell a little, though, when she said: “I had wanted to go unmedicated and I tried, but I got the epidural at one point…” The only other mom standing there and I both reassured her that she had gotten her baby here, and that’s what mattered.
Beyond conversation, guilt and shame over choosing medicated birth is embedded in more popular sources, including influencers. The shaming is not often direct–it’s given more subtly, through a seeming elitism, a view from inside the Inner Ring. Catholic women are told, from multiple angles, that they shouldn’t pursue interventions unless urgently necessary, lest they risk a birth that’s against what “God intended.” Meg Wells, a young Catholic mom of 3 and social media influencer, wrote a blog post that encapsulated this; speaking about birth, she refers to it as “something you should trust your body to do successfully untouched until proven otherwise.” Additionally, she speaks of the impossibility of safety in a hospital: “When you're in labor, you go instinctual. The ONLY thing that matters to your body on a neurological level, is safety. And safety can't be found on foreign ground surrounded by strangers.”
It’s worth noting that Wells shares elsewhere that she had a traumatizing experience in a hospital with her first birth. Her turning to another method of birth is no surprise, and I’m grateful she has access to a method that again, allows her to feel safe and not re-encounter a traumatic experience. The problem comes when her experience, shared to a number of devoted followers, becomes concretized as the only experience, and her choices from that experience become the only choices.
Even resources that are meant to be unbiased, like Haseltine’s book, cause a bit of whiplash and the subtle undertones are hard to interpret. In her section on epidurals, Haseltine says that “there is no moral implication from the decision to use medicated pain relief if you discern that it is best for you and your situation” (170). But, on the following page, she cites only three benefits to electing one, and lists 17 risks, and closes a different section with questions for discernment, including: “Are there other options I can consider? Has this drug or anesthesia been studied for safety? (Be aware that some hospitals and providers use medications outside of their approved FDA use)” (146).
Made For This’ social media reveals a clear bias against the medical system, only making Haseltine’s book more difficult to take as an unbiased source on birth that offers women education on all the options available to them when it comes to birth–and one that values every birth as a deeply spiritual encounter, no matter the circumstances. The places where she, and others, try to offer validation to women choosing differently than they recommend feels undermined by their strong statements elsewhere. Similar to the opinions of influencers like Wells, it’s not just safety that’s reserved solely for unmedicated birth outside the hospital system–it’s sacredness. Haseltine writes further on why women don’t opt for medication or interventions:
“Often women choose natural births for a combination of reasons. Some women are uncomfortable with the risks associated with the various options for medication. Others feel well prepared with birth classes and have an inner confidence that their body was made to give birth. Some women feel strongly that, since they were designed to do this, they only want intervention if there are strong medical indications for it. Still others are persuaded by spiritual reasons and the opportunity to enter into the story of salvation and the sufferings of Christ” (144).
Whether or not it’s their intention–I believe it isn’t–these voices and resources build the Inner Ring of birth with an ever-increasing stronghold that fewer women are able to get through. In Haseltine’s language, medication is a last resort that dims the spiritual experience at best, and cuts a woman off from “entering into the story of salvation” at worst. The assertions lean on hospital and medicated births being for women who are out of touch with their bodies, don’t believe they are “made to give birth,” and extreme circumstances only. The tone of many has become not advocating for natural birth, or birth centers, or homebirth, but rather advocating against birth as the vast majority of women experience it: medicated or containing interventions of some form, and taking place within a hospital. Further, to place such strong emphasis on natural birth being attainable through confidence can shake a mother’s self esteem deeply if a complication does arise. Births are as individual and unique as women’s bodies themselves, and to plant a woman’s confidence in herself and her body so squarely on how well she labors is incredibly limiting.
Haseltine is a birth doula, meaning that she has a great deal of experience in both the emotional and spiritual aspects of birth. Doulas can be an indispensable support for many women in any birth setting. But they are not medical professionals, and neither are most of the influencers vocalizing their distrust of any setting and system other than the one they personally prefer. While their opinions matter, it’s concerning that an increasing number of women are consulting women with no medical experience on medical processes. Both Wells and Haseltine have advocated for delivery of breech babies vaginally, a topic that carries contention in the medical field. While it’s possible to safely deliver a breech baby vaginally in certain situations, it’s recommended that a woman does so with the proper support and interventions available should her attempt fail or a complication arise.
It’s certainly not wrong for these women to hold the opinions they do, but it’s harmful to assign both inherent safety and sacredness to those opinions, and to propose that to a following that trusts them. Birth is a natural process, necessary to humanity–but that does not make it simple. Too many women and babies have lost their lives throughout history to consider it so.
I knew almost instantly when I found out I was expecting our second child that I wanted to give birth differently this time–I was blessed to have the choice between two hospitals with excellent maternal care. My husband and I felt confident in our choice, and I was actually looking forward to birth; or at least, I wasn’t anxious about it. As the day approached, though, I felt a gnawing guilt, and received several comments from other women that told me I had given up my place in the Inner Ring.
I don’t know what others think, nor do I know what the popular voices like the ones I’ve cited would say–maybe they’d sympathize with my first experience, and encourage me in my new choice. Maybe they’d say my experience was rare, a fluke. Or maybe they’d say it was my own fault, and I hadn’t learned the proper breathing techniques…I hadn’t believed in myself enough. Birth is a mind game, after all–and perhaps my mind just wasn’t strong enough.
I picked up Made for This in my third trimester this pregnancy, in the middle of the night during a bout of insomnia. I wanted to revisit some of the spiritual insights I had appreciated the first time around in the book, but quickly discovered the bias I’ve detailed above…those insights quickly felt like they were for unmedicated birth, not the one I was planning. I found myself not just feeling on the outside, but also feeling anxiety about having an epidural and other potential interventions in my birth plan. Perhaps I was wrong to choose these things, and I was giving up the potential for a spiritual experience that I had, by the grace of God, received the first time despite the trauma.
In the midst of the anxiety, I did what Haseltine recommends–I took my decision to prayer, again. And the answer I heard was loud and clear: “Peace is just as much a part of My heart as redemptive suffering is.”
For me, this is one of the hardest things about the Heart of God to believe–that He desires my peace and healing, and not my suffering–though He accompanies me in the latter time and time again. My spiritual director doubled down on this just a couple of weeks before the birth, saying: “It sounds like the Lord…wants a springtime with you.”
The voice of the Inner Ring called out many times, both in my interior as I re-evaluated some of the resources I had trusted throughout my first pregnancy and externally through conversations with others where my decisions were questioned. One person responded to my saying I planned to try medicated birth in a hospital this time by saying, “Wow, jumping from unmedicated birth in a birth center to an epidural in a hospital…those are two very different things.” I was a bit cranky (more than usual) in this particular situation so I said, “I don’t know, they both get a baby here, don’t they?” Others suggested another birth center nearby and wondered if I had looked into it before choosing the hospital, or maybe that “I would want to try that one next time.” The questioning and comments on the microcosmic level are indicative of the trends on the macrocosmic–as with many areas of our lives, we are becoming prone to radicalized beliefs that grow ever more narrow. Social media is certainly partly to blame, if not entirely–we are fed content by an algorithm that, in turn, feeds our biases. To advocate for natural birth is not radicalized behavior, but to emphatically condemn any other way–including the way a majority of women choose–might be.
I walked into the hospital on a slow Monday morning a few weeks ago, expecting to be sent home. My OB provider was concerned I was experiencing prolonged rupture of membranes (PROM), when your water breaks very slowly, sometimes without detection. As it turned out, she was right.
I was examined by a friendly midwife who told me before confirming that my water had broken that I could be admitted solely based on my feeling that my son’s movements had decreased. “You are the mother,” she said. “It’s always best to go with what you’re feeling.” She couldn’t have known how her simple affirmation was healing, in a quiet way–and let me know a different experience was indeed ahead. After it was confirmed my water had broken 24 hours prior, I was admitted for induction. The midwife was immediately positive and chipper: “We’re going to catch a baby by 7!” and encouraged me to eat, rest a bit, and let my husband arrive before we walked through the induction methods available.
The rest of the afternoon and evening passed with the same slowness that the day began. My experience being induced and medicated for this birth was not one of distance from my body, or lack of confidence in it–rather, it felt like reception of a peace I didn’t know was possible after my first birth. I did not once feel abandoned or written off; I felt seen and supported by each nurse, doctor, and midwife that walked in. Every choice, medication, or procedure was explained to us and left up to us–our desires were heard and respected. I did not experience the overbearing, robotic, or money-hungry professionals that many natural birth advocates continually warn of–though I’m sure, like in any field, they certainly exist. In sum, I felt cared for–truly, deeply cared for. And safe. I felt safe.
And, just like the Lord had spoken to my heart, I felt cared for by Him most of all. Where I had felt Him close in the intense suffering and pain in tangible darkness, feeling alone and unseen the first time around–I felt Him in the quiet calm, the gentle hands, the encouraging words, the picturesque sun shining through golden clouds over an ocean view–and yes, the peaceful alleviation of a great deal of my pain.
My son came quickly, amidst laughter and calm. No one interrupted our “golden hour”--the first hour after birth when bonding with the baby is especially crucial–rather, the midwife and nurses around me supported and protected that time. More importantly, I didn’t feel the dissociation and numbness mingled with joy and relief that I felt when my daughter was placed in my arms–the after-effects of trauma on my mind and body–instead, I just felt…joy. I welcomed him, as I had desperately hoped and prayed for, from a place of presence and peace. Choosing medicated birth allowed this experience for me, and I am forever grateful. Ironically, words from the resources I had taken in during my first pregnancy rang in my mind: “This is how birth should be.”
I began writing this a few days after giving birth, and as with most pieces I write, I found the beginning to be the hardest part. So, I went back to my beginning–when the idea of natural birth first appealed to me, through the words of Fulton Sheen. It was in re-reading the quote that I found my error; I had collapsed what is meant to be a lifetime of “sustained sacrifice” into one moment. I, like many of the natural birth advocates out there, had made the method of giving birth the measure of my motherhood.
This is the crux of the Inner Ring of natural birth elitism–that the way in which a mother gives birth determines the level of sacrifice she is capable of throughout her motherhood. Whether intentionally or not, the message to many has become that in order to join the ranks of virtuous, sanctified mothers, a woman must start her journey in one particular way. Staring this in the face, I find it not just saddening, but quite diabolical. As a friend recently pointed out to me, it’s also just like the enemy to strike division in the midst of what should be sacred and unitive.
Birth is difficult, no matter the circumstance. My friends who have had c-sections talk about the significance of being cruciform on the operating table as they give birth, with their arms spread out on either side of them–literally allowing their bodies to be sliced open for the sake of their child. Medicated birth is not without its sufferings, as well, a fact to which I can now attest–though I can spare you the gritty details. But more than birth being difficult and requiring us to sacrifice, motherhood is difficult. It is, like birth, intensely rewarding. But it’s the sacrifice of mind, heart, and body over a lifetime that Sheen calls the “Calvary of mothering”--it’s the nights spent soothing fevers, the days spent answering endless needs and requests, the moments of choosing a patient tone instead of snapping.
It’s the changing of a diaper only to turn around and change it again, two minutes later, because children’s bowels have impeccable timing; it’s the re-reading of Go, Dog, Go! to the point of having it memorized. It’s the potty training, the tantrums, the sidelining of your favorite music for the sake of playing Cocomelon again in the car. It’s the belly fat and love-handles that may never quite disappear, the stretch marks that you learn to slowly wear as a badge of honor, the lifelong task of crossing your legs when you sneeze so you don’t pee. It’s the sacrifice of your time, energy, and sometimes your dreams for the sake of attending to a life that you co-created. The letting go that you face with each passing year, as they grow taller and their problems more complex and their reliance on you decreases. More than anything, it’s the pain of watching your heart live outside your body and walk around, open to the wounding of the world–and knowing that you, like Our Lady, must in the end stand by and watch, trusting that Sunday morning will come for us all.
The invitation to enter into Calvary and the story of salvation extends so far beyond just our choices in birth, though it certainly includes those moments as well–but the arc of that story is only built with each moment afterward. The most painful part of childbirth is that the time of holding your child as close as a human being possibly can is over, and new life–with all its beauties, sufferings, toils, and redemption–has begun. No mother is exempt from that, whatever comes of her or her child’s life. No matter the method of giving birth, ushering life into this world requires us to die–over and over again, to die.
But what a sweet, beautiful death it is.
This deeply resonates with me. I had idolized unmedicated birth prior to my firstborn, and I was devastated when I had to transfer from my posh birth center to the hospital for an induction and (eventually) an epidural. Culture places such a heavy emphasis on the method by which we birth, it ends up eclipsing motherhood itself. There's a similar cultural thing going on in weddings vs. marriage - brides often fixate on making the wedding into a spectacular event rather than recognize that it's the marriage that matters. Perhaps this is because we're living in an era of astonishingly low time preference, where culture hyper fixates on the "right now" rather than the "long haul"?
Absolutely love love this essay. This is so funny, I was at a Catholic mom’s group yesterday and another woman mentioned she’d had an epidural in an almost ashamed voice! I reassured her that I had too.
Here’s the thing. I hope this doesn’t sound uncharitable, but to me part of something being sacred is that it is hidden. Hence the tabernacle, monstrance, chapel veils. Are we treating our birth as sacred if we are constantly splashing it on Instagram, especially for profit? I don’t know, I’d take my epidural again over that.