Are women socialized to fear childbirth or are midwives socialized to pretend childbirth isn’t fearful?

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Which came first, the chicken or the egg?

That question came to mind when I read an article in today’s Guardian, Growing childbirth terror disorder ‘fuelled by social media’.

Catriona Jones, a lecturer in midwifery at the University of Hull, who has studied tocophobia, believes social media is partly to blame for the phenomenon.

Speaking at the British science festival, taking place at the university, she said: “You just have to Google childbirth and you’re met with a tsunami of horror stories.

“If you go onto any of the Mumsnet forums, there are women telling their stories of childbirth – oh, it was terrible, it was a bloodbath, this and that happened. I think that can be quite frightening for women to engage with and read about.

Jones has adopted the position that the proverbial chicken came first. Fear of childbirth is implied to be a cultural construct that does not reflect the reality of nature. It arrives fully formed in response to socialization through frightening birth stories.

Midwives are employing the classic misogynist tactic of muzzling women who seek community and validation in sharing their experiences.

Medieval philosophers also thought the chicken came first:

By the end of the 16th century, the well-known question seemed to have been regarded as settled in the Christian world, based on the origin story of the Bible. In describing the creation of animals, it allows for a first chicken that did not come from an egg.

They “knew” the chicken came first because their Bible told them so. Similarly, Ms. Jones “knows” that the chicken of fear of childbirth came first because her bible told her so. It is an article of faith among natural childbirth advocates that pain in labor comes from fear and fear comes from socialization.

But science tells us that it was the egg that came first:

…[A]n animal nearly identical to the modern chicken (i.e., a proto-chicken) laid a fertilized egg that had DNA identical to the modern chicken (due to mutations in the mother’s ovum, the father’s sperm, or the fertilised zygote). Put more simply by Neil deGrasse Tyson: “Which came first: the chicken or the egg? The egg — laid by a bird that was not a chicken.”

Science also tells that it the pain and the death toll of childbirth that led to fear, not socialization. The pain of childbirth is thought to have had the evolutionary purpose of promoting the purely human behavior of assistance in childbirth. Human childbirth is inherently dangerous and assistance can mitigate the risk by manipulating the baby out of a difficult position or by massaging the uterus to prevent hemorrhage after birth. A woman in pain sought out help; a woman who sought out help was more likely to survive; ultimately painful labor spread through the population because it was evolutionarily advantageous.

The death toll of childbirth speaks for itself. In every time, place and culture childbirth has always been a leading cause of death of young women. In countries where pre-technological conditions remain, the lifetime risk of maternal mortality has been as high as 1:10 as recently as 1990.

Even if science didn’t give us the answer, history tells us that the idea that labor pain is a construct of modern Western culture is nonsensical. The people who wrote the Bible were so impressed by the extreme agony of labor that they explained it as nothing less than a grievous punishment from God.

May midwives insist that the pain of labor is a cultural construct for a very simple reason: self-dealing. They have lost the care of a large proportion of women to obstetricians because OBs can abolish the pain of childbirth and midwives cannot. Living in our culture, where people are socialized to imagine that anything they like is natural and anything they dislike is a cultural construct, they have resorted to the foolish claim that painful childbirth is result of socialization, transmitted in this case by social media.

Midwives thus make stupifyingly ignorant claims like this:

Julie Jomeen, a professor of midwifery and the dean of the faculty of health sciences at the University of Hull, said: “Tocophobia is a modern-day phenomenon. Some of these women really think they are going to die.

“Two hundred years ago people accepted that they might die from childbirth. Today we expect childbirth to be safe.”

What? Does Jomeen think that women didn’t fear childbirth prior to the 20th Century? We have copious written evidence from women themselves that they viewed childbirth with unalloyed horror, dreaded the pain, feared the deaths of their children, and perhaps most anguishing of all, were terrified that they would leave their older childbirth motherless.

Is Jomeen trying to suggest that prior to the 20th Century women accepted the possibility of their own deaths with equanimity? Every bit of historical evidence we have shows that all people (men and women) have feared their own deaths throughout recorded history. Yes, they were surrounded by premature death; yes, their religious practice was designed to prepare them for death; but they still resisted death any and every way they knew how.

What’s going on here? The irony is that the midwives accuse women of being socialized to fear labor are oblivious to the fact that THEY are the ones who are blinded by a cultural construct. THEY are socialized to believe, despite massive evidence to the contrary, that labor is enjoyable, empowering and worthy of embrace.

As Suzanne Moore, also of The Guardian notes:

Women fear childbirth because pushing out another human being through a small opening in your body is to be split asunder…

The fear is rational. When women tell each other birth horror stories nowadays, this is not an exercise in fiction. They are telling the truth.

But there is another larger and more tragic irony here. Midwives who claim to be promoting a feminist ideal of birth are employing the classic misogynist tactic of muzzling women who seek community and validation in sharing their experiences.

If you feel mentally and physically traumatised, please do keep talking. You are not spreading fear. Because women sharing their truths, however bloody messy these are, is actually how we change things.

It is only through sharing the agony of postpartum depression that women have forced medical providers to take action. It is only through sharing maternal deaths (including sharing by journalists) that women have forced providers to take action. Similarly, it is only through sharing stories (especially sharing by the Fed Is Best Foundation) of babies harmed by aggressive breastfeeding promotion that women are gradually forcing medical providers to acknowledge the dangers and take action against unscientific programs like the Baby Friendly Hospital Initiative.

Social media has serious problems, but those problems concern empirical facts not personal experiences. Indeed, social media can serve as repository of and witness to raw human suffering and can elicit the best in human nature through campaigns, emotional and financial, to support those who are suffering. Moreover, social media is remarkably democratic, allowing anyone to communicate with the world, not merely those who satisfy a publishers’ prejudices.

Disparaging women who share their stories of childbirth agony, injuries and trauma on social media is a particularly chilling way to control discourse. Not only does it blame the victim but it also seeks to disempower women from preventing victimization. If you don’t know about the dangers of childbirth, you can’t protect yourself from them. If you don’t know about the agony of childbirth, you can’t mentally prepare yourself for it. And if you don’t know about the suffering that childbirth causes many women, you may needlessly, regrettably end up blaming yourself when it happens to you.

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  • The Bofa on the Sofa

    I’ve said it before and I will say it again: 3000 years ago, childbirth was recognized as being so painful that it was attributed to being punishment from God.

    I don’t have to give birth myself to realize that childbirth is painful beyond my comprehension. I mean, the bible doesn’t talk about passing kidney stones as punishment from God. Or a hernia.

    So don’t tell me that horrible pain in childbirth is a cultural construct or any such nonsense.

  • The Computer Ate My Nym

    “Two hundred years ago people accepted that they might die from childbirth. Today we expect childbirth to be safe.”

    Whatthe? It’s okay to die in childbirth, so long as you aren’t afraid of it and of course people in the past back weren’t because they just accepted it? If they accepted it why did obstetrics even develop?

  • Jessica

    It’s not like this is only in history, either. In my own life, I know at least two women who have had stillbirths, as well as numerous others who suffered life-threatening complications (both to mother and baby) including prematurity, congenital defects requiring immediate post-birth surgery, cardiac myopathy, HELLP syndrome, preeclampsia, gestational diabetes, etc. I personally know two people whose babies died within days of birth, in the past five years. Even with medical interventions, the stillbirth rate remains around 1 percent. A baby’s birth date is the day it is most likely to die for the next 8 or so DECADES. No one looking at the evidence would conclude that childbirth is “safe” for mothers or babies.

    • Bugsy

      Same with me. I’ve recently started my own business in newborn photography. Since starting it, I’ve met one mom whose son passed away at birth and another whose son had a heart attack at 5 days of age. This is out of maybe 50 clients. A mom in my son’s kindergarten class last year had a newborn die the year prior – I’m not sure if he died in utero. Birth is risky.

  • 3boyz

    I’m a religious person and was raised religious. From the earliest age, I knew childbirth was painful and dangerous because of the Bible. The Garden of Eden. Rachel dying in childbirth on the way to Bethlehem. Various mentions throughout the Bible of “labor pains” as a metaphor for the good things that come from great hardship. This isnti new. Labor friggin hurts. And it sometimes kills people. I mean, I was never so scared as to let it take over my life (I had another child after a traumatic unmedicated birth, and am eager to have more even though the last one nearly killed me. Don’t worry, with my doctor’s full blessing). But a healthy dose of fear is absolutely warranted,and always has been.

  • attitude devant

    Actually, this discussion doesn’t have to be historical. As recently as 2002 the maternal mortality rate in Afghanistan was 1.6%. Bad as that is, the mortality rate among infants whose mothers died bearing them was 50%, because there was no cultural expectation that a motherless child would be fostered by another family member or family.

    That’s what good healthcare does. It saves mothers and babies. Even now.

    • Amazed

      Oh but Afganistan is so behind the rest of the world! It’s all because their women don’t have the advantages of good health and clean water!

      Let’s focus, instead, of what counts for the good years of Socialism as a whole and my country in particular. Healthcare was accessible to everyone. In every town, there was a hospital, doctors, and midwives ready to provide care. There was, of course, no pain relief because Socialism had too many money problems to waste resources on something as insignificant as labour pain but hey, this is a plus in midwives’ book! Much support from families. Decent outcomes with resources and equipment that were adequate (kind of). Not Afghanistan at all. And yet, in 1957, a neighbour of my grandmother’s died in childbirth due to a pre-existing kidney condition and her little boy was given up for adoption because neither the father nor the mother’s family wanted to have anything to do with him. Saving his mother would have made all the difference.

  • demodocus

    Sure I was socialized to be wary of childbirth. Socialized by history books! Even in biographies of men, the authors frequently mention how X’s first wife died in childbirth or Y’s baby only survived a couple days/hours.

  • Zornorph

    I’m thinking about books that I read in school that had births that went wrong. I’m sure it would be a long list, but off the top of my head:
    MacBeth (Emergency C-Section)
    Little House books (Stillbirth)
    Tess of the d’Urbervilles (Stillbirth)
    Snow White (Mom died giving birth)
    Oliver Twist (Another mum dying in birth)

    I’m sure there were more; I’m not even thinking about short stories and the like, much less actual history. But as a student, I learned how dangerous birth was for women and babies. I would assume most students learn that.

    • attitude devant

      Angelique de Scorailles, impregnated by Louis XIV, whose baby died and who’s childbirth injuries were so hellacious that she never had sex again and wound up in a convent. (Antonnia Fraser, Love and Louis XIV)

      In A Christmas Carol, the psychic wound that makes Scrooge such a curmudgeon is the death of his sister Fan in childbirth. (Dickens)

      Wuthering Heights–death in delivery of a premature infant (Bronte)

      The Kite Runner—Amir’s mother dies in childbirth (Hosseini)

      This is fun!

      • Merrie

        Seemingly half the mothers in Game of Thrones/A Song Of Ice And Fire.

        Luke & Leia’s mom in Star Wars.

        The protagonist’s wife in The Slave, by Isaac Bashevis Singer.

        • KQ Not Signed In

          No, no, no. You just can’t include Padme Amidala’s death as childbirth related. She was killed directly by plot stupidity. They literally had her die “for reasons we do not know.”

          Although to be fair, I did find this absolutely fascinating article about women’s health care and Padme’s death. Soooooooooo maybe it is fair to call it a childbirth complication.

          http://motherboard.vice.com/read/womens-healthcare-star-wars

          Doesn’t make it any less stupid or lazy though.

          • Merrie

            Plot stupidity is lethal in a surprising number of works! 😀

          • MaineJen

            Yeah, that one always smacked of “died of a broken heart” or some BS. Like…no dude. That’s not a thing.

          • The Computer Ate My Nym

            There is a medical thing called “broken heart syndrome”. It’s a non-ischemic myopathy due to emotional stress. It looks like a heart attack, but occurs during severe stress in people with no risk factors. I never saw episodes 2 and 3, but I doubt it showed Padme gasping for breath and grabbing her chest as she died.

          • MaineJen

            Huh. The more you know!

        • Merrie

          The treatment of childbirth in The Slave is pretty interesting now that I think more about it. The character in question is pretending to be of a different racial and religious background than she is and is worried that her accent will give her away, so she and her husband move to an area where nobody knows them and decide that she will pretend to be mute. When she gets pregnant they’re very worried that if she can’t labor silently, she’ll give the game away–while everybody else in town is kind of suspicious and wondering the same thing. And of course basically exactly this ends up happening as she is delirious and babbling during the birth and afterwards before she dies.

    • 3boyz

      There are more modern examples too! In Sharon Creek’s Walk Two Moons, the protagonist’s mother has a stillborn baby girl (at home) and in moderns times (i think late 80s or early 90s). And let’s not forget, Lord Voldemort’s mother died in childbirth! Sybil, in Downton Abbey, dies from eclampsia in season 3.

      • BeatriceC

        Ken Follet’s “Pillars of the Earth” has a particularly poignant scene where the first protagonist’s wife dies in childbirth and the resulting child, the primary protagonist, is abandoned, then found and raised by a small monastery outpost a short distance from the city where most of the story action takes place. He also describes how several of the mother’s other children died in infancy because her milk supply kept disappearing when the infants were several months old, and how the family was so happy for the short time they were relatively prosperous and could afford a cow to keep some of the babies alive until they could be fed solids.

        • Madtowngirl

          What? Low milk supply was enough a thing in history to make it into literature? Now you’re just making things up. (sarcasm, of course)

        • 3boyz

          Can’t believe I forgot that one, Pillars of the Earth is one of my favorites! (And the HBO miniseries adaptation was pretty good too). I recall that scene, it actually vividly describes the father delivering the placenta and noticing that it looked like it was missing a piece, and of course, the 12th century masonry worker has no clue what it means, but the 21st century reader is thinking uh oh, retained placenta… And then when the monks care for the baby, they feed him by having him suck on a rag dipped in goat’s milk.

          • Merrie

            That’s one of my favorite books. I had retained placenta too in my second birth, and lived to tell the tale because unlike that character, who gave birth unassisted in the middle of the woods not by her own choice or preference, I had an experienced birth attendant.

          • BeatriceC

            I love that book, and I bring it up as an example of the dangers of childbirth throughout history as told through literature. To be honest, the birth of that baby and subsequent death of his mother is the singular pivotal moment of the story not just in Pillars, but also in World Without End. It’s an extremely common occurrence throughout history that served as the first domino that set off all the action in both books.

      • sdsures

        “Midwives” by Chris Bohjalian. Homebirth attended by a lay midwife (ugh), gets snowed in, mother dies from an apparent stroke, lay midwife performs cesarean on “dead mom” to save the baby.

        Blood spurted from where she cut the abdomen, resulting in charges of murder or manslaughter, can’t remember which.

        Very well-written.

        • Kim Thomas

          A friend gave me the Chris Bohjalian book when I was pregnant. Which was interesting…

    • KQ Not Signed In

      Anne of Green Gables lost her first daughter shortly after birth, and nearly died (and was “ill” for a year) after her youngest son’s birth.

      Melly Wilkes Hamilton in Gone with the Wind nearly died having her first, was weak for the rest of her life, and died after a miscarriage in her second pregnancy.

      Meggie Cleary O’Neil nearly died during her last trimester with her first child in The Thorn Birds – she “suffered badly from fluid in her tissues” and the doctor kept “muttering words like eclampsia.” There is also a fair bit about the problems her mother had at childbirth.

      Dolores’s mother in She’s Come Undone lost her second child due to a cord accident at birth and suffered catastrophic postpartum depression.

      In Madeline L’Engle’s book Many Waters (part of the Wrinkle in Time series) there is a very graphic birth scene involving tearing and nearly hemorrhaging. That’s in a YA novel.

      That’s off the top of my head without any effort at all.

      • MaineJen

        LM Montgomery actually based that story of Anne on losing her 2nd child shortly after birth IRL. She had two surviving sons, but never recovered emotionally from losing that baby. It wasn’t just in stories.

        • Melissa Wickersham

          Didn’t Mary Shelley lose a child in childbirth, or was she the daughter of a woman who died in childbirth?

          • Who?

            Mary’s mother died within weeks of her birth; her own first and second children-born when she was quite young-died as infants, her third survived.

    • MWguest

      I remember reading a local history news story about the first settler cemetery in the county where I live.

      A woman died in/after childbirth- unattended by any sort of midwife or physician. Middle of winter. The area was being newly settled. A neighbor girl was sent to care for the newborn (there was no one else around ). So instead of having a blissful baby moon, these poor folks were plotting a cemetery to bury this poor woman in.

      I can’t imagine the trauma or devastation.

      The story was about the first cemetery in the area- not about the inherent danger of childbirth – because that was a well-known fact of of life.

      I remember it as a chilling story, because of its matter-of-factness.
      “And that’s how the first cemetery was founded on the hill behind the Johnson farm!”

      • MWguest

        If this woman wasn’t the first to be buried in that cemetery- we’d never had heard about her. Death in childbirth was common.

    • The Computer Ate My Nym

      War and Peace: What’s-her-name dies in childbirth. (Sorry, I can’t remember any names.) Anna in Anna Karinina thinks she’s about to die in childbirth but barely survives.

      • MaineJen

        Anna Karenina actually has a very graphic birth scene, which I have to think was unusual for the time. It’s…properly horrifying. It’s not bloody or anything, but his description of the mind-blowing pain this poor woman was in, and how it transformed her from a demure Victorian woman to a screaming, sweating mess, is unfortunately 100% accurate. Just read that, if you think that people back in the day weren’t terrified of childbirth.

        • The Computer Ate My Nym

          And she anticipated this. She had dreams about dying in childbirth and was certain they were prophetic, which was almost correct. Death in childbirth is not new nor is fear of death in childbirth. No one ever thought it was just fine for it to happen.

    • yentavegan

      Washington Square by Henry James

    • LaMont

      “Wisdom’s Daughter,” a novel about King Solomon’s daughter and her encounter with the visting Queen of Sheba, opens with the QoS mourning her dead daughter and granddaughter – childbirth. Solomon’s daughter’s mother died in childbirth too. In the prequel “Queenmaker” about Queen Michal, Michal’s husband Phaltiel’s first wife, and Michal’s sister Merab, both die in childbirth. Her husband eventually tells her to knock off lamenting her barrenness, he doesn’t favor her “risking herself” that way anyway.

    • rosewater1

      In Marion Zimmer Bradley’s “Mists of Avalon,” Morgaine and Vivienne both nearly die in childbirth. Gwenhwyfar (how she spelled Guinevere) had a very preterm delivery with what sounded like a postpartum hemorrhage.

      Ayla in “Clan of the Cave Bear” had a very long labor that left her weak and unable to nurse.

      • KQ Not Signed In

        Ohh, two good ones!!! I forgot about the horrific births in Mists of Avalon

    • sdsures

      There’s an emergency cesarean mentioned in Macbeth? Neat! Where exactly?

      • Zornorph

        Act 5 Scene 8
        MACBETH
        Thou losest labor.
        As easy mayst thou the intrenchant air
        With thy keen sword impress as make me bleed.
        Let fall thy blade on vulnerable crests;
        I bear a charmèd life, which must not yield
        To one of woman born.
        MACDUFF
        Despair thy charm,
        And let the angel whom thou still hast served
        Tell thee, Macduff was from his mother’s womb
        Untimely ripped.

        • sdsures

          Neat!

          I think there’s a reference to premature birth in Richard III.

          • Zornorph

            And, of course, it’s not stated, but it would have been obvious to anybody watching the play that Macduff’s mother had not survived having him ‘untimely ripped’ out of her womb.

  • Cartman36

    I disliked Ms. Moore’s assertion that ” In theory everyone wants a low-lit birthing pool”. I had no desire to give birth in water or naturally for that matter.

    • Now I’m wet, and I’m still hysterical!

      • attitude devant

        And in pain! Wet, hysterical, and in pain!

        • namaste

          One of my all time favorites

      • KQ Not Signed In

        I don’t like people touching my blue blanket!

        • Christine O’Hare

          thank you for going there with the blue blanket!

        • namaste

          It’s just that I’ve had it ever since I was a baby, and I find it very comforting.

          • yentavegan

            sigh….I am indeed among kindred spirits. I feel comforted knowing that this community has so much in common.

    • demodocus

      In theory, everyone wants fried chicken and corn-on-the-cob for dinner. Or is that just me

      • Daleth

        Roast chicken for me, not fried. The siren song of the crispy skin…

        So wow, it’s almost like people are different, even when they have a lot in common.

        • seenthelight

          Broasted, when you can get it, is amazing. Best of both worlds

    • Bugsy

      I personally enjoy baths greatly – it’s one of my favourite ways to relax. There was no way I wanted to spend either of my labours sullying up my love for baths. I had epidurals and happily enjoyed labouring from the bed.

  • kilda

    >>>Julie Jomeen, a professor of midwifery and the dean of the faculty of health sciences at the University of Hull, said: “Tocophobia is a modern-day phenomenon. Some of these women really think they are going to die.

    “Two hundred years ago people accepted that they might die from childbirth. Today we expect childbirth to be safe.”
    Wow. So as she sees it, the problem here is that modern women have developed the inappropriate, unreasonable expectation of surviving childbirth. Whereas those sensible women 200 years ago knew they might die and they weren’t whiners about it.

    • Who?

      I was left with the impression that Julie can’t hear herself talk. ‘Stupid’ is not a word I use often but it’s entirely appropriate here.

    • lsn

      So… modern women have an unreasonable fear of dying in childbirth which two hundred years ago was an entirely reasonable fear. So what changed then Julie? Because dying in childbirth is still a reasonable fear as far as I can see.

      • RudyTooty

        Reading your comment makes me think:

        Too many modern women have an unreasonable non-fear of childbirth. Particularly modern women in wealthy countries with lots of medical resources at their disposal.

        The ones who are giving birth unassisted, or assisted with a midwife and refusing everything, or freebirthing, or in a tub of water at 43 weeks after a prior cesarean section….

        THIS is an unreasonable NON-fear.

        They believe being fearless assures absolute safety and a perfect outcome – AND IT DOESN’T.

    • Heidi

      What leads her to believe that women 200 years ago didn’t fear the death? Sure, they may have accepted it, but I wasn’t aware you couldn’t fear something you’ve accepted.

      • Sarah

        It’s not like anybody was asking them what they actually thought, or paying attention to what they said.

    • Merrie

      Now it’s rare enough that it’s more one of those freaky nebulous fears, rather than being something that you know is stalking you and all your friends and you just have to live with and has probably happened to a number of people you know. See also, death of a child from preventable causes.

      Just among people I personally know I can count at least four or five instances where mom and/or baby would definitely or probably have not survived birth prior to the modern era. I don’t know how many deaths from childhood illnesses have been prevented by vaccines among my friends. I do know a kid who spent 3 months in the hospital after being born at 26 weeks, and another who almost died of meningitis and was in the hospital for a long time for that. There’s probably others I’m not thinking of.

    • guest

      ORLY?

      The men put in charge of the first government-funded studies done on public health in France in the 1700s were inundated with letters from women begging to know how they could prevent death in childbirth.

      The first large-scale government studies done on women and children’s health in the United States were begun in the early 1900s, and the female social workers in charge of the program received tens of thousands of letters from women wanting to know how they could prevent death in childbirth.

      There are Egyptian papyri and Sumerian clay tablets and Roman scrolls that document women, in desperation, seeking the advice of priests and physicians and sages, trying to avoid death in childbirth.

      I think women today are much like the women of previous eras – they want to be alive to raise their children and enjoy their lives.

      My father lost a leg to sepsis thirty years ago and now wears a prosthetic. Should he and his doctors have just accepted that people used to die of sepsis, and let death claim him? Should he have lost out on decades of life, productive work, and raising his family? Would it have been reasonable to call him irrational and a whiner for wanting antibiotics and surgery?

      What exactly is different about a woman wanting medical intervention to survive serious injury in childbirth?

      Sexism and gross misogyny, that is what.

      Sorry for the rant, but this really gets me riled up on so many levels.