A friend who read my blog came away with the impression that I think the experience of birth is more important than the outcome, meaning that I would advocate for risky but meaningful births, or deny that death is worth avoiding.
This is a common misperception. More than just wrong, it expresses the limitations of this culture’s understanding of birth as a dangerous impediment to life.
To some birth might be good, it might be bad, it might be traumatic, it might be empowering, but at the end of the day if birth results in a mother and child who survive, it is successful. In my experience as a labor doula, this is an attitude I witnessed all the time in the hospital from nurses, doctors, anesthesiologists, and family members.
In this understanding of birth, survival is success and labor is the inherently risky passage that stands between the life promised by pregnancy and the intact bodies delivered at its end.
In many places around the world birth IS dangerous, many women die and even more are injured in ways that compromise their lives. The United Nations Human Rights Council just adopted a resolution recognizing maternal death and illness as a human rights issue.
Some would interpret this tragedy as evidence that survival ought to be the top priority, that because labor is an inherently risky passage anything that minimizes that risk is better than the riskiness of labor unchecked.
I agree that women are needlessly suffering and dying as a result of childbirth. But instead of locating the tragedy in the natural process of women’s bodies, I locate the tragedy in poverty and the devaluation of women’s lives. This devaluation is cultural, religious, economic, interpersonal, internal - pervasive.
Anything that fails to address the pervasive devaluation of women’s lives is the real tragedy. This is why I cannot agree that any birth that results in survival is a success, or that survival should be the exclusive top priority.
To survive in a context where your existence is disparaged, where you have no options, where your body is valued only to the extent that it can be used, is also a tragedy.
And this tragedy is reinforced when labor is viewed as the inherently risky passage that stands between the life promised by pregnancy and the intact bodies delivered at its end. In this view, women’s bodies are still valued as a means to an end, and this risky passage is cut away from women as if diseased. This kind of cultural surgery might promote survival, but it does not affirm life, especially women’s lives.
To illustrate the difference between what is survival and what is life affirming, a story about mountain climbing:
Next year my dad turns 60, and to celebrate he wants to climb the highest mountain in Colorado. My eight year old son is already planning to join us, he knows that I climbed one of the most challenging 14ers in Colorado when I was his age.
I get choked up thinking about him on that mountain next summer, challenged to his core, challenged at a level he can’t even conceive of yet. I think about his little body, about the large and unforgiving mountain, about the very real riskiness of his ascent. And I realize that inviting his participation is not risking his life, but affirming it. By inviting him to do something challenging, something hard but beautiful, I renew my commitment to him, my belief in his wholeness, his capacity for and worthiness of life.
This is a gift that my dad gave me when I was eight and over again in many ways throughout my life. Climbing Longs Peak in the middle of the night as an eight year old is inherently risky. And yes, I survived, but in that risky passage I was more alive than I had ever been. The hike taught me the difference between life and survival, taught me that I was powerful, profoundly vulnerable and ultimately capable.
During labor, I had a similar sense of perspective: I felt terribly vulnerable and at the same time immeasurably important. I was excrutiatingly aware that I could die, and that this life that pregnancy promised was more of a hope than a guarantee.
I did survive. And so did that beautiful baby. But I was ready and willing to die for the journey, just as I have been time and again on the face of a mountain. The journey is life.
And when women’s lives are valued, labor offers itself as a life affirming inherently risky journey that’s an honor to be be invited to consider. We don’t need childbirth to experience this fullness of life, but it’s here, built into the landscape like the glory of those snow-capped peaks that make no guarantees.
Childbirth, like the landscape, can be unforgiving and harsh, or it can be empowering and fulfilling. Much of this depends on the terms of engagement. For many women in the world, birth is not an opportunity, but a requirement mandated by custom, religion, and biology. 
Today, in the United States despite infant and maternal health statistics that leave a lot to be desired, most women and babies survive. Some survive because of intervention during that risky passage called birth, but most survive because they have been able to escape the crushing impact of poverty on the bodies of women and children.
Instead of having a cultural understanding of poverty and the devaluation of women as risky, we have a cultural understanding of birth as risky. And somehow, instead of understanding that our distance from poverty and our access of our human rights is what promotes our survival, we have an understanding that our ability to intervene in labor is what promotes our survival.
This places the blame for death on women’s bodies, and also ends up making it seem as though impoverished women and families were to blame for their own suffering.
Instead, as the U.N. finally recognizes, when women die and are injured as a result of childbirth it is a human rights issue. Yes, we should protect the bodies of women, yes, survival is an important condition of life. We should do what we can to honor the lives of women, as my father has. The journey of childbirth should be an invitation first and foremost. When it is it can also be a celebration of our power and vulnerability, indeed, a true celebration of life.
When I talk about the experience of childbirth it is not meant to take pregnancy out of context, but rather, to insist on its context.
When I talk about seeing the sunrise from the keyhole on Long’s Peak it is made all the more beautiful because of the context; I have chosen to participate in the beauty of life, I am small, the mountain is large, my body aches, and I am grateful.
When we take birth out of context - where the passage of labor is an inherently risky opportunity to be affirmed, acknowledged, valued, and capable - real damage is done not only to survival, but more importantly, to life.