Birth and Sex

The Power and the Passion

Sheila Kitzinger

• Publisher: Pinter & Martin
• Year: 2012
• eBook ISBN: 9781780660530
• Topic: Medicine
• Subtopic: Gynecology, Obstetrics & Midwifery

Birth and sex are often talked about as if they were contrasting experiences. In fact, they each involve the same rush of hormones in an action drama in which mind and body work in harmony. When a woman is free to follow her instincts and give birth naturally, waves of endorphins surge in the bloodstream with the same energy as in ecstatic lovemaking. Birth and sex mingle to become one in the thrilling, sweet, intense and overwhelming experience of creation. Yet in the Western high-tech birth culture the environment often inhibits the spontaneity of birth, resulting in pain and distress. Pregnancy and birth are de-sexed and treated as medical conditions. Women are turned into objects on which doctors act. In this compelling and controversial new book Sheila Kitzinger explores the complexity and depth of female sexuality during pregnancy, birth, and after the baby comes. She shows what can be done to create an environment in which a woman is able to trust her instincts and be confident in her body. By rediscovering the power and passion in our bodies, we can reclaim the spontaneity and sexual ecstasy of childbirth.

1
DE-SEXING BIRTH

If you have had a painful labour or one which was distressing because you felt trapped (even if it was not particularly painful), you may think that sexual excitement and feelings during birth have no connection with each other. The sensations of labour obviously have nothing to do with being sexually titillated. Yet in a strange way the energy flowing through the body in childbirth, the pressure of contracting muscles, the downward movement of the baby and fanning open of soft tissues, can be powerfully erotic.

Some women compare birth with orgasm. One says, ‘It’s like having a baby. You build up to a climax. Then you push the baby’s head out. It’s the most wonderful feeling in the world … the end feeling is the same.’ Another woman tells me that the release she feels with orgasm is like that when her waters broke as she gave birth to her son.

Pain and pleasure are often very similar. Orgasm can bring a bitter-sweet pain: ‘Orgasm is like a pain, a sweet pain that gets bigger and bigger and fills you up. Then as it ebbs you are left feeling content and throbbing.’ One woman tells me that it is ‘sensuous bordering on painful’, and another, ‘Sometimes the pleasure is so acute it is almost too much to bear, almost painful.’ For many women there is a narrow, almost razor-edged separation, between intense pleasure and pain. Orgasm is a paradox: ‘A painless pain, an ecstatic agony, a paralysed movement.’ When women talk about orgasm they nearly always introduce the idea of ‘tension increasing to explosion’ which is followed by relaxation and a feeling of tiredness and heaviness. It is like ‘bursting balloons’, ‘exploding bombs’ or ‘erupting volcanoes’. Time and time again they introduce images of waves crashing on the beach.

Orgasm is also essentially a giving and a flowing, ‘like squeezing juice from a lemon’. For some it is a rhythmic blossoming: ‘A flower opening’. For some it is movement, achievement and bliss: ‘Like dancing on a sort of spring – getting higher, slipping back a bit – getting higher still and back a bit, and so on until you reach the top – the sort of explosive release which comes – like a broken honey pot with honey spreading through your body. It’s lovely!’

For some women there is danger in these intense feelings: ‘An orgasm builds slowly and bubbles before it finally explodes, then returns to a simmer once again. I would describe it as a kettle boiling.’ One says, for example, that it is: ‘A high buildup of electric power. When you have an orgasm it is like just before the fuse blows.’ And there is a sense of urgency, having to put something right, ‘like the car screaming out for someone to change gear’. Orgasm may be associated with an increasing sense of constriction – mounting anxiety, being lost or blinded – and then an overwhelming sense of relief – a fall into freedom. Another woman expresses this constriction followed by release when she says that, for her, orgasm is ‘like a train going through a tunnel and suddenly emerging into bright daylight’.

Debra Pascali-Bonaro, an American birth educator, made a film called Orgasmic Birth. She said of her own birth-giving, ‘It was the most overwhelming pleasure I have ever felt in my life.’⁸

In the second stage of labour each contraction can bring a series of orgasms as each one climaxes in pushing and release, mounts again, culminates in another, and so on. Unlike the male orgasm, which is usually a single tide of release, after which a man loses his erection, women have a multiple orgasm. It is the same with giving birth. Every contraction brings (for a while at least) waves of desire, climaxing in fulfilment when a woman’s breathing speeds up and her breath is held voluntarily. This may happen two, three, four times – perhaps more – with each second stage contraction. It is the right time, and the only time, to push.

Women who have not experienced waves of orgasm – longing and climax – may think that references to orgasm are about the birth as the baby slides out. This is how it is for some women who have had an ecstatic birth, but a more general analogy is a multiple orgasm that comes in great rushes with each longing to push.

We are told that sex is different from childbirth. In the same way, it is considered indecent to experience intense physical satisfaction from breastfeeding. I understand why many people are embarrassed by the idea and believe that if a woman enjoys the rushes of the second stage she must be a sadomasochist. The important thing is that the orgasm is a side-effect, not the goal. We don’t want mothers or midwives feeling that they have failed if the woman doesn’t have an orgasm. There is already enough pressure on women to achieve the perfect birth these days, so adding orgasm to the wish list is a pretty tall order. And I would say to all the men out there, ‘Please don’t expect your partner to produce an orgasm. She may be faking it in bed, but don’t expect her to fake it in childbirth.’

The Rhythm of Labour

The locus of many of the sensations felt in labour is an area about the size of your hand, deep in the pelvis. If you rest a hand above your pubis you will find the right place. The cervix opens beneath this area and much of the pain felt comes from it as it opens and is pulled up and over the baby’s head. It may feel like a glowing fire which bursts into flames as a contraction builds up. Pain spreads from the cervix round into the small of the back until you are held in a tight grip from front to back for half a minute or so, after which it fades away again. This tightening is not haphazard. It is firm, regular, rhythmic. A woman who is enjoying her labour swings into the rhythm of contractions and her birth-giving may stimulate her to break into a powerful dance, her uterus creating the beat. She watches for it, concentrates on it, like an orchestra following the conductor.

It has been tempting for me to act this belly dance on demonstration marches if the police have urged us to ‘keep moving’. It happened in 1990 when we were demonstrating in Vancouver for the re-creation of midwifery in Canada, for example. I welcomed police instructions and with my realistic baby doll and foam rubber vagina danced my way in front of the College of Medicine giving birth.

The sensations a woman experiences are at their most powerful in her sexual organs. Feelings of intense excitement pour through her genitals. In antenatal classes you may never learn this, or, because medical language obscures what we really feel, it may never be put into words which enable you to anticipate any powerful sexual sensation. The uterus, the vagina, the muscles enfolding the vagina and rectum, the lower back, the rectum and the anus, the buttocks, tissues around and between the vagina and anus, and the clitoris are all suffused with heat as if with liquid fire and pouring with radiant colour. It can be the most intensely sexual feeling a woman ever experiences, as strong as orgasm, even more compelling than orgasm. Some women find this sexuality disturbing because they feel out of control as the energy floods through them and they can do nothing to prevent it.

The Place of Birth

Michel Odent believes that women should give birth in the place they make love. Marsden Wagner, former Director of Women’s and Children’s Health in Europe for the World Health Organisation, says in Debra Pascali-Bonaro’s film: ‘It’s got to be how it is when you make love with someone. It’s got to be safe, secure and uninterrupted.’

The sexuality of natural birth stands in startling contrast to the institutional setting usually provided for the experience. It is as if we had to make love, pouring ourselves, body and mind, into the full expression of feeling, on a busy airport concourse, or in a gymnasium. Birth is usually treated as a medico-surgical crisis. Women are fed into the hospital system at one end, are processed through it, and come out at the other with a baby. Instead of being a personal, private, intimate experience, the mother is on an assembly line. Even the way she sits or lies is dictated by the position of electrodes and catheters attached to her body and tubes tethering her to machines. And though professionals may be kind, labour becomes an ordeal because she is imprisoned in a situation outside her control.

‘We need to restrain your hands otherwise you might contaminate my sterile field’, the obstetrician explains, as the obstetric nurse or midwife puts the wrist straps onto the labouring woman. Her legs are raised and parted wide in lithotomy stirrups so that he has easy access to the perineum.

Now come the drapes, enveloping the lower half of the patient, including her feet, with a hole over the vagina for the baby to come through. The woman is effectively split into two halves, the lower end the ‘working part’, which is the property of the obstetrician, and the upper segment, consisting of head, neck, shoulders, breasts and arms, which, one suspects, the technician working down the other end would do away with if it were feasible.

In the position of a beetle on its back she is instructed to push the baby out.

One of the most pronounced differences between birth films in England and those in the USA is that in contemporary English ones the baby emerges from a hole in the woman’s body which is seen to gradually open up, stretch wide, and give birth, whereas in American versions the baby often emerges through a hole in a sheet, and the woman who is bearing the child seems a long way from what is going on.

In England the tradition of midwifery means that the woman can co-operate as an active partner in the birth process, in any position in which she is most comfortable, and it is assumed that when she bears down she would prefer her head and shoulders to be well raised, rather than flat on a delivery table. Because almost invariably obstetricians do deliveries in the USA women are expected to submit as they might to a surgical operation. The lithotomy position rather than midwives is employed as routine in all deliveries and the woman is expected to push uphill without the force of gravity to help her and the baby give birth.

Even with a fairly sophisticated audience – one in Harvard – I realised that in showing an English birth film in which the woman’s hands are not manacled and her whole perineum and vulva are put on view I was submitting them to a shocking experience. For above all in America the body is de-personalised. It is an object on a delivery table, and if, as in some films designed to show how good birth can be, the mother displays delight at delivery, the expression on her face takes place at the other end of the great divide between the birth-giving body swathed in sterile hospital garments and the head end where there is a person who feels emotion.

Women who have discovered that birth is a passionate sexual experience are likely to have given birth in their own homes or in birth units where there is unusual flexibility to enable them to behave without inhibition. In some hospitals and in birth rooms within them, a woman can have her baby without unnecessary intervention, in an atmosphere of peace and close intimacy, with helpers who have become her friends. She can explore the possibilities making a list of her priorities. The sexuality of birth is for the first time being experienced by women who are less concerned to remember all their breathing and relaxation exercises learned in antenatal classes, than to get in tune with their bodies and allow the energy of labour to flow through them. Even ten years ago a woman who cried out or grunted or groaned in labour often thought that she had ‘failed’. She was anxious to ‘keep control’. This stemmed from the teaching of ‘psychoprophylaxis’ which introduced a military-style discipline into preparation for childbirth and emphasised raising the pain threshold by keeping alert and using distraction techniques under the direction of a labour ‘coach’. It is not surprising that women inculcated with such teachings, though they did well in labour and had a tremendous sense of triumph at delivery, were unlikely to experience childbirth as a psychosexual process.

It was very different for Elizabeth Davis, a midwife, who wrote of her own birth: ‘For me, the ecstasy of the second stage occurred when my uterus and I were working as one, beyond signal and response. In this mode, a woman can literally deliver her own baby, sensing exactly when she can take more stretch and when to ease up, effortlessly breathing her baby out…. Later, my midwives said they wished they had the birth on tape, it was so perfectly controlled. But ‘controlled’ is not the way I would describe my process, as I wasn’t really holding back. Beyond attunement, there was union, perfect union.’⁹

Elizabeth Davis discussed the relations between sexuality and bonding, too. Sexual hormones play an important part in behaviour immediately following birth. Research conducted with sheep has shown that when non-pregnant sheep are given oestrogen and progestogen and stimulated vaginally they react to newborn lambs as if they were their mothers. Newly delivered ewes accept lambs that are not their own. Sheep whose pelvic floors are anaesthetised during labour, however, are likely to reject their newborns in the first half-hour post-partum.^10,11

Many procedures that are an accepted part of childbirth today, and which make it difficult for a woman to discover anything sexual in labour, have been introduced to formalise the relations between professionals and patients and to repress and inhibit any expression of emotion. These practices are part of the hospital institution, sanctified in the form of unquestioned routines that are justified on the grounds that they are for the safety of the baby, even when no research has been done to examine these claims.

Barbara Katz Rothman described the second stage of her labour: ‘I felt myself opening, felt the head push through, a beautiful total sense of openness …’¹²

Speaking to the conference of the 1992 Midwives’ Alliance of North America she said:

‘The history of Western obstetrics is the history of technologies of separation. We’ve separated milk from breasts, mothers from babies, fetuses from pregnancies, sexuality from procreation, pregnancy from motherhood. And finally we’re left with the image of the fetus as a free-floating being alone, analogous to man in space, with the umbilical cord tethering the placental ship, and the mother reduced to the empty space that surrounds it.’¹³

Even if a pregnant woman came to feel that birth could be sexual and sought to let her body come alive in labour in the same way as it does in passionate lovemaking, she would usually find that she was up against so many obstacles in hospitals that it was easier just to give in and let the professionals take over. There are very few institutions in which a woman can feel free to be herself, allow emotions to sweep through her and do whatever she wants to do. She becomes, in effect, an object on which doctors act.

Images of Birth

Women have depicted birth and the life-giving power of female sexuality in richly varied ways long before the start of recorded history. The earliest known portrayals are the ancient fertility goddess, and these images have survived the centuries and are still to be found in traditional cultures in Mexico, Peru and other South American countries today. This goddess also appeared as a geometric shape, the hooked diamond, often with a cross inside the diamond to represent the child, as in Turkish kelims. The shape persists in women’s weaving and other artefacts made by women in many countries all over the world, including North Africa, India, Thailand and the islands of Oceania. It is the birth symbol, usually unknown to men.

Another symbol is the teardrop familiar in Paisley designs which represents the tree of life and dates from the Babylonian era. This fertility symbol originally depicted a curled palm frond. The motif passed into Celtic art and, probably in the seventeenth century, to Kashm...

Table of contents

• Cover
• Title
• Copyright
• Dedication
• CONTENTS
• INTRODUCTION: WHY I WRITE ABOUT BIRTH AND SEX
• 1 DE-SEXING BIRTH
• 2 GENITAL GEOGRAPHY
• 3 SEX AND PREGNANCY
• 4 ACTIVE BIRTH-GIVING
• 5 ACTIVE MANAGEMENT
• 6 EPISIOTOMY
• 7 BIRTH AND LANGUAGE
• 8 BIRTH DANCE
• 9 WATER BIRTH AND SONG
• 10 HOME BIRTH, MIDWIVES AND DOULAS
• 11 SEX AFTER THE BABY COMES
• 12 CHANGING CHILDBIRTH
• ACKNOWLEDGEMENTS
• REFERENCES
• INDEX