Natural versus C-section
Jul. 11th, 2008 05:49 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
sawylToday's Guardian has an intersting piece about childbirth, which focuses on the split between the perceptions of midwives and obstetricians.
According to the article, despite the advice of government and the midwifery profession, many obstetricians opt for birth by Caesarean section. Their reasons? That they want to minimise the trauma of the birth for their child and to avoid the potentially unpleasant side effects of a natural delivery — this, it seems, is something of a misnomer since the article claims that only 47 percent of births occur without some form of medical intervention. But it may not be that obstetricians have the clearest view of those involved in the birthing process since they tend to focus on women who have a higher risk of complications.
But what really interests me about the article is the idea that there is something necessarily good about things that are natural and not about things that are man-made. Thus, the default assumption is that natural childbirth, despite it's relatively high rate of complications is necessarily better than a C-section. Not knowing the precise medical details, I'm not really going to comment other than to note that maternal mortality in humans is relatively high — the consensus seems to be the basic rate where modern birth practices are unavailable is around one percent — which doesn't exactly prove that natural is good. Rather, the features that have made humans evolutionarily successful — a clever mind, a big brain in large heads — are precisely the features that would seem to make childbirth a dangerous prospect, relative to birth in other mammals. Again, it would seem that natural isn't necessarily good.
And this is not, a particularly surprising conclusion. From what we know of evolution, we wouldn't expect it to produce results that are necessarily optimal. Instead, we would expect existing features to be recycled to produce something just about good enough to perform the current task. And, unsurprising, that's largely what we do see. So the idea of good doesn't really seem to enter into the process at any point.
Thus, it may well be that there are reasons to prefer natural childbirth over a Caesarean — in fact, the article mentions haemorrhage, thrombosis, infection and that any scaring may make subsequent births more difficult. But equally there are risks with the normal birthing process — this time womb prolapse, urinary and faecal incontinence, etc. So it's a question of weighing up the options, the risks and the benefits. What it isn't a case of doing is arguing that one option is natural and therefore good, whilst the other is human created and therefore bad; it is, or should be, an empirical decision, rather than an a priori one.
According to the article, despite the advice of government and the midwifery profession, many obstetricians opt for birth by Caesarean section. Their reasons? That they want to minimise the trauma of the birth for their child and to avoid the potentially unpleasant side effects of a natural delivery — this, it seems, is something of a misnomer since the article claims that only 47 percent of births occur without some form of medical intervention. But it may not be that obstetricians have the clearest view of those involved in the birthing process since they tend to focus on women who have a higher risk of complications.
But what really interests me about the article is the idea that there is something necessarily good about things that are natural and not about things that are man-made. Thus, the default assumption is that natural childbirth, despite it's relatively high rate of complications is necessarily better than a C-section. Not knowing the precise medical details, I'm not really going to comment other than to note that maternal mortality in humans is relatively high — the consensus seems to be the basic rate where modern birth practices are unavailable is around one percent — which doesn't exactly prove that natural is good. Rather, the features that have made humans evolutionarily successful — a clever mind, a big brain in large heads — are precisely the features that would seem to make childbirth a dangerous prospect, relative to birth in other mammals. Again, it would seem that natural isn't necessarily good.
And this is not, a particularly surprising conclusion. From what we know of evolution, we wouldn't expect it to produce results that are necessarily optimal. Instead, we would expect existing features to be recycled to produce something just about good enough to perform the current task. And, unsurprising, that's largely what we do see. So the idea of good doesn't really seem to enter into the process at any point.
Thus, it may well be that there are reasons to prefer natural childbirth over a Caesarean — in fact, the article mentions haemorrhage, thrombosis, infection and that any scaring may make subsequent births more difficult. But equally there are risks with the normal birthing process — this time womb prolapse, urinary and faecal incontinence, etc. So it's a question of weighing up the options, the risks and the benefits. What it isn't a case of doing is arguing that one option is natural and therefore good, whilst the other is human created and therefore bad; it is, or should be, an empirical decision, rather than an a priori one.
