In this episode, Obstetrician and Gynecologist Amy Tuteur asks us to consider, “Why do good mothers feel so badly about themselves?” Tuteur, a mom of four herself, tells EconTalk host Russ Roberts that the natural parenting movement deserves much of the blame. How many of the decisions mothers make during pregnancy and childbirth are subject to pressure, and without demonstrable health benefits for the baby? Can the origins of trends in breastfeeding and attachment parenting help us understand the pressures women feel today? Are we judging women’s decisions about childbirth too harshly? Have we under-emphasized- or even forgotten- just how dangerous childbirth was in the not too distant past?

What are the incentives at work in the process of childbirth, and whose interests dominate? How can economics help us think about changing trends in American parenting? There are a lot of questions- and opinions!- that emerged from this week’s episode. We hope our questions here can help us continue the conversation.


1- To what does Tuteur attribute the dramatic rise in C-sections in the U.S. in recent decades? Who has the greatest incentive to press for a C-section- the parents? The mother’s doctor(s)? The mother’s insurance provider? The hospital? Others?


2- What is the relationship of eugenics* to the natural parenting movement beginning in 1930s and 40s, according to Tuteur? Is her explanation more or less convincing than Roberts’s characterization of attachment parenting as “paleo-fantasy?”


3- What is “medical colonialism,” according to Tuteur? Who is most harmed by it, and what does Tuteur propose as a better solution to help those most harmed? To what extent do you think her suggestion might be efficacious? Explain.


4- In what ways does Tuteur believe the re-emergence of midwifery in the United States has impacted the (medical) experience of childbirth in America? While Tuteur does not make any distinctions in her explanation, there are a variety of types of midwives– some accredited and some not. Should midwifery be subject to occupational licensing? How might licensing change the effects Tuteur describes? To what extent would these changes be for the better?


5- In their discussion of breastfeeding, Tuteur quips that “moralization parallels monetization.” What does she mean by that? What does she propose as a better way to help babies in this regard? What are your thoughts? Is this “monetization” also the cause of the black market in breast milk? Tuteur expresses concern about this black market… but are black markets always dangerous? How should we respond to this one?




*Tuteur’s claim may not be too far out there… We’ve run many pieces over the years on the relationship between eugenics and economics. See here, here, here, and here.