"Imagine mankind as dwelling in an underground cave...in this they have been from childhood, with necks and legs fettered...they cannot move their heads round because of the fetters, and they can only look forward, but light comes to them from a fire burning behind them higher up at a distance..."

"Now consider," said I, "what their release would be like...What do you think they would say, if someone told [them] that what they saw before was foolery, but now [they] saw more rightly, being a bit nearer reality... Don't you think [they] would be puzzled, and believe what [they] saw before was more true than what was shown to [them] now?" "Far more," said he.

-Plato, The Republic, Book VII



I hope that my readers will grant me a brief escape from the analytical confines of my own "standard procedures" and allow me here the literary luxury of a freer flow. Many of the women in my study group were offered mirrors, held by doctor or nurse, so that they could, if they wished, visually as well as physically experience their baby's entrance into independent life and their own transformations. Aware that mirrors often symbolize reflexivity, I have pondered for a long time the possible interpretations of the meaning of the mirror in hospital birth. To look in a mirror can entail a certain degree of self-consciousness, but it seems to me that who holds the mirror, and the situational context in which it is held, can have a profound effect on the cognitive content of what one sees.

Myerhoff and Ruby have provided me with some helpful insights into the nature of reflexivity:

"Reflexive"...describes the capacity of any system of signification to turn back upon itself, to make itself its own object by referring to itself: subject and object fuse....Within the self, detachment occurs between self and experience, self and other, witness and actor, hero and hero's story. We become at once both subject and object. Reflexive knowledge, then, contains not only messages but also information as to...the process by which [this knowledge] was obtained. It demonstrates the human capacity to generate second order symbols or metalevels--significations about signification.

-(1982:2)

As Babcock says of Narcissus, his tragedy

is that he...does not reflect long enough to effect a transformation. He is reflective, but he is not reflexive--that is, he is conscious of himself as an other, but he is not conscious of being self-conscious of himself as an other, and hence not able to detach himself from, understand, survive, or even laugh at this initial experience of alienation.

-(1982:2)

From the mother's point of view, birth becomes reflexive when she becomes aware not only of the Other, the baby, but of herself giving birth to the Other. This can be at once an experience, not of alienation, but of some degree of distance from the physical sensations of birth and of the integration of consciousness and body in the act of giving birth:


Pain. Grinding, blinding, absorbing intensity. Only pain, and pushing in spite of the pain. Only pain, and pushing. Then a voice, summoning forth my consciousness from its burial in the depths of sensation. I emerge, suddenly aware that I am here, that there is still a Me that can be called forth from this primordial absorption. The voice says Look! Look in the mirror. I look, and there is hair. Blonde, white blonde hair, starkly and miraculously framed by the curly dark locks on the sides of my distending vagina. I am stunned. There is not only this pain, this grinding, bone-crunching agony of raw sensation. There is Another! A baby! A not-me. My hair is dark. But in the mirror, I see blonde hair framed in my vagina. Oh yes. That is what I am doing. I am giving birth to a baby. There is a baby. I am birthing it. My pushes are working! My pain is for something! I push again, and watch transfixed as the oval of hair grows larger. It's working! I am working. I am doing this; it is me, this is Me, doing this, giving birth.

I fall back, exhausted, and rest until the next contraction seizes me in its bony grip, and I galvanize every fiber in my body and PUSH. I know what I am doing now.

A sudden sharp burn. I gasp in surprise, lost in the sensation once more. And then the voice says, reach down. Reach your hand down. And I reach down--what am I reaching for? What am I? And my hand encounters a head-- warm, wet, enormous. I will never forget that sensation--it is imprinted in my hand's palm and my heart's memories. And I rest between contractions, cradling my baby's head in my hand, perfectly sure now that there is Another. I am giving him birth.

-Elizabeth Davis, from a story she wrote about her birth

For many birthing women, there is no such self-awareness. Many wave the mirror away, too immersed in the imperatives of their bodies to desire the dissociation of consciousness from experience that looking entails:

You know before it happened, I thought that maybe I'd have this mystical sense of connecting with womankind and all this kind of stuff, and somehow that I was crossing some kind of barrier, you know--but at the time I was so preoccupied with physical sensation that you don't have time for all those mystical kinds of thoughts. I didn't even look in the mirror to see her come. It's just such an animal kind of feeling that takes you over that you just instinctively grunt and moan and push and puff and just want that big thing, that is very uncomfor tably lodged in your birth canal, you just want to get it out.

-Constance O'Riley


Others, like Elizabeth, gaze in awe, their pain suddenly secondary to the overwhelming realization of the reality on the other side of Plato's fire. When the process by which her reflexive knowledge was obtained is her own process, for the mother who watches herself push the Other into his Otherness, whether in the hospital or at home, her birth will forever stand as a symbol of her ability to give birth, and as a metasymbol for her significance in life.

But what of the woman who is technocratically removed from her birth process? To watch one's body give birth to a baby without one's participation is also to internalize "information as to the process by which [reflexive knowledge] is obtained" (Myerhoff and Ruby 1982). In this case, as we have seen, the information internalized will reflect the woman's conscious awareness that not she, but It, gives birth to the Other; she takes the role of Witness to a process clearly demarcated as separate from the boundaries of her Self. Society, through its medical representative, holds up the mirror so that she can see how its product is born. In that act, society itself stands Witness to its self- regeneration.

But when the mirror is held for the woman who births the baby herself, society stands witness to its dependence on women for its regeneration; then birth for society becomes a metasymbol of that dependence. Perhaps that one reason alone is enough to explain the careful and ordered sequence of the procedures of hospital birth. Through these procedures, each necessitating the other, society creates the illusion that the shadows on the wall are indeed all there is to life. What would happen if all the birthing women in the cave were suddenly released from their chains? Would they, as Plato thought, be blinded by the fire and turn back to the comforting familiarity of the shadows on the wall? Or would they put out the fire, and leave the cave?


Wheelchair|The "Prep"|Partner |Clothes|Shaving|Enema
Bed|Fasting |IV|Pit Drip |Analgesia|Amniotomy
EFM|IEFM |Cervical Checks|Epidural|Push/Don't Push
Transfer |Lithotomy|Sheets|Episiotomy
Apgar |Washing|Eye |Vitamin K|Bonding|Separation
Bassinet|Wheelchair|Nature to Culture|Summary
Introduction