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Ethics and “Normal Birth”


  • Anne Drapkin Lyerly MD, MA

    Associate Professor, Director, Corresponding author
    1. Center for Bioethics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
    • Social Medicine, Chapel Hill, North Carolina, United States
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Address correspondence to Anne Drapkin Lyerly, MD, MA, 333 South Columbia Street, CB#7240, 333 MacNider Hall, Chapel Hill, NC 27599-7240, USA.


The concept of “normal birth” has been promoted as ideal by several international organizations, although debate about its meaning is ongoing. In this article, I examine the concept of normalcy to explore its ethical implications and raise a trio of concerns. First, in its emphasis on nonuse of technology as a goal, the concept of normalcy may marginalize women for whom medical intervention is necessary or beneficial. Second, in its emphasis on birth as a socially meaningful event, the mantra of normalcy may unintentionally avert attention to meaning in medically complicated births. Third, the emphasis on birth as a normal and healthy event may be a contributor to the long-standing tolerance for the dearth of evidence guiding the treatment of illness during pregnancy and the failure to responsibly and productively engage pregnant women in health research. Given these concerns, it is worth debating not just what “normal birth” means, but whether the term as an ideal earns its keep. (BIRTH 39:4 December 2012)