Belly Tales

A few weeks ago, Dark Daughta over at One Tenacious Baby Mama asked me for a contribution to her new weekly series entitled Reloaded, which happens every Sunday and features old posts that are worth posting and reading a second time (oldies but goodies, as she calls them). She wanted posts that I was particularly proud of, “something that really kicks ass analytically, politically” etc., and I quickly discovered when I was combing through my old posts that I don’t really have much in the analytical/ political/ highly opinionated/ kick-ass vein. It seems that my blogging style overall tends to be of the objective-news-reporting variety, or at best the highly-researched highly-factual variety; in other words, the variety that is so factual and evidence-based that no one can really argue or disagree with what you’re saying; in other words, the risk-free variety. Which is good to know about yourself, I guess, because it then prompts a bunch of really good questions, like: WHY AREN’T YOU TAKING MORE RISKS? Why aren’t there more highly opinionated, highly political, highly analytical, highly kick-ass posts on your blog? What are you scared of? Pissing someone off? Causing controversy? But really…is there any other point to a blog than opinion? If all we’re after is the news, we’ll read newpapers and news sources, thank you very much. Blogs are supposed to comment on things. So, good to know. Note to self: enough with the reporting on things. Get commenting instead. Go out on that limb. It’s about time, don’t you think?

Anyway, I sent Dark Daughta a few posts. One on the Keeper (still one of my proudest feminist and environmentalist statements), one on the UK’s new birth agenda (Maternity Matters), and two on female circumcision (Circumcision or Mutiliation? and Further Thoughts on FGM).

I was curious to see what Dark Daughta would think of them. Leave it to Dark Daughta to not only think about them, but to write an explosive 1000 word treatise as well. She picked my posts on female circumcision, of course, and then ran with them. Ran is a polite word for what she did. More like smacked the posts upside down, flipped them inside out, and then shook all of the loose change out of their pockets. She took everything I had thought after my first encounter with a circumcised woman, and all of the conclusions I had come to at that time (and this had involved a lot of thinking back then, trust me), and managed to turn all of those thoughts, all of those culminations of thought, absolutely, irrevocably, upside down. In the space of just one post. Leave it to Dark Daughta to challenge the hell out of you.

Just a few highlights, here:

Dear Student Midwife:I’m glad that you’re asking yourself questions about how best to proceed. …Maybe examining the culturally based and biased and ofttimes downright racist, response of many privileged feminists who were not born into cultures where genital circumcision is practiced might offer some much needed space inside which there might be less emotionally and politically charged room for a true examination of the issues.There is a power relation here. Are parents in western societies hunted down and denied access to safe male circumcision? Why is the WHO advocating for this procedure when there is a fast growing segment of the male population that is crying out against it?

When male circumcision of babies who can’t make the choice for themselves is enshrined as a part of at least major world religion, are health care practitioners strategizing about how best to stigmatize grown men who present penises that are mutilated? Are feminists of conscience refusing to sleep with men who are circumcized? Are we looking on them with pity and defining them as mutilated? Are we strategizing about how best to divest them of custodianship of their sons so that we can keep them safe from circumcision? Is anyone noticing that the actual side effects of male circumcision…besides those that go horribly wrong…are minimal because these surgeries are done by skilled practitioners in sterile settings?

I don’t agree with either kind of circumcision. But I can’t fail to notice that one is filled with shame and stigma heaped on those who experience it, while the other is thought of as a throwback that should be done away with but is still tolerated and executed in hospitals.

Being useful is definitely not going to include making any circumcized wimmin feel uncomfortable and on the spot about the decisions of their parents. So, labeling a woman’s cuts “mutilations” without checking to see what if anything she says about her own genitalia will go a long way to making a practitioner seem like a judge and not as someone a woman can potentially confide in or turn to.

Because really, the shock and the unfamiliarity with the view below is ours, not theirs. If we’re gonna pay lipservice to accepting the anatomy of the vulva, we’re going to need to work at really understanding and respecting that wimmin come in all sorts of configurations for all sorts of reasons.

This “who is civilized” and “who is babaric and uncivilized” binary split that serves the west/the north, giving our cultures a much needed oppressive ego boost needs to GO!

Yowsa. And those are just the highlights. I’d highly reccommend that you go and read the rest of the post, because she writes with so much passion and conviction, and has this incredible way of phrasing things in ways that I would never, ever think of.

Now, how do you respond to a post like that? I didn’t even know where to start. First I had to do a lot more thinking on the subject, which I’ve been doing for the past several days and nights. I wrote an e-mail response to her, which she published in last Sunday’s Reloaded V which started to flesh out some of my thoughts. And now I find myself here again, having done yet another 180 on the subject (my apologies for repeating some parts of my e-mail, but this is pretty much where my thinking is at right now).

I think Dark Daughta is right on a lot of counts. There is indeed an inherent racism/ oppression in a viewpoint which has decided to call one form of ritual cutting “mutilation” while at the same time leting so many other types of cutting fall under the category of “circumcision” or some other word, and therefore under the umbrella of cultural acceptability (male circumcision, labioplasty, clitoral hood piercing, episiotomy etc.). I can see how that is indeed our culture (and by that I mean western culture) taking its own viewpoint on what constitutes a healthy vulva and setting it forth as “right” and “correct” and that anyone else who does anything different to their vulva (especially something brutal or harmful and something we as a culture don’t fully understand) is therefore wrong and backwards and oppressed and brutalized by their own culture…and that this “mutilation” is therefore a form of violence against women. This viewpoint then lays the groundwork for our invasion of their culture; in other words, this viewpoint basically gives us permission to enter their culture and tell them what’s right and wrong, and that they have to stop this cultural practice. And many huge, big name organizations like UNICEF, the World Health Organization, the US Dept. of State, Amnesty International, USAID etc. etc. have all issued policies and statements which call for an end to this practice, and have programs or policies in place which exist to help educate and save these women from their fate.

Calling something “mutilation” implies, by its very nature, that those who are “mutilated” need to be saved. That makes sense, and I see that now, but I had never before thought of it in those terms. So further thinking on this is prompting me to start to refer to this ritual as “circumcision” again rather than “mutilation”. I do appreciate that my view of what constitutes a healthy vulva is certainly not everyone’s view, and who am I (or who are we?) to decide what is or is not the right kind of vulva? Why is labioplasty or clitoral hood piercing okay, while female circumcision is not? And what would happen if circumcision was done well, by medically-trained people using sterile instruments, sharp instruments, making clean, hygienic cuts? So many of the problems inherent in this practice comes from the scarring and infection which is secondary to the cuts themselves. If there was no scarring, if there was no infection, would the damage be less? As Dark Daughta pointed out, female sexuality stems from a lot more than the tiny nub of flesh which is the clitoris. If the clitoris is removed, but in a clean and precise manner, using sharp, sterilized instruments (rather than a rusty tin can or a piece of glass etc.), would women be able to retain a higher level of sexual functioning? I never, ever would have thought that an underground feminist movement to provide clean, hygienic, medically-trained female circumcisions is not that far off from what feminists were doing in the 70s with their underground abortion clinics to provide clean, hygienic, medically-trained abortions, but yeah, I do see the similarity.

I wrote in a comment on my first post that “I undrstand that there are a lot of cultural and personal reasons involved in choosing [male] circumcision, and I don’t feel like it’s my place to say.” So if I can so graciously back out of the debate when it comes to males, why can’t I do the same with females? To say that these girls aren’t educated about the pros and cons of the procedure, that they’re forced into it by their parents and their culture at a young and vulnerable age (usually at puberty), and that they therefore aren’t making informed consent doesn’t hold up, either, because the same can be said of male circumcision. Baby boys are absolutely, positively NOT making an informed decision when it comes to having their penises cut or not. It’s a decision that their parents are making for them for many different reasons, just as it’s a decision that the culture/ parents are making for the girls who are receiving female circumcision. And I ask again: what right do I have to step in to this decision-making process and tell someone that they’re wrong, or that this decision is wrong? I have no right whatsoever.

Now, before someone comes along and rips into me, let me just make this very very clear: I am not advocating female circumcision, nor am I advocating male circumcision. I am not condoning either practice, nor am I saying that they’re both fine and acceptable, and that they should continue unhindered. All I am saying is that it’s not my place to judge these practices, and it’s not my place to make these decisions. Since I’m not a member of a culture that practices female circumcision, the rich cultural context with which this practice resides is lost on me. The shame or humiliation someone of that culture might feel by not being circumcized and therefore not being a full participant of their culture is something I’m never going to be able to empathize with. And I am questioning whether it is right for our culture (Western culture) to go on huge “Stop Violence Against Women” campaigns in cultures which are not ours, in contexts which we don’t fully understand (and probably can never fully understand).

I do think that these practices need to stop. But I don’t think that the impetus for changing this is going to come from us (from the West), and I don’t think it should. If it’s going to change, it needs to come from within; from women and advocates who are of these cultures, who understand the context, who can see the patriarchy at work in such acts, and who want to rise up against it. And when they do, we as Westerners can and should support them with all of the resources our rich, privileged cultures afford us.

I guess the only sticking point I still have at this point is the following: if you’re a member of a culture, and if it’s all you know, and if you’re never exposed to anything else, you will never have the objectivity necessary to ever question or rise up against these practices that you have seen and been a part of since birth? And maybe that is where an organization can step in and offer education to members of these cultures; ideally, the education should come from members of the culture themselves. I think the folks over at RAINBO are on the right track, and if we as Westerners want to support the education of women (and therefore indirectly the hope that eventually these practices might stop), we can do this by supporting organizations like this.

As far as being a practitioner, the take-home lesson here is once again very simple, and very difficult to fully learn: LISTEN TO WOMEN, and DON’T JUDGE. How is it that I can see this so clearly on issues like abortion, where I absolutely, 100% feel that it is not my place to say, and that since I’m not carrying her baby or walking in her shoes, I have no right to judge at all….and yet issues like female circumcision still bring about huge, heaping amounts of judgement? As a white woman from a privileged background, I’ve been trying for awhile to own my privilege, and see the way that this affects my point of view on everything. This is a difficult, never-ending task, and while I feel that I’ve managed to own this on several more obvious issues, this is an issue I hadn’t even picked up on. I guess the ultimate, life-long goal for every evolving human soul is to continue to move towards a state of less and less judgement. To become as close to non-judgemental as you can possibly be. I say possibly, and “close to” because I think being non-judgemental is an impossible goal. Our psyche, our sense of self, our identities, our culture, our experiences and background and upbringing, everything we use to know ourselves as who we are–all of this is based on judgements which we have formed through living, judgements which we have consciously or unconsciously absorbed, and I think it’s impossible to seperate yourself from them. I am not using this as an excuse. Moving towards a more non-judgemental state requires very close and painful examination of those life experiences and background and upbringing and culture. It requires seeing the ways that your life experiences and culture has potentially prejudiced you, seeing the ways you are privileged, seeing the ways that power affects your identity–power you have, or don’t have, or have in some areas but not others. It requires seeing where you come from, seeing the way that this has formed your world view, and then seeing the way that this outlook affects how you see others. That’s a huge part of becoming less judgemental.

The LISTEN TO WOMEN and DON’T JUDGE take-home message means that all future encounters with women who have been circumcized will involve calling it circumcision, following her cues, and letting her talk or not talk about it, as she desires.

Anyway, those are my thoughts on this subject at this moment in time. Granted, I will continue to think, and I’m sure my thoughts will continue to evolve. I’d be really interested to hear what others think about this as well. It is a very sticky subject, and it’s not about to get any more clear any time soon.

After signing off yesterday, I had some lunch then promptly attended three educational sessions in a row, two of which I paged. The first was entitled Cervical Ripening: What We Know and Why A Paradigm Shift is Needed for Reducing the Incidence of Preterm Birth, which focused on how our preterm labor treatments (tocolytics) are very utero-centric and concerned only with stopping contractions, while cervical ripening is often a much predictor for preterm labor. There is a lot of new research in this area, and new therapies aimed at counteracting cervical ripening might be more effective in stopping preterm labor than simply stopping contractions (which may, but often does not stop cervical ripening in any way). The speaker was very knowledgeable on her topic, which was her area of research and interest, but aside from presenting her own research, which is microscopic tissue analysis of the cervix under ultrasound to assess for markers of tissue disruption and increased water retention (precursors to ripening), there was not much which was immediately applicable to take away from her lecture. You get the sense, however, that in another 5-10 years, there will actually be drugs and assessment tools and treatments available to combat this aspect of preterm labor, which is very exciting.

The next educational session I went to was on sexual dysfunction, presented by a doctor who has spent years heading up a sex clinic in downtown Chicago and mentoring other medical and nursing students in sex therapy. While she had many, many (often sad, often hilarious) fascinating stories to relate, she really didn’t get into the nuts and bolts of sexual dysfunction in any great detail, at least not in any way that is immediately clinically applicable in terms of helping, counselling and treating couples with dyspareunia, anorgasmia, vaginismus, unconsummated mariages and premature ejaculation (although apparently you can use SSRIs, which notoriously have libido-killing side effects, to help delay and slow down men who have rapid ejaculation problems). Still, it was overall a fascinating topic, and really made me realize how little I know about sex therapy and sex counselling, which is indeed something a midwife should be pretty well versed in. While I certainly feel comfortable asking women about their sex lives, and discussing all aspects of sex and a person’s sexuality, specific treatments and counselling techniques are not at all in my repertoire, which is something that can be fixed with a little bit of reading and education.

The third educational session I attended was Menopause: Case Studies of Hormone Therapy, which was fabulous. I was astounded by how well the researchers knew the material. They made the very valid point that even though the Estrogen/Progesterone arm of the Women’s Health Initiative (WHI) was ended in 2002 due to the alarming increase in the rate of breast cancer, the other arms of the trial continued, and information is still pouring in from all sides, as well as from other studies that are now in progress. One of the speakers (Mary Brucker, CNM) termed it “research sushi”: after a large randomized control trial such as the WHI, you’re often left with more questions than answers, and in the ensuing years different aspects of the larger study are often chopped up (like sushi) into more specific questions and newer, smaller studies are mounted to try to tackle all of the questions raised. With hormone replacement therapy (HRT) at the moment, we’re apparently very much in the research sushi phase. It’s still a very grey, very unclear and ambiguous area, with very few clear guidelines or answers. While the WHI did a great job of scaring people so much that HRT is now often avoided at all costs (even when it can be very beneficial on a short-term basis for symptomatic relief of menopause), some of the information gleaned from WHI is actually, surprisingly saying the opposite. While the combined estrogen/progesterone arm increased the risk of breast cancer, apparently the estrogen alone arm of the study actually had no increased risk in breast cancer among the women treated with estrogen , and and a nearly significant decrease in risk (28% in the estrogne-alone arm, v. 34% in the placebo arm), which raises the question of whether all hormones are bad, across the board, period, end of story, or whether some hormonal therapy might actually have a very valid place in symptomatic relief (it also raised the question of what to do about women receiving unoposed estrogen without progesterone to balance it out, which has been shown to increase the risk of endometrial cancer). As you can see, very confusing stuff. They also delved into alternative treatments, such as the use of soy and phytoestrogens, Tibolone (which is used in Europe and actually had a worse Relative Risk for developing breast cancer than the combined and estrogen alone arms of the WHI), and compounded, bio-identical hormones, which also might not be the be-all-end-all cure that they are often touted as. Really, really fascinating stuff. I wish I was better versed in all of this, too, but I still find menopause and HRT very confusing.

Today started bright and early after a fairly late night dinner with a few other student midwives from Florida and North Carolina, mostly spent comparing our program experiences, mutually stressing about the board exams, and reviewing test questions that one of the students had from the test prep workshop she’d attended earlier that day. This morning I attended a great lecture on the Social Marketing of Breastfeeding, and how commercial marketing techniques can be very effectively used to market breastfeeding, especially when you break it down in terms of product, pricing, placement and promotion. She had all kinds of examples of ads from formula companies, which we then deconstructed in the class to root out the hidden, and often very sneaky and damaging hidden messages in them. Again, realizing how important language is: using the word “breastmilk repleacement” instead of “formula”, which makes it sound like a far inferior version of breastmilk, rather than a special, carefully planned, secret recipe which is just as good as breastmilk. We also talked about the importance of not only talking about the benefits of breastfeeding, but the risks involved with not breastfeeding. Again, none of this was new to me, but it was a very well put together and very concise presentation, full of good tips and suggestions, and it has really inspired me to work harder on my breastfeeding promotion and education (”selling” this amazing product—breastmilk!).

The schedule got a bit messed up, there are a few announcements on room changes and cancellations and switching of times, so the lecture on hormonal contraception counselling which I really wanted to attend, I missed. Instead, I ended up in a fascinating discussion panel on the horrific health disparities which still exist in our country, and the ways that midwives can work harder to amend these. We watched a small section of an upcoming PBS special entitled “Unnatural Causes: Is Inequality Making us Sick?”, which will air this winter in a 7 part series, and was incredibly eye-opening and terrifying in many of its implications. For example, the clip we watched demonstrated again and again that the areas of a county or city or state which have the lowest socioeconomic standing (which goes hand in hand with the highest crime rates) also have the highest rates of heart disease, pre-term birth, infant mortality, death by diabetes, hospitalization for asthma, lowest environmental standards, highest pollution and toxin exposure…the list went on and on. From the PBS website on the series:

Former U.S. Surgeon General Dr. David Satcher and his colleagues calculated that in 2002, 83,570 African Americans died who would not have died if black-white differences in health did not exist, a rate of 229 “excess deaths” per day. That’s the equivalent of one Boeing 767 being shot out of the sky and killing everyone on board every day, 365 days a year. And they are all Black. According to a by-now landmark study by Dr. Colin McCord and Dr. Harold Freeman, African American males in Harlem are less likely to reach age 65 than men in Bangladesh.

There are by now thousands of studies tracing the pathways by which racial and socio-economic status affect health. But there is virtually no popular media—no print, TV, nor web—that translate this research into forms that can build public understanding of how social policies are de facto health measures. As a result, the ‘common-sense’ wisdom remains that the poor and peoples of color get sick because they have unlucky genes, or they are just too lazy and undisciplined to to eat right, exercise and abstain frm drugs and booze. Similarly, it’s still widely believed that top executives who are dropping dead from heart and artery disease when in truth it’s their subordinates.

After watching the clip, we then moved into a very fascinating, (and very encouraging!) roundtable discussion. Midwives have always traditionally worked with underserved, indigenous populations, and it was amazing to hear about some of the changes and work that is being done around the country right now. You could feel the energy building in the room as people continued to come to the mircophone to speak. By the time the sesssion ended, the conversation had barely gotten started. Because the session is going to be repeated tomorrow, it was suggested that rather than starting over, we simply pick up the conversation again where we left off, which may or may not happen depending on how many people from today’s lecture attend the session tomorrow. In any case, though, I would watch the PBS documentary when it comes out, because it is going to raise A LOT of questions, and cause a media-world storm to descend on this long ignored issue.

Which now brings me to the present moment.  Time to find some lunch, and then sit in on an afternoon session review of the 2006 STD Guidelines (because, while I’m here, might as well attend lectures which will be useful on our board exam).  Tonight is the opening ceremony and dinner, followed by the long-awaited opening of the Exhibit Hall.  I can feel my money disappearing already.  Can’t wait!  Much more to come!

One of the midwives at the clinical site where I am working has a sign on her locker that says: Support Midwives, Make Love.

In that vein, here are eleven tips which were given to us by our guest lecturer on Sexual Health last year:

For a Better Sexual Life:

Suggestions that Work!

1. Connect before you caress—do things alone together that make you feel closer. At least weekly, spend anuninterrupted hour doing something that is fun or mutually satisfying (i.e. take a walk, have brunch, see a romantic movie).

2. Don’t forget romancing outside the bedroom—court each other.

3. Plan time together (when children arrive, or life intrudes, spontaneity leaves). Make a “date to make love”.

4. Create privacy (lock the door, turn off the TV and phones).

5. Sex is adult play—be sensual–let your skin and senses wake up to touch and caress. Use oils or power so that your hands can glide.

6. Dont expect mind reading—let your partner know what you would like: the kind of touch, the movements, the pace you enjoy.

7. Think about enhancing the variety of your sexual activities. Occasionally, try something “new” or slightly “forbidden”.

8. Stay positive and constructive—criticism never made anyone a better lover.

9. Keep your sense of humor—things often go wrong. Humor is the best lubricant.

10. Forgive easily—don’t let the little things ruin sexual intimacy.

11. Make your partenr feel valued—give a gift of yourself every day—a word of praise or a compliment, a hug or caress outside the bedroom, a flower, a card or special food, a few minutes of your full attention, your special helpfulness.

A loving connection is the most important goal.

—Drs. Marian E. Dunn and Sandra Leiblum

Better late than never: check out this article from the New York Times magazine last weekend, which featured a long, in-depth look at the growing anti-contraception movement in America. A few highlights includes a detailed description of the entire Plan B over-the-counter approval-process debacle which happened last year, culminating in the resignation of Susan Woods, then director of the FDA’s Office of Women’s Health…and we’re still waiting for a response from Lester Crawford, acting Commissioner of the FDA, aren’t we? We may be waiting for quite some time. At least “Senators Hillary Clinton and Patty Murray are holding up the nomination of Andrew von Eschenbach as F.D.A. commissioner until the F.D.A. issues a verdict on the drug.” Go go Senator Clinton!

Oh, and this is very interesting:

One thing that happened, which Dr. Wood and many others may have failed to notice, was the change in conservative circles on the subject of contraception. At a White House press briefing in May of last year, three months before the F.D.A.’s nonruling on Plan B, Press Secretary Scott McClellan was asked four times by a WorldNetDaily correspondent, Les Kinsolving, if the president supported contraception. “I think the president’s views are very clear when it comes to building a culture of life,” McClellan replied. Kinsolving said, “If they were clear, I wouldn’t have asked.” McClellan replied: “And if you want to ask those questions, that’s fine. I’m just not going to dignify them with a response.” This exchange caught the attention of bloggers and others. In July, a group of Democrats in Congress, led by Representative Carolyn Maloney of New York, sent the first of four letters to the president asking outright: “Mr. President, do you support the right to use contraception?” According to Representative Maloney’s office, the White House has still not responded.

Apparently the White House can’t give a straight answer to what should be a very straightforward question. Three cheers Congresswoman Maloney for asking the question repeatedly in the first place, though (in fact, Congresswoman Maloney a deserves an entire post of her own just to list all of the amazing work she’s done on behalf of women, children and women’s rights).

A few other chilling highlights:

In addition to providing an information center for the abstinence industry that has blossomed in recent years, [Leslee Unruh] takes her message directly to kids. Besides “Girls Gone Mild,” she sponsors “Purity Balls,” which fathers attend with their teenage daughters. “We think the relationship between fathers and their daughters is the key,” she told me. At the purity ball, a father gives a “purity ring” to his daughter — a symbol of the promise she makes to maintain her virginity for her future husband. Then, during her marriage ceremony, the daughter gives the ring to her new husband. Abstinence Clearinghouse’s Web site advertises the purity ball as an event “which celebrates your ‘little girl’ and her gift of sexual purity.

Better yet, check out Feministing’s take on the subject: Daddy’s little hymen.

Women’s Health News also had a very astute break down of the entire article, which is well worth reading.

As the 2007 federal guidelines for program financing state, “It is required that the abstinence education curriculum teaches that a mutually faithful monogamous relationship in the context of marriage is the expected standard of human sexual activity.”

I can’t even touch that, it leaves me so angry.

I’ve been thinking a lot lately about pain and birth. Or actually, pleasure and birth. Kimberly Bobrow’s website is what first got the wheels turning. In addition to the article on the language of breastfeeding that I was raving about last week, I also discovered this very interesting discussion about the eroticism of birth (a discussion that was so controversial it needed to be removed from the forum board it was originally on, and placed somewhere else). It’s so rare to even hear about stories like this! Almost invariably, when people talk about birth in this country, the focus is on pain. First time mothers spend sleepless nights worrying about it, birth education classes spend most of their time trying to prepare you for it, nurses measure your painscale while you’re in labor, modern obstetrics (and modern anesthesiology) is devoted to providing you with modern pain relief so that you can enjoy labor while numb up to your waist, and even celebrities like Britney Spears are so concerned about pain that they’d rather undergo major abdominal surgery than labor. Our culture can’t dissosociate pain from birth; they’re nearly synonymous, the horror story that grandmothers scare their grandaughters with (”just wait until you’re in labor someday”) or the guilt-trip sometimes used to keep children in line (”I went through 36 hours of excruciating pain for you”).

However, apparently it’s not painful for everyone! For some women, labor is an intensely sexual experience, amazingly erotic, and sometimes quite pleasurable—the ultimate turn-on. What an amazing idea that is! The sexual and erotic aspect of birth is something that is not even acknowledged in most of the literature I’ve ever seen, let alone something you would ever encounter in the hospital, which has been carefully designed to be as frightening, clinical and un-sensual as possible. This is something Robbie Davis-Floyd touched upon in her book, Birth As An American Rite of Passage: the cultural necessity of removing the sexuality from the obviously sexual process of birth. She writes:

It is precisely female sexual functions that the technocratic model finds threatening and labels both “defective” and “tabu”. So effective are hospital routines at masking the intense sexuality of birth that most women today are not even aware of birth’s sexual nature. For example, stimulation of the laboring woman’s breasts and clitoris has been proven to be extremely effective in strengthening labor, yet is utterly tabu in most hospitals, where the snythetic hormone pitocin is administered intravenously instead. The routine performance of episiotomy is another excellent example of the desexualization of birth in the hospital: an effective alternative recommended by many midwives is perineal massage with warm olive oil, far too overtly sexual a procedure for most obstetricians.

She goes on to discuss how this desexualization was something that was consciously desired, partly to avoid the embarassment of women performing sexual acts and acting sexually towards doctors or hospital staff during birth, and also partly to avoid the embarassment of something other than a penis giving a woman pleasure…in this case, the baby’s descending head! You could see how many people would find this not only controversial, but outrageous, bordering on sinful, and evoking ideas of incest. One nineteenth century doctor even went so far as to suggest that the purpose of the pain was to keep women from experiencing the underlying ecstasy of birth, and that birth should always be unmedicated in order to prevent women from discovering just how sexy it really was.

I think that my own thoughts on this subject need some time to ripen; pain and birth has been hardwired into my brain as well, and it will take some time to undo the pattern. Women are capable of experienceing birth as erotic and pleasurable. I know that Ina May has been quoted several times as saying something about how the same sexy energy that got that baby up there in the first place is the same energy needed to get the baby out. I wonder if this is something you see more often in a homebirth, becuase this is certainly something you’d never see in a hospital! I wonder how many of the sensations of birth are interpreted as painful just because that is how we’ve been socialized into thinking about it. I wonder if there are ways to keep a woman open to the possibility that birth may not necessarily be painful.

Slate has put together a very amusing slide show on the history of vibrators. For centuries, women were treated for “hysteria”, which, as it turns out, was just a glorified term for the expression of female sexual needs outside of the penetration alone paradigm. Touch-starved well-bred Victorian women who weren’t getting off on their husband’s idea of sex, but who were all hot and bothered anyway, with no release (especially when masturbation was unthinkable for women), were often labeled “hysteric” and sent to the doctor’s office for treatment. Treatment was vulvular massage to the point of “paroxysm”, and was often viewed as a lucrative but menial chore by many doctors. Fed up with the time-consuming tedium of stimulating a woman to paroxysm (which could sometimes take over an hour—how dull and difficult!), an enterprising British doctor invented the first vibrator in the 1880s, which mechanized the entire process and made it a whole lot faster, allowing the doctor to relieve more patients in less time. And thus the first female sex toy was born.

It’s a great slide show, check it out. The book mentioned in the slide show (The Technology of Orgasm : “Hysteria,” the Vibrator, and Women’s Sexual Satisfaction, by Rachel P. Maines) looks pretty interesting, as well.