2004-05-01 - 11:32 p.m.
Tonight's second entry. Wench has referred again to my Eskimo entry and I realized that I never responded to her objections. And I still don't have time, even now, but I will say just a little something here.
I never ever said that women didn't have pain during childbirth. I did say that a woman could "relax" during a water birth, but the whole concept behind Dr. LeBoyer's book, Birth Without Violence, was to spare the baby the violence of birth, not the mother.
Of course, more primitive people seem to have suffered less pain; the literature is filled with stories of migrating tribes and the women squatting down, giving birth, and then continuing along the journey. And yes, many did die during childbirth for various reasons, as do some animals. This does not mean, though, that it makes sense for something as natural as giving birth having, now, as a norm, to be treated like a terrible disease requiring hospitalization. Something is just very wrong if that is the case. Judging by the Australian aborigines, people have been on this earth for at least 40,000 years and, of course, they have been around for a lot longer than that. Hospitalization for giving birth has been around for only a couple of a hundred years, yet somehow our species survived without it.
Of all the concepts I have ever expressed in my life, the one concept that consistently receives the most female wrath is the one I learned from Michael Crichton in his collection of autobiographical essays, Travels, in which in one chapter he talked about the painkillers given to women in labor in hospitals not actually stopping the pain, but making them forget the intensity of it. I wonder if he, who wrote the thing, ever generated as much controversy as I have for repeating it?
I like Michael Crichton a lot and relate to the kind of person he is. Crichton is a brilliant, observant, and adventurous man who first assumed he wanted to be a doctor and went through Harvard Medical School (that ought to tell you something about his brain power right there). However, he got disillusioned about medicine (and the people who practiced it), with very good reason--medicine is not the Olympus that most people seem to want to make it out to be, and its practitioners are anything but gods. Somewhere during his internship or residency, Crichton wrote a medical thriller, The Terminal Man, which was a success, and he realized that he could achieve a lot in this different career. He became a very successful writer and film director, which is as he is now best known.
While working his obstetrics rotation during his residency at Boston General Hospital, Crichton observed an interesting and surprising phenomenon: women who were undergoing the pain of labor, and were given the pain killers that they begged for, continued to scream and yell and swear like sailors throughout the whole ordeal, despite the pain killers, whereas women who were given no pain killers at all seemed to have an easier time with the labor. The pain killers didn't seem to help, at least not fully, and not having them at all seemed, in the long run, to give the mothers a better experience.
During the writing of this, I interrupted myself to do some research on the pain killers given to women in labor, to see what they do and how they work. It is clear that there is no perfect solution. Some medications only lessen the anxiety of the pain but do not lessen the actual pain...these are usually given during the first stage of labor. Another type of medication lessens some of the pain, but the mother still feels the pain of the uterine contractions. This type of medication is given during the second stage of labor. A third type of medication, the epidural injection in the spine, numbs the entire lower half of the body, but it lasts for only a short time and then it dissipates. A variation of the epidural injection (the "walking" epidural) doesn't block as many of the nerves and lasts longer, but works only spottily. And, finally, there is the whole anesthesia "putting to sleep", which would be done for emergencies or caesarian births.
All of the medications pose risks for both the mother and for the baby, and have a negative effect on the effectiveness of the labor, which is often the case with medicines--while they offer pain relief, they also slow down or interrupt the process that is causing pain and that is undesirable, may lengthen the process, or make it more dangerous. So some kind of balance has to be struck.
Crichton observed that the women who were not given pain medications were either those who subscribed to the principles of natural birth, or else were unwed mothers who, Crichton felt, were being "punished for their sin" by the hospital and were denied the pain medications. It was as if it was the hospital's attitude that unwed mothers needed to truly "feel" the consequences of what they had done. And yet Crichton observed that those "punished" mothers seemed to fall into the breathing and timed relaxing/pushing processes that mothers trained in natural childbirth techniques followed, and both of those types of mothers soon fell into a quiet, rhythmic pattern that worked with nature instead of against it and had what could be described as "blissful" experiences with childbirth.
Almost every time I have mentioned these observations of Crichton, I have had women screaming and yelling at me that as a man I had no right to interfere with a woman's birthing process and if I thought that giving birth was painless, then I should experience expelling a bowling ball through my ass, or some other equally colorful experience. And yet then, as now, I have never said that childbirth was painless or that women ought to suffer. I have only repeated the observations of Michael Crichton that women who did not have pain medication and who followed the principles of natural childbirth had an easier time of it. That is all. If I were a woman, I would look into that and think about it, but it is still their choice to follow whatever path they want to take and I am not arguing against whatever choice they make.
I do know a woman who actually did have a completely painless childbirth. (We three were part of a group of ten partying rowdies when we were students at Berkeley. Then the three of us went to law school, differents ones, and after a while, she and I took a good look at law, similar to Crichton's look at medicine, and said "Unh, unh.") She was a marathon runner, and each year was a winner in her running class. The New York Times even wrote an article about her, calling her "The Pregnant Marathoner," because her doctor gave her permission to keep running all the way until the last month of her pregnancy. She joked for the Times that if she and her husband took a taxi to the hospital and they got stuck in typical Manhattan traffic, she would simply get out of the taxi and run the rest of the way to the hospital!
She and her husband took the LaMaze course in natural childbirth, and did make it to the hospital without her having to run there. While in the hospital, she was just sitting there calmly in the waiting room (reading Running World, no doubt), while her husband kept track of her progress. Ultimately, he noticed that she had dilated the number of centimeters that they had learned from the course meant that the baby was on its way out. He flagged down a nurse, explaining that his wife was this very minute giving birth. The nurse simply said, "Calm down, calm down, nothing is happening, she hasn't even begun screaming yet." The upshot of this was that the husband delivered the baby in the waiting room while the pregnant marathoner calmly watched in amazement. Whether this was so rare as to be one for the Guiness Book of Records or actually more normal than most people think, I still think that for every reason it is worth it for a woman to at least look into alternative birthing techniques and get herself out of the automatic "hospital," "screaming labor," "lots of pain medication" mindset. Maybe an all-out "midwife, birth at home" may not be a good idea for a modern woman who is not perfectly healthy, but I'd still check it out. Forty thousand years of human history can't be completely wrong.
�
 |
 |
�
