Epidurals are empowering

Unassisted birth advocate Rixa Freeze ponders how different women can view epidurals very differently:

Epidural + empowerment are two words that don't always get put together in the same sentence, even among women who gladly choose epidurals for pain relief. For me--huge caveat that I'm speaking about my own thought processes here, not generalizing myself onto all women--an epidural is the opposite of empowerment. Not just emotionally or psychologically, but in the literal sense, too, because an epidural causes full or partial paralysis from the waist down. The thought of losing sensation, of literally being unable to walk or move, isn't something I would look forward to in labor. To me, labor = movement. I cannot imagine having a contraction without moving in response to it.

She views epidurals as disempowering because they limit movement and sensation, yet there are many women who find them empowering because they eliminate pain. Dr JaneMaree Maher of the Centre for Women’s Studies & Gender Research at Monash University in Australia,offers a very different way of conceptualizing pain and empowerment, one that resonates with the majority of women. In her article The painful truth about childbirth: contemporary discourses of Caesareans, risk and the realities of pain , she observes:

... Pain will potentially push birthing women into a non-rational space where we become other; ‘screaming, yelling, self-centered and demanding drugs’. The fear being articulated is two-fold; that birth will hurt a lot and that birth will somehow undo us as subjects. I consider this fear of pain and loss of subjectivity are vitally important factors in the discussions about risks, choices and decisions that subtend ... reproductive debates, but they are little acknowledged. This is due, in part, to our inability to understand and talk about pain.

As she explains:

... [W]hen we are in pain, we are not selves who can approximate rationality and control; we are other and untidy and fragmented. When women give birth, they are physically distant from the sense of control over the body that Western discourses of selfhood make central; they are very distant from the discourses of choice that frame the caesarean rates debate. I am not suggesting here that women become irrational in childbirth ... I am however suggesting that we continue to frame birthing experiences and decisions as if that model of subjectivity were the relevant one and in so doing, we move further away from articulating the realities of birthing, of pain and of the ways in which women engage.

So epidurals, as the most effective form of pain relief, give women control over their own bodies and control over the way in which they behave. This allows women to represent themselves to others in the ways in which they wish to be seen, instead of pushing them into a "non-rational" space.

While women like Rixa value the ability to move above all else, and therefore consider forgoing an epidural empowering, most women value the ability to control their own bodies and control the way that they behave. For them, pain is disempowering because it robs them of the control they value, and robs them of the ability to articulate other desires or even speak.

The bottom line is that there is nothing inherently empowering about pain or pain relief. It depends on what each individual woman values and wishes to control. Wanting to move in labor is no more or less important than wanting to be comfortable in labor. Women who choose epidurals find them very empowering.


This piece first appeared in February 2010.