Research on The Modern State of The Childbirth

Implications of Childbirth

You are wheeled through automatic doors into bright fluorescent lighting. An empty hallway stretches in front of you, save for a few scowling nurses. In no time, your heels are up in stirrups in a room full of strangers and you are constantly being examined without any explanation. Everyone seems to know what they are doing, but there is a roughness to their expertise. Because you are uninformed about what is going on, decisions that affect your body are being made by these people. When you entered the hospital to give birth, a sense of control leaves.

This loss of control in this case has lasting effects on mothers, especially when things suddenly take a turn for the worse. Technology has led to the modernization of childbirth in developed countries, sending women mixed messages about their bodies in the typical hospital setting. Giving birth is no longer the social event that still persists in other cultures, but rather often takes place in a sterile, unfamiliar environment. This experience (being surrounded by strangers, restrained, invasive procedures, no control over choices made about her body) have been compared to rape. We are left to wonder if postpartum depression is actually misdiagnosed PTSD. This will be compared to descriptions of childbirth in more traditional cultures. Also addressed here are concerns regarding women’s sense of control, population, patriarchal relics and influences that affect the choice to have children.

Analysis of Traditional Cultures

For a basis of comparison, let’s look at how other cultures regard childbirth, past and present. Once in labor, food, alcoholic beverages, potions and herbal teas to ease pain were brought to a woman in Medieval Europe by her “godsibs”, friends who would care for her after the husbands were essentially kicked out (“godsib” would eventually morph into “gossip”). Much of food and drink would also be used for the postnatal celebrations (Kitzinger 2012). Midwifery would consist of a social group of women, not dependant on the expertise of an individual, “She was never at a loss of a shoulder to grip, a chest to lean against, or a strong hand to steady an ankle or knee. If one woman tires or had to return to her children, another would quickly take her place...ready to support her in any way she wished. Sometimes she knelt or lay on her side and at other times stood with her arms around a friend’s neck” (Kitzinger 2012, p. 302). Social anthropologists are regularly shocked at how many women are involved, cramming into the hut, crowding the room with loud laughter and chatter. Social births, compared to what we will later call medical births, have an important function in maintaining and reinforcing the community relationships, primarily among the women (Kitzinger 2012). These relations are not only strengthened by the birthing event itself, but also deliberately facilitated by the main midwife. Social conflict is believed to disrupt the laboring process, and actions will be taken to ease social conditions and stresses on the mother, creating an environment of positivity and empowerment of the new mother (Kitzinger 2012).

Japanese, Indian, Native American cultures and countries like Uganda, New Guinea and those in West Africa all continue to emphasize the importance of touch, massage and movement during delivery (Kitzinger 2012). Technocratic cultures like the US, where the woman lays on her back, is the exception to the generally accepted “birth is movement” idea. Swinging from ropes, suspended by other women who join in this dance, the birthing process follows the rhythm of the uterus during contractions.

This is very different than the typical birth in a developed country, where it is considered a medical event exclusively and regarded in terms of risk. This has left women feeling like they have missed out, “Evidence is mounting that distress after childbirth—often attributed to postnatal depression, an illness issuing from within the woman—is not depression, but posttraumatic stress disorder following an experience in which she has been disempowered by a medical model of childbirth that entails obstetric management, physical immobilization, lack of emotional support, frequent interventions, rigid timing, and an operative delivery. The result is that birth is for many women an experience comparable to rape. They feel helpless, mutilated, isolated, and often in an emotional double bind because they have been violated by the very people who have “given” them the baby (Kitzinger 2012, p. 304). Kitzinger is calling for awareness of the political agenda and profiteering methods of medical births in benefitting pharmaceutical and medical equipment companies.

Attributes of Control

The broader, physiological effects on mothers reflects the message sent to many women, that their bodies “are not capable of giving birth without medical intervention” (Meyer 2013, p. 221). Four attributes were identified in an attempt to quantify the degree of control experienced by women during delivery. Decision making, access to information, personal security and physical functioning. Decision making was the most prevalent in women’s relationship to the concept of control during birth, including choice to use or refrain from pain relief, location of the delivery, and creating birth plans by thinking of scenarios ahead of time. Choosing a home birth was directly related to a woman’s desire to be the primary decision maker during the process. This choice gave them the freedom of movement, a consideration of one woman who had a hospital birth during the study, “I knew I would be stuck on the bed and I would be strapped to a monitor and I wouldn’t be able to move around” (Meyer 2013, p. 222). Being at home allowed the women to do or say what they pleased, as well as have control over who entered the space (rather than remain in a room full of strangers or interns).

Being well-informed was another core aspect to feeling in control during the process. Women expected to be told how a routine labor and birth progresses by a staff member. Having questions answered thoroughly and discussing potential interventions in the case of a medical event could prevent a traumatic birth experience (Meyer 2013). Personal security is directly related to the woman’s relationship with the people around her. In the case of a hospital birth, personal security is forged when relationships with the staff are created and maintained before birth and during the pregnancy. It is about how well supported and respected the mother feels in that environment. A relationship with staff prior to the birth was most important during cesarean sections, allowing the women to feel comfortable and assured that someone she trusts is making the right choices for her body during the need for medical attention. On the other hand, during home births, midwives often place trust in the mothers themselves, giving them the confidence they need to know that they have control over their body (Meyer 2013). Physical functioning is the last core component of control during delivery. Much attention is rightly given toward pain relief regarding heat packs, moving around and mental state going into the delivery room (higher expectations of control actually led to increased experienced control). As for epidurals, some women felt more in control with the opioid pain relief, letting them focus on something other than the pain. Other women felt that without an epidural, they would feel less in control if they were otherwise cursing or yelling/screaming (Meyer 2013). Meyer (2013) concludes that the woman’s control is the determinant factor in whether the birth was a positive experience or a negative one. The sense of satisfaction or fulfillment following a successful birth in the eyes of the mother improves self confidence, and their experience outcome also affects women’s future decisions on childbearing.

Broader Implications - Population

The choice to continue having more children or to have any at all is one that governments have taken for granted in the past. Up until recently, it was rightly assumed that the number of children being born would cause population growth. However, some modern society climates have created circumstances where the fertility rates are falling below replacement levels (Longman 2006). Isolated areas are experiencing dropping population rates (for individual countries like Russia, Canada, Singapore, South Korea and others); still true even that now infant mortality rates have also decreased (Longman 2006).

Countries have taken an active role in encouraging women to revert back to being baby machines. Family tax incentives in France, endorsed speed dating in Singapore for busy professionals and day care compensation in Sweden are all attempts to encourage procreation in order to prevent further aging of the population (Longman 2006). Longman (2006) attributes this chronic emphasis on larger population to the historical importance of numbers during the imperialist age. Generally whoever have the most troops won, and this study even suggests that Britain’s decline as a world power was related to its decreasing fertility rate. These rates (the number of women who have children) also decrease due to increasing taxes on the dwindling population (Longman 2006), creating a spiral of reluctance to conceive. One larger consequence is that single-child families, with a more libertarian, and usually more educated, mindset, are dwindling fast. It’s a simple fact that having only one child doesn’t contribute much to the future population. What happens is that more traditional, and religious families continue to have higher numbers of children, adhering to a more patriarchal fundamentalism while smaller families are more individualistic (Longman 2006). Longman outlines the potential shift in population values based on the potential of smaller, libertarian families to diminish greatly while larger, more nationalistic and religious families essentially take over (2006). These societal shifts tend to propagate typical patriarchal characteristics (Idiocracy is a comedy movie that exaggerates this same concept).

These characteristics evolved after the agriculture revolution and with it, surplus food to sustain families and growth (before this, limitation of the population was more pressing to prevent starvation). In these societies, we see marginalization of “bastards” or “illegitimate children” because they don’t carry on the legacy of their fathers. “Legitimate” children will take the last name of their father, with the notion that they belong to the father’s family, not the mothers. Essentially, this gives men powerful, emotional motivations to take responsibility for their children who become successful and also results in multiple attempts to have a son in particular (Longman 2006). This is what we see even today; one stipulation of the one-child policy in China is that rural families could have a second child if their first was a female (to try and get a son). In addition, women who remain childless in Western society are often questioned harshly or hypocritically considered selfish (Longman 2006). Leaving women with few other desirable choices other than to be a mother, more children are born into a prophecy of diminished individualism, and we see these values increasing, not decreasing in our society, despite the post-industrial decline in overall birth rates.

Factors of Fertility

What drives these birth rates around the world is diverse and complicated. We already know that economic growth, or lack thereof, has significant effects on fertility rates. Higher literacy rates among women worldwide correlate with them having fewer children (Robbins et al. 2014). Access to condoms, reproductive healthcare on demand, social/political autonomy all affect women’s ability to make individual choices for herself. The choices a woman makes within the domestic sphere can range from almost complete autonomy to none at all. The degree of separation between the public sphere of men and the private realm of women has much influence on how many children she will have. An influential woman with a demanding career within a city will usually bear less children than a stay at home mom in a suburb. Suburbs are an example of this division between worlds; woman are kept on the outskirts of cities to take care of the household full of kids while men commute to work, which we discussed in class. While naming this the entrapment of women might be an exaggeration, this is how architecture has reflected patriarchal values during the good-housewives era. We see extrinsic forces keeping females in domestic roles in the natural world as well. Roughgarden discusses mate guarding, a behavior where the male actively keep females in their shelters and prevent them from leaving (2004). In the case of ground squirrels, the male blocks the exit of the den hole after mating to prevent the female from leaving and males from entering to ensure the offspring remain his own (Roughgarden 2004). She also explains guarding in terms of mammals versus avian species. Internal gestation of mammals makes the female in control of the embryo; in order to have control over the offspring, the male must also have control of the female. For birds, eggs can be directly controlled, and flight gives female birds autonomy over their own behavior (Roughgarden 2004). In humans, the solution of many of the world issues can be found entangle with women’s rights and autonomy around the globe.

Power Within Sex and Gender Roles

We discussed previously how a cross-cultural analysis reveals an increasing disempowerment of women in western society with the standardization and medicalization of giving birth. Compared to more traditional societies, women are facing a lack of control and experiencing power over their body being handed over to a stranger in an hospital. Power dynamics between men and women are so integral to our everyday life that its’ normalization makes it almost invisible. Women face the emphasis to stay at home everywhere in their life; husbands, workplace and most of all, other women. While patriarchal values are the basis for the subordination of women worldwide and husbands provide the typical pressure to stay at home, it is otherwise other women in the family or friends, that, through ridiculing and gossiping, shame women who do not make having children and taking care of them their first priority.

Personal Reflections

The expectation of women to give up their lives to become reproducing machines is so ingrained in our history that the world is blind to how obsolete it has become. Today, the pressure to have many children is a relic of the past and the direct evidence of organized religion with a misogynistic agenda. In the USA, we longer need more children to increase the population, to fight child mortality or to have more labor on the farm due to urbanization. To really even think about calling a woman selfish for not having a child is a hypocritical embarrassment. Let’s dissect this a bit. When people talk about having kids, they talk about “having a baby.” Many people just want the experience of having a baby for their own personal growth and out of boredom with their lives, usually completely disregarding the fact that in order to remedy this boredom, they are bringing a human life into existence. They forget that that these babies grow into, yup, actual people. People that have to deal with overpopulation, poverty and dwindling resources. I’m pretty sure that is the definition of selfish.

And yet even still, we harass childless women. More so, we extensively question and condemn women who want to be sterilized. Why aren’t those who wish to raise a family, a huge responsibility, going through the same countless appointments, interviews, condemning doctors, and bewilderment that women who just want to carry on as they are go through before and after sterilization? We treat the choice to not have children and living our own lives as a bigger responsibility than we treat the choice to bring human life in existence to care for. This is simply not true. To think that a being mother is the only and greatest job a women can achieve is an insult to every female capable of conceiving as well as every female not capable of conceiving.

As a child, uneducated yet, I assumed I would be a mother eventually, and a young me settled with the number of three children. And with feminine magic I would produce two sons and a daughter at will. Clearly this was a personal bias, as it was the same structure of my actual family; it seemed to work out just fine. Boys would be fun to raise, surely I’d need two to occupy each other, and a daughter would be more relatable. I thought that being a mom would be the epitome of my life, and would take all my other desires to learn, travel and experience bigger parts of life away.

Obviously, I’ve learn more about the reality of having kids. Beginning just a few years ago, my ideals have changed dramatically and they continue to change today. I’ve seen my young mom, a mother at 19 years old, worn down and inflicted with depression and unsatisfied. My education in humanities and sciences has opened my eyes and mind to the consequences of harsh expectations placed on young women, to the issues of overpopulation, and the real sacrifices that millions of mothers silently relinquish for love of their children. Do I really want a child? Or do I just want the experience of raising one? Am I willing to devote my body to a demanding fetus, ending with tearing pain? Will I be happy having living a life that is no longer my own, but for someone else? These are questions that have been brought to my attention before, but have reflected on more seriously during my research. They are not questions I want to share with family or partners. But this unwillingness to talk about these realities potential mothers face is the exact reason why they end up having kids and hiding an unhappiness; the option to have children may be made to please someone other than the woman carrying the baby.

And some women are content being mothers. I just want to advocate for those women who want to put some thought behind their choice before jumping in. I know more than I did as a child, that pregnancy continues long after the beautiful, glowing phase some are blessed with. And I still have much to learn, relearn and unlearn. If I were a male, I would be oblivious to these uncomfortable questions faced during this decision making unless otherwise stated explicitly. The reason they were brought to my attention is due to the pressures placed on me as a female in the first place. I can’t speak for all men or all women obviously, but I do understand that it is difficult for some people, of both genders, to comprehend why a women may need any convincing to have children. To the more arrogant types, the possibility of a women not needing a man for conceiving purposes is a hit to the ego, and is often why independent woman and lesibans often are faced with the brunt of harassment from males. We do not exist for the purposes of others. Even lesibans are erotizied in porn for males to still find some enjoyment from, and when couples do not fit the standards of media and porn, they are ridiculed because women who are of no use to men are seen as worthless.

So now it’s just me left to wonder about my predicament. Am I so critical of having children for some social justice effort? Or do I actually not see myself as a mother? I used to justify my critical feelings with overpopulation, to not burden the world with more humans. But, even if I could somehow manage having negative children, there will always be families having enough kids to substitute for dozens of me. Still, I don’t want to bring a child onto a dying Earth, into a nation increasingly full of ignorance and hate. And part of me resents becoming the suburban soccer mom whose social circle is more like a 24/7 passive-aggressive flock of she-hens.

But the part of me that doesn’t want to be the cookie-cutter mom is battling against the side of me that does want to raise an intelligent, kind child. Surely this side is more biological, I’m not immune to the pangs that adorable children and infants constantly inflict on us. All of this concern and fretting is because I want to do it right and with the right intentions. And the part of me that dreads having more than one child is also battling against the side that fears the mentality of some only-childs. I know that having siblings was a huge part in developing a sense of humility and understanding that the world doesn’t revolve for me, and unfortunately my experience with only-childs my own age has been the opposite. But I understand this is a product of parenting, a variable I wish to be aware of in the future. My mini-crisis as a 20-something will be choosing to pursue the fulfilling role as a mother to child I want to make aware of the world, or to pursue an equally fulfilling life learning about that same world and experiencing it first-hand while maintaining current relationships.

Goals of a More Complete Understanding

It is a peculiar phenomenon, the taboo surrounding childbirth in developed countries. For reasons made obvious in the countries most arrogant citizens, we tend to forget that coming out of a vagina is the reason we are here to begin with. So, does this explain why we shy away from the topic? Some might say addressing it would be addressing our own mortality. Or, is it the socially sexualized female anatomy that makes public schools and concerned parents cringe? What if this feat of human strength and survival, of bearing life itself, is too much credit to hand to women by a patriarchal society? The historical dampening of female power may have basis in the fear instilled in man’s ego by these unparalleled bodily feats and their threat to overcome male dominance if recognized fully. In allow for positive change, we need to permit mothers to feel comfortable being more willing to discuss what they face. And that means other women need to stop shaming other mothers for vocalizing their own fears and it also means no civilized man should expect a women to stick around solely for the purpose of producing and caring for his children. If choosing to be sterilized requires paperwork and a process, then becoming a mother should include a process and paperwork that will harvest the respect that it deserves. We need to further research the effects having children has on a relationship or marriage instead of ignoring the fact that 50% of marriages end in divorce. The role of fathers has only been seriously studied since 2000, and if we are going to make both parties responsible, we need to better understand the changes that take place during the transition into fatherhood. Lastly, we need access to affordable midwifery care to allow women more choice in the style of their birth, and comparing the experiences to hospital births will give women information on what they need to know before decisions are made for them.