At one time or another, people regarded childbirth as something that should be painful, painless, completely forgotten, fully remembered, natural, surgical, experienced at home or experienced in a hospital.
Randi Hutter Epstein has written about that spectrum of truisms in her new book, Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank.
Epstein, a journalist and a medical doctor who teaches at the journalism school at Columbia University, says that people have driven themselves crazy over childbirth for "hundreds and hundreds of years."
"We're trying to control the uncontrollable," she tells NPR's Robert Siegel. "In terms of doctors and midwives, I think we women have a history of being a feisty bunch, so we've pushed and asked for things — some good, some bad."
Her book describes people who have made great advances in the history of childbirth — but it also unveils some characteristics that are hard to admire.
The Chamberlen family came to England from France in the 1500s with forceps — a safe way to extract babies — but they wanted to capture the market and be doctors of royalty, so they hid the forceps, Epstein says.
They even hid them "from the woman giving birth, as if she was gonna be taking notes and trying to figure out what that forceps was and make her own afterwards," Epstein says.
Another controversial figure is Dr. J. Marion Sims, who is credited with figuring out how to cure vaginal fistulas, or tears in the vaginal walls.
Epstein says this advancement saved "thousands and thousands of lives" — but Sims had a secret.
"The part of the story that he always liked to bury when he came to the North from the South, was that he figured out his remedy by practicing on slave women that he bought, and stitching them up over and over and over again," Epstein says.
And then, in 1908, with the advent of the cesarean section, Dr. Franklin Newell of Harvard wrote an article advocating more C-sections, called "The Effect of Overcivilization on Maternity."
We're trying to control the uncontrollable. In terms of doctors and midwives, I think we women have a history of being a feisty bunch, so we've pushed and asked for things -- some good, some bad.
The "overcivilized" were wealthy women who spent all of their time indoors and needed C-sections, Newell wrote, because they weren't sturdy and hardy like the poor women who worked in the fields, who were able to get out and exercise, and give birth easily.
"He just felt we ruined our bodies," Epstein says. "Not only was it their lifestyle, but the more bookish they became, the more those reproductive energies were sucked up into their brain so they just didn't have the energy to do it all."
Epstein says childbirth is still evolving.
"We can laugh about what they said then, but it's not that long ago that, when we were picking sperm and egg for in vitro fertilization, that we said, 'Gosh, that sperm, he's swimming fast and straight, he's the one.' And now there's studies emerging saying, 'No, the kind of loser-ish crooked ones might be the ones that are the best to make a baby.' So someone is going to be laughing at us probably 50 years from now.
"I like to call today the 'era of extremism,' " she says. "I've interviewed hundreds of women. I've spoken to women who will say, 'Because of everything we know — and I'm so informed — I want all-natural, I want to be at home or in a hospital that looks like a home, and this is going to be a wonderful, cherishable experience.' I've spoken to an equal amount of women who have said, ... 'Get me in a hospital, get me as many drugs, I really look forward to motherhood, but I don't really need this childbirth experience.' Among informed women, we're really at polar extremes."
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