Pain in childbirth - can anyone help me with my thinking around this?

[SomersetBelle]

I gave birth 18 months ago and it was the most horrifically painful experience of my life so far.

I think about the birth a lot, and wonder why on earth I was so determined to go without pain relief.

I am also more and more aware of the inequalities and pure horror associated with childbirth around the world. There was a picture of a maternity ward in Manila in the paper today which made me feel so angry.

I am a feminist but not a very well read one. I am learning so much from the posters and threads on here and was hoping someone could help me advance my thinking around childbirth to help me articulate my feelings. Can feminist theory help me?

I see where you are coming from, but I don't think the "you're not ill" part is relevant, because I think that they key point is that however your pregnancy went and whether you are ill or not, childbirth is a time of vulnerability. It isthevulnerability that makes it important that the MW be sensitive and respectful. I don't think caring for other vulnerable humans is a sex-specific trait.

This part of this thread just made me feel a little odd, as it seems to be the opposite of what I believe as per threads about raising and children in this section. Sensitivity and caring are not innately female traits.

lisianthus - I completely agree that sensitivity and caring are not exclusively female traits. However, I don't think your comparison of obs/gyn to female HCPs treating testicular cancer patients or prostate patients quite holds up - these HCPs will be treating both men and women in the course of their work, either as urology specialists or oncology specialists. I think there is only obs/gyn where you are exclusively treating one gender - and it seems odd to specialise in something where you are only treating the opposite gender, and treating them in situations where it all about their femaleness and when they are at their most vulnerable/exposed. It's not that I don't think men can't be caring and sensitive (and as I said, I had good care from male midwives and doctors) - it's just that I don't understand why they are motivated to be in this field of medicine of all the ones they could choose from (plenty of other opportunities to be caring and sensitive).

I don't know why I feel like this. It unsettles me that I feel like this (you use the word odd - i feel that too). I have no issues with male nurses/doctors in general, male nursery workers, male teachers, male carers. But something deep down makes me feel that being male and an obstetrician or midwife is just somehow wrong... I guess because childbirth was not a medical condition historically (although it is now) and because it is where a woman is at her most vulnerable and most primal it seems wrong for a man who is not closely involved with the woman (i.e. the child's father) to be present, let alone directing her / making decisions for her / taking the credit for the delivery etc.

I'm a lot less worried about male gynecologists actually - it's purely something about the birthing experience that makes me think the male involvement should be nil (apart from potentially as birthing partner)

I feel exactly the same way tortilla. I think that many if not most women would prefer female caregivers whilst giving birth, for the same reason that my 93 year old grandma prefers a woman to help her to get into her nightclothes and give her a bath. It is easier to feel more comfortable when your genitalia (and probably your breasts too) are on display, if there are only women in the room. The comfort and safe feelings of a woman in labour are important to the woman as a person and to the progress of her labour. They are more important than a man's right to choose to be a midwife IMO. I was SA as a child so I accept my views on this may be skewed.

But what about a female midwife who had no children, or who had only had c sections? I feel like Lisianthus - that empathy and respect is more important.

I think empowering women in childbirth is a cliche but is what the goal should be - I don't understand why this is talked about as if it's synonymous with a drug-free birth though. I agree with those who have said that there is potential for much better designed pain relief and medical interventions, if only it weren't set up as either/or.

x-posted with sprogger - 'in control' is probably a better and less cheesy way of saying 'empowered'!

Nothing can prepare you for giving birth. For me (and I think for many) there was the pain of course, but also the unfamiliarity of being part of the medical/hospital system for the first tine. although I'd read the books been to antenatal class I think I had an unrealistic idea of the role of the MW. On telly (I know this sounds stupid..) they are always there holding the woman's hand going ' you can do this' buy in real life they are popping in and out, checking your monitor, bring all procedural and not very sympathetic. Which came as a bit of a shock.

I do think women are stuck between a rock and a hard place - between the natural child birth chearleaders and the hospital bureaucracy that is nrcrssary with anethesthesia, risk management and accountability.

I've no problem with male obstetricians and MWs - male or female they are all strangers who see you in a vulnerable position - same as your kidney Dr or whatever. I just want them to respect me and listen to me and i had HCPs of both sexes who were good and bad at this.

I had a terrible first birth, so for the second birth I had a doula. Which was the best money I've ever, ever spent. Having someone there who had done it herself, who knew what I wanted who most importantly worked for me was brilliant. It was just a different role from the HCPs who in the end work for the hospital.

Completely agree Himalaya. I had a really bad birth experience and a very good one, the reason I did not suffer trauma with the bad one wasbecause my mum was there and represented and supported me so I always felt respected. For the good birth experience, my mum could not be there so a doula performed that role which again made me feel safe. During I had good and bad female and male HCPs but I saw them as performing a different, safety related role. I guess the question is should we be expecting some of the (female?) midwives to have a 'doula' aspect/ responsibility within their job role?

Off topic but because doulas are super expensive, I got a respected doula to recommend a trainee, and hired them in the last six weeks of pregnancy. Was not the full experience but was enough and a lot more affordable.

I think there definetly is a culture of 'your a real woman' doing it as natural as posssible

when I told realtives I had barely any PR they were like youre part of the womans club now, I think its probably harks from an earlier time when women did have much PF so had to make the best of that situation?

I'm finding this thread fascinating. wrondecade -

'I think there definetly is a culture of 'your a real woman' doing it as natural as posssible' (This isn't your quote?)
My experience is thta people think I'm crazy and don't use PR to 'prove' something . and am making it harder on myself. I guess you just can't win can you.

I also know people who have been tricked into an epidural and have completely lost confidence in their bodies negatively impacting on subsequent births.

For myself I've had one in hospital (planned HB) and two at home. The one in hospital I had to really fight to give birth upright and was told that I didn't neeed to push when I did (she examined me and the head was out of the cervix) tried to cover me up for 'modesty' when I was so hot my PJs were soaked in sweat. When I went in they tried to get me on drips to speed up labour etc and this was all female MWs.
My homebirths were great. I wandered around naked, they were quick, no one told me I didn't need to push or to lie on my back or suggested extra PR (didn't have time with DC3 - MW arrived 7 mins before she did).

I don't think I would have had a problem with a male MW it depends for me on whether they listen to me and respect my choices and don't judge me by the fact that I look a lot younger than I am.

Snowmama -

I think its sadly too much to expect for MWs to play the coach and advocate role for women in hospital -- I think they do in home births, but that is not for everyone.

So I think it's more realistic to seperate out the female friend/supporter role from the HCP - whether it's your mum, sister, friend or a doula. Dads can be at the birth, but even if they are your complete soul mate they just don't fulfil this role.

I know doulas can be expensive, your trainee idea sounds good (sorry OP, we have strayed so far from theory ... ;-) ). For lots of women who can afford, or whose family/friends want to give them a ridiculously expensive travel system etc... I think there is a 'because I'm worth' it aspect to saying the baby will be ok in a second-hand pram and umbrella fold buggy, but that it is worth saving up for a doula. It is a practical expression of the much more theoretical discussion on the other thread about valuing what women do in giving birth.

WOTMania I think you hit the nail on the head, you can't win either way!

Purpoisefull Yes, empowerment in birth should be about a woman having any of her choices respected. I think it depends on where she gives birth. The woman who had the hypnobirth on OBEM was mocked and even laughed at afterwards for not serenely giving birth. I think they showed her in transition (begging for pain relief but her mum refused on her behalf? I didn't see it all) which is not usually a calm time anyway. A lot of people I spoke to were pleased that she asked for pain relief, in a smug "ha! That'll teach her" kind of way.

I wish pregnant women were credited with having brains and people didn't judge them for their birth/PR choices. In fact, slightly off topic but when I was pg with DD I was in a meeting with my very senior manager and about 5 men who are my equivalents. I made a comment and the senior man said "ignore her, she's pregnant. It's all just rubbish that comes out of her mouth now". I sat shocked, the men laughed and then they continued their conversation as though I had never spoken. V humiliating.

good book

Thanks again everyone, lots to think about. I feel more confident articulating my opinions now on this, much appreciated.

Although it has been briefly mentioned my view is very swayed by my experience of hypnobirthing. I was anxious about giving birth to my first which is why I went on a course. The theory is that women often have a subconcious, ingrained fear of pain in childbirth through cultural conditioning and if you are afraid you will realease adrenaline which directly interferes with oxytocin and other birth hormones, so your body works against itself. That ingrained fear of birth comes from the message that is culturally all around us. Think about how birth is described - labour, contactions, dilation all very medicalised terms. Think about how birth is presented on TV - screaming and dramatics. Think about the language used to describe birth - pain is always present. I think us women do not do ourselves any favours, when I was pregnant other women took great delight in telling me how painful and long thier labours were. We are conditioned to believe labour is painful and that builds fear. The medicalisation of birth has perpetuated this adding the fear, vulnerability and apprehension a women experiences. Choices are taken away. Women are dictated how they should position themselves, what they should be feeling and what should happen when. THey are made to feel they aren't doing it right. 'oh you are only x cm dilated' , 'stop making such a fuss'. The idea behind hypnobirthing is that it replaces that negative subconcious fear of giving birth and gives you confidence in your own body and what it was designed for - we have evolved to give birth. The idea that birth should be painful was as someone already mentioned borne out of religious dogma that birth was punishment for original sin.
My mother didn't understand why I needed to do hypnobirthing classes. For her the fear of childbirth was removed by her asking an aunt when she was a child what it was like to give birth. Her aunt's reply was 'its just like doing a big poo!' for my mother that was good enough!
I believe a women should have pain relief if she needs it. Only the individual experiencing their labour knows what pain they are in and how much they can cope. I do however think that the medicalisation of birth and the interventionist nature of birth is producing a viscious cycle of fear and therefore pain.