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The riddle of the extreme ends of the birth experience: Birthing consciousness and its fragility

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Abstract

This paper focuses on the riddle of the extreme ends of the birth experience. On one end, are women who experience relatively successful childbirth as traumatic, and suffer from poor mental health during postpartum, varying from baby blues to postpartum depression and up to childbirth-related PP-PTSD. On the other, are women who experience childbirth as a highly positive, life-altering event. I offer that both extremes can be understood from the phenomenon of birthing consciousness and its fragility. When natural birth is uninterrupted, there are more chances for a natural birth process. At the end of an undisturbed natural delivery, women report ‘natural high’ sensations. However, even minor physical and environmental interruptions to the birthing woman stop the birth from progressing, thus requiring medical interventions. Out of analyzing the psycho-physical states during birth – natural and undisturbed versus highly medicated births – I claim that the fragility of birthing consciousness is the answer to the riddle of the extreme ends of the birth experience. Thus, the question ‘how does a low-risk woman get to a highly medicated birth?’ should be answered, not only in a physiological orientation, but also in a psycho-physiological and environmental context. Typical modern hospital birth environments often interrupt birthing consciousness, leading to a cascade of medical interventions and highly medicalized births with extremely negative birth experiences, which often results in poor mental health in postpartum. I argue that the first step to support a woman during a physiological birth, is to acknowledge the particular psycho-physical state of the birthing woman and its fragility, and not interrupt it unnecessarily.

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Data Availability

Data sharing not applicable to this article as no datasets were generated or analyzed during the current study (this is a theoretical article).

Notes

  1. i.e., physiological-undisturbed birth (natural birth), versus birth with medical interventions (such as synthetic hormones and medications to promote delivery, instrumental delivery, episiotomy, and C-section).

  2. Some argued that violation of childbirth expectations can produce negative feelings and experiences such as disappointment, guilt, depression, and even trauma (see for example DeCoster, 2018; Lobel & DeLuca, 2007), while others disagree and argue that PP-PTSD is not related to the woman’s expectation of the birthing process in particular, or her will regarding the way she wants to birth (see for more details Maggioni, Margola, & Filippi, 2006). I note that this issue is beyond the scope of the current paper, but the hypothesis I offer is more in line with the second view.

  3. Dystocia, for example, means abnormal labor that results from abnormalities of uterine contractions or maternal expulsive forces; the position, size, or presentation of the fetus; or the pelvis or soft tissues of the birthing woman. Labor dystocia is rarely diagnosed with certainty (American College of Obstetricians and Gynecologists, 2003). One of the indications for medical interventions in labor or cesarean surgery is dystocia (Kissler et al., 2020).

  4. There are also women, of course, that have a fear of birth, perhaps because they are socialized into a medicalized birth culture, in an increasingly technology-dependent society, thus prefer epidural anesthesia or elective cesarean section (Stoll, Hall, Janssen, & Carty, 2014).

  5. It can be argued that the rise in the rate of Cesarean sections in the U.S. is driven primarily by fear of litigation (Currie & MacLeod, 2008). This is an important perspective concerning different reasons for the cascade of interventions, but it is beyond the scope of current paper.

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Acknowledgements

I thank Joram Feldon for insightful discussions about the “birthing consciousness” research project and his valuable comments concerning this paper. I also thank the anonymous reviewers for their helpful comments and suggestions.

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    Orli Dahan

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Dahan, O. The riddle of the extreme ends of the birth experience: Birthing consciousness and its fragility. Curr Psychol 42, 262–272 (2023). https://doi.org/10.1007/s12144-021-01439-7

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