The term natural childbirth refers to a group of approaches to managing childbirth that share the common aim of facilitating childbirth without medical intervention. A variety of techniques may be used to achieve this aim. Although there have been, and there still are, wide variations in cultural practices surrounding childbirth, the dominant trend in Western industrialized societies has been to medicalize birth. This means that birth has become increasingly attended and managed by medical professionals in medical settings such as hospitals. Natural childbirth approaches stand in contrast to the medicalization of childbirth, and indeed developed in response to it. From early in the twentieth century there was concern amongst obstetricians that Western civilization had impeded women’s ability to labor with the brevity and ease of their less "civilized" sisters. One response was to treat childbirth as a risky, pathological process requiring medical intervention and management: in particular, to anesthetize the birthing woman and to use episiotomy and operative delivery such as with forceps. Hence the popularity in the United States from 1914, when the New England Twilight Sleep Association was formed, into the 1940s of administering scopolamine and morphine to induce "twilight sleep," which meant that women were barely conscious through their deliveries, and had no memory of the event. Proponents of natural childbirth took the opposite view, arguing that obstetrics was becoming too mechanistic, indeed "veterinary," and that its orientation needed to broaden to include psychological, social, and spiritual aspects of childbirth as well as the biomechanical. One means of achieving this was to involve women in antenatal physiotherapy and exercises to prepare for childbirth. The most influential response, however, came from Dr. Grantly Dick-Read in his 1933 analysis of labor pain, Natural Childbirth. In it he argued that fear of childbirth in Western society had produced physiological responses in birthing women that prolong labor and make it more painful. He developed an approach to foster the active involvement and conscious cooperation of birthing women that empowers them and makes them less fearful of birthing. The potential advantages of minimizing medical intervention and maximizing women’s control over their bodies in natural childbirth included shorter labor, less pain, a more satisfying birth experience, and a more alert (and hence healthier) baby because of lack of exposure to morphine and other drugs in utero. As a result of both mother and baby being conscious and alert at delivery, affective bonds between mother and child could also develop immediately and naturally from the moment of birth. Opponents of natural childbirth cite the risks associated with birthing, including maternal and neonatal mortality, as justification for using medical interventions preventatively or in immediate response to potential problems.
A number of different techniques for natural childbirth have evolved in Europe, the United States, and elsewhere. They are associated with practitioners such as Fernand Lamaze, Frederick Leboyer, Michel Odent, and Frances Vaughan, who stress different aspects of childbirth such as the setting (e.g., quiet, dark, water births) or positions that facilitate natural childbirth (e.g., squatting). In the United States, Robert A. Bradley developed Dick-Read’s approach and expanded it from the 1960s to include fathers in the antenatal preparation and the coaching of their partners through childbirth (the "Bradley method"). In more recent years this has been further expanded to include other support persons for the birthing woman; these may include friends or family members, or a paid "doula." In most Western societies birth attendants must be licensed to practice and generally include only doctors and midwives. The practice of most midwifery, particularly for autonomous or independent midwives, is premised on the understanding of birth as a normal, holistic, physiological, emotional, and social process, and hence encourages natural childbirth approaches. Many women’s and consumer groups are also supportive of natural childbirth approaches.
