In “Natural births: better after all?” (9/5), author Ambika Bhushan equates vaginal birth with “natural birth.”

While the vagina is the natural and normal birth canal, a vaginal birth is not necessarily a “natural birth.”

In the study she summarized, there was no mention as to whether women in the vaginal birth group had epidural anesthesia, narcotic pain relievers or other medications that interfere with the natural, unadulterated and non-medicated birth process.

Medical studies repeatedly show that babies whose mothers receive narcotic pain relievers in labor are less responsive at the time of birth and often need resuscitation immediately after birth.

Mothers, too, are under the effects of the opioid at the time of delivery, therefore inhibiting their “natural” or unmedicated first encounter with their newborn.

With epidurals, which nearly all laboring women in this country receive while in labor, there is an increased rate of vaccuum and forceps deliveries, external oxytocin administration (the hormone cited in the study that is linked to maternal behavior) and maternal fever, which results in the baby being placed in the intensive care unit, away from its mother.

While this study is a step in the right direction, the ultimate control group would be a group of women who did not use any medications in labor.

A discussion as to the effects of a vaginal birth on bonding, even if not “natural,” would have been interesting because this could suggest that, even in the presence of strong medications, there is something about entering the world through the normal route that is important to mother-infant bonding.

Jessica A. Pettigrew

School of Nursing Student