Betty Dodson with Carlin Ross

Better Orgasms. Better World.

• Login
• Join

Search this site:

There was a recent article published in The Washington Post and on Slate called “The Truth About Epidurals”. This article presents some neutral information but chooses language that favors epidurals and it reinforces ideas that childbirth is nothing more than painful and scary.

Conveying a similar message to the article is a sign I photographed on the wall of a labor and birth room at a local hospital:

 

Here are my concerns when reading an article such as the one in The Washington Post/Slate Magazine and seeing this sign in a hospital room:

I do not believe our foremost concern with regard to childbirth should be the relief of pain. I believe the relief of pain should be an option, but not our greatest concern. I also do not believe we should be in a polarized battle about whether epidurals are good or bad, right or wrong.

I may be one of these natural birth proponents of whom the author speaks. As such, I am not concerned about what a woman chooses (natural, epidural, cesarean…), but how she chooses and how she is responded to in her choices. My concern is that we as women, and as mothers are being distanced from our own experiences (of birth, our bodies, our sex lives and ourselves) and our own authority by our culture - advertising, medicine, general societal messages, and so much more. We are being manipulated, frightened and threatened into choices and experiences that are not necessarily true to our deepest longings and instincts as humans, as women, as mothers.

Spending our lives with our number one priority being avoidance of pain is a losing battle. I think more realistic goals might be having the support and guidance around us to have a full spectrum of life’s experiences and come out the other end; from pleasure, joy, trust, health, ease and connection to pain, challenge, and fear.

I do not want women to choose an epidural birth because she is petrified of a natural, vaginal birth nor do I want her to choose a natural birth because she is petrified of an epidural. Do women feel fear before giving birth? Indeed they do. Most of us feel fear as we embark on a new, intense and unknown life experience/transition. But fear should not negate the possibility of fully considered choice.
The process of giving birth is about so much more than “pain or no pain”. The process of giving birth is diving into the unknown. It’s about potentially touching into and exposing a deeply primal, animal part of yourself – some women relish these types of experiences, some women feel unsafe in them. It’s about making some of your first decisions as a mother, or as the mother of this particular child that you’ve grown.

It’s about deciding whether you feel more comfortable having mobility and sensory information from your body or if you feel more comfortable having little to no sensation and knowing that information and choices are in the hands of machines and care providers that can make educated guesses. It’s about the terrifying feeling of being deeply in love with a human being that has grown within your body and whom you want to touch and see on the outside, whom you want to protect and insure he or she is okay, will be healthy and happy, while knowing that life can never give us a guarantee and that being deeply in love, that having a child, is a huge risk.

As a proponent of natural childbirth, I do not feel, as the author says, that “epidurals contribute to the over-medicalization of motherhood”. I feel that the mockery, dismissal and polarization of natural birth is a sad truth that exists, and that this truth weakens the power of women and pits women against each other. I feel that the over-medicalization of childbirth is not the result of epidurals but rather that instilling a sense of terror in pregnant women (terror about the health of their baby, terror about the unknown, terror about the supposed absence of wisdom, strength and resilience of the female body, terror about pain) such that medicine, doctors, nurses and machines can take over with a supposed guarantee – this is what has caused the over-medicalization of childbirth. I feel that regarding women as unwise and weak, afflicted by the disease of pregnancy, this is what has caused the over-medicalization of childbirth.

Epidurals and cesareans are not the over-medicalization of childbirth, they are the medicalization of childbirth – and sometimes very wonderfully so. It is the excessive use of them based on false perceptions of the childbirth experience, based on threats, manipulations and disregard for a woman’s voice as a key component of healthy pregnancy, childbirth and postpartum, based on expectations that doctors and medicine can save us from the uncertainty of life, and based on a doctor’s concern of a malpractice lawsuit or interference with a vacation – THIS is the over-medicalization of childbirth.

The author states that the only way to do a truly comprehensive study on cause and effect with epidurals and cesareans would be to “split laboring women into two groups at random, giving one epidurals and the other no pain medication, and then watch what happens. But most doctors agree that it would be unethical to withhold medication from laboring women in the name of science.” What’s wrong with this? The implication is that while it is unethical to withhold pain medication against a woman’s wishes, it is ethical to withhold full sensation from laboring women in the name of science. I believe that both of these are unethical.

Unlike the sign posted in this hospital room – I do not believe our #1 goal should be pain relief. I believe childbirth, medicine, and maternity care would be vastly improved if the sign read something like:

Goals:

#1 Healthy Mom, Healthy Baby
#2 Listen to mom’s questions, concerns and preferences
#3 Respect mom
#4 Respect baby
#5 Respect partner
#6 Provide mother and partner with information required to make informed decisions
#7 Support mother’s choice with regard to use of pain relief