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The Misogynist History Of Natural Birth

Image from page 137 of "Labor among primitive peoples. Showing the development of the obstetric science of to-day, from the natural and instinctive customs of all races, civilized and savage, past and present" (1883)

I wanted to give birth without an epidural. But much of the natural birth movement is rooted in the idea that women deserve to feel pain.

I had always been terrified of giving birth. I called my mother after I watched the first episode of One Born Every Minute and told her, in no uncertain terms, that I was never going to be able to have a baby. She laughed at me and said I would, and she was right. Eight years after that conversation, I was looking at the window on a piss covered litmus stick, where one pink line was darkening up beside another. I burst into tears — I was going to be a parent! — but they weren’t happy tears. Nope, no matter how much I wanted it, I wasn’t ready, because to reach motherhood, I was going to have to give birth.

I frantically Googled things like “pregnant scared to give birth” and “elective caesarean.” I floated the idea of a cheeky C-section with my consultant obstetrician. He told me to put my pants back on as if he hadn’t heard me. Back to Google then, and pretty soon afterwards, I discovered hypnobirthing, a practice that promised I could be so blissed-out during labor I wouldn’t even be aware of the pain. My fears evaporated and I began to study for labour like it was a test.

I received books about natural birth for Christmas and I’d devoured them before the turkey was on the table. I laid them out in the rapidly diminishing triangle of space between my crossed legs every night. I read them in the bath; I dropped them in the bath. I listened to hypnosis tracks that were supposed to tap into my neocortex, and send me into a serenity so deep that I would not feel my daughter leave my body. I bought a diffuser so that I could use holistic oils to transport me to the pain free labors of my past lives (and this is only a mild exaggeration).

My hypnobirthing instructor was a magnificent force who believed in the power of mind over matter, and had not used anesthesia at the dentist in five years. She explained that adrenaline would hinder my labor, and that I needed to create feelings of joy throughout the experience to heighten levels of oxytocin, the body’s “happy hormone,” which would speed everything along. She asked me what I loved more than anything in the world, and without even a passing glance at my husband I said our dog. She advised me to plaster the inside of the car with pictures of the dog, so that our ride to the hospital could be stress-free. I printed out 20 photos of him later that day. Also printed was my birth plan — a neatly bulleted list of exactly how the experience would play out. Double spaced, 12pt, Lucida Serif. On heavy cream vellum paper, like a wedding invitation.

I was doing what I thought I needed to do to bring a child into the world purely and unharmed. I had come to believe that my body was designed to give birth, so giving birth should be easy and, if I just studied hard enough, could be painless. The natural birth movement claims that childbirth used to be safe and easy before the advent of modern medicine and roots for a return to drug-free home birth. When I mentioned this to my husband he said he thought he’d prefer it if I had our baby in the hospital. To be honest, I thought he was a prick for not letting me give birth in our freshly carpeted bedroom, but telling him that didn’t really sit with the new earth mother persona I was curating, so I just smiled serenely and meditated for a while.

I had come to believe that my body was designed to give birth, so giving birth should be easy and, if I just studied hard enough, could be painless. Click To Tweet

When my water broke at 10am one Monday morning I made myself a cup of tea, got into the bath and read my book. Calm mothers have their babies quicker, I’d been told; so I waited, thinking about how in eight hours — or who knows, maybe six if I was really calm — I’d be holding my perfect baby in my arms.

24 hours later I was in the car on the way to the hospital, listening to my hypnobirthing tracks. “Three, two, one,” said the clinically composed female voice through my headphones, “relax, relax, relax.” Just need to get in that birthing pool. Just really. Need to. Just want to feel that nice water. Make it better. Dog pictures not really working. Three, two, one, relax. Dog. Birth pool. Relax. Three. Dogpool.

My contractions were coming every four minutes, but when the midwife took a cursory look at me, she told me I was only one centimeter dilated. “We won’t admit you until you’re 4cm,” she said. “Not enough beds.”

“But I have been in labour for 24 hours,” I argued, worrying I was already ruining my perfect birth experience, “I think it’s time for the birth pool — I think if I could just get in the-”

“You need to go home,” she said.

Four hours later, I was in the car again. I was screaming in pain. I went back into the hospital and told them, under no uncertain terms, that I wanted an epidural. They examined me again and I was only 2cm dilated. “As I mentioned, we don’t normally admit women until they’re 4cm,” the midwife said conversationally, looking from my vagina to my vitals and back again. I didn’t care. I needed relief.

Then, a change of plan. “Your baby is in distress,” said the midwife, looking again at the two heart rates on the screen. “You’ll need to be constantly monitored from here onwards. You won’t be able to have your water birth after all. And we can give you an epidural, if you like.”

Within half an hour, I’d signed a form that gave an anesthetist permission to lodge a huge, hollow needle into my back and absolved me of the right to sue if he paralyzed me. Ten minutes later, I could feel nothing at all from the waist down. “I’m terribly sorry,” I said to the midwife, “I think I swore at you downstairs. That’s not really me. I do apologize.”

“Don’t worry,” she said, “I’ve had much worse.”

My husband stood at my bedside staring at me in uneasy wonder. “The epidural,” he announced, “is modern medicine at its finest.”

Though many ancient cultures attempted to treat the pain of childbirth, for centuries in Western society a biblical misogyny infiltrated the medical care given to those in labor. Christians portrayed pain relief in childbirth as blasphemous, believing it contravened God’s punishment for Eve’s original sin (“I will make your pains in childbearing very severe; with painful labor you will give birth to children” [Genesis 3:16]). According to Steve Ainsworth at Midwives Magazine, incense and prayer (yeah, really) were an accepted analgesic, but “anything else might upset divine intent.”

It wasn’t until the mid nineteenth century that attempts at pain relief during birth began to be widely normalized — by Queen Victoria, no less. Victoria enjoyed a famously rich sexual relationship with her husband, Prince Albert, and bore nine of their children. She hated being pregnant, however, and was “repulsed” by childbirth, developing a keen interest in technological advancements in pain relief as a result. In 1853, during the birth of her eighth child, Prince Leopold, she used chloroform’s anesthetic properties to reduce her labor pains. As the head of the Church of England, her decision signified the church’s direct acceptance of pain relief. Chloroform was subsequently known as “anesthesia à la reine” and was used by doctors to lower labor pain until after the Second World War. 

a painting of young queen victoria holding baby prince arthur under a tree
Queen Victoria with Prince Arthur, Franz Xaver Winterhalter, 1850

At around the same time that Victoria was pregnant with Leopold, a French surgeon, Charles Gabriel Pravaz and a Scottish doctor, Alexander Wood, each independently combined a hollow hypodermic needle and a syringe. Wood discovered this could be used to manage neuralgic pain. The epidural progressed in 1885 when neurologist James Leonard Corning injected a dose of cocaine into the sacrum of a healthy man. It went through several updates before reaching its current form of local anesthetic, continually administered by a catheter inserted into the “epidural” space just shy of the spine. It was first used in childbirth in 1909 and began to be regularly employed as pain relief in labor in the 1940s. At that time, although many still believed that pain in childbirth was a necessary part of the experience, more progressive doctors saw that pain relief was vital in creating a safe and healthy birth culture. In 1949, in his presidential address to the Section of Obstetrics of the Royal Academy of Medicine in Ireland, leading obstetrician Dr. O’Donel Browne said:

It is wrong to withhold relief from pain from poor or rich, and the argument that analgesia cannot be made applicable to domiciliary midwifery must not prevent us making every effort to reach that goal. Many difficulties confront us, but I am convinced that we can overcome them with comparative ease if we are prepared to take a little trouble over the problem, and to agree that the slight additional expense is warranted.

Amongst gynecologists, Browne represented a growing movement that recognized the importance of reducing maternal pain regardless of cost. At present, NHS hospitals in the UK aim to provide epidurals free of charge to any woman who requests one. This means that British birthing people are among the luckiest in the world; in the United States in 2016, for example, the average cost of an epidural was $2,312. But British people’s choice to labor pain free, for free, has been threatened before. In 2006, the Education and Research Committee of the Royal College of Midwives recommended charging for the procedure. Maureen Treadwell of the Birth Trauma Association said:

The women least able to pay would get the rawest deal. Some professional women can just put the cost of an epidural on their plastic cards but women who can’t afford it will suffer.

She went on to describe a woman who had been persuaded by a midwife not to have an epidural and was left with post traumatic stress disorder as a result of the unrelieved pain. Indeed, recent research has shown that the administration of an epidural during childbirth can reduce the possibility of postnatal depression and conditions such as PTSD. This could be a very important factor for expectant mothers with existing depression or anxiety to take into account — but unfortunately, it is still not widely shared. More research found that amongst pregnant people who had been intending to deliver naturally but chose to receive pain relief during their labor, levels of postnatal depression were higher. Understandably, for those who have invested large amounts of time, energy and money in the natural birth movement, a feeling of failure follows the use of pain relief in childbirth.

Scratch the surface of the natural birth movement and you’ll find disturbing, decidedly anti-feminist roots. Fernand Lamaze is arguably the most famous player in the natural childbirth game, a French obstetrician who developed the psychoprophylactic, or ‘Lamaze’ method of childbirth, which puts focus on breathing and massage. Lamaze thought little of his patients, and reportedly ranked the “performance” of the laboring women on his ward from ‘excellent’ to ‘complete failure.’” Other male obstetricians such as Robert Bradley and Grantly Dick-Read (his real name, I shit you not), both sons of farmers, developed techniques for unmedicated births based their methods on delivering calves. According to obstetrician Amy Tueter MD, Dick-Read’s method centered the premise that “‘inferior’ people were having more children than their ‘betters’ portending ‘race suicide’ of the white middle and upper classes.” Meanwhile, Bradley became the key proponent of Husband-Coached Childbirth™️. Oh yes, you read that right; he literally trademarked mansplaining giving birth

More research found that amongst pregnant people who had been intending to deliver naturally but chose to receive pain relief during their labor, levels of postnatal depression were higher. Click To Tweet

More progressive doctors claimed that these techniques “needlessly primitivized” birth — I’d go further, and argue that these doctors entirely fictionalized new reasons for labor pains to better suit their agenda. Dick-Read’s technique, which predated Lamaze’s, was premised on the idea that contractions were a result of unnatural physical tension caused by fear. This is categorically untrue. Contractions are the result of the pituitary gland releasing oxytocin and causing the uterus to tense and relax which pushes the baby down into the birth canal. Dick-Read, Lamaze, and Bradley must have known that: it was discovered by Sir Henry Dale in 1906. It’s not fear that hurts in this situation (but if you’re scared, I don’t blame you), and yet a multi billion dollar industry has been born from that lie. In the US, C-sections are at an all time high, and many women are given them simply because they are convenient for the doctor, and often more lucrative for the hospital. It makes sense, then, that there’s a social movement in favor of natural birth among people who feel like their agency is depleted in an over-medicalized system. I gave birth in the UK, where healthcare is free and natural birth is encouraged by hospitals, as it works out cheaper for them. I took the information I was given and ended up at hypnobirthing, believing all I read about stress causing maternal pain.

It’s not fear that hurts in this situation (but if you’re scared, I don’t blame you), and yet a multi billion dollar industry has been born from that lie. Click To Tweet

It turns out, however, you don’t have to listen to a movement started by cisgender men in the 1940s that likens you to a laboring cow. In 2004, the American Congress of OB/GYN and The American Society of Anesthesiologists put out a joint statement to remind us that, “there is no other circumstance where it is considered acceptable for an individual to experience untreated severe pain, amenable to safe intervention, while under a physician’s care.”

My pregnancy was as far from happy as I could imagine. I was diagnosed fairly early on with Symphysis Pubis Dysfunction (SPD), a condition caused by the hormonal loosening of the pelvic ligaments, which leaves the pelvis misaligned and causes constant physical pain so intense that it’s difficult for some sufferers to walk. The only thing that relieves SPD is delivering your baby, and because I was preparing to use hypnobirthing, I was excited to do it.

In the time leading up to my daughter’s birth, I was calm, and when I reflected on it later, I was glad I’d used hypnobirthing to those ends; but that’s because, in spite of the unwitting danger I put myself and my child in, we escaped harm. We are lucky. Many people have lost babies through the dogmatic approach to natural birth that certain hospitals adopt.

Hypnobirthing is grounded in the teachings of Dick-Read, Lamaze and Bradley; the same old misogynistic doctrine that women are animals and pain is empowering. It is repackaged for the modern, middle class mother; the book I bought, with its cover image of a beautiful, serenely pregnant woman lying on a huge taupe cushion looked more like the front of an Ibiza lounge compilation CD. It’s assumed that you have enough free time to lie in bed meditating to 12 six-minute-long hypnosis tracks a day. These are mostly compiled of a woman, who I always imagined to be the pregnant Ibiza lounge woman, slowly repeating the words, “three, two, one, relax, relax, relax.” As if it were that easy.

I wasn’t frightened about giving birth because I never imagined the type of birth I was actually going to have. I readily believed everything I read about my body being expressly designed to cough out a child. Because of that, and because I thought that my body’s production of oxytocin would be halted if my natural laboring rhythm was interrupted, I wrote into my birth plan that I didn’t want to be touched during labour, and — as is very common in hypnobirthing — I included internal examinations in this.

Unfortunately, I only discovered in the middle of my labor that the natural birth movement doesn’t account for any of the problems that I encountered. It doesn’t acknowledge that, of the four different pelvis shapes, only one is deemed medically “ideal” for labor. It misses out the babies that are positioned back to back, breech, transverse or in a “brow” presentation — coming out face first, like a little sloth — like mine was, which is the cause of 6% of maternal mortalities worldwide. No amount of oxytocin was going to help me with that.

If I’d ignored my hypnobirthing rulebook and allowed an earlier internal exam, they might have picked up my daughter’s position. By the time I consented and the midwives realized she was brow, she was too far down the birth canal to be delivered by caesarean; I was given an episiotomy and she was pulled out by ventouse, at which point the doctors realized that her dropping heart rate had been caused by the umbilical cord which was wrapped around her neck, constricting her every time my body contracted.

Unfortunately, I only discovered in the middle of my labor that the natural birth movement doesn’t account for any of the problems that I encountered. Click To Tweet

Natural childbirth relies on a tightrope walk between oxytocin, the aforementioned “happy” or “love” hormone, and, latterly, adrenaline, which produces a “fight or flight” response in humans. Telling a woman to refuse medical exams, keep calm and look at pictures of puppies to release a flow of oxytocin will only work to speed up her birth if she and her baby are perfectly positioned for it.  My belief that I could give birth completely naturally hindered my labor.

It doesn’t fit with the hypnobirthing mission statement to condone deviation from the birth plan, so stories like mine do not make it into hypnobirthing books. One of the first things I noticed when I began to be visibly pregnant was the startling regularity with which other women would go out of their way to tell me stories about their births. Some of them were horrific, whilst others dismissed my ideas about how I wanted to give birth. Hypnobirthing discourages all but the most perfect narratives, and anyone who begins a hypnobirthing “journey” is advised to ask other women not to mention any negative birth experiences. What’s more, if you do an online search for phrases like “hypnobirthing back to back birth” or “hypnobirthing brow presentation,” there are exactly zero results that discuss hypnobirthing in these circumstances. Yet these are very real risks that accompany every single pregnancy and it is at least disingenuous, at most very dangerous, for a widely used method to erase the existence of these stories.

The fact is that every birth is different, and there is not one “journey” that is better than another. The acceptance of pain relief to avoid post traumatic stress disorder is not “failure,” and anyone making money out of telling you so does not have the best interests of you, or your baby, at heart. Whether it comes from midwives, the Old Testament or hypnobirthing instructors: the vilification of the epidural is nothing but misogyny under another name.