The Dawn Chorus

Fresh Australian Feminism

The contentious debate about pain relief during childbirth

Posted by Nic Heath on July 20, 2009

Dr Denis Walsh, one of Britain’s leading midwives, caused a global furore last week when he spoke out against the ‘epidural epidemic’ currently sweeping the UK. Dr Walsh claims, among other things, 20 per cent of epidurals are given to women who don’t need them, and advocates alternative methods of pain relief during labour such as yoga and birthing pools.

Despite being reported by the BBC as saying in some cases epidurals are very useful, Dr Walsh’s comments have been taken as a personal insult by women all over the internet.

The collective outrage has been fed by provocative and misleading headlines:

Just put up with pain of childbirth: UK professor Dr Denis WalshHerald Sun

Male Midwife Tells Women Take Pregnancy Pain Without DrugsFox News

Dr Walsh’s comments seem to have struck a sensitive seam of guilt felt by many women in relation to childbirth. The many stories and blog posts on the web about the issue have drawn thousands of comments from readers, and many mothers speak defensively about guilt and of being judged.

 Remola from Wagga on a Herald Sun forum:

“All I can say is I AM A SUPER MUM just for being a mum and I’m happy to say I took the drugs 2 yrs ago and I will take them again if I feel the need despite what is said.”

Mammamia reader claystep asks “do mothers really need more stuff to feel guilty about??”

Another point of contention is Dr Walsh’s gender.

Liz45 on Crikey:

“To have a male carry on in this manner is just too ludicrous for words. What the hell would he know? … He can say what he likes, safe in the knowledge that he’ll never have to experience it!”

Mia Freedman struck up the refrain, ‘no uterus, no opinion’, in her blog post on the subject, ‘Brave man tells women in labour to toughen up because pain relief is for wussbags’, which many of her readers reiterated.

This is surely a counterproductive and reactionary response to Dr Walsh’s comments, not to mention one that is plain sexist. The reasoning behind it is dangerously exclusionary. It’s too easy to substitute one element and end up with something much more malevolent – say, ‘no uterus, no admission’ etc. Suddenly such logic is pretty clearly discriminatory.

It is the sort of thinking that many feminists have been seeking to overturn for years – when applied to circumstances such as the role of women in professional sport like AFL.

Dr Walsh is a senior midwife and associate professor in midwifery at Nottingham University, a good reason to take into account his opinion, and there have of course been more rational responses to his views.

Royal Australian and New Zealand College of Obstetricians and Gynaecologists president Dr Ted Weaver:

What we want to get away from is the sort of maternity care where mothers are given an epidural to shut them up so they can…be baby-sat while the labour progresses.

Alison Bailey commenting on Crikey:

“As women, we have been inculcated to believe that childbirth is a horrible and scary experience full of pain and fear. It is well known that fear increases pain and no doubt also increases the number of women opting for epidural, regardless of how their labour may or may not go.”

This whole episode raises a number of questions – like why have women reacted so strongly to a man recommending more options for women during childbirth, while actions to limit choice – the new restrictions on homebirths – have been almost entirely unremarked upon? Why would a woman feel guilty about her labour? And what can be done to make childbirth a more positive experience for women?

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13 Responses to “The contentious debate about pain relief during childbirth”

  1. caitlinate said

    Over the years there have been many male doctors telling women to suck it up when it comes to pain – the first I think of is the complete denial that period pain existed until they realised they could make money selling women pain medication for it. I don’t think that women showing a fair amount of skepticism towards a male doctor – no matter what his qualifications are – instructing women on their experiences is particularly outrageous. I agree that the outrage might be misguided and that more research into what he actually said could have been done by various bloggers however… you seem to be implying that distrust of Walsh is tantamount to sexism? Really?!

    • Nic Heath said

      I think it is sexist if the distrust is based on his being a ‘male midwife’. As a well-qualified midwife his ideas should be subjected to scrutiny, but not de-valued because he isn’t a woman. Historically these ideas have kept women out of male-dominated fields

      And I thought it odd that male OBs have been helping women deliver babies for years (altho I’m not advocating this approach to childbirth).

      • caitlinate said

        The difference is that sexism is about power and privilege based on gender being exercised, not just discrimination. I think this article sums up my thoughts on this pretty well (rather than me talking about it at length here).

  2. blu-k said

    Thanks for a really even-handed and intelligent response to this debate! It makes a refreshing change.

  3. Leah said

    I completely agree with your take on the ‘no uterus, no opinion’ argument. To critique a man’s opinion is certainly not sexist (as Nic pointed out) but to completely disregard it on the grounds that he is a man is certainly sexist.

    I recently got into a debate with two female colleagues about whether men can be feminists – I think they can, since I see it as a political ideology or opinion that anyone can take up, rather than something that demands one have experienced life as a woman. And I guess more to the point, I think feminism is just as much about men as it is about women, therefore would be mad to exclude men. Also, my view of feminism is that it should be as inclusive and constructive as possible, whereas I think the whole ‘you can be involved, but you can’t’ is divisive and destructive. Anyway, I was actually shocked that anyone would claim men can’t be feminists – had not even occurred to me before.

    • Clem Bastow said

      I always rather liked (putting aside his litany of transgressions, natch) Derryn Hinch’s statement about men only being able to be 99% feminist because they’ll never experience childbirth.

    • caffeineadddict said

      Of course men can be feminists. But there are certain embodied experiences that are specific to women, and I honestly believe that people’s perspectives about things are shaped by these embodied experiences. What is at issue is when people (e.g. men) claim to know about others (women’s) bodies better than they themselves know their bodies. When some male doctors/scientists have a wealth of medical knowledge, and then go on to say that this is superior to the woman’s perceptions of pain, and her ideas about whether she needs an epidural, I find that quite problematic.

      While I personally find Mia Freedman’s ‘no uterus, no opinion’ comment counterproductive, maybe rather than just calling her a sexist and leaving it there, why not dig deeper and look at the long historical governance of women’s bodies? In order to understand where comments like this come from (not that they are okay, but that is not my point)one needs to think about how heavily regulated women’s bodies are ( from conception, to birth, to childcare and onwards, it keeps expanding indefinitely).

      Sexism towards male doctors is not the way forward, but neither is falling back into the trap of gender neutrality, where we presume that Dr Walsh is just offering an objective, helpful, purely scientific perspective on epidurals. Pregnancy is something that is predominantly only experienced by women. Therefore arguments based on gender neutrality are highly flawed.

      • Red said

        “…maybe rather than just calling her a sexist and leaving it there, why not dig deeper and look at the long historical governance of women’s bodies? In order to understand where comments like this come from … one needs to think about how heavily regulated women’s bodies are

        Sexism towards male doctors is not the way forward, but neither is falling back into the trap of gender neutrality, where we presume that Dr Walsh is just offering an objective, helpful, purely scientific perspective on epidurals.”

        Really agree, a little bit of historical perspective and knowledge about the nature of sexism wouldn’t go astray in this article.

  4. lachie said

    Clem Bastow, Derryn Hinch’s statement isn’t, in my opinion, an intelligent contribution to the debate regarding men being able to identify as feminists. Firstly, “they’ll never experience childbirth”, yes of course this is true, but what about women who don’t experience childbirth? Are these women also only capable of being 99% feminist? This calls to mind the antiquated male idea that women are essentially vessels to carry babies. And also what kind of brainless idea is it that a person can be feminist in percentage?

    A male doctor speaking out against epidurals is completely absurd. And yes its relevant that he is a man because he cannot begin to fathom the experience of giving birth. (I’m not professing to be able to fathom this either, so I would never dare to make a recommendation on what a women should/should not do). My Dad’s partner recently gave birth, and she described her experience as being like 25 hours of hellish hallucinogenic torture. It’s paramount that women are able to control their own bodies, and a male doctor discouraging epidurals does nothing at all to further this cause.

    I’m not saying that men should or shouldn’t be able to call themselves feminist, I don’t really know. My friend’s mother who was heavily involved in second wave activist stuff pointed out to me that if it was accepted for a man to identify as a ‘feminist’, it would allow, theoretically, for feminist theory to become a male-dominated theory. She argues that feminism must be preserved as something created by women, for women. This, she claimed, is the only way that it can be protected from becoming yet another school of thought internalised within the patriarchy.

    At the time I thought what she was saying was obsolete and reductive; however after thinking it through I saw that there is actually something really important in what she was saying. Imagine if Wom*n’s spaces at Universities weren’t able to exist because they were considered sexist against men. That would suck in many ways, and I would think it to be very antifeminist. Moreover, men should remember that they live a life of male privilege (whether they like it or not), and have never been at the receiving end of sexism and misogyny. In this sense, I often that feel men are perhaps a bit under qualified when talking about ‘feminist issues’.

    That being said, a lot of issues which receive feminist attack are a direct concern for male people as well. For example, rape, violence against women, pornography, objectification, sexual assault and sexism are rife in this society, and they concern men because men usually are the perpetrators. So whether men who care about this stuff call themselves feminists or pro-feminist or whatever, there should be more male-identifying people who are concerned by these issues. And I hope that the males who do care about this stuff would not be inclined to want to ‘take over’ feminism. I agree with what Leah said in some ways, but I don’t think ‘including’ or ‘excluding’ men is too relevant. My sex = male, and I would describe my views/values/politics as being feminist in nature, but I feel neither excluded from nor included in feminism, and I don’t think it’s really too important.

  5. Nic Heath said

    I acknowledge that women’s bodies have long been presided over by men, and our reproductive processes medicalised. Dr Walsh’s comments – that labour does not always need to be medicated as soon as it starts – is in keeping with midwifery’s approach to childbirth, which is one of treating wellness, not sickness. This man’s meddling to me seems to be in aid of women having more choices and taking a more active role in childbirth. He is not suggesting taking epidurals away from women who need them.

    Childbirth continues to be a closely controlled medicalised event – see the rise of caesarians, anecdotally substantiated by Blue Milk; and she also writes about proposed changes to legislation that would effectively outlaw home births. This removal of choice I find more worrying, and more worthy of hysteria, than a midwife expressing his professional opinion that epidurals are not the panacea they are currently held to be.

  6. Marn said

    The comments made by Dr Walsh are well founded and based around a concept that early intervention in labor via drugs leads to a cascade of intervention in the birthing mothers body. Many, many epidural induced mothers end up with vacume extraction or forceps around the baby’s skull to ‘get it out’ as the heart rate begins to drop with the drugs, the mother tires of labor and the obstetricians begin to panic.

    What sort of ‘freedom’ and ‘empowerment’ does that bring a birthing woman I ask you?

    As the proud mother of a big, long 4 kg plus baby born without drug intervention I can tell you I count it as THE MOST empowering experience of my life. It was ‘painful’ and the body responded appropriately by taking me into another head space to deal with that pain – naturally. I found myself in a liminal space, fully conscious and in total control of bringing life into the world via my body.

    I feel for women who are so frightened by the current cultural attitudes towards birth, pain, life etc Seems to be an epidemic in Australia at the moment (and now with the proposed banns on home birth – what is going on??!)

    I’m so supportive of a MALE midwife coming out against the establishment and making a recommendation that IS clinically better from mother and baby (outcomes on this issue are becoming more readily available).

    The saddest issue is that Australian press belittled this man and that many Australian women jumped on the pro-drugs bandwagon not to mention all the sexist comments about him being a male and therefore rendered voiceless on the matter! I was embarassed by our simpleton approach to the issue.

    I’m due for baby no. 2 and really hope to re-experience the birth through my body, naturally, hormonally and powerfully. Just a personal opinion, though seemingly not a maintstream one at present.

  7. Nic Heath said

    Some more interesting links about the debate (from Blue Milk):

    http://feministphilosophers.wordpress.com/2009/07/13/a-brief-defence-of-my-current-hero-denis-walsh/

    http://rixarixa.blogspot.com/2009/07/burn-male-midwife.html

  8. [...] Heath rounds up “The contentious debate about pain relief during childbirth” at The Dawn Chorus. (Fill yourself in on the background to this at non-DownUnder blogs Stand [...]

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