Reclaiming Childbirth as a Rite of Passage: Weaving Ancient Wisdom with Modern Knowledge

"Including the book on this list, and quoting it in my book Womb , was a carefully considered choice. The debate around birth is so polarised that the phrase ‘normal birth’ is almost a bad word—and as a midwife writing about birth, I’ve had to be incredibly careful about how I approach this schism between the two phenomena of what Reed calls physiological birth (when there are no interventions to change or interrupt the biological birthing process) and very interventional obstetric birth. “Birth is a transformative event; it is of ancient, really visceral significance to the person who goes through it” I like how Reed doesn’t discount that latter option, but does point out that birth is a transformative event; it is of ancient, really visceral significance to the person who goes through it. She talks a lot about rites of passage and ritual and points out that medical interventions are also rites of passage and ritual, and they’re not necessarily evil or bad, but we have to understand that they too have their own ritual significance, they too carry meaning and have consequences that we need to question and challenge quite carefully. So I think Reed has a really good, considered approach to this central tension. There are many times that interventions are life-saving and many times a woman’s body doesn’t actually know what to do. We’re very grateful that we have intervention in those circumstances. But what I would question, and what Rachel Reed questions even more fundamentally, is the widespread usage of certain interventions and the pregnancy pathway that is built around the needs and preferences of the system rather than the needs and preferences of the person moving through it. So for example: if a baby at full term is found suddenly to have stopped growing and has no amniotic fluid left around it, you could quite reasonably say this baby needs to be induced. By contrast, you could look at a policy that says all women should be induced at 39 weeks, which was very close to becoming a real policy in the UK not that long ago. This is the kind of instance that Rachel Reed is warning us against, where that intervention, that rite of passage, is sending the very clear message to the people subject to it that your body is not trusted, your body is always wrong, everybody’s body is wrong and we, as the system, know how to do it better. I would never argue that women shouldn’t have pain relief, or that they should only have access to certain kinds of pain relief, because I’ve seen countless times in my own practice how some women find an effective epidural really liberating: it helps them enjoy the experience, they found the pain really traumatic and they like the fact they can have a sleep. But I’ve also seen other women with the same kind of analgesia feel very disconnected and rather than experiencing an increase in control they feel quite distressed by the lack of control, the limitations in their mobility, and they feel almost disembodied from the whole process. So it’s a very subjective judgement: these rituals have very individualised meanings, and we have specific cultural expectations about the kinds of pain relief that are available to us, how they will feel, and what they will mean. And, putting my medical hat on, we have to recognise that these are drugs, and they will have positive and negative effects. She’s not anti-pain relief, but she doesn’t think we should enforce or advocate certain types of pain relief over others just to suit the needs or momentum of the system. And she would argue that we need to recognise that the extent to which we are embodied within the birth experience will have a lasting effect on our memories of that experience. Yes, and Reed very much argues that we need to preserve this ancient body of wisdom that midwives and other birth attendants have acquired over millennia. So, yes, there are things like epidurals and morphine and gas and air, but we also have this body of wisdom around other ways to create a comfortable environment and use mobility to reduce pain and use water, and use breathing, and use visualisation. I don’t think she’d argue that we must only use the older low-tech tools. But I think she’s arguing for the preservation of this body of wisdom to prevent the complete takeover of these more modern interventions."