why birth is difficult

A letter to the editors of National Geographic:


In contrast to the widely held belief (stated in the article "The Downside of Upright", National Geographic July 2006) that birth for human females is difficult primarily because of the shape of the pelvis and size of the infant, I'd like to offer the alternative (and scientifically valid) view that it is management of birth that creates most of the difficulty we experience.

Normality in birth for all mammals is dependent on the unimpeded release of sexual hormones; stimulation of the neocortex interferes with the functioning of the primal brain that regulates these hormones. Our highly developed neocortex makes humans especially vulnerable to conditions that disturb hormone release. Most people recognize the difficulties a cat would experience if it were expected to give birth in the same environment the average woman does -- under bright lights, observed, touched, and directed by attendants -- yet strangely it does not usually occur to them that these things make the process arduous for humans as well.

The World Health Organization has stated that, "By medicalizing birth, i.e. separating a woman from her own environment and surrounding her with strange people using strange machines to do strange things to her in an effort to assist her (and some of this may occasionally be necessary), the woman's state of mind and body is so altered that her ways of carrying through this intimate act must also be altered and the state of the baby born must equally be altered. The result is that it is no longer possible to know what births would have been like before these manipulations. Most health care providers no longer know what "non-medicalized" birth is. This is an overwhelmingly important issue."

There are, in fact, very few cultures that do not disturb the birth process in some way, either for cultural or medical reasons. If researchers continue to look only at assisted birth, it will remain impossible for them to say to what degree physiology alone is responsible for the hardships modern women endure in birth. One valuable lesson from the natural birth movement, in which more and more women are being encouraged to birth without direct assistance and according to their instincts, is that it is a myth that the human birth process is inherently long and painful and that it is difficult for women to catch their own babies and attend to them directly following birth. Women who are allowed to give birth spontaneously and who are not inhibited or distracted by the presence of attendants tend to experience the physical process of birth very differently from their managed counterparts.