Where Is the Real Information on Pregnancy and Childbirth? (2024)

This is the sixth post in a series.

In the book Matrescence: Pregnancy, Childbirth, and Motherhood, Lucy Jones talks about the shocking lack of information available to women regarding what childbirth is really like, what the actual consequences are of using pain relief during labor, and what some of the potential risks are during delivery.

Jones takes up the subject of "natural childbirth." She says that women have been told for so long that "natural childbirth" is best that this has pretty much become the ideal. However, she lets us know that the concept of "natural childbirth" has a very particular origin.

She says that this goes back a long way in medicine to a British obstetrician named Grantly Dick-Read, who coined the phrase in the mid-1900s and who portrayed childbirth in a highly idealized way. Dick-Read promulgated the idea that childbirth is not necessarily painful and that fear is the main cause of pain during labor and delivery. He developed a form of hypnotherapy that he said would help women be less anxious about going through labor and delivery and, therefore, experience less pain. His work is still used and quoted today.

However, according to Jones, Dick-Read had scant evidence for this theory. And he also had little evidence that hypnosis and relaxation techniques could make the birth process far less painful.

This will come as shocking news to most women—as these ideas are still popular and routinely disseminated in childbirth classes to this day.

However, for most women who have actually labored and or given birth while conscious, it is not news that labor and delivery are extremely painful with or without relaxation and breathing techniques. Labor hurts. Delivery is very painful. And all the exercises you learned usually go out the window after a certain point. Anyone who does not remember it being this way either has a very high pain threshold, or they are good at repressing painful memories.

Jones goes on to talk about the misinformation given to women about the risks of using epidurals and pain medication during childbirth. Women are often told that having an epidural will slow the rate of labor and result in an increased likelihood of having a C-section. As it turns out, neither of these is true.

According to Zha et al. (2021), labor is not prolonged by the administration of an epidural if it is given after the woman is 6 cm dilated, and there is no difference in birth outcome for babies whose mothers have or have not had an epidural. And Ashagrie et al. (2023) reveal in their literature review that there is not a greater risk of C-section for women who choose to have an epidural (Ashagrie et al., 2023).

Jones also talks about the consequences of delivery. She talks about how common it is for there to be tearing of the vagin*, the perineum, and the anus, and she says that women are usually not told about the risks of these occurring in advance of childbirth.

According to Okeahialam et al. (2023), 9 out of 10 women experience perineal tears during first-time deliveries, and 6 percent of first-time births include anal sphincter injury. A percentage of mothers also experience pelvic floor injuries during childbirth.

These things are important for pregnant women to know, not because they need one more thing to worry about, but in order to advocate for themselves prior to and following delivery. Especially for those women who choose home births, it is important to understand that prompt surgical repair of sphincter injuries is crucial to prevent fecal incontinence, something that will dramatically decrease a mother's quality of life following delivery. Mothers need to make sure their midwives are willing to check for such injuries and will tell them about them.

Moreover, it is helpful for first-time mothers to know that preventative measures can be taken. Doctors and midwives can manually protect the perineum during delivery if they know how. And prior to delivery, pregnant women can ask about whether their doctors or midwives are trained in such measures. Secondly, it can be helpful for pregnant women to know that perineal massage can be effective if done in the third trimester of pregnancy to increase the muscle elasticity of their perineum (Okeahialam et al., 2023). And lastly, it is important to know that women who have experienced pelvic floor injuries can seek out physical therapy following childbirth.

Lucy Jones says that not only are most women unaware of these issues, but many midwives, nurses, and OBs do not talk with their patients about these subjects.

It's time to talk about what childbirth is really like, and to be honest about it. And it is time for women to have the information they need prior to delivery in order to prepare for the realities of childbirth and life postpartum.

Thank you, Lucy Jones, for leading the way.

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