Why are women so overwhelmingly satisfied with nonhospital birth? It is likely that the answer lies in the unavailability of effective pain control. This may sound ridiculous on its face: how could a more painful experience lead to higher satisfaction rates? But as Elliot Aronson and Carol Tavris explain in their book Mistakes Were Made (But Not By Me), “…if people go through a great deal of pain, discomfort, effort, or embarrassment to get something, they will be happier with that ‘something’ than if it came to them easily.” Dr. Aronson found that when students are put through a more severe hazing process, they are much more satisfied with the resulting club membership than students who are put through a relatively mild initiation procedure. It follows that women who choose to experience more pain, discomfort, or effort during childbirth would be more satisfied with their birth than women who did not choose that experience. Speaking for myself, I remember being totally thrilled with my first birth, even though it was one of the most physically painful experiences of my life. But why are we more satisfied after experiencing more pain?
People with good self-esteem tend to view themselves in a positive way. I like to think of myself as competent, knowledgeable, educated, sensible, and a maker of good decisions. Therefore, when we make decisions that cause ourselves pain, we are psychologically driven to justify it. “I am a smart person who makes good decisions” and “I just chose to put myself through a lot of pain” are two thoughts that, when entertained in the mind at the same time, produce an uncomfortable state known as “cognitive dissonance.” When we experience cognitive dissonance, our minds immediately find justifications: “It was worth it because…” and we fill in the blanks. It was worth it because I love my baby more for it; it was worth it because my baby is healthier for it, which means I’m a better mother; it was worth it because I didn’t have to have any interventions; it was worth it because now I know I can do anything! My brain distorts my perceptions of the event so that I see only the upsides, and ignore any downsides. The result? I can maintain my sense of self: I’m a smart person who makes good decisions, and if I chose pain, it must have been for very smart and good reasons.
For most of human history, pain in childbirth was almost unavoidable for women. Indeed, in many parts of the world today, women have no choice as to whether they feel the pain of labor and birth. For women without a choice, there is no experience of cognitive dissonance; they have no need to justify their pain. It is only among women who have access to effective pain relief yet choose to forego it that self-justification becomes activated. They are not going through pain in order to get a baby, because they could opt for pharmaceutical pain relief if they so chose and still get a baby out of the deal, as so many of their acquaintances surely have done. They are opting to experience the pain so that they can achieve a natural, drug-free birth. As Tavris and Aronson explain, “…if a person voluntarily goes through a difficult or painful experience in order to attain some goal or object, that goal or object becomes more attractive.” The fact that women make a free choice to experience the pain of childbirth makes the attainment of a drug-free birth seem like a most worthwhile goal.
Of course, this is not a conscious process. Women do not believe the pain of birth leads to their view of drug-free birth as a worthy goal; they believe that they loved the experience based on its intrinsic merits. The students who went through the severe hazing process in order to get into a club did not believe that the hazing had anything to do with their enjoyment of the club. Even after a debriefing process in which the entire experiment was explained, they still insisted that they liked the club based on its own merits. The club was designed to be dull and worthless, and students who went though a mild initiation process invariably agreed that it was. It is entirely predictable that women who have chosen a drug-free birth would disagree strongly with the suggestion that the pain of childbirth was a hazing-like process that strongly influenced their estimation of drug-free birth as a wonderful experience.
When self-justification kicks in regarding a choice we have made, people often are driven to proselytize their decision. We feel even better about our choices, and far less dissonant, if we can convince others to make the same decision themselves. Nothing reduces dissonance more than seeing others follow your example: “What a fine example of a person I must be, that others have followed in my footsteps.” No wonder women who have experienced a natural, drug-free birth are such big advocates of the practice! Having justified the painful initiation for themselves, they turn to convincing others to choose the same.
Our judgments of others who make different decisions are also a function of self-justification. When a woman chooses not to have a drug-free birth experience, women who believe in the superiority of natural birth tend to think of her as less-than: she took the easy way out; she just doesn’t get it; she probably doesn’t really care about her health, or her baby’s health, as much as I care about mine. We justify our own choices by putting down others’. If we were truly to acknowledge her decision as a perfectly excellent one, it would diminish the stellar quality of our own choice.