March 2009

Beth Harrington

features

Child Birthing and the Parental Experience

As someone whose reaction to the idea of having a child is a tepid "maybe I could adopt or become a foster parent -- that way if they turn out bad I can blame it on the biological parents," I approach literature on childbirth and maternity with a blend of skepticism and curiosity. I am eager to find my choice not to reproduce vindicated and yet wonder what it might mean to be converted. Truth be told, consciously choosing not to have a child can leave one feeling excluded, like an outlaw even in contemporary society. How do you get your boyfriend to propose if you can’t use your biological clock as an excuse? What to say to those nagging relatives? Such was the mindset that informed me as I began reading Labor Pains and Birth Stories: Essays on Pregnancy, Childbirth, and Becoming a Parent, an anthology of stories written mostly by moms, but including a few dads, about the process of giving birth. According to editor Jessica Powers, it is the first anthology of its type, which is rather surprising given the prevalence of birth and parenting literature. What transpires is a journey that aims to invite the reader into one of the most crucial experiences of human life, yet at its conclusion leaves the disbelieving reader with more questions and reservations than answers about the passage to parenthood.

In terms of its structure, the book contains twenty-nine stories, plus a brief introduction and conclusion, at a mere two hundred twenty-eight pages long. Thus, these personal accounts average less than eight pages per story. Length does not necessarily correlate with quality and some of the shortest pieces in this collection are striking, while some of the longer pieces seem unfocused. They simply tell the story of a pregnancy and birth and lack a specific perspective or argument needed to distinguish themselves. Reading this collection is oddly similar to the experience of working as staff on a maternity ward. The reader is taken along for birth after birth yet the stories usually end when the infant is taken home from the hospital.

In relation to content, first and foremost, it becomes clear that the contributors to Labor Pains and Birth Stories are a fairly homogeneous group. They are middleclass and in stable relationships; for the most part, their pregnancies appear to be expected (according to the American Pregnancy Association nearly half of all pregnancies are unplanned*). Granted, there is one story written by a single mother who is expecting her second child while trying to disentangle herself from an abusive relationship. Another is about a mother living in the Upper East Side struggling to support her daughter whose biracial father is reluctant to contribute to the child’s upbringing while he attempts to pursue an art career. However, descriptions of shelling out twenty thousand for medical treatments for a birth mother in the event of a possible adoption and a couple who spend the days leading up to their child’s birth strolling the beach and watching movies evidence that these authors live in relative economic comfort and privilege.

The contributors are even more drawn together by their preference for alternative, New Age birthing methods. This in itself seems indicative of their socioeconomic status. (One has to wonder how many welfare mothers have access to such diverse treatments or even the resources to gain education about them.) Deliveries are frequently presided over by midwives as opposed to obstetricians at birthing centers or even at home instead of hospitals. The mothers use guided meditation, relaxation tapes, and “hypnobirthing” to help them through labors. There is even one case in which nipple stimulation (known to release the labor-inducing hormone oxytocin) is enlisted to bring on contractions.

Mothers who do not partake of alternative medicine during labor seem to feel compelled to justify their need for modern-day medical care. In her essay, "Don’t Even Bother: The Case Against Childbirth Preparation," Kelly Cunningham-Cousineau responds with nothing but insults to women who claim that childbirth was easy for them: “You are so full of shit. I don’t like you, I don’t trust you, and my kid is not going to play with your kids, you evil, Stepford-wife pods!” She qualifies her difficult labor and reliance on an epidural by informing the reader of her typically high levels of endurance: “I skied in minus-fifteen-degree weather until my nose was frostbitten. I drank a frat boy under the table in a shot contest. I am total chick macho.” She later informs us that “some of the women I know who have had the easiest labors are the biggest wusses with anything else.” Is childbirth the female equivalent of the military service? The long and short of it all is that I am dubious that Labor Pains and Birth Stories depicts the average birth experience of the ordinary woman -- at least in an industrialized nation. What is more, if you are a mother who wants to have an epidural in the event that you go into labor before your elective Caesarean-section is performed at a teaching hospital, this is probably not the book for you.

Caesarian-sections in particular are frowned upon in this book. They are generally reserved only for extreme situations such as that of twins born to a surrogate mother twelve weeks premature and a woman with a malformed uterus. One father goes so far as to label the elective Caesarian “a distortion for the self-pampering many.” Putting aside whether major abdominal surgery can actually be qualified as a self-indulgence, his viewpoint serves as a springboard for some of the controversies that reading this book may trigger. To start with, why are so many of these women determined to give birth sans medical intervention, forsaking in particular the relief of modern-day pain medication?

Natural childbirth instructor Frederica Mathewes-Green addresses the issue in her essay "Granddaddy’s Obstetrics," coincidentally in relation to the high rate of Caesarean deliveries, saying “the female body is designed to give birth, and we all are descended from a long line of birthgiving women.” Fair enough, but we are also descended from a long line of cave dwellers and that does not stop most people, mothers or not, from appreciating the comforts of a house inlaid with bricks or a stucco apartment complex. Additionally, the women who give birth in their homes or in birthing centers staffed by midwives are fully aware that should complications arise they are a mere ambulance ride away from an emergency Caesarean section or induced labor. Such is a far cry from the African mothers referenced in "The Zooming Birth of Jett" who may give birth a dozen times and hope only to live through the experience and for their babies to survive.

There is also the question of whether infants who are the product of natural childbirths actually fare better in the long-term as children and adults than babies born under more standard conditions. If the answer is yes (and even if it is, there is always the possibility that mothers who elect such methods may be more invested in becoming parents and feel more positively about motherhood in general -- causation is not correlation as the old adage states) then the issue of childbirth practices becomes akin to the debate that surrounds abortion rights. To what extent should a mother be expected to sacrifice of her own body for the good of her unborn (or being born) child? While it seems reasonable to expect that parents will make sacrifices for their children and that for women, whose bodies produce these babies, the sacrifices may be physiological, should a woman be expected to endure any amount of discomfort to ensure the most optimal experience for her infant, even if they occur at great cost to her? Can a mother who chooses to "self-indulge" during the birthing process recoup whatever losses her decision about birth incurs with the ones that she makes after the birth? Looking at it from a different view, if an infant’s first moments do majorly impact his or her life development, then what of infant who -- for all their parents’ efforts -- is born blue with the umbilical cord around its neck and must be rushed to another room for oxygen, or premature babies who must spend weeks in neonatal care separated from their mothers? Are we to assume that these children will suffer from some degree of post-traumatic distress or interpersonal difficulty that will follow them throughout their lives?

The women in the book do not ever cite definitive scientific studies showing that birthing outside of the standard hospital-setting ultimately leads to happier, more successful children in the long run. In fact, the reasons most women give for selecting a midwife over an obstetrician have to do with their expectations that the former will give them more individual attention than the latter and focus on their needs as a whole rather than simply their pregnancy. The women who opt for homebirths, in particular, do so because it feels more comfortable for them and thus they believe newborns will benefit in turn. Given the rationale that these birthing experiences are for the benefit of the mothers who request them, is it fair for society (and the contributors of this anthology) to judge these women more favorably than a woman who utilizes the various medical technologies for her own comfort?

It would be easy to conclude an investigation of such topics with a cliché about how women should not judge other women’s choices regarding motherhood or that ultimately a woman should obey her doctor’s counsel. However, I wonder if there is something else going on in all of this meticulous planning and determination to endure that has to do with what the writers of these compositions mostly gloss over. In the era of Dr. Phil and a few decades after John Bradshaw’s books about Toxic Parents, none of these expectant mothers and fathers expresses any notable doubts or misgivings about their ability to care for and nurture a child into adulthood. Occasionally, a contributor will make reference to the knowledge that the anxiety over keeping a child safe is no less immediate after they are born. “We are not out of the woods yet,” Pierre Laroche’s wife remarks in an essay titled, incidentally, "Out of the Woods," but on the whole there is very little discussion of “becoming a parent” -- as the subtitle states -- beyond caring for the needs of an infant. At no point is there any discussion of how these families will juggle raising their children with career responsibilities -- though again, this could be a class issue on the part of the authors. None of these contributors explore grievances with their own parents in juxtaposition to how they shape their confidence in and ability to be a good mother or father. The assumption seems to be that once the baby comes out, as long as it is properly bonded with in the postpartum stages, everything will be okay.

Thus, one cannot help but wonder if the determination of these parents to craft the optimal birth plan represents a test of metaphysical proportions for them. Namely, it is a way to prove to themselves that if they are capable of making the most excruciating sacrifices for their children when they are at their most vulnerable and dependent, then they will continue to do so even as their children grow up and individuate from them. The alternative to a happy, healthy childhood for their posterity is more unbearable for parents than even the longest, most difficult labor without analgesics. Yet the skeptic in me still finds myself wondering if these parents are not focusing too much of their attention on the wrong moments. Whatever experiential gifts these parents have the capacity to give their children at birth represent only the beginning of their life stories.

* "American Pregnancy Association". 2/23/2009.