Of Eve's Curse, Worship of Suffering and Childbirth
Pain- a notion that finds its roots, as legend has it, in the womb of the first woman on earth. When Eve ate the forbidden fruit, God punished her and all forthcoming birth-givers with the apocryphal Curse of Eve: pain during natural childbirth. Centuries after its induction, it remains one of the many biased narratives and cultural presets that glorify labor pains as a given, redemptive suffering meant to be naturally neutralized by the joyful prospect of having given birth to new life. Often perceived as untreatable and remarkably different from any other bodily pain, the story of how we perceive motherhood is another bead in the long history of neglect of women’s pain.
How Pain Became Womankind’s Second Nature
On average, in an emergency room, a woman would wait 65 minutes to be treated for the same abdominal pain a man receives attention for in 49 minutes.
Researchers found no medically approved reason for this prolonged period of observation, but what they did conclude was the presence of rampant sexist stereotypes on how a woman’s pain is exaggerated, less severe and therefore, not so much an emergency as that of a man.
The 18th Century society gave this biased intuition a name: hysteria. The word ‘hysterical’ itself stems from hystericus, meaning ‘of the womb’. Typical examples of 18th century female hysteria include symptoms of depression or PTSD, a case of infertility and a fondness of writing.
Researchers J. Crook and E. Tunks found in their study ‘Women With Pain’ that women with chronic pain conditions are more likely to be wrongly diagnosed with mental health conditions than men, and consequently be prescribed psychotropic drugs, as doctors dismiss their symptoms as hysterics. A majority of research in pain management has been conducted on male subjects, as they lack hormonal fluctuations commonplace in women subjects, making these results easier to reach.
History, for the most part, has been cruel in its treatment of womanly pain, hyperbolically normalising and fetishising it for its exclusivity to the female.
Is Pain the Apotheosis? Worship of Suffering
Most championing labor pain do not have first-hand experiences with natural births, and yet, see it as an indomitable part of motherhood, that must be endured regardless. The ability to undergo childbirth with the expressivity of a stoic is seen as a cultural symbol of a woman’s strength, pedestaling the experience and the suffering.
“The idea of childbirth pain being the most severe type of pain, intolerable, overwhelming, incomparable and unbearable as has been described suggests a pain that must be relieved rather than endured or tolerated.”
The assumption that every parent will see the experience of birthing a child as a positive and exclusive experience in their journey ignores the subjectivity of pain. In addition to the difference in the duration of labour, as most last up to more than 18 hours, a study on subjective pain perceptions during labour and its management from Hyderabad, India suggests that 66% patients found it an exhausting painful experience.
“Our societies have a high degree of importance that we place on maternal sacrifice and a kind of martyrdom that goes with being a mother,” says Anna Smajdor, associate professor of practical philosophy at the University of Oslo. “It's a badge of honor to show that you’re suffering, that you’re sacrificing yourself as a mother.”
What does Labour pain feel like?
While we are all too familiar with the graphic brutality of a childbirth process, if you run through studies on birth-givers, you will come across violent analogies used by respondents to express how painful labor is.
“Like you are being stabbed in the abdomen with a machete.”
It is important to remember that not only does the degree of pain vary from person to person, but so does an individual’s capacity to undergo the process. For these reasons, while some birth-givers find this experience to be acceptable, several think that it could be made better by adding an analgesic to the mix.
What are Labour Analgesics?
Regional analgesia has become the most common method of pain relief used during labor in the United States. Epidural and spinal analgesia are two types of regional analgesia. With epidural analgesia, an indwelling catheter is directed into the epidural space, and the patient receives a continuous infusion or multiple injections of local anesthetic.
The Consequences of Ritualistic Birth Pangs
In the example of Ethiopia, a lack of awareness of the importance of skilled hospital deliveries, cultural beliefs, and transport challenges paramount to a high death rate during childbirth.
In 2012, only 10% of deliveries took place in health facilities.
In stronger economies, freedom from labor pain is a basic right of the patient, and mostly, potential pain-relief options are thoroughly discussed and screened for complications before hand. However, the unavailability and inacceptance of labour analgesics do not even allow it to be an option for birth-givers in weaker economies.
In the developing world, the practice of obstetric labor analgesia is not known. The unavailability of these analgesics is only fueled by religious backgrounds and negative cultural attitudes towards pain relief in labor.
In a 2019 study on Perceptions of Obsteric Analgesia, researchers explored how midwives had never been trained in using obstetric analgesia. Many of them saw labor pain as an unpreventable natural phenomenon and an experience given by God.
As evidence shows, if labor pain exceeds a certain intensity and duration, it may have a negative impact on the lives of the expectant mother, her baby, and even family members.
A study on Barriers for Labour Analgesia in South India presented that only 14% of pregnant women were aware of labour analgesia. A majority of the women in the study said that if there was a safe and effective method of pain relief available, they would certainly opt for it. 95% of obstetricians felt that labour analgesia could improve the quality of childbirth.
So why are they not as readily available as they should be?
Rampant misconceptions about how epidurals increase caesarean section rates and prolongation of stages of delivery prevent them from reaching sufficient birth givers.
Systematic trials conducted by the American Congress of Obstetricians and Gynaecologists (ACOG) and the American Society of Anaesthesiologists, published in Cochrane Database resolved these misconceptions revealing that there is no direct relationship between epidural and increased caesarean section.
Where are we now?
Today, the incidence of practicing labour analgesia remains remarkably low at 11%, with the government healthcare sector contributes minimally at 0.8 %. Apart from the lack of awareness, poor infrastructure and lack of experienced anaesthesiologists remain a major reason why the greatest of physical and emotional distresses remain out of reach to many.
It’s the Garden of Eden all over again.
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