Sunday, December 14, 2008

Orgasmic Childbirth - Unicorn, Guilt Trip, or Taboo?

Now that I've been nominated for the honor of Hottest Mommy Blogger, I guess I have to live up to it by promiscuously mixing sex and maternity in a single post.

At the New York Times Motherlode blog, Lisa Belkin unleashed a storm of debate a few days ago by raising the question of whether childbirth can result in an orgasm. Belkin described a documentary entitled "Orgasmic Birth" that will air on ABC's 20/20 on January 2. (Correction 12/15/08: The 20/20 episode will discuss the topic but only show excerpts from the actual film.) While over the years a small number of women have reported experiencing orgasm during labor, it's quite uncommon. According to its director, doula and childbirth educator Debra Pascali-Bonaro, the film's intent is not to imply that orgasm during childbirth is attainable for all women; rather, she says:
"I hope women watching and men watching don't feel that what we're saying is, every woman should have an orgasmic birth," she said. "Our message is that women can journey through labor and birth in all different ways. And there are a lot more options out there, to make this a positive and pleasurable experience."
(ABC's entire promotional summary is here.)
Fair enough. But why, then, choose such a misleading title? Okay, ABC wants to drive ratings. Pascali-Bonaro wants people to watch her film. But dang it, the title is sure to generate more heat than light. (Oops - no pun intended.)

That's not to suggest orgasmic birth is entirely fictional, even if it is vanishingly rare. More than one commenter on Belkin's blurb reports having experienced an orgasm during birth.
No, it is not ridiculous, because some of us actually experienced it, but were too embarrassed to mention it.

It happened during both of my deliveries, and it’s kind of a relief to read this and know that it has happened to others - I didn’t even tell my husband, because it sounded so weird, and I was afraid it would make him feel really insecure!

— Nell
Nonetheless, orgasmic birth also appears to be very infrequent indeed. It's also not clear that what these women describe as "orgasm" is the same sensation they'd experience during sex. Of course there are different flavors of orgasms, even as experienced by the same woman at different times. But a couple of the descriptions given by those who've been there make me skeptical that this is actually "orgasm" as opposed to some other sort of pleasurable peak experience:

Yes, actually it’s true. I had that experience, and I sure wasn’t expecting it. It wasn’t like sex at all, it was more like surfing the best wave ever.

— Catherine

Well, I guess I’m in the minority here, but the birth of my first child was actually an orgasmic experience…So much so that the first thing I said to my midwife after I could see straight was “I want to do that again! Right now!”…What I experienced was not identical to an orgasm during sex, but it was intensely pleasurable and memorable enough that I couldn’t wait to go into labor with my second baby… — rebecca
Even Tamra Larter, the woman whose birth is shown in the film, qualifies her experience in a follow-up post by Belkin:
“I never claimed to have a pain-free birth,” she wrote, “but laboring with my daughter was awesome and for the most part felt really good.” The actual “orgasmic experience” did not feel like the climax of sex, she says, but rather “sensations which were something different than sex, but similar enough I feel O.K. using the word orgasmic. It was a wonderful feeling.”
If some mild skepticism is warranted about the nature of the experience, there are stronger grounds to worry that a few women's capacity for pleasure will get blown into another benchmark for all women's "performance" in labor, much as some women's (reasonable) preference for drug-free childbirth has too often been treated as a modern norm for the Good Mother. Concerned that this film will raise unrealistic expectations, one midwife writes:
As a Certified Nurse Midwife who has worked with thousands of women during their births, I can safely say I have never seen a single one come close to an orgasmic experience. Having said that, I work in a busy hospital, not in peoples homes. Most couples do not “mak[e] out” in the hospital. I could see an orgasm as a remote possibility if someone were deeply relaxed in the comfort of their own home.

— MSW
The thing is, most of us aren't that relaxed. Sure, tension exacerbates pain, but that doesn't mean the pain itself is illusory. The ABC promo for the documentary and its director's comments imply that pain in childbirth is avoidable. It's true that a lucky few women do actually experience a pain-free, unmedicated labor.
I certainly did not experience an orgasm with either birth, but I was quite surprised to find that the 2nd stage of labor (pushing the baby out), did not hurt at all (in contrast to 1st stage, which was like a hellish version of menstrual cramps). At one point, the midwife asked me to “push into the pain.” After a few repetitions of this instruction, I told her that I had NO PAIN. I’m quite prepared to believe that the experience of childbirth differs greatly from woman to woman, and from labor to labor; and I’m sure there may be a luckly few who even experience orgasm in 2nd stage labor.

— Laurel
While pain-free birth is highly unusual (though not as exceptional as orgasmic birth), it does exist, and anyway I would never presume to tell another woman what she did or didn't experience. I don't know what causes painless birth, but I can think of a couple of possible explanations. Maybe it's natural endorphins. Maybe just-right pressure on pelvic nerves cuts off sensations. Maybe mind triumphs over matter.

I do know that given the rarity of painless birth, the rest of us shouldn't be made to feel like it ought to be within everyone's reach.

One Motherlode commenter implies that if you do feel pain, it's because you're, well, a tight-ass. Or too tight somewhere, anyway.
Of course it [orgasmic birth] makes sense. Women’s bodies have been birthing babies for eons. When they are truly open, and energy is flowing, anything can be ecstatic, orgasmic. Same nerves, just have to be stimulated in a system that is open. There can be uterine contractions, but if the emotions are not contracted, of course it can be orgasmic. Proof is in the example given, and in the case of many.

— Robbie
Um, yeah. Those nerves need to be stimulated, all right. How they're stimulated matters very much. Most women have fairly specific preferences about how they like to be touched even under ordinary sexual circumstances. Most of us don't prefer levels pressure otherwise achieved only by pneumatic tools.

An advocate of hypnobirth who believes labor pain is merely a self-fulfilling prophecy chides us for forgetting our animal roots:
Watch animals in the wild who aren’t taught what to expect. They don’t cry out in pain. For others its the most painful thing they ever experience. I believe this is mostly due to that expectation combined with the way many hospitals pressure one to push and to see the whole experience as medical and anxiety producing.

— Erika
Well, wild animals don't generally walk on their hind legs, which necessitates a smaller pelvic outlet. They also don't spawn absurdly big-brained progeny. If you want to appeal to nature, let's be honest about our natural differences from other beasts. We're operating with a system with very narrow tolerances and no real clearance whatsoever. It's a tight fit, and sometimes the fit is simply too tight.

That's why for most of us, childbirth really does hurt like a sonofabitch. We're not deluded, uptight, or removed from nature. We're just responding to pressure on nerves that I'd be tempted to call inhuman if it weren't so characteristically human. Some Motherlode commenters compare labor pain to a root canal without anesthesia. Others just said it was excruciating. I sort of related to this description:
My first birth experience I’d liken to be turned completely inside out and then having a very large tractor run over me back and forth for 30 hours.

— Jenna
In my own experience, even the pain of early labor had nothing to do with mere cramps, whether a "hellish version" or not. When I had my first child, I had debilitating back pain within the first half hour of labor. It didn't feel like cramps. It didn't feel like the regular, five-minute-apart pains that all the books described. It was a wall of continuous pain.

I was one of the best-educated first-time mothers I've ever known, and yet, I had only one thought as I crouched on all fours on the bare linoleum of my apartment's hallway at 4 a.m. and waited for my husband to haul his butt out of bed: I am clearly dying. There was no point in timing contractions, because either I was in labor or I was in mortal danger. Either way, the hospital sounded like a brilliant idea.

Then there was the nausea. More surprisingly, there was the uncontrollable chills and shaking. By the way, that's another experience neglected by the What to Expect squad: the not-uncommon uncontrollable trembling that can occur during labor, and not just during transition. There's a world of difference between this and shuddering in ecstasy.

The other main objection to this documentary that Motherlode readers express is disgust at the idea that the birth of a baby could be a sexual experience (and not just the result of our sexuality). This reaction doesn't come just from defenders of the medical model of childbirth. Even some commenters who chose "natural" (that is, unmedicated) birth are repelled by the idea of orgasmic birth:
I’ve given birth three times. One in hospital, one in birthing center, and one at home. All were so painful I lost my voice. Orgasm during child birth seems gross and weird. Not to mention the midwife/ doctor/ nurse/ whatever around while you are giving birth and who would want to have an orgasmic birth with people watching you. Giving birth is hard enough, let along with people around watching you and then expecting you to orgasm while you are in the most insane pain anyone could possibly imagine. How intrusive and bizarre. I can’t even get my mind around it.

— Jennifer

Everything else aside, I feel like it’s going to be really awkward down the road when Baby Larter reads in The New York Times that he entered the world to his parents “kissing and caressing,” and he may have actually given his mother an orgasm. On camera.

— Ben A
It seems almost self-evident that the "gross" response is rooted in our incest taboos. People are icked out at the idea that you could get an orgasm from your very own baby. I suppose it might sound like it carries a whiff of pedophilia too.

Of course, this is nonsense. It's not as though women set out to have a baby because they think it'll be a sexual thrill to push it out. (Well, at least now they don't. Let's see what happens after this documentary airs!) Nor do women forgo pain relief in hopes of an orgasm. Those who do experience sensations they label "orgasmic" actually sometimes express confusion about it (like the first woman I quoted, who wondered if telling her husband about it would make him feel insecure).

More commonly, women experience sexual pleasure and sometimes even orgasm while breastfeeding. We don't talk about this, either, because it feels vaguely incestuous. Yet it's a widespread enough experience that taboos and silence only condemn women to feeling shame.

But this taboo is the real shame. It alienates women from their bodies, makes them feel freakish, and tries to shore up an untenable line between our experiences as parents and our existence as embodied creatures. That's a conversation I'd love to see this documentary inspire: how can our culture move beyond its anxieties about parents as sexual creatures? Unfortunately, the chance of that happening is about as likely as, well, a woman actually having an orgasm in childbirth.

Update 12/15/08, 1 p.m.: Laura Shanley, a proponent of "unassisted childbirth" who appears in the 20/20 show, has contributed her perspective in comments, so be sure to check them out. Also, to see a trailer for the documentary, go to its website, Orgasmicbirth.com. If you're at work, make sure your computer's sound is muted or pop on your headphones, because the trailer's soundtrack is pretty much what the title implies.

Also, if the film's publicity is not meant to play up its potential sensationalism, then it's doing something wrong. From its website:
Joyous, sensuous and revolutionary, Orgasmic Birth brings the ultimate challenge to our cultural myths by inviting viewers to see the emotional, spiritual, and physical heights attainable through birth. Witness the passion as birth is revealed as an integral part of woman's sexuality and a neglected human right. With commentary by Christiane Northrup, MD, and midwives Ina May Gaskin, Elizabeth Davis and other experts in the field . . . and stunning moments of women in the ecstatic release of childbirth.
It's hard not to read this as a blurb for soft-core erotica. Nothing wrong with erotica, mind you, but this way of framing the film won't focus attention on the larger issues of home birth, support for women, etc. that are supposedly the film's broader agenda.

7 comments:

Laura Shanley said...

Congratulations on your nomination! :) Regarding, Orgasmic Birth, I think if you saw the film you would see that it actually doesn't put guilt trips on women, and should inspire the sorts of conversations you're advocating. The film actually won't be shown on "20/20," but they will feature clips. The film itself isn't about how to have an orgasm in birth, nor does it claim this is the goal. It’s about viewing birth as a natural bodily function, not an inherently dangerous, painful medical event that needs to be managed, controlled and medicated. It’s about tapping into our own natural resources, rather than turning ourselves over to the medical establishment to “save” us from ourselves. Any natural bodily function – going to the bathroom, having sex, or giving birth – proceeds best when it’s done in privacy, and this is what the women in the film advocate. Try bringing a crowd with you into the bedroom or bathroom and watch what happens. The experience completely changes. And this is what has happened to childbirth. The medical profession pretends this isn’t a sexual act, yet it involves the same hormones and organs as sex. When we recognize the inherent sexuality of childbirth, overcome our fears and inhibitions, and keep strangers away as much as possible, birth can be ecstatic if not orgasmic.

I’ve been writing and speaking about these concepts for years, and will be appearing in the “20/20” program, although perhaps just in the homebirth segment (I was interviewed for both the homebirth and orgasmic birth segments). Those who are interested in learning more can visit the sensual birth section of my site - http://unassistedchildbirth.com/sensual.

Sungold said...

Hi Laura - and many thanks for stopping by again. I very much appreciate your inside perspective as a participant in the film.

I definitely do plan to watch the film in its entirety if possible, as well as whatever crumbs 20/20 will throw us. Why doesn't it surprise me that ABC plans to show only clips? I hate to be cynical but I'm afraid this scenario calls for it. I picture ABC both sensationalizing the topic, and being *totally* uptight about it. The word "prurient" might just sum it up. Oh, maybe they'll surprise me after all and give us excerpts that accurately reflect the film. But I'm skeptical.

Any idea how the actual documentary will be distributed? I seriously would like to see the whole thing. I live in a small college town in Appalachia where we can't expect the same palette of films as you'd find in NYC, for instance.

I do appreciate the "crowd" problem in the labor room. I agree that it's real, and laboring women do better with appropriate privacy. And yet, sometimes people need help. My kids needed assistance in learning to use the toilet. I was grateful to have smart, empathetic coaches in both my labors - and I don't mean my husband, I mean the midwives and labor nurses who actually had a clue. But they also had enough tact and sense to leave me and him together for extended times. I had good experiences along those dimensions.

I need to read up more on the hormones. Oxytocin is definitely a key hormone in both sex and birth, but is there more overlap? I know that dopamine, for instance, is a big part of new-relationship lust, but I don't imagine it plays much of a role in childbirth.

Thanks again, Laura, for your comment.

Laura Shanley said...

You're welcome! I'm actually not in the film, just the "20/20" motherhood show which deals with several topics - orgasmic birth, homebirth (both unassisted and midwife-assisted), long-term breastfeeding, and perhaps other subjects, as well. The childbirth educators interviewed in the film do recognize that complete privacy isn't always possible, and certainly doctors, nurses and midwives can be helpful to birthing women and their babies. As far as how the film is being distributed, it's now being sold (for $35) through their web site, www.orgasmicbirth.com.

Debra Pascali-Bonaro, the film's producer, has told me that she's very optimistic about the "20/20" piece. She feels it's going to be presented in a respectful way. The more negative comments will probably appear in the homebirth segment, as I was told by the producers that there will be doctors who will encourage women not to give birth at home. Still, the producer that interviewed me has said that the segment is "fair and balanced." I guess we'll know soon!

Regarding the hormones involved in birth, there are quite a few. I was reading recently that stress affects our ability to produce estrogen. Without estrogen, the cervix won't soften and dilate, nor will it close up after the birth, making hemorrhage more likely. This is why it's so important to be relaxed during birth.

Sungold said...

Thanks for clarifying, Laura. I've added a couple of updates to the post and also included a link to the film's website. I do think the website plays up the potential sensationalism, which is a bit of a pity if the intent is really to launch a debate on homebirth, etc.

Interesting point about estrogen. I'd read that at some point, too - but what I know about endocrinology I've learned in fits and starts, so I have trouble getting a grip on the big picture. I do know that lots of other factors play into the propensity to hemorrhage - I just tend to bruise a lot, for instance, and I associate that with my own tendency to hemorrhage after childbirth. (After my second delivery, I was the first person who realized there was an issue! One more instance where it's good to know one's own body.)

hesperia said...

Okay. Deep breath. Pant, pant, pant.

I also think I was the most educated woman to give birth, evah! I had planned a totally "natural" birth - what's an "unnatural" one? It didn't go that way. After 28 hours of labour, I was about to be pretty much forced into a caesarean section when my son finally decided to be born. But eight hours before that, I gave up the ghost and had an epidural. Honestly, I think I might have lost my mind if not for that. It's how I felt - I'm about to lose my mind.

I suppose if I'd had an orgasm while giving birth, I wouldn't have known it because of the epi. Without the epi, I wouldn't have cared.

When my son was born, I was able to experience the deepest pleasure I'd ever known. That's still true, but for the birth of my second son, also with epidural.

The drag of it all is that I believed I was an utter failure. I was so ashamed of having "given in" that I could barely talk about it and several times, I avoided telling the truth of it. And yes, a few of those whom I discussed it with felt that I wouldn't have had to do the epidural if I'd been more effective or had better support etc. - I felt I'd had everything I needed, except the ability to endure overwhelming pain for several days.

You can't deal with those arguments - the ones that say you could have been better prepared or any one of a number of details ought to have been better. There's no room left in that for disagreement.

But shame should never be a part of giving birth. I support any safe technique for giving birth and women who have orgasms while doing it - well, more power to 'em. But there shouldn't be a way to do it that excludes any woman's experience of what's doable and what just isn't.

Grrr. This makes me angry on behalf of my young self, all over again.

hesperia said...

Oh, btw, there wasn't anything remotely "sexual" as such, about childbirth for me. But it certainly was an ecstatic experience.

Sungold said...

Hesperia, you articulated exactly my position. Except that I knew I'd almost certainly want an epidural, with both labors. I had some unconventional help with my first birth, which was in Germany - including some homeopathic remedy and acupuncture when my baby got stuck, as well as going through the Kama Sutra of birth positions. The vacuum was necessary anyway, and in the end I was glad to escape a c-section, but also ill-informed on the risks (to me) of a vacuum delivery with the baby still quite high - his head would not properly engage. But that particular trauma would be the topic for another post, if I ever felt bold enough to write it.

Women face the potential for shame from all quarters when it comes to childbirth. You turn down technology, someone will tell you you're doing it wrong. You embrace medical assistance, and ditto! I do have certain hard limits when it comes to what I consider safe, but all in all I think women face *way* too much judgmentalism at a time that is often fraught with anxiety and vulnerability anyway.

Thanks so much for telling your story. And please know that I think I understand.