The recent unscientific attack in the UK on normal birth and the women and midwives who keep it in their sights as a desirable goal either presumes or posits that intervention in birth is safe, advantageous, scientific, and desirable to any right-thinking woman. The pursuit of normal/physiological birth is conversely posited as a dangerous obsession, a primitive madness in a modern world or even a "cult".
In fact, it is the over-use of Caesarean section and the all-too-ready recourse to it when labour stalls or takes longer that is becoming an increasing danger to women and babies. No-one including UM disputes the value of surgical intervention when lives and well-being are at risk. But most long, stalled, difficult labours are the result of women trying to give birth in uncomfortable clinical environments, in non-physiological positions, surrounded by strangers watching clocks and fetal heart monitors. Neither the human pelvis nor the hypothalamus were designed to function outside a comfortable, free, loving, darkish and gentle environment.
The Lancet has recently (2018) published three excellent papers that really should reach a wide audience and be made known to women and their families (free to access and download).
https://www.thelancet.com/series/caesarean-section
The first paper deals with the global epidemiology of CS, the second (and read this one if you only have time for one) covers the short and long-term effects of CS in women and babies, and the third looks at interventions to reduce unnecessary CSs.
Over 6 million excess (not medically indicated) CSs take place annually. The fact that higher-educated women are more likely to have a CS shows how good information about CS is not reaching women of child-bearing age, and enabling them make choices that may protect them.
The most promising "interventions"? One-to-one support in labour, midwifery-led continuity of care and birth in non-medical settings such as birth centres. The problem with this, of course, being that many policy-makers and doctors and self-appointed patient-safety gurus want to throw more technology at the problem rather than midwifery time.
