THE BIRTH EUPHEMISMS

All the euphemisms I grew up hearing—that birth is “natural” or “induced,” that it is “long” or “quick”—obscure that birth is violent. To speak the facts of birth is to sound like a brute. It rips flesh, pours blood, induces screams, convulses limbs, and routinely kills, all while doing something otherwise confined to science fiction or myth—the transfer of one human body out of another.

When we pretend that birth is pretty or that it runs according to plan, we may think we are protecting mothers. But we are only protecting an idea of the world in which human life does not depend upon a violent arrival and motherhood does not include bloodshed. This fantasy is desirable for everyone, for the delivering mothers and for the medical practitioners aiding them, for partners and fathers, for children who cannot and should not imagine their mothers in agony. And yet as desirable as the fantasy is, it sets many of us up to endure a violent experience that has no social honor, and therefore no easy way to be psychologically and physically processed.

Men of history and literature have always been honored for surviving violent harm at war or on a quest. Sometimes warrior women are, too. But birth is categorized differently. Perhaps because the foe in birth is not external but internal. Perhaps because the blood of birth is genital. Perhaps because all beings wish to be mothered, and to imagine motherhood as violent sullies that craving.

For whatever reason, birth’s violence is put in a separate genre, such that even well-educated modern mothers are routinely shielded from its violence until they undergo birth themselves. The consequences of this obfuscation can be terrible.

My friend whose arduous labor ended in a caesarean section of extraordinary complication once believed that her body would know what to do in birth. This was what she had been told by other mothers, by books, by her midwife, and by television: you were born to do this.

How shameful, she recalls, to discover instead that she belonged to “Team Born to Die.” I too belong to “Team Born to Die,” the team of women who would have died in childbirth were it not for our access to modern medicine. There are many of us alive today. (Our historic team is also enormous, albeit dead.)

One can understand intellectually that belonging to “Team Born to Die” is not a sign of physical error or physical weakness. That it is a natural consequence of a brutal natural order in which the very act required to keep life going quite often kills its key participants. But if you go into birth expecting that your body will “know what to do” only to find that it does not, you may understandably feel that something’s wrong with you, or that something’s wrong with women.

It took me a long time to realize that nearly dying in childbirth exposes not a personal nor sex-wide shortcoming but the bizarrely popular dream of motherhood as excellent cervical dilation. According to this dream, birth is something that we control, if not in our rational minds, then in our bodily skill. The dream goes something like this: if you breathe right, or prepare right, or just are right, your cervix will dilate quickly and widely enough to invite your baby on out. The reason this dream is so persuasive is because it comes true often enough to seem attainable.

My mother, for one, gave birth to me, and years later, to my brother, in a matter of hours. She remembers visualizing a gigantic rose unfurling its petals as her contractions began. By the time she reached the hospital forty-five minutes later, she was dilated nine centimeters. (I took two days of labor and an induction to dilate three centimeters.) I have read of women who pushed without pain; I once met a woman who sneezed out her baby. Birth books love such mothers. As Rachel Cusk writes in her memoir, A Life’s Work, birth is most often described as not so bad.

Some women find birth the most intensely pleasuarable experience of their lives, I read…Why not have it at home, amongst friends, in peaceful surroundings? In a warm birthpool perhaps? Photographs of this procedure are supplied. The pool, a sort of deep inflatable ring surrounded by house plants… ​

Such stories propelled me to assume that birth was a constructed experience like, say, gender. I could therefore construct the experience I wanted. Isn’t that why all the OBGYN’s and midwives asked women to write up our birth plans? Because we had a say in the matter?

Never one to doubt the power of our perspective over our experiences, I hired a therapist during pregnancy to train me in hypnobirthing. Every Wednesday evening of my second trimester, I climbed the stairs to our bedroom, plugged in my earbuds, and closed my eyes against the Connecticut winter. The therapist’s soft Germanic voice lilted through my earphones as I imagined myself riding waves, floating on top of clouds, effortlessly moving a painless body through space. “The ludicrous idea that contractions could bring pain…” On a hypnobirthing podcast, I learned of a woman who birthed a footling child while riding a wagon through Amish country in a blizzard. We were all modern women! Our birth experiences were our own to construct!

I prepared from all angles. I worked out every day; waddling past the university football team to grab the weights. My calves and arms bulged with muscle beneath the baby fat. I attended weekly appointments at the Yale-New Haven midwifery practice. I was signed up to deliver at a state-of-the-art birthing center with a doctor on call and an operating room on site. I only failed to attend the hospital’s childbirth prep classes because my OGBYN said they were unnecessary and because my friend who attended reported that the main thing they did was hold ice cubes and then choose what pain alleviation, if any, they might like to try during labor—ice cubes, apparently, being a proper analogue for contractions.

​In these ways, I deluded myself—and was deluded by films and books and doctors—into believing I was prepared.

*

I used to say as a sort of joke that every woman is born with one-thousand points toward childbirth. She loses one point each time she sees a delivery scene on television; she gains one point each time she pats a baby on the head. It doesn’t take a psychologist to suspect that I originated this theory because I fear pain and because I understood that birth was the one place in my otherwise secure life that I could not avoid it.

By the time my husband and I conceived, I was around 500 points: equally scared of childbirth as I was desirous of having a baby. Obviously, I was aware that pain is part of birth. But what I had not accounted for in a points system devised specifically to protect me from the shock of childbirth is that I had no idea what birth pain was. All I knew was what it looked and sounded like—in movies, in books, in medical trainings, and in the stories of other women.

In film and television, birth has an unpleasant yet comfortingly predictable style of representation. The actress who is usually so well put together now has no make-up. She sits up in the hospital bed, her hair stuck to the sides of her face. She huffs and she puffs. Her mouth makes a pained “o.” When she starts howling in earnest, the calm doctor plunges headfirst below the blue privacy blanket, and if the scene is especially radical, we get a glimpse of the baby exiting from a dark birth canal. The mother’s pain is acute and brief, forgotten immediately upon Baby’s arrival and recalled only in the service of jokes about adult diapers.​

One might well argue that it’s impossible to represent great pain through art, that you just cannot know until you’ve been there yourself—a refrain I’ve heard from many mothers. But watch a few war scenes, and you’ll be reminded of how good cinema is at translating pain. If you have seen The Revenant, you will recall—perhaps with a pang of nausea—the sound of bear claws tearing a man’s back flesh. If you’ve ever watched a strangulation scene like the one that begins The Return of the King, you may have been tempted to touch your own heart in self-preservation as the soundtrack heartbeat thuds slower and slower towards death. And if you saw Children of Men, you may recall the moment that made cinema history, when the leading man walks into a war zone and blood spatters onto the actual camera lens.

I have watched many birth scenes, both documentary and fiction, and I have never heard flesh tear, or a heartbeat slow, or blood spatter the camera, even though flesh wounds and heartbeat variations and stupendous blood loss are just as common to birth as they are to battle.

Unlike war cinema, birth scenes show birth without expressing the birthing person’s perspective. A heartbeat soundtrack slowing down focalizes through the strangulation victim: it shares, through the medium of sound, an essence of what he is feeling. A woman screaming and a cervix dilating on screen may look like birth, but it doesn’t share the feeling.

Virginia Woolf long ago lamented the impossibility of expressing pain through language. “English,” she writes in an essay titled “On Being Ill,” “which can express the thoughts of Hamlet and the tragedy of Lear has no words for the shiver or the headache.” And yet Woolf herself, who never experienced childbirth, describes childbirth better than anyone I've ever read, even though she was writing about general pain:

for pain words are lacking. There should be cries, cracks, fissures, whiteness passing over chintz covers, interference with the sense of time, of space; the sense also of extreme fixity in passing objects; and sounds very remote and then very close; flesh being gashed and blood spurting, a joint suddenly twisted - beneath all of which appears something very important, yet remote, to be just held in solitude.

*

In the room where I first labored—they had to transfer me once because there were so many of us at the Yale Birthing Center that night—there was a Christ figure on the wall, hanging from a little wooden cross. Except that he wasn’t exactly hanging. From the cot where I lay writhing, I understood his posture in a new way. He had drooped to one side because he could no longer hold up his own head. He was too tired. This was evident to me after just a few hours of labor. I understood for the first time in my cushy life that pain runs along an axis of time, not just an axis of intensity. A body can survive great pain for a long time, but not forever. (Later, I looked it up: Christ hung on the cross from nine in the morning to three in the afternoon. Six hours.)

I labored for three days with the assistance of morphine, Benadryl, an induction, an epidural, and a vacuum. The doctor’s note reads, “vacuum used due to maternal exhaustion,” which sounds like a mommy in need of a nap. But medically it meant that my body had announced its membership on “Team Born to Die,” and that I required modern tools to extract my son lest my husband go home alone.

While they were busy suctioning my son’s head and admonishing me to push harder than I had in the three previous days, I made my peace and exited my body.

How easy it was to leave the room, the planet, my husband, the caregivers with their earnest, cheerleading cries. How easy, it turned out, to leave even the precious fetus I had done all this for. It was over.

In my new galaxy, which did not include a hospital, I bobbed like a lifeless, floating buoy. The stars were strange and white. I had neither a baby to live for nor a body of my own to return to. That was the point. That was the gift the galaxy gave me: to push my body in a way that was only possible when it ceased to matter to me. In this way, my son was born.

*

Mothers are by definition veterans of an encounter whose components would be classified as violence in any other setting. Blood, pain, unpredictable actors, life and death stakes, high risk of injury and trauma: even a healthy birth is classified medically as an emergency. But unlike warriors whose social honor rises in direct proportion to their survival of violence, mothers’ social honor is sullied by the mention of pain or blood or suffering. The best mother is the one who gives birth naturally (the only time the naturalness of a woman’s body is considered superior) and who either feels no pain or at the very least feels no need to speak of it.

By now in American life, prudishness is so outdated to seem a quaint excuse for why mothers’ labor goes underrepresented. There’s something darker and more subliminal at work here than fear of mothers’ sexuality, and that is fear of mothers’ pain. Fear that mothers might be injured or die of pain. And fear that mothers—seat of tenderness and lullaby—might be hard enough to survive things that otherwise take place only in the torture chamber or on the battlefield.

In facing down the barrel of war, soldiers are educated in the violence and pain they may face. They are respected with the assumption that preparation stokes not fear but courage and honor. Like war scenes, birth scenes in film and literature and maternity classes cannot approximate real pain. But they can give dignity in that pain and company in that pain.

I, who thought I knew so many things, who had read the preparation books and seen the YouTube videos, lacked knowledge of the most important thing: that birth would take me beyond myself, and that I would be required to build my own beyond—intergalactic if need be.

We can let women enter birth like virgins who know nothing but euphemisms of sex. Or we can arm them, as we do men, with the knowledge that their pain can be power.