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Tuesday, October 14, 2008

Pioneer Press: Can childbirth be orgasmic?

ICAN of the Twin Cities helped co-sponsor the recent local screening of Orgasmic Birth. The St. Paul Pioneer Press interviewed the filmmaker, Debra Pascali-Bonaro and local doula trainer and midwife Gail Tully who spearheaded our coalition of birth advocates sponsoring the screening. Here is the article:

Can childbirth be orgasmic? Filmmaker Debra Pascali-Bonaro thinks so

A lot of mothers might say their experience of childbirth was intense, maybe even satisfying. But orgasmic?

It can be, according to Debra Pascali-Bonaro, a birthing assistant-turned-filmmaker who was in the Twin Cities recently for a screening of her documentary 'Orgasmic Birth.'

With that provocative title, she is quick to elaborate that while some women do have a sexual experience during labor, she's using the term more broadly.

'How come, in our culture, the common perception is that birth is about pain and emergency and a terrible event to get through?' she said. 'A small percentage of people need emergency care, but for the vast majority, birth is a normal experience. I think we've lost sense of the sensualness of birth as we've moved it into this realm of technology. And I want us to reclaim it as a sensuous and sacred arena.'

Pascali-Bonaro has found a sympathetic audience in the Twin Cities, where a screening earlier this month at the Riverview Theatre in Minneapolis was organized by a coalition of natural childbirth activists, midwives and doulas.

It drew 500 people, a turnout boosted by the fact Minneapolis has the nation's highest percentage of births attended by a doula, someone trained to provide support to a mother during birth. Pascali-Bonaro is a doula.

Individual DVDs of the film go on sale this week, and the film is capturing national and international attention for the way it redefines childbirth.

"It gives us a metaphor for the joy of actual labor," says Gail Tully, a doula and one of organizers of the Twin Cities screening.

So what exactly does birth have to do with sex, other than the obvious fact that one follows from the other?

"The same hormone that we release in lovemaking is also released in childbirth and in breastfeeding — oxytocin," said doula Gail Tully. "It's a hormone that gives us a heightened perception, and it can take the edge off of pain."

The problem, according to Tully and others, is many things that happen during a typical birth in the United States may inhibit the natural release oxytocin, which is necessary to stimulate contractions and dilate the cervix so the baby can come out.

Research suggests oxytocin is released when a woman feels safe and secure, when lights are dim, when there are few disturbances and there is quiet and privacy — not exactly the conditions in most hospitals.

Even routine questions can knock a woman out of the zone, says Tully, such as "What's your maiden name?" or "Is the temperature comfortable for you?"

"We know that if you want an animal to give birth, you don't surround them with bright lights and with a lot of people," Pascali-Bonaro says. "You will disturbthem, and their labor will slow down or stop. The same is true for humans."

In other words, the same conditions that are necessary for making love are necessary for having a baby.

"If we gave couples instructions on how to have an orgasm while they are lovemaking, well, we laugh at the idea," Tully says. "We understand that it would disrupt them, and they wouldn't have that hormonal release. You don't have sex with a cheering crowd. But we accept that at birth because we think it's necessary for safety."

Some women will experience an actual orgasm during birth, Pascali-Bonaro says, though that's obviously not a goal.

"I'm getting e-mails like crazy from people saying thank you for talking about this," Pascali-Bonaro says. "There are women who are saying, 'I literally had the most incredible orgasm, and I never told anyone because I thought it was kind of unusual.' It's not the kind of thing that you tap your doctor on the shoulder and tell him about. Many women hadn't even told their partner."


Medical interventions have become commonplace at most births in the United States. Nearly one in three births is by Caesarean section, even though many researchers say the medically necessary rate is closer to 10 percent to 15 percent.

Inductions are also on the rise. For example, a study published last month in the journal Medical Care found one in four pregnant women had labor induced at a scheduled time rather than waiting for contractions to start on their own, a rate that has tripled since the 1990s. The use of the artificial hormone pitocin to start or intensify contractions is now nearly routine.

"There are times when all our medical technology has a benefit and is life-saving for the mother and the baby," says Pascali-Bonaro, who lives in New Jersey. "But I know some hospitals are using pitocin 80 percent of the time. We need to question why that is. Are we in a rush?"

Pascali-Bonaro interviews nurses, doctors and midwives in the film who point out possible negative consequences of these interventions — higher rates of postpartum depression for women who have Caesareans, for example, or research that suggests women who deliver vaginally respond differently to the cries of their newborn babies than women who have had a Caesarean.

But the real focus of the film is on the couples in the United States and abroad who gave permission for Pascali-Bonaro to film their births. The film opens with a woman who gives birth outside on the deck of her house with her husband close at hand.

Most of the subsequent births, which are edited tastefully and artistically, are also home births without pain medication or medical interventions. Whether you question epidurals or embrace them, it's difficult to walk away unmoved.

The point of the film, says Pascali-Bonaro, is to show women, especially young women who have not yet given birth, an empowering image of birth that may certainly include pain but isn't about suffering.

"I hope it touches people in an emotional level to open their heart to see that birth is not just a day to say OK, we've got to get through it," she says. "It's a day to really think about and to really make an informed decision about. I hope it's a day that people will begin to enjoy so we can welcome our babies with absolute joy, ecstasy and bliss."


Pascali-Bonaro, who has worked in childbirth education nationally and internationally for 26 years, says she literally woke up one morning from a dream and knew she had to make a film.

With no cinematography experience, she enrolled in filmmaking classes. At one point, she had the opportunity to pitch her idea, along with dozens of other aspiring filmmakers, in front of a panel of established producers and directors.

"It was sort of like the 'American Idol' of film," she said. "You got 10 minutes to stand up and explain your idea."

When her turn came, she told the panel she was working on a film called "Ordinary Miracle: Global Models of Care." A panel member brusquely told her to sit down and said, "What makes you think anyone would be interested in that?"

She was humiliated. A friend happened to be with her who had heard her speak at a workshop about birth and sexuality. The friend nudged her and told her to stand up again and say, "Orgasmic birth."

"I figured, well, this is my one opportunity, and so I jumped up and said, 'Orgasmic Birth,' and the entire auditorium laughed, and the panel said, 'Is that for real? Because if you can make that film, you've got something,' " recalled Pascali-Bonaro.

She knew she was on the right track after she met with a focus group of young men and women. She asked if they would watch a childbirth film. A third of the women said yes, and none of the men did. When she asked if they would watch a film called "Orgasmic Birth," everyone raised his hand.

Pascali-Bonaro and a few other doulas filmed the births themselves, but the finished product is anything but amateur.

One of the women filmed in labor is the wife of composer John McDowell, who wrote the soundtrack for "Born Into Brothels," which won the 2004 Academy Award for best documentary. His soundtrack for "Orgasmic Birth" is sung by Sabina Sciubba, lead singer for the Brazilian Girls. Producer Kris Liem, who has won three Emmys for film editing, signed on to edit after being wowed by the music and raw footage.


Stephanie Johnson and her husband Andre Fischer of Minneapolis were at the screening.

"I haven't been thinking about the nursery or names, things that other people ask me about," says Johnson, whose first child is due later this month.

"All I've been thinking of is that day of labor. I liked what someone said in the film, that pain of a contraction isn't a warning sign, something to get over. It's squeezing and embracing the baby."

Her husband, Andre Fischer, who has children from a previous relationship, was also moved by the film.

"I cried, because not all the other births of my children were like these," he said. "It was very emotional for me."

Maja Beckstrom can be reached at 651-228-5295.


Debra Pascali-Bonaro is collecting birth stories on her Web site for a companion book to the film. In that spirit, the Pioneer Press talked to Liz Abbene, 28, of Lakeville about the birth of her third child, Lucia, born this summer.

Abbene is a doula and agrees with Pascali-Bonaro that women need to share their positive birth stories so other women facing childbirth can go into the experience with less fear and more confidence.

Abbene's first two children were induced, the first because Abbene didn't know the exact due date and the second because doctors feared the baby was getting too large. She had an epidural for the second, pushed for three hours, and the baby had to be taken to neonatal intensive care. As she recalls, "It wasn't a good experience."

This summer, when she went to her midwife appointment, she was nearly two weeks overdue and knew the medical staff would want to induce her the next day. The midwife "swept her membranes," a simple technique that can release hormones and lead to contractions. She explains:

"It just kicked my contractions into high gear. I went into labor in the hospital at 4 p.m., and my husband and I were not prepared for it. We thought we were going to go home again. So, we called a friend to bring our stuff to the hospital.

"My husband and I were alone in the room for a while. And as soon as I could get out of bed, we just hung out in the bathroom. We had made a birth playlist on my iPod, and we played Ray Lamontagne's "Be Here Now," Joe Cocker's "With a Little Help From My Friends" and Bob Marley's "Three Little Birds."

"I wanted to be really present for the birth. I wanted to feel exactly what was happening in my body.

"The contractions weren't painful. It was an intense feeling but nothing painful. I only felt it in my back. Within an hour, I was a couple of more centimeters dilated.

"Two hours into labor, my mom arrived. She used to be a labor and delivery nurse. She was using the shower head on my back, and I realized as I was standing in the shower that the feelings I was having were those feelings you have after you have an orgasm. I was like, 'Oh, this is kind of cool.' It wasn't ever painful, it was just intense.

"When I was about 7 centimeters, I got into birthing tub. Then, things picked up and got intense. Whenever I had contraction, I had my husband's hand touching my face. I felt very, very close to him. The midwife said, 'I can tell you're nearing the end of the labor.'

"I had one more contraction. I felt a pop. My husband put my hand down, and I don't think I even pushed. The head came out, and he received the baby and laid her right on my chest.

"We didn't know if we were having a boy or a girl. It was incredible. Just so relaxing and such a moving experience. It was so completely different from my other two births. I could never give birth any other way now.

"I think so much about birth, being a doula. And I think so much of the experience is in your mind. I teach childbirth preparation classes, and we talk a lot about fear and about how fear is what creates pain. Any time you're afraid of something, the more tension you have, and the more tension you have, the more pain you have. It's a vicious circle.

"You have to decide to let go and not be afraid.

"I always tell women, 'The power to give birth is within you.' If you're fortunate enough to get pregnant, your body knows what to do to give birth."

-- Maja Beckstrom

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