One of the arguments used against “natural childbirth” is “we don’t allow people to be in pain in any other circumstance: why would we allow women to hurt in birth?” But it simply isn’t true, and the disproof brings me to one of my favorite childbirth analogies: athletics. The metaphor of birth as marathon has certainly been done before, but if you will indulge me, I wish to explore some of the specifically misogynistic implications of this particular assertion using this particular analogy once again.
(My other favorite analogy to dispute this assertion is sex, as it also potentially dances most deliciously along the pleasure-pain divide: however, for the sake of accessibility for the squeamish, and to divorce this discussion from the shame we also apply to sex — particularly to highly vigorous sex in which women enjoy themselves thoroughly — I will stick with the old stand-by of athletics.)
In athletics we certainly do “allow”, and even celebrate, people enduring pain (sometimes referred to in athletics as physical discomfort) in pursuit of some goal — often a goal much less worthy or significant (dare I say important?) as bringing a new person into the world. We do not consider that pain to be suffering, because it is chosen pain (or at least the pursuit is chosen, and the pain is considered an acceptable cost of the pursuit), “good” pain. Is not the pursuit of birth at least as worthy?
Just like in athletics (thinking here particularly of amateur and charity races), there are different types of pain in birth: most is the “normal”, expected pain (which can be anywhere from negligible through, shall we say, highly noticeable) of a body hard at work, stretching, moving, doing. In birth and in athletics, we can be overwhelmed by this normal, physiologically healthy pain, if we don’t have the means to cope with it or it is unexpected. The pain of birth might be inescapable for most, but suffering is unnecessary: in athletics, it is framed as discomfort, we are taught to expect it, and told it is normal, not an indication of anything wrong; and we are cheered through it, exposed to dozens of ways to cope, from improvements in form and pace to mindfulness meditation, music, and massage. Why do we expect women in labor to engage in that physical endeavor with any less? (It should come as no surprise that I blame the kyriarchy, as will become clear.)
There is also, rarely, pathological (problematical) pain, from something going wrong: a muscle is pulled, a ligament tears, a blood vessel ruptures, or a body is simply pushed past its limits. In those cases, in both birth and athletics, we of course have medical assistance available, from something simple like oxygen or oral analgesics, to anesthesia and surgical intervention.
And, just as in athletics, there is no shame in choosing not to finish, in needing assistance, in choosing to skip the experience altogether. Only the kyriarchy and those under its influence say otherwise, in an attempt to control and shame us, and such beliefs should be shouted down as roundly in birth as in athletics.
Rather than coerce with stick or carrot, what we do in athletics (again, thinking especially of charity racing; a particularly apt comparison to birth as it is physical effort that benefits another) is cheer, support, encourage, commiserate. No one stands at the sidelines of a charity marathon yelling “give up! it’s not worth it! stop trying to be a martyr! you’re not going to win a medal!” Nobody whispers in their ear when they’re doubting, “take these drugs [that will actually make running harder], let us drive you to the finish [we'll tie you behind the car], finish in five minutes or we’ll whisk you away for surgery [for a torn ligament you don't actually have].” No one tells an athlete she can only have a “trial” of running if she has no food or drink, if she’s hooked up to machines that purport to measure how hard her muscles are working, that take her blood pressure and heart rate and temperature and send it all to the medics’ station and meanwhile are hindering her movement and reminding her she’s on a clock and she’s not running fast enough (or running too fast and they’ll “have to” stop her “for her own good”).
Who would be surprised if the rate of marathon completion plummeted if all those conditions were placed on athletes, all those hurdles erected in their way, all those unkind and untrue statements flung at them? And yet we expect the laboring woman to function under those circumstances, and shame her when she doesn’t “succeed”, or tell her it wasn’t really worth it anyway, and use the “failure” rates to “prove” it’s an unrealistic expectation.
And why is it worth it? Leaving aside that unhindered birth is, barring medical conditions, unequivocally better for the baby and birthing woman, there is also value in the sheer physicality of it for the woman undertaking it. Everyone has heard of and no one doubts the existence of “runner’s high”, so why do we start plugging our ears and rolling our eyes and flapping our tongues when we speak of “birthing high”? Just as in athletics, in the absence of intolerable pain and unnecessary interferences (the latter of which is all too often responsible for the former), birthing has the potential to produce the most delicious chemical cocktail which feels good. (Divine even: I certainly felt like a birthing goddess afterward.) Even discounting that, or in its absence, there is potential for pride and a sense of accomplishment: something we value so much in athletics, yet scoff at in childbirth, where our effort benefits both us and another. We deny women that pride in accomplishment (for which support of athletics is so vital to girls’ sense of self and women’s equality), that boost in self-esteem and feeling of competency, right when we need it most: at the start of parenting, one of the most demanding journeys a person can undertake.
Again, there is no shame in birthing with the assistance of medications or medical intervention, whether by choice or necessity — much less in choosing not to birth at all — but so much value in birthing autonomously, so much value even in trying.
More to the point I am trying to make with the exploration of this analogy is that as a culture we must value birth, must value and celebrate what our bodies can be capable of. We celebrate and encourage athletic performance, and we pay men millions of dollars for engaging in war games (colloquially known as “sports“), and yet we don’t even give women respect: indeed, often our only “payment” from society for daring to birth “naturally” is scorn — sometimes to the extent of having our children taken away from us. At best, we are praised for performing a “miracle”, and doing the “best thing” for our babies; ignoring or dismissing the entirely human mundanity of the achievement (well within reach of 95% or so of the population possessing a functional uterus and vaginal canal), and removing the focus from us and our process to another. While natural birth is best for babies (or rather, is what babies biologically expect, and lose out on when interference is added unnecessarily), I am not asking that women once again be shamed into martyrdom for the sake of others.
For do not get me wrong: advocacy of pharmacological analgesic in childbirth can be (and at its inception was) feminist, even if I believe it misguided. And surely it is all too easy to construct a pro-”natural” birth position that is deeply misogynistic: for hundreds if not thousands of years in much of “western” culture, the physiological pain of birth was seen as due suffering for the theological sins of women’s ancestress. I am not here trying to say that all natural birth advocacy = feminist = good, nor all medicalized birth advocacy = misogynist = bad, which would be as ridiculous as it would be fallacious.
Rather, I am saying that kyriarchy’s construction of labor and birth as unbearably painful, as unworthy (as opposed to war games or athletics), and women as either too weak or too “advanced” to tolerate it, is inherently misogynistic. Whether an individual woman follows the biological default and has (or pursues) unhindered birth, or elects to make use of the medical interventions available to most of us in developed nations, does not reflect on her moral standing, any more than participating in, or not participating in, athletic events does. But the current cultural construction of birth must change: not by moving backward to a time when women had no options in childbirth, and were expected — even encouraged — to suffer, and in which there were no medical interventions for when they were truly needed; but forward, to a time when our bodies are valued, our spirits are supported, and the work of birth is seen as hard, yes, and even sometimes painful, but within reach of most of us, and oh so worth it: just like athletics.
There should be no moral value placed on individuals’ choices or unchosen courses in childbirth, and although I speak of enlightened athletics as though all cultural messages were as positive as the cheers at the end of a charity race — no more for the first than the last — I know there most certainly are different levels of respect awarded to the “couch potato” and the Olympic triathlete (different again to the star American quarterback). Still, the microcosm of culture surrounding some segments of athletics give me inspiration and hope. As cynical as I may seem about the present, I remain optimistic about the future: we can create a world in which birth is valued as the rewarding work it is, women’s autonomy held sacrosanct, and babies welcomed gently and with joy no matter how they arrive.
And we must.