Reactions to medicalised birth
Reactions to the medicalisation of birth have been various. For some women, the technology and surveillance that is brought to bear on the birthing body is welcomed as a comforting presence to help ensure that the baby remains safe and well. Whilst it is vital that we recognise this, it is worth remembering that it is the routine medicalisation of childbirth practised either as a form of defence or idiosyncrasy that is in question here.

Many women, and others, have been critical of the medicalisation of birth and have sought ways of subverting this.

Pressure groups, including the National Childbirth Trust (NCT), the Association of Radical Midwives and the Association for Improvements in Maternity Services, amongst others, have campaigned against many aspects of the medicalisation of childbirth. They have been particularly critical of the routine use of medical procedures, such as induction and episiotomy and continue to campaign for improvements in maternity care.

Many women, often supported by some of the groups described above, also seek to resist and subvert intervention in childbirth. For some women, this may mean booking a home delivery. For others it may mean writing a birth plan, attending alternative childbirth preparation classes, or booking a water birth.

The feminist movement has also been influential in the reaction against the medicalisation of childbirth. For many feminist writers, the obstetric medical domination of childbirth has denied women the right to control their own bodies and make their own decisions. They argue that women no longer have faith in their own bodies and are afraid of giving birth.

Many midwives, and some obstetricians, have been critical of the medical management of childbirth in our society.

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The future of birth and the role of the midwife
We live in a world where we no longer really believe that women can give birth without pharmaceutical, technological or medical interventions. Shulamith Firestone (1979) once compared giving birth to 'shitting a pumpkin' and, yes, childbirth hurts - a lot - but it is nonetheless a normal, everyday event for many women all around the globe. The routine medicalisation of childbirth robs women, midwives, and society, of the knowledge and experience of what it is to have a normal birth.

Maternity Standard 11 of the National Service Framework for Children, Young People and Maternity Services states that women should:

'. . . have as normal a pregnancy and birth as possible, with medical interventions recommended to them only if they are of benefit to the woman or her baby.'
(DoH, 2004)

To this aim, 2005 sees the launch of a major new UK-wide initiative called the Campaign for Normal Birth. This campaign, launched by the Royal College of Midwives, aims to inspire and support normal birth practices and is underpinned by the philosophy of pregnancy and birth as normal physiological processes. The campaign is underpinned by a commitment to the reduction of unnecessary intervention and surveillance during childbirth.

If we are to turn back the tide on the medicalisation of birth it is important that we recognise the place of technology in today's world. We must, however, remember that giving birth is a normal physiological process and that the majority of women - given a chance - can achieve a normal birth without intervention.

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