Dear New York Times, since when is treating women’s pain an “intervention”?


Proving yet again that newspapers should not opine on medical issues, The New York Times tackles the safety of midwifery in Are Midwives Safer than Doctors?

Let’s leave aside for the moment the fact that the Editors don’t really understand the new UK recommendations and their back story, and let’s focus the misogyny directly regurgitated from the propaganda of the natural childbirth movement.

Doctors are much more likely than midwives to use interventions like forceps deliveries, spinal anesthesia and cesarean section.

Oops! Spinal anesthetics are used for planned surgeries; the Editors are apparently referring to epidurals.

An epidural, the single most effective method for relieving the agonizing pain of childbirth, is an interventions?

Since when, dear Editors, is treating pain an intervention? Oh, right, when it’s women’s pain. No one ever thinks treating men’s pain is an intervention, do they?

The truth is, however, that adequately treating women’s pain, in childbirth or from any other cause, is a feminist issue.

Let’s look at some empirical facts about labor pain:

1. Childbirth is excruciatingly painful. Indeed the pain of childbirth is so impressive that ancient cultures imagined that the only possible explanation was divine punishment of women for their transgressions.

2. Severe pain should be treated. No one would ever suggests that cancer pain be ignored or that pain from a broken bone should go untreated.

3. Medical professionals have an obligation to treat pain. Every human being is entitled to the medical treatment of pain if that’s what he or she desires.

But all too many midwives, prisoners of the philosophy of natural childbirth, view birth as a piece of performance art, wherein a woman demonstrates her intrinsic worth by attempting to recapitulate childbirth as they imagine it occurred “in nature” (minus all that death, disability, subsequent incontinence, etc., of course); that means no relief for excruciating pain.

In other words a woman’s need for pain relief is rendered invisible.

How do natural childbirth advocates do it?

  • Blaming the woman for her own pain – if she did it “right,” childbirth would not be painful.
  • Blaming the woman for not using “natural” methods of pain relief – regardless of their questionable value in providing adequate relief.
  • Blaming the woman for not embracing the pain as an “empowering” aspect of her biological destiny.
  • Blaming the woman for not understanding that childbirth is “good” pain, even though it is biologically identical to all other forms of severe pain.
  • Treating women’s need for pain relief as an “intervention,” although, to my knowledge not a single form of pain relief for men is ever considered an intervention.

Simply put, according to natural childbirth dogma, a woman’s pain in labor is irrelevant.

There is a long and disreputable history of ignoring women’s pain.

The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain, Journal of Law, Medicine & Ethics, 29 (2001): 13–27, provides a disturbing description of the ways in which the pain of women is systematically devalued, disbelieved and undertreated.

Given that women experience pain more frequently, are more sensitive to pain, or are more likely to report pain, it seems appropriate that they be treated at least as thoroughly as men and that their reports of pain be taken seriously. The data do not indicate that this is the case. Women who seek help are less likely than men to be taken seriously when they report pain and are less likely to have their pain adequately treated…

The study by McCaffery and Ferrell of 362 nurses and their views about patients’ experiences of pain found that while most of the nurses (63 percent) agreed that men and women have the same perception of pain, 27 percent thought that men felt greater pain than women. Only 10 percent thought that women experienced greater pain than men in response to comparable stimuli. This result has no justification in the literature … The same study also found that almost half of the respondents (47 percent) thought that women were able to tolerate more pain than men as compared to 15 percent who felt that men were able to tolerate more pain than women…

These erroneous attitudes are particularly prevalent in regard to childbirth:

Bendelow found that “the perceived superiority of capacities of endurance is double-edged for women — the assumption that they may be able to ‘cope’ better may lead to the expectation that they can put up with more pain, that their pain does not need to be taken so seriously.” Crook and Tunks point to the influence of the psychoprophylaxis movement in the United States with its implicit assumption that it is good to experience childbirth without the aid of analgesia. As a result, some women who have “gone through psychoprophylaxis classes, feel guilty if they relent at the last minute and ask for an epidural”; according to the authors, “these attitudes imply that we have a value system endorsed by some parts of our population that suggest women should be encouraged to keep a stiff upper lip.”

Most natural childbirth advocates appear to be unaware of the deeply sexist and racist history of the philosophy of natural childbirth. Grantly Dick-Read, the found of the philosophy, was a eugenecist who was preoccupied with visions of “race suicide” with primitive people overwhelming white people of the “better” classes. He thought that upper class women could be diverted from their insistence on greater political and economic rights back into the home where they belonged if only they didn’t fear the pain of childbirth. Therefore, he told women that the pain of childbirth was all in their heads; he lied in claiming that primitive women (i.e. black women) experienced painless childbirth because they were unafraid of it. In other words, the pain of childbirth is all in women’s heads. Never mind that is was a spectacular lie with a sexist, racist purpose. Contemporary natural childbirth advocates are still spouting the same misogynistic clap trap, counseling women that childbirth pain is a result of fear.

The end result is that, women’s pain is discounted and ignored, and treating women’s pain is derogated as an “intervention.”

But, dear Editors, women’s pain is should NOT be discounted and ignored. The treatment of women’s pain is never an intervention; it is feminism at its most basic.

Claiming that treating childbirth pain is an intervention is both brutally misogynistic and hideously cruel.

Please correct your mistake as soon as you possibly can.