The Last & Most Important UNTOLD Story of the 20th century – Intro

by faithgibson on August 3, 2012

Unpublished Manuscript ~ Copyrighted; non-economic Fair Use OK
Faith Gibson, LM, CPM~ February 2008

How Normal Childbirth Got Trapped on the Wrong Side of History: the perfect storm that turned healthy women into the patients of a surgical specialty and normal childbirth into a surgical procedure

Statements of scientific or statistical fact will be cited in the next draft

Notes on Vocabulary ~

Linguistically, childbirth is a slippery sloop as soon as the word ‘child’ is separated from the word ‘birth’. I specifically use the word “childbirth” to encompass the whole biological process of laboring and giving birth as a continuum of activities that originate with the mother. As a biological category, it is the mother who gives birth, which includes being pregnant and the entire physiological process of laboring, including the birth of the baby. After the fact, the baby is said to have been born and the occasion is said to be the baby’s ‘birthday’.

The qualitative difference we have created in our minds and in our medical system between ‘labor’ and ‘birth’ is one of language rather than biology. Except in language, hospital architecture and obstetrical billing codes, there is no actual bright line between ‘labor’ and ‘birth’. In fact, labor is the on-going process of uterine contractions that dilates the cervix and helps (along with the mother’s abdominal muscles and her voluntary efforts) to push her baby down into her pelvis and through the birth canal. Each contraction and each push by the mother helps to advance her baby down through the birth canal. Finally that one special push comes when the head slips over her perineum. During these few minutes, we say the mother is “giving birth” and after the baby is completely free of its mother’s body, we say the baby was born. But the reality of laboring and giving birth is a process that lies on a continuum and remains intrinsically intertwined.
However, language does allow the last few minutes of labor — those moments when the baby is being born — to be renamed ‘the delivery’ and subsequently categorized as a separate activity or ‘procedure’ performed by the birth attendant (instead of the mother) and controlled by institutional policy. When the act of giving birth is defined as a medical procedure, hospitals have a legal right to refuse to perform the ‘procedure’ of vaginal birth. Currently, the definition of childbirth as a ‘procedure’ is used to deny some women the fundamental right to give birth normally. This reflects a hospital policy that forbids the procedure of vaginal delivery when the mother-to-be has had a previous Cesarean, her baby is breech, is thought to be bigger than average, she is expecting twins or the baby is overdue, etc. In these cases, hospital policy requires that obstetricians on staff perform the invasive surgical procedure of Cesarean section. The take-home message is that words surrounding childbirth are a big deal and it matters how they are defined and who does the defining.

One last linguist note: There is no such stand alone verb as “birthing”, unless you are quoting dialogue from the Civil War movie “Gone with the Wind”, when the maid tells ‘Miss Scarlet’ that she “don’t know nothin’ ‘bout birthin’ no babies!” In real life, the active verb is “to give” and ‘birth’ is the object of that action. The mother is the source and giver of the energetic efforts that produce the baby. Birth is what happened, passively, to the baby. Having been born myself at one time, I am grateful to my mother for all her hard work. Having given birth three times myself (preceded by painful fertility surgery), I remember all that hard work! Out of respect for all the women who gave birth gazillions of times over untold millions of years, I decline to diminish the mother’s central role and cheat her out of this accomplishment by using a linguistic short-cut that skips over the ‘giving’ and substitutes the bastardized passive verb: birthing.

I encourage others to likewise remember and honor the verb: To Give Birth.