“I Thought I Was Going to Die”: Examining Experiences of Childbirth Pain Through Bioarchaeological and Ethnographic Perspectives

Abstract

This chapter analyzes the pain associated with human childbirth, combining bioarchaeological analysis with biocultural data, focusing on Latin American birthing processes, specifically birth in Mexico and the Dominican Republic. It will explore challenges to childbirth across time, adaptive strategies, and individual agency related to the acceptance of the amount of pain endured during the process. Human childbirth is notoriously difficult, with maternal and infant mortality as distinct possibilities, and labor pain a near certainty. Past tendencies to see childbirth through the lens of the obstetrical dilemma created a framework for discussing reproduction as pathological. There are adaptations that suggest an alleviation of the obstetric dilemma, for instance, in correlating pelvic size and shape with head size. The traditional obstetric dilemma neatly packages the difficulty of human birth, but disregards several environmental and evolutionary factors that complicate the birth process of human infants. Given the numerous complications associated with pregnancy and birth, it is not surprising that most of the bioarchaeological cases include individuals who died right around the time of parturition. The need for medical intervention due to obstetric hazards is clear, as seen in the cases of dystocic labor where fetal bones are found in the pelvic cavities of pregnant women due to bony obstructions of the birth canal, misaligned pelvic bones, mismatched canal versus baby size, and breech and prolapsed infants. Pain in childbirth is highly likely, given the obstetrical dilemma with the complicated physiological process of moving a fetus through the birth canal. This chapter addresses the evidence for different facets of pregnancy and birth in the bioarchaeological and ethnographic records, conjecturing that many of the women would have experienced some level of pain in their childbirth. Some of this pain would even have been excruciating—especially in the cases leading to complications such as dystocia, obstruction, or placental abruption. Ethnographic data add richness to this issue, as they can tell us if certain conditions produce pain that is out of the ordinary. Ethnography is also a key way to explore why women would choose to undergo purposeful pain in childbirth.