Pregnancy & Birth
Recommended Books and Films About Childbearing
These authors step outside the system. They remove themselves from the modern "obstetrical gaze" (Arney) by learning about childbearing practices and politics of other cultures (Newton, Jordan, Kitzinger, Ashford), by gathering and describing midwifery techniques, experiences and philosophies (Baldwin, Gaskin, Davis, Steiger, AWB, Holmes) and by going to the very heart of birth to listen carefully to the stories women tell (Lang, Gaskin, Odent). In this realm, "Women's culture, when it disentangles itself from the medical monoculture, is so rich, so full of variation and interesting detail...women (give) birth in ways totally unknown within hospitals." (Jutta Mason, "The Meaning of Birth Stories," The Birth Gazette, Vol.6, No. 3, pp. l4-19).
For instance, in A Wise Birth, we read about the matter-of-fact births in Amish homes which take place in an atmosphere of peace and quiet, with "power...grace and simplicity." (34) Sometimes the authors use language that may sound extravagant and flowery, but it succeeds in capturing the wealth of information that women take in through all their senses. It is poetic, using metaphor and the words of everyday life lived intensely. It is blessedly free of medical terminology.
The midwife talks about a birth: "Later she got back on the bed and not too long afterward we smelled the burst of sweat that marks the beginning of the pushing phase of labor...the ligaments and tendons, warmed by the vigor of labor and pressured by waves from the contracting uterus, eased out..."(19) "Penny, one hand on a woman's knee, has seen (power) steal into a lackluster labor and radiate a child out. I felt it erupting in me when I had my children. It sounds in our bodies." (20). "The subtle moves of muscle and bone..." (49) "Seeing birth work well, seeing that women generously attended abide its pain and rejoice in its fruition, we remember that nature wants her young."(24) The authors mention episiotomy: "It is shocking to see vibrant muscle cut...maybe we don't think of these women's muscles with the same regard (as male athletes' muscles) because of where they're located. We don't see them crossing and gliding as they make our hips swing; we don't watch them spreading into broad ribbony bands when we squat down. We don't imagine them roiling with sex. Because we can't see them, maybe we think of them as static...but I have seen the muscles in women...when the cut was made across three or four major muscle groups, I've seen them retreat and lie there...the music of the body, the resonance and the potential for rapture are interrupted." (39)
And finally, "We do not woo women into giving birth. We do not trail our fingertips on the beds we've made up, anticipating their coming. We do not bake their favorite bread, pick flowers, hurry down the path to greet them, settle down with them, and ask them about their trip...We do not touch them, rejoice in them, admire them, laugh with them, or stand by them. We do not treat them as if they were all our daughters, whom we have adored and who are taking up major work...we have chosen to show little love." (236)
A French midwife speaks in Birth Reborn (BR): "...Let the roles be reversed!..I'm listening to you. What are you feeling?..Talk to me, teach me...I can sit back, listen, be part of an intimate act. The woman is standing. She lets me know what's going on: that she feels changes in her body; that she wants to push; that she has to open a bit more; that the membranes full of waters are bulging between her fingers...She expresses her feelings...that I'm not always as gentle as she would like me to be; that she wants it to be over; that she wants to scream; that she is going to do it. I hear her as she cries out, and I no longer try to quiet her. She becomes my teacher...I myself am also pregnant...with her words, her pains, her strange cries which even she does not recognize as her own...She is creative, inventive, full of life...She is exhausted and yet so vital. As she throws herself upon me, I am covered in her sweat. I am obliged to do as she wishes. But she is beautiful, she is the life that she is about to bring forth." (113).
This language of feeling, compassion and sensuality expresses an awareness and a form of skilled knowledge practically unknown to the medical world, or if encountered there, devalued, vitiated or ignored. It focuses upon the humanity, womanliness and strength of the mother. It relegates pertinent medical knowledge or occasional intervention to the ancillary place where they belong.
Birth Reborn (BR) by Michel Odent (deliberately and proudly "unrevised," 1994) serves as a bridge between two worlds. It tells the story of how practitioners in a hospital setting unlearned many of their medicalized attitudes by paying careful attention to the women who came to give birth at Pithiviers. "For both men and women, childbirth was an intense, intimate, all-encompassing experience. As the doctor, I was far from the central figure in the drama; at times I even felt like an intruder..." (6) Little by little, midwives and doctor alike significantly altered their philosophy and practice. Increasingly, they questioned their most accepted procedures, one after another, and discovered that breaking the amniotic sac, wearing rubber gloves, and using high tables and bright lights for deliveries hindered the concentration of women in labor. They began to see themselves as "facilitators...whose task was to intervene as little as possible..." (7) To disturb the physiology of labor is to hinder the body's natural powers. (14-15) Many photos in the book show women intensely concentrated upon their labors, close to their partners or the midwives assisting them. Women's and midwives' stories give the text depth.
Discussion of obstetrical interventions occurs only toward the end of the book in a chapter called "Anti-Obstetrics." Women who would automatically be labeled "high-risk" in the U.S. generally have few problems at Pithiviers. "We have had at least our fair share of difficult cases. Yet for nine out of ten women who give birth at Pithiviers, warmth, calm, quiet, freedom of movement, and the presence of sensitive birth attendants are sufficient to insure a smooth progression of labor. Indeed, the harder we expect a labor to be, the more we pay attention to the quality of the atmosphere." (94) The attendants' dedication to helping women give birth on their own determines when and how they intervene should a problem arise. Since every woman's situation is different, there is no standardized pattern of intervention. (94) Amniotomies, episiotomies and cesareans are performed only when absolutely necessary.
Yet, a caveat: While the climate at Pithiviers offered choices unavailable in conventional hospitals, it exerts subtler forms of coercion. It is no accident that "Most women…give birth in supported squatting positions," (BR 47) considered by Odent to be the most physiologically and psychologically efficient. (Midwives attending home births often find that women give birth most comfortably lying supported half-upright on a bed). While this sort of pressure is relatively benign, other expectations can become oppressive. An emphasis upon finding alternatives to medicalized birth may mean reintroducing very old ideas into modern culture, as when Odent speaks of restoring women to their "proper, central place" in childbirth (12) by letting – nay, expecting – them to "forget" themselves and undergo changes in their level of consciousness in the "salle sauvage" (the "natural room"); as when he mentions the beneficial role that relaxation, endorphins, human touch and warm water play in labor. While this approach can be empowering, note that once again that a man is once again presenting an ideology of birth. Beliefs and practices that seem radical and liberating at the outset may become as prescriptive and controlling as medical interventions. Once they become the "Way" and freeze into dogma, they will inevitably fail to correspond with some women’s needs and desires, as all women are different.
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