Culture and Birth: The Technocratic ImperativeThis aticle was published in the
International Journal of Childbirth Education, 9(2):6-7, 1994
Through the act of controlling birth, we disassociate ourselves with its raw power. Disassociation makes it easier to identify with our "civilized" nature, deny our "savage" roots and connection with indigenous cultures. Birth simultaneously encompasses the three events that civilized societies fear--birth, death, and sexuality.
--Holly Richards, "Cultural Messages of Childbirth: The Perpetration of Fear," ICEA Journal 7(3):28, May 1993.
Asked to write on "Culture and Birth," I found myself remembering the excellent article by Holly Richards quoted above, in which she makes many of the same introductory points about the cultural shaping of childbirth that I would have wanted to address. She argues that Western society, in its effort to dominate and control nature, has worked to make women fear birth and its attendant pain, as these are powerful reminders of our ultimate dependence on nature. Here I will extend her argument.As Richards points out, our Western cultural attitude toward birth is fear-based. Since the dawn of the Industrial Revolution, the emerging technocracy has sought to dominate and control nature, a "right" that was chartered early on in Genesis when God gave man dominion--but could only be fully carried out with the emergence of modern technology. "What you resist, persists," the psychotherapists say. The more able we became to control nature, including our natural bodies, the more fearful we became of the aspects of nature we could not control. This led to the emergence of the technocracy--a society organized around an ideology of technological progress--and of a phenomenon that anthropologist Peter C. Reynolds has labelled the "One-Two Punch." Take a natural process that is working well--say, a river in which salmon annually swim upstream to spawn. Punch One: "Improve" it with technology--build a dam and a power plant, generating the unfortunate byproduct that the salmon can no longer swim to their spawning grounds. Punch Two: Fix the problem created with technology with more technology--take the salmon out of the water with machines, let them spawn and grow the eggs in trays, feed the babies through an elaborate system of pipes and tubes, then truck them back to the river and release them downstream.
Reynolds' brilliant insight was to see that, while most people see Punch Two as an accidental byproduct of Punch One, the deeper truth is that Punch Two is the point. We in the West have become convinced that culturally altering natural processes makes them better--more predictable, more controllable, and therefore safer. For example, when the Corps of Engineers lined the banks of large sections of the waterways of the Everglades and installed floodgates, most people thought of this as an improvement. No matter that the effect has been to lose huge portions of this natural resource to soil erosion.
It is not hard to see how this One-Two punch of mutilation and prosthesis applies to birth. We fear the birth process--like the waterways of the Everglades with their frequent floods, it seems to us to be chaotic, uncontrollable, and therefore dangerous. So we "improve" it with technology. First we take it apart--deconstruct it--into identifiable segments. Then we control each segment with the obstetrical equivalent of dams and floodgates (EFM, pitocin, drugs.). When the unfortunate byproduct of this technological reconstruction of birth is a baby in distress from a now-dysfunctional labor, we rescue that baby with more technology (episiotomy, forceps, Cesarean section). Then we congratulate ourselves on a job well done, just as the builders of the salmon hatchery Reynolds visited in California put a plaque on the wall to congratulate themselves for "saving the salmon."
An excellent example of this One-Two Punch comes from a newspaper article handed to me yesterday by Michel Odent, in which he writes about birth from a holistic viewpoint in response to remarks by technocratic physician Dr. Karl Murphy, a representative of the European College of Obstetricians and Gynaecologists. While Dr. Odent points to the mounting evidence of harm caused by electronic fetal monitoring (more Cesarean sections) and ultrasound (more left-handed children, according to a Norwegian study, and more cases of intra-uterine growth retardation, according to an Australian one), Dr. Murphy advocates the "active management of labor":
The passive approach to the management of labour, where nature is allowed to take its course and intervention is carried out only when an obvious problem arises, has been promoted by many in response to the notoriously high induction rates of the early 1970s. But there is mounting evidence from studies in Dublin and the US that by managing the labour in the early stages--rupturing the forewaters, for example, and using oxytocin hormone infusion to correct slow labour--the Cesarean section rate can be significantly reduced. ["Thwarting the Cruelty of Mother Nature," The European, 18-24 March]
His words show the influence of the One-Two Punch on obstetrical thinking--create a problem with technology (a Cesarean rate that is too high), then resolve it with more technology (active management of labor). His reasoning is entirely tautological, of course, but if you accept the underlying premise that technology improves nature by making it safer, then his arguments make perfect sense.
Reynolds' One-Two Punch is a powerful motivating force in American society--I call it the the technocratic imperative. This impetus to improve on nature through technology has as its ultimate aim to free us altogether from the limitations of nature. We seek freedom from the limitations of the earth through the development of space technology, from the limitations of our bodies through computers and robotics, from death through cryogenic freeze, from the limitations of natural reproduction through the New Reproductive Technologies, and from the limitations of birth through obstetric tools. Childbirth educators, like all health care practitioners, feel the impact of this technocratic imperative, and must make their own decisions about how they will respond. The culture in which we live will always seek to shape us into conformity with its dominant values and beliefs. Only conscious awareness of hidden cultural forces like the One-Two Punch can leave us free to choose.
Resources Davis-Floyd, Robbie E., 1992. Birth as an American Rite of Passage. Berkeley: University of California Press.Reynolds, Peter C., 1991. Stealing Fire: The Mythology of the Technocracy. Palo Alto CA: Iconic Anthropology Press.