Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank by Randi Hutter Epstein. Social history of pregnancy and childbirth
This book is an examination of the way childbirth reflects societal attitudes. Epstein touches lightly on ancient history through the Eighteenth Century. She really beings to look in depth at childbirth in the late 1700s when doctors started to play a significant role in childbirth. One of the topics covered in every chapter is the continual war of words between midwives and doctors over who is better qualified and equipped to get your baby out of you, a process that in most cases is going to happen whether they are there or not.
Epstein’s book is eye-opening. Many of the troubling trends in childbirth today are continuations of trends that began hundreds of years ago. There have also been continual reversals in what was judged to be “best.” Feminists used to demand the right to be knocked out, now they defend the rights of women to refuse any and all drugs so as not to miss a moment of the experience. It’s still all about perceptions of what is right and various factions fighting for control of the event.
The inclination of doctors more worried about what happens if they don’t intervene surgically driving an extremely high C section rate is a repeat of the increased use of forceps following the death of an English princess in the early Nineteenth Century. After this upper class women and men started to demand forceps assisted births. The need for forceps was tied to the upper classes of western society. A luxurious western upper middle class lifestyle made women who were physically incapable of dealing with the pain and effort required to push a kid out. Wealthy women have been too posh to push for a couple hundred years
Ours is not the first period in which “primitive” women have been held up as paragons of easy, natural child birth (they just squat and keep working! Ever think that woman might want a break but is so poor she can’t afford to stop work for a couple of minutes to have a fucking baby much less take a couple of months off to care for her newborn? Women are often blamed for what goes wrong during childbirth. Doctors at the turn of the twentieth century accepted that germs caused post partum infections but were convinced that the germs spontaneously emerged or that women were just dirty, rather than accept that their own unwashed, mostly male, hands could carry infection.
The book does mention the ‘lower class’ or ‘primitive’ woman occasionally. When they are mentioned it highlights a truth the author touches on: the woman and doctors fighting over the centuries over the ‘best’ way to give birth have all been wealthy. The very idea of having options in childbirth is a conceit of the west and a privilege of the upper classes. The author may refer to some of them as middle class but in a larger world view a middle class western European woman is wealthy in comparison to women the world over.
While doctors have fought with women the newest and best medical and non-medical theories, most women in the world still have to give birth in a place not of their choosing, whether it is in a field or a shack in a slum or an overcrowded hospital. The drive to improve childbirth has always come from a small vocal group of upper class women disaffected with current practices. It is one of the front waves of feminism. The trends that took off were the ones for which wealthy women were willing to pay a premium. This leaves the current state of childbirth as an artifact of wealthy women which is then forced on every woman who gives birth in western society. This is not to say childbirth has not become safer for all women because of the advancements pushed by a vocal minority.
There is a balancing act between the view that childbirth is natural act and the fact it is undoubtedly a dangerous condition. The risks inherent in childbirth are played against its normalcy. Doctors want to treat it but it’s not an illness. Some women want to celebrate it but who wants to go to a party when the guest of honor dies? It is a question that should never be settled but negotiated continually as it has been for the last several hundred years.
-fh