Week 20: Reading Childbirth Without Fear

Childbirth Without Fear is a fascinating example of how a sensitive, compassionate and feminist man can support natural childbirth – and how that support, when coming from a man, does not equal the same support coming from a woman.

Grantly Dick-Read empathizes with women’s experiences giving birth in a way very few doctors, and very few people who haven’t given birth, can. He writes about how a piece of music, heard during a traumatic incident in his childhood where he heard someone being shot, could re-trigger the same feelings years later. His comparison between that triggering and what a woman may feel when re-thinking her traumatic birth is striking in its compassion and respect for the lifelong impact that a violent birth experience may have.

Likewise, his moving story of lying in a rehab hospital after the war, half blind and paralyzed, and hearing people say “at least you are alive!” virtually replays the ignorant “at least you have a healthy baby!” comments heard so often these days (and probably in his days, too). The nurse who holds his hand in silence and peace is a model for doulas and midwives, and he says obstetricians should give laboring women the gift of silence, peacefulness and undisturbed support too.

The book is wordy in true British style. It’s also extraordinarily well written and contains nuggets like this:

Each constituent of the ordinary is so extraordinary when understood. It is so in nature, in every sphere, one if its great fascinations. It is more thrilling to watch an avalanche crash in a cloud of snow to the bottom of a ravine, than to lie on the edge of a Norfolk marsh. Yes, more thrilling – until you have looked quietly and closely into the reeds.

or this:

Frequently fear and pain are initiated by the physician himself owing to his entire lack of understanding of the true significance of the phenomena of pregnancy and childbirth. It is difficult to give confidence when you have none; it is not easy to eliminate fear in another when you are apprehensive yourself.

This quote describes perfectly the attitude of many obstetricians I have encountered; whether they are afraid of a bad outcome, a lawsuit, reproach for violating hospital policy, or of something undefined, fear characterizes their every interaction with their patients. Combined with a lack of understanding of the stages of normal labor, and with the fact that few have ever sat with a woman in labor from start to finish, it is no surprise that most OBs increase fear, tension and pain by their conduct.

At the same time as I agreed with his ideas, a strange feeling bothered me as I made my way through the text. I only realized after I had finished the book that the same weird feeling dogged me all the way through Memoirs of a Geisha.

Memoirs of a Geisha is a novel telling the story of a traditional geisha, written in the first person. It was recommended to me as a true story, fictionalized, and I didn’t realize until the very end that it had been written by a man.

The weird feeling came from reading an account of women’s lives written by a male author. No matter how much he understood and appreciated the geisha character’s experience, he could not remove his patriarchal position of privilege and authority from his interpretation of her point of view.

And it’s the same with Dick-Read. I deeply sympathize with what he is trying to say; it’s clear he has made an important contribution; and he seems like a good person – but he is still a man. That fact removes him from his subject. It places him in an automatic position of authority, whether or not he wants to be there. And as a member of the patriarchy, he can only do so much to improve things. Don’t get me wrong, I think he’s probably doing all that he can from his position – but it is a position within a hierarchy that consistently places women at the bottom.

Perhaps this is why I want to remain a doula and feel apprehensive about the possibility of becoming a midwife one day – and why I would never become an obstetrician. No doubt I could do very good work in those positions, but I do not want to take up a position within the accepted structures of our patriarchal society. Speaking from that position, I would inevitably be speaking – at least in a small part – on behalf of the system.

Childbirth Without Fear remains an interesting historical document and should be read by those interested in obstetrical history. But let the women’s voices be louder. I’m talking about Ina May Gaskin, Penny Simkin, Sheila Kitzinger, Pam England, Sara Buckley, Ricki Lake, Robin Lim, and others – some birth professionals, some not. Their voices are the ones that should be amplified.


About investigatingbirth

My investigations of birth began in 2009 when I was trained as a doula. I helped women consider the evidence on common interventions, and helped them prepare for the physical and emotional challenge of giving birth. After some time it became clear to me that there was another type of challenge that I was unable to adequately prepare them for, the challenge of the maternity system. But it was only after my own traumatic birth in 2013 that I realized how little I had understood. I began to ask questions that few around me - doulas, nurses, midwives, doctors - were comfortable hearing. Questions like: Under what circumstances, and for what reasons, do doctors not practice informed consent? How do hospitals deal with other patient populations vulnerable to abuse? How does loss of professional autonomy, for obstetricians, and professional authority, for midwives, impact the quality of care they are capable of providing - regardless of their training? This blog will collect noteworthy information that attempts to answer these and other questions. Most of what you see here will be aggregated from other sources and analyzed. You will also see original interviews, and the occasional opinion piece or personal story, as I try to piece together a clear picture of the system in which American women give birth.
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