OTI Online
Winter 1995

Natural Childbirth: From Option to Orthodoxy
by Nicole Bokat



"I did it!" a beaming Elizabeth announced to our mother's group. "Chloe was born naturally" The other women clustered around mother and baby, nodding in approval that Elizabeth had passed the childbirth test with flying colors. Once again, a feeling of alienation crept over me. Pregnant with my second child, I planned on requesting anesthetics the moment my labor pain got too intense.

Unlike me, many women today strive to have natural childbirth. Even Maria Maples "had no anesthetics," Donald Trump bragged to The New York Times. The most popular way of achieving this goal is through Lamaze training; to distract the laboring mother by focusing her attention on complicated breathing techniques. According to a 1992 article in Forbes magazine, half of the parents of the four million babies born in 1991 went through Lamaze training. This figure doubled from 25% in 1987. Why are we so caught up in the trend?

If all things come in cycles, then our culture is immersed in a growing moralism when it comes to motherhood and, as a by-product, childbirth. Having proven that we can be independent, high functioning, high earning, and aerobically fit, women are also striving, once again, to excel at motherhood—beginning with our marvelous feats of endurance in the delivery room. How many other long, arduous procedures do people brag about surviving without the benefit of modern medicine? Has anyone ever heard of "natural open-heart surgery"? How about a "natural vasectomy"?

While avoiding drugs to minimize the risk to one's baby is the underlying aim of natural childbirth, conquering the process has, inadvertently, become a status symbol. Having a child, "naturally," is considered a badge of honor among some mothers; perhaps this is similar to surviving a bullet among men who've been to war. The more militant portray triumphant veterans of childbirth battles in grandiose terms, conjuring up images of Mother Teresa, Joan of Arc, or the Mighty Lioness of the Jungle. But, even for the more mainstream, "natural childbirth" has become a catch phrase; one that appeals to the "good mother" in us. What has been lost is the message of the women's movement: Every woman should be free to make her own choices about pregnancy and motherhood without being judged.

Yet, too many pregnancy books, peers, and care providers insist that if we fail at natural childbirth, we are settling for an inferior experience or, worse, exposing our infants to potential risks. Tracy Hotchner's Pregnancy and Childbirth is representative of a slew of guides for expectant mothers. The author advises women to try and avoid medication, warning that any drug might harm the baby. Yet, in the next breath she explains that maternal anxiety—a reaction to pain and fear—can adversely affect labor. Enjoying every minute of your labor is thus the only guilt-free choice.

We seem to have regressed mightily from the mid-nineteenth century, when the anesthetic use of chloroform was discovered and endorsed by Queen Victoria, who had nine children, despite the clergy's protestation that women needed to suffer in childbirth to atone for Eve's sin. As Jessica Mitford describes in her wonderful book The American Way of Birth, for the next 80 years, the fashion in childbirth—for those who could afford it—became avoidance of pain through anesthetics. Then, in the 1930's Grantly Dick-Read, the author of Childbirth Without Fear, and later Frederick Lamaze, attempted to steer women away from the use of much coveted anesthetics. Dick-Read believed that women's anxiety creates the pain of childbirth. Lamaze acknowledged that the process was painful, but insisted that women themselves could control the degree to which they felt that pain. Both men advocated the "conditioning" of women through breathing based on Pavlov's experiments with dogs. Once again, women were held to ridiculous standards of perfection while simultaneously viewed as victims of their own imagination and fears. Today, those who most ardently advocate natural childbirth have merely politicized women's suffering for a new purpose: the health of the baby. In doing so, they have embraced the age-old image that true femininity requires martyrdom.

With my first son, my doctor assumed that my husband and I were in sync with the times; it was understood that I would attempt natural childbirth and then breast-feed our baby for the acceptable six months to one year period. We listened to the rhetoric, felt guilty for any doubts we harbored, and signed up for Lamaze. In the class, the nurse chided women who planned, in advance, to have epidurals. She cheerfully reassured us that we could "push our way to victory," since we were ''made for having babies." Having secretly hoped for a loophole that would require my using painkillers, I suddenly questioned whether or not my cowardice pointed to a maternal deficit in me.

Then came the endless stories of successful drug-free births from friends and acquaintances. Alice allowed her older child into the birthing room until the final hour, then, valiantly, gave birth in a shower! Jane rocked on all fours in the final stages of labor. Two of my neighbors popped out sons en route to maternity centers, then bragged about the births as if they were stellar achievements rather than lucky accidents of nature.

Along with my admiration for these audacious sisters, I couldn't help but wonder: What's next in this "Can you top this" atmosphere? Giving birth in the workplace? While jumping out of a plane? Birthing theaters (selling tickets and having people attend "improvised" productions)? Despite our courageous performances, our choices do not always reflect what's best for mother and child. One woman I know romanticized the idea of a home birth, free of medical intervention. An emergency complication—coupled with the distance to the hospital—turned her experience into a nightmare. Sadly, she is now unable to have more children. Women who grow nostalgic about the less intrusive, less technological environment of yesteryear seem to forget how often their foremothers died "naturally" in childbirth.

My own reservations notwithstanding, I finally succumbed to the dictum that labor was a crucial test of my maternity. Unfortunately, my first son's birth turned out to be unnaturally brutal. During the pushing stage, he lodged himself on my spine, refused to budge, and caused me unbearable distress. Treating my labor like a difficult sporting event, my obstetrician shrugged and exited "to get a Snickers bar" when—after three hours of pushing—I received an epidural. As I was leaving the hospital, I spoke to a top administrator who shook her head at my story. "It was much more civilized in my day," she said. "They put you out, and, when you woke up, you had your baby."

This second time around, I've already informed my new doctor that I harbor no fantasies of winning the delivery room medal of honor. Since women's childbirth experiences range from exhilarating to agonizing, we should be encouraged and supported to understand both our options and their limits in what is, finally, a dive into unknown waters. Each of us should balance the needs of our infants with our own mental and physical health. Planning and daydreaming should center on the baby, not the birthing event.

I've flatly rejected all rhetoric that exalts the advantages of breathing like a hyena. I'm ignoring the cheerleading tactics of those in the medical and motherhood community who make women, like me, feel inadequate because of discomfort and "natural" fear about childbirth. I believe that it's time for the childbirth industry to stop making women feel guilty for not blindly embracing the latest childbirth craze. The pain of childbirth needs to be depoliticized and viewed exclusively for what it is: suffering. Finally the myth of the perfect versus the malicious mother must come to rest, beginning in the labor room. After all, our ultimate aim is to be mothers, not heroes or symbols. What could be more natural than that?

Nicole Bokat has a doctorate in English and teaches at the New School for Social Research in New York City.

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