So, I’ve been reading this book pretty much non-stop for the past few weeks, and I have been completely blown away. C o m p l e t e l y. This is the book that finally answers the maddening question “WHY????”. Why does modern obstetrics insist upon the use of routine and often unecessary interventions, even when evidence-based research has shown that these interventions often do more harm than good? Why does the practice of modern obstetrics place the obstetrician and hospital staff at the center of the delivery, rather than the woman and her family? Why do so many women collude with a system that so fundamentally disempowers them at every turn, not only allowing these obstetrical interventions to be performed upon their hapless bodies, but doing so with nary a protest—instead, with smiles of gratitude and profuse thanks?
The answer, it would seem, lies in ritual.
We’re suckers for ritual, we really are. There’s something about ritual that taps very deeply—inexorably—into our human psyches. Every culture, every religion, every myth and ethos and society, has ritual hard-wired into its very core. Ritual is one of the ways that a society explains the world and perpetuates itself and its beliefs. Not surprisingly, then, the rituals of a society are pretty important and unavoidable, and of course, nearly invisible; if the socialization process of a society has succeeded (and naturally, in order for a society to survive, there has to be a pretty high success rate), fully socialized members will not even be aware of most of the rituals that surround them. Also not surprisingly, our own culture is no different, despite our airs of scientific detachment and firm belief that our streamlined, modernized world has evolved well beyond the primitive mumbo-jumbo of our anscestors.
The important rites of passage in the human lifespan (birth, puberty, marriage, death etc.) are dangerous times for a society, as these are the times when a member is in between fixed social categories—a teenager is no longer a child, but not yet an adult; a pregnant woman is no longer a maiden, but not yet a mother. It’s during these times that a person is most likely to perceive and question the strictures of society (and possibly rebel), so from a societal standpoint, it’s critical that these “in-between” phases are tightly controlled, and that its members are more deeply socialized and indoctrinated into the beliefs and practices of that culture at these points. Hence, the Rite of Passage, a symbolic journey which takes place at set times in the human lifespan with the express purpose of teaching and revealing certain cultural truths and beliefs to the participant, thereby socializing them into the same worldview held by the dominant culture.
In Birth as An American Rite of Passage, Robbie Davis-Floyd, examines birth from an anthropological perspective, carefully dissecting all of the routine procedures performed in the hospital, explaining how they serve ritual purposes, and deciphering the deeper cultural truths and messages they are intended to convey. Like any good rite of passage, birth in this country shares many of the feautures of ritual which have been widely documented by anthropologists: it begins by seperating and isolating the initiate from general society, then slowly simplifying her cognitive framework through hazing and strange-making, using symbolism, repetition, rhythm and redundancy to break down her current world view, and inevitably imrpinting her with the new messages and deeper truths the ritual is trying to convey.
In our society, the deeper truths run something along these lines: technology is transcendent, the institution is more important than the family, the body functions as a machine, and in the case of women and pregnancy, the machine is often defective, liable to malfunction or break down at any point, which is why we need technology to step in to save the day. The obstetrician and hospital is placed at the center of the birth, many routines are performed for the doctor’s convenience, rather than the woman’s (and often despite sound medical research to the contrary), labor is veiwed as a production line that can be stopped or started, sped up or slowed down as needed, and the baby (the outcome of the production line) is seen as much more important than the producer (often, many of the messages tell the woman that she is harmful to her baby, that the purpose of technology is to keep her dangerous, defective body from putting her baby at risk). These beliefs and rituals are our society’s way of trying to control the uncontrollable, and to turn birth into something that is predictable, manageable and cultural. The end result of this ritual is a woman and family who has been socialized into accepting the transcendenc of technology and the importance of the institution, her baby claimed by and for society, and the stamp of the hospital left all over her birth experience. The success and pervasiveness of this socialization is amply demonstrated by the fact that these days, the idea of having your baby anywhere other than a hospital is considered dangerous and selfish, whereas only three generations ago, the majority of women still gave birth at home.
This book was a very fast and absorbing read, simple to understand and yet comprehensive in its approach. Davis-Floyd interviewed 100 pregnant women and mothers regarding their birth experiences, often quoting long sections from their birth stories to illustrate or illuminate her points, and these womens’ narratives give this work a personal and deeply moving touch. I was amazed, in fact, by how sound her theory was, and how accurately it accounts for so many of the apparent conflicts in modern obstetrics. It was, overall, a highly educational read, meticulously researched, and a book that I know I will turn to again and again in the years to come.