From Kat:
I had the natural high that comes with any exertion that makes your body produce endorphins. It is remarkable.... and it is nothing like an orgasm.
From Susanne:
Well, and what, there's some shortage of orgasms such that you've got to ensure that you have one during the handful of times that you give birth? If you have hundreds or thousands of them over the course of your life, you don't need to chase them like that. Chasing an orgasm during birth seems like the province of those who are otherwise deprived.
From Indy:
If Ina May compares giving birth to having an orgasm then one has to wonder what in the world Stephen is doing wrong? 
From LadyinRed:
"If Ina May compares giving birth to having an orgasm then one has to wonder what in the world Stephen is doing wrong? "
Bwahaha!!!
From Susanne:
Maybe Ina May would engender more respect if she and the people in her books looked like they bathed every once in a while.
From Grace:
I don't think Ina May is on a 'campaign' for orgasmic birth- I think the people who made the movie are, and they interviewed her. She did not make the film. She certainly states it as a possibility and some women do have 'orgasms' during childbirth. Too bad most of us don't. And certainly too bad if it gives women false expectations of what to expect in labor. At the same time, we have to examine the root cause of why films like this are made. Women are often made to feel very unempowered and voiceless in the hegemony of the hospital system. Now I know that you think 'experience' shouldn't matter, Amy, but wouldn't you agree that the ultimate goal should be BOTH a safe outcome AND a good experience?Like it or not, a good experience is important to a lot of women. That good 'experience' part so rarely happens in a hospital, I see the orgasmic birth movement as a radical intervention on the system which probably sees female orgasms in general as what Mary Douglas calls 'Matter out of place'. It may or may not work, but its a reclaiming of power and voice, which is what the feminist movement has historically done, and is ultimately the reason why even have the opportunity to be a Doctor as a female in this day and age. I am a centrist at heart and just wish we could all find a common ground somewhere in the middle. Safe and prepared facilities, warm, caring, 'people' centered, not 'liability' centered, doctors, nurses and midwives.
From Ericacrochets:
"I see the orgasmic birth movement as a radical intervention on the system which probably sees female orgasms in general as what Mary Douglas calls 'Matter out of place'."
Please explain what you mean by this. Why do you think the "system" sees female orgasms as "matter out of place?"
From Ericacrochets:
Ina May is quoted as saying in reference to orgasmic birth:
"I mean, it’s not a guarantee,” she said, shrugging her shoulders and smiling, “but it’s a possibility.
“It’s the only way I can think to market it to (this) generation.”
http://www.msnbc.msn.com/id/2323...3239361/page/2/
The question is why does Ina May feel the need to market/evangalize natural birth to my generation?
From Antigonos:
If birth is "orgasmic" I wonder what these women experience as an orgasm. Nothing even remotely similar to what I experience, I'm sure.
From Surprised:
I agree with the author's sentiments about the "hippy homebirth" connotations. It's an unfortunate stereotype. This article however is promoting homebirth as a mainstream alternative (in line with proposals from the national maternity services review). Surely you don't agree with that, Amy??
From Myriam:
I am of the generation that was taught "never trust an old hippy". Whatever happened to that? It surprises me to see the blind devotion that Ina May Gaskin inspires in young women.
From Myriam:
"Like it or not, a good experience is important to a lot of women. That good 'experience' part so rarely happens in a hospital"
I think that's the point of the post. Most of the process of childbirth is inherently unpleasant, whether it occurs in hospital or at home. Don't you agree? People are likely to end up disappointed if they are led to believe otherwise.
From Myriam:
"Like it or not, a good experience is important to a lot of women. That good 'experience' part so rarely happens in a hospital"
I think that's the point of the post. Most of the process of childbirth is inherently unpleasant, whether it occurs in hospital or at home. Don't you agree? People are likely to end up disappointed if they are led to believe otherwise.
From Esther:
Am I the only one not surprised that hippies and their modern-day counterparts are still in search of the "high" (orgasmic or not)? LSD, "natural" birth...same difference.
(Mind you, as far as I'm concerned, the hippies can keep homebirth. It's hospital VBACs I'm interested in prying from their hippie clutch).
From Liz1:
Grace: I wouldn't argue with the proposition that birth should be a good experience - but define "good". I suspect your definition and mine would be a long way apart. To expect it to be even remotely orgasmic or "empowering" is to set women up for either a lot of disappointment or a form of false consciousness that does no-one any good. I think perhaps some of the ideologues have maybe witnessed too many births as spectators, and confuse the euphoria and relief of holding a living child with the far less appealing process of getting to that moment. The idea that either the hippy-dipppy mysticism or the eugenics based naturalism do anything to give power or voice to women seems to me quite laughable. Historically, these things were denied to women on the grounds that they were unsuited to power, and if given a voice would use it to babble inanities. Far as I am concerned, the Ina Mays of this world go a long way to confirm this prejudice.
From Susanne:
Liz1: "I wouldn't argue with the proposition that birth should be a good experience - but define "good". I suspect your definition and mine would be a long way apart. To expect it to be even remotely orgasmic or "empowering" is to set women up for either a lot of disappointment or a form of false consciousness that does no-one any good."
Exactly. Look, it's going to be painful (even if you have "get me an epidural stat" tattooed on your forehead). It's going to be messy and bloody and possibly scary and just not a hell of a lot of fun. It's a physical process you have to go through that marks the end of the pregnancy and gets the baby out, and if there is intelligent design out there, our particular structure sure isn't intelligently designed. I don't see why everything has to be a "phenomenal experience." It says to me that these are women who are otherwise lacking in their lives, such that they have to wait around for 9 months to have an "experience." Why can't friendly, courteous, professional, competent service on the part of attendans be *enough? Next, they'll be telling us that when we have mammograms it has to be an orgasmic experience too, if only our breasts were handled a certain way.
From Rena:
I'm curious: what is painful about labor with an epidural? I thought they were administered early (since studies now seem to show the stage of labor at administration of epidural does not increase the risk of c-section or other complications) and that they were very effective in entirely treating pain.
From Liz1:
Well, no personal experience, but I can describe my daughter's. Induced Saturday evening. Several painful internal examinations through the night, painful early labour Sunday morning, scared witless. (Pre-eclampsia, premature baby) Walking epidural - calm and optimism. Allowed to wear off for pushing, which now cheerful daughter told me hurt a lot, but who cared? All in all, from epidural onwards, a good experience. Possibly even empowering. The relief of "I did it!" is not restricted to homebirth.
From desiree:
rena, i think it's that there's no getting around the pain/discomfort of the recovery.
it's funny to me that the "birth experience" is such a big deal to some. i've had a crash c/s after about 12 hours of labor and a scheduled c/s, and the births themselves were equally amazing. i mean, my babies were born! there's nothing like it in this world. so, from my perspective, the "birth experience" is amazing regardless of how it happens. so i can only conclude that these women are really chasing a certain labor experience. which is fine if they want labor to go a certain way, but i'm not buying that it makes the actual moment of birth any more miraculous.
From Brooke:
Its interesting that everyone has failed to recognize that in the dictionary, of the 5 meanings of "orgasm" and "orgasmic" only 2 refer to sexual excitement. The thesaurus even uses synonyms like "cosmic." I wouldn't say that giving birth to my daughter without the use of drugs was physically pleasant...but it was filled with emotional climax and an overwhelming sense of a cosmic-ness that only the miracle of building a life and then seeing that life and holding it can give.
From desiree:
but brooke, that's exactly my point. do you think you were any more thrilled to hold your ncb-born babies tha i was to hold my c/s ones? of course not. they're actualy talking about having physical orgasms from pushing the baby out.
which sounds gross to me, frankly. i've heard that women can have orgasms nursing too, and that it prompts many/most of them to wean because of the weird factor. seems similar to me.
From Liz1:
I am still mulling over the idea that the Ina May brand of feminism has anything to do with women entering the medical profession. Wouldn't it be closer to the truth to day that it has a lot more to do with the "Save me from the nasty hospital" brand of wimpishness?
I don't like hospitals. They ARE places of our "deepest, darkest fears" Not crazy about doctors, either, male or female. My husband's aunt was a doctor, who qualified when you had to be a real tough cookie to make it. Not the most sympathetic woman in the world, and she would have made mincemeat of the touchy feely brigade, but a sensible, competent woman. I think it is a pity that medical training seems to drain the humanity out of a lot of doctors - that and the daily exposure to people at their weakest and most irrational. But birth is safer now than at any time in history and that is amazing and wonderful. If today's feminism is set on telling women otherwise, I despair.
From Susanne:
"which is fine if they want labor to go a certain way, but i'm not buying that it makes the actual moment of birth any more miraculous."
Or why it's THAT moment. It's like taking a special day - your wedding day - and reducing it down to THAT VERY MOMENT where you both said "I do" (or whatever your particular ritual is). The excitement is the whole EVENT and what it means, not the actual 5 seconds of reciting vows / the actual 5 seconds baby slips out of the vagina.
From Susanne:
"I'm curious: what is painful about labor with an epidural?"
It's still a lot of pressure, Rena, even if it's not excruciating pain. It's still a physical effort of sorts. You're still going to have some soreness afterwards and a recovery period. It is what it is, a big baby coming out of a tiny hole.
From Susanne:
"I wouldn't say that giving birth to my daughter without the use of drugs was physically pleasant...but it was filled with emotional climax and an overwhelming sense of a cosmic-ness that only the miracle of building a life and then seeing that life and holding it can give."
But here's the thing. Our mothers' generation was knocked out and then hours later they brought the baby to them. And they were thrilled to see us and marveled at counting our little toes and what-not. What, was their joy any less since it was 3 hours postpartum? I think not.
And what if your first sight of your baby isn't that cosmic-ness miraculousness? What if it's "Boy, he sure has Uncle Fred's ears" or "I'm so exhausted, I need to sleep" and you don't experience that magic moment til a few days or weeks later when you hang over the crib and marvel at your lovely sleeping infant? So what? Does it matter in any sense of the word? It's such a weird competition, IMO, that it has to occur Just. Then. At. That. Moment. Or. Else. It's like these women are competing with one another to out-ecstacy or out-intensity one another.
From Brooke:
Well, Susanne,all I can say is that Ina May did say that not everyone does experience it. AND, I have had friends report and have read several comments and blogs that say that after having a C-section or using an epideral, several women did feel that their experience was somehow less-than. Not that seeing the baby for the first time isn't as wonderful, but the experience as a whole has been somehow stripped of its full physical and emotional process.
From chris:
"I'm curious: what is painful about labor with an epidural?""
All epidurals are not created equal. Some work better than others. Some don't work at all. Depends a great deal on who put it in and what is going into it.
Even with the best epidural women should expect a fair amount of pain. The thought that childbirth is painlesss with an epidural really sets women up for disappointment.
I worry about this orgasmic birth crap setting women up for post partum depression. Many women feel like emotional open wounds after childbirth even with the best experience. It is not all follow the yellow brick road and all will be lovely.
I do what I can to make the experience as pleasant as possible. But it is not a pleasant process historically. And post partum depression is a huge problem that many women still feel they cannot talk about or seek help and that concerns me a great deal.
From desiree:
AND, I have had friends report and have read several comments and blogs that say that after having a C-section or using an epideral, several women did feel that their experience was somehow less-than.
less-than what? less than the unmedicated births they had before or afterwards? or less-than they believed birth "should" be? brooke, do you think its at all possible that these women are measuring their births against some kind of ideal? do you think that by telling your birth story as some kind of ideal experience, that other women who didn't have the same experience might feel bad about themselves? do you think that your expectation that an unmedicated birth makes for the best possible experience played any role at all in the way you processed your birth experience? when other women feel "less-than" about their births, does that make you feel even better about yours?
From Liz1:
after having a C-section or using an epideral, several women did feel that their experience was somehow less-than
Less than what, though? Less than they had expected, imagined, been promised? Any chance unreasonable expectations figures in it? Any other momentous life experiences that left them feeling "Is that it?" In a long and quite eventful life, one of the more interesting things is how often life can surprise you, and how useful and instructive it is to deal with what you actually feel instead of what you expected to feel, or were told you should feel.
From Squillo:
Brooke:
"I have had friends report and have read several comments and blogs that say that after having a C-section or using an epideral, several women did feel that their experience was somehow less-than. Not that seeing the baby for the first time isn't as wonderful, but the experience as a whole has been somehow stripped of its full physical and emotional process."
Do you accept the converse? That there are plenty of women who find unmedicated birth somehow less-than? Who find that experiencing the full physical process has a negative effect on the emotional process?
If that's the case, how do you propose to talk to women about childbirth? Does it make sense to extol the virtues of one kind of birth or another?
From Leelee:
Most of the women who posted to the NYT article about orgasmic birth who did experience some kind of rush, hastened to clarify that it was *not* actually like an orgasm achieved through sex. So even for those handful for whom birth is a huge rush, it seems it's not technically an orgasm.
Personally I think dangling the carrot of "you might have an orgasm" is pernicious. When I was planning natural childbirth I was under no illusion it wouldn't hurt. if I have any advice for a woman planning an unmedicated birth now, it would be that if it's going to work, you'll know it as it's happening. Everyone I ever talked to who had a positive experience with unmedicated birth, they talk of it as things just "working." Everything just happened to go right, their labors weren't too long, they were somehow just fine. It didn't work out that way for me, and it took me a while to process that it wasn't because of something I did wrong. (That's a separate issue from the fact that my hospital advertised certain supports they had for unmedicated labor which in fact weren't available - whatever the general institution's attitude towards unmed labor, if the hospital says it has something available which could be key to practicing the pain management taught in the hospital's own childbirth class, it should be there.)
From Leelee:
Susanne: "It says to me that these are women who are otherwise lacking in their lives, such that they have to wait around for 9 months to have an "experience.""
I didn't view it that way. Aside from viewing it as potentially the least complicated way to do it with the fewest risks and fastest recovery, I think I was hoping to gelan something good out of what is almost universally held up as a *horrible* experience. It was wanting to believe that perhaps I would be one of those for whom it wasn't so awful. My mother was one such; she did have an epidural late in labor and through delivery, but she just never dramatized anything and said it "wasn't so bad, it was over so quickly." She apparently famously (infamously) sat up minutes after the delivery, and my amazed/jealous aunt exclaimed "oh my god, she's *sitting up*!"
I just wanted to focus on something other than the kind of story my godmother told: that it was the "worst pain of [her] life," and "you'll be screaming for the drugs." Birth was unavoidable one way or the other, I was hoping it would be as positive an experience as possible. For me, that plan was sans epidural, though after I got the epi i think I would have been perfectly happy if I were able to just labor and deliver. My greatest fear was surgery, and that's what I got, after a nice long unproductive labor just for good measure. I wish I had been more sanguine about it, but I was cocky, not because I bought full scale into any propaganda, but even worse: I believed genetics to be on my side.
From lurker:
antigonos said:
If birth is "orgasmic" I wonder what these women experience as an orgasm. Nothing even remotely similar to what I experience, I'm sure.
~~~
You're joking right??
I've had 2. My first was back labor, my second was actually quite comfortable and easy. Felt like sex physically and i twirled my hips and vocalized and had my baby. I wouldn't say it was orgasmic, but it was enjoyable.
So what??? Who cares???
by "orgasmic" birth, whether they mean enjoyable, pleasurable, or if they actually have an orgasm (which if you ask me doesn't seem all that impossible, it's in the same area. baby's head could certainly bump along the g-spot enough to cause an orgasm...)
who the hell cares?? i mean i do get what y'all are trying to say. if i squint and read between the bitching and ranting about the witch witch, she's a witch...er i mean home birth crowd.
child birth is intense. some women experience extreme hardships and pain, some minor cramping with one hell of a transition. some experience pleasure like i did, and some *gasp* orgasm...
From sarahz:
You CAN'T be serious Susanne. The world is RIFE with anecdotes of women being like 'whose baby is this?' when they were brought to them after Scopolomine induced anesthesia. I mean I just have heard of this SO much that I can't believe the wife of an OB would not be familiar with that part of anesthetic history. Also, please don't act as if history began 3-4 generations ago.
It is also funny how it is 'still pressure' when you are having an epi vaginal birth, but section pain under an epi is totally unfathomable to y'all.
The thing is, we can all agree that there is a continum of labor pain, because we all agree that some women experience especially painful labors, so much that any regulation of anesthesia would be inhumane. So if women experience more painful labors, it follows that some some women experience less painful labors.
I haven't seen the movie, but I will and judge for myself. I believe all mothers could stand to watch more births, before birthing.
From sarahz:
Can y'all not admit that there is some fear of women's sexuality at work in the entire medical system. Even female doctors are encouraged to act 'manly' and suppress all emotion, etc.
When women are not allowed to stimulate their breasts during labor with a breast pump or otherwise, what of that? Does that mean we are trying to sell Pitocin? Or that the hospital tends to suppress all expressions of personhood or sexuality?
From Jolene:
"which sounds gross to me, frankly. i've heard that women can have orgasms nursing too, and that it prompts many/most of them to wean because of the weird factor. seems similar to me."
This is a really interesting conversation. What is an orgasm really? One major part is that the uterus contracts. The other major part is the mind assigning pleasurable sensations. Oxytocin has a role in there somewhere too.
Am I missing anything?
A baby moving through your vagina, uterus contracting.... I don't see why that COULDN'T be experienced as an orgasm.
I've also heard of women experiencing orgasms while nursing. Oxytocin, uterine contractions.... why not?
OTOH I don't think you can experience one just because you "decide to".
Why exactly do we object to Ina May and her ilk saying it's possible? Does it make us feel somehow less-than because we didn't? (and I sure as hell didn't) I doubt that's the case.
I think I read you all as saying that you think it's somehow wrong to "lead" women to believe they can. And I object to the notion that anyone can lead women anywhere they wouldn't have otherwise gone.
Women are not brainless, helpless, believe-anything people. I can think for myself, thank you. And I tend to believe most women do think for themselves. They may not think in exactly the way I do, nor give equal weight to exactly the same considerations I do.
I have zero desire to experience an orgasm during the birth of my child. But I have no problem with someone who really really wants to.
I am not sad for them either, when they are disappointed that they didn't.
I just don't jump on the band wagon afterward when people start with the "oh, the poor little woman. She was led to believe she could have an orgasm (NCB, pain-free labor, pre-e free pregnancy) if she just followed steps 1-3. And she didn't. Even though she tried really hard to follow steps 1-3. They led her to believe she could. Those bad bad people should be chased out of town."
From Caryn:
Can y'all not admit that there is some fear of women's sexuality at work in the entire medical system. Even female doctors are encouraged to act 'manly' and suppress all emotion, etc.
Yeah, 'cause we all know women are intrinsically all sexy and emotional, especially at work.
From Jen:
"I just don't jump on the band wagon afterward when people start with the "oh, the poor little woman. She was led to believe she could have an orgasm (NCB, pain-free labor, pre-e free pregnancy) if she just followed steps 1-3. And she didn't. Even though she tried really hard to follow steps 1-3. They led her to believe she could. Those bad bad people should be chased out of town.""
I'm trying to understand where you're coming from here. Are you saying you don't have a problem whatsoever with people (individuals or groups of people) deliberately leading someone to have unrealistic expectations of something? I mean maybe the people believe what they're advocating, maybe not...but you don't see the problem with it at all? Because that's how I'm reading that, and I'm just having a hard time understanding how that's not bothersome...
Please correct me if I've misunderstood
From sarahz:
Whatever, if you don't feel like women's sexuality and the medical system is at odds now, wait until you've had a hysterectomy or a mastectomy. You'll see it then, I promise. It is the whole way they treat women.
From sarahz:
So is it a problem then, when the medical establishment promises every woman a pain-free epi labor, and then the epi doesn't work out for x percentage of women? (only works on one side, never works, etc.)
Because they are in a way better position to expect that you can trust what they say, than say, some film-makers.
From Kat:
I don't think any woman is buying that she can have an orgasm in labor.
I don't care if every NCB advocate chanted it all day long from the rooftops, nobody is going to buy it.
Sure, it could happen. Everything is in the realm of possibility, but I just don't think this idea is going to catch on.
I think this is one of the situations where you don't have to worry about women being "deceived" by the NCB advocates. It is funny, yes, like lotus birth, but for most women, it gets filled under, "HA!". Nothing more.
The idea that a woman somewhere is being hoodwinked into expecting a big O is ridiculous to me. I think we can just laugh at this one....
From Jolene:
"I'm trying to understand where you're coming from here. Are you saying you don't have a problem whatsoever with people (individuals or groups of people) deliberately leading someone to have unrealistic expectations of something? I mean maybe the people believe what they're advocating, maybe not...but you don't see the problem with it at all? Because that's how I'm reading that, and I'm just having a hard time understanding how that's not bothersome..."
Jenn, I'm more with Kat on this one. It's just funny to me to think somewhere someone is expecting an orgasm as they give birth.
But the point I'm making, is that this situation is similar to a few others that routinely come up on this blog. Examples are: If you eat the "brewer diet" you won't get pre-eclampsia. If you have a NCB you won't get PPD.
So many times people on this board are "angry" at the midwives and NBA who "lead" women into believing. I think those women lead themselves. Nobody is being sold a bill of goods here. Women can think critically for themselves (or choose not to) and nobody has to feel sorry for women who feel hoodwinked when they didn't get what they wanted.
It is a (not so) subtle form of sexism to say that the poor woman was led to believe a certian thing. As if she didn't choose to believe it. It was "fed" to her somehow, like on a pretty spoon. And because the spoon was pretty, she ate it right up.
Nope.
If somebody feels upset that they didn't have an orgasm, they really need to take a look at themselves, and the way they set up their expectations. Not run to lay the blame at Ina May's feet.
From Jen:
"It is a (not so) subtle form of sexism to say that the poor woman was led to believe a certian thing. As if she didn't choose to believe it. It was "fed" to her somehow, like on a pretty spoon. And because the spoon was pretty, she ate it right up."
I can certainly see this.
I don't think it is black and white where it's EITHER the women's "fault" or the advocates "fault."
I do kinda see parts of the HB and NB movement being very cult-like (especially on MDC)...and if a woman (OR man) joined a cult that, say, lead her to believe she would never be sick again, as long as she REALLY believed and then she got cancer (or pnuemonia or AIDS or diabetes or...) and died because she just kept trying to believe more (or, conversly, even if she came to her senses and fled to recieve medical help), who do we blame for the false expectations to begin with? I certainly don't believe we lay the blame squarely at the feet of the woman because she chose to believe it. It's just more complex than that, and more often times than not, I think the blame goes both ways.
That's just my two cents
From Jen:
"The idea that a woman somewhere is being hoodwinked into expecting a big O is ridiculous to me. I think we can just laugh at this one...."
If only that were true. I agree that *most* women wouldn't really give it much credence, but that doesn't mean there AREN'T women out there who DO fall for it. Hopefully only a very few...
From Jolene:
"I certainly don't believe we lay the blame squarely at the feet of the woman because she chose to believe it. It's just more complex than that, and more often times than not, I think the blame goes both ways."
I don't disagree with you here.
I guess I just question why we each have to lay blame in most of these situations. Maybe I see it as less serious than your example.
It's just as silly the other way as well, ya know? Somebody's crying that their epidural didn't completely eliminate the pain. While I feel sorry that they felt pain they didn't want to feel, I stop short of lynching the "epidural advocate" that led her to believe she would have a pain free birth if she just got that early epi.
I don't mean to be making light of what happens when we birth. Because our experiences are important, I agree. I would go so far as to say that as in the Buddhist sense, the journey can be as important as the destination. (and how shallow is it to say the journey is ruined because of a VE... Sheesh, now I sound like Susanne)
It's just that we women have heads on our shoulders too. And sometimes we make mistakes in judgement calls and things don't turn out the way we wanted them to. We can choose to check up or not, on our sources. So like Leelee in the other thread, we go back over it, find out where we went wrong. (and if we were lied to, then call 'em on it) And vow to do better next time.
From JJ:
I didn't get a birth high either time. Annoying, but not exactly a tragedy seeing as I received a lovely baby both times.
I do think orgasmic birth is possible. Several hours of active labor during my first baby's birth were pretty darn awesome - felt like sex with each contraction. It wasn't an orgasm and the contractions were somewhat painful, so it wasn't 100% enjoyable, but there was a very sexually enjoyable aspect to it. 'Course that went out the window when transition hit, but it was nice while it lasted. I see no reason why orgasm isn't possible (or sensations like it) during birth. I would guess it's pretty darn rare, though.
I can't agree that giving birth vaginally is like pushing a football through the eye of a needle. (Though Amy comments: "I couldn't have said it better myself.") That's a rather extreme (and useless) hyperbole. I could go on and on (and on) about how stupid this comparison is, but I'll spare us all. Suffice to say it's an idiotic comparison and pointless hyperbole.
From Elizabeth:
Although it's impossible to know just how many, there's a non-negligible number of women out there who don't know what an orgasm is.
I recall a scene in Lucky Louie, Louis C.K.'s short-lived HBO sitcom, in which the wife has her first orgasm ever. Her husband says to her, "wait a minute, I thought you've come lots of times," and she replies "well, it always felt really good towards the end, but this was like uurrrrnnhh!!!" I think that sums up the experience of many women. The social pressure to be completely satisfied with PIV intercourse is overwhelming (cf. Freud), so whatever pleasure they do experience during sex gets labeled "orgasm" in their mind, whether it actually is or not. I am pretty sure this is what's going on when women who have easy labors describe the pressure on the vagina as orgasmic. My suspicion on this count is strengthened by the argument that sex and childbirth "involve the same parts." It's a statement that could only be made by someone whose sex life does not involve the clitoris.
From Jolene:
"My suspicion on this count is strengthened by the argument that sex and childbirth "involve the same parts." It's a statement that could only be made by someone whose sex life does not involve the clitoris."
Hmmm, interesting. I don't have an agenda when I ask, couldn't this be turned the other way though, and say that women who must have clitoral stimulation to orgasm are the ones who are unable to experience it during birth? (and point out as well, that some women DO stimulate the clitoris during labor)
I mean, *I* personally need clitoral stimulation to have an orgasm. But does that HAVE to apply to all women? Because I don't think it does. I believe some women (no idea of the percent) orgasm without. (or after... or?)
From Jolene:
What I mean is, when we measure the stages of sexual arousal and orgasm.... scientifically speaking....does it have to involve clitoral stimulation?
My knowledge on this matter consists of what I remember of a book I read as a teen. So somebody with more knowledge than I may step in here and correct me if I'm wrong.
But I seem to remember blood directed to the area....causing some kind of plateau.... followed by contractions of the uterus when the orgasm began.
From Yehudit:
"My suspicion on this count is strengthened by the argument that sex and childbirth "involve the same parts." It's a statement that could only be made by someone whose sex life does not involve the clitoris."
Depends a bit on what you mean by "the clitoris", doesn't it?
http://www.jurology.com/article/...8572-0/
abstract
From Jolene:
Wow. Thanks for that Yehudit. Now for a 3D diagram.....
From Yehudit:
And then again, people are constantly telling women to "push into their bottom" or that it's like doing the biggest, most difficult poo ever....as if that's the same place!
From Liz1:
Jolene, I think you make a good point. I am one of those who gets angry at the "selling" of a particular version of birth, but I am just as aware that the majority of women don't buy it, some who do handle their disillusion with humour rather than disappointment, and it is minority who swallow the doctrine whole.
So why do I still think it is a problem?
Is it because there is something very insidious and destructive about women defining themselves through childbirth? Retreating into a particular construction of the "feminine" which serves no useful purpose? Is it because it appeals to a strain of irrationality, the dominance of woo that is enormously counter-productive in a very complex world? I honestly don't know why it bothers me so much - but it does.
From Myriam:
Yehudit, I've been wondering about that "push into the bottom" thing. I thought, well it doesn't make sense but I guess they know what they're talking about, if they meant vagina, they'd say vagina, surely. I literally did push into my "bottom" as instructed. How annoying. Why can't midwives say vagina? Ludicrous!
From Elizabeth:
Depends a bit on what you mean by "the clitoris", doesn't it?
Point taken, and granted I was referring to the external part, but I suspect that is what 99% of the lay public understands as "the clitoris." I'm sure some women do experience orgasm through indirect stimulation of the clitoris through the front wall of the vagina. But I am concerned about the narrative here. Historically, there's a long-running agenda to drive attention away from the glans clitoris, toward the vagina, and to define a properly feminine sexuality as one that is satisfied with penetration and has no problem leaving (direct, external) stimulation of the clitoris off the menu. The idea that childbirth can lead to orgasm definitely has its home in that narrative. It's like the ultimate penetration! The bigger the better, right? This is what you were made for! Pay no attention to that little thing in front - it's an irrelevant vestige of more important, internal (ahem) structures.
some women DO stimulate the clitoris during labor
*sigh*
OK, this rather seems to me like putting the cart before the horse. Masturbating while giving birth to your child? Who decided that was a good idea? I had strong feelings of arousal while breastfeeding, but I didn't feel impelled to help them along by masturbating. It might have been "natural" to do so, but I have a certain sense of boundaries that puts it completely out of the question, just as self-stimulation was out of the question in the presence of my birth attendants, even if I'd been so inclined. Just because you can get off, doesn't mean you have to. Mastery of that concept is one of the markers of adulthood, I should think. Sarahz complains that the medical establishment represses women's sexuality. I can't get on board with a definition of "repressive" that includes "please don't masturbate in front of me." And as Susanne points out, there will be plenty of other, more appropriate opportunities.
But I suppose all of that goes by the wayside if you believe your worth as a woman is bound up with birthing well and liking it. What better way to prove that you accept "what you were made to do" than to not only do it without pain relief, but get off on it as well? Even the religious patriarchs of the middle ages never dreamed of raising the bar for female worthiness so high.
From angela:
I noticed the following quote from the article, from a testimonial from the Orgasmic Birth website:
"I sang my birth song, a low moan, and he (my husband) sang with me. I was surprised by how much birth sounded like sex!"
There is an extraordinary naiveté to thinking that the moans or groans, grunts or screams, of an unmedicated birth (particularly as they are played up in televised birth scenes, by actresses), just because similar sounds might also be made during sex (particularly as they are played up in televised sex scenes, by actresses), feel the same as sex.
It reminds me of a bunch of prepubescent boys watching one of those dramatized, unmedicated birth scenes, and sniggering at the sounds because they remind them of "sex sounds." (Why do women act like birth hurts and all? Look at them! They like it. Something really big is in her vagina and she likes it.)
When I hear the "orgasmic birth" thing (besides the fact that I can tell I'm being manipulated), I think of a bunch of pimply-faced 14-year olds who don't know anything about sex (even though they think they do) and even less about a woman's orgasm.
From Yehudit:
I literally did push into my "bottom" as instructed. How annoying. Why can't midwives say vagina? Ludicrous!
+++++++++
It's more complex than that, Myriam.
Women don't have an experience of 'bearing down' into the vagina outside of childbirth. (I guess someone might, to get out a recalcitrant mooncup, or 'lost' tampon - but these are not quite the same thing).
Most women will have an experience of bearing down when constipated. Therefore, midwives are referencing something with which women are familiar, in order to encourage an action which has some similarities.
Of course, directed/valsalva-style pushing has many drawbacks (as previously discussed), so whether midwives should be telling women how to push (rather than supporting spontaneous pushing efforts) is itself a question.
From angela:
It's not the "big O" per se that most women actually believe, I think, but the whole picture: birth is "empowering," the pain (or getting through it without pain relief) is a "high" ... even-for-some-orgasmic. Just sayin'. Just puttin' that out there. The little O thing. You know. Birth is on that continuum. But only if you do it without drugs. Well, there's no way we can prove some 1/10,000,000 women somewhere didn't feel a little "oops! was that a ...?" during birth, so nobody can argue with it. And of course, you have to be pretty relaxed to have an orgasm, so it plays into that whole brouhaha. (It's only because you aren't relaxed that you don't enjoy one's clumsy attempts at ... I mean, birth.) Most of us are pretty skeptical or sense we are being manipulated (nowhere in the NCB "literature," for instance is it ever suggested that an orgasm during birth is anything other than a freak occurrence; to the contrary, the suggestion is that it is ever so much more common than "medical society" would have us believe), but ... still, the impression given—whether you buy it or not, intellectually—to someone who has not yet given birth is that birth is one willlllld ride that you are just missin' out on if you don't do it precisely THIS (the "natural") way. It's all part and parcel of an under-handed way to give/add to the impression that the physical process of birth—even the parts where it's miserable—is or should be "empowering" ... maybe even more. So, shut up and enjoy it!
The whole orgasm thing is more than mere salesmanship, too. It's the female version of "your dick isn't as big as mine." And it's an extension of the 1950s "frigidity": if you can't orgasm through vaginal intercourse alone, you must be "frigid." A very traditional, male-oriented view: it's all in the vagina. Sex is all in the vagina (not the clitoris, not the mind). Birth is all in the vagina (not straight out of the uterus as in a C/S, not processed by the mind as well as the body).
From Yehudit:
But I am concerned about the narrative here.
++++++++++++
Now, I'm confused. Because I thought that we were concerned with the science here, not worrying about what 'narrative' the science may or may not endorse.
From Yehudit:
And Myriam, sorry that was meant to be an apologia for midwives not saying vagina when they mean vagina, more by way of an explanation.
FWIW, it's something I've pretty much vowed not to say, not least because many women are very concerned about whether they will poo and it seems unhelpful to make that analogy.
Similarly, I don't think there's any call for "getting angry with the baby" or indeed "getting angry with me".
From Elizabeth:
Which narrative do certain people carry forward with cherry-picked science?
That, I think, is very much part of what we are concerned with here. Yes, the clitoris has underlying structures that can be stimulated via penetration. That's not in dispute. What's the purpose of bringing it up in a given context?
From Susanne:
"You CAN'T be serious Susanne. The world is RIFE with anecdotes of women being like 'whose baby is this?' when they were brought to them after Scopolomine induced anesthesia."
And then, what? Once they awoke fully, they realized it was their baby, and then what happened? They went on to live long, happy lives with their children. What difference did it make in any sort of long run? Or even short run?
It's like it's a Full. Stop. to you if the exact moment of childbirth isn't the grandest thing ever. It's like the 18 yo who dreams of the Perfect Wedding Day where all will be ruined if something is even slightly out of place. No, make that an 8 yo.
You know, women who adopt children from foreign countries often meet their children at the airport, or in not-very-prepossessing orphanages or other way stations. Enya isn't playing, the jasmine-scented candle isn't burning, the birds aren't chirping, the rose petals aren't strewn at their feet. Do you think that they give a darn? Why is it that women in those circumstances are able to look at the bigger picture as to what makes something joyous, and not the minutia of the surroundings?
From Susanne:
"Can y'all not admit that there is some fear of women's sexuality at work in the entire medical system. Even female doctors are encouraged to act 'manly' and suppress all emotion, etc."
The concept of being professional about something completely flies over your head, doesn't it, sarahz?
From Yehudit:
How is an accurate anatomy of the clitoris "cherry-picked" science?
It is merely a refutation of the claim that the clitoris is only the external clitoris - one that is not now supported by any science, cherry-picked or otherwise.
In any case, I'm skeptical of the importance given to the "discovery" of the clitoris in the narrative of women's sexual liberation. Not because I'm a vagina-fetishist, but because I'm not a biology-fetishist. (Lynne Segal writes very coherently on this, and I couldn't hope to do justice to her argument, but it is worth reading "Sensual Uncertainty: or why the Clitoris is Not Enough", I think also reprised in Straight Sex: The Politics of Pleasure).
From Yehudit:
Do you think that they give a darn?
++++++++++++
Yes, I think they give an enormous darn.
Otherwise, the decision to embark on the road to adoption would not be as complex as it is for most women and couples.
Almost no one decides to adopt simply because they prefer that route to having children over pregnancy and childbirth. Ditto contracting a surrogate to carry your child.
By pretending this is all just so much chocolate and vanilla ice cream, it is you that trivialize these other ways of becoming a parent.
From Caryn:
But the point I'm making, is that this situation is similar to a few others that routinely come up on this blog. Examples are: If you eat the "brewer diet" you won't get pre-eclampsia. If you have a NCB you won't get PPD.
In all these cases what I find amazing is the quality, or lack thereof, of the training of the care providers who are making these assertions.
I mean, we can *actually go check* and see if the Brewer diet prevents preeclampsia, or if a natural childbirth prevents postpartum depression. Why not try that first, before training a whole class of care providers to believe it?
From A Sarah:
Jolene: Women are not brainless, helpless, believe-anything people. I can think for myself, thank you. And I tend to believe most women do think for themselves.
The fact that we can think for ourselves does not mean that it's illegitimate to cry "foul!" when we see social constructions that are deeply sexist (such as the idealization of blissful "natural" childbirth as some kind of proof of the mother's worth as a woman.)
In fact, quite the opposite.
From Elizabeth:
How is an accurate anatomy of the clitoris "cherry-picked" science?
It is merely a refutation of the claim that the clitoris is only the external clitoris - one that is not now supported by any science, cherry-picked or otherwise.
Perhaps cherry-picking wasn't the right word, but I think presenting an isolated fact as though it carries the whole of your argument within it is sloppy and dishonest.
What is your argument, anyway? Do you really think that a fully feminine woman is one who requires no direct external stimulation of the glans clitoris in order to achieve orgasm, and in fact finds penetration so satisfying that she orgasms while giving birth? Or are you just playing another round of pedantic gotcha?
Nobody "claimed" that the external part of the clitoris is the only part. I used the word "clitoris" to reference that part, which is the common non-technical usage. Do you really want to claim that indirect stimulation through the walls of the vagina is so effective for most women that the common laywoman's distinction between "vaginal" and "clitoral" stimulation is meaningless? How then do you explain the fact that women find that distinction meaningful, and that scientifically, the majority do not experience orgasm through penetration alone? You knew what I meant from the start, and you are playing word games in order to muddy the waters for your own recreation.
And now you're telling me to read something on "the politics of pleasure"? Two posts ago you dismissed concern for narrative as flimflammery. Which is it?
From Caryn:
Whatever, if you don't feel like women's sexuality and the medical system is at odds now, wait until you've had a hysterectomy or a mastectomy. You'll see it then, I promise. It is the whole way they treat women.
Psssst: and all those male doctors are *actually Mr. Spock.*
Boys aren't emotional. Girls are. And they're being sexist at the hospital not to treat you like a precious flower who might just, suddenly, come really hard.
Or, maybe not.
From A Sarah:
Can y'all not admit that there is some fear of women's sexuality at work in the entire medical system. Even female doctors are encouraged to act 'manly' and suppress all emotion, etc.
Interesting that you assume that female doctors are (socially) encouraged to act a certain way; while the default mode for all women everywhere is to be emotional. I rather think it's the mask of traditional femininity -- wherein we're encouraged throughout girlhood to be vulnerable, cute, silly, weak, emotive people in need of assistance big strong men; and to obsessively examine and tend everyone's emotional needs without expecting thanks -- that's the social construction.
From Yehudit:
Yes, this blog is recreation for me. What is it for you, Elizabeth?
One doesn't have to give any credence to "Orgasmic Childbirth TM" (I don't) to know that the vagina is, amongst other things, a sexual organ for most women (albeit not the origin of orgasm) and that the following comment is absurd:
"My suspicion on this count is strengthened by the argument that sex and childbirth "involve the same parts." It's a statement that could only be made by someone whose sex life does not involve the clitoris."
Perhaps I should have simply said that the above statement was made by someone whose sex life does not involve the vagina?
You should try Lynne Segal - I think you'd enjoy her work.
From A Sarah:
And they're being sexist at the hospital not to treat you like a precious flower who might just, suddenly, come really hard.
lol Caryn!
And I say that as someone who is very emotional. Partly because I'm very intense, but also because I learned early on that the way to get what I wanted was to be "upset," because, since I was a highly intelligent female, I was far too threatening to be listened to when I was simply stating my opinions.
If I cried, though... well, people felt more comfortable. I wasn't threatening then. I could be indulged as a weaker precious little pathetic thing. Of course, I also lost all respect, but my immediate needs got met.
From Mrs B:
It felt like a sweet penetration....
when our daughter dropped down the birthcanal and i felt her head coming out an inch or so, unexpectedly and my husband was asleep, and I hoped soon to be, I had been sitting on the toilet for 2 minutes and thought hmmm strange - nothing, I just felt like something less pleasant than a baby was about to crown. I had no intention on giving birth, I didn´t even know I was dilated that much. No bloody show, no water leaking - no painful contractions. back to when I realised that it was going to be a long night...after I felt our child about to enter the world. I somehow felt slightly irritated; sigh baby coming now? Hey we will have a baby I tried to tell my sleeping spouse Hope the water doesn´t leak into the moneyvault - Go to bed he said. No get up I said, and that´s it. - this will hurt I believed and decided being afraid would not help. Well it didn´t hurt, she plopped out, and then the water rushed out.
( we rented an apartment in the bank, Our daughter was born 6 feet away from it, on the opposite side on the wall)
I will never forget the feeling of that birth - there was as if something holy entered the room, and it filled me with a joy and inner strength and peace I never known would exist in this world. You can laugh all You want at that I admit I would have too if someone told me.
half an hour later we wondered how we were going to get the placenta out. I caught 2 times and to my amazement it flew out. Our kid is strong and very intelligent.
I am pregnant again 38 weeks, see If I have any time to figure out where to give birth. brag brag brag - I am in great shape and all healthrecords on me and our babe are very good I am not a strong homebirthfanatic but I am better prepared and have studied some complication material, somehow everyone keeps telling me It might happen fast this time too. Hopefully not on the schoolfloor on our coastal navigational course. I do not condemn those who choose homebirth nor those that want a hospital birth. Life sort of happens, whether we plan it or not.
From Yehudit:
As for my view on "Orgasmic Childbirth" as a physiological description? Pretty much nonsense.
On the other hand, if they are using orgasm as a metaphor for the overwhelming and involutary sensations of birth, well, it's a stretched metaphor, but no worse than the melon through your nostril one.
From sarahz:
Just try to touch your clitoris in a hospital while giving birth and see what happens. Some women say it helps with labor pains. But yk, I am betting it will get your hands tied down. Has happened before.
Having worked in both Male Dominated and Woman Dominated fields, (Early Childhood Education and Academic Administration) I can safely assert that a woman's construction of 'professional' and a man's construction are deeply different. In the medical system, I see the colder, but not more effective or necessarily more 'professional' construction as being dominant. I don't believe we have reached the era where woman doctors really have their own construction, save maybe in woman only practices. I see them trying to act like their male counterparts in mixed enviroments and not the other way around.
From A Sarah:
Having worked in both Male Dominated and Woman Dominated fields, (Early Childhood Education and Academic Administration) I can safely assert that a woman's construction of 'professional' and a man's construction are deeply different.
Construction: you keep using that word; I do not think it means what you think it means. Like, it means that the social meanings of "masculinity" and "femininity" is CONSTRCUTED, not innate. Moreover, they serve the interest of a sexist system that benefits males. You and I have both been taught that by virtue of our being female we are supposed to care a lot about children and to use emotionally-freighted language and facial expressions and to require "emotional support" and "help." And in a sexist system, those kinds of work and activities are then devalues *precisely* because they are coded as "things women do and care about." That's the nature of an unjust social construction.
I don't particularly enjoy caregiving, most expressions of "emotional support" creep me out, and I have a fierce analytic mind. I'm also very creative and emotionally expressive. I got a lot of permission and reinforcement for the latter; the former has at times been treated as an embarrassment or - as you have done - as something that can't POSSIBLY really just be how I am, and therefore must be some defect. Well, screw that. I don't owe it to anybody to make my personality accommodate narrow gender strictures. I'm way smart, I get creeped out by ooey-gooey support, I don't enjoy caregiving, and I'm emotional. If that causes problems for someone's cherished "What Are Little Girls Made Of?" jingle, it's their problem, not mine.
From A Sarah:
oops, should be "are constructed"
From A Sarah:
also should be "devalued," not "devalues." Sorry, was having a disagreement with my husband while typing.
From A Sarah:
Oh for heaven's sake. Should also be "CONSTRUCTED," not "CONSTRCUTED," or whatever the heck I typed.
I'll stop now, even if I find more.
From Mrs B:
Well, I must say I have never heard any women that gave birth in a hospital say it was a pleasant painless experience - NOW I am afraid of THAT. Going to hospital, I mean. I admit birthing our first child could might have happened safer in hospital but really there is not much choice anymore on where to give birth when the baby is crowning, I could certainly not have walked out of the door. That would have been unsafe and painful if not rightout dangerous.
From Elizabeth:
Just try to touch your clitoris in a hospital while giving birth
Um, no thanks.
So, the argument seems to have shifted somewhat from "some women have spontaneous orgasms during labor" to "it's a good idea to masturbate during labor." But if the argument is basically "masturbation makes childbirth less unpleasant," that could go for anything. Masturbation could make a root canal less unpleasant, but if you do it they won't waste time tying your hands down before throwing you out, I'll bet. I bet masturbation makes mammograms less unpleasant, too. Why not try it to ease the tension next time you go in for a pap smear? Waiting in line in the grocery store would be a lot less boring if you just "touch your clitoris"; but the possible downside is a lot worse than having your hands tied down. Etc etc ad infinitum.
Do you really want to masturbate in front of other people? Why?
More to the point, what about childbirth and motherhood and being a woman makes masturbating in front of other people during childbirth any less inappropriate than in any of those other situations?
From Yehudit:
Why do presume that a woman should have no privacy in childbirth? What business is it of the care giver what the woman does with her own body? Is the rule now "only my hands on your genitals"?
And you could say the same thing about any number of other things: exposure of genitals, unacceptable in public; state of undress, unacceptable in public, swearing, unacceptable in public, grunting and moaning, unacceptable in public.
But there is no reason whatsoever that the delivery room in a labour ward need be regarded as a "public place" in which these norms apply.
From lurker:
Then are you against nipple stimulation as a natural way to increase the contractions as well??
there are some women that rubbing the clitoris makes the labor feel better, almost along the lines of rubbing up against the door frame for back labor.
yet you turned it into masturbation and look at it as if it's a dirty act when it's not. it's normal, and some women do it during labor... big deal.
From Elizabeth:
How on earth would they stop you touching your clitoris if they weren't in the room with you?
If they are in the room with you, the same argument could be made WRT mammograms, and the yearly pelvic, and dental treatment....
So congratulations, I guess, to Yehudit for having no problem with people masturbating in front of her. From the provider side that may actually be correct (but I still want to know why we don't think so concerning the dentist or the mammography technician).
The question still remains: what kind of person isn't internally inhibited from masturbating in front of a person who's not their intimate partner? Where is this coming from?
From Elizabeth:
yet you turned it into masturbation and look at it as if it's a dirty act
1. Rubbing the clitoris just is masturbation. What else would it be?
2. It's not a dirty act. It's just not something I do in front of other people. I want to know why others do. All I keep getting back is various forms of "it's my perfect right!", which is a non-answer. Why would you want to?
From Yehudit:
I have no problem with women shitting in front of me either - it happens, in context - but I also appreciate that many women prefer privacy for that too if it can be easily achieved. If they would rather go to the bathroom, that's more than fine.
So, it suits both care provider and women/their partners for there to be some times of privacy, for all sorts of purposes.
From Yehudit:
But you don't expose your genitals to other people, in the normal run of things. And yet, during childbirth, you expose your genitals to lots of people.
From Elizabeth:
So... it's OK to masturbate in just any medical situation in which one's pants are off?
Or just childbirth?
What makes the difference?
From sarahz:
Yes, I LOVE how it is okay for a provider to stick their fingers way inside your cervix (if this isn't penetration, what is it???), but it isn't okay, when you are trying to push something out of your vagina, to touch your clitoris. Now I am supposed to equate the L&D room with the dentists office or the grocery store? And equally public? Maybe that is the problem, no???
My DH performed ORAL nipple stimulation on me in labor. The only reason he was 'allowed' to do this is because I had one of the more open-minded OBs in the entire country and a fierce private CNM advocating for me. But it made PERFECT medical sense, my contractions were slowing, my baby's heartrate was too fragile for Pitocin, and my DH was an electrican, so rough rough hands. So yk, should I have had a section instead lest I offend the delicate sensibilities of the prudent professionals standing by??? Guess what? It worked perfectly.
If you want to be in a medical environment where everyone is proper and no one ever touches their clitoris or takes a dump while trying to push a baby out, perhaps you could try dermatology, I am SICK of people who should be no where near a laboring woman trying to put their work-a-day prudishness onto other women's births. The world is not a bank or a Jane Austen novel.
From sarahz:
You know, I will take a liberty with the phrase 'well behaved women rarely make history'
"Sexually repressed women rarely have vaginal births"
From Elizabeth:
"Sexually repressed women rarely have vaginal births"
You just made my point for me. Thanks.
From Liz1:
Sexually repressed women rarely have vaginal births"
And isn't that just part of the whole tripey sub-text? Maybe it is in reality the whole of the sub text.
"I am woman, hear me roar"
Give - me - a - fucking - break.
As a way of bolstering an entirely spurious sense of superiority, it is priceless.
From Yehudit:
So... it's OK to masturbate in just any medical situation in which one's pants are off?
Or just childbirth?
What makes the difference?
+++++++++
My point was that many things are different in childbirth from the rest of life, and those differences might include shitting in front of other people, exposing one's genitals, etc... They may or may not include masturbating. But the argument that you only usually masturbate in private won't hold without further explanation. (e.g. that the exposure of genitals is necessary to childbirth - and yet, when I see what appears to represent US births, they seem much much more exposing than is strictly necessary for the purpose of giving birth (in terms of numbers of people present and positions).
I do think we work very hard to separate the 'vagina as object of medical scrutiny' from the 'vagina as part of a woman'. (sorry, poorly expressed, but maybe the following anecdote gives the sense of what I mean). When I went for colposcopy, I was really interested to see my cervix up huge on screen. I mean, it's not a view you see everyday. There were two medical students in the room, in addition the nurse and doc. And I got the sense that I was somehow not acceptable for me to express "oh wow! that's how my cervix looks" in part because I was drawing attention to the fact that this cervix was part of me - a fact that everyone else in the room was trying to avoid acknowledging, for the sake of medical decorum.
Now, not everyone wants to look at their own cervix blown up huge on screen. But maybe some women want to.
And not all women would want to insert their own speculum before an exam or smear, but the logic of giving them the opportunity to do so makes perfect sense to me.
http://www.bmj.com/cgi/content/f...321/7274/1454/
c
Of course, both those situations are different from childbirth, which is not inherently a medical event.
From Yehudit:
Sexually repressed women rarely have vaginal births
++++++++
Bullshit.
However, it is possible for a woman to be so concerned about not to poo during delivery that it seems to interfere with her ability to push.
From Kat:
Well, I learned something new today. I had no idea there were women who thought it was a wonderful idea to masturbate during labor.
*shaking head*
From Mama Liberty:
"You know, women who adopt children from foreign countries often meet their children at the airport,"
My aunt adopted a child from an eastern European country and let me tell you... it was a process and a journey... two words I would also use to describe my pregnancies and child births. My aunt's experience wasn't the same physically as mine, but she did "give birth" in a certain way. She wasn't just handed a child at the airport. It was hard work and the process was was part of becoming a mother for her.
I don't understand why we can't all just own what our desires, emotions and experiences of childbirth are with the understanding that not every woman feels the same. Yes, my childbirth "experiences" were important to me for a variety of reasons. So what? There is so much hypocrisy here. You are only a sane, intelligent, giving mother if you see things the way Dr. Amy does. If you are a homebirthing mother, you are duped, selfish, and have never taken a statistics class.
From Pharmacist:
[quote]That good 'experience' part so rarely happens in a hospital[/quote]
How could you possibly know that? I have had 4 good hospitals births, I know many women who have had good hospitals births. Of course, I guess I'm ignorent of this "orgasmic" birth stuff, I certainly didn't have an orgasm in any of my 4 labors. However, all 4 experiences were good and I was very satisfied with them.
From sarahz:
Medical decorum is BS, IMO.
And I will bring a freaking vibrator if necessary. IF IT ISN'T SEXUAL PENETRATION WHEN A DOCTOR STICKS HIS FINGER UP TO YOUR EYEBALLS REPEATEDLY, IT ISN'T MASTRUBATION WHEN YOU STIMULATE YOUR CLITORIS FOR THE PURPOSE OF STIMULATING UTERINE CONTRACTIONS.
Maybe y'all have never mastrubated, but it also serves to widen and 'balloon' the upper part of the birth canal. Could be helpful, no?
Even calling it 'Mastrubation' is putting a creepy subtext on it. Remember that term originates from all the medical system sponsored attempts to end the practice but genital mutilation and psychological shaming. These were brought to you by physicians folks.
And if it isn't sexual repression to hold up your labor for fear of embarrassing yourself in front of medical professionals, what is it?
From A Sarah:
"Sexually repressed women rarely have vaginal births"
Even if this were true - which you have absolutely no way of knowing - so what? Women with burns all over their scalps rarely have natural updo's suitable for the Emmy awards. But that's kind of the least of their problems, in other words.
You might have said simply that women who complain of being sexually repressed rarely enjoy sex as much as they might. That's problematic because they're not enjoying sex and are presumably bothered by it. Not because it might cause them to make choices in childbirth that some other woman doesn't find totally awesome and meaningful and wonderful.
From A Sarah:
sarahz, knock yourself out! Masturbate in labor. Or just put a vibrator on your clitoris while your husband licks your nipples but call it something else. There are few things in this world about which I have less of an opinion on. I don't care to follow suit, and plenty of other people don't care to. So, yes, some people will be apathetic to this choice of yours. Others will be creeped out, particularly if they're watching. Sort of like you seem to be incredibly creeped out by plastic bottles and conventional produce and vaccines, while others take such things in stride. This is what happens when you have more than one person in the world. Their reactions to things won't match one hundred percent of the time. This is not an insult, an affront, a disempowerment, or a big scary thing. It's not a problem to be solved.
From Mama Liberty:
"And I will bring a freaking vibrator if necessary."
But SarahZ, you are not permitted to take the matter of pain relief into your own hands (so to speak). It is not approved by the FDA!
From sarahz:
I am sure. I was just thinking, I am not a vibrator person per se, but my SIL has a tiny Butterfly that is hands free that would be perfect for childbirth. I am traveling really far for a hospital where they won't confiscate these things next time, but I suspect that in 99% of american hospitals such a device would be immediately confiscated. 
From Indy:
I, for one, am thankful for sarahz sharing her thoughts. I am also thankful she does not have a Delete button.
It is fairly obvious she doesn't actually read her own posts using the handy Preview function and just types out the first thing that comes to mind.
I thought she was a loon before, but wow. Be sure to add fresh Duracells to the ole' birth plan next time.
From Elizabeth:
Yehudit, people in medical situations shit in front of you because they can't help themselves. It's not as though they want to make you watch them shit and it's up to you to "let" them or not. Their preference not to be shitting in front of another person is far in excess of any desire providers may have not to see it.
If we were discussing psychiatric patients, or people who had lost their faculties, the same would go for masturbation. If you were treating people with no understanding of what they were doing, and came on all "and the one person was masturbating! how awful of them!" I would think you were in the wrong.
But for normal people, sexual activity is a choice, and one that has significant meaning. And when a person in possession of her faculties chooses to behave sexually with non-partners looking on, we can ask "why" in a way that doesn't make sense about pooing or about masturbation by people who don't know what they're doing. You can repeat all you want that childbirth is an exception from other general norms, but that doesn't prove anything. By social consensus, the exception doesn't extend to performing sexual activity in front of third parties. You may think this norm is wrong, but you haven't explained why, other than to gesture at the fact that it is a norm.
Also, nobody yet has so much as pretended to explain why women should masturbate during labor, but not during mammograms, or their yearly check-up, or a root canal. What about men? If a man goes into his dentist for a root canal, and refuses anesthesia, saying "I prefer to cope naturally," then proceeds to jack off, does the dentist have grounds for complaint? Why or why not?
From Mama Liberty:
I don't understand why anyone thinks it is their place to judge whether or not it is appropriate for a woman to masturbate during labor. Don't want to? Then don't. And why do you have to do it in front of someone? Isn't a woman in labor entitled to a little privacy? I know I like privacy during labor. That is why a birth at home when possible. (And no, I don't masturbate, but I don't know why the hell anybody cares what another woman does to cope with labor).
From Jolene:
"But SarahZ, you are not permitted to take the matter of pain relief into your own hands (so to speak). It is not approved by the FDA!"
That made me giggle.
From Elizabeth:
Don't want to? Then don't. And why do you have to do it in front of someone?
Because the comment that started it off was "just try doing it, and see what happens!" which assumes that there are others around to see what you are doing. Oh, and if you don't want to, you are repressed, or at least so says sarahz. I don't condemn anyone who does it, I am just very concerned, without reference to any individual, about the view of female sexuality (namely, that motherhood is its apex) lurking in the background when childbirth is eroticized.
From sarahz:
***But for normal people, sexual activity is a choice, and one that has significant meaning. And when a person in possession of her faculties chooses to behave sexually with non-partners looking on, we can ask "why" in a way that doesn't make sense about pooing or about masturbation by people who don't know what they're doing. You can repeat all you want that childbirth is an exception from other general norms, but that doesn't prove anything. By social consensus, the exception doesn't extend to performing sexual activity in front of third parties. You may think this norm is wrong, but you haven't explained why, other than to gesture at the fact that it is a norm.***
As soon as a root canal involves removing a tooth through a man's urinary canal, then your analogy will be a great one.
Any norm that prevents a woman from doing something that pysisologically may be helpful during labor is WRONG. In the extreme. If that norm serves to sell more Pitocin, which has greater risks than a little clitoral stimulation, well it is wrong AND motivated by profit.
Engaging your sexual organs during childbirth is not a choice. They are done engaged. The only choice is whether or not to facilitate their task (dialation, oxytocin release, etc)
How would mastrubation during a mammogram facilitate the mammogram Elizabeth? As soon as it would, I would be fine with it.
Have you ever seen a picture of the nerve structure of the female reproductive system Elizabeth? Nerves extend DIRECTLY from the clitoris to the uterus. And they can cause contractions. Uterine contractions. Aren't these also part of labor? Also clitoral stimulation releases oxytocin.
AGAIN as soon as clitoral stimulation in labor becomes Mastrubation, vaginal checks in labor become 'fingering' at best and forced penetration (yk rape) at worst. You really can't have it both ways and still be a friend of logic. How would anything a woman does for herself be dirty indulgent and sexual but anything done to her be innocent and medical and non-sexual??? This is yet another attempt to say 'medical professionals are qualified to deliver babies, women are utterly unqualified to have them.' I just do not accept that.
I just read a GREAT story of a RN who checked herself a few times during labor. Does this mean she was really 'fingering' herself???
The hospital is NOT IN PLACE TO ENFORCE SOCIAL NORMS. As soon as that is its express purpose, it becomes not a hospital, but a prison/reform school. Also, I don't even agree a strict taboo on touching your own clitoris or breasts during labor IS a social norm, I believe YOU are uncomfortable with it Elizabeth, and while you have a lot of company, it cannot be said to be a universal social norm (have you read how often Babycatcher used Nipple Stim at the Bottom?), and you are hardly the judge of social norms worldwide.
You are ASSuming that women are only touching their clitoris during labor for some type of self indulgent unrelated past time and ignoring the biological realities of the situation (that clitoral stimulation contracts the uterus, releases oxytocin, and balloons the upper part of the birth canal).
From sarahz:
This is yet ANOTHER example of how our prejudices against women and childbirth interfere with evidence/biology based medicine. Like forced shaving of pubic hair. Very nasty oppression from the past and IMO quite similar to a ban on touching yourself.
From lurker:
Yehudit:
And not all women would want to insert their own speculum before an exam or smear, but the logic of giving them the opportunity to do so makes perfect sense to me.
OT but...
Ya know, to be real honest, i never thought about asking to do this. especially considering i've only ever had ONE caregiver repeatedly insert it with literally no pain....
From Ericacrochets:
"If a man goes into his dentist for a root canal, and refuses anesthesia, saying "I prefer to cope naturally," then proceeds to jack off, does the dentist have grounds for complaint? Why or why not?"
I'm about to die from laughing, but I do think it's a good point.
Also, if the woman's water isn't broken, should she and her partner be allowed to DTD in the labor room?
From Antigonos:
I have a terrible confession to make. I LOVE general anesthesia. All three of my kids were born by C/S, with GA. I like the swirling colors I saw with GA, the feeling that the C/S only took a second, and that I woke to find that Christmas, Easter, Hanukah, and all my birthdays had been rolled into one and I had the best gift imaginable! My Baby!
Yeah, my tummy was sore, so I put a pillow on it and held my baby in my arms with the pillow underneath him/her and so the weight didn't make my incision hurt. I nursed all of them right away, and they, in spite of being horribly drugged [sarcasm here] grabbed on and nursed vigorously.
I needed pain medication frequently for the first 24 hours with each birth, then almost nothing beyond the odd paracetamol. With #1 I flew to the US 10 days after he was born and felt perfectly well. My husband and I resumed relations much earlier than if I'd had a vaginal birth with episiotomy or tear would have allowed.
Ain't I awful, and me a MIDWIFE??? Frankly, I wonder about a woman who values the experience of giving birth more than the child who is born. But then, I can't understand why anyone would want to go bungee-jumping, either. The "high" is so sublime?
And I think about the evolution of the NCB movement. Once, it was all about keeping a baby from getting the sedating effects of twilight sleep -- which was a valid concern in the days of the IV triple whammy. Now, there almost seems to be a desperation: you not only get to FEEL EVERYTHING, you can have an ORGASMIC EXPERIENCE!!!!! As well as the need to feel superior about it when other women think you're off your rocker. Something's gotten twisted, somehow.
From Antigonos:
lurker: child birth is intense. some women experience extreme hardships and pain, some minor cramping with one hell of a transition. some experience pleasure like i did, and some *gasp* orgasm...
~~~In 40 years of obstetric experience, caring for literally thousands and thousands of women, I have NEVER heard ANY woman tell me she enjoyed labor, let alone had an orgasm. Most cope, some better than others, some manage without medication, most don't. But birth itself as PLEASURABLE? Only in the same way that a man hitting his head against a wall finds stopping pleasurable by contrast. In fact, almost without exception, the first thing they say is, "Thank God, THAT'S over!"
IMO, you are [1] either a medical novelty, [2] have a very odd sexual response capability, or [3] have astoundingly easy labors, or [4] just plain weird. [5] all of the above.
From Antigonos:
sarahz: When women are not allowed to stimulate their breasts during labor with a breast pump or otherwise, what of that? Does that mean we are trying to sell Pitocin? Or that the hospital tends to suppress all expressions of personhood or sexuality?
~~~Or quite possibly because it is necessary to have good contractions and nipple stimulation doesn't have much effect at all.
From Antigonos:
Jolene: This is a really interesting conversation. What is an orgasm really? One major part is that the uterus contracts. The other major part is the mind assigning pleasurable sensations. Oxytocin has a role in there somewhere too.
~~~Then why are uterine contractions that occur during nursing commonly referred to as "afterpains" and can be so severe as to cause vomiting? That's someone's idea of "pleasurable"? Makes me wonder, once again, what is passing for an orgasm in women like this. Are they into BDSM?
Another way I'm defective. Nursing only....tickled. I seem to have insensitive nipples.
From Antigonos:
From sarahz:
Whatever, if you don't feel like women's sexuality and the medical system is at odds now, wait until you've had a hysterectomy or a mastectomy. You'll see it then, I promise. It is the whole way they treat women.
~~~Do you think that sexuality ends with the menopause? And that HRT is a massive conspiracy to keep women in sexual thrall to men? [Just wait until you have drenching hot flashes every 15 minutes. I lived in a sauna for 5 years, and yes, I swallowed everything herbal, in giant quantities. Not one iota of relief]
From Antigonos:
From sarahz:
Whatever, if you don't feel like women's sexuality and the medical system is at odds now, wait until you've had a hysterectomy or a mastectomy. You'll see it then, I promise. It is the whole way they treat women.
~~~Would it help the patient in any way if the doctor cried with her? I want a surgeon to be completely dispassionate about the operation. The loss of my femininity, which is not a physical thing but an abstract concept, is entirely secondary to the loss of my life, which I'd rather not lose, thank you.
From Antigonos:
Re orgasm: The response in women is very complex. Masters and Johnson identified three different sets of PHYSICAL responses, based on certain parameters. But of course they could never quantify the non-physical side, and it seems that in women this is a larger component than in men [whose orgasmic response is quite simple: ejaculation]
I think there are large numbers of women who never actually know if they've had an orgasm or not but who are quite satisfied with their sex lives. They certainly haven't experienced the single, overwhelming, easily identifiable orgasm which is similar to a man's.
I know for myself that my own sexual response has changed since menopause. I no longer have the very strong type of orgasm, but I have the lower-level, "wavelike" type of response, which is quite nice [and much more predictable than the stronger type, which was only occasional] I also have orgasms in dreams, which never happened before [I used to wake up at the critical moment, now I "go all the way" -- dunno where that comes from!] Is it differing hormone levels? I'm also more sentimental than before.
My own personal feeling is that orgasm, while it has certain physiologic effects which can be measured, is also a psychological phenomenon. Freud, being male, probably never considered this. Orgasm has a single meaning for a man.
From Antigonos:
Yehudit:
Almost no one decides to adopt simply because they prefer that route to having children over pregnancy and childbirth. Ditto contracting a surrogate to carry your child.
~~~I had a woman in my clinic yesterday, 44 years old, with a teenage daughter from her previous marriage, who wanted to discuss fertility treatment. It seems she is about to marry a 50 year old man who's never married before. This woman confided to me that he is so adamant that they MUST have children that he's booked an appointment with a fertility specialist before the wedding, since every month reduces their chances of conceiving. She's terrified that she won't be able to "perform". [apart from anything else, like her age, she's needle-phobic]. Apart from this "small problem" that he wants at least one child which is biologically his and hers, she assures me he's a nice guy.
This is really sad. She can't even see that he isn't marrying her, he's marrying a uterus.
From Antigonos:
From Jolene:
"But SarahZ, you are not permitted to take the matter of pain relief into your own hands (so to speak). It is not approved by the FDA!"
That made me giggle.
~~~I'm thinking of all the toxic chemicals from that plastic vibrator sarahz will be absorbing through her vaginal mucosa....better let your husband go down on you, but make sure he rinses his mouth first, or you might get some nasty additives from the Coke he bought in the hospital canteen. Have you checked, btw, whether the sheets you will be lying on, sarahz, in that hospital are made from organic cotton washed only in rainwater and ecologically-friendly soap?
Now that Kelby's gone, thank God for you, sarahz!
From Yehudit:
Or quite possibly because it is necessary to have good contractions and nipple stimulation doesn't have much effect at all.
+++++++++++
Strangely enough, you are wrong there.
http://mrw.interscience.wiley.co...3392/
frame.html
From Liz1:
Well, this got mind boggling fast!
SarahZ, if you want to advocate masturbation as an aid to labour could you learn to spell it?
I'm having some trouble here with diferentiating between liberation and exhibitionism. All those You tube videos - the miracle of birth, or the chance to waive your fanny in the world's face? And, personally, all those cries of "rape" seemed to me to come from fear or repression rather than liberation.
I would like to share SarahA's tolerance. Generally, I agree that difference should not be a problem. If some women derive an (infantile?) comfort from masturbation, who cares? But to ADVOCATE it? To mark as repressed those who do not, quite, feel the need?
The miasma between some people's ears is truly amazing.
From Myriam:
I entirely agree with you about the Youtube videos. However, to be fair I think those advocating masturbation during labour are doing so because of its supposed analgesic effects, not masturbation for masturbation's sake.
The question is, if you are doing it in front of birth attendants, how are you going to feel in the morning?
One of the most excruciating things I have ever seen is a video in which a man is groping his labouring wife at her request in front of an assortment of midwives. He just looks like he wants to curl up and die to the point that you have to wonder about the long-term consequences on their marriage. And it's not even clear that his wife is getting anything out of it. It's as though she's just doing it because she has read somewhere that she should. Now where did I see that? Can anyone help me out?
From Susanne:
"it was a process and a journey... two words I would also use to describe my pregnancies and child births. My aunt's experience wasn't the same physically as mine, but she did "give birth" in a certain way. She wasn't just handed a child at the airport. It was hard work and the process was was part of becoming a mother for her."
Well, yes. But she didn't have the luxury of arranging the airport lounge with Enya music, scented candles, and a Rabbit tucked in her panties so she could have an orgasm the moment that the social worker handed her her new much-wanted child. But I'm betting your aunt was pretty over-the-moon over the BIGGER PICTURE that she had a new child to love, not the particulars that it was in a given setting. All the fuss over it being a certain way is just bridezilla-ish. And now we're upping the ante with orgasms. Why not put a Rabbit in your panties and time it such that when the preacher pronounces you husband and wife, you have an orgasm? That'll make it the Very Bestest Wedding Experience Ever!
From Susanne:
"If a man goes into his dentist for a root canal, and refuses anesthesia, saying "I prefer to cope naturally," then proceeds to jack off, does the dentist have grounds for complaint? Why or why not?"
Congratulations on winning the Internet, Elizabeth. (folds cards)
Just to follow this train of thought, if you're saying that sexuality and the medical system shouldn't be separated, then there'd be nothing wrong with a male doctor getting an erection at the sight of an undressed female patient, or expressing to her that she had lovely breasts. Right? Or if the woman didn't have a husband / partner around, it'd be ok for the nurses and / or doctor to perform said nipple stim or clitoral stimulation, since it's just natural pain relief that aids her experience. No?
Or do those examples above cross a very bright line, sarahz?
From Susanne:
"More to the point, what about childbirth and motherhood and being a woman makes masturbating in front of other people during childbirth any less inappropriate than in any of those other situations?"
I would really like sarahz to try to answer this question from above.
From Leelee:
Elizabeth; "But I suppose all of that goes by the wayside if you believe your worth as a woman is bound up with birthing well and liking it. What better way to prove that you accept "what you were made to do" than to not only do it without pain relief, but get off on it as well? Even the religious patriarchs of the middle ages never dreamed of raising the bar for female worthiness so high."
LOL, Elizabeth - I'm reading a nonfiction book right now entitled "Fallen Bodies: Pollution, Sexuality and Demonology in the Middle Ages. Apparently they set the bar in the opposite direction back then - the *less* a woman enjoyed either sex *or* childbirth, the worthier she was!
BTW for the non-Medieval History or Theology majors, "Pollution" in this context means masturbation or any other kind of autoeroticism.
From Leelee:
Antigonos: "Or quite possibly because it is necessary to have good contractions and nipple stimulation doesn't have much effect at all."
Antigonos in next post: "Then why are uterine contractions that occur during nursing commonly referred to as "afterpains" and can be so severe as to cause vomiting?"
Color me ignorant, but did you directly contradict yourself here? Is the major difference that one is intrapartum and the other is post- ? Is effectiveness of contraction stimulation somehow directly in relation to production of milk (or colostrum)? What about women who are leaking colostrum throughout the latter part of their pregnancies?
Now I have to read Yehudit's link....
From Leelee:
Yehudit, I just read your Cochrane link -- do they explain anywhere why there were 4 perinatal deaths out of n=~700? I don't really see how it's relevant to effectiveness of nipple stim since there was no hyperstimulation reported, but the number jumped out at me as high.
From sarahz:
An act can be defined by its purpose. Mastrubation is for the purpose of achieving sexual release and pleasure. Clitoral Stimulation for the purpose of contracting the uterus or ballooning the upper part of the vaginal canal is NOT MASTRUBATION just as the doctor sticking his digits into your cervix repeatedly is NOT FINGERING. If a man needs to produce an erection for a medical procedure, the stimulation he does of his penis is also NOT MASTRUBATION but is just for the purpose of the medical procedure at hand.
I am sorry if y'all don't have real physiological orgasms, but I definitely do and I think most women of my generation do. They involve: increased blood flow to the pelvic area, uterine and vaginal contractions, ballooning of the upper part of the birth canal, etc. All helpful in childbirth. Please tell me how these would NOT be helpful.
If you don't understand the difference between jacking off during a root canal and clitoral stimulation during uterine contractions, I really can't help you. Maybe an anatomy and physiology class can. The mouth is no where near the penis. And there is nothing about mastrubation that would faciliate the root canal.
Also, doctors and nurses DO perform Nipple Stim on their patients in countries that are not as sexually repressed and eager/able to sell Pitocin as the US. Do y'all even read Baby Catcher's Blog? It seemed very effective, and she used it almost every day.
How would a doctor getting an erection facilitate his task??? Hmmmm??? It seems it would impede it.
Also, yes, the plastic from the vibrator would indeed not be ideal. I just felt like it would be a compromise with a hospital that can't stand yk, the patient being touched at all by a human. They seem to be more comfortable with machines, so why not try to meet them where they live?
Also, there is nothing admirable about the hospital using pesticide cotton washed in chemical detergent. Do they not have to serve any chemically sensitive patients??? I would think that chemo patients might develop some chemical sensitivities no? Health Care without Harm is a great organization working on the negative impacts of hospital business. Cotton is one of the most pesticide intensive industries ON EARTH. Hospitals regularly create dioxin when they incinerate medical waste. Dioxin is the most carcinogenic chemical on Earth. Nothing too admirable about this folks, more like lazy and disgusting. Isn't it ironic that the place that is susposed to cure cancer also creates it? This irony may be lost on y'all here, but it isn't lost on the Environmental Scientists of this world, people do know about it, and don't think it is permissiable or something that can continue long term.
From sarahz:
P.S. Y'all WISH my husband drank Coke. He doesn't, neither of us have any use for HFCS or Phosphoric Acid. Isn't it a problem that the Hospital (filled with Diabetics, the immunocompromised and others who shouldn't expose themselves to 34g of Sugar per can) sells so much Coke? When I was in the hospital with DS, Soda was definitely ON TAP even though most hospital nutritionists would tell you to avoid it completely. Just another place where the hospital lives in the Dark Ages. (Or shall I say the 'conflict of interest contract with Coca Cola ages')
And BTW: just as a FTR for y'all's tiny little (& pervy) minds, my husband DID go down on me during my labor. Before we got to the hospital of course, after 2 days of prodromal conctractions. Oh guess what? I went into active labor like oh, 20 minutes later. My midwife (CNM) actually advised non-penetrating intercourse. And since semen contains prostaglandins JUST LIKE cerverdil with fewer side effects, maybe there is some connection y'all are overlooking here. It seems like the entire chemical experience at the hospital (Ceverdil followed by Pitocin) is chemically designed to simulate what could be produced naturally through interaction with a loving partner.
From Myriam:
This discussion reminds me of something I read about midwives in the Middle Ages helping virgins to masturbate in order to cure them of "green sickness".
Completely by the by, I know, but a piece of miscellania that always tickles my fancy (as it were).
From Yehudit:
Leelee,
1 of the deaths was in an oxytocin group (being compared with the breast stimulation group) and 3 in the breast stimulation group. The control (i.e. no attempt at induction) had 0 deaths. All groups were tiny (they all come from one study Damania 1992, and were 17, 20 and 20).
The association of breast stimulation with increased perinatal deaths could either be a 'true' finding or it could be the result of simple chance. The confidence intervals are absolutely huge (CI 0.40 to 30.8
and there is no way of knowing whether the apparent finding in a tiny study would be replicated in a larger study. The effect could simply disappear. The only way to know would be to do a much bigger study.
At the same time, the studies done prior to this review are not large enough (individually or aggregated) to say whether this is a safe method of induction in high risk women (I think all the perinatal deaths are from a single small trial, Damania 1992, which was all high-risk women). A paper reporting on the trial is here -> http://www.jpgmonline.com/articl...;
aulast=Damania
So you can judge for yourself what you think of the quality of that trial. If you look at the indications for induction, they include IUGR, and it's certainly questionable whether a genuinely IUGR fetus (as distinct from small for gestational age) should be subject to induced labour (i.e. if on balance of risks and benefits, delivery should be expedited, then CS is probably the preferable method). However, they do not show the indication for induction in each of the perinatal deaths, so this is simply speculation on my part. Forced speculation, because the data isn't presented.
Anyhow, yes - it does leap out, and it's a reason that breast stimulation cannot reasonably be advocated as a method of labour induction outside the context of clinical trials, at least for high-risk indications. I did hear that there is a current trial on breast stimulation for induction in women with diabetes being undertaken at one of the London teaching hospitals, but I don't know when that is due for completion. It should be large enough to give a better indication of any safety issues though.
What the research does show is that breast stimulation is capable of producing an effect on labour onset.
From lurker:
well i'm no medical novelty...
i used Hypnosis. which i know around this board is something i shouldn't say lest i be hounded for some odd reason.
like i said, my first birth wasn't so pleasurable. i wanted something different for my second.
From Yehudit:
And since semen contains prostaglandins JUST LIKE cerverdil with fewer side effects, maybe there is some connection y'all are overlooking here.
+++++++++
Hmmm, yeah - well, true semen does contain prostaglandins. But there really isn't sufficient evidence to say that sexual intercourse works as a method of induction.
http://mrw.interscience.wiley.co...3093/
frame.html
If you are in the "bored of being pregnant, at term, can't hurt, might help" category - then, why not? As long as you are happy to have sex.
But if you are in the "Fetal and/or Maternal benefits of induced labour are greater than continuing pregnancy" category - then using a method of unknown efficacy rather than a method known to be effective is a pretty bad idea.
From Ericacrochets:
All right, I am personally thoroughly grossed out by the idea of clitoral stimulation without a fairly high level of sexual arousal. Reducing human sexuality to the bare mechanics of it repulses me.
Not getting good contractions? Rub your clitoris. Put a vibrator on. Ugh. I don't think I'd ever want to have sex again.
If a person wants to fetishize and eroticize birth, that is their business, but it seems vastly impractical given the danger inherent in human birth and the need for other people to be around in order to make sure the mother and baby are safe and healthy. I suggest picking another fetish.
From Pharmacist:
--If a person wants to fetishize and eroticize birth, that is their business, but it seems vastly impractical given the danger inherent in human birth and the need for other people to be around in order to make sure the mother and baby are safe and healthy. I suggest picking another fetish.--
I agree, whatever happened to normal fetishes like high heels or leather boots?
Childbirth??? I don't find anything sexual in that at all.
From sarahz:
It is NOT a fetish UNLESS the physican 'fingering' you is an equal fetish. It is not a sexual act to stimulate your clitoris for the purpose of producing contractions or widening the upper part of the vaginal canal, just like it is not a fetish when a doctor sticks his finger vagina. In both cases it may APPEAR to be the same act as those used in sex, but as they say, context is everything.
I am always amazed at this blog: The message seems to be 'go to the hospital, in an emergency the safest transfer distance is down the hall' BUT then the message also seems to be: if you go into a hospital, there are some very strict rules you will have to follow even in non-emergency situtations, including: NO ONE but the doctor or the nurse is EVER allowed to touch you and they will only be touching you with a scalpel for the most part. Your husband is not allowed to touch any part of your body below your waist and you are not allowed to touch any part of your body below your waist or we will call the psych ward and tie your hands to the side of your bed? Remember the 50s? Well they aren't that long ago, honey, we can still tie you up if you don't do as we say, the only acceptable methods of augmentation here cost $1000 and you WILL be paying for them.
So, yk, am I supposed to be willing to trade this totalitarian, repressive atmosphere for proximity to the OR? I suppose if I were a 'real woman' it wouldn't matter to me, but it makes this woman want to cry and run.
From Ericacrochets:
Here's an analogy. When you go to a public restroom, you will be touching your genitils or parts very near your genitils. However, if you choose to have sex in a public restroom stall, as Larry Craig found out, or masturbate, you will get in trouble because in our society, we are not allowed to have sex in public places because it offends others.
If a man stimulates himself to ejaculation in order to produce sperm for fertility treatment, that is still masturbation. He's expected to get in the mood and use magazines or videos. If a woman stimulates her clitoris for analgesia or contractions, it is still masturbation. And it is impractical for labor when others are present or in and out of the room.
I cannot understand how a person CAN stimulate their clitoris outside of a sexual context without it causing physical pain and emotional distress, but I guess not everone has the same anatomical responses as I do.
From Kat:
"I have a terrible confession to make. I LOVE general anesthesia. All three of my kids were born by C/S, with GA. I like the swirling colors I saw with GA, the feeling that the C/S only took a second, and that I woke to find that Christmas, Easter, Hanukah, and all my birthdays had been rolled into one and I had the best gift imaginable! My Baby!
Ain't I awful, and me a MIDWIFE??? Frankly, I wonder about a woman who values the experience of giving birth more than the child who is born. But then, I can't understand why anyone would want to go bungee-jumping, either. The "high" is so sublime?"
The high is sublime. But it comes no matter what really. Meeting your baby tends to do that. Personally, I love GA too. Pretty colors and happy thoughts and a nice nap.
From Caryn:
This is yet ANOTHER example of how our prejudices against women and childbirth interfere with evidence/biology based medicine.
No, it isn't. To have it be evidence-based, you'd have to have some good data supporting the claim that clitoral stimulation makes labor more effective or reduces pain.
And obviously it wouldn't be an RCT. People are rather bound to notice which group they or their patients have been randomized into.
You'd have to make the suggestion, before labor, to half of the matched case-controlled women that if they wanted to try self-stim as a means of enhancing either pain relief or efficacy, they could, and then ask them to report during labor, and offer them both Pitocin and epidurals when it became medically indicated, i.e. after they'd fallen off the curve/needed induction and/or after they requested pain relief.
Also, the idea "you should masturbate during childbirth if you want to because you believe it might help" *begs the consent of the other people in attendance*.
If you masturbate in front of any paid provider apart from a prostitute, *because* only prostitutes have given their consent, that's either public indecency or assault. Unless you're assuming that medical and health care providers have intrinsically given consent to be masturbated at by virtue of performing their jobs.
In private, during labor, if it works for you, I doubt anyone really cares. But it is unethical not to get the consent of the providers here, and unethical to demand that they provide you with this particular sort of care.
The question still remains: what kind of person isn't internally inhibited from masturbating in front of a person who's not their intimate partner?
Well, exhibitionists, and as I understand it they don't really get why it is that other people don't share their particular kink.
From Kat:
The idea that sarahz is bringing a vibrator to the hospital is a bit odd. I would suggest it be reserved for the privacy of the restroom provided in the hospital room.
It is inappropriate to stimulate yourself in public. There is no excuse for it.
I can assure you that your baby will come out without use of a vibrator and if you really feel the need to go there, please have some decency for other people's feelings and practice some decorum.
Also, after thinking about this myth of the orgasmic birth, I tend to agree that there is a movement that is getting a bit crazy. Not only is birth supposed to be blissful, now it supposed to be orgasmic. Well, ain't that a big heap of lies.
I don't worry about women falling for it, I think we know better. We have heard the stories, we know it usually hurts no matter if a medicated birth, unmedicated, c-section, the end result is worth it though. To elevate birth to orgasmic though is doing a disservice to the real sacrifice women make to bring life into the world.
I worry that this misconception could spread through the laborless masses. Obviously if you didn't love labor or orgasm, you did something wrong. The reality is no, labor hurts and that is normal. But why are we starting to ignore the reality of labor? Why are some women trying to prove not only that it is blissful, but is sexual as well?
I really don't know the answer to that. I will keep thinking....
From Yehudit:
And obviously it wouldn't be an RCT. People are rather bound to notice which group they or their patients have been randomized into.
+++++++++
Not all RCTs can be blind (planned vaginal vs. planned CS for breech? radiotherapy vs. surgery vs. active monitoring for prostate cancer?) but it doesn't necessarily invalidate the results, especially not if some kind of objective measure of an outcome could be used (e.g. intrauterine pressure monitor in this case).
From Yehudit:
consent to be masturbated at
+++++++++
"masturbated at"?
From Caryn:
"And obviously it wouldn't be an RCT. People are rather bound to notice which group they or their patients have been randomized into."
+++++++++
Not all RCTs can be blind
Yes, the word "blind" was omitted from that sentence.
From A Sarah:
"masturbated at"?
I've been masturbated at without my consent, twice. Once by a drunk homeless guy on the steps of my church and once by a stranger in a train station. I experienced it as something between harassment and assault. I'm not sure what you were questioning about the "at" part, Yehudit, but that's what I thought of.
From Jolene:
I've not been masturbated at as an adult, but as a child I was used as a tool for masturbation a couple times. (today, they would call it abuse)
Don't you think being (accidental) witness to masturbation by a woman in labor would be a bit different?
A flasher on the street uses the act as assult. So does the abuser. I have a VERY difficult time imagining a woman in labor intending assult by touching herself.
I also have a difficult time imagining a caregiver feeling assulted by it. Seriously, what's the harm?
We don't have to want to DO it to be tolerant of it.
From Kat:
"I also have a difficult time imagining a caregiver feeling assulted by it. Seriously, what's the harm?"
I wouldn't feel assualted, I would feel that the person needed psychiatric help if they didn't understand such simple social mores.
The harm is that I have never desired to watch a woman touch herself, and without asking my consent would be very rude, disgusting, and glaringly disrespectful.
To bring the analogy home, would it bother me if a male patient proceeded to jack off while I was giving an enema? Yes, it certainly would.
From Kat:
To put it this way, if a woman wanted to stimulate herself during labor, fine. But there is not a single reason it should be done in front of anyone and force them to watch. If I was a midwife/OB and my patient wanted to go to the restroom to touch herself I would have no reason to stop her. If she did it in front of me when I was checking her vitals, I would be worrying about her mental status.
From Yehudit:
I'm not sure what you were questioning about the "at" part, Yehudit, but that's what I thought of.
+++++++++++++
I suppose I'm questioning the idea that a woman who masturbating during labour would be doing so "at" a careprovider, rather than "in the presence of".
Why are we even comparing the steps of a church and train station to the labour room provided a woman in labour? I think a woman in labour has a reasonable expectation of privacy, and that she is admitting the presence of caregivers into an intimate situation and it is a reasonable expectation that they provide unobtrusive care that doesn't unreasonably interfere with her own self-determination.
I'm not a "fan" of masturbation in labour. I don't think it's a necessary or even particularly useful thing to do. I don't know why someone would even want to do it particularly - apart from holding/rubbing a part that hurts is a commonplace reaction. I don't know what it's trying to achieve.
But in the arguments against it, the position of the woman in the hospital is revealed: she is in a public space, must act with a decorum dictated by the hospital, it is a medical event, etc...
I can see why the price for having routine care in labour might be that you have to not be verbally or physically obnoxious TO the people providing your care (and let me tell you, even that is not a given). But I don't see why the price of routine care in labour must be that you don't hump your partner's leg or gyrate to Rod Stewart singing "Do you think I'm sexy" if that's what you want to do. Why do care givers have to make it about themselves when it so clearly isn't?
From Yehudit:
What do you think about perineal massage in labour?
From Yehudit:
If she did it in front of me when I was checking her vitals, I would be worrying about her mental status.
+++++++++
Do you think that would actually happen?
From Kat:
I can see your point about hospital labor not allowing a woman to do whatever she wants.
That is true, she won't be able to smear feces on her head because it makes her feel better, or get a dildo and go to town. If these things are very important to a woman in labor, she may need to find an open care provider or consider homebirth.
If she will not tolerate labor as well without performing socially unacceptable acts, it is up to her to find a solution that doesn't include subjecting people to her quirks.
From Susanne:
"I also have a difficult time imagining a caregiver feeling assulted by it. Seriously, what's the harm?"
So then why do doctors or nurses who are gathering sperm samples for fertility purposes ask the man to go into another room and masturbate? If it's so not-a-big-deal, why don't they have the guy drop trou right then and there? What's the harm to the doctor or nurse by witnessing the man masturbate -- after all, they're going to be dealing with his sperm, right? Aren't we denying men's sexuality and Othering them by insisting they go into another room?
What a strange new world the crunchies have -- the doctor who examines your vagina with MERELY medical intent on his mind is committing sexual assault, but the woman who masturbates in public and subjects all her caregivers to it isn't acting inappropriately, at all. @@ Whatever.
YK, if women can claim the "I know he was just examining me, but it FELT like sexual assault, so by golly it IS sexual assault," then bystanders who have to witness someone masturbating at them get to claim the same and get to be equally uncomfortable.
From Susanne:
"But in the arguments against it, the position of the woman in the hospital is revealed: she is in a public space, must act with a decorum dictated by the hospital, it is a medical event, etc..."
In other words, you're suggesting that the woman is being put in an "inferior" position because she's in a public space, must act with decorum, etc.
How is that any different from my dentist's office, during which I'm allowed to listen to my iPod to make the time go by more pleasantly but I'm not allowed to masturbate to make the time go by more pleasantly? What's the damn difference? Does that mean I'm subjugated in the dentist's chair too and my dentist is pulling a power play by not letting me touch myself? Don't confuse adherence to common norms of decency as subjugation. It just doesn't fly.
"But I don't see why the price of routine care in labour must be that you don't hump your partner's leg or gyrate to Rod Stewart singing "Do you think I'm sexy" if that's what you want to do."
So why can't a man providing a sperm sample for fertility purposes -- or heck, even to check vasectomy effectiveness -- open his Penthouse magazine, put on some Barry White, and go to town in front of everyone? Why do you think caregivers want him to do that IN PRIVATE and not in front of them? Isn't that subjugating males? Those nurses at the fertility clinics must be on power trips, by sending the guys to another room.
From Yehudit:
Susanne, the issue is one of consent - as well you know. The doctor (or midwife) certainly needs the express consent of the woman before doing a vaginal examination. (At least in my part of the world).
The question is whether the woman needs the midwife to consent to her touching her OWN body. And if so, where do you draw the line.
It is now quite commonplace for a woman to be encouraged to reach down and touch their baby's head while it is still inside her - for the purpose of encouragement, so she can feel the efficacy of her own pushing effort, whatever. Similarly, perenial massage is positively encouraged in the antenatal period. It would be very difficult to construct guidelines that permitted these acts, but prohibited masturbation.
Smearing faeces on your head? That's certifiable, whether you have privacy or not.
Going to town with a dildo? Have you seen an "Epi-No"? http://www.epino.de/index.htm
From Susanne:
"The question is whether the woman needs the midwife to consent to her touching her OWN body. "
No, the question still remains, as Elizabeth put it, what kind of person isn't [i] internally [/i] inhibited from masturbating in front of someone who isn't a sexual partner.
Look, I expect OB's to control themselves from masturbating in front of particularly attractive patients, lol, so I don't think it's too far of a stretch to expect women in labor to refrain from masturbating in front of other people.
Because if masturbating in front of others isn't offensive, then why *shouldn't* someone masturbate at the dentist's office / while getting your hair cut / while doing the cutting?
From A Sarah:
Yehudit: I suppose I'm questioning the idea that a woman who masturbating during labour would be doing so "at" a careprovider, rather than "in the presence of".
Ah, I see. I thought you were questioning what could be meant by "masturbated at," as though there was no such thing. I get you now.
From Yehudit:
Why do you think caregivers want him to do that IN PRIVATE and not in front of them? Isn't that subjugating males? Those nurses at the fertility clinics must be on power trips, by sending the guys to another room.
++++++++++++
It's quite different. The guy wants privacy, the nurses want to give him privacy and there is no reason to interrupt his privacy.
In the case of intrapartum care, the woman may well want privacy, but there are a number of reasons why they don't usually get it.
You'd be surprised at the level of inhibition that exists and the frequency with which women seemingly feel the need to apologize for their existence. "Sorry" for crying "in public". "Sorry" for swearing "in public". "Sorry" for being so noisy. "Sorry" for vomiting. "Sorry" for pooing. Etc, etc... And that has a little bit to do with the hospital as a public space, and the necessary, but not necessarily comfortable, presence of the midwife.
From Susanne:
"It's quite different. The guy wants privacy, the nurses want to give him privacy and there is no reason to interrupt his privacy."
How do you know? Maybe some guys would prefer the hot nurse stand right there, and maybe bend over a little bit too, while they produce their samples.
From Yehudit:
I think it would be unreasonable for a woman to ask a midwife or Ob to assist her to in achieving orgasm - either through physical or visual stimulation. That's a different question from the level of privacy that a woman might reasonably expect.
And there is no need to scrutinize what a woman is doing with hands and genitals just because you are in the room observing e.g. frequency of contractions.
From Susanne:
"And there is no need to scrutinize what a woman is doing with hands and genitals just because you are in the room observing e.g. frequency of contractions."
So again, what makes this different from saying there's no need for my dentist to scrutinize what I'm doing with my hands down my pants when she's supposed to be doing that root canal? Why is one different from the other?
From Yehudit:
Because having a baby is not dentistry. Sorry, I can't give a better answer.
A room in which a woman could, theoretically, masturbate, is also a room in which a woman doesn't have to be concerned about whether her bottom is showing, is free to moan, shriek or swear as sees fit (not AT me, just vocalize because sometimes that's a release), etc..etc...
I am more concerned about the lack of privacy that women have in the average labour ward, with interruptions to borrow equipment and the like, than I am in policing women's sexuality. It's just not a priority for me to be worked up about the the horrific thought of it, I guess.
And Susanne, what do you think about perineal massage? Who should be allowed to perform it, where and in whose presence?
From Elizabeth:
"Sorry" for crying "in public". "Sorry" for swearing "in public". "Sorry" for being so noisy. "Sorry" for vomiting. "Sorry" for pooing. Etc, etc...
That's not inhibition, it's manners. I'm sure I said "sorry" several times during my hospital stay. The one time I'm quite sure was when I got out of bed for the first time and blood dripped down my leg to the floor. I said it like you say sorry when you step on someone's toe. There was no guilt or anything like that. Of course, it would be wrong if the nurse were anything but reassuring and gracious, but I think it's pretty arrogant to think that when somebody briefly says "sorry" to you, they are groveling. Women aren't that pathetic. It's just a word, repeated by force of habit. We're not required to drop our civilized personas and turn into growling animals in order to prove that we are sufficiently natural, empowered, unrepressed or what have you.
I think it would be unreasonable for a woman to ask a midwife or Ob to assist her to in achieving orgasm - either through physical or visual stimulation.
Only an exhibitionist is capable of achieving orgasm in front of a HCP. If your simply being there weren't a help to them, they wouldn't be doing it.
From Ericacrochets:
"What a strange new world the crunchies have -- the doctor who examines your vagina with MERELY medical intent on his mind is committing sexual assault, but the woman who masturbates in public and subjects all her caregivers to it isn't acting inappropriately, at all. @@ Whatever."
According to Sarahz, a woman stimulating her clitoris during labor is NOT masturbating and is able to stimulate her clitoris in a completely nonsexual way.
From Yehudit:
Arrogant for thinking that women feeling like they need to apologize for crying or being noisy or whatever in labour has something to do with lack of privacy? M'kay - if you say so....
From Liz1:
It seems to me that touching or clutching at yourself for comfort or ease, or in the erroneous belief that it will be some kind of aid is a long way from making some kind of obvious and blatant display of sexuality. In the latter case, you have got to be very indifferent to the feelings of strangers, or positively enjoy their discomfort - which I believe is the motivation of your average perv, anyway. We all do very strange things in extremis, but usually manage to feel somewhat embarrassed afterwards. Do it if you must, I suppose, but don't rationalise it as some superior form of liberation.
You don't have to be terribly sophisticated to know that there are some people who will jump at any opportunity to display their sexuality publicly - and very boring they are, too. It isn't so much that one is shocked or offended by their antics as that it is offensive to assume you want to watch.
From Susanne:
"Of course, it would be wrong if the nurse were anything but reassuring and gracious, but I think it's pretty arrogant to think that when somebody briefly says "sorry" to you, they are groveling. Women aren't that pathetic. It's just a word, repeated by force of habit."
Brava. People say "sorry" to dh all the time after they've called him at 3 am, LOL. And of course he tells them no need to be sorry -- because there isn't, that's part of the gig. It's just part of normal social graces and convention to say these things. It's no more "oppressive" than it is to say "thank you" when you sneeze and someone says bless you.
From Susanne:
And of course I would say "sorry" to the person who had to clean up my poo that I couldn't help, even though I obviously didn't do it on purpose, couldn't help myself, blah blah blah. Are you all really the kind of people who wouldn't? It doesn't mean groveling of any sort; it just means "I'm sorry this happened and that you have to deal with it; I recognize it's your job, and I didn't do it on purpose, but I am able to focus on something other than my own self long enough to realize that it might not be the funnest task in the world for you."
From Pharmacist:
--We're not required to drop our civilized personas and turn into growling animals in order to prove that we are sufficiently natural, empowered, unrepressed or what have you.--
Very true! Obviously there are a lot of uncontrollable things during a labor, but many women do appreciate any semblence of normality and manners they can use, and it has nothing to do with groveling.
From A Sarah:
Just wanted to say happy 2009 to all, before I get too buzzed to type coherently. (Actually, I kid about the drinking; my husband and I have had two cocktails each and I think that's plenty. But maybe the rest of you are living it up more intensely than we are.) Of course those of you in the UK and in Israel are already in the new year! Anyway, best wishes to all. SG, if you still read here, I've been thinking of you and praying for you over the holidays, hoping you found some joy, though I'd certainly understand if the sorrow outweighed the joy. You're in my thoughts; I just wish I could help more.
From Antigonos:
From Yehudit:
What do you think about perineal massage in labour?
~~~~From what I was taught, and from my experience [which may have been affected by what I expected to see] it actually can increase the possibility of a tear at delivery. It seems that massaging fairly fragile tissue, already stretched, causes separation and micro-tearing of fibers, which then makes them more vulnerable to ripping apart completely at delivery. We were also cautioned against the use of a warm compress on the perineum, to ostensibly relax it, but by dilating blood vessels, also makes it bleed more if it tears/episiotomy is cut.
I must say I've seen some rather odd behavior over the years, including an opera singer who sang arias between contractions as a way of relaxing, but I've never had a patient masturbate in front of me.
From Antigonos:
LeeLee: Color me ignorant, but did you directly contradict yourself here? Is the major difference that one is intrapartum and the other is post- ? Is effectiveness of contraction stimulation somehow directly in relation to production of milk (or colostrum)? What about women who are leaking colostrum throughout the latter part of their pregnancies?
~~~Yes, it is largely because of when. Nipple stimulation does release small amounts of oxytocin; unquantifiable amounts, which probably affect some uteri more than others. However much one might dislike pharmaceutical oxytocin, it is in a standard dilution, and can be titrated to the patient's needs.
The uterus, after birth, is contracting down on itself, not on a baby. And there's a large raw area inside it, where the placenta was attached. In effect, it is a wounded organ which takes about 3 weeks to heal itself. The sensation of afterpains is quite different from labor. Nipple stimulation at this time [via nursing, which is actually much more powerful than either manual or oral stimulation by a partner] may provide a smaller amount of pitocin but the uterus is exquisitely sensitive to it.
I'm not sure what colostrum has to do with anything, unless your husband likes to lick it off. Its leaking out hasn't got any connection with pitocin production unless you are actually expressing it, which is the same as nipple stimulation. I have had women arrive at L&D with false labor who admit to having expressed as much colostrum as possible, because it was staining their bras and they thought they could stop the leaking that way. The contractions stop as soon as the stimulation stops.
From Antigonos:
sarahz: Do y'all even read Baby Catcher's Blog? It seemed very effective, and she used it almost every day.
~~~She used it because she had no alternative. I'm sure she would have preferred pitocin, but probably not only didn't have it, but had only limited IV supplies --fluids, administration sets, Venflons, etc. --with which to give it, and so it was reserved for actively hemorrhaging women. Medical professionals don't return to the Middle Ages by choice.
From Antigonos:
Ericacrochets: Not getting good contractions? Rub your clitoris. Put a vibrator on. Ugh. I don't think I'd ever want to have sex again.
~~~It is perhaps not surprising that a significant number of women I've dealt with find that certain kinds of foreplay become unpleasant after giving birth because there are mental associations with the vaginal exams during labor. When hubby starts groping around, they feel "like I'm back in my gynecologist's office". Says something about both the husband and the gynecologist, I think.
From Antigonos:
sarahz: widening the upper part of the vaginal canal,
~~~I think you have a fetish about this "ballooning" of the vagina. You mention it in nearly every post. It really doesn't amount to much. Certainly it doesn't make much difference to a baby with a biparietal diameter of 9.5 cm. If it did, your husband would be a very unhappy man, with no contact with you at all except at the vaginal introitus.
From Antigonos:
Yehudit: You'd be surprised at the level of inhibition that exists and the frequency with which women seemingly feel the need to apologize for their existence. "Sorry" for crying "in public". "Sorry" for swearing "in public". "Sorry" for being so noisy. "Sorry" for vomiting. "Sorry" for pooing. Etc, etc... And that has a little bit to do with the hospital as a public space, and the necessary, but not necessarily comfortable, presence of the midwife.
~~~That's part of the British Stiff Upper Lip, and discomfort with expressing strong emotion. I had women apologizing after every contraction in Cambridge, for making virtually no sound at all. It's less common in the US.
From Liz1:
Just curious, but does the presence of children as spectators have any effect on all this unfettered sexuality?
From Holly:
From Susanne:
And of course I would say "sorry" to the person who had to clean up my poo that I couldn't help, even though I obviously didn't do it on purpose, couldn't help myself, blah blah blah. Are you all really the kind of people who wouldn't? It doesn't mean groveling of any sort; it just means "I'm sorry this happened and that you have to deal with it; I recognize it's your job, and I didn't do it on purpose, but I am able to focus on something other than my own self long enough to realize that it might not be the funnest task in the world for you."
I know there's no way you can know this, Susanne, so it's alright, but when you're pushing a baby out of your vagina without pain medication it's impossible to think of anything other than the fact that you're pushing a baby out of your vagina. The thought process goes something like: "OMFG WTF IS GOING ON!!!!! GET THIS MOTHERFU----- BABY OUT OF MY G--D--- VAGINA NOW!!!" There is no "focusing on yourself" and there is no "focusing on someone other than yourself". There is only your vagina and the fact that there is a baby coming through it and the fact that you are in an unfathomable amount of pain. There's not really room in that thought process for "Wow, I'm really sorry that I'm shitting right now, Nurse X. Thank you so much for cleaning it up." Just saying. Unless you were talking about women with epidurals.
From Yehudit:
IIRC, Susanne gave birth to one baby without an epidural (contraindicated for medical reasons....?) and had her second twin by CS ?under GA?
I could be getting that completely wrong - and I'm not about to schlep back through comments to find out - but, still, never presume holly.
From Pharmacist:
--There is no "focusing on yourself" and there is no "focusing on someone other than yourself". There is only your vagina and the fact that there is a baby coming through it and the fact that you are in an unfathomable amount of pain.--
I don't know why people insist that their experiences during labor must be the same for everyone.
With my 2 unmedicated labors the pain was overwhelming over my entire body--there was no thinking about my vagina because the pain was everywhere. I didn't yell about getting the baby out of my vagina because I'd forgotten all about the baby at that point, I yelled "I'm going to die, I'm going to die, I'm going to die"
From Susanne:
Yehudit, I had one twin vag with an epidural and the second twin CS also with an epidural. No GA. Epidural initially contraindicated due to low platelets (HELLP) but platelets rebounded. Thank God for that, because who wants unfathomable pain like what Holly just described? LOL.
And Holly, I think it's amusing that you are ascribing your experience of having had unfathomable pain as being some kind of universal. Have you noticed that the thread was about women having orgasms during unmedicated birth? This "generalize your experience to everyone's" is a common theme with you, it seems.
From Caryn:
Because having a baby is not dentistry. Sorry, I can't give a better answer.
Welding isn't dentistry either.
Care providers who are not willing to be put in the position of being either voyeurs or the target of exhibitionists are not going to give consent to masturbating patients to engage in the behavior while they are in the room. Some care providers are going to be not just uninterested but repelled by public (i.e. not restricted to the view of intimate partners) sexual behavior on the part of patients.
Does that mean that only people with those particular sexual kinks should be maternity care providers, on your view? Will we start screening midwives and OBs for this?
From Susanne:
"but when you're pushing a baby out of your vagina without pain medication it's impossible to think of anything other than the fact that you're pushing a baby out of your vagina. The thought process goes something like: "OMFG WTF IS GOING ON!!!!! GET THIS MOTHERFU----- BABY OUT OF MY G--D--- VAGINA NOW!!!"
You might want to talk to sarahz, who is gravely concerned with the state of her clitoris at that moment, LOL.
From Yehudit:
I don't think acceptance of masturbation specifically is a requirement of the job.
I do think acceptance that of woman's autonomy or freedom of choice about what she does with her own body, is a requirement of the job.
Obviously, there are the limits of what she does with her body that might impact on you - but we have to tread carefully here, otherwise we are on a slippery slope of saying "my being uncomfortable with you doing X, trumps your desire to do X" - even if X happens to be wearing your own clothes, or standing up, or eating and drinking, or having your husband present.
However, being kicked in the head (hi Vicky!) is certainly not a requirement of the job.
"Allowing" a woman to touch HER OWN genitals, might not be a requirement of the job, under some definitions. But it rather depends on whether you think the woman who does this is doing something *to* you, or indeed *at* you. I don't happen to think so.
Is the woman who uses perineal massage (however misguidedly) doing something *to* you, that you would feel compelled to disallow?
Is the woman who takes her nightie off doing something *to* you, that you would feel compelled to disallow?
My basic presumptions (some already stated above) are:
The labour woman is the woman's private space for the duration of labour. The midwife/Ob attend the woman with her permission, and fundamentally on her terms. (i.e. I can't physically stop her eating if she wants to, and I can't physically force her to have her BP measured). Childbirth is regarded as an intimate occasion by most women, if not by all care givers. The role of the midwife is to provide unobtrusive and individualized care which accommodates to the needs/preferences of the individual. (In addition to recommend and provide safe care, etc...).
If 'individualized care' is to mean something than maybe it means having to accommodate women's eccentricities and not policing social norms. Yes, there are limits, and mostly one proceeds by negotiation (in an actual scenario, I might explain that I would give her privacy and be back in the room every fifteen minutes to listen in, extra - and she could press the other button if she needed me) - but generally, in drawing those limits, I would prefer to err on the side of the care provider having to accommodate to the woman insofar as we can and not the other way round.
That's where I'm coming from.
I'm not a voyeur, I just don't think I'm in the business of allowing or not allowing someone to masturbate in that context. Frankly, that is the least of my concerns.
From Yehudit:
The labour woman is the woman's private space for the duration of labour.
++++++
Obviously, that should have read "The labour room..."
From Caryn:
"Allowing" a woman to touch HER OWN genitals, might not be a requirement of the job, under some definitions. But it rather depends on whether you think the woman who does this is doing something *to* you, or indeed *at* you. I don't happen to think so.
Many people don't experience any degree of tolerance for sexual behavior in public, where "public" means "in front of others who are not intimate partners", but are instead repulsed by it. Should those people be restricted from becoming maternity care providers?
The midwife/Ob attend the woman with her permission, and fundamentally on her terms.
I disagree; the woman *cannot dictate care*. In particular, she cannot dictate that the care providers tolerate public sexual behavior on her part. As I said clearly, I cannot imagine it being an issue when the care providers are not in the room. But when they are...
From Yehudit:
the woman *cannot dictate care*
+++++++++++
I agree that a woman cannot dictate care.
She can say she doesn't want her BP measured. But she can't dictate whether I do it with a manual or electronic sphyg.
If she wants ME to stimulate her clitoris (perhaps the bump is too big and she can't reach?) I can certainly refuse.
However, I don't agree that a woman touching her own genitals amounts amounts to dictating the care provided by me.
From Yehudit:
Many people don't experience any degree of tolerance for the exposure of nipples and genitals in public, where "public" means "in front of others who are not intimate partners", but are instead repulsed by it.
And yet, its pretty normal on a labour ward, and not only in a functional "end of second stage delivering a baby" context.
From Caryn:
However, I don't agree that a woman touching her own genitals amounts amounts to dictating the care provided by me.
If you haven't consented to watching her touch her own genitals, and you're in the room, then why not? Consent to sexual activity includes consent to watching others partake of it; that's why exhibitionists are committing crimes when they masturbate in public, since they haven't gotten consent.
Again, on your view should we be requiring maternity care providers to be tolerant of sexual behavior in labor and delivery rooms?
From Caryn:
Many people don't experience any degree of tolerance for the exposure of nipples and genitals in public, where "public" means "in front of others who are not intimate partners", but are instead repulsed by it.
And yet, its pretty normal on a labour ward, and not only in a functional "end of second stage delivering a baby" context.
And presumably the care providers consent to it.
From angela:
Interesting. On the one hand, an orgasmic birth is the claim to superiority that we (natural birth advocates who make claim to it) are so "unoppressed," we can orgasm in public, with no inhibitions at all. On the other hand (a la sarahz), stimulating your clitoris during birth is merely a dry, operative act to get labor going—nothing sexual in it at all.
From Ericacrochets:
This has me thinking. Mandatory shaving of pubic hair is gone. Enemas are gone. Episiotomies are way down. Hospital rooms are "homey," and some of them even offer water birth. Many offer showers and baths for labor. Many women can have a CNM attend their birth. Most babies room in. Many of the objections of yesteryear to maternity care in hospitals have been taken care of.
What's a homebirth advocate like Ina May Gaskin to do? Let's see, hospitals must be bad for some reason, uh, yeah, they are not conducive to orgasms! Clitoral stimulation is not considered appropriate in that setting! The nurses won't let women masturbate in front of them!
So, yeah, I guess if you can convince women that they need to have a really big O during birth, that is a good marketing tool, since it's unlikely that hospitals are ever going to encourage the mother and her support people to have an orgy in the labor room.
From Yehudit:
And presumably the care providers consent to it.
+++++++++++++++
Who knows?
Sometimes there is a little battle of wills: woman gets out of the pool (presumably nakedness is acceptable there?), midwife asks "can I get you a gown?" (hoping woman will say yes?), woman takes her question at face value and says "No, I'm fine thanks". What has just happened there? Has the midwife given implied consent with the question? Does the woman have to ask the permission of the midwife "Is it okay if don't wear a gown?" What I do know is that it would be unthinkable that a midwife force a woman to wear a gown (is she going to call the police and have the woman charged with exposure?) and that in the relative privacy of the labour room plenty of women don't wear one in advanced labour.
As for glimpses of bottoms in gowns with splits up the back, etc... - for goodness sake, it's a labour room. If the midwife has to explicitly consent to witnessing that....
Sorry, Caryn - it's another universe. I can't see where you are coming from at all...
From Yehudit:
Interesting. On the one hand, an orgasmic birth is the claim to superiority that we (natural birth advocates who make claim to it) are so "unoppressed," we can orgasm in public, with no inhibitions at all. On the other hand (a la sarahz), stimulating your clitoris during birth is merely a dry, operative act to get labor going—nothing sexual in it at all.
+++++++++
right on the button, angela
From Holly:
And Holly, I think it's amusing that you are ascribing your experience of having had unfathomable pain as being some kind of universal. Have you noticed that the thread was about women having orgasms during unmedicated birth"
I don't believe in orgasmic birth. I think it's a myth perpetuated by the natural child birth movement and is only "experienced" by women who have been socialized to believe it exists. (Sorry if anyone here claims to have and an orgasmic birth.) I also don't think that childbirth can be without pain. Painless birth, orgasmic birth, to me it's the same as talking about hobbits, elves and fairies. They don't exist. Period. It's an entire person coming out of a very small orifice. It didn't hurt? Um, okay. I don't believe you.
So far as me ascribing my experience to everyone, that's bullshit Susanne. I bet if you were to survey all of the women in the world ever who have had pain-med-free child birth, you would find that the VAST majority of them would describe the experience as "very painful". It would be like if someone had their leg sawed off by a piece of farm machinery, and later described it as painful. Susanne comes along as says "Well, you can't know that it's painful for everyone. Maybe some people like it. Maybe some people even had an ORGASM when their leg was sawed off." Well, yes, Susanne. Maybe so...
From Caryn:
If the midwife has to explicitly consent to witnessing that....
Right. So you seem to be suggesting that it is implicit, in the role of maternity care provider, to consent to viewing nudity.
Is it implicit, in the role of maternity care provider, to consent to viewing sexual activity?
From Ericacrochets:
"I don't believe in orgasmic birth."
I believe it's possible, but I think it's more like a gym orgasm, something that happens sometimes but is not a goal you can really set out to acheive. Some people's bodies respond in an unusual way to certain stimuli.
From Yehudit:
Is it implicit, in the role of maternity care provider, to consent to viewing sexual activity?
++++++++++
If you can think of a reasonable way to reliably differentiate (for the sake of enforceable guidelines about what is and isn't allowed) between a woman touching her own genitals because
a) her vulva hurts (varicosities?) and cupping helps (with her hand! not some crazy alternative-yiddishkeit-medicine)
b) she has practiced perineal massage antenatally, and would like to do so in labour
c) she would like to touch the head of her baby as it is being born
d) she feels like having a wank
Then we can talk about the issue of consent to "viewing sexual activity".
Common sense and negotiation have to make more sense than invoking legislation on this one.
From Yehudit:
a gym orgasm
++++++++
A gym orgasm?
From Holly:
It's not appropriate behavior to go around naked in public either, and yet we don't expect women to always wear a gown when in labor...
From Ericacrochets:
"A gym orgasm?"
This came up the last time orgasmic birth was discussed on this blog. Some women have orgasms from doing core exercises.
From Ericacrochets:
"Common sense and negotiation have to make more sense than invoking legislation on this one."
No one said anything about enacting legislation! I agree with you that there are times when a woman in labor might touch herself that would be completely appropriate and understandable and that she should be given the benefit of the doubt.
Perhaps we can all agree that it is a bad idea to go intor labor expecting to have a sexual experience or with the plan to use masturbation as a coping mechanism. And that people should leave their vibrators home. And that Ina May Gaskin should stop spreading misinformation.
From Sesshoumaru's Girl:
Elizabeth:
I was really going to avoid this topic, but what the hell.
If a woman feels so inclinded to masturbate during labor, what of it? If things are stable, what she does is her own business. Last I checked, nurses and Dr's are NOT in the room 24/7. There is nothing wrong with asking for some private time (regardless of why)
Why is this such a "taboo" thing? I can understand how medical staff would be uncomfortable if a woman was doing that right in front of them, I get that.
Also, the reaction here is just damn interesting. So if a woman has ANY sexual feelings or pleasure during her birth, she must have "boundary" issues?
Feh!
Some women experience arousal during labor, some don't. One is not better than the other. My best friend "took matters in hand" early in her labor, I didn't give a shit, I was more than happy to take my time getting snacks from the gas station across the street. (She didn't tell me why she wanted me to leave, she just asked me to give her and her husband some privacy, no big deal)
Anyhoo . . . carry on!
From Sesshoumaru's Girl:
So, Kat . . .would you take issue with a woman asking for some private time? (for WHATEVER reason)
From Jolene:
"Is it implicit, in the role of maternity care provider, to consent to viewing sexual activity?"
Why not just avert your eyes?
To me this sounds like the arguement against nursing in public. They say you can't force us to view your nursing baby! My answer to that is why not avert your eyes? And I think it applies here as well.
From Ericacrochets:
"Why not just avert your eyes?
To me this sounds like the arguement against nursing in public. They say you can't force us to view your nursing baby! My answer to that is why not avert your eyes? And I think it applies here as well."
That doesn't make any sense. Breastfeeding is not sex. There are laws in most states protecting mothers who breastfeed their babies because our society has decided it is too much of a burden to force mothers to hide away every time their child eats, even though the breasts are normally considered private parts in our culture.
By your logic, people should be allowed to masturbate in public since people can just avert their eyes.
If someone masturbates during labor and takes steps to keep it private from their HCP's (unless they have made other arrangements with their HCP), fine.
From Sesshoumaru's Girl:
Ericacrochets:
"If someone masturbates during labor and takes steps to keep it private from their HCP's (unless they have made other arrangements with their HCP), fine."
How many women are going to have "that" conversation with their HCP? LMAO.
Not that there are actual numbers on this, but I would assume women would just ask for time alone and not make it an issue. This really isn't something one would need approval from their hcp for. :D
From Caryn:
Not that there are actual numbers on this, but I would assume women would just ask for time alone and not make it an issue. This really isn't something one would need approval from their hcp for. :D
Women only need approval from their hcp to masturbate *in front of* their hcp, assuming that there's no implicit consent to viewing sexual activity implied by the act of acting as an hcp.
I've no response to the claim that it is impossible to differentiate between the various sorts of activity, followed by definitions of same.
From Yehudit:
Very clever, except that you don't explain how you are going to actually going to differentiate them in the labour room. That is, how is the distinction going to be enforced?
Are we going to ask women their intentions and purposes when they touch their own genitals? Get them to sign something?
From Sesshoumaru's Girl:
Caryn:
How realistic is that, how many women would actually do that in fromt of their HCP? Don't you think most would just ask for some privacy?
From Caryn:
Very clever, except that you don't explain how you are going to actually going to differentiate them in the labour room. That is, how is the distinction going to be enforced?
Probably the same as the porn definition: you know it when you see it. But I'm no lawyer.
From Sesshoumaru's Girl:
Yehudit:
"Are we going to ask women their intentions and purposes when they touch their own genitals? Get them to sign something?"
ROFLMAO! Priceless.
From Caryn:
How realistic is that, how many women would actually do that in fromt of their HCP? Don't you think most would just ask for some privacy?
Ask sarahz. She seems to have a reasonable amount of experience with the issue.
From Jolene:
"By your logic, people should be allowed to masturbate in public since people can just avert their eyes."
We are discussing if the Labor room is a "public" place, for purposes of social norms. I think Yehudit has done a good job of explaining that if indeed it is, it SHOULDN'T be. In that a woman should be able to be in various states of undress, and behave in a way that one wouldn't in a public place.
I agree. The labor room should be a private place, which the caregivers enter when needed. If it isn't private in this sense, then I find that a big problem.
But if indeed we take the attitude that a labor room is a public space, then I suggest the HCP avert their eyes if they see the laboring woman with her hands "down there". Especially since, the HCP can not possibly know what intent the woman has.
Does anyone have a suggestion of what should be done if a HCP does encounter a woman touching herself with an assumed intent they do not consent to? Call security?
From Jolene:
"Ask sarahz. She seems to have a reasonable amount of experience with the issue."
Are you saying that SarahZ is representive of a number of women? I thought she had been accused of being a Troll.
From Yehudit:
If women are touching their own genitals, how about: I keep the notes and partogram up to date and don't scrutinize closely enough to be able to distinguish between "cupping for purely comfort purposes" and "wanking".
Or alternatively, I could call my lawyer. And then sue her!
Hahaha.
From Sesshoumaru's Girl:
Jolene:
Unless its a serious situation, don't nurses/dr's knock on the room door, rather than just walk in?
During my stay on L&D, no one walked in without knocking.
From Caryn:
Does anyone have a suggestion of what should be done if a HCP does encounter a woman touching herself with an assumed intent they do not consent to? Call security?
Withdraw care?
If women are touching their own genitals, how about: I keep the notes and partogram up to date and don't scrutinize closely enough to be able to distinguish between "cupping for purely comfort purposes" and "wanking".
And as I said much, much earlier, some hcps will have a higher level of comfort with this than others.
Does that mean that hcps with a low level of comfort shouldn't be maternity care providers? Are we going to start screening them?
From Sesshoumaru's Girl:
Caryn:
"Withdraw care?"
No, unless the nurse/ob/mw needs to "take a peek" . . . what the women is doing under a sheet really isn't important. (and asking what she is doing, seems nosey to me)
From Caryn:
You're missing the point. Women *cannot dictate care*. They can't declare that their hcps *ought* to be comfortable with their self-stim in public.
Private? Go to town. Under a sheet? Might be private enough for L&D; I wouldn't know. With a vibrator in front of your "open-minded" OB? Well, if there's consent there, sure.
In front of someone who *hasn't* consented? Why couldn't they withdraw care?
From Susanne:
"Is it implicit, in the role of maternity care provider, to consent to viewing sexual activity?"
"Why not just avert your eyes?"
Why can't my dentist just avert her eyes if I want to touch myself while she's doing my root canal? @@
From Susanne:
So, if I'm having my breasts examined during a routine exam, it should be ok with my OB if I decide to touch myself and add to the stimulation, right? I mean, it's not his or her problem, he or she is just concerned with finding lumps in my breasts and where my hands are, is completely irrelevant. How does that work?
From Sesshoumaru's Girl:
Caryn:
If people are knocking before they enter a room and the woman in labor is making an effort to be considerate of the feelings of others (ie asking for alone time and being descrete etc)
then there shouldn't be an issue. Period.
From Yehudit:
In the UK future midwives are "screened" insofar as every midwifery degree interviews applicants, and the interview (and personal statement) carry quite a bit of weight, especially given that courses are universally oversubscribed.
Every interview that I've heard about (my own, and those of plenty of others at a large number of different institutions) has included questions about women-centred, individualized care, and about the role of the midwife. Moreover, every course that I know of in the UK does teach about privacy in the labour room, and that it is important that woman feels it is her space, etc... (not always seen in practice).
So, you could say that there is an admissions policy that selects for people who prioritize "woman-centred care". Even if the boundaries of that in practice have to be negotiated according to the comfort levels of individual practitioners which vary.
There are plenty of people who would be inwardly shocked at the time, provide good professional care nonetheless, and then it would become one of their funny stories to tell on quiet night shifts.
From Yehudit:
To clarify, as posted above much, much earlier:
"I don't think acceptance of masturbation specifically is a requirement of the job.
I do think acceptance that of woman's autonomy or freedom of choice about what she does with her own body, is a requirement of the job."
The second of these is, in the manner described, screened for in the UK.
From Sesshoumaru's Girl:
Yehudit:
I agree that women deserve a certain level of privacy while in labor . . .amd it IS possible to give good care while giving women their space.
Thanks!
From Caryn:
If people are knocking before they enter a room and the woman in labor is making an effort to be considerate of the feelings of others (ie asking for alone time and being descrete etc)
then there shouldn't be an issue.
To quote my prior post: Also, the idea "you should masturbate during childbirth if you want to because you believe it might help" *begs the consent of the other people in attendance*.
If you masturbate in front of any paid provider apart from a prostitute, *because* only prostitutes have given their consent, that's either public indecency or assault. Unless you're assuming that medical and health care providers have intrinsically given consent to be masturbated at by virtue of performing their jobs.
In private, during labor, if it works for you, I doubt anyone really cares. But it is unethical not to get the consent of the providers here.
From Caryn:
I don't think acceptance of masturbation specifically is a requirement of the job.
So why can't maternity care providers who are uncomfortable with self-stim withdraw care? Or can they?
From Caryn:
To make that a bit more explicit, why in the world is anyone arguing with me on this point? You all seem to *agree* with me.
I admit I failed to spell out the idea that self-stim was perfectly okay in private but then I assumed we were all clear on that. So I restricted my claim to: the idea "you should masturbate during childbirth if you want to because you believe it might help" *begs the consent of the other people in attendance*... In private, during labor, if it works for you, I doubt anyone really cares. But it is unethical not to get the consent of the providers here.
So what's the real objection here? Is it that hcps should share the values of the women they care for because that's woman-centered health care (as distinct from medical care) or what?
From Emma B:
So why can't maternity care providers who are uncomfortable with self-stim withdraw care? Or can they?
I suspect EMTALA would probably come into play here. The hospital has a legal obligation to provide treatment to a pregnant woman in active labor until the baby is born and the placenta delivered, unless there is adequate time to transfer her safely to another facility.
If an ER patient becomes abusive or disorderly, he or she is generally restrained and/or tranquilized and given the medically required treatment. That's not to say hospital staff must be subject to abuse, but they still have to provide care after the patient is rendered unable to abuse them. Any ER doctor or nurse has a story about a patient who verbally, physically, or sexually assaulted them, and who got tied down or sedated (and sometimes given dubiously necessary foley catheters or large-bore IVs). Any given provider might be able to convince the hospital to permit another provider to step in and care for the patient, but at the end of the day, *someone* has to take care of the patient.
In the labor-masturbation situation we're talking about, a hospital would want to be very, very careful about restraining or involuntarily sedating the patient. The latter could affect the baby, and the former could open up a legal can of worms. Pregnant women, unlike many abusive ER patients, don't tend to be mentally ill, drunk or high, or criminals, and frequently have the resources to make the hospital's life unpleasant. Unless the patient were being really aggressive about it, I think a doctor might well get told to suck it up and deal with the situation.
From personal experience, I got involuntarily sedated while in the hospital a year ago for asthma. I was having breathing difficulties in the middle of the night when my scheduled nebulizer treatment wasn't given, and a nurse took it on herself to decide that I was only hysterical. As soon as the drug wore off enough for me to work the phone, I started making a stink, as did my doctor, when he heard. Within hours I had the nurse manager and hospital staff trying to resolve the situation, clearly afraid of legal trouble.
Of course, I wasn't doing anything to impose on anyone else, but I also wasn't in labor, a state when it's generally understood women don't necessarily behave according to the usual rules. Labor is a fairly unique situation, in that it's hard to think of another endeavor of equal pain and duration, and people behave in unpredictable ways under that level of physical stress. Root canals and mammograms aren't comparable, because they don't last for 24 hours or more and are performed with anesthesia. If a provider's safety is not being put at risk, and the patient isn't being deliberately malicious, I do think she should ignore behavior that would be clearly inappropriate in other contexts, like cursing or witnessing masturbation or nipple stimulation.
That doesn't explain why a woman couldn't just ask for some privacy or wait until the provider leaves the room, and I would certainly be squicked out if I had to watch it, but the provider doesn't have a lot of options. She can't legally refuse treatment to the patient, and there's not much else to do other than tie the patient down or drug her. Is that what you're suggesting be done, for our hypothetical recalcitrant masturbator?
From Caryn:
The hospital has a legal obligation to provide treatment to a pregnant woman in active labor until the baby is born and the placenta delivered, unless there is adequate time to transfer her safely to another facility.
But not if she declines the care on offer, and she can't dictate care, no?
What I'm getting at is the idea that if she declines the offer of care so long as she isn't masturbating at a hcp who doesn't consent, the hospital is not required to treat her. Because everyone has basic rights not just the patient, and some behaviors are not protected speech.
(Of course some people are going to take exception at what both you and I just wrote, because there isn't necessarily medically indiated treatment as you suggest since pregnancy and delivery aren't necessarily medical conditions, and because she's not a patient as I suggest but a client. But hey.)
But I know very, very little about EMTALA. Perhaps it does require this, but then surely they are screened for it -- and we have several hcps posting here who have objected.
From Antigonos:
I wouldn't have a problem with a woman rubbing herself in front of me, although I'd think she's a bit odd -- just be poker-faced, probably. I'd be REALLY upset, however, if her husband was rubbing HIS crotch while watching her, however
In point of fact, as I've said, I've never had a woman do this in front of me. I don't think touching the crowning head is in the same category as masturbation. Nudity also doesn't bother me; many women find clothing, even hospital gowns, uncomfortable in active labor.
From Esther:
I imagine the overwhelming majority of women (if any) do not find masturbation to be of any help in pain relief during labor, otherwise it would probably be more common. I can honestly say that it was just about the last thing on my mind during transition.
But this all points to a recurring theme in NBA/NP thinking: the idea that because common courtesy can't be legislated, I (the "natural one") have the legal right to do whatever I want when I want...even if it makes someone else uncomfortable, or perhaps because it does. And if they object, I get to accuse them of 1) violating my rights, and 2) being "repressed".
From Yehudit:
Emma B, that is absolutely horrific. What happened to you, and what happens to others who are regarded as "out of line" or "difficult".
Yes, everyone in healthcare has experience of difficult customers (which is maybe why I just don't get worked up about the masturbation thing, it just seems so - relatively - inoffensive). If it gets more than you can handle, call security (they are trained to handle difficult people, and it doesn't take you away from your job). But perform unnecessary procedures as 'revenge'? Give drugs without consent? That is so incredible. What sort of everyday ethics, not to mention ethics education, do these people have?
And yes, Emma B - you get it. Totally. Labour is not root canal or a mammogram. If something is making a provider feel uncomfortable (and there are plenty of things that can) then if a colleague is able to take over care, they likely will.
From Caryn:
And if they object, I get to accuse them of 1) violating my rights
What I find interesting here is that the complaint is that the act of *defending the provider's rights* gets framed as *policing the woman's behavior*. HCPs have no right to police the behavior of others what with not being police at all, and anyone who does, a la Emma's example, is clearly violating laws, as Yehudit points out.
But obviously HCPs can protect their *own* rights, and aren't put in a position where they actually *lose* rights because of their responsibilities to others.
From Yehudit:
we have several hcps posting here who have objected.
++++++++++++
We have?
chris is concerned that the lack of realism surrounding "Orgasmic Childbirth TM" might set women up for psychological problems.
Antigonos would be poker-faced and get on with providing professional care, but would draw the line at the partner masturbating.
Are the people who are most "squicked out" actually hcps providing labour care?
From Caryn:
Labour is not root canal or a mammogram.
I keep thinking of a Venn diagram with an oval labeled "not a root canal or a mammogram" and then an interior circle labeled "a root canal or a mammogram" when you say things like that.
The fact that labor is a uniquely stressful situation that causes some people to behave erratically doesn't excuse abusive behavior on their part. It may *explain* it, but it doesn't *excuse* it.
Women in labor also cannot hit their HCPs, or steal their stuff, without violating their rights. They don't get to violate other people's rights just because they're stressed, even if they're uniquely stressed.
I don't see what it is that's so controversial about this claim.
From Caryn:
I believe Kat objected, and I'm thinking there was one other as well, though perhaps that was Pharmacist.
From Caryn:
Oh, and you. I don't think acceptance of masturbation specifically is a requirement of the job.
So even though you personally would provide care, you also think that the provider's consent is relevant here, right? You objected to the idea that it was an implicit requirement of the job that maternity care providers tolerate masturbation if they weren't willing to do so.
From Yehudit:
Kat said: "If I was a midwife/OB and my patient wanted to go to the restroom to touch herself I would have no reason to stop her." Which implies that she does not actually provide any labour care, though I might have misread that.
And while Pharmacist has had four good hospital births herself, and knows of other people who have had good hospital births, she doesn't actually say anything about the practicalities of providing labour care to all different kinds of people. Perhaps because she's a pharmacist who doesn't provide labour care to all different kinds of people?
As for the venn diagram...if you assert that something should not be allowed in labour because it should not be allowed during an mammogram/root canal, then you are making a claim that there is something especially similar in these situations that is pertinent to the discussion. I'm not 'getting' the similarity (beyond "all involve hcps").
I've stated ad nauseum that the difference has to do with the degree of privacy one might expect in the labour room, labour as an intimate occasion, that labour care doesn't trump the woman's autonomy etc...In these respects (and in the way that Emma B states) labour is different from root canal and mammograms.
From Caryn:
the difference has to do with the degree of privacy one might expect in the labour room
Well, and the nudity thing illustrates this. Women in labor are in a room away from others except those who are implicitly consenting to seeing them naked, and nakedness is common in labor rooms. We deal with the fact that nudity is something you generally engage in in a private space by providing a space in which only the HCPs who are dealing with the maternity care of the woman in question and the intimate partners the woman allows in are admitted.
But the maternity care providers are not intimate partners of the woman; they're providers who've consented to seeing her naked while they provide her care, and they expect, as a part of the normal course of their jobs, to interact with naked people.
By contrast, they're not assumed to have consented to seeing her masturbate, and once they enter the room, she is no longer in private with only her intimate partners. Because there are other people who are not her intimate partners in the room.
I think we generally agree on this point, btw. I'm just not seeing what it is that you're objecting to in my wording, and I'm asking for clarification.
From Liz1:
I think I take exception to the idea that those of us who are not convinced that overtly sexual behaviour in public in just one of those things are "squicked out" by it. I assume that translates to unreasonably squeemish. I have no problem with the idea that people in extreme discomfort or distress can behave in erratic ways, and that under those circumstances a tactful blind eye is probably the best way of dealing with it. I would be puzzled at the idea that touching oneself, reaching down to a baby's head, had anything at all to do with masturbation. No, what would bother me would be the behaviour of those "liberated" women who have bought into an IDEA that birth is sexual, orgasmic, and believe that their sense of entitlement is all that matters. Especially if it was a double-act. Personally, I find the idea of birth as performance art requiring an audience both disturbed and disturbing.
People with extreme "learning difficulties, autism have a problem understanding why such a pleasant pastime as masturbation in public is unacceptable. Should they let it all hang out as well?
From Yehudit:
Oh, and you. I don't think acceptance of masturbation specifically is a requirement of the job.
So even though you personally would provide care, you also think that the provider's consent is relevant here, right? You objected to the idea that it was an implicit requirement of the job that maternity care providers tolerate masturbation if they weren't willing to do so.
++++++++++++
But I also said
acceptance that of woman's autonomy or freedom of choice about what she does with her own body, is a requirement of the job.
And that the system we have here positively selects for candidates who also have that sort of understanding.
Conflicts between providers and women should be resolved by common sense and negotiation, not by the kind of adversarial set-up you seem intent on introducing. By the same token that I don't wish to be in the position of "allowing" or "not allowing" a woman to touch her own genitals for whatever purpose (they are HER genitals), she can't "allow" or "not allow" me to leave the room (me exercising my autonomy over my own body). However the professional also has a duty of care, and it is for the professional to resolve that dilemma between her own comfort and the duty of care, if indeed it is a dilemma for him or her.
And the reason I take that line is not because I'm wedded to defending masturbation in the labour room, but because "my being uncomfortable with you doing X, trumps your desire to do X" is just a bad way to resolve differences between midwives and women.
If this seems difficult, consider the situation of a woman having a late termination of pregnancy, and therefore on the labour ward. Conscientious objection in the UK only covers the administration of the induction agents (and not even that if feticide has been performed) and not the other care required for a woman having a termination. Obviously, the midwife coordinating will not ask a midwife who conscientiously objects if she can help it. But if the only midwife available is someone who COs, then she still has a duty of care and it is her professional duty to provide the care that follows on from having a termination in that situation.
Now, that is a real conflict between woman and provider. Compared to which, someone masturbating in the same room as you is trivial.
From Caryn:
Conflicts between providers and women should be resolved by common sense and negotiation, not by the kind of adversarial set-up you seem intent on introducing.
Why is it adversarial for maternity care providers to be able to protect their own rights, and for women to be able to protect *their* own rights?
But if the only midwife available is someone who COs, then she still has a duty of care and it is her professional duty to provide the care that follows on from having a termination in that situation.
But this is because she's implicitly consented to provide that care, as a part of the requirements of the job.
From Yehudit:
Squicked out was Emma B's term, and I'm sorry if by using it I trivialized your objection Liz1.
I do think that it is interesting that the most forceful objections are from people who have seem to have developed some elaborate fantasies based on a "what if" of someone masturbating *at* a healthcare provider.
Whereas most providers probably have quite a bit of direct experience of providing care in situations where they are not entirely comfortable, so they are thinking about how they handled those occasions, rather than inventing a worst case scenarios.
From Yehudit:
Why is it adversarial for maternity care providers to be able to protect their own rights, and for women to be able to protect *their* own rights?
+++++++++++
Because when you couldn't come up with a practical way of distinguishing touching genitals with different intents, you suggested that this was a question better addressed by lawyers. Seems pretty adversarial to me.
From Caryn:
Because when you couldn't come up with a practical way of distinguishing touching genitals with different intents, you suggested that this was a question better addressed by lawyers. Seems pretty adversarial to me.
Lawyers are ordinarily the people who handle conflicts between the rights of individuals. I am not a lawyer. I just know a bit about social and political philosophy, the kind that has to do with rights.
So: my claim has been In private, during labor, if it works for you, I doubt anyone really cares. But it is unethical not to get the consent of the providers here, and unethical to demand that they provide you with this particular sort of care.
And apparently everyone, including you, agrees with me that this is true.
From Caryn:
I do think that it is interesting that the most forceful objections are from people who have seem to have developed some elaborate fantasies based on a "what if" of someone masturbating *at* a healthcare provider.
So is your actual objection that maternity care providers *shouldn't* feel like they're being masturbated at, or that they *don't* feel like they're being masturbated at?
Remember, this whole discussion got touched off by an assertion on sarahz's part that it wasn't evidence-based care to deny women the right to masturbate during their labors. I replied that a) there wasn't evidence supporting the idea that it helped, so allowing it wasn't evidence-based either, and b) that if you were going to do it, the consent of the provider was relevant here.
And it is common, in philosophical arguments such as this one, to construct "what if" scenarios to elucidate the problem more clearly. Think of Plato's Allegory, or what Mary didn't know. The use of metaphor and allegory and thought experiments hardly disallows the arguments.
From Yehudit:
If a woman touches her own genitals during labour while I am in the room, and she doesn't ask my permission before doing so, I don't think she has done something unethical. She may have given me a conflict that I need to resolve, but that doesn't mean her act is unethical.
In fact, asking for my permission makes the act more "in my face" (so to speak), deprives me of the opportunity to simply ignore it and makes me more involved in it, in some way. (Not that asking permission would be unethical either, just in terms of how I felt about it).
Ideally, I would listen-in every 15 minutes, do the maternal obs as indicated, but otherwise in the fifteen minutes gap, and provided I'm not needed for anything just allow the woman to forget that I'm there (blend in to the wall and simply observe frequency of contractions and that the woman is okay and well-supported from the other side of the room).
That is the context in which I'm imagining that someone might touch her own genitals, not a situation in which she is "masturbating at" me.
From Caryn:
Bringing in a vibrator would make it rather more "in your face", would it not?
From Yehudit:
a) there wasn't evidence supporting the idea that it helped, so allowing it wasn't evidence-based either
+++++++++++
This argument would apply to treatments
I quite agree that we shouldn't be recommending masturbation as a treatment.
I'm not talking about treatments, I'm talking about the woman's autonomy and ability to behave spontaneously in labour.
You can have as many thought experiments as you want, but if they don't apply to the situation at hand, they don't have any traction in the real world.
From Caryn:
Your right to swing your fist ends at the other person's face.
The autonomy of the woman ends where she is forcing other people who do not consent to observe her public sexual behavior.
Rights conflict. That's just what they do.
From Yehudit:
Bringing in a vibrator would make it rather more "in your face", would it not?
+++++++++
I believe that was sarahz's joke on the grounds that many hcps feel more comfortable with technology.
From Yehudit:
Your right to swing your fist ends at the other person's face.
++++++++++
Actually, way before it- since threatening behaviour doesn't have to include physical violence.
But I do believe we've been over this particular ground.
Yes, rights conflict. Where possible I would err on the side of the rights of the woman. I believe we've been over that particular ground before too.
From Caryn:
Yes, rights conflict. Where possible I would err on the side of the rights of the woman. I believe we've been over that particular ground before too.
And that's *you*, not *everyone*. We've been over that before too.
So I think we're in agreement here.
From Susanne:
"By the same token that I don't wish to be in the position of "allowing" or "not allowing" a woman to touch her own genitals for whatever purpose (they are HER genitals), she can't "allow" or "not allow" me to leave the room (me exercising my autonomy over my own body)."
You still haven't articulated why this scenario differs from the dentist's chair, though. My dentist doesn't have to "allow" me or "not allow me" to touch my own genitals in front of her; I just don't, because I have a sense of boundaries. I don't see why it's any different in a labor nurse. Yes, granted, in the labor setting the genitals are involved, but they're involved in a medical / clinical sense, not a sexual one. I've given consent for my HCP's to see / touch my genitals in the course of evaluating a medical situation. It is still part of the implicit social contract that we are still not intimate partners or witness to intimate sexual acts, despite them having seen my private areas.
Being in labor seems to be the Excuse to Trump All Excuses, for some, apparently.
From Yehudit:
And that's *you*, not *everyone*. We've been over that before too.
++++++++++++
But that is based on a concept of providing woman-centred (rather than practitioner-centred) , individualized care.
I said "If 'individualized care' is to mean something than maybe it means having to accommodate women's eccentricities and not policing social norms."
(incidentally, I'm surprised that "policing" to mean regulate or control is not in your lexicon)
So, that's not just *me*, that's how things look to me from within a system that positively screens for those sorts of attitudes. (I think "non-judgmental" is the buzzword).
From Yehudit:
Because there is no scenario in which you are in the dental treatment room for long periods, getting on with the biological business of having a tooth emerge from your gum, with the dentist not actively providing any treatment.
If a woman chooses the very moment that I'm about to listen in or take her pulse to start masturbating, that would be closer to what you are describing in your dentist scenario.
From Caryn:
But that is based on a concept of providing woman-centred (rather than practitioner-centred) , individualized care.
So what if she wants to punch you? What if she wants to steal your stuff? She's in labor, and so she's under a lot of pain and stress and she's going to behave unpredictably and use coping techniques that aren't necessarily socially acceptable, right? Is it the job of the maternity care provider to accomodate the woman's values in those respects, rather than policing social norms?
incidentally, I'm surprised that "policing" to mean regulate or control is not in your lexicon)
You would neither be regulating nor controlling the woman's autonomy or control over her own body to *refuse care to her*. If she doesn't want to take the care on offer, that's entirely her choice. You could leave the room, and she could keep at it.
You would consent. That doesn't mean that all maternity care providers would. That doesn't mean that any maternity care providers wouldn't. It just means that *you* would consent, and it doesn't mean that the consent of the maternity care provider is irrelevant.
From Yehudit:
We have already talked about the limits, haven't we?
"Obviously, there are the limits of what she does with her body that might impact on you - but we have to tread carefully here, otherwise we are on a slippery slope of saying "my being uncomfortable with you doing X, trumps your desire to do X" - even if X happens to be wearing your own clothes, or standing up, or eating and drinking, or having your husband present.
However, being kicked in the head is certainly not a requirement of the job."
And by extension if she wants to punch me.
As you reminded me, this all got kicked off with sarahz's comments.
"Just try to touch your clitoris in a hospital while giving birth and see what happens. Some women say it helps with labor pains. But yk, I am betting it will get your hands tied down."
Since we're into thought experiments (even ones without much traction) that would come into the category of "regulate and control", would it not? I'm not interested in doing it.
Temporarily leaving the room does not have to mean withdrawing care.
From Caryn:
You seem to be suggesting, in other words, that the woman's compliance would be coerced. But we routinely coerce people in this sense -- we don't let them assault us, we don't let them steal our stuff, we don't let them yell fire in a crowded theatre even if they really, really want to.
From Caryn:
I'm not interested in doing it.
Right. You consent, and from within the system you're in, that seems reasonable to you.
From within the system *I'm* in, whether or not the provider consents is relevant.
From Caryn:
but we have to tread carefully here, otherwise we are on a slippery slope of saying "my being uncomfortable with you doing X, trumps your desire to do X" - even if X happens to be wearing your own clothes, or standing up, or eating and drinking, or having your husband present.
How do any of those actions violate the rights of the maternity care provider, precisely?
From Yehudit:
Actually, no one in the system I'm in would be in a position to tie down the hands of a woman to prevent her touching her clitoris without all kinds of negative consequences for themselves.
I'm not interested in doing so (the regulation and control bit) but someone who was interested in that sort of policing wouldn't be able to act on their interest.
From Caryn:
Actually, no one in the system I'm in would be in a position to tie down the hands of a woman to prevent her touching her clitoris without all kinds of negative consequences for themselves.
I didn't suggest you tie her hands down, did I? I suggested that if a maternity care provider didn't consent to being present during public sexual behavior, she could make explicit to the woman that she would provide care to the patient *if* the patient refrained from assaulting her in that particular fashion, and if the woman declined care, the maternity care provider could leave the room.
From Susanne:
"Because there is no scenario in which you are in the dental treatment room for long periods, getting on with the biological business of having a tooth emerge from your gum, with the dentist not actively providing any treatment."
Complete non-sequiturs. What does the period of time have to do with anything? What, the social constraints against masturbating in front of others go away if you're with them for longer periods or if they go in and out of the room during that time? (When I get my eyes dilated, my eye doctor is out of the room for 20-30 minutes while the dilation occurs. Wouldn't it be more than a little odd if I decided to masturbate to pass the time? And wouldn't he be quite entitled to feel put-out if he came back in and there I was, and my response to his discomfort was "avert your eyes"?)
From Yehudit:
if* the patient refrained from assaulting her in that particular fashion
++++++++++
Doesn't assault require hostile intent?
From Caryn:
Doesn't assault require hostile intent?
IIRC, the difference between simple and aggravated assault is intent.
But you're not a lawyer, either.
From Susanne:
Cool beans, then! Then all the ninnies who complain that they were Birth Raped (TM) because of a vaginal exam or somesuch that they really didn't want, don't really have a case, because there wasn't malicious intent! Oh wait -- those women claim it's the *recipient* who gets to define how something feels to them, not the perpetrator. Which way do you want to have it? Because surely you don't believe in double standards.
From Yehudit:
Well, actually I was using the OED definition not a legal one (and which rather brilliantly includes the obsolete "to tempt"...)
I don't think we have that simple/aggravated distinction in the UK. As far as I understand it (and this is primarily studied from the point of view of practitioners can do, so apologies) in my own jurisdiction
"An assault is committed when a person intentionally or recklessly causes another to apprehend the immediate infliction of unlawful force."
Unlawful force requires physical contact (though not injury).
I'm sure there are possible legal sanctions, but I think they would come under the sexual offenses act.
From Susanne:
I'm not a lawyer, but something needn't rise to the level of assault (from a legal standpoint) for it to be inappropriate.
From Yehudit:
Okay, well having looked at the sex offenses act of 2003 (our latest legislation) I don't think it is even technically illegal!
Exposure
(1)A person commits an offence if—
(a)he intentionally exposes his genitals, and
(b)he intends that someone will see them and be caused alarm or distress.
No mention of masturbation per se, and since genitals are routinely exposed and since intention counts...
We do have a law against "Causing a child to watch a sexual act" but (perhaps strangely) not a law against "Causing an adult to watch a sexual act".
We do have a law against "Causing a person to engage in sexual activity without consent" but that doesn't include the simple act of being present or watching. And also a law against sexual activity in a public lavatory (which is particularly ironic, since going to the bathroom for the purpose is one of the solutions proposed above).
From Yehudit:
Of course, but then you wouldn't be saying to a woman:
"I won't provide care unless you stop *assaulting* me" (as proposed by Caryn).
Feelings and disagreements about what is appropriate or inappropriate are not best dealt with in this way.
From Yehudit:
the last was in response to Susanne.
From Sesshoumaru's Girl:
Caryn:
"I suggested that if a maternity care provider didn't consent to being present during public sexual behavior, she could make explicit to the woman that she would provide care to the patient *if* the patient refrained from assaulting her in that particular fashion, and if the woman declined care, the maternity care provider could leave the room."
A room on the L&D floor is hardly a football feild, its not "public" in that sense.
Maybe its just me, but considering how much time alone a woman has in her room (in general) I do not see this happening very often, if at all.
I spent alot of my labor alone with just Dh, perhaps it was because of our situation but the nurses didn't spend much time in my room at all.
IF in the unlikey event that a cp entered a room and the patient was "going to town" . . . I think most would just turn around and walk out and only make an issue of it if the patient in question kept doing it on purpose (and not asking for alone time)
From Liz1:
Am I the only one that thinks we are being somewhat prissy about describing behaviour that might be objectionable? As far as I am concerned, their is a clear difference between simply touching one's genitals, for whatever reason, and actively and possibly noisily, masturbating in pursuit of orgasm. I would have thought it was relatively simple to ignore the first but that the second comes under the heading of unacceptable behaviour bordering on exhibitionism. Under those circumstances, in my opinion, a care provider is at least being subjected to an assault on her sensibilities or is agreeing to adopt the position of voyeur, willingly or unwillingly.
I think most women, while well aware of the sensuality/sexuality involved, are pretty keen to blank that out of their minds. Without the ability to do that, the idea of strange men/women inserting their fingers into your vagina would be disturbing. I belong to a much more inhibited (but not necessarily repressed) generation, and I find the idea of nipple stimulation, for instance, a bit gross. During my adventures, I had more than one stress test. Would I have been happy to have my nipples stimulated by a stranger? No thanks. Would I have been happy to have my husband invited to participate? Again, no thanks. In extremis, of course, all inhibition can go out of the door. But I still think you have to be a bit strange to brag about it. And if I had a care provider that took it in their stride, I'd think they were a bit peculiar, too.
From Caryn:
Okay, well having looked at the sex offenses act of 2003 (our latest legislation) I don't think it is even technically illegal!
In the US I *think* -- and any lawyers out there can pile in -- it's either a form of sexual assault, or it's public indecency.
From Caryn:
Maybe its just me, but considering how much time alone a woman has in her room (in general) I do not see this happening very often, if at all.
From Caryn:
Oops.
Anyway, it's a *thought experiment*, for goodness sake. Construct an example, push it to the extreme, see where it breaks.
What *are* the obligations of a maternity care provider here, and why?
From Kat:
I think everyone can agree that the idea of stimulation is a bit odd but that a woman in a labor ward is completely entitled in her privacy to go ahead and have fun if she wants.
Where the argument comes to play is the HCP and their feelings. However, I would think that during an exam a woman would stop her self stimulation or would stop when the HCP entered the room. If I was a HCP and I walked into it, well, that isn't someone trying to masturbate in front of me. I would walk out and knock a minute or so later.
The issue is whether it is acceptable to masturbate in front of your HCP and no it is not. I also don't think it is prissy, I think it is decency.
From Caryn:
Feelings and disagreements about what is appropriate or inappropriate are not best dealt with in this way.
From Sesshoumaru's Girl:
Kat:
"I think everyone can agree that the idea of stimulation is a bit odd but that a woman in a labor ward is completely entitled in her privacy to go ahead and have fun if she wants."
I wouldn't call it "odd" I wouldn't call it anything, it is what it is.
Otherwise, I agree . . .
From Holly:
From Caryn:
Okay, well having looked at the sex offenses act of 2003 (our latest legislation) I don't think it is even technically illegal!
In the US I *think* -- and any lawyers out there can pile in -- it's either a form of sexual assault, or it's public indecency.
What about old people having sex in a nursing home? When I did clinicals at the nursing home, we were told that sometimes this happens and that if we walk in on anything, we should just turn around and walk out. OR...maybe we should file sexual assault charges...
From Caryn:
*sigh*
Anyway, that one was supposed to be followed up by the observation that there's a difference between *feelings*, and *rights*. Feelings can be in conflict without rights being in conflict.
If rights *are* in conflict -- as is the case for masturbating in front of your care providers in the US, and is *not* the case for allowing the husband into the room -- then unless there's some implicit consent on the part of the caregiver to the loss of rights, or the caregiver is willing to consent or the woman is willing to consent, then the next best choice is to hand over to someone else who *does* consent, if that's possible.
I don't see that it's obvious that it *has* to be the caregiver who relinquishes rights here.
From Caryn:
if we walk in on anything, we should just turn around and walk out. OR...maybe we should file sexual assault charges...
If you walk into a private room without permission, then it's your fault, no?
From Jolene:
"I think everyone can agree that the idea of stimulation is a bit odd but that a woman in a labor ward is completely entitled in her privacy to go ahead and have fun if she wants."
It looks to me like this is exactly what has not been agreed upon.
Is the labor room a public or private space? If it is a private space, then the HCP is entering a private space and should be prepaired to see private sorts of things going on. If the Labor room is a public space, then how is the decorum different in say, the dentist's office?
We have identified that there are other public exposure laws which are being broken, by necessity, such as exposure of the genitalia, and nudity. IF the labor room is public, we have made consessions for these things to happen.
Caryn is asking where to draw the line then? If the space is public, then the HCP has agreed to witness nudity in this public place. Must they also agree to witness masturbation?
I personally have strong feelings about the labor room being considered a public place at all. I'm rather surprised that most commenters here are comfortable with that definition.
Should the Labor room be considered a private room, the whole masturbation point would be moot.
From Holly:
From Caryn:
if we walk in on anything, we should just turn around and walk out. OR...maybe we should file sexual assault charges...
If you walk into a private room without permission, then it's your fault, no?
How is that different from a hospital room?
From Holly:
The labor room is a private space. If it's considered public domain, I'm having another homebirth I can tell you that much.
From Liz1:
What about old people having sex in a nursing home?
Completely different - assuming it is in some private, or semi-private space.
I must say, I find the idea that a labour ward, or any hospital space is a good location for "fun" a bit strange.
How about if you are recovering from, say, an appendectomy, or surgery on your big toe? Do you still have a right to "fun", regardless of the feelings of reluctant spectators?
From Caryn:
How is that different from a hospital room?
Did you read the nudity example above?
From Kat:
"It looks to me like this is exactly what has not been agreed upon."
I can't think of one person who disagrees that if the woman is with her partner or by herself, she can stimulate herself. The problem is whether she can/should do it in front of the HCP and if so, is she violating rights.
If the HCP is not present, everyone here agrees she can do what she wants with her body. Unless I am missing something...
From Liz1:
Well, I suppose "I might feel like a quick fuck" is no more a bizarre reason for chooisng a home birth than any other.
From Holly:
It's not about a "quick fuck", it's the principle of the matter. Am I giving birth in public, or do I have a right to privacy? I dont' expose my genitals in public. If the labor room is considered public, then I'm not giving birth there. If it's considered private, then I'll rub my clit all I want.
From MommMonster:
OT help needed please!!
I'm really sorry, but I've been googling like crazy and can't seem to get the right combination for the info I need. I knew someone here would have it.
Could someone please help with a link to info on the rates of scheduled vs. emergency csections? Someone on another board is mixing data where it's to her advantage, then separating it later to prove her point. I want to show her the flaw in her logic, but hate doing it without the data.
Thanks so much!
From Jolene:
I am glad Holly brought that up.
I, like probably a good 99.9 percent of people, have ZERO desire to stimulate myself while in labor. Indeed, like Liz, I'm a bit disturbed by the idea.
But I *DO* have a philosophical problem with the Labor room being considered a public space.
I can see how this viewpoint makes people of a certain disposition (me?) throw it all to the wind and go for a homebirth.
From Kat:
"Is the labor room a public or private space? If it is a private space, then the HCP is entering a private space and should be prepaired to see private sorts of things going on. If the Labor room is a public space, then how is the decorum different in say, the dentist's office?"
It is somewhat private.
When staying for two hospital births I was a bit disturbed by the constant traffic into my room, very annoying while pumping or using the bathroom while they knock to see me. I slept there, ate there, used the restroom, showered and expected a small amount of privacy.
I found that it would have been inappropriate for me to sexually please my husband in that room or to masturbate in the presence of others.
If during labor I chose to, I should choose to stop once the HCP comes into the room.
If it is a private room, just like a home, I do not masturbate in front of other people. If I visit a friend for coffee and her migraine is acting up, I would hope that she would not start touching herself for relief in front of me.
Even if it is a private room, that doesn't mean we should lose all of our sensibilities. That is what is being discussed. Private or public, you cannot masturbate in front of people without their consent.
From Jolene:
"If it is a private room, just like a home, I do not masturbate in front of other people. If I visit a friend for coffee and her migraine is acting up, I would hope that she would not start touching herself for relief in front of me.
Even if it is a private room, that doesn't mean we should lose all of our sensibilities. That is what is being discussed. Private or public, you cannot masturbate in front of people without their consent."
But you cannot dictate to someone what they can and cannot do in private. That's why we are debating this point. If in the case of your friend's migrane, she (or you) can leave to find a more suitable place. In a Labor room, where does one GO to find a more private space? The HCP can leave if they are uncomfortable, the patient cannot.
IF the labor room is private, then it's a matter of deciding where the onus is. Is it on the patient to be polite? Or is it on the caregiver to take it all in stride?
But I think we are far from agreeing that the labor room is, by legal definition, private.
From Kat:
"But I think we are far from agreeing that the labor room is, by legal definition, private."
It is legally private. That doesn't mean that someone should be allowed to masturbate without consent.
The laboring woman can go into the restroom to stimulate herself if she wants complete privacy.
From Jolene:
"It is legally private."
Can you demonstrate that? the last thousand comments have been unable to do so.
From Kat:
Sure.
http://books.google.com/books?
id...esult#PPA166,M1
Basically, for media purposes, a hospital room is considered private. Since that is all I can find on hospital rooms, a lawyer could easily use that to extend to other situations. However, this doesn't mean that a woman can masturbate in front of people without her consent as that is always against the law.
From Holly:
"The laboring woman can go into the restroom to stimulate herself if she wants complete privacy."
What makes a private bathroom in a hospital any different from a private room? If the nurse could just walk into the room without knocking, couldn't she just want into the bathroom without knocking? It's a hospital. This is the patient's "private" room. Either the entire room/bathroom complex is private, or none of it is.
From Liz1:
Public/private: Is this a distinction without a difference? We are talking about the difference between public and private behaviour, and I don't see that is particularly affected by the space, but rather by the people who are occupying that space. Nothing more private than a bathroom, but that wouldn't mean that you would feel as uninhibited in the presence of a plumber as in the absence.
From Kat:
Nurses do not barge into bathrooms and most remember to knock when coming into the room.
Either you are paying for the nurses and HCP'ers to help you deliver a child or you aren't. If you expect 100% privacy at all times, you are wasting your money, their time, and are UC'ing in the comfort of a hospital room.
From Caryn:
I don't see that is particularly affected by the space, but rather by the people who are occupying that space.
Right. Your home is a private space, but when people who aren't your intimate partners are in your home, you don't engage in sexual activity in front of them without their consent.
From Liz1:
...UC'ing in the comfort of a hospital room...
Well, given that my objection to homebirth and UC is that vital help might be missing when you need it, I wouldn't actually have a problem with people UC ing in a hospital. Maybe they should just hire out rooms with good locks and panic buttons, then everyone could be happy!
From Kat:
I think you may have found the wave of the future. In the birth centers they will have standard hospital rooms, cutesy homey rooms with midwives, and then locked rooms with panic buttons for the UC'er.
From Holly:
No, I don't follow that argument. I have a right to do whatever I want to do with my own body in a private space regardless of who is there (so long as it's an adult). If I am at home, and someone comes into *my home*, and I masturbate, I have a right to do that (so long as that "person" is not a child). That's not illegal. I am not forcing that person to watch me masturbate. I am not locking the door behind them or tying them down. They can leave whenever they want to. Leave, goodbye. We are not talking about what is decent behavior, we are talking about rights. And when you're talking about rights and what is legal, the only people in the privacy of your own home/room/whatever you have to be concerned about engaging in sexual behavior in front of is children. So, no, the definition of private does not waver depending on who is in the room (so long as it's an adult). If I'm in my room, and you walk in, I am not obligated to any form of acceptable behavior regarding my own body parts by law. I can do whatever I damn well please with my own body. Why? Because you came into *my space*. I didn't come into your space. You came into my space and then expect ME to conform MY behavior to what YOU find acceptable. It doesn't work that way. You can be horrified by my lack of decency, but I have a right to do it and it's legal.
From Yehudit:
Actually, a lock on the door (like the ones we have on the bathrooms that can actually be easily opened from the outside if required) is not a crazy idea for a birth room. It would prevent the disregard for privacy which is pretty commonplace.
The whole knock and WAIT thing...doesn't seem to have really caught on. By the time you've had a hundred experiences of knocking and getting no answer because the expectation (of other professionals) is that you will just knock and come in, well - you are well on your way to being socialized not to bother with the waiting part.
This is something I care a lot more about than any thought experiment about inconsiderate masturbators.
From Kat:
I would be open to locks on the rooms, since yes, the traffic in and out of hospital rooms is excessive and some people don't bother knocking or waiting.
I can't imagine that it is legal to masturbate in front of a non-consenting adult in your home. I will have to look into that, because you can bet I would call the police if I was visiting a neighbor and he exposed himself and began pleasuring himself. I would leave, and then I would call the police. Ick!
From Holly:
But Kat, they are consenting. They consented to walking into the house. And then they consented to stay, or leave.
From Kat:
Ok, yes, it is illegal to masturbate in front of someone that doesn't consent.
"...Masturbation in a public place, and in cases where somebody else is unexpectedly confronted with it, is usually considered "lewd and lascivious" or "dissolute" behaviour, or at least indecent exposure, both of which are misdemeanors."
From Kat:
Nope Holly. By consenting to come into someone's home I do not consent to be subjected to them masturbating.
From Sesshoumaru's Girl:
Kat:
"Either you are paying for the nurses and HCP'ers to help you deliver a child or you aren't. If you expect 100% privacy at all times, you are wasting your money, their time, and are UC'ing in the comfort of a hospital room."
Who's wanting 100% privacy all throughout their labor, that's unrealistic in a hosiptal.
There is no "either or" here, Kat. Asking people to knock/asking for a few mintues alone is hardly wasteing someones time. Also, like I said ealier, most women have plenty of time by themselves during labor anyway (someone isn't in the room 24/7)
From Kat:
"There is no "either or" here, Kat. Asking people to knock/asking for a few mintues alone is hardly wasteing someones time. Also, like I said ealier, most women have plenty of time by themselves during labor anyway (someone isn't in the room 24/7)"
I agree. That is why I don't understand the issue with masturbating in front of your HCP. It doesn't need to be done.
From Holly:
"...Masturbation in a public place, and in cases where somebody else is unexpectedly confronted with it, is usually considered "lewd and lascivious" or "dissolute" behaviour, or at least indecent exposure, both of which are misdemeanors."
Okay:
1) This does not say "home". It says "unexpectedly confronted". If I'm in labor, you might expect me to masturbate to stimulate my contractions. This isnt crazy. Lots of people do it and it works. So no, it's not illegal.
2) The word that is used is "usually".
From Holly:
So, Kat, what about having loud sex where other people could hear (dorms, apartments)? What about having sex in your own home where other people could see (window open)?
From Kat:
Actually, a man was convicted for masturbating in his own home because the blinds were not shut and the public could see him.
Loud sex, eh, noise complaint since you cannot prove sex.
And since the HCP have not ever witnessed a laboring patient masturbating, it would not be expected. Do I think she should be charged? No. But technically, she would be breaking the law if she continued to masturbate where it was obvious to the HCP as they were assessing her.
Anytime someone unexpectedly masturbates, say at a dinner party onto the ham, yes, it is lewd.
From Jolene:
"Ok, yes, it is illegal to masturbate in front of someone that doesn't consent.
"...Masturbation in a public place, and in cases where somebody else is unexpectedly confronted with it, is usually considered "lewd and lascivious" or "dissolute" behaviour, or at least indecent exposure, both of which are misdemeanors."
And now we've come full circle, because this is exactly what Caryn has been saying in many different ways, and in many different posts.
And now for Yehudit's point? How can we differentiate between different kinds of touching? Are we going to legislate that the woman may not touch her genitals? (just in case she gets some kind of pleasure out of it) Or are we going to require that care givers give blanket consent to masturbation as well as nudity?
Which one?
From Holly:
Wow, this is crazy. And kind of funny. I've had um, friends, who have had sex in parking garages, on beaches, in cars parked at beaches, in dorm rooms where their roommates were sleeping...All criminals. Hahahaha. That's funny.
From Kat:
I think, just like porn, you know it when you see it.
Also, I don't think she needs to be arrested.
Obviously, if you can't stop masturbating for an exam from your HCP, you have a lot of problems and pity would be my first emotion.
From Kat:
Holly, you really didn't know having sex in public is illegal? Hey, I have been a criminal in that aspect way back when but at least I knew it. 
From CharlotteDad:
The fact that it is illegal is what gives it the allure and excitement. The risk of being caught is the attraction.
From Holly:
I would never have sex where other people were around and could see me. I have had sex knowing that other people could probably hear me. But if it's dark, and really late at night and I'm on a remote location on a beach, I don't see the big deal. I'm not hurting anybody.
From Sesshoumaru's Girl:
We got caught messing around in our (fenced) backyard a few years back.
The neighbor that caught us just laughed and said "I'll drink to that." and left.
Needless to say, we beelined to the house, LOL
From Kat:
I was going to say something about what the neighbor could have done in the privacy of his backyard but I decided it went too far.
From Holly:
Haha, SG. I once had a cop tell my boyfriend and I that he was going to call our parents. We were completely clothed. I thought "What are you going to tell them? We were sitting in a car? Yep, that's scandalous."
From sarahz:
So my health care provider consents to watching me pee on the floor (yes happened in my wild labor) (is this 'water sports?' 
), and possibly defecate in good proximity to their face (happens and is essential to getting the baby out at times), but NOT at any time to touching my hot button or even more discrete, attaching a small hands-free vibrating egg to my hot button???
You have to remember that vibrators are a MEDICAL DEVICE INVENTED AND ORIGINALLY USED by Physicans.
It is ridiculous to tell a woman who may defecate publically in front of a whole room of strangers (surely there is a fetish for this too) to 'hang on to her sensibilities' and maintain some decorum.
Interference from your 'front brain' where you hold your inhibitions can interfere with the progress of labor, IMO. If you are worried about offending someone, you may not be able to relax enough to yk, give birth, and for me that is the cheif problem with the pendulum swinging toward hospital room as public space. It operates in this weird limbo, but people are free to barge in and out. In the US we have the luxury of offering our laboring mothers physical privacy (as LDRP rooms have 4 walls and a door with a lock) but we just can bring ourselves to offer it entirely, huh?
Also, if someone mastrubates onto a shared food item, this is effectively bio terrorism, but unless you are one of the rare women with lucrative porn careers who can ejaculate across the room, you are posing no SAFETY hazard to your providers by touching yourself. A greater hazard would be posed by the aforementioned defecation, the breaking of your bag of waters or bleeding from an episiotomy.
And if we are in a hospital chiefly for proximity to the OR in an emergency, I don't see what the problem with 'low-intervention' rooms could be. As y'all have pointed out, there are already large periods of time where a laboring women is left alone at the discretion of the HCPs (who could really be only women with associates degrees in Nursing).
From Caryn:
How can we differentiate between different kinds of touching? Are we going to legislate that the woman may not touch her genitals? (just in case she gets some kind of pleasure out of it)
Why can't we just say that the care provider can consent, or not, to the woman's behavior? That's what they do with nudity. Not all hcps consent to exposure to the sort of nudity common in L&D, particularly not the ones providing community vaccinations etc.
We draw similar lines in the case of physical assault. Touching another person isn't always assault, but sometimes it is, and it depends on how the individual being touched perceives the touch.
In this case, it would depend on how the maternity care provider perceived the woman's behavior, no?
From Yehudit:
Why can't we just say that the care provider can consent, or not, to the woman's behavior?
+++++++++++++++
So a midwife could prohibit a woman from touching her own genitals/baby as her baby is being born (i.e. on crowning) because she perceived the woman's behaviour as inappropriate?
From Caryn:
Can a woman withdraw consent from a pelvic exam because she perceives the touch of the care provider to be inappropriate?
From Emma B:
What I'm getting at is the idea that if she declines the offer of care so long as she isn't masturbating at a hcp who doesn't consent, the hospital is not required to treat her. Because everyone has basic rights not just the patient, and some behaviors are not protected speech.
I'm not a lawyer or a doctor, but I've done a little reading about EMTALA, in the context of VBAC and CS refusal. I've also talked to my brother (an internal medicine resident) about it, when he's told stories about crazy ER patients.
EMTALA is unique in that it requires that the hospital provide care unless the patient explicitly refuses treatment. I don't think "failing to comply with requested behavior" qualifies as an explicit refusal; if it did, hospitals could just expel violent or disorderly patients from the ER, instead of sedating/restraining and then treating them. That they routinely do the latter argues that the hospitals understand EMTALA to mandate an absolute duty of care regardless of patient behavior. It's my sense that the refusal has to be explicit rather than implied. This very helpful EMTALA FAQ stats that a hospital must secure the refusal in writing, and that the patient must attest to being "informed of the risks and benefits of examination or treatment".
More broadly, there is a slippery-slope problem with declaring that a refusal to follow a specific order constitutes a global decline of care. By that logic, a provider could declare a woman's refusal of, say, pitocin augmentation to be a refusal of care, and kick her out of the hospital in active labor. Of course, pitocin refusal doesn't impinge on the provider's rights in the same way masturbation does. Still, it's dangerous to go conflating what we might call negative and positive refusals in an emergency situation.
I imagine Amy could probably provide some clarity on this point, as I'm sure she's had to deal with unruly patients during her career. Amy, what would you do with a laboring patient who committed some form of assault (verbal, physical, sexual)?
From Yehudit:
She can withdraw consent from a pelvic exam for any reason (and having nothing to do with the intentions of the care provider, or her perceptions of them).
From Jolene:
"We draw similar lines in the case of physical assault. Touching another person isn't always assault, but sometimes it is, and it depends on how the individual being touched perceives the touch.
In this case, it would depend on how the maternity care provider perceived the woman's behavior, no?"
Wait. Isn't this backward?
The assault depends on what the intent is, not how the touch is percieved. Right? Because if it's the way you said it, then the cry of "birth rape" would be acceptable, because it's is dependant on the perception of the touch, not the intent. And we all agree (here) that if the intent is to examine, it isn't assualt/rape?
From Yehudit:
But she can still withdraw consent, regardless of intent.
So, even if the person doing the exam has the best of intentions, it is still a problem (not sure if it could be battery under UK law? Not sure, but certainly open to prosecution...) to continue a pelvic exam after consent has been withdrawn. Is there disagreement on that point? (Not on the legal status, but that the person doing the pelvic exam should stop if consent is withdrawn, for whatever reason?)
From Ericacrochets:
"This does not say "home". It says "unexpectedly confronted". If I'm in labor, you might expect me to masturbate to stimulate my contractions. This isnt crazy. Lots of people do it and it works. So no, it's not illegal."
Correction. A very small percentage of women masturbate during labor, and there is no evidence that it does anything.
From Holly:
"Not all hcps consent to exposure to the sort of nudity common in L&D, particularly not the ones providing community vaccinations etc."
But that's the thing. L&D is different from giving vaccinations. In this instance, touching yourself serves a purpose beyond sexual gratification. So, it would make sense that someone giving a vaccination wouldn't approve of a woman being naked, but a nurse in L&D would approve of a woman being naked. Masturbating in labor isn't about orgasm. It's about what the orgasm achieves- stimulation of uterine contractions. If achieving orgasm can stimulate contractions and allow the woman to hold off on needing pitocin, then she should be allowed to do so. To give a woman pitocin when she obviously desires a low-intervention method to increase contractions that also involves touching herself, wouldn't this be suppression of the sexual when it can be useful? What does that say when we would rather give a woman a drug than let her touch her own genitals to accomplish the purpose of encouraging contractions? What does that say about us as a society, that we are afraid of women's bodies and are instead more comfortable with drugs?
You know what I think this has to do with, I think it has to do with patriarchy. Men don't like the fact that a woman can achieve an orgasm all on her own. I know. I've encountered this in my own relationship. It makes me obsolete in the sexual relationship if a woman can do it all by herself, and that makes men uncomfortable. All of a sudden the penis isn't as useful as it was previously. Poor thing its feelings have been hurt. So it carries on over even to this. We're afraid of women masturbating. We're afraid to let them do what is natural and what can even, in this situation, be useful. This is about patriarchy. It's not about "sexual assault" as the nurse can walk out of the room and remove herself from the situation at any time. It's just cloaked in that. This is about upholding a traditional, prudish standard that glorifies the male genitalia, even if only subconsciously.
From Yehudit:
there is a slippery-slope problem with declaring that a refusal to follow a specific order constitutes a global decline of care.
+++++++++++
ITA Emma B!
From Kat:
Sarahz, the difference between peeing and pooping in labor and masturbating is clear.
The first two (which I have done) were unexpected. I did not intend on peeing during a difficult contraction, I did not try to have a BM near my HCP'ers face.
In this context, if a woman accidently has the allusive Orgasmic Birth then fine. However, trying to stimulate yourself with little care to the feelings of others would be very similar to pooping on the floor for fun in front of your HCP. Disrespectful and lewd both come to mind.
I say do what you want but being a tad respectful of the feelings of others never goes out of style.
From Kat:
"To give a woman pitocin when she obviously desires a low-intervention method to increase contractions that also involves touching herself, wouldn't this be suppression of the sexual when it can be useful?"
Where is the evidence that this is useful?
From Holly:
Where's the evidence that it's not?
From Kat:
I don't know. Suppose we need to do a study, eh?
I also don't agree with it being related to patriarchy. Everyone knows at this point that women can have orgasms, and that women touch themselves. At least I think this is well known.
I think the problem is with masturbation in front of non consenting adults, which just isn't in vogue. Blame it on our puritanical ways but leave poor men out of it.
I am sure if they had their way touching yourself would be entirely legal at all times. At least that is the impression I get from my touch happy sons.
From Yehudit:
Holly is right on this one.
Since there is no evidence either way. And since the "treatment" is self-administered (we are going to regard it as treatment of the purpose of Holly's argument). If it doesn't pose a health & safety risk to anyone else and if it's not illegal, the woman can use it.
Similarly, we can't prevent someone using homeopathic pills, even though there is no evidence for their effectiveness (and less reason to think they would be effective than clitoral stimulation, which at least has some kind of consistency with what is none about the physiology).
From Holly:
But it's not in front of non-consenting adults! The nurse can leave whenever she would like. No one is locking the door behind her. No one is tying her down.
From Yehudit:
what is none about the physiology).
++++++++
what is KNOWN about the physiology.
I seem to be typing on autopilot today!
From Kat:
It is still illegal. Holly, you CANNOT masturbate in front of people.
*you* in the general sense.
From CharlotteDad:
"Where's the evidence that it's not?"
Making a statement based on its inverse not having been proven true is not compelling evidence of the validity of the statement.
There is no evidence that talking like Yoda helps ease the pain of contractions. Do you require evidence that it does not help before you believe it is useless?
Contractions I am having, hmmm?
From Emma B:
We draw similar lines in the case of physical assault. Touching another person isn't always assault, but sometimes it is, and it depends on how the individual being touched perceives the touch
Another slippery slope, which brings us back to the birth rape discussion from above.
I unintentionally came close to kicking an HCP today, during an unbelievably painful pelvic procedure. (It hurt so badly that I couldn't help thrashing around and screaming, one of those things where you actually wish you were tied down, so you wouldn't have to worry about trying to stay on the table.) I wouldn't have meant it as assault, but would it have been fair for her to decide it was, and have me arrested?
There is a certain level of pain at which it is really, really difficult to maintain control and give a flip about social norms, especially when the pain is of long duration. That level of pain isn't generally experienced during root canals or mammograms, or during most other medical procedures for that matter -- people usually get analgesia or anesthesia for things that painful. We have largely agreed in past discussions that the pain of childbirth can be that agonizing in some cases; can a woman in extremis be forgiven for violating behavioral standards?
I mean, I don't normally consider screaming "OH F***" to be acceptable behavior I'd be upset if someone were wandering around the mall yelling "F***" over and over, and would expect her to be arrested for public obscenity and disturbance of the peace. But that was me today, and it's been me under a few other extreme gynecological circumstances (mainly those involving a tenaculum). I wouldn't consider whipping a vibrator out of my purse and having a go, and personally I was too busy digging my fingernails into my palms, but I could see how another woman might grab at herself to make it stop hurting. If I did so, and the HCP perceived it as inappropriate, would that make it sexual assault?
From Holly:
CharlotteDad, If there is no proof that it's useless, and if it's not hurting anything, then she should be allowed to do it. Otherwise, there are underlying motivations to suppressing this behavior.
From Kat:
"Gross, wanton and public indecency that is outlawed by many state statutes. A sexual act that the actor knows will likely be observed by someone who will be affronted or alarmed by it."
Just another definition of lewd behavior.
And you know it when you see it.
i.e clutching the genitals from pain, normal. A man clutching himself after being kicked in the genitals wouldn't have people racing to call 911.
Also, I see no reason to have anyone arrested for momentary obscene behavior, but please, call a spade a spade.
From Holly:
"A sexual act that the actor knows will likely be observed by someone who will be affronted or alarmed by it."
Right. And I don't think a labor and delivery nurse should be alarmed or affronted when a woman touches her genitals during the labor and birth of her child.
From Holly:
If a L&D nurse is affronted by a woman touching her own genitalia during the course of a vaginal birth, she shouldn't be a L&D nurse. And my goodness if a midwife is affronted by a woman touching her own genitals during the vaginal birth of her child, she really needs a new job.
From Holly:
Further, why restrict it to the vagina? Can a woman touch her breasts? Do self breast exams count? There isn't really any good evidence showing definitively that SBE are effective. What if she touches her breasts and someone walks in?!?! What if they are affronted by it?
From Holly:
And what if while performing a self breast exam on herself, she gets aroused. Is it lewd behavior then?
From Kat:
I guess only people who like to watch people masturbate should be in L&D.
This discussion is absurd but I am enjoying the debate about whether one should masturbate in front of their doctors or not.
From Kat:
"And what if while performing a self breast exam on herself, she gets aroused. Is it lewd behavior then?"
Would it bother you in the least if you were a nurse coming to check my husband's blood pressure and he happened to decide it was a good time to check for testicular cancer. And then he became aroused and proceded to ejaculate while you checked his blood pressure? Or would that be lewd?
From Liz1:
I am very much in favour of calling a spade a spade. So the faux indignation about women touching their genitals, or their breasts, is getting on my nerves.
Anyone round here ever clutched at themselves when desperately needing a pee in the absence of a suitable location? Anyone ever found themselves absent mindedly scratching their arse when it itches? Or wishing they could, when in a public place? Anyone confused as to whether or not this is the same thing as masturbation? What do you teach your children about appropriate behaviour? How do you feel, how do you react, to their innocent exploring? Where do you keep your vibrator? On the kitchen table, just in case you feel the urge? And would you feel not the slightest inhibition should your mother in law drop in for tea?
Lot of high flown talk about "rights" here. I dunno, maybe this is another transatlantic or generational gap, but it seems pretty muddled to me.
From Holly:
That's not a comparable situation, Kat. Checking your blood pressure has nothing to do with a testicular exam. Stimulating the clitoris for the purpose of encouraging contractions has everything to do with labor and delivery (not in the sense that it works, but in the sense that it's absolutely relevant to the situation). And no, I dont' think I could ever be upset by a man *in a medical setting* performing a TSE.
From Holly:
The labor and delivery room is NOT A PUBLIC PLACE! You are naked, your vagina is hanging out, your breasts are hanging out, you have liquid dripping from your vaggy, someone is routinely sticking their fingers inside of you and eventually will have their face all up in your vaggy. None of that would be appropriate in public, but guess what? It is in the delivery room. It's not the same, it is different and if you can't see that a room in which a woman births a baby should have different "rules" than a public place, then I can't help you. It's a sad state indeed.
From Kat:
The testicular exam was in reference to self breast exam. No need to check for lumps while giving birth.
But to me, it is easy to see the differences between touching yourself and *touching* yourself.
I contend that masturbation in view of non consenting adults is at the least rude, and at the most, illegal.
But maybe I have different standards and am a big prude. Could be.
From Yehudit:
There is no evidence that talking like Yoda helps ease the pain of contractions. Do you require evidence that it does not help before you believe it is useless?
+++++++++++
Well, it would be very irritating (for care provider) but don't think you could prevent someone doing it...
From sarahz:
What if a man was having difficulty passing a kidney stone through his uretur and decided that inducing uretur contractions through ejaculation would speed up the process? Could he be accommodated then?
Because unless he is actively trying to PASS something through the exact same organs that sexual stimulation affects, you HAVE no valid analogy.
In every attempt at an analogy that has been made, we are comparing totally unrelated mastrubation on a whim to clitoral stimulation to facilitate, as the title of this post asserts, the passage of 'a football through the eye of a needle'.
Also it is worth noting that when men ejaculate, there is a chance that the HCP will come into contact with BODILY FLUIDS, not the case when a woman stimulates her clitoris, kwim?
From Ericacrochets:
"Well, it would be very irritating (for care provider) but don't think you could prevent someone doing it..."
Correction:
It doing for care provider very irritating would be but think you could prevent someone doing it from don't...
From Yehudit:
haha. very good.
From Ericacrochets:
If clitoral stimulation is so great at augmenting contractions, why is it that it has now been shown that sex cannot start labor. A pregnant woman can sit at home and masturabate all day, orgasm all she wants, and it's not strong enough to actually put her into labor.
Why is that in labor clitoral stimulation suddently becomes this amazing tool for augmenting contractions?
Of course, the answer is that it doesn't.
From Holly:
There is no evidence that clitoral stimulation does not encourage uterine contractions.
From Susanne:
"What does that say when we would rather give a woman a drug than let her touch her own genitals to accomplish the purpose of encouraging contractions? What does that say about us as a society, that we are afraid of women's bodies and are instead more comfortable with drugs?"
Holly, sometimes I have a hard time believing you're really studying to be a nurse. If you want to encourage contractions, you want to do so in a way that is a) consistently effective and b) "titrable" (for lack of a better term). Administering X amount of a medication is measurable. Just doing random shit because it pleases you falls into the does-no-harm category, but that's about it. It's not replicable. It doesn't say anything about "women's bodies" other than that health care providers prefer to use logic rather than emotions.
From Holly:
I have heard, countless times, of women being offered breast pumps by midwives IN THE HOSPITAL to augment labor contractions. It's the same physiology. Does it work? That hasn't been proven. But what's the harm in it?
From Yehudit:
why is it that it has now been shown that sex cannot start labor.
++++++++++++
It hasn't been shown that sex CANNOT start labour.
There is currently insufficient evidence to show whether or not sex can start labour.
An important distinction in understanding the results of any trial, or metanalysis.
(I think I posted the link before to a systematic review of the research to date, but here it is again http://mrw.interscience.wiley.co...093/frame.html)
The review concludes: "The role of sexual intercourse as a method of induction of labour is uncertain. This is an important issue to pregnant women and their partners. There is a need for well-designed randomised controlled trials to assess the impact of sexual intercourse on the onset of labour. Any future trials investigating sexual intercourse as a method of induction need to be of sufficient power to detect clinically relevant differences in standard outcomes."
The other issue with trials of "sex for induction" is that they usually don't measure the intervention directly (i.e. prescribe a particular kind of regime, and record compliance), but are actually trials of 'advice giving' vs. control. Given that there is a high level of awareness of "sex for labour induction" in the community, it would be good to know what proportion of the treatment (i.e. advice-receiving) group actually had sex for labour induction, and what proportion of the control were also doing so.
That's not to say it should be recommended (there's no evidence that it's effective), just that evidence to date doesn't show that it is ineffective either.
From Susanne:
"There is no evidence that clitoral stimulation does not encourage uterine contractions."
There is no evidence that wearing Mickey Mouse ears does not encourage uterine contractions, either.
Is that the standard of proof you guys use in your nursing school, Holly? "There's no evidence something doesn't do something, so what the hell?"
From Holly:
Susanne, Sometimes I have a hard time believing you were able to marry someone smart enough to finish medical school. Some women will always choose a low intervention method before medication. They should be allowed to do so.
From Susanne:
"Wow, this is crazy. And kind of funny. I've had um, friends, who have had sex in parking garages, on beaches, in cars parked at beaches, in dorm rooms where their roommates were sleeping...All criminals. Hahahaha. That's funny."
You didn't know that sex in public places is technically illegal? Ooo-kay then.
From Ericacrochets:
I must be a prude.
I can understand that a woman might have sexual feelings due to the pressure or blood flow or whatever and might (in private) want to have some release. I can understand that a woman in great pain might want to use masturbation to make herself feel better.
But what I can't understand is this scenario: Contractions are weak, labor is sluggish! But wait! Let me just stimulate my clitoris before we go to (evil) Pitocin!
I think sex should result from sexual feelings, that's all, and it's very unideal when it does not. (Couples who "try" for a long time to have children find it very demoralizing.) I think most women would find drugs preferable to trying to force themselves to have an orgasm for clinical purposes.
From Susanne:
W"hat makes a private bathroom in a hospital any different from a private room? If the nurse could just walk into the room without knocking, couldn't she just want into the bathroom without knocking? It's a hospital. This is the patient's "private" room. Either the entire room/bathroom complex is private, or none of it is."
I think you skipped the classes on social norms, Holly. General social norms are such that a hospital bathroom is more private than a hospital room. For the same reason that I visit my friends in the hospital but I don't walk with them into the bathroom (unless they were to request / require my help). Because urinating is considered private, defecating is considered private, and self-stim is considered private. In the case of labor, one may not be able to help / prevent urinating or defecating, but one can surely prevent self-stimulating, unless one has some kind of mental or emotional problem and is incapable of controlling actions.
From Holly:
I think sex should result from sexual feelings, that's all, and it's very unideal when it does not.
Really? That's interesting. There are all sorts of reasons to have sex, only one of which is orgasm, at least in my opinion.
From Susanne:
"You know what I think this has to do with, I think it has to do with patriarchy. Men don't like the fact that a woman can achieve an orgasm all on her own. I know. I've encountered this in my own relationship. It makes me obsolete in the sexual relationship if a woman can do it all by herself, and that makes men uncomfortable. All of a sudden the penis isn't as useful as it was previously. Poor thing its feelings have been hurt. So it carries on over even to this. We're afraid of women masturbating. We're afraid to let them do what is natural and what can even, in this situation, be useful."
Get a grip, Holly, maybe you dated guys who were cavemen, but that has nothing to do with anything. We're not "afraid" of women masturbating. We find it gross to do in front of others not-an-intimate-partner, and wonder why your sensibilities are such that you don't apparently get social norms. And your posts about masturbating in front of someone in your home, that they've "consented" by walking in the door, are quite frightening.
From Yehudit:
It's not replicable.
++++++++++
Mechanical methods can be replicable though. Membrane sweeping, (stripping in the US) for example. I'm sure that different providers do that in subtly different ways, and some have better success with it than others, and in some sense it is not as reliably replicable as pharmacological methods. Yet it is a technique sufficiently replicable to be the subject of research that shows it is effective at reducing the need for other methods of induction.
I'm sure it would be possible to design a trial to test the efficacy of clitoral stimulation for labour augmentation. I'm pretty sure it would be less effective than syntocinon, but that doesn't mean it wouldn't be better than nothing. (the problem of blinding remains, of course - but are we against placebos if they work?)
From Holly:
The labor room is an intimate place, Susanne. Anywhere my vaggy is exposed is an intimate place. And my vaggy sure as hell is exposed in a L&D room. Obviously you are just a tool of the patriarchy.
From Yehudit:
"There is no evidence that clitoral stimulation does not encourage uterine contractions."
There is no evidence that wearing Mickey Mouse ears does not encourage uterine contractions, either.
++++++++++++
Actually, there is very good evidence that clitoral stimulation to orgasm results in uterine contractions. (In fact, it is one of the basic descriptions of what an orgasm *is* in women). That is female reproductive physiology 101.
The question is whether clitoral stimulation to orgasm is effective as augmentation of labour. And there is no good evidence on that, because it has never been studied.
But the basis of the hypothesis is quite different from the basis of a hypothesis about wearing mickey mouse ears.
From Yehudit:
Susanne: 'We're not "afraid" of women masturbating.'
Holly: 'Obviously you are just a tool of the patriarchy.'
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Maybe Susanne is the patriarchy? What a thought!
From Holly:
Perhaps.
From Liz1:
What kind of logic is it that says that disaproval of public masturbation equals fear of women's bodies?
I wonder how people would feel in the unlikely event that public, vigorous masturbation was found to be am essential aid to a safe birth? Would that be an advance for womankind, I wonder?
And would you have to have an embargo if you didn't want to go into premature labour? All those women who go post-dates having eyebrows raised about their technique?
Why on earth do women want to invest in this nonsense? Isn't it complicated enough as is?
From Ericacrochets:
"I wonder how people would feel in the unlikely event that public, vigorous masturbation was found to be am essential aid to a safe birth? Would that be an advance for womankind, I wonder?"
Yeah, that's what bothers me. It almost makes me want to get a T-shirt made that says:
Sex: Recreation NOT Medication
From Caryn:
If I did so, and the HCP perceived it as inappropriate, would that make it sexual assault?
I don't know. That's what I'm asking: is it a requirement of maternity care providers to implicitly consent to observing it?
And I don't think a labor and delivery nurse should be alarmed or affronted when a woman touches her genitals during the labor and birth of her child.
A L&D nurse can be alarmed or affronted all she wants, so long as she provides the care she's required to provide, whatever that care might be. The *feelings* of the nurse in question have nothing in particular to do with the *rights* of the nurse, or the rights of the patient. Is she required to implicitly consent to observing masturbation as a condition of employment? The whole *point* of this discussion is to figure out where, precisely, the line is.
Whether or not the maternity care provider has an intent to cure or an intent to care or an intent to harm comes down to the definition of medical care, and the definition of health/nursing care, and no one's been able to provide that -- not even nursing theorists.
I find it fascinating that this discussion, too, has collapsed into a discussion of what it is that constitutes medical care, and what it is that constitutes health care.
From Caryn:
The labor room is an intimate place, Susanne. Anywhere my vaggy is exposed is an intimate place. And my vaggy sure as hell is exposed in a L&D room. Obviously you are just a tool of the patriarchy.
So all I have to do to redefine the mall as an intimate place is to take my pants off?
From Sesshoumaru's Girl:
If sex doesn't effect labor at all, than why are women (who are at risk for PTL) told to refrain from sexual activity?
From Yehudit:
Sex: Recreation NOT Medication
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Excellent. You could sell them on Cafe Press.
From Sesshoumaru's Girl:
Caryn:
Oh come on :D. . .you can't compare an L&D room to the mall.
Some bozo cannot just wander the halls, eating popcorn, peeking in all the rooms like an idiot, he'd get tossed out.
But at the mall, that is acceptable.
From Holly:
There are all sorts of purposes for sex. Why does it have to be confined to a loving act between two people for the purposes of orgasm? That is so silly.
From Holly:
From Liz1:
What kind of logic is it that says that disaproval of public masturbation equals fear of women's bodies?
And this would be a reasonable comment if the labor room was considered public. Alas, it is not.
From Holly:
Do women in the UK not give birth in private rooms? Maybe this is why this concept of a labor room being private is difficult for some?
From Yehudit:
They do give birth in private rooms. (At least, as private as any room in a hospital is).
From Caryn:
And this would be a reasonable comment if the labor room was considered public. Alas, it is not.
Well, *you* say it's not. A lot of other people are saying it's semi-private, at best. It's certainly not private property under the woman's control.
The issue here is whether or not the care provider has consented, and it's not the case that they've done that simply because they're in a room with you with the door closed. The maternity care providers do not become my intimate partners simply by virtue of being in a room with me.
The three ways out of this are:
1) to define masturbation as not a sex act. That would depend on community standards, which are not exhausted by what it is that's legal or illegal. If it's not illegal people might be able to get away with it, but still might be wronging others. (An example of this might be any kind of promise-breaking, but not in a way that's technically illegal. Adultery might be morally wrong, but not illegal in some states. And so forth.)
2) define it as a special sex act (i.e. the it- stimulates- uterine- contrax argument.) Then you'd need to show some sort of empirical evidence supporting the idea that it's an effective treatment, because unlike homeopathic remedies, you can make the argument that it actively harms the maternity care providers.
3) or to say look, even though it is a sex act, you don't have to get permission from maternity care providers to perform it. It seems to me that requires advocates to show that maternity care providers have already given implicit consent, because it's part of maternity care practice.
From Yehudit:
Then you'd need to show some sort of empirical evidence supporting the idea that it's an effective treatment, because unlike homeopathic remedies, you can make the argument that it actively harms the maternity care providers.
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If it actively harms the maternity care providers, then it doesn't matter whether it is effective treatment or not.
From Caryn:
If it actively harms the maternity care providers, then it doesn't matter whether it is effective treatment or not.
What would you call being forced to assist with an abortion if you were a CO?
From Emma B:
And would you have to have an embargo if you didn't want to go into premature labour?
You do, actually. Pelvic rest includes orgasm as well as intercourse.
From sarahz:
Radiation and oncology treatments have been shown to actively increase the adminstrators risk of getting cancer someday, yet we are fine with those. Should radiologists refuse to accept ACTUAL PHYSICAL personal harm in this case?
Just because something has not been studied, this is not the same as something having been studied multiple times and shown to have no affect. Again, econ 101 drop-outs: studies are FUNDED when there is a PROFIT to be made. That is almost entirely how it works. No possibility of return = no investment. Cash rules everything around me and is primarily what makes medicine suck, the profit motive. Love of money is certainly the root of all evil especially in medicine. That is why I would only even consider a religious hospital, because at least their allegiance to money isn't 100% clear cut.
If something is biologically plausible (nerves from clit are very clearly connected to nerves surrounding the uterus) it deserves a fair shake, IMO. Otherwise medicine would never progress. Mickey mouse ears, having no physical connection to the uterus in any way, fail the test of plausibility.
Susanne, you keep CLINGING to the idea that clitoral stimulation would only have any affect because it is psychologically pleasing to the woman, when we have very clearly explained it is because it is physically capable of causing uterine contractions that it is even being considered. This is a (weak, IMO) attempt to discredit an argument by ignoring the real argument and arguing with a fake argument (isn't this called a straw man?)
From Yehudit:
COs aren't forced to assist with an abortion.
Midwives care for women in labour, and sometimes those labours are a consequence of the abortion process. That is not assisting in performing an abortion (otherwise they would be exempt, since they are COs).
Every effort will be made to provide the woman with a midwife who is not a CO, both for the sake of the woman and the midwife. And if it's not possible that is a real dilemma. But attending a woman having a late-termination is no picnic for a someone who is fully supportive of providing access to abortion. So, yes, that part the job has the potential for harm - but that is part of midwifery, to care for labouring women - however they come to be in labour. You could just as well say that firefighters shouldn't be sent in to fires because they are traumatic.
But a particular mechanical (e.g. clitoral stimulation) or pharmacological treatment demonstrated to be actively harmful to midwives, surely you're not saying that's fine as long as it is effective but not if it's ineffective?
From Caryn:
surely you're not saying that's fine as long as it is effective but not if it's ineffective?
I'm saying you would have to make an argument in favor suggesting that the benefit to the patient outweighed the harm to the maternity care provider.
We balance harm and benefit all the time. Surgery is one obvious example; we accept the risk of harm because we also anticipate benefit. Wrt COs, this is a reason there's an argument over the difference in responsibilities between draftees and enlistees -- enlistees *chose* to go into the service.
Can the responsibilities of maternity care providers to their patients outweigh the risk of harm to themselves sometimes? And when? Again, do they *implicitly consent* to such harm by accepting the training?
From Emma B:
The three ways out of this are:
4) Take the utilitarian approach, and decide what you're willing to do with a non-compliant woman.
If you're not willing to throw a laboring woman out of the hospital, or think EMTALA prevents it, your choices are to forcibly restrain her or sedate her. Are you prepared to endorse any of those alternatives, and do you think they'd be viable in the current medico-legal climate? If not, seems to me you've got to put up with it.
From Em:
Oh my, there's an Australian Amy Tuteur!
Hey, if Avril hasn't experienced it, it can't be real, and the only possible response is dripping with disdain for those who have. And blaming them for revealing it, because we all know that one woman's pleasure is terribly damaging to every other woman.
Hey, really, that's OK. We didn't used to know that orgasm is a normal part of female sexuality. No blame could be attached to setting or technique...
For what it's worth, I wasn't trying for one, didn't expect one and didn't have one. But I was close, and without bright lights and a roomful of people screaming at me, who knows?
From Em:
Oh, and this conversation, what little I'm going to read of it, is hilarious!
What a horror, a woman touching her genitals in front of you when you could be slicing them so nicely and neatly instead!
I came to see if there was any comment on Dr. Pierce, you know, how quickly La Tuteur would turn it into a psychopathological treatise on Catherine Skol... but this is enough awesomeness for me, right here.
I try so hard not to stereotype OBs, but you make it so exquisitely hard to resist!
From Kat:
Emma B- Most likely a HCP would put up with it. That doesn't make it any less crass.
I also don't believe it does anything in labor other than provide a temporary release.
The fact that there are women who actively want to masturbate in labor without regard to the feelings of their HCP'ers is very interesting to me. It speaks of a larger issue that I am trying to grasp. Perhaps it is the decadence of natural birth advocates. It is disturbing, interesting, strange and absurd all at the same time.
I am all for the most straight forward labor with a comfortable mother, but I cannot understand the need for masturbation in front of HCP's, or vibrators, or, well, it seems absurd. Sad, empowered masturbating and coming women. Well, the baby WILL be born, with or without your stimulation, but whatever.
From Brenda:
"If clitoral stimulation is so great at augmenting contractions, why is it that it has now been shown that sex cannot start labor. A pregnant woman can sit at home and masturabate all day, orgasm all she wants, and it's not strong enough to actually put her into labor.
Why is that in labor clitoral stimulation suddently becomes this amazing tool for augmenting contractions?
Of course, the answer is that it doesn't."
Just totally curious about the fact that sex cannot start labor.
I was 38 weeks pregnant w/ my last baby and had had no contractions yet, and me and my hubby did the deed and I immediately had a contraction, then another then another- then had a baby a few hours later. Was 6 cms by the time I got to the hospital a couple hours later.
I know it's only anecdotal but I think it's silly to say something "cannot" cause something when many people have experienced it. It obviously may not happen w/ many if not the majority of people, but it did for me. But I probably wasn't included in any of the studies
From Elizabeth:
Obviously, if you can't stop masturbating for an exam from your HCP, you have a lot of problems and pity would be my first emotion.
This is exactly right, and most competent healthcare providers would treat such behavior as a prima facie psychiatric symptom. In most places these days that does not mean automatic, punitive restraint or sedation. Let alone arrest, which is a silly strawman. (Although I think the logic of "you can't [or wouldn't] have me arrested for it, therefore there are no reasonable limits on my behavior" is very telling.) The proper clinical response to such a behavioral symptom may be merely to note it and be on the lookout for other signs of trouble. Perhaps to offer gentle redirection. But that differs as much and as obviously from Yehudit's deferential, unquestioning averting of the eyes as clutching at oneself in pain does from jacking off.
Liz asks,
What kind of logic is it that says that disaproval of public masturbation equals fear of women's bodies?
The logic of exhibitionists who don't understand the difference between the exercise of their fetish and a healthy, normal sexual appetite.
If I masturbated in front of a guest in my home, I could certainly be arrested and charged, and "they could have just left if they didn't like it" would definitely not be a defense. A fortiori with respect to hospital rooms etc.
Incidentally, I think the "sex for induction" fad among the crunchies is just another instance of their narrow "All Body, All The Time" vision of women's lives.