Friday, October 12, 2007

Why talk about good pain rather than good pain relief?

Kathryn Alexander, co-author of Easy Labor, Every Woman's Guide to Choosing Less Pain and More Joy During Childbirth, has a piece on Babble, entitled Insufferable, Why do people talk about managing pain, not eliminating it?. The article is both funny and though provoking.
At the final meeting of my childbirth preparation course, the instructor finally broached the subject of labor pain relief... Even then, in the eleventh hour of the class, all I heard were words like "trust," "empowerment" and "self-confidence." Was this a scout meeting? Trust, empowerment and self-confidence are not anesthetics.
Alexander asks:
This claim by the experts that women become better people, possibly even better mothers, for having successfully given birth without the benefit of medical pain relief, led me to wonder what excruciating physical challenge my husband should triumph over to become a superior father — and would I get to choose?

Even before my own difficult labor, the attempt to reframe the pain of childbirth as "good pain" struck me as a bit of a sham. I found myself wondering why my teachers were talking about good pain rather than good pain relief...
She raises the most important question of all:
Childbirth professionals with a nature-worshipping bias against medical pain relief seem to suggest that only self- indulgent, entitled control freaks — void of spirituality, feminist enlightenment and the ability to bond with their young — would want a pain-free birth. But the wish to avoid pain is not an upper-middle-class whim. It's a basic human instinct, one that has been useful in preserving our species. Since when did childbirth become about having a transformative personal experience rather than about getting a healthy baby and not dying (or wishing you were dead) in the process?
Alexander acknowledges that birth may be over medicalized, but asserts:
... [P]ain relief is not the culprit. These are care issues that have to do with how physicians practice, how legal threats loom and how big institutions can't seem to deliver comfort — even with pretty new wallpaper and lots of big pillows.

Contrary to the suggestion made by its opponents, the epidural is not an unnecessary medical intervention that deprives women of satisfaction and empowerment while giving birth. Moreover, telling pregnant women they should attempt to deal with their pain as an exercise in "plumbing the depths of their inner resources," rather than honoring their choice to give birth on their own terms, without pain, is in itself disempowering.
She sums up with a sentiment that is shared by the vast majority of mothers:
... [F]or me, giving birth was the fulfillment of a lifelong wish to have a baby, not a means of self-actualization.


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