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I have been a “fan” of the Sunday Edition for the past 13 years.  I first tuned in while resting after giving birth to my first child.

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I have hollered at, argued with, and disagreed with many of your guests over the years–albeit from the sanctity of my kitchen or garden.  But I haven’t felt compelled to write in to the program until now.

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I listened with interest last week to your interview with Dr. Fernando Cervero, the chronic pain specialist.  The topic hit close to home: six years ago, while my husband waited for 2 years for a double hip replacement, he was mired in chronic pain, and ended up dependent on dilaudid (a narcotic pain medication) until after his surgery when he quit cold turkey, which was a feat in and of itself. The particularities, vagaries and politics of managing chronic pain are certainly important issues and needs to be further explored in our society.  I appreciated much of what Dr. Cervero had to say.

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Sadly however, Dr. Cervero’s comments about birth betrayed a complete ignorance on his part, of the science and physiology of childbirth, and of women’s experiences of giving birth, especially outside of a medical context.

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I mentioned that I first became a listener of your program after giving birth to my first son.  He was born at home, and so were my subsequent 4 children.  I am also an independent birth attendant and freebirth consultant, so I speak with many of women about birth, every day.  Contrary to what many might think, we “homebirthers” and “freebirthers” are not a radical sect, but a cross-section of women from all walks of life, (although we do tend to be very well-educated, statistically).

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And while birth is absolutely the most intense physical experience I have had, I could never call it “painful”.  Otherworldly, meditative, ecstatic, wild, and even excruciating at certain points.  But not painful.  And it may surprise you that most of the women I talk to who have chosen to give birth at home have a similar experience–birth is intense, ragged, primal, and there are moments of what some mothers describe as pain, but when the delicate filigree of hormonal interactions that underly the birth process are uninterrupted by bright lights, the presence of strangers, or machines and technological equipment, human birth actually looks very much like the birth processes of other placental mammals, with whom we share a surprisingly similar hormonal design.  And for women who choose to approach birth as the normal physiological event that it is, who choose to stay home rather than go to the hospital, birth is almost always a euphoric, transcendent experience.

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Please understand that I encourage women to make whatever choice for their birth experience that they feel comfortable with, whether that be home or hospital, or surgical birth, and I respect the right of all women to give birth where, with whom, and how they choose.  But I do worry that many women may be effectively deprived of true informed consent due to the misinformation that still so widely circulated about birth and in particular about pain and pain relief during birth–often from the medical community.

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The missing “rational argument” that Dr. Cervero alluded to against epidural pain relief has nothing whatsoever to do with morality, or any vestiges of religiosity, but rather is given by the most cutting edge science and biology of birth.

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When women choose to have epidural analgesia injected into their spinal columns, their bodies become numb from their breasts to their toes.  As is obvious, epidural drugs do affect the baby, and this has been associated with breathing problems in infants, unresponsiveness and other issues, and there are many researchers who feel that there is a strong link between epidural drugs during the birth process, and learning difficulties & behavioural issues later in life.  Epidural also changes the physical process of birth (which would otherwise be a hyper-sensitive, fluid and highly dynamic dance between the mothers’ and baby’s bodies). Because the mother is no longer an active participant in the process, the result is a much higher incidence of further interventions including the need for forceps and surgical birth, which can result in damage to the mother’s pelvic floor, incontinence, among other adverse effects.

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But perhaps most significant reason a mother might choose to decline an epidural is the overarching fact that the epidural completely disrupts the flow of hormones that interact so specifically in the mother and infant’s bodies during the birth process, including oxytocin, the hormone of love and connection, endorphins, the hormones of transcendence, adrenaline, the fight or flight hormone, and prolactin, the hormone of lactation and nurturing. Science is just beginning to discover the myriad and extremely complex ways that these hormones interact during birth.  But we do know that it is these hormones that not only ensure a safe and effective birth process, but which also lay a foundation for attachment between mother and baby, their breastfeeding success, and also that child’s hormonal blueprint for love and empathy.  Pioneers of this field include Dr. Sarah Buckley an obstetrician from Australia and Dr. Michel Odent also an ob., from France.  Their work, and the work of other experts on the physiology of birth, suggests that perhaps one of the reasons we in the developed world see such high incidences of postpartum depression, breastfeeding problems, colic, and possibly even depression in adults, can be traced at least in part to the shocking percentage of children who are born drugged, without the hormonal blueprint that all mammals are so specifically hardwired to receive during birth.

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Dr. Cervero’s statement that “women who choose to have childbirth without pain can have a much nicer experience, and it becomes a joyful event rather than an awful one” suggests to me that he has never witnessed an autonomous, unmediated, unmedicated, intervention-free, spontaneous human birth outside of the hospital.  The recent science of birth corroborates what so many women know:  that spontaneous birth in which the mother is the full authority of her experience is most often absolutely, transcendent, blissful and perfect.  This is, after all, how our bodies are designed to “do” birth.

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Pain and joy during childbirth are not mutually exclusive.  I wish it were not the case that so many women I speak to who obliterate the physical sensations of birth through epidural, find themselves dealing with what often ends up being a much more insidious, persistent, and long-term pain than the brief and instantly forgotten pain of birth, followed by a radiating otherworldly euphoric joy and a feeling of utter clarity and energy as the mother bonds with her baby in those never-to-be-replicated essential moments following birth.  Certainly not every women who experiences a medicated birth ends up disappointed.  But such a large number of women do, that I think the attitudes our culture and our medical communities hold about birth must be scrutinized and questioned.

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As I mentioned, I work with pregnant and birthing women, and although I am a  private person (believe it or not), I did choose to share the video of the birth of my youngest child with the world, because I think it is so important to show to other women how normal, hilarious, sweet and strange birth can be.  If you do decide to click on the link, just be aware that it’s a video of, well, birth, and as such it is extremely graphic and explicit, but at the same time, lovely, and dignified, and human, I think.

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