Objects of Our Affection

Walking Wombs and The Medical Mediation of Childbirth

Art by Erika Altosaar

We’ve all heard the story. Woman gets pregnant and becomes an irrational, moody animal capable of biting the head off of her own husband. Husband runs around to satisfy her whimsical wishes and cravings, as she puts on weight and takes interest in interior design. One day her water breaks and the couple rushes to the hospital, trying not to forget the quirky exercises their hippie parenting instructor has taught them. At the hospital, husband loses it, wishes his college days had never ended. Woman screams, maybe even crushes her husband’s hand. Woman asks for drugs. Nurse gives her drugs. Baby is born.

This narrative has carved its place in Western society’s culture. It’s accepted as the normal succession of events that culminate in human birth. We banalize women’s pregnancy experience; we dismiss their feelings as hormone-level fluctuation and treat them like children—scared children.

Considering that pregnant women go through a lot from the moment they find out they’re expecting until, well, the rest of their existences as mothers, it’s only reasonable that those around them try to give them some sort of comfort.

But being ushered around in a wheelchair, being fed large portions of fatty, industrialized food and being felt sorry for doesn’t help.

Wherever this comfort might come from—partners, family, or caregivers—and despite the good intentions, these actions are often rooted in a male perception of the world, in which bearing a child is not a normal part of life.

Little do they know that they are only contributing to a matter much bigger and worse than one woman’s pain—the oppression of women by shrinking their womanhood down to the size of their uterus.

A Cure for Pain

For one of Quebec’s pioneers in midwifery, Jeen Kirwen, childbirth is still feared in our society; it is considered dangerous and a risk.

“It’s not like when women get pregnant they think, ‘Oh good, I’m going to have a natural birth, I’m going to breastfeed, and everything will be fine,’” she said.

“It’s more like, ‘Oh my god, hope everything goes well, I hope my baby is fine and that the birth isn’t horrible. Most of the thoughts right away are very negative.”

What most expectant mothers aren’t told is that fear itself can be a factor in how enjoyable their experience is, and can even alter their pain levels.

“Some people don’t have pain, some people do, and it depends on your endorphins and your ability to just let go,” said Kirwen.

“Women who end up being delighted with their birth are those who can tell themselves to let go, and accept the fact that their body knows what to do. These women have way less pain during childbirth, because they’re not resisting something horrible. They’re going with something wonderful.”

But wonderful things are not necessarily painless. Pain can also release hormones into the woman’s bloodstream that will bring her to a higher level of awareness.

These hormones, namely oxytocin, prolactin and endorphin, travel from mother to baby, engaging them in a crucial period of hormone-induced love and bonding.

This period is crucial because babies are altricial beings—they depend on adults for nourishment, growth and care.

“That moment, mother and baby meet each other on the same state. This is where commitment for life is born with parents,” said Kirwen.

This doesn’t happen, however, when women are sedated or have a caesarian birth. “The woman is no longer in touch with her pain—you need the contractions to bring the oxytocin to your body,” explained Kirwen.

Stéphanie St-Amant, a semiotics doctoral candidate at Université du Québec à Montréal who’s writing her thesis on the process of childbirth, said most women are not aware of the effects of drugs administered to them.

Artificial oxytocin and epidurals are readily available for women who request them, but unfortunately, most women are not aware that the oxytocin being administered to them is not exactly the same as what they produce naturally, and a much larger dose is required to mimic the natural production.

The effect of an epidural is even worse for the mother. Although it numbs the pain, it also slows the natural process and often even stops contractions. At this point, even more oxytocin is administered to induce contractions, creating a vicious cycle of drug intervention, and the narcotics numb both the mother and the baby.

“Women who have epidural might just want to go to sleep. They’re not in an exalted state,” said Kirwen.

This practice can actually bring complications to the birth process as the babies are numb too and might descend incorrectly, risking getting stuck in the pelvis and requiring the use of a forceps.

Not explaining the implications of their choices to women is evidence of a practice that looks at women as big, pink, tender wombs, and not much else.

A Womb of One’s Own

Hélène Vadebonceur is another pioneer in Quebec midwifery, as well as a research and midwifery professor at Université du Québec à Trois-Rivières and at Université de Montréal. She said that during childbirth, women are treated as if they were “only a uterus.” The baby is seen as a product, and nothing else is important.

“Sometimes people come into the room and they don’t even introduce themselves, and instead of talking to the woman they talk about her, in front of her, as if she were not there,” said Vadeboncoeur. “Some women feel like an object, not a human being.”

The impact of this objectification is so deep that some women are traumatized by their birthing or caesarian experience—so much so, that as of the mid-‘90s childbirth was included on the list of experiences that can cause post-traumatic stress disorder.

Doctors and nurses should not to be demonized, though. Most of the time, they’re just doing their job. They also don’t want to see mother or baby suffer, and they want to make sure that no one is in danger. It’s their training.

It’s also women themselves who want to pass off the responsibilities to people who are authorities on the subject. “Most people in our society, when they get pregnant they want to be taken in hand,” said Kirwen. “They want to be told, ‘You do this, you do that, and you’ll be fine.’ They don’t want to learn how to deal with their pregnancy and they don’t want to have to worry about pain.”

The business side of the medical practice could be a major driving force behind retaining this authority. The revenue generated through childbirths is steep, and pharmaceutical companies come out on top.

“If women give birth without any help, no one is making any money. They love to say that women need them, and their surgical process, and it works,” St-Amant noted.

“Some women feel like an object, not a human being.”—Hélène Vadebonceur

Where We Came From

Childbirth was not always done in a hospital setting, or even by doctors. Prior to the seventeenth century, childbirth was a social event left in the hands of women, with the mother surrounded by lay midwives and family.

Through the 17th and 18th centuries, however, midwives were gradually cut out with the growth of the medical profession—another patriarchal institution that maintained power and status over women.

Through force and persuasion of the church and governments, women and families were told that other women were incapable of providing sufficient service to a mother in labour, and that the process must be directed by a doctor.

As a result, the process of giving birth is no longer directly in the woman’s hands, but has been standardized through medicine by men and the medical institution.

This lack of control and power over one’s own biology is a frequent theme in women’s struggle to equality and rights.

Rivka Cymbalist, doula and director of Montreal Birth Companions, pointed out that no one, doctor nor mother, truly has control over a birth, as it is such a spontaneous and fluctuating process.

However, more often than not the presence of doctors and nurses, paired with the foreign hospital environment, leads to the woman accepting choices she usually would not. Sometimes, they are not even offered the choice.

“If you go into the hospital wanting to have a natural birth and then they insist that you lie down and get on the monitor, then certainly there is way more risk that you’re going to have to request or accept other interventions. That’s the problem with a hospital birth—that snowballing effect of interventions,” said Cymbalist.

The struggle between a mother’s intuition and the medical machinery and apparatus is a central issue. In the fight to make birth a timed, decent and controlled practice, it seems that a woman’s urges and intuition have fallen to the wayside.

Often, women feeling contractions and urges to push will be told not to push, as nurses and doctors refer to machines and drug doses to determine the best timing.

The thought of giving birth entirely on their own is likely terrifying for most women; but as mammals it is a capability that women possess. Once in a hospital, however, that capability is ignored in favour of the male-dominated sphere of science and practice.

“Normal contractions are not viewed as effective by the everyday nurse,” commented St-Amant.

This often results in pushing at the wrong time for women, and drawing out the birth as a much longer and sometimes more painful process.

Even the common position that a woman is placed into is not the most effective. By lying a woman on her back, with legs in stirrups, the doctor is just making it easy for himself. Women prefer a variety of positions, but squatting or kneeling on hands and knees is generally the most effective for a woman.

By laying a woman on her back, “you are compressing the main oxygen provision for the fetus. It is anatomically absurd,” said St-Amant.

The difference between those who gave birth naturally and those who gave birth through a medical process is remarkable.

“Women are describing their birth experience like ‘powerful’ and ‘empowering’. They feel pain, but after that they take a lot of power in their life. They feel strong, beautiful, and competent,” said St-Amant. “Why are women deprived of that experience?”

Breaking Away From the Pack

A woman’s biological capabilities and reproductive capacities have a history of being controlled. Reproduction becomes male-dominated as patriarchal institutions set standards for women’s reproductive activities.

In Quebec, even in the 1950s and 1960s, women were bombarded with pressure to reproduce constantly. A woman was told that her place was in the home, and her occupation was producing children. If she wasn’t at home taking care of kids or pregnant, there was a level of guilt instilled.

“Quebecers have been used to this sort of authority over families, so women aren’t used to making their own decisions, and only now we’re seeing a turning point,” said Kiwen.

Education is that starting point to understanding and collaborating. Women and mothers need to be provided with further education and accessible information concerning childbirth and their options for giving birth.

Women can only exercise their right to choose alternative birth plans if dialogues and communication are opened up between practices such as midwives and the public. If the Ministry of Health devises a budget for communication, these avenues to talk about alternative practices will appear.

There is a new generation of mothers as well, a generation defined by their inward focus and critical analysis of the services and products available.

If the new mothers begin questioning the standardized hospital practice of childbirth and are simultaneously given access to information and communication paths to discover alternative birthing methods, the rigid system just might start to adjust.

These women will begin the demand more from their government and health services upon realizing that the birth process is not entirely pain and loss of control, as we have been led to believe.

Whether a woman decides she prefers hospitalized birth, or decides to do a completely natural home birth, the paradigm needs to be shifted a bit. Before the demands for alternatives and information begin, the fear that’s already been instilled in so many women must also be cracked.

“In a sense, I don’t want to blame just the hospital, [and] ‘the bad old doctors.’ Women are afraid, and they go in [to the hospital] and they don’t like pain because we as a culture don’t like pain,” explained Cymbalist.

The communication necessary to witness change must involve a new framework for how we communicate childbirth and how we see representations of it.

The screaming, crying, sweaty mother we see in movies will not make women eager to try more natural processes—it will make them want drugs as soon as possible.

Women need to be aware of their options before they can make an informed decision about their own birth process.

Through this, control can be placed back into the woman’s hands and she can direct her own body and biological experiences, and childbirth can stop being viewed as a medical condition to moderate and standardize.