There’s something pornographic about the way we depict childbirth. A woman’s agony becomes either the brunt of a joke, or else it is discussed as an awesome spiritual experience. One of the central ways women are socially constructed and treated as sub-human is through the normalization and glorification of women’s pain. In the case of sex, we normalize women’s pain during intercourse (“It always hurts the first time”) or we glorify it through sadomasochistic practices (“Physical abuse is liberating!”). Similarly, we talk about the pain of childbirth — with few exceptions, the most excruciating, exhausting, and dangerous ordeal within human experience — as valuable in and of itself. Hurting women is sexy.
The euphemistically termed “natural childbirth” is often justified on the basis that it is a woman’s choice, that pregnancy and birth is a “natural process,” and that it is best for the woman and baby (both for medical reasons, and because a woman won’t feel attached to her child otherwise). Put into context, these arguments ultimately boil down to “women’s suffering is good.”
Meghan Murphy has already done an excellent job of describing why “choice” is problematic. But there are specific concerns with childbirth because — unless a woman is in a hospital with an anesthesiologist nearby, she isn’t in so much pain that she can’t communicate, and she isn’t being bullied by a midwife — she doesn’t have a choice at all. Unlike BDSM practices, she can’t use a safe word to make it stop (taken as the idealized way in which these practices are presented, not the actuality where women are coerced into these practices). It is beyond unreasonable to think that a woman, in labour and at home, can drive herself to the hospital if she decides she wants an epidural. The condition of birth means that a woman is exceptionally vulnerable, and it is not only reasonable but obligatory that she should expect compassionate, attentive, and excellent medical care.
When people tout “natural birth” as an “empowering choice” (sound familiar?), they conveniently ignore all the women who have been harmed by these practices and for whom giving birth was (completely understandably and legitimately) one of the worst experiences of their lives. Natural birth advocates, just like many in the pro-sex movement, don’t seem to be concerned about the harm that women suffer through this practice or finding ways of preventing this harm from occurring. Women can choose, as long as they choose to suffer and see themselves as liberated through suffering.
The other problem with this ideology is that, as we know from the well-documented phenomenon of adaptive preference, women feel entitled to things that are available to them, not the other way around. If we normalize women’s suffering and refuse to provide palliative care, that is what women will expect. That is what they already are told to expect, given that they are socialized from infanthood to believe that their bodies are things to be used and hurt by men. They are bullied, coerced, told they are selfish or wimps or bad mothers. This ideology is pernicious in two ways. First, this will remove the motivation for finding safer and more effective means of pain management during birth. Second, if this ideology gains enough traction, we will likely regress to a society — as the UK has already done to a great extent — where women are systematically denied pain medication during birth.
Another argument for the natural birth ideology is that childbirth pain is “natural” and that pregnancy is a “natural physical process.” There’s nothing unnatural about any form of pain and, unlike what natural birth advocates would have you believe, all pain has a purpose: the purpose is to tell us when we are sick or injured. And if a midwife says that this pain is different from pain that occurs in response to injury, she obviously knows nothing about birth: childbirth is extremely dangerous and can, quite literally, tear a woman’s body apart. Others argue that the pain is just like exercising or running a marathon — but of course, this is presumably pain that (a) is not as extreme as childbirth, (b) we undertake for our own well-being, and importantly (c) we can stop anytime we like. Indeed, the fact that a pain may not be the result of some injury isn’t reason to refuse treatment: although migraines are very painful they are generally not harmful, and it would be absurd for doctors to refuse migraine sufferers pain medication just because they don’t have a brain injury. But according to this ideology, if a woman is in pain, even if the pain is extreme and prolonged, pain management is no longer necessary.
The argument for the “naturalness” of pregnancy and childbirth is inconsistent on several fronts. First, a healthy woman in the natural course of her life will not get pregnant; something very specific has to occur (these advocates don’t seem to know much about reproduction). It is also not part of healthy bodily functioning for a woman: pregnancy and childbirth is inherently dangerous and damaging to a woman’s physical and psychological health. Often the damage to her body is permanent. Second, death, unlike pregnancy, is something that every healthy person will go through, and yet we do not therefore argue that we shouldn’t try to prevent it or that we shouldn’t make it as painless and comfortable as possible. If we are take “naturalness” as reverting to a time without medical technology, then “naturally” many women would die in childbirth and “naturally” many infants would die before reaching adulthood (in fact, one of the main reasons for overpopulation is that people are living longer and more children are surviving than they would “naturally”). Conveniently, people only advocate “naturalness” when it disadvantages and harms women.
“Natural birth” advocates also claim that pain medication is “harmful” to the woman and the fetus and prevents her from having proper attachment to her child. But if we value women as human beings, we cannot claim that the welfare of the fetus trumps a woman’s right to bodily integrity and appropriate medical care any more than it is acceptable for women to be forced to suffer serious harm or death to carry a fetus to term (in fact, there is no empirical evidence that suggests pain medication during labor causes the fetus significant harm).
What about the argument for women’s health? We probably wouldn’t give much credit to an argument that we should strap patients to the operating table and refuse them anesthetic during surgery, even though general anesthetic is usually the most dangerous part of surgery. Rather than eliminating palliative care, we seek safer and more effective means of performing surgeries and administering anesthetic. Natural birth advocates are not concerned with women’s welfare, because they are not advocating for safer and more effective forms of pain management; they argue they should be eliminated, because women’s suffering is itself a good. And while feminists applaud efforts to give women support and comfort during the birth process (e.g., emotional support, more home-like birthing environments, etc.), this is compatible with providing women pain medication. Once again, the danger of anesthetic only becomes an issue — rather than a normalized part of medical treatment — only when and because it can be used to hurt women.
The “attachment” argument is based upon neuroscience that shows oxytocin (the “feel good” attachment chemical) is released during birth and the idea that women won’t feel attached to their child unless they suffer horribly first. This would entail that adoptive parents (not to mention fathers, aunts, uncles, and grandparents) are incapable of feeling a strong attachment to their children, and that seems false. Suffering is neither necessary or sufficient for women to feel attachment or accomplishment as mothers (why, we should ask, do we justify it on this basis when we don’t think that someone needs to be tortured in order to love someone or to feel accomplished earning a degree?). As for the neuroscience, oxytocin is also increased when we pet our dogs or hug our friends — no pain required.
To be clear, a woman’s right to refuse (or agree to) any particular medical treatment is never at stake. I am not arguing against informed consent or women’s autonomy in making medical decisions. The question is whether we normalize and provide adequate palliative care, or whether we coerce women and deny them palliative care. Some may argue that medical practice is fundamentally misogynist. Women are often subject to painful, unnecessary, and unnecessarily painful procedures; there is inadequate research and attention to women’s health issues; and traditional medicine fails to treat the “whole person.” I agree with all these critiques. However, the natural birth movement is not taking back medical practice to benefit women; instead, it is returning it to an earlier and darker time when women were told that labor pain was Eve’s punishment.
Most midwives and natural birth advocates may be women, but that should not surprise us. Ritual hazing is often perpetrated by people who have suffered the same and who are not necessarily the dominant person in the group (consider female genital mutilation or military hazing). Military training works because, by being objectified, hurt, and abused, soldiers identify with objectified self so that they will have no trouble harming others on behalf of the group. Often, we can only give what we are given, and when others fail to treat us with compassion we learn to be uncompassionate to others. Childbirth, subordination to men, sexual harassment and sexual violence—these are normalized by women, because through systematic abuse they have been given no self, no identity, outside of the system of oppression. And that is precisely, as feminists, what we need to fight against.
C.K. Egbert is a current graduate student in the Philosophy Department at Northwestern University. Her research focuses on feminism and equality.