Let’s talk about childbirth, shall we? Nice, natural childbirth. Let’s talk about lying belly-up in an inflatable pool of detritus, humming and gnashing your teeth while looking at pictures of puppies. Isn’t it just everything you ever imagined it to be?
I was always terrified of giving birth. I called my mother after I watched the first episode of One Born Every Minute and told her, in no uncertain terms, that I was never going to be able to have a baby. She laughed at me and said I would, and she was right. Eight years after that conversation, I was looking at the window on a piss-covered litmus stick, where one pink line was darkening up beside another. I burst into tears—I was going to be a parent!—but they weren’t happy tears. Nope, no matter how much I wanted it, I wasn’t ready, because to reach motherhood, I was going to have to give birth.
I frantically Googled things like “pregnant scared to give birth” and “elective cesarean.” I floated the idea of a cheeky C-section with my consultant obstetrician. “Oh go on,” I wheedled, “please?” He told me to put my pants back on as if he hadn’t heard me. Back to Google then, and pretty soon afterward, I discovered hypnobirthing. My fears evaporated, and I began to study for labor like it was a test.
I received books about natural birth for Christmas, and I’d devoured them before the turkey was on the table. I laid them out in the rapidly diminishing triangle of space between my crossed legs every night, poring over them because they held the answers to everything I wanted. I read them in the bath; I dropped them in the bath. I listened to hypnosis tracks that were supposed to tap into my neocortex and send me into a serenity so deep that I would not feel my daughter leave my body. I bought a diffuser so I could use holistic oils to transport me to the pain-free labors of my past lives (and this is only a mild exaggeration).
My hypnobirthing instructor was a magnificent force who believed in the power of mind over matter and had not used anesthesia at the dentist in five years. She explained that adrenaline would hinder my labor and that I needed to create feelings of joy throughout the experience to heighten levels of oxytocin, the body’s “happy hormone,” which would speed everything along. Then, she asked me what I loved more than anything in the world. Without even a passing glance at my husband, I said our dog. She advised me to plaster the inside of the car with pictures of the dog so our ride to the hospital could be stress-free. Pleasurable, even. Noted. I duly printed 20 photos of his stupid li’l face off later that day. Also printed: my birth plan, a neatly bulleted list of exactly how the experience would play out. Double-spaced, 12-point Lucida Serif on heavy cream vellum paper, like a wedding invitation.
I was doing what I thought I needed to do to bring a child into the world purely and unharmed. I had come to believe that my body was designed to give birth and that giving birth should be easy and, if I just studied hard enough, could be painless. Of course, once I started down that path, I began to read more about the natural birth movement, which claims that childbirth used to be safe and easy before the advent of modern medicine. The movement roots for a return to drug-free home birth. When I mentioned this to my husband, he said he thought he’d prefer if I had our baby in the hospital. To be honest, I thought he was a prick for not letting me give birth in our freshly carpeted bedroom, but telling him that didn’t really sit with the new earth mother persona I was curating, so I just smiled serenely and meditated for a while.
When my waters broke at 10 a.m. one Monday morning, I made myself a cup of tea, got into the bath, and read my book. Calm mothers have their babies quicker, I’d been told; so I waited, the embodiment of calm, thinking about how in eight hours—or, who knows, maybe six if I was really calm—I’d be holding my perfect baby in my arms.
Twenty-four hours later, I was in the car on the way to the hospital, listening to my hypnobirthing tracks. “Three, two, one,” said the clinically composed female voice through my headphones, “relax, relax, relax.” Just need to get in that birthing pool. Just really. Need to. Just want to feel that nice water. Make it better. Dog pictures not really working. Very cute, just not working. Weird. Maybe I printed the wrong ones? Not sure. Three, two, one, relax. Dog. Birth pool. Relax. Three. Dogpool.
My contractions were coming every four minutes, but when the midwife took a cursory look at me, she told me I was only one centimeter dilated. “We won’t admit you until you’re four centimeters,” she said. “Not enough beds.”
“But I have been in labor for 24 hours,” I said, picturing my cute little dog in my mind so that adrenaline didn’t kick in and ruin my perfect birth experience. “I think it’s time for the birth pool. I think if I could just get in the—”
“You need to go home,” she said.
Four hours later, I was in the car again. I was screaming in pain. I went back into the hospital and told them, in no uncertain terms, that I wanted an epidural. Now. They examined me again. Two centimeters dilated, they said. “As I mentioned, we don’t normally admit women until they’re four centimeters,” the midwife said conversationally, looking from my vagina to my vitals and back again, “which you’re not.”
“I don’t care,” I said. “I need some fucking pain relief.”
“You’re only two centimeters,” my husband said, with a lovely, smoothing voice like a butter knife. “Are you sure the pain is—”
“How shall I murder thee?” I wondered. “Let me count the ways.” Out loud, I told him, “Yes, it’s pretty bad. I wish I could somehow show you.”
“Actually,” the midwife said, slowly, looking again at the two heart rates on the screen in front of her. “Your baby is in distress.” We both looked at her. “You’ll need to be constantly monitored from here onward. You won’t be able to have your water birth after all. And we can give you an epidural if you like.”
Within half an hour, I’d signed a form that gave an anesthetist permission to lodge a huge, hollow needle into my back and that absolved me of the right to sue if he paralyzed me. Ten minutes later, I could feel nothing at all from the waist down. “I’m terribly sorry,” I said to the midwife, “I think I swore at you downstairs. That’s not really me. I do apologize.”
“Don’t worry,” she said. “I’ve had much worse.”
My husband stood at my bedside staring at me in uneasy wonder. “The epidural,” he announced, “is modern medicine at its finest.”
Though attempts to treat the pain of childbirth were made in many ancient cultures, a biblical misogyny infiltrated the medical care given to laboring women for centuries in Western society. Christians portrayed pain relief in childbirth as blasphemous, believing it contravened God’s punishment for Eve’s original sin: “I will make your pains in childbearing very severe; with painful labor you will give birth to children” (Genesis 3:16). According to Steve Ainsworth at Midwives magazine, incense and prayer (yeah, really) were an accepted analgesic, but “anything else might upset divine intent.”
It wasn’t until the mid-19th century that pain relief began to be widely normalized—by Queen Victoria, no less. Victoria enjoyed a famously rich sexual relationship with her husband, Prince Albert, and bore nine of their children. She hated being pregnant, however, and was “repulsed” by childbirth, developing a keen interest in technological advancements in pain relief as a result. In 1853, during the birth of her eighth child, Prince Leopold, she used chloroform’s anesthetic properties to reduce her labor pains. As the head of the Church of England, her decision directly contravened the accepted Christian narrative and was actually seen as the church’s direct acceptance of pain relief. Chloroform was subsequently known as “anaesthesia à la reine” and was used by doctors to lower pain in laboring women until after the Second World War.
At around the same time that Victoria was pregnant with Leopold, the epidural was close to being invented. Independently of one another, a French surgeon, Charles Gabriel Pravaz, and a Scottish doctor, Alexander Wood, both combined a hollow hypodermic needle and a syringe. Wood discovered it could be used to manage neuralgic pain. The epidural progressed in 1885 when neurologist James Leonard Corning injected a dose of cocaine into the sacrum of a healthy man. It went through several updates before reaching its current form of local anesthetic, continually administered by a catheter inserted into the “epidural” space just shy of the spine. It was first used in childbirth in 1909 and began to be regularly employed as pain relief in labor in the 1940s.
At that time, although many believed pain in childbirth was a necessary part of the experience, more progressive doctors saw that pain relief was vital in creating a safe and healthy birth culture. In 1949, in his presidential address to the Section of Obstetrics of the Royal Academy of Medicine in Ireland, leading obstetrician O’Donel Browne said:
Among gynecologists, Browne represented a growing movement that recognized the importance of reducing maternal pain regardless of cost. Nowadays, the U.K.’s National Health Service—set up one year before Browne’s address, in 1948—is globally renowned (and, shamefully, under threat). At present, NHS hospitals aim to provide epidurals free of charge to any woman who requests one. This means that British birthing women are among the luckiest in the world; in the United States in 2016, for example, the average cost of an epidural was $2,312. But British women’s choice to labor pain-free and for free has been threatened before. In 2006, the Education and Research Committee of the Royal College of Midwives recommended charging for the procedure, provoking Maureen Treadwell of the Birth Trauma Association to state:
Treadwell’s sentence bears striking resemblance to Browne’s from over 50 years prior. Treadwell went on to describe a woman who had been persuaded by a midwife not to have an epidural and was left with post-traumatic stress disorder as a result of the unrelieved pain. Indeed, recent research has shown that the administration of an epidural during childbirth can reduce the possibility of postnatal depression and other conditions that point to birth-related psychological damage, such as PTSD. This could be an important factor for expectant mothers with existing depression or anxiety to take into account—but unfortunately, it is still not widely shared.
More research found that among cisgender women who had been intending to deliver naturally but chose to receive pain relief during their labor, levels of postnatal depression were higher. Understandably, for women who have invested large amounts of time, energy, and money in the natural birth movement, a feeling of failure can follow the use of pain relief in childbirth. But scratch the surface of the natural birth movement, and you’ll find disturbing, decidedly anti-feminist roots.
Take Fernand Lamaze, arguably the most famous player in the natural childbirth game. He was the French obstetrician who developed the psychoprophylactic or Lamaze method of childbirth. You may have heard of it; with psychoprophylaxis, there’s a lot of talk about “empowerment” of birthing mothers and much focus on breathing and massage. Yet Lamaze himself was a misogynist who reportedly ranked the “performance” of the laboring cisgender women on his ward from “excellent” to “complete failure.” And he was not alone; other male obstetricians, such as Robert Bradley and Grantly Dick-Read (his real name, I shit you not), developed techniques for unmedicated births too. Both were the sons of farmers, and both based their methods on delivering calves. According to obstetrician Amy Tueter, Dick-Read’s method centered around the premise that “‘inferior’ people were having more children than their ‘betters,’ portending ‘race suicide’ of the white middle and upper classes.” Meanwhile, Bradley set up the American Academy of Husband-Coached Childbirth. (Oh yes, he literally registered a company with the sole aim of mansplaining giving birth.)
More progressive doctors claimed that these techniques “needlessly primativized” birth. I’d go further and argue that they entirely fictionalized new reasons for labor pains to better suit their agenda. Dick-Read’s technique, which predated Lamaze’s, was premised on the idea that contractions were a result of unnatural physical tension caused by fear. This is categorically untrue. Contractions are the result of the pituitary gland releasing oxytocin and causing the uterus to tense and relax, which pushes the baby down into the birth canal. Dick-Read, Lamaze, and Bradley must have known that: It was by then common knowledge, having been discovered by Sir Henry Dale in 1906. The uterus is, by weight compared with the force exerted, one of the strongest muscles in the human body, and it contracts to move a person through a hole the size of a satsuma. Needless to say, it’s not fear that hurts in this situation (but if you’re scared, I don’t blame you), and yet a multibillion-dollar industry has been born from that lie.
So how’s this for an idea: You don’t have to listen to a movement started by cisgender men in the 1940s that likens you to a laboring cow. As if to prove it, in 2004, the American Congress of Obstetricians and Gynecologists and the American Society of Anesthesiologists put out a joint statement to remind us that “there is no other circumstance where it is considered acceptable for an individual to experience untreated severe pain, amenable to safe intervention, while under a physician’s care.”
My pregnancy was as far from happy as I could imagine. I was diagnosed fairly early on with symphysis pubis dysfunction (SPD), a condition caused by the hormonal loosening of the pelvic ligaments that leaves the pelvis misaligned and causes constant physical pain so intense it can be difficult for some sufferers to walk. The only thing that relieves SPD is delivering your baby, and because I was preparing to use hypnobirthing, I was excited to do it.
In the time leading up to my daughter’s birth, I was calm, and when I reflected on it later, I was glad I’d used hypnobirthing to those ends; but that’s because, in spite of the unwitting danger I put myself and my child in, we escaped harm. We are lucky. Many people have lost babies through the dogmatic approach to natural birth that certain hospitals adopt.
The thing is, hypnobirthing is grounded in the teachings of Dick-Read, Lamaze, and Bradley—the same old misogynistic doctrine that cisgender women are animals and pain is empowering and totally manageable. It is repackaged for the modern, middle-class mother, sure; the book I bought, with its cover image of a beautiful, serenely pregnant woman lying on a huge taupe cushion looked more like the front of an Ibiza lounge compilation CD. It’s assumed that you have enough free time to lie in bed meditating to 12 six-minute hypnosis tracks a day. These are mostly compiled of a woman, who I always imagined to be the pregnant Ibiza lounge woman, slowly repeating the words, “three, two, one, relax, relax, relax.” And I mean, why wouldn’t you be calm after listening to that?
I wasn’t frightened about giving birth because I never imagined the type of birth I was actually going to have. In fact, I didn’t know that type of birth existed. I readily believed everything I read about my body being expressly designed to cough out a child. Because of that, and because I thought that my body’s production of oxytocin would be halted if my natural laboring rhythm was interrupted, I wrote into my birth plan that I didn’t want to be touched during labor, and—as is common in hypnobirthing—I included internal examinations in this.
Unfortunately, like many women, I only discovered in the middle of my labor that, in reality, the natural birth movement doesn’t take any of the problems that I encountered into account. It doesn’t acknowledge the four different shapes of pelvis that women can be born with, only one of which is deemed medically “ideal” for labor. It misses out on the babies who are positioned back to back, breech, transverse, or in a “brow” presentation—coming out face first, like a little sloth—like mine was. In cases of breech and transverse babies, vaginal delivery can be very dangerous or impossible; in back to back and brow deliveries, labor is often dramatically prolonged and intensely painful. That was what happened to me—known as “obstructed labor,” it is the cause of six percent of maternal mortalities worldwide, and no amount of oxytocin was going to help me with that.
If I’d contravened my hypnobirthing rulebook and allowed an earlier internal exam, my daughter’s position might have been picked up on. By the time I consented and the midwives realized she was brow, she was too far down the birth canal to be delivered by cesarean. I was given an episiotomy, and she was pulled out by ventouse, at which point the doctors realized that her dropping heart rate had been caused by the umbilical cord which was wrapped around her neck and constricting her every time my body contracted.
In a perfect situation, natural childbirth relies on a tightrope walk between oxytocin, the aforementioned “happy” or “love” hormone, and adrenaline, which produces a fight-or-flight response in humans. Telling a woman to refuse medical exams, keep calm, and look at pictures of puppies to release a flow of oxytocin will only work to speed up her birth if she and her baby are perfectly positioned for it. In fact, my belief that I could give birth completely naturally hindered my labor. I should have been examined long before I was because my waters were leaking out of me due to a slow puncture. By the time I eventually delivered, 50 hours after labor began, we both presented with chorioamnionitis, an infection that affects mothers and babies who have been left too long with broken waters. My daughter was born exhausted and in shock, didn’t cry, and was immediately taken to intensive care.
It doesn’t fit with the hypnobirthing mission statement to condone deviation from the birth plan, so stories like mine do not make it into hypnobirthing books. Furthermore, hypnobirthing actively discourages women from seeking alternative narratives. One of the first things I noticed when I began to be visibly pregnant was the startling regularity with which other women would go out of their way to tell me stories about their birth. Some of them were horrific while others dismissed my ideas about how I wanted to give birth.
I’m going to hazard a guess that if you’ve made it this far, you’re not averse to a miserable birth story (at least, that makes me feel a little less guilty for sharing mine), but women who begin a hypnobirthing “journey” are advised to ask other women not to mention any negative birth experiences. What’s more, if you do an online search for phrases like “hypnobirthing back to back birth” or “hypnobirthing brow presentation,” there are few results from the hypnobirthing camp that discuss hypnobirthing in these circumstances. Yet these things—brow and back to back presentation, breech, and transverse babies—are real risks that accompany every single pregnancy. It is, at the very least, disingenuous of the proponents of a widely used method to erase the existence of these babies from view, and at most, very, very dangerous.
The fact is that every birth is different—but don’t rule out pain relief on account of a movement that claims a slick of coconut oil can stop a human head from tearing the perineum. The acceptance of pain relief to avoid post-traumatic stress disorder is not “failure,” and anyone making money out of telling you so does not have the best interests of you, or your baby, at heart. Whether it comes from midwives, the Old Testament, or hypnobirthing instructors: The vilification of the epidural is nothing but misogyny under another name.
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