We simply cannot separate birth outcomes from what we do to women in labor and birth. To do so is intellectual dishonesty. Birth has variable outcomes but when we interfere, change, alter, add to, mess with, give drugs, force induction, break water, *we* have altered an outcome and there is no longer a “this would have happened anyway” because we simply don’t know what the effects are of what we did. In the face of iatrogenic changes before we have a reason to act, we lose the honesty of birth and the knowing that things would unfold in a specific direction. We become a force of action that is outside of the original dyad.

-Shannon Mitchell