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Birth as an American Rite of Passage
By Robbie E. Davis-Floyd
UNIVERSITY OF CALIFORNIA PRESSCopyright © 2003 The Regents of the University of California
All rights reserved.
The Stages of the Pregnancy/Childbirth Rite of Passage
I didn't know I was an adult until I had a child. —Linda Moore
SEPARATION: "OH MY GOD, I THINK I'M PREGNANT!"
The phase during which the newly pregnant woman gradually separates herself from her former social identity has its beginnings in her very first flutterings of conscious awareness of the possibility of pregnancy. For a time she will probably live with the intensely personal experience of the wondering; finally, wary of misinterpreting what her body tells her, she will usually seek the scientific confirmation of the drugstore test. If the results convince her, her next moves will usually be to tell the baby's father and call the doctor, not always in that order.
The first days of beyond-a-doubt pregnancy will be ones of inner turmoil—maybe excitement, maybe anguish, certainly some panic and much self-questioning. Already her conception of self is being tested—her body is doing things on its own, and she must cope with her total lack of control over these changes. By the time she has fully accepted the reality of her pregnancy and gone public with the news, neither she nor those close to her will see her quite as they did before.
That this separation process is a structurally discrete phase of the pregnancy/childbirth rite of passage can be understood by a look at the steadily increasing number of women who opt for amniocentesis (a medical test in which the amniotic fluid is drawn out with a needle and tested for evidence of genetic defects). These women experience separation phases that are considerably longer than usual, for the amniocentesis can only take place in the fourth month of pregnancy. In her recent study of the psychological effects of amniocentesis, Tentative Pregnancy (1986), Barbara Katz Rothman documents the agonizingly uncertain attitudes these women must take toward their pregnancies until the test results are in. For if the tests indicate genetic defects, most women will opt for abortion. To say that the long period of waiting on the test results can drag out the length of the separation phase considerably is not mere academic hairsplitting: the woman's full acceptance of her pregnancy, or lack of it, can have a definite effect on her relationship with the baby and on her ability to psychologically prepare herself for birth and motherhood (Bowen 1983; Chamberlain 1983; Rothman 1986). Thus, this process of separation from her former structural identity can be considered complete only after the woman herself has fully accepted the pregnancy.
TRANSITION: PREGNANCY AS TRANSFORMATION
One interesting thing about pregnancy viewed from a Turnerian perspective is that it is both a state and a becoming. (Webster's gives the etymology of "pregnant" as L. praegnans—prae "before," gnans "being born," and defines pregnancy as "the state of being pregnant." Translated literally, that would be "the state of being before being born.")
The liminal phase of pregnancy, this lengthy "state of being before being born," can be best understood as lasting from the woman's final acceptance of her pregnancy until three to six weeks after her baby's birth. During this phase the pregnant woman fully experiences the cultural overlays on her physiological process of becoming a mother.
John McManus (1979a) discusses "alternation" between models of reality, and "resolution"—ultimate acceptance of the model of reality presented by ritual—as chronological features of ritual transformation; and indeed these processes are so experienced by pregnant women. "Becoming mothers" in this society usually find themselves living out their pregnancies in near-constant alternation between the contradictory paradigms (in the sense of "model of reality") of pregnancy extant in several different and clearly separate experiential domains, which I have labeled personal, public, medical, formally educative, and peer group (Davis-Floyd 1983). Each domain will present the pregnant woman with a different type of ritual and symbolic response to the physiological reality of pregnancy, which will be based on the paradigm of pregnancy and birth peculiar to that domain. These often-conflicting perceptions offer the pregnant woman a set of possibilities from which to choose how she will interpret her own unique experience of becoming a mother. Her ultimate resolution of these paradigmatic conflicts, as we will discuss in Chapter 5, will be heavily influenced by the type of rituals which ultimately surround and shape her perceptions of her birth experience.
TRANSFORMATION IN THE PERSONAL DOMAIN
Suddenly, everything is so different! I don't know who I am any more.
What Turner calls liminality, pregnant women experience as a sense of change, of growth, of detachment, fear, wonder, awe, curiosity, hope, specialness, simultaneous alienation from and closeness to themselves and their families, irritation, frustration, exhaustion, resentment, joy—and a trembling sense of unknown, unknowable potentiality. Inner emotional and physiological transformations are reflected almost daily in outward changes. Old habits and patterns drop off and new ones develop as pregnant women struggle to find new ways of doing something as simple as tying their shoelaces, and as complex as balancing their increasing needs for peace and emotional support with the daily demands of their marriages and careers.
Rapid psychological growth and change are possible in pregnancy as they are not in usual structural life. Psychologists have noted the ease and speed with which pregnant women can benefit from psychotherapeutic techniques (Brazelton 1973; Peterson 1981), for the near-constant inner and outer flux of pregnancy keeps the category systems of pregnant women in a continuous state of upheaval as old ways of thinking change to include new life. For example, growing a baby inside, as well as mothering a newborn, puts a woman in much closer touch with her own childhood experiences, allowing old, deeply buried thoughts and emotions to surface. Hopes and fears from the past and for the future merge at the surface of her daily consciousness, as time compresses in the physical experience of pregnancy, and past, present, and future together are carried in her womb.
Because of the psychological state of openness and receptivity that pregnancy tends to induce, the manner and direction of a woman's personal transformation is very likely to be heavily influenced by the sort of treatment she encounters in the public domain.
TRANSFORMATION IN THE PUBLIC DOMAIN
Is it just my imagination, or is everyone staring at my tummy?
In order to understand better the cultural and individual significance of pregnancy as a liminal process of becoming, we need only recall that in our society pregnancy has but recently been accepted as appropriate to the public domain. Before World War II, pregnant women were examples of the "structural invisibility of liminal personae" (Turner 1979:236)—very nearly as hedged about with ritual and tabu as Turner's Ndembu initiates. They were expected to remain secluded in their homes, as their presentation in public was somehow felt to be improper. When in public their pregnancy was to be disguised. Even the word "pregnant" was too pregnant to be used. Just as people did not die, but "went to sleep" or "passed away," pregnant women were "with child," "p.g.," "in the family way," "expecting," or "baking a bun in the oven." The mysterious procreative powers of nature, made undeniably manifest in the visibly pregnant woman, were apparently too threatening to a society that wanted to believe it had ultimate control. These euphemisms helped to mask the fact that it is nature, not society, that controls the creation of new human beings. Moreover, the pregnant woman, unlike all other human beings, holds two individuals in one body. This undeniable but highly anomalous phenomenon of nature refutes at least two of our culture's most powerfully held categories—the cultural idea of one individual per body, and the mathematical law that one does not equal two. As the Ndembu youth, no longer boy and not yet man, is both sacred and contaminating to society, so the pregnant woman, neither childless nor mother, public proof of a sexuality properly kept private, walking representative of nature in a culture that seeks to deny nature's power, structurally resident in a liminal period for nearly one whole year, still crosses too many categories for comfort.
In the last four decades pregnancy has "come out of the closet." Today we see pregnant women everywhere, from the classroom to the executive office, from the night club to the formal dinner, and it is only a few old die-hards who mutter under their breath about unseemly display, or raise eyebrows at Loretta Lynn singing "Pregnant Again" on "The Tonight Show." Concurrent with this rise to respectability has been pregnancy's redefinition from a private and feminine to a public and medical event (Rothman 1982:29; Oakley 1984). (In the United States, in 1900, "less than 5% of women delivered in hospitals ... by 1939 half of all women and 75% of all urban women were delivering in hospitals" [Wertz and Wertz 1989:133]. Today, the figure is 98 percent [Cunningham et al. 1989].) As the rites and rituals of pregnancy and childbirth have been moved out of the home and away from the tutelage of the pregnant woman's family and midwife, and into doctor's offices and hospitals, the announcement has been made to society-at-large that these forces of nature are now "under control," and society has lost some of its fear of them. Yet, though accepted as a state, pregnancy as a "becoming" is still tabu-laden and ritually hedged, only now the tabus are cast as medical necessities, and the rituals are thought of as scientific or educational procedures pertaining to the state. In other words, I suggest that pregnancy's recent rise to status and respectability serves to disguise the still forceful perception of it as a ritual process.
Turner stresses that an important aspect of liminal phenomena is that their symbols tend to have common emotional meanings for all members of a given group (1968:2). A common experience of the women in my study was that in the public domain, the visible physical fact of pregnancy frequently turns women into symbolic objects. Many find that their public symbolic transformation is sometimes negative. Some men, formerly friendly, begin to avoid them as their bellies grow, occasionally admitting openly that the big stomach embarrasses them. Some women find that during conversations, people stare at their stomachs instead of their faces, increasing their sense of being made into objects. Sometimes it is other women who withdraw, viewing the pregnant one as a symbol of female subjugation by males or as a slave to her own body and to the forces of nature.
Other common experiences, mostly seen as positive, are of being viewed as Mother Nature Personified, as the Venus of Willendorf (i.e., as a fertility symbol), as Earth Mother, or as representing Motherhood or the Essence of Womanhood, or the Creative Force at Work in the Universe, the Future Incarnate, the Continuation of Mankind, the Mystical Union of the Male and Female Principles, Yin and Yang, the Oneness of Humankind. Many pregnant women eventually come to perceive themselves in one or another of these ways:
I enjoyed it. People treat you very special—you'll notice that. That's fun, a lot of fun. And the glow. I don't know if I believe that but there were quite a few people who say there is a special glow, you can just tell. Well, and sometimes I could look at myself in the mirror, and I would be feeling really in touch with my body, in touch with my baby, and I could sort of see what they mean. (Patricia Hellman)
One of the days we were there, I went out into the ocean by myself. It was a glorious day, and I just settled deep into the water and the sand, and let the waves lift me and float me around. All of a sudden I became aware of the baby in my womb, floating in his own salty water in the amniotic sac. I had such a powerful sensation—how can I describe it? It was a real physical sensation of the water within and without, and the life within and without—I was in the water, inside of the ocean—inside of the womb of the earth, my mother, and the baby inside of me was in that same water—I felt like the child and the mother of the universe all at once. For just a few moments, I felt totally at one with myself, my child, the water and the earth—I really physically experienced the unity of all of life. (Elizabeth Davis)
Reinforcing these perceptions of specialness is the behavior of men (and sometimes other women), who rush to open doors and pick up dropped coins, who tote suitcases across the airport and give up seats on the bus, sometimes sheepishly admitting that nowadays pregnant women are the only ones to whom a man can safely offer his chivalric services. Apparently pregnancy increases the force of the stereotype of the weak female, or at least combines it with the cultural tabu against women lifting and carrying heavy things. The combination seems to open the door to a chivalry nowadays oft-suppressed. To these sorts of ministrations, the barely showing pregnant woman may at first react with scorn and disgust. Pregnancy has not weakened her one bit, and "I can carry my own suitcase, thank you!"
But by the seventh or eighth month, whether delighted or simply resigned to the inevitable, she has adapted to her new symbolic status and the social rituals that accompany it. She probably no longer even flinches when strangers reach out to pat her stomach, having learned and accepted the social reality that her belly is now a part of the public interactional domain. She may come to regard with more sympathy those who avoid her—sometimes she would like to avoid herself! Many pregnant women find it ultimately very comforting to adopt and utilize the cultural beliefs encoded in the symbols thrust upon them as a framework within which to conceptualize and interpret their new physical realities. This process seemed to become an integral part of their rite of passage, of their separation from their former conceptions of self, as anthropologist Michelle Rosaldo described:
One thing that struck me was how, when pregnant, an aspect of taboo/liminal status was becoming, as it were, public property: in a shoe store, the saleswoman told me not to buy stack heels; hands-on-tummy; concern (don't reach, lift); then "your baby will get a cold if you don't put a hat on" when I was walking; comments/concern around my failure to observe the seclusion rule on return from the hospital ... the "end" of it all was that loss of the public eye, the recognition that pregnant women no longer looked at me and my baby and smiled. (Personal correspondence, Sept. 15, 1981)
TRANSFORMATION IN THE MEDICAL DOMAIN
The first time I heard the heart beating through that thing he put on my tummy, I thought I would die from the joy.
The paradigm of pregnancy dominant in the medical domain is the technocratic model of pregnancy and birth, which is explicated in detail in Chapter 2. Implicit in this model are the assumptions that the baby develops mechanically and involuntarily inside the woman's body, that the doctor is in charge of the baby's proper development and growth, and that the doctor will deliver (produce) the baby at the time of birth. Although the vast majority of their pregnant time is lived out in the personal, public, or peer group domains, most American women experience this medical paradigm as providing the overarching conceptual and structural framework for their experience of pregnancy, whether or not they espouse its basic tenets.
Thus, the pregnant woman will seek official confirmation of her pregnancy from her obstetrician and will mark its progress in routine monthly visits to his office. She will be reassured when he3 assists her to hear her baby's heartbeat. She will tell the doctor when she first feels the baby move, and he will tell her that she is now halfway through the pregnancy. Her first baby picture will be from the ultrasound machine in his office, which may also tell her whether she carries a girl or a boy. She will eagerly await the due date her physician sets with his standardized formula (even if she is sure the baby was not conceived when the chart says it must have been). As her due date approaches, her visits to the obstetrician will intensify to every two weeks or more. If the due date comes and goes with no sign of labor, she will grow increasingly anxious with each passing day in which she does not conform to standardized expectations. If she goes more than two weeks past her official due date (one week, in some places), her labor will be artificially induced. She will call the doctor when labor begins, enter the hospital for labor, birth, and the early neonatal period, and take the baby to the pediatrician at around one week of age to make sure he or she is all right. Finally, she will go for a postnatal checkup at the obstetrician's office six weeks after the birth.
Excerpted from Birth as an American Rite of Passage by Robbie E. Davis-Floyd. Copyright © 2003 The Regents of the University of California. Excerpted by permission of UNIVERSITY OF CALIFORNIA PRESS.
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Table of Contents
Preface to the Second Edition, xi,
Introduction: Birth as a Rite of Passage, 1,
1. One Year: The Stages of the Pregnancy/Childbirth Rite of Passage, 22,
2. The Technocratic Model: Past and Present, 44,
3. Birth Messages, 73,
4. Belief Systems About Birth: The Technocratic, Wholistic, and Natural Models, 154,
5. How the Messages Are Received: The Spectrum of Response, 187,
6. Scars into Stars: The Reinterpretation of the Childbirth Experience, 241,
7. Obstetric Training as a Rite of Passage, 252,
8. The Computerized Birth? Some Ritual and Political Implications for the Future, 281,
9. —Or Birth as the Biodance?, 292,
Appendix A Interview Questions Asked of Mothers, 309,
Appendix B Interview Questions Asked of Obstetricians, 313,