Lecture Nine

What's the first word that comes to your mind when you think of birth—of the actual labor and delivery of a baby? If you're like most people, it's PAIN. Searing, burning, ripping you body to shreds kind of pain. Insurmountable pain. P. A. I. N. Funny thing is, when we look at women in different cultures who grew up with different messages about birth, their first words aren't pain. That doesn't mean that they don't think the whole thing won't hurt like the Dickens, but they just don't associate the process with mind-blowing pain. So we're going to dig into this a bit more and figure out just why this is, where do we get these messages, who benefits from this sort of thinking, and what it all means for women.

So where do we learn about birth? Well, where do we learn about everything in life? Who teaches us all of the most important lessons? If you say your parents, I want to know how many of you dress, think or even talk like good ol' Mom and Dad. Um, that's what I thought. So, let's try this again. Who teaches us about life, the universe and everything? That's right, the media. And what does the media have to say about birth. Nothing, you may think. We can flip over to TLC and watch a Baby Story if we want to see that sort of thing; otherwise it's just not on the radar. Wrong again. Check out Season 4 of Sex in the City , where Miranda gives birth. Or, Season 8 of Friends , where Rachel pops out a wee one. Did you see Star Wars, Episode III where the lovely Padme dies just after her freaky space-age birth of twins? So you may be wondering, what do sitcoms and sci-fi have to do with birth? Well, these flicks actually teach us a lot about childbirth—about pain, about fear and about a lack of confidence in women's bodies to do the hard work of labor. After all, if skinny models passively posing in glossy ads can teach us volumes about what a woman should look like, why wouldn't we believe that television, movies and pop culture would teach us about what birth should look like?

So what does our media actually tell us about birth? Well, the main messages are the ones that we all probably hold near and dear—birth hurts, get the epidural, or better yet just schedule a cesarean section (C-section) and be done with it. That's what Britney Spears just did. Madonna did it too, as well as a bunch of other celebs who are, I guess, just too darn posh to push . Today, nearly 30% of women in the US deliver via C-section , and about 70% of women choose to have an epidural. This is not to say that there is anything wrong with having an intervention, in fact having a necessary C-section can save the life of a baby and a mother when nothing else is possible. The thing is, no other developed country has medical intervention rates this high, many have a C-section rate around 10% and an epidural rate of around 20%. Take the Netherlands , for example. They've got a C-section rate of 5% and a huge rate of homebirth. (Yep, that means they are actually pushing out their babies at home with a midwife!) You'd expect them to have a really high rate of infant mortality with all that homebirth, right? Wrong. They're right at the top in terms of healthy mamas and babies, meanwhile the US doesn't even make the top 40, we're down at #42 along with Cuba . Yikes. The US also has a higher rate maternal mortality than those countries. All this medical technology and intervention is actually hurting mothers and babies! So why are so many women choosing to have these medical interventions that compromise both her health and that of her baby?

As usual, we've got to do a bit of digging and ask what is going on here and how is it related to gender and power in society? If we are curious as to who benefits, it's easy to see that Health Management Organizations, hospitals, doctors, etc. would all be raking in extra dough if women are having more expensive births. (Remember, someone has to pay for all of those gadgets.) So is this a conspiracy theory against the Medical Establishment? Well, not quite. After all, women are choosing these interventions; they are not exactly being forced to schedule their C-section at gunpoint. But why would women be making these choices in such high numbers, and what is different about America that encourages more and more women to opt for a highly medical birth?

Let's get back to the pop culture. What is the story that's being told on Friends or Sex and the City or anywhere else? Usually, it's that birth is painless and fast. The mama stays perky and calm and does a few cute pouty grimaces and is then holding her baby. If this what we regularly see, how are we really supposed to know any different? So what happens when your experiences don't reflect the stories that you've been told? Many women end up believing that something is wrong with them—it's not uncommon for women to say that they didn't expect the pain to be so intense, they didn't expect labor to be so hard. They are discouraged and dispirited and choose an epidural, a C-section or whatever is offered to them because they didn't know what to expect. Women aren't always sure that their bodies can do the hard work of labor. And can we blame them? With all of the messages that women and girls get about their bodies (from encouraging them to stop menstruating to hormone replacement therapy in menopause ) our society is not exactly reinforcing women's body confidence.

So is birth a feminist issue? Feminists have seen it as one, and have worked to change the American system of birth. They have suggested that the birth decisions women are making don't happen in a vacuum—we need to understand why trends happen and what they mean for women. Some people have said that the rising cesarean rate and the increased levels of medical intervention are the equivalent of a feminist jackpot… giving women more choices. Instead of accepting this as a fact, feminists encourage us all to wonder about what these birth options mean for women. Why does the US have this unbelievably high rate of birth intervention and an even higher rate of infant and maternal mortality? Why are American women increasingly electing unnecessary and sometimes dangerous interventions? Medicine and science have taught us many things about childbirth, but a total reliance on these technologies may not only be unhealthy but may in fact jeopardize the lives of babies and mothers.