Made by a woman. For women.

No, I’m not talking about a certain alternative menstrual product. I’m talking about something Robbie Davis-Floyd, Ph.D, a medical/cultural anthropologist, natural/home birth advocate, and a detractor of the patriarchal, male OB-directed “technocratic model of childbirth”, calls the “perfect technocratic tool”.

That evil, horrible, birth-experience underminin’… epidural.

I’m sure most of you have never heard of the late Gertie F. Marx, MD (1913-2004). But she turned the practice of obstetric anesthesiology on its ear by fighting to have epidural analgesia used on laboring women, and for the best of feminist reasons:

Before the late 1960s, women had one of two options: either accept the well known risks of general sedation or anesthesia for themselves and their babies or undertake sometimes difficult deliveries without any pain relief, a process that could be brutal for both mother and newborn. “There was no in-between,” said Dr Ingrid Hollinger, professor of anesthesiology at Mount Sinai School of Medicine, New York.

Dr Marx suggested that epidural anesthesia could provide pain relief without the risks of respiratory depression, aspiration pneumonia, and death that accompanied systemic sedation. But many obstetricians and midwives argued that epidural anesthesia would slow delivery and cause an increase in cesarean sections. Some even cited a passage from Genesis in the Bible, “I will greatly multiply your sorrows and your anguish. With sorrows you shall bring forth children,” indicating their belief that childbirth was meant to be painful.

Despite the sometimes acrimonious opposition, Dr Marx held her ground and was able to demonstrate that epidural anesthesia provided excellent pain relief, did not cause a rise in cesarean section rates, and was safe for the newborn—even though it might, arguably, prolong the first and second stages of labor.

The use of epidural anesthesia also helped to usher in a new era in which fathers could be present with mothers as they gave birth. Epidural anesthesia could be delivered in the birthing room instead of the operating theater, allowing the father to be present. With the mother alert, childbirth could be a shared event for mother and father.

In 1993, Queen Elizabeth presented Dr. Marx with a lifetime service award and a college medal from the Royal College of Anesthetists. (QEII may have acquired her taste for pain relief in labor from her great-great grandmother, Queen Victoria.). She also has had an epidural needle named in her honor.

So next time you hear a so-called “feminist” rant about how male OBs are out to undermine womens’ sacred “birth experience”, spare a thought for a true feminist who genuinely sought to help laboring women. And given that some 80% of women use her product, I’ll say she succeeded 🙂 .

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10 Responses

  1. Interesting. Thanks for sharing that history. I’m planning on a natural birth with my pregnancy, but I know many women who opt for epidurals and are pleased.

  2. Thanks for that! I have no problem with anyone wanting a natural childbirth, but I don’t believe that having one makes you any better or more noble or more feminist or more anything (except maybe more brave than I am!)

  3. Wow! Thank you for this post, and thank goodness for Dr. Marx . I would have hated to miss the experience of my children’s birth by c-section. Their birth was beautiful and the epi allowed me to witness it.

  4. You’re welcome, ladies. 🙂

    Stephanie – I feel exactly the same way about getting to experience my emergency CS with my oldest. General anesthesia SUCKS.

  5. Very interesting.

  6. But is you have an epidural you will probably have an episiiotomy /forceps or vaccum delivery/and very probably a C-Section!
    And have you heard that you might have complications then with consequent births?
    Or that you may be turned down for life & health insurance because you had a C-Section?
    Plus it is painful, life threatening and interferes with Breastfeeding & bondling..you knwo that like tacky thing that imprints your baby’s limbic brain for life?

    • That is absolutely not true. In fact, as a labor nurse for 13 years I saw many cases in which a woman was able to finally relax and dilate after her epidural. And whoever advanced the idea that an epidural interferes with either breastfeeding or bonding-totally ridiculous. Bonding can take place no matter what the circumstances. You think those of us born during the paternalistic 40s, 50s, and 60s didn’t bond with our parents? We are not ducklings, to blindly bond with the first fence post we see

  7. Lynn,

    A slightly higher chance of episiotomy and/or forceps delivery does not mean a woman will “probably” have one. And many women (myself included) consider that elevated chance – not certainty – a fair trade for the nearly 100% chance of not feeling labor pains.

    Epidurals do not raise a woman’s chances of getting a CS, period. Anyone who tells you so is misinformed. I wouldn’t go to an insurance company which raises its premiums (I doubt they actively refuse these women) on women who’ve had CS’s, because there is no reason to think these women are at greater risk for anything but in childbirth – and even that is not such a huge excess risk.

    Epis are not anywhere near as painful or life threatening as birth itself. Nor is there any evidence that epidurals interfere with bonding – nor is “bonding” as all-important as Odent and co. would have you think. I’ve written about this here.

  8. “Nor is there any evidence that epidurals interfere with bonding – nor is “bonding” as all-important as Odent and co. would have you think. I’ve written about this here.”

    Not to get all hippy-dippy on you here, but you seem to be implying that it isn’t important to you to bond with your newborn after giving birth. That, like so much of what you talk about here, is a personal choice that I won’t question – I respect your right to choose the way you conduct your childbirth experience. It’s yours, and far be it from me to tell you how you should do it.

    But, for me, I felt after giving birth like the only thing in the world I was interested in was to hold my child, snuggle him and feed him from my breast. I personally was not interested in him being taken from my body, placed in a plastic tub, examined as though he were an alien, and whisked away from me immediately after leaving my body. I felt that it was necessary to comfort him. I didn’t do the classic “AP/NP” bonding routine with him because some researcher told me it was “best” – I did it because it felt right and I wanted to.

    If, after you give birth, you just want people to leave you alone so you can figure out how to go to the bathroom again, I respect that, and I respect your right to choose that, just as I imagine Dr. Marx would have. So I don’t ridicule your way of doing things – I simply acknowledge your right to have things that way, and then I peacefully go ahead and do things another way. It seems the tone of many of your posts seeks to undermine or dehumanize the choices that women like me have made, and as a raging, diehard feminist, I really resent it.

    I wish this side of the argument could see how anti-feminist modern hospital birth really is. Because it’s insulting and pathetic to drag someone like Dr Marx, who genuinely fought for expanding birth choices, into this debate, when you simultaneously give the impression that people who disagree with you are dangerous and wrong. To me, that’s not feminism – that’s how Fox News likes to have an argument.

  9. cat:”Not to get all hippy-dippy on you here, but you seem to be implying that it isn’t important to you to bond with your newborn after giving birth.”

    Not at all. But I think the whole concept of bonding is very ill-defined, and happens over a period of time. Unlike geese and goats, we don’t have a “sensitive period” in which an all-or-nothing bonding experience takes place. Nor is it true that having an epidural or a CS prevents the hormonal cascade which leads to those feelings (and it’s not really well-established that the hormone levels are solely responsible for those feelings, anyway).

    “If, after you give birth, you just want people to leave you alone so you can figure out how to go to the bathroom again, I respect that, and I respect your right to choose that, just as I imagine Dr. Marx would have. So I don’t ridicule your way of doing things – I simply acknowledge your right to have things that way, and then I peacefully go ahead and do things another way. It seems the tone of many of your posts seeks to undermine or dehumanize the choices that women like me have made, and as a raging, diehard feminist, I really resent it.”

    If all “natural” birth advocates were like you, I wouldn’t need to write this blog in the first place. My issues are with people like Odent and Sears and their lay disciples (Hathor the Cow comes to mind), who try and misrepresent science to claim their preferred methods of parenting and birth are superior. I have no problem with another woman’s choices, as long as they’re not endangering anyone and as long as they’re stated as a personal preference, not The Superior Method to do X (TM). I’m merely trying to provide ammunition to the women who feel browbeaten by the Odents and Sears of this world, and giving them tools to answer them.

    And I happen to think that most women are better-equipped to deal with the bonding postpartum if they’re neither doped up on IV narcotics, nor exhausted and shaky from the pain of a long labor. Which is why Dr. Marx’s gift to womanhood is so important, IMO.

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