What does contemporary midwifery have in common with Stalinist Russia?

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Jessica Grose, writing in this week’s edition of The New Republic, reviews a new book about the history of the Lamaze movement. The piece, entitled Why We’re So Obsessed with ‘Natural’ Childbirth; A new history of Lamaze explains the origins of the mythology reviews the book Lamaze: An International History by medical historian Paula A. Michaels.

Grose’s review explores many of the themes I have written about over the past few years:

The typical birth narrative that you read online is a tale of harrowing disappointment. The mother had “spent months—if not years—dreaming” about her baby and her pain-medication-free birth… But, by dint of fate and unhappy circumstance, these moms are forced by medical professionals—sometimes even midwives or doulas—to have C-sections or epidurals. They are “treated disrespectfully or without compassion at that most vulnerable time.”

As Grose notes, however, reality is quite different from the dystopian fantasies of natural childbirth advocates.

Indeed, it’s my experience that even at big, impersonal city hospitals, the language and protocol surrounding maternity care is sensitive and catered to a woman’s desires.

Grose also notes the pernicious influence of the father of the natural childbirth philosophy, Grantly Dick-Read:

… Dick-Read promoted some insanely retrograde ideas—that birth pain is psychological; that women of the upper classes should be the ones having lots of babies—but other parts of his philosophy sound like they could have been cribbed from crunchy mommy blogs. Birth, Dick-Read wrote, is “an ecstasy of accomplishment that only women who have babies naturally [i.e., without anesthesia] appreciate.”

In other words, NCB was created by a misogynist eugenicist as a way of convincing women of the “better” classes to have more children. NCB is not feminist, not matter how much its contemporary avatars, midwives and doulas, try to pretend that it is.

The leading exponent of contemporary natural childbirth philosophy is Lamaze International, and the history of the Lamaze movement is also surprisingly retrograde. Before it was popularized by a French obstetrician, the philosophy of Lamaze natural childbirth was created with the encouragement of the Stalinist government to paper over the horrific quality of Russian maternity services. Simply put, the Russian government couldn’t afford obstetric anesthesia, so they set out to convince women that non-pharmacologic methods of pain relief were both equally effective (which they knew was a spectacular lie) and “better,” a value judgment they felt compelled to promote rather than acknowledge the dire state of Russian medical care.

What is most striking to me is that the Lamaze method, just like Dick-Read’s philosophy, was a deliberate attempt to manipulate women into accepting the future that men wanted for them, or in the case of the Russian government, the only future they could afford to provide.

And in a nearly seamless transition, the philosophy of Lamaze has been adopted by midwives, doulas and childbirth educators for the same cynical reason is was invented in the first place. What does contemporary midwifery have in common with Stalinist Russia? Neither can provide effective pain relief for childbirth, so both resorted to hoodwinking women into thinking that pain relief is unnecessary, and that unmedicated childbirth is an accomplishment.

In other words, contemporary midwifery and Stalinist Russia tried to make a virtue of necessity. They couldn’t (in the case of the Russians) and still can’t (in the case of contemporary midwifery) provide effective pain relief. The Russians couldn’t afford it and the midwives don’t know how to do it and can’t bill for it. In both cases, women are manipulated into making a virtue out of necessity, literally.

There is nothing inherently better, healthier or safer in any way about giving birth without pain relief and there never was. The Russians made it up because they couldn’t provide pain relief, and contemporary midwives promote it because they can’t provide pain relief, either.

Effective pain relief for severe pain is a basic human right. Those who make a virtue of denying women pain relief or shaming them for wanting it and enjoying it should be recognized for what they are: selfish and manipulative individuals who praise what they can profit from and demonize anything they can’t.

  • Looloo

    I am Russian. And let me tell you Russians shame you if you want an epidural. Why? Because you are a selfish and horrible human being if you harm your baby like this! They shame you beyond belief for even talkjng about pain relief. They are afraid to give epidurals because they don’t know how or afraid to do it the wrong way. So it is easy to shame the mother for not wanting to go through hell birth pains. had my baby in South Korea , and there I felt so relieved because nobody was judging me for asking to have my baby pain free. I had a Csection because mentally I was not ready to do it naturally. I have many personal reasons for my Csection and I don’t regret it. But I get so many negative comments and people saying how I am not a real mother and how I was robbed of the magical experience. It is unbelievable how ridiculous women are when they argue with me about the benefits of natural birth. It is almost like they hate me for choosing what I think is right for me. My baby was born with a true knot in the embilical cord and I still get comments how I should have tried natural anyway.
    Thank you Dr Tuteur for supporting Csection mothers.

  • LibrarianSarah

    Let me make a prediction. In a year or two, NCBers are going to be all over this post. A lot will be said about how mean and hateful Dr. Amy is and I will once again be wondering why they wait so long to comment.

  • Zornorph

    These woo women should be made to read Stephen King’s novella ‘The Breathing Method’ – It’s about a woman who gives birth even after being decapitated in a traffic accident. If they think they are so tough, let them try that!

    • Jessica S.

      Good Lord, that’s terrifying! I had to stop reading King many years ago, as much as I love his writing. It was giving me regular nightmares. I guess that’s a great endorsement for him, however! :)

    • http://safermidwiferyutah.wordpress.com/ Safer Midwifery Utah

      Stephen King has 10 kids and all were born at home. He thinks that fear has a lot to do w/the pain of childbirth.

      • Dr Kitty

        He has 3 children, not 10.
        Naomi, Joe and Owen. I have no idea whether they were born at home or not.

        He thinks fear has a lot to do with everything…have you read his books?
        This is a man who says his number one fear is death, and his second biggest fear is beetles.

        • The Computer Ate My Nym

          Death and beetles. Works for me.

      • anion

        I’m pretty sure they weren’t born at home, either. I don’t have my copy of ON WRITING handy, but he tells a story in it about being at a drive-in movie when his wife went into labor with their first, and an announcement being made over the loudspeakers saying that “Steve King” needed to get to the hospital because his wife was in labor. (He drove away to a chorus of honks and cheers; it’s a sweet little anecdote.)

      • MaineJen

        Yeah…that’s not true at all :)

        • http://safermidwiferyutah.wordpress.com/ Safer Midwifery Utah

          Can’t remember where I read it soooo I’ll accept my fate of ULTIMATE WRONGNESS (for now).

  • anion

    You know, last week I had the fantastic experience of having two complicated tooth extractions (both requiring slicing deep into my gums and stitching them back up) with failed anesthetic. I felt every cut, every tug, every twist, every stitch, and was unable to make the oral surgeon (like I said, complicated extractions, I had to be referred by my regular dentist) stop or understand that I was not numb because my mouth was propped open. I wailed through the whole thing while the surgeon yelled at me to be quiet.

    Not one single person to whom I have told that story has suggested that it was anything other than horrifying, or that the oral surgeon was anything less than grossly irresponsible, or that I shouldn’t complain until I’m blue in the face. Not one person has told me that it was better that way or that the pain somehow made me stronger or a better person, or that I should be proud of how I was able to endure it all. Not one single person has said that it only hurt because of my own mental failure to realize that there’s actually nothing inherently painful about having one’s mouth carved up like a goddamn turkey and one’s teeth ripped out.

    And yet, had I been giving birth, those NCB people would be insisting that the pain was really all in my head, and that anyway it made me a better person and it was an ennobling experience that I should be glad I had. They’d have told me that my agony was just weakness, that I didn’t really need painkillers, that it was silly to expect them when people have had teeth yanked out without them for hundreds of years because that’s the way nature intended it.

    And awful and terrifying and traumatic as that was, it only lasted about half an hour.

    So why, exactly, are the same people who would never dream of insisting it was normal and right–and even superior–for me to undergo painful oral surgery without pain relief insisting that women should be forced to undergo labor and childbirth without pain relief?

    • auntbea

      Holy crap. Are you going to sue? That was some seriously bad care.

      • anion

        I have talked to a lawyer, but honestly it’s probably not serious enough to justify a lawsuit here in the UK. We’ll see.

        Thanks you all so much for the support, guys. I really appreciate it.

        • DaisyGrrl

          At the least you could write in a complaint to his governing body (I’m assuming there’s a college of oral surgeons or the like in the UK). Not a lawsuit, but something that would be investigated and might convince him to change his ways lest he attract further attention.

          • anion

            Yep, definitely doing that. :-) There is a complaints procedure, so we’re starting down that road as well.

          • KarenJJ

            Good luck! I’m about to make a complaint to my health authority for something far less traumatising then that.

    • Zornorph

      Well, you could use that as a base to make up a story and go on Oprah talking about how you had tooth work without pain medication so you wouldn’t get re-addicted to drugs again.

      • anion

        Lol. Me and Johnny Cash.

    • Jessica S.

      That is AWFUL. I feel panicked just thinking about it. Great analogy but good grief. Awful!

    • Jocelyn

      Ahhh! Anion, I am so sorry!

    • Guest

      Is there really any significant number of people arguing that all women should be forced to forgo pain relief during childbirth? I don’t doubt that there are a few but I am not sure the NCB movement really advocates that (?)

      • http://safermidwiferyutah.wordpress.com/ Safer Midwifery Utah

        Guest- they make women really really beg for it before they help. They think women who want pain relief really just want encouragement. The president of a midwives college, a member of MEAC, and a DONA certified instructor told my doula class as much in 2011 (to be clear all those titles belonged to one person- the instructor). A lot of home birth stories have women begging for relief and being ‘reminded’ of the fact that they didn’t want to before. its creepy and weird.

        • Young CC Prof

          Yeah, if I decide to run a marathon, and then talk about giving up, encouraging me to continue is an acceptable response. (Especially since the people doing the encouragement are probably not in a position to physically stop me from quitting if I feel I really must.)

          If you decided you want natural childbirth (having never experienced labor) and change your mind once things get going, and state clearly, between contractions, that you want an epidural now, the appropriate response isn’t coaching, it’s sending for the anesthesiologist. Promptly. And as for that sort of behavior with women who made it clear from the beginning that they wanted pain relief… No. Not remotely acceptable.

      • DaisyGrrl

        I think so, especially in the NCB movement. They’ll claim that they have good pain relief options, but the truth is that these pain relief options are usually breathing, movement, water (tub/shower), tens machine, and nitrous oxide. None of them are terribly effective for most women. The idea seems to be that labour pain is all in your head and thus can be managed without effective analgesia. My impression is that NCB is against anything that can only be had in a hospital setting (IVs, epidurals, inductions, forceps, c-sections, etc).

        As an anecdote, my sister delivered in a hospital with a midwife. She was told that epidurals are dangerous to the baby and delay labour by several hours. When the nitrous oxide did nothing and my sister requested an epidural, it took three hours before the midwife called the anesthesiologist. I honestly think the midwife was hoping to delay the epidural until it was too late (sis was at 9.5 cm when she got her epi).

        • Jessica S.

          Three hours!! I wonder how that midwife would feel if she broke her knee cap and we locked her in a room for three hours, telling her “yes, we’ve called for pain meds. Just remember dear, the pain in all in your head!”

        • Spamamander

          Wow. My first birth was in the hospital with a CNM. I had it in my head I had to “try” not to have pain relief. I sheepishly asked the midwife after about 12-14 hours of labor that maybe I would like an epidural, is that ok? She immediately had one downstairs and flagged him down in the hallway to get to me first, since the lady down the hall had a history of easier labors.

      • The Computer Ate My Nym

        NCBs periodically argue that “no one ever died of pain” (not entirely true, actually, but let that go by for the moment) but that people can die of epidurals and other forms of pain relief (unfortunately true, but extraordinarily rare) so that pain relief should not be used in any situation. It’s an argument that is problematic on a lot of levels, from the removal of autonomy to the fact that pain is a stress that CAN kill in some circumstances.

      • sarahh.rosanne@gmail.com

        Pain medication isn’t just discouraged, it is painted as unnecessary and disproportionately unsafe. Here is a fantastically ridiculous article (on so many levels) that suggests pain relief, like elicit drugs, is the result of peer pressure. http://www.midwiferytoday.com/articles/epiduraltrip.asp
        That is the kind of thinking that permeates the NCB movement. It’s not so much force as manipulation. If there was a recognition that the need or desire for pain relief (or even necessary intervention) was valid, there would not be a mainstream natural childbirth movement.

    • http://safermidwiferyutah.wordpress.com/ Safer Midwifery Utah

      I’ve heard of support groups for people who were awake but paralyzed during surgery. I think they are ‘awareness victims’ groups or something- you might be able to find support there. You were tortured. So awful.

      • anion

        Thank you! I know what happened to me was nowhere near as bad as having major surgery while awake and unable to communicate, but it was still awful.

        • FormerPhysicist

          Um, you were awake and unable to communicate effectively.
          I would file a complaint, insisting, AT MINIMUM, on an apology and the institution of a protocol to prevent this in the future (if you wish to be nice to others). They could have asked you yes/no questions, or had a way for you to signal them that you needed to communicate urgently.

          • anion

            I remember thinking, “Can’t they see I’m actually crying? Surely one of them will notice and stop to ask why, right?” But they never did.

          • http://safermidwiferyutah.wordpress.com/ Safer Midwifery Utah

            I hope you’ve talked to a professional about this. It is too much to take on alone.

          • moto_librarian

            This warrants a report to his licensing board. He should have stopped and asked. This is horrible.

          • Jessica S.

            I don’t think you should be responsible for paying them, either. At least, not in it’s entirety. Do you have dental insurance? If so, someone there might be able to help you and if anything, know that this was an issue with the dentist! I agree with what everyone is saying here: you shouldn’t down play it, it’s a huge deal and deserves to be addressed!

        • auntbea

          I know you are trying to be gracious and avoid overreacting, but seriously, this is bad. There is NO REASON this should have happened, and NO REASON you should downplay it. Even if he didn’t intend to hurt you, your dentist showed profound negligence in failing to ascertain that something was wrong.

        • http://safermidwiferyutah.wordpress.com/ Safer Midwifery Utah

          Dental nerves are so sensitive though. And I am pretty sure that there is like a threshold on pain (like a 10/10 on the pain scale) where people don’t really compare who had it ‘worse’. This is one of those situations. There is an element to your story that is actually worse than most of the awareness in surgery peoples, its that you protested, and were ignored. Most people aware during surgery weren’t able to cry out. That is a major element to torture and other psychological traumas that can cause victims to lose faith in other people in general. Someone ignored your pleas. That is very different than something that just happened to have gone wrong.

          I got a lot of milage out of “trauma and recovery”. Its a good book if you want a guide to traumatizing situations and how people (and society) deal with it.

        • Crunchy edges

          I had a similar incident as a child having four molars removed to make space before braces were fitted. As the others have suggested, I see a dentist who gives me anxiety meds, and if I need lots of work fine, it is done under a general anesthetic, which I pay for myself as medical aid won’t. I was refused an epidural in labour as the nurse refused to call the anesthetist as she said he would shout at her as he had been at the hospital two hours before. I coped better with the unintentional drug free birth than the tooth extractions. We had a doula, who was so kind and even told the nurse she would phone the doctor herself, rather wish I’d had a dental doula ;) I let my teeth get into terrible shape from refusing to see a dentist for years after that. Do your best to find another one – who is competent. I still get panic attacks in the waiting room, but I cope better knowing this dentist will stop if I lift my right hand up.

      • Anonymous

        This normally happens when the anesthesiologist really, really screws up. We had someone do this once on a guy and once he regained movement he hit the roof. Can’t say I blame him either. Needless to say that was the last time that person worked with us.

    • Amy M

      Oh my god. I’d never go to the dentist again. I realize that’s the attitude that many homebirthers take, but I would seriously rather have my teeth fall out than suffer that. Of course that’s my own teeth, I would not be putting anyone else’s teeth (or life) in danger.

      • anion

        The irony is, the two that were really painful (I had three taken out, but the first was straightforward so didn’t hurt quite as much) were two that didn’t really trouble me, and I didn’t know when I went to the appt. that he planned to take them; I was informed just before he started–and I didn’t think I could refuse. If I’d known I could, I would have at least asked to do those at another time. I’m tired of eating mush.

        I’m going to have to have implants put in at some point, and I admit I’m terrified. I hadn’t been to a dentist in twenty years because of my fear, so this was really not a great way to start the road to better teeth.

        • DaisyGrrl

          I know there are dentists out there who specialize in fearful patients (and give anti-anxiety medication as part of the appointment). Maybe when the time comes you can find one who can work with you and your completely understandable fear. For example, having a preliminary visit where you explain what happened, then go over everything that will happen and what signals you will use if you need to communicate. It would cost more, but be completely worth it if it prevents another nightmare like the one you just had.

          I’m just aghast that your oral surgeon treated you that way. When my dentist is doing fillings, if I so much as move or make a sound he asks if I’m okay. Anything other than a clear “uh-huh” gets everything removed from my mouth so I can tell him what’s going on! I would expect at least that much during extractions.

          • Anj Fabian

            I have a nerve that causes a reflex grimace when the water spray hits it. I tell every hygienist about it because they’ll stop and ask if I’m okay if I don’t warn them.

            Most in dentistry are very keen on having their patients comfortable.

        • The Computer Ate My Nym

          Might I suggest at least a different oral surgeon, maybe a different dentist? Any surgeon should be aware of the possibility that anesthesia can fail and have a better response to a patient who is crying out in pain (even if it’s incoherently because their mouth is propped open) than yelling at them to be quiet. I consider that unsafe practice–what if you’d had a heart problem that couldn’t tolerate the stress of that much pain and resulting hypertension, for example?

        • http://thefresstyler.blogspot.com/ Hannah

          Yeah, as someone whose teeth are in pretty awful condition due to fearing the dentist (only dentists, I am fine with all other medical establishments), you need to persist and find a good surgeon. A great oral surgeon would have explained everything to you, checked why you were screaming, etc etc. What he did was unprofessional. More than that, it was dangerous.

          I am sorry you had to suffer through that :(

  • lookingforinfo

    OT: The Science & Sensibility blog is already trumpeting ACOG’s new Obstetric Care Consensus (http://journals.lww.com/greenjournal/Abstract/2014/03000/Obstetric_Care_Consensus_No__1___Safe_Prevention.41.aspx). I really wish I could see more than the abstract, which is incredibly vague. Interestingly, the chart republished by Science & Sensibility doesn’t say anything about neonatal mortality.

  • Amy Tuteur, MD

    Homebirth advocates really have problems with irony, don’t they? First Aviva Romm writes a post about the power of words and then censors the comments, now TFB, Miss “I’ve been a doula at 20 births,” is excoriating Jessica Grose for daring to write an article about childbirth having had “only” one baby.

    http://thefeministbreeder.com/one-baby-makes-expert-maternity-care/

    • Petanque

      Of course, TFB has has 3 times the birth experience of Jessica Grose. Her knowledge is tripled!

      • http://shameonbetterbirth.wordpress.com/ Shameon Betterbirth

        Should we all defer to michelle duggar then? She has had a few c-sections under her belt and gives birth in hospitals even after trying home birth.

      • Captain Obvious

        Ah, but her absolute experience is still small, so that relative experience means nothing.

    • Stacy21629

      Waiting on TFB to defer to YOU then, Dr. A…seeing as you have one more “little” than she does! One more way in which you are the superior expert. ;)

  • Karen in SC

    I am ashamed to say that twenty years ago, I bought into the woo and thought that epidurals delayed labor, drugged the baby and interfered with breastfeeding. Also, I hate needles and IVs so it was an easy choice for me to go without. It hurt like hell, I was out of my mind with pain, but I was convinced of those “facts” and that a woman could handle the pain if she would just commit to it. Unfortunately, I may have shared this opinion a few times. I don’t think I changed any minds though :)

    Now I know better about epidurals but it’s too late for a “healing epidural birth.” I did just tell my niece to “get all the drugs she wants” because pain doesn’t have to be part of the birth experience.

    • The Bofa on the Sofa

      I was convinced of those “facts” and that a woman could handle the pain if she would just commit to it.

      Then again, in the absence of an alternative, what is the choice? The baby is going to born, pain or no pain.

      You know what it takes for a woman to “handle the pain”? Refuse to give her relief from it.

      It sounds pretty sadistic to me, but if you don’t have any thing to do to help her, “deal with it” is basically the only option.

      • Karen in SC

        In my case, I chose not to ask for an epidural (and those scary needles). There were some positives – when it was over, it was over, no pain and I wasn’t connected to anything. So I could move freely, shower, whatever.

        But you are right, when no pain relief is offered, or available, there’s no other choice.

        • The Bofa on the Sofa

          Yeah, the more I think about, I think the lessons are:

          1) The easiest way to get women to handle the pain of childbirth is to refuse to let them have any relief, and
          2) When you put it like that, it sounds barbaric

          • Jessica S.

            Then to make it less barbaric, they slap the lipstick of empowerment and class and privilege, etc. on it. Even better, make science-y sounding claims about how pain meds, etc. are actually bad for you.

          • The Bofa on the Sofa

            Friends quote:

            Joey: Let me get this straight. He got you to beg to sleep with him, he got you to say he never has to call you again, and he got you thinking this was a great idea.

            Phoebe: Um-hum.

            Joey: This man is my God.

            That’s the way they are. They have to get women to think it’s better to forego pain relief, because if they didn’t, everyone would realize how sadistic it is. So they convince women that pain is good, and that they should avoid pain medication, and, somehow, this is virtuous!

          • Sue

            In contrast, in my clinical practice, it IS considered barbaric to withhold or under-use analgesics, and there are international campaigns to improve the quality and timeliness of pain management.

            Radical-NCB lives in a world of its own.

        • Susan

          I think those positives are probably the most valid ones. It’s definitely nice not to have the IV, foley, tube in your back etc… whether that is worth it to an individual in terms of getting the great pain relief the epidural provides is personal preference.

          • Trixie

            I felt “trapped” in my body by my epidural. Like…claustrophobic would be the best way to describe it. It was necessary at the time that I got it, but my threshold for wanting one in my next labor was pretty high because it was worth a lot of pain to me to not feel trapped like that again.

          • Pillabi

            May I ask how long ago you had your epidural? I had one two years ago and I didn’t have any claustrophobic feeling (whereas I did feel somehow “trapped in my body” with the spinal anesthesia during my c-sec, three years before, so I think I understand what you mean), but I think this kind of experience was more common with epidurals only a few years before.
            I mean, progress in pain relief has been amazing!

          • Trixie

            About 5 years ago. It was a very well done epidural. I could still move my legs and feel pressure and I had a clicker thing to up the strength if I needed it. Again, I’m grateful for the pain relief, and I think my experience was probably in the minority, but even though it sounds weird I felt better feeling the pain but also feeling my body. Of course my second labor also progressed much faster and wasn’t with a posterior asynclitic baby, so it was easier to cope with :-)

          • http://shameonbetterbirth.wordpress.com/ Shameon Betterbirth

            Trixie I agree, it was totally totally weird. I remember having other people assure me that my legs were not freezing cold, I was convinced they were. It was way better than pain though, of course. I think I mighta had a posterior baby because of how intense and focused the pain was in my back. Unfortunately my medical records only say ‘vertex’ so I’ll never know.

    • EllenL

      I think you have redeemed yourself by setting your niece straight!

      I actually had a “healing epidural birth.” It was beautiful.

      • moto_librarian

        So was mine!

        • EllenL

          I’m so glad!

          I have taken to being upfront with people:
          “I’m a proponent of Unnatural Childbirth.”

          Why should we hide in the shadows and let NCB nuts dominate the conversation?

    • Danielle D

      As a friend (older, male, speaking of his memories of his wife’s experience I believe) from church said, “When they ask you if you want an epidural, the answer is ‘yes.’”

      (Not that one has to elect that choice, of course. But I found it jolly to hear after wheedling from the natural crowd.)

  • MrG

    Actually, I hate to say it, but before Stalin there was Hitler and the Nazis.
    In 1935 and 1938 the Nazis implemented a law, the “Reichshebammengesetz”(google it!).
    It had the goals to return to “natural” medical procedures, and also requiring that German women are delivered by German midwives (whereas until that time many were delivered by obstetricians, and many of them were Jewish).
    The Nazis’ attempt to shift deliveries to midwives was successful “every German child is lovingly delivered by a German midwife…”.
    The new law stated that to become a German midwife you have to attend at least 50 deliveries (coincidentally (?) the exact same number as required by MANA).
    The head of the midwife association Conti was the mother of the Nazi health minister (Reichs Health Fuehrer) who said midwife deliveries were safer than hospital deliveries.
    The Nazis said midwifery births at home were healthy and more natural than hospital births and interventions should be considered only in emergencies.
    Deja vu all over again?

    • The Computer Ate My Nym

      One underappreciated point about the Nazi era is the extent to which it was an anti-feminist movement, as well as, obviously, a racist and nationalistic movement. Prior to that time, Germany had a feminist movement that was at least somewhat effective in getting the idea that women might be able to do something other than make babies across. The Nazis, of course, did not approve and hence the push not only to make babies but to define women as “real” only when they can make babies “right”, i.e. without intervention or pain control. Very convenient for them: women either did what they wanted or were dismissed as “inferior”.

    • Young CC Prof

      Hmm, rather thought so.
      http://www.populstat.info/Europe/germanyc.htm

      Note that in 1935 the population STILL had not returned to the 1915 level. WWI and the subsequent epidemic put a dreadful dent in the population, and I doubt many people were making babies in the twilight of the Weimar Republic if they could possibly help it.

      So they weren’t pushing reproduction just to oppress women. They needed the people. (To try to take over the world and oppress everyone else.)

      • The Computer Ate My Nym

        Well, WWI, the Spanish flu, emigration, and territory loss. This year there’s a nasty H1N1 flu about again. Kids, get your vaccines before you contribute to your country’s population loss.

        • Young CC Prof

          Hey, don’t laugh. Out of the last 35 or so years in the USA, the only years in which age-adjusted mortality did not decrease were years with particularly hard flu seasons.

          Yup, the signal of flu deaths actually stands out of the noise of the millions of deaths from chronic diseases of old age.

          • Trixie

            I actually listened to a woman selling ginger at a market the other day explain to a couple that they could grate ginger into water, let it steep, strain the ginger off, and then use that water in a neti pot as a flu remedy. Derp derp de derp.

          • Young CC Prof

            Um, putting saline up my nose is one thing. Why on EARTH would I put ginger up my nose????

          • auntbea

            Smells good? Perhaps you need to mask the scent of a nearby landfill? Or perhaps a dead body?

          • Trixie

            Probably because she was selling ginger? Thank goodness she wasn’t selling jalapeños.

          • The Computer Ate My Nym

            Oh, I meant it seriously, if a bit snarkily. I’ve seen several flu deaths already this year. True, they were in “classic” high risk patients (already had multiple medical problems, older, etc) but this is a year with flu deaths in younger people, including children. It’s a nasty one and I seriously do mean get your shots. (Which you should every year, but this is not the year to skip.)

          • Young CC Prof

            This year’s H1N1 is the number-one reason why seven-week-old Baby Prof doesn’t go to the grocery store or friends’ houses. (Numbers 2 and 3 are RSV and pertussis.) Next winter when he’s vaccinated and tougher, I won’t be such a germophobe. But right now I feel NO shame.

    • slandy09

      Now that’s just scary.

    • MaineJen

      And a common theme in both Stalinist and Nazi regimes was…they reviled the feminists. There was a big push to put women back into the home, so having children was glorified as this huge accomplishment. (Not that it’s not a huge accomplishment, LOL…just saying). For the Nazis, anyway, the theory had a hard time catching on; once the war started, all the young working men disappeared to the front, and women were needed in the work force, so the birth rate actually FELL during the late 30s-early 40s in Germany.

      I really find it so ironic that the NCBers claim to be feminist, because it seems like whenever their theories have been put into practice on an official, state level, the regime in power has been anything but feminist.

  • http://shameonbetterbirth.wordpress.com/ Shameon Betterbirth

    This explains a lot. What a neat article!

  • Danielle D

    As a scholar of women’s history, I am very excited to read this title. As others have taken pains to argue, eugenics never went away; it merely changed it’s colors. This is one of many examples of that fact.

    On a personal level, I was struck when I got pregnant for the first time two years ago and found that most of the substantive literature on childbirth in my local library (in a major US city) argued that pain relief during labor was dangerous and that as a caring mother I would have to forego it. Authors then proceeded either to celebrate pain as a proof of material metal or to dismiss maternal pain as a factor easily controlled (with sufficient training/virtue). Now, if the only pain relief available were really dangerous, that would be one matter; but so far as my lay eyes could tell from the literature, there is no great body of evidence for that assertion. And to lie about that medical fact, and to be so quick to imagine that there is something special or transcendent about pain in childbirth–not childbirth itself, but pain– is really damaging, because it denies women’s very real bodily experiences and tries to remove the options they have to minimize pain, experience greater control, and so on.

    • Rochester mama

      I think part of the number of books available on NCB is that you can have many different methods to deal with the pain that take 200+ pages to explain. Explaining an epidural fits in a pamphlet. No one writes The Medicated Birth or Epidurals, Ahhh Relief.

      • Danielle D

        This is actually a real problem, because it can lead to the impression that “all the research agrees with Lamaze.” The two detailed books in my local library were from Lamaze and Ina May’s “classic”. This can easily lead to the wrong impression when a mom-to-be decides to “do her research” by pulling the biggest titles off the library shelf. I did encounter one book, “Epidural without Guilt,” which was pretty good but would come on a little strong for some women and is obsessed with one particular kind of epidural. (This led me to have a confusing conversation in which I inquired about “walking epidurals,” which I thought meant, “when I get an epidural, can I control the amount of medication I am receiving?” I was told the hospital didn’t do “walking epidurals,” but when I was admitted, I discovered that whatever type of epidural they do offer gave me the control I was interested in, anyway.) Another book, “Easy Childbirth,” seemed balanced and not at all strident, and pretty much explained the options. That book also contains anecdotes from women who chose various options, which was refreshing.

        It’s amazing to me how many books I read finding one that simply explained what each of the options were and how they worked. It was especially nice not to be told what to do.

        Anyway, more books like this need to be sitting directly next to Ina May in public libraries and bookstores.

        • Danielle D.

          (Sorry for the typos.)

        • Karen in SC

          I am going to check out the selection at my library and make donations if necessary. I have some friends who work there so I can make sure the books end up in the collection.

          Other libraries where I live have used a form for book suggestions. I think that’s a good idea if a donation isn’t possible. Find the form and fill it out and maybe some better references will be available.

        • moto_librarian

          Most librarians love to get user recommendations. Whether or not there is money to buy them is, unfortunately, another matter…

  • EllenL

    Here’s the latest edition of Childbirth Without Fear by
    Grantly Dick-Reed:

    http://www.amazon.com/Childbirth-Without-Fear-Principles-Practice-ebook/dp/B00CX914HO/ref=sr_1_1?s=books&ie=UTF8&qid=1392838719&sr=1-1&keywords=grantly+dick+read

    Notice the expression on the laboring woman’s face?

    Looks like she hasn’t fully overcome her fear-based pain.
    Shame on her!

    • Trixie

      Nah, that’s just her O-face.

      • auntbea

        According to someone commenting on the reviews, she was shouting, “I love you, baby!” Which seems like an odd thing to shout.

        • realitycheque

          What a load of crap!

    • http://shameonbetterbirth.wordpress.com/ Shameon Betterbirth

      That book was fucking impossible to read. It was written terribly.

  • http://Www.awaitingjuno.blogspot.com/ Mrs. W

    BC may have more in common with Stalinist Russia then it would ever care to admit.

  • EllenL

    I’m so glad someone has written a book putting the natural childbirth movement in proper historical perspective.

    NCBer’s love to point out the long history of natural birth, as though this lends it credibility.

    I think credibility goes out the window for most women when they encounter labor in real life, as opposed to what they’ve read in books and articles. It’s a big disillusionment, and for some it’s devastating.

    I’ve always wished that Grantly Dick-Reed could have experienced labor himself – a long, excrutiating and unproductive labor, one where the baby was hopelessly stuck at the end. How would his idiotic philosophy get him out of that?

    Fear causes childbirth pain? No, Dr. Dumb. Pain causes fear, and rightly so.

    I can’t wait to buy and read the book by Ms. Michaels.

    • Jocelyn

      “I think credibility goes out the window for most women when they encounter labor in real life, as opposed to what they’ve read in books and articles.”

      My sister was (very slightly) in the woo before she gave birth last year, and I was talking about pushing, and she said something along the lines of “pushing wouldn’t be that bad, because the baby’s going to come out either way. Your body is strong and it will push them out all by itself if it has to.” Well, she sure changed her tune after a labor that involved 4 1/2 hours of pushing and that ended in forceps. She’s realized that without assistance she and her baby would have died, and she’s told me so.

    • The Bofa on the Sofa

      NCBer’s love to point out the long history of natural birth,

      I think the real history of NCB needs to be sure to cover all the attempts that have been made to try to avoid it.

      Just as the history of breastfeeding needs to cover all things done to try to avoid that, too.

  • MaineJen

    Along the same vein, I would like to share a quote from a VERY interesting book: “Hitler’s Furies: German Women in the Nazi Killing Fields” by Wendy Lower. (It more than lives up to its macabre title, by the by…not for the faint of heart.) In one of the early chapters, I ran across this gem of a quote. “The mass campaign of selective breeding mustered German women across generations and classes who ended up suffering from, as well as advancing, the Nazi racial war. Midwifery as a profession exploded. In keeping with the regime’s exaltation of purity and nature, cesarians were restricted and breastfeeding was rewarded…” Women were given medals for having more than 4 children, and were taught that their duty was to surrender their bodies for the greater good, and to endure pain without complaint. Juuuuuust some food for thought.

    • theNormalDistribution

      Gross.

    • Trixie

      My MIL’s mother got more food rations in East Germany if she was breastfeeding… She nursed my MIL well into toddlerhood for that reason.

    • Irène Delse

      Chilling. Eugenics in all their gruesome glory. :-(

    • EllenL

      Unfortunately, that idea – that women should be breeders for the cause – is alive and well in some religious movements today.

      • Nashira

        Quiverful. :(

    • Jessica S.

      Surrender their bodies and their minds, indeed. Sheesh.

    • sarahh.rosanne@gmail.com

      They were onto something with the medals… a lot of the women I know who had “successful natural births” want merit badges. If we literally gave them medals, would they shut the h*** up? lol. In fact, I want the “Golden Chalice of Suffering Medal” and an “Order of the Stalled Labor”. We could wear little sashes like the girl scouts.

  • Mel

    This brought back memories from my Facebook feed from various HS and college acquaintances who decided to go without pain meds during labor. Several of them found the mantra “Made for pain!” comforting. I found the mantra disturbing.

    Upon reflection, I realized that I found the mantra insulting personally. I have fairly mild cerebral palsy and as a side effect I end up with tight, cramping leg muscles. The cramps are very painful and sometimes need physical therapy to resolve. My last bout took 2 weeks of MD appointments followed by muscle relaxants and 4 weeks of PT to resolve. I had far more sleepless nights and restless days of pain that moved between mild to severe pain before the right combination of relaxants/PT kicked in.

    Coming off of that, I’ve found myself especially irritated by people bragging about their stoicism during labor. At the risk of being rude, labor sucks, but it’s a whole lot shorter than most other pain episodes. I would have gladly taken an epidural during my pain episodes, but I didn’t have that option. Plus, you get a baby at the end.

    • Alenushka

      I have a rare form of RA that time to time causes me a lot of pain. I am irriated by people who brag about their drug free labors. Big deal. Anything can be tolerated for a day or tow. Try being a productive citizen, mother, volunteer and just a human being living with a chronic condition that will never get better.

      • Mel

        I’m glad I’m not the only person who feels like that. I’ve always had a nagging feeling of guilt that I’m being too oversensitive about it.

        • Anka

          I can’t compare my condition to either of yours, but I do have debilitating migraines that can affect my ability to function. I agree with both of you! I also think that fetishization of pain or pain one-upmanship is stupid, and inconsiderate to people who have to deal with pain frequently.

        • Dr Kitty

          Agreed.
          Chronic pain is not “empowering” or “ennobling” unless you’re in What Katie Did.
          It sucks.

          Being triumphalist about managing severe pain without pain meds for 24hrs ignores the lived reality of people managing chronic pain.

          • http://www.antigonos.blogspot.com/ Antigonos CNM

            I have not had a day free from pain since the spring of 1986, when I suffered a slipped disc [which has progressed to a ruptured disc with degenerative involvement of more vertebrae.] Most days it is “merely” about a 4 or 5 on the pain scale: I can do what I have to do, but I just always feel that I’ve been whacked in the small of my back by an invisible metal rod. It exhausts me. Most of the time I feel like I’m breaking in two. No pain meds, or combination of pain meds gives really satisfactory relief.

            Chronic pain is no joke and I’ve become convinced that people without it cannot really appreciate how debilitating it is. Acute pain sufferers generally get sympathy and treatment; chronic sufferers are called “complainers”.

        • Nashira

          I don’t think you are oversensitive. Those of us with chronic pain, especially more severe pain, aren’t supposed to talk about it or expect help for it, especially if we have the misfortune to be women. A woman who manages a day or two of severe pain for labor is a real woman, according to these folks, meanwhile I get told to never have kids because I’m broken and on drugs. -_-

          Of course, I might be pissy because I just spent a week with no breakthrough pain meds due to the East Cost Snowpocalypse and an unreadable fax.

  • Are you nuts

    My mom was talking about her Lamaze instructor back in the 80s who had 3 home births that ended with going to the hospital via ambulance. One of those births, the mom almost died, another the baby almost died. Yet she was still spewing this crap! FTR, my mom is only slightly crunchy, opting for natural births in the hospital…

    • Young CC Prof

      You know, generally if you try something twice and wind up in an ambulance both times, you don’t try it a third time.

      It’s not getting back on the bike after ONE accident, it’s getting back on the bike after all two attempts ended in disaster.

      • Trixie

        I’m sure that even competitive cycling is much safer than homebirth, though.

    • http://www.antigonos.blogspot.com/ Antigonos CNM

      The doyenne of the Lamaze Movement in the 70s, in NY, who was extremely effective in popularizing the technique in the US, Elizabeth Bing, gave birth herself only once — by C/S.

  • Alenushka

    I grew up in Soviet Union. I still remember the horror of the maternity ward during my clinical. The screams of the mothers, the yelling of the staff, and the suffering of all. I was terrfied of the even idea of pregnancy for years. Yes, the nurse midwives were repeating the mantra of “you’re strong woman” again and again. it did nothing to stop the screams and tears.

    • auntbea

      I’m so strong, I’m going to punch you in the face unless you give me something for this pain.

    • Are you nuts

      It’s hard to believe there are people in this country (lots, actually) who pass off this same thing as if it’s somehow feminist!! I can’t think of anything more feminist and empowering than having the choice to bypass much of the labor pain that has plagued moms for millennia.

      • EllenL

        The book Our Bodies, Ourselves, which came out in the early 1970’s, was influential IMO. All of the feminists I knew had a copy, including me.

        There was a very strong bias against the medical establishment in that book. Many feminists took up the natural birth cause as a result. I’ve always felt that the merging of feminism with natural childbirth was most unfortunate. It’s an embarrassment to feminism, really.

    • Anka

      My ancestry is partly from the former Soviet Union, and my husband is too (Central Asia). One really unfortunate thing I’ve noticed while pregnant and interacting with his immigrant community is the combination of this phenomenon with a heavy helping of North American-style childbirth woo. It’s kind of shocking how the two things mesh so easily–all this “you must be a strong woman” stuff with “drugs in childbirth will RUIN your baby! Natural is good! No c-section!” (The last part being after I told them, as I thought at the time, that I’d have to have a medically indicated c-section.)

    • guestguest

      I gave birth after a war to my child, now a teenager. There were no sheets on the beds in the hospital , no hot water, and no pain medication whatsoever available on entire maternity ward. No blood test were available, no induction drugs, one baby monitor was there for the entire ward and the only ultrasound in the entire hospital that was working was three floors away. Instead of packing the bag with baby clothes I went in there holding a plastic bag with essential medical supplies like gloves, surgical thread, syringes, local anesthetic, Rhogam shot – those pregnant women who could afford these things and had someone who could smuggle them across the border were asked politely to bring them please.

      After the birth, the next morning, the pain was so bad that when a family member came to see me tears were streaming down my face and my legs were jerking uncontrollably. I was unable to speak coherently. A midwife who was making rounds took pity on me out of twenty women who were in the same boat that morning so I guess I looked the worst. She went to the children’s ward and brought me half of bottle of ibuprofen syrup.

      I am still thankful for every sip of it.

      • Jessica S.

        Wow. I hope this doesn’t come across as trite, because it’s genuinely felt: this gives me pause and reminds me that I’m grateful for the medical advances available to me. Thanks for sharing your story, it’s incredible.

    • Jessica S.

      As I said to guestguest below, reading accounts like yours make me thankful for what’s available to me. It shouldn’t be taken for granted. That must have been a harrowing experience!

  • The Bofa on the Sofa

    Interesting. The Stalinist resort to non-medical pain relief reminds me more of the Mao-ist transition to “traditional Chinese medicine” and “accupuncture.” They didn’t have near enough resources in actual medicine to treat the billion people under their control, so they invented a promotion of cheap stuff, such as TCM and accupuncture, knowing full well it wasn’t all that effective, but, hey, they had to do something.

    • Irène Delse

      Indeed. And as with acupuncture became popular in the West due to its “traditional, non-imperialist” the Lamaze methods

      • The Bofa on the Sofa

        It’s the irony of the “ancient Chinese method of acupuncture” that is the amusing part. a) It’s not really ancient – the current version of acupuncture dates all the way back to the 1920s. Real wisdom of the ancients, eh? (btw, if you read some of the acupuncture literature about the history, they talk about “needling” that was going on back in the 1000s BC. However, that consisted of using nails the size of railroad spikes. Not quite the same, is it? But somehow, that is supposed to be evidence of the ancient art of acupuncture?) b) add in the fact that the only reason the Chinese used it was because it was cheap, and nothing to do with whether it worked.

        ETA: I’ve mentioned before, in terms of the TCM – TCM was so effective that in the 1920s, the lifespan of a rural Chinese farmer, the one most likely to be relying on TCM, was 25 years. 24 for the women (death in childbirth being the source of the difference). That’s a real testament to the efficacy of TCM I have to say.

        • KarenJJ

          In in the book “Mao’s Last Dancer”, the narrator describes his mother being ill and how they couldn’t afford real medicine and had to resort to the bare-foot doctor stuff and how he feels it prolonged his mother’s illness. Even rural peasant Chinese knew they were being fobbed off with ineffective, cheap attempts at medication.

        • anion

          Hey, man, trepanning is totally natural! Why are you putting your medicoindustrial bullcrap on me?!

  • Rochester mama

    I studied for six month in Hungary in the 90s and it certainly rings true to me. One of my favorite tourist places was the park where they put all of the creepy communist statutes removed from Budapest that celebrated the “Worker” and mothers were always depicted as the strong peasant types that squatted in a field then got right back to work.

  • Dr Kitty

    It’s all a little bit Orwellian isn’t it?
    Doublethink in action.

  • Meredith

    I read the title of this article and thought, “Oh yes, I’m going to enjoy this, aren’t I?” And I did. I am continually fascinated by how anti-feminist and anti-scientific NCB is. Now I can add “anti-democratic” to the list.