Thursday, July 15, 2010

Contraception and American Birth Culture

I recently had the privilege to read an amazing article by Penny Simkin called "The Experience of Maternity in a Woman's Life" (Journal of Obstetric, Gynecologic, and Neonatal Nursing, March/April 1996: 247-252). In this article, Simkin looks at the history of women's roles in the United States in order to discover the reasons for our 20th (and now 21st) century American birth culture of highly managed, medical childbirth.

The entire article is fascinating, but her observation that the introduction of birth control and the subsequent divorcing of sex from babies in the 1920s was partly the cause of the change in our birth culture is particularly so. After the introduction of contraception, women felt free to flaunt their sexuality becuase they were "protected" from the sex = babies equation, but, ironically, even as they gained this perceived control over their sexuality, they began handing over their control of the birth process:
Several other trends combined to lead women to relinquish the control they had in childbearing and to foster the medical perception of the human body as a complex machine that is devoid of feeling. The practice of birth control, leading to a steady decline in the birth rate, meant a reduction in women's personal experience, knowledge, and self-confidence in giving birth. Grand multiparas had been important teachers.... But now there were fewer grand multiparas. (249)
The sexual liberation provided by birth control not only affected birth, but also breastfeeding -- artificial formula meant "freedom from child care" (249). Women wanted freedom -- freedom to be out in public when pregnant, freedom from nursing their babies, and freedom from pain in childbirth. When twilight sleep was introduced (a combination of scopolamine and meperdine) and touted as the way to achieve best outcomes for mother and baby, women demanded to be put under to be delivered of their babies.

In the 1960s, the introduction of the Pill and the desire of many women to return to the workforce heightened the problem. Enter the Women's Liberation movement and the birth of feminism. Enter also the degradation of the position of mother and housewife. As Simkin puts it, "No longer could women find fulfillment, respect, and pride in housework and motherhood. Such work was no longer valued in society" (248). To stay at home and raise one's own children was perceived as low class and ignorant. What was the result of this matrix of attitudes about children and work? Simkin argues that
[t]he belief that anyone can raise a healthy, happy, competent child lowered the value of child rearing and produced a careless attitude toward day care. People who could not do anything else could raise children, so only minimal standards of safety and cleanliness were set, and day care centers...proliferated to meet the needs of mothers who entered the work force. (248)
Today, the combination of overworked parents who have little time for or interest in preparing for childbirth, the uptick in medical malpractice litigation, and the perception that it doesn't really matter how you birth your baby (250) has led to a birth culture where more than 1/3 of women will give birth by cesarean section and almost 3/4 of women will opt for epidural anesthesia (see the Listening to Mothers Survey II at Most companies allow new mothers six weeks to give their full attention to their babies, and then mothers find childcare arrangements and go back to the office. We need only look around or listen to the news to see that quantity, not quality, still dominates child care in this country.

I find Simkin's article so illuminating because it demonstrates that the sexual relationship between man and woman -- and one that is open to the creation of a child -- is absolutely integral to society as a whole. The violation of that order through artificial contraception has had devastating ramifications across the board.

We need to do some hard thinking as a culture regarding our attitude toward children. If they are perceived as a burden, an inconvenience, or something that needs to be scheduled around career or something else, can we really expect women to desire normal, natural childbirth, with all its unpredictability and emotional and psychological intensity? And when we as a culture have rejected babies and motherhood, why should we expect it to welcome and celebrate birth?


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