Wednesday, February 14, 2007

Traditional birth attendants

Grantly Dick-Read fabricated the idea that "primitive" women had painless childbirth. Nonetheless, many of his acolytes still claim to believe that pain in childbirth is the result of social conditioning, and that indigenous women do indeed have painless labor. The professed belief in this fabrication is belied by the actions of believers, though.

If indigenous women and women living in poor rural areas of third world countries really had painless labor, it would stand to reason that we could learn a lot from observing them. Moreover, traditional birth attendants, who presumably preside over these painless labors, would have a great deal to teach us about natural methods of preventing or eliminating pain in labor. So why aren't lay midwives rushing over to third world countries to observe and learn for themselves? Why aren't they attending traditional midwifery training in third world countries? Why aren't midwifery schools inviting traditional birth attendants to give guest lectures or attempting to lure them away from home to be faculty members?

Why? Despite fervent protestations that they truly believe that indigenous women have painless labors, deep down they know that is not true. If indigneous women really had painless labors, midwives (and obstetricians) would be rushing to third world countries to see how it is done. Midwifery schools would be vying with each other to fill their faculties with traditional birth attendants. The best midwifery students would head to Africa or South East Asia for their training, and they would bring back this important knowledge to share with their colleagues in first world countries. None of this is happening, because everyone knows that pain is an inherent part of labor in all cultures, in all countries and at all times.

Addendum: I have been reviewing the literature on the perception of labor pain in different cultures. I have found papers about women from the Yoruba tribe, Nigeria, Mozambique, Tonga, Guatemala, Korea, China, Lebanon, Jordan, Kuwait and other places. I cannot find even a single instance of painless labor reported among these women in the medical literature, the anthropological literature or the sociology literature. There is not a shred of evidence to back the claim that "primitive" women do not experience pain in labor. Grantly Dick-Read made it up and the only people who still accept this fabrication are advocates of philosophy driven ("natural") childbirth.

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