Great strides have been made in the last few years in terms of educating the American public about the safety of home birth.
Numerous studies have shown that not only is home birth a viable alternative to hospital birth, but in many cases it has actually been proven to be safer. Of course, many women are simply unaware of these findings. But of the ones who are, most of them are still choosing a technocratic, physician-centered hospital birth, over a holistic, woman-centered home birth. It would help all of us if we could understand the reasons behind this choice.
Pressure from parents and in-laws, inability to find a midwife or physician who will deliver a baby at home, and desire to escape the demands of being a housewife and mother for a few days, are all reasons I've heard women give for choosing a hospital birth. But at the top of the list, second only to safety, is the desire for pain relief.
"I love the idea of a home birth," one woman told me, "but I've been through birth before and I NEED that epidural." A caring midwife can give a woman a tremendous amount of emotional and physical support to help her endure and even lessen the pain of labor, but if she can't eliminate the pain by the use of drugs, many women will opt for the emotionally sterile, but "relatively" painless hospital delivery.
My question is, why must we have only have two choices? Isn't it possible to have our cake and eat it too? I believe it is, but first we must be willing to examine the nature of our beliefs.
According to numerous sources, both historical and contemporary, what we believe about birth, and about life itself, has a direct and profound effect on our labors. If we believe, for instance, that there is a vast, loving intelligence who created our bodies with the expressed purpose of reproducing (among other things), we are less apt to fight the contractions of labor and therefore less likely to experience them as painful. On the other hand, if we believe that life is the result of an accidental chemical reaction, and that our bodies are poorly designed, we will most likely resist our labor contractions and consequently suffer a great deal of pain in the process.
Many authors have written about the power of our thoughts and beliefs but few as extensively as the late Jane Roberts. According to Roberts in her book The Nature of Personal Reality, thoughts and beliefs are not simply nebulous words floating about in our heads. They are instead electromagnetic realities, which once conceived, have an intense desire to manifest themselves in our lives. The stronger the thought, the more quickly it will come into our experience. We get what we concentrate on. Or, as author Richard Bach states in his book Illusions, "We magnetize into our lives whatever we hold in our thought."
Our day to day life will always seem to reinforce our beliefs. Physicians, for instance, can present us with numerous examples of women who would have died had they not given birth in the hospital. What they refuse to see, however, is that they, and the women they "deliver", all believe to one degree or another, that birth is painful and dangerous--otherwise they wouldn't be doing it in a hospital equipped with all of the latest technology. Their belief then, is precisely what makes it so.
Early natural childbirth advocate Grantly Dick-Read had a deep understanding of the importance of not only the laboring woman's beliefs, but also those of the people who attend her. In Childbirth without Fear he wrote:
Suggestion of pain is conveyed by the atmosphere of the labor room; it emanates from doctors, nurses and relatives. They believe in pain; subconsciously or consciously they suggest, expect and even presume pain. Upon the sensitive mind of a woman in labor such authoritative [suggestions are] a powerful adjuvant to painful sensations.
Lester Hazell, the former president of the International Childbirth Education Association, wrote that "what happens at birth tends to be guided by our belief system about birth." Childbirth educator Carl Jones writes in Mind Over Labor:
A positive image of birth is the cornerstone of a safe, happy birth experience. If you believe your body is meant to give birth efficiently, naturally, and without complications and that birth is a joyful event, you are more than halfway to a safe, natural birth. Positive beliefs and attitudes contribute to a happy birth experience, enabling the mother to labor more efficiently and to open for her baby with less effort.
This concept is certainly not a new one. Many childbirth authors have written about it in the last few years and many midwives routinely help women to uncover their beliefs about birth, their bodies, and life in general. But in reading numerous birthing books and speaking with many midwives in the last few years, I've noticed that there seems to be a self-imposed limit on just how far we can take this. It's not uncommon for a midwife to tell a woman that pain in labor is actually desirable. In an article in Midwifery Today titled "Birth in Holland," midwife Beatrijs Smulders made the following statement:
We tell our women that pain is a must. You can handle the pain, it's functional. Without the pain you take away the heart of the event. It's change, it's tough, but your body is made for it.
If our bodies are made for birth, why then must it be painful? Would God or nature design our bodies so that conceiving a child feels wonderful but birthing one does not? As Grantly Dick-Read said, no other natural bodily function is painful and childbirth should not be an exception.
So why then is childbirth painful for the majority of women giving birth today? Many people are familiar with Dick-Read's"fear/tension/pain syndrome" and I believe his theories are profoundly correct. But I also believe there's more to it than that. Perhaps too many of us see pain as a badge of courage--proof that "we are just as strong as men." If men can suffer on the battle field, we can suffer in childbirth and then tell ourselves how brave we were to have endured it. Or maybe, in keeping with the mechanistic view of life, we firmly believe that our bodies are poorly constructed and therefore incapable of opening up without tremendous pain or surgical intervention.
In a recent New York Times article, Jessica Mitford, an advocate of home birth, actually espouses the very beliefs that make women want to run to physicians when they're in labor.
It's amazing how badly designed the human body is...The Creator must have been laughing up His sleeve...as He drew up the blueprint for the vagina, urethra and anus--jumbling them together in a most incommodious little space and in a way bound to be very awkward, given their separate and distinctly incompatible purposes...As for the system for giving birth, in which the baby makes its painful way through a passage fraught with peril to both itself and its mother, some equivalent of a zipper down the mother's abdomen...would have made everything so much easier.
Obviously many physicians must agree--the cesarean rate is now over 20% in this country. As I was reading Mitford's statement, I was reminded of a similar one written by Dr. Robert Sokol, professor and chairman of OB/GYN at Wayne State University and Hutzel Hospital in Detroit: "The vagina is not made for having babies any more than the penis is." If we accept the idea that our beliefs create our experiences, it's easy to understand why most women in our culture have painful and often difficult labors.
However, not all women in our contemporary society have adhered to these beliefs. Around the turn of the century, many of the early feminists believed that the pain and problems in labor were a direct result of the commonly held belief that the female body was inherently inferior to that of the male. They heard about the Indian women who were giving birth easily and believed that with the proper mind set, they could do the same. Childbirth, then, became a way for women to prove to themselves and others that women were strong and capable of determining their own fates. Elizabeth Cady Stanton wrote:
If you suffer, it is not because you are cursed of God, but because you violate his laws. What an incubus it would take from woman could she be educated to know that the pains of maternity are no curse upon her kind. We know that among Indians the squaws do not suffer in childbirth. They will step aside from the ranks, even on the march, and return in a short time bearing with them the new-born child. What an absurdity, then, to suppose that only enlightened Christian women are cursed. But one word of fact is worth a volume of philosophy; let me give you some of my own experience. I am the mother of seven children. My girlhood was spent mostly in the open air. I early imbibed the idea that a girl is just as good as a boy, and I carried it out. I would walk five miles before breakfast, or ride ten on horseback....I wore my clothing sensibly....I never compressed my body....When my first four children were born, I suffered very little. I then made up my mind that it was totally unnecessary for me to suffer at all; so I dressed lightly, walked every day...and took proper care of myself. The night before the birth...I walked three miles. The child was born without a particle of pain. I bathed it and dressed it myself.
Today, women around the world are re-learning just how pleasurable childbirth can be when one has the right beliefs. Many women are finding that it can actually be orgasmic. Jeannine Parvati Baker claims that with one of her births she spontaneously began having orgasms without any manual stimulation. She writes:
I feel the baby come down. The sensation is ecstatic. I had prepared somewhat for this being as painful as my last delivery had been. Yet this time the pulse of birth feels wonderful! I am building up to the birth climax after nine months of pleasurable foreplay....How glad I am for all those years of orgasms! Slow orgasms, fast ones, those which build and subside and peak again and again. That practice aids my baby's gentle emergence so that he doesn't spurt out too quickly. He comes, as do I.
Author Helen Wessel also gives examples of women who found that birth could be an orgasmic experience. In Natural Childbirth and the Christian Family she quotes one woman as saying, "It was the most intense orgasm!" Another woman says, "It was ecstatic, wonderful, thrilling. I heard myself moaning-in triumph, not in pain! There was no pain whatsoever, only a primitive and sexual elation....With the most spiraling, fascinating thrill of all, I felt my baby slither out. I wanted to shout with joy."
In Marilyn Moran's book Happy Birth Days, Donn Reed gave the following account of the birth of his baby:
As the baby crowned, I knew from Jean's look and sounds that she was having an explosive orgasm, which rolled on and on. What a long way from the pain and agony of conventional myth! Years later we asked a sympathetic doctor about this. "Yes," he said, "I've seen it a few times. It may even be that many women have orgasms during birth, but interpret them as pain because the sensations are more intense than anything previously experienced and because women are conditioned to expect pain."
To this I would add that many women are simply too ridden with guilt and shame of their sexuality to allow themselves to experience birth this way. Unfortunately, years and years of sexual repression in our society have had a tremendous effect upon the psyches of both men and women.
This is not to say that we should condemn ourselves in any way. The act of giving birth itself takes tremendous courage and we should commend ourselves for it fully. But wouldn't it be nice if we could remember our births as the most pleasurable experience of our lives rather than the most painful? None of us need to be martyrs when it comes to giving birth. We are all deserving of pleasure and I believe it is there to be found.
So what can we as midwives, childbirth educators, and women do to help all women make childbirth more pleasurable? We can start by changing our own beliefs about birth. We can free ourselves from the mechanistic view of life and embrace a new holistic philosophy which does not presume to put arbitrary limits upon women, the experience of giving birth, or life itself. We can stop telling women that "pain is a must" or "pain is the heart of labor" and tell them instead that "trust is a must" and "love is the heart of labor." We can help women to embrace their sexuality and love their bodies without shame and without guilt. We can encourage them to listen to the voices within themselves for it is there that the answers will be found.
It may take us several generations before we will be able to free ourselves fully from the societally imposed fear, shame and guilt that keep many of us from allowing ourselves to experience pleasure in any area of our lives. But if we can at least present pleasurable childbirth as a possibility, we will all have something to work for, and someday, we are bound to achieve it.