Both my kids celebrated their birthdays recently, and since I’m not planning on having any more children (my husband and I have no intention of letting ourselves be outnumbered), I feel entitled to look back on their births with a certain amount of nostalgia.
I knew childbirth would be tough, but until I experienced it firsthand, I hadn’t realized that it isn’t merely the process of giving birth to a child. Among middle- and upper-class Americans, childbirth has become something like a technical certification program, with dozens of competing theories, training courses, and exit exams. You can have your baby underwater, under hypnosis, or in your own living room with your entire extended family present, if that’s what you (and they) want. You can choose the Bradley method or Lamaze; you can have a midwife or a doula or a plain old garden-variety obstetrician. It’s a bewildering array of choices. And it’s great that women have all these choices, even if we don’t avail ourselves of them. Personally, I just wanted to have the kid dislodged from my womb with a minimum of fuss. I wasn’t interested in joining a combination gym/sorority/church, which is what a lot of the methods my friends chose sounded like.
Home birth, for example. I appreciate the logic here: Hospitals are for sick people, and childbirth isn’t an illness. If you don’t feel comfortable in a hospital, you shouldn’t have to have your baby there. I myself don’t feel comfortable in hospitals, but I had my children in one, I guess because I never expected to feel comfortable while eight solid pounds of homegrown love and affection worked its leisurely way out of my body. What did make me feel comfortable was knowing I had an army of medical staff close by if anything went wrong. This turned out to be a wise precaution in my daughter’s case, since her shoulder got stuck in the final phase of delivery and it took three people to pry her out. The doctor had to break the poor girl’s collarbone to do it, too, and after that traumatic introduction to Life on the Outside, she needed some oxygen. I’m not saying she wouldn’t have survived a home birth, but we had a lot less to worry about, being in the hospital.
Natural childbirth was another popular option we took a pass on. A lot of women want to have their babies without any drugs, and kudos to them. I’m not an advocate of drugging newborns. I did feel, however, that if doctors have regularly been using anesthetic to relieve the mother’s pain during childbirth without seeing real problems, I would be happy to have some of that mojo, thank you very much. Long before I ever experienced labor, I had been through some intense pain, and I didn’t find it a redeeming experience. It fucking sucked.
Again, that’s just me. Some women prefer to experience the pain of childbirth full-on. They take comfort in that knowledge that they are letting nature take its course. I think that’s gutsy and those women deserve a lot of respect. But it’s also an indisputable fact that natural childbirth has killed millions of women—historically, about one out of every 100 human births kills the mother. Humans have one of the most dangerous birthing processes of any organism on the planet. I wanted to be in my right mind when I went up against those kinds of odds. Given a choice between being natural and being lucid, I’ll take the brain function every time.
So for both of my children we opted for hospital births with epidural anesthesia (also called a “spinal block” which is not entirely accurate but far more descriptive). Our doctors were fine with our choices—in fact, during both my pregnancies I was continually impressed by the willingness of doctors and nurses to let us make our own decisions. As long as we had the information they felt we needed, they treated us like adults.
I can’t say the same of the Lamaze lady.
We didn’t realize we were signing up for Lamaze when we enrolled for the “childbirth classes” at our hospital. The classes were sold as an opportunity to meet other parents who would have babies at about the same time as us, to get a tour of the birthing rooms and nursery, and to ask questions about the stages of labor and delivery. We didn’t realize we’d also be getting indoctrinated in the virtues of drug-free childbirth. We didn’t realize (and I could never have imagined) that we would be told how important physical pain was to the process of becoming a mother. And we definitely didn’t know that the whole dog and pony show was underwritten, in part, by a consortium of health insurers who were interested in reducing the amount they spent on anesthesia during delivery.
Now I want to stress that this happened fourteen years ago, and I have no reason to think that our Lamaze lady typified Lamaze instruction generally. But she did nothing to incline me toward natural childbirth. Quite the opposite, in fact. By the time we had finished the classes, I was a complete reactionary on the subject, and would have asked for, and taken, anything the doctor had within reach, from aspirin to laudanum. It was the principle of the thing.
Because the class wasn’t so much about How to Have a Baby as it was about Just Saying No to Pain Relief. Pain, the Lamaze lady informed our class, is a natural part of childbirth, and if you don’t experience the pain, you’re missing out on one of the most beautiful parts of becoming a mother. She warned us that many women are disappointed if they have to have anesthesia during delivery because they feel they missed out on a life-changing experience. Well, that’s sad, I thought; why doesn’t someone reassure those women that experiencing pain doesn’t actually make you a better mother?
My husband and I initially thought our “childbirth class” instructor was laying on the “avoid drugs during delivery” spiel a little thick, but she seemed very earnest, and we had already discussed the matter with our doctor anyway, so we sort of ignored the proselytizing tone. It wasn’t until we got into the particulars of active labor, and how my husband was supposed to support me through it, that we realized we had some fundamental differences of opinion.
“Now, when she really starts feeling pain,” the Lamaze lady explained to my husband, “She’ll probably ask for some pain relief. Your job is to tell her, ‘No, you don’t need it.’”
My husband somehow refrained from laughing outright, but he also refused to lie to the woman. “I’m not going to do that,” he told her flatly. She was obviously taken aback, but she didn’t know me, and he does. He knew when he married me that he was getting an educated, well-informed woman with very strong opinions and piss-poor impulse control. He happens to agree with me that women should get to make their own choices about their bodies. Plus he’s seen me break boards. One reason we’ve remained married for 21 years is that neither of us presumes to tell the other how much pain is OK for that other person to suffer. Especially when one of us is giving birth to the other’s child.
“But if you go ahead with the epidural,” she cautioned me, “You can’t go back. You won’t get the full experience of childbirth.”
The “full experience”? I thought. I’m not going to a goddamned weekend spa. My husband recognized the expression on my face and, cutting me off adroitly, managed to convince the Lamaze lady that I would be making my own choices about pain management, and that his “job” would be to support me in whatever decision I made.
It’s a sad fact that arguments for women’s autonomy carry a lot more weight when they are voiced by big muscular husbands. “Well, I certainly respect that decision,” she said, to him. “And, if you really want something,” she told me, “The doctor can give you a little Demerol. It won’t relieve the pain very much, but it will relax you.”
I couldn’t believe what I was hearing. A narcotic, for fuck’s sake? And it won’t even relieve the pain? Oh yes, please, make me less rational while I’m in labor. That’s how I want to cross the threshold into motherhood: Writhing in agony and smacked into a trance. I mean, God forbid I should retain the use of my cognitive faculties during one of the most important moments of my life. Jesus Christ, I thought, looking around the room at the other couples hanging on this idiotic woman’s every word, have any of you people even heard of Mary Wollstonecraft?
This was my introduction to the hierarchy of evil in childbirth drugs, or, as I have come to think of it, the anti-feminist pharmacopeia of inverse rationality. Here’s how it works, from the natural childbirth standpoint, which you would do well to remember is also (by an astonishing coincidence) the health insurance industry’s standpoint: The “best” option is no drugs to relieve the pain. Result: You will be out of your mind with pain, but you won’t cost the insurance company anything. The “next best” option is something that doesn’t take away the pain but does seriously impair your connection to reality. Result: You will be out of your mind with pain and high as a kite, but you will be more tractable and presumably not asking for other, more expensive drugs. The “worst” option, from the Lamaze lady’s perspective, was the spinal block, which stops the pain and doesn’t impair your cognitive faculties. Result: The pain goes away and you can think and make decisions, just like a real grownup! But you have cost the insurance company twelve hundred dollars.
Strip out the bits about money, and it’s even worse . Because men can’t experience the pain and irrationality of childbirth, the logic goes, pain and irrationality are inherently feminine. Thus if women choose reason over pain, we are being unnatural and unwomanly. If we choose to avoid certain gender-linked experiences, we are being “unnatural,” and we’re probably going to be horrible mothers to boot.
Choices, choices. We’re lucky to have so many of them. The thing is though, once you admit that women ought to have choices, you have to let them make choices. You can’t make them choose the thing you’d choose for yourself. And you shouldn’t try to guilt them into choosing what you think is best for them by telling them they are bad mothers or unwomanly or sure to suffer burning, life-long regret if they don’t. And you’d better not ever, ever use some fatuous, two-dimensional, martyrdom-based version of motherhood to cover up the fact that economic factors are driving the discussion about choices.
When I told people I didn’t plan to breast-feed my daughter (I only told people who asked; I’m old-fashioned that way), I met a fair amount of incredulity. “But don’t you want to give your child every possible advantage?” I was asked. Not really, I replied. This kid will be born white and middle class in America; she’s already ahead of 95% of the rest of the world. Why does she need every advantage?
One advantage my kids do have is a mother who weighs her own needs and preferences, seeks out information, makes her own choices, and doesn’t feel compelled to do one thing or another with her body because someone tells her it’s more womanly. They don’t exactly brag about this at birthday parties but they don’t seem to mind too much either. They just assume it’s natural.