Barbara Katz Rothman: Birth

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The Future of Birth


Barbara Katz Rothman


Does birth have a future?  Will the new people come into the world much the same way people have always come into the world, grown in someone’s body, pushed out of that body with pain and difficulty, emerging naked and vulnerable through a naked and vulnerable body?  Or are we really on the verge of that brave new world, babies started in vitro, finished in artificial wombs of one sort or another?

Birth itself, not pregnancy and the growing of the baby, but its actual emergence, may already be disappearing – in the United States, over one-third of all births take place surgically, babies lifted out of slit abdomens.  In some places the rate of that quaintly named ‘caesarean section’ is considerably higher. Some people think of that as progress – the bloody, intimate, relatively unpredictable labor and birth replaced with the standardized factory-like control of the hospital.

Standardizing bodily management has been the direction we have moved in pretty much everything.  Consider food.  The demands of the body are universal: we need protein, carbohydrates and nutrients, and every cultural foodway must find ways of supplying those while avoiding contamination, or ‘food-poisoning’. Historically though, these universals resulted in diets as different as a plate of corned beef and cabbage, a fish curry, a bowl of borscht and a bento box – each created out of specific cultural and social demands, as much as out of the universal demands of the human body.

In contrast, consider industrialized food.  A can of beans, a loaf of mass-produced bread, a case of soda, a bag of processed flour – these items of industrialized food are increasingly found throughout the world, produced and distributed by the same large companies.

And so it is with birth.  There is the universal and there is the local.  That awkwardly shaped big head and knobby shoulders have to move through that narrow vaginal corridor. That is universal.  But birth in squatting cultures or in chair cultures, where menstrual blood is taboo and where it is ordinary, where women live in nuclear family units and where women live separately from men – these differences resulted in differences in how birth was done. And just as ideas about who should be cooking for whom influenced food preparation, ideas about who should be physically intimate with whom, about nudity and about bodily fluids, all influenced the ways that birth was understood and done.

In contrast, consider hospital births, with fetal monitors, delivery tables, scalpels and suturing supplies – industrialized sameness overpowers cultural difference.  Walk into a McDonalds or into a hospital, and other than the language used on the signs, it is hard to know what country you might be in.

Think too about the area of closest overlap between the worlds of food and of birth: breastmilk, like amniotic fluid, smells of curry or of hot paprika or garlic depending on the diet of the mother; infant formula is identical wherever it is found.

Is this progress, this standardization?  We can – and plenty of people do – argue endlessly about the safety concerns, balancing dietary deficiencies against sugar-loaded diabetes and obesity rates, comparing maternal and infant mortality rates across time and space.  But it was industrialization itself that caused so many of the problems we then thank it for solving – moving from self-sufficient farms to factory-based city life brought us rickets and other problems that ‘nutrient added’ foods could then solve.  First, second, third babies among healthy, well-nourished women were surprisingly safe for both mothers and babies over time – and I say surprisingly because we have been so thoroughly taught otherwise.  Move those women into crowded tenements with bad diets, and birth gets dangerous.

More and more people are concerned about industrialized food and the modern diet, responding to its health and environmental costs with social movements to recreate different systems of agriculture and food preparation.  And so it is with birth, as we see a growing home birth movement in the United States, a new appreciation for midwifery care and home birth in this country and throughout the world.

The future is not what it used to be after all – for a long time, it looked like the future of food would be packets of nutrients, scientifically determined and mass produced.  People have rejected that future – walk through any city, and see the fabulous diversity of restaurants and food shops, the rebirth and strengthening of ethnic variety.  And maybe instead of babies grown in artificial wombs of the Brave New World imagery, we will see a proliferation of birth centers and home births, where labouring women are lovingly tended to as they bring forth their new babies.


Note: This essay draws on ideas developed in Barbara Katz Rothman, A Bun in the Oven: How the Food and Birth Movements Resist Industrialization (New York University Press, 2016).



KatzRothman_Barbara - portrait photoBarbara Katz Rothman, PhD, is Professor of Sociology, Public Health, Disability Studies and Women’s Studies at the City University of New York, where she runs the Food Studies concentration. Her books include In Labor: The Tentative Pregnancy; Recreating Motherhood; The Book of Life; Weaving a Family: Untangling Race and Adoption; Laboring On (with Wendy Simonds), and the new A Bun in the Oven: How the Food and Birth Movements Resist Industrialization.  She is Past President of Sociologists for Women in Society; the Society for the Study of Social Problems, and the Eastern Sociological Society. She is proud recipient of an award for “Midwifing the Movement” from the Midwives Alliance of North America.





Banner Image: Detail from A Bun in the Oven, courtesy of NYU Press.

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