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Writer looks for healthiest, happiest approach to childbirth

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Is natural always better? Bay Area-based writer Nathanael Johnson seeks to answer that very complicated question in his new book, “All Natural.” In this reported memoir, Johnson, a self-described skeptic, seeks to discover if a more natural approach to life makes one happier and healthier.

Johnson has written for California Watch, reporting on maternal health and how much medical intervention is really necessary during childbirth. One investigation revealed that for-profit hospitals saw higher rates of cesarean section deliveries, which are more expensive. Data revealed in another story that elective births can increase health risks for the mother and child.

I spoke with Johnson over the phone and via email, about how a writer tackles a topic with such oppositional viewpoints – especially when he's seen both sides of the argument. The interview has been edited and condensed.

Marie McIntosh: How much of this book is tied to how you were raised? Did that inform your own reporting while writing the book?

Nathanael Johnson: I grew up in a kind of hippie, all-natural family. The book starts with a description of this photo of the family the morning after I was born at home, on Benvenue Avenue in Berkeley. We are all clustered together in this redwood-paneled room, and everything looks so idyllic and warm. It's a visual metaphor for my early relationship with the idea that what's natural is healthy. That idea is tenderly knit to my sense of childhood innocence. And then, at the same time, growing up in this family gave me a front row seat on the ways that going all natural can fail. The result is that I'm both deeply sympathetic and deeply skeptical about these ideas of natural birth, natural diets and alternative medicine. A lot of what's been written about this stuff is polarized – it's either totally credulous or totally dismissive. And because I was so fascinated by all the cool nuances in the middle I ended up writing this book.

MM: How did the reporting you did for California Watch figure into the genesis of “All Natural”?

NJ: I didn't know that there was a book here until I started on the reporting I did for California Watch. Because, if everything I found was just a confirmation of conventional wisdom, that wouldn't have sustained my interest. So when I found out that birth was actually getting more dangerous and that people were being hurt by too much medical care, well, that just felt counterintuitive and unexpected.

MM: So, how do you make decisions on these issues when viewpoints seem so polarized? 

NJ: Just do exhaustive research and get beyond your bubble with scientifically objective information. A big part of this book is focused on this work of uncovering evidence that upset my assumptions and led to pragmatic changes in my life. The problem is, that information only goes so far – the sum of our ignorance always exceeds the sum of our knowledge. I think (writer) Wendell Berry posed the question best: "How does one act well – sensitively, compassionately, without irreparable damage – on the basis of partial knowledge?”

And a big part of acting well, unfortunately, is simple acceptance – acceptance that we just don't know. I kept coming across ways that we do ourselves harm by grasping at certainty: C-sections are a good example because you are trading the uncertainty of biological labor for what feels like a sure thing, at least in the moment. But when you look at the big picture it's clear that having too many C-sections creates more uncertainty and danger than it prevents. Americans are fixers and problem solvers – you hear about Yankee ingenuity, not Yankee acceptance. But often the most reasonable thing to do is relax into the terrifying uncertainty of life. That's certainly a hard one for me.

Read an excerpt of Johnson's new book, “All Natural.” For more information on the book or where to buy it, click here. He'll also appear in conversation with Michael Pollan on Jan. 31 at Book Passage at the Ferry Building in San Francisco.

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