Follow-up: Orgasm Out of the Box

After her Salon presentation on “Illuminating the Intersections Between Passion, Sexuality, & Birth,” Carrie Flemming wished she’d had time to answer a couple more questions. Fortunately, with this blog, there’s no time limit. Here’s what she wanted to say:


Follow-up: Orgasm Out of the Box

By Carrie Flemming

After we watched the unassisted birth of a Russian midwife featured in the film, Birth Into Being, a woman in the audience asked,

“How come this is the first time I am seeing this kind of birth?”

Tatyana’s birth is calm, gentle and confident as she squats in a clear plexiglass tub surrounded by her partner and children in her home. The births we see in popular media are often traumatic, full of drama and have the overall feeling of a medical emergency. These images live in our cells and minds, shaping the way we perceive and feel about human birth throughout our lives.

But there is another image of birth we rarely see outside of women-centered childbirth education classes. This is the image of a woman listening and moving from her innermost knowing, following her instincts and birthing from the depth of her power. It is inspiring and satisfying to watch.

So, how come this women-centered imagery is rarely seen in mainstream culture?

To find the answer to this question we need to understand the history of midwifery, the creation of the field of obstetrics by a young, male (and largely uninformed) medical community, and the eventual medicalization of birth. We also need to ask ourselves who benefits from this arrangement?

Luckily, there are many wonderful resources available. For those who wish to read more in-depth about the history of birth practices in the United States I recommend:

The American Way of Birth by Jessica Mitford. 

A chronological examination of the history of Western birth from midwives to obstetrics.

Immaculate Deception II by Suzanne Arms    

History, practices and culture of Western birth.

Birth Matters: A Midwife’s Manifesto by Ina May Gaskin

Outlines the history and future of birth from a midwifery perspective.

The Caliban and the Witch by Silvia Federici.

Gives a broader understanding of the state’s control of reproductive rights as it relates to western capitalism and conquest.

The Business of Being Born, 2008 

A documentary created by Abby Epstein & Rikki Lake
Watch the trailer here: 

Stream it here: 


The second question that came up was:  

“Is home birth as safe as hospital birth?”

There are no definitive studies that compare the safety of home vs. hospital birth. The Farm Midwifery Center put forth a study in 1992 based on their birth outcomes over 30 years. Read the study here: The Safety of Home Birth: The Farm Study, A. Mark Durand, MD

The prevailing wisdom is that for low-risk pregnancies home birth is as safe as hospital birth. There is no one answer for every woman. Each woman needs to weigh the different factors that will help her feel most safe and confident to birth her baby.

Many practitioners from the women-centered, midwifery perspective believe that the possibility for a safe and satisfying birth increases when a woman:

~Feels secure in her environment and her body

~Is surrounded by people who support her decisions

~Is physically, emotionally and psychically comfortable

~Has minimal lighting and observation by people & machines

~Has the freedom to move & express herself the way she wishes

For some this will be at home with a midwife and for another it will be in a hospital with doctors and nurses. Some women will choose to birth at home unassisted with only their partner and children present. And yet others will opt for a birthing center.

There is no right or wrong choice and there are no guarantees. On a positive note, it is exciting that we have so many possibilities. I do think we have the right (and the responsibility) to be fully informed of our birthing options and their consequences. I believe all women deserve to have access to the information and resources that allow us to make the best decisions for ourselves, our bodies and the new humans we choose to bring into the world. 

Also, continuous labor support from a doula has shown to improve birth outcomes and to be highly beneficial to the mother well into her first few months with her baby. Read more information about continuous labor support here:

The Effect of Doula Support During Labor on Mother-Infant Interaction
Women’s Perceptions of Their Doula Support

The Proven Benefits of Having a Doula

To learn more about increasing the possibility for a safe and satisfying birth for you and/or your clients, I would recommend:

The Birth Book: Everything You Need to Know to Have a Safe and Satisfying Birth by William Sears, MD and Martha Sears, RN.

Ina May’s Guide to Childbirth by Ina May Gaskin

Orgasmic Birth by Debra Pascali-Bonaro and Elizabeth Davis

The Thinking Woman’s Guide to a Better Birth by Henci Goer

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