Friday, February 26, 2010

Celebrating pain relief

There's an interesting stoush taking place between some of my very different friends on Facebook.  Just to demonstrate the shallowness of some people, these friends have never met each other, but are arguing over personal choices made by others relating to the birth of a child.  This should be a happy event - as I've said in the past, the only satisfactory outcome is a live baby and mother - and yet some people take the opportunity and use it as a platform for their own agenda.

The stoush started innocently enough - someone said they had just given birth, and the congratulations were numerous.  Then someone asked what sort of birth they had.  The word "epidural" was mentioned, and now I am choosing to no longer look at my Facebook account, other than to send messages of sympathy to my now beleaguered friend.  It is clear that there is a warped line of logic that believes a person's individual choice demonstrates the apparent subservience of women to men.  The name of an obstetrician in the UK, Dr Denis Walsh, has been thrown around as providing some sort of wisdom on this topic.  In return, the less than intelligent comebacks have focused on the lack of uterus of Dr Walsh, and therefore his lack of credibility, to make such a statement.

I stare at these comments, and all I can come up with is the deeply intelligent and articulate, "What the ....?"

Birth pains are nothing to celebrate, and I would take a guess that it was degenerate feminists, rather than ignorant men, who first argued that childbirth should be a painful rite of passage.

Dr Denis Walsh is a Professor of Midwifery, who argued that birth pains help mother and child bond.  He criticised women for their "antipathy to birth pain", and criticised the "epidemic" use of epidurals.

Oh dear.

There are many reasons to criticise Walsh, but the fact that Walsh is male is not one of them.  Yes, it is true that Walsh will never give birth, and so will never experience the pain of delivery (although a part of me does hope that he will perhaps experience the pain of kidney stones as some consolation), but that does not explain his apparent lack of understanding and empathy.  Most men and women will never suffer pain because of, say, nerve degeneration, cancer, or travelling kidney stones, but that does not mean they cannot understand such pains and provide sympathy.

There is no reason why anyone should be expected to endure pain from an acute trauma such as childbirth.  Nobody expects victims of car accidents or those undergoing surgery to just "withstand" the pain.  Modern analgesic procedures mean that pain relief can be readily provided, and the patient can be rendered both more comfortable and more likely to make a full recovery.  No procedure is entirely risk-free, of course, including painful childbirth, and women should be made aware of the risks associated with an epidural so as to make an informed choice.  But the risks can easily be exaggerated, as Walsh does in his article, to scare women away from what is an essentially safe, effective and routine procedure.

Walsh is not alone in his crusade against pain relief during labour.  There is a widespread belief that childbirth pain - but not other pain - should be endured, and even celebrated.  A good reason not to get overexcited about Walsh being male is that the origins of this idea lie in feminism.  Having failed to secure equality, around the mid-1970s, feminism took a degenerative turn towards praising the special virtues of women and attacking maleness.

Women were presented as having special empathetic and  nurturing qualities that made them less destructive, and put them into closer contact with nature.  Their ability to give give birth, and their experience of the painful process of giving birth, were held up as evidence of their inner, female wisdom.  Business, politics and medicine were seen as problematic because of male domination.  Thus, for example, it is argued that the Enron debacle might have been avoided if only there were more female CEOs and accountants, Governments would be less corrupt and destructive if there were more female MPs, and medicine would  be more humane and less arrogant if there were  more female doctors.


Women can be destructive and arrogant, just as men can be empathetic and humble.  It might be true that medicine in the 1970s was excessively arrogant and paternalistic, but that had little to do with the male character of medicine and more to do with the high esteem in which medicine was held within the profession and by society at large.  This is certainly no longer the case, and modern medicine is, if anything, now too diffident and understanding at the expense of making tough clinical decisions.  That's partly why nonsensical discussions of "natural" childbirth and pain control techniques (such as yoga, hypnosis, water baths, massage, acupuncture, moxibution, to rattle of just a few) now dominate childbirth discussions.  Non-pharmacological techniques might have their place for some women, but effectiveness is limited and the doctors know that.  As it happens, so do many women.  The use of epidurals during childbirth is known to be increasing because epidurals work and women demand them.

And rightly so.  There is no reason why any woman should endure an entirely preventable pain if she doesn't want to.  The fact that there is a choice available should be what is celebrated, not the personal decision that was made.


Amnion said...

So very well said.

We don't need another reason to bash women, other women!

Birth hurts. Some prefer the hurt without ameliorating drugs, others really want to cope and choose drugs. That's ok
This is 2010, we don't have to live in agonies to prove we are more 'womanly'.

Yes analgesia has some risks, sometimes their can be a cascade of interventions. I've done it 4 different ways, I preferred the drug free but that was me. The drug free was probably possible because they were quicker and less exhausting! But add severe pain to exhaustion and no one has any right to judge who 'should' use analgesia. It is as safe as it could possibly be.

But what matters is a live and healthy mother and baby at the end of it. Really that is what matters. I say this as someone who has attended probably up towards the thousand births. If you asked any mother if they wanted a fulfilling birth experience or a live baby, I know what they would choose.

So if you want the full pain experience go for it. But dont use that as some kind of bat with which to beat "lesser" women who had epidurals, or gas, or pethidine. BIRTH IS HARD. It HURTS. At times it is complete shitty agony and I cannot see how that much pain is any kind of character building.

Nothing about the pain of birth facilitated my bonding with my children, that happened at the time of their conception.

Well said! And judgemental, smug all-knowing women who would scorn others for making choices different to you, AND tell them about it.... Shame on you!

Chavah said...

I've never understood why women bash other women over their birthing choices. It's just that, a choice! Nothing right or wrong about any of them.

Leonie said...

I cant understand why women bash each other either, about birthing options or any other choice they make. we should support and show empathy but unfortunately many women are so judgemental.

I was very fortunate to have quick births with my three but did have an epidural with the first, Im terrified of needles so made the choice to do the second two without (yip would rather the pain of labour than a needle!) But my choices were always made about what is best for my babies and me, it wasnt anyone elses business.

The other thing that upsets me is women who make judgements about other women's choice to stay at home with their children or go back to work. Really, we all make these choices based on our own families needs at the time. I have done both and both are REALLY HARD.

I find it really disturbing that there is so much of this going on amongst women.

Mark.V. said...

It was Queen Victoria who insisted on using chloroform to ease the pain of childbirth, this was opposed by her Doctors who insisted that it was Biblical for women to experience pain when giving birth.

Nothing much has changed since then it seems.