October 08, 2004

The inherent sexuality in childbirth

For the last two days I have been in Inverness, working with a group of midwives from Raigmore Hospital, the main hospital and referral centre in this part of Scotland and nearby maternity units on Skye and Fort William. They were a fun group, full of laughs and very experienced.

At the end of the first day, I always show a video and I was tossing up whether to show “Giving Birth, Challenges and Choices” or the film “Inner Strength”. Being in Scotland, and knowing that there is a high use of diamorphine (heroin) in labour and many epidurals, the issues of the effects of drugs, as explained in ‘Giving Birth: Challenges and Choices” would certainly be useful. In the end I chose “Inner Strength” because it is a beautiful film for demonstrating the physiological behaviours of women labouring without drugs and also for showing the role of the midwife.

Afterwards, I asked the group for their feelings about the film. Several commented on the very sexual nature of these births and one said that if we were only listening to these women it could easily be assumed that they were having some great sex rather than giving birth. I was pleased that this was the facet they chose to emphasise because the innate sexuality of childbirth is a topic that is often avoided. The midwives in this film were able to create a human environment where the women could be completely free and spontaneous, where all behaviours were acceptable and nothing would be considered shocking or “not nice”. This is easier to do in a birth centre where the midwives know the women in advance and where the physical setting is comfortable and private. However, even in such a place, a midwife still needs to project her complete acceptance and trust of women when they give birth and this is a quality that some midwives may struggle with.

In a hospital setting the odds are stacked against privacy, midwives are often unable to work effectively with women to create a trusting relationship and the pressures to “conform” can overwhelm the need for intimacy and freedom. Creating the right kind of human environment in a maternity hospital is a difficult challenge, but one that I believe is achievable. Tomorrow we will explore some strategies that may help make it happen.

I believe that many of the disappointments that women experience when they give birth stem from others making judgements about their performance (not big enough, not fast enough, not efficient etc) and these are really veiled challenged to their sexuality. Perhaps this is not clearly understood by either the women (or those making the judgements), but I believe that its effects can be devastating, leading to depression and grief. It may well be one reason why women will elect to have a caesarean when they have been found “wanting” in an earlier birth.

Posted by andrea at October 08, 2004 09:18 PM