You are so right that there’s nothing wrong with vocalizing in labor. Personally, I’m a quiet sort, but I think I ought to be free to scream if I wanted to. However — and I know you agree because I have seen your comments on the My OB Said What blog — there’s a big difference between focused vocalizing and hysterical screaming, between making noise because you are working hard, and losing control because the pain is unbearable. I imagine the latter does happen to some women, even sometimes with natural labor. I know that when my third baby was born in 45 minutes I was initially shocked by the force of the contractions, and I couldn’t have done that for 8-12 hours (the length of my other births). But most normal labors are manageable, even if they are hard work, so it’s good to see a mainstream celebrity *managing* it.