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Labor, Delivery, and Double Standards

Mon, 2009-07-13 12:29 — figleaf

Interesting post at Jezebel called Male Midwife: Women Need Childbirth Pain To “Prepare” for Demands Of Motherhood”. Anna N quotes a midwife, Dr. Denis Walsh, who says

Pain in labour is a purposeful, useful thing, which has quite a number of benefits, such as preparing a mother for the responsibility of nurturing a newborn baby.

What. Ever. The only thing interesting about this guy is that he’s a guy in the first place. At least in American midwifery (where women midwives outnumber men by… um… I’ve never heard a male midwife named before, let alone quoted, even though I know there are a few of them) that kind of “no pain, no gain” school of thought is very common. So the only interesting thing about the original article is that they found a male one.

(Aside: Exactly WTF about everyday motherhood is so exacting or extraordinary that only the pain of unmediated labor and delivery can prepare one for it?)

Finally, as observers of pregnancy, childbirth, and parenting around the world frequently note, Dr. Walsh’s affection for maternal pain and suffering is not confined to midwives.

For the record there are other, less ideological schools of thought in midwifery that strongly advance maximizing control of labor and delivery decisions (a.k.a. agency), and minimize medicalization for the convenience of caregivers, without… um… fetishizing pain, risk, and potential loss for its own sake. Loss of control is loss of control, shaming is shaming, and “shut up, this is good for you” is just as crappy regardless of the ideology of the individual or institution making the pronunciation.

But!

That’s not what I wanted to post about. Instead it’s the interesting proposition raised by Kiskilili of Zelophehad’s Daughters

Eve’s curse is famously (at least, depending on how one parses it) twofold: “in sorrow thou shalt bring forth children; and thy desire shall be to thy husband, and he shall rule over thee” (Genesis 3:16). Eve is punished both with painful parturition and with marital subordination.

Granted, we’ve softened the language of that second mandate somewhat. But, I wonder, by what hermeneutical criterion have we rejected the first section entirely while adopting the second, even in modified form? Why do Church leaders not issue statements reminding women that God has always intended for childbirth to be painful, and therefore to avoid epidurals (or anything else that might unnecessarily ease the process)? If, on the other hand, we contend that the first statement to Eve is nothing more than a description, on what basis can we maintain that the second is meant prescriptively?

Furthermore, in comments Kiskilili adds

I’ve sometimes wondered myself why, for example, men don’t formally take upon themselves the obligation to work by the sweat of their brows. It looks very much to me as though we’re picking and choosing our commandments when it comes to this story.

The full quote from Genesis 3 (King James Version) is



 16 To the woman he said,
    “I will greatly increase your pains in childbearing;
    with pain you will give birth to children.
    Your desire will be for your husband,
    and he will rule over you.”

 17 To Adam he said, 
    “Because you listened to your wife 
    and ate from the tree about which I commanded you,
    ‘You must not eat of it,’
    “Cursed is the ground because of you;
    through painful toil you will eat of it
    all the days of your life.

 18 It will produce thorns and thistles for you,
    and you will eat the plants of the field.

 19 By the sweat of your brow
    you will eat your food
    until you return to the ground,
    since from it you were taken;
    for dust you are
    and to dust you will return.”

So… what’s the takeaway here?

Mine would be that even if you were a Biblical literalist… maybe especially if you were a Biblical literalist, you’d read that passage as a straight-up punishment of Adam and Eve for their specific behavior and that would be the end of the story. And literalist or not, there’s nothing there holding their descendants to different standards either of sweat or suffering depending on gender.

Mon, 2009-07-13 13:34 — 3058 (not verified) #permalink

I had a friend post about this earlier today. This was my response to that quote:

“Pain in labour is a purposeful, useful thing, which has quite a number of benefits, such as preparing a mother for the responsibility of nurturing a newborn baby.”

Wait, what?

How is this at all comparable?

That’s like saying that breaking my leg would have prepared me for the responsibility of college.

I mean…what?

I know raising a newborn isn’t a walk in the park, but it’s not like it’s painfully extracting itself from your vagina every day.

And I do note that it doesn’t advise men to start engaging in excruciatingly painful behavior in order to prepare themselves for the responsibility of child-rearing.

Mon, 2009-07-13 13:45 — 3058 (not verified) #permalink

I think Denis Walsh is getting a bad rap from the UK press on this. Not that unsubtle journalism should be news to anyone.

I am going to cheat and refer you to A brief defense of my current hero Denis Walsh rather than repeat most of what she says in my comment here.

I will add that I’ve just finished reading Ina May’s Guide to Childbirth by Ina May Gaskin which basically says much the same thing as Walsh’s Evidence-based Care for Normal Labour and Birth: A Guide for Midwives. Gaskin is probably North America’s most prominent midwife and advocate for better care for pregnant women. And she agrees with Walsh that epidurals interfere with normal delivery by muting the bodies normal signals, thus increasing the need for technological interference in the birthing process, with all the risks that entails.

That doesn’t mean women should never have an epidural. It does mean that their use should not be anything like automatic.

(Not sure if this adds to my credibility or reduces it, but like the poster at feminist philosophers my interest is not just academic — I’m expecting myself in just over 3 weeks.)

[Hi E. As I said here only thing at all remarkable about the original statement was that they quoted a male acolyte of Ina May Gaskin rather than any of her tens of thousands of female acolytes. Many, many of whom make similar pronouncements not about the virtue of normal, non-medicalized childbirth but of the virtue of pain and suffering during childbirth. That plus the overflowing buckets of shame and judgment behind “well, if you’d done it right you wouldn’t have needed to…” Luckily there are other schools of thought in midwifery that manage to produce very similar outcomes (successful home, birthing-center, and hospital births with no higher rates of intervention and with very high rates of feeling satisfied and in control) minus a lot of the deflation that comes from feeling you’ve somehow done something wrong if things don’t turn out the way you’d intended. And for the record, the midwife for our children’s births (and my partner’s miscarriage) was awesome! Due in three weeks huh? Congratulations in advance, E! —fl]

Mon, 2009-07-13 14:06 — 3058 (not verified) #permalink
That is beyond ridiculous. Not only by that reasoning are fathers, adoptive parents, step-mothers, relatives, siblings, and babysitters unfit to take care of the baby, but also how does pain tell you anything meaningful about child care? What about stuff like knowing how to change diapers and sterilize rubber nipples? What about things like multi-tasking? What about knowing about child development? Of course, this guy might say that pain instills patience. But I know lots of people who have endured endless amounts of pain, and have little or no patience for anything or anyone.
Mon, 2009-07-13 14:17 — 3058 (not verified) #permalink

And you know, since we as dads have NOT experienced the excruciating pain of childbirth, we’re less prepared for the responsibility of parenthood, to continue that logic.

Don’t Scientologists object to the use of pain relievers during labor and delivery?

To follow up on what E said about epidurals interfering with normal labor and delivery, it is true that they can prolong labor because not only do they effect afferent (pain receptor) nerves, but they also partial block motor nerves, diminishing the strength of contractions.

Mon, 2009-07-13 14:22 — 3058 (not verified) #permalink

Just in case this gets lost in the shuffle, or for those who won’t click through to the link in my comment.

“Pain in labour is a purposeful, useful thing, which has quite a number of benefits, such as preparing a mother for the responsibility of nurturing a newborn baby.” is almost certainly a misquote or misleadingly edited and probably pulled out of context to boot. Walsh does in his work talk about the importance of the natural hormonal process of childbirth, and the importance of natural signals, including pain, for guiding the process. That is not to fetishize pain for its own sake.

Mon, 2009-07-13 14:37 — 3058 (not verified) #permalink

I don’t what other women have felt, but when labor is over, its over. There’s no lingering memory or reminders like earthquake aftershocks. If I were to learn anything it would have been in my sleep, because I was so tired I fell sound asleep between the contractions.

Mon, 2009-07-13 14:54 — 3058 (not verified) #permalink

Arguably, in a symbolic sense, the Biblical passage is accurate.

AIUI, the reason for painful childbirth is basically that human children are born with big heads, which are required to accommodate our large brains. With the large brain comes hard work to earn a living (due to sophisticated social structures), and also, a knowledge of right and wrong (the name of the forbidden tree in Eden was “The Tree of Knowledge of Good and Evil”). So in a way, it can be seen as a genuine expression of the payoff between brains and suffering.

But, of course, in that symbolic sense, there’s no reason not to do all we can with those huge brains, to try to mitigate the effects of it (by making work less laborious, and labour less arduous).

Mon, 2009-07-13 15:02 — 3058 (not verified) #permalink

E-

Though the quote itself is preposterous, I think that saying it’s taken out of context is likely accurate.

If one thinks about it logically—whether in childbirth or any other scenario where one is using their body (rock climbing, running, walking…) it’s crucial to be able to feel period, lest one pose a danger to one’s self.

Despite my earlier objections (and they still stand), I think that what Walsh was probably more accurately objecting to is the over-medication during childbirth. It doesn’t mean that a woman has to be in pain, but it’s probably quite good for her not to be entirely numb, lest she be unable to consciously help the body with its natural process.

Mon, 2009-07-13 16:35 — 3058 (not verified) #permalink

Something that I’ve heard somewhere, but can’t remember where exactly: “If something goes wrong during birth, you’d be better off with a midwife than a doctor. If something goes really wrong, then you’d be better off with a doctor than a midwife.”

(reCaptcha includes a paragraph symbol which I have no idea how to type.)

Mon, 2009-07-13 22:16 — 3058 (not verified) #permalink

Period pain is just as natural as childbirth pain and far less intense, but I don’t think I’ve ever heard someone argue that it’s something that must be endured and to take Midol would somehow rob you of full womanhood.

Personally, I do think that giving birth unmedicated would be an interesting rite of passage and I’d like to do it if I can, but then again I haven’t actually felt it. I reserve every right to change my mind on that and absolutely no rights to tell other women what to do.

[Actually, when Motrin first came out (prescription only back then) a number of women in my circle of radical, hippie friends actually did grumble about how it erased a monthly rite of passage. But not the ones who turned green and couldn’t get up because they hurt so much. I still have friends who won’t take anything for it. In fact I brought someone a hot-water bottle just last night. They used to be the next best thing to finally being over your cramps before ibuprofen but I wonder how many people still remember that. As for your second paragraph, yes, exactly! It’s one of the reasons I like Penny Simkin so much — she has a pain scale that goes from “I want to be unconscious before labor begins” to “I don’t want anything even for a c-section.” Obviously nobody goes to those extremes but she does it to make clear it’s your choice and your decision! And, like you, she doesn’t say it’s wrong to change your plan when you’re in the middle of it all. I like her a lot. Thank, Holly. —fl]

Tue, 2009-07-14 14:33 — 3058 (not verified) #permalink

“As I said here only thing at all remarkable about the original statement was that they quoted a male acolyte of Ina May Gaskin rather than any of her tens of thousands of female acolytes. Many, many of whom make similar pronouncements not about the virtue of normal, non-medicalized childbirth but of the virtue of pain and suffering during childbirth.” – figleaf

I guess I don’t see this in the actual writing of Gaskin or her followers. What I do see is the message that for the vast majority of women childbirth can be both pain free and non-medicalized if labour is properly supported and the body’s signals are respected. Hell, Gaskin talks about orgasmic childbirth — I’m pretty sure that isn’t what Christians have in mind when they talk about the suffering of Eve.

The Guardian and Daily Mail make it sound like Walsh was praising the virtues of pain and suffering, and without a recording of the interview it is hard to know what he said, but that isn’t consistent with the published record.

[Hi E. I’ll just say I agree completely and 100% that childbirth isn’t a medical condition and shouldn’t be routinely treated like one. Nor should the birthing mother be treated like anything but an active, primary, and (ideally but not necessarily) prepared participant instead of a passive patient. And finally, based on conversations at my mom’s knee, at the side of my partner, and with quite a few doulas, midwives, nurses, and physicians, I agree that labor and delivery needn’t be dreaded, and can indeed be ecstatic. Also, seriously, without reservation or caveat, I hope your labor and delivery goes wonderfully and well. But I still disagree with the quote that pain in labor (which, Gaskin says isn’t necessary to begin with) “prepares a mother for the responsibility of nurturing a newborn baby.” I’m aware that it’s the one sentence in what seems to have been an otherwise perfectly sensible interview but Grandfather’s nose hair that sentence insured that nothing else he said was heard. And finally I’m glad to hear Gaskin’s moderating. Her Farm was basically just down the road from my town in the 1970s and she and her group were pretty absolutist. (Admittedly that may have just been a function of the 1970s when pretty much everybody who was any kind of activist was abolutist.) Thanks, E. —fl]

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