Happy Giving Birth Day! (In celebration of mothers.)

I recently had another birthday roll around. But getting older really doesn't bother me. Having lost several friends way too soon, I have come to realize that getting older sure beats the alternative of not getting older!

But the other day it did occur to me that when it comes to birthdays, we are wrong to focus all of our attention only on the person who came into the world on that day – the child. After all, I had very little to do with orchestrating the day of my birth... I was just along for the ride. And while birth is a huge stress on little babies, it is also an act of great courage and generosity – as well as stress – on the part of the mother.

But we tend to take the role that women play in the survival of our species totally for granted. So I would like to suggest that in addition to celebrating the child, we should also take time to recognize and honour the great effort (and sacrifice) that the child's mother made on that day.

This is not an idea that is original to me, but it is one that I absolutely think needs further elaboration and promotion.

Giving birth is risky! Even in the "developed" world where I live, giving birth can be a matter of life and death. When my own daughter was born, both she and her mother did very well physically, but that very night another woman who was also in that same small Canadian hospital to give birth to her baby had a hemorrhage and very nearly died. The pale, worried looks on the faces of all of the nurses told me all that I needed to know about how close it had all come to being a great tragedy.

In countries like Canada where people have decent access to medical care, maternal death as a result of childbirth is comparatively rare, but it still happens. In Canada the maternal death rate is 12 women per 100,000 live births. And in Canada, one woman in 5,600 will die from giving birth at some point during her lifetime. In Australia the maternal death rate is 8 women per 100,000 live births, and one woman in 7,400 will die from giving birth. In the United States, with its lack of a decent social safety net, its greater disparities in wealth, and its often difficult-to-access healthcare, the maternal death rate is 24 women per 100,000 live births, and one woman in 2,100 will die from giving birth. This level of maternal death puts the USA on a par with Lebanon, Oman, Saudi Arabia, Romania, Turkey, and Ukraine.

(By contrast, most of western Europe and Scandinavia have maternal death rates that are below 10 per 100,000 live births, and fewer than one woman in 10,000 will die from birth-related complications.)

While rates of maternal death in the USA are far higher than they should be (two times higher than in western Europe and three times higher than in Australia), in other parts of the world the story is far worse. There are still areas of the world where women face maternal mortality rates that have not significantly improved in centuries. In Afghanistan, for example, there are 1,400 maternal deaths per 100,000 live births. One in 11 Afghan women will die at some point due to birth-related complications. This rate is only slightly lower than what women would experience when delivering babies with no medical assistance at all!

But Afghanistan is not the only place where women face grave danger when they have babies. In Chad the rate of maternal death is 1,200 per 100,000 live births, and 1 in every 14 Chadian women will die from giving birth. Women in Somalia face the same odds of dying in childbirth -- 1 in 14 (or over 7%) of all Somali women will die while or soon after giving birth. In Niger the number is 1 out of every 16 women will die in this way. (Stats from unicef: http://www.childinfo.org/maternal_mortality_countrydata.php)

According to the World Health Organization, during the past 20 years maternal deaths have decreased by about 30%. And that is great news. But even so, approximately 1,000 women still die from pregnancy-related issues every day. (Source: http://www.who.int/mediacentre/news/releaseshehe /2010/maternal_mortality_20100915/en/index.html)

Giving birth is nothing to take for granted. And yet we do. In the “developed” world, we just expect to be able to say that “mother and child are doing well.” We generally ignore the reality that tragedy can – and does – strike.

Every-day complications. But even every-day, “normal” deliveries bring lots of large changes to a woman's body. Childbirth itself is very painful. As the American comedian Carol Burnett once observed: “Giving birth is like taking your lower lip and forcing it over your head.”

Christianity still carries the unfortunate teaching that a woman’s experience of pain during childbirth is punishment for Eve’s sin in having given Adam the apple. But according to evolutionary theory, the pain associated with birth is thought to be related to the compromise born of needing to send a baby that has a head large enough head to hold an advanced brain down through a narrow birth canal. There is a trade-off between wanting to maximize cranial size and what women’s bodies can bear.

Fully one fifth of all births involve what is called “complicated labour” when labour comes to a stop, and other means must be used to assist with delivery. Sometimes this assistance takes the form of a c-section, which is a major surgery – with all the associated risks. (The incidence of c-section has exploded in recent years, an increase that and has become the focus of increasing discussion and critique.)

But even in uncomplicated labour, vaginal birth injury with tearing (or an episiotomy) is common. And internal tissue tearing (as well as nerve damage) occurs frequently. Many women will also experience some kind of incontinence after normal delivery.

And yet as a society we continue to take the act of giving birth for granted. We ignore women’s pain and suffering and physical changes, and focus only on the baby. We don’t recognize – much less honour – what a woman puts her body through in order to welcome a new generation into the world. And we shouild.

The “fourth trimester”… and beyond. As any woman who has given birth can tell you, pregnancy-related changes to the body do not suddenly reverse themselves with the delivery of the baby. Some people have begun to speak of the 90 days after having the baby as a “fourth trimester” wherein the mother’s body is still recovering from the trauma of giving birth. The model Cindy Crawford once said: “It's a huge change for your body. You don't even want to look in the mirror after you've had a baby, because your stomach is just hanging there like a Shar-Pei."

And while the arrival of a baby is usually a cause for great joy, when the little one is there we tend to devote almost all of our attention to this new life, and spend very little energy on the mother whose body is still very much recovering from the trauma.

And some changes remain for far more than just another three months.

I had a friend who was doing research for the US Army, trying to find out why servicewomen who had delivered babies 12 months earlier were still not back in peak physical condition by the time their babies were one year old. And the stunning answer the research team came up with was this: the main reason why women who had given birth twelve months earlier were not yet back in peak physical condition was... [drum roll please!] … that they had given birth twelve months earlier!

Healing, reclaiming and rebuilding your body takes time, people!

(A second finding of the research team was that most mothers of infants lack the support they would need in order to get to the gym. I take this as more evidence that while we claim to celebrate motherhood, in reality most new moms are on their own when it comes to raising their little one.)

Another common pregnancy-related change is post-partum depression, which occurs in up to 25% of all new mothers. Unfortunately, because we simply take the role of mothers for granted, women who experience post-partum depression are often made to feel like they are just bad mothers. Which of course only adds insult to their injury.

Rarer, but even more terrifying, is post-partum psychosis, which can occur in 1 birth in 1,000.

And there are many, many other permanent physical and psychological changes that occur with a woman’s body when she conceives, carries a baby to term, and then cares for her newborn. But we just take it all for granted.

She did it for you. So if you are reading or hearing this essay, it is because a woman – your biological mother – carried you inside of her. She sacrificed her body, really – for you. She brought you into the world, and in doing so changed her life forever as well. In countless ways. You don’t remember you birth. But most likely that day is etched indelibly into her soul.

Have you ever taken a moment to thank her for her sacrifice? To thank her for all that she did for you? And, if you were adopted, please remember that you were lucky enough to have two mothers, the one who brought you into the world, and the one who raised you.

So, the next time your birthday comes around, take a moment to acknowledge your mother’s sacrifice. And find a way to say “thank you."

And although my birthday is already passed, I would like to take a moment to say to my mother:

"Thank you, Mom, for all that you did for me in order to bring me into the world. Happy giving birth day!”