Women and pain in childbearing: a Christian perspective

Today as I cleared folders from the shelves in my office, assigning most to the recycle bin, I came across a paper, Women and pain in childbearing, that I wrote in April 1993.

Family pic 1992

Twenty-one years ago, as I was launching a new phase of my midwifery career, I put down on paper a brief discussion of my understanding of this topic.  In those 21 years, I have been with women, in the various phases of childbearing; reaching the climax in exquisite pain, and coming through to the new realm of personal strength in motherhood - this has been the terrain of my life.  




[Twenty-one years ago, before we had the Internet, before blogging or downloading, before social media or messaging. I have the paper copy.  Who knows where the backup floppy disk is, and if I would be able to read it with any of the devices we use today?]

Today I would like to copy that paper, with only minor edits, and place it here for my readers, and for the completeness of my own body of writing.  This essay is different from most of my writing that is available on blogs, because, rather than an exploration of midwifery, its focus is primarily about my own Christian faith, and my understanding of the foundational teachings of the Bible - that of God's plan for redemption of anyone who believes in Jesus, the precious son.


Women and pain in childbearing
Joy Johnston  April 1993

Recently a young friend asked me "What do you make of the curse in Genesis about pain in childbirth?"
I could have given a quick and easy answer, but realised that this is an issue that I should explore carefully.   It's one of the big questions of life and faith.  The story of the Fall follows closely the story of Creation: when GOD created; and the final act being the creation of the human person, male and female, who was made in the image of GOD; and that GOD looked at what he had created, and said it is good!  The maleness of the man and the femaleness of the woman were, equally amazingly, in the image of the Creator, and were good! 

In Genesis [Chapter] 3, [Verse] 16 we read "To the woman he (GOD) said, "I will greatly increase your pangs in childbearing; in pain you shall bring forth children, yet your desire shall be for your husband, and he shall rule over you."

Jesus used the fact of pain in childbearing to explain to his disciples the pain they would feel when "A little while, and you will no longer see me" (John 16:16).  He said, by way of illustration, "When a woman is in labour, she has pain, because her hour has come.  But when her child is born, she no longer remembers the anguish because of the joy of having brought a human being into the world." (John 16:21).


The issue of a woman's pain in childbearing has prompted lengthy debate through the ages. I am seeking to understand and integrate the Biblical teaching of the first sin as recorded in Genesis 3, with my knowledge of childbirth as a normal and amazing function of a woman's body. 

Whatever effect this (Genesis 3:16) consequence of sin has on women in childbearing today it cannot be answered simply.  As a midwife with more then 20 years' experience [at the time of writing] I know that the suffering endured by women in childbirth is not dependent on their relationship with God.  Many women find labour extremely painful yet, as in the Lord's illustration (John 16:21), forget the anguish after the birth.  Others experience severe pain which they never forget.  This may be related to complications which would result in the death of the baby or mother or both if skilled medical intervention were not available.  Modern care provides analgesia and anaesthesia, and a range of surgical options at such times. 

And what of the women who do not suffer pain in childbirth?  Many women, Christian or otherwise, face labour with eager anticipation instead of fear; find ways of actively assisting their bodies; and report minimal or no pain.  Have these women overcome the pain of Eve in a way that other women have not?

Ruth Tucker's writings helped me understand the significance of the 'curse' on our first parents:

"... neither Adam nor Eve was 'cursed', as is often assumed.  Satan was cursed and the ground was cursed, the latter had a very real effect on Adam, but neither he nor Eve was the direct object of the curse." (page 48)  

This view has not always been popular in the Christian church, as Tucker illustrates with a story from the sixteenth century [reformation] Scotland. 

"... Eufame MacLayne took a pain-killing herb to sustain her through the birth of twins.  She and the babies survived.  However, someone found out what she had done.  Painkillers were forbidden to women in childbirth.  It was against God's law.  The Bible said so, their punishment for Eve's sin.  So Eufame was brought before those who decided punishment....  Her babies were taken from her arms, and given to someone else's care.  Eufame was tied to the stake.  Bundles of wood were laid at her feet.  The new mother Eufame was burned alive." (page 52)

[note: my heart has ached every time I have considered this mother, Eufame MacLayne in Scotland.  I have descended from Scots, and I am a member of the Presbyterian Church, with direct links to Scotland.  The murder of Eufame MacLayne, at the hands of the leaders of the Christian Church of that time, was barbaric, and simply wrong.]  

The stories of creation and the fall are incomplete without the story of redemption, which God had planned from before the beginning.  "Christ redeemed us from the curse of the law by becoming a curse for us" (Galatians 3:13).  How does the redemption in Christ influence the Christian person's relationship to 'the curse'?

The answer follows in Galatians 3:19.  "Why then the law?  It was added because of transgressions, until the offspring would come to whom the promise has been made."  As Paul explains the great doctrines of law and faith, bondage and freedom, he makes a pronouncement that must have amazed many of his hearers: "There is no longer Jew or Greek, there is no longer slave or free, there is no longer male and female, for all of you are one in Christ Jesus" (Gal 3:28.  The barriers which divided mankind - in relation to race (Jew or Greek), power (slave or free) and gender (male and female) - all had arisen as a direct consequence of sin.  Redemption through the blood of Christ removes these barriers.  How we long to see the final fulfilment of Christ's victory over sin when he returns to earth.

Having received freedom in Christ from the curse, how is a woman today to approach the pain of childbearing?  Or, the logical extension to this question is, how should a man and women relate to one another in marriage? 

Pain in childbearing is a general reality for all women.  The degree to which any particular woman suffers from that pain is influenced by many physical and psychological factors.  A woman who is in Christ is free from the ultimate sting of the curse which is death, because death has lost its power over us (1 Corinthians 15: 50-57).

A powerful enemy of the birthing woman, and indeed her husband, is fear.  Fear and anxiety produce muscle tension, fatigue, and a sense of failure.  Fear has often been nurtured by ignorance and, regrettably, a vague idea that pain is a woman's 'lot'.  I cannot suggest that positive thinking will ensure a particular outcome in the childbirth process, but conversely, I observe that the negative-thinking person is rarely surprised.  Perhaps this fear of pain is a direct consequence of the fall, passed on from generation to generation until today.

A Christian couple approaching childbirth are able to claim Christ's power over the curse of the law and its consequences.  Our Lord Himself will be with them, with strength and comfort for every situation.  In accepting freedom from fear the woman is able to work willingly with her body through the labour, and other times of stress.  Should medical intervention be necessary her trust in God to work in all things for good will sustain and strengthen her.  The time of childbearing can bring a new sense of God's blessing into the lives of the parents and those who have the privilege of being with them.


[Scripture references are quoted from the New Revised Standard Version.]

Reference:
Tucker, Ruth A. (1992)  Women in the Maze - Questions and answers on Biblical Equality.  Intervarsity Press.


Thankyou for your comments

Preparing for change

In the morning I went to the farmers market, parked the car a block away, outside an historic bluestone Roman Catholic Church, and strolled past the stalls.  It was a lovely sunny morning in Spring, not really warm, but not cold either.  Bright yellow daffodils were gaily nodding in the light breeze.

I had on my list eggs and potatoes, so I got a dozen eggs from the interesting poultry stand, and a bag of potatoes from Bert who was selling them from the back of his truck.  Then I noticed some plants that would make good little additions to my daughters' gardens, so I waited at that stall.  The lady behind the table was explaining to a customer that she protects plants by standing a wire hanging basket upside down over the plant, to protect it from chooks, rabbits, and other garden inhabitants.  What a good idea!

I asked for a couple of the alpine strawberry plants, and a pot of dwarf Irises.
"This is a good one," she said.  "Wait about a month after it has flowered, and then you will be able to divide it and plant it out in the garden."

I found this lady very welcoming, and as there were no other customers waiting, we chatted.  I told her that we are moving from Melbourne; that we are looking forward to the change.

with our daughters, Miriam and Bec, and our newest grandchild

Time is steadily marching on, and events in my life are opening up like the spring flowers.  I have attended my last booking for birth, and our seventh beautiful grand-baby has been born.  Our house has been sold, and we have bought a lovely house on 5 acres in Kyneton.  We are now working on discarding much of the accumulated paper and magazines and non-valued books and other items of clutter that have occupied cupboards and filing cabinets and book shelves in our home of 30 years.

A midwife is required to retain birth records for 25 years from the date of the baby's birth.  Of course the trend is towards electronic record keeping, but my records are all 'hard copy'.  The essential parts that I will keep are my birth registers, and the clinical notes associated with pregnancy and birth.

Having been a midwife all these years, and having almost surprised myself with the passion I developed for my profession, I wonder how I will manage as a retiree.  I wonder if I will long for the past, or if I will embrace new goals and challenges.  I know my body has become much less flexible in the past few years - knees and shoulders and hip joints get creaky.  My husband's too!  Will we be able to stave off the ageing processes and enjoy an active retirement for the next 10 or 20 years?  I hope so!

I hope I will also be able to keep writing.

I expect my writing style to change.  The posts in this and other blogs are closely linked to my professional life.  I have found the events around birth to be uniquely energising, as though a special part of my mind is opened up as I reflect on being with woman.  I know I crave the special thrill of birth.  Midwives often refer to ourselves as 'oxytocin junkies.'  When we work in harmony with the amazing natural processes in birth, there is plenty of love to go round, and then some!  When we sit calmly with them as the baby takes nourishment, as hormonal surges in the mother release the life-giving milk, and reinforce the bond that opens the mother's selfless heart to her child, the wonder of mother-love overflows into other lives.

As I prepare for change, I realise that I have been blessed to experience something that is deeply related to all women, regardless of their society or time.  Many women have given birth and raised their children, unaware of this wonder.  The natural process in birth and the nurture of the infant can open a woman to new experience as she takes up the mother role.  The midwife does not 'help' or 'assist' or 'facilitate' or 'empower': the midwife accompanies the woman through a timeless and God-given process that brings new life and blessing to our race.

As Michel Odent said,

“One cannot actively help a woman to give birth. The goal is to avoid disturbing her unnecessarily.”

Saturday afternoon, a time for quiet reflection

I am not writing to a particular audience today. According to the blogger program, the readership of this site is very small. That's OK by me. My writing here is introspective, making a record that I will be able to return to.

In years past I would write the weekly letter to my parents, and often ponder the seasons, and the wonders of nature. I haven't written weekly letters for some time now, and I think in some ways, blogging has replaced that ritual. As a blogger I have not sought a large audience. In some ways I see this record as something that one or two of my grand-children may read and appreciate one day, as I have enjoyed reading the brief writings of some of my forebears. I have not attempted to divulge deeply personal thoughts: I hope the things that are not said speak as loudly as the written words.

A good fire in the wood stove

Today I am setting into the record a few home-based memories; things that usually happen without anyone paying any attention.

Most of my recent blogging has been at villagemidwife, exploring some fairly heavy issues around regulation of the midwifery profession.


This morning we cut up some old Red Gum fence posts that are now stacked up as fire wood, ready to keep our home warm through the winter.

dwarf peach

With Noel's help I transferred two dwarf peach trees from the garden, where they had out-grown their allocated space, to styrofoam containers that will allow me to keep them healthy until the time comes to plant them out again.  The skills I have acquired with Bonsai have given me confidence to prune the roots as well as the canopy. 

This particular dwarf peach is a white fruit variety that I have known for as long as I can remember.  My dad grew them in his garden, and told me that they were special because the plants are true to type: that the seeds would grow into the same old variety of dwarf peach tree.  This is different from modern grafted varieties.  He gave me some seeds from his fruit, and these two trees have been growing near the washing line in my back yard for most of the past three decades.  From time to time I plant seeds from these trees, and have passed small potted trees to various family members and friends, just as Dad did all those years ago.

Japanese Maple

I don't want to miss the opportunity to record the last of the Autumn colours for this lovely little Japanese Maple. [See my comments about this tree in previous post, End of Summer]

Poppy making Pumpkin Scones

This week my beautiful 10-year old grand daughter Poppy asked me to help her make a batch of Pumpkin Scones to take to school for a class lunch. 

For the record, here's the recipe I use.  It's based on the Queensland PWMU (Presbyterian Women's Missionary Union) recipe, with a few of my personal changes.

Pumpkin Scones
Turn on the oven and set to hot.
Using a knife blade ... (not a wooden spoon),
Mix well 1/4 cup caster sugar and 1 tablespoon butter.
Add 1 cup cold mashed boiled pumpkin.
Add 1 egg and mix well.
Stir in 2+3/4 cups self raising flour, and 1/4 cup milk (with a dash of vinegar to make it sour)
Turn out onto a floured surface, and knead lightly with your fingertips. (the dough should stay cold)
Roll lightly, cut with scone cutter or small glass. (that's what Poppy is doing in the pic)
Bring the remainder of the dough together lightly with your knife, knead lightly, roll and cut.
Place scones on baking sheet, and cook 10 minutes, or until they are light to tap, and starting to turn golden brown.

When you take the scones out of the oven, place on a wire rack that has a tea towel on it.  Cover and cool in the tea towel.  Serve warm with butter, and home made plum jam.



Thankyou for your comments

the end of summer

A Japanese Maple bonsai tree in my garden

Readers may have read in previous posts that I am planning my retirement from attending births in the coming year, and eventually from the practice of midwifery.  I can't ignore the sadness that comes to my mind as I contemplate this huge step.  Midwifery has been my passion; to a great extent my identity, for many years now. 

Yet, just as I celebrate the changes of seasons, and tend my little garden, and look forward to the autumn colours on this little bonsai tree that I have tended for the past five years, since it was just a seedling, I am also choosing to celebrate the passing of time in my life.  I am also looking forward to the new freedoms and opportunities that will present when I am no longer 'on call'.  I am coming to the end of the 'summer' of my life: the time of productivity and strength.  I have the autumn and winter ahead.

I have, in the past couple of months, informed my colleagues and potential clients of my intention to retire.  I do not have any particular reason to retire, other than age.  I am in good health, and I think I am in possession of all my faculties.



In the past few years I have witnessed major changes in the midwifery profession in this country.  Many of these changes have been related to the legislation governing the practice of midwifery, and I have written at length on this and other sites.

In the past few years I have also witnessed a migration of midwives, from mainstream hospital employment, to private practice.  Of the twenty-or-so midwives practising privately in the Melbourne area, about ten have been part of the exodus from hospital jobs, since 2010.

This phenomenon, by which the number of midwives practising privately in Victoria has doubled in only three years, has translated into a decrease in the demand for my services as a midwife.  There are plenty of midwives looking for work.  New midwifery practices and businesses are working hard to promote their services, and to compete for clients.  I am content that the Melbourne (and surrounding areas) women who are seeking private midwifery services, either for planned home birth, or hospital support, will have midwives willing to work with them when I have called it a day.

Some of the garden produce this year: figs, peaches,tomatoes ...

A midwife’s scope of practice is not related to the business model under which she or he works.  This means that any midwife, except those who have specific restrictions imposed by the regulatory body on their registration, is able to practise midwifery without supervision, in the way that they choose. 

Mainstream maternity care is within hospitals and health services.  When a person applies for employment in a hospital or health service, the application will be reviewed by experienced peers, and processes will be followed to confirm that the skill and experience levels are suitable for the position.  This aspect of due diligence is expected of employers.

In private practice there may be no employer, other than the woman.  The onus falls on the individual midwife to ensure that they are competent for the work they undertake.  The main setting for private midwifery practice in Victoria today is planned homebirth.  Midwives who have practised in hospital maternity units in this country, whether for a graduate year, or for many years, may have had very little experience of caseload practice or homebirth.  They may have idealised notions about the women who employ midwives privately, and about what happens in homebirths.  

Midwives who have achieved Medicare eligibility and set up private practice have, in the past three years, quickly transitioned to homebirth practice.  This can be seen as a positive step: attending homebirth is, after all, basic midwifery practice.  Yet we need to proceed with caution: there is a body of knowledge and a set of skills that are specific to homebirth and caseload midwifery practice.  As some wise person said: “you can take the midwife out of the hospital, but can you take the hospital out of the midwife?” 

Until hospitals are willing to set up collaborative agreements, and support eligible midwives for the full scope of midwifery services, including attending births in the hospital, this will continue to be the case.  It cannot be assumed that the good outcomes that have been demonstrated in homebirth in Victoria for the past couple of decades will continue.  Midwives need support as they extend and develop their private practices.  This is not happening.

As I move into the autumn of my life, handing births over to younger midwives has to happen.  I hope these midwives are reflecting on their own practices, speaking honestly to colleagues, and reading widely in midwifery literature - even places like this.  And I hope many are writing their stories.  I don't see much evidence of that - it seems to be the exception rather than the rule, to have midwives who are not academics committing their practice to writing.

I know that this blog has only a few regular readers.  I don't know who you are.  I hope something I have written is meaningful and useful to you.

Many more visit the other midwifery blogs that I write: villagemidwife and midwivesVictoria.



Thankyou for your comments