Should childbirth be pain-free?

A doctor wonders why any woman would choose to have a baby without anesthesia.

Published July 24, 2006 4:30AM (EDT)

In a cover story in the Boston Globe Sunday magazine yesterday, Dr. Darshak Sanghavi asks why some women choose to go through labor and delivery without the aid of drugs.

"One justification I've often heard is that labor pain 'empowers' women or gives them a sense of 'control,'" writes Sanghavi. "But many women accept pain for a more mundane reason: They are poorly educated about obstetrical anesthesia and don't have access to compassionate and technologically advanced medical care." Other reasons for a drug-free birth proffered in this pro-epidural article: Some people, including natural childbirth proponent Ina May Gaskin, believe that birth offers the potential for an ecstatic labor that includes intense orgasms. And many people simply don't believe that birth pain needs to be treated because it's not pathologic.

Still, nearly two-thirds of women delivering at large hospitals nationwide do receive epidural anesthesia, probably because, as Sanghavi writes so vividly, "the vaginal canal is so richly supplied with nerve endings and pain fibers that it's almost uniquely suited to create agony."

If you can get beyond Sanghavi's bias against natural childbirth -- at the end of the piece he admits that having a baby without pain medication strikes him as "odd" -- there are some fascinating historical details in the article. My favorite: Fanny Appleton, the second wife of Henry Wadsworth Longfellow, was the first woman in America known to receive anesthesia during childbirth. A world traveler, she knew that women in Europe were receiving drugs to quell the pain of labor and delivery and wanted to score some for herself. When Appleton couldn't find an obstetrician to dispense any, however, she resourcefully called on a Boston dentist for some vapors. Appleton, who had already birthed two children naturally, described the dentist to a friend this way: "[One] would like to have the bringer of such a blessing represented by some grand, lofty figure like Christ, the divine suppresser of spiritual suffering."

By Lori Leibovich

Lori Leibovich is a contributing editor at Salon and the former editor of the Life section.

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