Preserving the Inaccessible: Natural Childbirth, Voluntary Pain, and Moral Agency
Travis Pickell, Lecturer and postdoctoral College Fellow at the University of Virginia; Sarah Gauche Pickell, MSN, CNL, University of Virginia Health Systems
In a pain-averse culture, women who refuse readily available medical pain-relief during childbirth are something of an anomaly. The preference for a “natural birth” raises interesting questions about the relationship between cultural values, moral agency, and the willed experience of bodily pain. Of course, there are many reasons why a woman might choose to experience a more painful childbirth. Some, but my no means all, of these reasons are religious or theological in nature. Whatever the motives, the act of willingly undergoing bodily pain clearly sits uneasily within the modern social imaginary.
This paper considers voluntary pain in childbirth as a lens for understanding a particular form of moral agency, which is neither fully active and controlling nor fully passive. In one sense willful, and in another sense suffered or borne, this form of agency teeters between the poles of the false binary of activity and passivity, of mastery and impotence. Medical anthropologist Pamela Klassen, drawing on Talal Asad, notes how women who choose pain in childbirth are (ironically) choosing to preserve the “inaccessibility of the body” as a form of self-conscious meaning-making. As Eric Cassel notes, the capacity for meaning-making is a central difference between an experience which is merely “painful” and one that constitutes “suffering” in a strong sense.
Without drawing any conclusions about the particular reasons adopted by women who choose pain in childbirth, we may note an interesting parallel between the form of agency they enact and analogous forms enacted through spiritual practices in various religious traditions. For example, Servais Pinckaers has proposed the importance of the early Church’s “spirituality of martyrdom” for contemporary Christian life, for martyrdom “does not represent one tiny spirituality among others; rather, it is written in the very heart of the Gospel.” This is not to glorify or endorse suffering or pain as such. Rather, the martyrs’ significance lies in their steadfast obedience, by the grace of God, even in the face of persecution and potential death. They thereby enact a patient submission and reliance on God, which accepts the “inaccessibility” of their situation to the notion of control. Pinckaers suggests “the martyrs invite us, in our turn, to bear witness to our faith in Christ with intelligence and patience, faithfully and proudly, relying on the grace of the Spirit and on prayer more than on our own abilities and resources, whether personal or technical.”
The parallel described above holds relevance in a medical culture that prizes control and assumes a moral imperative to alleviate pain and suffering. As medicine struggles to moderate the technological inertia which sometimes compounds suffering rather than relieving it, the medical imaginary might be well served by preserving a space for the “inaccessible.” This may, at times, entail the preference for painful experience that can be made meaningful, rather than modes of care that eliminate pain while also eliminating the possibility of meaningful experience.
This paper considers voluntary pain in childbirth as a lens for understanding a particular form of moral agency, which is neither fully active and controlling nor fully passive. In one sense willful, and in another sense suffered or borne, this form of agency teeters between the poles of the false binary of activity and passivity, of mastery and impotence. Medical anthropologist Pamela Klassen, drawing on Talal Asad, notes how women who choose pain in childbirth are (ironically) choosing to preserve the “inaccessibility of the body” as a form of self-conscious meaning-making. As Eric Cassel notes, the capacity for meaning-making is a central difference between an experience which is merely “painful” and one that constitutes “suffering” in a strong sense.
Without drawing any conclusions about the particular reasons adopted by women who choose pain in childbirth, we may note an interesting parallel between the form of agency they enact and analogous forms enacted through spiritual practices in various religious traditions. For example, Servais Pinckaers has proposed the importance of the early Church’s “spirituality of martyrdom” for contemporary Christian life, for martyrdom “does not represent one tiny spirituality among others; rather, it is written in the very heart of the Gospel.” This is not to glorify or endorse suffering or pain as such. Rather, the martyrs’ significance lies in their steadfast obedience, by the grace of God, even in the face of persecution and potential death. They thereby enact a patient submission and reliance on God, which accepts the “inaccessibility” of their situation to the notion of control. Pinckaers suggests “the martyrs invite us, in our turn, to bear witness to our faith in Christ with intelligence and patience, faithfully and proudly, relying on the grace of the Spirit and on prayer more than on our own abilities and resources, whether personal or technical.”
The parallel described above holds relevance in a medical culture that prizes control and assumes a moral imperative to alleviate pain and suffering. As medicine struggles to moderate the technological inertia which sometimes compounds suffering rather than relieving it, the medical imaginary might be well served by preserving a space for the “inaccessible.” This may, at times, entail the preference for painful experience that can be made meaningful, rather than modes of care that eliminate pain while also eliminating the possibility of meaningful experience.