Just like athletics: exploring a childbirth analogy

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.

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27 Responses to Just like athletics: exploring a childbirth analogy

  1. I’ve been looking forward to this post ever since you mentioned it on Twitter. As always with your writing, it did not disappoint. It’s a very apt analogy and you expounded upon it wonderfully. I too hope that some day we can champion natural birth without being ridiculed, dismissed or accused of setting back the feminist movement 100 years.

    • The fascinating part about the accusation of “setting back the feminist movement in 100 years” is that 100 years ago (or so) was when all the feminists of the day were advocating for so-called twilight sleep!

      (And thank you!)

  2. This is a very balanced and thoughtful perspective, thank you. The post was worth the wait.

    I agree that in birth we need to do a better job of supporting everyone and removing the moral judgments. Mothers and babies deserve no less. I also feel the same way about breastfeeding and many other parenting choices. There is no such thing as a single objective ‘good’ and ‘bad’ for everyone, so let’s stop acting like there is.

    • There’s a big difference between the statements “On the whole, maternal and infant health would be better if homebirth and unhindered birth were promoted and supported and fewer women had epidurals and cesareans” (which is true) and “Homebirth is best for EVERYONE!!!1!” (which is not).

      I think it’s objectively true that, just like with breastfeeding, we need to be promoting and supporting the most biologically appropriate option, and just like with breastfeeding, there are a thousand circumstances under which interventions might actually be best in that particular circumstance. And it’s so not up to me to judge when or what those are for any individual woman.

  3. Nobody whispers in their ear when they’re doubting, “take these drugs [that will actually make running harder]…”

    I responded to this point on Twitter, but it didn’t really make sense in <140 characters :)

    To continue your analogy, I think it's worth pointing out that professional athletes are actually pressured to take “performance-enhancing drugs” (check out the number of news stories on the topic this year). The difference, when it comes to the birth analogy, is that use of such drugs is monitored rather strictly in professional sports organizations, and that it’s considered disappointing at best if an athlete is discovered to have violated drug regulations–ask the fans, and they’ll call it cheating.

    This is not to say that I think use of prescription medications during birth is “cheating” (indeed, I hold relatively few personal viewpoints on the topic of birth, considering I have relatively little personal perspective), but to follow up on your comparison, I find it interesting that in our culture, professional athletes are discouraged from taking drugs intended to make strenuous activity easier–that it is considered dishonorable, even–but that for women giving birth, drugs are generally treated as a given, often without a second thought.

  4. It’s interesting that you talk about value at the end of this. My feeling is that birth is just one of the many “mundane” acts that have been devalued over the years… We’ve removed the value from so many everyday things by taking shortcuts or buying our way out that it’s hard to tell which way is up or down. I wonder if we made a list of everything that has lost its value (socially or otherwise) over the years, how much of it would belong to the patriarchy? I’m guessing very little.

  5. Yes, and yes. Although I must be honest, I found it hard to read and had to gloss over bits, not because of the writing which is excellent but because I still feel an unbelievable amount of anger when I think about how I was treated during my child’s birth, and getting that angry isn’t always a good thing for my health.

    But yes. Yes, and yes.

  6. This is a great analysis of the childbirth-athletics analogy. The analogy is chronically misinterpreted as women trying to be “macho” and competitive with other women. It’s so lost on some people that I gave up on it a long time ago. You just said what I’ve never been able to. Thanks!

    And thank you for the link. :)

  7. Yes and thank you! So much of our culture’s views on birth seems to be an attack on women. We’re too weak, our bodies don’t work, we can’t handle the pain, there’s no reward in trying. And yet when big men pull a tractor across a field they show the highlights on ESPN and call it a sport.

    • I have no desire to have birth be classified or commodified as “sport” (which is where the sex metaphor surpasses the athletics metaphor — a little privacy please, people! birth is not a spectator sport), but a little bit of the recognition and support that “sportsmen” get would sure be nice.

  8. Ah, yes! I love it!

  9. This says very well what I’ve always thought: childbirth is difficult but within the capacity of most women, and what a great achievement it is: not martyrdom, but a successful completion of a process our foremothers have done since time immemorial. Yay! Way to go! I’m also reminded of the perhaps prototypical kyriarchical story: 19th-century white men saying that women are too delicate to be exposed to work or asked to make decisions like voting, and Sojourner Truth replying that she pulls a plow and picks cotton, and “Ain’t I a woman?” We’ve been “protected” out of our ability to have any sense of accomplishment!

  10. Ah, thank you for the charity race analogy. I will definitely use that in conversations with people. Sam and I were chuckling as I read your imagined discouragements aloud. I loved “You’re not going to get a medal,” because people can’t stop saying that in regards to natural birth! I don’t want a fricking medal. It’s not a competition. I want a baby.

    I liked the commenters mentioning breastfeeding as well, because it seems that whatever we decide to do as parents, when it’s natural/attachment-oriented, is derided as “martyrdom.” As if that’s the ony way to look at it: win/lose, and in such instances you’re fighting your own baby.

    And, Ruth — yes. Garrr. Still angry here, too.

    • As I was writing about “athletics”, I started thinking about all the ways in which competitive sports are seriously screwed up, and I realized that the attitude I was thinking of (of pure support, of running/biking/whatever for the joy of it, of doing something pleasurable and hard for a greater good) was primarily found in charity races.

      Most of the analogy holds for any type of athletics, but there is something special about charity races that makes it a particularly apt comparison.

      Glad you and Sam enjoyed it!

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  12. As a runner and a natural childbirther, I love this analogy (though my labour lasted so much longer than any marathon!)! One thing I find really interesting about the analogy is the parallels between the push for pain meds in childbirth and the history of women in athletics, and in running in particular. Women were excluded from competitve running until recent history. The Olympics did not include a women’s marathon event until 1984. One of the original reasons for this exclusion – it was felt that if a woman ran more than a mile, she would damage her reproductive organs and not be able to have children.

  13. Lurker surfacing here: I love your posts, they’re well thought out and eloquent and I usually wander away feeling “thank god I’m not the only one who’s laughing and/or outraged”. On this post you are definitely piercing a “veil of illusion”…Thanks for putting it out there.

  14. Thanks for this. It’s an ever-timely reminder of the value in appreciating our capabilities (physical and mental – no matter what the challenge. I’ve compared labour and childbirth to mountain-climbing – or even a decent hill-climb. Sure you might get to the top on a chair-lift and enjoy the spectacular view, but there’s nothing like hoofing it yourself and having an even greater degree of satisfaction with that view – combined with the confidence and satisfaction that comes with triumphing the trepidation and the unknown. It makes all the challenges to come that much easier to contemplate too.

  15. Good post. I enjoyed the extended comparison to athletic performance, as a previous athlete myself. I remember the push to complete in a competition, the way we pushed our bodies beyond all conceivable limits, the way we were cheered and supported. It is all very true. No one every told me, “oh, best not even try for that triple, you’ll never make it” and even if it was clear that another team was going to win, our coach didn’t come up to us and say “eh, forget it, you won’t get the medal.”

    Perhaps the most veracious part of your post is in regards to the ‘birth high.’ True, true, true. Post partum depression shouldn’t exist. It’s a contradiction. They say 1 in 3 women will have the baby blues or PPD or even worse, a combination of PPD and PTSD. This is such a huge sign that something is wrong. I was high for weeks after my daughter’s birth. Just thinking back to any part of the labour would give me a warm tingly feeling. I am more in love with my husband than ever before (he was my birth attendant). Women believe they are making the safe choice when they choose an OB and a hospital, but it’s because they can’t even imagine what they are missing.

  16. I just found your post and I so agree. I also think moms do deserve a medal for birthing!

  17. Not sure why I never read this post before, but YES! Birthing highs were something I’d never even heard of before my little one was born but I certainly experienced it. I felt like a goddess for about the first four days – and then the PPD hit full force. So, it is possible to experience both from the same birth.

    @ Johanna – I love your example of Sojourner Truth!

  18. When I got about halfway through your post I was absolutely blindsided by the fact that what I was reading was nearly identical in a lot of ways to something that I had been reading yesterday. Except the thing that I was reading yesterday was written in early decades of the 20th century by Dr. Clelia Mosher.

    She spent a whole career scientifically ripping apart the idea that menstruation was horrible and debilitating and painful and the only thing you could do when “the curse” came around was to lie in bed for a week and suffer. Women really believed this and expected to be miserable one week out of four.

    Then she worked against the fear that menopause would cause women to undergo some sort of unavoidable nervous collapse, which was apparently very widespread.

    The parallels absolutely beat me about the ears. These are the same words. That commonly taught expectation of dysfunction and pain and inescapable suffering in a normal physical process, just because it’s uniquely female.

    In some ways it’s hard to believe that we’ve still in this place almost 100 years later. We can do better than this.

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