Dr. Amy Tuteur wants mothers to stop feeling guilty if they didn’t experience idyllic, natural childbirth; if they didn’t breast-feed and if they didn’t co-sleep and or practice attachment parenting.
In her book “Push Back: Guilt in the Age of Natural Parenting,” Tuteur gives plenty of reason for women to feel OK with whatever childbirth experience they had, however they decide to feed their babies and whatever parenting practice works for them. What she doesn’t want is for their experiences to be hijacked by people and groups who label themselves experts and their sanctimommy followers. Yes, she’s talking about you, midwives, La Leche League followers and Dr. William Sears, the guru behind attachment parenting.
Tuteur, a Boston-area obstetrician, wrote her book in response to seeing women in tears after giving birth because they couldn’t follow their birthing plan. They felt like failures when they had to be induced or if they had to have a Cesarean section or chose an epidural.
This guilt is a recent phenomenon, she says. Before the 1970s, women worried about surviving the birth and the health of their baby. And then, the natural childbirth movement came on strong and women were encouraged not to have an epidural and even not to have a hospital birth at all.
Women forgot that the day they give birth is the most dangerous day in their lives, she says. They forget the mothers and babies still die in childbirth. The Centers for Disease Control and Prevention estimated in 2013 that 18.5 mothers out of 100,000 die in childbirth and 6.1 infants die per 1,000 live births.
“Expecting childbirth to go beautifully is kind of like asking a 3-year-old where do eggs come from and they say, ‘the store,'” she says.
Women think childbirth is safe because of the routine use of medical intervention by doctors. Often, women don’t even realize that their doctor actually has saved their lives during delivery. It’s that routine medical intervention that natural childbirth advocates are against, Tuteur says.
The problem with a home birth, she says, is that you’re trusting midwives who are trained for a normal birth, but not experts in complications. She cites a homebirth advocate Caroline Lovell from Australia, who bled to death because she had made the midwife promise before the birth not to take her to the hospital. When the unexpected happen, the midwife would not abandon the original plan despite Lovell’s pleas.
What Tuteur also noticed was it was women of a certain privilege, usually white women that are well off financially, that were wanting to have natural childbirth at home.
The recent immigrants Tuteur treated were happy to have births in a hospital with modern medication because their priorities were about the health of their babies and their own health, rather than earning a badge for a perfect, unmedicated birth, she says.
Tuteur would like women to stop making birthing plans because those plans just lead to disappointment. Instead, moms-to-be should take a class that shows a variety of births and educates about the mechanics of childbirth, but “you should be very suspicious of anyone telling you there’s a right way to give birth.”
And after the birth, it’s nobody’s business how you give birth, she says. “If they ask, ‘Did you have an epidural?’ that’s like asking, ‘Do you use pads or tampons?’ How is that your business?”
She also wants women to stop beating themselves up about not breast-feeding. In “Push Back,” she offers chart after chart of research that shows little difference between breast-fed and formula-fed babies with access to clean water. “The benefits are a few less colds over the first year,” she says. “That’s it.” All the other stuff — obesity rates, diabetes, IQ — “That’s not true,” she says. “That’s been debunked.”
She worries about women feeling like bad mothers when their milk doesn’t come in or babies have trouble latching. She’d rather they switch to formula and feed their babies rather than stick to breast-feeding with a hungry baby as a result.
When it comes to co-sleeping and attachment parenting, Tuteur reminds that it’s almost impossible for mothers to do that without staying at home. And co-sleeping can be very dangerous. A 2014 study found that 73.8 percent of the infants younger than 4 months who died in their sleep were bed-sharing with an adult.
Tuteur sees hospitals promoting co-sleeping by insisting that babies room-in with their mothers. “If you had 40-hour labor, how can you take of the baby 24-7?” she asks. “That’s dangerous.” She points to babies who died in accidents in the hospital by either being dropped by their mother or suffocated when the mother fell asleep.
The advocates behind natural childbirth, lactivism and attachment parenting, she says, have lost sight of the babies. “They are about mothers and their identity and building their identity around their mothering choices,” she says. “They make them out as superior mothers, but it’s not really true. It doesn’t work or it kills babies. They refuse to believe it.”
Tuteur is the mother of four children, two born with natural childbirth and two born with epidurals. She says she’s not going to stop anyone from having an unmedicated vaginal delivery in a hospital and breast-feeding afterward as long as it’s safe, but she’s not going to pressure any mom to do that.
“Children don’t need any of those,” she says. “What children need is love.”
“Push Back: Guilt in the Age of Natural Parenting”
By Dr. Amy Tuteur