The Medicalization of Birth (Episode 493)

Full Transcript: Episode 493

Lisa: Today’s episode is all about birth, and it’s certainly one of my favorite topics. My guest, Allison Yarrow, had a profoundly different birth experience than I did, and it led her to write a whole book exploring the issues within our medical birth system.

Allison: I’m a journalist and mother of three. My inspiration for writing *Birth Control* came from my personal birth experiences. Though I had covered reproductive health and abortion policy for years, I didn’t initially question the systemic sexism and racism in birth itself—until I went through it.

Lisa: That’s such a powerful realization. It’s wild that your childbirth class taught you how to defend yourself against the medical system. My entire strategy for birth was just that—avoid unnecessary interventions by planning home births.

Allison: I was terrified. I didn’t know anyone who had given birth at home. It wasn’t until later that I began unlearning what I’d internalized about birth being dangerous and medicine being safe. I ended up having my third birth at home, unmedicated like the first two, but with a completely different experience.

Lisa: It really underscores the importance of childbirth education. I knew by 18 or 19 that I wanted to give birth at home. But many women only learn about physiological birth through trauma or frustration. Your book helps bridge that gap.

Allison: That’s why I wrote it—to give people that information before they’re in the thick of it. I surveyed over 1,300 women and birthing people, and what I found was shocking. We have a managed care model that moves people through the hospital system as quickly as possible, often without centering evidence-based care or patient autonomy.

Lisa: It’s heartbreaking, really. And it’s so unfair that we have to fight for care that honors us. It shouldn’t be that way.

Allison: Absolutely. The system is designed around profit and liability—not patient-centered outcomes. And the trauma it causes is real. Nearly half of women describe their birth as traumatic, and the data backs it up.

Lisa: I’m struck by how common trauma is in medicalized birth. So much of it seems normalized now. People often don’t even realize how much they’ve been disempowered.

Allison: Yes, trauma isn’t always about what was done to you physically—it’s about how you were made to feel. Not being listened to, not being supported, and being kept in the dark during birth can be incredibly damaging.

Lisa: And we’re still not educating girls properly. What you shared about those 10-year-old girls in Brooklyn—it’s so telling. Shame around menstruation starts young, and it disconnects us from our bodies.

Allison: Exactly. It’s not just birth—we need better education across the board. The fact that so many people don’t even know you can only get pregnant a few days a month is staggering.

Lisa: So what’s the solution? Is it up to schools, parents, or us as individuals?

Allison: All of the above. But first, we need to recognize the system is broken. Most of us trust it without question. We don’t realize we’re handing over authority to institutions that don’t always have our best interests in mind.

Lisa: It’s true. I always say we need to be the CEOs of our own health. Doctors are there to advise—not to dictate. But advocating in labor is incredibly hard. The work has to happen before you’re in that moment.

Allison: Birth is inherently powerful. The body knows what to do, but the system doesn’t support it. What we need during birth—quiet, comfort, privacy—is denied in most hospital settings. That’s not accidental.

Lisa: The training OBs receive doesn’t help. They’re taught surgical solutions, not physiological birth. So when you’re moaning through labor, they see it as a crisis rather than a normal process.

Allison: That’s why the midwifery model of care is so important. It centers the birthing person and sees birth as a process to support, not control. The evidence is there—midwives and doulas improve outcomes and reduce trauma.

Lisa: But the system doesn’t change easily. And not everyone wants to opt out. Some women choose C-sections, and that’s okay too—as long as it’s an informed choice.

Allison: Exactly. The subtitle of my book is *The Insidious Power of Men Over Motherhood*—not to be provocative, but because it’s true. The system was built by men who have never given birth, and that power dynamic is still in place today.

Lisa: And it’s not just patriarchy—it’s also profit. The financial incentives to push interventions are huge. You’re not in a surgical suite because you need surgery—you’re there because it’s billable.

Allison: That’s the hard truth. But even with all the cynicism, I still believe in the power of awareness. Birth doesn’t need to be medicalized for most people. We were designed to do this.

Lisa: And that’s the perfect note to end on. Thank you, Allison, for your insight and your voice. For anyone listening, go check out her book *Birth Control*. This conversation is just the beginning.