I’ve had children before, so I knew exactly what to expect when the nurse handed me my pregnancy report and it read: Pregnancy +ve. In my experience, the nine months of pregnancy were split into three trimesters: The first three months of nausea and overwhelming fatigue that made one want to sleep the days away regardless of uncooked dinners and unwashed clothes. Then, three months of irritability that made one snap at others like a bad tempered barracuda and an appetite that seemed to have gone quite mad.
And the last three months of prowling the house at night while everyone slept the comfortable sleep of the non-pregnant, eyeing one’s bulging belly like a time bomb that’s ticking away slowly and surely…to the climax. The rush to the hospital, the beep-beep of the fetal monitor, the sinister clink of glass and steel in the labor room, the rows of shining, sharp surgical instruments and ohhhhhhhhhh the pain…
Let me confess: I’m one of those human beings who can be scientifically classified as “chicken”. I need to be well anesthetized before submitting to a little drilling by a dentist…can you imagine what the process of having a baby does to me? I’ve endured endless ribbing by friends and family over this. Someone even once told me: If you can’t stand the heat, get out of the kitchen. Simply put, if I couldn’t deal with the pain, I shouldn’t have more babies.
After hearing something as drastic as that, I was determined that this time, things would be different for me be-idhnillaah. After all, in Islam, pregnancy and childbirth are not seen as a punishment for women for misleading man and “eating from the forbidden tree”, unlike Judaism and Christianity. On the contrary, the Qur'an considers the pain and discomfort undergone by a woman in pregnancy and birth as a basis for showering extra love, respect and consideration to mothers.
"And We have enjoined on man (to be good) to his parents: in travail upon travail did his mother bear him, and in years twain was his weaning: (hear the command), "Show gratitude to Me and to thy parents: to Me is (thy final) Goal." (Qur'an 31:14)
"We have enjoined on man kindness to his parents: In pain did his mother bear him, and in pain did she give him birth. The carrying of the (child) to his weaning is (a period of) thirty months. At length, when he reaches the age of full strength and attains forty years, he says, "O my Lord! Grant me that I may be grateful for Thy favor which Thou has bestowed upon me, and upon both my parents, and that I may work righteousness such as Thou mayest approve; and be gracious to me in my issue. Truly have I turned to Thee and truly do I bow (to Thee) in Islam." (Qur'an 46:15)
In seeking a better birth experience -- one in which I felt composed, confident and in-control instead of feeling at the mercy of care-givers at a hospital-- I felt I was only seeking my due as a Muslim woman whom Allah has naturally equipped with the ability to give birth.
Nothing to Fear but Fear Itself
First, I had to deal with my fear of pain. It wasn’t as irrational as I had earlier thought. The complete medicalization and consequent mechanization of labor and childbirth in hospitals has put this morbid fear in innumerable women. There’s even a medical term for it: tokophobia. In severe cases, women completely deny the reproductive urge and choose not to have a baby at all rather than go through all the pain that comes with childbirth.
In the name of a “safer birth process”, childbirth and labor are now considered medical events that need to be monitored and manipulated to the satisfaction of hospital staff, rather than a natural rite of passage for a woman. From the arrival of a woman in labor to the hospital to the cutting of the umbilical cord after the baby is delivered, typical hospital procedures seem to conspire to undermine a woman’s confidence and sense of control. Consider this: As soon as she arrives at a hospital, the woman is made to lie on her back – a position that doctors concede prolongs the labor because it forces the baby to go against gravity. She is hooked to fetal monitors in a supine position, which increases the painful pressure on the lower back, causing her to tense up and may slow down contractions. She is not allowed to move, eat, drink or even prop herself up in a more comfortable position.
From then on, it’s a downward spiral of one medical intervention after another. To increase the force of contractions a woman may be given drugs which cause tonic contractions that are far more painful than normal. Unable to cope with the excruciating pain, the woman asks for and is usually given pain-killing medication, narcotics or anesthesia. True, epidural anesthesia relieves the pain, but it also numbs the woman's body so much that she cannot apply the muscular pressure needed to push the baby down the birth passage. In the mind of hospital staff, this warrants even more aggressive intervention – an episiotomy, forceps, vacuum extractor and as a last resort caesarean section – all of which leave a woman feeling like a failure for not being able to give birth naturally.
WHO statistics say that a more than 10% rate of caesarean sections in a given population amounts to abuse of medical technology, yet more and more urban mothers are going under the scalpel thanks to the restrictive hospital atmosphere and the panic it brings on. Contrast this with the Qur’anic narration of the Prophet Isa's (Jesus, may peace be upon him) birth:
22. So she conceived him, and she retired with him to a remote place.
23. And the pains of childbirth drove her to the trunk of a palm-tree: She cried (in her anguish): "Ah! would that I had died before this! would that I had been a thing forgotten and out of sight!"
24. But (a voice) cried to her from beneath the (palm-tree): "Grieve not! for thy Lord hath provided a rivulet beneath thee;
25. "And shake towards thyself the trunk of the palm-tree: It will let fall fresh ripe dates upon thee.
26. "So eat and drink and cool (thine) eye. And if thou dost see any man, say, 'I have vowed a fast to ((Allah)) Most Gracious, and this day will I enter into not talk with any human being'"
[Qur’an 19: Surah Maryam]
Notwithstanding the fact that Maryam (peace be upon her) was specially favored by Allah above all the women of her time, she suffered from childbirth pains just like any other woman. Yet, with Allah's guidance, she bore her pain with patience and prayer.
As the Qur’an says:
Nay, seek ((Allah)'s) help with patient perseverance and prayer: It is indeed hard, except to those who bring a lowly spirit, - [Qur’an 2:45]
Doctors and Old Wives Tales
Pain is inescapable in childbirth – there’s no refuting this physiological fact. However, how one deal with that pain is what makes the difference between a nightmarish childbirth experience and a dream run. I found it interesting to compare the efforts of doctors trying to help women give birth naturally and the tips offered by experienced women who had been-there before.
In the early 1900’s, Dr Grantley Dick-Read guided one of his patients through labor which appeared relatively painless, mainly by encouraging her to relax and by following her lead instead of telling her what to do. When he was able to repeat similar experiences with other patients, he began questioning the prevalent concepts of birthing. He concluded that what made some labors “painless” and “easy” was the absence of fear. This started the mental fear—muscular tension—more pain cycle theory, which since has been clinically proven many times over.
In the 1940’s Dr. Robert Bradley, a natural childbirth proponent, also came to the same conclusion and pioneered the husband-coached childbirth classes. He found that 90% of his patients were able to give birth without drugs or medical intervention simply by involving the husband as a “coach” instead of letting the woman take orders from a caregiver and a form of mild hypnosis or “deep relaxation”. During the 1950’s, Dr. Ferdinand Lamaze documented the essential components for a comfortable birth by a method called “psychoprophylaxis” or ‘mind prevention’. The idea was the same: to control the body’s responses by getting the mind to relax.
In the 1970s, Dr. Herbert Benson studied the ‘relaxation response’ and found that in a relaxed state the body had a particular physiological response and brainwave pattern. What’s interesting is that this pattern was the same in different states like hypnosis, meditation and …prayer. Dr Benson’s contention was that by interrupting the mental fear—muscular tension—more pain cycle and preventing the woman from developing a “flight or fight response” a woman could have a shorter, easier childbirth experience. Among the factors that doctors consider helpful in making a woman relax in labor, one is a comfortable environment perceived as “safe” and “familiar” by the mother.
Primitive societies had a “birthing hut” in the community or a “birthing room” in the house where the woman would give birth attended by midwives and women from her own community, which may include her own mother, siblings, in-laws and married friends. The woman would have seen the hut/room many times in her life and would be reassured by the presence of so many familiar caregivers, lulling her mind and body into a relaxed state. In this state, the body releases “feel-good” chemicals called endorphins lessening the pain and making the childbirth experience a positive one.
In contrast, the rush to a hospital as soon as labor begins automatically activates the woman’s limbic system -- the primitive part of the brain that controls childbirth and other involuntary functions. The sight of strangers –doctors, hospital staff and caregivers, the bright lights and unfamiliar sounds , smells and surgical instruments cause an adrenaline rush, which acts as a signal for the body to ‘fight or flee’.
One way to deal with this is to have a written birth plan that you can discuss with your doctor/nurse/midwife in antenatal check ups and visits. It’s a good idea to familiarize oneself with the labor room and nursery, ask questions about typical pre-birth procedures that may be required and to be mentally and physically prepared.
Women are also advised to "create a cocoon" – a private space within an institutional setting where a woman can retreat mentally even if her surroundings may be distressing or disruptive. Doctors say one way to do this is to have a mental device— a particular sound or word, a fixed gaze or focus on breathing – which requires enough concentration to wean one’s mind off the pain. Amazingly, that’s almost exactly what seasoned old mothers say!
Muslim women are encouraged to recite prayers from the Qur’an or from the Prophet’s prayers or adhkaar during labor. Cementing this belief is the saying of The Prophet (may the peace and blessings of Allah be upon him) that a believer is compensated for every little hurt -- even a cut to his/her finger -- by expiation of his sins. Abu Sa'id al-Khudri reported that the Prophet said: "Whenever a Muslim is afflicted with a hardship, sickness, sadness, worry, harm, or depression --even a thorn's prick, Allah expiates his sins because of it." (Sahih Bukhari)
And “Expect good, because Allah makes a believer’s sickness an expiation (for his sins) and a period of repose”. The intense pain experienced by a woman during childbirth is considered an expiation and a means of earning extra rewards or 'ajr. According to another hadith (prophetic saying), a woman who dies in childbirth is considered among the seven categories of shaheed (martyrs) who do not die on the battleground, but due to other painful afflictions.
Some adhkaar (supplications) which have been mentioned by birthing women as especially beneficial are: the kalimah tawheed [Laa ilaaha illallaah], Surah Fatihah, tasbeeh [ Subhaanallaahe wa behamdehi/subhaanallahil adheem/Subhaanallaahe rabbil arshil adheem/Subhaanallahe haleemul kareem], prayers of the Prophet SAW : Allaahumma laa sahla illa ma ja`altahu sahlan/ wa anta taj`alul huzna sahlan iza shi’ta and Hasbunallaho wa ne`mal wakeel/Ne`mal maula wa ne`man naseer and prayers from the Qur’an.
Women also often find that taking up the positions of salaah – sitting up, standing, squatting, laboring on the hands and knees and especially prostrating helps manage the pain better. While considering natural childbirth as the most viable option for a Muslim woman, one must not overlook the benefits of obstetrical medicine especially in case of a high risk pregnancy, health complications or unforeseen emergencies, since Imam Ahmad narrated, “ The worshippers of Allah use treatments (for their diseases)."
Narrated Jabir ibn Abdullah RA, The Prophet SAW said: "There is a remedy for every malady, and when the remedy is applied to the disease it is cured with the permission of Allah, the Exalted and Glorious." (Sahih Bukhari)
Yahya related to me from Malik from Zayd ibn Aslam that a man received a wound in the time of the Prophet (may the peace and blessings of Allah be upon him), the blood clotted in the wound and the man called two men from the Banu Ammar tribe. They looked at it and claimed that the Messenger of Allah (may the peace and blessings of Allah be upon him) said to them, “Which of you is the better doctor?” They said, “Is there any good in medicine, Messenger of Allah?” Zayd claimed that the Prophet (may the peace and blessings of Allah be upon him said, “The one who sent down the disease sent down the remedy.” (Hadith Muwatta)
Muslim women must realize that there is no weakness of eemaan (belief) in availing of medical and interventional benefits since Allah has guided us to ease instead of hardship.
