expectations of naturalness, and the dire consequences of not following
the natural way, don’t
just start with parenting the baby. They start with pregnancy, and
especially to what is so frequently called “The Birth Experience.”
For some women, labor
and delivery goes like this: labor begins, whether through the thrilling
rush of the amniotic fluid rupturing or through a sense of menstrual
cramps that grows into something definitely ‘other.’
Either way, the woman contacts her doctor or midwife and goes to
the place—home or hospital—where she has planned to
give birth. Labor becomes uncomfortable and intense, but she manages.
She has the help of a loving, supportive partner and perhaps another
coach, a calm and competent practitioner, breathing exercises, back
massage, ice chips. She imagines the face of her new baby to get
her through the difficult moments. Perhaps someone comes in and
suggests she needs stronger medical intervention, such as an IV,
an epidural, or the baby monitor. “No,” she, or one
of her devoted coaches says, “it’s not in the birth
plan,” at the mention of which all attempts at intervention
stop, never to be resumed. And then she pushes and grunts, feeling
more powerful than she ever has or will again in her life. The baby
is born, everyone cries, and the infant is placed on the mother’s
chest. They stare into each other’s eyes with mutual recognition
and then the baby roots out the breast, latches on and sucks vigorously.
The woman’s birth experience is complete.
For some women, labor
and delivery goes like that. For most women, it doesn’t. For most women, something—even
if the something is nothing more than the overwhelming, unimagined
intensity of the pain—goes wrong. Insulated from pain as we
are by the Tylenol we take for even minor headaches, nothing in
our lives has prepared many women for the pain of labor. Certainly
not the books.
In the section on Labor
and Delivery in What to Expect When You’re Expecting,
the “Bible” of modern pregnancy, pain is hinted at exactly
twice. It is called “increasing discomfort with contractions”
(293) during the active phase of labor. The transition stage is
referred to as “exhausting and demanding.” (297). What
to Expect also tells a woman that her “self-pity”
may make her “perception of pain”(298) worse. Instead
of feeling this self-pity—and thus the pain of labor—they
inform us that the pregnant woman should be “Thinking about
how lucky you are and about the wonderful reward ahead.” (298).
This certainly didn’t
work for me—when I was in the full force of active labor and
living in the hell that is waiting for the anesthesiologist to deliver
the epidural, my nurse told me to think of the baby to get me through.
“Fuck the baby,” I roared, meaning it more than any
almost other emotion I have ever had in my life. An unknown baby
was no match for the contractions of labor. Later, the nurse told
me that was a mild statement compared to what she’d heard
many other women say.
What to Expect,
while technically stating the words all women are different and
any healthy birth is a good birth, actually uses its language to
promote a very particular kind of birthing experience: one where
“natural” is good, and most medical intervention is
wrong. Here, for example, is what they have to say about asking
for strong pain reliever during labor:
If you feel you
need some pain relief, don’t be afraid to discuss it with
your attendant. He or she may suggest waiting for 20 minutes or
half an hour before actual administration—at which point you
may have made so much progress that you won’t need it, or
you may have found renewed strength and no longer want it (294).
Assumption #1: That
there is something to be afraid of in asking for pain relief.
Assumption #2: That
a laboring woman in need of pain medication is able to “discuss”
anything. Demand, rage, plead, roar or moan are more likely verbs here.
Assumption #3: That
your attendant does not want you to have pain relief.
Assumption #4: That
if you are strong you won’t need it.
Assumption Guiding All of the Above: There is something
wrong with using pain medication while in labor and you don’t
like these that guide their language, What To Expect quite steadily
pushes its agenda of a particular kind of birthing experience. More
insidiously, it assumes that this is the experience most women will
The image of the laboring
mother maintaining her power and control, where the pain remains
manageable and support surrounds her like a warm bath, where medical
intervention is solely devoted to enhancing the mother’s birth
experience, where the birth plan works and breast feeding is easy
and mutually enjoyable, is held out to be the ideal, what all women
not only should strive for but naturally, automatically want. Dr.
Sears tells women to “take responsibility for orchestrating
the birth you want”(5), as if this action is easily achieved.
When they don’t
get it, many women feel that they have failed, even when they deliver
a healthy baby. Susan Maushart, the author of The Mask of Motherhood,
says that the relentless focus on the woman’s “performance”
during the “birth experience,” rather than the child
it produces, creates “the greatest shift of all in our social
construction of childbirth: that the “object” of the
enterprise is no longer seen to be the end product (the baby) but
the process itself (69). Maushart states that for the modern woman,
who is almost guaranteed a healthy baby, the loss of control during
labor is the most frightening part of the experience, and the disjunction
between our expectations of control and performance, and “the
sheer brute force of the birthing body” (72) leads many new
mothers to feel anger, shame and “a yawning psychic chasm”
(73) after the birth of their baby.
Childbirth is dangerous.
I’m sure that the Bible, for example, does not describe childbirth
as a punishment for women because there is some “discomfort”
involved. Medical intervention is sometimes unwarranted, certainly
driven to some extent by the overwhelming law suits directed towards
physicians who don’t intervene and then something goes wrong,
but almost always intended to insure the safety of both the mother
and unborn child. The truth is, American women go into labor with
an almost 100 percent statistical certainty that both they and their
child will survive. This is the first time this has been true in
human history and is in large part due to medical intervention.
Yet the language of natural childbirth would have us believe that
medical intervention is itself the danger.
Childbirth is not an
experience we can control. It is, to use a cliché, one of
the 2 great mysteries of life (death being the other) and as such,
almost completely out of capacity to understand, let alone organize
to our liking. We can, to some extent, given the requirements of
our health insurance (if we’re lucky enough to have it), determine
our physician or midwife. We can take our breathing classes, learn
about the stages of labor, equip ourselves intellectually for the
experience, hopefully arrange for an experienced woman to be with
us in the labor room along with a life partner, if we are lucky
enough to have one. But when labor starts, the woman’s intellect
is her least valuable or accessible resource.
Labor controls the woman,
the woman does not control the labor.