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Some women are actively pursuing pleasure in labor
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When Chelsea Bray found out she was pregnant with her second child, she knew she wanted her next birth experience to be different. While she describes her first birth two and a half years prior ? an unmedicated hospital birth ? as ?wonderful, by all accounts,? she went home feeling generally dissatisfied by her hospital experience. Rather than a baby-focused approach, she wanted more continuity of care for her as a whole person, not just a vessel for the baby.
Her second birth ? a home birth with a midwife ? was different: She thought that the process was considerably shorter and more comfortable than her previous one. But, to Bray?s surprise, her second birth wasn?t just pain-free, sans medication. It was actually pleasurable ? orgasmic, even. When the baby?s head lowered into her birth canal, Bray says she experienced an overpowering, whole-body physical sensation she compares to an orgasm: ?I just remember roaring a sound I didn?t know I had the capacity to make.?
Bray says her birth experience switched from merely tolerable to pleasurable when she decided not to be afraid during the intense, physical sensations. ?From that point on, it was a trip, literally ? I felt high. It was like a full-body explosion of feeling,? Bray says. ?The things about birth you?re told to fear were not painful for me. They were the climax, so to speak.?
Birth may not seem sexy, but some researchers say the experience of delivering a baby is deeply intertwined with a woman?s sexuality ? and that embracing it as such can not only decrease pain in labor but cause actual, sexual pleasure. Some women claim their birth is ?orgasmic? in the same way that a good piece of dark chocolate might bring heightened sensory awareness, while others say they have literal ?birthgasms? due to the baby?s convenient positioning in the vagina.
?It?s quite obvious that birth is part of our sexuality ? it?s how we created the baby, and it also involves the sexual parts of our bodies,? says Sarah Buckley, an Australian physician and hormone researcher. ?Birth is intrinsically a passionate experience, but what?s happened is that in order to medically administer birth, we?ve had to desexualize it.?
Another way the birth experience connects to a woman?s sexuality is the cocktail of hormones triggered during labor and delivery. Oxytocin ? the same hormone released when a woman has an orgasm ? peaks in the brain and body during labor, prompting uterine contractions, which move the baby down toward the birth canal. The oxytocin and endorphins released during labor can also play a particularly powerful role in affecting a woman?s pain levels, says Buckley, who authored a 2015 report on the hormonal physiology of childbearing.
?Orgasmic birth is something that can happen, but I wouldn?t want it to be a performance standard. I think we have enough on our plate in labor.?
Studies show that in addition to its antidepressant and anti-anxiety properties, oxytocin is a powerful pain reliever. Researchers think it increases pain tolerance, meaning it doesn?t lessen the actual pain intensity of birth ? it merely changes a woman?s perception of it. ?Oxytocin and endorphins don?t necessarily abolish pain, but they contribute to an altered state of consciousness that allows mothers to transcend stress and pain, so they?re not the whole focus,? Buckley says. For some women, this hormonal flood results in a painless or even ?orgasmic? birth.
But most women, Buckley says, experience the most intense levels of oxytocin after pushing out the baby (think about it as a ?post-birth high?), which serves an evolutionary purpose ? these hormones kick-start a woman?s maternal behaviors by motivating her to do the things that will keep the baby alive. ?The release of oxytocin in the brain activates the reward and pleasure center, so when the mother meets her offspring, she will connect taking care of her baby with that pleasure,? Buckley says.
So if all women supposedly experience the same surge of hormones when delivering a baby, why is it that so few women ? one 2013 study estimated only 0.3% ? have euphoric or pain-free births?
Hormone levels aren?t necessarily biologically straightforward ? they largely depend on context. Just as hormones affect a woman?s emotions, a woman?s emotions and mindset can affect her hormones. This means when a woman is scared or stressed, the flow of oxytocin may be impeded, which Buckley says causes labor to be more painful or scary.
?In any stressful situation, your circumstances matter, your environment and who?s there matters, so the chance of it being a positive experience is much higher if you feel like people are taking care of you, if you?re in a familiar place, if you feel like your emotional needs are being met,? says Buckley.
Dr. Randi Hutter Epstein, author of Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank, acknowledges that mindset can impact a woman?s experience having a baby. But she believes the process of having a child is often more complicated than just overcoming a fear of uterine contractions. ?We can?t just say, ?It?s all in your mind,?? she says. ?Birth isn?t painful because you?re uptight, but because it?s generally discomforting when your birth canal is widening to push something out that?s potentially the size of a watermelon.?
Debra Pascali-Bonaro is the director of the film Orgasmic Birth and a birth doula trainer with DONA International, the largest doula training organization in the United States. She teaches people how to emotionally and physically assist mothers in the birth process in addition to equipping women and their partners to bring sexuality back to birth.
Reorienting women with the sexual aspect of labor comes partly in response to the increasing number of moms reporting traumatic birth experiences. While childbirth-induced PTSD can affect women?s ability to bond with their babies, a growing body of research shows feeling empowered during birth leads to less trauma. For Pascali-Bonaro, this means encouraging women to embrace the inherent sexuality of the birthing process. ?Women who prepare for their birth in wholeness, body, mind, spirit, sexuality, can really take back their power.?
While some women, equipped with a conducive environment and mindset, experience the orgasmic birth sensation spontaneously, others intentionally take a sexual approach into the birth room. Pascali-Bonaro says her clients have used kissing, nipple stimulation, masturbation, and vibrators to reduce their pain and experience pleasure, since these things bring more oxytocin into the birthing process and, as a result, distract women from the pain. ?Pleasure can be an incredible tool. If we can experience moments of pleasure between contractions, we?re going to relax more, so that next surge of contractions is not as painful.?
But there are barriers to reintegrating pleasure with birth, Pascali-Bonaro believes. In her experience, an empowered, pleasurable birth is contingent on a few ingredients: feeling safe, private, and unobserved, all of which are unlikely to happen in the typical hospital environment.
The general lack of ambiance in the hospital setting may affect a woman?s mindset. Pascali-Bonaro says that with its scratchy gowns, limp pillows, and clinical lighting, the United States ranks last of all the industrialized nations in opportunities for comfort and pleasure in childbirth. ?It?s not that hospitals are bad places, and when needed, they offer great, life-saving tools, like epidurals and cesarean sections. But we?re overusing these tools and underusing so many other ways we could make birth easier.?
While there may be some significant barriers to enhancing birth with pleasure, some see focusing too much on sexuality as a potential barrier to safety ? which, in light of the increasing maternal mortalities in the United States, should be the first priority.
Pascali-Bonaro agrees that if the pursuit of pleasure in labor and delivery shames women or compromises safety in any way, it might not be worth focusing on. ?Orgasmic birth is something that can happen, but I wouldn?t want it to be a performance standard. I think we have enough on our plate in labor,? she says.
If an epidural and a hospital birth feel like the healthiest, safest choice, Epstein says that?s what a woman should choose, especially since there?s just no guarantee that everything will go smoothly during the process.
?I?m a big believer that there?s no award that goes out to women who don?t have drugs in delivery. If you?re the kind of person who wants that epidural, that?s not telling of the kind of mom you?re going to be,? she says. ?It?s a very personal decision.