The Universal Aspects of Childbirth

The birth of a human individual is a fascinating event that always has attracted the attention of artists, philosophers, priests and scientists.

It is possible to look at the very fundamental process of birth from as many angles as there are fields of human interest. We can study the mechanism of the birth process, paying attention to the size of the baby and the measurements of the pelvis, pondering over the cause and significance of the internal rotation of the child. We can study the physiology of birth, looking for causes of the onset of labor and uterine contractility, causes of postpartum hemorrhage. We can study the emotions of the expectant parents, their feelings of pride and anxiety, and their expectations of the newborn baby. We can speculate about the sensations that the process of birth evokes in the unborn and newborn baby. We can study the significance of social conditions on the birth process and the influence of the number of births on social conditions. In short, birth (like death) belongs to the very fundamental and basic facts of life.

In this paper I would like to put forward three theses:

1. The number of the problems connected with childbirth is so immense that it is not justified to leave the solution of these problems entirely to one discipline like obstetrics. Every human being is entitled, even compelled, to have an opinion on the significance and meaning of this phenomenon, and is able to contribute to solutions.
2. The branch of medicine called obstetrics claims to be the science of human reproduction, including the science of human parturition. Like all other branches of natural science, the so-called experts become narrow-minded and become so absorbed in a part of the whole problem, that they neglect other parts which are even more important. Obstetricians must accept that the so-called layman sometimes has a broader view. At any price obstetricians must avoid territorialism.
3. Childbirth evokes strong emotions, among them, anxiety. In that situation, many people expect more of an obstetrician than he is able to give, since they try to make him responsible for the outcome of pregnancy. If this tickles his vanity and if he accepts these expectations, then, if everything goes well, he gets far more gratitude than he deserves. If, on the other hand, disaster ensues, then his feelings of deficiency become sometimes extreme and can lead to an exaggerated degree of self-defense, or, on the other hand, to suicide (Michaelis, Croft).

In both situations it makes the obstetrician very sensitive to criticism. An attack on his behavior by colleagues in other branches of medicine (neonatologists, psychiatrists, logists, theologians), or worst of all, by his "patients" is often answered with fury and with very hard feelings. A scientific reply is often replaced by emotional outbursts, the more so because very often the attack itself has been brought forward in an emotional way as well.

As to thesis one, I should like to draw attention to the problem of pain during labor. Almost all human beings have thought about this problem and many people, especially men, hold extreme views, ranging from: "childbirth is essentially painless" (Grantly Dick-Read) to "childbirth causes the worst intense pain that the human organism endures" (Lyll and Hingson).

The human birth process shows many similarities with the birth process in other mammalians, and comparative obstetrics reveals among differences many resemblances, but there is one very fundamental difference in this respect between human beings and animals. Only human beings are able to worry about the future, to know beforehand that pregnancy is followed by labor, that labor can be dangerous, that it will give rise to the birth of a new individual, that the child can be deformed and handicapped, and so on and so forth.

Very beautifully this difference between man and animal is pictured in Genesis III 5-16. After having eaten from the tree of knowledge, "the eyes of Adam and Eve were opened," and "they became as gods, knowing good and evil." The punishment for that came soon thereafter: "Unto the woman he said, I will greatly multiply thy sorrow and thy conception; in sorrow thou shalt bring forth children." And unto Adam he said, "Cursed is the ground for thy sake, in sorrow shalt thou eat of it all days of thy life."

Thus knowledge about good and evil made the most important creative tasks human beings have to fulfill (bringing forth new individuals and toiling for the daily bread) loaded with sorrow, that is; with mental pain.

Anxiety and fear made pregnancy and childbirth for human beings more difficult than for other