IdealLabor should be painless, natural, and emotionally fulfilling.

FactLabor can be unbearably painful, medically assisted, and emotionally traumatic.

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You bought the pregnancy books. In your last and longest month, you read the chapters on labor over and over, wondering whether you'd recognize a contraction when you had one or whether you'd be one of those lucky women who does most of her dilating in her sleep.

You did Lamaze, attending classes religiously, reading the handouts, practicing the breathing at home. You overcame your squeamishness and kept your eyes open during the birth movie; you cried when the head crowned. You toured the hospital.

In short, you were as prepared for birth as anyone could ever be. If labor had been a final exam, you would have aced the course.

Perhaps you did. Your labor progressed pretty much as you expected, with a degree of pain you found perfectly manageable, or no pain at all. You may have wondered what all the fuss was about.

But perhaps you feel you blew it. You went through hell. You lost control. You yelled at your husband or threw up on a nurse or screamed and screamed or accepted a painkiller or needed forceps or ended up with a cesarean. Or all of the above.

If that was the case, it's not unusual to emerge from the delivery room feeling shocked, embarrassed, guilty, betrayed, and disappointed in yourself. "Why didn't anyone tell me it could be like that?" you think one moment, and the next, "Was it supposed to be like that, or did something go really wrong?"

The fact is, not only is it possible to do all your reading and studying and practicing and still not be prepared for the reality of labor, it's possible that all the reading and studying actually set you up with unrealistic expectations about labor. Today, women get much of their information from advocates of a particular technique of childbirth, who tend to present drug-free, intervention-free, painless labor as the goal all women should aspire to.

Unfortunately, as a quick look back through history shows, this is merely the newest Utopian vision in a long line of fads dictating what a woman's labor should be like. And all these visions — of births painful and painless, drugged and undrugged — have been promoted by their advocates as the most "natural" method.

In the Beginning

Many childbirth writers insist on a scenario in which our uncivilized ancestors had an "intuitive" knowledge of the childbirth process, allowing them to give birth "naturally," without pain or fuss. But since our ancestors didn't leave memoirs, it's a hard theory to prove.

However, we do know that as far back as the fifth century B.C. the Greek playwright Euripides gave his character Medea the comment: "They say that we lead a life without danger at home, while the men go to war — but they are wrong: I would rather stand in the hoplite ranks three times than give birth once."

And the writers of the Old Testament had seen enough childbirth agony to feel compelled to explain its origins — in Eve's bite of apple. "In sorrow thou shalt bring forth children," God proclaims in Genesis, implying that not only is the pain "natural," women deserve it.

This biblical attitude sailed into America with the Puritans, and women continued to redeem their sins with suffering. Wrote one nineteenth-century mother, "I went down to death's door to bring my son into the world, and I've never forgotten. Some folks say one forgets, and can have them right over again, but today I've not forgotten, and that baby is thirty-six years old."

Then, in the mid-1800s, medical science stumbled upon anesthesia, which was immediately adopted for surgical use and was shown to reduce labor pain. But an enormous debate ensued among "experts" of the day who felt that anything used to reduce pain in childbirth was undesirable because it was "unnatural." In Pain, Pleasure and American Childbirth, Margarete Sandelowski...