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Thursday, Dec 10, 2009
What's so feminist about a painful childbirth?
Aug 3, 1999 | When I was pregnant last year, I was practically the only woman I knew who admitted to planning an epidural. "Oh, I'm keeping my options open" or "I know drugs are there if I need them" were the typical responses of women who invariably went for an epidural at the earliest opportunity.
At first, I found this timidity surprising. Nobody waits to see if, say, root canal surgery is painful enough to require medication. Surely after thousands of years of human history, the evidence on childbirth is in. Even in ancient Greece, Homer talked about the "agonies brought on by the harsh, birthing spirits."
But after making my way through prenatal yoga, childbirth education class and a heap of pregnancy books, I discovered a childbirth culture that makes women embarrassed to want pain relief -- one that worships the "natural," unmedicated birth as an experience verging on the mystical. This birth culture is extremely influential even though it is out of sync with women's obvious needs: Although 80 percent of pregnant women opt for epidural medication when they feel the pain of labor, many feel guilty about having "failed." Some even require counseling.
It's a culture that has been shaped by an array of professionals, including doulas, who offer labor and post-partum support, and midwives. It offers books like the classic "What to Expect When You're Expecting." It has brought into the mainstream not only birth-education classes but also birth plans (a woman's instruction to her hospital on everything from her delivery position of choice to the kind of lighting she prefers), prenatal yoga, birthing tubs to soak in during labor and birth art -- from nude profiles of the expectant mom's swollen shape to plaster-of-Paris "belly masks." Some devotees of the culture call themselves "birth junkies."
To be sure, the culture has many good points. Most pervasive among feminists, it has encouraged women to wrest back control of their pregnancy and birth from patronizing doctors. The medical establishment has been forced to pay attention, accommodating women's desires to be conscious for the thrilling moment of their babies' arrival and to have their partners in the delivery room to support them. It has also challenged unnecessary medical interventions, such as inducing a baby early so that a doctor can deliver during office hours.
Yet at some point, the movement became almost as proscriptive and patronizing as the establishment it was fighting against. Natural birth ceased to be merely an option and became the "right" kind of birth -- a sign of true womanhood. It is taken for granted in this culture that every woman should go into labor intending to take as much pain as she can stand -- and maybe more. Never mind that there's nothing particularly feminist about women in pain, or that the use of childbirth pain medication began in the first place because an earlier generation of feminists had fought for it. That was when feminism produced the suffragette; today, it gives us the earth mother.
All this reveling in pain seems even more strange in light of a new book on the history of childbirth drugs called "What a Blessing She Had Chloroform: The Medical and Social Response to the Pain of Childbirth from 1800 to the Present." Written by an obstetric anesthesiologist, Donald Caton, this insightful if earnest book shows that women have eagerly sought an escape from natural birth ever since there was one available. For a long time, women couldn't get childbirth drugs without a fight.
Caton's balanced work helps explain how we have reached such a diametrically opposite point today. One of his most fascinating revelations is that the natural childbirth movement owes its genesis not to modern feminism but to one man -- and an extremely sexist man at that.
The use of childbirth drugs began in 1847 when Scottish obstetrician James Young Simpson introduced ether as an anesthetic during labor. Pioneers in the field soon started using chloroform as well. At first, only the rich and powerful could avail themselves, in part because it was believed that only the most "cultivated and refined" women were "sensitive" enough to feel pain in childbirth. Queen Victoria was an early customer for chloroform, which she used for her eighth and ninth deliveries. She was so pleased that she saw to it that her eldest daughter, Vickey, received what the queen called "this blessed chloroform" during labor as well. But childbirth anesthesia was so controversial that even the queen's use came under attack by the founding editor of the medical journal Lancet.
In many ways, Caton's book reveals, the early arguments against childbirth pain medication are remarkably familiar. Many scientists of the time considered drugs an unnecessary "intervention" that would interfere with the "natural" process of childbirth -- by diminishing contractions, for instance. They also felt that anesthesia posed a risk to the life of the mother and the well-being of the newborn. In addition, many then saw childbirth pain as a dictate from God. So it was only the rare, courageous physician who was willing to use the new childbirth drugs.
